On social networks you will find videos with all kinds of recipes for cleaning or “making detox” of the liver. From celery and apple smoothie to bay leaf and rosemary infusion, including lemon olive oil. Next come herbal supplements like milk thistle, artichoke extract, dandelion or horsetail.
All of this leads us to think of our liver as the air filter in the car carburetor, full of dirt, lumps and sticky secretions – and in some social media images it is presented that way – but nothing could be further from the truth.
“The vast majority is pseudoscience,” says Dr. Francis García Iglesias, an internist at the Crezando Center in Madrid, about these so-called recipes for cleaning it. “A healthy liver does not need to ‘detoxify’. This is precisely its function: it is an organ that has very effective physiological mechanisms to metabolize and eliminate toxins. In fact, the concept of ‘accumulation of toxins’, which, according to the advertising of these products, should be eliminated through their use, is not medically defined.”
A healthy liver does not need to “detoxify”. This is precisely its function: it is an organ with very effective physiological mechanisms for metabolizing and eliminating toxins.
Francis Garcia Iglesias
— internist
The liver is a laboratory, not a filter
The liver is the body’s great chemical laboratory. It receives much of the blood that comes from the intestine, loaded with nutrients but also potentially harmful compounds, and decides what to do with each: what is stored, what is processed, and what is expelled.
One of its main functions is to regulate blood sugar, storing sugar in the form of glycogen and releasing it when needed. Additionally, it synthesizes compounds we need like cholesterol, triglycerides, and lipoproteins that transport these fats in the blood. It also makes proteins such as albumin and clotting factors.
So what is its role in relation to toxins? The liver does not retain toxins, but transforms them into harmless compounds which are then eliminated through urine or bile. “The liver is an incredibly efficient organ that already performs the function of detoxification naturally. If you are healthy, you do not need outside help,” explains endocrinologist Joaquín Puerma Ruiz.
A clear example is alcohol, which is toxic. When we drink alcohol, it passes from the intestine into the blood, reaches the liver and is broken down there in different stages until it turns into CO₂ and water, which are eliminated. It is also responsible for the metabolism of many drugs and compounds in our diet, transforming them into others more useful for the body and, as we have seen, neutralizing toxins that can reach us. But this is all a dynamic process, like a treadmill. It’s not a warehouse.
Precisely, when the liver gets sick, it’s because this treadmill can’t cope or gets stuck.
Why does the liver suffer?
When he becomes ill, he does so in several ways that are now well known. Some of the most common conditions include nonalcoholic fatty liver disease (NAFLD), cirrhosis of various causes, and chronic viral hepatitis.
NAFLD, increasingly common in countries with high obesity rates, consists of an accumulation of fat in liver cells. The distinction is made because this disorder is normally associated with alcohol consumption, but in the absence of alcohol it can be caused by metabolic syndrome: excess weight, insulin resistance, hypertension and high triglyceride levels. In short, too much fat for the liver to process. This fat produces inflammation and progressive fibrosis and, in the worst cases, leads to cirrhosis and liver cancer. Fortunately, the liver can recover and treatment is as simple as a healthy diet and regular exercise.
The big enemies of the liver are not the “magic” toxins of the Internet, but much more common things.
Joaquin Puerma Ruiz
— endocrinologist
“The big enemies of the liver are not the ‘magic’ toxins of the Internet, but much more common things: excess alcohol, a diet rich in ultra-processed foods, being overweight, a sedentary lifestyle and the use of over-the-counter medications or supplements,” explains Dr. Puerma.
When there are problems, for example due to very persistent toxins, massive doses of toxins (such as a binge) or genetic diseases, the damage is caused by saturation or failure of metabolizing processes in the liver, and not because it has suddenly become a reservoir of poisons.
The idea that the body, and particularly the liver, gets dirty and requires regular “cleansing” is not new. For centuries, different medical traditions have proposed bleeding, purging, infusions, or fasting as a means of removing “humors” or toxins, long before the biochemistry of the liver was understood. Currently, despite the evidence, the market for juices, teas, supplements and ‘detoxification hepatic” grows without stopping.
Why supplements don’t work
But then, isn’t it possible to “help” the liver to do its job better? “The best care for the liver in healthy people is not to overload it,” says Dr. García. “There is no strong scientific evidence to support that a ‘detox’ tea, shake or supplement improves their processes in healthy people.”
The so-called “plans” detox” They generally produce a subjective feeling of improvement because they are based on calorie restriction, that is, being hungry, eating more fruits and vegetables and fewer ultra-processed foods, as well as mild diuretics that increase urination or laxatives that speed up intestinal transit. Most of the time, water is lost and sometimes weight, but there is no evidence that mysterious deposits of toxins are removed from the liver.
On the contrary, some of these products can be harmful. “Some herbal supplements can be hepatotoxic and cause liver damage or even liver failure,” warns Dr. García. “Just because a product is ‘natural’ doesn’t mean it’s safe,” he concludes. For his part, Puerma confirms that “cases of acute hepatitis and liver damage have been documented due to their use, especially when taken without medical supervision. This is also what the American Association for the Study of Liver Diseases warns.”
Dr. Puerma warns to avoid generalizations in the other direction: “Does this mean all supplements are bad? No, but their use must be punctual, with a clear medical indication and knowing exactly what you are taking. For liver health, as with almost everything, more is not better.
“There is no button to improve liver function, but there are many ways to prevent liver damage,” says Dr. Puerma. The good news is that in many liver diseases, the liver has a great capacity for regeneration if action is taken in time.
According to Dr. García, the most important measures for our liver to do its job well are:
- Avoid or minimize alcohol. This is the most effective measure with the greatest impact.
- Balanced diet, with evidence in favor of the Mediterranean diet.
- Regular physical activity, both aerobic and muscular, even without significant weight loss.
- Prevention of infections, vaccination against hepatitis A and B when indicated and control of risk factors.
- Maintain a healthy weight.
“The liver does not need special products, but healthy habits maintained over time,” explains Dr. García. “What harms and protects it is well identified and supported by decades of research. The idea of ’improving’ an organ that is already functioning properly is more in the realm of marketing than medicine,” he concludes.
In short, the relationship with our liver is only toxic if we harm its proper functioning. The liver does not need to be cleansed, it must be allowed to do its job with fewer obstacles.
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