Guest blog post by Kyle Hill.

Perhaps it is a product of the "green/natural/organic" movement, but there seems to be a war on chemicals in the US. The problem with using language such as "natural" to label a product is that it automatically implies the opposite for other products, namely that they are "unnatural," "harsh," or "synthetic." As a result of this chemical turf war, numerous commercially available products have sprung up seeking to remove the harmful chemicals from our lives. The concept of "detox" claims that chemicals are causing us stress, poor health, and disease. But what does "detoxing" actually do? What are these dangerous "toxins" that need removal? Do any detox products actually work? Science has something to say about all of these questions, and the answers bring about a serious need for consumer awareness.

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What is "Detox"?

Detoxification therapies are typically advertised as some sort of "natural" product such as body wraps, foot pads, or folk potions that claim to help treat illness and disease by removing harmful/deadly "toxins" from the body. These therapies claim, on the more harmless end, to treat a wide array of vague symptoms such as fatigue or headache, and on the more harmful end, neurological disorders like dystonia (a movement disorder) or cancer.

"Toxins," the indistinct targets of detox products, are widely claimed to be the root of all disease and wholly man-made. Even though they are the main focus of these products, toxins are rarely if ever specifically defined, usually meaning some chemical that may negatively affect your health.

The way that many of these detox products work involves some sort of change in diet, ingestion of chemical products or folk remedies, or even enemas, each of which are supposed to flush out the aforementioned toxins and thus restore health to the body. Examples of detox products would be the popular detox foot pads, which claim to remove toxins through the bottom of your feet, and coffee enemas, which are supposed to wash away the harmful substances residing in the body's intestinal tract.

Of course, the entire idea of commercial detox products would fall flat if we could demonstrate that "toxins" are not the source of all disease, that the products do not have any effect when tested, that they rely on misconceptions about the body, or that these toxins are not actually toxic.

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Are Toxins the Cause of All Disease?

The answer to this question should be painfully obvious to anyone who has ever had a cold. The number of diseases and ailments that are caused by bacteria and viruses alone is evidence enough that toxins do not cause every illness (unless you consider a virus as a concatenation of chemicals, but I do not think these products are being that sophisticated). Some aliments certainly are caused by harmful substances entering the body, as is the case with smoking (which contains hundreds of carcinogenic substances and harmful chemicals) and lung cancer. However to say, as some die-hard detoxers do, that all illness is the product of the chemicals we produce is absurd. What toxins cause leukemia? Which man-made chemical produces cystic fibrosis? Even if we sealed someone inside a sterile chamber that had no contact with the outside world, they could still get sick from genetic disorders and complications arising from aging.

Do Toxins Accumulate in the Body?

The function of detox products is to allegedly remove harmful chemicals from the body that the body cannot on its own (if it could, why buy the product?). This premise rests on two points: that toxins are present in the body and need removing, and that the body cannot remove them without help. Both of these points are incorrect.

Science does not know of any "toxins" that accumulate in your body at dangerous levels that can be removed by foot pads or diet. The basic premise of accumulation is correct; many chemicals are fat-soluble, which means that instead of being excreted in the urine, they are stored away in fatty tissue until they reach a toxicity point (like vitamin E, for example). Some harmful chemicals certainly do accumulate, like PCB's (polycholrinated biphenols), but these are few and far between. If dangerous bio-accumulating chemicals really were as prevalent as detox products suggest, we would be see far more cases of chemical overdose. But we do not.

The idea that our bodies are basically holding vats of harmful chemicals waiting to be removed by an expensive detoxification regiment is then nonsensical. By creating a supposed problem, detox marketers capitalize on fear and ignorance, and make millions upon millions of dollars doing so.

Does Your Body Need Help Removing "Toxins"?

A main reason one might buy a detox product is that the product claims to remove something from the body and "restore energy and balance," suggesting that the body cannot remove harmful chemicals by itself. However, the human body is already an excellent remover of harmful substances.

Our waste disposal system has evolved over millions of years and has kept our ancestors alive when there were "toxins" in the environment. This system works 24 hours a day to remove harmful substances from the body; it doesn't need the help of a foot pad. For example, the gut prevents bacteria and many "toxins" from entering the body on its own. Furthermore, our metabolisms are highly efficient at dissolving and concentrating harmful substances so that the next time you go to the bathroom you can void them. Not one of the detox products on the market could ever compete with simple urination.

Because the human body is already so good at removing harmful chemicals, the inundation of commercial products which claim that the body cannot detox on its own is a great deception.

Are These "Toxins" Really Toxic?

According to the Merriam-Webster dictionary1, "Toxin" is defined as:

A poisonous substance that is a specific product of the metabolic activities of a living organism and is usually very unstable, notably toxic when introduced into the tissues, and typically capable of inducing antibody formation (see botulinum, i.e. botulism).

So detox products don't even get the definition of toxin right. These products use the word to mean any chemical they consider "bad for your health," and not in the more biological sense, as outlined above. The definition of "toxin" is consistently obscure. Products often reference heavy metals but typically only mention "chemicals" in the most general sense. Detox products certainly never say, "removes polycyclic aromatic hydrocarbons" (a DNA mutagen), because the products have to remain vague enough to fly under the radar of regulation. Once they begin making specific claims, they can be sued or investigated.

It is important to understand that basically anything can be toxic; it is all a matter of dosage. Sugar can be toxic, iron can be toxic, and even water can be toxic; it is all about the dose. Most of the chemicals that we encounter in our daily lives are found in such low doses that they are not toxic to us. For example, every time we eat a tuna salad we are ingesting mercury. Though the detox products would have you believe that you need something to remedy this, the levels in which you ingest the mercury are essentially harmless. We don't see people keeling over after eating Chicken of the Sea (when properly regulated of course). When we do ingest a small amount of harmful chemical, many times it harmlessly passes through the body's already adept waste-removal system. Even things like vitamins and drugs can be toxic at the right dosage. The thing to remember is that for many chemicals, there is a threshold beyond which the chemical will do harm to your body, below which it is harmless.

Because detox products are so confused when it comes to definitions, and the toxins they claim to remove can be basically anything with an atomic bond, we could assume that there isn't much or even any real science to back up their claims. Just look on the back of any bottle of detox pills, that statement at the bottom, "These statements have not been evaluated by the FDA...," means that no/minimal testing was required to get the product on the market. Proof of efficacy or scientific merit was not required of the product.

Lastly, detox products continuously characterize chemicals as bad things. If we are to believe that everything that is a product of chemistry is harmful to us, we better stop eating, breathing, drinking, and living. The world is a sea of chemistry, sloshing together and reacting in wonderfully interesting ways. To characterize all chemicals as forever harmful and disease-causing agents is to say that all matter is harmful. Anyone will realize how farcical that statement becomes when applied to detox products.

The fact is that without chemistry and chemicals, there would be no life. To take this fact and contort it in a sinister way for a marketing ploy is deceptive and dishonest. Detox products do not define or understand chemicals or toxicity. The wide variability between products and the lack of consensus showing an "anything goes" marketing model demonstrates that the claims they make are not science-based but money-driven.

When Tested, Do Detox Products Have Any Effect?

According to Professor Edzard Ernst, the recently retired professor of complementary medicine at the University of Exeter, it would be very simple to test whether or not detox products actually worked. A simple blood test from a group of volunteers and a control group would clearly demonstrate if chemicals in the blood were being removed faster than the body typically removes them. However, when these therapies are tested, Ernst states:

...There are no studies that demonstrate this effectiveness. The reason is simple: these products have no real effects2.

Science advocacy groups like the UK-based Sense About Science have taken it upon themselves to test detox products. Sense About Science has investigated 15 detox products, ranging from foot patches to ‘detox' hair straighteners, and asked the manufacturers for evidence to justify their claims. They found that:

No one we contacted was able to provide any evidence for their claims or to give a comprehensive definition of what they meant by detox2.

This squares with what we have already discussed about the lack of definitions in these products. If they stay nonspecific enough, they can avoid regulation.

Arguments against detox therapies will surely run up against the familiar "Well, it worked for me!" rebuttal. It is true that while these products probably have no physiological effect, they can have a psychological one, i.e. placebo. When a treatment is purely placebo-based like homeopathy3, acupuncture4,5,6, or detox, a patient can feel subjectively better without having any objective change in symptoms. That is to say, when someone says, "Well, it worked for me!" they can be mistaken about their objective health. Unless the entire process was blinded, controlled, and replicated, personal experience lends nothing to the efficacy of detox products.

Conclusions

After laying it all out, the conclusion is fairly obvious: detox therapies are potentially harmful, pointless pseudoscience. All of the mechanisms for "toxin" removal are implausible. No rigorous detox product testing has shown any effectiveness. The treatments are unregulated (and therefore are not known to be efficacious) and have a great potential to do more harm than good. Your body is the best detoxer we know of, and does not need any help. Detoxification is a real thing, and your body has evolved to be very good at it. For example, chelating agents, or chemicals which bind to and remove metal ions and molecules, are used in patients with cases of heavy metal poisoning. But beyond these few instances, there is no science to show that non-specific "toxins" accumulate in your body. In fact, because the science does not show that this toxin accumulation causes disease in the first place, the whole commercial detoxification industry does not have a leg to stand on.

Until there is the research to back it up, I believe that we can confidently say that commercial detoxification is useless pseudoscience, joining the ranks of dejected therapies like the cranial excision of spirits.

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Aqua Bath Image via Wikipedia



References :

1. Merriam-Webster. (n.d.). Toxin. Retrieved June 16, 2012, from Merriam-Webster: http://www.merriam-webster.com/dictionary/toxin

2. Naish, J. (2011, December 12). The great detox deception: From mud wraps to drinking syrup, detoxes are 'pointless, dangerous claptrap'. Retrieved June 16, 2012, from The Daily Mail: http://www.dailymail.co.uk/health/article-2073322/The-great-detox-deception-From-mud-wraps-drinking-syrup-detoxes-pointless-dangerous-claptrap.html

3. Edzard, E. (2002). A systematic review of systematic reviews of homeopathy. British Journal of Clinical Pharmacology , 577-582.

4. Ersnt, E., & White, A. R. (1999). A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology , 143-147



5. Ezzo, J., Berman, B., Hadhazy, V. A., Jadad, A. R., Lao, L., & Singh, B. B. (2000). Is acupuncture effective for the treatment of chronic pain? A systematic review. PAIN , 217-225.

6. Madsen, M. V., Gøtzsche, P. C., & Hróbjartsson, A. (2009). Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ.

Bio:

Kyle Hill is currently working as a research assistant at Marquette University in Milwaukee, Wisconsin, where he graduated magna cum laude with a bachelor's degree in Environmental Engineering and is now pursuing a master's degree in Communication with a focus on science, health, environment, and sustainability. His research is focused on how personal motivations and website characteristics affect the depth of information processing. You can follow him on Twitter under the name @Sci_Phile.