Do you really need to detox?

Consumer Reports on Health: January 2009

Place a Kinoki footpad on the sole of your foot before bed, "and by morning the pad will have collected toxins from your body." Or so said one ad for this widely advertised product.

Problem is there's no good evidence to back up the promise. And the ad is hardly the only one to make dubious claims about a product's ability to "detoxify" the body. Indeed, proponents of detoxification often make sweeping statements "for which there is no substantive evidence," says Robert S. Baratz, M.D., Ph.D., president of the National Council Against Health Fraud.

Our medical consultants question whether the body even needs detoxification. "The notion that you can and should flush out your arteries or your intestines may seem plausible. but it's not," says Edzard Ernst, M.D., Ph.D., professor of complementary medicine at Peninsula Medical School in Exeter, England.

For example, many people think that the liver and kidney act as physical filters that trap potential toxins, such as alcohol, drugs, and other chemicals—hence the idea that you can detoxify them by fasting, for example, or by taking certain supplements. And the idea that the body needs to detox, central to traditional medicine in China, India, and elsewhere, has been adopted by some alternative-medicine practitioners in the West.

But science does not support the idea that those organs are lint traps for toxins and require cleaning. Instead, the liver converts toxins into compounds that are eliminated through the bile and urine, and the kidneys separate the substances that the body needs from harmful or unnecessary ones, which they eliminate. Here's our take on three common forms of detoxification.

Detox diets

Fasting for a day or so is generally not harmful and might shake you out of an unhealthy eating pattern. But detox diets often involve severe caloric restrictions for a week or more. Moreover, while some focus on fresh produce and whole grains, others drastically limit the foods you eat. Such diets can lead to nutrient deficiencies, blood-sugar problems, severe diarrhea, nausea, and fatigue.

Colon cleansing

Some people regularly take laxatives or give themselves enemas to prevent supposedly harmful substances from building up in the gut. But those treatments are generally useful only in treating occasional constipation. When administered frequently, laxatives and enemas might prevent normal bowel movements and lead to a potentially deadly depletion of vital electrolytes. Coffee enemas have been linked to several deaths due to extreme electrolyte imbalance and infection.

Even riskier is colonic irrigation, a procedure in which a machine pumps water into the rectum through a sterile tube, flushing out the entire colon. We could find no study to support its use to enhance general health. Moreover, in addition to sharing all the dangerous side effects of laxatives and enemas, colonic irrigation might cause bacterial infections from contaminated equipment, and perforation of the rectum, sometimes even resulting in death.

Chelation therapy

This treatment introduces chemicals into the body that will bind with toxic metals, allowing them to be eliminated during excretion. It has been used since the 1950s to treat acute poisoning from lead and iron. Early uncontrolled studies suggested that it might help treat cardiovascular disease, and proponents say it also helps treat autism, cancer, and diabetes.

But we could find no solid research to support such claims. For example, some practitioners administer the chemical EDTA to try to remove calcium from artery-clogging plaque deposits. But several clinical trials show that chelation therapy is ineffective against leg pain stemming from clogged leg arteries. And research has identified several risks of the treatment, including bone loss, abnormal heartbeat, and death.

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