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  • Herbal Detoxification: Traditional Wisdom and Modern Evidence
  • 1Vishwabharati Academy’s College of Pharmacy Ahilyanagar, Sarola Baddi, Tal-Dist.- Ahilyanagar 414201
    2Pravara Rural College of Pharmacy, Loni, Tal- Rahata, Dist.- Ahilyanagar, 413736
    3ACS’S College of Pharmaceutical Science and Research Ashti, Tal-Ashti, Dist.-Beed, 414203

Abstract

Detoxification is a complex physiological process essential for maintaining health by eliminating harmful substances from the body. The liver, kidneys, gastrointestinal system, and skin are the primary organs involved in this process. The modern environment, however, has increased exposure to various pollutants and toxins, highlighting the need for enhanced detoxification strategies. This review explores the roles of nutritional and herbal approaches in supporting detoxification, emphasizing their impact on liver function, blood purification, and overall toxin elimination. We also examine the evidence behind popular detox diets and address the potential benefits and risks associated with these interventions.

Keywords

Toxines, Lifestyle, Liver, Detoxification.

Introduction

Detoxifying our bodies with herbs has been a popular technique since ancient times, and while its popularity waned in the latter half of the twentieth century, it appears to be rebounding in recent years. Herbal detoxification, in its most basic form, is a natural technique to stimulate the organs of our body that are responsible for detoxification. Even though the human body is meant to expel all hazardous elements on a daily basis, the amount of toxic elements to which we may be exposed has increased unnaturally in our period due to an increasingly polluted environment and an irregular lifestyle. As a result of the increased exposure to toxins, natural detox chemicals have become increasingly important, resulting in a variety of health problems, including degenerative diseases and chronic symptoms. Detox-diet is a well-known concept that refers to a diet that allows our bodies to naturally rid themselves of poisonous substances. Any proper and fully fledged herbal detox treatment must include a proper diet. However, it would be entirely incorrect to assume that a regular diet and a detoxification diet have any similarities. A general diet is designed to help you lose weight and/or get the body shape you want in a short amount of time. When it comes to battling harmful substances, this type of diet isn't very effective. A detoxifying diet, on the other hand, focuses on cultivating the habit of consuming what nature provides us depending on our unique health requirements and conditions. There are many plants in nature that provide the greatest answers for treating various diseases and health concerns with minimal negative effects. The practise of herbal detox can be divided into numerous categories based on the herbs employed, including organ detox, heavy metal detox, fat detox, and alcohol detox.The detoxifying effects of herbs and their mechanisms in several important organs are the main emphasis of this section.

“Let Food Be Thy Medicine”

“Let food be thy medicine,” as taught to us by Hippocrates, is as true today as it was in 400 BC. Using a focus on food to support the highly complex processes of detoxification and biotransformation is the wise approach. If an apple contains at least 700 different phytochemicals, it is better to eat the apple as one of a variety of foods than to try to replicate its benefits with single nutritional supplements. A recent review of this subject stated this concept succinctly; It is very difficult to imagine how a single phytochemical— [that is] selected as representative of a whole food, such as lycopene in tomatoes, resveratrol in grapes, sulforaphane in broccoli, and beta-carotene in carrots—would offer an advantage [when] used as a food supplement, because a variety of fruit and vegetables seems necessary to provide the mixture of vitamins and minerals that appear to favor protection against neoplasia. Ingesting whole fruits and vegetables exposes the digestive milieu to enzyme modulating components of varying amounts and proportions in which unpredictable synergistic and /or antagonistic (or both depending on the enzyme involved) interactions occur among thousands of different chemicals in their natural matrix.—How can we imagine that these benefits could be reproduced just by supplements of single representative phytochemicals? The beneficial or harmful outcomes of a single compound can be quite different from those elicited by the same compound within complex mixtures.[10] [1]

Detoxification And Biotransformation

Pathways

The process of detoxification involves multiple steps in the biotransformation of primarily nonpolar, lipid-soluble toxicants into polar, water-soluble, and excretable derivatives,as originally postulated by R. T. Williams in his monograph Detoxification Mechanisms followed by his paper “Detoxication Mechanisms in Man”.Since then, a large body of literature has been published, leading to the current understanding of how detoxification can be used in the prevention and treatment of disease in clinical practice.[6]  Figure 1 shows an important tool that summarizes the phase I and phase II detoxification and biotransformation pathways and provides a conceptual framework for clinicians and patients. [7] Toxicants originate from exogenous sources such as drugs (pharmaceutical and recreational); heavy metals; chemicals, such as herbicides, pesticides, insecticides, food additives, household cleaners, and other pollutants; and microbials. Toxicants also originate from endogenous sources, such as bacterial endotoxins and the end products of metabolism.[5] It is important to realize that steroid hormones and fat-soluble vitamins are also metabolized through these pathways.

Phase I Detoxification

The majority of the detoxification and biotransformation processes occur in the liver and in the enterocytes that line the intestine, colon, and appendix. Detoxification and biotransformation are done to a lesser extent in other tissues, such as the brain, lungs, kidneys, and skin. The phase I system comprises at least 57 pathways known as the cytochrome P450 (CYP) family of mixed-function oxidases. Nine of the most commonly used CYP enzymes are 1A1,1B1, 2A6, 2B6, 2C9, 2C19, 2D6, 2E1, and 3A4. In phase I, toxicants are transformed to more polar, less lipid-soluble forms through oxidation, reduction, hydrolysis, hydration and dehalogenation reactions. For the P450 enzymes to be present and conformationally active, an individual must consume high-quality, bioavailable protein as well as a host of phytonutrients, botanicals, minerals, fats, and carbohydrates. These nutrients are required for epigenetic influence (ie, changes in gene expression, during transcription and production of the various CYP enzymes as well as enzymatic cofactors and energy). After going through the phase I processes, the activated toxicants are often more toxic than their parent compounds. If these activated, intermediate metabolites are not further metabolized via the phase II conjugation pathways; they can cause cellular damage bycovalently binding to various proteins, lipids, and nucleic acids within cells. Reactive oxygen species are also a by-product of phase I activity. Therefore, to quench the propagation of free-radical activity, adequate protection from antioxidant nutrients is required using a number of plant derivatives, including (1) the carotenes—lycopene, (3-carotene, lutein, zeaxanthin, and astaxanthin; (2) ascorbic acid; (3) tocopherol (vitamin E); (4) selenium; (5) copper; (6) zinc; (7) manganese; (8) coenzyme Q10; (9) thiols, found in garlic, onions, and cruciferous vegetables; (10) bioflavonoids; (11) silymarin; and (12) pycnogenol Other nutrients include (1) N-acetylcysteine; (2) a-lipoic acid; (3) polyphenols such as pomegranates, green tea, and raspberries; (4) anthocyanins found in blueberries and blackberries; and (5) curcumin.

Phase II Detoxification

The majority of intermediate metabolites progress to the phase II conjugation pathways, where they are joined to constituents such as glucuronide; sulfate; glutathione; various amino acids, such as taurine, glycine, arginine, glutamine, serine, and proline; and acetyl and methyl groups. The bio transformed polar and water-soluble toxicants are then excreted via the bile and feces or the serum, kidneys, and urine. As the various nutrients required for conjugation are bound to the toxicants, they potentially can become depleted unless an ongoing dietary supply exists. Therefore, excellent nutrition is imperative for a detoxification lifestyle. After conjugated toxicants exit the liver via the bile, they are excreted into the feces. One component of bile is the variety of bile acids that are necessary to emulsify and solubilize dietary fats. In the distal small bowel, 90% to 95% of the bile acids are reabsorbed and returned to the liver, thus recycling and conserving them. This cycling of bile acids occurs approximately 12 times each day and is known as enterohepatic circulation.[8] Microbes found in the intestinal lumen contain enzymes, such as |3-glucuronidase, that can cleave conjugated toxicants, reactivating them and allowing them to reabsorb into the portal system which returns them to the liver. The enterohepatic circulation allows essential compounds, such as estrogen and vitamin D, to be conserved. Some evidence in animal models shows that the alginate Chlorella has the potential to inhibit the absorption of certain heavy metals and organic pollutants across the intestinal mucosa, thus decreasing the enterohepatic circulation of these toxicants. [9,10,1]

Herbal Detoxification Agents and Blood Purification

Herbal agents have been used for centuries to support detoxification, with a renewed interest in their efficacy for liver, kidney, and blood purification. Recent research highlights the potential of various herbs to enhance the body’s natural detox processes, particularly in blood purification, which plays a central role in overall detoxification.[4]

Liver Detoxification: 

Herbal detox agents for liver

Zingiber officinale, often known as African ginger, Gingembre (French), or Jengibre (Spanish), is an extensively utilised rhizome used for medicinal and culinary purposes. Undocumented ethnomedicinal uses include stimulation of salivary duct secretion, toothache alleviation, nasal decongestion, cold,  cough,  and  asthma when the plant's peeled rhizome component is chewed raw, processed, or decocted. Additional uses include diuretic, expectorant, antirheumatic, carminative, and infective hepatitis and other liver disorders. An ethanol extract of Zingiber officinale rhizome was tested for its effect on carbon tetrachloride (CCl4) and acetaminophen-induced liver damage in rats.[12]

The primary phenolic compounds in  the  three  plant  extracts  employed  to  study liver detoxification treatment dandelion—leaf and root extracts, as well as a commercial root powder—were identified  by  HPLC  analysis.[13]  Oil  Red  O  staining and triglyceride levels study both revealed lower lipid and triglyceride buildup. The MTT assay was used to  investigate  cytotoxicity,  and  the  results  showed  that  none of the doses tested were harmful. The extracts regulated the expression of a number of genes and long non-coding RNAs that are important in the control of adipogenesis, according to DNA microarray analysis. Our findings suggest that the dandelion extracts utilised in this investigation may have a substantial role in adipogenesis and lipid metabolism, suggesting their therapeutic potential as possible candidates for obesity treatment.

Through its antioxidative, anti-lipid peroxidative, antifibrotic, anti-inflammatory, immunomodulating, and liver regenerating effects, Silybum marianum (milk thistle) has been shown to have clinical applications in the treatment of toxic hepatitis, fatty liver, cirrhosis, ischemic injury, radiation toxicity, and viral hepatitis10. In the process of liver fibrogenesis, hepatic stellate cells play a key role. They multiply and change into myofibroblasts in response to fibrotic effects (e.g., prolonged ethanol exposure, carbon tetrachloride, etc.). Myofibroblasts are responsible for the deposition of collagen fibres in the liver. The effect of silybin on the transition of hepatic stellate cells into myofibroblasts was studied in a recent study. Silybin [10-4 mol/l concentration] inhibited 75 percent of the growth of freshly isolated rat hepatic stellate cells. It also inhibited the conversion of stellate cells to myofibroblasts and suppressed the gene expression of fibrosis-related extracellular matrix components. The effects of alfalfa plant and sprout saponins on diet-induced liver cholesterol accumulation, bile acid excretion, and jejunal and colonic morphology, as well as alfalfa plant and sprout saponin-free alfalfa plant saponin-free alfalfa plant saponin-free alfalfa plant saponin-free alfalfa plant saponin-free alfalfa plant saponin-free Cholesterol-saponin interactions have been proposed as explanations underlying alfalfa's hypocholesterolemic effects and morphological alterations in the intestine. Significant amounts of cholesterol were bound by alfalfa plant saponins in both ethanol solution and micellar suspension. Saponins from alfalfa sprouts had a smaller but still substantial interaction with cholesterol. Another indicator of saponin-cholesterol interaction was the ability of sprout saponins to strongly suppress the growth of Trichoderma viride. The interaction between saponin and cholesterol is a major aspect of alfalfa's hypocholesterolemic effect. Turmeric, a bright yellow spice extracted from the tuberous rhizome of the plant Curcuma longa, has been used for centuries in traditional Indian and Chinese medicine to treat a variety of ailments, including jaundice and hepatic disorders, rheumatism, anorexia, diabetic wounds, and menstrual problems. Curcumin's anti-inflammatory benefits are supported by anecdotal and experimental evidence, however, there is insufficient clinical evidence to warrant further clinical research and development of this phytochemical as a safe nutraceutical medication for chronic human inflammatory illnesses. Curcumin is a poor regulator of humoral or cell-mediated immune responses, according to the research. Curcumin appears to boost antibody production, according to limited experimental evidence. Curcumin, on the other hand, reduces the synthesis of cytokines by macrophages and lymphocytes, particularly those with proinflammatory effects, as well as T- lymphocyte proliferative and cytotoxic responses in vitro. Curcumin's inhibitory effects on T-cell activities in vitro have yet to be tested in vivo to see if they can prevent transplant rejection or reduce the severity of T-cell-mediated inflammatory disorders. Curcumin appears to have a key role in inhibiting T-cell proliferation, cytokine production, and inflammation via inhibiting transcription factors  NF-B and AP-1.


 

 

Herbal Agents

Active Constituents

Mechanism of Action

Zingiber officinale

6-gingerol,

6-shogaol, and 6-paradol.

Protects against CCl4 and acetaminophen-

induced damage.

Dandelion

Beta-cryptoxanthin, lutein and zeaxanthin, vitamins A,  B1,  B2, B3, C, E, and K; alpha and beta carotene; beta-cryptoxanthin; beta-cryptoxanthin; lutein; zeaxanthin; tannins; caffeine;

caffeine and coumaric acid;

Decreases lipid and triglyceride accumulation. Inhibits adipocyte differentiation.

Milk thistle

silibinin (silybin), silychristin, and silidianin,

increased protein synthesis and antifibriotic action, as well as anti-inflammatory and immunomodulatory properties, are only some of the potential benefits

of this compound.

Alfalfa

The flavonoids, isoflavonoids, sterols, and derivatives of coumarins, as well as protein  and  vitamins A, B, B1, and  B6,  as well as vitamins C and E and vitamin K,  as well as minerals

calcium, potassium, and iron and zinc

Alfalfa's steroidal saponin fraction, combined with fibre from the plant, is thought to be responsible for alfalfa's hypocholesterolemic.

Turmeric

curcumin (diferuloylmethane), desmethoxycurcumin, and bisdemethoxycurcumin are the major constituents responsible for

turmeric's yellow hue.

TNF-? activated human endothelial cells, which were inhibited in their inflammatory response by interfering with the NF-?B pathway.


Skin detoxification using herbal agents

Many dietary plant items, including as fruits, vegetables,  drinks,  herbs,  and spices, contain polyphenols. Several of these substances have been discovered to suppress inflammation and cancer in experimental animals, as well as possessing significant biological characteristics. Furthermore, epidemiological studies have shown that those who eat foods high in  particular polyphenols have a lower risk of developing inflammatory diseases. Polyphenols in food have anti-inflammatory properties. Inflammation has long been treated with aspirin and other non- steroidal anti-inflammatory medicines (NSAIDs). COX-2 expression in mouse skin was reduced by pre-treatment with green tea extract enriched with catechin and epigallocatechin gallate (EGCG), which was activated by the tumour promoter 12- O-tetradecanoylphorbol-13-acetate (TPA). In TPA-stimulated human mammary epithelial cells (MCF-10A) in culture, EGCG inhibited COX-2.[14] Both green tea catechin and EGCG reduced IL-1-dependent  pro-inflammatory  signal transduction in cultured respiratory epithelial cells and showed COX inhibition efficacy in LPS-induced macrophages[15] This shows that downregulation of COX-2 in skin fibroblasts may be one of the anti-inflammatory mechanisms  used  by these drugs to combat skin inflammation such atopic dermatitis.[16]Triacylglycerols, sterols, tocopherols, and  diterpenes  of  the  kaurene  family  make up the majority of the lipid fraction in  green  coffee  beans,  with  the  latter accounting for up to 20% of the total lipids. Green coffee oil is used in cosmetics for its properties of maintaining natural skin humidity [17]and may also  have  a potential as a sun protector due to the ultraviolet absorption property of the main fatty acid, linoleic acid. Commercialized coffee fruit extracts containing CGA,condensed proanthocyanidins, quinic acid, and ferulic acid have demonstrated promising results in facial skin care.


 

Herbal Agents

Active Constituents

Mechanism of Action

Herbal Tea

compounds such as carotenoids and phenolic acids as well as flavonoids and coumarins.

Inhibition of proinflammatory enzymes  like  cyclooxygenase 2  (COX-2),  lipoxygenase (LOX), and inducible NO synthase may also be a molecular mechanism for tea polyphenols' anti- inflammatory effects (iNOS) in

various epithelial cells.

Coffee

triacylglycerols, sterols, tocopherols, and diterpenes, Green coffee oil, CGA, condensed proanthocyanidins, quinic and ferulic

acid,

maintains natural skin humidity and acts as a sun protector.


Kidney Detoxification: 

Herbal detox agents for kidney

Pedalium murex Linn (family: Pedaliaceae) (P. murex), also known as Large Caltrops and Gokhru (India), is a shrub native to India's southern Deccan area and parts of Ceylon. The plant's many parts are used to cure a variety of diseases, including coughs, colds, and as an antiseptic. The plant's nephroprotective properties have been studied pharmacologically. In a Cisplatin-induced renal damage model on Wistar rats, the nephroprotective effect of the ethanolic extract of the dried fruits of P. murex was assessed  utilising  serum creatinine,  blood urea, and change in body weight as indices of kidney damage. The typical medication was cystone. The impact of extract on Cisplatin-induced kidney damage in rats was studied in five groups (n=6). For 10 days, Group 1 was given similar amounts of vehicle (distilled water), which served as a usual control. Cisplatin 5 mg/ kg body weight, single dose, i.p. was given to groups 2, 3, 4, and 5. (intraperitoneal). To check  for the persistence of renal injury, blood was taken from group second on the 5th day and from  group  third  on  the  15th  day.  The fourth group received a curative regimen of 250  mg/kg  ethanolic  extract  of Pedalium murex linn, whereas the fifth group received  cystone  (standard medication) 500 mg/kg combined with cisplatin 5 mg/kg  for  five  days.  Animals were anaesthetized with chloroform and slaughtered after two weeks of therapy. Blood was subsequently drawn through heart puncture, and the kidneys were promptly dissected and placed in 10%  formalin  for  histological  examinations[18],[19]. At a dose of 250  mg/kg,  p.o.,  the  results  demonstrated  a  significant  change  in body weight, serum creatinine, and urea levels. When compared to cystone, the ethanolic extract of P. murex dried fruits demonstrated  considerable nephroprotective effects[20]The effects of  ethanolic  and  aqueous  extracts  of  P. murex fruits (300 and 600  mg/kg,  p.o.  body  weight)  on  cadmium  chloride- induced (3 mg/kg/s.c.) renal toxicity in rats were measured using blood  urea nitrogen, serum creatinine, urinary protein, urine to serum creatinine ratio, lipid peroxidation, gluthione, and catalase in the kidney. The results show that in a dose-dependent manner, ethanolic and  aqueous  extracts  with  CdCl2  greatly reduced kidney damage[21],[22] Traditional herbalists have utilised fenugreek seeds to treat renal issues[23]. The primary alkaloid phytoconstituent of fenugreek seeds, trigonelline (Nmethylnicotinic acid, N-methyl betaine), suppresses oxidative stress in the kidney and reduces renal cell death and fibrosis. The antiurolithiatic properties of fenugreek seeds are thought to be due to increased diuresis, antioxidant activity, and a decrease in urine concentrations of stone-forming components.In cultured rat embryos, chlorpyrifos was also found to cause mitotic defects and dose-dependent apoptosis. Organophosphates have been shown to cause apoptosis in immune cells by exerting a direct effect on mitochondria, resulting in DNA damage and cellular death. Apoptosis in immune cells occurs as a result of a direct influence on mitochondria, which results in DNA damage. Reduced mitochondrial function eventually leads to alrered reabsorption in the proximal convoluted tubule, resulting in urea, uric acid, and creatinine balance problems. Curcumin is essential for the detoxification of chlorpyrifos-exposed kidneys. Curcumin keeps biochemical levels like urea, uric acid, and creatinine in check. It also restores Glomerulus, Bowmens capsule, PCT, and DCT to their  original state, ensuring normal nephron absorption and reabsorption. Curcumin appears to promote a higher level of bioremediation of chlorpyrifos-induced kidney injury.


Herbal Agents

Active Constituents

Mechanism of Action

Pedalium murex Linn.

Polyphenolics(flavonoids and phenolics), glycosides like sapogenin (diosgenin- 0.06%) and soluble proteins (20.14 mg/g).

Pedalium murex (P. murex) Linn. is used traditionally for various ailments in India and has been investigated for its antiulcerogenic, nephroprotective, hypolipidemic, aphrodisiac, antioxidant,

antimicrobial and insecticidal properties.

Saunf (Trigonella foenum- graecum)

carbohydrates, proteins, lipids, alkaloids, flavonoids, fibers, saponins, steroidal saponins, vitamins, and minerals, nitrogen compounds

Reduces oxidative stress in kidney and increases the production of urine.

Curcuma longa

curcumin (diferuloylmethane, the primary constituent responsible for yellow color of turmeric), desmethoxycurcumin, and

bisdemethoxycurcumin.

Maintains the  level  of urea, uric acid creatinine, absorption and reabsorbtion in nephrone.


Herbal detox agents for gallbladder

Hitrechol® is a herbal drug that has been used to treat gallstone disease since the 1970s. It is useful  to  treat  early-stage  cholesterol  gallstones,  as  well  as  solitary and numerous cholesterol gallstones. Hitrechol® is made up of a pure extract of G. hederacea that contains saponins, essential oil, and phenolic chemicals (such as flavonoids, tannins, caffeic acid, and  chlorogenic  acid. The  chemical structure of Hitrecholsaponin ®'s ursolic acid is comparable to that of UDCA, one of the bile acid compositions in mice gallbladders that has been shown to be efficient in dissolving gallstones via lysis of cholesterol crystals [24] and modifying bile secretion. [25] Saponins and essential oils have been shown to lower total cholesterol levels [26] considerably. Anti-inflammatory, antispasmodic [27], liver- protective[28] , choleretic [25], litholytic [29], antioxidant, antibacterial [30], and anticancer are all probable pharmacological properties of G. hederacea active components, according to certain investigations. It can assist to minimise the inflammatory process induced by mechanical irritation in the gallbladder wall due to gallstones, as well as relax the muscle cells in the bile ducts, allowing bile  to flow more freely. Hitrechol® TID (three times daily) was found to be the most effective dose regimen for reducing gallstone formation and improving liver protection by modifying bile composition, increasing antioxidative biomarkers, and suppressing IFN-gamma release.Psyllium (PSY) has a well-documented lipid-lowering action. PSY lowers  the lithogenic index and reduces the production of cholesterol gallstones.[31]


Herbal Agents

Active Constituents

Mechanism of Action

Glechoma hederacea

Saponins, flavonoids, tannins, caffeic acid,

and chlorogenic acid.

Decreases gallstone formation and increases

liver.

Psyllium

hexoses, pentoses, and uronic acid are all examples of this.

absorption of more water and the stimulation of regular bowel

movements.


Heart detoxification using herbal agents

Garlic (Allium sativum), a Liliaceae family member, is a popular cultivated food all over the world. Garlic is  one of the earliest cultivated plants, hailing from  Central Asia. Fresh garlic homogenate (FGH) 250 mg/kg  in  combination  with  captopril (CAP) was found to be more  efficient  in  lowering  SBP,  cholesterol,  triglycerides, and glucose. [32] Catalase activities  in  heart  tissue  were  dramatically  increased  in rats treated with FGH, SACS (Sallyl cysteine sulphoxide), CAP, FGH+CAP, and SACS+CAP, in addition to Super  Oxide  Dismutase  (SOD).  In  addition,  combining FGH 250 mg/kg with CAP resulted in a significant decrease in blood  LDH  and Creatine Kinase Myocardial Band  (CK-MB)  activity  as  well  as  an  increase  in cardiac  tissue  homogenate.  Furthermore,  the  combination  of  SACS  and  CAP  had a super-additive (synergistic) effect on blood pressure reduction and angiotensin converting enzyme (ACE) inhibition. Concurrent usage of garlic or its bioactive ingredient, SACS, with  captopril  may  have  a  positive  effect,  according  to  this study. In albino  rats,  the  alcoholic  and  aqueous  extracts  of  Caesalpinia  crista  were tested for protection against  isoproterenol-induced  myocardial  infarction  (85 mg/kg bw). Increased levels of  marker  enzymes  such  as  creatine  kinase- isoenzyme (CK-MB), lactate dehydrogenase (LDH), serum glutamate oxaloacetic transaminase (SGOT), and serum glutamate  pyruvate  transaminase  (SGPT)  in serum, along with increased lipid peroxide  and  reduced  glutathione  content  in heart homogenates, indicated heart damage caused by isoproter. The increased marker enzyme levels in serum and heart homogenates in isoproterenol-induced myocardial infarction were significantly reduced (p 0.01) after pretreatment with an ethanolic and aqueous extract of  Caesalpinia  crista  at  a  dose  of  400  mg/kg body wt,  orally  for  30  days.[33] Histopathological  examination  demonstrated  that the extract provided significant protection against cardiac necrosis [34].


Herbal Agents

Active Constituents

Mechanism of Action

Allium sativum

phytoconstituents such as quercetin and other sulfur- containing phytoconstituents are found in sativum.

Inhibiting ACE reduces a number of pathways known to reduce plasma volume and vasoconstriction which contributes to garlic's ability

to lower blood pressure.

Caesalpinia crista

ethanolic seed extract of Caesalpinia crista for the presence of flavonoids, alkaloids, tannins, triterpenoids, coumarin glycosides, and proteins.

The polyphenols in C. crista extracts quench free radicals in many ways. Antioxidant activities were shown by extracts, which also protected DNA and the cell membrane from oxidative stress. As a result, herbal medicine may be utilised to treat oxidative stress-related illnesses. Thus protecting the heart from isoproterenol induced myocardial

infarction.


Detox-focused Core Food Plan[3]

A cursory look at the detox-focused core food plan reveals the various macronutrient food groups, beginning with fats and oils in the upper left corner, and gives examples of nuts and seeds, protein, legumes, low-fat dairy products or alternatives, grains, fruits, and starchy vegetables. In the center of the diagram is the nonstarchy vegetable group. Patients who need to focus on a detoxification lifestyle will want to emphasize eating the foods in the green shaded areas of each food group. By doing so, they will consume the thousands of micronutrients and phytochemicals known to support balanced phase I and phase II detoxification. Within each food group, each individual food item has beside it the amount that constitutes 1 serving. A person on this plan should consume a minimum of 4 servings of fruit and vegetables and at least 1 serving from each of the 4 nonstarchy vegetable groups. Forty percent of the daily calories should come from carbohydrates and 30% from proteins and fats. Although water is not listed, it is of the utmost importance to consume adequate high-quality water throughout each day—0.5 fluid ounce (14.8 mL) of water per pound (0.45 kg) of ideal body weight per day. the health professionals companion guide20 to the detox-focused core food plan. The important foods to avoid and the foods to emphasize for phases I and II are reviewed; the tool highlights the 4 primary phase II pathways of conjugation: (1) glucuronidation, (2) sulfation, (3) methylation, and (4) glutathione support.Each food group within the detox-focused core food plan contains foods that are selected for their unique array of phytonutrients.

Fats and Oils. These foods are important because they provide excellent sources of energy for the detox and biotransformation processes. The selected oils in the green shaded area are high in medium-chain triglycerides.

Nuts and Seeds. The highlighted nuts and seeds provide excellent sources of energy as well as fiber that assists in proper excretion and elimination. They also have a positive impact on reduction of bacterial deconjugating enzymes.

Proteins. High-quality, bioavailable protein is important as a source of amino acids for the production of the phase I CYP enzymes as well as the provision of substrates for phase II enzymes, particularly glycine, L-glutamine, methionine, L-cysteine, and taurine. Protein is also a good source of inorganic sulfate.

Legumes. Legumes provide a good source of soluble and insoluble fiber as well as a variety of amino acid precursors for phases I and II and antioxidant phytochemicals.

Low-fat Dairy and Alternatives. These foods provide amino-acid substrates for the phase II pathways as well as inorganic sulfate and selenium.

Fruits. The foods in the shaded area provide a wide variety of phytonutrients, such as (3-carotene, lutein, and anthocyanins that have protective antioxidant properties. Fruits are also a good source of soluble and insoluble fiber, promoting healthy intestinal transit of toxicants. Fruits in general are high in water content, which aids in detoxification.

Grains. Grains supply excellent sources of soluble and insoluble fibers that are vital for healthy intestinal transit.

Vegetables. Starchy vegetables provide excellent sources of fiber and phytonutrients similar to fruits. The nonstarchy vegetables, including the Brassica genus, provide a wide variety of phytochemicals that impact detoxification and biotransformation. They directly impact many of the phase I CYP pathways in the metabolism of estrogens, favoring production of the 2-hydroxy estrogens. Many of the phytochemicals also provide antioxidant support to quench reactive oxygen species. They also increase the flow of bile as well as the alkalinity of urine. Coriandrum sativum (cilantro) has a direct chelating effect on a number of heavy metals such as mercury and lead.The spectrum of phytochemicals outlined in the food groups listed above provide broad and comprehensive tools for individuals to support phase I and II detoxification processes to benefit their health.

Companion Guide for the Detox Food Plan

The Detox Food Plan calls attention to what one could eat to incorporate natural and whole foods to support, modulate, induce, or inhibit various biological processes related to optimal detoxification and elimination. It is modified from the Core Food Plan. This version identifies the key foods known to improve the metabolic cleansing process and aid biotransformation.Not all food is created equal, especially when viewed through the metabolic detoxification lens. When making dietary choices to support detoxification, it is best to choose the shaded areas within each food grouping because they indicateThe foods listed below are organized based on the specific detoxification pathway

These lists are helpful for choosing foods that support specific biotransformation and detoxification processes.

Phase 1 Detoxification

Induce (avoid) Charbroiled meats, high caffeine- and alcohol-containing beverages

 Inhibit (minimize)

Grapefruit (naringenin), high saturated and hydrogenated fat diets, low animal protein or a lack of complete proteins

Activate (promote)

Cruciferous vegetables, diets adequate in protein (meat, fish, eggs, and plant-based foods that provide complementary essential amino acids)

Phase II Detoxification

Glucuronidation

 (promote)

 a- and (3-carotene-rich foods: (highest to lower): pumpkin, carrot, squash sweet potato, collards, red peppers, spinach, mustard greens, chard, dandelion greens, cantaloupe, romaine lettuce

Quercitin-rich foods: apple, onion, kale, cherry, red wine, extra virgin olive oil, beans, broccoli, tea

High chrysin and luteolin-rich foods: (highest to lower): broccoli, chili pepper, celery, rosemary, honey

High D-glucaric-acid-rich foods: (highest to lower): apple, grapefruit, alfalfa sprouts, broccoli, Brussels sprouts, adzuki beans, tomato, cauliflower, mung beans, cherries, apricots, spinach, oranges

Citrus foods: grapefruit, orange, tangerine Watercress and turmeric (curcumin) Dietary plant fibers

Magnesium-rich foods: (highest to lower) halibut, almond, cashew, soybean, spinach, oatmeal,potato, peanut, wheat bran, black-eyed peas, baked beans, brown rice, lentils, avocado, pinto beans

Sulfation (promote)

Sulfur-rich foods: (highest to lower) scallop, lobster, crab, peanut, shrimp, veal, mussel, chicken, Brazil nuts, haddock, sardine, cod, oyster, beef, dried peach, egg, turkey, almond, cheddar, Parmesan cheese, dried skim milk, spinach, onion, cabbage, Brussels sprouts, chickpeas, figs, beans/peas, leeks, endive, potato

Methylation (promote)

Folic acid-rich foods: liver, chicken giblets, egg yolk, dried beans, lentils, split peas, soybean, almonds, whole wheat, potato, sweet potato, spinach, beet root, Brussels sprouts, broccoli, cauliflower, kale, cabbage, bok choy, asparagus, banana, orange, peach

 Bn-rich foods: liver, beef, chicken, pork, ham, fish, egg, milk, cheese, yogurt, clam, rainbow trout, salmon, haddock, tuna

Glutathione Support

 Cysteine-rich foods: duck, yogurt, egg yolk, whey protein, ricotta cheese, cottage cheese, yogurt, red pepper, garlic, onion, broccoli, Brussels sprouts, oat, granola, wheat germ, sprouted lentils

Bifunctional Modulators

Adapts Phase l & ll Detoxification to Variable Exposures: pomegranate, turmeric (curcumin), cruciferous vegetables, green tea, artichoke heart.

       
            pic-1.png
       

 Nutritional Aspects of Detoxification

The first step in the use of nutritional support to promote detoxification is to remove foods and beverages from the diet that may be contributing to the total body burden of toxicants. Examples include removing (1) foods containing petrochemical residues from farming practices; (2) foods containing polycyclic aromatic hydrocarbons such as charbroiled meat; (3) trans fats; and (4) water contaminated with metals and chemicals. Next, it is important to add foods to the diet that nourish the organs of detoxification, providing substrates and cofactors for optimal detoxification, as well as foods that positively modify genetic expression and cell signaling.[11]A useful therapeutic tool is the comprehensive elimination diet, in which the most common allergenic foods and beverages are removed from the diet and replaced with nonallergenic choices for a 4-week period. The allergenic foods and beverages are then added back to the diet every 4 days, one food group at a time. The patient is instructed to observe the reactions of his or her body carefully to note any adverse changes in health. "This approach helps patients to become their own medical detectives in discovering the foods or beverages that cause their bodies to react. This diet can be used under the direction of a registered dietician, certified clinical nutritionist, or physician, with menus and recipes provided. Another effective clinical tool is the detoxfocused core food plan which includes the variety of foods required to supply key nutrients to maximize the effectiveness of detoxification. [1]

Metabolic Pathways for Malathion

An excellent source of reliable information regarding malathion and other toxic substances is available at the Agency for Toxic Substances and Disease Registry. The toxicological profile for malathion is 327 pages long. Malathion is an organophosphate pesticide used to kill insects found on agricultural crops, golf courses, home gardens, and nurseries where trees and shrubs are grown. It is also used in killing mosquitoes, Mediterranean fruit flies, fleas on pets, and head lice on humans. Malathion is first metabolized through the CYP2B oxidation pathway and is then biotransformed into the highly toxic intermediate malaoxon, an acetylcholinesterase inhibitor. Interestingly, the phase II pathway used to biotransform malaoxon is the GSTM1 pathway, which was genetically absent in the current case study’s patient. Therefore, with the absence of this phase II pathway, the highly toxic intermediate malaoxon was released into the patients body. A review of the multiple symptoms associated with malaoxon exposure reveals that they are related to the inhibition of acetylcholinesterase at the nerve terminals of the central, peripheral, somatic, and autonomic divisions of the nervous system. This type of release leads to symptoms and signs involving several of the body’s systems including, but not exclusive to, the nervous, respiratory, cardiovascular, and gastrointestinal systems. Potential effects of malathion exposure include difficulty breathing, chest tightness, vomiting, cramps, diarrhea, blurred vision, sweating, headaches, dizziness, loss of consciousness, and death. [1]

Nutritional Support for Detoxification

Diet plays a critical role in enhancing detoxification. A comprehensive detox diet focuses on eliminating foods that contribute to the body’s toxic load, such as processed foods, artificial additives, and pesticides. Cline’s work emphasizes using a detox-focused core food plan, which includes cruciferous vegetables, berries, citrus fruits, and sources of high-quality protein to support liver function and facilitate bile production. In addition, the consumption of antioxidant-rich foods, such as green leafy vegetables, garlic, and onions, is recommended to quench free radicals produced during phase I detoxification. These foods not only provide essential nutrients but also modulate the activity of detoxification enzymes . A diet rich in fiber also promotes the elimination of toxins through improved bowel movements and binding of toxins in the gastrointestinal tract  .[1][3]

Detox Diets: Evaluating the Evidence 

Klein and Kiat’s review of commercial detox diets presents a critical analysis of their effectiveness and limitations . Detox diets are often marketed as short-term interventions aimed at rapid toxin elimination and weight loss. However, there is a lack of rigorous clinical evidence to support these claims. While some detox diets have shown preliminary benefits, such as improved liver function and increased elimination of persistent organic pollutants (POPs), these findings are based on studies with small sample sizes and flawed methodologies . For instance, the UltraClear® supplement demonstrated enhanced phase I liver detoxification in one small study, but the lack of a control group limits the reliability of these results . Similarly, ingredients like coriander and Chlorella have shown potential in animal studies for eliminating heavy metals, but their efficacy in humans remains unproven .[2]

Is there a role for nutrition in detoxification?

The human body has evolved highly sophisticated mechanisms for eliminating toxins. The liver, kidneys, gastrointestinal system, skin and lungs all play a role in the excretion of unwanted substances . The pathways used for detoxification depend on the particular chemical, although they include conversion to a less toxic form (e.g. methylation of arsenic), metabolism or conjugation to produce a water-soluble form for renal excretion, conjugation with glutathione for gastrointestinal elimination,and intracellular metallothionein binding of heavy metals  Foreign chemicals that are not easily removed by these processes include POPs and some metals POPs tend to accumulate in adipose tissue as a result of their lipophilicity and can take years to break down. The half-life of the banned pesticide dichlorodiphenyltrichloroethane (DDT), for example, is 7–8 years Heavy metals can also accumulate in the body, depending on the organic ligands to which they are bound. Mercury has a half-life in blood of approximately 57 days,whereas lead has a half-life in bones of 20–30 years  Although there is currently no evidence to support the use of commercial detox diets for removing toxic substances from the body, there are some preliminary studies suggesting that certain nutritional components possess detoxification properties. Considering the vast number of synthetic chemicals to which we are exposed, this is an interesting and worthwhile area of research. It is possible that some of the food items discussed below may provide the basis for an evidence-based detox diet in the future

Nutritional components for eliminating metals


Nutritional component

Chemical eliminated

Evidence in animals or humans?

Malic acid

Aluminium

Mice

Citric acid

Aluminium

Mice

Succinic acid

Aluminium

Mice

Citrus pectin

Lead

Humans

Coriander

Cadmium

Rainbow trout

 

Lead

Mice

Selenium

Mercury

Birds, fish, mammals

 

 

Humans

Chlorella

Mercury

Mice

 

Lead

Mice

 

H6CDD

Mice

 

PCDDs

Rats

 

PCDFs

Rats

Nori

PCDDs

Rats

 

PCDFs

Rats

Olestra

HCB

Mice

 

PCBs

Humans


HCB-hexachlorobenzene,H6CDD-1,2,3,4,7,8hexachlorodibenzo-p-dioxin,PCBs-polychlorinated biphenyls,PCDDs-polychlorinated dibenzo-pdioxins, PCDFs- polychlorinated dibenzofurans [2]

CONCLUSION

Detoxification is a complex process that can be supported through a balanced diet rich in antioxidants, fiber, and key nutrients, as well as the judicious use of herbal agents known for their detoxifying properties. While certain herbs like neem, ginger, and milk thistle show promise in enhancing detoxification, more robust clinical studies are needed to validate these effects. Consumers should approach detox diets and supplements with caution, opting instead for long-term lifestyle changes that promote natural detoxification, such as a healthy diet, regular exercise, and adequate hydration.

REFERENCES

  1. Cline, J. C. (2015). Nutritional Aspects of Detoxification in Clinical Practice. Alternative Therapies in Health and Medicine, 21(3), 54-63. 
  2. Klein, A. V., & Kiat, H. (2014). Detox diets for toxin elimination and weight management: A critical review of the evidence. Journal of Human Nutrition and Dietetics. 
  3. Yadav, G., Monika, M., & Rani, A. (2022). Herbodetox agents: Naturally detox our internal organs. International Journal of Health Sciences, 6(S5), 7912–7932.
  4. Soni, N., et al. (2023). Nature’s detoxifiers: Powerful herbs for blood purification. World Journal of Pharmaceutical and Medical Research, 9(6), 249-252.
  5. Zienolddiny S, Campa D, Lind H, et al. A comprehensive analysis of phase I and phase II metabolism gene polymorphisms and risk of non-small cell lung cancer in smokers. Carcinogenesis. 2008;29(6):1164-1169.
  6. Estabrook RW. A passion for P450s (remembrances of the early history of research on cytochrome P450). DrugMetab Dispos. 2003;31(12):1461-1473
  7. Liska DJ. The detoxification enzyme systems. Altern Med Rev. 1998;3(3); 187-198.
  8. Jandacek RJ, Genuis SJ. An assessment of the intestinal lumen as a site for intervention in reducing body burdens of organochlorine compounds. ScientificWorldJournal. 2013;2013:205621.
  9. Uchikawa T, Yasutake A, Kumamoto Y, Maruyama I, Kumamoto S, Ando Y. The influence of Parachlorella beyerinckii CK-5 on the absorption and excretion of methylmercury (MeHg) in mice. / Toxicol Sci. 2010;35(1):101-105.
  10. Morita K, Ogata M, Hasegawa T. Chlorophyll derived from Chlorella inhibits dioxin absorption from the gastrointestinal tract and accelerates dioxin excretion in rats. Environ Health Perspect. 2001;109(3):289-294.
  11. Zhao L, Lee JY, Hwang DH. Inhibition of pattern recognition receptor-mediated inflammation by bioactive phytochemicals. Nutr Rev. 2011;69(6):310-320.
  12. Bhandari PR. Garlic (Allium sativum L.): A review of potential therapeutic applications. International Journal of Green Pharmacy (IJGP). 2012;6(2)
  13. Bohdan M, Kowalczys A, Mickiewicz A, Grucha?a M, Lewicka E. Cancer Therapy-Related Cardiovascular Complications in Clinical Practice: Current Perspectives. Journal of Clinical Medicine. 2021 Jan;10(8):1647.
  14. Di Bisceglie AM, Lok AS, Martin P, Terrault N, Perrillo RP, Hoofnagle  JH. Recent US Food and Drug Administration warnings on hepatitis  B reactivation with immune?suppressing and anticancer drugs: just the tip of the iceberg?. Hepatology. 2015 Feb;61(2):703-11.
  15. Dwivedi S, Kushalan S, Paithankar JG, D’Souza LC, Hegde S, Sharma A. Environmental toxicants, oxidative stress and health adversities: interventions of phytochemicals. Journal of Pharmacy and Pharmacology. 2022 Apr;74(4):516-36.
  16. Ferrari, M., Ravera, F., De Angelis, E., Liverani, F. S., & Navarini, L. (2010). Interfacial properties of coffee oils. Colloids and Surfaces A: Physicochemical Engineering Aspects, 365, 79–82.
  17. Gavali K, Kumar S, Kumar A. Clinical Study of Samwardhana Ghrit & Hapushadi Yapan Basti In The Management Of Children With Cerebral Palsy. Journal of Ayurveda. 2015 Apr;9(2).
  18.  Patel DK, Laloo D, Kumar R, Hemalatha S. Pedalium  murex  Linn.:  an overview of its phytopharmacological aspects. Asian Pacific journal of tropical medicine. 2011 Sep 1;4(9):748-55
  19. Podda M, Zuin M, Battezzati PM, Ghezzi C, Fazio DC, Dioguardi ML. Efficacy and safety of a combination of chenodeoxycholic acid and ursodeoxycholic acid for gallstone dissolution: a comparison with ursodeoxycholic acid alone. Gastroenterology. 1989;96(1):222–9.
  20. Reuben A, Koch DG, Lee WM. Drug?induced acute liver failure: results of a US multicenter, prospective study. Hepatology. 2010 Dec;52(6):2065-76.
  21. Sandoval R, Leiser J, Molitoris BA. Aminoglycoside antibiotics traffic to the Golgi complex in LLC-PK1 cells. J Am Soc Nephrol 1998;9(2):167–174
  22. Schnellmann  RG.  Toxic  responses   of   the  kidney.  Casarett  And   Doull’s Toxicology, the basic science of poisons. 2008;1:583-7.
  23. Scott Luper ND. A review of plants used in the treatment of liver disease: part1.           Alternative medicine review. 1998;3(6):410-21.
  24. Speer, K., & Kölling-Speer, I. (2006). The lipid fraction of the coffee bean. Brazilian Journal of Plant Physiology, 18, 201–216.
  25. Story JA, LePage SL, Petro MS, West LG, Cassidy MM, Lightfoot FG, Vahouny GV. Interactions of alfalfa plant and sprout saponins with cholesterol in vitro and in cholesterol-fed rats. The American journal of clinical nutrition. 1984 Jun 1;39(6):917-29.
  26. Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Get vaccinated when it is your turn and follow the local guidelines. International Journal of Health Sciences, 5(3),
  27. Trautwein EA, Kunath-Rau A, Erbersdobler HF. Increased fecal  bile  acid excretion and changes in the circulating bile acid pool are involved in the hypocholesterolemic  and  gallstone-preventive  actions  of  psyllium   in hamsters. The Journal of nutrition. 1999 Apr 1;129(4):896-902.
  28. Treadway S. An Ayurvedic herbal approach to a healthy liver. Clin Nutr Insights. 1998;6(16):1-3.
  29. Volkova M, Russell R. Anthracycline  cardiotoxicity:  prevalence,  pathogenesis and treatment. Current cardiology reviews. 2011 Nov 1;7(4):214-20.
  30. Walker PD, Barri Y, Shah SV. Oxidant mechanisms in gentamicin nephrotoxicity. Ren Fail 1999;21(3/4):433–442.
  31. Williams PD, Hottendorf GH, Bennett DB. Inhibition of renal membrane binding and nephrotoxicity of aminoglycosides. J Pharmacol Exp Ther 1986;237(3):919–925.
  32. Yemitan OK, Izegbu MC. Protective effects of Zingiber officinale (Zingiberaceae) against carbon tetrachloride and acetaminophen?induced hepatotoxicity in rats. Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 2006 Nov;20(11):997-1002.
  33. Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti- inflammatory properties. Yonsei medical journal. 2005 Oct 31;46(5):585-96.
  34. Zamorano, J.L.; Lancellotti, P.; Muñoz, D.R.; Aboyans, V.; Asteggiano, R.; Galderisi, M.; Habib, G.; Lenihan, D.J.; Lip, G.Y.H.; Lyon, A.R.; et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Eur. Heart J. 2016, 37, 2768–2801.
  35. Zorov DB. Amelioration of  aminoglycoside nephrotoxicity  requires  protection of renal mitochondria. Kidney Int 2010;77(10):841–843.

Reference

  1. Cline, J. C. (2015). Nutritional Aspects of Detoxification in Clinical Practice. Alternative Therapies in Health and Medicine, 21(3), 54-63. 
  2. Klein, A. V., & Kiat, H. (2014). Detox diets for toxin elimination and weight management: A critical review of the evidence. Journal of Human Nutrition and Dietetics. 
  3. Yadav, G., Monika, M., & Rani, A. (2022). Herbodetox agents: Naturally detox our internal organs. International Journal of Health Sciences, 6(S5), 7912–7932.
  4. Soni, N., et al. (2023). Nature’s detoxifiers: Powerful herbs for blood purification. World Journal of Pharmaceutical and Medical Research, 9(6), 249-252.
  5. Zienolddiny S, Campa D, Lind H, et al. A comprehensive analysis of phase I and phase II metabolism gene polymorphisms and risk of non-small cell lung cancer in smokers. Carcinogenesis. 2008;29(6):1164-1169.
  6. Estabrook RW. A passion for P450s (remembrances of the early history of research on cytochrome P450). DrugMetab Dispos. 2003;31(12):1461-1473
  7. Liska DJ. The detoxification enzyme systems. Altern Med Rev. 1998;3(3); 187-198.
  8. Jandacek RJ, Genuis SJ. An assessment of the intestinal lumen as a site for intervention in reducing body burdens of organochlorine compounds. ScientificWorldJournal. 2013;2013:205621.
  9. Uchikawa T, Yasutake A, Kumamoto Y, Maruyama I, Kumamoto S, Ando Y. The influence of Parachlorella beyerinckii CK-5 on the absorption and excretion of methylmercury (MeHg) in mice. / Toxicol Sci. 2010;35(1):101-105.
  10. Morita K, Ogata M, Hasegawa T. Chlorophyll derived from Chlorella inhibits dioxin absorption from the gastrointestinal tract and accelerates dioxin excretion in rats. Environ Health Perspect. 2001;109(3):289-294.
  11. Zhao L, Lee JY, Hwang DH. Inhibition of pattern recognition receptor-mediated inflammation by bioactive phytochemicals. Nutr Rev. 2011;69(6):310-320.
  12. Bhandari PR. Garlic (Allium sativum L.): A review of potential therapeutic applications. International Journal of Green Pharmacy (IJGP). 2012;6(2)
  13. Bohdan M, Kowalczys A, Mickiewicz A, Grucha?a M, Lewicka E. Cancer Therapy-Related Cardiovascular Complications in Clinical Practice: Current Perspectives. Journal of Clinical Medicine. 2021 Jan;10(8):1647.
  14. Di Bisceglie AM, Lok AS, Martin P, Terrault N, Perrillo RP, Hoofnagle  JH. Recent US Food and Drug Administration warnings on hepatitis  B reactivation with immune?suppressing and anticancer drugs: just the tip of the iceberg?. Hepatology. 2015 Feb;61(2):703-11.
  15. Dwivedi S, Kushalan S, Paithankar JG, D’Souza LC, Hegde S, Sharma A. Environmental toxicants, oxidative stress and health adversities: interventions of phytochemicals. Journal of Pharmacy and Pharmacology. 2022 Apr;74(4):516-36.
  16. Ferrari, M., Ravera, F., De Angelis, E., Liverani, F. S., & Navarini, L. (2010). Interfacial properties of coffee oils. Colloids and Surfaces A: Physicochemical Engineering Aspects, 365, 79–82.
  17. Gavali K, Kumar S, Kumar A. Clinical Study of Samwardhana Ghrit & Hapushadi Yapan Basti In The Management Of Children With Cerebral Palsy. Journal of Ayurveda. 2015 Apr;9(2).
  18.  Patel DK, Laloo D, Kumar R, Hemalatha S. Pedalium  murex  Linn.:  an overview of its phytopharmacological aspects. Asian Pacific journal of tropical medicine. 2011 Sep 1;4(9):748-55
  19. Podda M, Zuin M, Battezzati PM, Ghezzi C, Fazio DC, Dioguardi ML. Efficacy and safety of a combination of chenodeoxycholic acid and ursodeoxycholic acid for gallstone dissolution: a comparison with ursodeoxycholic acid alone. Gastroenterology. 1989;96(1):222–9.
  20. Reuben A, Koch DG, Lee WM. Drug?induced acute liver failure: results of a US multicenter, prospective study. Hepatology. 2010 Dec;52(6):2065-76.
  21. Sandoval R, Leiser J, Molitoris BA. Aminoglycoside antibiotics traffic to the Golgi complex in LLC-PK1 cells. J Am Soc Nephrol 1998;9(2):167–174
  22. Schnellmann  RG.  Toxic  responses   of   the  kidney.  Casarett  And   Doull’s Toxicology, the basic science of poisons. 2008;1:583-7.
  23. Scott Luper ND. A review of plants used in the treatment of liver disease: part1.           Alternative medicine review. 1998;3(6):410-21.
  24. Speer, K., & Kölling-Speer, I. (2006). The lipid fraction of the coffee bean. Brazilian Journal of Plant Physiology, 18, 201–216.
  25. Story JA, LePage SL, Petro MS, West LG, Cassidy MM, Lightfoot FG, Vahouny GV. Interactions of alfalfa plant and sprout saponins with cholesterol in vitro and in cholesterol-fed rats. The American journal of clinical nutrition. 1984 Jun 1;39(6):917-29.
  26. Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Get vaccinated when it is your turn and follow the local guidelines. International Journal of Health Sciences, 5(3),
  27. Trautwein EA, Kunath-Rau A, Erbersdobler HF. Increased fecal  bile  acid excretion and changes in the circulating bile acid pool are involved in the hypocholesterolemic  and  gallstone-preventive  actions  of  psyllium   in hamsters. The Journal of nutrition. 1999 Apr 1;129(4):896-902.
  28. Treadway S. An Ayurvedic herbal approach to a healthy liver. Clin Nutr Insights. 1998;6(16):1-3.
  29. Volkova M, Russell R. Anthracycline  cardiotoxicity:  prevalence,  pathogenesis and treatment. Current cardiology reviews. 2011 Nov 1;7(4):214-20.
  30. Walker PD, Barri Y, Shah SV. Oxidant mechanisms in gentamicin nephrotoxicity. Ren Fail 1999;21(3/4):433–442.
  31. Williams PD, Hottendorf GH, Bennett DB. Inhibition of renal membrane binding and nephrotoxicity of aminoglycosides. J Pharmacol Exp Ther 1986;237(3):919–925.
  32. Yemitan OK, Izegbu MC. Protective effects of Zingiber officinale (Zingiberaceae) against carbon tetrachloride and acetaminophen?induced hepatotoxicity in rats. Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 2006 Nov;20(11):997-1002.
  33. Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti- inflammatory properties. Yonsei medical journal. 2005 Oct 31;46(5):585-96.
  34. Zamorano, J.L.; Lancellotti, P.; Muñoz, D.R.; Aboyans, V.; Asteggiano, R.; Galderisi, M.; Habib, G.; Lenihan, D.J.; Lip, G.Y.H.; Lyon, A.R.; et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Eur. Heart J. 2016, 37, 2768–2801.
  35. Zorov DB. Amelioration of  aminoglycoside nephrotoxicity  requires  protection of renal mitochondria. Kidney Int 2010;77(10):841–843.

Photo
Sayali Gade
Corresponding author

Vishwabharati Academy’s College of Pharmacy Ahilyanagar, Sarola Baddi, Tal-Dist.- Ahilyanagar 414201

Photo
Dr. Ravindra Jadhav
Co-author

Pravara Rural College of Pharmacy, Loni, Tal- Rahata, Dist.- Ahilyanagar, 413736

Photo
Dr. Sagar Muley
Co-author

ACS’S College of Pharmaceutical Science and Research Ashti, Tal-Ashti, Dist.-Beed, 414203

Sayali Gade*, Dr. Ravindra Jadhav, Dr. Sagar Muley, Herbal Detoxification: Traditional Wisdom and Modern Evidence, Int. J. of Pharm. Sci., 2025, Vol 3, Issue 1, 493-508. https://doi.org/10.5281/zenodo.14614988

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