David Purow, MD, remembers days in high school when his breakfast consisted of prepackaged pastries and fruit punch.
Thinking back on it today, Dr. Purow said his own son would be horrified at the idea of such a morning meal—not because of the high sugar intake or the lack of protein and fiber, but because of the color dyes present in the two sugary treats.
"The generations now feel very different than we did in the past when I grew up," said Dr. Purow, a gastroenterologist at Northwell Health. "There's more of a general awareness of what's out there and the effects that it may have on our body."
Northwell Health is part of the AMA Health System Member Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
That growing awareness is a good thing, but sometimes the response can go a bit overboard, according to Dr. Purow.
Look no further than the growing desire to “detox.” While detoxing in a medical setting has often been used to refer to treating a patient after an overdose, the term is being used more colloquially to mean removing substances that are getting into our bodies.
In 2025, the detoxification industry worldwide was valued at over $71 billion, and some estimates have that number approaching $120 billion by 2034.
Detox trends can range from eliminating highly processed foods and implementing liquid-only diets to focusing on eliminating exposure to microplastics and heavy metals. But are these voluntary detoxes actually necessary? Are they even healthy?
Dr. Purow answered those questions and more in the latest episode of the AMA podcast “Health vs. Hype,” which is produced in partnership with iHeartRadio.
"Health vs. Hype" takes on medical misinformation, viral health trends, DIY medicine, and common health myths to help listeners understand what’s real, what’s risky, and what’s backed by science. Host Trace Dominguez fact-checks popular health claims, explains how medical misinformation spreads, and reveals the real-world consequences of getting it wrong.
While exploring the growing detox fad, Dr. Purow explains the realities of how bodies work and whether he thinks these extra efforts are helpful or hurtful.
Quick-fix options aren't the best solutions
Dr. Purow said he often has patients who come to him and say, “I feel like crap, I'm exhausted all the time, and I have brain fog. What can I do to fix that?”
He added that “in this day and age, you can go online and find 12 different ways to do that very quickly. It's just not needed, nor is it going to be effective.”
"Sometimes we may need to try various things," he said. "It's not easy to sleep more, it's not easy, necessarily, to exercise more or change our diet or our habits. It's really an investment in doing so, and some people don't want to make the investment that that requires. That's one of the reasons that some of these detoxifying methods have become so popular."
Normal exposure to “toxins” won't harm health
"Different objects that we come in contact with are going to have small amounts of what some people are going to label toxins," he said. "Very high concentrations of those might have the potential to have deleterious effects on the human body. However, the amounts that are really present in most people … are really very small and never going to meet the threshold to really cause damage to our bodies because of the natural ways of defense that we have to detoxify things that are coming into our body."
"I don't feel that people need to be concerned," he added, "that we're living in a world of toxins that are all out to get us and they give us cancer and put us into an early demise."
You shouldn't feel worse during a dietary detox
"There are some people that say you should feel worse," Dr. Purow said. "No, you shouldn't really feel worse when you're doing a detox. That might be an indicator that something's wrong."
"If you see increased fatigue, then you may not be getting some nutrients that you need. If you're feeling more dehydrated or more tired, then you're probably doing something to your body that you're not getting enough rest or not getting enough fluids."
The body naturally detoxifies in multiple ways
"The main ways are going to be through the liver, the kidney, the skin, the lungs, and even newer research actually shows the brain can basically have mechanisms via which to get rid of what we'll call metabolic waste," Dr. Purow said. "Essentially, the brain can flush out some byproducts of reactions that can be considered metabolic waste. Interestingly, this is most active when we sleep."
How detox trends can be helpful
"The main manner in which they're effective is they probably support our natural methods," Dr. Purow said. "If someone isn't sleeping well, they may get brain fog. If they just sleep better, they might have less brain fog as opposed to ingesting something that's going to get rid of their brain fog."
Meanwhile, "improving hydration, eating better and making healthier choices, in addition to exercising, all of those things are going to be helping to promote our natural barriers and our natural ability to detoxify things," he said. "So some of the detoxifying regimens are helpful, but not for the reasons that they're proclaiming. They more augment our own natural ways to detoxify things than really ever actually detoxifying substances themselves as they proclaim to do."
