Death and Toxins: Tackling the Main Driver of Chronic Disease

Smokestack Sunset cropIf Ben Franklin were alive today, his famous aphorism would likely read, “Nothing can be said to be certain, except death and toxins.”

It’s no overstatement to say we are wallowing in new-to-nature toxic chemicals. They’re in our food, water, air, the products we use in our homes and businesses. The cosmetics we spread on our skin. Many have considerable power to disrupt our physiology.

According to Joseph Pizzorno, ND, physicians have been asleep to the toxin threat for far too long. With his new book, The Toxin Solution (HarperOne, 2017), Pizzorno is sounding the alarm---and providing practical strategies for response.

“Toxins are now the primary cause of chronic disease. They are driving much of what we see as clinicians. We need to reckon with the fact that our population is incredibly sick, and toxins are a major driver,” says Dr. Pizzorno, a founder of Bastyr University, one of the nation’s leading naturopathic medical schools.

“We are doomed to huge burdens of disease if we don’t get our act together on this.”

Consider the following:

  • 94% of Americans are exposed to enough polycyclic aromatic hydrocarbons to double their lifetime risk of asthma.
  • 60% of US women carry loads of PCB187 sufficient to double their risk of breast cancer.
  • 33% of Americans have lead levels high enough to double the risk of Amyotrophic Lateral Sclerosis (ALS).
  • 25% are exposed to enough aluminum to double Alzheimer’s risk.
  • 25% carry enough PCBs to double the odds of rheumatoid arthritis.
  • Women in the top quintile for phthalate exposure have a 9-fold increased risk of osteoporosis.

These are just a few of the troubling stats chronicled in The Toxin Solution. It’s the culmination of a decade of Pizzorno’s work to distill clinically significant features from an ocean of epidemiology and toxicology.

Though exhaustively referenced and scientifically sound, the book is written for ordinary people seeking to improve their health. It includes symptom assessment tools, lab test recommendations, safe product guides, and a comprehensive 9-week program for self-detoxification.

Pizzorno, the editor of Integrative Medicine: A Clinician’s Journal, bases his arguments on rigorous calculation of:

  • Incidence of common diseases in unexposed populations based on well-vetted epidemiological literature;
  • Thresholds of specific toxin exposure beyond which disease risk rises;
  • Percentage of the US population with typical exposures above the risk-raising threshold;
  • Odds ratios for each disease in people with exposures above the thresholds
  • The “attributable fraction,” designating the percentage of disease incidence that can be reasonably attributed to a given toxin.

He acknowledges the limitations of any estimates based on statistical maneuvers like these. They depend on the quality of available data, which is variable. Given the ubiquity of toxins these days, it’s hard to guarantee “unexposed” populations are truly unexposed, and practically impossible to achieve true independence of variables.

That said, he believes his calculations underestimate rather than overestimate the burden of toxin-related disease.

Myriad Menaces

A wide range of common chemicals can raise disease risk. Some provoke non-specific increases in oxidative stress; others poison specific enzyme systems. Lead, for ToxinSolutionCoverexample, interferes with enzymes involved in making hemoglobin. Still others, like benzene in gasoline, cause direct chromosomal damage. Some heavy metals disrupt cell membranes and cellular ion channels.

A host of compounds in plastics, pesticides and herbicides affect endocrine function, either by exerting direct hormonal effects or by blocking receptors.

Aside from specific occupational exposures, the majority of Americans get the lion’s share—about 50%-- of their toxins in conventionally grown and processed foods. Another 15% comes from plastics in food packages, with 10% coming from cosmetics and personal care, 10% from household or yard chemicals, and another 10% in ordinary drinking water.

Diabetes: It’s Not Just the Sugar

Type 2 diabetes (T2D) is the condition on which Dr. Pizzorno has spent the most research time. It turns out, toxins are as big a driver as sugar.

While there is a correlation between sugar intake and T2D prevalence, Pizzorno points out that average per-person sugar consumption rose steadily in the US for more than a century—from roughly 20 lb per year in 1860, to 80 lb in 1960-- before there was a noticeable uptick in diabetes.

Even into the early 1960s, prevalence was still around 1% among US adults. It was unheard of in children and teens.

Diabetes prevalence actually tracks much more tightly with production of synthetic organic chemicals (pesticides, herbicides, flame retardants, “non-stick” compounds, etc) than with sugar consumption.

DiabetesChemicals NeelIn the early ‘60s, when US production of synthetic organic compounds was around 25 billion kg per year, T2D prevalence was in the range of 1%-2%. By 1990, when chemical output hit 100 billion kg, prevalence had increased to 3%. By 2010, with chemical loads in the range of 275 billion kg per year, diabetes topped 6% (Neel BA, et al. Diabetes. 2011; 60:1838-48).

“Many different toxins damage or occupy insulin receptor sites,” Dr. Pizzorno told Holistic Primary Care.

The odds ratio for T2D is almost 12-fold higher among people in the 90th versus the 10th percentile for persistent organic pollutants (PCBs, oxychlordane, etc), according to a study published more than a decade ago (Lee DH, et al. Diabetes Care. 2006; 29(7):1638-44).

In a cohort of over 1,200 people, those in the top quintile for the five most common POPs had three times the prevalence of insulin resistance and “prediabetes” as those in the lowest quintiles (Ukropec J, et al. Diabetologia. 2010; 53(5): 899-906).

Pizzorno says phthalates—used in plastics, personal care products, and in enteric coatings of drugs and supplements—are, “the single most important toxins with regard to diabetes. They bind to insulin receptors so the cells can't respond to insulin, making the pancreas work harder to put out more insulin.

He estimated that 55% of Americans carries enough phthalate residues to double lifetime risk of diabetes. These compounds are also endocrine system disruptors. Several studies show they increase risk of breast cancer in women.

According to a CDC report from 2009, the vast majority of Americans have significant levels of phthalate metabolites in their urine (Phthalate Fact Sheet, CDC. Nov 2009). More recent data indicate that some children show levels as high as 20 times the tolerable level.

“Toxicity has become the new normal,” says Pizzorno.

Arsenic: Common & Dangerous

POPs are not the only toxins that increase diabetes risk. Heavy metals also play a role, and arsenic is a major culprit.

“Phthalates and PCBs poison the receptor sites, while arsenic poisons the pancreas itself,” Dr. Pizzorno explained.

People chronically exposed to arsenic have a 3.6-fold increased lifetime risk of T2D, compared with those at the lowest exposure levels (Navas-Acien A, et al. JAMA. 2008; 300 (7): 814-822).

Arsenic also raises risk for several forms of cancer—especially lung cancer. It is a major component of cigarette smoke.

But these days, you don’t have to be a smoker to expose yourself to arsenic. Just drink water. According to the Department of Health & Human Services, 10% of all US public water supplies have arsenic levels sufficient to raise disease risk.

Since it is often in water, arsenic ends up in produce. Rice has a particular propensity for absorbing arsenic from water. “It doesn’t matter if its organic rice or not. Organic rice will absorb arsenic just as readily as conventional rice will.”

Pizzorno added that arsenic-containing drugs are routinely used in large-scale poultry farming to destroy parasites and fatten the birds. Though the FDA suspended use of Roxasonethe most widely used of these drugsin 2011, other similar arsenic-based agents are still in use.

A 2013 paper by Johns Hopkins researchers showed that half of all conventionally-grown chicken samples contained high arsenic. In contrast, none of the samples from organically-raised birds showed the toxin. Though the absolute quantities were small (mean of 1.8 ug/kg), repeated exposure of that much over a typical American lifetime is enough to raise bladder and lung cancer odds (Nachman KE, et al. Environ Health Perspect. 2013).

Arsenic also increases gout risk, especially in women. “Gout in women is generally rare, but it correlates strongly with arsenic exposure. If you see gout in a woman, check for arsenic, said Dr. Pizzorno.

Mercury, Cadmium & Lead

“Everywhere there is coal burning, there’s mercury. It’s not a theoretical problem. It’s very real.” Mercury exposure correlates with risk of dementia, ADHD, and a host of dr joseph pizzornocognitive and neurological problems. In kids, it diminishes IQ scores.

Cadmium is a big risk factor for many types of cancer, as well as renal failure, obstructive lung disease, and osteoporosis. It is present in cigarette smoke, fertilizers, and many conventionally grown soy products.

In general, when plants are grown in mineral-depleted soils, they absorb toxic metals more easily. A study published more than 40 years ago looked at spinach grown in healthy versus zinc-depleted soil. The plants in the depleted soil not only contained less zinc, they showed considerably more cadmium.

“Soy is grown with fertilizers that contain cadmium, and the beans are very good at concentrating it,” Pizzorno explained. This is problematic given that cadmium raises breast cancer risk, and practitioners (and marketers) are routinely telling menopausal women to eat more soy.  

Like many toxins, cadmium has a long half-life--about 16 years to be exact. Much of it ends up in the kidneys, and it accumulates over a lifetime. In one recent study, the mean blood cadmium level among Canadians aged 20-39 years was roughly 0.35 ug/L. Among the 40-50 year olds, it was nearly doubled to just under 0.6 ug/L.

Lead is another major issue. “It’s a brain toxin, and there’s no “safe” level,” Pizzorno says. The criminally negligent lead levels in Flint, Michigan’s water are the most egregious and headline-grabbing example of lead exposure. But one need not live in Flint to catch a nasty dose.

Lead levels as high as 10 ug/L can be found in commercial chicken soup products. That’s because lead concentrates in chicken bones, which many companies use to make their soups. Bone-broth fans need to be diligent about using organic chicken.

Glyphosate & BPA

Glyphosate, the main ingredient in Monsanto’s Roundup weedkiller, has become a superstar among toxins in recent years. Exposure has been linked to B-cell lymphoma and other cancers. It may also disrupt the gut microbiome.

Back in 2015, the World Health Organization classified it as a “probable human carcinogen.” One year later, WHO back-pedaled, stating that the compound is “unlikely to pose carcinogenic risk to humans from exposure through diet.”

“Most of the published glyphosate research is fraudulent,” asserts Dr. Pizzorno. But it’s not for the reasons Monsanto claims. “When you look at Roundup, which is 50% glyphosate, the rest is "inert petroleum distillates" many of which are way more toxic than glyphosate. It may be that glyphosate is a marker for these other toxins.”

The case against Bisphenol A, used to make many common forms of plastic, is stronger. BPA is found in food containers, drink bottles, and the linings of cans.

It is clearly estrogenic, it binds to thyroid hormone receptors, and it has been linked to anxiety, depression, aggression in children, asthma, and several forms of cancer. It also binds to insulin receptors and confers an odds ratio of 1.45 for T2D. Dr. Pizzorno estimates that 22% of the population is stockpiling enough BPA in their blood to double the diabetes risk.

An individual who eats canned soups several times per week can easily accumulate BPA levels high enough to raise risk.

BPA has generated considerable media attention, prompting some food companies to adopt "BPA-free" cans. Don’t be fooled.

“They replace BPA w/ BPS or some other related compounds, which either don't have human toxicity data, or may be just as toxic as BPA.”

Its Up to Us

The research that supports connections between toxins and illness is weaker than it ought to be, says Pizzorno. This is partly because for many toxins, the animal models for toxicity do not match well with humans. Further, researchers tend to study toxins individually, but in the real world, they work in concert.

“When you look at toxins in isolation, at typical human exposure levels, the increased risk is often fairly small. However, they become far more problematic when combined with other toxins. As more and more toxins enter the body, they deplete the body’s physiological ability to protect itself.”

Dr. Pizzorno puts little faith in government to stem the tsunami of toxin-driven disease. Toxin-producing industries are far too good at playing politics, and even when regulators do score an occasional ruling, the implementation and enforcement are uneven at best.

Since the wave of effective environmental regulations in the 1970s—including the EPA driven phase-out of lead in gasoline—there have been few decisive victories in federal efforts to keep chemical toxins out of our food, water, and air. Industry efforts at self-regulation are piecemeal at best, fraudulent at worst, but mostly non-existent.

That means people concerned about toxins need to figure out how to manage the risk themselves. There’s no benevolent “they” to protect us.

Three-Stage Process

Based on his years of clinical experience, Dr. Pizzorno looks at detoxification as a three-stage process.

The first is to minimize exposure. That means eating clean, organic produce, increasing fiber intake, avoiding heavily processed foods, and eliminating personal care products containing phthalates, parabens, and other additives.

It also means avoiding plastic food containers and aluminum or Teflon cookware wherever possible, and reducing exposure to herbicides, solvents, and chemical-laden cleaning products. In many cases, patients should consider home air and water filters.

The second step involves preparing the body’s systems of elimination for intensive detox. “You really have to prepare the gut, the liver, the kidneys. Detoxing when the body is not really ready for it is a very bad idea. Start with the gut, by getting rid of the wrong bacteria and replacing them with healthy flora.”

The Toxin Solution details the herbs and nutraceuticals Dr. Pizzorno has found effective for priming the liver and kidneys, and for eliminating stored toxins.

The final phase is an intensive program of caloric restriction, green vegetable juices, botanical protocols, massage, and saunas.

sauna photo 1 385x365Dr. Pizzorno is a firm believer in the therapeutic power of saunas, noting that one can move a lot of toxins out of the body through sweat. The specific type of sauna doesn’t matter as much as the frequency and duration of exposure. He recommends 30-minute sessions every other day, with temperatures in the range of 110-130o F.

Be aware that along with the toxins, intensive sweating eliminates trace minerals. It is very important to replace these quickly, along with fluids.

Public interest in “detoxing” is extremely high these days. Yet there is a tremendous amount of misinformation about it, and many people approach it in a haphazard, often dangerous way.

Pizzorno says the medical community needs to take the toxin issue seriously, recognizing it as the dire public health threat that it is. Detox strategies should be part of basic, routine patient care.

Despite a huge investment in conventional medical research and in healthcare, we have seen a relentless increase in virtually all chronic diseases in all age groups. Something is seriously wrong.”

Using T2D as an example, he stressed that it has become “the most expensive of all diseases on a population basis, accounting for a worrisome 15% of all healthcare expenditures, and one third of all Medicare expenses.”

Medical efforts to manage it focus a lot on glucose control, but doctors seldom look at things like phthalates, Bisphenol A, and organochlorine pollutants.

“We need to change that.”

He’s cautiously optimistic about the growth of the organic food movement. “We have organically-grown foods in Walmart now. If you show corporations and government leaders that it’s big business to produce products that are toxin free, they pay attention. If you show that its good economics, you have a chance to shift things.”

“Let’s be honest, businesses want to make money. Lets give them a better model for making money.”

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