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What Doctors Don't Tell You

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May 2019 (Vol. 4 Issue 3)

Do you need to detox?

About the author: 

Do you need to detox? image

With the New Year, our thoughts turn to health and perhaps even a detox. But does it really help, or is it more a myth or marketing ploy than medicine?

Just like homeopathy, detoxing is another of those absolute no-go demarcation lines between the sceptics and alternative therapies and therapists (referred to by sceptics as anything from quacks and charlatans to Voodoo merchants). Embraced by celebrities such as film actress Gwyneth Paltrow as an essential part of their health regimes, detox is equally derided by sceptics who say it’s a quick way for charlatans to make easy money.

Although it’s the buzzword du jour, the idea of detoxing goes back many hundreds, if not thousands, of years and is found in several ancient healing traditions. India’s Ayurveda medicine describes cleansing and purification processes, while traditional Chinese medicine (TCM) has a host of procedures for jie du, or removing toxins. Detoxing is also at the heart of naturopathic medicine, which maintains that a ‘toxic load’ may be the basis of many diseases.

Its proponents say it’s an effective way to cleanse the body of toxins that would otherwise affect health and even cause chronic diseases, like muscle and joint pain, headaches, depression, gut problems, heart disease and even cancer. And there’s a myriad of products that claim to help you achieve that, including special detox smoothies and juices, vitamins, teas and tinctures.

In the opposing camp are doctors, dietitians and sceptics. Doctors give it short shrift—in medicine, detox refers to a way to get an addict clear of drugs or to reverse a case of acute poisoning—while sceptics claim it’s an unnecessary process, as the body is fully capable of getting rid of toxins by itself. In fact, they say, if our body wasn’t getting rid of toxins all the time, we’d be dead.

Toxic overload

That’s true—up to a point. One study of non-Hodgkin’s lymphoma patients, for example, discovered they had far higher concentrations of polychlorinated biphenyl (PCB) pesticides—which have now been banned—in their blood than did healthy people, which increased their risk of this cancer of the immune system.1 The US National Human Adipose Tissue Survey found 20 toxic compounds in 76 per cent of the fat samples being tested, while five compounds were discovered in every sample and at high levels.2 This suggests that the body can’t always rid itself of toxic agents.

Then there’s the ‘smoking gun’ evidence: the correlation between children and adults exposed to chemicals and pesticides and the presence of chronic health problems. For example, sheep farmers exposed to organophosphate-based pesticides are far more likely to have psychiatric disorders and even to commit suicide.

In one study of 146 farmers exposed to pesticides just three times a year, when they ran their sheep through sheep dip, most were suffering from psychiatric disorders compared with a similar number of quarry workers, who don’t work with pesticides and toxic pollutants.3

While the liver and kidneys can cope with many toxins in our food and environment, there is the danger of accumulation and overload, which can especially be a problem in people who have a particular sensitivity or have an occupation—such as farm work, hairdressing and dentistry—where they have daily exposures.

How long to detox?

There’s no one answer to this question, as it depends on the problem you’re dealing with. Detoxing programmes can last for anything from two days—probably a fast with only vegetable and fruit juices or shakes being consumed—to a 10-day programme in which all processed foods are stopped and
the focus is on fresh vegetables and fruits, and detoxing proteins like fish and eggs.

An elimination diet—where all known allergens are removed from the diet—traditionally lasts for four weeks, but if you want to overcome a chronic health problem, a 16-week programme may be needed, according
to WDDTY panellist Dr Sarah Myhill.

Detox’s two phases

In fact, there are several factors that determine whether or not you can naturally rid your body of toxins, according to nutritional medicine. Biochemist Dr DeAnn Liska says the immune system’s natural detoxification process can be compromised by age, genetics, lifestyle and the buildup of toxins from diet or occupation, and by habits like smoking and excessive drinking.

In healthy people, natural detox has two phases: in the first, enzymes known as cytochrome P450 reduce, or oxidize, toxins; and in the second, toxins are transformed into water-soluble compounds that can be excreted through urine or bile. “Detoxification is not one reaction, but rather a process that involves multiple reactions and multiple players,” she says.4

But if the body can’t eject toxins naturally, is there some kind of detox exercise or process that does the job instead? Sceptics argue that there’s no evidence to suggest that detoxing works, but while it’s thin on the ground, there is indeed some evidence—and this is more a reflection of the nature of medical trials than the effectiveness (or not) of detoxing. Most trials are sponsored by drug companies, and it’s hard to find funders for studies where there’s no obvious financial benefit.

Toxic proof

Several clinical trials have shown that commercial detox products enhance liver detoxification processes, and others have eliminated organic pollutants from the body; however, no randomized controlled trials—the ‘gold standard’ for scientific studies—have been carried out, say researchers in Sydney, Australia.5

One case study from North Carolina reported that a patient who had been exposed to malathion, an organophosphate insecticide, suffered from a range of debilitating symptoms—including severe vomiting, headaches, night sweats, joint pain and shortness of breath—but was helped by following a detoxing food plan.6

However, after one of the few available clinical studies demonstrating that detoxification works, the message was discredited because of who the messenger was—at least in the eyes of sceptics. The Church of Scientology—an organization founded by L. Ron Hubbard that counts Hollywood film star Tom Cruise among its supporters—carried out its own detox programme on rescue workers who had helped after the Twin Towers in New York City were attacked in 2001, using its Narconon International Drug Rehabilitation Program, based on high-dose niacin, but which also includes other vitamins, minerals and polyunsaturated oil, plus physical exercise and sweating induced by sauna.

But other evidence comes from a study by Jonathan Prousky, a professor at the Canadian College of Naturopathic Medicine in Toronto, who reported that “niacin, as a component of the Hubbard regimen, does augment detoxification by lowering the body burden of lipid-stored xenobiotics”.7

There have also been numerous case reports, studies and non-randomized controlled trials (where people are deliberately selected to undergo treatment) that demonstrate that even a detox regimen for drug abusers and people suffering from other chemical exposures can remove toxins and also reduce other health problems, including neurophysiological and psychological disorders.8

Detoxing, or detoxicology, is still in its infancy as a therapy, and most of the evidence is anecdotal or derived from case studies. But, says Marc Cohen, a professor of complementary medicine at RMIT University in Victoria, Australia, a lack of scientific evidence doesn’t necessarily mean a lack of effect or effectiveness.9

Your detox foods

Is your usual diet hampering your body’s natural capacity to detox and rid itself of toxic intruders? Sugars, processed foods—including cakes, biscuits and white breads—excessive alcohol, and colas and sodas all affect the body’s detoxification pathways. A typical Western diet of ‘bad’ carbohydrates packed full of sugars is especially harmful.

The foods that can help kick-start the body’s detox processes include proteins from chicken, fish and eggs, as well as vegetables and fruits, beans and lentils, avocados, raw nuts and seeds, and olive oil. Try gluten-free grains like brown rice, millet and quinoa. In addition, drink 1.5 litres of water or herbal tea every day.

You should also be supplementing with B vitamins (thiamin, riboflavin, niacin, pyridoxine and choline), along with vitamins C and E, magnesium and selenium.

What’s your poison?

Sense About Science, a pharmaceutically funded lobbying group, produced a report—The Detox Dossier—in 2009, in which it investigates 15 commercially available detox products. The involved manufacturers weren’t even able to identify which toxins the body needed to get rid of, the group claimed, whereas scientists would perhaps have less difficulty identifying them and the role they can play in causing disease.

These toxins include:

Pesticides, which remain on some vegetables and fruit even after washing. These have been associated with diseases ranging from cancer to birth defects.

Sodium nitrate, a preservative used in processed meats and linked to a range of cancers.

BHA (butylated hydroxyanisole) and BHT (butylated hydroxytoluene), food preservatives listed as carcinogens by the International Agency for Research on Cancer (IARC), which are suspected of disrupting hormones and male fertility.

Recombinant bovine growth hormones (rBGH/rBST), given to cows in the US to increase their milk production. They raise levels of insulin-like growth factor (IGF)-1 in dairy products; IGF-1 has been associated with breast, prostate and colon cancers.

Sodium/potassium aluminium sulphate, used in processed cheeses and baked goods, and suspected of having adverse effects on our reproductive and nervous systems.

Bisphenol A (BPA), a chemical used to harden plastics that’s now been banned in baby products and toys. It can cause breast and prostate cancers, and disrupt the reproductive system.

Polycyclic aromatic hydrocarbons (PAHs), which are carcinogens created when fat is scorched, especially on barbecue grills.

Heterocyclic amines, carcinogens created when fish and meat are cooked at very high temperatures—again, especially on barbecues.

Acrylamide, yet another carcinogen, this time in potatoes and grains that are cooked, baked or fried at high temperatures.

Brominated vegetable oil (a complex mix of triglycerides), used in fruit-flavoured drinks and sodas. It can lead to reproductive and behavioural problems.

Artificial food colourants and dyes, which are linked to neurological disorders like ADHD (attention-deficit/hyperactivity disorder).

Dioxins, pollutants found in fatty foods. They can lead to cancer, liver damage and birth defects.

There are many other pollutants of concern. At least 100,000 man-made chemicals are used around the world every year—on farms, in industrial processes, in parks and recreational spaces, and in home products like non-stick frying pans, fire-resistant sofas and tin cans. Even pesticides that have supposedly been banned are still being used in some countries and are being imported.

In the shops

There are many products that claim to help you detox. Shona Wilkinson, head nutritionist at NutriCentre, outlines the ones she rates highly.

Daily Fibre Plus by Pukka Herbs is a gentle way to help bowel cleansing. This powder blend of soluble and insoluble fibre from psyllium husk, flaxseed, inulin and slippery elm is mixed with aloe vera to stimulate the bowel.

Psyllium Intensive by BioCare is another powder that aids bowel cleansing. It’s designed as a 10-day programme based on psyllium and fructooligosaccharides, a type of fibre that serves as a prebiotic.

Hepa’Phyt by Diet Horizon is a new liver-cleanse product based on milk thistle and two herbs, Fumitory and Desmodium, combined with green tea, and lime and rosemary extracts.

BotaniCleanse by Nature’s Plus is a whole-body cleanse in a tablet that combines more than 20 herbs, including milk thistle and dandelion. An alternative is the 9 Day Detox Pack by Patrick Holford, a four-in-one supplement that includes a liver-support formula, enzymes to help break down food and a probiotic.

Clean Greens Powder by Pukka Herbs contains 12 green foods, including nettle leaf, kale and wheatgrass, as natural green foods are a more gentle approach to a whole-body cleanse. An alternative is Green Purity Super Blend by Terra Nova, a freeze-dried powder comprising 11 detox-supporting foods, including kale, burdock, parsley, nettle and coriander.

Pre-Diet Cleanse Kit by Nature’s Plus is a three-day detox programme based on vitamins, minerals, concentrated whole foods and herbs, and is important for supporting any gut cleanse.

Detoxing: What works?

Diet. The elimination diet is a good place to start. It removes all foods known to cause allergies or toxic overload—such as wheat, dairy, sugary and processed foods, refined carbohydrates like white bread, cakes and biscuits, and coffee, non-herbal teas and alcohol—for around four weeks.

Exercise. Intense exercise seems to fast-track the detox process. To assess how much exercise can boost detoxification, researchers gave 335 subjects measured doses of caffeine and traced its degradation in the body by monitoring levels of caffeine metabolites (breakdown products of caffeine in the body) in urine. After 30 days of aerobic exercise, the rate of caffeine degradation had increased substantially in all participants.1

In another study, a single session of aerobic exercise on a stationary bicycle doubled levels of detoxification enzymes in 11 healthy volunteers.2

In an investigation of firemen exposed to toxic polychlorinated biphenyls (PCBs) and put through a two- to three-week detox programme—involving dietary changes, daily saunas and 30–60 minutes of exercise twice a week—all of them showed an improvement by the end of the study period. The results suggest that such a regimen is a useful part of an effective detox programme.3

Supplements. Dr Sarah Myhill, a member of WDDTY editorial team, recommends taking magnesium (400 mg/day), zinc (25 mg/day) and selenium (200 mcg/day)to help the body’s natural detox processes, while glutathione (250 mg/day) is another essential supplement.

She also recommends taking 1 mg of B12 (methylcobalamin), 800 mcg of folate, 50 mg of B6 (pyridoxal-5-phosphate) and 100 mg of phosphatidylserine twice a day. The treatment duration depends on the severity of the toxicity, but she has found that, on average, it takes 16 weeks.

Heat. Sweating it out is another effective way to aid the detox process. Saunas can help to reduce high blood pressure, and improve blood flow and heart functioning, in short, 15-minute sessions, whereas toxic chemicals and heavy metals can only be safely shed during longer sauna sessions, say researchers.4

Yoga. An Indian practice known as Shankhaprakshalana (deep colon cleanse), which uses lukewarm salt water together with five yoga postures, is a proven way to cleanse the bowel.

In one study of 54 people preparing for colonoscopy screening, those who practised Shankhaprakshalana—they drank 480 mL of lukewarm saline, made by adding 9 g of sodium chloride to a litre of lukewarm water, while doing the postures—had better colonoscopy results than those who used a standard colonic preparation (polyethylene glycol 3350, sodium chloride, sodium bicarbonate and potassium chloride).5


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