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Activated charcoal is a special form of charcoal that is made porous by processing at very high temperatures.
Historically, it has been used for cleaning water. During the 18th and 19th centuries, scientists showed the efficacy of activated charcoal as an antidote for poisoning in medical emergencies. The knowledge of the applications of activated charcoal has been evolving, so has been the process of “activation.”
Typically, carbon-rich materials such as tree branches and shells are burnt at a very high temperature to obtain an odorless black fine powder (charcoal). Further processing involves passing it systematically through a series of chemicals such as oxygen, steam, certain acids, and others at a very high temperature. This process makes the material more porous in nature.
The resultant increase in surface area makes the activated charcoal an excellent adsorbent. The molecules of toxins and certain chemicals are entrapped in the crevices on the surface of activated charcoal, largely by physical and to some extent by the electrical phenomenon.
Activated charcoal traps chemicals and prevents their absorption in the body. A range of the uses of activated charcoal is attributed to its adsorbent properties.
Activated charcoal is most widely used as an emergency treatment of poisoning. Overdoses of prescription drugs such as sedatives as well as over-the-counter medicines such as analgesics can be treated with 50-100 grams of activated charcoal mixed with water or sweetened liquid.
The timing of activated charcoal administration is of paramount importance. When administered within five minutes of drug ingestion, the chances of damage are minimized. The longer the duration of the drug overdose and the administration of activated charcoal, the higher the chances of drug absorption into the systemic circulation.
In certain cases, physicians also employ multiple dosage regimens of activated charcoal for complete eradication of toxins from the gut. However, activated charcoal has limited efficacy as an antidote in cases of heavy metal poisoning.
Activated charcoal does not adsorb absolute alcohol, and hence, it is not a treatment of choice in cases of alcohol poisoning. However, as alcohol is usually consumed as a mixture with other liquids, activated charcoal can reduce toxic effects of these liquids, and thereby reduce the severity of alcohol poisoning symptoms. Some physicians also consider it to be useful in preventing a hangover.
Patients with trimethylaminuria (a genetic condition characterized by the fishy smell of urine, sweat, and breath) can benefit from the use of activated charcoal. The accumulation of odorous trimethylamine can be reduced by adsorption with activated charcoal after systematic multiple dosing regimens. Additionally, activated charcoal also finds its use in the alleviation of gas and bloating after consumption of gas-producing meals.
Scientists also found activated charcoal to be helpful in reducing cholesterol levels across several clinical studies. Bile acids and high-fat content from food were adsorbed on the surface of activated charcoal in the gut. This, in turn, reduced the absorption of fat from the gut. Moreover, low-density lipoprotein (LDL, “bad cholesterol”) level was reduced, and high-density lipoprotein (HDL, “good cholesterol”) level was increased in one study.
The traditional application of activated charcoal as a water cleanser is still relevant today. Fluoride and other heavy metals are effectively removed with the help of activated charcoal filters. However, it is not useful for removal of viruses and bacteria from water. Therefore, modern water purifiers contain multiple filter components targeted for different impurity types.
It is also useful as a teeth whitener. Brushing the teeth with activated charcoal power twice a week can help whitening the teeth stained from long-term consumption of tea, coffee, or wine. Activated charcoal is also claimed to be effective in treating skin ailments such as acne, and also in treating snake bites, albeit the reliability of these claims is not well-documented clinically. Moreover, it is also often used as household mold-cleaning agent for the floors, hard surfaces, and edges.
Despite numerous proven as well as anecdotal benefits of activated charcoal, every instance of its use should be backed up by the fine medical judgment to avoid any unwarranted complications.
Activated charcoal should not be used without consultation with a toxicologist. Also, aspiration of the substance into the lungs can cause severe complications. The nasogastric position should always be confirmed with a chest X-ray before administering activated charcoal. Lastly, activated charcoal should be given within 1 to 2 hours of poisoning.