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Detoxification ordetoxication (detox for short)[1] is the physiological or medicinal removal oftoxic substances from a livingorganism, including the human body, which is mainly carried out by theliver. Additionally, it can refer to the period ofdrug withdrawal during which an organism returns tohomeostasis after long-term use of an addictive substance.[2][3] Inmedicine, detoxification can be achieved bydecontamination of poison ingestion and the use ofantidotes as well as techniques such asdialysis and (in a limited number of cases)chelation therapy.[4]
Manyalternative medicine practitioners promote various types of detoxification such asdetoxification diets.Sense about Science, a UK-based charitable trust, determined that most such dietary "detox" claims lack any supporting evidence.[5][6][obsolete source][independent source needed]
The liver and kidney are naturally capable of detox, as are intracellular (specifically, inner membrane of mitochondria or in the endoplasmic reticulum of cells) proteins such asCYP enzymes. In cases ofkidney failure, the action of the kidneys is mimicked bydialysis;kidney andliver transplants are also used for kidney and liver failure, respectively.
Heavy metal detox, ordetoxification, is the removal oftoxic heavy metal substances from the body. Inconventional medicine, detoxification can also be achieved artificially by techniques such asdialysis and (in a very limited number of cases)chelation therapy. There is a firm scientific base inevidence-based medicine for this treatment.[7]
Manyalternative medicine practitioners promote various other types of detoxification such as "diet detoxification". These procedures generally possess no sound scientific basis and are often seen as unnecessary.[8][medical citation needed]Alcohol detoxification is a process by which a heavy drinker's system is brought back to normal after beinghabituated to having alcohol in the body continuously for an extended period of substance abuse. Serious alcohol addiction results in a downregulation ofGABAneurotransmitter receptors. Precipitouswithdrawal from long-term alcohol addiction without medical management can cause severe health problems and can be fatal. Alcohol detox is not a treatment foralcoholism. After detoxification, other treatments must be undertaken to deal with the underlying addiction that caused alcohol use.
Clinicians use drug detoxification to reduce or relievewithdrawal symptoms while helping an addicted person adjust to living without drug use. Drug detoxification does not aim to treat addiction but rather represents an early step within long-term treatment. Detoxification may be achieved drug-free or may use medications as an aspect of treatment. Often drug detoxification and treatment will occur in a community program that lasts several months and takes place in a residential setting rather than in a medical center.
Drug detoxification varies depending on the location of treatment, but most detox centers provide treatment to avoid the symptoms of physical withdrawal from alcohol and from other drugs. Most also incorporatecounseling and therapy during detox to help with the consequences of withdrawal.
An animal'smetabolism can produce harmful substances which it can then make less toxic throughreduction,oxidation (collectively known asredox reactions),conjugation andexcretion of molecules from cells or tissues.[9] This is calledxenobiotic metabolism.[10][11][12][13] Enzymes that are important in detoxification metabolism includecytochrome P450 oxidases,[14]UDP-glucuronosyltransferases,[15] andglutathioneS-transferases.[16] These processes are particularly well-studied as part ofdrug metabolism, as they influence thepharmacokinetics of a drug in the body.[17][18][19]
Certain approaches inalternative medicine claim to remove alleged "toxins" from the body through herbal, electrical, electromagnetic or other treatments. These toxins may not be linked to symptoms and treatments have no scientific evidence,[20][21] making the validity of such techniques questionable. There is little evidence for toxicaccumulation in these cases, as theliver andkidneys automatically detoxify and excrete many toxic materials includingmetabolic wastes.[21] Under this theory, if toxins are too rapidly released without being safely eliminated (such as when metabolizing fat that stores toxins), they can damage the body and causemalaise. Such alternative therapies includecontrast showers,detoxification foot pads,oil pulling,Gerson therapy,snake-stones,body cleansing,Scientology's andNarconon'sPurification Rundown,water fasting, andmetabolic therapy.[22]
