How does the liver remove toxins from the bloodstream?

Dr. Michael Roizen, MD
Internal Medicine
While we commonly think of de-tox as some 30-day program for troubled celebs, the natural de-tox program happens inside your liver all the time.

Here's how: Most of what you put into your mouth isn't exactly pure. Plants are sprayed with chemicals, animals are injected with potent hormones, and lots of foods are genetically engineered with so much stuff that they make Frankenstein look as natural as a puppy. What's that mean to us? For one, it means that these toxins enter our body and can potentially destroy your tissues or create damage to your cells. So it's the liver's job to cope with these toxic chemicals as they travel from our environment via food into our bodies, almost like a drug smuggling border crosser that tries to make it past customs.

How does the liver do this? Rows of liver cells are separated by space, and those spaces act like a sieve, which is where the blood flows. This sieve-like the customs agent finding out what illegal goods you're bringing across the border-removes toxic substances from the bloodstream.

Those toxins can come in the form of everything from drugs and alcohol to chemicals and microorganisms. The way it does this isn't with drug-sniffing dogs, but with special cells called Kupffer cells that eat up and break down the toxins.

In short, these cells de-arm the toxins by converting a dangerous chemical to a less harmful one or by packaging them for easier disposal through our bile or urine. The latter approach reveals how the sly liver doesn't always have to fight its enemies head-on. Instead it often uses a martial arts approach, and paralyzes toxins by wrapping them in a water-soluble chemical so they land in your toilet rather than a vital organ.
Leopold D. Galland, MD
Internal Medicine
The liver performs two phases of detoxification: Phase One (oxidation) and Phase Two (conjugation).

In Phase One, the liver uses oxygen and enzymes to burn toxins. This process is called oxidation, and makes the toxins more soluble in water. Making them more water soluble is necessary so they can be more easily excreted from the body by the kidneys or the liver. Most environmental toxins are fat-soluble to start with, and therefore difficult or impossible to eliminate without the liver's help.

Although Phase One is crucial for detoxification, it poses risks. Sometimes the end product of Phase One detoxification in liver is more dangerous than the compound being detoxified. Benzene, for example, a dangerous organic solvent, is present in gasoline and cigarettes and a known carcinogen. Phase One enzymes oxidize benzene, producing benzene quinones, which are a source of increased toxicity. To complete the detoxification of benzene, your liver relies on Phase Two enzymes.

The bottom line on Phase One detoxification is: you need it but you don’t want Phase One activity to exceed the ability of your liver’s Phase Two enzymes to finish the job, otherwise you’re in trouble.

To rid itself of toxins produced by Phase One detoxification, the liver performs a second phase, called conjugation. In this phase, oxidized chemicals are combined with sulfur, specific amino acids, or organic acids, and then excreted in bile.

This phase of liver detoxification is inhibited by nutritional deficiency, toxic exposures, and medications such as acetaminophen (brand name Tylenol), alcohol consumption, and low protein intake that deplete glutathione which is needed for acetaminophen detoxification.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.