Unmasking Everyday Chemical Exposures That Contribute To PCOS

Lyn Patrick, ND

Thank you, Dr. Gersh. I am happy to be here. It’s my honor to speak at your summit. This is a crucial topic, and we’re going to go into great detail about the wide range of environmental exposures that have an impact on both women and men in terms of reproduction, as well as other health problems. How did I get into this field? I’ve been teaching and researching in the field of environmental health and environmental medicine for a little more than 20 years. The way I got into it was in my practice, where I saw a lot of patients who had become sick as a result of multiple mercury amalgam fillings. A good percentage of my patients were dentists. I’ve been practicing for 40 years, and I’m dating myself. But back in the day, dentists were taught to roll amalgam fillings in their bare hands without wearing gloves. That’s dermal exposure. It goes into the hands. I was at least given a little bit of insight into the effect of metals on the health of these individuals. I learned how to get mercury out of the body, and people recovered, and everybody was happy. Then in the year 2000, I went to a daylong workshop by a doctor named Dr. Walter Crinnion, who had spent the prior 15 years running a clinic, where he focused on environmental exposures and their effect on health and helping sick people get better by looking for the cause of their illness. I sat there in the audience all day long, listening to the case after case after case, and my mind was just exploding because these were my patients. I couldn’t get better. I didn’t know how to get better. There they were, up on the screen in front of me, with all of their toxicant levels being shown. patients just like the ones I had treated. I was sitting next to an internist, Dr. Sharon Khalsa from California, and we kept elbowing each other, going, “That’s my patient.” At the end of the day, she and I ran up to the front of the room. We kind of accosted Dr. Crinnion. We said, You have to teach us everything. That was the beginning of what became a post-graduate course in environmental medicine. It was called Spirit Med. Dr. Crinnion taught that from about 2001 until he left the planet. He passed away in 2019. Then I took over that class, teaching a year-long postgraduate program in environmental medicine. Between 2001 and 2019, I left my family practice and specialized in environmental medicine. We had an actual clinic that was built for and worked with patients who had environmental exposures. I learned quite a bit. But what I began to learn is that when I started teaching, I taught with Dr. Crinnion in those early years, in 2003 or 2004. I started teaching, focusing on metal toxicology and then expanding into a field called endocrine disruption, as well as looking at the effect of pesticides, solvents, and other toxic exposures on the health of everyone. that back then, I would say in the eighties, when I first started practicing, it was rare. 

I’m sure that because you were practicing medicine, seeing someone who was sick because they were exposed to a chemical is very rare. Today, whether our patients know it or not, chemical and environmental toxicities and exposures are common. It’s ubiquitous. We are marinated in a sea of what people refer to as toxins, but it’s a wide-ranging class of chemicals. The problem is that they don’t know it. They’re not aware of what’s in the food, water, and air that we breathe. They’re affected in a way that is pretty sneaky because there’s no knowledge of that exposure. Our job as physicians is to play detective. We have to test for those chemicals. We have to help our patients find out where they come from, and then we have to help them avoid exposure as well as deal with what’s called a body burden. We accumulate some of these chemicals. The one we’re going to talk about today is one of those chemicals. When we get into it, we’ll talk a little bit more about how it gets stored in the body and how we can get it out. That, in a nutshell, is kind of my history, at least in the last 23 years of my practice. What I do now is teach physicians from all over the world. We have an online program where we take a whole year because that’s literally how long it takes. We learn about all these chemicals, how people are exposed to them, what kinds of illnesses they get as a result of that exposure, what kinds of signs and symptoms there are, and how we can address those chemicals and avoid contact with them. First of all, it is not as hard as it might sound, and how to get them out of the body so that people can recover.

Felice Gersh, MD

Well, we are going to delve into a lot of those different facets because they’re critical if you’re going to be optimally healthy. It’s just an under-recognized, huge, ubiquitous problem for all of humanity at this time. We have much in common because I followed in your footsteps, but about a decade later, I took Walter Crinnion’s course and met you. I was speaking at his conferences, and that’s how we got connected. One of the terrible, ubiquitous chemicals we’re going to focus on initially is bisphenol A, also known as BPA. The reason I got interested in it as a particular toxicant is because that is the one that has had the most focus in terms of women with PCOS, in terms of its exposure in women who are pregnant and then how that affects the fetal development part of the endocrine system, like at the get-go, and how that impacts on the receptor function, particularly of estrogen, but not just estrogen. Others, like melatonin and testosterone, then show that women who have PCOS, when they’ve tested them, seem to carry a higher load of BPA, whether they’re exposed to more or perhaps they’re not quite as good at eliminating it from the body. We’re going to touch on that. BPA is like many others, but this is the one that has had the most research and is critically important for the health, reproductive, metabolic, and other aspects of women with PCOS. I’m hoping that you will share some vital information on this terrible chemical, including where we find it, what we deal with it, the effects, and how we can avoid it precisely.

Lyn Patrick, ND

Pertinent to this topic of PCOS and women’s reproductive health as well as men’s reproductive health, it’s hard to talk about this one all without talking about the politics of the chemical industry, because, as Frederick vom Saal, who is a friend of mine, a colleague, and probably one of the most well-known, well-educated researchers in the field, has said, BPA is the poster child for chemical endocrine disruption globally in the world. Bisphenol A is a high-production-volume chemical, which means that we produce it or import it in billions of pounds a year. We make a lot of bisphenol. It is kind of the underpinning of the new plastics industry. We all know, and those of us who are old enough know because we watched the movie Mrs. Robinson, that plastics were a very big part of our industrial growth back in the fifties and sixties that kind of shored up what we know today as an incredible industry. The important thing to remember about this chemical, and this involves the story of Frederick vom Saal, is that he was the first scientist to do research looking at these endocrine effects with bisphenol at levels 25,000 times lower than any researcher had ever dared try to find an effect. 

What he found is that at extremely low doses, this is true for all endocrine disruptors. In very low doses, they can act like hormones. Hormones in our body are active at extremely low levels. He published some of the first studies, and these were in animals, of course, looking at reproductive toxicity at extremely low levels. Now, remember, 93% of all Americans have detectable levels of bisphenol A in their urine; there’s an alphabet soup of bisphenol: there is S, F, AF, bisphenol B; and bisphenol P, bisphenol Z. There are a lot of different types of bisphenols, but A is the one that’s most commonly produced. He got on the radar of the American Plastics Society as a result of publishing this research. He was at the University of Missouri at that time, and I had the great honor of knowing one of his colleagues, Dr. Theo Colborn, who was one of the first researchers to identify and write a book about endocrine disruption. I worked with him to help all of us understand this phenomenon: that we have created chemicals that work in infinitesimal amounts to affect our bodies, and that leads to what’s going on politically with bisphenol, but before we talk about that, it’s probably important to talk about what bisphenol A does in the body. It is an estrogen mimic; it affects both males and females in that way. The problem is that it just doesn’t affect estrogen. I know, Dr. Gersh, that bisphenol A damages the pancreatic beta cells in the pancreas. The pancreatic beta cells are those specialized cells that produce and secrete insulin. When we look at levels of bisphenol in the urine and blood in Europe, they measure both bisphenol and blood. Here in the United States, we measured in urine, but there’s a relationship between how much bisphenol A is in the blood and the urine and the risk for type 2 diabetes. As you said, this can happen in utero as we’re growing in our mother’s wombs. We can be affected by bisphenol A. It does get into cord blood, it does get into the placenta, and it does get into fetal circulation, and it can increase the risk of diabetes at that point or later when we’re children, adolescents, and adults. The research is pretty amazing. They’ve done research where they’ve looked at the blood levels in both men and women, followed them for about nine and a half to ten years, and then looked at who became diabetic and whether it was related to their body levels of bisphenol. They looked at different types of bisphenols, and, yes, it was to the degree that it could double or triple the risk of diabetes. Now, that is huge to have an increased risk for diabetes. That’s two or three times that of someone who does not have levels of bisphenol in their blood. This kind of research has been published. There are thousands of studies now, both in animals and in humans, looking at the effect of bisphenols on diabetes, obesity, and all kinds of male reproductive problems like infertility and infertility in women, as well as the failure of IVF to take place in in-vitro fertilization. 

Higher BPA levels in women who are getting in vitro fertilization make IVF less likely to be successful. There’s some very damning research on obesity and bisphenol levels, both in adolescent males and in adults. Their diabetes chance is that they cause diabetes or obesity since they are reproductive toxicants. They affect the entire endocrine system; they don’t leave a hormone untouched. We have to look at polycystic ovarian syndrome, where there is a direct linear relationship between levels of bisphenol A in the urine and the risk for PICOS. Women with PICOS have higher levels. As you said, we don’t know why. Is it because they’re exposed to more or because they can’t get it out of their bodies? They’re not as good at metabolizing and excreting it. You may know more than I do about this, but in my mind, much more research needs to be done because we need to understand why there are higher levels. We know that people who are exposed to thermal receipts, for example, don’t have one handy here, but when you go to the grocery store, you get handed a receipt. 

That’s a thermal receipt. The technology for making thermal receipts necessitates bisphenols. Now you can substitute bisphenol S with bisphenol A. But it doesn’t matter because the bisphenol is what causes the damage. Dr. vom Saul did this brilliant study where he had graduate students who get a lot of this go to a fast food restaurant. They used Purell, which dissolves a little bit of your skin barrier. Then they grabbed the receipt from the fast food person. They held that receipt in their hand for 20 seconds, and then the researchers figured out how fast the bisphenol was absorbed into the arm, and it took seconds for this animal to be absorbed. They had the graduate students eat french fries with those same fingers, and it had a thermal receipt. They figured out if the bisphenol would be transferred from fingers to French fries to mouth to stomach. They were able to look in the blood and the urine and figure that out. What they found out, especially for women, is that we, as females, put more personal care products on our skin, and part of those personal care product constituents are what are called skin softening agents. They break down the natural barrier in the skin that allows the bisphenol to be absorbed much more quickly. The women had higher levels quicker than the men did. This is just an example of one of the ways that we’re exposed to a very significant endocrine-disrupting chemical in our daily lives. Fast forward to a researcher named Todd Hagobian, a brilliant man who researched women, looking at two groups of women teaching how to avoid bisphenol A. He did this by giving them BPA-free makeup and teaching them about avoiding canned food, especially coconut milk, which is high in bisphenol A. The higher the fat content of the inside of the can, the more bisphenol A. Beverage cans; any aluminum cans are alline with bisphenol A; and beer cans as well. Any beverages. He taught them about thermal receipts. That one group went on a bisphenol-A-free and probably bisphenol-period-free lifestyle and diet for several weeks. Then he had another group of women that he was following with no instruction whatsoever. They just lived their lives. 

What he found was that the level of bisphenol A in the urine of the group that was trying to avoid it went down significantly, and they gained less weight over that intervening period, which was only among the women who were not avoiding bisphenol and had a demonstrable weight gain. This was a small study that needed to be repeated with a larger group, but it was significant. The findings were significant. Now he’s doing more clinical research, looking at women who are avoiding BPA and seeing if there are any other changes, like their blood sugar regulation. Their insulin levels, their hemoglobin—anyone sees all that stuff. He’s doing wonderful research, and we can all learn from his interventions. I’ve corresponded with him. He spoke at my conference, and he said it wasn’t that hard to teach these women how to avoid bisphenol A and all the other bisphenols. The important thing about avoidance is that you don’t have to touch thermal receipts. There’s no reason you can bring an envelope or not take it. Since I read his study, I have become kind of religious about it, and I just bring an envelope and say, Just throw the receipt in the box or throw it in here. 

It’s not a big deal. Avoid canned foods. I learned that from Dr. vom Saul. He has no canned foods in his home. He hasn’t eaten out of a can for decades because he’s tested the BPA in the canned food, and he’s seen that there is a significantly low level of BPA in the canned food. Sadly, we now have a cultural phenomenon. I’ve seen it. I’ve talked to the doctor and refined my use of my colleague’s education about the fact that many people are now drinking canned beverages. There are all kinds of canned beverages, sparkling waters, teas, and other things that come in cans. Every single one of those cans is lined with bisphenol A. There’s one company that makes a plant-based resin that they line their cans with. It’s Eden Foods, but they don’t make beverages. They just make beans, canned beans, and things like that. There are no bisphenols in their food. Other companies are following suit. But what you’ll see is a little stamp on the can that says BPA-free. Here’s where we get into what we call regrettable substitution: substituting bisphenol A with another one of the alphabet soups, bisphenol side B, S, F, P, V, Z. There’s a long list of bisphenols, and many of those companies will say BPA-free, but they’ll be using BPS in their cans. Don’t be fooled by that.

Felice Gersh, MD

You’re being very thorough. I just wanted to make one comment on bisphenol A: that it first appeared on the scene trying to be a pharmaceutical and that it would be marketed as an estrogen. That’s where people need to know that there are chemicals that are pharmaceuticals. One of the things that I have read about is that when they measure BPA in pregnant women, it concentrates on the fetus. The fetus can have multiple times the level that the actual mom has when she’s pregnant with that fetus. So, it’s just like this toxic poison goes into the baby, into the fetus. creates havoc in the developing endocrine system. But I thought maybe just as a quick recap what an endocrine disruptor is like the definition, and then you know I want you to just continue because this is like the most important takeaway is that every woman, especially women with PCOS or women who have PCOS who are now struggling to get pregnant or who become pregnant, can help to lower the risk for their own. children that they’re creating. We want and are always told that people who have children are especially vulnerable during developmental and puberty periods, and so on. continue, Lyn. I just love all this information that you’re getting into.

Lyn Patrick, ND

Thank you. That was crucial—your perspective and your understanding. an endocrine disruptor. The Endocrine Society, which is a global group of physicians, researchers, and scientists, has defined this. What they’ve said is that any substance or chemical, and there are some naturally occurring endocrine disruptors, such as soy isoflavones, affect hormones. They could be thought of as endocrine disruptors. It’s any substance that interferes with the production of a hormone or how a hormone travels through the body. Anything that alters the way that a hormone binds to a cell and sends a signal to the cell—it’s the entire journey of a hormone, not just the production of what we’re doing. For instance, BPA affects the thyroid. It’s not well known, but it is a thyroid disrupter. It affects how thyroid hormones connect to and communicate with every single cell in the body. That’s a simplistic but perhaps adequate explanation of what an endocrine-disrupting chemical is. We’re thinking about, as you said, melatonin, which is made in the intestinal tract as well as the brain, and how its ability to act as a hormone is interrupted, maybe in multiple ways. Maybe it’s not just one way; maybe it’s multiple ways. 

As I said, 93% of Americans have detectable, significant levels of BPA in their urine. That’s not meant to upset or scare anyone. It is meant to empower everyone who now knows that BPA is a problem. It is the poster child for chemicals that disrupt all hormones. I’ve been reading about BPA for 20 years, and I just don’t see any hormones that BPA does not affect the body. It is a ubiquitous hormone and endocrine disruptor. We have to focus on what we are going to do about our exposure, and the number one thing that we can do and how we can be empowered around this is to avoid exposure. Now, there are some exposures we can’t avoid like BPA becoming airborne. It does evaporate from waste dumps. There is some airborne exposure, but the main exposure for us as humans is food—our diet. We have control over that. We can choose not to drink out of cans or eat out of cans unless we know that they’re bisphenol-free, and we can choose to avoid thermal receipt. Dermal contact with thermal receipts—that’s easy. We can increase our body’s ability to excrete BPA. Now, that’s what you mentioned, Dr. Gersh, is that we do metabolize and excrete BPA. It goes in through our mouths and our skin. We metabolize it, and we urinate it away. Our ability to do that is dependent on having good liver function. There’s a specific process in the liver that metabolizes certain chemicals. For BPA, it’s called glucuronidation; plant substances increase the body’s ability to glucuronidate some nutrients. We can easily add those, but we call them botanicals. They’re plant medicines that have a medicinal effect. We can increase our intake of those wonderful plants, like dandelion root. There is probably a list of them, and I could probably go through about 50 different foods that increase glucuronidation. Chlorogenic acid is my favorite botanical found in coffee. One of the reasons coffee is beneficial is because it contains chlorogenic acid. Now you know you don’t want to put high-fructose corn syrup in other things that make it do it. That kind of negates the beneficial effect. However, there are a multitude of plants and nutrients that improve the body’s ability to excrete BPA. We do store it in our fat tissue. It is what we call lipophilic fat-loving. It will be stored in the body. Not a lot of it, but there will be some, and there are various methodologies for increasing fat turnover, like intermittent fasting, which is a great one. Increasing the use of heat in saunas is also known to increase fat turnover. All of us who are schooled in what we call functional medicine talk about increasing the body’s ability to burn fat. Dr. Gersh is an expert in that area; I’ll let her talk about that. But that is one way to decrease the body’s burden of bisphenols, in addition to avoiding them via our changes in diet and changes in what we choose to touch. What do we choose to have contact with?

Felice Gersh, MD

Since I began my journey to understanding the effects of these environmental toxicants, like BPA and its cousins, within that family. And in our household, we got rid of all the hard plastics involving any touch of food. I just feel horrified that there was a time when I bought microwave plasticware, and of course, that is not happening in my home. The only canned food is Eden; I do it sometimes for emergencies when I don’t have time to cook. And they’re not sponsors or anything. We just know that they are great as long as they have safe cans.

Lyn Patrick, ND

Yes, I’ve had conversations with them. I called them up, and I had a conversation with them. Interestingly, they never used bisphenol in the lining of their cans; everybody wondered what it would be used for before we had bisphenols. We used a plant resin compound to line the seams of the cans so they wouldn’t rust. They said we just never switched to bisphenols.

Felice Gersh, MD

Fantastic.   If you do well, you don’t even know it. That’s even better—to stay with the old ways. If you think about your great-grandmother, she didn’t have a life of plastic because it didn’t exist. In the old days, I would take plastic wrap and wrap all my food in plastic wrap, so it’s a different kind of—you get the phthalates—another conversation. But the reality is that I know that if I can change and do all these things, getting rid of, as you said, the cash register receipts if I take them at all, I have like a little baggie. It’s like, put it in the bag. An envelope. A paper envelope. Sounds better.  You’re not doing that. Even the plastic bag thing. It can be part of your new way of living to be plastic-free. I know no one can live plastic-free, but you can do a lot, like when I look at water bottles. Many people are walking around with water bottles, and they’re all plastic. Now you can get glass and stainless steel. There are other options because the manufacturers know that there’s a whole category of people who have learned about bisphenols, and they’re trying to do everything to avoid that. This is doable. Back then, my oldest child was getting a bottle, and now I know I didn’t know anything at the time was BPA in the plastic bottle, and then you’d heat up with hot pot formula to go into this plastic. Oh, my gosh, I don’t know how many years ago they prohibited that one, but I don’t know if they still have plastic bottles. It’s probably just a cousin now—a different bisphenol.

Lyn Patrick, ND

Yes, that was some legislation that affected many children’s toys, but affected bottles. I was just reading an article that was a conversation between Dr. Ramsdell and Susan Nagel, who I know is his protege and an amazing professor of obstetrics and gynecology. She said we have tested the nipples, and they do have small amounts of BPA. For some moms, they don’t have an alternative. For moms who are not able to breastfeed or choose not to breastfeed, they don’t have an alternative. But what they can do as soon as their babies can eat solid food is give them high-nutrient plant foods to help them eliminate that BPA from their bodies. It is impossible to completely avoid BPA. But think about this. The study that Dr. Hagopian did was just with them; they weren’t Ph.D. students. They weren’t doctors. His group and his patient group in this study were just regular folks who knew nothing about BPA. But he educated them, and they made a decision to enter the study to be in the intervention group, they were able to avoid BPA so significantly that some of them dropped their levels down to undetectable in their urine just by doing the things that he asked. It’s possible to do that. 

Remember, those were the two groups of women? The women who avoided BPA did not have demonstrable weight gain throughout the study. The women who did not avoid BPA had a significant, demonstrable increase in their weight throughout the study. It’s what matters to me as someone who’s reading that study; there’s a difference. That difference probably goes beyond just weight to other parts of their physiology, to their endocrine system, to improve the health of their endocrine system as a whole. Where we are at this moment, and this is a conversation you and I were having before we went into the recording, is that at this very moment, literally this week, Dr. Gersh and I are signing on to an article, a meritorious statement, with many other researchers and doctors. This statement is going to the European Union, which is in the process of deciding whether they’re going to follow the guidance of this organization called EFSA. It’s not exactly like the FDA, but it’s kind of a regulatory body. They have recommended to the European Union, the Commission, to lower the allowable levels of bisphenol A 20,000 times based on their complete review of all of the research. This is the first time that EFSA has not been owned by the chemical industry. There’s a whole story behind that, but it’s now a more fair, unbiased body, and they took a look at all the literature, and they said allowable levels of BPA are way too high. They need to be lowered. 20,000 times. The allowable exposure level, or intake level, is called total daily intake. Food and water need to be lowered 20,000 times. If we translate that to the United States of America, that means that we in the United States have been exposed to 5,000 times less BPA than we’re currently exposed to. What this would do is wipe BPA off the table in terms of it being a chemical that we use in production, which is what needs to happen. When I first started teaching and was not educated about BPA, I didn’t understand how toxic it was. But now that I’ve had a chance to read all of Dr. vom Saul’s research, I see that he just published a seminal paper looking at the risk for bladder cancer and kidney cancer in animals who are exposed to BPA at levels that we as humans are exposed to daily, much lower than if you’re trying to poison an animal. You know, he was just giving these animals the amount that we take in daily. It remains to be seen what’s going to happen because this is kind of political theater, but we’re going to do our best to try to get the European Union, the Commission on Health (I can’t remember the exact name), to accept the recommendations of the regulatory body and eliminate BPA from commerce. That’s what we have to do.

Felice Gersh, MD

We can’t poison all the people and the planet itself to just maintain an industry; nothing like that can be too big to fail. When you think about not just the direct poison to humans but to the environment and wildlife, these things don’t break down. All of these plastic items and more exist indefinitely on Earth. They leach into the water. It’s just not acceptable. Like you said, it gets into the air. It’s just time to deal with it. That’s why I’m proud and honored to be part of this publication and to take a stand for humanity. we’re going to be, but before we end at the end because we’re not there yet, I want to see how we can maybe help people become involved, to want to become involved as environmentalists, because everyone who’s hearing this should be an environmentalist to care about the environment for ourselves, for our future generations, and for our planet. But talking about the planet, I want to just make a little diversion here, because now when we’re recording this, which is not at the same time, it’s going to play, but this is going to happen over and over. We know this, and that is that there are wildfires throughout Canada spreading smoke through a great part of the United States, covering areas that have never dealt with this sort of thing before. Maybe you could just tell people what they can do to deal with fire, produce, and smoke. Just because this is poisonous, you can just say a few words about smoke.

Lyn Patrick, ND

For those of you who live on the West Coast, you remember 2016, 17, 18, 19, when we had all the wildfires on the West Coast and how terrible the air quality was, especially in the state of California. But throughout the West, what we have to do is avoid exposure to the smoke because the smoke is not just soot. The smoke is a group of particles, some of which are small; they’re called ultrafine particles, invisible to the naked eye. These ultrafine particles are breathed into our respiratory tract, but they go beyond the lungs; they get into the bloodstream, and they end up being deposited in organs like the brain and the liver. There’s good evidence for this. A researcher from Mexico City, Dr. Calderon Garciaduenas, has published a study looking at autopsy results from infants, children, and adolescents. She’s also looked at some of the brain function in college-age humans as a result of exposure to these ultrafine particles. We can find these ultrafine particles in the brains and some of the organs of infants as a result of their exposure, both in utero and as infants. this, particularly in Mexico City, which is well known for having the highest level of particulate pollution in the world. That’s something that the pediatricians I know in Mexico City would prefer that their children’s parents take them to another city. That’s because it’s difficult for them to avoid that. That’s the problem. It’s not just the soot; it’s the level of ultrafine particles. The other issue is that these ultrafine particles—their little carbon particles—are magnetically charged. Imagine that you’ve got this little particle that’s wrapped in Velcro, and what can stick to that Velcro is a pesticide and a metal like mercury, which we have in our air as a result of trees burning. Trees grab onto mercury and store it in their needles. Conifers, trees with needles like pine trees—this little particle is not just soot. It’s not just carbon. It is a little toxic balm that your body is inhaling. That’s finding its way into your bloodstream. Let’s talk about avoidance. When there is a fire and there’s smoke, the first rule of toxicology and the first rule of environmental medicine is: how can we avoid the exposure? Well, we’re just finishing up a consumer course. 

We mostly teach doctors, but as a result of the Palestine train derailment and now the fires in Canada, we put together a course for consumers. We’re explaining what a good air filter is. There are some air filters on the market, very sadly, that are not good. They don’t have enough carbon because we’re filtering the air with carbon. They don’t have enough carbon in them to filter the air. Some air filters are higher-end, and yes, they’re expensive, but unfortunately, we live on a planet now where, according to the World Health Organization, only 10% of the planet’s air is fit to breathe. The World Health Organization came out with that about three or four months ago. It’s pretty recent. We must prioritize clean air, particularly for our children and pregnant women. We have to make it a priority. The HVAC system in most houses has filters called Merv filters. MERV is just a rating. There’s a number after it. It’s either ten or 11 or 12 or 13 or 14. It goes all the way up to 20. The MERV level of 13 is good filtration. 

Now, I don’t want to try to pretend that I’m an HVAC expert. I’m not. But in general, you can get these at Home Depot or Lowe’s. They were not expensive. Putting a MERV filter in your system and changing it regularly is important because, as you can imagine, when there’s a wildfire event and there’s smoke in the air, your HVAC system will pull the particulate matter into the filter. But once the filter gets full, some of that particular matter is going to get pushed back out into the air. You want to change your filters regularly. When we had our wildfire events on the Pacific Coast, we were telling people to change their MERV filters every couple of days, especially if they lived in an area where the level of pollution was pretty high. That’s one thing: you can get a box of MERV filters and just have them ready to put in your HVAC system. You can investigate portable air filtration technologies. Again, these are not cheap. The good ones are up around $750 to $1000. If you can’t afford that, there is a technology called the Corsi Rosenthal homemade box fan filter technology. Now, this was invented by some researchers by taking these MERV filters, putting a box fan in the middle, and then just taping the MERV filters; they’ve got one on top and four around the outside of the box fan, literally pulling the air through the MERV filters. This was a technology that was created to try to filter viral particles out of the air. The SARS-CoV-2 virus was pretty good at it. The problem with adapting that technology for other exposures, like mold or wildfire smoke, is that these filters get clogged up pretty quickly within a week or so. You have to take that little box fan apart and make a new one. Some doctors use this technology. They say it works great, especially if you’ve got mold in your air or if you live in a moldy environment. It is better than nothing, clearly better than nothing, but it gives one a false sense of security because, to do a good job of protecting the inhabitants of the house, the Corsi Rosenthal filter would have to be changed every few days as opposed to a portable air filtration unit. That literally would be fine for weeks to months because of the amount of carbon in the filter, which is the filtration media. That is a step toward avoidance. using a high-end MERV filter in your unit of 13 or above, and again, not an HVAC expert. The strength of your system—in other words, your furnace and your air conditioning—will determine how high a MERV filter you can use. They go all the way up into the twenties, and MERV 17 is great if your system can handle them. You’ll have to do your homework and figure that out. 

Portable air filters: My mentor, Dr. Crinnion, used to say that it’s not voluntary technology anymore for those of us who either have respiratory problems or environmental exposures; we’re trying to stay healthy. I kind of pooh-poohed it, honestly. Then I started reading the research, looking at interventions that have been published, placing these portable air filtration units in homes with children who have asthma, and seeing incredible improvements in their asthma, as well as looking at the effect of air pollution on pregnant women. We know that that’s another growing choice for children in the rooms of their moms who are at the top of the vulnerable ability scale. In terms of vulnerable humans, the life stage at which we’re most vulnerable is when we’re developing in the womb. Then there’s part two, and part two is about nutritional support. There have been studies looking at giving, and this is a long list; I’m not going to go through the whole thing. But for either people who have respiratory problems and are exposed to air pollution just through the natural course of their lives or there is research looking at exposing people to certain amounts of air pollution in what’s called the pollution chamber, this chamber is something that you sit in. 

They can type in a certain amount of PM 2.5, which is just a measure of particles, a certain type of particle, and they can measure how your cardiovascular system and your heart respond to that exposure. The way that your heart responds is reflective of the toxicity of the pollution and how it’s going to damage your nervous system. It’s called heart rate variability. Research has shown that simple interventions like B vitamins and simple. A penny a day minimizes the damage of air pollution. I’m going to substitute wildfire smoke here because it is the same and because it’s not just trees that are burning anymore. It’s the buildings that are burning. all of the plastics and metals that are in the buildings. Are also burning. B, vitamins, fish oil, vitamin C, small amounts, no megadoses, just 2000 milligrams a day. Vitamin E, just 800 international units a day. What we would consider a standard daily supplement has been shown to protect the body from damage from air pollution exposure. The last one that I’ll talk about is a supplement that is becoming kind of a household word, which is N-acetyl cysteine. N-acetyl cysteine is an amino acid. It is available over the counter. It’s not a prescription drug. There’s good research on humans, not animals. In humans with N-acetyl cysteine, it is possible to mitigate or protect the body from damage from wildfire smoke exposure. N-acetyl cysteine is available over-the-counter. It usually comes in 600-milligram capsules. A standard daily dose for an adult is three 600-milligram capsules or 1800 milligrams. There were probably, at the last time I looked there, about 25,000 studies on N-acetyl cysteine in PubMed in the medical literature I published. It is probably one of the most protective nutrients. I want to call them nutrients, even though we don’t find N-acetyl cysteine in food. We have to take it and perform some of the most protective nutrients from damage to pollutants that we have available to us. It is available in pediatric dosing; although I’m not a pediatrician, I’m not going to talk about that. However, it is available and is safe in small doses for children and adolescents as well. That’s kind of a very short version of the lecture on wildfire smoke and air pollution. But I’ve kind of hit the highlights for you.

Felice Gersh, MD

Well, that was fantastic.  talking about all those nutrients,  they’re all potent antioxidants. They work through the critical pathways of every cell to maintain optimal function. Reduced free radicals and oxidative stress and nasty has been shown to help women with PCOS. Just giving it to every woman with PCOS to help them ovulate. That’s like a wonder supplement, in terms of what it can do. We could do a whole show just on some of these supplements and probably should because they are important.

Lyn Patrick, ND

It makes me wonder to speculate because one of the damaging effects of bisphenol A is oxidative stress. It causes oxidative stress in the body. We don’t know. I’m just speculating that it may be useful in terms of minimizing damage from this one as well.

Felice Gersh, MD

Well, it’s safe. Of course, an AC is a treatment for acetaminophen overdose, which is the number one cause of acute liver failure because it can be toxic. The difference between a safe and a toxic dose is not very great and, unfortunately, inadvertent. Overdosing with acetaminophen is not uncommon. That’s the treatment in IV form. This is just the takeaway from the last two minutes. Everyone must go back and listen to this whole thing because, whether it’s a fire or air pollution, it’s all toxic throughout the body and not just in the lungs. As you can see, this is a total body-wide effect. In your analogy, I could just see it like these little toxic bombs; it’s like a perfect picture that was created and will make everyone want to get the best air filter they can and think about it. There’s no place where you can avoid air pollution, like you said. Where do you go? Where’s that 10%? I do not know.

Lyn Patrick, ND

It’s in the middle of the Pacific Ocean.

Felice Gersh, MD

Oh, well, that’s not where you live. There you go. This was phenomenal. We could talk, like we said at the beginning, for hours. Everyone out there wants to learn more. You mentioned that you have a course. What else can they do? How can they follow you and what you’re doing?

Lyn Patrick, ND

Okay. We’re just about finished with the course. It will be live by the time you’re listening to this. The organization is called Environmental Medicine, Education, International Global. EMEI Global—that’s how you find us on Instagram. That’s our Web site, dot.com. We will have a lot of information for physicians because that’s what we specialize in teaching. But this is going to be two courses, one on wildfire exposure and one on chemical disasters as a result of the—I don’t even know what to call it. The debacle called the East Palestine train derailment that everyone needs to understand went far beyond the limits of East Palestine. Ohio. We’re going to have short courses with lots of handouts and directions about step-by-step, what you can do, and how to prepare. Because, according to the Environmental Protection Agency, a chemical disaster occurs in the United States every other day. We decided, as a result of the bungled situation in Palestine and the poor guidance from all of the agencies involved, that we needed to guide people. We are just at a place in our culture now where we have to have a level of knowledge and education that helps us protect ourselves and be prepared for whatever we may encounter. It’s not rocket science. It’s very basic. But we wanted to give people good recommendations. We’re not selling anything. We just wanted to talk about science, good recommendations for masks that are appropriate to protect against wildfire smoke, and good recommendations that I talked about in terms of HEPA filtration for the HVAC. How to seal off their house in the event of a chemical disaster. Unfortunately, information is not being shared by our federal agencies. EMEI Global is where you’ll find us.

Felice Gersh, MD

That’s the best advice I’m going to give to all of my patients: get these courses and be prepared.

Lyn Patrick, ND

These are simple, easy, and inexpensive ways to protect yourself from exposure—from air and water. We talked about food as well today. That’s one of the reasons we’re going to leave that out. We’ll talk about food as well. But there’s a way to protect yourself from these chemicals.

Felice Gersh, MD

This is an issue that the medical schools that are educating the newest doctors are not dealing with properly. It’s just neglected. We have to fill in the gaps. I’m a little bit behind you, Lyn. I am watching everything you’re doing and trying to learn from you and this one. Like I said, one needs to be aware. The first step in solving a problem is to be aware of the problem and to understand what we’re facing—not to be like you said, like grim and doomsday talk, but rather so that we can take effective, actual action. that we can do something—not just whine and worry, but take effective action. That’s what it’s all about.

Lyn Patrick, ND

In my own experience and the experience of many of the doctors that I train and many of my patients, when you do have that knowledge and you are prepared, your stress level goes down, not up.

Felice Gersh, MD

Knowing the enemy is the first step, for sure—knowing what you’re dealing with—and that’s what you are doing. Lyn, I cannot thank you from the bottom of my heart for what you’re doing to help improve the health of everyone out there, particularly my PCOS watchers for this particular episode. Thank you very much.

Lyn Patrick, ND

It’s been my pleasure and my honor, and I am thankful to be part of this and to be on your team.