Is detoxing your liver worth the hype?

0:00People just shelling out the dosh for some expensive wee. Yep, or indeed expensive diarrhoea. Oh, oh God. Don't blimey. I can't believe what I've just seen. Why were her feet so mucky? Do we actually need to detox? Or is this whole kind of detox thing, is it just fundamentally flawed? Sure. So I'm not sure I buy into the idea of sticking it where the sun doesn't shine as it were. I'm not planning on it, I'll be honest with you. Hello and welcome to the very first episode of Strange Health from The Conversation. And this is the show where we're going to explore all the weird and wonderful things that your body gets up to.

0:40We're going to decode the science behind the wellness trends and we're going to do that with the help of researchers who study this stuff for a living. I'm Katie Edwards and I'm the health and medicine editor at The Conversation. That's an independent source of news and analysis and it's powered by academics and journalists. and we work together to make evidence as accessible as possible. Now, I'm here with my mate Dan, who I've worked with loads. I turn to him for advice and guidance and all the odd and strange things that I need to know about for my job. This is Dan Baumgart, everybody.

1:17Dan Baumgardt:Hi, I'm Dan Baumgart, and I'm a lecturer in health and life sciences at the University of Bristol, and I also work as a GP there in the city of Bristol too. Now, Katie and I have known each other for a while as she said and we've worked together on over 60 articles for the conversation and we both share this morbid fascination with the intricacies and improbabilities and also impossibilities of the human body and the feats that it's capable of and we're here as I said to decode that science and try and find out which part of it belongs in a realm of reality and which needs to be confined to the dustbin or to books of myths and not legends.

1:52So Dan in this episode of Strange Health, we're talking about detoxing because it's January and everybody's eaten too much. They've drunk too much. They've slept badly. They've had too much time with the family. Social media is now aggressively and sometimes a bit rudely advertising, you know, green juices, charcoal powders, and some are called a seven day liver reset. But they're all promising the same thing. They're all saying that they'll detox, remove all the toxins from our bodies and make us purer. But if these products really did purge our bodies of harmful toxins, then there'd be loads less illness, wouldn't there?

2:34And if they don't work, aren't people just shelling out the dosh for some expensive wee? Yep.

2:42Dan Baumgardt:Or indeed expensive diarrhea. Oh, you've got to go there, aren't you, Dan? I know. Sorry, lowering the standard from the word go promise i was staying up there for the viewers and there you are what you mean to carry on katie oh well i know that so every week we're going to be looking at some examples of what we're talking about so today i've got a couple of videos should we have a look at them dan yeah let's have a look and this is sort of some of the current trends that are out there at the moment yeah one of the best things you can do to support and promote a healthy liver is to drink fresh squeezed beet juice over an extended period of time so this is a woman very very toned in workout wear um all matching and she's wearing a face mask and that all seems to mean that she's very healthy and now she's just putting a lot of beetroot celery and carrots to make a smoothie i mean she's not really doing a lot is she you know for a detox like she's just putting a few veg into a a blender isn't she yeah and i mean you know on the on the face of things or the hannibal lector face of things as we can see here it's sort of like the you know beetroot's impossibly good for you i mean i'm quite a fan of beetroot i used to loathe it as a kid but now i'm sort of found ways in which i can enjoy it but at the same time i think that you know there's lots of things within you know juicing beetroot juicing other vegetables and stuff like that that's not going to do your body any harm?

4:15Dan Baumgardt:Perhaps boost up those antioxidants and boost up the nutrients that your body's longing for, especially if you haven't had a particularly good diet before. But is it going to change things within the space of 24 hours or 48 hours for you? It needs sustainability more than anything else. I think that's the problem with a lot of these detox fads and detox diets. Are you going to stick to them for a long period of time or come first week of January? Yeah, back to where you were before. Have you tried any detoxes yourself? Yeah, I have. I have. But I felt rubbish. They made me feel terrible. I got a banging headache from them.

4:51Dan Baumgardt:Yeah. And I think that's the general gist. They're producing all these symptoms like headache and fatigue and all these other bits and pieces like, you know, real lethargy and an ability to get out of bed in the morning. My detox experiences involved, you know, two very non-sustainable periods in my life where I had, one of them was a fruit and vegetable based diet. Another one involved lots of juicing and teas. And I can't remember what prompted me to do it in the first place. It remains unclear to this day, whether it was sort of temporary insanity or that sort of feeling of virtuosity you get after New Year, where you think my body is a temple and a temple it will be.

5:30oh wow yeah no i just i just felt a bit rough when i did it i wasn't too worried about my body being a temple and dan i've seen loads of people trying to detox through the feet you know like i've seen them putting onion rings not not lamb battered ones but you know fresh onions on the bottom of the feet i've seen them um you know doing these ionized foot baths where you just put your feet in water and apparently it detoxes them um and then there's these these like foot pads and i think we've got um an example of like these foot patches that you stick on your feet

6:05Dan Baumgardt:oh go for it let's have a look we're on day five of these foot detoxing pads oh god blimey other than the fact that i sleep like an actual baby believe it or not the color on this is actually drastically lighter than the first day so it's definitely pulling stuff out now before you come for me about that because i know so many people are so skeptical about it i don't even care because i got the good night ones they have like magnesium and all that stuff in it and the way that I'm sleeping, I'm not even going to ask questions, okay? But, like, this is disgusting. And somebody please explain to me why it's wet, okay?

6:33Dan Baumgardt:I do not sweat, so you cannot use that as an excuse. Explain to me why it's wet. I don't even know. The one thing that I do know is this is absolutely disgusting. This is what the bag looks like. It's got, like, magnesium, zeolite, lavender, chamomile. I feel a bit sick, Katie, don't you? I can't believe what I've just seen. I honestly, I can't believe what I've just seen. why why were her feet so mucky i don't what happened there she put them pads on and they'd got a bit of magnesium in them they'd got a bit of what lavender chamomile they were supposed to make her sleep better she pulled them off and they were wet and filthy what's that something homeopathic i can't explain that because you know the the bottoms of the soles of our feet is where you would find the thickest skin possible.

7:21Dan Baumgardt:So to, I think, make the claim that you can exude toxins from the skin of your feet is probably the most unlikely thing that I could, you know, I could come across anatomically speaking. And I say just simply because the skin on your feet is so thick. Perhaps if it would come off elsewhere, you know, if you were thinking about other parts of your skin. But even then, the minimal amounts of toxins that leave your body via your skin and virus were dissolved and sweat is absolutely minimal which is why i think anything that any detox product which has got the label sweat it out sweat those toxins out don't believe it because only very very much trace amounts and there's nothing that can sort of change that it's mostly your kidneys and your liver that allow you to get rid of the products of metabolic waste and toxins from your body so have you do you know i know you're into your case studies do you know of any like weird case studies to do with detox?

8:11Dan Baumgardt:Well, actually, I have. And there's, you know, everybody assumes that detox is something that's been within our lives over the last sort of couple of years, or maybe even a decade or two. But actually, it goes all the way back to donkeys years ago, it goes back to the times of bloodletting, and the times of King Charles II, and George Washington, who were bled. You know, they it was the belief that at that time, there was an excess of bad humours. You know, when we go back to the days of the sort of sort of like the humours of the body like bile and phlegm and blood and to remove blood either by taking it away or popping a couple of those leeches on your back or your sides to take blood away was beneficial of course we know now that blood is absolutely essential the circulation is absolutely essential to keeping us healthy and so unfortunately it promptly ended the lives of people like king charles ii and queen anne and all this quacker and poor old george washington himself but then other things have been marketed so things like mercury and arsenic were used to treat things like syphilis and um other other bodily afflictions and actually before they found out it's terribly bad for you to receive mercury compounds and um arsenic and stuff like that and then there's these coffee enemas you know there's there's loads and loads of strange cases that predate the modern idea of detoxing.

9:30Dan Baumgardt:And actually, have we come far as a result of it? Well, we know, first of all, that blood and mercury and arsenic original ideas back then were completely off piece and completely wrong. But we've reached this stage now where I think we need to find out if we are going to detox our bodies, what is the best way of doing that? Or how do we help our bodies do the function that we're naturally geared up to do? Thanks, Dan. Okay, well, it's time we found out a bit more about detoxing and what it actually does to the body and whether we even need it. So I got in touch with a lovely liver expert to ask her expert opinion.

10:10So Trish Layla, you're a professor of experimental heptology at the University of Birmingham, where you're an expert in all things to do with the liver. Welcome to Strange Health. Hi there, Katie. It's very nice to meet you. Thanks for having me on. So in this episode, we're looking at detoxing because, you know, at this time of year, people are using like solutions and products and stuff in an attempt to like detox the liver and detox the body and go back on everything that they've done to themselves over Christmas. All the damage of Christmas. Yeah. Exactly. So let's start with the big question, Trish.

10:43Do we actually need to detox? So actually, probably the honest answer is that your body's really set up to do it by itself. um so i'm particularly interested in the liver that's the organ that i would work on and the liver is the primary organ in your body which does this so-called detoxing so essentially eliminating harmful chemicals from your body um it sort of partners up with the kidneys and the intestines as well so once it's kind of deactivated things they'll then be excreted through the um kidneys or or you know out through poo essentially but it's the liver that does that job so usually i would say that it that you know as long as your liver is healthy then you probably don't need to be investing in these kind of crazy teas and detox type approaches.

11:25Does the liver actually need a reset then after Christmas? Well, probably not, to be honest. As long as you normally have quite a healthy diet, so you've got plenty of vitamins and antioxidants on board, you're not like me, slightly on the overweight side, your liver's probably going to be able to deal with most things that you throw at it. Challenges come if there are, it can only deal with so many insults at once so if you are on the perhaps the overweight side you might have a tendency to store fat in the liver and that makes it work slightly less efficiently also I hate to say it but as you age your liver gets slightly smaller it gets slightly less good at repairing itself it's slightly less good at sort of detoxifying things so you've got to take a little bit more care you know what it's like you can you can't drink like you did when you were young I don't know what it's It's like, I've got a massive liver.

12:19There you go. So you're fine. The rest of us, mere mortals, you know, I've noticed that I'm sort of less capable as I get older. So I think it's just being careful, isn't it? And being sensible. But generally, the liver is there. Its job is to help you detoxify and process and eliminate materials from the body. So we're going to do a bit of a quickfire thing about detoxes. So the kind of things that people are doing at this time of year. Yeah. So what would actually happen then if someone did, you know, like these master cleansers, these three day juice cleansers? Yeah. Yeah. What actually did, what did they do to your liver?

12:56Are they any good? Yeah. So, so in principle, what you're doing is eating probably more good stuff because a lot of them are fruit juice based or tea based sort of thing. So you're eating more good stuff and less bad stuff. So that's going to be good for your liver. You're not eating artificial chemicals, et cetera. also they are predominantly liquid and quite a lot of the the plant ingredients in them are kind of diuretic so what that means is you're kind of speeding up the process of elimination of waste through your body and through your kidneys so that's probably quite good they also tend to be reasonably low calorie unless there's a lot of fruit juice in them with a lot of sugar in they're reasonably low calorie so that will encourage your liver to use up its energy reserves so in a way a short term and you don't want to do them for too long two or three day clear out will probably speed up your liver function, speed up your kidney function.

13:43And also the fibre in those drinks is quite good for speeding the transit of food and waste actually through your intestine. And also some of them, they've got herbal ingredients, some of which are quite beneficial. So there were some things like turmeric, ginger, those kinds of things, which are quite nice. You know, they reduce bloating. They can promote some of the detox functions of the liver. They're quite good. But equally, there are some ingredients in there that are perhaps less well characterized or maybe there might be impurities and things in them depending on where you bought it from so there have been cases where people have done them rather than just the three days maybe they keep doing them keep doing them and then you've seen cases where people have either developed allergies to some of the herbal ingredients or you can actually get liver toxicity for some of the either contaminants or some of the herbs aren't supposed to be taken in high doses so i think as long as you do it as advised and you trust the manufacturer where you bought it from and it looks like it's, you know, it's fruit juices or teas, whatever, it's probably not going to do any harm in the short term.

14:44But the reason it's working is because it's making your body do what it would do anyway, just do it a bit better, I guess. And another thing. Trish. I'm loving these places. What's coming now? I'm thinking about charcoal supplements. Oh, yes, yes. So, you know, this idea that they soak up toxins in your liver. Do they really do that? like would they do that inside a healthy person it's a really interesting idea i think you hit the nail on the head with the idea of the healthy person actually so charcoal the idea is is that it's just it's not like eating burnt toast it's little tiny particles of charcoal which you swallow so you ingest and it's it just binds material so it sucks up toxins and essentially they go all the way through you and you poo them out so it's a way of taking toxins out of the body and they are used medically.

15:33So in our liver unit, which is literally just outside the window here, patients that have had maybe a drug reaction, that could be a medical drug, not an intentional overdose, or it could be something like a paracetamol or an alcohol overdose. One of the ways you can manage that if you get to the person quick enough, because you have to do it quite quickly, is you give them these drinks containing carbon and it'll mop up some of the toxin and then they hopefully poo it out. There are some really nasty autoimmune liver conditions where the body's own immune system attacks cells in the liver. And they seem to be linked to what's happening in your gut and the toxins that are made by perhaps the microbiome, some of the bacteria in your gut.

16:13And so there's a new trial live, I think it's recruiting currently, where they're doing exactly this. So they're giving people these drinks of carbon particles, tiny particles, which and the idea is they'll mop up the toxins in the bowel and intestines so that they don't then traffic to the liver and help cause the liver damage so i think there is something to be said for the idea that carbon particles can mop up toxins but i think when you said healthy individual you were absolutely right i think the average healthy individual probably doesn't need to do that unless they've you know they've ingested something which they shouldn't in which case you should probably be seeing a doctor rather than, you know, drinking a over the counter kind of carbon drink sort of thing.

16:55Yeah. So and then, you know, there's all detox teas and they said that the flush out impurities. Yeah. I mean, what what does a detox tea flush? I guess I mean, I guess it's kind of oxidants and kind of toxic, you know, the generic toxins we all hear about in the system. I mean, certainly there's lots of evidence because tea's been used for thousands of years. There's lots of evidence that, you know, black and green tea in particular has got some really nice sort of polyphenols and molecules in them that are really nice antioxidants, but also seem to turn on some of those enzymes I mentioned, things like those that break down alcohol.

17:32There's a whole different isoforms, many of those different types of enzymes. And I think there's really good evidence from lab studies where if you expose cells to the ingredients of tea, they get better at making those enzymes and they get more functional. but also that it sort of beefs up how you oxidize fat so it might actually if you had a slight tendency to a fatty liver i think there's a suggestion that maybe some of these teas might help with just beefing up your liver and make it more efficient also they're they're liquids so it's going to you know they're going to have a diuretic function as well which is which is quite beneficial to sort of you know excrete materials in urine um and beef up your kidney function so i think those t's you know again if if they're used as advised there's probably some evidence that they certainly won't do you any harm and they might do you a bit of good is there any like any point where they could be risky um it depends what's in them so so so again there's always evidence if you look at there's there's some tox resources which are sort of um resources that tell you what what the current things are that people are coming in with liver failure for and there's always a little bit of a signature for some herbal teas and it's usually when they're not used as advised they use for too long or people take too much of it then there's active ingredients in there particularly some of the plant derived herbal derived molecules which can cause liver toxicity in excess but i think if you're using it as recommended and it's from a reasonably good manufacturer you're generally all right and people not you know the people take like milk thistle, is that right?

19:07Yeah. Yeah, they take that, you know, or turmeric or, you know, various other things for liver cleansing. Is there any reliable evidence that they work? Actually, it's really interesting. Those are two molecules, one of a better word, which are actually, you know, they're used in traditional therapies. And there is a reasonable body of medical evidence that says in people with perhaps liver damage of another kind, maybe viral hepatitis or alcohol exposure, whatever it is. There's both lab-based evidence and evidence in people that I think it's silamarin, which is the active ingredient of milk thistle.

19:41And there's also turmeric has, I think it's called curcumin, which is an active ingredient. They're plant kind of flavonoid type molecules. And I think they have really good antioxidant function, which is very helpful. But also they are, again, they're priming the anti-inflammatory functions of your liver. So there is reasonable evidence that they work. The challenge with all of these kind of medications is it's all about the dosing that you use. It's inconsistent between one study and another. So there's no really big grand studies that are really well controlled that can say absolutely, if you give turmeric to people with metabolic liver disease, it's going to have benefit or it's really good for healthy individuals.

20:21But I think there is at least some signatures out there for both of those molecules that says they're having some kind of beneficial effect. Trish, what do you think about these coffee enemas that influencers are doing to detox the system? Yeah, sounds bonkers, doesn't it? There's a couple of grains of potential interesting biology in there. So firstly, the idea of an enema. I mean, I've certainly seen cases where people have burnt themselves or they've given themselves infections or they've perforated themselves or tried to self-administer. So advice number one is don't do this to yourself, kids but actually that route of giving a medication your intestines your colon is quite well supplied with blood so it's a really good way to get something absorbed and into your bloodstream that's why they give medicines as suppositories and things sometimes so that route is good because it goes straight into the blood supply which delivers immediately to the liver so anything that you absorb through that route is going to make it to the liver quickly which is good and And then there's also evidence that actually coffee, so its ingredients, things like caffeine, but also it's got some of these kind of theobromines and things in it as well.

21:32There is quite a lot of evidence now, or accumulating evidence, that it does have some beneficial effects actually. So the liver particularly, so it looks like it might be anti-inflammatory. It looks like there's a bit of a signature for it helping with fibrosis, so that scarring of the liver. So there's some evidence that it has benefit in that place. And also when you're looking at these things called meta-analysis, which is where somebody compares the evidence from hundreds of clinical studies. And caffeine is one of those things where people have done these meta-analyses and looked at whether it has benefit.

22:03And it seems to be in moderate doses, so maybe a couple of cups a day. There's benefits in all causes mortality. So people who drink coffee do a bit better. But also if you break it down into disease type, it does seem to have some a bit of a signature in liver disease. and also possibly some other, maybe cancer as well, some cancers. So it looks like a certain amount of coffee certainly isn't going to do you any harm and may be doing you some good. The challenge comes if you drink a lot. So there's scientific conferences, we just drink coffee all day and everybody's mad by the end of it. So it does cause hypertension.

22:39So it can be a bit challenging to your cardiovascular system. So I think there's some signatures that too much coffee, however you have it, whichever route is probably not a great thing and I think you know it's the usual story pregnant women etc need to be a bit careful so I'm not sure I buy into the idea of sticking it where the sun doesn't shine as it were but I think you know there's a reasonable amount of evidence that a little bit of coffee probably is is not a bad thing right I'm glad we've uh we've cleared that one don't do it yourself yeah whatever happens don't do it yourself yeah oh perforation oh yes so are there any over-the-counter products that improve liver function in healthy people or is this whole kind of detox thing is it just fundamentally flawed sure i mean the kind of boring but probably true answer is that if you have a healthy diet and you're minimizing your exposure to toxins and you're drinking plenty and you're having plenty of fiber that's probably all your liver needs if you're a healthy individual but that's boring so so based on what my colleagues is doing medically, there's a couple of things that look like they're quite interesting.

23:44And I think they are in some of these over-the-counter products. So there's a couple of vitamins. So vitamin E, which obviously you can ingest through your diet, but you can take as a supplement. There's some really nice evidence now in human studies of people with this metabolic liver disease. So this is associated with cardiovascular disease, obesity, where you store fat in the liver and you start to get liver damage. It looks like people who take, they give vitamin E either on its own or is it adjunct to other therapies it does look like the kind of antioxidant capacity of vitamin e is quite protective so vitamin e isn't bad and then the other one which is great at this time of year is vitamin d so you know you can make that yourself if you go out in the sun if you're pasty like me you avoid the sun so i take that's about the only thing i take is vitamin d because it's really good at sort of improving the function of your immune system but the reason it's interesting in the context of liver disease is again my colleagues who treat these patients with these autoimmune liver conditions but also things like viral liver diseases you know various you know inflammatory liver conditions there's been some really nice trials where they've given high dose vitamin d and it's really had benefit in those individuals the other thing is there is some antioxidants you would get them in you know plant foods prunes etc but patients again who come into the liver unit, perhaps with a drug overdose, they are sometimes given something called N-acetyl cysteine.

25:12So that makes, it's a precursor, almost like an amino acid molecule, which makes glutathione in the liver. And glutathione is a really important antioxidant that can protect your liver function. And I've certainly seen cases where you can see these over-the-counter liver kind of things, which have either N-acetyl cysteine in them as an actual molecule, or they have cysteine in them, which is the precursor for that. So I think those are possibly quite interesting as well. Again, probably more if you think you've got liver injury rather than a healthy liver, but that might be something that could have benefit.

25:47But again, it's in meat, it's in eggs. So there are ways that you can generate that just through a healthy diet. And so if somebody's going on like a stag weekend, they drink really heavily every weekend and then they do a bit of a detox at the start of the week, does that offer the liver any real protection or are they still playing with fire? Yeah, it's a good question, isn't it? I mean, the liver is amazing. It's probably the only organ that can regenerate itself completely. So it's really cool in situations like this, a big transplant unit here in Birmingham. And so you can almost do a bit like when a parent donates a kidney to a child, you can do something called a split liver transplant, where say a mum will donate a portion of her liver to a child and in the mum her own liver will regenerate itself back to its normal size so you can the liver is quite good at fixing itself the challenge comes when the the injury so the booze or you know whatever it is is repeated and constant over a long time and also as you age so your liver gets less able to repair itself so I think if you're constantly drinking and you're not giving your liver chance to regenerate that's bad but also if you're slightly older you're less able to regenerate anyway if you keep drinking so usually the advice i mean i enjoy your drink as much as the next person but usually the advice is by all means have a drink drink within the limits that are recommended by the government because they're put there for a reason but also try and dilute the alcohol you know have a few drinks of water or whatever in between and give yourself some days off to let the liver regenerate.

27:22So don't drink every day, you know, have a few days off in between. Well, that's absolutely fascinating, Trish. I'm still quite concerned by the idea of, you know, enemas perforating the colon. I don't think I'm ever going to lose that visual that you've created. But anyway, thank you. It's putting you off, so that's good. I'm not planning on it, I'll be honest with you. It's not one of my ambitions. But thank you very, very much. That was really brilliant. Really, really interesting. Thank you so much, Trish. That's great. It's lovely to meet you. Lovely to talk to you.

28:01I'm Gemma Ware, host of the Conversation Weekly podcast. Each week, I speak to an academic expert about a topic in the news to understand how we got here from global politics.

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29:02So Trish was brill. She told us loads of really good stuff about how your body works, about detoxing, about, you know, charcoal supplements, which actually sound really quite interesting. um so what if you wanted to like support your body's natural detoxing then dan what does that

29:23Dan Baumgardt:realistically look like well i think that trish sort of hit the nail on the head with it really because the liver which is her main specialist interest is number one it is the number one detox organ comes equipped with 500 individual functions and it's performing a 24 7 um role in your body and detoxifying, removing products of metabolic waste. So it's remembering, I think, that liver is number one. And how do we best take care of our livers? We give them the time and the ability to do the job that they do so well. So hydration is one thing, making sure that we're well hydrated and also considering as well as alongside your liver and working alongside your liver and sort of beavering away very well are your kidneys and making sure that we're treating these organs kindly so we're not overloading them with alcohol and making sure as well that we're taking into effect the important role that they also play in order with the gut.