Is Activated Charcoal Messing With Your Medications?

by | May 8, 2019 | Uncategorized | 0 comments

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Is Activated Charcoal Messing With Your Medications?

The activated charcoal fad has followed a predictable trajectory. It started as an innocent Instagram trend with ink black ice cream, smoky lattes, and charred croissants. Then came the juices, supplements, and claims that charcoal detoxifies your body.

But as the trend proliferates, scientists are warning that consuming activated charcoal could interfere with your medication. The whole point of activated charcoal is to soak up and stop the effect of drugs in your stomach. Emergency room doctors and toxicologists regularly use it to treat overdoses and poisonings. Charcoal isn’t a discriminating detoxifier either; it will adsorb vitamins, minerals, and medications alike. This includes antidepressants, birth control pills, over the counter painkillers, anti-epileptics, beta blockers and anti-arrhythmic drugs, medications for diabetes, and even steroids from asthma inhalers.

“It’s essentially a pseudoscientific application of a remedy that’s used in real medicine,” says David Kroll, a professor in the Department of Pharmaceutical Sciences at the University of Colorado Denver. “You name the chemical and charcoal’s been used to at least partially adsorb it after someone commits an overdose or is otherwise poisoned.”

Charcoal is made from burning peat, coal, wood, or coconut shells. The “activated” part comes from blasting it with an oxidizing gas that, according to the Natural Medicines Comprehensive Database, “causes a highly developed internal pore structure in charcoal, which increases its overall surface area.”

Charcoal’s larger porous surface area means it has more space to soak up nearby molecules. By adsorbing drugs or toxins in the stomach, charcoal prevents them from being absorbed into the bloodstream. Eventually, the charcoal passes through the intestines and you poop it out, along with whatever’s bound to it. That’s good news if you overdose on a drug, but it could cause a problem if you take medication because of a health issue.

Although activated charcoal has the potential to interfere with medication, none of the three experts interviewed for this article had heard of that happening from food or beverages. The concern is largely related to supplements of charcoal.

The key variables are time and dose. Simply put, in order for charcoal to have a detoxifying effect, it needs to be in the gut at the same time as the drug (or toxin) that it’s trying to rid from the body. There also must be a large enough amount of charcoal to adsorb the drug. If the drug gets into the bloodstream first, the charcoal is useless.

A 2005 study showed that when activated charcoal is given within five minutes of ingesting a drug, only 26% of the drug is able to enter the bloodstream. If taken 60 minutes post-ingestion, that number rises to 60%, and after two hours, 84% of the drug is absorbed.

The rule of thumb is that people should take 10 times more charcoal than whatever it is they’re trying to adsorb. In the ER, a typical dose of activated charcoal is 50,000 milligrams. You can buy activated charcoal supplements online or in health stores in 250 milligram and 500 milligram capsules. A black juice has about 10 milligrams of charcoal in it.

Prozac is prescribed in 20, 40, and 60 milligram tablets, so the 10:1 rule suggests that a charcoal supplement — but not a charcoal juice — could counteract the drug if taken at the same time. Yasmin, a popular form of birth control, contains 0.03 milligrams of estrogen and 3 milligrams of progestin, so the risk of adsorption is much higher, according to Kroll.

“I think in a majority of people it’s probably a low dose [of charcoal] and won’t make a difference if they’re being smart and not taking it at the time of their medications,” says Christopher Holstege, a professor of emergency medicine at the University of Virginia and director of the Blue Ridge Poison Center. “If they’re taking a really small amount that’s diluted in water or another liquid drink, it’s probably not going to have any effect and will go straight through you. But nor will it have any benefits.”

Very little research has looked at whether consumer amounts of activated charcoal interfere with medication absorption. There are two conflicting studies from 1986 and 2001 about whether activated charcoal interferes with estrogen and progesterone, the hormones in birth control pills. One study found no changes in hormone levels or the drug’s efficacy in preventing ovulation from taking 5,000 milligrams of activated charcoal three hours after taking the pill. The other study showed that charcoal did interfere with absorption of estrogen, even when it was given three hours later.

One thing activated charcoal does not bind to? Metals. So ignore any claims about charcoal supplements detoxing your body of heavy metals. Another myth is that charcoal can be used to prevent hangovers. Activated charcoal can’t bind to alcohol — it’s one of the few drugs that doesn’t — but it has a strong effect on Tylenol and Aspirin. That means downing two painkillers with your charcoal detox juice may do less for your hangover than if you took the pills with water.

“People are trying to detoxify themselves with charcoal. The question always comes… what are you trying to bind?” says Holstege. “It’s a little puzzling to me what people are trying to utilize it for. It seems like a waste of money to me.”

Registered dietitian Kristen Smith, a spokesperson for the Academy of Nutrition and Dietetics, also says there’s no need to take an additional detoxifying agent. “Your body already has a natural detoxifying system,” she says. “Your liver and kidneys are already doing a good job of detoxifying. Your liver helps to break down toxins while your kidneys help flush them out.”

So is taking activated charcoal supplements a bad idea? If you’re on medication, you may want to reconsider. Is drinking a charcoal lemonade or cocktail going to cause an unwanted surprise in nine months? Probably not, but hypothetically it could. So enjoy your overpriced latte if you want, but consider staying away from the supplement aisle.

Is Activated Charcoal Messing With Your Medications?

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