Happy New Year! Today’s post updates some old – but still relevant – material.

New Year, New You, right? It’s 2023. It’s hard to believe that we’re entering the fourth year of the pandemic. Resolutions are popular this time of year – particularly in the first week of January where you may still be enjoying some holidays, contemplating your plans for the year. This year’s theme, you decide, will be to get serious about your health. You’re another year older, after all.

But first, you need to cleanse yourself, eliminating 2022’s lifestyle and dietary sins. Supplements, tea, homeopathy, coffee enemas, ear candles, and footbaths all seem to promise better health. Amazon has entire detox and cleansing categories in supplements and books. The descriptions suggest detoxing will deliver a cleaner, healthier body. Goop has 383 articles tagged detox, which is a slightly more that this blog. Wouldn’t a purification from 2022 be a good way to start the year? Before you buy anything, there’s something very important that the detox promoters aren’t telling you.

Detox is a scam

“Detox” is a case of a legitimate medical term being turned into a marketing strategy – all designed to treat a nonexistent condition. In the setting of real medicine, detoxification means treatments for dangerous levels of drugs, alcohol, or poisons, like heavy metals. Detoxification treatments are medical procedures that are not casually selected from a menu of alternative health treatments, assembled from your spice cupboard, or pulled off the shelf at a health food store. Real detoxification is provided in hospitals when there are life-threatening circumstances.

The “toxins” that detox advocates claim to cleanse are another thing entirely. This form of detoxification is simply the co-opting of a real term to give legitimacy to useless products and services, while confusing consumers into thinking they’re science-based.

Detox search trends on Google spike reliably every January.

While detox searches trend every January, should we take the gradual decline as a positive trend?

One of the widely promoted ideas about “detox” is that it acts like some sort of cleaner for your organs. Detox marketing describe your liver and kidney as acting like filters, where toxins are physically captured and retained. It’s argued that these organs need to be cleaned out periodically, like you’d rinse out a sponge, or change the air filter in your house or car. But the reality is, the kidney and liver don’t work this way. The liver performs a series of chemical reactions, using enzymes, to convert toxic substances into ones that can be eliminated from the body through the bile or the kidneys. The liver is self-cleansing – toxins don’t accumulate in it, and unless you have documented liver disease, it generally functions fine. The kidney excretes waste products into the urine – otherwise the substance stays in the blood. To argue that either organ need a “cleanse” simply demonstrates a lack of understanding in biochemistry. Your organs will be fine without that supplement, smoothie, or fad diet. Just leave them alone.

Image via @statsguyuk

But toxins!

There’s a reason we can be sucked in by the marketing of detoxification — we seem hardwired to believe we need it, perhaps related to our susceptibility to ideas of sympathetic magic. Purification rituals date back to the earliest reaches of recorded history. The idea that we’re somehow poisoning ourselves and we need to atone for our sins seems to be a part of human nature, which may explain why it’s still a part of most of the world’s religions. It’s not miasmas or sin that we’re as worried about today, however. As our knowledge of biology grew, these fears manifested as “autointoxication“, to be treated with colonics and purgatives. Clean out the bowels, went the theory, and you could cure any illness. Science discarded autointoxication by the 1900s as we gained a better understanding of anatomy, physiology, and the true cause of disease. Yet the term persists today – but now it’s a marketing slogan. Today’s version of autointoxication argues that our environment is increasingly toxic, and it’s making us ill. Man-made chemicals are absolutely in our environment, so the reasoning goes that it must be making use sick. Depending on who you ask, some combination of food additives, salt, meat, fluoride, prescription drugs, smog, vaccine ingredients, GMOs, not “eating clean”, or perhaps not “eating paleo” are causing a buildup of “toxins” in the body. So what is the actual “toxin” that is causing you vague but apparently real harm? Detox kits and treatments never name the toxins that they remove, because they’ve never been shown to actually remove toxins.

Alkali anything is a scam

The idea that our body’s acidity needs monitoring and adjusting is regularly promoted by “alternative” health providers. There is the persistent belief that anything that makes the body “acidic” is bad and anything basic or “alkali” is good. But all of this is nonsense, designed to confuse you about basic biochemistry. The pH scale is a measure of the acidity of a liquid. A pH of 7 is neutral. Anything lower is called acidic, anything higher is basic, or alkaline. The pH is a logarithmic scale – that is, a difference of 1 pH is a 10x difference.

Our blood’s pH is 7.4 – slightly alkaline or basic. Enzymes that facilitate chemical reactions in the cells work only in a narrow range of pH. Any significant change means almost certain death. A series of buffers and compensation mechanisms keep the pH in our blood from moving far from 7.4. Because the blood circulates throughout the body constantly, it can compensate any changes in pH in any of our organs (e.g., our muscles during intense exercise). Carbon dioxide (CO2) is the most prevalent acid in our body, and is a product of cellular activity. The blood carries CO2 away and eliminates it in the lungs. The lungs actually provide the biggest source of acid elimination in our body.

Everything we eat is broken down by stomach acid. The pH in our stomach is about 3 – very acidic, due to production of hydrochloric acid. Everything that is ejected from our stomach, into our intestines, is then immediately neutralized by digestive liquids and enzymes. The net effect is that everything we eat or drink and digest will eventually be at the pH in our intestines. Nothing you eat or drink will have a significant effect on the pH of food once it reaches your intestine to be absorbed. And claims that “acidity is the root of all disease” are without basis, reflecting a lack of understanding of basic physiology and biochemistry. If your detox claims to “restore” your acid-base balance, or is supposed to make you more “alkali” – it’s a sure sign of a scam.

What about coffee, but not the kind you drink?

A coffee enema – almost, but not quite, totally unlike tea.

Consuming coffee for the vast majority of people is safe and possibly even beneficial. However, there is the persistent alternative health belief that the real benefits of coffee are realized when you flush it into your rectum. Despite the hype, coffee enemas are considered unsafe and should be avoided. Rare but serious adverse events like septicemia (bacteria in the bloodstream), rectal perforation, and electrolyte abnormalities have been caused by coffee enemas. Deaths from the administration of coffee enemas have been reported.

Coffee enemas have their roots as part of the “Gerson Treatment” for cancer, developed by physician Max Gerson in the 1940s. His regimen included coffee enemas, supplements, juice, and injections of calf liver. The approach has been investigated and been shown to be useless for the treatment of cancer. Some proponents of coffee enemas believe that the chemical components of coffee stimulate liver and gall bladder function. There is no credible evidence to suggest this occurs, or that it is necessary.

There are no quick fixes

The hardwiring of “purity” and “contamination” fears in the human brain means we are unlikely to ever be rid of scams like “detox”. The idea that we’re somehow poisoning ourselves (some even believe that the COVID vaccines are poisonous) and we need to atone for our sins seems to be a part of human nature. Popular ideas of detoxification and cleansing have no basis in reality. There’s no published evidence to suggest that detox treatments, kits or rituals have any effect on our body’s ability to eliminate waste products effectively. “Detox” focuses attention on irrelevant issues, giving the impression that you can undo lifestyle decisions with quick fixes. Improved health isn’t found in a box of herbs, a bottle of homeopathy, or a bag of coffee flushed into your rectum. The lifestyle implications of a poor diet, lack of exercise, smoking, lack of sleep, and alcohol or drug use cannot simply be flushed or purged away. Our kidneys and liver don’t need a detox treatment. If anyone suggests a detox or cleanse to you, remember that you’re hearing a marketing pitch for an imaginary condition.

Author

  • 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.