It’s the first week of January and the word “detox” is probably trending again. It has, like clockwork, for the past five years. From juices and supplements to foot baths and diet regimens, detox products become more popular this time of year. But what do these treatments and programs actually do — and do you really need one?
Detox treatments or programs purport to cleanse the body of “toxins,” often without specifying which ones. The medical definition of a toxin is “a poison, usually one produced by a living organism,” according to Harvard Health Publishing. Food and even water can be harmful in large doses, even if they aren’t necessarily considered toxins.
Our bodies naturally process everything we put in them, including things that can harm us. Many things we consume, like alcohol or acetaminophen, can be poisonous in excess, but our organs — the liver, the kidneys and lungs in particular — work to pass them through the body and eliminate the byproducts.
Scientific literature doesn’t back up the efficacy of most detox treatments and regimens. A 2014 review, which looked into preliminary evidence on the possible benefits and harms of detox diets, found that there was no “compelling evidence to support the use of detox diets for weight management or toxin elimination.”
Ten years later, that hasn’t changed, says Australian cardiologist Dr. Hosen Kiat, who co-authored the article.
“The reason is very clear. Toxins are best to be avoided instead of treated.”
The promise of a silver bullet
For many, it’s tempting to look for a silver bullet after over-indulging over the holidays — but toxicologist Dr. David Juurlink says unfortunately, that just doesn’t exist.
“This idea that we might take something to help purge ourselves, rid our bodies of toxins that accumulated over the course of time — nobody needs that,” said Juurlink, who practises toxicology at Sunnybrook Hospital in Toronto.
If detoxes were effective, he says, studies would show it, doctors would prescribe them regularly and they’d be more commonly used.
“But none of those things are true. These products don’t do anything helpful for people.”
Detoxing is a broad term used to market a range of products and regimens. Some — like a meal plan consisting of whole foods like fruits and vegetables — can end up being helpful by stopping some harmful behaviours, like eating processed food.
But the benefits stop there, says Dr. Jordan Feld, a medicine professor at the University of Toronto, and the director of the Toronto Centre for Liver Disease.
“For people that have been drinking too much, eating too much, stopping those things is helpful. Unfortunately, most of the so-called detoxing products have very little evidence that they actually work,” Feld said.
What’s worse, he says, certain detox products can cause serious harm and even hospitalization.
“We usually see a couple of people every year that have taken something, often for the purpose of detoxing or improving liver health or something, that actually causes liver injury. In some cases, that can be severe enough to go onto liver failure, and even lead to a liver transplant.”
Some herbal remedies, like chaparral leaf or valerian root, have been reported in case studies as causing liver damage, says Feld.
Health products aren’t as tightly regulated as prescription drugs, so what’s on the label may not be what’s inside the capsule, Feld says. That can also make it difficult to know what exactly a patient has taken, and determine the appropriate treatment.
Diets that purport to ‘detoxify’ the body can also be very restrictive — like a juice cleanse. Feld says there’s no evidence such diets are helpful. In some cases, he says, it can be quite harmful. Juices, smoothies and massages
A multibillion-dollar industry
Nonetheless, detoxes are a popular — and lucrative — business. According to one recent market forecast, the global detox drink market alone is expected to grow from $5.65 billion US to $9.66 billion US by 2032.
Canada has no shortage of detox regimens. Farmacia Health Bar, a Toronto juicery, offers a three-day detox program of smoothies, juices, vegetables and supplements for $275.
Owner Steve Sanna says the program is “personalized” for each individual. “Whatever your issues are, we work with different fruits and veggies and herbs and herbal medicine,” he said.
He says his detox will clean and strengthen one’s liver, offering up screenshots of a client’s blood test results from before and after a detox as evidence. He says before the juice program, her liver enzyme levels were abnormal. Afterwards, he says, they were back in the normal range.
Sanna disagrees with doctors who say detoxes don’t work — he says the programs feed the organs.
Juurlink says that claim doesn’t hold up.
“The heart and the liver don’t need detoxification and if they did, it would certainly not come from a smoothie.”
“If there’s a benefit, it’s that they might taste good, they might feel good,” said Dr. Feld, “but I think it’s important not to do harm.”
Another common trend: lymphatic drainage massages.
“It’s basically good for everyone. Elderly, young, pregnant, post-surgical,” said Dr. Nidhi Jalota, a part-time family doctor and the medical director of Etobicoke, Ont., wellness and aesthetic boutique My Aesthetic Lab.
The lymphatic system is an important part of the immune system. It’s a network that filters and drains excess fluid — called lymph — which contains white blood cells that fight everything from germs to cancer cells.
Jalota says the massages help push that fluid out faster..
There’s some evidence that lymphatic drainage massages can help reduce swelling caused by an excess of fluid in the lymphatic system — known as lymphedema. The condition is most common in those who have had breast cancer treatment, or surgery or physical trauma.
What’s less clear is whether people with a healthy lymphatic system would also get the same benefits from the massage. That’s why Jalota says she tries to manage expectations before the service.
“I always say anytime you’re doing any procedure, you want to lay out the expectations and let them know, like, ‘Hey, this isn’t maybe perfectly evidence-based.'”
Juurlink says he’d like to see the evidence Jalota cites.
“It’s probably healthy, might make you feel better,” he said.
“But the idea that it helps remove toxins from your body is just — and I don’t mean to be overly critical — it’s preposterous,” he said.
“The laying of hands to the lymphatic system is not going to change how the body eliminates any kind of compound.”
Jalota’s response?
“Try it and you’ll see” — as long as you’re willing to pay $199 per massage.
