Understanding Environmental Health And Toxins

Jill Carnahan, M.D.

You’re welcome, glad to be here!

Kashif Khan

This is awesome, because in almost every conversation we’ve had, it gets led down a few roads, always. One is like sleep, you know, let’s talk about sleep, and another one is environmental health. But this is a sort of new concept for a lot of people. Not for you, this is what you’ve been screaming from the rooftops for a long time. But we are finally gonna dive deep, and silo this, and focus on it as a topic. Everyone has said, “Yeah, work on your toxins, work on your environmental load, open up that channel to get rid of toxins, et cetera, et cetera.” But we haven’t dove deep, so we’re gonna do that today. To start, what is even a toxin? Like what should people, for the very basics, the ABCs, what does it even mean?

Jill Carnahan, M.D.

Yeah, so I love talking about this topic because people more and more just don’t feel well. They’re like, maybe I’m aging. We give all kinds of excuses, and I don’t believe in just the aging excuse is I don’t feel well. I wake up more achy and my brain is not as clear. So this is one of those things that I call the elephant in the room, which is the thing that is really suppressing our immunity and changing our world, and for many reasons that we can dive into. So toxins are everywhere. They’re in the air that we breathe. They’re in the water that we drink. 

They’re in the food that we consume, and they’re all over in our environment. And we should have, I don’t wanna make this a doomsday talk, because the truth is, our bodies have the capacity to detoxify. We are created and made to do that. We are good organ… Like that’s one of our main functions, is how do we not accumulate these kinds of things that are harmful. So the good news is if we give ourselves the right nutrients and the right tools and the right things, which we’ll talk about, we have everything we need to live in a world that is a little bit toxic. Things that are toxins that you may not think about, our water supply often contaminated with things like arsenic or runoff pesticides, herbicides from farm. Super common, glyphosate is being used everywhere. And so, even now they’re finding trace glyphosate or Roundup in organic wines in California.

Kashif Khan

Oh, wow!

Jill Carnahan, M.D.

So it’s everywhere. Even in, you know, it’s getting… ‘Cause if someone’s spraying a crop, you can’t like have a line in the air where there’s no spray in the organic field and there’s spray… So there’s ways and places that these are everywhere. The other thing that’s happening is we manufacture goods and services and new products. We have all kinds of new, innovative ways to do things, but what’s happening as well is literally thousands of chemicals, exponentially, are increasing and being approved for use each year. And a lot of these have no safety data, number one, in synergy with other chemicals and number two by themselves in human safety. So we feel like the environmental protection agency is there to protect us and they are, but they’re not testing each of these chemicals on humans for decades before they’re released. So there’s a lot of new things in our environment. Even for example, BPA we know is harmful. 

So now there’s new types of BPAs that they say are better, but I’m not convinced that the new BPAs are any less dangerous. So we have things like phthalates that are in perfumes and lotions and creams and things we put on our bodies. We have things like parabens that are same thing, shampoos, conditioners, things like that. We have things like organic phosphates, pesticides, things in our food supply that are used on farming and glyphosate. We have things like heavy metals. And now with the wildfires all out west, I’m in Colorado where it’s a huge area, California, a lot of these places are experiencing more wildfires and more climate change than ever before. 

And in the smoke from the wildfires, we just had a massive fire in my community at the end of the year. And what I realized through that was the toxins in the air quality was just as bad as a toxic mold exposure. And I saw the labs of patients change just with the smoke in the air. So it’s everywhere. And as like the trees are burning, there’s residues from metals and things, so we’re getting… And then if you think about houses nowadays, the back porches are made of plastic types of materials. So this stuff is burning and when things are burning and creating air quality issues, as well as all of these things accumulate, our systems just get overloaded. So that’s just a small glimpse, snapshot. There’s many, many other kinds of things in our environment. And it’s exponentially increasing.

Kashif Khan

And what you said makes so much sense because a lot of people, you’ll see social media comments online or replies to videos and people will say, “Oh, you guys are quacks. This stuff is safe.” Right? And why they say it’s safe is because the people they rely on to vet it for them tell them. This is not necessarily like, go eat this, it’s safe. But there’s no red flag.

Jill Carnahan, M.D.

Right.

Kashif Khan

And that thinking of well, did the science happen in the same context that the human experiences it? And that point you made is so valid and so important because most of it is in a Petri dish, right? Science happens in a lab. It doesn’t happen the way a human actually experiences that chemical and the co-factors, what else did it touch? Where did it come from? To what degree, for how long and consistently did it happen? So you have to understand that how you live is not the way things are tested.

Jill Carnahan, M.D.

Yeah, and two really simple examples that everybody can relate to, number one, glyphosate, Roundup. It was tested, human cells in a lab, it said safe for humans. No problem. But what they didn’t test was the effects on the gut microbiome. It’s a chelator of minerals. That’s how it was originally discovered. And so what happens is in the gut, it chelates the minerals that number one, we need, number two, the plants need, which is why it harms the plants. And number three, our microbiome needs. So the biggest effect of Roundup glyphosate is actually on our microbiome, which affects our whole body, but it’s not the cells of our body, right? That’s one example where it has a dramatic effect on human health, but it’s not necessarily the way that it was tested. The second example is synergy of some of these chemicals. 

They have hermetic effects, which means very, very, very tiny doses. Normal toxicology has, okay, there’s this curve, and at some point, there’s a dose that causes toxicity in 90% of humans. And they use that dose to, you know, regulate what’s the toxic levels of these chemicals. Well, a lot of these types of endocrine disruptors, which mean they have a hormone like effect in the body around organophosphates or pesticides, these will have a biphasic disruption in human growth and development and function. And they’ll have effect it incredibly tiny levels because it’s almost like a hormone on the body and then the standard toxicology levels, and they’re not testing those. And then the other thing that we find is in synergy, when you put two of these together, it’s not just like one plus one equals two. It’s one plus one equals a hundred, or 300, or whatever. So the toxic toxicology changes, and it’s not a typical curve that the toxicologist is looking at.

Kashif Khan

Yeah, it’s exponential in nature when you start to get into those mixings. So when we look at the ABCs, going back to B6, I’m convinced if this was the first time I would ever heard it, that yes, there’s an exposure. There’s stuff out there. Second step is, well, convince me that that’s a problem. Why is that bad for me, right? There’s a lot of people that still say, “It’s fine. My ancestors live this way. It’s fine.” So what does it do to you?

Jill Carnahan, M.D.

Yeah, so it’s all about toxic load. I love talking about this to doctors ’cause anyone, layperson, doctors, whatever, it all makes sense. It’s almost like, and this has to do with genetics. We’re all born with a bucket. If you have genetic snips that affect some of your detoxification, like glutathione or whatever those things could be, your bucket may be smaller. And so you’re born into this world with a smaller capacity for that toxic load. We all can handle some load, and we’re meant to do that. And what we do is, it’s almost like bailing out the water of the bucket. If our detox genetics are working pretty well, we’re bailing out at the same rate it’s coming in, and we’re fine. But at some point, many people reach the threshold or the top of their bucket, it starts spilling over the top.

 They can’t keep up with that bailing motion of getting rid of the toxic load. And someone like me gets cancer at 25 years old. And that was an evidence of my toxic load getting too high for my body. And then it started to damage DNA and cause cancer to develop at a very young age. So what happens is when someone has a capacity, whatever they do, genetically, some people it’s that, you know, the 95 year old that smokes and drinks and is fine and lives to be 105, that person has a very large bucket. And so their capacity… But some of us, like myself, genetically, have a smaller bucket. And so we reach the threshold in our twenties, and we start to be it overloaded. And we have auto immunity, cancers, and neurodegenerative diseases as the top three things that we see. And if you look at the statistics around autoimmunity of all types, neurodegeneration, Parkinson’s, Alzheimer’s, ALS, et cetera, MS, and then also around cancers, those are exponentially increased in number related to this toxic load. So when you think about load, it’s basically like we can handle it to a certain point. But when that load in our environment overcomes our ability to bail out the bucket, then we get sick, and it happens to everybody. It’s just some people have a larger bucket.

Kashif Khan

And that’s the challenge is you get this one size fits all approach. Like, “Grandma smoked ’til she’s 90. I don’t believe you.” Right? “It’s fine. In fact, that was her treatment. She would say, I have a sore throat, give me a cigarette.”

Jill Carnahan, M.D.

Yes, or whiskey, right?

Kashif Khan

Or whiskey, huh? So yeah, I can understand why that would lead people down the path of like, this doesn’t make sense. But you’re off to ignoring the bottom 20 or 30%, and you don’t want be in that bucket. And guess what? For the middle, which is the bulk of us, that person that has those amazing genes that can drink paint and pee it out, and just, you know, no problem. We’ve seen it in our data. It’s far, like it’s maybe, I think certain GST genes, it’s like less than 5%. The GSTM1, which is more around the gut, I think like something like 80% of people are off and aren’t doing well. It varies, tiny fraction, less than 9% actually do that properly, right? So, yes, you’re gonna hear stories about people that have no problem, but you’re more likely in the 91% than the 9%. So what then actually happens to the body? Say you’re this person who has the small bucket, who is gonna express some kind of problem. What does the toxin actually do to cause damage?

Jill Carnahan, M.D.

You got it, yeah. And I also wanna mention real quickly. One thing I think about that makes it super simple, and I might have mentioned it earlier is clean air, clean water, clean food. It comes down to really simple things, and we can go do a 21 day detox, or go to Switzerland to the clinic and do a liver… Like we can do these really intense detox things, but the truth is, and this is great for your listeners, ’cause you don’t need a functional expert. You don’t need to go to a doctor. You can start with basics and choose to put clean things in, drink clean water, eat clean food, breathe clean air. And those things don’t have to cost a lot, and they can be very simple inputs that can prevent that toxic load from accumulating. So you can do things, and we’ll talk about each of those categories, and what can you do. 

But your original question was more like, how might we know, how might we know that we’re exposed? So this is where a lot of the toxicity symptoms, and then what does our body do? I’ll talk about both those things. First thing is how would we know? Basically, the symptoms of toxicity can be very vague. And so this is where, like I mentioned before, someone might just think, “Oh, I’m getting older.” They wake up in the morning. They’re more achy or they’re stiff. So pain in general is accentuated by toxicity. Brain is a big one. Brain is affected on all levels. So a lot of people will say, “I’m forgetting things. I have more memory issues. I have cognition issues.” We’re finding mold in particular, which we didn’t even mention yet, and was one of my favorite topics, absolutely affects the brain. And probably the number one complaint we have is cognitive dysfunction. And that’s a toxin in the air that we breathe. 

So that basics of clean air, clean water, clean food, and then the symptoms can be brain, they can be skin, they can be digestive, they can be neurological. So almost any symptom sounds kind of like, it’s not true. But it’s true, almost any system can be affected by this. And you could be more prone to get sick. You could be more cognitively impaired. You could be more rashy or hives or issues with the skin. A lot of times the skin is one of the detox organs. So we will manifest toxicity with acne breakouts, rashes, mast cell activation, which is another whole hot topic where the mast cells that cause release of histamine and other chemical mediators can be activated and cause symptoms all over the body. So those are kind of the symptoms. And then I think your next question was, what else can we do about it? Or where would you like me to go?

Kashif Khan

Yeah, so essentially, like in between, I got exposed to mold and I now have eczema or a migraine, what actually happened? What did the toxin do to me?

Jill Carnahan, M.D.

Yeah, okay, thank you. So how we detox is we do detox through the lungs, through the air that we breathe, and we can externally exhale toxins. More, the primary method is through our enterohepatic circulation. That’s the liver, the gallbladder, and the gut. And I’ll briefly describe this, ’cause if you understand how this works, then those methods that we use to help detox or some of the symptoms might make more sense. So basically, we have toxic exposure. Some of them are water soluble, and they can go in through our body, into the blood, filter through the kidneys, and then out through the urine. Those are fairly easy to deal with, and the kidneys help us in that case. And the urine is the way that we excrete them. Other toxins are fat soluble. 

These are a little more tricky, because we maybe inhale them, or get them in our body through exposure to the skin, or even eating them. And then they can go into our fat tissues and be stored. This is where we need to actually get them out of storage, into the bloodstream. Bloodstream is filtered by our, it’s like the filter in the car is a liver. And that filter of the car basically takes those toxins, transforms them into an intermediate through phase one of the liver, and then that intermediate is actually more toxic than the original. So you don’t wanna stay there. Phase two then takes that intermediate into a water soluble toxin that’s now been changed in form and releases into the bile. 

The bile is stored in the gallbladder, but then the bile goes out, drip, drip, drip through the gallbladder into the small bowel, and the small bowel should excrete it in the stool. But we’re really good at recirculating and basically, recycling the bile. So about 95% is the effectiveness of our bile recycling. So we often use things that have a charge that will actually pull out the toxins through our stool. That’s why we use like clay and charcoal and Zeolight, and some of the binders, because they have a little bit of a charge, and they’ll grab onto the toxins in the bile. And they’ll escort them out permanently through the stool and the body through the gut. So that liver phase one, phase two into the bile, into the gut through the stool is a really prime way of detoxifying some of the fat soluble toxins that get into our tissues. But we still have to have, before we get to the liver in the bloodstream, we have to have a way to kind of release them from the tissues. And that’s where things like dry brushing, infrared sauna, PEMF mats, sweating, all those kinds of things are super helpful. It’s starting to get the body to release that load of toxins in the tissues.

Kashif Khan

Hmm, that’s really cool. And PEMF, so what’s going on there? ‘Cause what I understand is you’re sending electrical currents into your system. So how would that help with toxicity?

Jill Carnahan, M.D.

Yeah, so I’m a huge fan of that and all these other things I mentioned. So anything, any way that you can energetically stimulate the enzymes of your cells to work better, you’re going to get all of these functions better processing. So one thing, like my PEMF mat has infrared and a little bit of heat. So you’re getting a little bit of sweat with that. But even that electrical stimulation, just like one of the mat settings is the Schumann frequency, which is the frequency of the Earth’s surface. So you could technically, that’s why we feel better if we go on vacation to the beach and we walk barefoot on the sand. We’re literally connecting to the Earth’s magnetic frequency. It’s like natural PEMF. And one of the reasons why we love vacations, because if we are on the coast, on the beach walking barefoot, we usually feel better because we’re naturally getting that energetic from the earth surface. But of course we can make it happen with our mats. But those will actually stimulate the… And they’re gonna stimulate mitochondria too, ’cause mitochondria really related to energy. Mitochondria gonna be the main powerhouses that power each cell, and each cell is going through the process of detoxing as well. So that would be the way that…

Kashif Khan

So lying on the sand is literally a form of cellular rejuvenation.

Jill Carnahan, M.D.

Absolutely, yeah! And that’s why key people feel better camping or on the ground. If you go out in nature and you actually are connected to the earth, a lot of people are like, “I feel better.” Because…

Kashif Khan

That’s awesome. That’s awesome. And intuitively, people know that when you feel something, something’s happening, right? Yeah, there’s some pleasure in being away from work, but you know, that lasts so long. When you truly feel rejuvenated, maybe you are. Maybe something happened, right? So going back to what you said about the three key inputs, it’s what you breathe, what you eat, you know.

Jill Carnahan, M.D.

Water.

Kashif Khan

And water. When I think about eating, to me, that becomes complex. And I’ll give you an example with myself. So there was a drink that I really enjoyed that was a carbonated drink that had stevia in it, so I kind of felt guilt free, right? There was very little in it. It was carbonated water, stevia, and a natural flavor, right? I drank it for three, four days in a row, and I started getting headaches. And I thought, what did I change? And the only thing I could see was this. So I stopped drinking it, and the headaches went away. So I looked up natural flavors. And I found a natural flavor is derived from a plant or an animal, so it’s natural. So I said, “What’s wrong with that?” Then I found, in order to process it and get it into that drink required 75 chemicals.

Jill Carnahan, M.D.

Wow.

Kashif Khan

Yeah, and it’s usually up to a hundred. It’s 75 to a hundred, right? But none of those are required to be listed because they’re not ingredients. Those are processing chemicals to take that thing extracted from the plant, get it ready, put it into the chemical, put it into the food, whatever. So how does somebody know what’s clean? Like even you go buy a bag of organic quinoa chips and you feel all great about yourself. It was still processed on a heavy metal machine that’s cleaned with sprays every couple of days. Where do you start?

Jill Carnahan, M.D.

So this is such a great question, ’cause it can be totally overwhelming. And you just put a perfect example as far as like, “Okay, I’m trying to do this good thing.” And patients nowadays are so confused ’cause they hear keto, they hear paleo, they hear vegetarian, they hear everything in between. And like, what am I supposed to do? And here’s an interesting thing that I’m sure a lot of listeners will relate to. Dilution is the solution to pollution.

Kashif Khan

Wow.

Jill Carnahan, M.D.

‘Cause our bodies, if they’re polluted, they’re going to dilute, and gain weight. How many people have you heard now that are struggling with unexplained weight gain? Can’t lose weight more than ever before in my practice and people who are eating good, exercising right, they’re doing the right stuff. But it’s not calories in, calories out anymore because the body is smart. And it’s like, if you’re toxic, I’m going to protect you by putting more fat in your system to dilute the pollution. So this is a big deal because as they gain weight, they’re confused. They’re like, “What am I gonna do?” And the same thing with the diet, they’re like, “I’m eating really clean. I’m doing everything I’m supposed to do. I’m not losing weight.” I hear that all the time. And the first thought that I have as a clinician is there’s a toxicity issue. 

And what I know to be true is we can do all the right weight loss things in the world, but if they’re super toxic, like say they had a mold exposure, or say they had chemical exposures, or heavy metal, mercury, or lead issues in their body, it’s going to be very difficult for them to lose weight. Because when they start diluting, they become more toxic. So when they actually lose the weight, and I’ve seen that over and over again too, for someone in the wrong order wants to lose weight first, before they detox. They get very sick when they lose weight. And they don’t feel well, and they gain it back. So this is a big deal with our people. So it is a what to eat, back to your original question, what to do. What’s unfortunate is this the right limiting factor for all of us, including me, is convenience.

Kashif Khan

Right.

Jill Carnahan, M.D.

And I’m gonna pause there, because if you think about it, if you could grow your own food, you could harvest it, you could cut it up, chop it up, and eat it, and it was real, whole food, we all know that’s the right way to eat. But how many of us, including you and I, have time? Unless we have a full time gardener and chef, right? Like that is not practical. So what we have done is we’ve sacrificed what’s really good for us, which is local, organic, homegrown, if possible, as close to your source as possible, and one ingredient, two ingredients, maybe three, you know? Then cooking with these real foods or having chickens in the backyard for eggs, if you’re eating or that kinda thing. That’s the way it should be. The practicality of that for most of us is almost impossible. 

So then we have to compromise by how can we get, even for example, for me, I’m gonna confess here. I would rather grow my own broccoli, cut it up, have it for salads and stuff. I buy it cut up. It’s organic, but it’s cut up in a package. It’s got plastic around it, right? Because that saves me five minutes and five minutes to me is valuable. And again, I’m just confessing here ’cause I don’t do things all right either. But if I were doing things right, you know? So we all know like going back to real food, real sources, things we can identify with one or two ingredients is ideal, but then how do we do it in a real world? Anytime you take even a grain, for example, rice, if you take full, you know, whole grain, organic rice, and you cook it for a half hour, and make your rice or quinoa, that’s gonna be better than if you take a product made of rice and process. So rice crackers, rice cookies, rice cakes, quinoa cakes, quinoa grain.

So anytime you take something to the more processed form, even if it’s organic and made of a few ingredients, you’re losing quality. So I always say go to the more, less complex form. But again, you have to figure in the time factor. And then as far as what’s right, grains have become kind of villainized. And so a lot of people are on paleo diets. The part of the issue there is I think our digestion has been impaired by a lot of this. So we have more trouble digesting grains. And if you have bacterial overgrowth, or fungal overgrowth, or issues in your gut, sometimes the grains will exacerbate. But a bigger issue no one’s talking about that I think might be the real culprit, is grains are the most commonly contaminated with molds and microtoxins. And as our grain and food supply is adulterated and stored in bins and things like that, I think that maybe the reason people are feeling better on a grain-free diet is ’cause they’re avoiding most of the microtoxins.

Kashif Khan

That makes a lot of sense. And I feel the same. And there’s also chemicals use to dry things and preserve them, which are not listed as ingredients, right?

Jill Carnahan, M.D.

Yes.

Kashif Khan

I know in Canada, there’s a chemical that’s actually illegal in most of Europe, that’s used to dry wheat so that it could be stored in the grain silos.

Jill Carnahan, M.D.

Yes.

Kashif Khan

So that it could be processed and held. And it’s a pure toxin, I don’t know else to describe it. And that’s why it’s literally illegal in other countries. So this is awesome because you start to think about how it goes in, and what you’re putting in, and doing the right thing. Going back to the water, which is two of three things. What does clean water mean? How do I know I’m doing the right thing there?

Jill Carnahan, M.D.

Well, we trust our city’s and municipalities to test and treat and that we should be getting clean water. Granted, that hopefully is the case in many cities, but there are still quality issues of water, even in our city and municipal water supply. So I recommend patients test their water, and I think we should all have good water filters either in our fridge; the fridge filters can be great, but often the free standing pitchers are things that you can buy. I have a Berkey water filter. You can get reverse osmosis for a whole house and under your sink. You can get like Clearly Filtered is another great brand. So there’s different brands of things that you can have. And they, most of them are incredibly good at filtering out all the particulate. The two that I mentioned, I think there’s 200 chemicals that they’ll filter out. 

The reverse osmosis, which is the most common for a whole house filter is great. But there’s a caveat. Reverse osmosis will also remove minerals. And we need minerals. And minerals create a more alkaline product, which is why I do recommend we drink, like I’m right here, have a glass of San Pellegrino, which is just any good or European mineral water. Because it’s still, it has the rich minerals from the rock and that actually alkalinizes our body. When we’re more alkaline, we do better detox. So just by drinking mineral water, still or sparkling, we’re going to help our detox between meals. But when we go to reverse osmosis, it’s a very acidic water, ’cause the minerals have been stripped away. So if you are using reverse osmosis, it’s a very clean water, but you’re losing minerals. And if you drink that acidic water, your body has to buffer, because it keeps the pH steady in your blood. 

So what it’ll do is it’ll pull minerals from your bones. So you could be more prone to something like osteoporosis if you drank only acidic mineral, you know, reverse osmosis water your whole life and didn’t replete minerals. So patients who do use reverse osmosis, I always recommend taking a mineral supplement, calcium, magnesium, phosphorus, et cetera, zinc. And then I am a huge fan for detox, as well as encouraging patients between meals to drink mineral water from European or other sources like that. But it can be tricky ’cause we just went through that whole thing and you can’t use, you know, ROS gonna cause acidic, but test your water. Make sure that there’s no issues there.

Kashif Khan

What do you use to test it?

Jill Carnahan, M.D.

So most counties and cities will have free testing. So you can actually use that. There are a few paid tests. Off the top of my head, I don’t know the companies, but you can actually get a water test, send in a sample, and get a report. And again, because cities have to do this and they have to share if you would ask your city, they would have to give you a report of their water testing.

Kashif Khan

Oh, wow!

Jill Carnahan, M.D.

You could ask who they use. So first of all, I’d just ask for a report. It’s free. And then second, I would maybe do an independent test if you were concerned. Recent example, I had a patient who had natural gas. They had a well water, and so well, for sure, if you have a well in your farm or your place, then absolutely, you need to test that. Because of course, you’re the one regulating that. There’s no one watching that for you. I grew up on a farm and had cancer at 25, and we drank well water. And I have no doubt in my mind that some of that well water probably had contamination from the runoff of chemicals from the farm.

Kashif Khan

Yeah, it makes a lot of sense. People think of things as siloed, like the land is there, the water’s here. No, it’s all working underground and doing things that you’re not thinking about. And it’s all seeping in, right? And then the last one, I mean, other than walking around with a hazmat suit, how do you deal with air? Because I could understand in your home, but how do you manage that?

Jill Carnahan, M.D.

Okay, so this is big, because even, I’m super knowledgeable on environmental toxicity. And when I heard Walter Crinnion, maybe five years ago, talk about this, and he said 80% of our environmental toxic load is from the air that we breathe. I was shocked, but it’s true. So this is probably the biggest one. And again, we take it for granted, ’cause we’re just breathing every day. We don’t know. I, like I said, after the wildfires here, I realized how toxic the air quality became because of the burning of all this materials that are manmade, and plastic, and everything, and the trees, and everything as well. So air quality, what to do? I would recommend at this point in time that most of us have a good quality air filter in our homes and offices. So for me, in my other room, I have a standalone Austin Air air filter. I actually have three in my condo and five in my office, and we have really good air quality because of that. 

You don’t need to use that brand. There’s many, many other great ones out there, but what I recommend is you get a good HEPA filtration system. That’s gonna be the particulate, and then you also wanna have a good VOC, that’s volatile, organic compounds. These are like fumes from chemical off gassing, things like formaldehyde. And the way that a filter will have a VOC is usually it’ll have a clay, or charcoal, or zeolite center where they actually pull out, from the air, those VOCs. And that’s really important, as well, because as we look at the studies, the nano particulate from exhaust and the VOCs like off-gassing from carpet and cabinets and mold, those are probably the most toxic. And they’re gonna be way too small to be filtered by HEPA. So these are like 2.5 microns and smaller, and you really need a VOC filter to get those. For example, the one I mentioned has a VOC filter up to 2.5 microns. It will filter viruses. So it’s funny,

Kashif Khan

Wow!

Jill Carnahan, M.D.

actually during COVID, we had five filters in our office. Our office worked the whole time. We all remained well the first two years. And part of it, I think, was our air quality.

Kashif Khan

Yeah, that’s makes a lot of sense. There was a lot of companies out there that dealt with sort of industrial air cleaning. For example, food processing facilities. And they did study saying that, wait a second, when we put this in a certain environment, you can’t find viruses. You know, that’s literally, they proved it. This didn’t get out into the mainstream, but there’s plenty of papers. I know the University at Florida, I believe, published something with one of these companies. So going back to what you were saying earlier about telling us some of the ways you may feel. Here’s some of the warning signs. So I get that, now all of a sudden, if there’s, you know, all the question marks. Migraine, skin, why is this happening? How does someone then know which environmental insult is causing that?

Jill Carnahan, M.D.

Got it. And one thing I wanna mention too, that’s real important that I ask in my histories, is have you gone on vacation recently and felt better? Now we have those things like walking barefoot that help too. But environment is gonna change with our location. So often, if you’re questioning, “Okay, could this be my house or my office or the outdoor air?” ‘Cause there was fires or something in my location, if you change locations, so for example, say someone moved to Denver five years ago, and their whole family’s having health issues now ever since they moved. There could be multiple reasons. But if it’s their whole family in the same house in a new environment, there’s a high likelihood that in that house, there could be something like mold or natural gas or maybe fracking that’s affecting the water, which we didn’t even talk about. So some of these things that could affect their environment.

So one clue that it’s environmental is if you feel different in different environments. And granted, there’s things like altitude, there’s things like air quality, there’s things like water, so there’s more than one input, but that is a big clue. I had a patient who had, you know, mold in her house. She went camping outside for 10 days and all of her symptoms resolved. So we knew there was an issue with that environment. We didn’t know what, but we knew there was an issue with her home. So that’s one thing real important, because if you change environments and you feel better, there’s something going on in your environment. Or if all of your family is sick ever since you’ve went to a new home, there’s something going on in that environment. So that’s the first thing. And then like you said, it can affect any system, any kind of thing, cognitive’s big, skin’s big, all of that. What to do about it? Is that our next?

Kashif Khan

Yeah.

Jill Carnahan, M.D.

I keep going up off on tangents ’cause I get excited, and then I’m like, “Okay, pull me back in and tell me where we’re going.” So first of all, find out if there’s an issue, and ways you can do that. Mold is a big one. And I’m just gonna talk a little bit about that because it’s kind of a prototype for a lot of the other toxins. So say, for example, you had a little water leak from your dishwasher or under your sink, and you thought no big deal. You’d dried it up. But over the next two years, there was mold behind the walls you couldn’t see, ’cause that wood particle board got damaged. Most of the time, if I would just say, do you have mold in your home? 99% of people are like, “No, there’s no mold.” Because it’s not visible. We don’t think about that. But most of the time, if it is in your home or environment, it’s hidden, it’s behind a wall, it’s under a sink, it’s under floors. And it can still be a big issue because it’s constantly this living, growing organism that’s putting off these volatile organic compounds that are so toxic to humans. And we can get sick from that even if it’s hidden, and we can’t see it. So that’s the first thing. 

Second thing is you wanna think about, have I had any water damage, water intrusions, is the attic sealed? How’s the crawl space? Have the windows been leaking? Is there condensation that’s not supposed to be there? Is there water leaks under the sink, dishwasher, or washer dryer? Is the vent of the dryer appropriately vented? So all that, is the bathroom properly vented? So there’s not humidity accumulation. So all these things matter. And then the second thing is how do you feel in that environment? And if there’s an issue, you can start by testing the dust in your environment, through a qPCR test, any patient or person can get that themselves. And just see if there’s any evidence of mold in the dust of your home or environment, because that’s a great way to kind of test. And say you find a loads of stachybotrys chartarum, which are really black, toxic molds, then you can go deeper and hire an inspector and say, “Well, where is this coming from?” But it’s a nice, easy way to check. 

As far as air quality, you can buy on Amazon, a air quality meter yourself. There’s super high quality in the thousands of dollars that you might get from an inspector. And there’s ones that you can use for personal use that are a hundred dollars or more, but much lower cost. And they do work. They check particulate matter, like we mentioned, that 2.5 or below. They can check the particulate in the air, which can be from even cooking or from particulate from fires. They can check the VOCs, the volatile organic compounds, which can be from like cabinetry, or new carpet, or any sort of new materials, or they can be from mold. And they can also check levels of formaldehyde. So you can actually get a meter yourself and check your air quality in your home. And that’s a good way to start, as well.

Kashif Khan

So in your home, there’s a level of control. It’s your environment. You make decisions. Then many people have to go to other environments, like work or family. And if, you know, like you said, especially if it’s work where you have to go daily and you know that’s the place that makes you feel not so well. Are there things you, ’cause you can’t convince, maybe you can, but you can’t convince the whole building to be ripped apart and fixed because you don’t feel well. So are there things like supplements or other things you could do to support, you know, you not feeling well in an environment you don’t control?

Jill Carnahan, M.D.

Okay, great question. ‘Cause this happens all the time with landlords or workplaces or whatever, where the patients are stuck, and they have to either go to work, or they’re renting a place and their landlord or their boss doesn’t understand. So yes, number one is that air filtration. So if it were me and I was to have an office cubicle or I was in a situation where I couldn’t change it, even rental, I would get a standalone air filter, sitting right beside me. And like actually run that, again, if I’m sitting in the office, because that will help a lot. ‘Cause that makes a bubble around you, the air quality at least there is pretty filtered, and it’ll decrease the load of what you’re being exposed to. If you’re really, really, really sick, some people have to make choices of leaving the job are changing, because if you are really sick, which is a caveat, some people just have mild symptoms. They maybe have allergies that they can deal with. 

But if you’re really sick, you probably won’t get well if you’re gonna stay there. Because it’s just one of those things where you’re like bailing out, kinda like the bucket. Your bucket’s become full and you can’t really unload, but things that you can do and have control over. For example, I travel a lot and I’m still mold sensitive, but hotels all the time are moldy. So I take charcoal with me everywhere I go. It’s in my travel bag right here. And literally if I feel funny or feel a mold exposure, I will take charcoal. It helps me almost immediately. It’s incredibly effective, incredibly cheap, just plain, old activated charcoal you can get at your local drugstore. You don’t need a special brand or kind or anything. So that’s a really helpful tool. Anything you can do to enhance your glutathione production, so you can take liposomal glutathione. You can get IVs, you can take under your tongue, you can take oral, but some people don’t tolerate that. And there’s precursors as well. 

Those would be acetyl Cysteine, glycine, glutamine, vitamin C, selenium, you can take all of those things, or one or two of those things to enhance. I take most of those every single day. So I just have in my system, a lot of precursors and a lot of support for that glutathione production. In the situation where your lungs are affected or someone maybe has asthma, or they have a chemical irritant to the lungs, you can actually nebulize. You’d want, this would be a prescription from your doctor. You don’t wanna use over the counter, because it needs to be sterile. But you can get glutathione or NAC to nebulize in a nebulizer, as well. So you’re breathing it in, and that’s a great, if people have primarily lung symptoms, I will give them nebulized glutathione or NAC. And it’s incredibly effective. Even post COVID, I would give people that because it really helped clear up the lungs and the inflammation there.

Kashif Khan

Yeah, well you make me think of, you know, people when they finally agree to get to work, meaning yeah, this is something I need to focus on and fix. You think of that in the context of your home. That’s where your brain goes, right? And people will do all that work, go to work, and really never put two and two together. Because they don’t think of it as an environment they control, so they never even start to think about what they can change. And it reminds me of, so I’m in Toronto. Not far from Toronto, there’s a city that is considered the cancer capital of Canada, right? It is also the steel manufacturing capital of Canada. So the industry that that city is built on is people working in these steel manufacturing factories, breathing in toxic chemicals from them processing the metals all day long. And it’s the cancer capital. But if you look at, you know, go to their homes, things are clean and organic and nice. And then the exposure maybe isn’t at home, and it’s just, even just the cognition and bringing that forward, and even thinking about it, it’s hard to even get there for some people.

Jill Carnahan, M.D.

It really is. And I love that you say that, ’cause these are not easy solutions. Like that’s why this topic can be very depressing. Like, okay, I give up, right? ‘Cause it’s just, it’s environment. Nothing I can do. And for example, with the wildfires, I talked to some experts right after the wildfires. We could all tell, literally, the outdoor air was worse than indoor. It was horrendous. I would get headaches and not feel well, ’cause there was so much soot and chemical from those fires in our air for the couple weeks after. And I literally talked to some experts and they said, okay, go get an N95 respirator, which is one of those that has charcoal. I’m sorry, not N95, N100. And it literally is the kind that has the-

Kashif Khan

A doomsday mask.

Jill Carnahan, M.D.

Exactly! And you wear that around, along with… She recommended I wear that out in public when I’m walking my dog. I’m like not gonna do that, even though… And granted, it’s a great recommendation, but it’s so extreme to go to those levels, right? That it’s like, okay, we’re weird. There’s something wrong here. And we’re not, it’s just like protecting our bodies. It makes sense. But that level of protecting yourself can sometimes be really inconvenient or feel really strange. And if I really had wanted to protect myself, I should be wearing that N100 mask around outside, well, you know, three weeks after the fire.

Kashif Khan

Yeah, what people think is a real big priority. That’s a problem, right?

Jill Carnahan, M.D.

Yeah, it is.

Kashif Khan

What are they gonna think? How is it gonna make me look versus how am I gonna feel and what am I slowly doing to myself over time? So yeah, it starts at awareness and understanding that it’s even something to look at and then it starts with habits at home and habits at work, and understanding the day is 24 hours. Not just when you’re sitting in your bed, right?

Jill Carnahan, M.D.

Speaking of, that’s one little thing I wanna mention too, if you have to, all of these things, whether it’s buying organic or shopping local, we have to make choices. ‘Cause none of us can do it all perfectly. And that’s okay. You’re gonna be fine if you don’t, but you mentioned something is sleep. We spend eight hours or sometimes seven in our bed, in our bedrooms. So if you have a choice of where to focus and you can’t do everything, that’s where I would focus is the air quality in your bedroom and your bedroom sanctuary. Like if you had to make a choice, that’s where I’d put the air filter. That’s where I’d focus on, you know, those kinds of things, because you’re spending a lot of time there. And during the night is when our immune systems regenerate and do most of their work. It’s when our liver does most of the work. It’s when we, a lot of the things that happen in our brain through the lymphatic system, which is the detox of our brain, it all happens overnight. So if you have to focus on something, think about your sleep and where you sleep, and the quality of air when you sleep. And those kinds of things in the bedroom would be great.

Kashif Khan

That makes so much sense because you’ve just taken literally 30% of your day and dealt with it. And it’s a time, like you said, it’s isolated. You’re in a room and you’re detoxing anyway. And you can support that process. So how often do you have to get into things, like people’s mattress or blankets, or things like fire retardants, memory foam, how important are these things?

Jill Carnahan, M.D.

Yeah, so a couple little areas, furniture. The sad thing is almost everything, legally, has flame retardants on it. I think California’s the most progressive state. So a lot of times manufacturers in California or sales in California, they’ll actually list a lot more clearly what the harmful chemicals are in a product. Whereas like here in Colorado, we may not have the same disclosures because we don’t have the same legal protection in place. So you can sometimes see in the state of California, this thing is considered a carcinogen, where you wouldn’t see it in other states. And that can be important. Mattresses, furniture, very commonly contain flame retardants. So again, if you’re spending a lot of time, especially a mattress, you want an organic one that does not contain flame retardants. And granted, it’d be great to have all organic cotton sheets and stuff, because then you don’t have all those chemicals. 

We do absorb a lot through our skin. So women and men, bath and beauty products are a huge source of toxins. Young women, makeup is a lot of, they often would have heavy metals, or parabens, or thalates, or those kinds of things in there. I remember when I got cancer at 25, one of the things was why did I get cancer at 25? And I went through all of my bath and body and cleaning products over a year or two, and really started understanding how much was in the things that I was using. A great resource that’s free and nonprofit is Environmental Working Group. They have a database on chemicals in different products, especially hair, beauty, makeup. So if anyone’s wanting to look up their product and see if it’s safe, that’s a great resource. You can go there, it’s free, and you could look that up.

Kashif Khan

That’s awesome. And something you just touched on there, I mean, we could spend an hour just on this. But in general, everything we’ve been talking about applies to everybody, but then when you look at women, there’s a whole other threat when you have environmental toxins interrupting your hormone cascade. Which yes, and for sure, it also has a problem for men, but the impact is just so much more aggressive, severe, obvious when it comes to women. How much of that do you see in terms of hormone disruption, because somebody’s already environmentally sick?

Jill Carnahan, M.D.

Massive, massive, massive. And again, my cancer was breast cancer, which is a hormone related cancer at 25. So it was absolutely part of my story. One thing I found, you mentioned chemicals that were banned elsewhere and not in Canada. There’s one that is still used in the US called atrazine. And this was made famous by “Silent Spring,” that movie and book about how a lot of the runoff of waters was causing changes in the frogs. And they were all of sudden not being able to recreate or produce any frog babies, because they didn’t have the right genitalia. And that was all from the atrazine runoff. So it was a massive endocrine disruptor. It was banned around the time I got cancer 20 years ago in the EU, in the European union. 

It’s still used today, frequently, in the US and the area I grew up in was a farm area, is one of the highest concentrations in the entire United States. So talk about endocrine disruptors, there’s no doubt in my mind, there was probably some atrazine exposure to me and probably in the water supply, in the well water, and had a hormone like effect. And what that does, a hormetic or hormone like effect, or endocrine disruptors, all this means is these chemicals act on our body like a hormone would. So it confuses the body and starts to stimulate or do something that a hormone would in excessive levels. And women could have endometriosis, PCOS, uterine fibroids, dysmenorrhea, which is irregular, painful cycles. They could have infertility, a big one for both men and women, and cancers like breast and prostate. Those are all things that are becoming more common because of the endocrine disruption.

Kashif Khan

Yeah, and this is why we say that it’s a red flag for women because women have to deal with estrogen toxicity, which men really, yes, it’s also existent for men, but the amounts are trace, so it’s not really a big deal. But there’s a whole other health concern women have to deal with. So if you already are estrogen toxic, which so many women are, and then you’re adding a whole other layer of, really, estrogen, because that’s what your body treats it as, hormone. Then you’re fueling that fire in a big way. And you wonder why so many more women have breast cancer issues, ovarian cancers, all these estrogen toxicity problems. So how do you then deal with that? Because a woman’s gonna come in with fibromyalgia and she’s gonna say, “Treat this.” And you’re telling her that it’s a toxicity problem. And she’ll say, “Well, no, fix my problem. I have fibromyalgia.”

Jill Carnahan, M.D.

Yeah, and you asked another question earlier that I ran right by. And it was like, how do you know what to go for? And what do you… So we do like in my clinic, in functional medicine, we do testing. But one thing, as I teach clinicians, it can be overwhelming, this topic. And to find every toxin in your bucket can feel like a insurmountable type of thing. So the important thing is to know we’re all toxic, period. Some of us feel a lot better than others, but we can assume there’s toxicity. Now, granted there is different ways to detox different chemicals, and what we do is urinary testing. We can do blood testing. There’s different ways to test for these and get kind of an idea of what’s happening, but there’s no perfect test, and there’s no panel that does all of them. So the best we can do is kind of get an idea of what might be happening. 

Is it more the paraben, sulfates, persistent or organic pollutants, pesticides, or is it more the heavy metals, or is it more mold, or something else? And then what we can do is the great thing about detox is the same principles that work for liver, gallbladder, gut, some of the stuff I described. They will detox most chemicals. So you can put patients on a detox protocol, which would involve some way of mobilizing toxins that could be dry brushing, infrared sauna, epsom salt baths, PEMF mat, getting outdoors, sweating, exercising, mobilizing the toxins. And then the supplements would be something along the lines of the stuff we talked about for glutathione, liver support is huge. 

So milk thistle, NAC, acid, anything in the realm of supporting that liver detox pathway; B vitamins, methylated B’s, sulforaphanes, and things that are related to phase two, and all of that. And then binders, binders are a huge part of it. And you can do different type of binders for different types of chemicals, but basics are clay, or charcoal, or zeolite, or glycomanins, or chlorella, those are all common detox binders. That will do a protocol that would detox most of the toxic load. Now, if you’re dealing with a certain heavy metal, you usually need something like DMSA or EDTA or something stronger that specifically binds to that metal. Zeolite can also be helpful, but those are kind of the basics of detox.

Kashif Khan

That is so awesome. I’m thinking that I need to come to Colorado and spend a week in your clinic. So do you actually clinically see patients too?

Jill Carnahan, M.D.

Yeah, I do.

Kashif Khan

That’s awesome. So how does somebody work with you and your team?

Jill Carnahan, M.D.

Well, I have a very busy clinic and a wait list. So I do have a PA who sees patients, who’s taking new patients. And this is one reason why I’m on here with you. I do free blogs. So the best way is I’ve got tons of free resources, ’cause there’s a lot of who can’t see me. So on my website, jillcarnahan.com, there are 10, you know, a decade or more of free blogs, all about these topics. If you wanna know more, Jill Carnahan, M.D. there. So I often post articles and blogs there. And of course I have a podcast called Dr. Jill Live, which is on iTunes and Stitcher. And everybody can find it in YouTube channel, as well. Where again, just trying to get out the information and empower patients to help themselves.

Kashif Khan

That’s awesome. And I’ve been watching you do that for some time now. We originally met, it may have been three or four years ago. I’ve listened to the podcast. I’ve seen you on various podcasts speaking and you have never stopped going out there, and just preaching, preaching, preaching, preaching, because there needs to be awareness. If you three years ago, nobody knew what environmental health meant.

Jill Carnahan, M.D.

Right, right.

Kashif Khan

And you’ve been doing it for a long time. But now people are starting to understand, and you’re seeing more articles about endocrine disruptors, and women are starting to learn, and it’s becoming sort of normalized. But it was your work that made that happen.

Jill Carnahan, M.D.

Thank you.

Kashif Khan

I mean, thank you for that.

Jill Carnahan, M.D.

Oh, thank you.

Kashif Khan

And again, you’ve done it here again today. You know, we thank you for your time. So this was amazing. It’s great that you’re able to join us and part your knowledge on us. I would advise anyone that wants to learn more, go to the blogs, get the books, listen to the podcast. Jill has been everywhere. So it’s very easy to get that information. Thank you, again. This was amazing.

Jill Carnahan, M.D.

You’re welcome! Thank you so much!