The silly season has ended for another year and many of us are feeling the effects of overindulgence. This time of year there is much talk about getting healthy, cutting back on the bad stuff and “detoxing”. But what exactly is detox and is it really effective? Today on Dr Rachie Reports, we delve in to the weird world of detox to look at the science (or lack there-of) behind this multi-billion dollar industry.

What exactly is detox?

Conventional detox has an established place in medicine, where it refers to weaning addicts off drugs or alcohol or eliminating poisons that have been ingested or injected (1). In alternative medicine the word detox has been hijacked to include a grab bag of pills, powders, supplements, kits, diets, magic water/drinks, colonic irrigation, chelation therapy and even shampoos and body brushes. Indicative of this, no two companies selling detox products use the same definition, as outlined by the Oxford English Dictionary as the removal of toxic substances or qualities. The word detox has simply been hijacked as a method for marketing expensive kits and supplements.

Taken from the Network of Young Scientists 'Debunking Detox" flyer

Why detox?

Many detox products refer to the large number of toxins – from cigarette smoke, exhaust fumes and pesticides to caffeine, alcohol and medicinal drugs – that our bodies are exposed to in today’s world. They talk of how toxins accumulate in the body, and of the extra burden this places on the body’s natural detoxification mechanisms. And they point the finger at this toxic overload as being behind a host of ills including constipation, bloating, flatulence, poor digestion, heartburn, diarrhoea, lack of energy and fatigue (2).

Claims on detox products include “stimulate your body’s natural detoxifying functions”, “improve the functioning of your digestive system”, “work like an intestinal broom”, “flush away potentially harmful toxins from your system” and generally give your body a “spring clean” and “improve your general health and wellbeing “and leave you feeling “revitalised” (2).

Does detox work?

Conventional detox can be life saving, however in alternative medicine, detox is a scam (1). In 2005, Choice (Australia’s consumer watch dog) conducted a study of 7 detox kits and concluded that, “Detox supplements provide little or no known benefit over a healthy diet. A week or two on a detox program won’t absolve you from a year of unhealthy eating, smoking or drinking too much alcohol. We suggest you save your money.” For full details see the report here.

Taken from the Network of Young Scientists 'Debunking Detox" flyer

Furthermore, a 2009 report from the Voice of Young Science Network (VoYS) and published by Sense about Science UK, reviewed 15 products from bottled detox-water to face scrub and concluded that “…at worst, some detox diets could have dangerous consequences and, at best, they were a waste of money”. You can read the full detox dossier here.

This report was the topic of a discussion between Dr Ben Goldacre (of the excellent BadScience column and website ) this week and the managing director of Detox-in-a-Box on the Today programme on Radio BBC 4. When asked if we ever need to detoxify, Dr Goldacre responded with an emphatic “No”. He went on to explain “..it is a purification ritual, it’s symbolic. The idea that you can fix things in just a month of healthy eating…is…dangerous because it means that people will imagine they are doing something quite useful for their lives when actually they’re not.” And in the words of Simon Singh and Edzard Ernst from their book Trick or Treatment; “the only substance that is being removed from a patient is usually money” (1).

Detox products that deserve ridicule

Detox foot pads

This gem is based on the concept that “toxins” can be removed through the soles of your feet. Now please. Just stop and think about this. The human body is well equipped with organs whose primary role is to get rid of waste products. You may have heard of them; the liver, the kidney and the skin, NOT THE FEET. Seriously, is science literacy so bad and are humans so gullible that we spend money on this stuff? My advice is, just don’t.

Here’s a brief overview of what how this thing “works”. Foot pads are like nappies or diapers for your feet. A pouch, reminiscent of a tea bag, containing a mixture of dried ingredients is secured to the soles of your feet usually overnight. When you wake up in the morning and peel of the pads, they will appear brown and sticky. Manufacturers will tell you the brown sticky stuff are the “toxins” which seeped out of your feet whilst you slept. If it sounds too good to be true that you can detox in your sleep, that’s because it is.

Foot pads contain various ingredients, including wood/sap or tree vinegar and hydrolysed carbohydrate or starch. Wood vinegar (or any other name) is a by-product of wood combustion and is highly hydroscopic, meaning it attracts and absorbs moisture readily (a little like silica beads which you find in foods to absorb moisture) upon which it turns brown. The sticky feeling described on the packaging is none other than the hydrolysed carbohydrate or sugar, which upon becoming wet feels sticky. As you can imagine, when these things are stuck to your feet overnight, you wil perspire. A recent investigation into foot pads by the NoYS reported this response from customer service upon enquiring about the reason for the foot pads turning brown and sticky; “Yes, the footpads turning brown is due to the ingredients getting wet...”(3).

Colonic irrigation

Enemas, colonic irrigation, colon hydrotherapy or colonics are marketed as a deep, whole-system cleansing method designed to remove toxins from intestine and “cleanse our body’s elimination system“. This treatment is sometimes administered with coffee (made popular by celebrities) or with various herbs. Based on the popular misconception that toxins build up over time in our bodies, this treatment is supposed to be effective against gastrointestinal disorders, migraine, obesity, allergies, bloating, cramping pains, acne and other skin complaints, arthritis and many other chronic conditions including chronic fatigue syndrome. Treatment involves insertion of a narrow tube via the rectum and flushing with considerable amounts of fluids. The fluid is flushed out through a viewing tube, so that what is eliminated may be monitored (nice!).

There is no scientific evidence that colonic irrigation has any benefit, as previously stated our bodies are perfectly equipped to eliminate toxins through various physiological processes. There have been reports of colonic irrigation causing harm by perforating the bowel or depleting the body of electrolytes. I can’t understand why anyone would voluntarily place a tube up their bottom and want to examine the resulting deposits; it’s a waste of money and a hazard to your health (1).

Is detox safe?

If these products do nothing then there’s no harm in detox right? Not necessarily. Many detox kits or detox diets involve several facets, such as pills, drinks, exfoliants and may even include a booklet advising about exercise and increasing fluid intake. Many of them recommend increasing the amount of water you consume, under the false pretence that this will assist your liver with detox and flush your system.

In July 2008, an English court awarded a woman 800,000 pounds after she suffered permanent brain damage whilst on a detox diet. Dawn Page began vomiting uncontrollably after commencing “The Amazing Hydration Diet” in 2001 and later suffered a seizure which damaged her memory, speech and concentration. She was diagnosed with hyponatraemia, a condition involving dangerously low salt concentrations induced by excessive water consumption.

Hyponatraemia or water intoxication occurs when a person drinks too much water, diluting salts and electrolytes in the blood which can then essentially “flood” cells and tissues. All cells in the body are bathed in a “salty” environment, but if the outside fluid becomes more dilute, it can rush inside the more salty cells, essentially flooding them and causing them to burst. In extreme cases, this causes organs such as the brain to swell up, and can stop it working properly, putting the drinker in serious danger.

In an article from the BBC entitled “The Dangers of too much detox Professor Graham McGregor of St George’s University of London “In normal circumstances, when people should drink when their body tells them to – when they get thirsty. Anything else is completely unnecessary, and will just leave you standing in the queue for the toilet. Detox diets are a complete con in that respect.”

Some people are a little slow to catch on it would seem. Here’s a quote from naturopath Spiro Sindos from the Naturopath Practitioners Association taken from an interview on the breakfast magazine-show Sunrise in Australia. Listen to his response about what detox is; “…what you’re trying to do is clean your body out I suppose, is the best way to put it, the best way to do that is to improve your diet, improve your lifestyle and drink copious amounts of water”. Ummm, Spiro, drinking copious amounts of water can kill you. I guess that sorts out your detox, when you’re dead you won’t need to bother.

Taken from the Network of Young Scientists "Debunking Detox" flyer

Should we detox?

The short answer is no. The bottom line is that no studies have shown that a detox regimen increases the elimination of toxins (4). As Trick or treatment reminds us; “Detox, as an alternative medicine is based on ill-conceived ideas about human physiology, metabolism and toxicology. There is no evidence that it does any good and some treatments such as colonic irrigation (enemas) and chelation therapy can be harmful”.

If you’ve overindulged this silly season, the best thing you can do is eat fresh fruit and vegetables, get some sleep, drink some water and stay off the booze and fags. Just like most things in life there is no quick fix for detox.

Further reading and references

(1) Trick or Treatment: alternative medicine on trial. Simon Singh and Edzard Ernst, 2008, Bantam Press, London, UK.

(2) choice.com.au

(3) Bad Science. Ben Godacre, 2008, Forth Estate, London, UK.

A recent article from Fairfax press about one person’s experience with a 10 day post-Christmas detox

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