Do Detox Cleanses Work? An Honest Look at the Evidence

Do detox cleanses work? Not in the way the packaging suggests. A 2015 research review found no compelling evidence that detox diets help with weight management or remove toxins from the body. The National Center for Complementary and Integrative Health (NCCIH) describes the studies that do exist in people as few and of low quality. The waste removal you actually need happens without a kit: your liver helps remove poisons, and your kidneys filter your blood every minute of the day.

What a detox cleanse can do is much narrower. It can make you lose weight quickly, mostly because you eat very little. If it contains laxatives, it can send you to the bathroom more often. Neither is the same as removing toxins, and the weight tends to come back. Some ingredients and methods also carry risks that are easy to overlook, from laxative dependence to kidney problems from very high-oxalate juices. Below, we set out what the evidence says and what to do instead.

What your body already does

Your body has its own waste-handling system, and it works around the clock.

• Your liver. MedlinePlus describes the liver as the largest organ inside the body. It helps digest food, store energy and remove poisons.
• Your kidneys. According to the National Institute of Diabetes and Digestive and Kidney Diseases, healthy kidneys filter about 120 ml (half a cup) of blood every minute, removing wastes and extra water to make urine. Each kidney contains about a million tiny filtering units. The kidneys also remove acid made by your cells and keep the right balance of water, salts and minerals in your blood.

Genuine poisoning is a medical matter, not a shopping decision. NCCIH notes that the Centers for Disease Control and Prevention recommends chelation therapy, a medical procedure, for removing toxic metals in specific serious cases. That is entirely different from anything sold as a retail cleanse.

What cleanse programs usually involve, and what the evidence shows

NCCIH lists the common approaches. They include fasting, drinking only juices, eating only certain foods, taking supplements or other products, and using herbs. Others involve cleansing the colon with enemas, laxatives or colonic irrigation (flushing the large bowel with water through a tube), or reducing exposure to things in your environment.

The table below sets the marketing claims beside what is actually known. The middle column is what these products are sold to do, not what they have been shown to do.

Approach	What it is sold to do	What the evidence and safety record show
Juice-only days	Flush toxins, reset the body	Early weight loss from low calories, usually regained; risks from unpasteurized juice and high-oxalate juice
Laxative teas and capsules	Clean out the colon	Stimulant laxatives such as senna are for short-term constipation; frequent use can cause dependence
Colon cleansing	Remove built-up waste	Limited evidence; side effects can be serious, especially with bowel, kidney or heart conditions
Water and herbal tea with no food	Flush the system	Can lead to dangerous electrolyte imbalances
Detox supplements	Bind or neutralize toxins	Regulators have acted against products with hidden ingredients or false disease claims
Fasting programs	Detox and weight loss	Other forms of fasting are being studied, with no firm conclusions; can cause headaches, fainting, weakness and dehydration

What research reviews found

NCCIH summarizes the research plainly. Only a small number of studies have tested detox programs in people. Some reported improvements in weight, body fat, insulin resistance or blood pressure, but those studies had design problems, few participants or no independent peer review. A 2015 review concluded there was no compelling research to support detox diets for weight management or for eliminating toxins. A 2017 review found that juicing and detox diets can cause initial weight loss through low calorie intake, but tend to lead to weight gain once normal eating resumes. No studies have looked at the long-term effects of detox programs at all. So a juice cleanse that leaves you lighter on day three is showing you the effect of eating less, not proof that anything was removed.

Regulators have also stepped in. NCCIH reports that the FDA and the Federal Trade Commission have taken action against companies selling detox and cleansing products. Some contained hidden ingredients that could pose significant health risks. Some were marketed with false claims about serious diseases. Some colon-cleansing devices were marketed for uses that had not been approved. The NIH Office of Dietary Supplements adds wider context for products sold for weight loss: between 2004 and 2012, weight-loss supplements made up 27 percent of the dietary supplements subject to the FDA’s most serious class of recall, mostly because they contained drug ingredients not listed on the label.

The risks worth knowing

• Laxative dependence. Some cleanse teas and capsules include laxative herbs. If yours lists senna, it contains a stimulant laxative. MedlinePlus says senna is for short-term use and should not be taken for more than a week without talking to a doctor. Frequent or continued use can make you dependent on laxatives and cause your bowels to lose their normal activity. Side effects include stomach cramps and faintness, and rectal bleeding needs prompt medical attention.
• Dehydration and electrolyte problems. NCCIH warns that laxatives can cause diarrhea, which can lead to dehydration. Drinking large amounts of water and herbal tea without eating for days could cause dangerous electrolyte imbalances. Electrolytes are the salts and minerals, such as sodium and potassium, that your body keeps in careful balance.
• Kidney harm from high-oxalate juices. Leafy greens and beets are high in oxalate, a natural compound that can form kidney stones. A 2013 case report described acute kidney failure in a person who already had chronic kidney disease, after heavy drinking of oxalate-rich juices. The review alongside it looked at 65 patients with oxalate deposits in the kidneys and found three cases likely caused by diet. NCCIH advises people prone to kidney stones to limit high-oxalate foods.
• Food poisoning. Unpasteurized juices can carry harmful bacteria. The most serious illness is seen in children, older adults and people with weakened immune systems.
• Colon cleansing complications. NCCIH notes that harms are more likely in people with a history of bowel disease, colon surgery, severe hemorrhoids, kidney disease or heart disease.
• Nutrition gaps. Diets that severely restrict calories or types of food usually do not lead to lasting weight loss, and they may not give you all the nutrients you need.

Questions to ask before buying a cleanse

1. Which toxin does it remove, and how was that measured? Vague talk of “toxins”, with no named substance and no before-and-after testing, tells you the claim has not been tested.
2. Does it contain a laxative or a stimulant? Check the ingredient list for senna and for herbs that contain caffeine.
3. Does it promise to fix a disease? Supplements are not allowed to be marketed as remedies for diseases, so a disease claim is a warning sign.
4. How long does it ask you to go without food? Multi-day fasts with large amounts of fluid carry the electrolyte risks described above.

What to do instead

If the appeal of a cleanse is feeling lighter, more regular or more in control of your health, there are steadier routes with better evidence behind them.

• Go easy on alcohol. MedlinePlus lists too much alcohol among the causes of liver disease.
• Use fiber, not laxatives, for regularity. Fiber from food, plus a supplement such as psyllium husk taken with plenty of water, supports regular bowel movements without stimulant laxatives.
• Review your medicines and supplements. A pharmacist can check for duplicated ingredients and interactions, including products marketed for weight loss such as CLA.
• Keep up with check-ups. Regular reviews of blood pressure, blood sugar and medicines with your care team are a better use of your effort than a cleanse.
• Avoid stacking products. Taking several supplements or teas at once makes it harder to tell what is helping, what is causing side effects and what might interact with your medicines.
• Get persistent symptoms checked. Tiredness, bloating or brain fog have many possible causes, and they are worth identifying properly.

Who should be careful

• People with diabetes. NCCIH advises following the eating plan from your care team and talking to them before making major changes to how you eat.
• People with kidney disease or a history of kidney stones, given the oxalate and fluid risks described above.
• People with bowel disease, past colon surgery, severe hemorrhoids or heart disease, who face higher risks from colon cleansing.
• Children, older adults and anyone with a weakened immune system, for whom unpasteurized juice is a particular risk. If you are pregnant, check with your clinician before any cleanse or fast.
• Anyone taking regular medicines. MedlinePlus notes that some senna products may affect how other medicines work and should be taken at least 2 hours apart from them. Ask your pharmacist before starting one.
• Anyone with a history of restrictive eating, for whom fasting-style cleanses can be harmful. Talk with a clinician before starting one.