Naturopathy, rooted in a holistic philosophy, recognises the importance of addressing the whole, unique person to improve health, wellbeing and vitality. The impact of our modern lifestyles, poor dietary habits and environmental toxins is recognised as detrimental to health in the Therapeutic Order, a central concept within naturopathic medicine. Guided by this understanding, naturopaths are able to tailor their approach to each individual patient’s needs for safe and effective care.^1-3

In the context of detoxification, naturopaths frequently utilise ‘detoxification therapies’ to treat patients for environmental exposures, gentle cleansing/preventative medicine, gastrointestinal disorders, autoimmune conditions, and inflammation especially. While ‘detoxification therapies’ varies widely, this approach commonly involves cleansing foods (i.e. Brassica family foods), vitamin/mineral/antioxidant supplementation and reduction of exposure to environmental toxins. Such interventions serve to reduce the body burden of synthetic chemicals that contribute to adverse health effects.⁴

A professional, practitioner-led detox program is designed to ensure that these fundamental aspects are not overlooked when prescribing detoxification therapies. The program enables practitioners to help their patient:

• Prepare for detoxification
• Avoid exposure to toxins and reduce the accumulation of toxins
• Support gut health
• Support liver detoxification (biotransformation and elimination) to lessen the body burden of chemicals
• Protect against oxidative damage

Foundational herbs and nutrients that support detoxification include:

• Brassica oleracea var. italica (Broccoli) contains glucoraphanin which is metabolised to biologically active sulforaphane. Sulforaphane induces nuclear factor erythroid 2-related 2 (Nrf2), a key regulator of the body’s detoxification and antioxidant enzymes.^5,6
• Curcuma longa (Turmeric) and its main anti-inflammatory and antioxidant polyphenol, curcumin. Curcumin also induces Nrf2 and protects against oxidative damage in various cells and conditions.⁷
• Glutamic acid (glutamine), glycine and cysteine are amino acid precursors for the glutathione which acts as an antioxidant, free radical scavenger, and detoxifying agent.⁸ Cysteine also contains sulfur and plays a crucial role in phase II liver detoxification via sulfation.⁹ Collectively, phase II reactions are essential for promoting the detoxification of xenobiotics, including environmental pollutants, alcohol and drugs (pharmaceutical or recreational).^9-11
• Glycine and taurine are important for amino acid conjugation, a phase II liver detoxification pathway;¹² and for bile acid conjugation.^13,14 Bile is one way in which xenobiotics can be eliminated from the body.¹⁵

Figure 1. Herbal and Nutritional Support for the Three Phases of Detoxification¹⁶

To dive deeper into each of these herbs and nutrients, refer to Phytotherapist’s Perspective No. 170 Herbs & Nutrients to Support Phase II Detoxification & Liver Function.

Combining highly indicated ingredients with clinical expertise to deliver personalised care is how naturopathic practitioners can support their patients to achieve their best health. Supporting detoxification comes back to educating patients to make healthier choices, optimising liver function, and improving antioxidant defences to enhance the neutralisation and elimination of toxins.

References

1. Dewangan S, Kumar BB. The relevance of naturopathy as a therapeutic tool in the modern era: a narrative review. Altern Ther Health Med. 2024 Apr;30(4):38-41.

2. Finnell JS, Snider P, Myers SP, Zeff J. A hierarchy of healing: origins of the therapeutic order and implications for research. Integr Med (Encinitas). 2019 Jun;18(3):54-59.

3. Christianson A, Murray MT. Hypothyroidism. In: Pizzorno JE, Murray MT, editors. Textbook of natural medicine. 4th ed. St Louis: Elsevier Churchill Livingstone; 2013.

4. Allen J, Montalto M, Lovejoy J, Weber W. Detoxification in naturopathic medicine: a survey. J Altern Complement Med. 2011 Dec;17(12):1175-1180. DOI: 10.1089/acm.2010.0572

5. Hodges RE, Minich DM. Modulation of metabolic detoxification pathways using foods and food-derived components: a scientific review with clinical application. J Nutr Metab. 2015;2015:760689. DOI: 10.1155/2015/760689

6. James D, Devaraj S, Bellur P, Lakkanna S, Vicini J, Boddupalli S. Novel concepts of broccoli sulforaphanes and disease: induction of phase II antioxidant and detoxification enzymes by enhanced-glucoraphanin broccoli. Nutr Rev. 2012 Nov;70(11):654-665. DOI: 10.1111/j.1753-4887.2012.00532.x

7. Shahcheraghi SH, Salemi F, Peirovi N, Ayatollahi J, Alam W, Khan H, et al. Nrf2 regulation by curcumin: molecular aspects for therapeutic prospects. Molecules. 2021 Dec;27(1):167. DOI: 10.3390/molecules27010167

8. National Cancer Institute. Glutathione [Internet]. Bethesda: National Institutes of Health; [cited 2024 Dec 4]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-drug/def/glutathione

9. Zhou SS, Zhou YM, Li D, Ma Q. Early infant exposure to excess multivitamin: a risk factor for autism? Autism Res Treat. 2013;2013:963697. DOI: 10.1155/2013/963697

10. Kalra A, Yetiskul E, Wehrle CJ, Tuma F. Physiology, liver [Internet]. Treasure Island: StatPearls; 2023 [cited 2024 Dec 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535438/

11. Correia MA. Drug biotransformation. In: Katzung BG, Trevor AJ, editors. Basic & clinical pharmacology [Internet]. 13th ed. New York: McGraw-Hill Education; 2015 [cited 2024 Jun 24]. Chapter 4. Available from: https://dl.pezeshkamooz.com/pdf/dglibrary/book/medical/poisoning/clinical-pharmacology-13th.pdf

12. Markey SP. Pathways of drug metabolism. In: Atkinson AJ, Abernethy DR, Daniels CE, Dedrick RL, Markey SP, editors. Principles of clinical pharmacology [Internet]. 2nd ed. Amsterdam: Academic Press; 2007 [cited 2024 Dec 4]. Chapter 11. Available from: https://www.sciencedirect.com/book/9780123694171/principles-of-clinical-pharmacology

13. Chen I, Cassaro S. Physiology, bile acids [Internet]. Treasure Island: StatPearls; 2023 [cited 2024 May 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549765/

14. Hofmann AF. The continuing importance of bile acids in liver and intestinal disease. Arch Intern Med. 1999 Dec;159(22):2647-2658. DOI: 10.1001/archinte.159.22.2647

15. Boyer JL. Bile formation and secretion. Compr Physiol. 2013 Jul;3(3):1035-1078. DOI: 10.1002/cphy.c120027

16. Liska D, Lyon M, Jones DS. Detoxification and biotransformational imbalances. Explore (NY). 2006 Mar;2(2):122-140. DOI: 10.1016/j.explore.2005.12.009