Online Health Chat with Melissa Young, MD
June 3, 2014
Environmental toxins are all around us. From the food we eat and water we drink to the products and energy we consume. Toxins have been found in beauty products, household cleaners, carpets, furniture, mattresses, house dust―and even in foods and products from natural sources. Being surrounded by chemicals on a daily basis can have some harmful effects on your health. However, there are steps you can take to avoid undue toxins as well as make proper choices that can minimize your exposure to these toxins.
We all know that pesticides keep our fruits and vegetables free from bugs and disease, but pesticide residue can remain on your produce, even after washing it. The Environmental Protection Agency has restricted the use of most toxic pesticides, including highly toxic organophosphates (i.e., PCBs) that were phased out of farming in the late 1970s and 1980s. However, residue of these chemicals can still be seen in today’s leafy greens. Purchasing organic produce can be an easy alternative to conventionally grown produce. In particular, conventionally-grown strawberries, apples, celery, cucumbers, grapes, spinach and potatoes contain the highest amounts of pesticides. Although it should always be remembered the benefits from a diet rich in fruits and vegetables will always outweigh the risks of pesticide exposure, you should just limit your exposure as much as possible.
Filtered tap water or bottled water, which is healthier? Bottled water, with pictures of flowing streams and mountain springs on the label can actually be more harmful than you think. In 2008, the Environmental Working Group conducted a study on 10 different brands of bottled water. Their results showed 38 pollutants from disinfection byproducts, to industrial chemicals and bacteria. Unlike, water utilities that are regularly checked, tested and reported to the consumer, the bottled water industry rarely reports if contamination was found. The best solution is to stop drinking bottled water and opt for filtered tap water instead. Not only will you lower your risk of possible chemicals and bacteria, but you will also reduce plastic waste and the burden on your wallet.
These tips and many others are logical ways to minimize your exposure to toxins and improve your wellness.
About the Speaker
Melissa Young, MD is an integrative medicine specialist who is board-certified in internal medicine. She completed a two-year Integrative Medicine Fellowship with the Arizona Center for Integrative Medicine at the University of Arizona, Tucson, studying with Dr. Andrew Weil, a pioneer in the field of Integrative Medicine. To help bridge the mental and emotional aspects of healing, she has done additional training in Mind-Body Medicine with The Chopra Center, The Center for Mind Body Medicine and the University of Massachusetts Center for Mindfulness.
She completed her residency in internal medicine at Lenox Hill Hospital in New York City. She received her medical degree from Albert Einstein College of Medicine in New York. In addition to her integrative medicine background, Dr. Young has training and experience in functional medicine. Dr. Young has written chapters on the Integrative Medicine Approach to the Prevention of Colon Cancer in the first and second editions of the Textbook "Integrative Medicine", by Dave Rakel, MD.
Let’s Chat About Environmental Toxins and Your Health
Moderator: Welcome to our chat today with integrative medicine specialist, Dr. Melissa Young. We are thrilled to have her here with us to share her knowledge about environmental toxins. Let's begin by chatting about some general information regarding today's topic.
Environmental Toxicity Basics
arlo: What causes environmental toxicity?
Melissa_Young,_MD: We are exposed to many different toxins from our environment. There are toxins in our food supply, in household items such as furniture, particle board, bedding, mattresses, and in our air.
listener: What are ways environmental toxins can enter the body?
Melissa_Young,_MD: Environmental toxins can enter our body through various ways. Through our skin, the food we eat, the water we drink, the air we breathe and through cleaning products that we use in the home as well as beauty products that we put on our skin.
doors: What are the risk factors for being exposed to environment toxins?
Melissa_Young,_MD: Everyone is exposed to environmental toxins on a daily basis. Some people are at greater risk based on their hobbies, occupational exposures, and personal habits. In addition, some people have decreased ability to detoxify these chemicals, which increases their risk of disease.
honeybee: What are ways to avoid environmental toxicity?
Melissa_Young,_MD: There is no way to completely avoid exposure to toxins, but you can absolutely make choices everyday to decrease your exposure.
- Do not wear your shoes in the house. (Most household dirt, pesticides, and lead comes into your house on your shoes.)
- Open your windows frequently to ventilate. Indoor air pollution is significantly higher than outdoor air pollution.
- Avoid air fresheners that are petroleum based and contain endocrine disruptors.
- Dust at least once a week, as pesticides and allergens are carried in dust.
- Obtain a shower filter. Many contaminants in tap water are aerosolized in hot water.
- Choose green (natural) beauty and cleaning products at home.
- Avoid personal fragrance, cologne, perfume, body creams, etc. with the word fragrance on the label. These contain phthalates, which are hormone disruptors.
Environmental Working Group – “Dirty Dozen”
Sunnydays: Where can I find information or a list displaying which products are most harmful to our body?
Melissa_Young,_MD: You do want to start reading product labels on your cleaning and beauty products. A great resource for learning more about harmful toxins in our environment is the Environmental Working Group at www.ewg.org. They have multiple consumer guides for different categories of environmental exposures, where to find them and how to avoid them.
Gail Ann: I am confused. You stated to choose organic fruits and vegetables from the “Dirty Dozen” list. Can you further explain this?
Melissa_Young,_MD: The Environmental Working Group tests fruits and vegetables annually for levels of pesticides and herbicides and then creates a "Dirty Dozen list" and a "Clean 15” list. Unfortunately, in 2013 the Dirty Dozen list was actually increased to 15. Instead of going through the expense of buying all of your produce organically, if you choose to buy organic from the “Dirty Dozen” list, you will significantly decrease your exposure to pesticides.
sullins47: Where can you get the “Dirty Dozen” list?
Melissa_Young,_MD: The Environmental Working Group at www.ewg.org.
cyn3: I consider myself half-way educated, but the bombardment of information pertaining to toxins in the human body leaves me bewildered. I know I have been exposed to environmental toxins. (I live in a 100 year-old house with documented environmental toxins in the soil and food and water on farm.) However, I am not sure where best to get tested, or what tests are most appropriate. Are there websites (besides the Environmental Working Group [EWG]) or books you would suggest for specific information?
Melissa_Young,_MD: I agree. The amount and depth of information in this area can be overwhelming. The expression of symptoms and disease is always an interaction between our genetics and our environment. Even small changes in our environment for example, decreasing exposure via better choices in food, beauty and cleaning products, ventilating our homes, eating a nutrient-dense and whole foods diet can make a significant difference in our risk for development of disease.
If you feel you have had significant exposures over your lifetime, working with an integrative medicine provider to review your history and potentially do testing for specific toxins then creating a medical detoxification program may be appropriate. I find the EWG one of the best and accurate resources for the consumer to learn more.
Environmentally Safe Cleaning Products
nadolsk: Specifically, what brands are best in terms of safe household cleaning? I am also interested in safe baby products (body washes, shampoos, soaps, etc.)
Melissa_Young,_MD: Brands that you would find at most health food stores, including Seventh Generation and Ecover, are environmentally safe and much better choices than the conventional cleaning products you would find elsewhere. Be cautious even with natural cleaning products. Some are still heavily scented and even though they are natural scents, they can cause reactions in very sensitive people. Don't forget, you can go back to basic methods of using baking soda, lemon, and salt for cleaning your home as well. Safe baby products, California Baby is a good company.
hunter16: Are there any long-term effects of being exposed to contact cement in a poorly vented area?
Melissa_Young,_MD: I do not have specific knowledge of what constitutes cement. However, I do highly recommend in general whenever there are construction projects underway that areas are always well ventilated. Certainly if you have any persistent symptoms after exposure to something like cement in a poorly vented area, you should seek out an integrative medicine physician to take a detailed history and assess the impact of that possible exposure.
Environmental Toxins and Medical Conditions
colloq110: Are there diseases and conditions linked to environmental toxicity?
Melissa_Young,_MD: There are many conditions now being linked to environmental exposure including cancer, respiratory diseases (asthma), neurological diseases (Parkinson disease and multiple sclerosis), endocrine problems (thyroid), diabetes and obesity.
clara: My husband was recently told he has Parkinson disease. Is it true that pesticides contribute to Parkinson? What advice can you give him?
Melissa_Young,_MD: There are links to pesticide exposure and heavy metals in Parkinson disease. My best recommendation is consultation with an integrative medicine specialist to assess his past exposures, his ability to detoxify these exposures, and nutrient levels, which are cofactors in detoxification reactions.
gatorfrog: I know that environmental toxins definitely affect one's health and will be looking forward to what is covered on here. How do you test for them concerning health issues I have, like fibromyalgia, chronic fatigue syndrome, heart disease and pulmonary disease? I am always wondering how toxins might have played or play a part in these.
Melissa_Young,_MD: We can absolutely test for various toxic exposures through blood and urine tests mostly recommended by integrative medicine physicians. As we know, everyone is toxic. We can access someone's individual toxic load by history and don't always need to test, which can be expensive. We can do therapeutic cleanses with people depending on their individualized needs. Certainly exposure to these environmental toxins has known health effects. However, when we think about fibromyalgia and chronic fatigue in addition to chronic exposure, I often think about leaky gut syndrome. An integrative medicine consult might be appropriate to access all possible causes of complicated medical problems.
pilatesgirl: What is the latest thinking about environmental toxins and glandular health, especially the reproductive glands and the thyroid?
Melissa_Young,_MD: There does appear to be links between environmental toxins and glandular health. Many environmental toxins are endocrine disruptors to name a few phthalates, parabens and BPA which are found in personal beauty products, cleaning products, fragrance and plastics.
loveitaly: I am very sensitive to skin allergies, and can easy get an insect bite that becomes swollen and have to take cortisone and antibiotics. I have been coloring my hair for many years with ammonia-free hair color. I had never had a reaction from it, but I always do it with caution. Last year, I had severe urticaria, apparently from an insect bite, which lasted like six week. I cannot take Benadryl® (diphenhydramine), Allegra® (fexofenadine), etc, because I take a non-FDA medication for severe Meniere disease, which is a histamine. So, I can't take any antihistamines because they counteract.. Months passed by, and I had a severe vertigo crisis, which lasted months. Little-by-little all of my hair coloring went and I am totally gray now. I am only in my late 50s. Would it be safe try coloring again since my hair is completely virgin now or would I be more prone to allergies or reactions? I have received different opinions.
Melissa_Young,_MD: You have a complicated history and I highly recommend a personalized, in-depth consult with an integrative medicine provider.
pilatesgirl: Do toxins affect people with autoimmune disease differently? For example, I have celiac disease.
Melissa_Young,_MD: I don't have actual data on whether particular toxins affect people with autoimmune diseases differently. Because people with celiac disease often are malnourished due to impaired absorption of nutrients in the small intestine, they may be at greater risk because those vitamins and minerals are critical in the detoxification pathways.
cyn3: I use a CPAP (continuous positive air pressure) device. Air is being forced through plastic into my airways. Am I at risk of toxins in the plastic being forced into my lungs and causing long-term damage?
Melissa_Young,_MD: We do not have specific information on this question, but plastic in general is most harmful when heated so I believe that the benefits of using your CPAP far outweigh any possible harmful effects (which should be very low.)
Organic Foods and Diet
KareninBluffton: Isn't eating a whole food, plant-based diet more protective against pesticides and other environmental toxins than eating our standard American diet consisting of animal products and all that comes with them?
Melissa_Young,_MD: When we're talking about environmental exposure via our food then absolutely eating a more whole food, plant-based diet with many phytonutrients from fruits and vegetables is protective. (Think of the rainbow—the phytonutrients are in the colors of the skin of the produce.) It's important to eat less animal protein and more plant protein. However, if you choose to eat animal protein, it should be sustainably raised without antibiotics or hormones and pastured (grass-fed) instead of grain fed. It is as important what you choose to eat—as what you choose not to eat—in avoiding toxins. You should obtain the highest nutrient-dense diet that supports health and detoxification.
faride: What about foods that they are not organic? How dangerous it is?
Melissa_Young,_MD: Most importantly eating a more whole food, plant-based anti-inflammatory diet will support health. If finances permit, it is ideal to choose sustainably raised (grass-fed, and hormone- and antibiotic-free) animal products, and choose organic fruits and vegetables from the “Dirty Dozen” list. If that is not possible, it is still highly recommended to eat nine to 11 servings of fruits and vegetables daily of diverse color and variety to obtain your phytonutrients and antioxidants.
Moderator: Dr. Young has mentioned a plant-based diet. In April we had a chat with another integrative wellness physician about this topic. You may be interested to read the transcript:
sullins47: Is coffee safe or is it full of toxins?
Melissa_Young,_MD: Unfortunately, both coffee and tea are heavily sprayed with pesticides. I highly recommend choosing only organic coffee and tea. In addition, know that the decaffeinating process is typically done with chemicals. I recommend looking for natural water decaffeination for your coffee.
Gail Ann: How can one be certain that fruits and vegetables sold as organic are organic?
Melissa_Young,_MD: This is a good question. The government USDA organic sticker certifies that this product is organic.
nadolsk: I have read that soaking your produce in a vinegar and water solution will significantly reduce pesticide exposure. Is this true, and worthwhile?
Melissa_Young,_MD: There are mixed opinions on whether soaking your produce in a vinegar and water solution—or any other natural or chemical solution—actually reduces pesticide exposure. The best way to actually reduce exposure is to either buy organic produce when it is listed on the “Dirty Dozen” list, or peel fruits and vegetables that do not have a thick skin.
Gail Ann: Is there a natural water decaffeination for tea?
Melissa_Young,_MD: I do not have an exact answer for the decaffeination process for tea, but your best option would be to choose organic tea.
Environmental Toxins and Water
Gail Ann: You had mentioned to stop drinking bottled water and opt for filtered tap water instead. Not only will you lower your risk of possible chemicals and bacteria, but you will also reduce plastic waste and the burden on your wallet. In the Cleveland area, if requested, would the water department provide the consumer with an analysis of the tap water or would one have to hire an independent company to provide this? What type of filter for the tap would you recommend?
Melissa_Young,_MD: This is not a simple question to answer. It is my understanding that city water departments must provide information about the content of their municipal water if asked. For some people it may be a good option to hire an independent company.
The subject of water filters is complicated. Reverse osmosis filters seem to be the most comprehensive filters the drawback being they use a great deal of water during the filtration process. Simple carbon filters found in Brita® or Pur® that can be used on your faucet or countertop can be a great and cost effective option. They may not filter a full range of contaminants but are cost effective.
pilatesgirl: Can you explain the different detoxification pathways? I find it confusing. Would I have more difficulties with passing toxins if I were on medications or drinking alcohol?
Melissa_Young,_MD: In brief, there is phase one and phase two detoxification in the liver. Phase one actually produces a more toxic intermediate product that must go through phase two detoxification to then be eliminated through urine and feces. Vitamins, minerals and nutrients are critical cofactors in these detoxification pathways. So, we must be nutrient replete for adequate detoxification. Also, the more we are exposed to additional toxins from medication, alcohol and everything we've been talking about today, including beauty products, cleaning products, air pollution, food (pesticides, artificial colors and flavors, and chemicals), our body and liver must work harder for adequate detoxification of all these exposures.
jgf0214: What is the most recommended detoxification regimen and what is the likelihood of improved Parkinson disease symptoms (tremor in right hand) after detox?
Melissa_Young,_MD: With a serious neurological condition a detoxification assessment and protocol is best individualized. I would strongly recommend a consult for testing and assessment.
EDTA and Chelation
bjt: Do you think it beneficial to do EDTA infusion for high levels of lead in the bones that result from a provoked urine test when the blood levels are low?
Melissa_Young,_MD: Blood levels of heavy metals tend to reflect recent exposure provoked urine assessment are a more accurate way to measure body burden. I cannot answer your question specifically, but with this information I would talk with an integrative medicine physician about your test results. Ask for a more in-depth explanation of your results and about the differences between these different ways of assessing for metals, particularly for lead.
Moderator: I am sorry to say that our time with integrative medicine specialist, Melissa Young, MD is now over. Thank you for sharing your expertise and time to answer questions today.
Melissa_Young,_MD: The Environmental Working Group, which is a non-profit organization, is an incredible resource not only for the “Dirty Dozen” list, but for common exposures to toxins and suggestions to decrease that exposure. I highly recommend this website to learn more about how you can create a healthier home for you and your family. Thank you for your wonderful questions.
To make an appointment with Dr. Young or any of the other specialists in our Center for Integrative Medicine at Cleveland Clinic, please call 216.986.HEAL (4325). You can also visit us online at clevelandclinic.org/integrativemedicine.
For Health Information
On Integrative Medicine
For quarterly eNewsletters: http://my.clevelandclinic.org/wellness/integrative-medicine/newsletters/default.aspx
For More Information
On Cleveland Clinic
At the Center for Integrative Medicine, our holistic psychotherapy clinicians specialize in the treatment of physical illness and disease, emotional issues, family dynamics, stage of life issues, work-related issues, sexual abuse, trauma, addiction (substances, food and unwanted behaviors), and stress and anxiety. It does not take the place of traditional medicine, but does work in conjunction with it to help the healing process. Holistic psychotherapy primarily looks at specific areas of the body from an emotional, spiritual and energetic perspective and is designed to help heal the origin of the disease.
On Your Health
MyChart®: Your Personal Health Connection, is a secure, online health management tool that connects Cleveland Clinic patients with their personalized health information. All you need is access to a computer. For more information about MyChart®, call toll-free at 866.915.3383 or send an email to: email@example.com.
A remote second opinion may also be requested from Cleveland Clinic through the secure Cleveland Clinic MyConsult® website. To request a remote second opinion, visit eclevelandclinic.org/myConsult.
This information is provided by Cleveland Clinic as a convenience service only and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. Please remember that this information, in the absence of a visit with a health care professional, must be considered as an educational service only and is not designed to replace a physician’s independent judgment about the appropriateness or risks of a procedure for a given patient. The views and opinions expressed by an individual in this forum are not necessarily the views of the Cleveland Clinic institution or other Cleveland Clinic physicians. ©Copyright 1995-2014. The Cleveland Clinic Foundation. All rights reserved.