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What Is ‘Detox’ and Does It Work?

Posted on 10 December 2020

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Practices that are supposed to cleanse or detoxify the body of harmful substances existed millennia before modern alternative medicine began to promote them. Our ancestors, however, lacked basic medical knowledge about how the body handles harmful substances. The detox rationale forms the foundation for perfectly sensible diet plans and baseless alternative medicine alike. Based on current scientific knowledge and evidence, however, is there any merit to this concept?

What Is Detox?

Detox or detoxification is simply the removal of toxic substances from the body. Examples of toxins include ammonium, alcohol, and most of the components of cigarette smoke. The liver is able to detoxify the blood by converting such substances into less harmful forms, or by excreting them into the gut. The kidneys are also a site of detoxification, as any molecules small enough to pass through the kidney‘s filter will enter the urine if not specifically reabsorbed.

In the case of organ failure or ingestion of poisons, medical detoxification may be necessary. This includes dialysis (blood filtration) and the administration of antidotes. Detoxification may also refer to the withdrawal period for an addictive substance, in which case it has nothing to do with actually removing toxins from the body, but rather the cessation of intake.

In the context of alternative medicine or health fads, detox does not refer to any of the above. In most cases, detox refers the concept that there are all kinds of toxins floating around in our bodies, substances that build up as a result of our environment. The exact nature of these toxins is often only vaguely alluded to, but proponents will tell you that they are bad and that certain diets and practices can remove them. So, is detox a legitimate concept that has been misappropriated by alternative medicine, or is it a waste of time?

The Fundamental Problem With Detox

The idea of detox has a fundamental flaw in that the body is already extremely efficient at ridding itself of harmful chemicals. This is partly down to the way in which the kidneys function: for the most part the kidneys don’t actively throw out unnecessary molecules. Rather, everything that passes the kidney’s filter will be excreted in the urine by default unless reabsorbed. Molecules (including those too large to enter the kidney tubules) may also be removed by the liver. If these systems were not already very effective at clearing commonly encountered toxins from your blood, you would be in serious trouble. Indeed, these systems are effective enough that they become a problem in pharmacology, as drugs must often be given in much higher doses than would otherwise be necessary on account of their swift removal from the blood.

There are situations in which these systems could be impaired, overwhelmed or damaged (excessive alcohol consumption, for example). However, for the average individual not dying of liver or kidney failure, there’s really no reason to believe that any kind of detox treatment would be necessary.

Photo by julien Tromeur on Unsplash

But wait! What about ‘forever chemicals’? It is true that some chemicals take considerable time for the body to remove, such as heavy metals and persistent organic pollutants. This is because some compounds can bind to molecules within the body, which significantly slows their natural clearance. While exposure to such substances is generally a lot lower today than it once was, they may still have some toxic effects at low levels. Would it not make sense to adopt some detoxification practices as a precautionary measure? Unfortunately, this brings us to the next problem when it comes to detox.

Surely There’s Some Evidence?

You have heard why detox is probably unnecessary, but perhaps you don’t want to take the chance. You are worried that toxic chemicals have accumulated in your body over years of exposure, and you want to get rid of them. What are your options? Here are some of the most common approaches to detoxification:

  • Fasting
  • Drinking vegetable juice, smoothies and tea
  • Drinking specific drinks like lemon juice or salt water
  • Exercise
  • Sauna use
  • Eliminating alcohol, caffeine or refined sugar from the diet
Photo by Claudia Soares on Unsplash

Some more outlandish methods include:

  • Foot pads that are supposed to pull toxins from the body
  • Oily mouth washes
  • Electric footbaths
  • Laxatives, enemas or ‘colon cleanses’

Some of the above undoubtedly have health benefits, while others are just plain bizarre. However, they all have one thing in common: there’s little to no evidence that they help eliminate toxic compounds from the body. Some of them are actively harmful. Some detox products are even designed to deliberately mislead the buyer into thinking they work, such as foot pads that release sticky substances when dampened with sweat. The most plausible strategies on this list for eliminating toxins are arguably exercise and sauna use. This is because both cause sweating, and there is some (limited) evidence that sweat contains a not-insignificant amount of heavy metals. Whether this actually has health implications is unknown.

L'escroquerie Detox Foot Pad • Quackwatch

Cutting down your consumption of substances that can be considered toxins (such as alcohol) will reduce the concentration of said toxin in the blood, but no one needs an 800 word article to tell them that.

The Take Home Message

In summary, while some detox practices may be healthy, the idea of detox itself for general health is not well supported by science. There’s no solid evidence that detox is necessary and no solid evidence that it works. At its best, detox is simply a relabelling of healthy practices that may motivate people to make healthy lifestyle choices. At worst, it is a term used by alternative medicine proponents to mislead people into buying useless products.

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