The dubious practice of detox By Harvard Women's Health Watch
Posted: May, 2008; updated October 17, 2021; No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Internal cleansing may empty your wallet, but is it good for your health?
Spring usually makes us think of cleaning — putting our records in order
for the tax season, emptying our closets of winter coats, and readying our
gardens. As if those chores aren't enough, we're now hearing that our bodies
need a thorough internal cleansing as well. A growing number of
infomercials, Web sites, and print articles are urging us to eliminate the
systemic buildup of toxins that supposedly results from imprudent habits or
exposure to hazardous substances in the environment. Such toxins, we're
told, will sap our vitality and threaten our health unless we take measures
to "detox" ourselves.
This message isn't new. For thousands of years, human beings have been
trying to rid their bodies of perceived toxins. Native Americans have long
used various forms of ritual cleansing and purification, such as the
sauna-like sweat lodge. Bloodletting, enemas, and fasting were regarded as
legitimate medical therapies until the early 20th century. Today's renewed
interest in self-administered detoxification reflects concern about a
variety of things, such as emerging pathogens, lead in toys, mercury in
fish, smog in the air, pollutants in rivers and lakes, tainted beef,
pharmaceuticals in the water supply, and synthetic chemicals with unknown
properties. But do detox practices really offer the benefits claimed for
them?
What is detox?
Before it was co-opted in the recent craze, the word "detox" referred
chiefly to a medical procedure that rids the body of dangerous, often
life-threatening, levels of alcohol, drugs, or poisons. Patients undergoing
medical detoxification are usually treated in hospitals or clinics. The
treatment generally involves the use of drugs and other therapies in a
combination that depends on the type and severity of the toxicity.
The detox programs now being promoted to the health-conscious public are
a different matter. These are largely do-it-yourself procedures aimed at
eliminating alleged toxins that are held responsible for a variety of
symptoms, including headache, bloating, joint pain, fatigue, and depression.
Detox products are not available by prescription; they are sold in retail
stores, at spas, over the Internet, and by direct mail. Many are advertised
as useful for detoxifying specific organs or systems; others are portrayed
as "whole body" cleansers. Here is a review of some of the most widely
promoted procedures and products.
Nasal irrigation
Also known as Jala Neti or nasal lavage, this yoga-derived technique
involves the use of a small pitcher (neti pot) or syringe to stream a saline
solution into first one nostril, then the other. The solution passes through
the nasal passage and out the other nostril or the mouth.
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Purpose. Clinicians sometimes recommend nasal irrigation to
rid the nose of environmental irritants, alleviate post-nasal drip, and
reduce congestion from colds and allergies by flushing mucus, foreign
particles, bacteria, and viruses out of the sinuses. Daily nasal
irrigation is promoted for preventing sinus infections and headaches.
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Evidence of effectiveness. In a handful of studies, nasal
lavage has been shown to lower bacterial concentrations in nasal
passages. One small study found that it eased symptoms in sinus
sufferers. Some research suggests it can reduce the risk of sinus
infections.
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Risks. Fluid buildup in the sinuses.
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Cost. Syringes and pitchers range from $4 to $300.
Detox diets
A seemingly infinite array of products and diets is available for
detoxifying the entire body. One of the most popular is the Master Cleanse
diet, favored by a number of Hollywood celebrities. Dieters take a quart of
warm salt water in the morning; consume a 60-ounce concoction of water,
lemon juice, maple syrup, and cayenne pepper throughout the day; and finish
with a cup of laxative tea in the evening. Proponents of the Master Cleanse
diet recommend adhering to it for at least 10 days.
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Purpose. To restore energy, lose weight, and relieve
symptoms of chronic conditions like arthritis and fibromyalgia.
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Evidence of effectiveness. There are no data on this
particular diet in the medical literature. But many studies have shown
that fasts and extremely low-calorie diets invariably lower the body's
basal metabolic rate as it struggles to conserve energy. Once the dieter
resumes normal eating, rapid weight gain follows. Much of the weight
loss achieved through this diet results from fluid loss related to
extremely low carbohydrate intake and frequent bowel movements or
diarrhea produced by salt water and laxative tea. When the dieter
resumes normal fluid intake, this weight is quickly regained.
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Risks. The diet is lacking in protein, fatty acids, and
other essential nutrients. Carbohydrates supply all the calories — an
extremely low 600. The daily laxative regimen can cause dehydration,
deplete electrolytes, and impair normal bowel function. It can also
disrupt the native intestinal flora, microorganisms that perform useful
digestive functions. A person who goes on this diet repeatedly may run
the risk of developing metabolic acidosis, a disruption of the body's
acid-base balance, which results in excessive acidity in the blood.
Severe metabolic acidosis can lead to coma and death.
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Cost. The price of the book and a handful of food items.
Intestinal cleansing
Numerous kits are marketed for this purpose, most of which include a
high-fiber supplement, a "support" supplement containing herbs or enzymes,
and a laxative tea, each to be used daily. Manufacturers of the herbal detox
kits recommend continuing the regimen for several weeks. Such regimens may
be accompanied by frequent enemas.
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Purpose. The aim is to eradicate parasites and expel fecal
matter that allegedly accumulates and adheres to the intestinal walls.
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Evidence of effectiveness. Several studies suggest that milk
thistle, which is often included as a supportive supplement, may improve
liver function with few side effects. But there's no medical evidence
for the cleansing procedure as a whole. Promotional materials often
include photographs of snake-like gelatinous substances expelled during
cleansing. When these pictures are not faked, they are probably showing
stool generated by large doses of the regimen's fiber supplement. More
important, the rationale for intestinal cleansing — to dislodge material
adhering to the colon walls — is fundamentally mistaken. When fecal
matter accumulates, it compacts into firm masses in the open interior of
the colon; it does not adhere to the intestinal walls as the "sludge"
depicted in the advertisements.
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Risks. Like fasting, colonic cleansing carries a risk of
dehydration, electrolyte imbalance, impaired bowel function, and
disruption of intestinal flora.
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Cost. A month's supply of the supplements and laxatives sold
on most Web sites is $20 to $70. The manufacturers recommend continuing
the procedure for two to three months.
Foot detox
One method employs a special type of adhesive pad worn on the bottoms of
the feet during sleep. Another approach is to immerse the feet for 30
minutes in a basin, sometimes referred to as an "ionic foot bath,"
containing salt water and two electrodes that supply a low-voltage electric
charge.
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Purpose. Toxins are allegedly drawn out of the body through
the soles of the feet.
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Evidence of effectiveness. Both methods claim to emit ions
that stimulate the outflow of toxins through the feet. The pads contain
tourmaline crystals, which are purported to emit ion-generating infrared
rays. The foot baths allegedly generate ions by running an electric
current through salt water. However, there is no scientific evidence
that ionic changes in the environment can stimulate a discharge of
toxins through pores in the feet — or any other part of the body, for
that matter. Promoters assert that the success of the process can be
monitored by a color change in the pad or in the water of the foot bath
as impurities are leached from the body. But the pads, which are
impregnated with wood vinegar, have been shown to turn the same dark
color whether they absorb foot perspiration or are sprayed with tap
water; and the color of the foot bath changes because the metal
electrodes corrode.
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Risks. No ill effects on health have been reported for
either method.
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Cost. Single-use pads average $1. Ionic foot bath sessions
are available at spas for $40 to $50. Ionic foot bath devices are sold
online at prices ranging from $85 to $2,000.
Oxygen detox
Air containing an 85% to 95% concentration of oxygen is delivered through
a mask or nasal tube.
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Purpose. Concentrated oxygen is said to boost the immune
system, relieve headaches, increase energy, and improve cognitive
function.
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Evidence of effectiveness. Pressurized oxygen has long been
used in treating people with respiratory distress or chronic lung
conditions like emphysema, because their lungs cannot extract enough
oxygen from normal air. Since the late 1990s, detox spas and oxygen bars
have been marketing a short version of the treatment to healthy people.
There is no evidence that healthy lungs need more oxygen than is
contained in normal air to supply the body with adequate oxygen. (The
FDA has warned that it is illegal to administer oxygen from a tank
without a prescription, but most states have failed to enforce the
ruling, enabling oxygen bars to thrive.)
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Risks. Although there is little danger from inhaling
concentrated oxygen, the FDA cautions against "flavored" oxygen, which
may contain fragrant oil suspensions that can irritate the lungs.
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Cost. Sessions last 15 to 20 minutes and cost about $1 per
minute. Some establishments require users to buy or bring their own
masks or nasal tubes.
The body's own detox system
We tend to forget that the body is equipped with a detoxification
system of its own, which includes the following:
The skin.
The main function of the body's largest organ is to provide a
barrier against harmful substances, from bacteria and viruses to
heavy metals and chemical toxins. The skin is a one-way defense
system; toxins are not eliminated in perspiration.
The
respiratory system. Fine hairs inside the nose trap dirt
and other large particles that may be inhaled. Smaller particles
that make it to the lungs are expelled from the airways in mucus.
The immune
system. This exquisitely orchestrated network of cells and
molecules is designed to recognize foreign substances and eliminate
them from the body. Components of the immune system are at work in
blood plasma, in lymph, and even in the small spaces between cells.
The
intestines. Peyer's patches — lymph nodes in the small
intestine — screen out parasites and other foreign substances before
nutrients are absorbed into the blood from the colon.
The liver.
Acting as the body's principal filter, the liver produces a family
of proteins called metallothioneins, which are also found in the
kidneys. Metallothioneins not only metabolize dietary nutrients like
copper and zinc but also neutralize harmful metals like lead,
cadmium, and mercury to prepare for their elimination from the body.
Liver cells also produce groups of enzymes that regulate the
metabolism of drugs and are an important part of the body's defense
against harmful chemicals and other toxins.
The kidneys.
The fact that urine tests are used to screen for drugs and toxins is
a testament to the kidneys' remarkable efficiency in filtering out
waste substances and moving them out of the body.
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The bottom line
The human body can defend itself very well against most environmental
insults and the effects of occasional indulgence (see "The body's own detox
system"). If you're generally healthy, concentrate on giving your body what
it needs to maintain its robust self-cleaning system — a healthful diet,
adequate fluid intake, regular exercise, sufficient sleep, and all
recommended medical check-ups. If you experience fatigue, pallor,
unexplained weight gain or loss, changes in bowel function, or breathing
difficulties that persist for days or weeks, visit your doctor instead of a
detox spa.
Commentary by researcher/author Dr. Walter Sorochan: Although Harvard Women's Health Watch does point that the human body has a built-in detoxification system, they omitted the most important part of body detoxification .... how the lymphatic system and exercise causing muscles surrounding the lymphatic vessels to contract, thereby squeezing out the lymph fluid and all the toxins in it to be excreted into the blood system and then filtered out by the kidneys as urine. This formation is vital to understanding how the detox system works in the body.
Morano, likewise, neglects to mention the lymphatic system.
References:
Harvard Women's Health Watch, "The dubious practice of detox," Harvard NewsLetter, May, 2008; Harvard: Body detox 2008
Morano Marianne E., "Detox Your Body With Exercise," Cancer Schmancer; Morano: Detox with exercise
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