Toxic waste (of money): detoxes and cleanses

Cross-posted from Dietitian at Home.

Apparently we are all chock-full of toxins that need to be flushed out of our bodies; who knew? If we are to judge this claim based on the number of detox kits and programs available, I’d say this problem has hit epidemic proportions. Removing bad stuff from our bodies to feel better and prevent disease, and lose some weight to boot, what’s not to love with this diet trend.

Before we move on, we will need to get these horses to catch up with the cart. Our zealous, hyper health-conscious society simultaneously encourages fear over threats to our well being and aggressive, excessive measures to purge the ills and return to purity. The idea of a detox in the sense intended above is full of assumptions that are often glossed over by the marketers and not actively sought by the consumers. This fantastic article outlines the common myths around detox claims, I highly suggest you read it. To summarize briefly, despite the many claims promoted by these regimens, all fail to explicitly show key evidence for the need for the product. It is not demonstrated that our bodies are truly under attack and unable to cope with environmental exposures. There is no evidence or consensus of which, if any toxins are causing disease. There is no good or compelling evidence to show that these programs are effective in removing any toxins or treating any other illnesses we may have.

As is often said, the dose makes the poison. We encounter thousands of highly toxic substances every day, some naturally occurring, some a product of the human-made environment. Given this hellscape, we still manage to survive to see another day because most of these toxins are in such minute quantities that they pose no health risk, and our bodies are able to effectively eliminate them. The human body has excellent, built-in detoxification systems in the form of the liver and kidneys. These organs are not merely fleshy filters; they are able to convert toxins and waste products into safer forms and safely eliminate them from the body. The best part is that they are self-cleaning, no vitamin-and-cayenne-pepper-laced organ drain-o needed.

Similarly, the intestines (often claimed to harbor toxin-laden sludge) are, by their very nature, self-cleaning. Specific foods/herb mixes/protein shakes/etc. will not make these organs work better or clear more wastes from your system. As for the weight loss accompanied by, or at least touted by these cleanses, this is usually a result of:

  • a) following a very low-calorie diet for a week. Some provide as little as 500-600 calories a day, while 1200 kcal is often considered a bare minimum intake for adults.
  • b) water and muscle loss, particularly with programs involving laxative use.
  • c) removing most processed and restaurant foods from the diet.

When finishing the detox and returning to normal dietary patterns, the weight lost will more than likely return. No, this is not toxins reaccumulating, it is simply the body responding to weight loss and a return to higher calorie intake.

So how to respond to those who report feeling so much better after a cleanse. This is likely the placebo effect at play, often in combination with a more healthful diet. A person wanted to feel differently, so they made a change they believed would be beneficial, they expect positive results, and they are then more likely to report positive results regardless of the clinical outcome of the intervention.

The only times that person will truly experience a toxic overload of a particularly substance is a short period of high exposure, chemical dependency (as with opiates or alcohol), or if the liver or kidneys are failing. If this is the case, these detox kits remain useless and one should seek science-based medical advice immediately. This, though, is a rare occurrence and not one most healthy people should worry about.

Detoxes often make extraordinary and numerous claims, for which they provide little to no evidence. A cleanse product that may plausibly work would need to identify which toxins it removes (preferably explaining the process in a physiologically sound way) and provide good quality evidence to back up the claims. Seeing the dearth of such products at present, best to save your money and spend it on fruits, vegetables, and some stress relief strategies. Your liver and kidneys have got you covered.

The opposite of stumped: 9 unanswerable anti-vax questions answered

9 Questions That Stump Every Pro-Vaccine Advocate and Their Claims found its way onto the Facebook page for the Winnipeg Skeptics when a member’s friend posted it, along with the qualification “if you can give me a good, scientifically-backed answer to each of these questions, I will vaccinate my children.”

Oh, if it only were all so easy! The article claims:

I have never encountered one pro-vaccine advocate, whether medically or scientifically qualified, who could answer even 1 let alone all 9 of these questions.

Well, here’s one non-immunologist, non-virologist, unqualified physiology & medical student who had zero problem with finding scientific answers to any of their questions. Let’s dive right in, shall we?

1. Could you please provide one double-blind, placebo-controlled study that can prove the safety and effectiveness of vaccines?

Yes, although you can’t find any modern studies of old vaccines, because it’s unethical to deviate from the standard of care. However, there are tons of modern (i.e. internet searchable) literature on the subject. Honestly, go to Google Scholar and search “double blind placebo vaccine” I’ll start you off:
Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial

2. Could you please provide scientific evidence on ANY study which can confirm the long-term safety and effectiveness of vaccines?

Yes. Seriously, it took me 30 seconds to find this. Google Scholar is your friend.

3. Could you please provide scientific evidence which can prove that disease reduction in any part of the world, at any point in history was attributable to inoculation of populations?

4. Could you please explain how the safety and mechanism of vaccines in the human body are scientifically proven if their pharmacokinetics (the study of bodily absorption, distribution, metabolism and excretion of ingredients) are never examined or analyzed in any vaccine study?

You can’t study the pharmacokinetics of something which is not physically acting on the body—rather, vaccines are designed to be acted upon. I can’t answer this; not because of a conspiracy, but because this is an unanswerable question. It’s like asking, “Why haven’t they studied the mating habits of tennis shoes?”

5. Could you please provide scientific justification as to how injecting a human being with a confirmed neurotoxin is beneficial to human health and prevents disease?

Neurotoxins are a matter of dosage, just like radiation, and all interventions are a risk-benefit ratio. You accept the risk of getting a chest x-ray if you might have pneumonia because the dose is very low, and you won’t have it done repeatedly. Also, for something to be a neurotoxin and have effects on the brain, it must be able to pass the blood-brain barrier. This is very, very difficult and chemists spend their entire lives trying to design something that will get across. Just because something can be toxic doesn’t mean it is, just because something has risk doesn’t mean it’s not worth doing, and just because something has theoretical potential to do harm doesn’t mean that it will do harm.

‎6. Can you provide a risk/benefit profile on how the benefits of injecting a known neurotoxin exceeds its risks to human health for the intended goal of preventing disease?

See the above study on measles vaccines saving hundreds of thousands of lives. Any risk of “injecting a known neurotoxin” (Which one? At what dose? Neurotoxic to who? Correlation or causative?) is unequivocally lower than the very real and potentially lethal risk of an outbreak in an unvaccinated community or one with a low uptake.

7. Could you please provide scientific justification on how bypassing the respiratory tract (or mucous membrane) is advantageous and how directly injecting viruses into the bloodstream enhances immune functioning and prevents future infections?

Different parts of your body have different types of antibodies associated with them. In the mucous membranes of your body, like the GI tract and the respiratory tract, white blood cells at the membrane produce IgA antibodies on exposure to a pathogen. In the blood stream, you have direct access to the memory cells which produce IgGs: the more robust antibodies that provide lifetime immunity against a particular pathogen. Those memory cells will stay in your lymph nodes, ready to produce an onslaught of deadly (to the pathogen) IgGs whenever the body recognizes it again. IgAs are incapable of this, and many respiratory pathogens are defeated after exposure by the body’s initial defences, before an specific set of antibodies can ever be manufactured.

8. Could you please provide scientific justification on how a vaccine would prevent viruses from mutating?

Viruses mutate as they replicate, but fortunately, by definition, viruses require the machinery of living organisms to do so. To do this, viruses must enter the cells and hijack their function to produce more viruses. If the body is prepared to identify the pathogen, it can respond immediately to the pathogen in a matter of hours instead of days. Given that viruses can replicate at phenomenal rates, the faster the body responds, the less replication will happen, the less likely a beneficial (to the virus) mutation will occur. Furthermore, even if a mutation does happen, if individuals around the infected patient are all immunized, the mutation will not be carried on. The nice thing about adaptive (post-exposure) immunity is that it identifies a bunch of different parts of the pathogen as foreign, so even if little bits of it change, one antibody might be useless but all of the others will still work!

9. Could you please provide scientific justification as to how a vaccination can target a virus in an infected individual who does not have the exact viral configuration or strain the vaccine was developed for?

Although I sort of just addressed this, it’s a matter of phylogeny. If you look at human beings (obviously far more complicated than viruses, but work with me) almost all of our diversity and mutation is contained in a fraction of a fraction of a percentage of our DNA. This is because we all come from a common ancestor and we have been building off of that base DNA ever since, so we have more in common than not. Viruses work the same way. Each type of virus has certain defining characteristics, defining proteins that make it work. For retroviruses, this is something like reverse transcriptase, which allows the HIV to copy itself into our DNA and hide. So, if the vaccine causes you to develop an antibody against a particular protein, say one on the surface of a influenza virus, it’s going to make antibodies against little chunks of it, and the odds of a related virus having mutated all of those little chunks beyond the wiggle-room there is in these sorts of processes is pretty low.

Think of pathogens like fugitives and antibodies like really zoomed in “wanted” photos that the body has put up in the Post Office. The fugitive tries to hide by dying their hair, so maybe that photo of their hair is useless. And maybe they’ve changed their shirt, so throw out that photo too. But that hand is still a hand, and that mouth looks like the right mouth even though it’s got a moustache now. The fugitive is spotted—the white blood cells are primed to look for that mouth and that hand—and the pathogen is “arrested”.

That’s not to say that an imperfect match is going to lead to the best result. If you can put all those little snapshots together and get the whole thing, you’re even better off, just like a perfect match is going to trigger a wide variety of antibodies to be produced and the response will be more robust, but immunization with a closely related virus is going to provide some protection.

So no, Random Internet Website that hasn’t even bothered to try and learn about the immune system (I cannot reiterate enough that I am not an immunology expert and all of this information is freely available via appropriate internet search): none of these are stumpable questions. If someone is confused by your questions, it’s because they don’t make sense or because they are so unbelievably broad as to be useless.

Asking questions is good, and should be encouraged! You should know these things before you vaccinate your kids! However, critical thinking can teach you to ask better questions. For example: What sort of evidence is there for the 25 year safety and efficacy of the Canadian childhood MMR vaccine in a healthy Canadian population? This a specific, quantifiable, discrete question to which discrete answers can be obtained. These are the sort of questions that scientists ask—and the ones that drive the clinical trials you’re asking for.