The Liver & Detoxification
The liver is an extremely complex organ involved in multiple immune and metabolic processes. If the liver is not detoxifying optimally, it will be virtually impossible to have success with any disease including thyroid and hormone imbalances. Unfortunately, many patients are given hormones without a thorough analysis of their liver’s ability to metabolize hormones. This can do more harm than good due to a build-up of unmetabolized hormones or incompletely metabolized hormones circulating in the blood- stream causing abnormal hormone responses. Partially metabolized hormones can bind to hormone receptor sites blocking normal hormones from binding and causing abnormal responses.
Nutrition, toxin exposure and genetics are all key factors in liver detoxification. I have seen many patients who were put on hormones and had impaired liver detoxification systems only to result in a worsening of their condition and even cancer from excess estrogen. Many studies have shown that impaired liver detoxification can lead to fatigue and autoimmune disease – both major factors in thyroid health. The majority of thyroid hormone is converted into its active form in the liver. If the liver is not functioning optimally, signs and symptoms of hypothyroidism will arise. The liver is also important for balancing sex and adrenal hormones due to its role in metabolizing hormones and detoxifying thyroid-disrupting chemicals. The process of detoxification is basically the conversion of fat-soluble compounds into water-soluble compounds that can be eliminated in the feces, urine and sweat. Hormones are fat-soluble compounds as well as environmental toxins, drugs, pesticides, and allergy-causing complexes.
There are two distinct phases of liver detoxification known as Phase I and Phase II. Phase I involves the cytochrome P450 enzymes and Phase II involves six pathways: glucuronidation, acetylation, sulfation, methylation, glycine conjugation, and glutathione conjugation. Liver enzymes can directly neutralize chemicals or convert them into waste products that can be easily excreted by the body.
Inflammation can put undue stress on the liver but can be reduced by compounds such as zinc, curcumin, fish oil and alpha-lipoic acid. L-carnitine, l-methionine, choline and inositol all help to metabolize fat in the liver-enhancing function and can reverse fatty liver disease. Phosphatidylcholine (from lecithin) can protect from liver alcoholic cirrhosis.
Insulin resistance puts major stress on the liver due to inefficient sugar-burning in the liver which leads to fatty acid production from the excess sugar. Over time, this leads to fatty liver disease.
A leaky gut will put undue stress on the liver due to a constant flow of toxins passing through the gut barrier and entering the liver which must then detoxify these compounds.
The following pathways must be supported for proper detoxification. This can be important for thyroid patients who have thyroid imbalances due to excess testosterone, estrogen, toxic metals and thyroid disrupting chemicals.
Sulfation basically involves binding toxins with sulfur-containing amino acids so they can be excreted. The enzyme used in this step is dependent on molybdenum. Sulfur-containing amino acids include methionine, glycine and n-acetyl-cysteine.
Glucuronidation occurs when toxins are bound to glucuronic acid which is produced by the liver. B-vitamins, glycine and magnesium are required for this process.
Methylation is required for compounds that have been altered in Phase I detoxification. This process requires folate, SAMe, methylcobalamin (B12), magnesium, trimethylglycine, pyridoxal-5-phosphate(B6), choline, vitamin E, vitamin C, betaine and methionine.
Acetylation depends on vitamin C, thiamine (B1) and pantothenic acid (B5).
Bile Synthesis Support
Bile is produced by the liver to break down fats in the intestine, act as a “detergent” and to carry toxins with it that are produced by the liver. Bile production and flow must be optimal for detoxification. Taurine, vitamin C, betaine (beet root), lecithin (phosphatidylcholine), methionine, inositol and l-carnitine have been shown to support bile production and flow.
I use many different detoxification programs depending on each individual case. Detoxification can be a vital part of optimizing thyroid function due to the multiple thyroid disruptors in our environment. Be sure to be adequately evaluated by a qualified functional medicine practitioner before beginning a detoxification program. A properly performed detoxification program should not result in sickness or severe symptoms.