Detoxification

Detoxification or detoxication (detox for short)[1] is the physiological or medicinal removal of toxic substances from a living organism, including the human body, which is mainly carried out by the liver. Additionally, it can refer to the period of drug withdrawal during which an organism returns to homeostasis after long-term use of an addictive substance.[2][3] In medicine, detoxification can be achieved by decontamination of poison ingestion and the use of antidotes as well as techniques such as dialysis and (in a limited number of cases) chelation therapy.[4]

For other uses, see Detoxification (disambiguation).

Many alternative medicine practitioners promote various types of detoxification such as detoxification diets. Scientists have described these as a "waste of time and money".[5][6] Sense about Science, a UK-based charitable trust, determined that most such dietary "detox" claims lack any supporting evidence.[7][8]

The liver and kidney are naturally capable of detox, as are intracellular (specifically, inner membrane of mitochondria or in the endoplasmic reticulum of cells) proteins such as CYP enzymes. In cases of kidney failure, the action of the kidneys is mimicked by dialysis; kidney and liver transplants are also used for kidney and liver failure, respectively.

Types

Alcohol detoxification
Main article: Alcohol detoxification

Alcohol detoxification is a process by which a heavy drinker's system is brought back to normal after being habituated to having alcohol in the body continuously for an extended period of substance abuse. Serious alcohol addiction results in a downregulation of GABA neurotransmitter receptors. Precipitous withdrawal from long-term alcohol addiction without medical management can cause severe health problems and can be fatal. Alcohol detox is not a treatment for alcoholism. After detoxification, other treatments must be undergone to deal with the underlying addiction that caused alcohol use.

Drug detoxification
Main article: Drug detoxification

Clinicians use drug detoxification to reduce or relieve withdrawal symptoms while helping an addicted person adjust to living without drug use; drug detoxification does not aim to treat addiction but rather represents an early step within long-term treatment. Detoxification may be achieved drug-free or may use medications as an aspect of treatment. Often drug detoxification and treatment will occur in a community program that lasts several months and takes place in a residential setting rather than in a medical center.

Drug detoxification varies depending on the location of treatment, but most detox centers provide treatment to avoid the symptoms of physical withdrawal from alcohol and from other drugs. Most also incorporate counseling and therapy during detox to help with the consequences of withdrawal.

Metabolic detoxification

An animal's metabolism can produce harmful substances which it can then make less toxic through reduction, oxidation (collectively known as redox reactions), conjugation and excretion of molecules from cells or tissues.[9] This is called xenobiotic metabolism.[10][11][12][13] Enzymes that are important in detoxification metabolism include cytochrome P450 oxidases,[14] UDP-glucuronosyltransferases,[15] and glutathione S-transferases.[16] These processes are particularly well-studied as part of drug metabolism, as they influence the pharmacokinetics of a drug in the body.[17][18][19]

Alternative medicine
Main article: Detoxification (alternative medicine)

Certain approaches in alternative medicine claim to remove "toxins" from the body through herbal, electrical or electromagnetic treatments. These toxins are undefined and have no scientific basis,[6] making the validity of such techniques questionable. There is little evidence for toxic accumulation in these cases,[6] as the liver and kidneys automatically detoxify and excrete many toxic materials including metabolic wastes. Under this theory, if toxins are too rapidly released without being safely eliminated (such as when metabolizing fat that stores toxins), they can damage the body and cause malaise. Therapies include contrast showers, detoxification foot pads, oil pulling, Gerson therapy, snake-stones, body cleansing, Scientology's Purification Rundown, water fasting, and metabolic therapy.[20]

See also

References
  1. "detoxification - definition of detoxification by the Free Online Dictionary, Thesaurus and Encyclopedia". Thefreedictionary.com. Retrieved 2013-04-21.
  2. "detoxify - definition of detoxify in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia". Medical-dictionary.thefreedictionary.com. Retrieved 2013-04-21.
  3. "Toxicology Primer". UIC. Archived from the original on 2013-10-31. Retrieved 2013-04-21.
  4. "Get the Lead Out - Autumn 2009 Living Bird". Birds.cornell.edu. 15 October 2009. Retrieved 2013-04-21.
  5. "Scientists dismiss detox schemes". BBC News. 3 January 2006. Retrieved 5 May 2013.
  6. "Detox diets: Do they work? - Mayo Clinic". Mayo Clinic. Retrieved 26 July 2016.
  7. "Scientists dismiss detox schemes". 3 January 2006. Retrieved 26 July 2016 – via bbc.co.uk.
  8. No proof so-called detox products work: scientists
  9. "Detox". Archived from the original on 2009-08-04. Retrieved 2009-07-18.
  10. xenobiotic metabolic process (2013-04-13). "AmiGO: xenobiotic metabolic process Details". Amigo.geneontology.org. Archived from the original on 2009-07-25. Retrieved 2013-04-21.
  11. L-60: Xenobiotic Metabolism (archived version).
  12. "Metabolism of Xenobiotics". Zoology.muohio.edu. Archived from the original on 2013-06-01. Retrieved 2013-04-21.
  13. Xenobiotic Metabolism-Oxford Biomedical Research Inc (archived version).
  14. Danielson P (2002). "The cytochrome P450 superfamily: biochemistry, evolution and drug metabolism in humans". Curr Drug Metab. 3 (6): 561–97. doi:10.2174/1389200023337054. PMID 12369887.
  15. King C, Rios G, Green M, Tephly T (2000). "UDP-glucuronosyltransferases". Curr Drug Metab. 1 (2): 143–61. doi:10.2174/1389200003339171. PMID 11465080.
  16. Sheehan D, Meade G, Foley V, Dowd C (2001). "Structure, function and evolution of glutathione transferases: implications for classification of non-mammalian members of an ancient enzyme superfamily". Biochem J. 360 (Pt 1): 1–16. doi:10.1042/0264-6021:3600001. PMC 1222196. PMID 11695986.
  17. "Small Molecule Drug Metabolism". Ionsource.com. 2012-09-01. Retrieved 2013-04-21.
  18. "Comparison of the Levels of Enzymes Involved in Drug Metabolism between Transgenic or Gene-knockout and the Parental Mice". Tpx.sagepub.com. 2001-01-01. Retrieved 2013-04-21.
  19. D M Dulik & C Fenselau (1988-04-01). "Use of immobilized enzymes in drug metabolism studies". FASEB Journal. 2 (7): 2235–40. doi:10.1096/fasebj.2.7.3127263. PMID 3127263. S2CID 27415918. Retrieved 2013-04-21.
  20. "More information on complementary and alternative medicine - American Cancer Society". Retrieved 26 July 2016.
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