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Can You Make Peace with Your Deadbeat Liver? Pt 2: A Doctor Speaks

9/15/2016

Last month, I wrote a post about juicing, cleansing, and detoxing. Because I have a laptop and lot of opinions!! But do I have facts? Or was my post an emotional reaction to my fear that people are trying to take doughnuts away from me and body-shame my liver??
To find out, I asked Michelle Griffith, MD, specializing in Endocrinology, Diabetes, and Metabolism. She’s so smart, she was recently featured as one of the top doctors in the entire city of Pittsburgh. She also happens to be my sister-in-law.
So what does Dr. Griffith think about juicing?
“Juice is the devil’s beverage.”
Oh. Okay. Cool. Care to elaborate?
“Many people have (often undiagnosed) insulin resistance, impaired glucose tolerance, etc. In those people drinking juice will indeed lead to rapid absorption and a big spike in insulin output, and possibly an elevated glucose level anyway (if they have IGT). Our digestive systems evolved to extract nutrients from fibrous fruits and veggies and I cannot see that we would be missing vitamins in a clinically significant way by keeping the fiber in there. Healthy people with no IGT or diabetes will not be harmed by juicing- -but for anyone with those issues my mantra is ‘eat the fruit, don't drink the juice.’"
From here, I went down a bit of a rabbit hole in realizing that the whole concept of “detoxing” is much broader and deeper than a glistening, cold-pressed Instagram post. The more answers I got from Dr. Griffith, the more questions I had. The more questions I asked, the more words like “cytokines” and “non-alcoholic steatohepatitis” she began throwing at me. Suddenly, I was no longer sure if I was asking about juicing, environmental toxins like BPAs, allegedly inflammatory foods (gluten/soy/dairy), or liver cirrhosis.
My one consolation is, I’m pretty sure the proselytizers of juicing and detoxing don’t really know, either.
Is sugar the enemy, or is microwaving leftovers in plastic containers the real danger?
“There's a spectrum of risk from these things. Some of the most dangerous liver toxins would rarely be encountered in day-to-day life. However, they are additive. So a person who drinks a lot of alcohol should not take excessive acetaminophen (Tylenol) and the recommended maximum dose for chronic use is lower for people who drink; the additive risk will be more than the risk to a person who does not drink and takes too much Tylenol. In day-to-day life, I think common sense is key. Basic cautions are fine. We are learning more and more about the dangers of plastics (e.g. BPAs- endocrine disrupting chemicals are a real thing)- while maybe not liver specific, we should not microwave food in plastic, etc. I think people think they can flush these kinds of toxins from the body, but I don't think there's good evidence that it makes a difference.”
Bottom line?
“A short-term detox cannot make up for chronic insults to the liver and kidneys,” she tells me.
Aside from introducing me to my new favorite phrase, #ChronicInsultsToTheLiver (new band name, anyone??), Dr. Griffith’s message of common sense rings true to me. You have to eat like a goddamn adult once in a while. If you think beer counts as a sandwich and a box of Mike & Ike’s is a USDA-approved serving of fruit, it’s probably time for a major overhaul. A three-day cleanse is not going to do the job. As Dr. Griffith puts it, “Our body weight is a record of what we’ve taken in over months to years, not days to weeks, and the health of our kidneys, livers, brains, pancreases, etc also reflects months to years of food, drink, and activity.”
So, to bullet-point a few takeaways: