Wednesday, January 2, 2013

Stop the Cleansing!

It's a New Year and people are ready for fresh starts.  I know I usually try to clean out my closets about this time and some people are also trying to clean up their diets in anticipation of a fresh start.  But what also comes along are several different kinds of programs that claim to "cleanse" your system after you have over indulged in holiday sweets or alcohol.  Are any of these things worth it?
I have written in a previous post that typically a lot of these programs are claiming to remove "toxins" from your system, and remember "toxin" is just a modern day word for "miasma" or "imbalanced humors." So, it is unlikely that you can be cleansed from something that doesn’t exist.  If you had in fact been poisoned, it is unlikely that drinking juices or taking the herbal product will help that.  I also wrote another post here about the problem with colon cleansing, which is also un-necessary and in no way evidence based.  The conclusion, of course, is that if you have been eating or drinking some things that are going against your health goals (like too many cookies), you can get closer to your goals by removing and/or greatly reducing the offending items and by making sure that you get an adequate amount of what you do need.  There is no magical item that will cleanse us of our perceived dietary sins, so to speak, but we can improve our health by eliminating certain items and by allowing our bodies normal metabolic processes to clear out the waste products.
But of course, I still get thrown articles like this (Clean your kidneys), which indicate that there is something accumulating in organs that can be eliminated by one simple natural thing!! (Notice how no one tries to sell you anything complicated).  The statement that got me was this one here: With time, the salt accumulates and this needs to undergo cleaning treatments and how are we going to overcome this?
To understand how ridiculous this statement is, let us talk a little bit about the anatomy of the kidney.   There is a more extensive and well done piece over here at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) here, but for now we will focus on the part of the kidney where the removal of waste actually takes place, in the nephrons.  Each kidney has a million nephrons, and each nephron contains a tiny little sieve called the glomerulus.  A normal functioning kidney will be able to gauge what needs to be filtered out into the urine and what needs to be reabsorbed, it's a delicate balance but our body has evolved to keep that whole process in check.  Sometimes, however, people have a chronic uncontrolled condition (like diabetes or hypertension) that put so much pressure on those delicate filters that they actually fall apart and become useless.  If enough of the nephrons fail, waste products and minerals build up in the body and the only way to remove them from the blood stream is by dialysis and/or kidney transplantation.  You can read more about that in the NIDDK piece, but it is not a process most people want to go through.
So, if your nephrons did actually accumulate salt in them like this article claims, you would need dialysis instead of a cilantro shake.  Fortunately, salt does not accumulate in the "filters" and therefore the need to add "cleansing agents" is not evidence based.  Now, some people with chronic kidney disease will experience swelling of the ankles/feet/hands when they take in too much sodium because their remaining nephrons cannot keep up with the demand.  Once again, the cilantro drink will not help you, but limiting your sodium intake in the future will prevent it from happening again (and some people even need medicine to help restore the balance).  And if you do have diabetes, hypertension, and/or are overweight, eating properly to control these conditions will help keep you nephrons in good working shape.
Oh, and one more thing, even if the cilantro did remove the excess sodium from the body, if you had too much of this you could develop a potentially dangerous condition called hyponatremia (definition) where the concentration of sodium in your blood becomes too low.  People with heart failure and chronic kidney disease who do have to take diuretics (aka "water pills") have to be monitored closely so that they don't have the delicate balance of sodium and water in their blood disrupted.  And any competitive athlete will tell you that they will usually have to consume an electrolyte solution during periods of intense training and competition (I've posted here about how that's likely not you).  So be careful of anything that claims to help you "lose" sodium because if it did work you might be in trouble.
Take home message—To keep your kidneys healthy stay hydrated and control chronic conditions like diabetes and hypertension, otherwise your body is doing fine on it's own.

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