A (4:02)

Thank you for having me. This is really fun.

B (4:04)

Thanks. We're going to talk about immune disrupting and endocrine disrupting chemicals. The effect that this has on health outcomes, particularly for women in perimenopause and menopause when we are going through a large endocrine shift in any event. So I thought we might start off our discussion like just getting right into it. So what is an immune disrupting chemical? And maybe for thoroughness we can also just lump in an endocrine disrupting chemical for someone who's never heard of those terms before.

A (4:34)

Yeah. And I think it's important to note that there's so much crossover between the two. But what I like to do is frame this conversation, at least from an autoimmune and immune disorders component when I'm talking to those audiences around how these chemicals have effects on not just the endocrine system, which is what's been written about most often. It's been written about in previous books of mine, but really robust. And now this conversation shifting and reframing to how there are immune system effects as well. Now keeping in mind that the endocrine system and the immune system are not siloed systems like these are systems, as you know of course, that communicate with each other. This is, this is a lot of crosstalk. In fact, we know this as an example that when we treat cancers, for example with car T cell and some of these high level newer age therapies, that signs of success can be the development of rheumatoid believe it or not. So that we now know that when you're modulating the immune system you can also subsequently have changes with clinical disease. And that the immune, the endocrine system is certainly part of that whole communication. So I want people to kind of think in different, you know, frameworks, but essentially what immune system or immune disrupting chemicals and endocrine disrupting chemicals are our environmental exposures to any number of substances. By the way, it could be natural, but it could also be synthetic is what I focus on that have effects to, on disruption of communication. So I really like the idea that disruption can mean a lot of different mechanisms. And that's exactly what's been found in the science. There's different mechanisms by which we disrupt that communication. So it leaves that very open ended for future research as well.

B (6:19)

So walk us through some of the changes and some of the mechanisms of change that some of these immune disrupting chemicals can have on our bodies and what might be the clinical picture in terms of clusters of symptoms, signs and symptoms that someone might experience and how they might be able to tease out whether this is coming from the environment or if it's coming from somewhere else, another vertical in their life that needs, that needs alteration.

A (6:43)

So before I wanna get into the mechanisms, but I wanna just start with some very broad statement just to get people in in line with the conversation of environmental health. We have thousands of chemicals in our environment that have just been created only within the last 100 years of human existence. So from an evolutionary perspective, the human body's intricate, vulnerable, phenomenal systems of protection and communication for hormone and growth, development and bone strength, all of these fascinating physiological effects have been in place. But chemicals have been new to the human body and to the modern day experience. And what's so important about that is that the chemicals themselves, at least in the US are far better in, in other countries, certainly Canada and the eu, those chemicals that are synthetic have been tested more rigorously in other countries. There's no required testing in the US for safety or toxicity. Especially, and most importantly in vulnerable populations, what we call vulnerable periods of development, which includes not just what we would think of as in utero and pregnancy periods, of course, toddlers and young kids, teenagers with lots of flux of hormones, but menopause and perimenopause, these are also all periods where the hormones are being built up, they're being broken down, and there's various mechanisms within those vulnerable periods and that make us a little bit more susceptible to the effects of some of these synthetic chemicals. And in the US, the number ranges from 95,000 synthetic chemicals and all of the products we love to 350,000 worldwide. So, you know, there's a constant flux into our bodies. Now, again, these chemicals, and you have to speak to them in terms of the ones that have been studied most carefully. There's classes of chemicals, right? We have the bisphenols, which is like bpa, which a lot of your audience might have heard of, bisphenol A, which was removed in baby bottles from baby bottles in 2012. Actually, a lot of the work of my co author for two previous books. His work, Dr. Vomsal, was really showing the hormone effects. The estrogen mimicking is what they first discovered. Estrogen mimicking at very, very low levels. We're talking parts per billion parts per trillion that were able to manipulate endocrine system, particularly of babies, which is why it's one of the only removals of synthetic chemicals that have taken place in the US market. And there's been regrettable substitutions, as they're called, where they created BPs and BPF and BPs IP shown to now have years later, some of the similar effects that BPA had. So again, it's like a whack a mole because we're chasing after the chemicals are, you know, created, distributed and put into the products that we use. But BPA was not only found at that time, 20, 25 years ago to have hormone effects. It also had the ability to change receptor numbers on receiving cells where that communication is traveling down, regulating, upregulating. BPA had effects on the immune system, which we now know, which can increase certain cell types, natural killer cells, cytokines, inflammatory promotion, basically of certain, you know, parts of the cascade. But, you know, not only that, there's direct effects. So when we're talking about gut health in the microbiome, there can be direct effects to the layer of the vulnerable layer of the microbiome that's part of the human GI system which has its effect. So you're seeing that disruption really incorporates a lot of different mechanisms that have been identified. BPA is a great example of one of the first endocrine disrupting chemicals. It's been so well written. But then you have phthalates as another class, you have heavy metals as another class, you have the perfluoroalkyls which are the non stick chemicals. So again you want to be thinking about sort of similar properties that can cause some overlying similar changes. But again they each have their own properties, their own half lives, their own ability to be broken down and so forth.

B (10:42)

Okay, so with the, with the bpa, with the bisphenols as a, as a class, you mentioned it's estrogen mimicking. I just made a note here as you were talking. It also changes the receptor number. Did I write that down correctly?

A (10:53)

It can.

B (10:53)

Or the density of.

A (10:55)

Well, it can upregulate the number of receptors, it can downrate the number of receptors, changing the signaling pathways. And that could be on breast tissue, that could be on any hormonally sensitive organs. It also has effects on the beta cells. So in terms of diabetes risk, it has effects on muscle cells in terms of insulin resistance and the ability for muscles to utilize sugar and glucose most effectively. So there's lots of different effects. There's even adrenal gland effects. So we have hypertension as a potential effect from exposure to BPA and endocrine disruptors particularly. So there's lots of different things that have been teased out. We, we know this by the way, which is so interesting for people to hear, is that the CDC, the U.S. you know, CDC actually has had in place for decades the bio monitoring and screening process by which they go across the country. Every two years they sample 250 US citizens, age groups and you know, a whole variety and they look at the chemicals that are on the list that they're been tasked to evaluate in terms of exposure. And Americans are filled with chemicals. We don't have to pay for an outside lab and lots of money to know that. We even have our government watching this. And that's been a way to figure out how to regulate some of the chemicals that are in our water systems, for instance. And so we have lots of ways to look for it. We just have to tell people how to manage it because regulations aren't going to happen anytime soon.

B (12:22)

Yeah, and it's been my just even in my clinical experience Whenever I'm reading something in the literature, it's usually somewhere between 10 to 20 years where we're seeing a consistency in you know, this consistent signal, let's say in the literature before it sort of makes its way into clinical practice and it's, well and clinicians are following it. So I think that there's value in this conversation because I think that there is a potential for us to go down a rabbit hole and be like, oh my God, I'm poisoning myself. And now I can like I'm never going to color my hair again. I'm never going to wear lipstick again. I'm never going to, you know, we'll talk about personal care products certainly today as well. But I do want to, I want to expose the audience, use of that word is intentional. I want to expose the audience to this, this world which might seem on initial hearing a little bit scary, but then also arm them with some strategies and actions in terms of what they can immediately do today to reduce we'll say toxic burden or toxic load and then what are some sort of low cost to no cost strategies and then you know, we can sort of move up the line from there for people who have the desire or more financial resources to, to think about things. So I want to, I want to make sure that we have options for everyone today. So coming, just coming back to BPAs for a moment. So changing up, regulating or downregulating the estrogen receptor numbers and then you mentioned with the immune system like just basically making it more pro inflammatory. So increasing the number of cytokines, natural killer cells just generally maybe tipping the immune system towards more of an attack like I'm being attacked. So I need to be able to create more of these natural killer cells, more of these cytokines, these, these pro inflammatory components that you need to save your life if you have an invading pathogen or you know, what have you. But obviously if there's a chronic activation of that we are going to see eventually some type of maladaptation. So can you, can you describe for us what a long, like a long term exposure to some of these, you know, immune disrupting chemicals might have in terms of systemic inflammation. Like what are some of the signs and symptoms that someone might, might start seeing?

A (14:31)

Yeah, and I write about some, you know, I still, I'm clinically practicing rheumatology. I, I write about some of my patients. In you know, the recent book that, that we have talked about. The idea is that you know, the human body is working as it should, right? It is Evolutionarily important to know that our body's immune system is doing its job of looking out for foreign invaders. We know this at the cellular level. So single celled mechanisms such as the cytosol, if you go back to biology back in high school, people have cytosol in between all the organelles. There's actually a surveillance system that involves something called the inflammasome that can actually pick up on environmental chemicals getting into the cells. Then you have at the, at the organ level, which is made up of all those cells. Right. You have different effects and then eventually you could have what's called the clinical expression. Right. So there's a lot of stuff that goes on under the hood before you actually get disease or something that you would pick up, whether it's a diabetes component and your hemoglobin A1C is all of a sudden bumped up. You know, whether or not you're having a rheumatoid arthritis expression, whether you're having skin related issues, eczema, there are a lot of things that bubble along until and unless perhaps you start to see clinical disease. And so I think it's important to understand where people might want to intervene, whether it's at prevention or if it's already at the point where you're expressing some type of illness. I get a lot of, obviously, as a rheumatologist, I'm seeing a lot of people with autoimmune and immune disorders. And the distinction is very important because autoimmune disease is when your body's immune system is doing what it should. In general, it's responding, but it's responding mistakenly to your own body. And so we see that with rheumatoid arthritis, classically, it's when your body's turning itself on the synovium of joints, particularly the small joints of the hands and the feet. In general, when you're talking about lupus, for instance, as an autoimmune disease, you see classically soft stuff like joint pain, hair loss and rash. But then you can also get the more extreme autoimmune symptoms and findings of kidney disease. Right. And lupus nephritis that shows up in perhaps protein in the urine, for example, as something that to be, to be watched. There's psoriatic arthritis where you have psoriasis but also a joint component. So, and not everyone with psoriasis has psoriatic arthritis, but it's certainly something to consider. So, you know, I'm seeing a lot of that. But there's also patients who show up who feel tired. I talk about a patient in my book who is, you know, extremely tired. And after doing a very traditional workup for thyroid and vitamin D and all the in iron levels and things that are just traditional contribute to fatigue, Epstein Barr virus history, all of that, it turned out that he had an environmental exposure that was very much linked to potential symptoms, which was the perfluor alkyls. And he was working in a pizza parlor and he was constantly taught handling, you know, recycled pizza boxes. And this was his, his job. And so when I felt the need to test for that chemical, that class of chemicals, it certainly proved to be a contributor along with his lifestyle. So again, it's never going to be one chemical because we're filled with mixtures of chemicals. Some of them have half lives that are short, like bpa, which is six to eight hours in general in a normal healthy body. Some of them are longer lasting and have, what are called, you know, forever chemical properties like the perfluor echol, nonstick, you know, pans, you know, Gore Tex, you know, some of these fabrics, stain proofing chemicals that I personally even sprayed on my couch back in the day. So there's lots guard the Scotch guard, which at the time with young babies, this made a lot of sense to me. So yeah, I think the goal is not to, to be so overwhelmed with the nuances and the details which I, I definitely try to share with everything I post and write about. It's look, I color my hair, my kids play lacrosse on, you know, turf and I have a whole podcast on turf and, and its effects. The idea is don't get hung up on the details. Think globally. And then when you think globally, you're handling a lot of those details without even realizing it or being a toxic. Excuse me, a toxicologist.

B (18:46)

Yeah, I, I think I just. Was there a study that just came out, gosh, maybe a month or two ago now. They was saying people who live near golf courses have a higher incidence of. Was it Parkinson's disease? Because of all of the spraying that they're doing on the grass. Like there's a. I don't know that they were saying that it's causative, but there's a very strong correlation between.

A (19:06)

Yeah, associations are a very big thing in environmental health because a lot of what we see cannot always be tested in isolation unless it's an animal study where we can control all of the environmental compone. Human studies are harder because they are, you know, variable in their lifestyle and their diet and access to certain foods. And their absorption and their excretion and all the different properties. But what we know from animal studies is taken into account when we look at human studies, when we look at occupational exposures, boy, that's a really big area where we can see a lot because those are the people that are handling those chemicals at much higher allowable doses because of the work they do. And so there's so much that contributes to this argument that we are in a lot of chemicals, they are very toxic on some level, depending on which classes and how much research is done, but that we absolutely have the ability to reduce these exposures if we take into account some very practical, low cost changes to our choices of products, our behavior, and understanding how to utilize and harness, you know, detoxifying properties of the body.

B (20:15)

So lots of the women who are listening to the Show in their 40s, obviously metabolism, body composition is a big concern, I think. I mean, whether you're your 40s or 20s, your 70s, I think that at some degree we're always thinking about how can we be optimizing our metabolism, how can we be looking and feeling our best? Maybe we can talk a little bit about what an obesogen is and how this can be directly influencing and affecting or indirectly affecting metabolism propensity for fat storage, what kind of fat storage. So talk to us a little bit about how maybe some of these environmental and immunogenic obesogens are making it harder to stay lean despite our best efforts and to, and to stay fit and healthy.

A (20:58)

It's a great question. By the way. I'm one of those women in the area of these, you know, where things are changing, my body is changing. And despite all my regular routine and all my exercise and you know, in everything I'm doing, there's no question that things are changing hormonally for sure. And I think it's important to know that reducing exposures has a lot to do with a piece of the weight loss puzzle and, or obesogenic components of our lives that not a lot of people are thinking about. So to your point about obesogens being a class, what it really was is it was a tease out of many of these chemicals that were found through research, through excellent studies to show changes of, in a variety of ways to weight. And it was started in mouse studies and what they were able to find, I say they, because I've listed tons of these, you know, these studies and multiple stuff that I published. But it's, it's all available for people to look up on pubmed and other Places. But the idea was that not only do the chemicals that they put into this subclass, right, subclass of chemicals that are able to affect weight and metabolism actually was a variety of mechanisms. Again, they are not only known to obesogenic chemicals to increase the size of adipocytes, which are fat cells. They are also also able to make stem cells which come from our long bones, you know, are the precursor cells to the whole body, turn them into adipocytes. So it actually can misdirect whether or not they turn into the, you know, correct cells or not for the human body. They can also affect, actually BPA is well known to do this, affect what's called adiponectin, which is also hormones that are affecting whether you store fat or not. And again through affecting muscles and beta cells can affect whether or not we store glucose appropriately. So again, that plays into some of the changes that go with having insulin resistance. So there's again, lots of different mechanisms that have been identified. And then these chemicals have been listed under obesogenic chemicals. They can still be immune system disruptors, they can still be hormonally disruptive, but they're very classically known. In fact, the most well studied are obesogenic. And that includes things like vinclosalin, which is a, a chemical that's used to clean the bottom of boats that is very pervasive. It can, can include BPA as an obesogen, atrazine. A lot of pesticides have been identified as obesogenic chemicals and they work on certain receptors called the ppar Gamma receptor, which can really is turns on and turns off sort of this production of fat. So, you know, the idea is that instead of again worrying about which chemicals are obesogens and which chemicals aren't, because BPA can do this, but BKPA can also do that, guess what the take home is? Let's try to reduce BPA so we don't sort of see these things develop or worsen. And where does that come from? Canned foods. We see lots of canned foods, if not all lined with a plastic interior. Classically known to have bisphenol A in it, not required to be changed out to any alternatives, by the way, and still in food packaging in the US for sure, and usually around the world because it's a late stage change that people might make. This includes organic, USDA organic foods. So food packaging is safe, separate from the foods it carries or drinks it carries. But in fact, our largest dose of BPA comes from what we eat. In terms of the food packaging, there's other areas, but studies that people reduce canned foods. You know, there's a wonderful one I talk about in terms of reducing canned foods. For lunch. They use Progresso soup and they changed out. It was a Harvard study where they had 75 participants that changed out only their lunchtime soup or their meal. For. They started off with either Progresso, which they used in the study for lunch, and then they had a washout for three days. And then they had the same 75 participants only have fresh, no package soup for the next. I think it was two weeks or so. And they had an 1100% reduction in BPA in their urine, which is where it's tested. So, you know, it's. It's doable. And everything I write about and recommend to high school students, college, even doctor's programs that I'm teaching at, is doable, practical, and not over the top. For sure.

B (25:28)

I think what frustrates me the most about BPA is that it was like. It's like this is part of the marketing now. It's like we're a BPA free bottle. But then I think you've mentioned this a moment, you know, in our. Just earlier in our conversation, where it's like they've swapped it out for bp, you know, for. I guess it would be BPF or bps, These maybe far more toxic bisphenols that cause even more chronic inflammation and potentially have more of an obesogenic effect. So what would be. I mean, obviously we can't all. Like, there's sometimes when it's just, I need water and I'm just gonna. I'm just gonna take the Evian or whatever it is. I'm gonna buy the $8 stupid price thing because I'm dehydrated and I haven't planned. But what are some of the ways that we wanna think about reducing our. What are some of the ways that we can reduce exposure to. So you mentioned canned foods. So maybe, you know, not the canned soups and the canned peas and corn and things of that nature. What are some other ways that we can think about reducing our BPA or F or S and lots of chemicals because.

A (26:30)

Yeah, and. And to your point. So from a food packaging perspective, I really recommend people eating frozen USDA organic produce.

B (26:40)

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B (28:10)

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A (29:42)

Yeah, we grew up thinking oh no, frozen's terrible for you and that's really like, ugh, you weren't cared for as a child if you had frozen food. I mean, I, I can tap into all of the childhood trauma, but all I can tell you is chi, like frozen. USDA organic, number one. USDA organic, just to mention, is the only regulation in the US food system that has any value. I mean, for sure it's not perfect, but it literally keeps thousands of fertilizer, chemicals, pesticides, manufacturing chemicals out of the process of making that produce. From the soil quality, there's restrictive, you know, there's restrictions all the way through. Not so much its packaging for sure, but certainly through its manufacturing. And you know, it's really important to understand USDA organic is really critical. Now that being said, the argument that it's more expensive is really, in my opinion, not panning out. And I talk about this in the book, all the different strategies for people to think about. But frozen bags of USDA organic produce is available literally across the country in big box stores that reach and cheap and accessible and they last forever. And you just want to take, take all that food and put it into glass and stainless steel if you're going to heat it, right? We don't want to heat and microwave steamer bags and all that. But the idea that because big box stores like Shoprite and Wegmans and we have a whole bunch of them, they know how lucrative it is to create their own USDA organic produce line and they've done it. And so now you can go into some of the most remote parts of the country and get a hold of that produce and you're not only going to get, by the way, another part of this conversation which I certainly want to mention is that nutritional value of food is this is the second piece, second big piece of helping to keep us healthy and remove chemicals. Because it's not just taking away chemicals, it's also understanding how malnourished, I should say malnourished, that's an actual how lower we have a deficiency of nutrients in our daily lives from the food quality we are getting in modern day times, from shipping, you know, travel time, from packaging, from low dose, you know, low fat refrigerator temperatures that they manage to do months before, you know, apples go to whole foods, for instance. So the idea is that we want to do two things. We want to take away as many chemicals. Again, it's progress, not perfection. I can't tell you how much I need to tell people that it's not about perfection. But you want to take away as many of those exposures as possible. And then you want to add in nutrition. Nutrition that's so valuable for the human body to not only live but to thrive and to manage detox processes and all that. So it's kind of a twofold thing. And there's lots of different hacks. So frozen foods, certainly packaging. When you're carrying your water, you know, I can show you I have my, my water bottle which is, you know, I have my tea and my coffee and my water. When I travel, I love filtered water. You know, reverse osmosis is now so accessible in terms of the most aggressive way to clean drinking water. So I have, you know, one at home under my kitchen sink. I have one here at the office. You don't necessarily have to buy a whole house filter, you know, ro filter because it's very costly and I want people to use that money wisely.

B (33:01)

I can't tell you the thing that chaps my ass the most when I go grocery shopping is I buy a pint of blackberries and the top and I look, I look at it before I buy it and I'm like, this one's perfect. And I take it home, I eat the, you know, I'll eat the whole thing. I'll eat a whole pint in one sitting and I'll, you know, I take off the first layer and then underneath it it's moldy. Like I cannot tell you how angry that makes me. And the fro, I have never had that problem with frozen. Never, never, never for sure.

A (33:28)

And I don't have time to return. And I know exactly what you're saying because they're usually a little bit more expensive if it's out of season, it's going to be more expensive if you're buying seasonally also. That's another way to ensure, you know, fresher fruits. But again, fro fresh foods, produce that make their way to the supermarket may be organic and have less chemicals, but they're not necessarily more nutritionally rich. And so if you've got farmers markets, I support local. I think it's a great way to go with your produce because it's picked that morning. If it's organic, even better. But it's, it's interesting that frozens have really come to the top of my list of as being the most win win of every situation in terms of, you know, low content of chemicals and high content of nutrition.

B (34:13)

And I think in order for you to taste something that's cold, the taste actually needs to be more concentrated. So with the frozen fruits in particular, they actually wait to harvest the blueberries, the blackberries, the strawberries, the mangoes, whatever it is that you're buying frozen, they actually wait to harvest them later so that you. The plant has been able to give all of its nutrients to the flower, right? To the. To the budding, you know, the blueberry or the BlackBerry or whatever, so that by the time it's picked, it is, like, peak sweetness, right? So you can taste that when it's cold versus a BlackBerry. Maybe it's been hydroponically grown, or even if it's organic, like, sometimes we'll, like, we'll, you know, buy fresh fruit. And I'm like, I don't. I can't taste nothing. Like, I get this little bit of tartness, but the. The flavor is not bursting in my mouth in the same way that maybe frozen would. So I actually think to your point around nutrient density, I think that there is something to be said around allowing the fruit to ripen until the last possible moment. Because if it's otherwise a frozen, you know, frozen fruit, you can't taste anything because you. You need a little bit more of intensity of flavor when something's cold.

A (35:19)

Oh. I took my kids to a local farmer's market where they volunteer, actually, and I don't think we've ever really wandered around and tasted a lot of food, but I brought over the organic. We happen to have an organic farm that sells at this farmer's market. We're in New Jersey here. And I had my boys taste strawberries that were just picked that morning, and I had them compare the kind that we pick up at the supermarket. We use Driscoll's or whatever as a very popular brand, but, you know, there's not that many. But anyway, I had them taste the two strawberries, and it was like night and day. Now, mind you, we don't have time to always go to a farmer's market, but I wanted them to understand the difference just from their own palate. And it is pretty remarkable. But for, like you said, frozen packaging tends to. They flash freeze soon as it's picked and it goes to the store. So it's flashing all of that flavor, but also that nutrient into the. Into the produce.

B (36:14)

The. The bisphenols. The other thing that you were saying, you know, so frozen maybe is better in terms of food packaging. The other thing that I've noticed, not that I do this very often, but anytime that I have ordered from Uber Eats, a lot of times the food comes in, like, it's almost like, slippery, you know, like the food Is like kind of slipping around inside. Like it's a cardboard packaging but then you, it almost is lined with like a shiny. Is that bisphenols as well or is that something else?

A (36:42)

So that's probably the perfluor alkyls which are sort of the grease proofing chemicals. That's the stuff that's used on nonstick pans. It's the stuff that's scotch guarded. That's the stuff that's on cortex on, you know, rainproof, waterproof gear. Food packaging actually had a big change. There was a big movement. I'm trying to remember when it was. But they are going to move phase out PFAS chemicals out of food packaging and fast food wrappers.

B (37:04)

Those are forever. Like we don't. There's no half life for them, right? Like they're.

A (37:07)

Well, yeah, there's no great half life. Although I've done it. I mean I take my own samples and I kind of use myself as sort of an experiment. So I don't have people spending tons of money to do it themselves. But I'll be honest, we can wash them out eventually over time. And it's not like it lives forever in your body. Just, you know, it tends to have a little bit more of a staying power, certainly in the environment, which means that it becomes pseudo persistent. So if it's always in your water system and it's always in your air and it's always in your soil, it's gonna always circulate into your body, whether your body breaks it down or not, fast or slow. So the goal is to really take your environments as best you can. Again, progress, not perfection. And do the best you can with your choices and with the things that are in your home and in your workplace as best you can. Because that's where you're most exposed. It's not like traveling where you can't make those decisions. You don't have access to things you need. It's not like birthday parties that you're gonna, you know, that's, that's kind of where I bring in, I'm sure you know, the four A's of environmental health navigation, which I talk about in the book to give everyone an idea that this is not about perfection. The A is assess the, you know, 50 question survey in the book. You know, you want to know where you're starting from. You want really great questions to work off of, like do you, you know, dry clean your clothes? You know, do you look up your personal care products for safety and toxicity? It's not to shame, it's to assess where you're starting from. The second A is avoid or swap. So reducing overall number of chemicals or products is actually a good way. If you could do less is more. And then if you really want those products, there's lots of good ways to look them up and I give all the resources to get safer versions of what you want to keep. The third A of these four A's of environmental health navigation is add. What do we need to add to the human body to help it thrive? That includes exercise and sweating to support detoxification, lymph nodes and how we can keep our lymph, which is another clearance mechanism in the body, keep that healthy through movement, sauna, sleep, which is so critical to how we manage environmental exposures and detox, detoxification processes. You know, how do we add in nutrition? Whether it's food alone or supplements that I talk about that are really important to get right for, for very many reasons. So the AD is so critical as a part of this process. And then the allow which is my fourth A is hair coloring. Right. It's my excuses for.

B (39:43)

It's my makeup, it's my make.

A (39:45)

Well, actually my makeup is swapped out. I mean it's again, but to your point, yes, it's the things that I either won't change or can't change. And that's okay because those are the choices I've made. But I and my kids play lacrosse, you know, and I'm not going to take them away from something they love. I'm going to teach them how to manage their exposure by requiring them to shower with soap and water because these are petroleum based chemicals that they're rolling around with. So there's lots of hacks that don't require costs. It's just more being aware and then understanding how to intervene. And that's, that's the take home for those forays.

B (40:21)

My, my big allow, I'll tell you, my big allow is leggings. I have people telling me all the time there's stuff in those leggings. I'm like, you know what? I'm sure there is. And the proportion, the cuter I look in the gym is directly proportional to how good my gym workout is for sure. You know, so I'm gonna wear the leggings. And maybe they have, I don't know, maybe it's pf. I don't even know what it is. Like there's a couple of people that have done.

A (40:46)

You're talking about the pfas and, and to be Honest with you, I feel like mine are so old and I probably don't want the new ones because they probably washed out all the chemicals after, you know, 15 years of using the same damn leggings. But you know, listen, I think you have to decide what means something to you. And I don't think this is a race. It is a journey for everybody. And I say this because I've been on this journey for 16 years and my first, you know, exposure was through my dog getting sick and how I managed that, that tragedy 16 years ago with him being a young golden retriever getting sick and exploring what he ate and drank and put on his skin. Whatever. Sixteen years later, I am now in a position where I can tell people what works and what doesn't work, what to expect even from, even symptoms from certain chemicals. But certainly not limited to we have to be thinking holistically about every aspect of our lives, not just chemicals. We want to be thinking about how we live our lives and what we can tweak to make us feel better and prevent disease. That's the goal. It's progress.

B (41:48)

So let's, let's talk about the third A. You mentioned ads. So the exercise, lymph node, sauna, sleep, nutrition, supplements. This is, this is my wheelhouse. This is what I love to talk about on the show. I love to talk about nutrition, I love to talk about fitness and movement. So talk to us a little bit around exercises. Specific, is it any, is it a specific type of exercise? Is it cardiovascular? Is it just, you're inducing a sweat. What type of exercises are you recommending or that you have studied or that maybe you're practicing yourself or you recommend to your patients that are helping to augment the management of some of these endocrine disrupting chemicals.

A (42:25)

So there's some really great, we think sweat obviously, because you know, for most people can understand that's another mechanism for clearance. But not everyone understands that, you know, we've been using sweat therapy. Well for thousands of years we've had saunas, right? But in modern day times when we have all these chemicals, they've been used for nine, 11 victims and first responders to reduce some of the chemicals that were exposed, they were exposed to during those, you know, terrorist attacks even before 9 11. Methamphetamine use in actually they, they looked at a bunch of folks who were part of the New York Police Department back in the 70s and they had that methamphetamine studies. I mean there's so many interesting studies on how the body is able to take exposures, break them down, and then, you know, make their way to the skin surface. It's not just for cooling. When we think of, you know, sweating, we think of also removal of many chemicals. Another area is, you know, when it comes to movement. So you think about, you know, exercise. Well, I have a lot of rheumatology patients who can't bear weight, right. They either have knee arthritis or back arthritis or severe debilitating, you know, diseases where they can't really go out and run or, or do a lot of gym work. Well, that's where sauna comes in. So sauna is a really great place where you can sweat without having to be able bodied 100%. So you want to be thinking about what are the ways to have a sweating experience that doesn't put you at cardiovascular risk.

B (43:52)

Right.

A (43:52)

You want to make sure you're, you know, checking with your health care provider and making sure you're not doing something against, you know, your, your health condition. Hydration. Super, super important. One of the ads that you have to think about, if our bodies are made up of 85% water, right? We gotta get this right because the water goes right through us, right? It's, it's being, it's a filter system. Not only our kidneys, but it certainly feeds the liver that needs to upregulate all of those breakdown enzymes and chemicals to be metabolites that are easier to discard. So hydration and water flow is just so critical. And I want to make a point about water flow that's just kind of so interesting to me. You know, my dad is actually a kidney specialist. He's a 86 year old practicing nephrologist, if you can believe that. Still loves his job and still practices, but he helped bring dialysis to New Jersey, which is the process by which, you know, we have help for, for people with kidney failure, right. They act as kidneys. Now, mind you, in the 70s, it was required that these patients federally from oversight had reverse osmosis water and still do. And in fact, I just, you know, toured one of his dialysis units where there's an entire room for reverse osmosis. Now we've managed fortunately over the last decade to go from a com, you know, a commercial RO system to these smaller ones that we can put in our kitchen under our sink. I had, I just gave one to my son. I dropped him off at college and I, I gave him like a mini RO filter. It was so cool. Like you add junk water from the kitchen sink or wherever these kids get it in the dorm room and it makes water on the other side. Right. 300. So I think it's been a real blessing. But to understand that if dialysis units, which are so key to reducing infection risk. Right. Is the key issue back in the 70s we didn't realize that that also had an effect on all the compounds that are even larger that are getting caught in that rock, you know, system. So I think it's important to be thinking about quality of water. The best you can do. There's a lot of things you can make choices about. Hydration to really make the body sweat to affect the lymph, lymph system, which is really primarily a water system. And movement. Yoga, breath, breath work with yoga is remarkable for the gut microbiome. That's another avenue where even doing physical activity has been shown to modulate the gut microbiome. And that is a wonderful thing for the human body to, you know, to experience. So there's different mechanisms, movement of any kind is going to be good for the human body. Weightlifting, we know that in perimenopause, we know that keeping up muscle strength, cell number, avoiding sarcopenia as they call it, those are important things to do, but they're also really good for managing chemicals because your muscles burn energy and can utilize, you know, some of its energy towards helping the body remove chemicals.

B (46:55)

Yeah. And just even coming back to the conversation we were Talking about with BPAs, you know, one of the beautiful, beautiful, remarkable things about muscle is that it can extract glucose from the plasma in an insulin dependent and insulin independent way. So muscle can actually sop up blood glucose in the presence of insulin or not. Right. So just through contraction of the muscle, you can actually augment your disposal of glucose, which is, you know, we were talking about insulin resistance and exposure to bisphenol. So I think that that's also something to just to note in terms of again, the reinforcing, like strength training. It just seems that it's just, it's related to everything in the same way. We would talk about like the immune system touches every point in the body, you know, the musculoskeletal system, every point in the body. Right. It's also going to help it with immune modulation as well for hydration. My, my boys, their, their grandfather, when he was still alive, so he came from Greece, you know, small little village, you know, kids dying all, you know, not all the time, but just like, you know, they would get knocked out from, you know, pathogens and what have you. One of the things that he would Do So he lived to. So their prospapu, like their great grandfather lived until. Oh, I hope I get this number right. I think it was 90, 92. I want to say I will fact check that with my family later. But he would boil water so we can do like the whole home filtration thing. I've done that. We've installed a whole home filtrate water filtration system in our home. We did it through Home Depot. No relationship to Home Depot, just that was an affordable. They came, they installed it, they did the whole thing for us. But my family member, one of the ways that very low cost, you know, very poor, didn't come to, you know, didn't come to this country with a lot of money, he would boil his water. So all, all the water that he drank, he would boil it first and obviously let it come to cool temperature, like put it in the, in the fridge and, and maybe that's not the most sophisticated way, but I share that as a, as a, yeah, you know, as a low cost, no cost way. If someone's like, hey, I don't even, I don't have 300 bucks to spend on an RO filter like this month, money's tight or whatever it is. There are other ways that we can do it. So that may or may not, you know, match the, that might not be at the level in terms of, you know, getting rid of all pathogens or what have you, but maybe. Are there other ways? Maybe it's like a Brita filter or not. Again, no. No affiliation. Just that's the one that I think of when I think of like a thing that you put in the fridge on the door. If you have a sweet tooth like me, you are gonna love Manukura Manuka honey. I typically put honey in my tea in the evenings and when I drizzle it over my high protein Greek yogurt snacks. And Manukura honey is a sweet superpower of a sweetener. It has three times the antioxidants of typical honey for daily immune defense, gut healthy prebiotics to support digestion and fighting skin conditions like acne and eczema. Manokora features something called mgo. It is a unique antibacterial compound that makes Manuka honey special. MGO and Manuka honey is linked to beneficial health properties like wound healing, improving digestion and it helps fight acne causing bacteria. It soothes skin inflammation and accelerates wound healing. Every single jar is ethically produced in New Zealand where the bees harvest nectar from the Manuka tea tree and Manukura third Party tests each batch for this MGO level and you can literally scan the QR code on each jar to see exact potency and the origin of your harvest. The over 200 is considered excellent and I just scanned my recent delivery and it was 912. So consider this honey with superpowers that you can actually verify. Head over to manicora.com better to save up to 31% plus $25 worth of free gifts with the starter kit which comes with the MGO850 plus Manuka honey jar, five honey travel sticks and a wooden spoon and a guidebook. Again manukora.com better to save 31% plus $25 worth of free gifts.

A (50:56)

So carbon block and I have a whole chapter on water. So people can really dive in if they're interested in this topic. And yes, there's lots of different ways to affect your water in a good way. So boiling will affect the risk for pathogens, so viruses and molds and yeast and bacteria. Okay, the little buggers. Right. But will have limited to no effect on most other chemicals or most other substances or contaminants because many of those contaminants were designed to withstand heat anyway. They're plasticizer chemicals or they're forever chemicals with fluorine, carbon and carbon connections which won't break down or you know, you know, the bisphenols or even heavy metals. Lead doesn't get affected by boiling. So I think it's important to know that anything is better than nothing in terms of preparing water. But thinking about things in a way that are either heat is going to kill stuff, but heat also doesn't affect things that are withstand. That is is something to be important, you know, to think about when it comes to lower costs. I actually will tell you this when you do a Brita filter or a carbon block as they're called, because it's a big chunk of carbon. Okay. And water.

B (52:00)

Carbon block. That's the right term.

A (52:02)

Carbon block is basically a big chunk of carbon. Right. And basically what it does is water flows through it and it goes through quickly and then you get cleaner water on the other side. But it's variable in terms of each brand and how much pure carbon, whether they use colloidal silver in there, whether there's other components, whether it's able to take off fluoride, whether it's able to take off lead versus the PFAs. There's so many different things to think about that you don't have to think about as a consumer I'm trying to make this simple, but the idea is carbon block is good, but it's not aggressive. But what I wanted to mention is that the cost of these drop in filter changes are pretty expensive. And when you think about something like replacing them with the pitcher filters or the refrigerator doors are also carbon block, I've done the math. This is my job. And I will tell you that an RO filter that costs 275 now that you either have on your countertop with no installation, not connected to your plumbing, or you pay a plumber 150. I test that to one hour of work, not more. I time the guy $400 upfront. You now have a system that doesn't need to be changed out for probably five to eight or 10 years. The cartridges are 30 bucks every six months and you don't have to do anything.

A (53:30)

So the idea is, is that it tends to be if people can wrap their head around upfront costs, that actually saves them a lot of money and is more aggressive in the long run. So I really try to get people to think about that picture. It's better to save up and get something that's going to be in your home for a while with not a lot of expensive cartridge fillers in my opinion. But I think anything is better than anything. The other thing is I talk about when you're, you know, some hacks when you're traveling or if you have a flood or some kind of climate related incident where you need to buy bott water, you can actually look at your plastic water bottle, which again we don't love microplastics but you have to use what you got to use when you need to use it, right? And you can look where it says ingredients. Most people don't think to look at ingredients on a water bottle and it'll tell you how that water was cleaned. And if it says reverse osmosis, that's the one you go with, right? Because you can't manage the plastics, you don't know where it came from, but you can manage how that water was filtered. And I show this, I post, I have the smart human. The smart human is my platform. And I'll walk around the airport and just show people, you know, on reels, Instagram reels and time give people ideas for how to look at water bottles even in an airport because there's like 20 different brands, right? So there's lots of things you can do. There's even the carbon block filters that are in airports now. And I'll bring this now And I'll fill up with the big carbon blocks because you know what saves money. And there are no microplastics technically. So there's lots of options. You just have to decide what you're comfortable with.

B (54:59)

Yeah, with our. We've had, we put salt in our whole home water and we've had to buy. I want to say we've had it now for probably two years, maybe three. And I think I've bought one full bag of salt, which was like 8 bucks. So I mean, there is an initial upfront cost to certainly putting that in. And I'm not saying that everybody has to do that.

A (55:21)

Sure.

B (55:21)

I will say I was saying to this, saying this too, before we got started, like, my hair, the softness of my hair, it was like measured, like it was very, very different.

A (55:29)

Yeah, that's hard water. Yeah, hard water is hard water for sure. And that's the minerals. And there's nothing to say that there's anything wrong with minerals. And people always say, oh, you know, if I drink RO water, there's no minerals. And I said, no, there's no minerals. You know why? Because you don't get nutrition from water. And the only way a reverse osmosis works is by getting the baby out with the bathwater. Like you have to move everything because it only knows size of the parts particle. So, you know, in your case, you were able to find a really nice win win where you get filtration and you get improvement with minerals put back in. And people can choose that. Even for RO filters, there's ways to buy those, but I don't, I don't recommend them because I don't want people to spend money, extra money when they can just have a nice big healthy meal along with their RO water and solve that.

B (56:13)

So let's talk about air. Let's talk about this is. I've had people on the show talking about air quality and how that is one of the easier lifts in terms of augmenting or improving health. And certainly with things like forest fires and you know, not too long ago there was a huge, like LA was burning like not too long ago. And you know, people were evacuated and whatnot. And in Canada, certainly across the, the prairies and across western Canada, like lots and lots of forest fires. I believe one day in, in Toronto, which is where I'm from, the air quality in Toronto was worse than Baghdad. Like the number one, it was the worst city in the world in terms of air quality because of the surrounding, you know, the surrounding forest fires. So what are some ways that we can improve our indoor air quality because we are for the most part spending most of our time indoors. The recommendation that I used to have was like, open your windows. But certainly when there's an active fire in and around your region and you're getting some of that into your lungs, I don't, I can't foresee that being a good thing for your, for your quality of life and for your toxic exposure. So talk to us about how we can think about improving indoor air quality. And then maybe when there are big events where there's like forest fires in the summer, you know, we're not going to talk about the politics of it, of course, because you know, it can be like man made versus climate change, like, who cares? It's just there's forest fires. What are, what are some of the ways that we can, if we are wanting to be outside, what are some ways that we can reduce our load there as well?

A (57:50)

Yeah, and this is a great question because you're right. There are so many modifiable ways to make sure our air quality is better. And it's gotten so much more attention. I mean, most people didn't pay a lot of attention to air quality until these fires happened because I think it was like an occupational exposure. Like it was such a high load and people were so clinically symptomatic that people pay attention. Right. It's the stuff that goes insidiously under the radar, which is what I talk about in my book and what I write about, is that you want to be paying attention to both, you know, the forest fires that blow up, but you also want to be thinking about sort of the low level exposures that add up to increased risk. And of course, not everyone has disease, but we want to think about what can we control. Right? So when it comes to air quality, I first I start to think about, well, what do we do to ourselves? Because most of the stuff we do to ourselves, like humans are great at doing this stuff. So we bring in a lot of junk into our home environment that aerates off, that gets into the home air quality that gets on surfaces. Because where do these particulate contaminants go? From cleaning products, from candles, from incense, from Febreze, from plug ins, from any number of things that we're marketed to to have cleaner smelling, you know, ocean spray, pumpkin spice air. A lot of that stuff will end up not leaving the home, but getting onto surfaces where not only do we breathe this stuff in, but we touch it and it gets on our paws of pets and Our children with the hand mouth behavior and on stuck on toys. So dust is a big issue, but that comes from the stuff we bring into our home. So one of the best way, ways to kind of, you know, fix a big problem upstream is to don't buy, you know, stuff that we don't need in the home. We don't need 20 different cleaners, you know, carpet cleaner, sink cleaner, doorknob cleaner, window cleaner. I can name 100 different types of cleaner that we've been marketed to. Thinking about what we bring in, how much vetting the stuff that we want. If you want a carpet cleaner, great. If you want certain things, then look up EWG's, you know, database on cleaning products. You know, dirty, think dirty. Clear. Excuse me, Clear. Yeah, there's a whole bunch of stuff and resources that are now available for free. So if we avoid bringing it into our home in the beginning, that actually starts to clean out our house over time. We're airtight, you know, economically.

B (60:11)

Like let's vinegar. Can we, can we love vinegar a little bit more? Yeah. My grandmother used to clean vinegar and she would squeeze some orange and that was it. That's what she would do.

A (60:19)

Yeah, for sure. And so we've created these airtight homes hot, you know, economically allowing keep heat in and air conditioning in and all that so that we've kind of done this to ourselves a little bit. So opening windows using vinegar, things that are just really safe for the human body have been vetted for decades. And you know, vinegar also happens to clear a lot of infectious etiology. We know. Look, I during COVID I carried around isopropyl alcohol, which is really just rubbing alcohol. Right. That has the enough staying power to kill off Covid. You know, I 70%. And the inactive ingredients, which people always should look at, not just the active ingredients, because you would be surprised what's in the inactive ingredients is tons of other junk where most rubbing alcohol is water. So I've actually shown that again on the smart human. So when I post. So I want people to understand that when you bring it into your home, that's the best place to intervene. Not only is it cheaper to not buy so many products, but you get easier at shopping if you just, you know, either make your own, which I have do it yourself recipes, or you could just vet out the, you know, vet out the products that are just lower risk in terms of their chemical load. So that's a really good place to start. The next thing is opening windows. And as you said, if you open windows and the Air quality outdoors is better. That's wonderful. Right? If you're living in a major city where there's lots of combustion, that might not be the case. You can always decide based on the apps like IQAir and a bunch of resources about how to check air quality, whether it's indoors or outdoors. You can bring in plants. There's so many interesting studies that I write about, you know, different types of plants. Dracaena, mother in law's tongue. That had been identified as being very helpful at cleaning indoor air, not only because of what they do from a photosynthesis perspective in terms of carbon dioxide, but also because the surface area of these beautiful leaves is where a lot of these chemicals will land. And you can collect that and remove it from your home. Same with dust. Right. And HEPA filters. So there's so many ways to intervene that are not costly or impractical. And, you know, you just want to get into the idea that what you breathe in goes into your body instantly, just like oxygen would. So whatever you can do in the areas that you have control over is worth considering.

B (62:42)

What about cooking indoors? I think that that's more of a recent phenomenon, even for like just humans in general. We used to cook outside by fire, and now we've sort of brought that fire indoors to our hobs, our stove, you know, stove tops and ovens. I certainly know I have an air filter in my kitchen area and I have one in my bedroom. And every time I cook, every time it's, and it's when I cook bacon and when I cook eggs, I don't know what it is, but the bacon. Always the good stuff. It's the good stuff. Those air filters start going crazy. So of course the reminds me. Yeah. So I have to, I'm like, oh, yeah, I forgot to put on the fan. So like, it's changing my behavior, which is a good thing because the air filter starts like worrying much further, higher. And then I'll usually open a door to kind of let the kitchen air out. But what, what do you think about cooking indoors and in terms of the, you know, I, I, I don't know what they be called, but the, the, you know, the compounds that are created under high heat, like when you're cooking bacon, bacon fat, I'm sure that that's creating something that's not great for lungs.

A (63:42)

Yeah, yeah. Or things like acrylamide, which is like toast. Right. Who wants to give up toast? Right. You know, anytime you, you kind of see singe carbohydrates. Synthetic, synthetic carbohydrates you know, like starches. You tend to get this thing called acrylamide, which is linked to a whole bunch of. But, you know, listen, we can't go nuts with all of this stuff. You know, like, I try to kind of put in perspective, but to your point, about indoor cooking, look, I have gas stove and gas appliances, and I had a podcast with someone who was interviewing me and they were talking about how, you know, they have electric conduction and this. And I felt like, you know, in a way that if I, you know, wasn't, I didn't know what I knew, I would be a little shamed by that conversation. And I think people need to understand you don't have to renovate your whole house and flip out. That's not what this is about. I had a flame retardant couch for literally seven or eight years that I knew full on all of the health effects, flame retardant chemicals. My kids are jumping on it, whatever. But we didn't have an extra three grand at the time to just throw away and go get a new couch. That was like, you know, eight or nine years ago. Now they're much more available. But the idea is that, you know, I have learned to manage around some things that you cannot change. It's like the seren, you know, serenity prayer. So our gas stuff has really great air filtration. To your point. You know, you want to open windows, you want to make sure your hood is working, you want to make sure that you're using the least amount of gas time that you can, that your exhausts work well and that there's no lint or dust blocking that exhaust for the dryer. You want to get rid of nonstick pans because whenever you heat them up, they're going to off gas. And it's been well studied and I write about it. They even, you know, stories about, you know, people living in small apartments that kill their birds because the birds are most sensitive. Right. Canary in a coal mine. Yeah, that's a legitimate story. When you burn, you know, nonstick pans, it can actually really release toxic gases. So. So again, it's not to throw everything away and flip out. It's how do you manage reasonably until you have a renovation or you want to remediate or you're up for a new appliance or a new couch, then I think it's really smart to layer those choices in, especially if they're costly.

B (65:53)

Yeah. And with the couch situation, I'll just say that I have two boys and they're feral, feral animals. And I am just waiting for them to destroy the couch. And it's like, you know, the couch is dying and once it dies, I will invest in a new couch as well. So it's like I totally get the, you know, maybe want to do it right now. It's like also, if you have young children, just know that they're going to destroy whatever pretty new couch that you buy anyway. So just wait it out, let them destroy it and then you don't care about that. You don't care about it. Makes sense.

A (66:23)

I mean, I think it's just having a reasonably almost like. Yeah. I mean, I'm at the point where I was on the ledge, you know, like flipping out for years because I was in this siloed world where only I. I'm like, why didn't I learn this in med school? And where was this not taught? And why do I have to reach out to EWG and work with all their toxicologists to learn this? And you know, I didn't understand why this wasn't part of our educational training when this, this, the material is so robust. So I went from making my own stuff and figuring it out and 10 year journey and now I've come full circle with two teenage boys and realized that life doesn't work black and white, that you have to really be kind to yourself and know that doing a good job swipping, you know, swapping things out, maybe it's one product a month or trying a new vegetable that's cruciferous and is, is able to churn up, you know, your liver detox pathways because cruciferous vegetables will do that. Maybe those are the things you incorporate in a positive way. And that way you start to fill up with lots of really great alternatives. And I, that that's to me, very positive.

B (67:28)

I think I started just personally I started just swapping out the plastic Tupperware just for glass. So we, you know, whenever we grocery shop, even still like the food packaging. I know I don't want to kind of harp on this, but God, it's like all the plastic, like if I buy anything, it's all, everything's always a plastic. You have to take the bag and you have to put the fruit in the plastic. But it's so annoying. So anyway, everything kind of goes into. And any foods that I prepare. That was the first change that I made was like a glass storage container.

A (67:56)

It's a good one.

B (67:56)

Yeah. And it's an easy one that's accessible to most. I think that That's, I think that that's a, you know, a reasonable request. The only thing I would say is if that isn't available to you right now, just whatever, just don't microwave anything in plastic. So if you want to warm something up, take it out of the plastic item, put it on the hob, put it on the stovetop, and then slowly warm it up that way. You mentioned nonstick as something that we want to avoid. Are there materials like ceramic, cast iron? What are, what are some of the things that we might want to look for if we're looking to like if you're doing your eggs every day or you're doing your stir fry or what have you. What are some of the materials that we want to be cognizant of? Cognizant. Cognizant of. If I can get that word out in terms of the materials that our cookware is made with and bakeware.

A (68:42)

So great question. So, you know, materials that don't break down, right? Plastics, we thought were so hardy. They break down the chemicals in plastics. And plenty of studies in the book, and I share that really, they migrate from plastics into the food and drinks that you are cooking with. And one example that I think is really so interesting and visible is that when you have Tupperware that's brand new and you run it through the dishwasher a few times, it becomes opaque. You can't see through it. That clearly is saying that high heat changes its, its properties. Whereas with materials like glass and, and stainless steel and cast iron, you know, ceramic is a harder lift for me because I know that certain glazes can be, you know, have lead in them. So I'm a little less of a ceramics gal unless there's really good third party testing or real, real information behind it. Otherwise it's a lot of marketing and there's no regulation. But I do like some stainless steel, 18/8 composition. There's different food grades of stainless steel and then there's, you know, glass and Pyrex and, and then cast iron. As a rheumatologist, I'm still practicing again, I think about nutritional deficits. Cast iron is a really interesting way to get iron because, you know, naturally. But you cook with cast iron and it absorbs, especially with fatty foods like eggs and, and oils that are healthy, you really can absorb some extra iron without having to take a pill or a supplement. So I'm looking for all of those ways to do it as naturally as possible, but also low tox as well from synthetic, you know, environment and I, and it does seem to work. And I will mention one other thing and you know, look, I'm, I'm here to tell you that I don't sell products, I don't sell anything. My work is in curriculum and it's always been that way. But the book also has a 21 day plan. And the reason I put that in there, and I didn't think it was going to get as much of attention as I actually see it's getting, is because it's hand holding and walking people through this whole journey in a way that makes sense. Right. It's built into this. Four A's of environmental health. Week one is assess. Where you're assessing, you're using this plan to look through different stuff in your cupboard. You're learning how to look through and assess. Week two of the 21 day plan is the avoid or swap, how to look up resources, how to reduce, what are your, you know, your recipes for personal care and cosmetics. Week three is the week about what do you add in? And so it's walking people through, I think a very overwhelming conversation. And it's not built on fear, it's built on just really good logical information. But just in case people are a little bit concerned about how to get started, I think that's just something to know exists.

B (71:31)

Do you like nerding out and learning about women's health as much as I do? If you do, then let's get you on my newsletter email list. Betty. Every week I put out a free newsletter calling it the Mini Paws. That's my take on menopause that tackles some aspect of female health. Everything from answering the question, is oatmeal stealing your nutrients? To how much Zone two should women be doing, how cold is cold for cold plunges, female training and so much more. Think of it as your weekly roundup of the best action items for women. 40 plus. Head over to drstephaniestima.com that'S-R-S-T-E-P-H-A-N-I-E-E-S-T-I-M a.com forward slash newsletter to sign up and you'll get your first one. For me this Saturday, let's talk about personal care products. This is the area that I think is potentially more relevant to women than men because women tend to use more products on our face, on our hair, on our body, in our. We have periods for many of us have, you know, menstruating, so there are bleached tampons and, you know, personal care products, feminine products as well. Talk to us a little bit about how we might begin to look at our makeup and hairsprays and all the things, lipstick liners and body lotions and perfumes and how we might begin to think about assessing, you know, what stays and what goes.

A (72:58)

Great question. So it turns out we have so much more accessible to us to look things up than I had 15, 16, 10 years ago. It is just a remarkable market change in terms of not only how to look up products without any cost. I do this with my high school students. I'll toss all these products at them and they'll look em up themselves and look at alternatives. And if, you know, I'm not there to tell them what to buy, I'm there to show them how to do it. Because it's better to have the fishing rod than the fish, right? In my opinion. So looking them up is really just such an easy way to work your way through your big ticket items, right? Shampoo, conditioner, maybe a lip balm, maybe lotions, just very basics. Now what's interesting is when you said women are kind of the most, you know, biggest culprits when it comes to products. It's interesting the data points to teenagers. The data, and it was actually Sephora.

B (73:52)

The Sephora Trips, but it's not, it's.

A (73:54)

The TikTok, it's the, all of the products that are directly marketed to teenagers. And I say this as a mom of two boys, they use so much product, you know, I've learned to pick my battles. But there is a million colognes in their room. They are talking about hair gels and hair sprays and, you know, zip creams and again, I get it, but the studies actually show that per 24 hours, you know, teenagers use the most products per 24 hours than any other demographic. They average around 17 products. You know, women tend to use about 12 and men, interesting but not surprising, use about six on average. So you know, when you're talking about these vulnerable periods of development, particularly when hormones are going nuts, including teenage years, which is why I'm working to get this curriculum into high schools as best I can. When you're talking about those periods where there could be more exposure and more health effects, whether currently or even down into future years, that is a really important place to start. And look, my kids don't listen to me. I'll be the first to mention it. If they do, I'm very shocked. But the idea is that you want to plant the seed and you want to get them to think, how do I have agency over my body? Why does it even matter? What are the places I can go, you know, to really look this stuff up? And I found in my, I did a, you know, a TED talk that was based on the research I did with Princeton High School. And I did two pilot projects with these kids. They want this information. They're self conscious and body aware. They're able to use obviously technology even better than me, right, in terms of finding apps and how to use them. And they're setting themselves up to prepare their bodies should they one day decide they do want to have children. So you're giving them all this education and you know, the tools really to think about water and food, but mostly also personal care products and how they think of in, on and around their bodies and menstrual care products that you talked about. For sure. People don't understand that when you have a lifetime of vaginal exposure to tampons, not only just the microplastics in the plastic applicators, which by the way get thrown out in the ocean, they're not, you know, part of medical waste or recycling.

B (76:11)

Little cute ducks, like it's, it's horrible. You all see these like little ducks that are like, you know, caught in a tampon applicator. It's like, what are we, what are we doing? Yeah.

A (76:20)

Oh my God. Because honestly it's, it's just, just to know how much waste of each particular tampon, the course of how many periods young women have over the course of a lifetime and talk about the exposure intravaginally, it's pretty remarkable. And I think that if that is one intervention, you know, parents, even dads, anyone can, you know, intervene. It's not hard to find these products.

B (76:41)

Now I've always hated tampons, like as a user, but also just generally I've always felt like, what am I putting in my body? Right? We talk about in midlife, vaginal estrogen, it's a very absorptive area. And it's like, yeah, sure. And when you stick, you know, a bleached, who knows, doused and however many, so it looks white.

A (76:57)

Antimicrobials, perfumes, I mean they're loaded with everything. We've been marketed to believe that the vaginal canal shouldn't be, when in fact the vaginal canal is one of the cleanest self cleaning ovens you can find. And so we just have to let that sucker breathe and be healthy and not try to be so, you know, chemical laden. I'm not Saying every case, but you know what I'm saying.

B (77:22)

Oh, but I can't say in like the douches. And it's like your vagina should smell like peaches and lilies. It's like, no, it shouldn't. That's not what vaginas should smell like.

A (77:31)

Cultural effects. I mean, listen, there are certain cultural cultures that sort of push some of these products more. Look, we have African American young girls that have, you know, products that have estrogenic chemicals and placenta, and we have, you know, Hispanic communities that use more douching and some of the cleaning. There's a lot of cultural, you know, kind of marketing that's been going on and I think we want to hit all women with the same concept that what you put in, on and around your body is something we absorb. It's. Your body's a sponge. So essentially. And we want to be able to keep that body as clean and free of these compounds as much as we can.

B (78:08)

Yeah, that's one that really gets me angry. Is this like your vagina or your, like, you know, what clean smells like? You know, not just not talking. It's like no scent. There's no scent. Right? You don't. You should never smell like lilies or anything. And of course, like the vagina, there's like a microbiome in there. So it's going to have a certain acidity to it and it's going to have a certain natural smell that is not dirty or gross in any way. So that again, chaps my ass. The other thing with, with teenage boys, so I also have teenage boys, what I find gets through to them because they also, they're like, oh, the Valentino, la la la, whatever. I mean, not nothing against that particular brand, but that's just the one I remember is, okay, this is gonna, this is gonna interrupt your. This is an androgen disrupting chemical. So this is going to change your testosterone potentially. Are you willing to make that trade off? Because I know you're really into building muscle right now, and we know going through puberty, you know, this is a peak muscle and bone building time. And if that's something and then, you know, we start talking about that and then they're like, you know, I'm good.

A (79:12)

Yeah. I mean, that's like Health Coaching 101 is what you're doing. You're hitting them where it affects them most in terms of what they value. And when I did lectures, you know, at the high schools, and I would say, you know, is my personal care, you know, Killing me or is it affecting my sperm counter? I mean, people showed up, right? They want to know if they're going to be viral. And you know, God forbid any of these products cause penis size change, right? They'll be first in line to learn about it. I mean, the idea, the idea is, look, I. My kids, they throw their cell phones in their front pockets. I can't tell you the number of times I've told them not to do that. Put it on airplane mode, put it in their back pocket. Because I said, I want to be a grandmother one day.

B (79:52)

Just get away from your junk.

A (79:53)

It's like having your. Your schwank in a mic. So the idea is that, you know, we want to be talking to them at the level where they're receptive and quite frankly, you know, it over time, I think either to appease me or just because it sinks in, or they see something that literally confirms what mom said from a tick tocker or a bro or something, then they start to listen. So whatever it is, it's touch points. Every time they hear it, it becomes more real. Right? So just keep at it, I guess.

B (80:24)

Yeah, just keep at it. I mean, I, I think that these, these conversations are really important. I do think, to your point, I think there is a cultural sensitivity around this because there are different cultures that will talk about. That will talk about female vaginal health in, in a certain way, you know, on, on. Unfortunately, some. Sometimes it's very derogatory, but you can't fault anybody for that because that's just like the culture. That's just, you know what happens, right? So we just, we're it, we're marinating in this culture. We can't see the jar. You can't see the label of the jar that you're in. I think what's important is, you know, mitigating, as you've been saying, mitigating your risk. And especially when it comes to feminine health and feminine care products. I mean, God, they shouldn't be taxed. But that's a whole, that's a whole other thing as well. It's like, why am I being taxed? Because I'm menstruating. Like, well, anyway, separate, separate conversation. All right, so let's. If there's one, if there's one big takeaway. Okay, so we've been talking now. We're like, we're at about a buck 15 in terms of an hour, 15 in terms of our time together. And I think that this is going to be so valuable for, you know, mothers and fathers that are listening in life alike for their children and for their own decisions. What is the, you know, if there's one big action item, one big takeaway that we can talk about in terms of how we can navigate a modern life, which is, you know, we are just marinating in these. I think you said 95,000. I think was the number you said.

A (81:42)

Upwards of three 50. 350,000 by some estimates. So yeah, it's, it's. But yes, we are marinating. And listen to your point with marinating. And we're in it. And the, the point is not to scare people away from making change. Right. It's to scare people to be actionable.

B (81:57)

Yeah.

A (81:57)

In just the right amount, but not overdoing it. Right. So. Because there's plenty of stuff that could scare people at a much deeper level, which I'm trying not to. You know, the studies that I put in here are so actionable and so purposeful and I want people to be, you know, thinking about what they can do. And so here's the take home. Our bodies are a sponge. This is what I said to my kids, high school, school. Our bodies are a sponge. The chemicals are not tested. They can affect health even at low levels over time. And you can intervene so you can reduce those levels. I test them myself. We have plenty of epidemiologic studies, occupational studies. I talk about all of them. When you change to organics, it changes the chemistry of your blood, your urine, your breast milk. It's doable with some very easy, low cost swaps. So you have to know we absorb. Our body physiology has never seen this in millions of years. We know that it's messing and wreaking with a lot of our systems because we have higher rates of, of, you know, autoimmune diseases and cancers in younger people. It's because of our exposures are a big piece of it. Right. Our genetics play a role, our lifestyle plays a role to dance between all three and our environment. But we have control over our environment much more than you would think. And it's not about waiting for regulation. It's not a waiting for any different ruling on any one chemical. Red dye number three or PFAS in water systems which have grossly been ignored for 50 years in terms of chemicals in our water system. It's about doing it for ourselves. And when you do it for yourself, guess what? It empowers you. And you see outcomes. You can feel better, you can get more energy, you feel more nutritious. And guess what? You're preventing risk for not only future health risk within yourself, but believe it or not, I don't want to get too into it, but you don't want to pass these genetic changes, they're called epigenetic changes, on to successive generations, which is also part of this exposure conversation. So you want to be thinking, really, let's start now and here and cover some of the real basics I talk about. Habits are a great place to start. Your tea for coffee, you know, your water for coffee and tea can be filtered. That's a great place to start because you're doing it every morning, right? You know, the ceramics that you drink your tea and coffee, instead of going and bringing Styrofoam or you know, paper cups from Starbucks, why don't you bring your own container and they'll honor that, right? So there's lots of things you can bring. I go to sports events and I bring my three gallon, you know, stainless steel water filter. I just fill it up at home and I take it with me on the road. There's lots of really easy things to do that just take a little awareness, more so than work. And you know, I, like I said, it's doable and we all hope to live a long, healthy life. This is one piece of it. Whether it's weight loss, whether it's autoimmune disease, whether any Alzheimer's and dementia, menopause, bone health, all of it is connected to a lot of these exposures, but also lifestyle and how to manage those chemicals if you're exposed.

B (84:54)

And the 21 day plan is in your new book, Detoxify. Tell us a little bit about that. It's, it's out right now.

A (85:00)

Yeah, it just came out in May. It's, it's, it's my third book. My first two were actually texts through Oxford University Press. So really, really heavily referenced and using, you know, this book is really more, I guess, personal and much more consumer friendly.

B (85:14)

Late.

A (85:14)

It's actually funny and self deprecating and very, very real. And you know, I really want people to use it as sort of a guidebook. And the 21 day plan is just to help people through the process. But there's, you know, a food pyramid that, that I've recreated from some others in terms of the emphasis on quality of what we eat and drink and food packaging and that kind of thing to take into account. But the 50 question survey I think is pretty cool and I think we should be thinking about just asking the right questions so we can do a little, you know, removal. So I hope people will Check it out. It's on Amazon and all booksellers online. But yeah, hopefully you'll share it with your family and. And spread the joy around.

B (85:55)

Dr. Ailey Cohen, thank you so much for your time, your focus, and your energy today.

A (86:00)

Thank you. And please follow the smart human. I post a lot there too, so people can just take a look at those little nuggets if they're interested.

B (86:06)

All in the show notes. Yeah.

A (86:07)

Awesome. I appreciate it. Thank you so much for having me and sharing me with your audience. I do appreciate it. Thank you.

B (86:13)

My pleasure. Thank you.

B (86:16)

Hey. Hey, friends. Welcome to the favorite. Your favorite part of the episode. If you're listening this far. It's the after party, the part where I tell you what I really thought of this episode. My highlights. Stuff I love the most. Stuff I love the least. Let's start with. Let's actually start with the stuff I love the least about this show. So this is me personally hoping that she was gonna let me off the hook. So when we were talking about cooking, I was like, all right, so tell me what some of your favorite cookware stuff is. So ceramic, obviously, cast iron. Those are the two options that I gave her, hoping that she would pick both of them. And she was like, well, you know, I really like stainless steel and I really like cast iron. I'm not so, like, sold on ceramics. And she told us about how the coating of the ceramics, sometimes they're, you know, they have PFAs in them. And I was like, damn it, I have ceramic pans. So I was secretly hoping that she was going to choose my two options that I gave her and she didn't, which is, okay, I have cast iron pans, but, man, they are. They are such a bitch to clean. But I am just gonna have to get over myself and start using my cast iron pans more and then seasoning them and doing all the things. So maybe that was the thing that I liked the least was the revelation that I probably should switch out my pans to stainless steel and. Or use my cast iron stuff. More stuff I really liked. Overall, I would say that Ailee had a very unbiased, non hysterical view around environmental disrupting chemicals and immune disrupting chemicals. I think that when you start diving into this science, it can get really scary really quickly. And so she often said throughout the entire episode, like, hey, we're not gonna go crazy. We're not gonna do this. And that we're just gonna start with what you can. Maybe it's, you know, at one point she said, like, just One thing a month, you're gonna change one thing a month. That's like 12 changes in a year. You know, we can. Something like that. So I really, really appreciated that. I liked the conversation around frozen food, actually, in particular, I love frozen food personally, because, I mean, listen, I gotta feed a family of four and it's generally cheaper. Like, you can buy a big old bag, like a two pound bag of blueberries, and it's probably, I don't know, you know, I'm. It's probably more expensive. Like, I'm gonna say a number. Like, for me, like I'm paying something like 9.99, 10.99 for a big bag that may or may not be more expensive or less expensive than what you're paying. But if you compare that to like the 8.99 or the 7.99 for a pint of blackberries or blueberries, all of a sudden there's a huge economical advantage to buying the frozen. And I always find that in my, you know, when I make protein ice cream or I make anything that's frozen. I've noticed that you need to intensify the flavors when something is cold. And I think that she said something really great, which was you have to flash freeze. Like, the berries have to actually stay on the vine or on the bush or wherever you're, you know, picking them from, a long, you know, the longest possible moment, and then they're flash frozen. So you get all of these different, you know, benefits, the polyphenols and all the things that are in berries, and they're flash frozen and preserved. So I loved, loved that. And it just reminded me of my love for frozen fruit economical, which I love. Mama loves saving money. And also that you're probably getting more nutrient dense fruit as well. And you don't have to have like, what did you feel me when I was saying? The thing that I hate the most and it literally chaps my ass, is when you get a. You look at this beautiful pint of blackberries, you take it home, you're ready to feast, and you take off the first layer, you know, you're enjoying your blackberries. And second layer, you see a mushy, moldy white BlackBerry. It is literally the worst. So love that talk. Also love the discussion around just home, like air purifying, like opening up your windows, the behavioral change around opening up fans, thinking about different ways that we can offload some of the toxins. So when we were talking about the exercise piece, I really liked that she said, hey, like, all types of exercise is great. And for some of her patients, like the rheumatoid arthritis patients, who, you know what we know about ra, it's an autoimmune condition, as she was mentioning, destroys the synovial joints typically of the hands and the feet, where this is where you start to see that deformation of the hands and feet who can't necessarily lift heavy. Right. Like, our whole goal and our whole protocol for an RA patient is actually just to preserve whatever range of motion you can. But I like that, she offered. Hey, you can still sweat, right? If you're an RA patient, you can get into a sauna or you can take a really hot bath. Like, if you don't have access to a sauna, let's say you can get into a really hot bath and sweat in that bath. So loved that as a, as an option as well. And overall, again, like, just thought that she was very thoughtful, especially with the personal care products, talking about to our beautiful daughters and our beautiful sons around some of the potential for endocrine disruption around, you know, it's like the TikTok and the going to Sephora and the colognes for the guys and the creams and the, you know, potions and lotions for the girls. Thinking about what that might have, what effect that might have on a newly menstruating person. If you're 16, 17, 18, I would consider you still learning how to ride the bike in terms of menstruation. Still not necessarily an expert at it yet. And then when you add in other factors like chemicals, like how that might affect bleed, the, the, the heaviness of the bleed, how uncomfortable you are before you start bleeding, how you are over the course of the menstrual cycle, how all that affects estrogen as well. And then the other thing, other thing I thought was really cool. Again, back to the bisphenols. I'm jumping around here a little bit, but just looking at my notes, the estrogen mimicking effects that bisphenols typically have and how they can actually make our muscle cells more insulin resistant. Right.

A (92:06)

So.

B (92:06)

And just generally systemically, but certainly if you're a listener to the show, you're quite, you should be quite interested, at least if you listen to me for more than five minutes. I usually find a way to talk about bones and joints and my muscles somehow, how we can be thinking about improving our insulin sensitivity through muscle building hypertrophy power and strength, but how some of these chemicals can also affect that, which I thought was really interesting. In the whole conversation we had around obesogens. So I'm curious. I have a question for you. Is there an action item that you are gonna take from today's show? Are you gonna swap out plastic Tupperware for glass Tupperware? Are you going to look for a different type of mascara? Are you going to swap out your Maybelline, I don't know, whatever, eyeliner, lipstick, whatever it is for something else? Are you going to start moisturizing your body with olive oil instead of the cream maybe that you're using? I. I'm just. I'm just, you know, giving you some ideas here. I would love to hear if you are going to make any changes. If any leave us a comment, let me know. We're looking at for them all the time so that we can actually uplevel and bring you the absolute best content on the planet, bar none. So with that, I will bid you adieu and I will see you next time. All right. All right. I hope you enjoyed today's episode and I must give you the obligatory legal and medical disclaimer here. This podcast, Better with Dr. Stephanie, is for general information only and the advice recommendations we discuss do not replace medicine, chiropractic or any other primary healthcare provider's advice, treatment or care in the consumption of this podcast. There is no doctor patient relationship that has been formed and the use and implementation of the information discussed are at the sole discretion of the listener. The information and opinions shared on this podcast are not intended to be a substitute for primary care diagnosis or treatment. In other words, guys, be smart about this. Take it with a grain of salt. Take this information to your primary healthcare provider and have a discussion with him or her to make the best choice. That is for you. Remember, I am a doctor, but I am not your doctor and these conversations are meant for educational purposes only.