Detoxes and Cleanses

Diet Reference Archive: a label for a group of products and programs

Detoxes and Cleanses

Short programs and products, among them juice cleanses, the Master Cleanse, detox teas and colon cleansing, that are sold as ways to rid the body of toxins. They are promoted for weight loss, energy and general health, and the studies reviewed do not establish that these programs increase toxin elimination from the body.

Family: Fad, extreme, and debunked diets Promoted by: no single owner; product companies, juice businesses, wellness practitioners and paid social media influencers First appeared: no single origin; a library catalog lists the Master Cleanse book in a 1976 edition Certainty of evidence: no single rating, because the name covers many different products and programs; this page's own judgment. Outcome ratings use GRADE and are in the review record; the highest is Very low, including nickel elimination inferred from hair in one 4-week trial

ON THIS PAGE

1. In brief
2. Overview
3. In practice
4. For the coach
5. The evidence (opens on request)
6. Mechanisms (opens on request)
7. Risks, contraindications and myths (opens on request)
8. Key terms
9. Review questions
10. References
11. Evidence rating and review record

The summary and sections 1 to 3 are the short version and are open when the page loads. Sections 4 to 6 hold the research detail, the biology, and the cautions. Each of those opens when you select its heading, and you can read the page without opening them. Back to the Diet Reference Archive index.

In brief

What is it? A name for short programs and products that promise to rid the body of toxins: drinking only juice for a few days, the Master Cleanse lemon drink, detox teas, supplement kits, and cleansing the colon with laxatives or water. There is no standard definition (National Center for Complementary and Integrative Health, 2025).

Does it work? The body already removes wastes and harmful substances through the liver and the kidneys (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-c; National Library of Medicine, 2026), and the studies reviewed do not establish that these programs increase toxin elimination from the body. A small controlled study reported changes in selected hair elements, but those measurements cannot establish whether the body eliminated more toxin (Jung et al., 2020). People lose weight on a juice-only or lemon-drink program mainly because they eat very little (Kim et al., 2015), and the weight tends to return once ordinary eating resumes (Obert et al., 2017). Most of the controlled studies found lasted days to weeks.

Is it safe? Not reliably. Case reports describe dangerously low blood sodium after detox teas, kidney failure after a juice cleanse, liver failure after a detox tea, and dehydration and kidney injury after colon cleansing; case reports show that a harm happened, not how often (Gillett et al., 2021; Kesavarapu et al., 2017; Makkapati et al., 2018; Mishori et al., 2011). A federal health agency states that some programs "can be unsafe and falsely advertised" (National Center for Complementary and Integrative Health, 2025).

Who should not do it without talking to a doctor or dietitian first? Anyone with diabetes, kidney disease or kidney stones, heart disease, or past bowel disease or surgery; anyone taking prescription medicine; anyone pregnant; and children and older adults, for whom juice that has not been pasteurized carries a higher risk of serious illness (National Center for Complementary and Integrative Health, 2025; U.S. Food and Drug Administration, n.d.-b). As a precaution this program takes, anyone with a current or past eating disorder as well.

Related pages: Very Low Calorie Diets, the separate archive page on medically supervised total diet replacement, and Intermittent Fasting. Full list on the archive index.

1. Overview

What you eat

There is no single plan, so what a person eats or drinks depends on the product or program. The National Center for Complementary and Integrative Health, part of the National Institutes of Health, lists the approaches sold under the name: fasting; drinking only juices or similar beverages; eating only certain foods; using dietary supplements or other commercial products; using herbs; cleansing the colon with enemas, laxatives or colon hydrotherapy; reducing environmental exposures; and using a sauna (National Center for Complementary and Integrative Health, 2025). This page covers the ones that work through what a person eats or drinks, along with colon cleansing, which is sold alongside them.

A juice cleanse replaces meals with fruit and vegetable juices for a few days. In one study, adults drank 6 bottles a day of commercial juice blends made from apple, cucumber, celery, romaine lettuce, lemon, beet, ginger and pineapple, with a lemon and cayenne water and a blend of almond, dates, sea salt and vanilla, for 3 days. The bottles supplied 1,310 calories a day (Henning et al., 2017). In another study, the juice-only version supplied 800 to 900 calories a day of cold-pressed juice for 3 days (Sardaro et al., 2025).

The Master Cleanse replaces food with a lemon drink. A 2025 lifestyle medicine textbook describes it as relying on lemon and cayenne pepper (Via & Mechanick, 2025). A Korean trial of a commercial lemon detox program used a mixture of maple and palm syrups and lemon juice for 7 days, followed by 4 days of easing back into food (Kim et al., 2015).

Detox teas are herbal blends sold to support weight loss and to cleanse the body; a 2026 review describes them as promoted to "boost metabolism, reduce bloating, flush out toxins, and promote weight loss." Many contain herbs that act as laxatives or that increase urine. The same review reports an earlier analysis of 12 diet teas sold in 3 grocery stores in Connecticut, in which 91.7 percent contained senna leaf, a laxative (Noor et al., 2026).

Supplement programs come as kits of powders, shakes or capsules taken for a set number of days. One tested program was a shake made from pea protein, flax, oat and buckwheat flours, beet, burdock, dandelion, milk thistle extract and other plant ingredients, taken 1 to 3 times a day for 28 days (Panda et al., 2023).

Colon cleansing takes 2 forms. One is products taken by mouth or inserted into the rectum, including laxatives, teas, powders and capsules. The other is colon irrigation, also called colonic hydrotherapy, in which a large volume of water, up to 60 liters, is passed into the rectum through a tube and drained out again, sometimes several times (Mishori et al., 2011).

What you avoid or limit

Juice cleanses and the Master Cleanse remove solid food for as long as they last; in those programs that is a hard rule. Some juice programs add a few days of restricted eating before and after. In one study, participants followed a 3-day elimination diet before the juice days, described by the researchers as following the instructions usually given with a juice fast: organic fresh fruits, vegetables, gluten-free whole grains, eggs and 8 glasses of water a day, with caffeine, sugar, processed foods, dairy, red meat and gluten removed, among other items (Sardaro et al., 2025).

Detox teas and supplement kits usually sit alongside ordinary meals, and any limits come from the product's own instructions. Colon cleansing limits nothing about food itself, though products taken by mouth are often sold as part of a longer program.

Where it came from

The idea behind colon cleansing is old. It rested on the belief that waste in the intestine poisons the body, a theory called autointoxication. Colon cleansing became popular in the early 1900s; in 1919 the American Medical Association discounted the theory and condemned the practice, which later regained popularity (Mishori et al., 2011).

The Master Cleanse is associated with Stanley Burroughs. A catalog record in Open Library lists his book The Master Cleanser in an edition dated April 24, 1976, from Burroughs Books (Open Library, n.d.); this page did not open the book itself.

Much of the modern marketing runs through social media. In 2020 the Federal Trade Commission settled charges against a tea company whose "Teami 30 Day Detox Pack" was promoted in paid Instagram posts by well-known influencers (Federal Trade Commission, 2020b), and the agency described it as its first case to challenge claims made in social media endorsements about the effectiveness of health-related products (Federal Trade Commission, 2020a). A content analysis of the most viewed TikTok videos under #detox and 2 other dieting-product hashtags found that 97 percent did not provide any scientific evidence for their claims (Raffoul et al., 2024).

A 2025 lifestyle medicine textbook places "detox" methods such as the Master Cleanse, and juicing, in a section on popular trends and misinformation, among fad diets promoted by online influencers, trending posts and traditional media (Via & Mechanick, 2025).

What it claims to do

The National Center for Complementary and Integrative Health summarizes the claims: these programs "have been suggested as ways to remove toxins from your body, lose weight, or promote health" (National Center for Complementary and Integrative Health, 2025). Advertisements for colon cleansing have promised relief from fatigue, headache, weight gain and low energy, along with better immune and circulatory function and sharper thinking (Mishori et al., 2011). Teas are promoted to boost metabolism and reduce bloating as well as to flush out toxins (Noor et al., 2026). In the Teami case, the Federal Trade Commission alleged that the company claimed, without reliable scientific evidence, that its detox pack would help consumers lose weight and that its other teas "fight cancer, clear clogged arteries, decrease migraines, treat and prevent flus, and treat colds" (Federal Trade Commission, 2020b).

These are the promoters' claims, reported as claims; section 4 reports how far the research supports them.

What it gets right

The wish behind a cleanse is often a reasonable one: to feel better, to take stock of how one has been eating, or to start fresh. That wish is a useful place for a coaching conversation to begin, even when the product is not.

Many juice programs are built from vegetables and fruit, and the American Heart Association's 2026 dietary guidance lists "eating plenty of vegetables and fruits and choosing a wide variety" among the features of a heart-healthy eating pattern (Lichtenstein et al., 2026). The difference is that a cleanse replaces meals for a few days rather than adding vegetables and fruit to ordinary eating, and the authors of one juice study note that juicing removes most of the insoluble fiber in whole produce (Sardaro et al., 2025). Where a short program does change a measurement such as insulin resistance, a lifestyle medicine textbook attributes the change to eating fewer calories rather than to the lemon or the cayenne (Via & Mechanick, 2025).

How clients describe it, and what it gets confused with

Clients say "I'm doing a cleanse," "a juice cleanse," "a 3-day reset," "a detox," "flushing my system," "a liver detox," "a colon cleanse," "teatox," or "the lemonade diet." Each can mean something different, from a bottled juice program to a tea taken with ordinary meals to a visit to a colon hydrotherapist. Ask before assuming.

The name is confused with several things that are not the subject of this page. Very Low Calorie Diets, a separate archive page, covers medically supervised total diet replacement, which is a clinical treatment rather than a product. Fasting programs overlap: some are advertised with detoxification claims, while intermittent and periodic fasting are being researched in their own right (National Center for Complementary and Integrative Health, 2025), and the Intermittent Fasting page covers them. Clean eating, the subject of a separate archive page, is a label for an eating style rather than a short program.

The word detoxification also has medical meanings unrelated to these products: medically assisted withdrawal from substances such as opioids (Maruti & Adelman, 2024), and chelation therapy, which the Centers for Disease Control and Prevention recommends for removing toxic metals in some specific serious cases (National Center for Complementary and Integrative Health, 2025). Colon cleansing has a medical use too, before radiological or endoscopic examinations, which federal regulations treat separately from cleansing for general well-being (Colonic Irrigation System, 2026).

2. In practice

A typical day of eating

What a day looks like depends on the program. On a 3-day juice cleanse like the one in the study described in section 1, a person drinks 6 bottles across the day in place of meals, such as green juices, a citrus juice, a beet and ginger juice, lemon water with cayenne, and an almond drink (Henning et al., 2017). On the Master Cleanse, each meal is replaced by the lemon drink (Kim et al., 2015). A person using a detox tea usually eats ordinary meals and drinks the tea once or several times a day; in 2 case reports on this page, people drank about 2 cups a day for 4 weeks and 3 cups a day for 14 days (Gillett et al., 2021; Kesavarapu et al., 2017).

Cost, products, and who profits

The searches for this page found no study reporting what a cleanse typically costs, so this page gives no dollar figure for the products themselves. What a client pays depends on what they buy: bottled juices, teas, supplement kits, home colon cleansing kits, or sessions with a colon hydrotherapist (Mishori et al., 2011). The vegetables and fruit that juices are made from can also be bought and eaten whole.

Money attaches to the name in several places. Product makers sell juices, teas, kits and colon cleansing devices. Practitioners sell sessions; a 2011 review reported that colon hydrotherapists in the United States were not licensed, and that some belonged to private organizations that set their own training and certification (Mishori et al., 2011). Influencers are paid to promote products. In the Teami case, the court order imposed a $15.2 million judgment, which the Federal Trade Commission described as the total sales of the challenged products, suspended on payment of $1 million because the defendants could not pay the full amount (Federal Trade Commission, 2020b).

Researchers can have a stake too. Four authors of a 2023 trial of a 28-day detox shake were employees of the company that makes it (Panda et al., 2023), and authors of a second 2023 trial of a detox supplement were current or former employees of the same company (El-Khodor et al., 2023). An employee author does not make a result wrong, and a reader should know it before weighing one.

Environmental footprint

The searches for this page found no study of the environmental footprint of detox or cleanse programs, so this page does not estimate one.

Cultural fit

This is a description of the programs, not a research finding. A cleanse that replaces meals with juice or a lemon drink sets aside the foods of every tradition while it lasts, including meals eaten with family and friends. Detox teas and supplements sit alongside a person's usual food. A client who wants to eat more vegetables and fruit can do it within the foods of their own kitchen, without a program.

What makes people stop

The searches found adherence information mainly in small, short studies, and the programs are short by design. In the 2 juice studies read in full for this page, nearly everyone completed the program: in one, all 25 enrolled participants completed the study, although 5 were left out of the published results because they could not provide stool samples; in the other, 23 of 25 completed it (Henning et al., 2017; Sardaro et al., 2025). Beyond those figures, what follows is observation rather than measured data: hunger, low energy, headaches, meals with other people, and cost are the reasons a person is likely to stop early.

What happens when you stop

In a single group of 20 healthy adults, body weight was 1.7 kg lower after 3 days of juice only, and still 0.91 kg below the starting weight 2 weeks after they returned to their usual eating; most of the changes in gut bacteria had partly reversed by then (Henning et al., 2017). The searches for this page did not identify longer follow-up after a juice program.

The National Center for Complementary and Integrative Health summarizes a 2017 review as saying that juicing and detox diets "can cause initial weight loss because of low intake of calories, but they tend to lead to weight gain once a person resumes a normal diet," and states that "there have been no studies on long-term effects of 'detoxification' programs" (National Center for Complementary and Integrative Health, 2025). Most controlled interventions discussed on this page were brief, and the longer uncontrolled or multicomponent studies do not establish the effects of repeatedly using a cleanse over months or years.

Common variations

Named versions a client may mention include the juice cleanse; the green smoothie cleanse, made by blending rather than juicing leafy greens and fruit (Makkapati et al., 2018); the Master Cleanse and other lemon detox drinks; detox teas, including teas sold as liver or kidney cleanses (Kesavarapu et al., 2017; Noor et al., 2026); supplement kits of 1 to 4 weeks; and colon cleansing, by products taken by mouth or by irrigation (Mishori et al., 2011). Very Low Calorie Diets, medically supervised total diet replacement, has a separate archive page and is not a cleanse.

3. For the coach

SCOPE OF PRACTICE

A health and wellness coach does not prescribe, adjust, endorse, or discourage a diet, and does not diagnose or treat. The coach helps the client understand what they have chosen, notice how it is going, and decide what to do next.

Several points belong to a clinician. A client with diabetes, kidney disease or kidney stones, heart disease, or past bowel disease or surgery, a client taking prescription medicine, and a client who is pregnant need their physician involved before a cleanse starts, and whether colon irrigation is safe for a particular person is a physician's question. A coach does not judge whether a symptom such as dizziness, confusion, cramping or diarrhea comes from a cleanse; working out the cause belongs to the clinician. If a client is following this diet, the coach's role includes making sure the client has medical oversight, and it does not include supporting the diet itself.

Who does what

The physician

Decides whether a cleanse, tea or supplement is medically safe for this person, given their conditions and medications. Orders and interprets tests when symptoms appear, such as blood sodium and potassium, kidney function and liver tests. Adjusts diabetes medication if the client's eating will change, and reviews any interaction, such as grapefruit juice with certain medicines or large amounts of leafy greens with warfarin, with the pharmacist where needed.

The registered dietitian

Builds an individual eating plan when a client has diabetes, kidney disease or a tendency to kidney stones and wants to change how they eat. Reviews a juice or smoothie routine that is heavy in high-oxalate greens for someone at risk. Helps a client who wants to eat more vegetables and fruit work them into ordinary meals, and runs any plan that removes foods and adds them back to test a suspected reaction.

The health and wellness coach

Finds out what the client hopes the cleanse will do and where the idea came from. With the client's permission, shares what federal health agencies say about these products, and explores how the client wants to use that information. Helps the client name the change they are really after, such as more energy, fewer late-night snacks, or a fresh start, and design a first step they choose. Notices how things are going, and holds the referral line when a symptom, a medication or a health condition puts the question in a clinician's hands.

What a client bringing this diet needs

A client may arrive wanting a fresh start after a stretch of eating they feel bad about, wanting to feel less tired or bloated, wanting to change their weight quickly before an event, or having seen a product promoted online. The coach does not take on a weight target as the goal of the work.

What the coaching conversation offers that a search engine cannot is room to separate the wish from the product: what a reset would look like in daily life, and what part of eating the client wants to change. The coach does not evaluate the product. With permission, the coach can share the federal fact sheet on detoxes and cleanses and explore what the client makes of it, and the decision stays with the client, within the referral boundaries below.

What to ask

• "What are you hoping a cleanse will do for you?"
• "If it worked exactly the way you hope, what would be different a month from now?"
• "Does your doctor know you are planning this, and are you taking any medicines they would want to hear about?"

Referral red flags

A client who reports dizziness, fainting, confusion, headache with nausea, muscle aches or weakness, a racing or irregular heartbeat, vomiting or diarrhea that does not stop, yellowing of the skin or eyes, or new abdominal pain during or after a cleanse needs a clinician promptly, and confusion, a seizure, fainting or chest symptoms call for emergency care. These are the kinds of symptoms in the case reports and federal fact sheet on this page (section 6). The coach does not guess at the cause.

A client with diabetes who uses insulin, a sulfonylurea or a meglitinide needs the prescriber's input before replacing meals with juice or a lemon drink, because eating too little carbohydrate, or skipping or delaying meals, can drop blood glucose too low (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-a). If such a client reports shakiness, sweating or confusion, they may be having a low blood sugar episode right now: the first step is the one in their own diabetes plan for treating it, with emergency help if the symptoms are severe or the person cannot manage them, and telling the prescriber is the separate step that follows.

A client taking warfarin who plans days of green juices or smoothies, any client taking prescription medicine whose program includes grapefruit juice, and a client with kidney disease or a history of kidney stones who plans juices made largely from leafy greens or beets should talk with the prescriber, pharmacist or kidney care team first (American Society of Health-System Pharmacists, 2026; National Center for Complementary and Integrative Health, 2025; U.S. Food and Drug Administration, n.d.-a).

A client who returns to cleanses again and again, uses laxatives or teas to undo eating, or speaks of food as dirty and of the body as needing to be emptied is worth asking about it directly. On its own a behavior tells a coach little, and none of this is a diagnosis. The questions are what the behavior is for, whether it causes distress, whether it is narrowing what the person eats, and whether it is getting in the way of daily life. Where the answers raise a real concern about disordered eating, the coach follows their own referral process, or takes the concern to the client's clinician under an existing care plan.

Special populations

Pregnancy and breastfeeding

The searches run for this page in October 2026, which screened a limited number of records from one database, did not identify a study of a detox or cleanse program during pregnancy or while breastfeeding. The U.S. Food and Drug Administration lists pregnant women among the people who risk serious illnesses or even death from drinking juice that has not been treated to kill harmful bacteria (U.S. Food and Drug Administration, n.d.-b). Any cleanse, tea, supplement or colon procedure during pregnancy or breastfeeding is a question for the obstetric clinician first.

Children and adolescents

The searches run for this page in October 2026, which screened a limited number of records from one database, did not identify a trial of a detox or cleanse program in children or adolescents. Both the federal fact sheet and the U.S. Food and Drug Administration warn that illness from untreated juice can be serious in children (National Center for Complementary and Integrative Health, 2025; U.S. Food and Drug Administration, n.d.-b). A coach works with the adult in front of them, and a child's eating belongs to the family and the pediatrician.

Older adults

The searches for this page did not identify a controlled study designed specifically to establish the effects of a cleanse in older adults. One uncontrolled 12-week program for 12 adults aged 47 to 73 with a high body mass index combined group lifestyle support with a commercial detox product taken over the first 28 days, so it cannot separate the effect of that product from the rest of the program (Bonakdar et al., 2020). The federal fact sheet and the U.S. Food and Drug Administration both name older people among those at higher risk of serious illness from untreated juice (National Center for Complementary and Integrative Health, 2025; U.S. Food and Drug Administration, n.d.-b). Two of the kidney failure case reports on this page involved adults aged 65 and 68 who had other risk factors (Chaudhari et al., 2022; Makkapati et al., 2018). An older client considering a cleanse involves their physician first.

Athletes and people with high activity

The searches for this page did not identify an intervention study establishing benefits in athletes; a survey documented use. Among 92 male professional mixed martial arts athletes, 3.3 percent reported a juice cleanse and 3.3 percent a colonic among their methods of cutting weight before competition, and the survey did not test any effect (Park et al., 2019). The juice-only programs studied supplied 800 to 1,310 calories a day (Henning et al., 2017; Sardaro et al., 2025); whether that meets a person's training needs is a question for a sports dietitian.

People taking medication for diabetes, blood pressure, or blood thinning

Replacing meals changes how much carbohydrate a person eats, which matters for anyone on insulin, a sulfonylurea or a meglitinide (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-a). Leafy green juices matter for warfarin, and grapefruit juice changes the blood levels of some blood pressure and other medicines (American Society of Health-System Pharmacists, 2026; U.S. Food and Drug Administration, n.d.-a). The standing rule applies: the prescriber is involved before the cleanse starts.

People with a history of disordered eating

The searches for this page did not identify a study of whether cleanses raise the risk of an eating disorder; one content analysis notes that use of weight-loss and cleanse or detox products has been associated with eating pathology (Raffoul et al., 2024). A Hungarian qualitative study, read as an abstract, describes observations at 2 juice cleanse camps where participants used laxatives deliberately and read the changes in their bodies as toxins leaving; the authors saw patterns resembling purging disorder and orthorexia, which describes what happened in those camps, not how often eating disorders follow a cleanse (Bóna et al., 2018). A program built on removing food, and sometimes on laxatives, can serve as a new set of rules for a person with this history. A concern goes to the client's clinician under the existing care plan, or through the coach's own referral process where there is none.

Client misconceptions

Three misconceptions are worth knowing. The first is that the body fills up with toxins that a cleanse flushes out; the liver and kidneys already do that work (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-c; National Library of Medicine, 2026), and the studies reviewed do not establish that these programs increase toxin elimination from the body.

The second is that the weight lost on a cleanse is fat, or toxins leaving, and will stay off; short programs lower weight because people eat very little, and it tends to return (Obert et al., 2017). The third is that natural means safe; case reports describe serious harm from teas, juices and colon cleansing, and some teas sold as natural have been found to contain undeclared drugs (Noor et al., 2026). Each is taken up, with its sources, in section 6.

🤝 COACHING CONNECTION

Rachel tells her coach she has bought a 5-day juice cleanse to "get the junk out" before her sister's wedding, and asks which brand is best. The coach asks what she is hoping the cleanse will do. Rachel says she feels sluggish and keeps snacking late at night. With her permission, the coach shares what a federal health agency's fact sheet reports: a review found no compelling research that detox diets remove toxins, and weight lost on them tends to return. The coach asks whether anything about her health would make her want to check with her doctor first. Rachel mentions her blood pressure pill and decides to call her doctor's office before starting anything. Then she wonders aloud whether the late snacking is about hunger or about being tired. Nothing was recommended, and the cleanse was never evaluated.

4. The evidence

(select the heading to open or close this section)

The research on detoxes and cleanses is thin and short. It falls into 4 groups: a handful of small controlled trials, most described as randomized, of commercial supplements, a lemon detox program, a detox meal program and juice diets; uncontrolled studies; reviews, which found few studies to review; and case reports of harm. The studies reviewed do not establish that these programs increase toxin elimination from the body. A small controlled study reported changes in selected hair elements, but those measurements cannot establish whether the body eliminated more toxin. The findings are about body weight, gut bacteria and blood, urine or hair markers measured over days to weeks. The certainty ratings for each outcome are in the Evidence rating and review record at the end of the page.

Several of the studies below were read only as abstracts, because their full texts were not open; the page says so where it uses one, and keeps to what the abstract reports.

Evidence from randomized controlled trials

A trial assigns people to a program by chance and compares them with people assigned to something else, which is the strongest way to test whether the program itself causes a result. A 2015 review of detox diets stated in its abstract that, to the best of its authors' knowledge, no randomized controlled trials had been conducted to assess the effectiveness of commercial detox diets in humans (Klein & Kiat, 2015). Seven small controlled studies published since were identified for this page, none longer than 4 weeks: 3 trials of detox supplements, a lemon detox program, a 4-week detox meal program, and 2 juice studies, one of them compared with a Mediterranean diet.

Removing toxins, and markers of the body's own detoxification

The one supplement trial read in full randomized 37 healthy adults affiliated with a university to a 28-day detox shake program plus a healthy diet education session, or to the education session alone, with a healthy meal; 32 were analyzed. Urine markers of liver detoxification and urine porphyrins, which the authors used as detoxification markers, did not change significantly in either group. Within the shake group, total antioxidant capacity in the blood rose by 40 percent and the activity of a detoxification enzyme, glutathione S-transferase, by 13 percent compared with the starting values (Panda et al., 2023).

Those results were compared within each group, against its own starting values, rather than between the groups, so the trial does not show that the shake did better than education alone. The groups also started at different antioxidant levels, 457.9 and 365.2 micromoles per liter. Four of the authors were employees of the company that makes the product, and the trial registration number printed in the paper is a placeholder of zeros (Panda et al., 2023).

A second trial, read in full, randomized 40 adults with symptoms the authors attributed to toxin burden to a detox supplement or, as an active control, a different product from the same company at half its label dose, for 28 days. Participants did not know which product they took, and both groups were given the same diet and lifestyle guidelines. Within the detox group, red blood cell levels of total toxic metals, urine porphyrins and urine mutagenicity fell compared with that group's own starting values, and symptoms improved in both groups (El-Khodor et al., 2023).

The paper does compare the groups on some outcomes, and it reports no significant difference between them in urine porphyrins. Its toxic metal results, though, are reported only within each group, so the trial does not show that the supplement lowered toxic metals more than the control product did. The number of people analyzed varied from test to test, outliers were removed, the company funded the study and supplied both products, and several authors were current or former employees (El-Khodor et al., 2023).

A third trial, read as an abstract, randomized healthy young women to a detox supplement containing senna leaf, cascara sagrada bark and 6 other plant ingredients, or to a placebo, daily for 4 weeks. Among the 22 who completed it, the abstract reports no beneficial or harmful effects on body composition, waist circumference, digestive symptoms or blood markers (Tinsley et al., 2019).

A trial in Korea tested a 4-week detox meal program, the Wellnessup diet, made of organic shakes, juices, salads and nut bars, against a calorie-restricted diet of similar foods bought from supermarkets, both about 1,220 calories a day, and against usual eating, in 45 women with overweight, 15 per group. Its main outcome was the level of 29 elements in hair, including metals such as nickel, lead and mercury. Nickel in hair fell more in the detox group than in the calorie-restricted group, and rhodium fell more than with usual eating, along with a few other selected contrasts; for most of the 29 elements, including lead and mercury, no clear difference between groups was detected (Jung et al., 2020).

Those results do not show that the body eliminated more toxin. Hair levels are an indirect measure, and the study did not measure the elements the participants took in or excreted. The paper describes the group assignment in 2 different ways, ran many unadjusted comparisons across 29 elements and 3 groups, calculated its sample size for weight change rather than nickel, and gives no confidence interval for the nickel contrast. Its acknowledgments state that a company supported the study (Jung et al., 2020). The rating for this result is in the review record.

Cardiometabolic outcomes

The lemon detox trial, described here from its abstract, compared 3 groups of premenopausal Korean women with overweight over 11 days: the lemon and syrup program for 7 days and then 4 days of easing back into food; a placebo drink with the same calories; or no change in diet. Insulin, a measure of insulin resistance, and the hormones leptin and adiponectin decreased in both groups whose calories were cut, and a marker of inflammation, C-reactive protein, decreased only in the lemon group (Kim et al., 2015). These are changes within each group; the abstract does not report a direct comparison between the lemon program and the placebo drink. The authors attribute the changes in body fat and insulin resistance to calorie restriction, as does the lifestyle medicine textbook that cites the trial (Via & Mechanick, 2025).

The searches for this page did not identify a trial of the short general-wellness programs reviewed here that measured heart attacks, strokes or other cardiovascular events.

Cancer

The searches for this page did not identify a trial of the short general-wellness programs reviewed here that measured cancer, and the studies reviewed do not establish any effect of these programs on cancer risk or outcomes.

Body weight, as measured

This archive reports body weight as something a study measured, in that study's own numbers, and not as a goal or as a measure of whether a program worked; see the standing rule in the review record at the foot of this page. The one exception is weight a person loses without meaning to, which can signal a health problem and is a reason to involve a clinician, never a sign that a program worked.

In the lemon detox trial, the changes in body weight, body mass index, percentage body fat and waist-to-hip ratio were greater in both calorie-cut groups than in the group that kept its usual diet; the abstract does not report a difference between the lemon program and the placebo drink with the same calories (Kim et al., 2015). In the 28-day shake trial, weight fell within the education-only group and did not change within the shake group (Panda et al., 2023). The 4-week supplement trial did not detect an effect on body composition (Tinsley et al., 2019).

Mortality

The searches for this page did not identify a trial of the short general-wellness programs reviewed here that recorded deaths as an outcome. Those studies were too small and too short to estimate any effect on survival.

Gut bacteria

One randomized study assigned healthy young adults, after a 3-day elimination diet, to 3 days of juice only, juice plus their usual food, or a plant-based whole-food diet of similar calories; 14 of the 23 who completed it were included in the analysis. No significant shift in the overall makeup of gut bacteria was detected with the elimination diet or the juice diets, while bacteria in saliva and on the inner cheek changed. The authors concluded that short-term juice consumption may negatively affect the microbiota (Sardaro et al., 2025). With 4 or 5 people in each group, the study can raise that possibility but cannot establish it.

Eating behavior and wellbeing

In the 28-day shake trial, physical and mental health scores on a standard questionnaire were similar in both groups at the start and remained stable (Panda et al., 2023). The searches for this page did not identify a trial that measured eating behavior or disordered eating symptoms after a cleanse.

Evidence from long-term prospective cohort studies

A cohort study follows people over time and records what happens to them. The searches for this page did not identify a cohort study that followed people who use detoxes or cleanses and compared their health with people who do not. The cohort studies found measured who uses these products. In 51,814 women in United States cohorts during the first year of the COVID-19 pandemic, 3.3 percent reported using a cleanse or detox supplement at the start of follow-up (Raffoul et al., 2023). In an analysis of the same cohorts, non-Hispanic Black participants had up to 2 times the risk of using supplements sold for immunity, energy, cleansing or detoxing, or weight loss, compared with non-Hispanic White participants, and experiencing chronic high discrimination was associated with more use of every type (Jackson et al., 2025). Both were read as abstracts.

Evidence from uncontrolled studies and case reports

One juice study followed a single group. Twenty healthy adults who usually ate fewer than 3 servings of fruits and vegetables a day drank only commercial juices for 3 days, then returned to their usual diet for 2 weeks. The paper describes participants as randomized, but every participant followed the same program, and there was no comparison group. Body weight was 1.7 kg lower after the juice days and 0.91 kg below the start 2 weeks later. The share of some major groups of gut bacteria shifted and had partly reversed by the end. A general well-being score did not change after the juice days and was higher at the end of the study (Henning et al., 2017). Without a comparison group, the study cannot separate the effect of the juices from the effect of eating far less.

For detox and diet teas, a 2026 review found 10 studies: case reports, analyses of products and their marketing, one study in rats and one human study. That human study gave a commercial slimming tea to 35 adults with overweight, reported a loss of about 1.5 to 2 kg, had no control group, randomization or blinding, and was run by investigators affiliated with the manufacturer (Noor et al., 2026). The review gives that study's length as 2 months in its text and 16 weeks in its table.

For colon cleansing, a 2009 systematic review concluded in its abstract that there were no methodologically rigorous controlled trials of colonic cleansing to support the practice for general health promotion, and that multiple case reports and case series describe its adverse effects (Acosta & Cash, 2009). A 2011 review searched for colon cleansing, herbal colon cleanse, colon detoxification and colon irrigation and found no scientifically robust studies supporting the practice (Mishori et al., 2011).

Case reports describe what has gone wrong; they cannot say how often it happens, and a single report does not prove the product caused the harm. With teas, a previously healthy 51-year-old woman who drank about 2 cups a day of an over-the-counter detox tea for 4 weeks arrived at a hospital confused after a seizure-like episode, with a blood sodium of 115 mmol/L and a low potassium (Gillett et al., 2021). A 2026 review summarizes the authors' view that the tea's diuretic effect was the most likely cause, and it describes further reports of severe low potassium with cardiac arrest, liver injury and heart muscle failure after teas sold for weight loss or detoxification (Noor et al., 2026).

A 60-year-old woman who drank a commercial detox tea 3 times a day for 14 days, as a cleanse, developed acute liver failure and died on the 17th day of her hospital stay while listed for a transplant. Her physicians, using a standard causality scale, judged the tea the probable cause; the score also counted her regular alcohol use as a risk factor, and she took a diuretic for blood pressure (Kesavarapu et al., 2017).

With juices, a 65-year-old woman developed kidney failure that progressed to end-stage kidney disease after a green smoothie cleanse made from leafy greens and fruit high in oxalate; she had had gastric bypass surgery and a long course of antibiotics, which the authors name as risk factors (Makkapati et al., 2018, read as an abstract). A Mayo Clinic report described a similar case after juicing and, among 65 patients with kidney failure and calcium oxalate crystals in the kidney seen there from 1985 to 2010, 3, including that case, with presumed diet-induced oxalate kidney injury on top of chronic kidney disease (Getting et al., 2013, read as an abstract).

A 68-year-old man with diabetes drank a daily blended vegetable drink built on about a third of a pound of raw spinach for 6 months, alongside meals heavy in spinach and chard; his oxalate intake was estimated at about 10 times that of a typical diet. He had also been regurgitating food several times a day, which left him dehydrated. He developed kidney failure and still needed dialysis a year later (Chaudhari et al., 2022). He was juicing for his health, not following a branded cleanse.

With colon cleansing, a 2011 review describes 2 patients. A 31-year-old woman with Crohn's disease and a past partial colectomy developed vomiting, diarrhea, low potassium and signs of kidney strain on blood tests after a colonic cleansing session. A 49-year-old man who had used a colon cleanser had vomiting, diarrhea, low potassium, kidney injury and pancreatitis, and had lost 24 pounds in 10 days. The review also lists published reports of abscesses, rectal perforation, acute water intoxication and deaths from amebiasis after colon cleansing (Mishori et al., 2011).

Highlighted studies

These 4 carry the most weight for this page: 2 juice studies, the detox shake trial, and a 2026 review of detox and diet teas. Each is described so that a reader can judge it without opening the paper.

On a narrow screen, scroll the table sideways to see every column.

Highlighted studies for detoxes and cleanses

Study	Design	Sample size	Duration	Finding	The limitation that matters
Henning et al., 2017, juice-based diet	Single-group study, no comparison group	25 enrolled, 20 analyzed, healthy adults	3 days of juice only, then 2 weeks of usual eating	Body weight 1.7 kg lower after the juice days and 0.91 kg lower 2 weeks later; shifts in gut bacteria that partly reversed	No comparison group, so the effect of the juices cannot be separated from the effect of eating far less; the paper calls participants randomized though all followed one program
Sardaro et al., 2025, juicing and the microbiome	Randomized study of 3 diets	25 consented, 23 completed, 14 analyzed	3 days of the assigned diet after a 3-day elimination diet, with follow-up to day 21	No significant shift in overall gut bacteria; changes in mouth bacteria with the juice diets	4 or 5 people per group, and only 14 of 23 completers analyzed
Panda et al., 2023, guided detox shake program	Randomized trial, investigators and outcome assessors blinded	37 randomized, 32 analyzed, healthy adults	28 days	No significant change in urine detoxification markers; within the shake group, blood antioxidant capacity and one enzyme's activity rose	Changes compared within groups, not between them; groups differed at the start; 4 authors employed by the maker
Noor et al., 2026, detox and diet teas	Mini-review of 10 studies	10 studies: case reports, product analyses, 1 animal study and 1 uncontrolled human study	Searched publications from 2002 to 2024	Minimal demonstrated benefit; case reports of low sodium, low potassium, cardiac events and liver injury; undeclared drugs found in some teas	A focused search of 2 databases, with no formal assessment of study quality

Head to head

The studies used several different comparison groups. In the randomized juice study, none of the 3 diets, juice only, juice plus usual food, or a plant-based whole-food diet of similar calories to the juice-only diet, produced a significant shift in the overall makeup of gut bacteria (Sardaro et al., 2025). In the lemon detox trial, both the lemon program and a placebo drink with the same calories changed body measurements more than usual eating did. The trial, as reported in its abstract, which is the version read for this page, did not establish that the lemon program provided an advantage over its calorie-matched comparator: the abstract reports no direct comparison between the 2, and its fall in C-reactive protein in the lemon group alone is a change within that group (Kim et al., 2015).

The supplement trials compared a detox product with education alone (Panda et al., 2023), with a different product used as an active control (El-Khodor et al., 2023) or with a placebo (Tinsley et al., 2019); the shake trial reported its marker results within each group rather than as a comparison (Panda et al., 2023). The detox meal trial compared its program with a calorie-restricted diet of similar foods and with usual eating (Jung et al., 2020).

One small study in Spain compared a cleanse with an established eating pattern. Fourteen adults with overweight or obesity followed either 3 days of juices and then 4 days of a reduced-calorie diet, or 7 days of a reduced-calorie Mediterranean Diet, 8 and 6 people. The paper calls its design semi-experimental and says participants were randomly divided without explaining how; the juice group weighed less at the start, and some table labels are unclear. Its tests between the groups did not detect a difference in the change in weight or muscle, so the study does not establish an advantage for either diet, and the authors' summary that the Mediterranean group lost more weight goes beyond those tests (San Mauro Martín et al., 2017).

Where the evidence is absent

The studies reviewed do not establish that these programs increase toxin elimination from the body. A small controlled study reported changes in selected hair elements, but those measurements cannot establish whether the body eliminated more toxin (Jung et al., 2020). Most controlled interventions discussed here were brief, from 3 days to 4 weeks, with at most 2 weeks of follow-up. Longer uncontrolled or multicomponent studies, such as the slimming tea study and the 12-week program described on this page, do not establish the effects of repeatedly using a cleanse over months or years; the federal fact sheet states that there have been no studies on long-term effects (National Center for Complementary and Integrative Health, 2025).

The searches for this page did not identify a study of the short general-wellness programs reviewed here that measured cardiovascular events, cancer or deaths. The controlled trials were small, and 3 of them enrolled women only. The searches did not identify a controlled study designed specifically to establish the effects of a cleanse in pregnancy, children, older adults or athletes (see Special populations in section 3). For detox teas, the only human efficacy study found had no control group (Noor et al., 2026). For colon cleansing, the reviews found no rigorous controlled trial (Acosta & Cash, 2009; Mishori et al., 2011). Harms are known mainly from case reports, which show that serious harm can happen but not how often.

5. Mechanisms

(optional reading; select the heading to open or close this section)

This section explains how the body handles waste and harmful substances, and how detox products are thought to work. You can skip it. Nothing in the coaching sections depends on it.

Established mechanisms

The body has its own systems for removing waste and harmful substances. The liver helps the body digest food, store energy and remove poisons (National Library of Medicine, 2026). The kidneys filter the blood, removing wastes and extra water to make urine, and keep a healthy balance of water, salts and minerals such as sodium and potassium (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-c). The large intestine absorbs water and turns the waste products of digestion into stool, and bacteria there help break down remaining nutrients (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-b). These organs work whether or not a person buys a detox product.

Several effects of cleanses are explained by well-understood processes rather than by detoxification. Weight falls on a juice-only or lemon-drink program because calorie intake is very low (Kim et al., 2015; Obert et al., 2017). Laxatives can cause diarrhea, and acute diarrhea can lead to dehydration, while drinking large quantities of water and herbal tea without eating for days can upset the balance of electrolytes such as sodium (National Center for Complementary and Integrative Health, 2025). Oxalate from foods is cleared by the kidneys, and a very large intake, especially with other risk factors, can leave calcium oxalate crystals in the kidney (Chaudhari et al., 2022; Makkapati et al., 2018). Grapefruit juice can block an enzyme in the small intestine that breaks down some medicines, so more of the drug reaches the blood (U.S. Food and Drug Administration, n.d.-a).

Proposed mechanisms

Makers of detox supplements propose that plant ingredients support the liver's detoxification enzymes and antioxidant defenses; the trials that test this measured changes in enzyme activity and markers within one group, not removal of a toxin (El-Khodor et al., 2023; Panda et al., 2023). The authors of the 3-day juice study proposed that changes in gut bacteria help explain the weight loss they saw, and called for further studies to confirm it (Henning et al., 2017). The authors of the 2026 tea review suggest that teas with laxative or diuretic herbs lower weight mainly through fluid loss rather than lasting loss of body fat (Noor et al., 2026).

A proposed mechanism is a reason to study a product, not evidence that it works. None of these is a reason to tell a client that a cleanse will do something for them.

6. Risks, contraindications and myths

(select the heading to open or close this section)

Warnings from professional or regulatory bodies

The National Center for Complementary and Integrative Health, part of the National Institutes of Health, states that "some 'detoxification' or 'cleansing' programs can be unsafe and falsely advertised." Its fact sheet also states that "the U.S. Food and Drug Administration (FDA) and Federal Trade Commission (FTC) have taken action against several companies selling detox/cleansing products because they (1) contained hidden ingredients and may pose a significant health risk; (2) were marketed using false claims that they could treat serious diseases; or (3) in the case of medical devices used for colon cleansing, were marketed for unapproved uses" (National Center for Complementary and Integrative Health, 2025).

On specific practices, the same fact sheet states: "Colon cleansing procedures may have side effects, some of which can be serious. Harmful effects are more likely in people with a history of gastrointestinal disease, colon surgery, severe hemorrhoids, kidney disease, or heart disease." It warns that juices that have not been pasteurized "can make people sick," that "persons susceptible to kidney stone formation should limit their consumption of high-oxalate foods as these foods can present a health threat," that laxatives "can cause diarrhea," and that "drinking large quantities of water and herbal tea and not eating any food for days in a row could lead to dangerous electrolyte imbalances" (National Center for Complementary and Integrative Health, 2025).

The U.S. Food and Drug Administration requires juice sold untreated in packages to carry this warning: "This product has not been pasteurized and therefore may contain harmful bacteria that can cause serious illness in children, the elderly, and persons with weakened immune systems" (U.S. Food and Drug Administration, n.d.-b). Federal regulations require premarket approval for colonic irrigation systems "when the device is intended for other uses, including colon cleansing routinely for general well being" (Colonic Irrigation System, 2026). In 2020 the director of the Federal Trade Commission's Bureau of Consumer Protection said that "social media is full of people peddling so-called detox teas, promising weight loss" (Federal Trade Commission, 2020b).

Nutrient gaps

A program that replaces meals with juice or a lemon drink for days supplies whatever is in the bottles and nothing else. The federal fact sheet states that "diets that severely restrict calories or the types of food you eat usually don't lead to lasting weight loss and may not provide all the nutrients you need" (National Center for Complementary and Integrative Health, 2025). The juice-only programs studied supplied 800 to 1,310 calories a day (Henning et al., 2017; Sardaro et al., 2025), and juicing removes most of the insoluble fiber in whole produce (Sardaro et al., 2025). Whether a particular program meets a particular person's needs is a question for a registered dietitian.

Who should not follow it without medical supervision

From the federal fact sheet: people with a history of gastrointestinal disease, colon surgery, severe hemorrhoids, kidney disease or heart disease, for colon cleansing; people susceptible to kidney stones, for juices high in oxalate; people with diabetes, who should consult their health care providers before major changes in eating; and children, elderly people and those with weakened immune systems, for juices that have not been pasteurized (National Center for Complementary and Integrative Health, 2025). The U.S. Food and Drug Administration adds pregnant women to those at risk from untreated juice (U.S. Food and Drug Administration, n.d.-b).

Anyone taking prescription medicine belongs on this list as well, for the reasons given under medication interactions below. And, as a precaution this program takes, anyone with a current or past eating disorder, for whom a program built on removing food can become a new set of rules.

Medication interactions

A coach never adjusts medication. The point of knowing these is to know when to send a client back to the prescriber or pharmacist. Insulin, sulfonylureas and meglitinides can cause low blood glucose, and eating too little carbohydrate or skipping or delaying meals makes it more likely (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-a). People taking warfarin are advised to eat consistent amounts of vitamin K-containing food from week to week and not to eat large amounts of leafy, green vegetables, and to talk with their doctor about grapefruit (American Society of Health-System Pharmacists, 2026).

Grapefruit juice raises the blood levels of some statins, some blood pressure medicines and several other drugs, and lowers the level of at least one allergy medicine; the U.S. Food and Drug Administration advises asking a doctor or pharmacist whether a medicine is affected (U.S. Food and Drug Administration, n.d.-a). Products sold as natural can carry hidden drugs: analyses of slimming teas and supplements have found undeclared sibutramine, phenolphthalein, bumetanide and phenytoin (Noor et al., 2026). Many detox teas contain laxative or diuretic herbs, and in one case report a detox tea's diuretic effect was judged the most likely cause of dangerously low sodium (Noor et al., 2026); a client already taking a diuretic or other prescription medicine asks the prescriber before adding one.

Signs it is going wrong

Physical signs a coach or a family member might notice are dizziness, fainting, confusion, unusual weakness or muscle aches, headache with nausea or vomiting, diarrhea that does not stop, a racing or irregular heartbeat, yellowing of the skin or eyes, new abdominal pain, and weight loss the person did not intend. Each is a reason to involve a clinician, not a diagnosis; the coach notices and encourages the client to tell their clinician, and working out the cause is the clinician's job. Confusion, a seizure, fainting or chest symptoms call for emergency care.

Behavior matters as much, and has to be read with care. A short change in eating can have ordinary reasons, so on its own it tells a coach little. Cleanses repeated to make up for eating, laxatives or teas used to empty the body, talk of food as dirty or of feeling clean only when empty, anxiety about eating after a cleanse ends, or turning down meals with other people carry more meaning and are worth asking about directly. The questions are what the behavior is for, whether it causes distress, whether it is narrowing what the person eats, and whether it is getting in the way of daily life. None of this is a diagnosis. Where the answers raise a real concern about disordered eating, the coach follows their own referral process.

Myths and where they came from

Myth: my body is full of toxins, and a cleanse will flush them out

Where it came from: the old theory of autointoxication, which held that waste in the intestine poisons the body and which the American Medical Association discounted in 1919 (Mishori et al., 2011). What is true: the liver, kidneys and intestine remove waste and harmful substances as part of their normal work (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.-b, n.d.-c; National Library of Medicine, 2026), and the studies reviewed do not establish that these programs increase toxin elimination from the body.

Myth: the weight I lose on a cleanse is fat and toxins leaving, and it will stay off

Where it came from: the scale drops quickly during a cleanse; in one study, by 1.7 kg in 3 days (Henning et al., 2017). What is true: short programs lower weight because people eat very little (Kim et al., 2015; Obert et al., 2017), the authors of one review suggest that laxative and diuretic teas lower weight mainly through fluid loss (Noor et al., 2026), and the federal fact sheet reports that weight tends to return once a person resumes a normal diet (National Center for Complementary and Integrative Health, 2025).

Myth: detox teas and cleanses are natural, so they are safe

Where it came from: marketing that presents herbal products as natural, often through paid influencers (Federal Trade Commission, 2020b; Noor et al., 2026). What is true: in the United States, teas sold as dietary supplements can be marketed without first showing that they are safe (Noor et al., 2026); some have been found to contain undeclared drugs; and case reports describe dangerously low sodium, kidney failure and liver failure after teas and juice cleanses (Gillett et al., 2021; Kesavarapu et al., 2017; Makkapati et al., 2018).

7. Key terms

Detox or detoxification

As this page uses it, a program or product sold to rid the body of toxins. The same word also names medical treatments, such as supervised withdrawal from opioids, which are not covered here.

Cleanse

A word used for the same kinds of products, as in a juice cleanse or a colon cleanse.

Juice cleanse

A program in which a person drinks only fruit and vegetable juices, usually for a few days.

Master Cleanse

A program that replaces food with a drink of lemon juice, syrup and cayenne pepper.

Detox tea

An herbal tea sold to cleanse the body or support weight loss, often containing herbs that act as laxatives or that increase urine.

Laxative

A substance that loosens stool or speeds its passage. Senna leaf and cascara sagrada bark are examples found in detox products.

Diuretic

A substance that increases the amount of urine the body makes.

Colon cleansing, colonic irrigation, or colonic hydrotherapy

Flushing the large intestine with water through a tube placed in the rectum, or with products taken by mouth or inserted rectally.

Autointoxication

The old belief that waste in the intestine poisons the body, which led to colon cleansing and which the American Medical Association discounted in 1919.

Electrolytes

Minerals in the blood, such as sodium and potassium, whose balance the kidneys keep steady and which nerves and muscles need to work normally.

Hyponatremia

A low level of sodium in the blood. Severe hyponatremia can cause confusion and seizures and is a medical emergency.

Oxalate and oxalate nephropathy

Oxalate is a natural compound in foods such as leafy greens and beets that the kidneys clear; oxalate nephropathy is kidney injury from calcium oxalate crystals deposited in the kidney.

Pasteurization

Heat treatment that kills harmful bacteria in juice and other foods.

Dietary supplement

A product such as a tea, powder or capsule sold to add to the diet. In the United States it can be marketed without first showing that it is safe or that it works.

Case report

A published description of what happened to one patient or a few. It shows that a harm can occur; it cannot show how often it occurs or prove the cause.

Single-group study

A study in which everyone follows the same program and is compared with their own starting values. Without a comparison group, it cannot separate the effect of the program from other changes.

Within-group and between-group comparisons

A within-group comparison measures how one group changed from its start; a between-group comparison measures whether one group changed more than another. Only the second shows that a program did better than the comparison.

8. Review questions

1. Name 3 of the programs or products this page covers, and say what each asks a person to eat, drink or do. Then name 2 medical uses of the word detoxification or of colon cleansing that are not the subject of this page.
2. This question draws on section 4. The 3-day juice study on this page reported that body weight was 1.7 kg lower after the juice days. Describe how the study was designed, and explain why it cannot show that the juices themselves caused the change.
3. A client who takes insulin tells you she is starting a 5-day juice cleanse next Monday to reset after a stressful month. Write what you would say and ask, and say exactly where the referral line is and what she should do if she feels shaky and sweaty during the cleanse.
4. Where did the idea that waste in the intestine poisons the body come from, and what does this page report about how the body removes wastes? Write the 2 sentences you would use, with the client's permission, if a client raised it.

9. References

Acosta, R. D., & Cash, B. D. (2009). Clinical effects of colonic cleansing for general health promotion: A systematic review. The American Journal of Gastroenterology, 104(11), 2830-2836. https://doi.org/10.1038/ajg.2009.494 (PubMed record: pubmed.ncbi.nlm.nih.gov/19724266)

American Society of Health-System Pharmacists. (2026, March 15). Warfarin. MedlinePlus, National Library of Medicine. medlineplus.gov/druginfo/meds/a682277.html

Bóna, E., Forgács, A., & Túry, F. (2018). A léböjtkúrák és az atípusos evészavarok lehetséges kapcsolata: Kvalitatív előtanulmány [Potential relationship between juice cleanse diets and eating disorders: A qualitative pilot study]. Orvosi Hetilap, 159(28), 1153-1157. https://doi.org/10.1556/650.2018.31090

Bonakdar, R. A., Sweeney, M., Dalhoumi, S., Adair, V., Garvey, C., Hodge, T., Herrala, L., Barbee, A., Case, C., Kearney, J., Smith, K., & Hwang, J. (2020). Detoxification enhanced lifestyle intervention targeting endotoxemia (DELITE) in the setting of obesity and pain: Results of a pilot group intervention. Integrative Medicine: A Clinician's Journal, 19(5), 16-28. pmc.ncbi.nlm.nih.gov/articles/PMC7815256

Chaudhari, H., Michaud, J., Srialluri, N., Mahendrakar, S., Granz, C., & Yudd, M. (2022). Acute oxalate nephropathy caused by excessive vegetable juicing and concomitant volume depletion. Case Reports in Nephrology, 2022, Article 4349673. https://doi.org/10.1155/2022/4349673

Colonic Irrigation System, 21 C.F.R. § 876.5220 (2026). ecfr.gov/current/title-21/chapter-I/subchapter-H/part-876/subpart-F/section-876.5220

El-Khodor, B. F., Zang, W., Gorby, H., Dominique, A., Hamrock, M., Metzger, B., Pecorelli, A., Varadharaj, S., & Valacchi, G. (2023). A plant-based dietary supplement improves measures of metabolic detoxification and the quality of life: A phase II multicenter randomized, blinded, placebo-controlled clinical trial. Integrative Medicine: A Clinician's Journal, 22(5), 28-39. pmc.ncbi.nlm.nih.gov/articles/PMC10734969

Federal Trade Commission. (2020a, March 6). FTC: Detox tea claims are hard to swallow. Consumer Advice. consumer.ftc.gov/consumer-alerts/2020/03/ftc-detox-tea-claims-are-hard-swallow

Federal Trade Commission. (2020b, March 6). Tea marketer misled consumers, didn't adequately disclose payments to well-known influencers, FTC alleges [Press release]. ftc.gov/news-events/news/press-releases/2020/03/tea-marketer-misled-consumers-didnt-adequately-disclose-payments-well-known-influencers-ftc-alleges

Getting, J. E., Gregoire, J. R., Phul, A., & Kasten, M. J. (2013). Oxalate nephropathy due to 'juicing': Case report and review. The American Journal of Medicine, 126(9), 768-772. https://doi.org/10.1016/j.amjmed.2013.03.019

Gillett, G., Shivakumar, N., James, A., & Salmon, J. (2021). Acute severe hyponatremia following use of "detox tea." Cureus, 13(3), Article e14184. https://doi.org/10.7759/cureus.14184

Henning, S. M., Yang, J., Shao, P., Lee, R.-P., Huang, J., Ly, A., Hsu, M., Lu, Q.-Y., Thames, G., Heber, D., & Li, Z. (2017). Health benefit of vegetable/fruit juice-based diet: Role of microbiome. Scientific Reports, 7(1), Article 2167. https://doi.org/10.1038/s41598-017-02200-6

Jackson, D. A., Beccia, A. L., Raffoul, A., Sarda, V., Chavarro, J. E., Hart, J. E., & Austin, S. B. (2025). Racial/ethnic inequities in potentially harmful supplement use: Results of a prospective US cohort during the COVID-19 pandemic. Public Health, 240, 104-111. https://doi.org/10.1016/j.puhe.2024.12.054

Jung, S.-J., Kim, W.-L., Park, B.-H., Lee, S.-O., & Chae, S.-W. (2020). Effect of toxic trace element detoxification, body fat reduction following four-week intake of the Wellnessup diet: A three-arm, randomized clinical trial. Nutrition & Metabolism, 17, Article 47. https://doi.org/10.1186/s12986-020-00465-9

Kesavarapu, K., Kang, M., Shin, J. J., & Rothstein, K. (2017). Yogi Detox Tea: A potential cause of acute liver failure. Case Reports in Gastrointestinal Medicine, 2017, Article 3540756. https://doi.org/10.1155/2017/3540756

Kim, M. J., Hwang, J. H., Ko, H. J., Na, H. B., & Kim, J. H. (2015). Lemon detox diet reduced body fat, insulin resistance, and serum hs-CRP level without hematological changes in overweight Korean women. Nutrition Research, 35(5), 409-420. https://doi.org/10.1016/j.nutres.2015.04.001

Klein, A. V., & Kiat, H. (2015). Detox diets for toxin elimination and weight management: A critical review of the evidence. Journal of Human Nutrition and Dietetics, 28(6), 675-686. https://doi.org/10.1111/jhn.12286

Lichtenstein, A. H., Khera, A., Anderson, C. A. M., Appel, L. J., DeSilva, D. M., Gardner, C., Hu, F. B., Jones, D. W., Petersen, K. S., & American Heart Association. (2026). 2026 dietary guidance to improve cardiovascular health: A scientific statement from the American Heart Association. Circulation, 153(18), e1285-e1295. https://doi.org/10.1161/CIR.0000000000001435

Makkapati, S., D'Agati, V. D., & Balsam, L. (2018). "Green smoothie cleanse" causing acute oxalate nephropathy. American Journal of Kidney Diseases, 71(2), 281-286. https://doi.org/10.1053/j.ajkd.2017.08.002

Maruti, S., & Adelman, S. A. (2024). History of alcohol and opioid use and treatment in the United States. In J. M. Rippe (Ed.), Lifestyle medicine (4th ed., pp. 1094-1098). CRC Press. https://doi.org/10.1201/9781003227793-113

Mishori, R., Otubu, A., & Jones, A. A. (2011). The dangers of colon cleansing. The Journal of Family Practice, 60(8), 454-457. mdedge.com/jfponline/article/64413/gastroenterology/dangers-colon-cleansing

National Center for Complementary and Integrative Health. (2025, March). "Detoxes" and "cleanses": What you need to know. National Institutes of Health. nccih.nih.gov/health/detoxes-and-cleanses-what-you-need-to-know

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.-a). Low blood glucose (hypoglycemia). National Institutes of Health. niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.-b). Your digestive system & how it works. National Institutes of Health. niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.-c). Your kidneys & how they work. National Institutes of Health. niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work

National Library of Medicine. (2026, July 27). Liver diseases. MedlinePlus. medlineplus.gov/liverdiseases.html

Noor, F., Chalise, R., & Tran, A. (2026). Safety and effectiveness of diet and detox teas for weight loss: A mini-review. Frontiers in Nutrition, 13, Article 1777795. https://doi.org/10.3389/fnut.2026.1777795

Obert, J., Pearlman, M., Obert, L., & Chapin, S. (2017). Popular weight loss strategies: A review of four weight loss techniques. Current Gastroenterology Reports, 19(12), Article 61. https://doi.org/10.1007/s11894-017-0603-8

Open Library. (n.d.). The master cleanser, by Stanley Burroughs, Burroughs Books edition dated April 24, 1976. Internet Archive. openlibrary.org/books/OL8524738M

Panda, C., Komarnytsky, S., Fleming, M. N., Marsh, C., Barron, K., Le Brun-Blashka, S., & Metzger, B. (2023). Guided metabolic detoxification program supports phase II detoxification enzymes and antioxidant balance in healthy participants. Nutrients, 15(9), Article 2209. https://doi.org/10.3390/nu15092209

Park, S., Alencar, M., Sassone, J., Madrigal, L., & Ede, A. (2019). Self-reported methods of weight cutting in professional mixed-martial artists: How much are they losing and who is advising them? Journal of the International Society of Sports Nutrition, 16(1), Article 52. https://doi.org/10.1186/s12970-019-0320-9

Raffoul, A., Beccia, A. L., Jackson, D. A., Sarda, V., Hart, J. E., Chavarro, J. E., & Austin, S. B. (2023). Associations between weight discrimination and the use of potentially harmful dietary supplements during the COVID-19 pandemic in the United States. Social Science & Medicine, 335, Article 116232. https://doi.org/10.1016/j.socscimed.2023.116232

Raffoul, A., Santoso, M., Lu, J., Duran, V., & Austin, S. B. (2024). Diet pills and deception: A content analysis of weight-loss, muscle-building, and cleanse and detox supplements videos on TikTok. Eating Behaviors, 55, Article 101911. https://doi.org/10.1016/j.eatbeh.2024.101911

San Mauro Martín, I., Paredes Barato, V., Sanz Rojo, S., López Oliva, S., Garicano Vilar, E., Gudalewska, P., Martín, M., Rui, X., Ciudad Cabañas, M. J., & Collado Yurrita, L. (2017). Are detox diets an effective strategy for obesity and oxidation management in the short term? Journal of Negative and No Positive Results, 2(9), 399-409. https://doi.org/10.19230/jonnpr.1585

Sardaro, M. L. S., Grote, V., Baik, J., Atallah, M., Amato, K. R., & Ring, M. (2025). Effects of vegetable and fruit juicing on gut and oral microbiome composition. Nutrients, 17(3), Article 458. https://doi.org/10.3390/nu17030458

Tinsley, G., Urbina, S., Santos, E., Villa, K., Foster, C., Wilborn, C., & Taylor, L. (2019). A purported detoxification supplement does not improve body composition, waist circumference, blood markers, or gastrointestinal symptoms in healthy adult females. Journal of Dietary Supplements, 16(6), 649-658. https://doi.org/10.1080/19390211.2018.1472713

U.S. Food and Drug Administration. (n.d.-a). Grapefruit juice and some drugs don't mix. fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix

U.S. Food and Drug Administration. (n.d.-b). What you need to know about juice safety. fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-juice-safety

Via, M. A., & Mechanick, J. I. (2025). Dysglycemia-based chronic disease. In J. I. Mechanick & R. F. Kushner (Eds.), Lifestyle medicine: Closing research, knowledge, and practice gaps (pp. 31-54). Springer. https://doi.org/10.1007/978-3-031-82888-1_3

Evidence rating and review record

The rated outcomes on this page use GRADE. Each row identifies its source or this page's own judgment and the comparison being rated. Ratings from different tools are not interchangeable. The banner at the top of the page carries no single rating, because the name covers many different products and programs. A high rating means the research is solid; it does not mean a product is right for anyone, and it does not mean a coach should recommend it.

Rows rated with GRADE use the same 4-level scale as the clinical guidelines you will meet in practice. High means further research is very unlikely to change the conclusion. Moderate means further research may change it. Low means further research is likely to change it. Very low means the conclusion is uncertain. GRADE rates each outcome separately. A row marked Not rated is an abstention, not a certainty level.

Three things about this table matter before reading it. Three rows are not ratings: the label as a whole cannot be rated; no study read for this page supplies a valid direct estimate of whether these products increase toxin elimination; and the shake trial reported its marker results within each group, so there is no comparative estimate to rate. The other 3 rows are this page's own judgments, because the searches found no published GRADE rating of any detox or cleanse outcome; they were assigned from the evidence given in each row's reasons, and one of them rates an indirect inference from hair measurements, not a measured removal of toxins. And the harms on this page are not rated, because they come from case reports, which show that a harm happened but cannot estimate how often.

On a narrow screen, scroll the table sideways to see every column.

Evidence ratings, their sources and reasons

Outcome	Certainty	Who rated it, and for which comparison	Why it is rated this way
Detoxes and cleanses as a whole	Not rated	This page's own judgment. No comparison is possible	A GRADE rating needs a defined intervention, a defined comparison and a defined outcome. The name covers juice programs, lemon drinks, teas, supplement kits and colon procedures, which ask very different things of a person, so there is no single intervention to rate. Each row below rates one exact comparison instead.
Directly demonstrated increase in toxin elimination from the body, any detox or cleanse product against any comparison	Not rated	This page's own judgment. No study read for this page measured the amount of a toxin leaving the body in a detox group and compared it with a control group	The relevant studies do not supply a valid direct estimate of elimination. The shake trial found no significant change in urine markers of liver detoxification in either group (Panda et al., 2023). A supplement trial, read in full, reports lower toxic metals in red blood cells only within the detox group, with no between-group result for metals (El-Khodor et al., 2023). A detox meal trial measured elements in hair, not elimination; its nickel result is rated separately in the next row (Jung et al., 2020). Not rated is an abstention, not a finding that the products have been shown to do nothing.
Increased elimination of nickel from the body, inferred indirectly from hair nickel, after 4 weeks of the Wellnessup detox meal program against a calorie-restricted diet of similar foods	Very low	This page's own judgment, using GRADE. Jung et al., 2020: randomized comparison of 15 women with overweight per group, 45 in 3 groups	Randomized trials start high. Lowered 1 level for risk of bias: the paper describes the group assignment in 2 inconsistent ways, does not describe how the assignment was concealed, and ran many unadjusted tests across 29 elements and 3 groups. Lowered 1 level for indirectness: hair concentration stands in for elimination, and the study measured no intake, output or body burden. Lowered 1 level for imprecision: 15 per group, a sample size calculated for weight rather than nickel, and no confidence interval for the between-group nickel contrast. Three levels down from high gives very low. A single study, so inconsistency could not be judged, and publication bias could not be assessed adequately. This rates an uncertain inference, not a measured clearance, and it does not extend to the other 28 elements or to other detox products.
Body weight during and 2 weeks after a 3-day juice-only diet, as measured	Very low	This page's own judgment, using GRADE. Henning et al., 2017: 20 healthy adults compared with their own starting weight, with no comparison group	A single-group study starts low, as observational evidence does. Lowered 1 level for risk of bias: the change cannot be attributed to the juices rather than to eating far less, a confounder the design cannot control, and 5 of the 25 enrolled were left out of the published results. One level down from low gives very low. Changes in fluid and gut contents limit any reading of the lost weight as body fat; they do not make the measured scale weight imprecise. The study tested one commercial product in healthy adults. Reported as a measurement, not as a goal.
Overall makeup of stool bacteria after 3 days of juice only, against juice plus usual food or a whole-food diet of similar calories	Very low	This page's own judgment, using GRADE. Sardaro et al., 2025: randomized, 3 diets, 14 healthy young adults analyzed, 4 or 5 per diet. Henning et al., 2017, a single-group study, is supporting evidence only	Randomized studies start high. Lowered 1 level for risk of bias: only 14 of the 23 who completed the study were analyzed, and some participants did not provide every stool sample. Lowered 2 levels for very serious imprecision: 4 or 5 people per diet. Three levels down from high gives very low. Inconsistency could not be assessed for this single small comparison; the single-group study measured a different comparison and is not a second comparable trial. Bacterial makeup is a measurement, and any effect on health is a separate, indirect question. Publication bias was not assessed.
Markers of the body's detoxification and antioxidant processes, a 28-day detox shake program against education alone, as a between-group effect	Not rated	This page's own judgment. Panda et al., 2023: 37 healthy adults randomized, 32 analyzed	The trial reports these markers within each group, against that group's own starting values, and supplies no usable between-group effect, so there is no comparative estimate to rate. The groups also started at different antioxidant levels. The rises within the shake group are described in section 4; they are not evidence of a benefit over education, and enzyme activity and antioxidant capacity do not measure any toxin leaving the body.

How this archive talks about weight. This page reports what studies measured, including body weight, and does not treat weight change as a goal or as a measure of a diet's success. Weight a person loses without meaning to can be a sign of a health problem, and where it is, the page names it as a reason to see a clinician. People are described the way the study described them.

Last reviewed: Reviewed and approved by James Peth, MS, MPH, PhD, on October 5, 2026, after a combined final review of the second batch of 5 archive pages, the repairs it asked for and a targeted recheck. Written October 3, 2026. The combined final outside review of the second batch of 5 archive pages was received October 4, 2026, and its findings were repaired the same day. What changed: a missed controlled study of hair element levels and a small comparison with a Mediterranean diet were added, with a new rating row; the toxin rows, the gut bacteria rating and the shake trial row were revised; absence statements were bounded to the searches; source details were corrected. After the outside recheck, the lemon trial's participant count was removed until its full paper can be read, and an author's name was corrected.

Updated October 21, 2026: The American Heart Association is now named as an author of its 2026 dietary guidance statement (Lichtenstein et al., 2026), as the publisher's citation credits it. No content changed.

Next scheduled review: August 2027. Pages built on annual guidance are rechecked each year. The federal fact sheets cited on this page are updated from time to time and should be rechecked first.

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Diet Reference Archive | One James

Prepared by James Peth, MS, MPH, PhD

© 2026–2027 One James. All rights reserved.

This page is for education and coaching practice. It is not medical or dietary advice.