186: Liver Detox - Skin Rash Connection (PART 2)

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As promised, I’ve put together a conglomeration of listener questions about the liver detox-skin rash connection.

I know this topic is complicated and much of what I say flies in the face of how you’ve been conditioned to think about detoxing.

But it’s an important one because there is just so much confusion out there!

I’m hoping this helps clarify for you my first podcast in this series — PART 1 — where I detailed the three phases of liver detox and WHY they’re so important for chronic skin rashes.

Plus, I’ve shared one of my favorite graphics below that helps you understand the priority of organ systems and how I address them in my practice.

I call it the “Priority Pyramid” will help you see why liver detox support isn’t something to just do briefly and then move on. It’s a big deal!

And yes, because I have even more to say on this topic, there will be a part 3 so stay tuned!

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

In this episode:

  • How to know if you actually need to do a liver detox
  • Is there a way to measure liver detox?
  • My recommendation on length of time to support liver detox
  • When to take your liver supportive supplements
  • Thoughts on Castor oil packs for Phase 2 detox
  • Why I don’t recommend collagen for liver detox (even though it contains glycine)
  • “Keto rash” + liver detox
  • Best protocol for liver detox support


Phase 2 liver detox pathways need nourishment, not detox supplements to “clean” or flush your liver.

The only solution if you develop an itchy rash after going on a keto diet is to increase your carbs + possibly leave ketosis.

Silymarin herbal medicine

Liver Detox – Skin Rash Connection PT2 (FULL TRANSCRIPT)

Welcome back to episode #186 of the Healthy Skin Show!

In today’s episode, I’d like to cover questions that I got from my previous podcast on the liver detox – skin rash connection.

I appreciate everyone who submitted questions because the way that we’ve been conditioned to think about liver detox and actually DOING a detox isn’t entirely accurate.

The reality is that liver detox isn’t black + white.

It’s not some fish filter that needs to be cleaned and wrung out.

The process of detoxification is way more complicated than just getting toxins out of your body. So if you’ve been under that impression because that’s how it’s been explained in the past, it’s time to put aside that inaccurate concept.

This episode is PART 2 of the initial Liver Detox-Skin Rash Connection from episode 177. If you missed that episode OR you don’t know that there are three distinct phases of liver detox, go check that episode out before diving into this.

My goal here is to answer YOUR questions so that you can make better, more educated decisions about your next steps to support your skin (and health).

Woman thinking about liver detox

Q1. How Do You Know If You Need A Liver Detox?

This might surprise you, but I rarely ever recommend liver detoxes.

For most people with chronic skin issues, liver detoxes aren’t necessary and sometimes can make things worse.

Those with psoriasis who demonstrate through testing elevated liver enzymes such that their doctor is concerned or diagnoses them with Non-Alcoholic Fatty Liver Disease (NAFLD) are an exception.

They could benefit after addressing some of the other hidden root causes (ie. gut microbiome imbalances) driving the problem in the first place.

So, if you’re listening to the Healthy Skin Show — your first step is to SUPPORT your Phase 2 Liver Detox pathways.

How do you support Phase 2 detox?

With the specific nutrients those pathways require (that often your body doesn’t make).

It isn’t accomplished by taking a detox supplement or milk thistle or eating a ridiculous number of green apples per day. Nor does it require binders or any sort.

These pathways need nourishment, not detox supplements to “clean” your liver.

Phase 2 pathways have the capacity to do what you think those detox products are doing. But because of a heavy load and potential low nutrient availability, they’re struggling to keep up.

So my simple answer here still stands from all the cases I’ve reviewed — if you have some sort of chronic skin rash concern like eczema, psoriasis, rosacea, hives, dandruff, etc., you need to support Phase 2 pathways so they can do their thing!

Woman thinking about measuring a liver detox

Q2. How Do You Measure Liver Detox?

Liver detoxification isn’t so simple to measure.

I look at the biochemistry of it all and have identified certain patterns from my clinical experience with labs and working with clients.

This has made it easier and less expensive for everyone in this community to not necessarily have to spend money on testing.

Since we know that the Glycine pathway requires both glycine and B6, your liver enzymes on a Comprehensive Metabolic Panel and even Homocysteine (if your doctor will run it) can provide insight into whether or not you need more B6.

There’s really no harm in adding in extra glycine which is why I commonly make this suggestion.

It’s imperative to support the Glycine pathway of Phase 2 liver detox for those with chronic skin issues.

Remember… this pathway can’t efficiently run and process toxins if supplies of glycine + B6 are low. So a backlog of toxins that head down this pathway will require higher intakes for a period of time (to be determined by your practitioner).

You can certainly measure other Phase 2 liver detox pathways thanks to urinary organic acid testing, but it may not be within your budget and frankly, it isn’t always necessary.

Woman laying down on calendar

Q3. How Long Do You Support Your Liver For?

This is a great question and not asked enough!

Most people assume that one bottle of whatever they decide to do will be enough.

Unfortunately that’s not the case.

It’s crucial to remember that by the time you’re dealing with chronic issues, you’ve likely got quite a backlog of items that your Phase 2 liver detox pathways need to deal with.

So in the beginning, you’re refilling those nutrient wells to address THAT backlog.

Beyond that point, you STILL have to support these pathways while working through your root causes because dealing with them can cause an increase of waste products as well.

My clients are supporting their Phase 2 liver detox pathways for anywhere from 75% to 100% of the time that we are working together either with glycine + B6, and even possibly P2 Detox Balance (which is completely herb free for those sensitive to them).

This isn’t a short term issue that you just check off your list.

And it’s a crucial piece that must be ongoing until you’re starting to see symptom resolution.

Milk Thistle

Q4. When Do You Take Liver Detox Support?

Typically I recommend that clients take it two times per day in the beginning — in the morning with breakfast and in the late afternoon or at dinner.

With time and as rashes begin to resolve, you should be able to reduce this to once a day without causing any flare ups.

If you are really sensitive to supplements where certain things will disturb your sleep, take the second round anywhere from 2 to 4pm.

There isn’t any caffeine or anything in Phase 2 liver support nutrients… it’s just that some people are more sensitive than others and need to make adjustments for their unique body.

Lastly, I haven’t found that it makes a difference taking it without or without food, so do what is easiest for you so that you will be consistent.

I can’t swallow pills (as many of you have heard me say on the show), so I empty the P2 Detox Balance capsules into my morning protein shake to get them in.

Castor oil capsules

Q5. Do Castor Oil Packs Help Liver Detox?

While I have discussed the use of Castor Oil packs on the show before HERE, they cannot support Phase 2 detox since there’s no additional nutrients that you’ll somehow get from doing these types of packs.

Castor oil packs can be helpful for some, but again — the issue I’m talking about is one focused on specific nutrient depletions that your body can’t make on its own.

Those nutrients must come into the system either through food (that’s appropriately digested and absorbed) or supplementation.

Foods with collagen

Q6. Can’t I Just Get Glycine From Collagen?

You can and will get glycine from collagen. (I wrote a detailed article on it here.)

I often recommend it as a supplement to those who can tolerate it (since not everyone can — especially those struggling with histamine overload).

However, I have found supplementing with glycine on its own more effective in my clinical practice.

So I don’t rely on collagen supplementation to provide enough glycine to really support Phase 2 detox once someone’s system is pretty overloaded.

Woman thinking about skin issues

Q7. Does The Detox I Start With Matter Depending On What Type of Health + Skin Issues I Have?

This is a great question which I’d like to preface by stating that it’s really common for clients in my practice to be dealing with a number of health issues beyond their skin concerns.

Some are struggling with eczema, celiac, and fatigue.

Others are dealing with psoriasis, thyroid problems, and joint issues.

I could literally put together an extensive list detailing the skin + health problems that each client has.

So while I do think it’s incredibly important to personalize your journey, this is one area where it doesn’t matter in the way you think it does.

For all skin issues I’ve talked about here on the Healthy Skin Show — eczema, psoriasis, rosacea, dandruff, hives, tinea versicolor, etc. — start here with supporting Phase 2 detox.

Priority Pyramid

It is a fundamental step that is high priority to address in the beginning as you can see from this graphic I created.

I’m not saying that your diagnoses don’t matter… they do!

But sometimes they can overcomplicate the road forward especially when you’re trying to figure it out yourself.

Yes there can be tiny nuances between the path for you versus someone else, but I can tell you that at this point, I haven’t deviated from the “support Phase 2 liver detox” step on any case — even when the case is more gut focused without any skin issues whatsoever.

That’s how important this is!

Keto meal

Q8. Can Liver Detox Cause A “Keto Rash”?

At this time, it’s not fully understood why some people develop an itchy rash on their skin not long after starting a keto-style diet.

For those of you unfamiliar with a keto diet, basically you increase fat intake and reduce carb intake such that your body begins to burn ketones instead of glucose as its primary fuel source.

The best suggestion to get the rash to stop is to increase carb consumption and exit ketosis.

This most likely will allow the rash to resolve on its own.

If this happens to you, I don’t think that it means you’ve failed, but more so that keto is not likely the best dietary approach for your body. Remember that you are unique and if one way of eating doesn’t work for you, there are other approaches out there that might be a better fit.

Woman thinking about detox protocols

Q9. Best Detox Protocols?

This episode is ONLY about the way that I focus on supporting Phase 2 liver detox.

I’ve repeatedly shared my recommendations about glycine, vitamin B6, and P2 Detox Balance (which is focused on amino acids to support Phase 2 detox without herbs + vitamins).

I can only give general recommendations here since I don’t know your case and you should run new supplements past your practitioner or doctor working on your case first.

  • Glycine — 3 grams 2x/day (can be added to a bit of water to drink it)
  • Vitamin B6 — 5 to 10 milligrams in AM (check other supplements to add up how much is already in there)
  • P2 Detox Balance — 3 capsules 2x/day

If you can tolerate cruciferous veggies (which is hard for some with salicylate sensitivity), broccoli sprouts are also great to add as well!

If you can’t tolerate salicylates — that’s a big clue that your Glycine pathway is in big need of support as I’ve discussed within this series.

Other detox methods like sweating, dry brushing, ect. are helpful for supporting other drainage/elimination pathways and moving the lymph around, but that’s a totally different conversation.

As I said in the beginning, if you need a refresher on the different phases of liver detox, go check out episode 177 which is Part 1 of this topic.

And if you’re interested in trying the P2 Detox Balance that I use in my practice (from Quell — use coupon code QUELL10 to get 10% off your first purchase), you’ll find it helpful to keep Phase 2 humming along.

If you’ve got any questions or thoughts to share about this, leave a comment below so I can address them in Part 3 of this series.

And this is a great episode (and series) to share with anyone who is considering doing a liver detox so that they can hopefully avoid a flare!

Thank you so much for turning in and I look forward to seeing you in the next episode!

Phase 2 liver detox pathways need nourishment, not detox supplements to “clean” or flush your liver.

Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.

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