Some articles online will convince you that liver detoxes are the best thing in the world for resolving chronic issues (or, for that matter, any health concern whatsoever). Other articles will suggest the whole notion of liver cleansing is complete hogwash and marketing hype which will lead you to buy tons of herbs, supplements, juices etc. all for no real reason, and at huge expense.
There was a time when literally everyone was juice cleansing. Then, as with all things ‘nutrition’, there was the inevitable backlash.
But what is the truth of liver detoxes? Are they any good? Do they work or are they nonsense? Perhaps more importantly: are they necessary? And what of the new ‘upgrade’ to detoxing which utilises fasting as opposed to juice cleanses? Are we really that toxic we all need a good clear out and/or a complete break?
To understand whether ‘liver detoxes’ are necessary, we first must comprehend the liver as an organ: what does it do, how does it work and is it possible for it to get overloaded, thereby needing these clean-outs?
Packaged ‘liver detoxes’ are normally expensive protocols (think juice fasts, coffee enemas and every permutation of gnarly supplement or herbal regimen you can think of), but it must be recognised that the notion of detoxification is, in fact, entirely pertinent to the liver. Detoxification is its primary function.
The main argument of those who choose to deride the process of ‘detoxes’ is that we have a liver whose sole purpose in our bodies is to do the job of detoxing perfectly for us. Therefore, we have no need to use anything fancy, extra or on top of simple, normal physiological processing. And this is true, our liver really does take care of toxins for us.
And yet, as with everything, there is a grain of truth to the notion that cleanses and fasts might assist us with the liver’s natural work. This lies in how the liver achieves its endless process of keeping us toxin-free.
Toxins are everywhere – in the air, the water, the soil, our food, our chemical products, household cleaners, personal care products and beyond. Each day we encounter substances in the external world (and, for that matter, from our internal biochemical processes) that must be gotten out of the body in an expedient fashion in order to not risk being ‘poisoned’.
These poisons, byproducts and unhealthy substances are, if everything is working correctly, excreted through three main bodily substances: faeces, urine and sweat. They are bound up with bile acids and secreted into the small intestine to leave via faeces or they are filtered by the kidneys and flushed out in urine or sweat.
In order to get into these toxins bodily fluids in the first place, they must be changed in structure – chemically. The liver is the organ that does this. Most toxins are fat soluble whereas bodily fluids are, as the name would suggest, liquids, not fats. The art of making something fat soluble into something water soluble so that it can be moved into bodily fluids is the liver’s domain.
The Liver’s Phases
To make a fat soluble toxin water soluble, two steps are involved:
- Taking off the fat molecule
- Putting on a protein molecule (sometimes with a bit of carbohydrate)
Phase 1 = pop off the fat. Phase 2 = add on the protein/protein-carb component so it can be sent to a bodily fluid for excretion (bile or urine).
You may have heard of Phase I and Phase II Liver Detoxification and this is the simplistic breakdown of what is being done during each of the liver’s two ‘phases’. This process of changing the chemical structure of the toxins actually neutralises them, enabling us to move them, without further damage, into our bodily fluids prior to elimination.
In the process of rendering toxins non-toxic, they (ironically) become more toxic. This is why you will hear that slowed Phase II Liver Detoxification is an issue. The flow of the liver’s phases must run in concert in order to be effective and non-damaging. Phase I produces a highly toxic end-product. Any hold up with Phase II runs the risk of this product being held in the body far longer, with a host of consequences.
The Liver’s Requirements
This oversimplification of the job of the liver may make it seem like light work. However, in order to continue to complete this task – day in and day out – a vast array of nutrient depleting chemical reactions must take place. There are many, many enzymes involved in this effort and detoxification is one of the most nutrient-hogging processes of the body. The amount of nutrients required depends largely on the levels of toxicity, but every single enzyme which is used in the process of neutralising toxins requires a broad spectrum of micronutrients in order to do its job. I could provide a comprehensive list of all the nutrients involved, but it would be like listing every single micronutrient involved in cellular health at any level, plus a host of amino acids which are essential to provide the protein backbone of Phase 2 (the bit that makes it water soluble). If you have ever seen infographics of the two phases of liver detoxification online you will understand what I mean when I say that a lot of things are required in order to make this process tick along nicely.
All of these nutrient demands means that if you pile on the nutrients – in the form of juices, smoothies and pulverised, nutrient-dense veggies then you are, by default, supplying the body with a lot of good vitamins and minerals. And yet, you are in no way providing the liver with everything it might need.
What Affects Liver Function?
Many factors can affect the liver being able to complete its two phases effectively. It is true that there are genetic factors which influence how both phases of liver detoxification work, but one of the most important factors affecting overall liver detoxification ability is simply load.
Almost everything in the human body is load-dependent, which means that beyond certain limits our metabolic engines start to struggle. The liver is no exception: normal levels of toxins can be processed expertly and efficiently, with little or no unexpected collateral damage. In the condition of excess toxicity, however, the liver can be overly taxed and the whole process slows.
It is not actually a case of the liver getting ‘clogged up’, as some detox programs would have you believe. In truth what is occurring here is that the liver is working hard and fast – and in so doing using up all of the nutrients that the body had to offer. In a state of micronutrient insufficiency its normal biological function is impaired and slowed. It desperately needs the raw materials to keep working. It does not, however, require a ‘rest’ or a ‘flush’, as the detoxification sales brochures might promote.
Though some would suggest that ‘modern toxicity’ is another urban myth, designed to scare people into feeling the need for eternal liver cleanses and expensive detox juices, it cannot be ignored that the modern Western lifestyle can resemble a barrage of excess alcohol, too much poor quality dietary fat, smoking, metals, chemicals, drugs (even paracetamol), moulds etc. etc. etc. Our world is definitely more full of toxins now and we also do less of the ‘restorative’ or ‘relaxation’ practices such as Sleep, Exercise (gentle), Socialising and Emotionally Connecting. We very much work hard and don’t rest…
All of which would suggest that giving our livers a bit of a boost by adding in some smoothies or juices might be a good idea, right?
Do Liver Detoxes Work?
When the detox promoted is a starvation diet, some weird enema protocol or a raw-food-only regimen, you will now understand that this is going to be next to useless to the body. Liver health is dependent on a plentiful supply of nutrients: enough to process the toxic burden. It is a simple case of supply and demand.
Juice cleanses, coffee enemas, water fasts and extended green-smoothie-pounding protocols don’t cover these requirements. Whilst juice and green smoothies might sound nutritious, in reality they are singular sources of vegetable-based nutrition. Most importantly, they are sorely lacking amino acids. If you remember back to our liver biochemistry lesson above, Phase II liver detoxification binds on a protein in order to facilitate elimination. Amino acids are the protein building blocks required for this ‘step’. Protein-limited diets are therefore not helping the liver to do this job. By default, every cleanse I have found online seems to be limiting all protein sources and/or advocating completely eliminating food altogether.
It is bizarre that in our modern, bro-science filled world, we have begun to think that the best way to help our bodies with their very nutrient-hungry processes is to… completely starve ourselves of nutrition. Fasting is one of those things that has amazing clinical application, in certain circumstances. But it has to be chosen and applied correctly, in the right context – not liberally, in everybody, for every situation as seems to be part of the current zeitgeist. Convincing yourself that you are ‘atoning’ for liver overwhelm by abstaining from all food for a while or ‘flushing’ your system is not only flouting some fairly basic biology, it also starts up a pretty unhealthy psychological perspective that nutrition, and the running of our bodies, revolves around cycles of guilt vs. penance.
It is absolutely true that avoidance of excess toxicity is the ultimate best strategy which avoids taxing the liver too much in the first place. But this doesn’t mean that post-binge atonement in the form of restriction, abstinence and enemas is going to ‘make up’ for the ‘sins’ of indulgence. All of these phrases are actually pretty conflicted and emotionally-laden sentiments around nutrition which belie other issues at play rather than simple liver overwhelm. Whilst deeper discussion of these phrases is beyond the realm of this article – the whole notion of this guilt relationship with indulgences and foods is what lies at the heart of the appeal of liver detoxes in the first place.
Those who promote liver detox regimens play not on the realities of biology but on the insecurities of psychology and the shame relationships we have with our bodies and our food.
The real, nutritionally sound, recommendation if you have been over-exposing your body (and your liver) to toxins is not about feeling guilty and trying to punish yourself by a punitive regimen. Instead, it is to make your diet incredibly rich in the very things that the liver needs in order to do its job: nutrients. And what might the richest single source of all of the nutrients required for liver function be?
Not some fancy shake or smoothie, nor some powdered blend of pre-digested amino acids mixed with synthetic supplements. It’s actually just LIVER. You know, like offal, liver – the kind that’s cheap as anything in the supermarket and the butchers, even for the fancy organic stuff. Organ meats are the nutritional powerhouse of the Paleo community because they actually contain the nutrients the organ needed in order to do its job in the animal of origin. Those nutrients are the very same nutrients that humans need for their organs to do their job properly. So if you want to help your liver, strategy number one should be eat liver. (And yes, this might gross you out but there are also things like Desiccated Liver capsules available which can sort of suffice, but ideally you can hide actual liver (chicken is the least overpowering, followed by beef) in any ground meat dish such as bolognese, chilli, homemade burgers, cottage pie etc.)
But what about things like coffee enemas? Oil flushes? Colon cleansing? Are we really bunged up with ‘stuck toxicity’, given our modern lives? Do we just need to push it all out?
Instead of ‘purifying’ or ‘alkalinising’ (nonsense, ignore this concept and anyone who promotes it) our body using green-vegetable-heavy juices, ‘flushes’ are concerned with moving toxic stuff through and out of our body … supposedly. They’re not so much helping out the liver – they’re clearing the waste products created after the liver has completed its two-phase efforts.
Again, here we have the naysayers, (“I have a gastrointestinal tract and a toilet so I’m flushing stuff out of myself fine, thanks!”) and the advocates, (“Oh my goodness that coffee enema made me feel so great afterwards!”).
Both are probably equally right and wrong. If your body is working well and effectively, colonic irrigation is not a necessary adjunct to your normal bodily functions. Sometimes in those with gastrointestinal issues it can feel as if it helps, though how much of this is placebo and to do with the nerve supply to the GI tract being affected by the sensation of ‘flushes’ is not something that’s been extensively studied.
There is no evidence to suggest that clinical application of regular enemas or cleanses are either necessary or have the effect of improving health outcomes. As someone who works closely with digestive disorders I would be far more interested in understanding why there is the sense that such flushing or enema procedures are necessary in the first place. Ineffective defecation is a symptom of something. It is unlikely to be a symptom of ineffective liver detoxification and rather than use ‘flushing’ as a temporary reliever of the sensations of ‘stuckness’, I would be far more interested in investigating the true nature of the issue.
Anecdotally, many people love colonics and enemas. There is some science showing slight benefits to the application of caffeine/coffee grounds to the sensitive blood vessels of the anal passages… but here we’re a million miles away from doing anything to the detoxification capacity of the body. By the time we’re at the colon we’re only dealing with elimination, i.e. getting rid of what has already been detoxified.
So is there really nothing to the juice cleanse, liver detox stuff?
You would be forgiven for thinking that I’m going to come down on the side of ‘it’s all nonsense’. But actually, there is something to the juice cleanse phenomenon which might be of benefit. It’s not really helping in the way people think, but sometimes the justification of a ‘treatment’ needs to sound sexy in order to gain traction.
If mislabelling a high consumption of vegetables as a detox cleanse gets more people doing it… that might actually be a good thing.
Juicing might help simply because it convinces people to shovel literally tonnes of vegetables into themselves, which is ALWAYS a positive. Drinking smoothies and juices provides far, far more vegetables than anyone eating the Standard American Diet. It probably provides even more veg than nutrient-dense, plant-based diets (which includes proper versions of Paleo diets, which are actually mostly vegetables). The act of pulverising foods means you can consume greater amounts, and all of those liver pathways will be supported by the high levels of nutrients that come from vegetables that may have been seriously lacking in the ordinary diet.
On another note, if someone chooses a ‘juice’ cleanse (rather than smoothies), all of the fibre is extracted from the end products. This is often heavily criticised because it provides highly-concentrated doses of fibre-less fruits and vegetables to the body and yet, for those with underlying gut conditions, digesting fibre can sometimes be complicated and symptomatic. This is due, in large part, to bacterial dysbiosis inside the digestive tract. Bacteria thrive on fermentable carbohydrates, especially fibre. A short period of a diet low in such fibres (such as a juice-only cleanse or a water fast) might give the digestive system enough of a break to both relieve symptoms, but also to shift the microbial balance and significantly alter the patient’s disease state.
This is a clinical application in a specific case, however. It is not a generalised prescription and the approach certainly could have adverse effects if trialled by someone with, for example, a predisposition to diabetes or an issue with adrenal glands and blood sugar. One apparently useful clinical application certainly doesn’t make juice cleansing, under the guise of ‘liver detoxification’ healthy or necessary for all.
OK, so it’s not necessary – but can it actually cause harm?
Long term, any ‘juice cleanse’ or ‘detox regimen’ is not benign. Nutrients are missing from vegetables and fruit juices. Amino acids and proteins that you really need for life are completely absent. Forgetting about the liver phases and focussing on basic nutrition – breadth and variety aren’t just ‘nice-to-haves’, they’re recommended for a reason. Singular sources of nutrition not only become boring, they also skew the microbiome, alter the immune sensitivity and change our nutritional profile in such a way that we could run the very real risk of becoming deficient in certain essential nutrients.
- The fibre that is removed from vegetables by juicing them is no loss to the bad gut bacteria, but the lack of fibre will ultimately lead to an undergrowth of all of the good bacteria that help with digestion, nutrient absorption and life itself.
- The sugar spikes and crashes that come with drinking your meals and taking a lot of calories in (in the form of vegetable and fruit sugars) in a short space of time is actually quite draining, metabolically damaging and adrenally taxing.
- Moreover, losing the fibre from your diet also means that you lose fullness sensations too – making ‘liver detoxes’ ridiculously hard to stick to, feel uncomfortable and making anyone doing them feel grumpy, hungry and pretty miserable throughout.
So short term, and as a habit change and a system reset, there may not be a harm to trying a liver detox … But there are better options.
If you know you struggle to get in the vegetable quantities, don’t buy the expensive juices, just make them yourself at home. You control what you’re drinking and you can add these ON TOP of your ordinary diet. If you’re struggling with the dietary issues associated with consumption of fibrous veggies then this is a symptom – and one we’d recommend that you seek assistance in resolving. And if you’re contemplating ‘flushing’ and read about the wonderful stories of how much ‘gunk’ people expel or stones or lumps of toxins… be very, very, very cautious. Flushing your body – however you do it – is not an easy or gentle process. It is intense, it releases many compounds (not all of which we know about) and it is, in fact, an entirely unnatural process which is unscientifically validated and medically not recommended. You are actually, ironically, asking more of your body when you push yourself through such a process.
I regularly see clients who have been on extended detox protocols of herbal supplements. They are exhausted, drawn and drained. They believe that the toxins they are trying to expel are creating the symptoms. In reality, however, it may very well be that their constant attempts to detox – the regular influx of herbal remedies, the permanent pill-popping of green algae and parasite ‘cleanses’ – are putting their body into a perpetual ‘detox state’ which is energy-intensive and ultimately self-defeating.
Sometimes STOPPING the cleansing is the single biggest service to the body. Our bodies really do know what to do in order to be and stay healthy. They have got all of these physiological processes down. Sometimes, admittedly, they need a nudge to help them back into optimal functioning. But I have never, ever seen them benefit from any longterm attempts to detoxify using external ‘help’. Vegetable smoothies are not, in and of themselves, a bad thing. But liver detoxification through powerful protocols is potentially dangerous. If you’ve been caught up in this conviction that your are ‘toxic’ and your liver needs support, please do seek the support of a professional. Being cleared of our stuck gunk sounds really appealing and utterly beneficial. As always within the body, however, actions can have consequences. If you are going to attempt a liver detox – especially one of the more complex and intense-sounding ones – be aware that you may be putting your body in a far worse place by trying to do some good.
If you would like my help to support your liver, stop your constant detoxing, wean you off the herbs that are keeping you ‘symptom-free’ (but which give rise to symptoms the moment you stop) please do get in touch today.