Image credit: www.activatedcarbonxk.com
In 1831, a French researcher named Tovery publicly swallowed a lethal dose of strychnine and walked away with no ill effects. And this was no trick: read on to learn more about how activated charcoal saves lives every day – and some of its less dramatic potential benefits.
What is Activated Charcoal?
Charcoal is usually wood that has had nearly everything burned out of it: all of the water and volatile compounds are removed through slow, dry heat, leaving only carbon behind [1].
Activated charcoal is a bit different: during production, it is exposed to any one of several chemicals that make tiny pores and bubbles in its surface. This process increases the surface area of the charcoal, thereby increasing its ability to bind to or adsorb other chemicals. This reaction and absorption capacity is why we call it activated [2, 3, 4].
Carbon, the sixth element in the periodic table, is the most important component of well-prepared activated charcoal. It can form bonds with heavy metals, volatile gases, and other poisons [5, 3, 6].
Many filtration systems include a layer of activated charcoal to bind heavy metals and prevent contamination with microbes [6, 7, 8].
People have used activated charcoal to survive poisoning since the heyday of the ancient Egyptian civilization. In 1831, one man by the name of Tovery stood before the French Academy of Medicine, took a lethal dose of strychnine, and survived.
How?
He swallowed a large dose of activated charcoal at the same time. The charcoal presumably adsorbed the strychnine in his stomach and intestines, preventing it from entering his bloodstream [9, 10].
Snapshot
Proponents:
- Stops poisoning and overdoses
- Supports kidney and liver function
- May support digestive health
- May lower cholesterol
- May support oral health
- Promotes wound healing
- Considered very safe
Skeptics:
- May cause nausea, vomiting, and constipation
- May bind to and inactivate drugs
- May prevent nutrient absorption
For Poisoning & Overdose
Activated charcoal has been a well-known antidote for poison for centuries; the ancient Egyptians may have been the first to use charcoal for this purpose [11].
It has been used as a “universal antidote” for decades [12].
Activated charcoal has a unique ability: it binds to many drugs and toxins in the gut. This binding prevents them from crossing over into the bloodstream, where they could have damaging effects [13].
As a result, activated charcoal is considered a very useful antidote to a variety of poisons and a remedy for overdose with certain drugs [13].
Overdose and Poisoning
In modern medicine, activated charcoal has been used to help people suffering from overdose and poisoning. Substances that have been cleared with activated charcoal include [13, 14, 15, 16]:
- Alcohols (ethanol, methanol and ethylene glycol)
- The drug of abuse phencyclidine (PCP, also known as angel dust)
- Sedatives like phenobarbital and benzodiazepines such as Xanax
- Drugs such as digoxin and theophylline
- Paracetamol
- Valproate, used for epilepsy and bipolar disorder
- Datura fruit (jimsonweed)
Certain drugs, such as PCP, remain in the body for a long time. The liver processes PCP and excretes it into the intestine with bile; it can then be reabsorbed back into the blood. People who have overdosed on PCP may be given multiple doses of activated charcoal to catch the drug as it moves from the liver back into the gut [14].
Activated charcoal is more effective the sooner it is taken after an overdose. In some parts of the world, paramedics are authorized to give activated charcoal in the ambulance to shorten the period between overdose and treatment [17].
The Bottom Line
While activated charcoal is an important detoxifying compound, it is not appropriate for all poisons, all overdoses, or all patients.
Do not attempt to self-administer activated charcoal for poisoning or overdose unless directed to do so by a professional. If you suspect that you have overdosed, call poison control immediately and follow their instructions [13, 18].
Does it Work for Detox?
If you suspect that your food or water is contaminated with certain compounds, activated charcoal may prevent your body from absorbing them. For example, it binds to many common water pollutants and to aflatoxin B1, a fungal toxin produced by Aspergillus molds [19, 20].
Activated charcoal may be beneficial in some cases, but keep something in mind: it does its work in the digestive system, so it can only “detox” the digestive system.
Once poisons and toxins have been absorbed into the blood, activated charcoal isn’t as useful. That’s why it’s so important for health professionals to give activated charcoal within the first hour after poisoning [17, 21].
Plus, activated charcoal also binds to vitamins in the gut. Using it long-term may prevent the body from getting all of the nutrients it needs [19].
Bottom line? Activated charcoal can stop your body from absorbing harmful pollutants and toxins, but there are better options for everyday use.
Potential Benefits of Activated Charcoal
The FDA has not approved activated charcoal for any health purpose or medical claim. Furthermore, certain jurisdictions (such as New York City) have actually banned activated charcoal as a food additive and defined foods containing activated charcoal as “adulterated.”
These are important caveats to keep in mind if you’re looking to use activated charcoal for health reasons. We recommend talking to your doctor before using activated charcoal.
Insufficient Evidence For
1) Kidney and Liver Function
The kidneys and liver are our detoxifying organs: they filter drugs, toxins, and wastes out of our blood and clear them from our bodies [22, 23].
Kidney Failure
Some researchers argue that, by binding to toxins in the digestive system, activated charcoal prevents them from entering the bloodstream, which decreases the amount of work left to the kidneys. In combination with a low-protein diet, activated charcoal improved symptoms and reduced the need for dialysis in elderly people with kidney failure [24].
Cholestasis
Cholestasis is a condition wherein the bile can’t flow out of the liver. As a result, bile builds up in the liver and causes severe itching, jaundice, and eventual damage to the liver and immune system [25, 26, 27].
Cholestasis is relatively common during pregnancy. In one study, the majority of pregnant women given activated charcoal had significantly decreased bile acid buildup, though itching symptoms did not improve [28, 29].
More research is required to determine whether activated charcoal is really effective against cholestasis.
2) Digestive Health
Some people believe that activated charcoal may reduce bloating, either by decreasing the amount of gas produced by the gut flora or by directly binding this gas.
In one study of nearly a hundred people, those who took activated charcoal had better results on their hydrogen breath tests and reported fewer symptoms of abdominal cramps and bloating [30].
More recently, end-of-life nurses and doctors have renewed their interest in activated charcoal.
In palliative care research, activated charcoal improved diarrhea and improved quality of life in elderly people. Researchers have not yet investigated this claim in other clinical trials [31].
3) Cholesterol
Some early research suggests that activated charcoal lowered bad cholesterol (LDL) and raised good cholesterol (HDL).
In the 1980s, three small clinical studies showed a significant decrease in LDL after 3-4 weeks. These results were supported by cell and animal studies; however, researchers have not reproduced or expanded these trials in recent years [32, 33, 34, 35].
4) Oral Health
Many activated charcoal products are labeled with claims of being the perfect toothpaste, able to whiten the teeth, protect the enamel, and clear toxins from the mouth.
Unfortunately, the evidence is mixed: in a review of over a hundred articles, researchers found that toothpaste containing activated charcoal did not necessarily clean better than conventional toothpaste [36].
However, these results may depend on the type and quality of the charcoal product.
One study investigated toothbrushes with bristles made of a charcoal and nylon blend, which are popular in south-east Asia. Charcoal bristles allowed less bacterial growth than standard bristles, supporting claims that charcoal is antimicrobial [37].
If these results can be repeated, charcoal bristle toothbrushes may help prevent gingivitis.
A recent study compared activated charcoal to other home whitening remedies and to a proven whitening toothpaste. Activated charcoal significantly whitened teeth; however, this study did not investigate any of the home remedies’ effects on the tooth surface or on how long the color improvement lasted [38].
The Bottom Line
Although recent studies have been promising, more evidence is required to support claims that activated charcoal significantly whitens teeth or improves oral health.
Despite this, various charcoal-based toothpaste, teeth cleaning products, and dental powders have flooded the market. These are advertised for “oral detoxification,” antibacterial action, and more. These are probably safe to use, but don’t expect miraculous teeth whitening [36].
Charcoal toothpaste also has a very obvious “dark” side: unlike charcoal bristle toothbrushes, commercially available or home-made toothpaste with charcoal can temporarily leave black stains on the tongue.
5) Wound Healing
Activated charcoal – with or without silver – is sometimes included in dressings for chronic wounds like pressure ulcers.
In one study, ulcers dressed with activated charcoal healed better than those with other dressings. Researchers suggest that activated charcoal may be able to remove fluids and bacterial toxins from the wound, thereby supporting healing [39, 40].
In people with extensive blisters and skin loss, activated charcoal and baking soda can also significantly decrease odor [41].
How Does Activated Charcoal Bind Toxins?
Each atom of carbon can bond to up to four other atoms. In charcoal, most carbon atoms are bound to other carbon atoms, but the atoms on the surface are exposed and available to bind chemical compounds. This surface binding is called adsorption [2].
The very high surface area and complicated shape of activated charcoal allow it to absorb more effectively than common charcoal [2].
The microscopic shape of this substance is so complex that 50 grams of very high quality activated charcoal can have a total surface area of about 175,000 square meters. For perspective, the average football field has a surface area of 5,351 square meters [13].
Safety & Side Effects
Accidentally breathing activated charcoal may be the most serious potential danger associated with its use; in one case, a middle-aged man breathed activated charcoal into his lungs and died as a result. This event is rare, however, and the benefits of activated charcoal far outweigh the risks of its use in overdose and poisoning [42, 43].
Other potential risks associated with activated charcoal include corneal abrasion: that is, scratches on the surface of the eye. If preparing face masks or toothpaste from activated charcoal powder at home, make sure to keep it away from your eyes to avoid this risk [42].
To avoid complications, people with damaged respiratory or digestive systems should not take activated charcoal [42, 44].
People with variegated porphyria (a rare genetic disorder) may experience skin disease worsening after taking activated charcoal and should, therefore, avoid taking it unless directed by a medical professional or poison control [42, 44].
Side Effects
People who take activated charcoal by mouth occasionally experience constipation, electrolyte imbalance, nausea, or vomiting.
Pneumonia was reported as a rare complication in people treated for overdose with activated charcoal.
In order to prevent constipation, people are often given activated charcoal in a sorbitol solution. Sorbitol is a laxative and helps the charcoal pass through the gut, but it may decrease the overall effectiveness of the charcoal [9, 45, 46, 47, 48].
Children and Pregnant Women
Activated charcoal is used in children and pregnant women in much the same way as in the rest of the population, though children are likely to receive smaller doses. Pregnant women with cholestasis are sometimes given activated charcoal to help clear bile acid from the liver, though this benefit has not been confirmed [49, 29].
Cats and Dogs
The low-calorie sweetener xylitol is a life-threatening poison to dogs. Some studies and anecdotal evidence have suggested that activated charcoal is useful in dogs that have eaten xylitol. Activated charcoal may also be used to treat poisoning in cats [50, 51].
No studies have investigated whether activated charcoal can benefit healthy pets. For this reason, we recommend strongly against giving your pets activated charcoal unless directed by a veterinarian or poison control.
Drug Interactions
Activated charcoal prevents many medications from working properly because it binds them in the gut and prevents them from being absorbed into the bloodstream.
If the overdose of a drug can be treated with activated charcoal, then that drug will not work in the presence of activated charcoal because it will be adsorbed before it can cross into the bloodstream. These include common painkillers like Tylenol and antidepressants like sertraline [14, 52, 53].
Your doctor may suggest taking activated charcoal at least 2 hours before or 1 hour after any medication or supplements to avoid interactions. To avoid any adverse effects or unexpected interactions, consult your doctor before using activated charcoal.
Commercial Forms (Pills, Powder) & Dosage
Activated charcoal is mostly available in capsule or powder form.
If you plan on ingesting the charcoal, read the label carefully. To safely ingest activated charcoal in its powdered form, mix the recommended dose into a glass of water, drink it, and then drink another glass of plain water. Follow the direction of a doctor or poison control carefully if you have been directed to use activated charcoal.
Note that some charcoal products, like tooth scrubs, may contain other ingredients such as calcium bentonite clay or herbal extracts. While these are not toxic, they may change the effect of activated charcoal in ways that have not been studied.
Some products will list the source of the charcoal (often coconut shells, but sometimes various types of wood). If the activated charcoal has been well-prepared, the source should not matter: everything except carbon has already been burned away.
Dosage
There is no safe and effective dose of activated charcoal for anything except overdose because no sufficiently powered study has been conducted to find one. Commercial activated charcoal products generally recommend between 1 and 3 grams of activated charcoal per day.
In elderly people, lower doses of around 250 – 750 mg/day were used to relieve constipation [54].
However, studies on charcoal as a digestive aid for people with impaired bile flow or high cholesterol typically used doses of 24 to 40 g per day [35, 32, 34].
The standard dose of charcoal given after poisoning or drug overdose is 50 to 100 g [13, 55].
Limitations and Caveats
Activated charcoal is a well-established antidote for poison and overdose, but much of the research on its use and mechanisms is several decades old. In particular, its other purported benefits (such as supporting digestive health and lowering cholesterol) have not been fully investigated.
Recent commercial interest in activated charcoal as a “cleanse” has caused a minor resurgence, but the evidence is still lacking in many areas. For example, claims of improved skin health are scientifically unfounded and have yet to be researched.
User Experiences
Most people who regularly take activated charcoal do so for gas and bloating; the majority of reviews are very positive. Many people report feeling better within half an hour of taking activated charcoal for gas. Some reported side effects like abdominal pain and constipation; rarely, activated charcoal would worsen symptoms of irritable bowel syndrome.
Some people took activated charcoal to help with the symptoms of food poisoning and reported that it did not help with their pain, bloating, or diarrhea.
Certain activated charcoal products had much higher average ratings than others. Read through the reviews to identify the highest quality products, and talk to your doctor before using activated charcoal to avoid side effects or interactions.
Takeaway
Activated charcoal is a special type of charcoal with an extremely high surface area that allows it to bind to most toxins and drugs in the gut, preventing them from being absorbed into the blood. It has been an effective antidote when taken within an hour of most poisonings and overdoses. It may also have more mundane health benefits, such as supporting kidney and liver function, but these are not well studied and the evidence is considered insufficient to support its use.
Some early studies suggest that it may lower cholesterol. It may also support oral health, whiten teeth, and even help chronic wounds stay clean and heal. Activated charcoal is considered very safe, though it can adsorb nutrients, medications, and other beneficial compounds if taken at the same time.
The most common side effect is constipation, followed by nausea, vomiting, electrolyte imbalance, and pneumonia (from inhaling the powder). Activated charcoal can prevent most drugs from working; avoid it if you are on important supportive medication or consult your doctor.
