Environmental Toxins, Fertility, and Finding Balance with Laura Adler (Episode 586)

Full Transcript: Episode 586

Lisa Hendrickson-Jack:

In today’s episode, we are delving into toxins. This is a big topic that can feel very overwhelming and I feel like in today’s episode, we cover a lot of ground. You know, we talk about the issue itself and the difference between personal responsibility — like what you can actually do to reduce your toxin exposure — but also what aspect of this is outside of your personal control, right? We don’t have control over which corporations are pumping which pollutants into the air and into our water. So there is — I think that one of the reasons that this topic can be overwhelming is when you look at the research and you look at all the data. I mean there’s a lot of data on the impact of toxins on health and it can be a huge rabbit hole. It can be extremely overwhelming. And so the approach that I’ve always taken with clients is perfection — I don’t think is a good goal — is to “I’m going to be totally clean and free of toxins” because you can’t be. You still have to breathe air and things like that. So there’ll always be some level of toxin exposure in our modern world. But the approach that I’ve taken more so is education and reduction. Let’s see what we can reduce. So before we jump in, let me share a little bit about my guest today. Today on the podcast, I’m joined by Laura Adler. She is an environmental health educator and science communicator with over 14 years experience helping health professionals and health-focused businesses understand the impact of environmental chemicals on chronic health conditions. Her work bridges established and emerging research with practical accessible strategies to minimize toxic exposures and build resilience against environmental challenges. Combining environmental health education with business consulting, she has helped over 5,000 health professionals in more than 35 countries elevate their expertise, achieve better client outcomes, and become sought-after leaders in their growing field of environmental health. So without further ado, let’s jump into today’s conversation with Laura.

Lisa: And I’m excited to be here today with Laura Adler. Thank you so much for coming on the show.

Lara Adler: Yeah, thanks Lisa for having me.

Lisa: Well, I am really excited to have you here because as I was saying in our pre-chat — huge conversation on toxins — to start by just asking you a little bit about how you got into this work. So, you know, I was a nerdy kid in high school who was reading books about animal agriculture, plant agriculture, and was just interested in mushroom growing and food workshops and all of this type of stuff. So I was very much interested in food and nutrition. And that was sort of my entry into conversations about health. And so I went to a health coaching program and began health coaching — people that were, they didn’t have any major health challenges, most of them just wanted to lose weight, and most of them were able to do that just by making some pretty simple basic lifestyle changes, getting better sleep, all those sort of fundamental basics. But then I had a couple of clients who did all those same things and nothing actually changed for them. And that was perplexing to me. And so I started digging into the literature around resistant weight loss and that’s what kind of cracked the door open for me. I was reading about obesogenic chemicals. These are chemicals that are known or suspected to alter our metabolism in ways that can lead to weight gain and that no matter what people do, some people are just going to struggle more with their weight than somebody else. And that might answer some of those questions. And it was really fascinating to me. I lived in New York City at the time, so I had the New York Academy of Sciences in my backyard and Mount Sinai’s Children’s Environmental Health Center also, and it was on their mailing list and going to every one of their workshops and lectures and symposiums that I could to just being a sponge for this information. And that really is what kind of kickstarted my obsession — if you will, healthy obsession — with this topic. And so I really started to dig into the literature and get a lay of the land, so to speak, of like what do we know, what don’t we know, where are there other questions, where is there research happening. And once I had a pretty decent grasp of the landscape, I decided to turn around and start sharing that with my peers because none of the health coaches, nutritionists, etc. that I was talking to had any — this wasn’t on anybody’s radar yet. This was in 2010. This really was — yes, there were some people involved in pushing for change in chemical policy and yes, we had decades of research, but it wasn’t in the sort of cultural conversation like it is now. Yeah. So I started teaching in 2012 and I have been doing that non-stop ever since. And going back to that thumbtack, because I was the nerd in high school that was vegetarian and interested in food, all of my high school papers were on that topic. I remember doing a demonstration on how to make chocolate pudding with tofu — it was so dumb, but whatever. And so about seven or eight years ago, I went back to my home where I grew up. And you know when you go back to your room where you grew up and you find little remnants of things that you never thought were important enough to take with you? I found a box of index cards that was the bibliography of this paper that I wrote in high school. And this was when we did bibliographies on index cards because it was the ’90s. And I randomly pulled out a card and the quote on the card was something about people turning towards vegetarian diets in part to avoid exposure to environmental chemicals. And I was like, wait, what? This has been on my radar in some capacity since I was a teenager. Also, my father works in the non-stick coating industry. He’s a consultant, he doesn’t work with the chemicals, but these are the PFAS chemicals that are ubiquitous. So I’ve also kind of had that perspective as well. So yeah, I’ve been in this conversation for a very long time and it’s been really exciting to see how it’s changed in that time span.

Lisa: I feel like the last 10 to 15 years in the health space have been very interesting. It seemed to coincide with the advent of social media and this whole shift in this concept even of social conversation which didn’t exist in the ’90s at all. At all. It’s hard for the millennials maybe to understand this, but there was none of that. And so it is really — I can remember when this was not on the forefront, so when you said that I can really resonate with that, and now everybody’s talking about it. So tell us a little bit about this whole concept of environmental toxins. So typically I’m looking at things from the view of the menstrual cycle lens and how things affect the cycle and how toxin exposure could affect whether it’s your periods, hormones, fertility, all of those things. But of course, it spans a very wide net. So maybe share a little bit of insight from your research over the years.

Lara: Yeah. So I mean, I think what helps kind of frame the conversation is to zoom out and look at some of the big picture stuff to help people kind of better contextualize what are we talking about here? And this has changed a little bit. So five, six, seven years ago, I used to say when people hear the phrase “environmental chemical,” they used to think — and many probably still do — of things like air pollution and polluted bodies of water and that kind of environmental toxin. Those chemicals, harmful chemicals that are in those places, are absolutely classified as environmental toxins. But the conversation that I’ve been focused on and that certainly a lot of people in the health space are focused on right now are the exposures that we get in our daily lives just by being a normal human being on earth trying to have a job and go to the grocery store and get showered and dressed and have a house. And so in the normal course of that, we are also exposed to a large number of chemicals, many of which are known or suspected to cause harm, to be bioactive, and that we are sort of micro-dosing these chemicals, if you will, like all day, every day. There has been an enormous body of evidence of published studies going back decades examining the effect that these chemicals can have in our bodies. And so that’s kind of the big bubble of what we’re talking about in terms of environmental chemicals. We are all exposed. There is no place on the planet that doesn’t have some exposures. Chemicals are measured in the human body. We have human biomonitoring studies, government-run projects in different countries around the world that are monitoring for chemicals, among other things, in the human population. And we have hundreds of chemicals in us. I don’t say that to scare people. I just say that to frame the idea that chemicals that are in the stuff that we surround ourselves with aren’t always bound to those things and that they come out and that they get inside us. The presence of a chemical inside us does not automatically mean that harm is being caused. Many chemicals are benign and we’ll take them in and pee them out immediately. And I’ll say everything is a chemical. So in this discourse around toxins, people like to position the word “chemical” as being inherently bad. Well, everything is a chemical. Hormones are chemicals. Estrogen is a chemical. Water is made of chemicals. And so it’s important that we — I know it’s a ridiculous thing to have to say, but there are people that look at anybody who’s talking about toxins and making this broad judgment that anybody who’s talking about this is fear-mongering, and that’s a common thing on social media, and that’s just patently false. Yes, sure, everything is a chemical. And yes, some of those chemicals are harmful. And yes, some of those chemicals are even harmful at extremely low doses. We know this. Lead has no safe level of exposure. There’s harm at every exposure level. So we’re all exposed. We all have some degree of chemicals in us. Sometimes we know or think we know what some of those health outcomes are. Other things we’re just learning. Microplastics are in all of us and we don’t actually know what the implications of that are. We’re just starting to tease that out now. And it will probably be at least a decade before we have more good evidence. But the reality is that we’re all exposed. Environmental exposures have the capacity to affect every organ system, every tissue in the body. And so there is this great sort of push to know more about chemicals that surround us, that make up our lives, and to regulate them in a way that minimizes exposure or minimizes harm because we do know that these exposures contribute to major chronic health issues across the board. Some populations have more exposure than others. Some jobs have higher exposures than others — if you’re a hairstylist or a nail tech, you have higher exposures than somebody who works in an office. Auto mechanics, firefighters, people in the airline industry, pilots, flight attendants, they all have different exposures. And then there are communities that have different exposures — low-income communities, fence-line communities, which are communities that live adjacent to or nearby things like industrial factories or toxic waste dumps, that have disproportionate exposures. So there are lots of different layers to the conversation, but that is in a large nutshell what we’re talking about in the context of environmental chemicals.

Lisa: It’s such a big topic. And what you said — it’s interesting. I feel like you’re obviously knee-deep in this, and so I could relate when you said fear-mongering. When I would talk about the birth control pill back in the day, like 10 years ago, people would come out of the woodwork saying, “You’re anti-feminist and you’re trying to fearmonger” — even if you just tell people what the actual research says about the side effects, you’re fear-mongering. There is a bit of a line there. I think with the toxin conversation, when you do get into the research about the different toxins, it is absolutely terrifying. Those are some of the hardest sections that I found to write about because you’re wanting to share what the data has to say in a way that is accurate, but you don’t want to create this fear in the reader. And one thing I also want to say about it is from the lens of menstrual health, when we start talking about toxins — as you just finished mentioning, they are literally everywhere. So from my perspective, when I teach about practical things you can do to reduce your toxin exposure, the keyword has always been to reduce. If your goal is to get yourself clean and free of all toxins, that is impossible. Because you still have to go outside and breathe air, you still have to leave your house, you have to drive a car, you have to wear clothes.

Lara: Yeah. I think the conversation is probably one of the most important ones because people have become so hyper-obsessed and perfectionist about everything — and not just the toxins conversation, it’s about food. I sort of banished always-never framing or language in my work. That framing of always-never, that binary black-and-white — it’s either all good or all bad — is really stressful for people. It adds so much unnecessary anxiety. I have seen people in my own life that have sort of succumbed to that and say, “Well, I can’t let my kid go to her best friend’s house because they have scented candles.” That is not what we’re aiming for. In the food world, this hyper-perfection of only eating “clean” has been dubbed orthorexia. It’s not in the DSM-5, so it’s not a clinical diagnosis, but people are actually trying to push for it because there’s some overlap. And this is coming from somebody who encourages people to read labels, but to not become obsessive about it. The reality is it is literally impossible to reach a place of zero toxic exposures. Polar bears in the Arctic have PFAS and flame retardants in their bodies despite being thousands of miles away from where these chemicals are used. And that’s because both of those classes of chemicals are persistent. So they go up into the clouds, they fall down as rain, they travel in wind currents, and so they are all over the globe. And so it is a futile effort to try to get to zero. All it does is push people towards inevitable failure because they can’t, and then they operate under that threat of failure when true “success” is impossible. So the goal is not 100% non-toxic living. It is just to do the best that we can to reduce exposure.

Lara: So going back to your discussion about menstrual cycle and fertility — when we’re looking at studies of, say, couples in fertility clinics and we’re looking at the birth outcomes of people that have high levels of phthalate exposure versus low levels, and the higher levels have more poor outcomes or longer time to conception or whatever the outcome is, at the low end of the spectrum it’s not zero. It’s just lower. And so we are not aiming for zero. We’re just aiming for less. And I say that talking through the lens of what’s avoidable, because not everything is avoidable. And the solutions or the tools or products that we buy, all the things that we do to try to reduce our exposures, those are not equally accessible to all people. And that is an important conversation that’s often left out — that not everybody can do all the stuff. Not everybody can buy the organic food or buy a $200 water filter. And so that I think is a part of the conversation that’s often left out in the discourse, especially online, when people are trying to condense whatever they’re sharing into like a 90-second reel or a 2,200-character Instagram post. There’s not enough space for nuance. And this is a conversation that literally exists in this incredibly nuanced gray area. The answer to every question I like to say is: it depends.

Lisa: I mean, it’s such tricky territory. And one of the interesting things about the fertility awareness charting field is that it does attract type-A, really intense individuals. And I feel like I can say that because I am one of them. And so a lot of what I do in my client work and working with practitioners has been to kind of deconstruct that a little bit, to really get at what the goal is. For example, with cycle charting, the goal can’t be to have a perfect cycle every single month because you’re not a robot. So then the question I want to ask out of that is — we’ve got these two extremes. We’ve got the “I want to get to net zero toxin, I’m only going to eat organic, do all the things perfectly” — that unrealistic expectation — versus the weight of this problem, actually thinking about how scary it is to be exposed to these toxins. And then the other end of the spectrum would be the apathy of, well, I can’t control any of it, it’s in everything anyways, right? So where’s the balance?

Lara: So I would actually reframe that because the two ends of the spectrum — yes, to the end of the spectrum that you just described where people are hyper-perfectionist, that end of the spectrum unfortunately is veering towards anti-science. These are folks that say sunscreen is toxic and it’s sunscreen that gives you skin cancer, not the sun. That is just patently false. The far other end of the spectrum are the cosmetic formulator influencers that are like all chemicals in skincare are totally safe and anyone who says otherwise is fear-mongering. So those are the two far ends of that conversation, and both of them are wrong. The truth is in the middle. It is in that gray area. The binary reductionist approach on both ends really hurts this conversation around environmental toxicity. People are aware of microplastics and PFAS and BPA now. And the people on the end of the spectrum that say pesticides are totally safe, all chemicals in commerce are safe — they’re doing that in reaction to this other extreme. And the people on the side that are dismissive of anybody talking about harmful effects of chemicals are ignoring decades of high-quality peer-reviewed research on environmental exposures and health impacts. One of the things that the folks at that end of the spectrum like to do is require absolute proof in these harms from chemicals. And one — proofs don’t exist in science. They exist in mathematics. There is only evidence in science. So we cannot have an RCT, double-blind placebo trial on “does this chemical cause this health problem?” That is profoundly unethical. And so what happens in the field of environmental health is we look first at animal research — that is the model that we use — and we use that to determine the mechanism of action. Do these chemicals have any effect? At what doses? And what is the mechanism? And we do that using animal models. People like to say “I’m not a mouse, I’m not a rat. Those studies don’t apply to humans.” And my counter to that is, rats are also used to determine safety. So if you are going to rely on research on animals that determines safety, that same model has to be appropriate to also determine harm. You cannot have it both ways. And so we look at animal data, and then we turn to epidemiological data — observational studies on humans — and we say: do we see these same chemicals in human populations? That’s what those biomonitoring studies I mentioned earlier do. And if we can see the same types of effects in humans — whether that’s a fertility outcome or a metabolic outcome or a cardiovascular outcome associated with these chemical exposures that we’ve already determined in animal models — then that is considered strong evidence. And that’s what we have. But somehow that’s not good enough for some people on this end of the spectrum.

Lisa: That’s really helpful. I think that because there’s this perspective about science that really irritates me — that it’s infallible. And as someone who also spends a lot of time in research, when you’re looking at different research papers, they are sometimes looking at an isolated chemical or an isolated nutrient and looking at a specific situation that may have been created. And what I always say is that research is done by people. And so you can have a result where you are looking at the same data as the researchers, but your conclusion would have been different. I’ve seen studies where the thing that is most interesting to me isn’t even in the abstract because they had a specific mindset or they are of a specific opinion.

Lara: Right. And if you are of the opinion that chemicals are largely safe, then when you read the same data that I read, you might provide a different explanation and a different interpretation. So it is important to understand how research is done. I’ll give you an example of where we did do a human trial recently and a test did get approval through the ethics board. So I think this was in 2018. This was a very small study — less than 10 people — so not something that we can make broad assumptions on, but it was an important first step. What researchers did is they gave volunteers a dose of BPA — bisphenol A exposure — that is equivalent to the maximum tolerated level already set by the EPA. So the EPA says 50 micrograms per kilogram of body weight per day is the safe limit. They got approval from the ethics board because a federal agency had already deemed that level safe. And what they found is that a single dose of BPA at that maximum level altered their body’s insulin response in a way that would, if left unchecked or continued, might lead to diabetes. And so — okay, yeah, it’s a small study, yes, we need to reproduce it. But it is like shining a flashlight into a dark cave of the unknowns and going, “Whoa, what’s that? Let me go explore that doorway for a minute.” To your comment about science — science is a process. It’s not a finished product. Science is fallible because it’s done by people, and people are fallible. Science is also fallible because as we learn more, our positions may change. And people can’t handle that. They say, “You can’t change your mind. You told us this and now you’re telling us this.” When in fact that is just the process of scientific discovery. Good researchers know that the process is to prove themselves wrong — that’s how you design a good study. And you can also find a paper to support anything you want. There’s always at least one paper out there that is contrary to whatever topic. You would have to have the wherewithal and understanding to look at those research studies critically. This is where consensus statements come in — let’s look at meta-analyses and systematic reviews that are looking at a lot of different papers and pooling the data. ACOG put out position statements a long time ago for clinicians to advise their patients in lowering exposures to endocrine-disrupting chemicals. They’re not going to do that if they don’t think there’s a strong enough body of evidence. And when we have large bodies like ACOG, like the Endocrine Society, like the NIH’s National Institute of Environmental Health Sciences — that is devoted to exploring this — they also have these position statements. We have to be able to make decisions and move forward even given uncertainty, otherwise we’re just in paralysis mode. And at the same time, we have to recognize that vested industries — the chemical industry, the tobacco industry — part of their procedure is to manufacture doubt. There’s a 2014 documentary called Merchants of Doubt that talks about this, that there are paid consultants at these large industries that intentionally sow doubt. And so I think a lot of the folks on the side of the environmental health conversation that are being dismissive have just swallowed that manufactured doubt and they don’t recognize it.

Lisa: What you’re saying is that these organizations are specifically paying people to go out there and say actually these chemicals are really safe. I remember watching Erin Brockovich — that movie — and what came to mind was that part of the movie where the families were told that the water was safe and how good it was for them.

Lara: Yes. But that has been repeated in countless industries. I’m in the middle of reading an excellent book called The Poison Squad, which has to do with Harvey Wiley, who was a chemist at the turn of the last century, late 1800s into the 1900s. He was instrumental in the passage of the very first Food and Drugs Act of 1906. And I’m listening to this book that’s talking about all of the lengths that the chemical industry at the time — there wasn’t really a pharmaceutical industry, but there were people selling what are called patent medicines. This is where the term snake oil salesman comes from. Milk would be preserved with formaldehyde so that they could sell spoiled milk and people won’t know. In the health space, folks love to glamorize the way our grandparents ate. “It was all pure. They didn’t have pesticides.” Girl, they had worse. The food was so bad. DDT was used as an insect repellent. Kids were sprayed with it, powdered with it on a regular basis. These industries recycle the same tactics. The documentary Merchants of Doubt highlights that the same literal human beings that were paid by the tobacco industry to manufacture doubt about the harm of cigarettes were also hired by people in the fossil fuel industry to discount the data on climate change — like the actual same person. So these are tactics that are utilized over and over and over again, which is why we’re in this really messy soup of discourse. That’s where like we have to take a data-forward view on this topic. And the data says these environmental chemicals — many of the ones that we are exposed to — are absolutely causing or contributing in some capacity to poor health outcomes.

Lisa: Before we started recording, one of the things that we were talking about was the difference between addressing toxin exposure as a personal issue versus a kind of bigger, broader problem. As a female, all of the products that are made for us are full of all kinds of chemicals. And there’s a lot of studies that show that if you just stop lathering that stuff all over your body, it really does reduce your exposure in a significant way. But why are the chemicals allowed to be there in the first place? So in the work that you’ve done, for the person who is a little bit more type-A and wants to be clean — where’s that middle ground?

Lara: So I think just to frame it in the fertility conversation — the primary things that I think are important to prioritize — I try not to talk too much about environmental chemicals through a condition-specific lens because all of the chemicals that negatively impact human fertility also impact cardiovascular disease, can impact cancer, can also impact metabolic conditions. So there’s redundancy, so much redundancy. A single chemical can have like a dozen different endpoints and we don’t know what makes it move down one path and affect this person this way and that person that way. It might be the timing of exposure, the dose, or genetic susceptibilities. The primary things I would prioritize within the context of human fertility, male and female, are endocrine-disrupting chemicals — primarily — and then things like heavy metals. The strongest evidence that we have in terms of environmental chemicals affecting human fertility are with phthalates, an endocrine-disrupting class of chemicals. Phthalates is not one chemical, it’s many chemicals that are used in different places. BPA — and I would extend that out to bisphenols in general — because BPA is just one chemical in a family like bisphenols. So phthalates are a family, bisphenols are a family. And then PFAS chemicals — that’s the third one. PFAS chemicals are a large family. We don’t even know how many, but it’s estimated to be at least 14,000 chemicals under the PFAS umbrella. And so the strongest evidence that we have is with those three classes of chemicals. Then the task becomes: where do those chemicals show up and how can I focus my time and effort without going overboard to — as I like to say — identify and address. So let’s identify where they are and then let’s address them in the ways that are reasonable and accessible.

So phthalates — there are two different types: high molecular weight phthalates and low molecular weight phthalates. High molecular weight phthalates are what are used in plastics. Soft plastics — this is things like a shower curtain, a rubber duck, a plastic PVC raincoat for kids, kids’ rubber boots, soft plasticky materials, sometimes even in food packaging like squeezable ketchup bottles. Low molecular weight phthalates are found in fragranced products. So perfume, but also makeup, and also your toilet bowl cleaner and your shower spray and your kitchen sink spray and your laundry detergent and your dryer sheets. And scented candles and air fresheners and Febreze and plugins and reed diffusers and incense and the whole gamut of fragrances. And so the recommendation is twofold: one, minimize exposure or use of soft plastics. I like to prioritize food packaging because that is exposure that we’re ingesting. That exposure route is likely to be more impactful than exposure from a raincoat. That said, materials shed chemicals for the most part. These chemicals that are used in all manner of products are not molecularly bound — they’re just kind of hanging out. And so those molecules can shed on their own. And where do they shed? They shed into our homes. And where do they settle? They settle in the dust in our homes. There was a meta-analysis of 14 studies done across the US of house dust studies, and 100% of dust samples across all of these studies contained phthalates. So phthalates are ubiquitous and they’re in the dust in our house. When they settle in our dust, then we inhale them and then we ingest them when we handle anything that fell on the floor and then we’re eating popcorn on the couch and drop something and pick it up and get a little dust. So house dust is a meaningful source of exposure. And so what do we do? We clean our homes more frequently — a recommendation that no one wants to hear. This is a low-cost or no-cost intervention: increase house cleaning so that there’s more frequency with the aim of capturing and removing dust. Not sweeping it with a broom because that’s just kicking it up and kicking it around. Using a vacuum — ideally getting a vacuum with a HEPA filter, but any vacuuming is going to be better than no vacuuming. And then wet dusting — just taking a cotton cloth, getting it damp, doesn’t have to be even with cleaning solution. Just water is fine. The idea is that we are capturing that dust and then we can wash that material and reuse it. That’s a really simple intervention. And then hand washing — wash your hands regularly even though you’re in your own house. And going back to the fragrances: ditch those scented candles and the air fresheners and the home fragrances. Those ones are super unnecessary. If people are using them because their house smells funky otherwise, go figure out what’s causing the funk and address that. Getting rid of those fragrances completely can lead to a reduction in phthalate metabolites in the body. Then when it comes to your personal care products and your household cleaners, use what you have, finish it up. The concern for exposure to all of these chemicals is not individual exposures like, “Oh no, I was in an elevator with somebody that had perfume on and now I’m going to have cancer.” That is not what we’re talking about. We are talking about low levels of exposure chronically over time, over years, decades. And so the sooner that we can intervene and lower those exposures and keep them low by maintaining these behaviors, that’s likely where the benefit will present. Ditch the home fragrances, use up the personal care products and household cleaners that you have, and then when it’s time to replace them, go for fragrance-free, unscented. Always look on the ingredient label. You’ll see the word “fragrance.” This is not a guarantee that the product contains phthalates, it is just an indication that it might. But that’s the general direction: getting rid of as many fragrances as possible, cleaning up our house dust, and prioritizing glass over soft plastic food containers when you can. Mayonnaise in a glass jar versus mayonnaise in a plastic container — it’s a high-fat food, phthalates can be pulled out by that. Go for glass over plastic when you can, but don’t stress about it. Make changes where you can. That’s a tall order in and of itself, and it might take somebody six months to tackle all that. That’s okay. This is a long game. Any reduction is better than no reduction.

Moving on to bisphenols — BPA, BPS, BPF. One of the conversation points that is often used in a dismissive manner about the discourse around environmental exposures is to target one specific exposure and dismiss the harm from that exposure. For example, thermal paper cash register receipts are coated in bisphenols — sometimes BPA, sometimes BPS, BPF. These are similar compounds that have similar health effects. A lot of times when products are marketed as BPA-free, that is just marketing garbage because that product still might contain BPS or BPF, which research shows has the same types of effects. Not better. It’s like a whack-a-mole. They whack one down and a couple others pop up in their place. And people are dismissive of this by saying the amount of BPA that you absorb from your cash register receipt is minuscule and doesn’t have any effect. Yes, that might be true. But what if we add the BPA from the cash register receipt, plus the BPA from the canned food, plus the BPA from your soup that you put in a plastic blender when it was hot and it pulled more of that BPA out? Now you’ve got multiple stacked exposures to BPA collectively. Do those matter? Yeah, I would wager that they do. There’s a field of research called exposomics — which gets its name from genomics — that is attempting to assess the totality of exposures and the impact of that totality. We have found that when we have two chemicals that have similar effects, together the outcome of that exposure is greater than the sum of the individual exposures. So it’s amplified. The good news about both classes — phthalates and bisphenols — is they have very short half-lives, meaning they are actually metabolized and excreted very quickly — rough six to twelve hours. That doesn’t mean that in that time they’re not kind of turning on and off some lights that maybe they shouldn’t have. And because we’re getting multiple exposures to say BPA all day every day, our exposure levels to these chemicals are constant because we’re adding them in faster than our bodies can take them out. And so that’s where we don’t need a detox. We don’t need a supplement to help get rid of BPA in your body. You just need to lower what’s coming in. And that’s a behavior change. So that means minimizing the consumption of canned foods. You can find BPA-free cans, but again, what are they using? BPS? BPF? We’re not aiming for perfect. We’re just trying to do what we can. Don’t handle thermal receipts too much. The bigger impact is going to be for people who work as cashiers or who work at a restaurant handling receipts all day every day — if you can, in those jobs, wear gloves. If you can’t wear gloves, wear what are called finger cots, which are like little condoms for your fingertips. Those are the interventions. Minimize canned foods. Minimize plastic. The general rule of thumb is do not put hot foods in plastic containers. Heat can increase leaching. Do not grind really hard foods in plastic blenders because you are abrading the surface of the interior of those plastics, which also increases leaching and migration of those chemicals. Don’t put plastics in the dishwasher — the dishwashing detergent is quite caustic, so it can damage those plastics.

And then the last one is PFAS, and this one’s really hard. Avoiding PFAS is really difficult because PFAS are ubiquitous in society. PFAS are these forever chemicals — per- and polyfluoroalkyl substances — and they are used in every sector of society: military, medicine, food, textiles, automobiles, weapons, literally every sector, cookware. And so the task becomes: avoid what’s avoidable, or reduce what’s avoidable. What that means in our day-to-day life is in the realm of cosmetics, we do not wear or buy long-wearing lipstick or waterproof mascara because those products likely contain PFAS chemicals. Anything that’s “fluoro” in an ingredient is an indication that you likely have a PFAS chemistry in there. In terms of textiles, couches and upholstered furniture — those fabrics are often treated with stain-resistant chemicals. Anything ScotchGuard-esque, those are PFAS chemicals. Don’t intentionally waterproof textiles with any spray. PFAS chemicals add oil resistance and water resistance to products. That also means that they’re in cookware. Non-stick cookware has PFAS chemicals. The more scratched that cookware is, the more those molecules of PFAS are leaching into the food that you’re eating. So if you have non-stick, time to get rid of them, throw them out. Replacing cookware doesn’t have to be expensive. The basics are stainless steel, cast iron, enameled cast iron, glass, carbon steel — those can be really inexpensive. I’m very conscious of not positioning these solutions as like, here’s a $500 red light device or sauna that you have to buy. We’re really just looking for practical, accessible solutions. You can look up your water quality report to see whether or not your water utility is monitoring for PFAS in the water. We did have some regulations that were brand new at the end of the last presidential term — regulations to regulate six PFAS chemicals. There are 14,000. And those regulations just got a pause or got thrown out under the Trump administration. So we don’t know if those regulations are actually going to be enacted. If you have PFAS in your water, I recommend filtering it. You’re going to be looking at a multi-stage under-sink filter that’s got multiple canisters of filtration media — that’s what’s been proven to be the most effective — or reverse osmosis filtration. Your Brita water filter is not going to do anything to remove PFAS. PFAS are ubiquitous, and so we do what we can. The most impactful way to reduce PFAS levels in the body is to donate blood and plasma. But that’s not a reasonable recommendation, especially when that blood and plasma just gets moved into the donation stream — we’re literally just passing on PFAS to whoever gets that blood or plasma. It is not a sustainable solution, but it is an evidence-based one.

Lisa: I really appreciate you going through the different categories and what we can do. What I really liked about what you said was that you positioned it as the goal is reduction. And it’s really not about that one time that you touch the receipt or whatever. It’s really about looking at the day-to-day, your repeated exposures, and where are those opportunities to reduce your chronic exposure.

Lara: Yes. Like I said, everybody’s at a different place. Everybody has a different budget. Everybody has a different mental bandwidth to even spend 10 minutes thinking about this. And so this is where perfect is the enemy of good. In my life, I swapped out my conventional mattress for an organic mattress. But it took me like seven or eight years to do that because it was a really big-ticket item. Those are expensive. And so I didn’t lie in my conventional mattress every night being like, “Oh no, I’m slowly dying.” That’s not the vibe. We’re just trying to make practical changes, modifications to our daily lives in ways that support minimizing exposure, but that don’t add stress. Because stress is also toxic — in a real way — because stress contributes to 80% of chronic illness and we are all stressed. It is 2025. If worrying about toxic exposures is adding to that burden, it’s time to take a step back and say what’s a very small thing that I can do and I’m going to forget the rest and just move forward. We do what we can. And I want to stress that again — we shouldn’t be fearful of exposures to things that we know or we suspect might have harmful chemicals. The balanced and pragmatic way that we can view this conversation while still taking some action — we’re all going to benefit from that. And we just are not going to benefit if we are stressing out and freaking out about every exposure.

Lisa: I mean, I couldn’t agree more. I really like how you make sure to get into the nuance of this topic because it can be overwhelming. It is overwhelming if you actually sit down to think about it. So it’s really important that we ground it in real evidence-backed information, strategies that are actually going to make a difference, and finding that common ground so that you’re not basing what you’re doing on the worst case scenario in your head. And the social media hype — social media currency is clicks and engagement. That’s where rage-bait content comes in. This overly sensationalized presentation of the toxics conversation is really upsetting because a reasonable person would look at that level of obsession and overblown science and go, “That’s crazy,” and therefore anything adjacent — like legitimate toxin research — is also dismissed. And so it really damages the very legitimate, very long-running massive pile of evidence and dismisses the work of thousands and thousands of environmental health researchers and scientists.

Lara: I really like for my students as health professionals, this is something that I’m trying to teach at every level. We don’t do that because that hurts the conversation. It unnecessarily scares and overwhelms people. I mean, on the one hand, I think there’s a lot of value in the fact that people are talking about it and having the conversation around how to talk about it is probably better than not having the conversation at all. The average person just is very black and white because they’re not in it, they don’t know all the different complexities. So I’m really happy that we were able to go through this. And for folks that just want some accessible information, they can go to Instagram — I’m there at @environmentaltoxinsnerd. There’s plenty of content in the feed to scroll through and learn little snippets of education and action. And if you happen to be a health professional of any type, you can go to my website, which is my name, laraadler.com, and check out the courses that I have there for health professionals of all types. I’m in the middle of rewriting my big course, so that’s like a six-month endeavor that I’m very excited about because it is pushing a lot more of this nuance and sort of delicate nature of this conversation, so that health professionals have a solid information base to be able to then share this with their audience.

Lisa: Love it. Well, for anyone who’s listening on the go, we will make sure to link all of those places to our show notes page. And Laura, I just want to thank you so much for being here. This has been such a great and informative conversation. So thank you so much.

Lara: Yeah, thank you so much for having me.

Lisa: Thank you for listening. If you enjoyed today’s episode and you’re wanting to share it with a friend or you’re wanting to grab any of the links that we talked about, head over to fertilityfriday.com/586. I hope that you enjoyed today’s episode with Laura. I feel like we covered so much ground. I do think that this audience is well-versed in the issue regarding toxins. We know that there is a connection between toxins and a variety of different health issues. And we also know that there is something that we can do about it. Especially for those of you who use menstrual cycle charting, whether you use it personally or whether you use it with clients — that is one of the ways that we can really gain insight into what’s happening. So it’s not always super obvious initially, but if you are working with a client who is heavily exposed to certain toxins and does start to make different changes, learns a little bit more about the different sources of toxin exposure, and starts to clean up their beauty routine and clean up their household cleaning products and then start to move towards more natural alternatives — often we see certain things shift on the cycle. We start to see hormones normalize a little bit. And how do we tell if hormones are normalizing? We look at the menstrual parameters. We look at the different aspects of the menstrual cycle on the chart. We also look at symptoms. One of the great things about charting is that we can actually see some of these tangible results. I think another really important focus was practical strategies. I think one way to look at it is also like a process instead of just a destination — a process that unfolds over time. So you kind of start with the lowest-hanging fruit. If you’re using scented products, you kind of finish those, you don’t have to throw them all out, but you work through those products. And then as you replace different products, replacing them with non-scented alternatives, alternatives that are more on the clean side, and then doing a bit of due diligence as you go about this journey. I know for myself it wasn’t this overnight thing where when I learned of all this, all of a sudden I threw out everything I had and the next day was using all clean products. I started my journey on this road decades ago when there wasn’t even a good selection of natural care products — back then some of the products didn’t even work. There’s a lot of positives now. One of the negatives is that there’s probably more chemicals out there now because every year corporations come out with thousands of new chemical formulations. But on the bright side, there’s a lot more alternatives now for those of us who are wanting to improve our routines. If you’re wanting toxin-free menstrual products, if you’re wanting toxin-free cleaning supplies, there are a lot of options now, and even regular brands will sell products that are free of dyes and fragrance. So you don’t have to search as hard anymore to find products. With that said, I hope you enjoyed today’s episode. The share link is fertilityfriday.com/586. Have a wonderful weekend whenever you’re tuning in to the show. And of course, as always, until next time, be well and happy charting.