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 Integrative Medicine: Introduction to the Digestive System 
 

The Liver and its Role in Detoxification of the Body
Once food is broken down in the stomach and small intestine, it is absorbed into the bloodstream, which travels first to the liver, where substances may be chemically changed. One of the main functions of the liver is to help the body modify toxic substances, so that they may be removed easily from the body through the urine via the kidneys or through the bowel via the feces. A failure of the liver to carry out this function properly will result in an accumulation of toxic substances that may be stored in the nervous system and in fatty tissues. This toxic accumulation may contribute to a wide variety of diseases and complaints.

For example impaired liver function may contribute to Alzheimer’s or Parkinson’s Disease, autoimmune diseases, Chronic Fatigue Syndrome, food allergies, chemical sensitivities, headaches, hepatitis, premenstrual syndromes, the development and outcome of cancer, and many other conditions. Basically, when the liver detoxification mechanisms are not functioning properly, the body is poisoned with a buildup of toxins. The toxins may originate from outside the body in the form of pesticides, alcohol, drugs, paint fumes, exhaust fumes and many others or from inside the body from the gut or from metabolic products.

So, in evaluating any patient one of the first steps we take is to evaluate the functioning of the stomach, intestines and other aspects of the gastrointestinal system and then treat any abnormality. A second step is to evaluate liver functioning, because a problem with this organ may contribute to so many disorders. It is important to realize that when a physician orders blood tests that are called liver function tests or a liver profile, which includes the measurement of SGOT, SGPT, bilirubin and alkaline phosphatase, he is not really measuring how well the liver is able to carry out its detoxification function. Rather he is generally measuring damage to liver cells, which result in an elevation in one or more of these enzymes. All of these tests may be quite normal, but the liver may still not be carrying out this function properly. To measure how well the liver is functioning requires a different kind of test.

How the Liver Carries Out its Detoxifying Functions
The liver helps in the removal of toxic and metabolic waste products from the body by converting them to a form which is soluble in water, so that they are easily eliminated in the urine formed by the kidneys. Other substances transformed by the liver are dissolved in the bile formed in the liver and eliminated in the feces after the bile passes into the intestines through the bile duct.

This detoxification process occurs in two phases, termed Phase I and Phase II. Phase I involves a system of enzymes known as the cytochrome P-450 mixed-function oxidase enzymes system. These enzymes react with toxins, drugs, alcohol, paint fumes and many other substances to form compounds that are capable of being transformed to water soluble substances by Phase II reactions. The previously mentioned substances may up regulate the cytochrome P-450 mixed oxidase system by inducing enzyme changes. Some of the products formed from Phase I reactions are actually more toxic than the original substances and can be harmful and even cancer producing if Phase II reactions do not take place properly. Also, during Phase I reactions, which often involve the oxidation process, free radicals may be formed, causing damage, unless sufficient amounts of antioxidants, such as Vitamins A, C, E and glutathione are present to neutralize them. With underlying liver disease, insufficient nutrients necessary for Phase I, damage from drugs, alcohol, birth control pills, amphetamines or Tagamet, Phase I is slowed down and this is called a slow detoxifier situation.

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 About The Author
Michael Schachter MD, FACAM Director of the Schachter Center for Complementary Medicine, Michael B. Schachter, M.D., is a 1965 graduate of Columbia College of Physicians & Surgeons. He is board certified in Psychiatry, a Certified Nutrition......more
 
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