Widespread media coverage has been given to criticism of a ‘detox tincture’ produced by Duchy Originals, a company owned by the Prince of Wales. The criticisms were made by a professor of complementary medicine, Edzard Ernst, who claimed that the remedy is “outright quackery”. The professor says that “detox is implausible, unproven and dangerous” as a therapeutic approach, and that it encourages unhealthy behaviour.
The tincture is marketed on the company’s website as “a food supplement to help eliminate toxins and aid digestion”. A spokesman for the company defends the tincture in The Guardian , saying it is not, and has never been, described as “a medicine, remedy or cure for any disease”. He states that its ingredients – artichokes and dandelions – have a “long history of traditional use for aiding digestion”.
Where did the story come from?
The Duchy Herbals Detox Tincture has been available since February from two high street stores. Professor Edzard Ernst from the Peninsula Medical School, Universities of Exeter and Plymouth, wrote a brief summary outlining his point of view, which was distributed yesterday by the Science Media Centre.
What is 'detox'?
‘Detox’ is short for detoxification. Professor Ernst uses a definition of it from the Textbook of natural medicine:
“‘Detox’ is based on the notion that “toxins damage the body in an insidious and cumulative way. Once the detoxification system becomes overloaded, toxic metabolites accumulate, and sensitivity to other chemicals, some of which are not normally toxic, becomes progressively greater. This accumulation of toxins can wreak havoc on normal metabolic processes.”
People also often use the phrase to describe abstaining from something, such as alcohol, for a fixed period of time.
What claims are made for 'detox'?
Sense About Science, an independent charitable trust that “promotes evidence and scientific reasoning in public discussion” published a dossier on 'detox' earlier this year. It reported that frequently made claims about 'detox' include:
- The toxins that build up in the body are harmful and need to be flushed out.
- The organs that eliminate toxins, mainly the liver, kidney and gut, need to be targeted and aided in eliminating the toxins.
- The ‘detox’ products also contain high level of antioxidants, which help to neutralise free-radicals in the body.
Is there any evidence that ‘detox’ works?
As Professor Ernst states, there is no evidence that the process of detox works.
Some producers of ‘detox’ products claim that they are mildly diuretic, meaning that they act in a similar way to alcohol and make the kidney produce more urine, thus expelling more toxins.
Professor Ernst says that testing the effectiveness of ‘detox’ would be simple. This could be done by taking blood samples from volunteers to test whether a toxin is eliminated from the body faster than normal. He suggests that these studies do not exist for the simple reason that these products have no real detoxification effects.
There is limited evidence for one of the specific ingredients – artichoke – in the Duchy Herbals Detox Tincture. A Cochrane systematic review found two trials (167 participants) that demonstrated significant reductions in cholesterol with artichoke leaf extract. However, the authors of the review, Max H Pittler and Professor Ernst, conclude that the evidence is not compelling and more research with larger samples and longer follow-up is required. No trials of dandelion (Taraxacum officinale) could be found.
How could 'detox' be harmful?
While most 'detox' products will do no more than harm your wallet, others, such as those that contain herbs, can potentially damage health. Herbal supplements can contain a variety of ingredients, many of which have not been tested for safety or for safe dosage levels.
There is also a risk that herbal products may interact with medicines and make these less effective or too effective. For example, blood thinners (warfarin) and the contraceptive pill are both affected by some herbal medicines.
Indirect harms are also possible. Some believe that the idea of ‘detox’ encourages people to take a more cavalier attitude towards their health, believing they can ‘detox away’ a period of unhealthy living, such as a week of heavy drinking.
There are also the ‘lost opportunities’, where people put their faith in ‘detox’ rather than changing their long-term behaviour or using remedies that have been shown to improve their health, such as exercise and a good diet.
Why don’t I need to 'detox'?
You don’t need to 'detox' because there is no evidence that it does you any good. The human body gets rid of excess metabolites, excess food or alcohol in a number of ways using normal processes. Some of this occurs by excretion through the kidney, metabolism in the liver, and occasionally through sweat. Generally, this happens constantly.
The British Dietetic Association said in January that “the idea of ‘detox’ is a load of nonsense”. It added that “there are no pills or specific drinks, patches or lotions that can do a magic job…for the vast majority of people, a sensible diet and regular physical activity really are the only ways to properly protect your health”.
Analysis by Bazian
Edited by NHS Website
Links to the headlines
The Guardian, 11 March 2009
The Daily Telegraph, 11 March 2009
The Daily Mail, 11 March 2009
BBC online, 11 March 2009
Links to the science
Cochrane Database of Systematic Reviews 2002, Issue 3
Cochrane Database of Systematic Reviews 2008, Issue 2