Liver function plays a key role in functional medicine protocols

Did you know your liver can play a role in inflammation, leaky gut, food sensitivities, chemical sensitivities, and autoimmunity? Tending to liver function and liver detoxification is a vital part of functional medicine protocols to address chronic health issues.

Liver detoxification involves making fat-soluble compounds water-soluble so they can be eliminated in urine, feces, or sweat. Examples of compounds the liver metabolizes are hormones, drugs, and chemicals that are foreign to the body but still pass through liver detoxification pathways.

The liver has two different detoxification pathways that make fat-soluble compounds water-soluble for elimination: Phase I and Phase II.

Phase I pathway

When a fat-soluble compound comes into the liver it first enters the “Phase I pathway.” The Phase I pathway changes the structure of the compound for the sole purpose of having molecules attach to it in the Phase II pathway to prepare it for elimination.

Phase II pathway

Phase II has several different functions that metabolize the compounds in different ways: methylation, glucuronidation, sulfation, acetylation, and glutathione conjugation. Once molecules are added to the compound in Phase II it is heavy and stable enough to be eliminated from the body safely.

When liver detoxification pathways don’t work

When a compound goes through Phase I it becomes more immune reactive and pro-inflammatory. Theoretically this is not a problem as Phase II is there to sweep in and stabilize these immune reactive compounds.

However, inherited genetic traits may cause variations or defects in how these pathways work, which is one reason medications affect people differently. Just because you have a genetic predisposition does not necessarily mean that gene will express itself, but factors such as diet or lifestyle can trigger these genes.

The detoxification pathways have also been shown to gradually lose integrity as we age.

When a person’s liver Phase II pathway is hindered, two different possibilities exist. One is that an already inflammatory compound, such as an environmental toxin, is made more inflammatory in Phase I. Because a hindered Phase II pathway is not capable of completing the job, this more toxic compound goes back into circulation, where it may activate the immune system and inflammation.

The second possibility is that compounds that normally wouldn’t react with the immune system are metabolized into immune reactive compounds.

Increased toxicants due to failures in detoxification increase your risk of developing inflammatory conditions and autoimmunity.

Kupffer cells in the liver promote inflammation

Cells in the liver called Kupffer cells can promote immune reactivity to proteins carried there from the lymphatic system.

What activates Kupffer cells? Toxic compounds in the liver and poor liver detoxification function.

If a person has poor liver detoxification function, these proteins carried to the liver by immune cells can elicit a more inflammatory response.

A person with leaky gut who is also struggling with impaired liver detoxification pathways will have a different battle to fight, but they must also include liver support in their protocol. This is just one example of why a standard leaky gut protocol doesn’t address some of the factors that cause loss of oral tolerance.

Nutrients to support healthy liver detoxification

Different nutritional and botanical compounds support the liver’s detoxification pathways. I use all of these, as they work well together and we can’t be sure which pathway is compromised.

Phase I and Phase II support:

• Milk thistle seed extract
• Dandelion root extract
• Gotu kola extract
• Panax ginseng
• L-glutathione
• Glycine
• N-acetylcysteine
• DL-methionine

Phase II methylation support:

• Choline
• Trimethylglycine
• MSM
• Beetroot
• Betaine HCl

Nutrients to support healthy bile synthesis and elimination:

• Dandelion root extract
• Milk thistle seed extract
• Ginger root
• Phosphatidylcholine
• Taurine

There are some good liver detoxification products on the market. Look for a reputable brand that combines many of the important nutrients. Start slowly with the protocol to avoid the unpleasant side effects of detoxifying too quickly and gradually work your way up.

For more in depth information about liver detox pathways and how they relate to other aspects of health, please see my book Why Isn’t My Brain Working?