What is the final phase of detoxification?

Phase III of the detoxification process is where the actual removal of the toxins takes place: elimination.


When addressing the process of detoxification, there is a tendency to focus on phases I and II. Still, it is in the last part of the process that the toxin is transported out of the cell, employing a membrane protein called antiporters.

At this stage, products of phase II – conjugated xenobiotics and toxins – are pumped into the bile and intestinal lumen by the antiporter system so they can be excreted. The effective elimination of these compounds is dependent on several factors; the most important of which is the presence of essential vitamins such as vitamin A, B2, B3, B5, B6, B9 (folate), B12 and and minerals like iron, calcium, copper, zinc, magnesium and selenium.

Detox diets claim to help the body eliminate toxins; it is mainly done through the use of botanicals – plants and herbs – that have a diuretic or cholagogues effect. Every day, the liver filters about 1.82 litres of blood, removing the toxins and breaking down old red blood cells, which is a recycling process for these red blood cells. In this process, the liver breaks them down into globin, heme and iron. Iron is transported via ferritin back to the bone marrow to be used in the creation of new red blood cells. Heme is broken down into biliverdin which eventually becomes bile. Changes in red blood cell health and hydration will impact bile production which ultimately becomes your stool.

A cholagogue is a substance that stimulates the flow of bile from the gallbladder to the first part of the intestine, called the duodenum. Bile secretion plays a very important role in the elimination of toxins. Impairment of bile flow may result in an accumulation of liver toxins which might lead to liver damage. The possible dysfunction of this process can manifest in some signs like digestive symptoms associated with the ingestion of fat. Bitters like dandelion or gentian root are often used to improve the absorption of fats and micronutrients.

Other examples of cholagogues

  • Milk thistle
  • Turmeric
  • Rosemary
  • Artichoke leaf
  • Beetroot 
  • Bile salts

A diuretic substance will increase urination. Some of the most common are available in every kitchen, like:

  • Green tea 
  • Black Tea 
  • Coffee
  • Ginger 
  • Parsley
  • Juniper Berry
  • Watermelon
  • Dandelion leafs

While promoting diuresis might improve phase III, it should be taken into consideration the kidneys' ability to deal with the increased load imposed on them as per the diuretic substances. Moreover, the body needs to be hydrated enough to dissolve the toxic waste.

It might sound simple but hydration requires the availability of amino acids and balanced electrolytes inside the cells. Therefore, the absence of these elements, such as potassium, sodium and chloride as well as calcium, magnesium and phosphate – due to poor dieting – in addition to stress and lower water intake will result in undesirable  effects on the detox process.

However the consumption of these substances will result in liver drainage which will not be useful unless both phase I and phase II are functioning perfectly well.

In a nutshell, many elements, substances and factors interfere in this intricate process of detoxification and due to the interconnection between the three phases, inefficient detoxification in any of these phases can be detrimental to overall health. In this last detoxification phase, water-soluble byproducts reach the kidneys to be expelled as urine and fat-soluble substances are combined with bile to be excreted via stools.

Correct elimination of toxins via the intestine requires a healthy gastrointestinal system, especially when it comes to defecation. Some conditions might compromise effective bowel movements like gastrointestinal inflammation, low fibre intake, low magnesium intake, pathogens in the digestive system and dysbiosis.

When the Elimination Phase is not working properly it might impact the regulation and excretion of metabolites and enzymes from the previous phases, resulting in a possible toxic build-up and oxidation.

One common example is the presence of high Beta-Glucuronidase in the stool. This enzyme is overproduced when there is a dysbiotic overgrowth of the intestinal flora and might bind to oestrogen, compromising the effectiveness of the detoxification process.

Strategies to promote and maintain an effective Elimination Phase:

  • Increase cruciferous vegetables 
  • Consume fibre-rich foods: apples contain pectin, a type of soluble fibre, known for its laxative* effects. Prunes contain fibre and also sorbitol- an alcohol sugar present in fruits and plants - that promotes water retention in the intestine and stools, making it easier to pass. 
  • Proper hydration 
  • Exercise

Regular movement, adequate sleep, nervous system regulation and a diversified diet also lay the ground to an optimised detoxification system. 

*Dietary fibre is known to increase stool frequency in patients with constipation. Laxatives are often used for constipation relief, although its  frequent use may have severe adverse effects outside a comprehensive treatment plan. An increase of dietary fibre, however, is recommended to treat constipation in both children and adults.

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