Hmmm, I don't know, but I'm not about to mess with a good thing. The flushes aren't fun, and if I'm going to put myself through it, I want it to work. I did find that I get better results when I add more lemon juice and less grapefruit, and lemons do seem more acidic. It also seems to get the stuff through my stomach faster - I don't get quite as nauseous if I use plenty of lemon juice. My friend's baby started pooping out Gallstones and bile for a few days around the start of the warmer weather. Our chiropractor said it was natural spring cleaning...and I know the little guy wasn't doing any liver flushes!