Season 2, Episode 8: How to Approach Environmental Toxins and Endocrine Disrupting Chemicals with Lara Adler

Evelyne: I’m really looking forward to this conversation, Lara, and I’ve known each other for a long time. I love the work that you do, and when we launched this podcast, I added you to the guest list right away. I don’t know if you know that.

Lara Adler: Amazing.

Evelyne: I was looking back through old emails today, and it’s almost exactly 10 years to the day that I last interviewed you on my own podcast. Yeah.

Lara Adler: Wow.

Evelyne: 2014.

Lara Adler: Very cool.

Evelyne: Yes. So Lara Adler is an environmental health educator and science communicator who teaches health professionals and individuals with health-based businesses to better understand the role of environmental chemical exposures in causing or contributing to chronic health issues so that they can more comprehensively support the clients and patients they serve. She trains practitioners to become experts in everyday toxic exposures so they can improve client outcomes without spending hundreds of hours researching on their own. Combining environmental health education and business consulting over the last 12 years, she’s helped nearly 5,000 health professionals, amazing, in over 35 countries around the world elevate their skillset, get better results for their clients, and become sought out leaders in the growing fields of environmental health and detoxification. Amazing, Lara, so first of all, how did you get so passionate about toxins? You started as a health coach.

Lara Adler: Yeah, I did. It sort of happened a little bit by accident, and I say a little bit because there’s a little twist to the origin story, if you will. So I was always interested in health and nutrition. That’s sort of what set me on the path towards health coaching. And it was really in doing that work that I kind of stumbled into this space of environmental health. I had clients at the time that were predominantly coming to me for weight loss, and this was kind of an easy thing to help. The average person, obviously there’s some cases that are a little bit trickier, but my clients were having success in losing weight and feeling good. They did all the things. And then I had a handful of clients that “did all the things” and their weight didn’t change at all, and they were frustrated and I was frustrated. And so I started digging into the literature on resistant weight loss to see what was I missing.

And this would’ve been around 2009 or 2010, so quite a long time ago at this point. And it was really through that kind of research dig that I stumbled into this whole field of environmental health, environmental medicine that looks at the ways, the multiple ways that exposure to environmental toxicants can affect people. And one of those ways was through metabolic changes that resulted in weight gain or resistant weight loss. And I was just so captivated, I was fascinated. Immediately, I was like, “Oh my God.” First of all, why did I never learn anything about this in my health coach training? Which certainly wasn’t the most academically rigorous, comprehensive thing out there. But in talking to the other practitioners that I knew, none of them had any understanding or awareness of this topic. And I just decided this is something that I get really fired up about, I’m very interested in this conversation. And so I turned my focus of my research and my work in that direction, and that has not let up ever since.

And the sort of twist in this story is a bunch of years ago, I went back to my home where I grew up in Connecticut, and you know when you’re an adult and you go back to your old childhood bedroom, the things that are left behind where you’re like, “Oh, yeah, I didn’t care enough to take this with me when I moved to college or whatever.” I found a box of index cards from, it was the bibliography of a paper I wrote in 1992 in high school. So the high school paper. And the high school paper was on vegetarianism because I was a vegetarian in high school. And I, at random, pulled an index card out of that box and it was a quote from a book or something, and it said something along the lines of, “More and more people are turning to a vegetarian diet to avoid the toxic chemicals found in food.” And I was like, record scratch. What?

Evelyne: That’s so cool.

Lara Adler: That was so long ago. That was in the early 90s, long before I stepped into health coaching. So it was just kind of an interesting connection.

Evelyne: Yeah, that’s amazing.

Lara Adler: So perhaps I’ve always been attracted to this space.

Evelyne: Yeah. That’s really cool. Along with weight loss, which is what caused you to look into this more, what are some of the most common issues that practitioners see where toxins probably play another role when you’ve exhausted some of the other options?

Lara Adler: Yeah, so I mean, it’s a simple question that’s actually kind of hard to answer because the answer can be anything. Environmental chemical exposure is ubiquitous. 100% of people are exposed to varying degrees to varying chemicals. And environmental chemicals as a whole, they can impact every single organ system in the body. And so the way that a symptom might show up for one person can be dramatically different from how the effect of a specific exposure might show up for one person. So even if we look, for example, at BPA or bisphenol A, there’s dozens of endpoints that can be affected, everything from inflammation in the gut and changes in the gut microbiome to cardiovascular disease and to obesity and to weight gain, and then hormone disruption. And if somebody is pregnant and exposed and their fetus is a boy, well that exposure might have a different impact than if the fetus is a girl.

So the answer is really, it’s hard to pin the tail on the donkey, which is why at a baseline, I really strongly believe that health professionals should be addressing as many avoidable exposures in their clients and patients, just to kind of clear the noise, if you will, kind of clear the mud because these exposures are going to be affecting everybody. But it is hard to pin the tail on the donkey because there’s so many different endpoints.

Evelyne: Right. Before we go further, I want to talk about the terminology a little bit of toxins versus toxicants. Can you explain that?

Lara Adler: Yeah, sure. So most people universally are using the word toxin. Under strict definition, a toxin is really something that is derived from a plant or an animal. So it is natural, whereas a toxicant is in reference typically to a manmade chemical like a bisphenol or a polychlorinated biphenyl or PFAS or whatever. So that’s generally the distinction. That said, there are still many people in the research realm in the published literature that will use the word toxin as it pertains to just any substance that has a toxic effect, including manmade substances. The correct term is toxicant, but a heavy metal is not manmade. That is a natural, it’s an element. And so that sort of, well, it’s not from an animal, but it’s not manmade, and so is it a toxin or a toxicant? The lines get kind of blurry. Some people in academia make a big distinction, and most spaces outside of academia don’t make that distinction as clearly.

Evelyne: Yeah. And I feel like now it’s accepted to say environmental toxins. So that’s what we’ll be using. Yeah.

Lara Adler: Yes. And that’s fine. And so in conversation, sometimes I will say toxin and sometimes I will say toxicant, but I am still referring to the same sort of discussion of toxic chemicals.

Evelyne: Yeah. So let’s contextualize this landscape of toxins a little bit from a chemical and a regulatory standpoint. Why does this all matter?

Lara Adler: Yeah, I mean, that also is a big question. We could be here for a whole hour just answering that. So roughly speaking, it matters because like I said, all people are exposed. There’s no corner of the planet where people don’t have some degree of exposure to some toxic chemicals. Certainly not all chemicals that we are encountering or exposed to are necessarily harmful. The problem is that we don’t have data on the majority of chemicals in commerce. So globally, there’s about 350,000 chemicals or chemical mixtures registered for use in all of the different governmental registries that exist around the world. And we don’t know anything about most of those.

Evelyne: That’s crazy.

Lara Adler: We don’t know anything about them. We don’t have safety data, we just don’t know anything about the molecular structure of them. Some of that is because the companies that manufacture this chemistry, they state that it’s proprietary, it’s a trade secret, they don’t need to tell anybody about it. And there is no filter that chemists need to put their … There’s no registry where a chemical gets registered and immediately it gets tested and it gets a stamp of saying safe, not safe. That process doesn’t exist. And that sort of ties into the landscape of the regulatory actions that exist around chemicals is in some places they’re stronger than others, but across the board, they’re not strong enough. And so we don’t have good regulations of chemicals and commerce here in the United States. We don’t. For decades, we have taken this innocent until proven guilty approach to chemicals, which really puts the consumer as the sort of the test bunny in this equation. And it puts the burden of proving harm on the individual who has to go up against a large multinational corporation. And that is near impossible.

And so the legal framework that we have in the United States to pursue recourse from chemical exposures also makes it very hard for consumers to sort of take down, if you will, the corporations that are behind the exposures that we’re all getting. So it’s kind of a minefield, but at the end of the day, like I said, there’s hundreds of thousands of chemicals. Certainly not all of them are bad. Not all of them are harmful. We don’t want to make that assumption. There are many chemicals that are in use that have made our lives better and safer and longer, and we have to appreciate those.

And at the same time, we are also seeing hundreds of chemicals that are being measured actively in people all across the planet through human biomonitoring studies that countries will run. Just because a chemical is inside us doesn’t automatically mean that it’s harmful. But we do have decades now of research exploring, “Hey, what is happening with these exposures that people are getting and are there detrimental outcomes?” And there’s, like I said, thousands, decades worth and tens of thousands of studies that are showing, “Hey, when we look really closely, we are actually seeing biological effect. We are seeing harm.” And that’s why this is something that we should all care about. We’re all exposed, we all have chemicals in us. Most of us are dealing with some type of health issue. I mean, I don’t know anybody that doesn’t have at least something, small or large, that they’re dealing with. And I think that’s part of this big conversation.

Evelyne: Yeah, and we’ll dive into some of those toxins in a little bit. I want to talk about something that I see when people, and I’m referring to things you see on social media when people say, “Oh, it’s not a big deal. It’s overblown in our field.” And of course I feel like they maybe have not looked at the research, but one of the arguments that comes up a lot is, “The dose makes the poison.” Can you explain why that might not be accurate and why maybe that’s looking at things too simplistically?

Lara Adler: Yeah, so “The dose makes the poison” is sort of the foundational dogma. The journal, Nature, published an article many, many years ago on this, and they refer to it as foundational dogma of the field of toxicology. And the concept of “The dose makes the poison” was developed by Paracelsus in the 16th century, so a minute ago. A minute ago. And not updated since. And so what “The dose makes the poison” says in essence is that in order for something to be harmful, it’s actually the dose that indicates that harm and it follows what is known as a linear dose response curve, which is if you plot XY in a graph, it’s just a straight line that goes either up or down, but it’s linear and it’s predictable. And what that says is the more exposure that you get to something, the worse it is and the less exposure you get, the less harmful it is.

And this paradigm of “The dose makes the poison” is what I like to call true, but partial. It is true. There’s no debating that many exposures to many things follow that linear path. And that’s sort of been the rubber stamp approach is the assumption that everything follows that path. So for example, we know that radiation has a linear dose response curve, a little bit of radiation, our bodies can tolerate that, it’s no big deal. Too much radiation and we will die. Period. So that’s a very linear, it’s a very predictable exposure path.

When it comes to environmental chemicals and specifically endocrine disrupting chemicals, of which I think there’s been about 1,400 that have been identified so far that have … These are chemicals that have endocrine disrupting properties, and I should say substances. It’s not all synthetic chemicals. It can be heavy metals. There’s some plant compounds that can behave in these same ways, but when it comes to endocrine disrupting chemicals, those chemicals don’t behave in that linear predictable way. That’s where we have, and I can get into how they do behave, but that “Dose makes the poison” kind of knee-jerk response because I also see it a lot on social media. Again, it’s true, but it’s outdated. It’s not a full scope. And when people pull that line out as a defense to what they’re saying or as an argument against what I’m saying or somebody else is saying, it shows me that they just don’t have a full understanding of how chemicals interact in our bodies.

What’s interesting to me is because I’ve had conversations with academics, the people that are actively doing in publishing research on this topic, I ask them if they have to have this debate about whether “The dose makes the poison” in their field. And the response that I’ve received when I asked that question is like, “No, it’s well accepted within academia” that what are referred to as non-linear dose response curves, which is the way that a lot of endocrine disrupting chemicals behave. They’re like, “Yeah, no, we get that. We don’t have to fight that battle within this pocket of academia because it’s well understood.” Outside of that pocket, people are still kind of poo-pooing this idea that low levels of exposure could actually be more harmful.

And if we think about the endocrine system, it really very clearly explains how that could be because the endocrine system, our natural endocrine system that is producing hormones, that are regulating everything from your mood and your body temperature to metabolism, to fertility, to growth, to development, to literally everything. The amount of hormones that move through our body to facilitate all of the things that hormones do is minuscule. It is a infinitesimally small fluctuation in hormone.

The example I often give is if you’ve ever been around a teenager going through puberty, or if you can recall when you went through puberty, or if you’re older and are going through menopause, although those feel like absolutely seismic changes in our physiology and our mood and our development, in reality, the changes in hormone levels in the body are very small. Parts per trillion type levels, incredibly small levels. And that’s because our endocrine system is designed to function with this incredibly low frequency or low volume of hormones that are messengers. We have a finite number of hormone receptors. We don’t have infinite hormone receptors. We have a finite number. And so less matters more because more, if all your hormone receptors are busy, more isn’t going to do more. They’re all full. All those receptor slots are full.

So because we know that the human endocrine system responds and functions at this incredibly tiny level, when we consider xenoestrogens or these endocrine disrupting chemicals that we’re exposed to at these similarly infinitesimally small levels, it’s no wonder biologically why they’re having an impact. If you think of it from sound frequency, the volume is low, it’s tiny, it’s quiet, and it’s at the same frequency that our body is naturally designed to work on. And that’s why endocrine disrupting chemicals are the most concerning, certainly to me, and certainly this is reflected in a lot of the people that are in this space academically, that endocrine disrupting chemicals are some of the biggest concerns because exposure is ubiquitous and we’re getting exposed at these teeny tiny levels. Which is exactly the frequency or level of exposure that our own body, our own biology, is designed to work on.

If you talk to a endocrinologist and a pharmacologist, they will both recognize as just a point of fact, that low doses of exposures can have a huge dramatic impact. You talk to toxicologists who are stuck in that Paracelsus, “The dose makes the poison” paradigm and refusing to budge from it, it’s like these different ends of the spectrum that don’t talk. And toxicology and pharmacology are the same discipline that just exists at different ends of the spectrum. It is the same discipline. They just don’t communicate with each other.

Evelyne: That’s a great explanation. So a couple of questions. What are the most common endocrine disruptors? And you talked about the receptor binding as one of the ways in which they have their detrimental effects. So what are some of the others? And then also, when does it matter most? When in life does it matter most?

Lara Adler: Okay, those were three questions. So the first one, I’ll see if I can remember all three of those as I move through this. So the first one is what are the most common ones? I think the question is for me, is where are we most exposed? And so we are most exposed to endocrine disrupting chemicals in our daily lives as just people alive on Earth is through plastics, through personal care products, through fragrances that are just ubiquitous in our personal care products and our household cleaners. There’s even, this is so stupid, but I saw last year at the hardware store that they were selling paint for your walls, and you can add lavender scent to your paint on your walls. Garbage bags are scented. There’s just so much scent that is utilized in so many different places that are just completely unnecessary. And so those are all exposure sources. Certainly we have PFAS exposure, which is ubiquitous also. PFAS are these per- and polyfluoroalkyl substances that are found in non-stick cookware, and food packaging, and drinking water among hundreds and hundreds of other places.

But these are the chemicals that are showing up most commonly in these human biomonitoring studies. I think 93% of people tested in the most recent data that we have levels of bisphenol A, 98% have phthalates. These are two plasticizers. Phthalates are found in fragrances and plastics, and BPA is found primarily in plastics, but certainly in other places as well. And it’s estimated that 99 to 100% of people have PFAS chemicals in their body. So these are some of the most ubiquitous, and I’ve already forgotten the other two parts of that question.

Evelyne: So what are the ways in which they function in our body to have their detrimental effects? But then what’s interesting about that, especially with the parabens and phthalates, they don’t actually stick around in our bodies like some other things do.

Lara Adler: Yes.

Evelyne: So we actually do eliminate them, yet they still have detrimental effects.

Lara Adler: Yeah. So I’ll talk about that and then I’ll get into some of the end points because to your point, hormone docking or hormone binding or hormone mimicry is only one sort of mechanism. There are many mechanisms, and in many cases, we’re still figuring out what the mechanisms are. We just see the associations and the associations can be strong, but we’re still figuring out what the mechanism is. But to your question about the things like parabens and phthalates and BPA and certain pesticides that actually are metabolized and move through the body very quickly, those are referred to as non-persistent chemicals that don’t build up in the body. That’s great. We know that for some chemicals like BPAs and phthalates, they can be broken down, metabolized and excreted within a 6 to 12 hour window. Amazing. That tells us a couple of things.

One, it tells us that our bodies do know how to get rid of this. It’s not going to build up, but that we have CDC data from NHANES, which is the biomonitoring study that we test chemicals in because we have populations that have 93% of the population has BPA, and 98% has phthalates. What that tells us is our exposure is coming into our bodies faster than we can metabolize them. So we’re just taking, it’s like I think … I always think of the I Love Lucy chocolate conveyor belt episode. She says, “Oh, there’s so many.” And she’s shoving them in her shirt and in her mouth. We’re taking them in faster than we can process them, and the result is they’re always there. So in a way, it doesn’t matter if our bodies can metabolize them quickly if our exposure is constant. So that’s sort of one thing.

The other thing that tells us is if we minimize what’s coming in, we can actually lower the levels in the body. We just need to give it a little bit of time, and that time might be 24 hours. And so we know there’s a number of interventions studies that are looking at both things like parabens and phthalates and bisphenols, as well as things like pesticides that say, “Hey, if we slow down the amount that’s coming into the body and we’re measuring urinary levels of these chemicals, we can see a dramatic drop in just a few days.” So there’s at least four or five different studies of pesticide avoidance interventions on both children and adults that all come to the same conclusion that if you practice avoidance behaviors, meaning switch from say a conventionally grown food to organically grown food, which has way less pesticides and none of those super toxic ones, that you can lower circulating levels of pesticides in the body by 80 to 90% in 3 to 5 days.

Evelyne: That’s a lot.

Lara Adler: That’s all it takes. It’s a lot, dramatically. Because you’re just not taking it in because if you just give your body the chance, it can metabolize them out. But it’s the give your body a chance part that we don’t … Unless you’re proactively seeking out ways to lower toxic exposures, that’s the part that’s not happening. That’s the part that’s not happening. So that persistence versus non persistence is really important, especially for practitioners that might be having this conversation because those are the biggest needle movers. You make those changes and you can have a dramatic impact on what’s in the body in a really short amount of time. And that might be enough in some instances depending on how a symptom might be manifesting to lower those symptoms. For people that are having respiratory issues or allergenic responses where it’s an immediate reaction to something, taking those things out can result in a immediate reduction of those symptoms.

Persistent chemicals, this is where PFAS come in, the per- and polyfluoroalkyl substances, they’re dubbed forever chemicals. Why? Because they don’t break down. They stick around. They do build up in our bodies, and we are taking them in faster than we can break them down, which is why 100% of the population is estimated to have these PFAS in their bodies. And so the interventions there from a practitioner side are a little different. We always want to center avoidance behavior. Yeah. Okay.

So getting back to that middle part of your question about what are some of the other endpoints. So there are endless endpoints. It’s not just hormone binding or hormone blocking, which is a very common endpoint, but we also see things, for example, like bisphenols are linked to gut dysbiosis, inflammatory bowel disease, inflammation of the GI tract that can lead to leaky gut. So that might be a contributing factor to whether it’s autoimmune disease or autoimmune flares, if people are dealing with leaky gut where they have food particles from their GI system leaking into their bloodstream and their body’s going, “Red flag, that’s not supposed to be here. Mount an immune response.” And so that is just one example.

Another example, and I find this to be one of the most interesting effects of certain endocrine disrupting chemicals, is the activation of what’s called the PPAR gamma receptor, which is this master regulator of fat cell development. And if PPAR gamma gets activated when a cell is in pre-development, like when it’s a stem cell, it can change the marching orders of what that cell will become and it will say, “Hey, we want more. We want you to be a fat cell.” And so what that results in is an increase in the number of fat cells in the body. Just the volume of fat cells are increased just through activation of this PPAR gamma receptor. And there’s many toxic chemicals that can activate that receptor.

Similarly, if that PPAR gamma is activated in the presence of existing fat cells, it can increase the capacity of those fat cells for storage. So that means the fat cells that we have can now hold more fat than they could before. And so both of those outcomes can result in weight gain, obesity, metabolic disorder, cardiovascular disease, if you just continue down that line. And that has absolutely nothing to do with food intake or energy expenditure. We know that there’s many pharmaceutical medications that have a side effect of weight gain. Some of them work on that same pathway. They’re activating PPAR gamma, has absolutely nothing to do with what you’re eating or not eating or exercising or not exercising. And in pharmacology that’s referred to as chemically induced weight gain because that’s what it is. And we know that some of the chemicals that we are exposed to, endocrine disruptors included, can have that fact. They can activate PPAR gamma. So that’s just another example. There are thousands of endpoints, like I said, every organ system, every type of tissue can be affected. It’s not just altering our hormones.

The challenging thing is you can have a single chemical like a bisphenol A, that in and of itself, it might have a dozen or two dozen different endpoints. So many different ways it can impact our health, not just through the process of altering our hormones.

Evelyne: Right. And then it’s hard to study the cumulative effect of all of these different things.

Lara Adler: It is, there’s more and more research that’s starting to look at either what’s referred to as the cocktail effect, which is this endocrine disruptor plus this one, plus this one, and how do they act synergistically in the body. It’s incredibly complex to do that because the more variables there are to adjust, the more kind of muddy the data gets. And so this is why things are studied in isolation because it’s easier, because you can clear out all the noise. So it’s either people that are looking at this sort of cocktail effect of one or two exposures happening simultaneously, or there’s a sort of subfield of exposomics, the exposome of what is the totality of exposures that people are getting across all types of chemicals and how does that affect us? And that’s obviously very complicated research, but it’s important to consider the totality of exposures that we’re getting because we’re not just getting one.

It would be so easy to say, “Oh, we are just getting exposed to phthalates in fragrances.” But also it’s phthalates, there’s dozens of types of phthalates. There’s phthalates in plastic that are high molecular weight. There’s phthalates in fragrances that are low molecular weight. Each one of those behaves differently. So it’s complicated.

But to your other question, which was the third part, which is what is the most vulnerable time or who matters the most?

Evelyne: Yes.

Lara Adler: Really that is anybody of childbearing age, anybody who is pregnant. That preconception and pregnancy window, that is the most important. Your developing fetus is the most vulnerable because the body’s literally being built and hormones are driving that construction process. And if we throw in some synthetic hormones in the form of these endocrine disrupting chemicals or whatever, it really can sort of throw off the direction of development. And that can result in everything from genital malformations. We certainly have seen that both in animal studies and in people as well as increased risk of chronic disease in adulthood. So there’s a field, again, another little subfield that’s looking at the fetal origin of adult disease, and it’s saying, “Hey, what happens in utero can ultimately be the origin story, if you will, of that cancer that develops when someone’s in their 40s, 50s, or 60s, or the metabolic disease that kind of kicks into gear after puberty.” That’s why this is such an important population.

So some of the students that I really love having in my community are people that are working in preconception planning and fertility. There’s so much good work that can be done there, that should be done there to really optimize the health of future generations through minimizing toxic exposures now.

Evelyne: Yeah. I think this is so scary because it’s like we don’t have any impact. Well, we do have an impact on what will manifest later on, but it’s like we obviously can’t go back. And I think as integrative and functional medicine practitioners, we’re aware of this because looking at that functional medicine timeline and talking about in utero exposures. But it’s scary to think when you’re born, you may already have the predisposition to develop an autoimmune disease in your 40s or 50s or 60s based on that. So yeah, it’s scary.

Lara Adler: Yes and, because this is where the power of epigenetics comes in because just because we have these genes does not mean that those genes are going to get expressed. And so we have a ton of really good research showing that lifestyle factors, everything from not smoking, to exercising, to managing your stress, to lowering your toxic exposures can positively influence your epigenome and the expression of your genes. So we can turn on and turn off the expression of these cancer genes and what have you. I know it’s not quite as simple as a light switch, but there is a lot of power that we have in how we live our lives.

And so for people that might be afraid in hearing about these prenatal exposures or pregnancy exposures and utero exposures is like, “Great, how can I get my child or myself to be the healthiest version of myself so that all of those, or as many of those ‘bad genes’ or genes that are associated with the disease can be tamped down, can be dampened?” And that we can optimize our health just through normal everyday behaviors. Eat nutrient dense food, get good sleep, move your body, manage your stress, all the basics. Those are all things that can positively influence our epigenome. So it used to be a gun analogy, which we’ve moved away from because we all don’t need to be talking about guns in 2024 for… talk about a health effect, is your genetics opens the door and environment pushes you through it. That’s the less violent analogy-

Evelyne: I like that.

Lara Adler: … Than the gun analogy that’s often used is your genetics might open the door to disease, but your environment, and that includes all those lifestyle things. That’s the thing that pushes you through that door or not in some cases.

Evelyne: You mentioned breast cancer genes, and I don’t remember exactly what they studied, but you mentioned a study to me last week in which they studied breast tissue. Can you talk about that study?

Lara Adler: Yeah.

Evelyne: I think it really speaks to this.

Lara Adler: Yeah. Yeah. So this was a small study that was looking at the various markers for breast cancer in otherwise healthy women. So no history of breast cancer, no history of any other type of cancer. I think the exception was melanoma, but that’s very obviously not … That is an environmentally triggered cancer. So there’s no genetic component to cancers for these women. And so what they did is just these are women using normal, your standard average personal care products. And at the beginning of the study, they took a fine needle aspirate sample of their breast tissue looking for these markers. And then they had them switch to personal care products that were free of phthalates, parabens and, which I think there might’ve been maybe one or two other ingredients in there that they were minimizing exposure to. But those were the primary ones.

And then they resampled the same women’s breast tissue after 28 days. And what they found were in healthy women that the breast cancer markers dropped after 28 days to a normal state, which implies that they were not normal prior, and all it took was 28 days. And all of those chemicals are non-persistent. They don’t build up in the body. So 28 days was sufficient to kind of flush them from the system.

And we have so many people in the cosmetic formulator space that will just say, “It’s a bunch of fear-mongering and these ingredients are perfectly safe and parabens are one of the most studied ingredients, blah, blah, blah. It’s been used for 50 years, blah, blah, blah.” As if that is evidence of safety. And we have decades now of research that are showing in multiple different ways, some of these endocrine disrupting chemicals are very strongly associated with breast cancer. And this was an interesting way to … We don’t know mechanism of action in that particular study. That’s not what the study was looking for. And it’s a small study and it needs to be replicated, but it was a really eye-opening study. And the study authors concluded by saying basically that avoiding or practicing avoidance behaviors when it comes to these ingredients is a viable breast cancer prevention strategy.

Evelyne: That’s amazing. Those are strong words.

Lara Adler: Yeah. I’m paraphrasing a little bit. I don’t remember the exact phrasing that they said, but we should be implementing this across the board. And so I think it’s just really interesting research. I mean, there’s so much good research that’s coming out and at this point, if people continue to be stubborn and not open to new science on things like ingredients in cosmetics, then they’re going to get left in the dust as the rest of us become more aware and look at the science. It’s really hard to dismiss 20 years plus of data on these topics, but we have people that really dig in their heels and they continue to do so, which is just frustrating and it does nothing but harm the consumer.

Evelyne: Yeah, definitely. And speaking of research, when you were talking about the biomonitoring studies and looking at cumulative effects, I did want to mention Dr. Robert Naviaux has a lab here in San Diego at UCSD. He was one of our speakers at our Designs for Health CASI Conference in 2022. And I didn’t realize until I met him and I actually got to go visit his lab that there are researchers actually doing these studies looking at cord blood, looking at breast milk and looking at the overall exposure. And it’s just very encouraging. I haven’t looked recently to see what research has come out of that lab, but hopefully over the next few years we will have a lot more information on that overall total toxic burden.

Lara Adler: Yeah, I mean definitely it is very heartening to see that we have this enormous uptick in interest in this topic, and that interest leads to more research, and that research leads to more data and more sort of crumb trails to follow and go, “Oh, wow, I just discovered this. Let’s go follow that.” And that’s the process of science. And I remember almost a decade ago setting up a Google Scholar alert for new research on endocrine disrupting chemicals. I remember at the time I would get one or two emails from Google Scholar a week and each email would have whatever since the last email was sent, whatever new studies were published that had those as keywords. And there used to be maybe two or three, three or four. Now I get a Google Scholar alert every single day, and sometimes there’s only one or two, but sometimes there’s six or seven every single day. If you go into PubMed and you do a search on endocrine disrupting chemicals and you see that little timeline graph that they have of the volume of studies that reference this, it goes right up.

And so I just love that there’s so much good research coming out and there’s so many curious people that are asking smart questions and trying to find answers. And it’s complicated because we don’t test chemicals on people. Ethically, that’s not it. Certainly historically, we have instances when that’s happened and those are not okay. But as a general rule, we don’t test chemicals on people. We test chemicals on animals, we use animal models, and then we look at mechanism of action. Typically, animal model testing starts at high doses, far beyond what people would be getting. And that’s one of the arguments against that, “Oh, well first I’m not a rat.” And then that rat was given 10,000 times the dose, 100,000 times the dose that I would ever get. And there’s lots of reasons for that, and that’s not the best reflective research, but it’s still important research. And then hopefully those animal studies are starting to dial back on that exposure model.

And we now have a lot of research that’s looking at what are called background levels, just like the levels that are comparable to what people are getting just from being alive and looking in animal studies at that. And so we have this animal data where we test directly and we’re trying to tease out what is the mechanism, what’s happening here?

And then we look at human epidemiological data and we are looking for associations that we see. And oftentimes the data that we see from human epidemiological studies mirror exactly what we see in animal studies, and it’s how we do nutrition science. I mean nutrition science, we obviously can do a little bit more. We have a little bit more leeway in terms of putting people on this diet versus putting people on that diet. But we’re just looking for these associations. And there are certainly some sort of detractors to this whole field of environmental toxicity saying, “Oh, it’s just a bunch of … The science isn’t there. It’s a bunch of fear-mongering, and these chemicals are totally safe.” And what I find fascinating is the data that they present to “prove safety” are animal studies. Yet at the same time, if you show an animal study showing harm, they go, “Well, I’m not a rodent. And so that’s not relevant to humans.” And it’s like, well, you can’t use that model to both prove safety and not prove harm. You can’t have it both ways. Either the model’s good or the model’s not good. Period.

And so I just see a lot of that sort of mental gymnastics in trying to prove a point in this conversation, which again, it just does a disservice to the individuals that are speaking out hopefully in an informed and educated manner on this topic. And certainly adds to the confusion for consumers. Consumers are so confused about this. Do I worry about it? Do I not? A lot of the confusion comes from the way that the topic is presented. If it’s presented in a sort of sensational or fear-mongering way, that’s going to turn people off. And science communication is an essential part. It’s one thing to have this knowledge for consumers and certainly for practitioners, it’s another thing to communicate it in a way that isn’t scaring the pants off people or opening the door to people just being like, “Ugh, whatever. We’re all going to die one day.”

Evelyne: Yeah. Lara, you’ve taken me right into my next questions.

Lara Adler: Amazing.

Evelyne: I love that you take a nuanced approach to all of this. It is very complex. It is overwhelming for consumers and for healthcare practitioners. And because you teach practitioners, not just everything we’ve been talking about, like the nuts and bolts of all the different types of chemicals and their health effects. But you also teach practitioners how to communicate those effectively with patients both in a one-on-one setting, a little bit also on social media because I mean, the reason I keep mentioning if … Someone listening is like, “Why does she keep talking about what’s on social media or in the news?” But that’s where people are getting their information.

Lara Adler: Where people learn.

Evelyne: So what are some of the most common mistakes that you see practitioners making when they are talking about toxins?

Lara Adler: I mean, there’s a lot, unfortunately. I think one of the biggest ones is in no particular order because all of these are equally offensive to me, is making really broad general statements. All chemicals are bad. If something is natural, it’s automatically safe. The sort of nature fallacy that’s really common that basically says, “Hey, if something is natural, it’s totally safe.” Well, you know what? Asbestos is natural, lead is natural, opium is natural. All these things, they’re not safe. They’re not safe. So that’s part of it. So just making broad general statements, isn’t it. I think that’s a big mistake because it really just shows that somebody doesn’t know the nuance. They don’t have the nuance to be able to say, “Yeah, this is harmful, that’s not harmful.” So that’s one.

Another one is not talking about toxicity and toxic exposures and health effects in general ways that don’t connect to the specific problem or problems that someone’s audience might have. And this is obviously very specific to practitioners. For people that are a general practitioner, okay, sure, they can have a little bit more of a broad conversation. But if somebody is talking, their client or patient base are people that have autoimmune disease or metabolic disease, then the way that we get people’s attention and to get them to see it’s important to discuss this is to make it relevant to them.

If somebody has a metabolic condition that they’re actively trying to find a solution to, and you are talking about environmental chemicals through the lens of metabolic disease and how these things might be contributing to what a patient is dealing with or what a client is dealing with, they’re going to pay more close attention than if you just say, “Hey, toxic chemicals are bad and plastic is bad and fragrance is bad.” So getting really specific I think makes a big difference.

It’s definitely top of my list, and I said in no particular order, but I’m going to rescind that there is a very particular order is the sensationalism and the fear-mongering. Oftentimes this can be unintentional, but it’s using language like, “These chemicals are making you fat, they can kill you.” That kind of heavy-handed language one, doesn’t factor in the nuance. There’s so much nuance. As I like to jokingly say, but not really. I’ve said it a couple of times here, is if you don’t start your answer with, well, it depends, you’re not doing it right because there’s so many variables and it does depend on those variables.

And so having that sort of over the top “OMG, I have something shocking to tell you.” That tone already incites anxiety in people. And I can tell you after being in this space for more than a decade, there is already enough anxiety around the topic of toxicity and toxic exposures. We do not need to be adding to that. And so that’s to me, the biggest defense is just taking that sensational fear-mongering kind of heavy-handed approach, threatening language, stuff like that. That’s not how we kind of motivate people to take action. We really want to take a balanced approach.

Evelyne: Yeah. And where do you suggest that all practitioners start with their patients? What are the top things that they can tell their patients to do right away that have the biggest impact, lowest cost?

Lara Adler: Yeah. Okay. I like this question because I think a lot of the instinct sometimes from the practitioner’s perspective is to kind of go full on and everything needs to get taken out, and that’s just not practical for somebody to implement in their daily lives. So I really look through the lens of start with what’s free and easy. So what’s free is things like ditching the scented candles. Just throw them out, all of those fragrance, the plugins, the sprays, the diffusers, the incense, all of that stuff, to just get rid of those because that is going to dramatically lower the types of indoor air pollutants that you’re constantly introducing into your space. Even if you don’t light the candle, it’s still polluting. And so just toss all those things and in the long term that will save you money because you won’t be buying them again. And so that is beyond free.

And then we have things like open your windows, get some fresh air into your home, take off your shoes when you come into the house so that you’re not tracking pesticides and heavy metals. It’s not just about dirt and dog poop. It is about some of these other contaminants that matters more in households that have children, small children that are crawling around on those floors. Or I should say if you have a pet in the house because pets are closer to the ground and interacting with those. So those are some of the really low hanging fruit is just those things that are free.

When we move into the easy space, this is where we start phasing out like plastics in our kitchen and say, “Hey, instead of using these plastic Tupperware containers or reusing my plastic takeout box or whatever, I’m going to just invest a really small amount in glass containers that aren’t going to leach endocrine disrupting chemicals into your food.” You can even reuse a glass pickle jar, a glass tomato sauce jar. If folks are on a budget and they don’t have the funds to go out and buy new glass containers, they can simply reuse a pasta sauce jar, reuse a pickle jar, use a peanut butter jar, provided that it’s glass. So that’s an easier intervention.

Certainly starting the process of addressing personal care products and swapping those out with ones that have better ingredient profiles, less of these toxic endocrine disrupting chemicals. Household cleaners, that’s another area that includes things like laundry detergent, and I don’t usually make the recommendation that if you have your classic standard household cleaners and laundry detergents Tide and whatever, you don’t have to throw those out. Just when you’re done, when the bottle is empty, replace it with something better. It’s a process. It’s the long-term exposure to these things that matters more than the short-term. And so it’s not a panicked mad dash to clear everything out of the house in a 48-hour period. That’s not what we’re aiming for. If somebody has the wherewithal and the budget to do that, more power to them.

But this is a process that can be stretched over time. I always used to share that I didn’t replace my bed, my mattress until I was seven years into doing this work because it was a big expense. So I did all the other things first, and then you can slide into those bigger heavy hitters. But the easier part, and I say easier because that’s relative. How easy is it for somebody that maybe is more affluent to suddenly swap out all their personal care products and their household cleaners. On somebody who’s less affluent, who’s at a really tight budget that might be harder for them. So it’s easier. It’s very relative, and I think as practitioners, we have to really be tuned into our audience and who is it that you’re serving? And on social media, we have to recognize that the audience is oftentimes a lot wider than who we might serve in our practice.

Evelyne: Yeah, absolutely. Yeah. Thank you for sharing all those. They seem very doable. I actually found myself exhaling a little bit as you were talking.

Lara Adler: Yeah, you do those things. Yeah, I mean, like I said, it’s a process that can take as long as it takes. I don’t care how long it takes for somebody. If they’re still taking forward steps and starting to minimize exposures in all the places that they know and that are reasonable and accessible to them. Amazing. Great. Keep doing that. I think there’s a lot in the wellness space, whether it’s intentional or not, there’s a lot of judgment and there’s a lot of positioning health and positioning wellness as something only some people get, and that some people are people that are more affluent, and I think that that’s not okay.

Evelyne: Yeah, thank you for sharing that. It took me a while too to gradually replace things, and even then, some things have snuck back in. More takeout coffees than usual, but overall, I feel like for probably as long as you and I have been in this space, we’ve had a general understanding of it, and hopefully we can get more people on board with that gradual process of replacing things with healthier options.

Lara Adler: That has happened. We have seen a huge uptick in awareness. Even in the 15 years that I’ve been in this space, so many more people now are aware of these topics, and some of that is because we’ve had these big public incidents, whether it’s lead in the drinking water in Flint, Michigan or the East Palestine train derailment in Ohio that released thousands of gallons of vinyl chloride, highly toxic into the environment. There’s an awakening, if you will, of PFAS being everywhere. So people are more aware now than they used to be, but they still have a lot of questions, and just because they’re aware of these things doesn’t mean that they know how to actively avoid them. And then also we have social media that didn’t exist in the way that we didn’t have it. We had Facebook 10 years ago, but we didn’t have Instagram and we didn’t have TikTok where information just spreads so quickly. And like you said, although it’s not the best place to learn, there are people that are learning about these topics on social media.

And for consumers, I think that’s great that they’re following accounts that are presenting information accurately. For practitioners, I don’t think social media is where we want to be doing our learning. The topic is way more nuanced and complicated than any single post could ever possibly get across in the 2,200 characters allowed in an Instagram post or the 90 seconds you have in a reel. You just can’t do it justice. So it’s a great place to get a feel for the topic, but there should ideally be some continuing education that happens, regardless of who that happens through, I think all practitioners should become more aware of this.

Evelyne: Yeah, definitely. And we will link to your Talking Toxins course, and I watched two of your webinars over the weekend to prepare. Excellent work. I just love everything that you put out there. You also have an environmental questionnaire that practitioners can download. Do you have that link?

Lara Adler: Yeah. So it’s just laraadler.com/intake, and this is a list of environmental health intake questions that you can ask and then kind of integrate or fold into whatever new client or patient intake that somebody has. Because asking the right questions just the same thing as it is with nutrition and lifestyle and anything else, it helps forge the path for the practitioner to say, “Okay, I can already connect some dots. I can see some red flags or some places where there’s opportunity to educate and maybe make some changes.” And if we’re not asking those environmental health related questions, we are potentially missing out on some really valuable information that can help us really optimize the health of the patients or clients that you guys are seeing, that everyone’s seeing.

Evelyne: Yeah. Thank you. And we’ll link to it in the show notes as well. One more resource that I wanted to share that I just learned about from you from watching one of your webinars was the Clearya app, C-L-E-A-R-Y-A. I downloaded it as an extension on my browser and was really impressed.

Lara Adler: Yeah, it’s really good. So Clearya, it’s both an app and a browser extension. On the app, you can scan product labels and it will tell you like, “Hey, these ingredients are respiratory triggers and these ingredients are allergenic and these are carcinogenic.” You decide what you want to do. And the browser extension does the same thing. If you’re shopping on Amazon or Sephora or Walmart or Target, it scans ingredients and will tell you if there’s any sort of warnings. What I like about that app is that it doesn’t use a rating system. A lot of the apps and sort of resources in this space to look up toxic ingredients in products use a rating system. So they’ll give the product either a numerical score or an A, B, C, D, E, F type score. I don’t typically recommend those because those ratings, the number or the grade that it gets is only as good as the methodology behind the scoring system.

And if we go back to what I had said, I don’t know, an hour ago, 50 minutes ago, we don’t have a lot of data on a lot of ingredients, and so it’s really hard to … What kind of weight do you give an ingredient that has very little data? You can’t do that. And so I don’t like the methodology of most of the apps out there, which is why I really like Clearya because it doesn’t use a rating system. It just tells you these ingredients have concerns and then there’s links out to all their sources if people want to read studies. So it’s a good app.

Evelyne: Amazing. We’re all about sharing resources and clinical pearls on the show. I have some more rapid fire questions for you to wrap it up that we ask every guest. I know we haven’t actually talked about supplements, and I actually love the topic of supplements when it comes to this conversation, but what are your personal favorite supplements?

Lara Adler: Oh gosh, probably just magnesium and honestly, a daily multi. I used to be way more intense with my supplement regime, but now if I can remember to take my multi, and I’ll just say, Evelyne, I talked to you last week. The dish of supplements is still sitting here. I still haven’t taken them. I have some favorites. Whether I actually take them is something else altogether. But yes, it’s mostly just a magnesium and a good once a day multi that fills in any gaps that I might have.

Evelyne: Great. And then what are your top favorite health practices to support your health and wellbeing?

Lara Adler: 100% sleep. I am obsessive about sleep. Years ago, I had some health issues that some of the manifestations, some of my symptoms were raging insomnia, and that lasted like a year, so not sleeping for a year, it was really bad. And so I became really obsessive about sleep hygiene and I have the white noise machine and blackout curtains and no electronics and it’s cold, and I have my humidifier because I live in the desert and I go to bed, I shut off my phone, all of those things. So that definitely is one of the top practices.

Certainly I walk my talk in this space, so I really do prioritize non-toxic across the board as much as I can, but I’m also a human being, and so I do go out and eat out and get leftovers, and they’ll put it in a plastic container and I’m going to go, “Okay, well, that’s what it is.” But I have less anxiety about it because I don’t do it that often. So just kind of walking my talk in that space would probably be sort of a broad practice.

And then definitely getting outside. Getting outside, going for a walk, doing something out in nature, away from computers and monitors where I’m on all day.

Evelyne: Yes, nothing better. And then the final question, what is something you’ve changed your mind about through all of these years in this field?

Lara Adler: A couple of things. When I first started doing this work, I myself was quite rigid. And the language that I used to communicate was steeped in “Always. Never. Always do this, never do that. Always do this, never do that.” And I realized over time that that’s so exclusionary because not everybody has the option to always or never in a given situation. And so my language in the way that I present information about this topic has shifted a lot frankly because of my experience on social media and being in front of so many more people than I would’ve otherwise, and really just listening to the feedback and saying, “Well, I can’t afford to do that. What am I supposed to do?” And listening to that. So I think shifting that approach to always, never and being very kind of hard line about like, “Oh my God, never do that. Never do that. It’s so bad.” That kind of tone. I don’t adopt that in any way anymore because I think it’s just not helpful. So that’s certainly one thing that I have … I think that’s probably the biggest thing, honestly.

I mean, there’s lots of small things in the science that I’m like, “Hey, maybe that’s not as bad as I thought after looking at the research again.” But I think that sort of perspective change of making sure that the information that I share and the education that I offer is as accessible. In real life terms, it’s accessible for people, both accessible for practitioners, but also what practitioners share to their clients and patients is also accessible. And so that’s definitely something that I’ve changed my perspective on. I don’t know if I’ve changed my mind on it, but my lens has changed.

Evelyne: Yeah, I love that. Thank you so much for sharing. And Lara, just in general, thank you so much for all of the work that you do, for this conversation today. I always feel so inspired when I talk to you. I do love your Instagram account. It’s Environmental Toxins Nerd. You share amazing information, super useful. And Lara, I just want to tell you as I was preparing for this show, so a little funny background story. At one point I asked Lara if we could write a book together. This was in 2013.

Lara Adler: Yes.

Evelyne: And we were actually working on it for a little while, but then we both got distracted and had too many things going on. But I just love your work around this, and I love that you’ve created a whole career out of teaching this. And just like you talking about toxins, it’s just absolutely fascinating to me. So I just got fired up all over again preparing for our show today. So are you still thinking of writing that book at all?

Lara Adler: Maybe. I mean, I actually still have that fantasy table of contents that we had worked on, I still have it somewhere. Maybe. I think the bigger project that is probably going to be an easier format is doing a podcast. That’s something that I really want to start this year. But the podcast is really going to be focused on interviewing academics. I want to talk to the people that are publishing the research. Oftentimes there is a gap between the research that academics do that are publishing on this topic or really any other topic. And then having a voice to communicate that science to other people outside of the sciences. So it tends to be a little bit of an echo chamber.

And so I’m really interested in talking to research scientists and journalists who do work in this area and clinicians that are doing work in this area, and having that conversation as a vehicle to educate and bring awareness still to practitioners, but really to anybody who wants to listen certainly. And I feel like the hard part about writing a book is you write a book and then by the time it’s published, it’s already outdated. This is such a fast moving space that I feel like a podcast is an easier way and a more timely way to get the same information out there in a more accessible format, especially given everybody’s shrinking attention spans and reading books. The podcast is the way to go.

Evelyne: Yes. Well, good luck with that, and I can’t wait to tune in. That’s awesome.

Lara Adler: Thank you.

Evelyne: Yeah. Well, thank you so much again for this conversation today. I really, again, applaud you for all the work that you’ve done. And thank you for tuning into Conversations for Health. Check out the show notes for the resources from today’s conversation. Please share this podcast with your colleagues. Follow, rate or leave a review wherever you listen. And thank you for designing a well world with us.

Voiceover: This is Conversations for Health with Evelyne Lambrecht, dedicated to engaging discussions with industry experts, exploring evidence-based, cutting edge research and practical tips.