Phase 2.5 Detox - Bile Salt Export Pump
This is perhaps the most overlooked part of detox, and probably the most critical based on my experience. It single handily can cause the dreaded 'herx' reaction.
There is a valve the exits the liver to the gallbladder called BSEP, the bile salt export pump. And there are genes that control it as well as genes that control the genes that control it:). This valve can become closed for several reasons, and when it closes, it shunts the bile (and toxins) into the blood stream, where they hit the brain (neuro-inflammation), kidneys (lower back pain, frequent urination), and the bile salts get pushed out to the skin (itchy skin, rashes, hives). Sound familiar when you push detox to hard?
What Causes BSEP To Close Off ?
Simply said 3 key issues are at play. First is genetics, where mutations cause this valve to malfunction. Second, when too many toxins flood the liver, and the phase 2pathways are not adequately supported - the liver protects the MRP2 proteins which shuttle toxins out of the liver through bile, and then pushes the bile and toxins out to the blood. I see this when people take loads of binders without supporting other pathways - the body gets the signal to dump toxins, but the rest of the pathway out isn't all clear yet. The last reason this valve can get shut down is high levels of estrogen.
How Do We Open BSEP and Protect MRP2 ?
Milk thistle helps protect the MRP2 proteins, phosphatidyl choline helps liquify the bile, and DIM and calcium d - glucarate can help lower estrogen. For folks who are reactive, or have genetic mutations this is literally ground zero.