Detoxes are huge right now - teas, diets, supplements, and even facial scrubs and bath salts are everywhere! While some focus on detoxing or cleansing different parts of the body, many seek to boost liver function. In light of the fact that the liver has over 300 vital functions, this spotlight on liver health makes sense (1, 2)! While some detoxification methods are much more effective and reliable than others (more info on this below), there is an underlying principle about the liver that rings true: if it isn’t working well, we won’t feel healthy.
Just what does the liver do, exactly?
Most people associate the liver with filtering out toxins and know that drinking too much alcohol can cause permanent liver damage. While these things are true, there is so much more that the liver does!
The liver is an organ located in the upper right portion of the abdomen (above the stomach, kidneys, and intestines), and has a characteristic triangular shape. It is made up of two main sections, called lobes, and is connected to the portal vein and hepatic artery. Oxygen and nutrient-rich blood come into the liver through these blood vessels, bringing blood from the heart and intestines that is full of all the components that we take in through our diet. The liver then works to filter that blood by (1, 2):
procuring available nutrients
filtering out poisons, toxins, bacteria, and other illness-inducing pathogens
metabolizing drugs and alcohol
breaking down fat
producing proteins and cholesterol
converting glucose into glycogen to balance blood sugar
processing hemoglobin and then storing the resulting iron
regulating blood clotting
producing bile, etc.
Once the liver properly filters the blood and removes or breaks down harmful substances, these by-products are expelled from the liver, transported either by bile or blood (2). Bile carries away toxins and other unusable or harmful substances, then brings them into the intestines, where they are eventually expelled through the feces. Any substance the blood carries away then enters the kidneys, is filtered again, and soon after leaves the body through urine (2). Without the liver, our bodies wouldn’t retain enough nutrients and would keep in far too many toxins, leading to any number of health issues.
Poor Liver Function Leads to Disease
When the liver isn’t functioning properly, it is unable to complete all of the processes mentioned above to the degree needed. This not only means that it expels improperly filtered blood and bile (affecting all the other organs and systems in the body), but that nutrients and macromolecules (such as fat) aren’t broken down as they should be (1, 2).
When fat isn’t broken down thoroughly, or when there is an influx of too much fat, it can begin to build up in the liver (3). If unchecked, this leads to non-alcoholic fatty liver disease (NAFLD), which is distinct from liver disease caused by damage from drinking too much alcohol (alcoholic fatty liver disease). When the liver develops fatty liver disease, the excess fat behaves as a toxic substance to liver cells. The cells respond by becoming inflamed and, as the liver works against this inflammation, the tissue scars (also called cirrhosis) (4). If left untreated, over time this inflammation and cirrhosis lead to a more aggressive form of liver disease called nonalcoholic steatohepatitis, which can ultimately result in liver failure (4).
While the exact cause of NAFLD is yet unknown, it is often linked to obesity, insulin resistance, and high blood sugar, as well as high fat content in the blood (3). Because these problems are so prevalent in America, it is no wonder that nonalcoholic fatty liver disease is the most common form of liver disease and affects at least one-third of the adult population (4). Other risk factors for nonalcoholic fatty liver disease include (3):
excess fat in the abdomen
polycystic ovarian syndrome
The Idea Behind Detoxification
The symptoms of lowered liver function and disease can be quite vast. It can cause yellowing of skin and eyes, swelling in the abdomen or legs and ankles, itchy skin, dark urine or pale stool, chronic fatigue, reduced appetite and weight loss, nausea or vomiting, easy bruising, or even confusion or trouble concentrating (3). Since symptoms of lowered liver function and even full-blown liver disease are often mild or vague (like nausea or fatigue), it can take time to recognize that the issues are stemming from the liver.
This is part of the reason why detoxification is becoming so popular, even among people who are relatively healthy but find that something is off about their health. Having more energy, reducing toxic buildup, encouraging more regular bowel movements, losing weight, reducing bloat, regulating hormones, and fixing skin issues are some of the most common reasons people seek detoxes (5, 6, 7). For those who do have liver disease, detoxifying and reducing liver fat deposit is crucial. Not only can those with NAFLD see these benefits through focusing on liver health, but they will see greater health overall and lowered risk of developing nonalcoholic steatohepatitis (2, 3, 4, 7).
How to Know if You Could Benefit from Detoxification
If you are experiencing the symptoms listed above, it is definitely worth talking to one of our physicians about your liver health. There are a number of blood tests that determine liver function through measuring markers such as glycogen, protein, blood clotting factors, cholesterol, fat, bile, and hormone levels (8). The results can also help indicate what may be causing lowered liver function. Whether it be inflammation and damage from toxins and excess fat, swelling due to an abscess or tumor, bile irregularities due to gallstones, or an underlying disease, blood tests can usually point toward the general direction of the liver issue (8).
After bloodwork, an ultrasound can be helpful to further determine what is causing the symptoms and rule out what isn’t. Ultrasounds are especially helpful to help determine if the underlying issue is fatty liver disease and help to get a sense of how progressed the disease is (9). At Temecula Center of Integrative Medicine, we offer executive physicals, which is an in-depth physical that includes a wide range of testing, including liver ultrasounds to screen for fatty liver disease. This allows us to get a very dialed-in and accurate picture of your overall health, including cardiac, lung, immune system, and liver health.
How to Promote Detoxification
As with any other type of issue, focusing on the 5 pillars of health is key to helping improve overall health. Since fatty liver disease is so often linked with other conditions such as metabolic syndrome, diabetes, obesity, and cardiovascular diseases, focusing on aspects of health like hydration, diet, exercise, maintaining a healthy weight, and proper sleep is crucial (3, 6, 7, 10). Anti-inflammatory treatments, diabetes management, eliminating alcohol use, and dietary changes may all be beneficial depending on your specific health risks (7). Focusing on removing toxins and heavy metals from your diet along with increasing water consumption can go a long way to heal some people’s liver inflammation and toxicity (10). For others, reducing sugar and working on stress management is the answer.
It is worth noting that not all detox protocols or products are equally effective. Some products, including natural herbs and teas, can be ineffective at best and harmful at worst. We focus only on protocols that are truly beneficial and are scientifically proven to promote liver detoxification. Because each patient is unique, we take the time to understand each person’s health and toxic load. We will discuss your health history, review blood work, ultrasounds, and scans, and create a specific detox plan based on your needs.
Whatever your needs may be, we would love to partner with you to help pinpoint your current health needs and make a plan to meet them. If you are curious about everything that an executive physical entails, have concerns about your liver health, or want more information about detoxification, please reach out! We would love to help you on your journey to greater health.
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
Anatomy of the Liver. UPMC. (n.d.). https://www.upmc.com/services/liver-cancer/liver/anatomy-liver.
Liver: Anatomy and Functions. Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/liver-anatomy-and-functions#:~:text=Functions%20of%20the%20liver,intestines%20passes%20through%20the%20liver.
Mayo Foundation for Medical Education and Research. (2020, October 21). Nonalcoholic fatty liver disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567.
Fatty Liver Disease. Center for Obesity and Metabolic Health (COMET). (n.d.). https://www.uclahealth.org/comet/fatty-liver-disease#:~:text=In%20the%20United%20States%2C%20the,prevalence%20is%202%2D5%25.
Signs You Need to Detox. Hopkins Medical Group. (2020, September 23). https://www.phopkinsmd.com/signs-you-need-to-detox/.
Signs Your Liver Needs A Detox. Quicksilver Scientific. (2020, May 17). https://www.quicksilverscientific.com/blog/signs-your-liver-needs-a-detox/.
ACR, R. S. N. A. and. (2018, February 14). Fatty Liver Disease and Liver Fibrosis. Radiologyinfo.org. https://www.radiologyinfo.org/en/info/fatty-liver-disease.
Lowth, D. M. (2017, July 30). Abnormal Liver Function Tests. Patient.info. https://patient.info/digestive-health/abnormal-liver-function-tests-leaflet.
Hernaez, R., Lazo, M., Bonekamp, S., Kamel, I., Brancati, F. L., Guallar, E., & Clark, J. M. (2011, September 2). Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology (Baltimore, Md.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197002/.
Dr. Anita Dhanorkar, B. H. M. S. (2021, January 4). How Do You Flush Out Your Liver? MedicineNet. https://www.medicinenet.com/how_do_you_flush_out_your_liver/article.htm.