Do you Detox? Apparently we encounter sooooo many toxins each and every day frankly I’m surprised we all live so long. I’ve had a lot of questions about toxins (thank you!) so while I sit here enjoying a high colonic and anticipate my coffee enema and bentonite clay smoothie I thought it time to get stuck in.

However I do suspect this will be the first post of a series on Aaaaargh! Toxins! – it’s a big subject so this is Aaaaargh! Toxins! 101 – I foresee more on Aaaaargh! Toxins! in vaccines as a separate post, for example, and there are a few specific ones you lovely people have taken time to ask about. I’ll get around to them, I promise, but first we need to do the basics. Sorry.

What is a ‘Toxin’??

A toxin is something poisonous to a living organism. For biologists like me it’s normally a protein produced by our Microbial Overlords, plants or animals and strictly speaking there is a distinction between toxins and poisons (and venoms) but here I’m blurring that. I’m also ignoring the naturalistic fallacy – that’s for another post. As are ‘superfoods’ and antioxidants. That OK? Thank you.

Toxins are ubiquitous and pretty much anything and everything can be toxic – depending on the dose. Some toxins have a dose range where they can be therapeutic or beneficial but outside that range can be dangerous. Water, oxygen, sugar, table salt, caffeine, nicotine – all toxins. It all depends on the dose. Chocolate too: theobromine is the bitter alkaloid in chocolate and is pretty toxic. But not to us in the concentration you find in a chocolate bar.

Dosis facit venenum – the dose makes the poison (Paracelsus 1493-1541)

We have evolved a bunch of ways to deal with the toxins we encounter – not just the physical protective responses like vomiting or diarrhoea to get rid of toxic stuff we ingest but more subtle things like the ‘disgust’ emotion and the sensation of nausea – these condition us to avoid exposure to crap that’s harmful. If something makes us sick we remember it viscerally and avoid it in the future.

Detox products and programmes play on this notion (or is it an emotion? ask a psychologist, FFS) of disgust. They often also add in the idea that the range of defences we have evolved over millions of years against the sea of potential toxins in which we are drowned are somehow, well, insufficient. Yet we seem to have survived for quite a long time without the need for a complete stranger to squirt a double mocha skinny latte or whatever up our Chocolate Starfish. Funny that.

How We Deal With Toxins

We have a very effective inbuilt system to deal with most of the toxins we ingest. Its principal constituent is called the liver.

The hepatic portal system directs blood from all parts of your gastrointestinal tract through the liver before it goes anywhere else. From the bottom of your gullet almost to your Chocolate Starfish everything ends up in the hepatic portal vein that feeds into the liver – which then processes toxins before anything is allowed into the rest of the blood system. (The liver does lots of other cool stuff too but let’s stick to toxins).

This ‘first pass effect’ means that therapeutic drugs need to account for any processing the liver might do and some exploit this; many oral medications are ‘prodrugs’ that use the liver to turn them into their biologically active form; for example oseltamvir (Tamiflu) is inactive – the liver hydrolyses it into the active version oseltamivir carboxylate.

But the liver can be bypassed and not just by injection: the lower part of the rectum drains into the internal iliac vein and so avoids the liver – which the principal reason some drugs are administered as suppositories. The exception to this is France where suppositories are available for just about everything – one assumes this peculiarity of the French must therefore be more for enjoyment than pharmacokinetics.

There are other ways we remove toxins: the kidneys filter the blood and remove harmful byproducts of metabolism (including many of those rendered safe by the liver) and get rid of them in urine. The liver also produces bile which drains to the gut. The skin removes toxins through sweat and the lungs remove carbon dioxide. But the liver is the daddy when it comes to dealing with toxins.

Proper Toxins

So, are toxins real? Yes. Abso-bleedin’-lutely. There really are some pretty nasty ones out there. Toxins found in food include those produced by our Microbial Overlords that can make you really ill really quickly: most rapid onset types of food poisoning are actually foodborne intoxication – where the toxin produced by the bug makes you ill rather than the bug per se. And many bacterial toxins found in food are heat-stable so cooking won’t inactivate them. You can read all about them in the Food Recto-BugWiki.

Indeed some of the most powerful toxins in nature are bacterial in origin: the botulinum toxin (sold to the vain and witless as Botox®) is incredibly powerful, as is the tetanus toxin, produced by C. botulinum’s cousin C. tetani. The clostridia really are the Addams Family of the microbial world – you can add gas gangrene, food poisoning and pseudomembranous colitis to their family repertoire. But intoxication from the by-products of our Microbial Overlords is relatively rare.

Some of the most common toxins overdosed are paracetamol (acetaminophen if you prefer) which can destroy the liver in pretty short order if too much is ingested leading to a protracted, painful and conscious death.

But vitamins and mineral dietary supplements are also frequently overdosed toxins. Crikey!

Vitamins all have deficiency syndromes but most are also toxic when taken to excess, especially fat-soluble ones (A, D, E and K) because – being fat-soluble – they can accumulate in the tissues.

Iron is a common intoxicant as well: the body keeps a very tight grip on iron metabolism not least because it is vital for bacteria to multiply. Keeping it locked down really pisses off our Microbial Overlords and helps keep them at bay. But iron is toxic if you take in too much – more than 10-20mg elemental iron per kilo body weight per day. (A 325mg tablet will have between 12-33% elemental iron depending on the iron compound in the tablet). Or, to put it another way, about 3g will kill a two year old. Double Crikey.

So, what else is out there? Pesticides can remain on fruits and vegetables but most are easily washed off. Seafood can contain methyl mercury plus small amounts of mercury compounds get released when coal or other organic stuff is burned. Mercury was used when wrangling felt in hat manufacture and this continuous environmental exposure cause neurological damage in hat makers of old – this is the origin of the phrase ‘mad as a hatter’. Point is, it’s elemental mercury (like wot used to be in thermometers) that’s really toxic. There is a belief that mercury amalgam from fillings in teeth can leach mercury compounds into the bloodstream but despite many studies no toxic effect has been demonstrated – apart from in dentists due to long-term occupational exposure. Lead can also cause neurological damage – which is why it’s now banned in paint. Lead paint tastes sweet which is why children (like me) used to eat it. Never did me any harm… honest…

But – again – it’s all in the dose. This is why any occupational exposure to potentially toxic chemicals etc in the workplace is tightly controlled. And even the botulism toxin – the most powerful ‘proper’ toxin known – has therapeutic uses but only when administered in very, very small doses.

Do We Need To Detox?

Having looked at a whole bunch of alleged ‘detox’ products and regimens my first issue is no bugger can tell me the specific toxin their particular woo is targeted at. It’s just these nebulous “Toxins!” and were I a cynical person I might surmise that if they actually said what the toxin was smartarses like me would be designing an experiment to see whether the woo had any effect. Yes, there are people that offer to analyse your hair to see if you’ve been exposed to – for example – heavy metals but this as a diagnostic tool is Utter, Utter Bollocks (µ²B) – there is no correlation between levels of anything in hair and levels in the body. It’s pure woo. And most people selling woo ignore the body’s ability to routinely process toxins – or they claim it’s insufficient (and I’m not talking about ‘proper’ exposure to a poison here that needs a medical intervention, obviously).

Let’s look at some examples…

Colon Cleansing

Your intestines are quite capable of cleaning themselves. Waves of involuntary contraction in the gut wall called peristalsis drive the food we eat along the digestive tract as it makes its journey from tongue to turd as the body breaks it down, removes the useful stuff and leaves the rest. Neither “Toxins!” nor old poo cling to the wall of the bowel or anywhere else. This notion is just Utter, Utter Bollocks (µ²B).

So coffee or any other ‘colon cleanses’ are not only of zero benefit but also carry risk: if you perforate your bowel our Microbial Overlords can escape into the rest of the body and wreak havoc. There are also oral colon cleanses where you eat some sort of guck that passes through the gut and isn’t absorbed. It then comes out the other end and it’s claimed this pseudo-turd is in fact toxins being removed but all the tests show all that comes out is the indigestible crap you’ve taken in. It’s Utter, Utter Bollocks (µ²B).

Ear Candling

OK. You stick a candle in your ear and set light to it. The burning wax draws out ear wax and toxins with it. Yeah? This is implausible for several reasons. For a start the body doesn’t get rid of toxins via ear wax. The technique will not create any negative pressure (suction) in the ear canal and so – unless we suspend the laws of physics – the lack of sucking action alone will remove precisely bugger all even if there were toxins there in the first place. But this process can be remarkably effective at removing cash from your wallet. Also analyses of the ash have shown it’s only made of candle. Who’d have thought it! I’m sure people find it therapeutic but like acupuncture you feel better because someone is fussing over you and the environment is soothing – until you get that flaming glob of goop down your ear or a perforated eardrum, obviously.

Detox Diets

Crikey. There’s loads of them. Some are mixes of herbs and stuff, some are diet regimes but none have any scientific plausibility and if you’ve had a high-fat, high salt diet, eaten badly for years, drank like a hole and smoked like a kipper you can’t suddenly eat yourself healthy by going on some woo diet for a week or a month. Sorry. It’s just Utter Utter Bollocks (µ²B). Sense About Science looked at this and found that not only were these ‘detox’ products worthless, many companies admitted to getting a generic product, putting some marketing bollocks on it with the word ‘detox’ in there and selling loads more.

Hydration Therapy

So, drink a lot of water and it will ‘flush out the toxins’. This is wrong on several levels; to start with which bloody toxins? Tell me! Also consuming water to excess can be very dangerous; if you exceed the body’s ability to keep its salt balance intact it can be fatal. Hyponatremia is when your sodium goes too low because your kidneys are overwhelmed. Delerium, seizures and permanent neurlogcial damage follow.

The body has millions of years of evolution behind it making the thirst instinct pretty bloody accurate and effective in managing our need for water. And that’s another post in itself.

The Foot Bath

This is a blinder. You put your feet in a bath, some magic electrical woo happens and you can SEE the toxins coming out of your skin. You can’t argue with evidence you see with your own eyes, FFS. Can you?

The dirty colour isn’t proof of toxins being ‘magnetically’ or ‘ionically’ drawn your body via your feet. Utter, Utter Bollocks (µ²B): the discoloration is from the metal of the electrodes and contaminants being electrolysed in the salt water. Switch one of these devices on without putting your feet in the water and you will still get the same effect.

Sooo….

I really can’t find a compelling scientific logic or plausibility behind any over the counter detox products or systems. (Note that I exclude specific medical interventions against specific toxins performed by those medically qualified to diagnose and treat so that excludes well-meaning woo-sters like naturopaths, obviously).

It seems to me that most of these appeal to a fear of being poisoned by what we eat, breathe or are otherwise exposed to and / or a hope that we’ll feel better or be healthier. And some do look or sound eminently plausible. Until you get into the science.

I can see this being a subject, dear readers, to which we may return…