Environmental toxicity and its effects on chronic illness is, in my and many prominent scientists’ minds, one of the most important health crises facing us today. While adults are certainly adversely affected, it is our children who are hurt the most. According to Dr. Leo Trasande, “We are in an epidemic of environmentally mediated disease among American children today. Rates of asthma, childhood cancers, birth defects and developmental disorders have exponentially increased, and it can’t be explained by changes in the human genome. So what has changed? All the chemicals we’re being exposed to.”1
The issue of toxicity and our children was most disturbingly reported by the Environmental Working Group’s release of an investigation called Body Burden in July 2005.2 The report revealed that they detected two hundred eighty-seven chemicals in the cord blood of newborn babies, one hundred eighty of which are known carcinogens, two hundred seventeen of which are known neurotoxins, and two hundred eight of which have been shown to cause birth defects or abnormal development in animals. This insult to newborns is unprecedented in human history and lays the groundwork for a dramatic upswing in chronic illnesses as these children mature into adulthood.
The cost of managing chronic illness in the U.S. alone is staggering. Estimates from the Centers for Disease Control put the number at nine hundred eight billion dollars a year.3 Three out of every four dollars spent in today’s healthcare system is on chronic illness.4 Obesity has become epidemic, which is a grave concern to health experts as it dramatically increases the risk of developing coronary heart disease and diabetes. The most disturbing part of this situation is how it is affecting the young. Over the past twenty years, the rate of obesity amongst two- to eleven-year-olds has almost tripled while in twelve- to nineteen-year-olds it has tripled.5 One in three children born today is likely to develop type 2 diabetes in his or her lifetime.6
If we do not face the reality of the cost—both in dollars and in suffering—of chronic illness, our society faces a crisis far greater than the threat of terrorism. In 2004, I gave a speech in Bellevue, Washington where I proposed that the healthcare system in the U.S. would financially collapse within twenty years if this emergency of chronic illness was not addressed and dealt with. No amount of healthcare reform would resolve this catastrophe.
Much can and needs to be done in order to deal with the issue of chronic illness, and the first step is to acknowledge the problem with environmental toxicity. Rachel Carson warned us in 1962 in her landmark book, Silent Spring.7 It would eventually lead to the formation of the Environmental Protection Agency a decade later, but now we are faced with a government more interested in corporate profits than in the health of its citizens as legislation is being drawn up to strip the EPA of much of its power.
The only way for people to have their voices heard is through education, personal responsibility, and the power of the purse. If we educate ourselves as to which toxins we are exposed to and how to avoid them through our choices as consumers, we can make the necessary changes. In this article I hope to inform readers on how to protect themselves and their families as well as society as a whole.
Before we delve more deeply into the subject of toxicity and chronic illness we need to define the term toxicity and the study of it, toxicology. Here I would like to quote the authors of Principles of Toxicology, Drs. Karen E. Stine and Thomas M. Brown, “Toxicology is the science of poisons and has as its focus the study of the adverse effects of chemicals on living organisms. Although any substance in sufficient quantities (even water) can be a poison, toxicology focuses primarily on substances that can cause these adverse effects when administered in relatively small quantities.”8
While the topic of toxicity and how it affects human health is a complex and difficult one, I believe that if you know your enemy (toxins) you are better able to defeat them or avoid them.
HISTORICAL PERSPECTIVE
When we look at the historical records we find that humans were aware of substances that adversely affected our health for millennia. The ancient Romans were well aware that the smokestacks that belched toxic fumes from metal smelting caused birth defects. The writer Strabo commented that they needed to build taller and taller chimneys to force the fumes further from the cities.9 By looking at the ice caps in Greenland we have noted that lead levels in the atmosphere during the time of Roman prominence were much higher than the times immediately before and after.10
It has also been postulated that the fall of the Roman Empire was in part due to their exposure to lead.11 Much of this came from lead-based goblets and water pipes, especially those used by the wealthier citizens. We now know that lead, even in the smallest doses, can lower IQ, especially in children.12 In a paper published in The New England Journal of Medicine, the authors saw that drops in IQ were higher even in the lowest exposure levels. Their conclusion was that no level of lead is acceptable in children.
Other civilizations have grappled with toxicity problems but none in quite the same quantity as in today’s world. If even small amounts of toxins can cause neurological problems, why are we not surprised by the explosive increase in disorders like autism and ADHD in children and Alzheimer’s and Parkinson’s in adults?13
While heavy metals have a long history with human populations, petrochemicals do not. Although the use of petroleum goes back thousands of years, its uses were limited. It wasn’t until 1847 when Scottish chemist James Young was able to distill petrochemical byproducts that its use vastly increased.14 From the 1850s through the early 1900s, production began to ramp up dramatically worldwide. What few knew was how toxic these chemicals are.
In the twentieth century society began to regulate the uncontrolled release of toxins into the environment, but that was for gross amounts. What we face today is a world where we come into contact with more than eighty thousand chemicals, many of which have not been tested for safety.
THE MOST VULNERABLE
All of us are vulnerable to the effects of environmental toxicity, but those most susceptible are the unborn and the very young. Before a child is even conceived, the effect of toxins can influence their propensity for developing any number of chronic illnesses, especially neurologic ones. The concept, known as transgenerational epigenetics, and which has been proven in numerous studies, says that an exposure to a toxin can cause an illness to future generations even if the individual is never exposed to the toxin again.20 There are studies showing this effect on obesity. Women exposed to certain toxins increase the risk of obesity to their offspring as well as to numerous generations in the future.21 One study suggested it could carry out to twelve generations.22 Exposure to DES (the synthetic estrogen diethylstilbestrol) can epigenetically cause a greatly increased risk of developing reproductive tumors in future generations.
What we are now beginning to understand is how our actions today affect the lives and health of children who will be born twenty to fifty years from now. They are susceptible to any number of chronic disorders before their existence is even imagined.
The next most vulnerable groups are those who are about to be born, neonates, and infants. Studies on one family of toxins called phthalates, which I will revisit later, indicate they can affect gonadal development, impair socialization, and cause endocrine disruption.23-26 We are still in the early stages of our understanding about how a child’s risks of developing chronic illnesses during adulthood are affected by environmental toxins.
It is well known that there is an epidemic of childhood obesity, unprecedented in human history. According to one study, in 2003–2006, 31.9 percent of two- to nineteen-year-olds had a BMI (body mass index) greater than or equal to the 85th percentile for age and sex.27 Children who are already obese are at increased risk for developing type 2 diabetes, cardiovascular disease, stroke, and potentially cancer.28-30
So what is causing this epidemic in children? First off, we know that their diets need a lot of work. They consume far too much sugar and other unhealthy foods along with not getting enough exercise.31-33 But there is another factor that is causing our children to become overweight, and that is the environment. The number of studies that have linked obesity to environmental toxicity is staggering. A paper I urge everyone to read is entitled, “Environment and Obesity in the National Children’s Study” by Dr. Leo Trasande, et al. It is from the prestigious journal Environmental Health Perspectives and can be found online at ehp.niehs.nih.gov/11839/#b78-ehp-117-159.
This matter is such a sober concern that a twenty-one-year prospective study was proposed to examine one hundred thousand children. The National Children’s Study unfortunately was halted in 2014 due to funding troubles as well as the difficulties of determining what the researchers were seeing. No doubt, industry pressure was involved as well.
The elderly is another group exceedingly vulnerable to the effects of toxicity. This part of the population is increasing rapidly and for the first time in human history soon there will be more people over the age of sixty-five than are under the age of five.34 Because they have been around a long time, they have been expoxed to toxins for a long time. Toxins are known to increase oxidative stress which increases the risk of cancer and cardiovascular disease.35
We have only recently been faced with the problems of toxicity and aging as many people in earlier times succumbed to infection, injury or illness before they reached an advanced age.36 Now with expanded life expectancy and the dramatic increase in environmental toxic exposures, we must meet new challenges. We are still working under an old and outdated medical model. Few healthcare providers look at toxicity as a cause of many chronic health disorders and instead look to managing illnesses, such as type 2 diabetes. Focusing on the root cause of disease, especially when environmental in nature, may result in a longer and healthier life.
Another great concern when talking about our aging society is of course cognitive function as it relates to toxic exposures. An example: as with children and lead we are becoming increasingly aware that the elderly lose cognitive function when exposed to this heavy metal.37 Alzheimer’s disease is rapidly becoming an epidemic. In 2014, over five million Americans were diagnosed with the disease. In 2050, the number is expected to rise to over fifteen million.38 A number of studies link different environmental toxins to this rise. One such study links the exposure of a fetus to lead to a far greater propensity to develop β-amyloid plaque when they get older.39 This plaque has been implicated in the development of Alzheimer’s.
As you can see, children and the elderly present unique challenges regarding the effect of environmental toxicity. In the article, “Aging Society and Environmental Health Challenges,” author Yun-Chul eloquently states that “Children are not just smaller adults, nor are the elderly just older adults; they are individuals with unique challenges and medical needs different from those of younger adults.” 40,41
THE TOXIC OVERLOAD
We’ve established that environmental toxins are all around us, but which ones should we be most cautious about and what are their sources? Can we reduce our load and exposure to prevent chronic illness or at least avoid as many of these toxins as possible?
PHTHALATES
Phthalates are a group of chemicals used to soften and increase the flexibility of plastics. They are also heavily used in personal care products, especially those that are scented. You will also find them in air fresheners that use heat to release the aroma. Even if you avoid all of these sources, you will be exposed because phthalates do not bind very tightly to the plastics and therefore are released into the atmosphere quite easily. This means that the main sources of exposure are inhalation, dermal absorption and ingestion.42
Several recent studies have revealed that many of the metabolites of phthalates (DEP, DnBP, BBzP, and DEHP) are found extensively in the general population.43,44 There is evidence that the exposures also have socioeconomic and sociodemographic divides, which place a greater burden on children of the poor.45,46
One of the mechanisms behind phthalate toxicity is its depression of testosterone. Growing evidence shows that phthalate exposure may express its effect on reproductive health, especially in developing males.48,49 It has also been implicated in miscarriages and birth defects.
Arguments against phthalate’s toxicity include its relatively short half-life, which is less than twenty-four hours.50 This assertion does not hold true, as we are constantly exposed to the chemical; thus, its effects are persistent, with a percentage of the population having unacceptably high levels of phthalates.51
The question is how to avoid exposure. To begin with, it is important to make sure that the personal care products you use do not contain them. A resource to find out which toxins are in your products is available through the non-profit Environmental Working Group at www.ewg.org. The site offers a database called “Skin Deep” which rates various products, lists their toxins, and suggests safer alternatives. Another quick tip to detect phthalates is whether the product emits an aroma; if it does, it likely contains this toxin.
A few years ago, I received a call from a physician at a midwestern university who was concerned that she was finding more and more males between the ages of eighteen and twenty-five with testosterone levels you would normally find in fifty- to sixty-year-olds. When we began testing we found that almost all of the young men with high phthalates had low testosterone. To me this was not a surprising finding given the popularity of body sprays.
The third major source I would caution you on is soft plastics like those used in water bottles. Phthalates are very heat sensitive, and if you ever suspect that a bottle has gotten hot, such as being left in your car during the day, discard it. When Whole Foods opened in Reno a number of years ago, they had a display of bottled water outside the store when the temperature was over 90 degrees F. I called the assistant manager and informed him that this was a good way of increasing the toxic load of his customers and that it might be a good idea to change the display.
BENZENE
The “-enes” are a family of petrochemical refining byproducts (benzene, xylene, toluene, and styrene). They are also found throughout the environment. Benzene is the most carcinogenic and one of the reasons why smoking is so dangerous. 52 An estimated fifty percent of the public’s exposure to benzene is due to cigarettes.53 The other exposures come from automobile exhaust, predominantly from diesel-powered vehicles.
In a report written a number of years ago, researchers found trace amounts of benzene in sodas that were formulated with vitamin C and sodium benzoate, a common preservative.54 When confronted with the problem, many of the manufacturers reformulated their products, not by eliminating the obvious source of benzene, sodium benzoate, but by removing vitamin C, which had caused a chemical reaction converting some of the benzoate into benzene. Mind you, vitamin C is also a preservative, but blame for the chemical conversion was laid to the vitamin.
Benzene itself is the most toxic of this group having been linked to an increased risk of leukemia. 55 A byproduct of diesel fuel combustion, it has also been implicated in neural tube defects, decreases in birth weight and head circumference during pregnancy and at birth, and impaired mental development in fetuses.56 Fortunately, it seems that some of these toxic effects can be mitigated with a diet high in antioxidants.57
XYLENE
Xylene is a very common petrochemical available at any home improvement store as a paint thinner and remover. It is also found in certain nail polishes, rust preventives, shellacs, air fresheners, degreasing cleaners, as well as cigarette smoke and carpet adhesives.58
Pesticide manufacturers add xylene to their products and claim that xylene is an “inert” chemical. You can go to your local hardware or home improvement store and see for yourself. Now to be fair, xylene is far less toxic than the actual pesticide. The main reason for xylene’s use as a carrier is its ability to penetrate wood, brick, and the soil to carry the poison to the pests. Of course, this ability to penetrate hard materials also makes it much more likely to be absorbed through your skin.
Xylene is a known carcinogen and neurotoxin that increases the risk of miscarriages and birth defects.59 The recreational use of alcohol should be avoided at all costs for anyone with xylene toxicity as it impairs the body’s ability to detoxify.60
TOLUENE
Toluene is the “anti-knock” agent that replaced lead in gasoline back in the 1970s.61 While significantly less toxic than lead, it is still a suspected carcinogen, endocrine disruptor, and interfering factor in fetal and childhood development.62 The U.S. produces about three million tons of toluene annually, which amounts to one-third to one-quarter of the world’s total production.63
The best way to find out what products contain toluene is to go to the National Library of Medicines’ Household Products database at householdproducts.nlm.nih.gov/. Avoidance is important in lowering your exposure.
STYRENE
Styrene is one of the most prevalent of all of the “-enes.” It is found in Styrofoam, which is ubiquitous in our everyday lives. While the least toxic of all, when added to the overall chemical onslaught we are exposed to, it compounds the demands made on our detoxification systems. Styrene was detected in the blood of Americans as a chance discovery in the 1970s. The first test to look specifically for styrene in the blood was done in 1982 and has continued to show the same ubiquitous results to this day.64
With this class of toxins, the best way to help detoxify is using the simplest amino acid, glycine. During Phase I detoxification, the chemicals are transformed into a benzoate compound. In the case of xylene and toluene they become 2- or 3-methylbenzoate, a chemical more toxic than the original one.65 Luckily for us, glycine has a strong affinity for benzoates and conjugates (binds) with them to create a hippurate molecule like 2- or 3- methylhippurate, which is easily excreted in the urine.
The conjugation of glycine to benzoate to create hippurate is the oldest known biosynthesis, first reported in 1842. Students in the early days of toxicology would ingest sodium benzoate and glycine and then measure the levels of hippurate.66
If you think you’ve heard about glycine from the Weston A. Price Foundation, you’re right. The main and best source of glycine is in the collagen-rich unctuous food known as bone broth. Collagen is about fifty percent glycine, so every time you drink a cup of broth you’re helping your body detoxify itself. If you need to supplement glycine, it should be taken at a dose of about three to five grams per day for an adult and one to three grams daily for a child under age twelve.
BISPHENOL A (BPA)
Another toxin that we come in contact with on a daily basis is bisphenol A (BPA). It is used to stiffen plastics so you find it in harder plastic bottles. You will also find it in the lining of canned food as well as on store receipts. Absorption through the skin and ingestion are the two main ways it enters the body, but inhalation is also a possibility because of the sheer volume produced, about 1.6 billion pounds annually.67
This estrogen mimicker was first discovered in 1891 as a major building block in what is now known as polycarbonate plastic, but it was first found to be estrogenic in 1936.68
One of the main problems with bisphenol A is that it is a reproductive toxin. Not only does it affect the female ability to reproduce because of its estrogenicity, but it has been shown to affect men as well.69 The industry argues that the amounts of bisphenol A humans are exposed to and assimilate are minute and therefore not a significant threat to health. They cite a single study.70 Other researchers are bewildered by this assertion as the number of studies showing quite the opposite effect is numerous.71-73
BPA is a very big business, and there is strong resistance to its being banned; however, pressure is mounting because of the growing number of studies demonstrating its toxicity. In what I would call a classic “bait and switch” tactic, many manufacturers are removing BPA but replacing it with bisphenol S and F, which have had extremely limited testing and which, in the end, may not be deemed less toxic.
The best way to deal with this ubiquitous toxin is avoidance. First, avoid using canned goods. Can linings contain BPA and it has been shown to leach into the food.74 The second source and more difficult to avoid is from store receipts. When asked if you want the receipt in the bag, say yes. When asked if he wants his receipt at the grocery store, one of my friends, who is a world renowned trainer, typically says, “No, I’m trying to give them up.”
When it comes to reusable water bottles, because of the switch from BPA to BPS or BPF, many sellers of these products proudly put “BPA Free” on the label, but does that make them non-toxic? Maybe or maybe not. My recommendation is to use glass bottles whenever possible, or stainless steel as long as they are not lined.
HEAVY METALS
I could devote an entire article to the subject of heavy metals. Our knowledge of the dangers of heavy metals like mercury, lead, arsenic and cadmium is extremely thorough. Because of the constraints on the length of this article I will only briefly cover two of them, lead and mercury.
LEAD
Lead toxicity has brought down a mighty civilization (the Romans) and has damaged the brains of countless millions of people. According to the CDC, there is no level of lead that is acceptable in children.75 Yet we have tens of thousands of tons of lead in our soil and atmosphere as well as in ground waters because of our indiscriminate use over the past few thousand years.
The major sources of lead contamination before 1970 in the United States were paint and gasoline fumes.76 While banned at that time, it persists in our environment to this day. Anytime an old house, office, or apartment is renovated the dust that is released contains lead, due to its use in white paint. The research focus on lead should be shifted from what the effects are into detoxification strategies including, among others, chelation therapy.
MERCURY
Mercury is one of the most toxic of all heavy metals; mercury exposure and its effect on chronic illness is an ongoing issue. We have extreme exposures such as those at Minimata Bay in Japan between 1953 and 1960, where a large number of deaths and congenital birth defects were documented.77 This is an example of a high-level exposure, but there have been numerous other studies showing that low levels of this toxic metal, especially methyl mercury, have wide ranging effects on fetal development, cardiovascular disease, cognitive function and other chronic illnesses.78 The authors of this study, led by Karagas, warned that while there is some evidence on low-level effects, more research is needed. In my personal opinion, much like with lead toxicity, the evidence should point us primarily towards the treatment of mercury toxicity and further research into its effects on chronic illness.
HOW TO DETERMINE YOUR TOXIC LOAD
Since 1996, I have been looking at different testing protocols to determine toxic loads in people. For many years, fat biopsy and blood tests were the gold standard, and to many, they still are. I feel that this approach is no longer necessary as it is expensive and painful. Why, you might ask? It is because we all have a large number of toxins in our bodies as we have seen in this article.
Unfortunately, in today’s medical environment, little thought is given to finding the causes of chronic illness. Instead, the main focus is on management of the disease once it has appeared in an individual. This ill-advised strategy is one of the main reasons why our healthcare system is overwhelmed and expensive.79 Seven out of ten deaths are due to chronic illness, often due to lifestyle choices, but in many cases are owing exposure to environmental toxins.80
Since we all have toxins in our systems, the testing method I recommend is looking at what we are excreting. The body has three main excretion avenues to rid itself of its burden. First is through the skin, second through feces, and third through urine. Urine analysis generally provides the most helpful results, although in the case of screening for heavy metals, fecal testing is also very useful.
Urine testing is beneficial in determining the level of exposure to petrochemicals and their by-products, and in many cases, the source. There are two commercial laboratories in the U.S. that do an excellent job of testing urine for toxins: U.S. Biotek (usbiotek.com) and Genova Diagnostics (gdx.net).
Over the years I have used the U.S. Biotek test extensively because of its ease of use. Using your first morning urine, you dip a dry strip into the collection, allow it to air dry for a few minutes then put the dry strip into a bag of desiccant and into an envelope for mailing. Within a few weeks you get the results for the markers for styrene, benzene, toluene, trimethylbenzene, parabens, phthalates and monoethyl phthalates. A comprehensive interpretation is also available which will provide you with safe and scientifically validated detoxification protocols along with listings of potential sources of exposure.
There is one more test that is quite important. It is the LEAP-MRT from Oxford Biomedical (nowleap.com). Xenobiotics (toxins) are a leading cause of inflammation which in turn triggers many chronic illnesses. They are also the main reason why people react badly to foods and food additives. If we take the path of detoxification, we also need to address any underlying inflammatory reactions until we are clear of the toxins.
LEAP-MRT is a blood test that looks at inflammatory reactions to food and food additives. When my daughter took the test at age nine and followed the recommended diet, her seizure activity dropped by eighty percent within five days. Since then, I have seen countless people show dramatic improvement in their health after detoxifying themselves and removing inflammatory foods from their diets.
CONCLUSION
Chronic illness in the Western world and in particular the U.S. is reaching epidemic proportions. Exposure to environmental toxins is one of the leading causes of this crisis in health. It is imperative that each and everyone be aware of the toxins they are exposed to, how to avoid them, and how to detoxify themselves. Choosing less toxic products will send the strongest signal possible to manufacturers of consumer products that the status quo is simply not acceptable.
Organizations like the Weston A. Price Foundation and the Environmental Working Group are at the forefront of education and activism in dealing with this plague of toxicity. All of us must be proactive in this venture. If we aren’t, the health and very future of our species are in peril.
SIDEBAR
A PLETHORA OF TOXIC EXPOSURES
It would be hard to cover all of the major environmental toxins in one paper, or for that matter in one book. This paper will focus on the major culprits that affect chronic illness. Some of them are released into the atmosphere in enormous quantities. Here are some prime examples:
• An average of 2.3 billion gallons of benzene, a known carcinogen, are produced each year in the U.S. alone.15
• Fifty-six billion pounds of styrene, another petrochemical, which is used to make Styrofoam and is a known neurotoxin, are released into the environment each year in the U.S..16
• Over 1.3 billion pounds of one of the most toxic phthalates (a plasticizer) are released into the environment.17
• An estimated twelve million pounds of arsenic and arsenic-related compounds (a toxic heavy metal) were released into the environment in 1999.18
• Dentists use approximately forty metric tons of mercury a year. They are the largest source of mercury in our wastewater treatment plants.19
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This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Spring 2015
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