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Toxic Exposures: The Cumulative Effect

Toxicity is one of the evolving topics that will be covered at IFM’s 2020 Annual International Conference (AIC), the online experience. Environmental toxicants, the exposome, and body burden in the context of chronic disease will be discussed by leading field experts, such as:

Toxic exposures and cumulative toxic burden are already vital considerations during clinical assessments for chronic disease treatment, and for strengthening resilience and overall wellness. During the COVID-19 pandemic, dealing with toxicity takes on increased importance. An overloaded body burden requires ample energetic resources for those metabolic processes involved with biotransformation and detoxification pathways, potentially impairing the availability of those resources for an adequate immune response to viral infection. In addition, exposures to toxicants such as heavy metals, pesticides, and other endocrine-disrupting chemicals (EDCs) are potential factors in the development of several chronic diseases and have also been associated with immune system dysfunction.

Passive Determinants of Health and a Downtrodden Immune System

In a recent IFM interview, Dr. Joe Pizzorno noted that people today are passively exposed to toxicants regardless of their lifestyle choices, shifting the perspective to consider “passive determinants of health.” A recent review suggested that phthalates and their metabolites found in a variety of items, including foods, drinks, routine household products, the air, and the general environment, are ingested passively by people and have the potential to cause various dysfunctions.1

Somewhat independent of people’s choices, the things which in the past have been normally considered healthy, or at least neutral, are now becoming significant sources of toxins for people.

– Dr. Pizzorno

While dose and duration of exposure may impact the severity of harm, recent reviews suggest that EDCs affect not only endocrine function, but may also impair immune system function.2,3 Elevated toxicity may be associated with various autoimmune conditions; a 2019 cross-sectional survey study with over 53,000 participants found elevated serum cadmium (Cd) levels in patients with rheumatoid arthritis (RA).4

The Cumulative Effect and Chronic Disease

In the modern world, everyone is exposed to a mixture of chemical compounds daily, from household toxicants to ambient air pollution. Even food-based toxicant exposures may contribute to poor health. Metallic compounds in seafood,5,6 pesticide residues in fruits and vegetables,7 and hormones found in many dairy products8 are examples. This accumulation of toxicants and potential chronic exposure may lead to an overloaded detoxification pathway, increased systemic inflammation, and clinical patterns such as immune dysfunction or endocrine disruption.

Through a variety of different mechanisms, all toxicants upregulate inflammation; they induce and exacerbate inflammation.

– Dr. Patrick

Exposure to hazardous chemicals, including toxic metals, has been associated with the risk and development of various chronic diseases, including cardiovascular, respiratory, and metabolic conditions.9-11 Specifically, a 2018 meta-analysis of 37 unique studies comprising 348,259 non-overlapping participants found that exposure to arsenic (As), lead (Pb), copper (Cu), and Cd is associated with an increased risk of cardiovascular disease and coronary heart disease.12 In addition, a 2018 systematic review reported that studies of As exposure consistently suggested negative impacts on incidence of chronic kidney disease (CKD), while studies of Pb exposure were mixed.13

Clinical Applications

In Functional Medicine, individual intake assessments are extremely important for the identification and evaluation of symptoms and patterns from potential toxic exposures, in addition to elimination capacity. These assessments assist in the development of personalized comprehensive strategies to ultimately identify and reduce the exposure, enhance detoxification through appropriate avenues, and promote the body’s healing.

Personalized treatments may include lifestyle modifications and other techniques to support the body’s own natural methods to increase toxicant elimination. Examples include:

  • Therapeutic diets with increased fiber and specific nutrients.
  • Promotion of glutathione production in the body.
  • Use of saunas to increase elimination of certain toxicants through sweat and urine.

Addressing toxicity and alleviating body burden may not only improve treatment outcomes for patients with chronic conditions, it may also allow the body to operate more efficiently and improve overall resilience. During the COVID-19 pandemic, addressing toxic exposure and its impact on immunity and health has heightened significance. Learn more about toxicity at this year’s AIC online experience.

Learn More About IFM's International Conference

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References
  1. Benjamin S, Masai E, Kamimura N, Takahashi K, Anderson RC, Faisal PA. Phthalates impact human health: epidemiological evidences and plausible mechanism of action. J Hazard Mater. 2017;340:360?383. doi:10.1016/j.jhazmat.2017.06.036
  2. Bansal A, Henao-Mejia J, Simmons RA. Immune system: an emerging player in mediating effects of endocrine disruptors on metabolic health. Endocrinology. 2018;159(1):32?45. doi:10.1210/en.2017-00882
  3. Gangemi S, Gofita E, Costa C, et al. Occupational and environmental exposure to pesticides and cytokine pathways in chronic diseases (review). Int J Mol Med. 2016;38(4):1012?1020. doi:10.3892/ijmm.2016.2728
  4. Joo SH, Lee J, Hutchinson D, Song YW. Prevalence of rheumatoid arthritis in relation to serum cadmium concentrations: cross-sectional study using Korean National Health and Nutrition Examination Survey (KNHANES) data. BMJ Open. 2019;9(1):e023233. doi:10.1136/bmjopen-2018-023233
  5. Pirkle CM, Muckle G, Lemire M. Managing mercury exposure in northern Canadian communities. CMAJ. 2016;188(14):1015-1023. doi:10.1503/cmaj.151138
  6. Tengku Nur Alia TKA, Hing LS, Sim SF, Pradit S, Ahmad A, Ong MC. Comparative study of raw and cooked farmed sea bass (Lates calcarifer) in relation to metal content and its estimated human health risk. Mar Pollut Bull. 2020;153:111009. doi:10.1016/j.marpolbul.2020.111009
  7. Hu Y, Chiu YH, Hauser R, Chavarro J, Sun Q. Overall and class-specific scores of pesticide residues from fruits and vegetables as a tool to rank intake of pesticide residues in United States: a validation study. Environ Int. 2016;92-93:294-300. doi:10.1016/j.envint.2016.04.028
  8. Malekinejad H, Rezabakhsh A. Hormones in dairy foods and their impact on public health – a narrative review article. Iran J Public Health. 2015;44(6):742-758.
  9. Fatima G, Raza AM, Hadi N, Nigam N, Mahdi AA. Cadmium in human diseases: it’s more than just a mere metal. Indian J Clin Biochem. 2019;34(4):371?378. doi:10.1007/s12291-019-00839-8
  10. Grzywa-Celi?ska A, Krusi?ski A, Milanowski J. ‘Smoging kills’ – effects of air pollution on human respiratory system. Ann Agric Environ Med. 2020;27(1):1?5. doi:10.26444/aaem/110477
  11. Meltzer GY, Watkins BX, Vieira D, Zelikoff JT, Boden-Albala B. A systematic review of environmental health outcomes in selected American Indian and Alaska Native populations. J Racial Ethn Health Disparities. Published online January 23, 2020. doi:10.1007/s40615-020-00700-2
  12. Chowdhury R, Ramond A, O’Keeffe LM, et al. Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2018;362:k3310. doi:10.1136/bmj.k3310
  13. Moody EC, Coca SG, Sanders AP. Toxic metals and chronic kidney disease: a systematic review of recent literature. Curr Environ Health Rep. 2018;5(4):453?463. doi:10.1007/s40572-018-0212-1

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