On September 19 2019, a Facebook user shared a warning (archived here) that urged fans of the “spooky season” to avoid foods colored with activated charcoal due to its purported ability to prevent your body from absorbing medications.
Alongside images of black-colored pancakes, ice cream, and coffee, text proclaimed:
As we head into the spooky season just a reminder:
IF YOU TAKE MEDICATIONS DON’T FALL FOR THE ACTIVATED CHARCOAL TREND!! Why? Because activated charcoal is used in oral overdose cases to BOND TO MEDICATIONS AND HARMFUL CHEMICALS TO PREVENT YOUR BODY FROM ABSORBING THEM. Why was I yelling? Because it’s rather serious, especially if you take meds that you can’t miss a dose of.
Thousands of readers shared the warning, but no additional information accompanied the post. A number of separate articles reported a “trend” of activated charcoal coloring in Instagram-friendly baked goods and dishes, owing to its unique ability to add depth of coloring to black foods.
A stub-like Wikipedia page titled “Charcoal in Food” was only created in 2017, suggesting that the practice was not exceedingly common until Instagram began driving interest in pictures of food. In May of that year, Self magazine shared a gallery of activated charcoal-colored foods along with advice to avoid such items for the same reasons cited in the post. In the piece (titled “The Activated Charcoal Food Trend Is Pretty, but You Should Definitely Avoid It”), its author concludes that the use of activated charcoal in food is necessarily detrimental based on its use in medical settings:
Doctors use activated charcoal to treat poisoning and drug overdoses, because it binds with the substance before your body absorbs it. But when you eat charcoal, it can also bind with stuff that you don’t want to get rid of — like vitamins, minerals, and phytonutrients — which obviously isn’t great. It can also keep your body from fully absorbing any medications you’ve taken while eating charcoal-filled foods. Not to mention, there are claims that it causes intestinal blockage… So unless you’re looking to suck some of the nutrients out of your body, you probably don’t want to consume any of these trendy foods or drinks. Activated charcoal is ineffective — and potentially harmful. Which is all the more reason to look, not eat. With that in mind, here are 14 pretty charcoal foods that got the Instagram treatment.
On first glance, that article appeared to quote spokeswoman for of the Academy of Nutrition and Dietetics Alissa Rumsey in reference to its claims. But on closer inspection, the item simply reiterated commentary provided by Rumsey on the efficacy of charcoal-based detoxification diets — not the risks posed by charcoal flavored foods.
In October 2017, the University of Utah’s Health blog examined the use of activated charcoal in foods as a colorant and a health supplement. That article mentioned constipation as a possible effect, and also surmised it could be problematic with respect to some medications (but adding a laundry list of mitigating factors.)
Noting that specific health benefits for activated charcoal solely as a supplement were unsupported, the site added:
What has been proven about activated charcoal is that it can be helpful in some instances of poisoning. The charcoal binds to the poison and keeps it from entering the blood stream. However, it is not always the best option. It should not be used unless the poison was recently ingested, and the patient is alert and aware. Also, it should not be used in cases where the poison in question is a liquid, a caustic agent, or a hydrocarbon like gasoline. “Activated charcoal should only be given in healthcare facilities,” [Amberly Johnson, Poison Information Specialist with the Utah Poison Control Center] said. “We do not recommend at home use of activated charcoal for poisonings.”
Poisons aren’t the only substances activated charcoal can bind to in the stomach. It can also bind to foods you have eaten blocking the absorption of nutrients and medications you may have taken reducing their effectiveness. “If you are taking a medication that requires a certain dosage to be effective you may be putting yourself at risk,” said Johnson.
In August 2018, food magazine Bon Appetit looked at the rise of activated charcoal in black-colored food. An expert consulted for the piece once again referenced clinical use of the substance to prevent the absorption of ingested poisons, but noted that there was only “some” evidence that it negated the absorption of vitamins:
“Activated charcoal has long been used in hospitals to remove poison from the gastrointestinal tract before it’s absorbed into the body,” says Maya Feller Ms, RD, CDN. Charcoal has made the jump from poison control and ER rooms to wellness-minded cafes over the past few years, but that doesn’t mean you should be adding it to your supplement rotation. Activated charcoal may be advertised as a “detoxifier” for fixing hangovers and overindulging on french fries, but it doesn’t just target “bad” particles — it sucks up whatever it can get, including valuable nutrients and even medication. “There is some evidence that activated charcoal has been shown to bond to vitamins, which means it may remove them from your system,” says Feller. “I would caution against daily use especially for people that are taking prescription medications or supplements.”
Bon Appetit‘s article may have inadvertently fueled the rumor that activated charcoal rendered birth control pills ineffective, as its author expanded on Feller’s remark by referencing that segment of medications in particular:
“The amount of activated charcoal included in detox drinks is usually not substantial enough to make a difference one way or the other, and any purported health benefits are likely negated by the bonding of the charcoal to the nutrients in the drink.” In other words, drinking a charcoal latte before or after a meal can potentially limit the amount of nutrients your body actually gets and even render prescriptions like oral contraceptives ineffective.
The article concluded by advising readers “don’t expect the charcoal soft-serve to make you healthier,” typically encompassing the opinions provided in food reporting on activated charcoal. Most of the experts consulted provided clinical context, as activated charcoal is primarily used in hospitals, which largely consisted of opinions that the substance was inefficient for detoxification, and additional speculation that in some instances, it could have an adverse effect when taken with certain medications. However, in that context, they also indicated that other factors such as dosage and timing factored into the potential effects of charcoal on prescribed medications and oral contraceptives.
It appeared that most forays into the effects of activated charcoal on medications came immediately back around to birth control, and unsurprisingly a number of articles tackled the specific question of whether eating a black-bun burger could render oral contraceptives ineffective. In June 2017, Insider.com reported that gynecologist Alyssa Dweck, MD “confirmed to INSIDER that it’s true” that activated charcoal in foods interfere with oral contraceptives. But then the article went on to say:
And charcoal is so good at its job that, in certain circumstances, it really can absorb your birth control’s active ingredients before your body gets a chance to. This, of course, can make the pill less effective at preventing pregnancy.
The good news is that small amounts of charcoal aren’t likely to cause a problem.
“I’d say if you’re eating, like, one ice cream with activated charcoal, you’re going to be fine,” Dweck said. “But if you’re taking in a big [dose], you’re going to possibly have a bigger problem.”
In that interview, Dweck confirmed what was already apparent — activated charcoal inarguably can be used in clinical settings to prevent absorption of specific substances. But Dweck went on to say that the small amount in non-supplement forms (such as a food colored with activated charcoal) was not likely to affect birth control. The article then went on to note that other contraceptives were not affected at all:
Dweck recommended leaving at least two hours between your pill and big doses of charcoal, like you might find in supplements or products included in “cleanse” diets.
And remember that this warning applies only to birth control pills you ingest: The effectiveness of the IUD, the implant, the NuvaRing, the shot, and the patch won’t be affected by charcoal in the stomach.
A gynecologist consulted by Bustle.com in November 2017 said that activated charcoal as food coloring didn’t pose much risk at all:
“While the risk is very low, charcoal could potentially decrease the effectiveness of birth control pills. In my opinion, it is not enough to avoid activated charcoal altogether,” Dr. Will Cole, a functional medicine practitioner and health and wellness expert, tells Bustle in an email. “However, if you want to take all precautions and still enjoy black charcoal ice cream, just be sure to avoid consuming it at least two hours before and after taking your birth control,” Dr. Cole says. “Every person is different though, so one person may be more sensitive to charcoal’s affects than another.”
A small 2001 study published in the medical journal Human Reproduction involved administering five grams of activated charcoal four times daily to women taking oral contraceptives to prevent ovulation (and thus, pregnancy.) During the study, none of the patients administered 20 grams of activated charcoal daily as well as oral contraceptives ovulated.
Nevertheless, myriad articles referenced the speculated risk without any additional input from gynecologists and obstetricians alongside alarming headlines such as “You Need to Skip This Food Trend If You’re on Birth Control — or Face Major Consequences.” One claimed no clinical trials had been conducted to examine the possible risk posed by activated charcoal to oral contraceptive users, but the above-linked research was published in 2001.
Many articles presented headlines in the form of a question, going on to examine the general rising popularity of activated charcoal as a colorant in food. In addition, some of those same articles revisited earlier pieces declaring activated charcoal a poor “detoxification” supplement, before speculating that it could still render birth control pills ineffective.
A popular Facebook post from September 2019 claimed that activated charcoal in food specifically posed a “rather serious” risk to people taking prescribed medication, but did not substantiate that claim. Despite the social media claims and blogosphere panic, we found no reported adverse effects in the years since activated charcoal as a colorant became popular. Articles speculated that activated charcoal affected birth control in particular, but when consulted, experts stated the risk was slim to none. In clinical research from 2001, administration of activated charcoal did not lead to ovulation in any of the women in a study examining its effect on oral contraception.