Activated charcoal is a fine, black, odorless, and tasteless powder. It is made from wood or other materials that have been exposed to very high temperatures in an airless environment. It is then treated, or activated, to increase its ability to adsorb by reheating with oxidizing gas or other chemicals to break into a very fine powder. Activated charcoal is pure carbon specially processed to make it highly adsorbent of particles and gases in the body’s digestive system, and is used to treat poisonings.
Activated charcoal has been used since ancient times to cure a variety of ailments, including poisoning. Its healing effects have been well documented since as early as 1550 B.C. by the Egyptians. Although it has a long history, it has only been during the past century that it has been widely used as an oral agent to treat poisonings, including those caused by overdoses and toxins.
Activated charcoal has considerable surface area, which provides its adsorptive capability. In other words, activated charcoal binds to certain toxicants, and therefore allows them to travel through the body without causing the harm they otherwise would. Research indicates that the typical surface area for activated charcoals average 800–1,200 m2 per gram, and so-called ‘‘super-activated’’ charcoals have about triple that surface area. This large surface area allows activated charcoal to adsorb many compounds, including organic compounds and poisons such as
potassium cyanide and an extremely poisonous form of mercury known as mercuric chloride. It does not work against all types of poison. For instance, studies have shown that activated charcoal is not effective against arsenic trioxide poisoning.
Activated charcoal’s most important application is for treatment of poisoning. It is used to prevent the absorption by the body of most poisons or drugs by the stomach and intestines. In addition to treating swallowed poisons in humans, charcoal has been used to treat poisoning in dogs, rabbits, rats, and other animals, as well. It is also used to absorb gas in the bowels, and to treat gas or diarrhea. Charcoal’s other and less widely employed medical applications have included treatment of viruses, bacteria, bacterial toxic byproducts, snake venoms and other substances, but these have not been supported by clinical studies. By adding water to the powder to make a paste, activated charcoal can also be used as an external application to alleviate pain and itching from bites and stings.
A review of activated charcoal that was published in a 2010 issue of the Journal of Medical Toxicology noted that evidence is and probably always will be lacking to ‘‘definitively guide use of activated charcoal for the overdose patient. There are just too many variables to study: the specific drug or poison; its formulation (liquid, solid, sustained release); when it was ingested, and in what quantity; the clinical condition of the patient; available antidotes or therapeutic agents; and the quality of available emergency medical care.’’
1. Poisons and drug overdoses
It is estimated that one million children accidentally overdose on drugs mistaken as candies or eat, drink, or inhale poisonous household products each year. Activated charcoal is one of the agents most commonly used for infants and toddlers. It can absorb large amounts of many poisons quickly. In addition, it is non-toxic, may be stored for a long time, and can be conveniently administered at home. Charcoal works by binding to irritating or toxic substances in the stomach and intestines. This prevents the toxic drug or chemical from spreading throughout the body. The activated charcoal with the toxic substance bound to it is then excreted in the stool without harm to the body. When poisoning is suspected the local poison control center should be contacted for instructions. They may recommend using activated charcoal, which should be available at home so that it can be given to the poisoned child or pet immediately. Depending on the type of poisoning and the amount of time that has elapsed from the ingestion of the poison, the recommendations of the poison control center may vary.
2. Intestinal disorders
In the past, activated charcoal was a popular remedy for gas. Even before the discovery of America by Europeans, Native Americans used powdered charcoal mixed with water to treat an upset stomach. Now charcoal is being rediscovered as an alternative treatment for this condition. Activated charcoal works like a sponge. Its huge surface area is ideal for soaking up different substances, including gas. Some studies have shown that people taking activated charcoal after eating a meal with high gas-producing foods did not produce more gas than those who did not have these foods. Charcoal has also been used to treat other intestinal disorders such as diarrhea, constipation, and cramps. There are few studies to support these uses and concerns also exist that frequent use of charcoal may decrease absorption of essential nutrients, especially in children.
3. Other uses
Besides being a general antidote for poisons or remedy for gas, activated charcoal has been used to treat other conditions as well. Based on its ability to adsorb or bind to other substances, charcoal has been used to clean skin wounds and to adsorb waste materials from the gastrointestinal tract. In addition, it has been used to adsorb snake venoms, viruses, bacteria, and harmful materials excreted by bacteria or fungi. Because of the lack of scientific studies to verify their effectiveness, these uses are not recommended. Activated charcoal is also used together with other remedies such as aloe vera, acidophilus, and psyllium to keep symptoms of ulcerative colitis under control, and to lower cholesterol. While charcoal shows some antiaging activity in rats, it is doubtful if it can do the same for humans.
1. For poisoning
Activated charcoal is available without prescription. However, in case of accidental poisoning or drug overdose an emergency poison control center, hospital emergency room, or doctor’s office should be called for advice. In cases where both syrup of ipecac and charcoal are recommended for treatment of the poison, ipecac should be given first to induce vomiting.
Activated charcoal is taken after vomiting has ceased. Activated charcoal is often mixed with a liquid before being swallowed or put into the tube leading to the stomach. Activated charcoal is available in liquid and pill/capsule form. Keeping activated charcoal at home is a good idea so that it can be taken immediately when needed for treatment of poisoning. For acute poisoning, the typical single dosage is as follows:
– Infants (under 1 year of age): 10–25 g (or 0.5–1 g/kg body weight) mixed with water.
– Children (1–12 years of age): 25–50 g (or 0.5–1 g/kg body weight) taken with at least 8 oz of water.
– Adults and teens: 25–100 g mixed with water. –
2. For diarrhea or gas
A person can take charcoal tablets or capsules with water or sprinkle the content onto foods. The dosage for treatment of gas or diarrhea in adults is 520–975 mg after each meal and up to 5 g per day. More than one dosage is sometimes recommended.
Parents should keep activated charcoal on hand in case of emergencies.
Charcoal should not be taken together with syrup of ipecac, as the charcoal will adsorb the ipecac. Charcoal should be taken 30 minutes after ipecac or after the vomiting from ipecac stops. Some activated charcoal products contain sorbitol. Sorbitol is a sweetener as well as a laxative; therefore, it may cause severe diarrhea and vomiting. These products should not be used in infants. Charcoal may interfere with the absorption of medications and nutrients such as vitamins or minerals. For uses other than for treatment of poisoning, charcoal should be taken two hours after other medications.
Charcoal should not be used to treat poisoning caused by corrosive products such as lye or other strong acids or petroleum products such as gasoline, kerosene, or cleaning fluids. Charcoal may make the condition worse and delay diagnosis and treatment. In addition, charcoal is also not effective if the poison is lithium, cyanide, iron, ethanol, or methanol. Parents should not mix charcoal with chocolate syrup, sherbet, or ice cream, even though it may make charcoal taste better. These foods may prevent charcoal from working properly.
Activated charcoal may cause swelling or pain in the stomach. If this occurs, a doctor should be notified immediately. Activated charcoal has been known to cause problems in people with intestinal bleeding, blockage or those who have had recent surgery. These patients should talk to their doctor before using this product.
Charcoal may be less effective in people with slow digestion. Charcoal should not be given for more than three or four days for treatment of diarrhea. Continuing for longer periods may interfere with normal nutrition. Charcoal should not be used in children under three years of age to treat diarrhea or gas. Activated charcoal should be kept out of reach of
Charcoal may cause constipation when taken for overdose or accidental poisoning. Medical professionals may recommend that a laxative be taken after the crisis is over. Activated charcoal may cause the stool to turn black. This is to be expected. Pain or swelling of the stomach may occur. A doctor should be consulted. Women who are pregnant or breastfeeding should consult a doctor before using activated charcoal.
Activated charcoal should not be mixed together with chocolate syrup, ice cream or sherbet. These foods prevent charcoal from working properly. Activated charcoal can also interfere with drugs, and should be taken two hours after any medications are used. Individuals should consult their medical professionals before taking activated charcoal.