How Does Detoxification (Detox) Work?

Detoxing, fasting, and cleansing have been around for a long time in various traditional systems of medicine and folklore, religions, and the holistic integrative health field.

If you’ve been in the natural health space for a while (like me!), chances are you’ve tried different forms of detoxification, such as juice cleansing, detox cleanse diets, or days/weeks of living exclusively on spicy lemonade.

Although the premise of most detoxification protocols is to help accelerate the release of toxins to improve health, the results can vary from:

“Oh my gosh, I’ve never felt so great in my life…I’ll never need solid food again!”

To “Heaven help me, I’m never ever doing this again…and where did this rash come from?!”

As a functional medicine doctor, I hear these stories all day long.

Sometimes, people experience incredible healing, while others have disastrous results, like new symptoms or worsening of the condition they were trying to heal.

So, why does this happen?

The answer to success and healing lies in understanding how detoxification works so we can support all three phases of detoxification.

In this article, you’ll learn the distinct phases of detoxification, how they work, and the safest and most effective way to detox.

What Is Detoxification?

Detoxification is your body’s ability to eliminate waste.

The process of detoxification takes place through specific detoxification organs and pathways.

The Gut and Digestive System

Your gut and digestive system, including the gut microbiome, play a vital role in nutrient absorption, assimilation, and elimination.

As discussed in previous articles, the gut can become permeable when inflamed due to an imbalance of bad bacteria and other infections. This can lead to intestinal hyperpermeability (aka leaky gut), which hinders the normal elimination of toxins.

An overabundance of bad gut bacteria can also produce endotoxins, which can increase intestinal permeability resulting in reduced glutathione levels. Endotoxins are harmful substances bound to the bacterial cell wall that are released when the bacterium ruptures or disintegrates. Salmonella, for example, is an endotoxin.

Constipation is another big issue because proper elimination of toxins requires regular bowel movements.

The Liver

Your liver is one of our hardest working (and often most misused and abused) organs of detoxification.

Think of your liver as your body’s detox quarterback, involved in every stage of detoxification.

This hard-working organ is a master at catching, neutralizing, filtering, and even storing toxins when necessary to protect your more delicate organs.2

The liver also plays the role of a defense man/woman, defending you against all types of toxins.

Here’s a short list of some of the liver’s daily duties: 3

  • Filters blood
  • Stores excess glucose (which can also become toxic) in the form of glycogen
  • Regulates amino acid levels (the building blocks of protein)
  • Plays a role in digestion via fat metabolism and cholesterol synthesis
  • Produces bile and other enzymes
  • Removes harmful bacteria from the bloodstream
  • Creates immune factors that protect from infection
  • Transforms chemicals, hormones, drugs, and toxins into water-soluble metabolites that can then be excreted by the intestines, kidneys, and skin

Nearly everyone’s liver could use some extra tender loving care.

Unfortunately, many extreme cleanses do the liver a disservice by over-burdening it with toxins and/or starving it of the nutrients it needs to perform essential functions, like amino acids and glucose.

The Kidneys

Your kidneys are another underappreciated player in the detox symphony.

These vital organs participate in detoxification by:

  • Filtering over 150 quarts of blood daily
  • Filtering out various toxins, and preparing them for excretion in the urine. Including ammonia, creatinine, heavy metals, urea, and other toxins conjugated by the liver in Phase II detoxification (more on this coming up).4
  • Participating in electrolyte balance
  • Playing a role in Vitamin D synthesis—a critical nutrient for detox, immunity, hormonal health, and more—into its active, usable form.5

Detox or cleansing programs that fail to support the kidneys risk translocation of toxins and may create an extra burden on the kidneys and urinary system.

The Skin

Did you know your skin is your body’s largest organ?

It’s true!

The skin has been called “the third kidney” because of its role in detoxification, primarily through sweat.6

Research has shown chemicals such as phthalates, BPA, and heavy metals can be excreted through sweat.78

This gives us some clues as to why sauna bathing and sweat lodges, for example, have been used for centuries to promote cleansing and healing.

Or why skin problems, such as acne or rashes, may often signal imbalance or a larger issue within the body.

The skin’s role in detox is also why I’m a huge advocate of sauna therapy.

A personal sauna or sauna blanket are convenient ways to promote sweating, detox, and stress relief (a couple of my favorites are linked here, and you can find discount codes on the Trusted Products page of our website).

The Lungs

In traditional systems of healing, the lungs are viewed as prized organs of detoxification.

In Traditional Chinese Medicine, for example, the lungs are considered the “yin” partner of the intestines; the lungs breathe in the new, and the intestines expel the old.

Inhaled toxins also often cause the worst problems (just think about asbestos and those warning labels on cleaning products, for example) because our lungs are designed for the exchange of oxygen and carbon dioxide.

We breathe in toxins, but we don’t necessarily breathe those same toxins out.

Often they may get trapped in the lungs and/or must go through other detox pathways to be removed.

Some common toxins we breathe in daily may include:

  • Environmental air pollutants
  • Cigarette smoke
  • Household chemicals found in cleaning products, air fresheners, and personal care products
  • Dust (which contains various chemicals such as heavy metals)
  • Mold & mildew
  • Pollen

Clearly, our lungs have a lot to contend with and deserve our awareness and support during detox and every day.

A good home air purifier is an excellent way to support your lungs by improving indoor air quality. I like AirDoctor, which removes things like carbon, VOCs, bacteria, viruses, mold, and particles ten times smaller than a standard HEPA filter.

The Cell Membranes

Now we’re really getting into the science behind detoxification!

So, what are your cell membranes?

Cell membranes are a double layer of lipids and proteins that surround your cells and protect them from the external environment.

You could think of them as a skin or shield of armor.

Cell membranes play a role in detoxification through their effects on metabolism—specifically:

  • The production of ATP, which produces energy, 9
  • And skin health.10

The lipid layers of the cell membrane are resilient but can become damaged by free radicals (unstable molecules) produced by (you guessed it) excess toxins.

This can lead to inflammation and symptoms of aging if left unchecked.

The Lymphatic System

If you’ve never even heard of the lymphatic system apart from swollen lymph nodes, you’re not alone.

Despite the lack of attention this system receives, it is arguably the most under-appreciated system of detoxification.

Your lymphatic system is an extensive system of nodes, organs (like the spleen and thymus), vessels, and ducts that flow throughout the entire body.11

The lymphatic system’s functions are extensive and include:

  • The clean-up of unwanted toxins, bacteria, and other pathogens
  • Playing an integral role in the immune system
  • Maintaining fluid balance
  • Playing a key role in gut health via the transport of fatty acids through lymphatic capillaries in the gut lining, immunosurveillance, and the removal of interstitial fluids from the intestines12

One interesting thing about the lymphatic system is, unlike the circulatory system for example, it doesn’t have an automated pump. Therefore, it relies on regular movement or massage to function properly.

This is why I always recommend exercise, walking as much as possible, rebounding, etc., during a detox—and regular daily movement.

All These Organs and Systems Work Together to Neutralize and Eliminate Toxins

They do this through:

  • Urine,
  • Stool,
  • Sweat,
  • And Breastmilk—so no detoxing while you’re breastfeeding, please!13

This detoxification system is heroic in protecting us from toxins, pathogens, and foreign invaders.

However, if it becomes compromised due to illness, chronic stress, a diet high in processed foods and low in plants, a sub-optimal lifestyle, lack of movement, or just too many toxins, it can make us sick.

Next, let’s look at the three detoxification phases involving these specific organs and systems.

All three phases must be supported for a detox to be successful.

The Three Phases of Detoxification

There are three distinct phases of detoxification. Each encompasses different organs, systems, enzymes, genes, and more.

And all three phases must be supported for toxins to be mobilized, neutralized, and eliminated safely and effectively.

Since this topic can get heady, we’ve provided a written description and a graphic to help simplify it.

Phase I Detoxification: Activation

Phase I is the first line of defense against toxins that takes place in the liver.

In Phase I, fat-soluble toxins are transformed into less harmful chemicals that can be metabolized by the phase II enzymes, which we’ll discuss coming up.

This process produces free radicals (unstable molecules that can cause oxidative damage* and inflammation in the body), which are checked by antioxidants such as vitamins C and E.

*Some familiar examples of oxidative damage outside the body include rusting metal or browning of cut fruit.

However, liver cells can suffer from free radical damage if we don’t have enough antioxidants to meet the demands of excessive toxins.

The danger here is if these free radicals accumulate, they cannot be metabolized by the Phase II detoxification pathways.

This can result in widespread oxidative damage that can lead to chronic inflammation, aging, and various types of chronic disease.

How do we prevent free radical accumulation? By supporting the next phase of detoxification, Phase II.

Phase II Detoxification: Conjugation

During Phase II detoxification, the liver transforms those fat-soluble chemicals, hormones, and toxins from Phase I into water-soluble metabolites excreted by the intestines, kidneys, and skin.

This process is called conjugation. 

The six major pathways involved in conjugation include:

  • Glutathione conjugation (more on this to come)
  • Methylation (we’ll touch on this below, too)
  • Sulfation
  • Glucuronidation
  • Acetylation
  • Amino acid conjugation

Glutathione is our master antioxidant and the most valuable player in detoxification.14

It prevents free radical damage and makes toxic chemicals more water-soluble so we can excrete them.

Glutathione is produced by the body and can be procured or enhanced from certain foods or taken as a supplement.

Phase III Detoxification: Transport

Phase III detoxification is the final stage of detoxification, where the transformed, conjugated toxins are eliminated from the body.

Gut health is critical to Phase III detoxification, which requires optimal bile production and fluidity to support the transport and elimination of toxins through stool.

Regular, healthy bowel movements are an exceptionally important part of detoxification and proper elimination of toxins.

Toxins are also excreted as the kidneys filter blood and make urine, and by the skin through sweating.

Why Understanding How Detoxification Works Matters

As you’ve probably figured out by now, understanding how detoxification works is critical to choosing safe and effective detox programs to support your healing journey.

However, detoxification strategies that fail to support all three phases can result in unfortunate health outcomes, including:

  • Toxin recirculation
  • Healing crises
  • Unpleasant detox symptoms
  • Worsening of existing symptoms
  • Or even damage to your health

In other words, it pays to be choosy about the type of detoxification programs you try.

I also wanted to mention, in all fairness, we didn’t know the science behind how detoxification worked even just a few years ago.

So, if you’ve tried or have been sold on other programs that did not follow these golden rules in the past, it’s likely because we just didn’t have the knowledge we do today.

That said, plenty of pioneering healers, doctors, religions, holistic health, and nutrition experts somehow understood how to do this correctly many years before the science caught up. So, hats off to them!

My Favorite Detox Program

My go-to science-based detox programs and supplements come from Quicksilver Scientific.

One of my favorites is their Advanced PushCatch Detox System, a four-week detox system that supports all three phases of detox.

This system includes:

  • Liposomal Glutathione for liver, immune, energy, and antioxidant support
  • Membrane Mend for cellular support
  • Dr. Shade’s Liver sauce for liver, digestive, and hormonal support—the ingredient DIM (Diindolylmethane) in this product can be helpful for women with excess estrogen
  • Kidney Care, to support excretion via the kidneys and urinary system
  • Ultra-Binder to catch toxins and promote safe elimination

I’m also a big fan of their PushCatch system, which is a simplified version that includes Dr. Shade’s Liver Sauce plus Ultra-Binder.

For those interested in daily detox support, I recommend their BitterX and Liposomal Glutathione, followed by the UltraBinder (which is available in powder or capsules, but I prefer the powder).

You can learn more about these programs in Do I Need A New Year’s Detox? or visit their website here and get 15% off with the discount code “MAREN15” at checkout.



About Dr. Maren

Christine Maren D.O., IFMCP is a board-certified physician and the founder of a virtual functional medicine practice in Colorado, Michigan, and Texas.  She is best know for her work in thyroid, gut and reproductive/ preconception health. Dr. Maren is board-certified by the American Board of Family Medicine and is an Institute for Functional Medicine Certified Practitioner (IFMCP)

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