To read the Internet ads, you'd think that our bodies were awash in "toxins" - usually unspecified - and that we should therefore go to dramatic lengths, like "colon cleansing" and chelation to get rid of all this bad stuff.
Don't believe it. Or, to put it a bit more gently, don't risk your health or your pocketbook on programs that promise to "detoxify" you, without at least doing lots of homework first. Like asking exactly what these supposed "toxins" are. And thinking twice - or 20 times - before undergoing chelation, a procedure that uses powerful drugs to rid your body of heavy metals such as mercury or lead.
Some alternative medicine practitioners, such as Dr. Glenn Rothfeld, medical director of WholeHealth New England in Arlington, believe - although research is skanty - that cleaning out the colon occasionally may help some people, particularly those with irritable bowel syndrome. "Though whether it helps by getting rid of toxins is not clear," he said.
There's evidence, Rothfeld said, that the digestive tracts of people who eat typical Western diets may move wastes along more slowly than those of people who eat more fiber. In theory, this longer "transit time" could mean that some substances, like nitrosamines, which are found in preserved meats and are carcinogenic in animals, have more time to cause trouble.
But generally, people don't need to take dramatic steps to "detoxify" themselves because human bodies have multiple systems for getting rid of wastes, by sweating, exhaling, urinating, and defecating. If you really want a "clean" system, eat more fruits and vegetables and less junk food, all of which we're supposed to do anyway.
One testimonial ad, next to a truly gross picture on drnatura.com, reads, "How would you feel if long pieces of old toxin-filled fecal matter were stuck to the inside of your colon for months or even years?" But it's simply not true that waste material gets stuck indefinitely in the colon - though the cleansing products themselves can form the gels that look like huge stools.
"I've heard my kids say that there's stuff in the GI [gastrointestinal] tract for seven years," said Dr. Douglas Pleskow, a gastroenterologist at Beth Israel Deaconess Medical Center. "That is the urban legend. In reality, most people clear their GI tract within three days."
The ads for colon cleansing are also remarkably vague about what toxins would be purged with enemas, laxatives, or special diets. Asked what toxins his colon cleansing dietary regimen called "Master Cleanse" gets rid of, author Peter Glick man, an advocate of a raw food diet, spoke of "metabolic toxins," parasites, and "environmental toxins . . . whatever kinds of stuff we're breathing in air."
Wrong, said Dr. Bennett Roth, a gastroenterologist at UCLA: "There is absolutely no science to this whatsoever. There is no such thing as getting rid of 'toxins.' The colon was made to carry stool. This is total baloney."
What's actually in the intestinal tract is mostly bacteria, which can aid in digestion. "An enema or laxative does not get rid of more 'bad' versus 'good' bacteria," said Dr. David Heber, director of the UCLA Center for Human Nutrition. It gets rid of both. "We don't like the idea of carrying bacteria so lots of folks want to cleanse, but remember bacteria can be your friend."
Moreover, colon cleansing would do no good at all for environmental pollutants such as PCBs and DDT, which are stored not in the gut but in fat, and can't be eliminated by colon cleansing.
Perhaps most worrisome, colon cleansing can actually be dangerous because most techniques draw fluid from surrounding tissues into the colon. This disrupts the balance of electrolytes such as sodium, potassium, chloride, calcium, magnesium, and phosphorus, said Pleskow of Beth Israel. This shift in fluids can lead to dehydration and low blood pressure.
As for chelation, it can be useful for getting rid of heavy metals such as lead in people with very high blood levels. But chelation can also be dangerous - the chelating drugs themselves can be toxic to the liver and kidneys.
It is totally inappropriate for people who have near-normal levels of heavy metals to get chelation therapy, said Dr. Rose Goldman, an associate professor of environmental health at the Harvard School of Public Health.
Beware of practitioners who use hair sampling to detect multiple heavy metals and elements, said Goldman. "This type of hair sampling is highly inaccurate," she said. Some practitioners push chelation on people who complain of vague symptoms like fatigue and difficulty concentrating, which could easily be due to problems other than heavy metal poisoning.
If you do decide on chelation, ask if the physician is board-certified by either the Accreditation Council for Graduate Medical Education or the American College of Occupational and Environmental Medicine. Be skeptical about practitioners who say they practice "clinical ecology," which is not a recognized medical specialty.
And before you jump to chelation, said Dr. Alan Woolf, director of the pediatric environmental health center at Children's Hospital Boston, make sure the environment is as free as possible of the contaminant in question, such as lead, so you don't recontaminate yourself. And try conservative treatments first, like adding calcium, zinc, and iron to the diet because these minerals can block absorption of lead into the body.
Before you fall prey to the country's rampant toxic phobia, ponder the whole notion of detoxification. And remember, your body has an extraordinary ability to cleanse itself.
Judy Foreman can be reached at firstname.lastname@example.org.