The One Factor That Determines 90% Of Your Risk For Disease with Dr. Todd LePine

The water that you drink, the air that you breathe, the food that you put in, and where you live in the United States. It can have a big impact on your overall health.

Hey everyone, it's Dr. Mark. I think we can all agree that we're thinking a lot about immunity these days, but the pandemic aside, I regularly see so many patients who struggle with recurrent infections. One of the most common is urinary tract infections. They're actually the second most common infection in the United States, especially in women. Now, there can be a lot of reasons someone might constantly be fighting infections like a UTI, but most of us have been over prescribed antibiotics at some point in our lives. We made too much sugar, we stressed out too much, and all these things can upset our microbiome, and that directly impacts the balance of bacteria in the urinary tract and the rest of our immune system. But a lot of women I talk to are doing the right things to try to avoid these recurrent infections, but without any luck. They've tried cranberry extract and they make sure to pee after sex, among other things, but they still get frequent bladder infections. so I was really intrigued to hear about a product my team recently discovered called Ucora. They were completely blown away by the results, two of them who constantly struggle with frequent UTIs hadn't had a single symptom since trying Ucora. Ucora's unique target drink mix blends easily with water and tastes just like the pink lemonade you like when you're a kid, but without the added sugar. It flushes and cleanses the urinary tract with well-researched ingredients like D-mannose and also boosts your immune system with things like vitamin C and B6. Eukora also makes a supplement called Control to cleanse the biofilm from the urinary tract and a vaginal probiotic called Promote to promote the growth of beneficial bacteria and discourage the bad ones. Both of these are a great addition to the Target Drink Mix for a more comprehensive protocol. Now, if you struggle with UTIs or bladder infections, I highly recommend checking out Eukora's potent line of products to promote urinary health. Right now, they're offering doctors, pharmacy listeners 30% off when you go to Eukora.com, .com/doctor. That's u q o r a.com/doctor. Now let's get back to this week's episode of the Doctor's Pharmacy. Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman. That's Pharmacy with an F-F-A-R-M-A-C-Y, a place for conversations that matter. And if you're wondering why you might have some chronic ailment and nobody can figure out This is a podcast you want to listen to because it's about something called the exposome, which you probably never heard of, but it's probably the most important thing that determines your health. And it's with none other than my colleague and friend, Dr. Todd LePine, who's joining us for this special episode in the Doctor's Pharmacy called House Call, where we at the Ultra Wellness Center discuss patients and diseases and mysteries that no one can figure out. and how we treat these patients every single day in our practice. And Todd and I have worked together for decades and we were together at Canyon Ranch years ago. He went to Dartmouth Medical School. He's board certified internal medicine. He's a leader in many aspects in the world of functional medicine, training physicians all over the world and is on the faculty of many groups, including the Institute for Functional Medicine, ACAM, A4M, and many other groups. So I'm just so excited, Todd, to have you here again to talk about something that nobody heard about, but is probably the most important thing that determines whether you're sick or not. And it's called the exposome. So, Todd, what is the exposome?

The exposome, okay. So the exposome is the term for the sum total of all the toxic exposures that we get in our environment. And they can be both internal and external toxins.

And it can be a thought, can be a toxin, right?

Yeah, very good.

If you have a bad inner dialogue, Excellent. It's literally talking to every aspect of your body.

Excellent, excellent. point. I actually didn't, I didn't actually have that in my, in my outline.

But it's literally everything that happens to you and watches over you your whole life is what you're exposed to throughout your life.

Exactly. Yeah. And, and even, even the stuff that you don't even know, which is the in utero exposure, you know, there's, you know, a lot of, like, some of the, the children who go, have parents or the mother who's in a very stressful environment, those stress hormones of the mother actually get the epigenetics gets transmitted to the child. so these kids who are, you know, born in war-torn countries, they actually have epigenetic stressors. They've actually shown that the epigenetic methylation of, of people that are brought up in war countries have a different genetic exposure. Yeah. Yeah. So the exposome, there's a, there's a paper in science that actually, uh, uh, goes over this. And when I first read this paper, it sort of, sort of put a light bulb on me to really sort of change the way of how I think of how is it that we interact with all of these environmental toxins. Now, the good news is that our body is able to detoxify. That's really a good thing. In fact, a lot of studies have shown that the people who age well and longevity is oftentimes associated with how our body deals with toxins. And I call that the George Burns gene.

Right?

George Burns had two martinis and a cigar and he lived to 100. So he had good ability to detoxify, you know, and my father, my father was a dentist and he was like George Burns. He liked his martinis and his cigars and he was exposed to mercury as a dentist and he lived in '94 and he was actually quite healthy.

Reminds me of U.B. Blake was a famous musician. He said he lived to be well over 100. He said, if I don't know I was going to live so long, I.

Would have taken better care of myself. Right, exactly. So we define the exposome is that sum total of both internal and external toxins. Now, unfortunately, today, we take the environment.

Of- Or influences, not just toxins. People think of toxins like pesticides, mercury, but it's really everything that happens to you.

Everything that happens to you, exactly.

Inside and out.

Inside and out. Endotoxins and exotoxins. So we actually live in a pretty toxic environment now. There's a lot of air pollution. So, you know, depending on where you live will determine your risk for asthma. When you live in more of a city where there's particulate matter from cars and diesel fumes, you are can be more susceptible to breathing issues. Your water, very, very important. I mean, our body is 60 to 70% water. So what type of water are you drinking? Does it have, you know, some of the chemicals that leach in? I think there's a, over in New York, there's a, was it, I think it was a case where they had some flame retardant that was being used by the military that seeped into the water systems. and now that people have to get bottled water.

Most tap water in America is full of all sorts of stuff.

Oh, Michigan had that big scandal with the lead in the water.

Yeah, Flint, Michigan. But, you know, just the average water in America, there's 38 contaminants according to one study I read, including everything from pesticides, flame retardants, antibiotics, hormones, prescription medication. Because when you take the birth control pill, where do you think that goes? When it's metabolized into your urine and then goes, where does that go? And then it gets all Exactly. Cleaned up and used again as your water supply. So, we are definitely exposed to enormous.

Amounts of these compounds. Right, and the concept in mainstream medicine is that, you know, the way they study toxicology is that you've got to give a certain dose to get cancer. And if you give that dose and you don't get or give a dose and you don't get cancer, then it's safe. So, we can use it, right? We can just use these chemicals. And that's an old way of viewing toxicology. And what we're finding out now is that, toxins at very low doses, things like BPA, which is bisphenol A, are actually endocrine disruptors. So two of the compounds that I find that potentially have one of the biggest impact in terms of very small amounts having a big impact are things like atrazine.

That's a pesticide.

Atrazine is actually an herbicide. Atrazine is an herbicide. And there's some fantastic work. If you go onto the internet and you google Tyrone Hayes, and Atrazine. He did some works, work showing that low doses of Atrazine, which is used in corn, actually has endocrine disrupting molecules and it can actually cause a male frog to turn into a female frog. That's not normal.

I wonder if that's why we're seeing a decreased male fertility. And, a lot of these are estrogen molecules. They're like estrogen. And, you know, we study them, like you said, in a lab and you get one chemical and you see if it's safe. But things combine together and become synergistic. Yeah, absolutely. It's not like one plus one equals two. It's one plus one equals 100. Exactly. It's like, for example, if you take Tylenol, that might be okay.

If you drink alcohol, that might be okay. If you drink alcohol and take Tylenol at the same time, even the normal.

Amount, you get liver failure. Exactly. It's a case report. I remember reading that in the New England Journal of Medicine. The guy was, you know, having one or two martinis and popping Tylenol, and he had liver failure in the normal dose, not like overdosing. Yes, right. And it's one of the most common reasons for admission to hospital with liver failure. So I think we have to be really conscious of all these combinations of exposures. And I, you know, when I think about the exposome, I think of our diet. I think of our thoughts and feelings and our emotional brain speaking to every cell in our body and our immune system. Our perception. Yeah, our perception. Even, even your thoughts influence your microbiome. So those little bugs in your gut are changing and listening to what you're thinking. not to put pressure on you, but if you have a negative inner dialogue, it's probably not benefiting your health.

Absolutely.

And of course, there's your environmental exposures, which we talked about, all these environmental toxins, both from pesticides and chemicals in our food and the air and the water and more. And then of course, there's our internal toxins, which can be produced by bad bugs in the gut, so your microbiome influences everything. and I think what I learned in medical school was that, you know, your health is sort of determined by your genes. Like, you know, you're at risk for diabetes, you're at risk for Alzheimer's, you're at risk for this and that, autoimmune disease. But turns out it's the exposome that is thing that determines 95% of what.

Happens with your health in terms of chronic disease.

It's not your DNA.

Exactly. And I, you know, you're in control. It's what your DNA is exposed to. Exactly. And I, you know, we do the genetic testing here and, There is this concept or this idea that your DNA is your destiny. You know, heart disease runs in my family, diabetes runs in my family, Alzheimer's runs in my family. And there may be a genetic predisposition. And my analogy to this is a loaded gun. Genes can be a loaded gun if you have genes that maybe push you in the direction of one biochemical pathway It's good to know that. But a loaded gun doesn't kill anyone until you pull the trigger.

Yes. Environment pulls the trigger. So the genes load the gun.

Absolutely. And what we've also found, this is really interesting, is that things that we thought were strict Mendelian genetics, like Huntington's Korea, they've actually studied the genes of people who have Huntington's genes, and they do not clinically manifest Huntington's disease. So there's more to it than we really fully understand. so genes are important, but they're not the, the main thing. I would venture to say that when you look at things, you know, from a number standpoint, it's probably 70 to 80% is environment and 20, 30% are genes. Yeah.

And, and, you know, in one, in one of the studies I read on the exposome, they said 95% of chronic disease is driven by the exposome. And, and I, you know, I think I heard a guy say recently that it's, it's not your DNA, it's your dinner that matters most. And I think that is a great quote because it sort of speaks to the fact that we can't change our genes, but we can change how those genes are turned on or off or expressed. And the exposome is essentially is talking about what our biology and our genes are exposed to over the course of our lifetime and how that influences the course of our health. And in functional medicine and here at the UltraWellness Center, the things that we do really well are look at the exposome. So tell us more about, you know, what are the kinds of things you think of when you're looking at a patient to assess their exposome and how.

That'S contributing to their health. Well, you know, you mentioned earlier about your experience with heavy metals. So heavy metals, metals can be disruptive. And so we oftentimes will look and assess for heavy metal toxicity, have a heavy metal burden. So when we check for heavy metals, guess what? Everyone has them. We all, we all have, we all have exposure.

I mean, I don't think I've ever seen a negative heavy metal. I did, I did a few times.

People who are, are vegans and never.

Eat fish and have always done that. Yeah. Have no fillings. Yeah. Very rarely do you ever see and.

Probably are good detoxifiers.

Yeah.

And then you just but almost everybody.

Else has some level.

A small amount, a small amount. Some have a lot. And they're in the environment, so burning of coal, coal gives off mercury and it gets into the water. In lead.

In lead, yeah.

So you get some exposure. So heavy metals disrupt enzymes in the body. They disrupt detoxification enzymes. So things like mercury, lead, aluminum, arsenic, cadmium for cigarette smokers. In fact, the first time I actually learned that is when I had a patient who was a heavy cigarette smoker and I checked heavy metals, the cadmium was off the charts. I'm saying, where is this coming from? And it turns out that- Cigarettes. Cigarettes, the tobacco, for whatever reason, it accumulates cadmium. And you see heavy cadmium in cigarette smokers. So heavy metals can be a source of toxicity. And they can cause all kinds of symptoms, right?

So give us some general symptoms that you'd see in a patient with heavy metal toxicity. 'Cause when you go to your regular doctor, they're like, what is your lead and mercury and arsenic and cadmium and aluminum levels? They're not checking that, right?

Yeah. Well, the other thing that's also interesting is that when you look at metals, there's this whole theory now about neurodegenerative conditions. And it's thought that metals play a role in what's called metallo-stasis. So metals disrupt the folding of proteins. So when you have excess amounts of metals in the body, it causes proteins to misfold. And misfolded proteins are tied in with a lot of neurodegenerative conditions, including things like ALS, things like Alzheimer's. And there's an interesting study that just came out this past week, and I'll send you the paper mark about the role of excess iron. So we think iron is good. Well, guess what? Too much iron is not good. And especially free iron. Iron is a very reactive metal. I was a chemistry major, so I always liked to always look at the chemistry. So when you look at- that explains it all. Yeah, exactly. I'm a science nerd. So when you look at metal- I.

Was a Buddhism major.

And so iron is reactive and it reacts with oxygen. So when you leave something metallic outside, it rusts because it oxidizes and interacts with oxygen. So our bodies actually keep iron wrapped up. and we keep that in the molecule called hemoglobin. We wrap up iron. And if you don't, if you have free iron in the body, you get the Fenton reaction. Basically, your body starts to rust. And I've seen this in patients with hemochromatosis. So when you have hemochromatosis, which is a genetic condition that causes you to.

Not be able to get rid of your, your iron, which is a metal.

Which is about 10 of the population has some degree of that. Exactly. Yeah. And what happens is iron is found in all tissues because blood is in all tissues. And when that iron can't get Detoxified, you build up iron in your liver, your heart, your pancreas, and your brain. And your joints. And guess what? You rust. You get a rusty brain, a rusty tin man. Exactly. You can develop, in fact, one of the first times I had your pancreas. Exactly. You get diabetes, liver failure, heart, cardiomyopathy, you name it. Heart failure.

Exactly.

Dementia. Dementia, right? That's a mess. So, we call it metal trafficking and looking at the role of metals is really, I think, important. Aluminum also. excess amounts of aluminum has been associated with increased risk for Alzheimer's. And again, it's probably related to these metals actually causing proteins to misfold.

So we shouldn't be using that aluminum.

Deodorant or cooking from those aluminum pans. No. Or aluminum, you know, antacids. Soda cans.

Yeah.

But like the.

Oh, yes. Oh, yes. Antacids often have aluminum. Exactly. Yeah. There's a lot of aluminum in us for. So. So heavy metal. So we. We see heavy metals as one of.

The big exposure areas. How. How, for example, would we assess someone's heavy metals? Because. we do the, you can do the urine provocation testing for, for heavy metals, which is, you know, what we do a lot in patients with provoking with dmps and. Or dmsa. Or dmsa. Exactly. Yeah, you can do that. You can also assess it in the blood. And there's, and there's different, like, when you check Mercury, there's two different forms of Mercury. Mercury takes organic and inorganic Mercury. And, you know, organic Mercury tends to accumulate in the hair.

So you can actually assess. That's more from, like, fish, for example.

Fish.

Yeah.

Like methyl.

Right, right.

So you can assess it in the hair, you can assess it in the blood, and you can also assess things in the urine.

And they sort of, each of them give you a different perspective. And the inorganic is from your fillings. From fillings. And from pollution. Yeah. You know, the thing is, people say, oh, you got these silver fillings or no problem. The dentists say they're great. But, you know, you and I both know that when we've seen these patients, they do have high levels of inorganic mercury. You can look at their tests, and it does affect their health. And you remove the fillings, and the mercury levels come way down. I've seen this. over and over again, and then patients feel better. Now, this is not well accepted as a thing in dentistry, except if you look at what most dentists do now, they've moved all the way from these, quote, silver fillings, which are mostly mercury. Yeah. Without saying they're bad, it's like, well.

They'Re not bad, but we don't do it anymore. There's too much of a liability. It's a can of worms. So basically, this is, if they were to admit that there's a problem, because once you remove mercury from the tooth, it now becomes a toxic waste product.

And it's fully regulated.

Fully regulated. Yeah, that's interesting.

Ask your dentist.

It's fine in your mouth, but remove.

It now it's a toxic product. Yeah, that's interesting. Ask your dentist, if mercury is so safe, then why can't you throw it in the garbage and why do you have to dispose of it by the regulations set forth by the EPA as a toxic waste? I always thought that's an interesting point. You know, if you can't answer that, then you shouldn't be putting it in your mouth. So we can look at the blood, we can look at the urine. The problem with the typical blood test is if you haven't had a current exposure, your body clears it after 90 days and it doesn't necessarily get rid of it. It might store it in your tissues and your liver and your muscles and your brain and so you can't really tell and that's why this challenge test can help pull it out. Exactly. And then we get a real more.

Accurate view of what's happened over the course of your life. And the big thing, this is a clinical program, I'm sure you've seen this, is lead. Now, we tend to have less lead toxicity now because we're not using lead paint, we don't use lead and gasoline. we don't have lead pipes, or at least unless you have old, old buildings. But I have seen this in a, in a few patients, especially in women, where in menopausal women, after menopause, they'll have accelerated bone loss. So lead gets stored where? In the bone.

Yes, in the bone.

So as a woman goes through menopause and she's had a body burden of lead and it's sort of sitting in the bones, and all of a sudden, you're now digging up the bones and you're peeing. When you go through menopause, you pee out your bones. That's how you do it. And we can, you can just do a test called bone resorption testing, which checks for the collagen breakdown products of bone. And when you see increased bone resorption, you know that they are peeing out their bones. And when you see high levels of lead, you know that they're actually getting exposed. And it's like dripping lead out of the body.

And, I mean, not actual bones coming out of your urinary tract. It's just a breakdown product.

Well, it's not a breakdown product.

But that would hurt. But it's sort of like, you know.

It'S like, you know, when you get osteoporosis, where do your bones go? You literally, you pee them out.

Well, speaking about the bones, digging up the bones, there was a study I read years ago that they had to dig up this graveyard in Europe and they had to remove the bones and put them somewhere else. And so what they did was they decided to check the bones for lead. and they compared that to today, and they found there was a thousand times more lead in the bones of modern people than there were 300 years ago.

Wow. Yeah.

So it's in there. That's incredible. And I think that mercury is also one of those factors that is just so common because it comes in our diet, it comes in our fillings, it comes in pollution. and it's probably one of the most undiagnosed things I've ever seen. And I certainly became an expert in it not by sort of design, but because I got really sick from mercury poisoning. And that's what led to me to have this, you know, chronic fatigue syndrome.

And kind of figure this whole thing out. And then, you know, what's the old, the old term is the mad hatter. Remember, you know, in Alice in Wonderland, the mad hatter, right? Well, they used to use mercury when they made hats. And what they found out is that when you got mad, if you had enough mercury, you, it affected your brain. you'd have delirium and other symptoms because it has a brain effect.

The other thing about these problems with toxins is that they don't manifest the same in everybody, right? So they might make you crazy, they might give you autism, they might give you Alzheimer's, they might give you chronic fatigue syndrome, they might give you an autoimmune disease. They might cause weight gain. I had a woman who was a fitness trainer and ate perfectly and she had these 40 pounds she couldn't lose. and I took her history and thought she might have some mercury issues and we tested her and she had very, very high levels and we treated her and over the course of the number of months without changing anything else just by treating her mercury, her weight dropped 40 pounds. Wow. Wow, that's amazing. So it can, yeah, because it's, we know that there's these compounds called obesogens, which are environmental toxins that cause obesity, they interrupt your mitochondrial function, your energy production, your hormones and metabolism. So really it's important really dig deep. So besides these heavy metals, you know, what other things can we look for that most physicians don't look for?

Pesticides.

Pesticides.

Big one. Big one.

Herbicides, pesticides.

Yeah, yeah. So pesticides are the compounds that we use on plants to keep the bugs from eating them. And there are, you know, there's a whole bunch of them. And you can actually measure them. There's labs that will actually measure pesticide levels. One of the pesticides, which is a real bad one, it's actually, I think, have been banned in Europe is neonicotinoids. That's the one that they associated with bee colony collapse. And pesticides, interestingly, are also associated with ADD and I think you had that study where they looked at the children who lived downstream from pesticide exposure and they checked how they would draw and such. And it was a big difference between those who had high levels of pesticides and how their brains worked versus those who had low levels of pesticides. 'Cause they're neurotoxins. They're basically a pesticide works on the nervous system of insects and our nervous system is not that different than an insect. And high levels of pesticides are not good things.

No. I mean, the other thing is farm workers and their kids, the kids through various diagnostics and neurologic testing, they found they lost 41 million IQ points being exposed to pesticides.

Yeah, exactly. And there's an interesting study that looked at pesticides in Japanese populations. And the interesting one is that they found higher levels of pesticides in people who ate more fruits and vegetables.

Yeah.

That's counterintuitive, right? But it's not counterintuitive because if you have pesticide-laden fruits and vegetables, you're gonna have higher levels of pesticides. So it's not just don't eat your fruits and vegetables, eat your organic fruits and vegetables.

Yeah. I mean, there was a paper recently published Linking pretty clearly the fact that that organic food eaters had much less cancer than people who ate traditional fruits and vegetables. And the Dirty Dozen is a great guide from the Environmental Working Group of one of the 12 most contaminated foods. So strawberries I love, but I would never eat a conventional strawberry because it's one of the most pesticide and herbicide laden things. And glyphosate, which is another compound, it's not a pesticide, it's an herbicide. It's sprayed on 70% of our crops. Yes. And it's the most abundant agrochemical used around the world. and it destroys our microbiome. It's literally like an antibiotic that kills your own microbiome as well as the microbiome of the soil. So at least all these other complications. And when you go to your traditional doctor, they're not measuring your glyphosate, they're not measuring your pesticide levels, they're not measuring your heavy metals, and you're coming in with all these symptoms that could be related. And so part of the difference with.

Functional medicine is we actually start to think about these things. And we have methods of diagnosing them and we have methods of treating them. So how do you begin to start.

Thinking about treating these things. Yeah.

You talk about glyphosate. That's. I think that's a big one. And. And that's. That's sort of the elephant in the room because it's ubiquitous. It's so prevalent. And we do testing for that now.

I don't know if you've been measuring. I do. I measured mine. I was shocked. I mean, I. I eat clean. I try not to eat GMO. I do travel, although not anymore. Maybe at levels are lower, but I. I eat organic, and I really am focused on detoxification. and my glyphosate levels were in the 50th percentile, which is pretty high considering I'm on the extreme end of paying attention to this because it's in everything. And if you don't know where your food's coming from, it likely has it because it's on everything.

Exactly. And you mentioned it because the glyphosate is actually an herbicide which is supposed to not affect the human system because it works on a different pathway, the shikimate pathway. And that pathway is actually in bacteria. so when you ingest glyphosate, it actually has an adverse effect on the, the gut microbiome.

Yeah.

And there's some interesting work by Stephanie Senneff, and she has a whole bunch of data linking the increased use of glyphosate with, linking it, not necessarily causative, but linking it, correlating it with autism. And I, I think there's some truth to that, because what you're doing is there is if you're having higher levels, especially early on, that you may be disrupting the microbiome, which is turn affecting the gut brain access. Absolutely.

I mean, we know that most kids with autism have terrible guts. By helping their gut, they get better. I mean, there's studies showing just giving a kid a fecal transplant who's got.

Autism helps fix their autism. Yeah. Right. Well, the other interesting thing about autism is that, you know, we talk about there's how, you know, kids with autism is their social interaction. And a lot of the, you know, the social hormone is oxytocin. It's the love molecule.

And what we found out is that.

The gut bacteria actually produce oxytocin.

The good ones.

The good ones. The good bugs.

Yeah.

So it makes sense that, you know, when you have disruption of the microbiome, you may be disrupting the, this, the social network of your gut, which may be playing a role, you know, one of many, many, many factors in, you know, this, this autism spectrum condition that we're seeing.

So if you want to have happy, healthy relationships, you got to fix your gut, too.

Yeah, exactly. Happy gut. Exactly.

So let's talk about once we started to identify all the factors in the exposome, right? Your diet, stress levels, the air you're drinking, I mean, the air you're breathing, the water you're drinking, you know, the light you're exposed to, these are also, you know, influences on your gene expression. Light pollution, light pollution, you know, environmental toxins, all these factors, your microbiome are influencing your genes and your gene expression and your health. but when we see a traditional doctor, and you're not here at the Ultra Wellness Center and the functional medicine doctor, you're not really getting evaluated for all these things, right? No. So here we were able to test and measure these things and we know which one to look for depending on the patient's story. And once we find these things, what can we do to relieve that burden? Because it's kind of depressing. You go, well, what can I do? I've got all these exposures, we've got all these toxins, but you related to me before a story about a woman who had a significant exposure to pesticides and you treated her and she got better.

No, it was actually PCBs. PCBs.

Yeah.

And we, up in the Berkshires with General Electric, we have the whole PCB saga up here. So PCBs are these persistent organic pollutants. They basically stay in the body. And in general, I'm going to make a generalization here is a lot of environmental toxins are lipid soluble, which means they love fat. so they get stored in fat. And when they get stored in fat, your body's not able to detoxify them as well. And as they accumulate, they can disrupt the endocrine system, cause insulin resistance. And PCBs have been known to do this. They affect the thyroid, they affect insulin resistance. And this lady wanted to be tested for it. And so I went ahead and tested her for it, and she had high levels of PCBs. So I started to support her detoxification with for for fat soluble PCBs with cholestyramine. And what's that? It's a it's a molecule that prevents the it's actually originally used for cholesterol. So it was because cholesterol gets recycled in the body. Your body eliminates cholesterol and then you're through the bile. Through your liver. Through your bile. Exactly. Because cholesterol is a good molecule. Cholesterol is the building block of all your hormones. It's for cellular membranes and cholesterol gets a bad rap, but, you know, cholesterol can be a very good molecule. But the compound cholestyramine was originally designed to lower your cholesterol to prevent the recycling of your cholesterol. And it works for other things. I think, you know, some of the work with Richie Shoemaker with his use of, it's an interesting story that he has, how he was using it for mycotoxins and how it helps the body to eliminate mycotoxins.

And when I treat this, those are mold related toxins. They just recirculate and create chronic inflammation. Yeah, it's like a merry-go-round. So you might have been exposed to mold 10 years ago, but the mold toxins keep in your body and keep causing neuroinflammation, which is why people have brain fog and fatigue.

Exactly.

That's another one of those things in the exposome is mold. We didn't even talk about that.

Yes.

That's another huge one.

Yeah, in mycotoxins, yeah, definitely. But in this lady, we treated her with lifestyle changes, but also I used cholestyramine and I did it sequentially over about a year. And slowly her levels came down and as she did that, guess what? but she started being able to lose weight. Yeah. And she was very, very happy. She helped to reverse her pre-diabetes and just felt so much better, you know, because when you're carrying around an extra 30, 40 pounds, that's like a backpack all day. You know, it's.

Yeah.

It wears on you.

I mean, you're right. I mean, you just mentioned diabetes, but. But we know for sure that environmental toxins cause obesity and diabetes. The data is very clear on this. Yeah. Whether it's. arsenic and diabetes or these persistent organic pollutants. So, it's not trivial to think about these toxins. And, if you look at fat registry biopsy studies where they literally took, let's say if you have a breast reconstruction, they take fat tissue and they send it to a lab or an autopsy, they'll take a bunch of fat tissue from people and they send to a lab. And, literally everybody's a toxic waste dump. If we were food, we wouldn't be safe to eat. and if you look at the kinds of things that are in there, it's dioxin, it's DDT, it's PCBs, it's flame retardants, it's heavy metals. I mean, these are the things that are stored in us. And so traditional doctors are not trained in toxicology except for if you have an overdose of some toxic or an extreme acute exposure. But if you have a chronic exposure over a lifetime, there's no model for how to deal with this. But the good news is with functional medicine, there is a methodology for helping people to upregulate their own detoxification system and to bind these toxins. So tell us about how do we do that in functional medicine?

You bring up a really good point, which is that fat is the storage depot. It's a toxic waste dump. And I often tell patients that if you're wanting to lose weight, you need to support detoxification.

Absolutely.

It's a critical, critical thing. In the science of how your body detoxifies, we sort of divvy it up into phase one and phase two detoxification pathways. So phase one is the oxidation process where your body sort of activates a molecule. And phase two is what we call the conjugation pathway where we stick molecules onto them like sulfate or glutathione to detoxify them.

So the first step sort of gets it ready. The second step packages it up to get rid of it.

Yeah, so you can think of it as like taking out the garbage. So every garbage, you wrap it up in a plastic bag or a trash bag, and then the guy comes out and takes it out. And that has to be in a balance. So if you have too much of phase one and not enough of phase two, it builds up and you get these reactive species. So you have to have a balance in that phase one, phase two, a part of detoxification. And glutathione is one of the great molecules that our body has, which is helps with detoxification. It's an antioxidant. and our bodies stick glutathione onto toxins. And that's one of the enzymes, one of the most important enzymes I think is the glutathione S-transferase. A lot of people say, well, I'll just take more glutathione. Well, it's not just taking glutathione, you've got to stick the glutathione onto the toxin. And that happens through glutathione S-transferase.

And the cruciferous vegetables upregulate that enzyme. So a lot of foods are, we use foods as medicine to upregulate these pathways. And you just mentioned the broccoli family. any of those foods, broccoli, cabbage, kohlrabi, Brussels sprouts, watercress, arugula, you know, those are all foods which actually upregulate these pathways. Green tea does also. And, and you need those. And I find those for me are a staple in my daily diet. I eat those every single day because they're so important. But there's a lot of other ways to upregulate these pathways. You write, you need various nutrients to help like selenium and, and all the B vitamins and all these things that help these pathways. So we really are focused on nutrition. and nutritional detoxification as the first step.

Yeah.

And then, and then what other, what other kinds of things can we do to help the body to get rid of toxins?

Well, there's also traditionally, there's, you know, there's been the phase one, phase two parts of detoxification. There's also a phase three, which Jeff Bland got me aware of, which is the urinary excretion of toxins. And it's very important to actually have an alkaline urine. So measuring your urinary pH is important because having a pH seven or above helps with the facilitation of detoxification. So, drinking- It's not just drinking water.

But you got to eat a diet that makes you more.

Right. And eating a more plant-based diet, a heavy plant-based diet will help to alkalize your- Plant-rich diet.

Yeah, plant-rich diet. Yeah, plant-rich diet. Exactly. So, we have to take these foods in. And then fiber also is such a critical component. You mentioned chloestyramine. Yeah. But there are other binders that are.

Just naturally found in fiber that help you eliminate these toxins. oh, yeah, absolutely. And that's, that's. I call it, you know, there's phase one, phase two, phase three, which is the urinary detoxification. And then phase four is the gut. You, you know, you gotta poop it out. That's really, really important. So making sure that you're moving your bowels one to three times a day is very, very important. Take out your garbage, you know?

And people tell me, well, how often are you moving your about? Oh, every three days. They're like, no, no, no. You don't want to do that. Yeah. I mean, it's true.

No, it's true. I mean, and, and people, Parkinson's, we know very clearly is linked to environmental toxins.

But it's also linked to constipation.

Absolutely. In fact, one of the key things is that way before people develop Parkinson's, they actually have constipation issues. And there's a strong evidence in the literature that Parkinson's actually can begin in the gut.

Yes. Well, it may be beginning in the gut, but also if you're not eliminating what's in there, it's exposing you to more toxins over time. So we use food. We also use a lot of special nutrients to upregulate these pathways that whether they're herbs or vitamins, things like milk thistle, selenium, and acetyl cysteine, lipoic acid. So we have a whole regimen in functional medicine to help you body detoxify. And there's other things you can do, right? Sauna sweating. Sauna, sweating, right? Sweating is- Exercise. Exercise, yoga, right? All these things help to detoxify your body and move things around and move your lymph and your blood around and actually helps you detoxify. So there's a lot of strategies we use in. sometimes we even use intravenous therapies to help people like IV glutathione and vitamin C and other things. So we have a really comprehensive approach to helping identify what your exposome is, how that's contributing to your issues and how to treat them very personally and specifically. Because it's different for each one.

Yeah, absolutely. And when you actually get into, you know, when you start reading into the literature, you really realize that this is a big problem. and you can sort of become, you know, pessimistic. It's like, oh, what do I do? You know, it's like, you know, we're living in this toxic world. And yes, that's true. But, you know, the, you know, the cockroaches that are survive are the ones that can eat DDT and do okay. So being aware, I think, is the. Don't try that. Yeah. Being aware of the exposome, I think, is the, is the first thing. Just sort of understanding that, you know, the water that you drink, the air that you breathe, the food that you put in. and where you live in the United States, you know, it can have a big impact on your overall health. And then you also mentioned, you know, your thoughts is it's really important. And I, I, I, I always, I always go back to this is my understanding of the power of the mind and the power of thoughts was with Bruce Lipton's book, the Biology of Belief, which is a fantastic. If anybody's not read it, I highly recommend it. It sort of changed the way I understand how your thoughts can actually affect the expression of your genes and change your physiology and your immune system and everything else. Absolutely. It's a game changer and I highly, highly recommend it. He's on the internet. You can read his book. You can watch some of his videos. And, when you listen to how he explains it, you really understand the importance of how you see the world and how you perceive the world, that internal dialogue that we have. And, when you have happy thoughts, you'll be happy. When you have negative thoughts, you'll be negative. Thoughts can be toxins.

Absolutely, absolutely, yes, absolutely. Relationships can be toxic. Exactly, yeah. All of that plays a role. And I think that the thing people should know is that there are ways to deal with this and to reduce your exposures. And one of the best resources is the Environmental Working Group. I'm on the board. If you go to ewg.org, you can learn about how to reduce your to your exposures through what skincare products you use, whether it's, you know, face creams or sunblock, household cleaning products, Foods, all these things we, we have control over, and you can't eliminate everything, but you can dramatically reduce your exposure. And then using the principles of functional medicine, you can help. And that's really what we do here at the Ultra Wellness Center. We're like medical detectives. We help you identify what is going on. We deal with mystery illnesses. You know, we, Todd, Todd, and I used to work at Canyon Ranch, which was a health resort, and they often call us the resort doctors because we're the doctors of last resort. And people come after they've seen everybody, done everything, tried everything, and they can't get better. And then we figure it out because it's not magic, it's just science. We actually have a method and an operating model called functional medicine that helps us navigate to what the real issues are and have a very specific way of addressing them. So don't fret, don't fear. Just realize that, yes, we have to deal with the exposome, but there is a lot of science around how to do that effectively.

Exactly. And then one other last thing I'll end is what I call the silent toxin, which is in the world that we live in, is EMF pollution. It's a real issue and you have continuous exposure to EMFs. Now, and you have what's called non-native EMFs, which is they're not found in nature. They're man-made things like, you know, wifi and cell towers and stuff like that. And there's a lot of evidence that these non-native EMFs at continuous exposure levels affect the immune system. There's some really good stuff on this. And I've had some patients who are, you know, quote unquote EMF sensitive. Yeah.

Everyone.

I want to define that. They they have a nervous system that actually picks up and we're energetic beings. I mean, our bodies are electric. When we want to measure how what are our brains working, we do a what an EEG, that's an electrical signal. we want to check the heart, we check an EKG. Those are electrical signals. So it only makes sense that our bodies interact with the, with bioenergetic fields. Of course. Absolutely. And you can't go to any mainstream doctor and get a test for EMFs. So you got to do it on your own.

And I turn my Wi-Fi off at night. Yeah, we bought one of those EMF.

Exactly.

EMF. Tri field meters. Yeah. You know, I put it next to my phone and it goes from like five to five. 5,000. Yeah. You, you know, in New York City, we had our apartment. It was, you know, always in the extreme danger range, even when nothing was going on. Everybody's Wi-Fi in the old apartments.

But, you know, in our house up in the, in Massachusetts, it's much less. And, and, and actually, there have been some, some studies showing that actually when people go camping and they're out in nature, they're not surrounded by EMF fields.

They will actually reset their circadian rhythm.

And they will sleep better. Oh, my God. I, I noticed that every single time. Yeah, I just sleep like a baby. And then you, there's actually some, even some things that this sounds a little crazy, but there are things that you can use in your house. They're called Stetzerizers and they actually decrease dirty electricity. If you've ever used those or heard of them.

We created a Faraday cage over our bed in New York City. We basically created this tent.

It was made of this cloth.

It's EMF. It's silver. It's silver. And a little thing under the bed. And it was the most interesting thing. You could go inside this tent in your bed. You couldn't make a phone call with your cell phone. You couldn't get Wi-Fi. It was completely impervious and you put that around you when you sleep and it's pretty cool.

Yeah, but there really is a science to that. We are affected by energetic fields. And, I always talk about, some people give off good vibes and bad vibes. That's energy. That's energy. And there is non-native EMF and I think that's one of the probably the things that's not really well talked about in mainstream medicine, even in alternative medicine.

It's hard to figure out what to do about it or, I mean, you.

Can reduce your exposures, but how do you actually diagnose that that's the issue? Yeah, yeah, exactly.

But I just think being aware of it and minimizing and just, you know, is an important thing. Well, Todd, this has been a fascinating conversation about something probably people have never heard of called the exposome, but it's probably the most important thing determining your health or your risk of disease. And it's something that you can do something about because it's an empowering idea that our genes are not our destiny, that what is washing over those genes over the course of our life is determining our health or our risk of disease. And it's something we can do something about, whether it's our diet, whether it's exposure to toxins, whether it's our thoughts, whether it's even our exposure to EMF. So we, we really covered a lot here. Todd, I think this has been an amazing conversation. Thank you so much for being on the doctor's pharmacy on this special episode of the house call. If you love this podcast, please share with your friends and family. Please leave a comment. We'd love to hear from you. Subscribe wherever you get your podcasts and we'll see you next time on the Doctor's Pharmacy.

All right, thanks Mark.

Hey everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do. introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to DrHyman.com/picks to sign up. That's DrHyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now back to this week's episode.

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