January 1, 2015

Dr. Virender Sodhi ND, MD (Ayurved) and Dr. Anup Mulakaluri, ND

Introduction:

The celebration of each New Year marks the opportunity to look ahead with a renewed sense of purpose and hope. The New Year celebration is one of the most widely observed holidays and is a cross-cultural celebration of the renewability of the human spirit. It is an affirmation of the faith that with the New Year, we can renew our effort to cultivate the good, true and beautiful parts of ourselves.

For many, renewal means the cultivation of good health. This is an especially urgent need because many of us develop a great imbalance in our eating, sleeping, and living habits during the winter months and holidays. The falling temperatures and the parade of holiday celebrations make us stay inside, remain inactive, and often over-eat. By the time we reach the New Year, people are ready to get back to being healthy. For this reason, some of the most common resolutions are: weight loss, detox, and self-improvement.

These resolutions are echoes of our intuitive desire for well-being. Detoxification is intimately related to promoting the “healing power of Nature”. The process of detoxification is the process of “removing the obstacles to health: an essential principle of Naturopathic medicine. What we are removing are the toxins; called “morbid matter” by old Naturopathic doctors, or called “ama” by Ayurvedic physicians. These toxins are physiological, mental, and emotional waste products that block normal function of the body. Their removal clears the way for restoration of health and well-being.

Detoxification is a fundamental practice for many natural medicine traditions because they recognize a basic truth. In the absence of obstacles (like pollutants, deficiencies, negative emotions, etc) our body function naturally begins to lean into balance. For this profound effect, it is important that detoxification occurs at all levels of being; from single cells up to the whole body.

Emunctorology: The science of detoxification.

The emunctories are described as organs of elimination that support the process of detoxification. There are 5 major emunctories:[1]

  1. Liver
  2. Lung
  3. Gastrointestinal tract – small and large intestine
  4. Kidneys / urinary tract
  5. Skin

The science of detoxification, Emunctorology, teaches us the language to understand and manage this process of detoxification.

The process of detoxification can be divided into two aspects:

  • Depuration: the purification of tissues that begins at the cellular level; includes the purification of fluids, organs, membranes, fatty tissue, etc. This aspect involves the packaging and the shipping of toxins, morbid matter, or ama to the emunctories, organs of elimination.
  • Drainage: the efficient elimination of toxins from their location in the emunctories. This is the final step to remove the burden of disease causing agents from the body. Healthy drainage is a constant need to maintain a disease-free body.

Depuration: Packaging and shipping toxins for elimination

If we think about the familiar process of digestion: it involves digestion of food, separation of nutrition from waste, and elimination of waste. The digestive process that occurs in the intestines is the gross depuration process that is easy to observe. It is a very good indicator of overall health and resilience.

Beyond the intestines, nutrition is again digested in the liver: which is a producer of cholesterols, glycogen, as well as a security gateway for chemical toxins. Beyond the liver, each cell in the body has a cellular digestive system; which harvests energy, repairs the cells, and eliminates toxic waste. Healthy digestive function at the intestinal, liver, and cellular levels ensures efficient regeneration tissue and efficient elimination of waste; the process of depuration.

The toxins, ama or morbid matter in our body come from two pathways[2]: 1) Endogenous, naturally produced waste from the body’s metabolic processes, like reactive oxygen species that cause oxidative damage, feces, urine, etc.; 2) Exogenous, all toxic substances that we get from our environment, food, and emotional influences. When the process of elimination of toxins is overwhelmed, toxins are “hidden away” in the body to protect vital organs like the brain.

These toxins are primarily hidden in fat cells (adipose tissue) of the body.[2] Depending on available space and preference, toxins also become stored in bones, muscles, connective tissue, and even the myelin sheaths that wrap around nerves. From their location in these tissues, toxins begin to block or modify normal physiological functions.

For an effective depuration process, elimination of toxins from all of these tissues is essential. 

Drainage: Elimination of toxins from the body

The process of elimination also occurs at cellular and whole-body level. The main organs of eliminations, emunctories are main external outlets of the waste products. Cellular and physiological processes are subtle, yet equally important for bringing toxins to the emunctories for elimination. So the complete process of drainage requires elimination of waste at cellular level and elimination of waste out of the emunctories.

Accumulation of toxins at the emunctories, without proper elimination can also cause many problems. For example: 1) Cigarette smoke, mold, bacteria, microbial toxins are all exogenous toxins for the lung – prolonged exposure to these leads to chronic lung inflammation.[3 ]2) Presence of heavy metals and other toxins can cause abnormal folding a proteins – a problem that is implicated in causing neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease, etc.[4] 3) Reactive oxygen species are created as part of cellular energy building process; as well as a side-product of inflammation; excessive amount can cause damage to DNA, cell walls, nerves, etc.[5]

Activation of Emunctories:

All emunctories, organs of elimination, are active at all times; constantly working to make ensure the best possible health and physiological balance. Their functions can be enhanced by targeted daily choices in activity, food, environment, and hydration. Here are some simple strategies for activation:

Lungs:

With every breath, we take in we get much needed nutrition, oxygen; and we throw out the toxicant, carbon dioxide (CO2).  This process is constant and well-known to most of use. However, most of us tend to be unaware of our breath and usually breathe very shallow. Deep, full breaths help to saturate our airway with oxygen – pressure helps to promote healthy gas exchange. This doesn’t just help to with CO2 elimination but also gets rid aerosolized toxins from your body.

To support this process, Ayurveda offers a wide variety of breathing exercises. Simplest of these is deep diaphragmatic breathing. Also called So-Hum breathing:

  1. Inhale through your nose, filling your lungs to full capacity.
  2. Hold the breath for 3 seconds, then slowly exhale through your mouth.
  3. Repeat this exercise 16 times, twice a day.

Liver/Pancreas:

These organs support the subtle digestive processes and absorption of nutrients. They also support absorption of medications in the system. As a result, these organs are constantly exposed to toxicant from our foods and medications. The simplest way of protecting these organs is to eat  organic, fresh, whole foods; avoid all processed foods.

The liver’s detox activity is conducted by phase I and phase II detox enzymes.[6] The liver also has a wide variety to antioxidant enzymes to protect itself. However, too much toxic material can overwhelm these. An easy way to protect the liver is through the following:

  1. Eat 2-3 servings of green leafy vegetables daily.
  2. 2-3 servings of colorful seasonal vegetables.
  3. Eat 1-2 servings of seasonal fruits daily.

Gastrointestinal tract:

Health of the gastrointestinal tract is the most common for my patients. This is where we are most vulnerable to absorption of toxins on a daily basis. The digestive tract is also the home of over 100 trillion bacteria that protect our health by supporting digestion and enhancing the immune system. Imbalance of the gut-bacteria has been shown to cause severe inflammatory disease like inflammatory bowel disease.[7]

The approach to protecting the digestive tract is achieved by protecting normal function and providing regular replenishment of the gut-bacteria:

  1. Several servings of fresh fruits and vegetables daily (same used for liver detox) – provide fiber and probiotic gut bacteria for normal activity of the intestines promoting regular bowel movements.
  2. Eat regular fermented foods: Yogurt, kimchi, sauerkraut, sour cream, kefir, etc. this is nutrition for replenishing gut-bacteria.
  3. All adults should drink 6-8 glasses of water every day.

Kidney/urinary tract:

The function of this emunctory ensures that we can efficiently get rid off water-soluble toxins from our body. It also helps to maintain electrolyte balance in the body so all our cells can function and communicate with each other. Health of the urinary tract is compromised when we don’t drink adequate water, pH of our body fluids, and imbalance of probiotics.

Ideal environment in the kidneys is low sugar, low protein, and relatively alkaline pH (pH near 7). High sugar and high protein in blood cause damage to the filtration system. Acidic pH can lead to increase urinary tract infections and formation of kidney stones.[8] Support kidney function with:

  1. Eliminate refined sugars from diet completely – 1-2 teaspoons of honey, daily is enough.
  2. Drink plenty of water: add lemon slices and/or mint leaves to alkalinize the water.
  3. Support probiotic intake: Yogurt, kimchi, sauerkraut, sour cream, kefir, as well as fresh fruits and vegetables, preferably home grown or picked up from farmers market; this is nutrition for replenishing gut-bacteria.

Skin:

The health of our skin is an important indicator of toxin build-up in our body. Expressions of acne, rosacea, eczema, psoriasis, etc. demonstrate different forms of imbalances in the body. Skin expresses what is not eliminated regularly from other emunctories. Therefore, effective support of all other emunctories is the first step to promoting skin health.

The main mechanism for toxin elimination from the skin is to sweat. Another way is to shed old skin to prevent build-up of dead materials. Here are some ways to support:

  1. Sweat regularly:
    • 20-30 minutes of aerobic exercise, done 5 times per week;
    • Sweat in a sauna or steam room after exercise for 20-30mins.
  2. Skin brush: use skin brush to gently scrub off old, dead skin. Brushing towards the heart also helps to promote lymph flow; For example: start at the hand and brush towards the shoulder.
  3. Apply oil: perform self-massage with sesame oil for Vata dominant body type, coconut for Pitta and Olive oil for Kapha body types, 2-3 times per week; ideally 10 minutes before going in the sauna to sweat. The oil nourishes the skin and sweating helps to pull out fat-soluble toxins from skin layers.

Mind:

The mind is our main interactive organ in social and emotional circumstances. It can become exposed to displeasure (anger, frustration, and irritability), emotional pain, trauma, as well as unhealthy thoughts and ideas. Emotional imbalance is often result of inadequate or improper processing of these exposures of the mind.

Peace, solitude, and rest are easy ways of inducing processing of these experiences. Here are some ways to do it:

  1. Meditation is a way to help quiet the activity of the mind. Regular practice of about 20 minutes twice a day can help to clear the mind and reboot.
  2. Walking is a moderate level exercise that also gives an opportunity to rest the mind from being engaged in doing things. Regular walks in the natural settings like the woods, has been shown to improve mood, self-esteem, and even boost the immune system.[9]
  3. Play time with family and friends: whether it is physical activity or creative projects – play time is an ideal way giving the mind a break from the daily grind.
  4. Sleep: 7-8 hours of sleep every night between the hours of 10pm-6am. This helps to align the hormonal activity in the body and the mind with circadian rhythm, the day-night cycle of nature.
  5. Infusing these simple activities into your daily and weekly routines can help to optimize your natural capacity for detoxification. This helps to sustain a good baseline of cleanliness for all your tissues, body and mind.

Herbal support of Detox:

Amla, Emblica officinalis:

This Ayurvedic rasayana is included in a class of herbs that have a cleansing and rejuvenating effect on the all the tissues of the body. It has been dubbed “The Ayurvedic wonder” for its wide range of healing effects. Some of these include; Anti-oxidant, Anti-microbial, liver supportive, heavy metal chelation, etc.[10] As an antioxidant, Amla helps to scavenge free-radical or reactive oxygen species directly and indirectly. Amla helps to restore antioxidant powerhouse enzymes like superoxide dismutase, catalase, etc.[11] This action has been observed in mitochondria of subjects given amla – indicating that amla supports cellular level protection, while helping to maintain cellular energy metabolism. Anti-oxidant activity of amla also extends to the brain. In an experimental study, animal treated with amla had lower levels of oxidative stress. Amla also improved levels brain antioxidant enzymes succinate dehydrogenase, NADH dehydrogenase, etc.[12] These protective effects of amla can be attributed to a variety of ascorbate or Vitamin C compounds found in the herb.[11]

While amla provides cellular level protection and cleansing for body and brain, recent research has further catapulted the value of this herb. Amla has been studied and proven to have a variety of effective anti-cancer properties. Antioxidants polyphenols from her have demonstrated DNA protective properties.[13] The review of research indicates that amla can be used in cancer prevention, as well as a supportive treatment of cancer. [13]

Haritaki, Terminalia cheluba:

This herb is often used in combination with amla, in the formula triphala. However, it also has great benefits when it is used independently. It is considered one of the more efficient bowel cleansers, that his neither habit-forming, nor too harsh on the body. Research indicates that haritaki has a stimulative effect on the intestines; that increases the transit-time.[14] Therefore, it is often indicated for individuals with tendency of constipation. Beyond this, researchers have confirmed many beneficial effects of haritaki in cleansing, healing, and rejuvenating the body. These activities include: antibacterial, antifungal, antiviral, antidiabetic, antimutagenic, antioxidant, antiulcer and wound healing properties.[15]

Triphala, traditional formula:

This formula is one of the most widely used Ayurvedic formulas in the world. It is a combination of three herbs: Amla, Haritaki, and Bibhitaki. The herbal combination has been observed beneficial effects on metabolism. These actions add up to give antioxidant, antidiabetic, and antiobesity effects in the body.[16] The formula is also rich in minerals like magnesium, potassium, calcium, iron, selenium and zinc.[16] The combination of these minerals support enzymatic activity in blood, brain, hormone production, and immune function. The direct beneficial effect of the formula is observed in the digestive tract. In a clinical study of this effect, “triphala was found to have good laxative property, help in management of hyperacidity and also improve appetite.”[17] Thus, triphala was found to cleanse the bowels, improves digestion, and reduce adverse effects of indigestion.

Guduchi,Tinospora cordifolia:

This herb is also called Amrita, meaning “Elixir of Immortality” for the wide range of beneficial effect on health. The wide use of the herb in traditional medicine has been validated through research. Guduchi has been observed to have “anti-diabetic, anti-inflammatory, anti-arthritic, anti-oxidant, anti-allergic, anti-stress, anti-leprotic, anti-malarial, hepatoprotective, immune-modulatory, and anti-neoplastic (anti-cancer) activities.”[18] In other words, guduchi support healthy metabolic activity, liver function, enhances immune activity, while protecting the body from inflammatory, allergic, and arthritic degradation.

In process of detox, liver-protective and immune-modulatory effects of guduchi are the main focus. The antioxidant properties are protective to the detox activity of the liver. The herb restores antioxidant enzymes, superoxide dismutase (SOD), catalase and glutathione peroxidase.[19] Experimental studies have shown guduchi directly protects liver from toxic chemical damage – supporting detox.[20] The immune-modulatory activity helps to reduce the allergic reactivity of the immune system.[19] This action protects from unnecessary oxidative stress and tissue damage – reducing toxic burden in the body.

Punarnava, Boerhaavia diffusa:

The name punarnava means “to make new again” – characterizing the rejuvenative effect this rasayana herb. Traditional use of this herb is widespread among various traditional medicine of the East, including Ayurveda, Traditional Chinese Medicine and Unani medicine. “According to Ayurveda, Punarnava is bitter, cooling, astringent to bowels, useful in biliousness, blood impurities, leucorrhoea, anemia, inflammations, heart diseases and asthma.”[21] Scientifically validated anti-aging, rejuvenating activity of punarnava include: anti-stress activity, antioxidant activity, immune-modulation, anti-oxidant, and brain rejuvenation.[24] 

The detoxification support of punarnava also comes from its supportive active activity for the liver and the kidneys. In experimental studies, the herb has shown liver protection in the presence of toxic chemicals. Taking punarnava has been shown restore liver function and enzymes: “aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase and gamma glutamyl transferase.”[22] Another experimental study demonstrated the renal protective effect of punarnava. Here, co-administration of punarnava protected the renal system against toxicity of drug, diclofenac sodium.[23] Punarnava has beneficial effect for short term detox through protection of kidney and liver; while providing long-term benefit through rejuvenation.

Kutki, Picrorrhiza kurroa:

Kutki has traditionally been used to treat disorders of the liver and upper respiratory tract, reduce fevers, weak digestion, chronic diarrhea, and scorpion sting. Research has validated many therapeutic activities including: liver protection, gallbladder stimulant, antioxidant, and immune-modulatory.[25,26] Treatment with kutki has shown direct regenerative effect on liver cell after exposure to multiple toxic chemicals like, galactosamine, thioacetamide, and carbon tetrachloride.[27] Kukti is also very protective for the kidneys – a very important activity for detoxification process and overall health. In animal model, kutki improved kidney function and destruction of the kidney associated with chronic kidney disease.[28] In diabetic model, the kidney protective effect of kutki was as effective as ACE inhibitor drug.[29] This range of activities of kutki including cancer prevention has been attributed to powerful antioxidant activity of this herb.[26]

Conclusion:

Detoxification is a natural and essential process for cultivating and maintaining health. It can be optimized by our daily choices and can become the foundation of disease prevention and longevity. Comprehensive detoxification allows the body to eliminate toxins effectively rather than just redistributing them. Engaging all the emunctories regularly in the detoxification process is the ideal approach to attaining this. While the foundational practices of diet, exercise, sleep, stress-elimination, meditation, laughter, and play help tremendously – herbs are great allies to expedite the process in order to achieve a healthy baseline.

References

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