Detox, short for detoxification, is the practice of removing toxins from the body. The most common forms of detox are liver cleansing and colon cleansing. Most doctors consider detox therapies to be pseudoscience, based on a misunderstanding of basic biology.
Moreover, mainstream doctors view detox products as either a waste of money or potentially harmful.
The practice remains widespread, proffered by testimonials and promoted on countless websites. Advocates of detox therapies start with the premise that the body accumulates toxins that can cause cancer and other diseases. Regularly cleansing oneself of such toxins purportedly reduces the risk of disease and endows one with a feeling of good health, more radiant skin, and having more energy.
It should be pointed out that detoxification as described here is different from the practice used in substance abuse treatment. According to the Center for Substance Abuse Treatment, detoxification "refers to a set of interventions aimed at managing acute intoxication and withdrawal." Supervised detoxification may prevent potentially life-threatening complications that might appear if the patient was left untreated. It is a process with three essential components: evaluation, stabilization and fostering the patient's entry into treatment.
The truth about toxins
First, a note on toxins. A toxin is a poison; yet toxicity — the degree to which something is poisonous — is based on dose. Most toxins in the body are not concentrated enough to be toxic, or actually harmful. Conversely, virtually any chemical, including water, is toxic (or deadly) at some dose.
It is true that the human body accumulates toxins from ingesting food, water and air. And, in this modern world of humanmade chemicals and industrial practices, alarming levels of toxins circulate in our bodies. Scientists aren't sure if this chemical soup inside us is harmful or, if so, how harmful. More worrisome, no one is immune, not even people living in remote areas.
What is clear, however, is that detox schemes — such as fasting or extreme juicing or herbal cleaning solutions — do not seem to make any difference in removing toxins. This might be a good thing, because a sudden, true release of toxins from where they were stored could send the body into shock.
Meet the liver
The body's main defense against toxins is the liver. Everything you breathe or swallow that is broken down and absorbed into the bloodstream passes through the liver. The body depends on the liver to regulate, synthesize, store, and secrete many important proteins and nutrients and also to purify, transform, and clear toxic or unneeded substances.
While the liver does detoxify the blood — turning potentially harmful chemicals into water-soluble chemicals that can be sweated or excreted — the organ does not function like some sort of lint screen that becomes saturated with intercepted toxins needing to be shaken loose.
That is, viewed from biology, there's no such thing as liver cleansing. Toxins might be completely or partially detoxified; they might pass through the liver again and again. But they do not accumulate in the liver. Exceptions would be with vitamin A, iron and copper, but this is rare and is a sign of liver disease.
At best, one could argue that so-called liver cleansers might help the liver function better to remove toxins. There are no convincing studies to support such claims, although some studies support the notion that dandelion and milk thistle promote liver health. [Related: Saucy Science: How to Flush Out a Hangover]
Meet the colon
Colon cleansing is on much shakier ground. Doctors at Georgetown University in Washington, D.C., in 2011 conducted a comprehensive review of the medical literature and found absolutely no scientific support of the practice of detoxifying the colon.
The notion that the colon is a cesspool of toxins is ancient … and logical, considering what empties from the colon. But as with the liver, the colon does not accumulate toxins. Again, the biology just isn't there.
First, hardened fecal matter doesn't get stuck in the colon the way, say, plaque builds up in the arteries. Any gastroenterologist will tell you this. The colon is too moist and flexible to allow this. So, this alone rules out two main claims offered by advocates of colon cleansing: that fecal matter traps toxins, and that fecal matter blocks absorption of nutrients (which happens in the small intestine, anyway).
Minus the fecal matter, there's still no reason why toxins, upon an imminent flush from the body, would suddenly be attracted to the walls of the colon.
Colon cleansing is not without its dangers, though. What you are washing away might very well be beneficial bacteria aiding in digestion. Also, with routine cleansing, the colon and rectum can lose the ability to generate proper bowel movements, and one can become dependent on enemas.
The most common side effects are nausea, vomiting, diarrhea and abdominal pain. Depending on the cleansing solution and amount of water used, patients can experience a dramatic loss of electrolytes. Case reports document serious medical conditions, such as kidney and liver failure, air emboli, rectal perforations, blood infections, and death from dysentery.
Meet the fat cell
A third, general detoxification scheme is done with fasting, juicing, swallowing an herbal solution or eating a raw diet.
In short, there are no foods or herbs that magically bind and pull toxins from your blood or organs. The toxins maintain many chemical forms, after all; and there's no reason why a so-called natural detox solution could locate and extract all that is harmful in a body and leave all that is good.
The raw, vegan diet — said to be detoxifying — offers an instructive example. The diet would imply that all raw, vegan species — cows, rabbits, and so own — are toxin-free. But they are as toxin-laden as humans. (And indeed, some vegans voice concerns about the toxins in beef and milk).
The most logical argument here is that fasting or juicing will help burn fat cells, which are known to contain toxins. Yet the body burns the fat in the fat cell, not the whole cell itself. Fat cells shrink; they usually don't disappear. If they did — as in a case of extreme starvation — doctors aren't sure what would happen to the toxins within.
The toxins wouldn't just fall out of the body but rather likely go through the liver again. It may be that a sudden release of toxins, accumulated slowly over the years and stored relatively safely in fat cells, could overpower the liver and cause serious damage.
The best advice to lower your toxic load is to reduce your exposure to toxins (smoking, urban pollution, unnecessary medication), maintain a healthful diet, and drink plenty of fluids to allow the kidneys, liver, lungs and sweat glands to do their job in eliminating as many toxins as possible.