The second phase of detoxification is called the conjugation pathway. In this phase the liver cells add another substance to a toxic chemical or drug, to make it less harmful to the rest of the body. In this process the liver makes the chemical or drug water soluble so it can be excreted by way of watery fluids like bile or urine.

There are essentially six phase II detoxification pathways: Glutathione conjugation, Amino acid conjugation, Methylation, Sulfation, Acetylation and Glucuronidation.

Conjugation means: the formation or existence of a link or connection between things. In the liver it means the molecules are being acted upon by specific enzymes to catalyze (cause the process to begin) the reaction step. Through conjugation, the liver is able to turn drugs, hormones and various toxins into excretal substances. For efficient phase II detoxification, the liver cells require sulphur-containing amino acids like taurine and cysteine. In addition the nutrients glycine, glutamine, choline and inositol are also required

Glutathione Conjugation.
A primary phase II detoxification route is conjugation with glutathione (composed of three amino acids – cysteine, glutamic acid, and glycine). The elimination of fat-soluble substances including heavy metals like mercury and lead is dependent upon adequate levels of glutathione, which in turn is dependent upon adequate levels of menthionine and cysteine. When the body has increased levels of toxic compounds present, more methionine is used for cysteine and glutatione synthesis.

Glutathione is an important antioxidant. The combination of detoxification and free radical protection results in glutathione being one of the most important anti-carcinogens and antioxidant in our cells. Lacking glutathione results in serious liver dysfunction and damage. Exposure to high levels of toxins depletes glutathione faster than it can be produced or absorbed from food resulting in increased susceptibility to toxin-induced dis-ease.

A deficiency can occur either by a state of dysfunction which increase the need for glutathione, deficiencies of the nutrients needed for synthesis, or dysfunctions which inhibit its formation. Smoking increases the rate of utilization of glutathione, both in the detoxification of nicotine and in the neutralization of free radicals produced by the toxins in the smoke. Glutathione is available through two routes: foods and synthesis. Glutathione is found in fresh fruits and vegetables, cooked fish, and meat and is absorbed well by the intestines.

Amino Acid Conjugation
Several amino acids: glycine, taurine, glutamine, arginine, and ornithine are used to combine with and neutralize toxins. Of these glycine is the most commonly used in phase II amino acid detoxification. People suffering from liver, thyroid, joint problems or have excessive chemical exposure are found to have poorly functioning amino acid conjugation systems. Glycine, and other amino acids used for conjugation, become deficient on a low protein diet, when people have difficulty digesting protein, and when chronic exposure to toxins results in depletion.

Methylation
Methylation involves conjugating methyl groups to toxins. Most of the methyl groups used for detoxification come from S-adenosylmethionine (SAM). SAM (sometimes known as SAM-e) is synthesized from the amino acid methionine, a process which requires the nutrients choline, the active form of B12 – methyl cobalamine, and the active form of folic acid folic acid – methyltetrahydrofolate.

SAM-e is able to inactivate estrogens supporting the use of methionine in conditions of estrogen excess, such as PMS. Its effects in preventing estrogen-induced cholestasis (stagnation of bile in the gall bladder) has been demonstrated in pregnant women and those on oral contraceptives. In addition to its role in promoting estrogen excretion, methionine has been shown to increase the membrane fluidity that is typically decreased by estrogens thereby restoring several factors that promote bile flow. Methionine also promotes the flow of lipids (fats) to and from the liver in humans. Methionine is a major source of numerous sulfur containing compounds including the amino acids cysteine and taurine.

Sulfation
Sulfation is the conjugation of toxins with sulfur-containing compounds. Sulfation is important for detoxifying several drugs, food additives and especially, toxins from intestinal bacteria and the environment. In addition to environmental toxins sulfation is also used to detoxify some normal body chemicals and is the main pathway for the elimination of steroid and thyroid hormones. Since sulfation is also the primary route for the elimination of neurotransmitters, dysfunction in this system may contribute to the development of some nervous system disorders.

Many factors influence the activity of sulfate conjugation. A diet low in methionine and cysteine has been shown to reduce sulfation. Sulfation is also reduced by excessive levels of molybdenum or vitamin B5. In some cases, sulfation can be increased by supplemental sulfate, extra amounts of sulfur-containing foods and the amino acids taurine and glutathione.

Acetylation
Conjugation of toxins with acetyl-CoA is the primary method by which the body eliminates sulfa drugs. This system appears to be especially sensitive to genetic variation, with those having a poor acetylation system being far more susceptible to sulfa drugs and other antibiotics. While not much is known about how to directly improve the activity of this system, it is know that acetylation is dependent on thiamine, pantothenic acid B 4, and vitamin C. 

Glucuronaidation
Glucuronaidation is the combining of glucuronic acid with toxins This can be reversed in phase Ii by Beta glucuronidase enzymes produced by pathological bacteria and cause toxins to be reabsorbed increasing toxicity. Many of the commonly prescribed drugs are detoxified through this pathway. It also helps to detoxify aspirin, menthol, vanillin (synthetic vanilla) food additives such as benzoates, and some hormones. Calcium d-glucurate, a natural ingredient found in certain vegetables and fruits can inhibit beta glucuronidase activity resulting in increased elimination of toxins.

Bottom line of Liver Detoxification:
If you put toxins into the body the liver has extra work to do to eliminate them, eat whole organic foods not processed chemical foods, use nonchemical cleaners in your home, don’t apply chemicals to your body, and try to avoid chemicals as much as possible on a daily basis. The body requires two substances to keep the liver cleaned out of toxins: enzymes and amino acids, or proteins If the digestive system is not working correctly and cannot digest protein the liver has a difficult time completing the process of detoxification. In order to maintain a state of health the body must be able to digest foods or have enzymes added to the daily regimen to do the process.

Foods to Eat for Liver Health:
There are certain foods that help to protect and detoxify the liver itself so that it can perform better to detoxify the entire body:
1. Apples contain pectin which helps to bind and excrete heavy metals right off the intestines. This directly helps to reduce the load of filtration on the liver.
2. Beets, carrots, red onions and aubergine (eggplant) contain flavonoids and beta-carotene which are potent antioxidants.
3. Garlic contains allicin and the mineral selenium, both antioxidants. It assists the removal of heavy metals from the liver.
4. Eggs, brown rice and whole grains, broccoli and spinach contain Bcomplex vitamins which improve liver function and promote liver decongestion.
5. Vitamin B12 helps to metabolize fats and improves liver health.
6. Cruciferous vegetables such as cauliflower, broccoli, cabbage, Brussels sprouts, Bok Choy, kale, radishes, and turnips contain glucosinolates
7. Grapefruits are rich in antioxidants and help in natural detoxification of liver.
8. Bitter vegetables such as bitter gourd, dandelion greens, mustard greens and chicory promote the production and flow of bile.

Tips for a healthy liver:

• Eat organically produced foods as much as possible to avoid toxic chemical residues.
• Avoid artificial flavorings and preservatives.
• Avoid hydrogenated fats found in many processed foods.
• Avoid chemical use inside and outside the body
• Avoid chemical use inside and outside the home.