What’s black and potent (but not peppery or licorice-sweet) and can be found in supplements, toothpaste and several specialty foods? If you guessed charcoal, you’d be correct! Actually, it’s not the common charcoal you grill with and use in a fish tank filter but activated charcoal that’s designed with greater porousness1 and surface area2,3 for human ingestion.  

Intended as a detox agent, activated charcoal is taken to remove toxins from the body3 – a small cry from its medical use to block the absorption of poisons in the gut. Handy for overdoses, but not useful for a hangover or to counteract overindulgences. Somewhere in between is the idea that pollutants and toxins accumulated in the body can be drawn out through the gut. Can activated charcoal even do that? 

Actions

Activated charcoal is a drug and chemical sponge that soaks up most of the molecules in its vicinity and prevents absorption,1,3 then passes through the gastrointestinal tract and is eliminated. 

Clinical allopathic use dates back to the early 1800s but activated charcoal wasn’t adopted for mainstream emergency treatment for poisoning until the 1960’s2. If given soon enough after poisoning,1,4-6 the charcoal binds to the poison in the upper digestive tract, preventing the gut from absorbing it3,5.  

Activated charcoal is known to bind only to certain substances2,5 if present in your stomach and intestines at the same time3. It works on phosphates (from hemodialysis)1,6 and particles from compounds and drugs such as: acetaminophen, amitriptyline, aspirin, carbamazepine, digoxin, nadolol, phenobarbital, phenytoin, quinine, sotalol, theophylline and valproic acid1,5,6. 

“you should only take it between meals so as to prevent blocking vitamin and mineral absorption from your food”

Limitations

Many people concerned with common contaminants like bisphenol-a “BPA” (an endocrine disruptor in food and drink packaging), oxybenzone (found in sunscreens, anti-aging products, and women’s fragrances), and glycophosphates (used in conventional farming) are turning to naturopathic and alternative medicine for solutions. Unfortunately, I couldn’t find any evidence that activated charcoal removes any of those compounds from the body.

Charcoal is effective at filtering BPA, as well as heavy metals such as lead, nickel and chromium5 from drinking water. Activated charcoal is also used in employee safety respirator cartridges to filter out airborne toxins from vapors of paints, adhesives and plastics5.

Consuming activated charcoal will NOT remove hydrocarbons (e.g. gasoline and paint thinners), petroleum-based compounds, some metals, such as salts of iron and lithium, alcohol3, electrolytes, or caustic substances (very acidic or very alkaline)3,5.

Oral activated charcoal cannot combat: 

  • Already absorbed drugs* or alcohol 
  • Inhaled particles 
  • Exposure to toxins by skin contact 

So, taking activated charcoal the morning after a drinking binge won’t detox the alcohol at all. Get medical testing for heavy metal poisoning prior to attempting chelation therapy or a blood and organ detox to remove heavy metals that have passed into your bloodstream and liver, kidney or other soft tissue. 

* There is only preliminary evidence (case reports) that suggests a potential benefit of repeated doses of ingested activated charcoal to reduce the serum half-life of certain intravenously administered substances through interference with gut and hepatic or systemic circulation2.

Interactions

Nutritionally, activated charcoal could inadvertently bind to and prevent the absorption of important micronutrients3. It follows that you should only take it between meals so as to prevent blocking vitamin and mineral absorption from your food.

Medically, activated charcoal can interfere with prescription and over-the-counter medications such as: antiarrhythmics, antidepressants, antiepileptics, arthritis drugs, beta-blockers, bronchodilators, diabetes medications, oral contraceptives, and painkillers3. The interaction would be most prominent when activated charcoal is taken within an hour of a drug dosed less than 50 mg3.

Safety

Activated charcoal is probably safe for most adults in recommended over the counter amounts as part of a limited time detox program. It should not be used as a long-term, daily supplement.

Side effects are generally limited to the gut and may include constipation, black stools1, and nausea or vomiting3,5. More serious side effects are rare – these include a slowing or blockage of the intestinal tract, gastrointestinal obstruction, fecal impaction, regurgitation into the lungs (aspiration), and dehydration1,3,5. 

Dosing

Physicians and pharmacists might use doses from 25-100 grams1,6 to 1 gram/kg body weight5 with patients, but that doesn’t translate to at home dietary use! Over-the-counter activated charcoal for general use comes in powder and liquid forms and is generally available in 500 mg capsules3 and 280 mg/tablespoon fluid. Anything stronger is intended as emergent remedy for overdoses.† 

Special Precautions

Consult with your healthcare professional before using activated charcoal if you are pregnant, take oral medications or have a gut motility disorder. 

The Bottom Line

Activated charcoal can remove some toxins from the air and water and from the gut by binding to them. Orally, it is only effective at certain doses against certain toxins and only while the toxins are still present in the upper digestive tract, not after they have been absorbed.

Currently, no scientific evidence supports the claim for general detoxification. Activated charcoal can cause adverse effects, especially in large or repeated doses, or used long-term. Experts don’t recommend the use of activated charcoal detoxes, as the potential benefits don’t outweigh the risks. 

† IMPORTANT: If you’re going to stock your home medicine cabinet for emergencies – first ask your doctor, pharmacist, or poison control center operator for information on how and when to use over the counter activated charcoal. In case of an overdose or accidental poisoning, call a poison control center at (800) 222-1222 or use the webPOISONCONTROL tool. “If a poisoning is serious enough to warrant the use of activated charcoal, the person should be monitored in an emergency room,” says Pela Soto, PharmD, BSHS, BS, a Certified Specialist in Poison Information7. 

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor. 

References

  1. WebMD (N.D.) Activated Charcoal. https://www.webmd.com/vitamins/ai/ingredientmono-269/activated-charcoal  Accessed 1.14.2020 
  2. Derlet, RW and Albertson TE. Activated Charcoal – Past, Present and Future. Western Journal of Medicine 1986 Oct; 145:493-496.  
  3. Smith DG. (2019, July 17) What Doctors Need to Know About the Activated Charcoal Trend. https://www.medscape.com/viewarticle/915693  Accessed 1.14.2020 
  4. Position Paper: Single-Dose Activated Charcoal. American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists. Clinical Toxicology (2005), 43:61–87. DOI: 10.1081/CLT-200051867 
  5. Caporuscio J. (2019, November 20) Can Activated Charcoal Detox The Body?  https://www.medicalnewstoday.com/articles/327074.php Accessed 1.14.2020 
  6. Silberman J, Taylor A. Activated Charcoal. (2019, October 9] Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482294/ Accessed 1.14.2020 
  7. Soto P. (2015, March) Activated Charcoal: An Effective Treatment for Poisonings  https://www.poison.org/articles/2015-mar/activated-charcoal   Accessed 1.14.2020