I have to be honest: I cringe when I hear the word “cleanse”. What should be a rather straightforward, natural concept often refers to any one of a number of faddish, mis-directed and possibly damaging attempts to rid the body of toxins. Given that it’s April, I’d like to use the topic of spring cleansing as a lead-in to explore this. For the purposes of this article, “toxins” will include normal byproducts from digestion, cellular metabolism and other bodily processes whose accumulation negatively impacts the body (urea and gout for example), chemicals from our food and environment, and drugs/drug metabolites (prescription, over-the-counter and recreational).

Spring cleansing is an ancient tradition that spans multiple cultures from Asia and Europe to the Americas. For places in the world with a cold winter, access to fresh greens and vegetables throughout the year is a recent development, relatively speaking. Fresh spring greens, new buds and shoots provided a nourishing diet that promoted what was traditionally known as “blood cleansing” after the heavier winter diet of preserved vegetables, meats and fats, and stored root vegetables. To cleanse the blood essentially means to support the organs of elimination that filter toxins out of the blood and expel them from the body. Many different types of roots and barks were also consumed as blood cleansing spring tonics…burdock, sarsaparilla, and birch to name a few. This is where root beer came from before it became the sugary, carbonated drink that we know today.

The bitter greens available in the spring facilitate the expulsion of wastes by promoting liver and kidney function, by enhancing digestive function and by providing vitamins and minerals to boost overall body function. Every spring, my Lithuanian grandmother sent my mother and her sisters out to gather fresh, young dandelion greens. I also picked dandelion greens as a child, but it was more as a novelty than a serious addition to the family diet (we were big on iceberg lettuce). Other cleansing, nutritious greens that show up in the spring, possibly as “volunteers” in your garden, include bitter cress, dock, sorrel, amaranth, lamb’s quarters, purslane and nettles. There are many recipes online to help you figure out what to do with them.

The body normally cleanses as part of it’s day-to-day functioning; otherwise, we’d be dead. It is a serious issue when a part of the body’s detoxification system breaks down, as exemplified by folks on kidney dialysis or requiring a liver transplant. Though the body is constantly cleansing, toxic accumulation can occur, either seasonally as described above, from the standard Western diet low in nutritious foods and high in processed foods, from regular drug usage (prescribed or otherwise) and/or from exposure to environmental toxins. Indeed, we ingest many of the pesticides, herbicides and industrial chemicals now ubiquitous in the soil, water and air, and many wind up stored in our fat cells. By doing a formal cleanse, we support the body’s organs of elimination in removing some of this accumulation. Ideally, this would mean striving for a healthier diet and lifestyle to support these organs at all times rather than persisting in what are, perhaps, bad health habits, with intermittent cleanses to patch things up.  Moreover, rapid or harsh cleanses can release a flood of these fat-stored toxins that overwhelm the systems of detoxification and elimination and intoxicate the body. More on this next…

Cleansing isn’t accomplished simply by subsisting on juice or water for a period of time. In fact, if done for more than a couple of days, such approaches will have a toxifying effect on the body. When fasting folks feel euphoric, they are quite literally intoxicated. To understand why, we need to understand a little about how the body naturally cleanses itself. This brings us to the organs of elimination: The liver, kidneys, lungs, and skin. When one of these isn’t working efficiently, the others have to take up the slack. An example of this is when skin issues manifest because the liver is overloaded and/or under-functioning.

The lungs rid the body of carbon dioxide every time we breathe out. We also exhale some water. I addition, the lungs can clear some other substances. Do you ever wonder why garlic breath is so strong? It isn’t due solely to the residual garlic mung in your mouth after horking down a loaf of garlic bread. It’s because garlic contains a pungent essential oil that winds up in the bloodstream and is eliminated in part through the lungs. If you cut a fresh clove of garlic in half and rubbed it on your feet, garlic’s essential oil will penetrate your skin, enter your bloodstream and eventually make it to your lungs resulting in…garlic breath. This is one reason raw or pickled garlic is so useful when you have a respiratory infection. It’s essential oil is strongly antimicrobial and goes right to the lungs. (The oil is changed chemically when garlic is cooked…it loses it’s antimicrobial capacity, though it can still boost immune system function). Another example is the fruity-smelling breath people may develop during a prolonged fast. This is because a metabolic byproduct, acetone (think nail polish remover), is produced from the breakdown of fats during fasting, and is excreted in part via the lungs.

Though many people don’t think of the skin as an organ, it’s the largest organ of elimination and the largest organ overall. Our skin excretes excess water, salts and urea (a breakdown product of proteins) through the sweat glands. Other substances can also be expelled through the skin. One of my teachers has studied and worked with essential oils for decades. At some point earlier in her career, she started smelling like essential oils even when she hadn’t applied or worked with any that day. Tests revealed that her liver enzymes were elevated, indicating that her liver had become overloaded from metabolizing all the oils that she worked with so closely. The oils, normally excreted rather quickly, were accumulating in her body. Thus, her skin kicked in as an additional route for eliminating them from her body. Excessive garlic consumption can also result in excretion of garlic metabolites through the skin. Luckily, I wasn’t dating much around the time I first learned this. Though maybe my garlic intake was the reason I wasn’t dating much.

Urine production is frequently thought of as the kidneys’ main function, but their job is really much more complex than that. On average, the kidneys filter about 200 quarts of blood per day through millions of tiny filters called nephrons, sorting out metabolic byproducts, excess salts and various toxins while retaining needed salts and water for proper fluid balance in the body. Indeed, the kidneys have a large role in blood pressure regulation. The kidneys send things like urea, creatinine (a metabolite that comes from muscle tissue) and small amounts of bilirubin (from red blood cell breakdown) as urine to the bladder for expulsion. Urine is aqueous (water-based). For things to be passed out of the body in the urine, they need to be dissolvable by water. This point will be continued below in the discussion on liver detoxification. Many drugs and/or their metabolites also find their way out of the body via the kidneys. In some cases, this can damage the kidneys. For instance the drug lithium, used in the treatment of bipolar disorder, can cause nephropathy (kidney disease) over time.  Even over-the-counter drugs like analgesics can damage the kidneys with long term use, or in a faster manner from overdosing.

The liver is another organ that filters the blood. All of the organs of elimination are important, but the liver is the major detoxifying organ. Much of what we ingest passes through the liver in some form. The liver also deals with many drugs and environmental pollutants, and participates in the breakdown of endogenous substances like hormones, red blood cells, proteins, etc. To get rid of toxic substances, the liver modifies them so that they can be carried out of the body.

The problem with cleansing protocols like the juice fast is related in part to how liver detoxification works. Hepatocytes (liver cells), contain detoxifying enzymes that act on toxins carried to the liver by the bloodstream. These enzymes function in a 2-step process. “Phase 1” enzymes act on the toxins first, followed by “Phase 2” enzymes. Phase 1 detoxification (see 1st diagram) is carried out by a family of enzymes known as the cytochrome p450 family (cp450), and converts toxins into a form that more easily dissolves in aqueous (water-based) solution.  (Many of the things the body wants to get rid of are more dissolvable in fat than water, making it difficult to circulate them out of the body). After conversion by phase 1 liver enzymes, the toxins are now “reactive intermediates”; they are more reactive than the initial toxin. This means that reactive intermediates stick to things more easily, such to as the carrier molecules that will escort them out of the body. It also means that they can bind to cells and tissues and cause damage if not quickly dealt with by the next step in the detoxification process, carried out by phase 2 enzymes (see 2nd diagram). Phase 2 enzymes are what joins the carrier molecule to the reactive intermediate. The carrier molecule then escorts the toxin safely out of the body.

So what’s the problem with juice fasts? Multiple days without a protein source and adequate nutrition actually causes two problems. First, toxins are released from fat cells at a higher rate than usual as fat is burned for energy (see 3rd diagram). Second, the phase 2 detoxification system becomes severely diminished. This is because many of the phase 2 detoxification pathways require amino acids, which we get from eating protein. Juice has very little, if any, protein.  The result?  An accumulation of damaging reactive intermediates generated by phase I detoxification that do not get carried out of the body (see last 2 diagrams).

There are several take home messages here. The first is that we should support our body’s constant cleansing by eating a clean, whole foods diet as much as possible. There are many cleansing foods, for instance, bitter greens and root   vegetables, that support the liver and other organs of elimination. Plenty of herbs and spices do this as well, including burdock root, turmeric, dandelion, Oregon grape and nettles, to name a handful.  Add to this some sweat-inducing movement to move toxins out through the pores and reduce the burden on the liver and kidneys, to improve circulation and to promote deeper breathing. The second message is that living an unhealthy lifestyle with periodic cleanses thrown in to try to clean up is neither useful nor sustainable. Finally, a formal, gentle cleanse based on nutritious but easily digested foods — for example, steamed greens and root vegetables, berries and other alkalizing fruits, broths, and kitchari or other well-cooked legume/grain combinations — can be helpful in relieving the body of toxic accumulations that have overwhelmed our ever active cleansing mechanisms. If all else fails, don’t forget the protein.


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