Detox Demystified

Los Angeles Times/September 3, 2001
By Shari Roan

Supporters say the practice rids the body of 'toxins.' But many scientists counter there's scant evidence it does anything the body can't do on its own.

In a second-floor classroom at the American University for Complementary Medicine in West Los Angeles, 15 adults are feasting on a vegetarian potluck dinner of plantains, tomatoes, lentils, avocados and dairy-free brownies. They've spent the last week on a liquids-only fast, part of a 21-day "detoxification" program. They are jubilant that their ordeal is over. They feel cleaned out. They feel pure.

Detoxification has become an essential feature of the holistic health movement. It is based on the controversial premise that people's bodies accumulate toxins that result in poor health and disease. According to proponents, humans are bombarded with substances that can poison them, ranging from food additives and other dietary culprits to hormone replacement therapy, chlorinated water, microwave radiation, even anger and other negative emotions.

The concept has struck a chord with a public besieged with warnings about the dangers of "mad" cows, Alar-laced apples, smog alerts and sugar substitutes.

"This is a movement that has no choice but to pick up steam because we live in a toxic environment," says Dr. Richard DeAndrea, the instructor for the program held at the West L.A. school. "The water doesn't taste right. The air doesn't look right. It's intuitive."

That message has spawned a mini-industry of books, seminars, health and beauty products, and other treatments that are based on the idea of enhancing health by cleansing, or detoxifying, one's body. "It's sort of like a spring cleaning," says Todd Runestad, managing editor of Nutrition Science News, a trade publication in Boulder, Colo.

Detox therapies run the gamut from sweat lodges and herbal supplements to invasive medical treatments, such as chelation, in which a chemical is infused into the blood to purify it. Another technique is colonic irrigation, a delicate procedure during which a rubber tube is passed through the rectum and warm water is pumped in to flush the large intestine. Detox diets, typically featuring juice fasts and a reliance on fruits and vegetables, are the most popular of the various methods.

Dr. Elson Hass, a Marin County physician who has written several books touting detoxification, explains the concept this way. Toxins, he says, "get into the fat tissue and the liver and connective tissue and cause the body to become less elastic or inflamed or congested or deficient of nutrients. Detoxification is about giving your body a rest from something, whether it is sugar or nicotine, alcohol, caffeine or chemicals in foods or drugs."

It's hard to argue with the idea that the environment is not as healthy for humans as it used to be. And the recommendation to eat a diet rich in fresh vegetables and fruit is widely accepted by medical experts. Though these two ideas provide a certain logical appeal to the detoxification movement, other aspects are controversial. The claim by detoxification proponents that our bodies stockpile a range of toxins-and that treatments and products can purify the body-is strongly disputed by many medical experts. They contend there is no scientific basis for the claims made by some doctors and other health practitioners who promote detox therapies.

One detox program marketed on the Internet makes the claim that people can suffer from "intestinal toxemia," a condition in which "food can literally rot inside the digestive tract and produce toxic byproducts." Another Internet site, http://www.fasting.com, advocates juice fasting for "removing the 5 to 10 pounds of toxic chemicals now locked into the average adult's cell, tissue and organ storage areas."

Though exposure to dangerous chemicals is associated with several illnesses, there is no evidence that widespread poisoning is causing things such as headaches and allergies, says Dr. Michael Hirt, director of the Center for Integrative Medicine at Encino-Tarzana Regional Medical Center. "A lot of people lack sleep, eat too much sugar and have too much stress. Toxins are not their problem. Their lifestyle is their problem."

Hirt believes that some people are turning to detox programs because they are not getting enough advice about dietary and lifestyle changes from their doctors or government health officials.

Believing that a person can rid themselves of poisons through detoxifying, he says, "is magical thinking. Toxins in the environment may be causing you trouble, but you won't necessarily be helped by these therapies that are loosely based on science."

Rich Cleland, a senior attorney at the Federal Trade Commission, says the word "detoxify" rings alarm bells with government investigators. The FTC only challenges detoxification claims if the manufacturer also says the product treats or cures disease. But many detox product claims skirt the law, Cleland says.

"If [consumers] interpret detoxification to mean that this treatment is going to remove all the harmful substances from their body, then a company would have to substantiate that," he says. "If they couldn't, then the claim could be considered deceptive."

On Aug. 21, the FTC announced that Liverite Products Inc., of Tustin, will pay $60,000 to settle FTC charges that the company made unsubstantiated claims. Liverite claimed the supplement, which contains extract of beef liver, detoxified the liver and helped treat alcohol-induced liver disease, hepatitis and cirrhosis. Other detoxification therapies, though not unlawful, are not based on science, critics say.

Chelation, for example, is an accepted medical practice for removing heavy metals from the blood in clear cases of poisoning. However, chelation has also become popular among some medical doctors who claim it helps remove from the blood substances, such as calcium, that cause heart damage. The American Heart Assn., for one, has said there is no evidence for such claims. In 1998, the FTC fined a Laguna Hills company for making claims that chelation therapy is effective for treating heart disease.

Another popular detox practice, colonic irrigation, is said to remove toxins that reside in the colon. But many doctors say there is no evidence that the intestines build up waste and that the colon naturally sheds its lining about every seven days.

Colonic irrigation and other colon hydrotherapy treatments date back to the 1930s when doctors believed that fumes generated in the colon were harmful to health, says Dr. Harris Clearfield, a professor of medicine at Hahnemann University Hospital in Philadelphia. But that concept was long ago disproved.

"We do colonoscopy on patients every day and clean them out remarkably well," Clearfield says. "I've never yet had a patient come up to me afterward and say, 'I've never felt better!"'

Only one state, Florida, licenses the people who perform colonic irrigation, and the procedure has been linked to injuries, infections, even deaths, says Stephen Barrett, a retired psychiatrist who is vice president of the National Council Against Health Fraud, an organization that is critical of many alternative medical practices.

The idea that one's health can benefit by cleansing the inner body has roots in ancient Chinese, Egyptian and Indian medicine and was first practiced in this country by Native Americans who did ritual sweating ceremonies with the change of seasons.

Moreover, some herbs common in Chinese medicine are thought to benefit the liver, which is the body's primary filter of harmful substances. Milk thistle, an herb, has been targeted as a legitimate area of research on liver health.

Despite ancient traditions, the major flaw in the detoxification theory is that no one can identify specific toxins that are stored in the body, causing illness, critics say.

Haas, the Marin County doctor who was an early proponent of detoxification in the 1970s, acknowledges that there is little evidence for many detox claims. "I wish I could give you the science behind it, but there is very little," he said. "It hasn't been studied."

Other detox practitioners say that studies linking certain foods to allergies, asthma, ear infections and migraines demonstrate that food can cause toxicity. They also contend that fat biopsies, hair analyses and caffeine clearance tests (tests to measure how rapidly the liver removes caffeine from the blood) can prove toxicity.

"We don't use these tests very much anymore because they are more expensive than just getting the treatment," says Kevin Conroy, of Bastyr University, a naturopathic medical school in Bothell, Wash. Even without diagnostic tests, he says, 90% of all his clients need detoxification. He says the symptoms of toxicity include bad breath, fatigue, sensitivity to chemicals, allergies, headaches and itching.

"People feel horrible as things are coming out" during the detox, says Conroy. "But after two or three weeks they feel wonderful. They have high energy. Their gastrointestinal and arthritic symptoms are resolved and they have mental clarity."

Some of the people who attended DeAndrea's recent seminar acknowledged that detox diets can be difficult to endure but said that breaking away from a diet of fast-food hamburgers and diet sodas eventually feels terrific. Lisa Trust, 36, and her husband, Michael Morris, 37, decided to detoxify as a pathway to healthier eating. Despite the lack of scientific proof, the idea simply appealed to them.

"We've wanted to change our eating habits for a long time, but we needed a jump-start," says Morris, who says she lost 18 pounds on a 21-day detox program. "This program is really just saying 'you are what you eat.' When you start thinking in those terms, you really want to put good things in your body."

How the Body Cleanses Itself

Liver-This organ is the principal detoxifier. Blood that passes through the intestines can reach the heart and lungs only after passing through the liver. One of the liver's two main functions is to filter toxins for excretion.

Lungs-In all breathing passages, mucus traps impurities while hairlike projections called cilia carry the mucus from the lungs and toward the throat. Impurities are then coughed out or swallowed.

Kidneys-Another filtering organ that cleanses the blood of waste products. The kidneys contain millions of tiny filtering units called nephrons that act to separate nutrients from waste and send waste into the urine.

Skin-Sweat glands carry waste products, primarily urea and ammonia, from the body to be excreted in the form of perspiration.

Intestines-The small intestine absorbs nutrients. The remnants enter the large intestine, which transports waste to the rectum for elimination. The large intestine also absorbs needed water and minerals.