No matter where or how you live, it is impossible to avoid exposure to environmental toxins. Toxins accumulate in our fat stores and our liver and exert many damaging health effects. The range and concentration of toxin exposure is staggering and includes pesticides, solvents, polyaromatic hydrocarbons chlorine, phthalates, and heavy metals. These pollutants have been implicated in a disturbing array of chronic diseases, including cancer, autoimmune disease, infertility, and developmental defects.

While reducing environmental exposures is critical, we must also address those which have already accumulated in our bodies. Herbal and nutritional cleansing offers one of the few means of protection and recovery from exposures. Throughout history, many cultures have practiced cleansing regimes. The most important principle to remember is that detoxification is a whole body process. Multiple, interdependent pathways of elimination must be activated simultaneously. Otherwise, harmful toxins can be mobilized from tissues without adequate means of elimination, resulting in an exacerbation of toxicity symptoms.

PHASE I: ORGAN DETOXIFICATION LIVER:
The master organ of metabolism and cleansing. As blood passes through the liver, toxins are transformed to make them easier to excrete. The liver makes toxins more water-soluble for excretion via the urinary tract, and also conjugates them to promote excretion via the bile and feces. Supporting liver and gall bladder function is vital to effective cleansing.

LIVER CLEANSING HERBS INCLUDE:

MILK THISTLE (Silybum marianum) provides rich nutrition for the restoration of damaged tissues, especially the liver. Its bitter properties also stimulate digestion and bile flow. Milk thistle seed extracts are rich in silymarin, an antioxidant bioflavonoid. Milk thistle should be standardized to contain 80% silymarin.

ARTICHOKE (Cynara scolymus) has anti-toxic effects in the liver. It is a liver restorative and tonic, which stimulates the production of bile. Artichoke has been shown to stimulate liver cell regeneration.

TURMERIC (Curcuma longa) rhizome has powerful antioxidant properties and protects against exposure to many toxins. Turmeric promotes healthy elimination and is thought to prevent chronic diseases, including cancer.

DANDELION (Taraxacum officinale) effectively supports the internal organs and is especially effective in gout and liver disease. Dandelion cleanses the blood, is a mild laxative, stimulates bile flow, and is richly nutritive.

URINARY TRACT: Hydration is an important part of cleansing because water is the medium through which many toxins are excreted. Herbal diuretics increase urine production, therefore facilitate toxin elimination via the urinary tract. Drink at least 64 ounces of water per day during a cleanse. Herbs that stimulate urinary elimination include cranberry (which balances urine pH and prevents urinary tract infections), asparagus (a diuretic that also promotes sweating), and parsley (a powerful diuretic).

SKIN: Fat deposits under the skin may become a major reservoir of toxins, which is why skin reactions are a common side effect of detoxification regimens. Blood cleansing herbs are popular for their specific actions on the skin and include burdock (Arctium lappa), red clover (Trifolium pratense), cleavers (Galium aparine), and Oregon grape (Mahonia aquafolium).

PHASE II: FIBER INTAKE
Low dietary fiber intake is linked with chronic constipation. Both soluble and insoluble fibers are indigestible, therefore good bulking agents for the stool. Fiber— particularly insoluble—absorbs and facilitates the removal of toxins, balances intestinal pH, and encourages the growth of beneficial gut flora, such as Lactobacilli and Bifidobacteria. Soluble fiber forms a gel in the gut, which has a soothing and bulking effect.

PHASE III: DIGESTIVE CLEANSING
When the liver is in a heightened state of detoxification, hastening transit time of waste through the intestines becomes imperative. Constipation can be dangerous during a cleansing regimen because slow transit through the bowels means toxins have more opportunity to be reabsorbed through the intestinal walls. During cleanses, the bowels should be stimulated to move at least once per day. Laxatives may be either stimulant or nonstimulant, depending on the mechanism by which they promote bowel movements.

Stimulants contain substances which mildly irritate the intestinal walls, increasing fluid accumulation in the bowel, thus stimulating bowel movements. Stimulant laxatives, such as Cascara sagrada, are ideal for short-term use in otherwise healthy adults. Use with caution in children, elderly, and those prone to laxative abuse.

Non-stimulants also increase fluid retention in the intestines, but the mechanism is by osmosis. Magnesium hydroxide, the active ingredient in milk of magnesia, is perhaps the best known non-stimulant laxative.

Triphala is a popular Ayurvedic herbal formula. Triphala is a gentle but powerful tonic formula containing three fruits: Haritake (Terminalia chebula), Amalaki (Emblica officinalis), and Bibhitake (Terminalia bellerica). Triphala is said to remove stagnation and excess, improve digestion and assimilation of nutrients, and to balance the three vital humours. It has many beneficial properties for cleansing, e.g., laxative, astringent, lubricant, and blood cleansing.

WHAT TO EXPECT DURING A CLEANSE
During a cleanse, some symptoms of detox may occur, such as headache, nausea, or skin rashes. These are common, but should always be followed-up by a qualified healthcare provider. The use of cascara is sometimes associated with abdominal discomfort or cramping. If this is a problem, consider switching to a nonstimulant laxative, like magnesium hydroxide.

Cleansing is a natural process that should be done minimally once per year, and ideally two to four times per year. The transitions between seasons (winter and summer solstice, vernal and autumnal equinox) are traditional times for cleansing. When choosing a cleansing program, make sure that it addresses all of the organ systems of detoxification: liver, skin, urinary tract, digestive tract, and bowels. Also make sure key ingredients are present in sufficient amounts to be effective, of the highest purity and quality, and correctly standardized.

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ABOUT THE AUTHOR
Jeremy Appleton, N.D., is a licensed naturopathic physician, writer, and educator in the field of evidence-based nutrition and botanical medicine. He has published numerous articles on topics relating to integrative medicine and the dietary supplement industry. He is co-author, with Stanley Jacob, M.D., of MSM—The Definitive Guide (Freedom Press, 2003). Dr. Appleton served on the faculty at Bastyr University of Natural Health Sciences and at the National College of Naturopathic Medicine. He is currently Director of Scientific Affairs at Cardinal Nutrition.