12 Signs You Need to Detox

By Sara Gottfried, MD | August 28, 2014

I didn’t learn about detox at medical school or residency; I learned about it first through yoga, particularly during my years at Kripalu in Western Massachusetts. My detox education began via the Ayurvedic principles of Panchakarma.

I learned about detox from feeling sluggish and like my liver was overtaxed, and finally realizing a good detox was in order… despite the relative silence on the topic from my mainstream medical education.

I used to think detox was a luxury, now I realize it’s an imperative.

What Are 12 Signs That You Need Detoxification?

Tally how many of these signs you’ve seen in your body over the past 3 months:

– White or yellow-coated tongue and/or bad breath

– Fluid retention and/or congested sinuses

– Increased belly or visceral fat

– Cravings and/or blood sugar issues

– Gallbladder issues or you had it removed

– Abdominal bloating

– Overheating/excess sweating

– Weight loss resistance

– Acne, rosacea, itchy skin

– Fatigue unrelieved by more sleep, especially in the morning

– Moodiness

– Autoimmunity

– Chemical sensitivity – you’re a lightweight when you drink alcohol or smelling fragrances makes you anxious

– Insomnia – especially early morning awakenings such as 1-4 a.m.

– Cravings

If you have 4 or more of these signs, you may have a congested liver that needs a vacation. I suggest a detox for a minimum of 21 days.

Your Liver At 40

Last year, a headline in The Wall Street Journal caught my eye: Drinking After 40: Why Hangovers Hit Harder.[1] The article describes the reasons why moderate alcohol consumption gets more complex when you’re middle aged.

Basically, you’re more sensitive to alcohol in your 40s and 50s compared to your 20s and 30s, so you feel the effects more strongly. There are several reasons for this but the one that hit home for me is the change in body composition as we age: we tend to get more fat and less lean.

Alcohol doesn’t distribute in your fat, so as you get less lean that you were at 20, alcohol becomes more concentrated in your blood. Additionally, your liver’s reserve goes down and it’s less efficient at getting rid of toxins like alcohol.

What does this mean for you?

Perhaps you’re like the women in my practice who tell me they can’t drink like they used to: one glass of wine is their upper limit because otherwise they don’t sleep well, or they get fat, or they feel dumb the next day.

In this article, I’ll make a few suggestions that may clear your liver, such as cutting out alcohol for a period of 3 weeks. My suggestions relate to the two key detox pathways that your hard-working liver is organized around: phase 1 and phase 2. That means a little science is in order so that the recommendations have proper context.

Very simply, phase 1 is oxidation, whereby your liver utilizes oxygen and enzymes to remove toxins by making them soluble in water, so they can be excreted in your urine and poop more easily. The enzymes are the superfamily known as the cytochrome P450 enzymes, which includes about 100 enzymes that are controlled by at least 57 genes with many variations. Each enzyme has a type of chemical that it detoxifies. Phase 1 is essential to detox, but there’s some risk involved: sometimes the daughter chemicals or metabolites are worse than the parent. That’s where phase 2 comes in.

Phase 2 is called conjugation, which is necessary to remove the metabolites.

What is conjugation?

It’s how your liver combines oxidized metabolites with sulfur, methylation, glucuronidation, by adding certain amino acids or organic acids, and ultimately excretes them in bile.

Here’s the tricky part: most environmental toxins overactivate in phase 1, and then exceed the capacity of your liver to complete the detoxification in phase 2. In other words, you develop excess phase 1 and slow phase 2. When that happens, you generate signs of toxicity, such as those above.

Lay Down Your Burden

Here are a few recommendations to unburden your liver.

1. Consume antioxidants.

Most people throw this term around and don’t really know why antioxidants are good for the body. For every molecule of toxin metabolized in phase I (such as from cigarette smoke or the pesticides on the golf course), you generate one free radical molecule. Free radicals damage DNA and accelerate wear and tear in the body, similar to rust on a car. Taking vitamins C and E, flavonoids, carotenoids, and reduced glutathione helps neutralize the free radicals you’re making each day in phase 1. Here are a few of the foods that are rich in flavonoids: berries, parsley, onions, green and black tea, citrus, and dark chocolate. Carotenoids? Get ‘em from carrots, pumpkin, squash, plantains, spinach, and sweet potato.

2. Add cardamom to your coffee.

I got this tip from a labor and delivery nurse from India, and learned the scientific underpinning later: take 3-5 cardamon seeds and add it to your coffee. I carry a small stainless-steel container of cardamom seeds in my purse. Cardamon increases the phase I enzyme that metabolizes caffeine.

3. Grow and eat broccoli sprouts.

The sulforaphane in broccoli sprouts strongly supports phase II detoxification. My friend, Tom Malterre, calls broccoli sprouts the “DNA whisperer” because they contain a particular sequence of potent anti-cancer elements even though it actually has a lower nutritional content than the full sized broccoli. The sulforaphane, in the sprouts, work as a catalyst to boost enzymes in the body and these detoxification enzymes trigger ongoing antioxidant action for at least 72 hours. By the way, this antioxidant activity last significantly longer than vitamin C, E, and beta carotene – while boosting the effectiveness of these vitamins.

4. Stop or substantially reduce the booze.

I know – I’ve heard the excuses. I understand that it’s hard to give it up, but alcohol affects and potentially harms both phase 1 and phase 2 detox pathways. Recently, a scientific review showed that 4 servings per week reduces live birth by 16 percent in women undergoing in vitro fertilization.[2] Women who drink 3 to 6 servings of alcohol per week have a 15 percent greater risk of breast cancer compared to nondrinkers, according to the Nurses’ Health Study.[3] Yes, low levels of alcohol confer risk.

5. Eat 3 servings per day of cruciferous vegetables.

Broccoli, cabbage, brussels sprouts help you reduce estrogen dominance and support both phase I and phase II detoxification.

What is the Next Step?

My friend and colleague Jeff Bland, whom I consider to be the father of functional medicine, once said: “While the principles of balance, moderation, and variety are excellent guidelines for constructing public health policies, they may not be specific enough for constructing the proper diet for a patient with a specific alteration in his or her functional capacity for detoxification.” Agreed.

Given the daily toxic exposures that most of us encounter and the fact that moderation doesn’t work for most people, ongoing and focused detoxification is imperative.

Start by limiting your exposure to toxins by drinking from a glass or stainless steel container, and avoiding plastics whenever possible. Use organic products on your skin. Avoid GMO food. Then add in periodic detoxification so that your liver is able to keep up with the demand.