Do you need to detox?

While your body does accumulate toxicants, cleanses (detox diets) aren’t supported by toxicological mechanisms or trial evidence, and they can occasionally be dangerous. Your liver, lungs, kidneys, and other organs work nonstop to “detoxify” you; a diet rich in protein, vegetables, and fruits will provide them with the nutrients they need to function optimally.

Our evidence-based analysis features 38 unique references to scientific papers.

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DETOX juice

If you’re feeling a bit sluggish or looking to kickstart your journey to better health, you’ve likely come across any number of quick-fix detox or cleansing programs that promise to restore vitality.

Such programs can claim to cleanse your whole body or specific organs. They commonly consist of a highly restrictive diet, with a possible array of supplements. The Master Cleanse, for example, prescribes 6–12 glasses of lemonade with maple syrup and cayenne pepper as your only sustenance. According to its creator, this program promotes “the elimination of every kind of disease” and is the most successful healing diet in the world.

If you’re thinking that “every kind of disease” is conveniently vague, you have a point. In 2009, an investigative report of 15 detox-program manufacturers found that none could provide a clear-cut list of the harmful substances being eliminated, and that no two even defined “detox” the same way.

Not only are most commercial detox programs ambiguous, almost none have been tested for their safety or efficacy.[1] Even the National Center for Complementary and Integrative Health states that “there isn’t any convincing evidence that detox or cleansing programs actually remove toxins from your body or improve your health.” They also warn that “some of the products and procedures used in detox/cleansing programs may be harmful to your health” — a warning supported by case reports on kidney damage from a green-smoothie cleanse[2] and liver failure from drinking too much “detox tea”.[3]

Commercial detox programs claim to eliminate harmful substances that accumulate in the body, usually through highly restrictive diet protocols. Those programs, however, are largely untested for their efficacy or safety, and most can’t even agree on a definition for “detox”.

Does your body need detoxification?

It definitely can — just not as detox companies sell it.

The Centers for Disease Control and Prevention’s Agency for Toxic Substances & Disease Registry defines detoxification as “the process of removing a poison or toxin or the effect of either from an area or individual”.

Medically, you need detoxification when you poison yourself with drugs, such as alcohol.

Standard medical detoxification involves shoving 25–100 grams of activated charcoal down your throat every couple of hours to prevent the swallowed chemicals from being absorbed from your gut into your bloodstream.[4][5] The charcoal binds the chemicals, allowing you to poop them out.

But then, can’t you simply take activated charcoal supplements every day “just in case”? No, you can’t, or rather you shouldn’t, because activated charcoal doesn’t differentiate between friends and foes: it will bind vitamins and essential minerals just as readily as it will dangerous chemicals.[6] Moreover, the doses in those pills are well below the 25–100 grams used medically, and activated charcoal can only bind chemicals in your intestinal tract — so not chemicals you’ve already absorbed, and not chemicals in your lungs.

Medical detoxification is warranted only in case of acute poisoning, and should be performed only under medical supervision.

Do you accumulate toxins?

Biohazard dinner plate

The short answer is yes: your body, like that of any animal, can accumulate toxicants (poisons), including toxins (poisons produced by a living organism). This process is called bioaccumulation. Mercury, for instance, is known to accumulate in predator fish and in people who eat those fish,[7] and even our beloved protein powders may not be entirely safe, according to tests run in 2012 and 2018.

Of particular concern are environmental persistent organic pollutants (POPs), a type of toxicant that accumulates in body fat[8]. In the short term, your fat can protect the rest of your body from acute harmful effects such as metabolic and hormonal disruption.[9] Over time, however, your fat releases POPs back into your system, causing low-level chronic exposure that has been associated with metabolic diseases.[8][9]

Your body can accumulate toxins and other toxicants, notably heavy metals, such as mercury, and liposoluble chemicals, such as persistent organic pollutants (POPs).

A side note on POPs and dieting

Few studies on obesity and fat loss consider the role of POPs,[10] yet POPs might help explain why weight loss doesn’t improve everyone’s health equally — in some people, the increased toxic load from POPs offsets the benefits of carrying around less fat.[10] More precisely, an inefficient excretion of the POPs released when dieting may reduce health improvements, as well as increase the risk of weight regain.[11]

Whether POP redistribution results in adverse effects in humans remains to be studied, but some data is suggestive. For example, in those with weight loss induced by gastric bypass surgery, greater serum POPs was associated with lesser health improvements from weight loss.[12] Weight loss induced by regular dieting also leads to an accelerated release of POPs from fat cells into circulation, with the increase in serum POPs being proportional to the weight loss.[13]

Fat loss appears to accelerate the release of POPs from fat cells into circulation, and greater serum POPs correlates with lesser improvements in health biomarkers. However, there is still little research on the role of POPs in obesity and weight-loss interventions.

Detoxing done right

Juicing

Your body has a built-in detoxification system: your lungs and other organs work around the clock to remove harmful substances. Your liver, for instance, transforms noxious chemicals into benign substances that are excreted in the urine (via the kidneys) or feces (via the gallbladder).[14]

There are three ways a realistic detoxification program could work:

1. By decreasing your exposure to known toxicants

Rinsing, peeling when possible, and cooking can reduce the amount of pesticides left on your produce.[15][16]

Organic produce (notably fruit) less often have synthetic pesticide residue than do conventional produce.[17] Trials in adults and children have shown that switching from conventional to organic produce can reduce biomarkers of known harmful pesticide exposure in as little as a week.[18][19]

Alas, organic products are not unilaterally safer than conventional ones: a 2018 test of protein powders revealed that organic ones had about half the amount of BPA (an industrial chemical) but twice the amount of heavy metals.

You could also reduce your exposure to airborne pollutants such as smoke, smog, and chemical fumes. You don’t always get to choose where you live (e.g., rural areas tend to have less air pollution than urban areas[20]), but you can at least reduce pollution accumulation in your home through proper air conditioning and ventilation.[21] You can also, if you live in a smoggy area, wear a face mask — how much it’ll filter will depend on its design, including how well it fits on your face.[22][23]

2. By improving your liver’s ability to metabolize toxicants

Current evidence suggests that some compounds in plant foods can upregulate your liver’s detoxification process and antioxidant activity.[24][25] One such compound is the sulforaphane in broccoli and other cruciferous vegetables, as was shown in humans[26] as well as in rats.[27]

Of the many supplements marketed for liver health, four are supported by strong evidence from human studies: milk thistle, NAC, SAMe, and TUDCA.

3. By enhancing your body’s ability to excrete toxicants

Fiber, especially soluble and/or fermentable, can enhance detoxification both directly and indirectly. Directly, by binding bile and its associated toxins, thus facilitating their excretion. Indirectly, by feeding the bacteria in your digestive tract, some of which create short-chain fatty acids and other metabolites that act on the liver and kidneys to increase their ability to excrete toxicants.[28][29] 

Sweating may help excrete heavy metals,[30] but sauna studies are scarce and rely mostly on subjective assessments, such as questionnaires about quality of life, rather than on objective measures of toxicant burden or excretion.[31] 

Toxicants, notably heavy metals and liposoluble chemicals, can accumulate in your body. Avoid them whenever possible. You can support your inborn detoxification system by eating a diet rich in fruits and vegetables (preferably organic ones, which have less known harmful pesticide residue) and possibly by sweating. Some supplements, such as NAC, can also help.

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Do commercial detoxes work?

A 2011 survey reported that 92% of naturopaths prescribed detoxification therapies, commonly as treatments for environmental exposure to toxicants. Said therapies consisted mainly in eating more “cleansing foods,” such as Brassica vegetables; eating more fruits and vegetables in general; opting for organic foods; supplementing with vitamins, minerals, and fibers; and minimizing environmental exposure to toxicants. More questionable treatments, such as homeopathy, were less common.[32]

But what about commercial detox programs, or “cleanses”? Studies on those are scarce and, according to a review from 2015, not very convincing, as they suffer from small sample sizes, sampling bias, lack of control groups, reliance on self-report, and qualitative assessments rather than quantitative measurements.[1] A more recent study shares these limitations, showing that following a detox program centered around eating a whole-food diet improves self-reported health compared to baseline, with no control group.[33]

The one randomized controlled trial we could locate separated middle-aged women into three groups: Master Cleanse (MC), placebo, and control. The control group kept eating as usual, whereas the MC and placebo groups ate only 400 Calories per day. As a result, both the MC and placebo groups lost weight and showed related health improvements, with no difference between groups.[34] In short, the “magic” was found to be in the caloric restriction only, not in the combination of lemon juice and Neera syrup (a blend of maple and palm tree syrups designed to have high amounts of minerals and trace elements). In the one study we could locate evaluating a commercial detox supplement without caloric restriction, it didn’t have much effect on anything.[35]

What little evidence there is on “cleanses” (commercial detox diets) is fraught with methodological problems. Cleanses’ short-term benefits (weight loss and related health improvements) seem to be mostly attributable to caloric restriction and placebo effects, not to special detoxification effects.

Explaining why it feels like detoxes work

Female standing on scale

Why do fad cleanses spread through word of mouth so quickly? The answer is threefold: rapid weight loss, removal of problematic foods, and the placebo effect. This could be great … if weight loss always meant fat loss.

If you slash your caloric intake, you probably slash your carbohydrate intake, and if you slash your carbohydrate intake, you don’t replenish your glycogen stores. Not only do you lose your stored glycogen, but you lose the associated water. To store 1 gram of glycogen, you need about 3 grams of water.[36][37] The average man carries 341–593 grams of glycogen in his liver and muscles, so about 1,364–2,372 grams (3–5 pounds) of glycogen+water.

In such a way, you can lose several pounds in a couple of days.[38] And of course, less food consumed also means less food moving through your intestines.

The result? Spectacular weight loss, in the short term. But cleanses are short term, so people never get to see them fail. All they see is the spectacular weight loss; they feel better because of it, and they attribute both their weight loss and perceived better health to their cleanse. And they still do when they resume eating normally and most of the weight they lost (all the weight from glycogen+water and food-in-transit) comes rushing back.

The short-term weight loss from a cleanse can be spectacular, but most of what is lost is glycogen and water, which come rushing back when normal eating habits are resumed.

So when people feel better from a cleanse, is it just a placebo effect? Not always. People who undergo a cleanse might also feel better because they stop consuming foods that don’t agree with them. In other words, cleanses work as de facto elimination diets.

An elimination diet is a diet that removes a food or category of foods that you suspect might negatively affect your health. Some people, for instance, will stop consuming milk (or all dairy products) to see if, after a few weeks, they feel better. Sometimes, people remove many foods at once; then, after a few weeks, if they feel better, they start adding the foods back, one by one, to determine which ones are problematic.

Bottom line

The Detox Equation

Toxicants, notably heavy metals and liposoluble chemicals, can accumulate in your body. Avoid them whenever possible. A diet rich in protein, vegetables, and fruits will provide your organs with the nutrients they need to function optimally, and some supplements may support your liver specifically. Sweating may also help you excrete heavy metals.
As sold to the public, cleanses (detox diets) do not work. Most of their benefits (notably a rapid, but mostly short-term, weight loss) can be attributed to the drastic caloric restriction, not to detoxification. A cleanse might also help by removing foods that don’t agree with you (i.e., by working as a de facto elimination diet).
In case of acute poisoning by a toxicant, go to the hospital.

While “detox diets” are better avoided, some supplements can support liver health. Check out our Liver Health Supplement Guide for practical, specific instructions on supplements backed by solid evidence, as well as those that show potential, and warnings for supplements which may be dangerous or are a waste of money.

References

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