Pathological Detoxifiers and Environmental Illness

A little while ago a member posted via the EiR Facebook Page about a subject which hasn't been addressed specifically on the site before, concerning people known in complementary and alternative medicine (CAM) as - 'Pathological Detoxifiers'.

I thought this subject certainly deserved more attention as it can be a vital piece in the puzzle for those suffering from environmental illnesses including multiple chemical sensitivity (MCS), fibromyalgia (FMS), chronic fatigue syndrome (ME/CFS), and Gulf War syndrome and many more, which we cover.

To define what it means to be a Pathological Detoxifier first we need to understand the basics of how liver detoxification works:
 
Liver Detoxification

The detoxification of toxins by the liver basically occurs in two phases. Substances the liver must detoxify can be split into two groups - exogenous (from outside of the body) such as alcohol, drugs, and pollutants like persistent plastics, heavy metals, chemicals etc. - or endogenous (from inside the body) such as hormones, gut microbes, or partially digested food.

Most toxins are fat-soluble which means they are easily absorbed and stored in the body (particularly fatty tissues, including the brain), but are unfortunately for us, are difficult to get rid of. The overall aim of Phases 1 and 2 of the liver detoxification system is to make toxins more water soluble so they can be easily excreted by the body in urine. Some remain predominantly fat-soluble and are excreted into bile and eventually removed from the body during a bowel movement.

Phase 1 mainly uses a class of enzymes known as the cytochrome P450 system to oxidise toxins and make them more easily excreted and/or easier for the phase 2 system to pick up and carry on the job. Some substances such as caffeine go through phase 1 and are then directly excreted in the urine without going through phase 2. Equally some toxins can bypass phase 1 and go straight into phase 2. In the most part however (and this will become important in terms of the Pathological Detoxifier), toxins pass through both phases of liver detoxification before the body can rid itself of them.

Phase 2 involves the binding, or "conjugation", of certain substances to the toxins coming out of phase 1 so they can be removed from the body. There are six different conjugation pathways - glutathione conjugation, amino acid conjugation (e.g. glycine, taurine), sulfation, glucuronidation, acetylation, and esterification. Glutathione conjugation is generally considered the most crucial but this is not to say the other pathways do not play an important role and all need to be functioning optimally for good health.

So basically - Phase 1 prepares toxins for conjugation by Phase 2 - which renders the toxins safe and able to be excreted by the body.. via a bathroom visit!
 
The Pathological Detoxifier 

Problems arise because when we are exposed to increased amounts of toxins which increases the rate at which Phase 1 operates and it can usually continue to work at this rate indefinitely. This isn't a problem if Phase 2 pathways can keep up. Unfortunately in many people, if Phase 1 activity remains elevated for a prolonged period the substances used by Phase 2 tend to become depleted and Phase 2 can no longer function efficiently and keep up with Phase 1.

When this situation exists in an individual they are said to be a pathological detoxifier. Substances coming out of Phase 1 can't all be taken care of by Phase 2, so instead they circulate throughout the body causing symptoms of toxicity and disease. What makes things worse is that substances produced by Phase 1 are sometimes actually even more toxic than the original toxins being detoxified. This is why it is essential that both phases of the detoxification process are in balance.

If you suffer from environmental illness or unexplained symptoms, or you feel "toxic"...it may be that you are a Pathological Detoxifier yourself - and you literally are toxic!

Fortunately there are simple tests available from various functional medicine labs that can determine if this is the case (a Naturopathic Doctor (N.D.) or Certified Nutritionist would routinely use these).

The test I personally underwent involved taking a small dose of caffeine, paracetamol, and aspirin, and then collecting urine over a specified amount of time (I believe - every 4 hours over 12 hours). By measuring the amounts of detoxification products of these substances in your urine the lab can determine how quickly Phase 1 and a number of Phase 2 pathways are working.

I had a Detoxification Profile carried out by Great Smokies Diagnostic Lab (now part of Genova Diagnostics (GDX) ) all the way back in the year 2000 to investigate the causes of the chronic fatigue syndrome (ME/CFS) I'd suffered from age 11 years old. My results suggested a definite trend towards me being a Pathological Detoxifier.

N.b. There are now much more advanced assessments available! e.g. the 'DetoxiGenomic' test from Genova Diagnostics (as of July, 2025)

I will upload my results so you can see a real-life example in the dedicated blog below shortly. Or, you can view now using the Web Archive's 'Way Back Machine' version of 'pre-hack EiR' - I have linked to these posts directly there for the moment.

Detoxification Profile Results - 'The Pathological Detoxifier and Chronic Illness'

(N.b. Also, you can visit the Genova Diagnostics website which has info and example 'DetoxiGenomic' Test Results here. This is their latest detoxification test (2025).

For information about treating imbalanced liver detoxification see this blog on the Way Back Machine:

'Foods and Supplements to Balance Phase 1 and Phase 2 Liver Detoxification'