This is a double post this week – both here and on the blog at Paleo In The UK because I’m off doing some fancy genetics course and am manically busy with clients in the run up to Christmas. But also, because there is a great deal of info in here that my clients are also going to be interested in – it’s all about the “Insurance Policy” of digestive health: Activated Charcoal. Is it all it’s cracked up to be.
Please bear in mind as you read this that this article is talking specifically about the consumption of ‘treat’ foods and utilising Charcoal to offset the ‘damage’ caused. This is NOT addressing the role of Activated Charcoal in comprehensive gut protocols or toxin clearing chelation-type protocols, should any practitioner have included this in your regimen.
There are so many questions that arise at this time of year about how to “do Christmas” or “enjoy New Year” whilst still being Paleo. Over the next four weeks we are going to share with you four articles which cover the most obvious of questions on how to navigate Christmas: what to eat, what to say when you’re not eating certain foods presented to you… whether to even explain, how to party, what to do at New Year… did cavemen even celebrate New Year? (We’re just kidding, we’re not going to address this last one…)
But today, before we kick off our December “A Paleo Christmas” season, we wanted to present to you a Deeper Science article about the topic of how to ‘cheat’… or whether there are certain, supposedly ‘natural’ substances that can enable you to be a little bit … shall we say ‘deviant’ (?) with your diet this Christmas. We asked our Functional Medicine founder, Victoria to wade in on the topic of something that every one of us here at Paleo In The UK has in their cupboards for times of emergency and/or voluntary ‘cheating’… Activated Charcoal.
Terminology: Breaking Down the Language of Food
Before we begin, we should be clear about the terminology used above. Food is emotive, and so is the language used to describe and refer to it. The concept of a ‘cheat’ implies that you are moving away from a set of rules to which you were adhering. If you’ve read our comments about our ethos or our About Page, or our Page on Paleo Purpose, Macronutrients and Weight Loss, or indeed many of our articles about this way of eating, we try to be incredibly permissive about Paleo.
By which we mean that we present this nutritional approach as one that removes inflammatory foods from the diet and helps people feel better as a result both subjectively, and objectively – demonstrated by many research studies into nutrition and systemic inflammation.
We do NOT present Paleo as a club that you instantly lose membership to if you fall off an illusory ‘diet wagon’. There is no ‘in’ or ‘out’ in the Paleo Community – there’s just food, and choice – and each person’s choices are dependent on their personal health, their goals and, quite frankly, their tastes. Broadly speaking the recommendations we make are just that: recommendations. They show you the physiological impact of the foods we eat… from there, the choice about what you eat is entirely yours…
So, in light of this approach, where do we stand about the language used in our opening paragraphs about ‘cheating’? Well, strictly speaking you cannot ‘cheat’ when there is no wagon to fall off and no rules to which you are beholden.
But in order to present our arguments, we cannot get lost in the semantics. So, for the purposes of explaining our meaning in this article we will state that by using the word ‘cheating’ we are referring to consuming foods and drinks that typically come with collateral damage, whether that is excess toxicity for the digestive system and liver to deal with, or metabolic and hormonal dysregulation due to the macronutrient load. This can include, but is not limited to, alcohol, gluten and dairy, sugar, processed meats, artificial sweeteners and flavourings… and this can also include just eating too much food.
So can Activated Charcoal do anything to offset the collateral damage of inflammation, bloating, distention, liver toxin overload, microbial imbalance and hormonal dysreguation that consuming the above products might entail?
What Is Activated Charcoal?
Activated Charcoal is an odd name for a product that you’re willingly going to ingest, because it is suggestive of burnt embers in a fire. In actual fact, Activated Charcoal is very similar to that. It is the resulting product after burning a carbon-based substance at a searingly high heat. This can be wood, plant debris or, most popularly for “medical” or “therapeutic” uses: coconut shells.
During this burning process the high heat removes the oxygen. The end product is then steamed (this is the ‘activation’ of the title) which erodes the internal surfaces of the product. This results in a substance which is highly porous because it has lots of tiny holes within it. As such, the surface area of the Activated Charcoal is considerably more than the outer shape would suggest – some of the surface areas quoted are like telephone numbers, with a couple of grams of Activated Charcoal having the actual area of a football field.
Activated Charcoal is, therefore, highly ‘adsorbent’ (note, that’s not a spelling mistake – see below in “Any Truth To The Rumours?”), by which we mean it can bind to things because it’s got so much surface area for things to stick to. This adsorbent charcoal is utilised in medical settings because it is highly microporous. It is also used industrially – those carbon filters you put in your kitchen’s extractor fan are active carbon… which is just another name for activated charcoal. These carbon filters are used to purify air, water, sewage, gas masks and respirators because they trap all of the contaminants in their pores… and it stays there.
What Is Activated Charcoal Rumoured to Be Able To Do?
In healthcare settings AND in modern nutritional medicine, Activated Charcoal is sold for its binding capacity, with the suggestion being that Charcoal will bind to things in the digestive tract in order to blunt their toxic effects and/or completely flush them out of our systems before they can do damage. Whilst in a hospital setting the proposed use for Activated Charcoal is to combat poisoning and drug overdose, in the nutritional setting, Activated Charcoal is sold as a security blanket which protects against ingestion of dietary “toxins”.
Our pots of Bulletproof’s Activated Charcoal state boldly, in several places, that this “Coconut Charcoal” (i.e. made out of the coconut shells mentioned above), fits in the “DETOX” category, used for “Gas Relief” and it “Supports reduction of intestinal gas”. We are promised that “Bulletproof Coconut Charcoal traps unwanted material and gas to help get them out of your body naturally – and quietly.”
When you look deeper into Bulletproof’s blog and articles on the topic, they pepper their writings with some pretty fancy explanations of how Charcoal can help, suggesting that the eventual surface area of Bulletproof’s Activated Charcoal is enormous due to its micropores and that this means toxins get ‘stuck’ to it. Apparently, this is helped by the fact that carbon carries a negative charge. This therefore means that things with a positive charge (such as aflatoxin and mycotoxins, common moulds found in foods such as peanuts and coffee: the nemesis of the Bulletproof brigade) will be attracted to it and stick there, allowing you to eliminate the entire product intact, without digesting/absorbing or suffering from the ingestion of these toxins. They state that you will eliminate the carbon, carrying the toxins with it.
You are cautioned everywhere that they sell or promote Charcoal that you shouldn’t take it with anything else, especially not medicines or other supplements. You also have to be careful taking it with nutrient-dense meals. Why? Well because Charcoal is rather non-specific – it just binds to everything, including (apparently) the good stuff in your meals and supplements and any active ingredients in your medications. Basically Activated Charcoal is sold as glue – it sticks to stuff, so use it to stick to stuff you don’t want to hurt you, but don’t take in near stuff you want to hang onto.
Any Truth To The Rumours?
The statements made on Bulletproof’s Coconut Charcoal bottle that we have quoted above are interesting. They ALL come with a little figure or asterix after them. The qualifying statements read, “Preliminary studies have indicated that activated charcoal relieves gas” and, the usual, “These statements have not been evaluated by the Food and Drug Administration… etc. etc.”
Now, the latter statement is on all supplements and shouldn’t be paid much attention to. The former, however, is interesting… because I’ve searched PubMed. If there’s preliminary data on Charcoal and gas, it’s very niche and it’s tough to find. I’m not a researcher so I may have missed it – so instead of stopping I felt it only pertinent to look on the Bulletproof site to see what links to actual studies they were quoting.
Beyond a recipe for some lavender beauty elixir I found several articles referring to Charcoal as some kind of master detoxifier. They mention that ancient Chinese medicine and Ayurveda have used Charcoal “for over 10,000 years… to soak up poisons and improve intestinal health through a process called ‘adsorption’ which means ‘to bind to’ rather than ‘to absorb’.” They go on to state that it’s used in modern hospital as an antidote to drugs and poisons… But there are no studies linked whatsoever.
Perhaps it is my language thing causing me issues again, but as far as I’m concerned an antidote should really counteract the activity of the drug and/or poison that has been ingested. An antidote to snake venom is a precisely calibrated, snake-species-specific concoction of immunoglobulins created out of purified horse’s blood after injecting them with that venom (no – really, Google it). This is an antidote – something that is made by our immune system (or a chemist) to precisely counteract the effect and the potency of a specific toxin/poison.
Charcoal is not that.
Charcoal doesn’t neutralise the toxicity, it just (again, apparently) draws it into its pores and prevents it harming the person or animal that ingested the toxin.
Nevertheless, Charcoal is found in hospitals and is rumoured to be used to treat drug toxicity and oral poisonings. This is because Charcoal is not an antidote that can go into blood: you don’t inject it and you really wouldn’t want it in the blood. Instead, its action is in the digestive system where is mops up anything – including toxic products – which prevents them being absorbed by the body or pushed to the liver for detoxification. This all sounds really great. The fact that HOSPITALS keep it on standby must mean it’s amazing, huh?
Well, actually – no. The studies or papers I can find state anecdotal, single physician experiences utilising Charcoal to deal with acute poisoning. There is one exceptionally useful paper which highlights the research up until 2010, but this is actually just a personal exploration of Charcoal in all its historic and current applications.
It is an interesting read, however, because it appears that Charcoal isn’t just a case of ‘negative attracting positive’, though this chemistry wherein opposing forces bind together is part of what makes Charcoal effective, in certain cases. Actually, this is more precise chemistry than that, wherein sufficient concentrations of Charcoal must be administered to match the dose of toxin, otherwise ‘desorption of the solute’ will occur (i.e. the toxin will essentially fall out of the charcoal). There’s no real consensus of what this dose should be… except “big”. A meta-analysis suggests a dose of 40:1. Which is a hell of a lot of Charcoal (obviously depending on the quantity of toxin consumed) and perhaps enough to have many other adverse effects such as constipation and binding to other essential minerals.
Additionally, the dose of Charcoal must be administered within an hour of ingesting a toxin – and it really only works to bind certain products. Essentially, this is ALL about chemistry. The ability to be adsorbed into Charcoal is based on how tightly bound particles are within toxic substances … fancy words such as ionisation and polarity, dissociating and non-dissociating particles and complex chemical equations are used to explain what are essentially chemical reactions like you did at school. What is interesting is that despite the lack of evidence about Charcoal for specific health outcomes, it appears that the chemistry of Charcoal’s binding capacity itself has been tested quite extensively and the boundaries and limitations of Charcoal’s effectiveness as a toxin binder and poisoning treatment has been established.
And the limitation boundary of Charcoal is really quite narrow. Larger compounds which are poorly water-soluble will be bound, indicating a preference for fat-soluble toxins… and the detoxification of fat-soluble toxins is kind of done by our livers anyway. Perhaps this saves the liver a job, you might think. But in reality, from all of the research, it seems that there are no guarantees with Activated Charcoal application. Each case appears to be different, with each toxin and dose of Charcoal yielding different results. The author of the above-referenced paper summed it up perfectly:
“We will probably never have all of the evidence we need from prospective randomized controlled trials to definitively guide use of activated charcoal for the overdose patient. There are just too many variables to study: the specific drug or poison; its formulation (liquid, solid, sustained release); when it was ingested, and in what quantity; the clinical condition of the patient; available antidotes or therapeutic agents; and the quality of available emergency medical care.”
In fact, many of the conclusions from the research studies I have read state that Activated Charcoal, in multiple preparations and dosages, has “neither beneficial nor harmful effects on the outcomes of… poisoned patients, regardless of the time from (the toxin’s) ingestion to administration (of the Charcoal).” And whilst all hospitals will have Charcoal on hand for the drug overdose and poisoning cases that come into A&E… there are absolutely no guidelines given in the training or hospital policies which suggest uses and application parameters for Activated Charcoal.
And it must be mentioned that the medical setting, where there is weak but definitely some evidence for the use of Charcoal to combat toxin ingestion, is VERY different from the home setting, or from the restaurant table to which Bulletproof suggest you carry your (Bulletproof Branded) Coconut Charcoal. There may be some indication that, when hospitalised, the use of Charcoal helps in acute poisoning, but there is absolutely no evidence that taking capsules of Activated Charcoal with your meal does anything – to gas levels, liver toxicity or intestinal symptoms, or anything else.
The complication with the evidence (or lack thereof) for Activated Charcoal is that whereas studies don’t suggest that this does anything to do with reducing gastrointestinal distress, subjective experience (from MANY individuals) seem to contradict this. Anecdotal stories claim that taking Activated Charcoal after being exposed to something that someone suspects is going to give them symptoms can actually calm any reactions and, in some cases, eliminate any issues entirely. Clearly, this is something that is going to be impossible to fully evaluate because the whole point of taking Activated Charcoal is to do so before a reaction has taken place. This makes it absolutely impossible to evaluate whether the Charcoal itself prevented anything from happening – because there’s no way of knowing what the reaction might have been.
Additionally, this could be a placebo response: one in which the expectation is a reduced inflammatory or intolerance reaction and the power of that mindset means that such a reaction does not occur. There is actually nothing overtly wrong with placebo. It is a powerful and useful medical tool – and something that is accounted for as a variable in proper research studies because it is known to be influential enough to change outcomes.
The reality of placebo is that if the substance you are taking that gives you a placebo effect carries no side-effects (as Activated Charcoal, broadly speaking, does not – save the malabsorption of some other nutrients) then using it might be precisely the right thing to do, irrespective of the scientific evidence of its efficacy.
The only real issue with this ethos, however, is one of psychology: if one believes one has a security blanket (especially at Christmas), the temptation is to throw caution (and common sense) to the wind and assume that you are immune to the impact of eating too much of the wrong kinds of food for you. It is clear from the science that Activated Charcoal cannot be seen as an insurance policy against overindulgence or eating things that you know you react badly to. Even if the placebo effect can temper the experience of symptoms a tiny bit – this is not, clearly, actually going to render toxic substances inert.
Now, we state again – there is nothing wrong with overindulgence – but if you get to the stage where you are going to intentionally consume something that makes you ill, Activated Charcoal is not something that you can use to help you not feel that way.
At Paleo In The UK we eat Paleo, year-round, even at Christmas, because it’s tasty and because it’s satisfying. We are not yearning for the mince pies or the Christmas Pudding, and it’s not something that we feel bereft because we are missing it. If we did, we’d probably indulge (providing, obviously, that there were no autoimmune and/or coeliac issues).
To speak of Christmas specifically, we do indulge in alcohol perhaps a bit more regularly than at other times of the year – but if you’ve read our All About Alcohol page you will know that our take on alcohol is not one of abstinence in any case. Additionally, the complex chemistry of binding regarding Activated Charcoal means that alcohol is actually one of the smaller compounds with polar substituent groups. It doesn’t matter if you don’t understand the terminology … the important take home point is that alcohol really doesn’t bind well to Charcoal. Then there’s the sugar and the gluten – two substances which, again, aren’t bound by Charcoal.
There’s a lot of things we could say about the psychology of treats, the biochemistry of indulgence in toxins etc. etc., but we’ve made our point. Christmas doesn’t need to include overindulgence to be a pleasure – and hanging on to supplements in the vain hope that they might make poisoning yourself a less troubling experience is a bit of a fallacy and has no merit in the science. That doesn’t mean you shouldn’t eat, drink and be merry – just that you don’t need to convince yourself that you’re ‘saving’ anything by spending on a supplement which is proven to be fairly useless in any case.
A Paleo Christmas
Over the next four weeks The Paleo In The UK team are going to tackle how to do a Paleo Christmas (including the food, the parties and how (or whether) to do New Year). This is not going to be your typical “eat this, make this” articles – though they will link to some of the best “Paleo Christmas” articles we’ve used in the past.
Instead, they’re going to give you an idea of how to get a great attitude with which to face Christmas – allowing you to be flexible, to be strict if you need to, showing you how to deal with others who don’t get why you’re not eating the Christmas Pudding and how to enjoy and indulge without feeling guilty – even if what you’re eating is not a strictly Paleo indulgence. So much of where diets go awry – at Christmas and at all times of the year – is in the psychology and the approach. At Paleo In The UK we’re all about the measured, science-based, permissive and accepting kind of Paleo.
But we also want to show you how we do Christmas. And why we don’t think Paleo needs to be about 80/20 when you feel that every day is a day where you get to indulge, nutritionally-speaking… which is why Paleo, to us, is about eating great food every day so we don’t feel the need to save up our pleasures to use on alcohol, sugar and gluten-laden treats at this time of year.
And if you want to just ignore everything we say and think of Christmas as the one day you can be ‘off’ your ‘diet’… the Examine team recently demonstrated that even a major caloric blow-out might not cause too much damage. Clearly, this is not true in health/autoimmune/intestinal permeability/immune system terms… but it is interesting to reflect on how our bodies don’t change with one meal, or even one whole day. They change and adapt over time, which is why a year-round nutritional strategy is always a more healthful one.
Head over to Paleo In The UK’s blog and sign up for our updates – and we’ll share in the coming weeks all of our views on how best to do – and how to approach – the “silly season” whilst being Paleo or AIP.