The truth about detoxes – by a liver specialist
Every January, the same wave of “detox” promises rolls in. Juice cleanses, detox teas, charcoal capsules and liver “resets” all sell a familiar story: you overdid it over Christmas, your body is full of toxins, and you need a product to flush them out.
Here is the inconvenient truth. Your body already has a detox system. It is called your liver, supported by your kidneys and gut, and it has been doing this job your entire life.
I am a liver researcher. I study how this organ works, how it gets damaged and how it repairs itself. So if you are wondering whether you need to detox, my honest answer is that most healthy people do not. In fact, some popular detox trends are not just unnecessary, they can cause harm.
When people talk about detoxing, they usually mean getting rid of harmful substances. That is a real biological process, but it is not something you can switch on with a tea, a supplement or a three day cleanse. Detoxification happens continuously. The liver neutralises chemicals and breaks them down into forms the body can use or safely remove, with waste leaving mainly through urine and faeces. This process is well described in human physiology and toxicology research, including detailed accounts of liver metabolism.
If you are generally healthy and not repeatedly overwhelming your system, you do not need a reset. What the liver needs most is time and consistency, meaning fewer repeated insults and enough recovery time to repair itself between them.
Alcohol: the liver can cope, until it can’t
Alcohol is a useful example of how detoxification works, because everything you drink is processed directly by the liver. After drinking, alcohol is absorbed through the gut and carried in the bloodstream straight to this organ. Liver cells, called hepatocytes, break alcohol down in stages. One intermediate product, acetaldehyde, is toxic and contributes to hangover symptoms before being broken down further into acetate, which the body can use or eliminate.
Read more: Hangovers happen as your body tries to protect itself from alcohol's toxic effects
Problems arise with binge drinking or sustained heavy drinking. Under these conditions, the liver relies more heavily on alternative processing pathways that generate larger amounts of acetaldehyde and increase oxidative stress. This means toxic by-products are produced faster than they can be cleared. Over time, this damages liver cells, triggers inflammation and contributes to fibrosis, which is the build-up of scar tissue. If scarring becomes extensive, it can progress to cirrhosis, a stage where normal liver structure and function are severely disrupted, increasing the risk of liver failure and liver cancer.
This is why how you drink matters, not just how much. Spacing drinks out keeps blood alcohol levels lower and gives the liver a better chance to keep up with detoxification.
Read more: How alcohol contributes to the epidemic of liver disease
Liver ‘cleanses’
When people replace alcohol and ultra-processed foods with liquids made from fruit, vegetables and herbs for a few days, they often feel better. That does not mean toxins have been pulled out of the liver. More often, it reflects lower calorie intake, fewer additives, increased fluid consumption and sometimes more fibre.
A short, sensible “cleanse” is unlikely to harm most healthy adults, but risks increase with very low calorie regimens, poorly regulated herbal ingredients or repeated long-term use.
Many detox products are sold as supplements rather than medicines, which means quality, dose and purity can vary widely. Higher doses and prolonged use increase the chance of adverse effects.
Some supplements have evidence in specific clinical settings. Vitamins D and E have been studied in certain liver diseases, and antioxidants such as N-acetylcysteine are used medically in cases of acute liver injury. These are targeted interventions used under medical guidance, not general detox tools, and they do not offset ongoing harmful behaviour.
Some high-dose detox “natural” supplements, such as green tea extract, can lead to liver inflammation, reflected in elevated liver enzymes on blood tests. This indicates liver cells are under stress or being damaged and, in severe cases, supplement-induced liver injury can progress to liver failure requiring a transplant.
Milk thistle and turmeric
Milk thistle and turmeric contain biologically active compounds with antioxidant and anti-inflammatory properties, and there is some evidence suggesting potential benefits in specific liver conditions. Milk thistle, for example, has been studied in alcohol-related liver disease and non-alcoholic fatty liver disease, but results are mixed and not strong enough to support routine use.
Read more: Turmeric: here's how it actually measures up to health claims
The main issues with both substances are dosing, formulation and study quality. Turmeric in food is poorly absorbed, which is why supplements often use concentrated extracts or additives to boost absorption. At that point, a culinary spice becomes a pharmacological dose. Higher doses increase the risk of side effects and interactions, and turmeric supplements, which are often concentrated sources of the active compound curcumin, have been linked to cases of acute liver injury. The UK Committee on Toxicity has warned about a potential risk to human health from turmeric and curcumin supplements. “Natural” does not automatically mean safe.
Activated charcoal
Activated charcoal binds substances, which is why it is used in medical settings for certain poisonings. It is non-specific, however, binding whatever is present rather than targeting toxins alone. That makes it useful in emergencies and risky in everyday use. Taking charcoal alongside medication may reduce how much of that medication your body absorbs. Charcoal supplements are not a safe response to suspected poisoning and do not replace medical advice.
Coffee enemas
Coffee, when consumed normally, is associated with better outcomes in several liver diseases and may be protective in some contexts. That evidence does not support putting coffee into the colon.
Enemas can cause burns, infections, dangerous imbalances in the salts your body needs to control nerves, muscles and heart rhythm, and bowel perforation. If you want coffee for potential liver benefits, drink it.
For most healthy people, the best liver support is unglamorous. It means keeping alcohol within recommended limits, avoiding binge patterns, eating a diet rich fibre and fresh fruit and vegetables, staying hydrated and allowing regular rest days from alcohol.
The liver is an extraordinary organ. It detoxifies the body every day without needing a cleanse, a tea or a reset. If you want to support it, focus less on dramatic short-term detox routines and more on reducing repeated strain over time. Consistency beats gimmicks.
And whatever you do this January, do not put coffee where it does not belong.
In the first episode of Strange Health, a new visualised podcast from The Conversation, hosts Katie Edwards and Dan Baumgardt put detox culture under the microscope and ask a simple question: do we actually need to detox at all?
Strange Health explores the weird, surprising and sometimes alarming things our bodies do. Each episode takes a popular health or wellness trend, viral claim or bodily mystery and examines what the evidence really says, with help from researchers who study this stuff for a living.
Katie Edwards, a health and medicine editor at The Conversation and Dan Baumgardt, a GP and lecturer in health and life sciences at the University of Bristol share a longstanding fascination with the body’s improbabilities and limits, plus a healthy scepticism for claims that sound too good to be true.
Strange Health is hosted by Katie Edwards and Dan Baumgardt. The executive producer is Gemma Ware, with video and sound editing by Sikander Khan. Artwork by Alice Mason.
Dan and Katie talk about two social media clips in this episode, one from 30.forever on TikTok and one from velvelle_store on Instagram.
Listen to Strange Health via any of the apps listed above, download it directly via our RSS feed or find out how else to listen here. A transcript is available via the Apple Podcasts or Spotify apps.
Trish Lalor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.