Outline 6 strategies for Mrs S for maintaining efficient liver detoxification and reducing her exposure to toxicity.

Liver detoxification Experiencing fatigue with nausea in the morning. Mrs S (47years old) feels fuzzy in the head and is bad tempered on rising. She finds that she cannot interact with family until she has had a strong cup of coffee and a shower. She has a greasy coating on her tongue every morning and her husband (very kindly) tells her that this is accompanied by fetid breath. Mrs S experiences sinus pain and congestion on a regular basis, finding it is difficult to breathe through her nose when she goes to bed at night. About once a month she experiences a headache with blurred vision and nausea. the pain lasts for about 24 hours does not respond to nurofen and dissipates of its own accord. She does not like taking drugs, so has not tried anything stronger. Mrs S has been experience palpitations and anxiety when she drinks more than one cup of coffee in a day. she has also noticed that it is difficult to get to sleep at night if she drinks coffee after midday. Recent medical history 6 months ago . Root canal filing after a protracted bacterial infection and abscess of a molar. 9 months ago. general anaesthetic for knee operation other information. BMI = 30kg/m2 Medications Naprosyn daily for arthritic pain of the knee. She has been taking this for the past 2 years. 6 months ago. High doses of nurofen for several months to alleviate her dental pain and 2 courses of penicillin to resolve her dental infection. She has been taking the oral contraceptive pill daily for the past 20 years. Occupation- She works as a cleaner for 15 years. Typical daily diet- Breakfast- strong black coffee , croissant with jam Morning tea- Doughnut and milkshake Lunch- Pastie with sauce and orange juice Dinner- Roast pork , mashed potato and peas, 4 glasses of red wine. Questions Review the steps of the Nutritional medicine detoxification treatment plan Once you have established the necessity for detoxification, the treatment plan follows five basic steps: ? Identify and reduce sources of toxicity ? Support Phase I and II detoxification ? Support elimination ? Re-establish microbiota ? Establish a maintenance plan. 1- Identify & reduce sources of toxicity (150words) Identify the potential contributors to Mrs Ss toxic state & indicate what phase of liver detoxification is involved in dealing with these toxic challenges. Outline how you would go about reducing or eliminating these contributors to toxicity. 2- Support phase I and II detoxification (200words) Devise a treatment plan that supports Phase I and II detoxification including dietary inclusions, supplements, dosages and lifestyle changes. Be clear about how your plan improves liver detoxification and support your plan with evidence from literature. Remember to reference your sources correctly using APA. 3- Support elimination of detoxification metabolites (150Words) Provide 5 strategies for eliminating the metabolites of liver detoxification from Mrs Ss body. 4- Re- establishing microbiota (150words) Provide a plan for re establishing the microbiota, in your answer explain how liver function and digestive function influences the microbiota. 5- Establish a maintenance plan (150 words) Outline 6 strategies for Mrs S for maintaining efficient liver detoxification and reducing her exposure to toxicity. Main referencing book clinical naturopathic medicine by hechtman and pubmed

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