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charcoal lemonade2Our diet is either the cause of, or solution to, all of life’s problems. I’m paraphrasing a great philosopher. We just can’t seem to let food be food. Today each ingredient we eat seems to be demonized or glorified. Gluten is the latest evil. It used to be fat. At some point in the past, it was MSG. Or it’s a superfood, preferably local, organic and GMO-free. Even on the healthiest diet, however, we’re apparently still ingesting too many harmful chemicals. After all, this is apparently a toxic environment we live in. Gwyneth Paltrow says so. So does the Food Babe. In an era of daily television quackery and loony internet health conspiracy websites, one might think that bizarre food ideas are a recent phenomena. But worries that we’re being poisoned from within are probably innate. One of the oldest surviving written documents is an Egyptian papyrus from the 16th century BCE that linked the cause of disease to digestive wastes in our colon. Since that time, our scientific knowledge about the cause of disease has advanced, but the underlying obsession with diet and elimination hasn’t waned. Anecdotally, it seems to be growing. The idea that our bodies need to “detox” is thriving, despite the fact that it has no scientific basis or validity. Part of the modern appeal of “detox” may be that detoxification is a legitimate medical term and treatment. However, in the alternative-to-health perspective, the word has been co-opted, but the science part has been ignored. Fake “detox” is easy. And now proponents of “detox” have taken it one step further. They’re using real medicine for a fake “detox” with. That’s how activated charcoal has become the latest health fad.

The popular use of charcoal got a big boost in 2014. After Gwyneth Paltrow’s magazine “Goop” named charcoal lemonade as one of the “best juice cleanses”, the idea of socially consuming charcoal really took off. If you spot someone drinking what looks like a bottle of ink, it could be “lemonade with activated charcoal” made with “alkali” water and sweetened with cane sugar. All this for just $8.99 for 500mL, making this fad a pretty costly one.

Paraphrasing another philosopher, if you integrate fantasy with reality, you do not instantiate reality. And when you add charcoal to lemonade, it doesn’t make your lemonade tastier, or healthy. Nor does it give a beverage any magical properties. It gives you black, gritty, gag-inducing lemonade that is in all likelihood even less nutritious than plain lemonade. So how did someone arrive at the idea that adding charcoal to lemonade might be a good idea? It’s based on the popular, but baseless ideas about the toxins that are apparently harming us.

True poisoning can be very real. “Detox” is pure marketing.

What’s popularly called a “detox” today has nothing to do with actual medical detoxification. In the setting of real medicine, detoxification means treatments for dangerous levels of drugs, alcohol, or poisons, like heavy metals. Real detoxification is a treatment for a medical emergency, when a poisoning may be life-threatening. Real detoxification isn’t something you contemplate based on a menu. You don’t order real detoxification treatments at juice bar, and it’s not delivered in smoothie format.

Fake detox, the kind you find in magazines, and sold in pharmacies, juice bars, and health food stores, is make-believe medicine. The use of the term “toxin” in this context is meaningless. There are no toxins named, because there’s no evidence that these treatments do anything at all, but it sounds just scientific enough to be plausible.

The fact is that we are constantly exposed to a huge variety of chemicals, both natural and synthetic. Given many naturally-derived substances can be exceptionally toxic, we evolved a remarkable system of defenses and mechanisms to remove unwanted substances. The skin, kidneys, lymphatic system, our gastrointestinal system, and most importantly, the liver make up this sophisticated system.

But there’s no question that those defences can be overwhelmed. In the setting of real poisonings, activated charcoal is one treatment that’s used to reduce the risk of harmful effect. Whether or not something is a “poison” depends on the dose. Acetaminophen is remarkably safe at appropriate doses yet causes almost-certain fatalities in overdoses.

Activated charcoal is a medicine and drug sponge. It’s not absorbed into the body, and is put into the gastrointestinal tract to reduce the absorption of drugs and other poisons after they have been ingested, but before they have been absorbed into the body (scientifically speaking, the contents of the mouth, throat, stomach, large and small intestine and rectum are considered “outside of” the body). While the overall effectiveness of charcoal isn’t well documented for all drugs and poisons, it has become a routine part of poisoning protocols. Huge doses of activated charcoal are given with the intent of clearing the harmful substance out of the gastrointestinal tract.

Activated charcoal is produced by heating wood (or another high-carbon product) to high temperatures, and then oxidizing it. The fine particles that remain are almost pure carbon, and the resulting structure has an enormous surface area. The preparation process gives the charcoal the ability to absorb various chemicals to its surface. This is why you’ll see charcoal as a routine ingredient as a filtering agent in commercial and household use, ranging from gas masks to water filters. Depending on the production process, its ability to absorb different chemicals can be made to vary.

Compared to real detoxification protocols, the amount of charcoal added to charcoal lemonade products is small. Given it’s more for aesthetics and marketing than any actual medicinal effects, ingesting charcoal should be well-tolerated with few side effects. It’s not entirely without potential negative consequences, especially when added to a regular diet (or even combined with juice). Activated charcoal doesn’t discriminate between the healthful chemical components of food, and any unwanted chemicals in the digestive system. Activated charcoal appears to bond vitamins like ascorbic acid (vitamin C), niacin, pyridoxine (vitamin B6), thiamine (vitamin B1) and biotin, so it has the potential to make food and drinks you consume actually less nutritious, not more.

Despite the marketing hype, activated charcoal has no ability to suck out the toxic chemicals from the rest of your body. Its effects are limited to the gastrointestinal tract only, and it’s been studied in poisoning situations only. There’s no evidence to demonstrate that the everyday consumption of activated charcoal is either beneficial or helpful in any way.

Charcoal lemonade does seem to have one profound effect though. At $9 per pint, the product does seem very effective at removing cash from the wallets of unsuspecting consumers. As I have noted before, if you hear the words “detox” uttered anywhere but an emergency room, keep in mind that you’re being marketed to.

 

 

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  • Scott Gavura, BScPhm, MBA, RPh is committed to improving the way medications are used, and examining the profession of pharmacy through the lens of science-based medicine. He has a professional interest is improving the cost-effective use of drugs at the population level. Scott holds a Bachelor of Science in Pharmacy degree, and a Master of Business Administration degree from the University of Toronto, and has completed a Accredited Canadian Hospital Pharmacy Residency Program. His professional background includes pharmacy work in both community and hospital settings. He is a registered pharmacist in Ontario, Canada. Scott has no conflicts of interest to disclose. Disclaimer: All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations that he may be affiliated with. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.

Posted by Scott Gavura

Scott Gavura, BScPhm, MBA, RPh is committed to improving the way medications are used, and examining the profession of pharmacy through the lens of science-based medicine. He has a professional interest is improving the cost-effective use of drugs at the population level. Scott holds a Bachelor of Science in Pharmacy degree, and a Master of Business Administration degree from the University of Toronto, and has completed a Accredited Canadian Hospital Pharmacy Residency Program. His professional background includes pharmacy work in both community and hospital settings. He is a registered pharmacist in Ontario, Canada. Scott has no conflicts of interest to disclose. Disclaimer: All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations that he may be affiliated with. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.