How to Address The Growing Threat of Environmental Toxins
A simple way to start with environmental medicine is to test patients for blood lead levels, test for arsenic in urine, and finally, test for A gamma-glutamyl transferase (GTT), said Joseph Pizzorno, ND, at the 2023 Integrative Healthcare Symposium in New York City.
“Everyone can do these three test, they’re readily available in a laboratory, and the insights that you can reduce for patients can be quite remarkable,” said Pizzorno.
In a panel, Pizzorno, editor-in-chief of Integrative Medicine, A Clinician’s Journal, and his colleagues, Lyn Patrick, ND, and Anne Marie Fine, NMD, FAAEM, spoke of today’s most prominent environmental toxins, their relation to disease, and the importance of testing for them.
The Pervasive Arsenic Problem
“Thirty-five percent of the population have arsenic levels known to cause problems with our health,” said Joseph Pizzorno, ND. “We should be paying attention.”
In 2016 the Agency for Toxic Substances and Disease Registry ranked arsenic as the number one on their substance priority list, Pizzorno stated. The agency determined that based on the chemical’s frequency, toxicity, and potential for human exposure, of all the toxic substances, arsenic posed the biggest threat to human health, taking priority over both lead and mercury.
Over the past 20 years, Pizzorno explained, human research on arsenic has increased dramatically. Studies have shown the substance to be highly disruptive of physiology, linking it to several diseases such as gout, diabetes, and multiple forms of cancer. In addition, arsenic exposure has been associated with immune dysregulation, premalignant skin lesions.
Once a causal relationship between a toxin and a disease is found, said Pizzorno, there are ways to determine what percent of the disease is due to toxin levels. “And the numbers are staggering.” For instance, he explained, 50 percent of gout cases are due to arsenic.
According to Pizzorno, arsenic exposure can come from an array of different sources including water, food, smoking, and wood treated in the past. Ground water is one of the most prevalent sources of arsenic. Ten percent of public water supply have levels of arsenic known to induce disease, Pizzorno stated, and only 50 percent of public water supplies have reported on arsenic levels.
“When you start looking for arsenic, you start to realize it’s all over the place,” said Pizzorno.
Different forms of arsenic, explained Pizzorno, have different half-lives. The two species commonly found in water, arsenate (v) and arsenite (III) are inorganic and can last two to four days in the body. Besides avoiding exposure in the first place, Pizzorno said keys for decreasing arsenic toxicity include maintain normal methylation, normal glutathione levels, and a bioflavonoid-rich diet.
“The need for out medicine is huge, and I hope this project I’ve worked on will serve as an inspiration,” said Pizzorno.
The Arsenic Prostate Cancer Case
Seventy-three million people in the United States are within three miles of highly polluted locations, or superfund sites. That’s 25 percent of all children, 30 percent of all Hispanics, and 26 percent of all African Americans, said Lyn Patrick, ND, medical director of Environmental Medicine Education International, LLC.
“Clearly this is an environmental justice issue,” she said.
For her presentation, Patrick explored the relevance of mercury and arsenic exposure to the diagnosis of prostate cancer. Mercury, according to Patrick, generates high levels of reactive oxygen species (ROS) and oxidative stress. It also depletes glutathione and thiols, leading to increased neurotoxicity. It has also been shown to disrupt the immune system, the endocrine system, and adrenal gland function. And according to Patrick, a significant proportion of people in United States are exposed to dangerous levels of mercury.
“At least five percent of our population is mercury toxic, if not more,” said Patrick.
Preliminary research has suggested that mercury exposure may be associated with prostate cancer. There is evidence of mercury storage in the prostate gland of one human subject, Patrick said. Studies of prostate cancer in animal models using injected mercury have also indicated a relationship.
Research on arsenic and prostate cancer is more plentiful, Patrick explained. According to a study in Environmental Health Perspectives, evidence in both human population and human cells in vitro suggests the prostate is a target for inorganic arsenic carcinogenesis.
“This study concluded that there was a very strong relationship between risk for human prostate cancers and arsenic exposure,” said Patrick.
Considering their harmful effects and their prevalence, it’s essential that practitioners are testing patients for these toxins. When testing for heavy metal exposure, blood tests are not always accurate, said Patrick. Blood levels reflect acute exposure. Inorganic arsenic, for instance, has a half-life of four to six hours in the blood and in turn, abnormal blood arsenic concentrations can only indicate significant exposure immediately after the exposure.
Consequently, Patrick explained, screening for arsenic with blood specimen is not best practice. Instead, urine is the preferred specimen for assessment of arsenic exposure.
It’s no longer a question of “is your patient toxic,” but, “how toxic is your patient,” said Anne Marie Fine, NMD, FAAEM, medical director at Environmental Medicine Education, LLC.
For her presentation, Fine focused on Bisphenol A (BPA), which Fine described as “the poster child for endocrine disrupting chemicals.” BPA, Fine explained, is associated with obesity, cancer, and diabetes. It’s also toxic to the reproductive system, immune system, and is a contributor to all-cause mortality.
Commonly found in plastics and epoxy resins, BPA is among the highest production volume chemicals found in our ecosystems, human fluids, ad tissues, said Fine. Plastic packaging is composed of many harmful chemicals. In fact, aside from commonly known toxins like BPA, which makes plastics hard, and phthalates which make plastics soft, it’s estimated that there 906 other chemicals involved in the manufacture of plastics.
“Unfortunately, we are so awash in plastics and microplastics that now, the human autopsies are showing it in every organ they look at,” said Fine. “And these bits of plastics are in our patients, and those plastics are full of chemicals.”
Toxic compounds like acrylamide, which can increase risk of cancers and cause neurological damage, as well as 1,3 butadiene, which has been associated with cancer and cardiovascular disease, are also found in plastics. Timing of exposure to endocrine disrupters is also very important, said Fine. Studies have shown that prenatal exposure may be particularly harmful.
In a case study, Fine described a 67-year-old female patient who drank water exclusively from polycarbonate bottles. She had suffered from kidney cancer two times, had cysts on her liver and both kidneys, and experienced a variety of allergies and rashes. He allergies, Fine said, were most likely not due to things like household dust because she had a very clean home.
“She had no carpets, and she was like a dust freak,” said Patrick.” “I mean, I got dusting tips from her.”
For this patient’s treatment plan, Fine prescribed:
• One teaspoon of liposomal glutathione per day
• 10,000 units a day of vitamin D for two weeks, then 5,000 units a day
• Two capsules of liver support per day
• Quercenase twice a day
• Poly resveratrol once per day
The patient was also instructed to follow a Mediterranean diet and have three to five Brazil nuts per day. Fine also suggested that she use a shower head filter, sauna three times a week, and start using a glass water bottle filled with spring water.
Now 72 years old, the patients reports no new cancer in her kidneys, no eczema on her hands, no rashes, and no need for an inhaler or other allergy medications. A scan of the patient did however show more liver cysts and no change, and her kidney cysts remained unchanged.
To conclude her presentation, Fine instructed practitioners to make BPA a priority and address it during a patient’s first visit. She the best way to prevent the adverse effects of BPA exposure is to products that contain the chemical. She suggested to stay away from plastic or canned food and drink containers as well as thermal recipes. In addition, she explained that filtering tap water is a must, and suggested using an air purifier in the home to prevent indoor air plastic pollution. Finally, she said to be mindful of disposable plastic materials like antibacterial wipes and masks.
“Once upon a time it was considered cringe or hippy to eat organic food but now it’s becoming common sense for people, and Costco places million dollar orders every day. I feel like it’s the same thing with environmental medicine,” said Fine. “It’s really arrived and it’s having a moment and if you apply it early and learn it properly, then you’re going to have the best success with your patients.”