A common question I get asked from women when they’re trying to balance their hormones naturally, especially during perimenopause, is do I need to detox?
Unfortunately there is a lot of misinformation about what detoxing is, why you should (or should not) do it, and how you “detox”.
The simple definition of detoxification is a metabolic process by which we change toxins into a less toxic and more readily removable substance. In other words, we’re just taking something that is in the body and transforming it into a substance that is easy to remove via a pathway like urine.
When we use the terms “toxins”, we immediately think of things like lead or mercury. But all substances can become toxic or cause dysfunction in high enough levels. Imagine if that cup of coffee you had this morning remained in your bloodstream indefinitely?
One common misconception around detoxification is that it is not something our body is doing all the time. This is just plain false as our body is constantly detoxifying substances we come into contact with on a daily basis. When we refer to “detoxing”, it’s rather that we’re supporting your body with the natural process of detoxification, which is likely not functioning as optimally as it could.
How We Detox
There are five ways that our body detoxes and removes these substances from our system, mainly through stool, urine, and sweat. To a lesser extent, we also remove toxins through blood via a menstrual cycle, and tears. The main organs responsible for detoxification are the liver, kidneys, and skin.
Scientifically, there are three main phases of detoxification that the body has to undergo. Phase one is transformation (turning fat-soluble substances into water soluble substances), phase two is conjugation (neutralizing the substances from phase one or making them less toxic), and phase three is elimination (urine, stool, or sweat).
The majority of reactions that take place during phase one and two are performed by the liver, which is why I usually focus most detoxification efforts on liver support. That being said, the liver is responsible for over 500 other identified functions such as controlling blood sugar, making cholesterol and proteins, and producing chemicals you need to clot blood. (For a great summary of all the liver’s functions, check out this TED-Ed video.) Thankfully, our liver is one of the only organs that can actually regenerate itself so when we remove things that are inflammatory to the body and give the liver a break, it is able to heal and repair itself.
But we can’t ignore the kidneys. We mostly associate kidneys with urine, but it has many other functions. The kidneys help to constantly filter the blood and remove any toxins. In fact, the kidneys get about 21% of our cardiac output. In other words, any time your heart pumps blood, over 20% of that is going to the kidney.
The kidneys are also responsible for maintaining our blood pressure. And because of their filtering process, the kidneys help to regulate electrolytes and our acid-base balance, which is crucial for life. They also clear hormones from the blood (once they’ve gone through that phase one and phase two process of detoxification). The kidneys even help detoxify free radicals, which can be a byproduct of phase one of detoxification. Free radicals damage cells so it’s important that they are neutralized quickly.
And then we have skin. Skin is the largest organ in our body and we mainly remove toxins via the skin through sweat. It’s one of the reasons why saunas and exercise are an important part of detoxification, to create sweat to help excrete toxins.
To Detox Or Not To Detox
Now you may be wondering if you should start a detox. If your body is already naturally detoxing all the time, isn’t that enough?
It would be if we lived three hundred years ago. With the Industrial Revolution came great progress but also an astronomical increase in exposure to chemicals. There are over 80,000 different chemicals in use in the US and a lot of those have not been thoroughly tested with regards to their impact on health. With all these extra chemicals we’re exposed to on a daily basis, our liver, kidneys, and skin are working overtime.
What we worry most about are the chemicals that act as endocrine disruptors. Endocrine disruptors do exactly what they say and they disrupt your endocrine system (think hormones).
Some endocrine disruptors can increase the production of certain hormones. However, others can decrease the production of hormones. They might imitate hormones, so mimicking a hormone in the body that’s not actually there or having a similar effect. It might convert one hormone to another (ie converting progesterone to cortisol). It can interfere with signaling of hormones or tell cells to die prematurely. Another concern about endocrine disruptors is they also compete for essential nutrients. They can bind to essential hormones and can even accumulate in organs that produce hormones, like our endocrine glands.
The effects of endocrine disruptors are quite varied and because hormones have body-wide effects, this can be extremely problematic, especially when it comes to hormone balancing. In fact, this is so important, there is an entire section dedicated to it in my perimenopause course, Reclaim Your Hormones.
For example, there are several chemicals that have been associated with disrupting thyroid function, a common concern in perimenopause. Some chemicals have been shown to increase the release of cortisol, one of our stress hormones, while other chemicals have been shown to cause decreased libido, cognition, and even early menopause.
Now, there are some people that should not undergo a detox, or at least not without being under medical guidance and supervision. Mainly, if you’re on any kind of medication, including birth control, undergoing a detox can increase the rate of clearance of these mediations and possibly make them less effective. Also, if you have any pre-existing liver or kidney conditions, talk to your healthcare provider first.
Reduce Your Exposure
There are two main strategies for detoxification: reducing your exposure and supporting your body to naturally detox on its own. As you can imagine, reducing your exposure can be an on-going project but is something that should not be ignored while doing a detox.
To reduce your exposure to toxins, it’s important to think about the sources of exposure. Our main sources of exposure can come via our food, air, water, home, and in particular for women, beauty products.
When it comes to food, our overall pesticide use has risen over 3000 percent since 1945! Buying organic is the healthier option since the food is certified pesticide-free. Contrary to what some people think, you can’t just wash pesticides off your food. They saturate the soil and will be absorbed into the plant itself.
That being said, buying everything organic can quickly become expensive. If budget is a concern, focus on buying any foods organic on the Dirty Dozen list by Environmental Working Group. Each year they update a list of the top 12 most pesticide-ridden foods (they also have the Clean Fifteen list, the 15 least pesticide-ridden foods).
Or an even better option, grow some of your own vegetables and fruits! That way you know exactly what has been put in the soil. It’s a great way to reduce toxin exposure with the added benefit of connecting to nature and your food.
Toxins can also come from air, which includes not only outdoor air but indoor air. In fact, indoor air pollution is generally significantly worse than outdoor. For example, the average American household’s indoor air pollution is two to five times worse than outdoor air pollution.
Sources of common indoor air pollutants can include carpet, cleaning and other products with fragrances, paint, and off-gassing from chemicals found in other household items like furniture, electronics, and more.
A simple way to help reduce air pollution is to open your windows. If you can get a cross breeze, that’s even better because it can help move those chemicals outside of your house. Even in summer and winter, just a few minutes a day can make a big difference.
In addition, plants help clean the air. NASA did a study on the top plants that clean indoor air. Having houseplants not only brings nature indoors, but it has the added benefit of reducing indoor air pollution.
Now, we can’t discuss detoxification and ignore cosmetics and toiletries. According to the Environmental Working Group, “Americans assume personal care products on the market today have been tested or approved by the federal government. However, they are largely unregulated. In fact, it has been more than 80 years since Congress last updated the federal law designed to ensure that personal care products are safe. The FDA does not even require the basic safety testing of ingredients in personal care products before they are used.”
One class of chemicals they are referring to are parabens and these have been shown to increase estrogen levels and negatively impacting detoxification. Parabens are largely found in cosmetics and toiletries but they can even be found in pharmaceutical medications, so that’s a source of exposure to consider.
Since it can be overwhelming to think about replacing your shampoo, conditioner, body wash, foundation, face wash, mascara, eye shadow, lotion, perfume, tampons, etc, I usually recommend that as you use things up, replace them with a healthier and safer option. Thankfully, the Environmental Working Group has a fantastic app that you can use to look up and find out what’s in your products, called Healthy Living. You can scan different products you currently use or products you’re considering purchasing to see how they fare when it comes to chemicals toxins.
How To Support Detoxification
Finally, let’s highlight a few ways to support your body’s natural detoxification process.
When it comes to phase one of detoxification, cruciferous vegetables can promote that process. These include vegetables such as cabbage, kale, cauliflower, brussels sprouts, bok choy, collard greens, and broccoli. These also help phase three of detoxification (elimination) since fiber will promote regular bowel movements.
Phase two of detoxification uses a lot of vitamins and minerals so I typically have my patients supplement to ensure they’re getting adequate amounts of highly absorbable vitamins and minerals, typically in the form of a detox powder.
Nutrition is a large component of supporting your detoxing pathways and eliminating inflammatory foods is key. Any food that promotes inflammation puts an extra burden on your detoxification systems and can gunk up the works, so to speak. That includes all the favorite vices such as coffee, sugar, and alcohol but can also include common food sensitivities such as gluten, dairy, or soy, to name a few.
While nutrition should be the main area of focusing during a detox, there are other ways to support your body.
Contrast hydrotherapy is an old but effective way to support detoxification. Some of the benefits of hydrotherapy is it helps stimulate circulation because you’re creating a vasodilation effect by using hot water and then a vasoconstriction effect by changing to cold water, thereby encouraging detoxification.
There are many different forms of hydrotherapy but the simplest and fastest way is to take a normal shower but at the last 30 seconds, turn the water to cold, to tolerance. This is easier to do in the spring and summer, but most people find it invigorating. While it can wake you up it’s also calming to our nervous system, so it’s a great option for stress. Ending showers on cold is a simple but effective tool you can use to help your body detox.
As we discussed earlier, toxins can be released through sweat and while movement is a good way to create sweat, saunas are another great option. Some cities have dedicated spaces with saunas but you can usually access one at your local gym.
We covered a lot in this article but I hope it gave you some important information and tools about what is involved in detoxifying. While starting a detox may feel daunting, it is a key part of maintaining hormone balance.