endocrine disruptors

The Ethics Of It All

4163 views

What if there is no future? We have always assumed that there would be a future, that somehow no matter what we did to ourselves or to the environment, life would go on. What if we were wrong? What if the very actions we embrace to prolong life, the technologies and conveniences that make modern living palatable, actually shorten it and shorten not just our lives, but life in general. What if the possibility of future life is not automatic but something that demands active consideration lest it disappear completely?

I had never thought about the possibility that a future might not exist. Sure, I recognized that I would not exist at some point, but I never considered the possibility of the death of humanity, until recently. Now, it seems as though it is everything I can do not to think about it. The magnitude of the environmental crisis that we face is compounded daily by the inability of contemporary leaders and thinkers to frame the crisis in a way that might allow us to address it. If we think about these toxicants, honestly think about them, it is difficult not to wonder how we did not know that all of the chemicals that we dump into the environment and into our bodies would lead to a poisoned environment and poisoned bodies. Seriously, what did we think would happen when we release poisons into the environment daily, year in and year out? Did we think they would somehow magically be absorbed and detoxified by the environment, and thus, effectively disappear? I believe we did and many still do.

I know that until I began the work here, I never gave this notion much thought. I, like most of us, embraced synthetic chemistry and all of the cool things we could concoct and manipulate. It was not until I began seriously investigating the mechanisms of these chemicals, outside the confines of academia, that I began to question the rationale behind these conveniences. I was taught that the dose makes the poison. This suggests that so long as the dose is low enough and administered in a controlled fashion that we can control the outcomes. In reality, however, the poison makes the poison. Small doses are just as deadly as large doses, the only difference is the time scale of the reaction. The body recognizes these poisons and adapts accordingly; so too does the environment. We simply cannot see those reactions until they reach a critical threshold and even then we have to be willing ‘see’ what is before us.

Let us consider glyphosate, which among its many deleterious effects on health, is a potent endocrine disruptor. That is, glyphosate overrides endogenous hormones systems in the organism exposed to the chemical. Per the Environmental Protection Agency’s (EPA) safety standards the maximal ‘safe’ exposure of glyphosate is 2 milligrams per kilogram of body weight or about 140 milligrams per day for a 70kg/154lb adult, which on the surface, seems like a minute amount and too small to worry about, but is it? If we buy the dose makes the poison approach, then we need not worry, but if we evaluate the chemistry and the math a little more closely, then an entirely different picture emerges.

Synthetic hormones, endocrine disrupting chemicals, exert influence in the body at staggeringly low dosages. A well-known researcher in the field of chemical endocrine disruptors describes this aptly.

“The issue of the amount of hormone that actually causes effects is very difficult for scientists to talk to people about because we’re dealing with numbers that are outside of the frame of reference that anybody is going to be thinking about. We see changes, profound changes, in the course of development of essentially the whole body of experimental animals, and we’re working with mice and rats, and we see these changes at fifty femtograms [a femtogram equals a quadrillionith of a gram] of the hormone per milliliter of blood. That’s 0.05 trillionths of a gram of this hormone in a milliliter of blood.

But what you have is the entire field of toxicology thinking of a millionth of a gram of a hormone or a chemical as being this staggeringly tiny amount, and to most people if I said there’s only a millionth of a gram of it here you’d say, ‘How can it do anything?’ A millionth of a gram of estradiol in blood is toxic. The natural hormone is actually operating at something like a hundred million times lower than that. So when you have a physiologist thinking of a millionth of a gram, you have that physiologist thinking this is a toxic high dose. When you are raised in the field of toxicology you are looking at that from the other perspective of ‘My gosh, that’s such a tiny dose, it couldn’t do anything.’” – Fredrick Vom Saal, PhD

If we thought 2 milligrams per kilogram was a small enough dose to be considered safe, how do we even conceptualize something that operates in femtograms per milliliter of blood, especially when 1 milligram = a trillion femtograms? That amount is inconceivably small, and quite literally, beyond comprehension, and yet, that is all it takes to disrupt hormone systems and cause illness; hormone systems that control not only reproductive capacity for the exposed individual but also affect the outcomes and health of the offspring across multiple generations. These chemicals directly affect the possibility of a future. One has to wonder if this is all it takes to disrupt critical hormone systems, what happens when we blanket the environment with tonnes of chemicals like we have done over the last 50 years or so.

Returning to glyphosate for a moment, as of 2014, over 826 million kilograms/1.8 billion pounds were used worldwide; a 12 fold increase since 1995. That is staggering amount of chemical exposure, and yet, it is just one of thousands of chemicals we are exposed to daily. Just one. There are currently over 83,000 different chemical entities being ‘monitored’ by the EPA. So, on the one hand, we have standards for safety that only partially recognize the dangers of small exposures (kg/mg) but are yet ineffective inasmuch as they are still several magnitudes greater than the dosages where the damage begins. On the other hand, however, none of this matters because the economic drivers push exposures well above those minimal safety standards and what any reasonable person would consider safe. And finally, neither the toxicology, nor the ethics consider what the cumulative body and environmental burden is with regular exposures to thousands of chemicals daily.

This brings me back to my original question, what if the possibility of the future is something that we should have been protecting all along? What if it isn’t a given? Shouldn’t there be some discussion of the ethical implications of using chemicals that damage not only the current generation but subsequent generations? Even if we ignore the chemistry or plead ignorance to the mechanisms of transgenerational effects, shouldn’t we at least consider whether it is ethical to release chemicals into the environment and into our bodies that potentially pose risks to future generations? Those who come after us inherit the world we have left. Shouldn’t we consider their health and the health of the environment that we leave to them? I think we should. Indeed, I think this ought to be part of any discussion of safety. It is not; partly by choice and partly because we have bought into this notion that the dose makes the poison and ignored the fact that the poison is the poison. We have eliminated the poisonousness of the chemical from the equation and out of any cogent discussion of danger. This allows us to proceed as if we have everything under control, as if we can recognize and mitigate any and all dangers that a particular chemical poses. This allows us to ignore the prospect that current actions influence future health and well-being. This allows us to reap the rewards of our technological prowess now and kick the costs of our ignorance down the road. Where are the ethics in this?

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Image: Dicklyon, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

This was published originally on March 7, 2019.

Share

Walking the Wrack Line: Thoughts on Plastic Pollution

4597 views

The more clearly we can focus our attention on the wonders and realities of the universe about us, the less taste we shall have for destruction.

Rachel Carson

The Wrack Line: An Ecological Bridge Between Land and Sea

For decades, I’ve been looking at the unimagined biological and genetic effects on planet earth caused by “better living through chemistry” capitalist mentality. While Rachel Carson’s seminal work, Silent Spring, cataloged just one aspect of the plethora of physiological effects on animal life, in 2021 we can confidently state there is so much evidence of all the pollutants, toxins, spewing gasses, pesticides, hormone disruptors, radioactive isotopes, forever chemicals, nanoparticles, fungicides, heavy metals and waste pits conspiring to completely disrupt all manner of life. Microplastics are a key contributor to this problem.

In that process of contemplating this recently, while railing against local older folk who will for Year Two have a Zoom Earth Day (April 22) instead of celebrating this day utilizing our amazing atmosphere and beachside waysides to bring people together, I walked the wrack line. This is that “line” of organic material that ends up on beaches when tides go back out. It is a biologically important micro-ecosystem of seaweeds, crustaceans, shells, decaying birds and fish, and mammals. This wrack line is studied by marine biologists. It provides an amazing supply of food and building components for living crustaceans.

Here on the Coast Surfrider Foundation and other groups have organized beach clean-ups, where the majority of junk found, collected, and disposed of, is plastic. The first part of the instruction for beach clean-up volunteers is to use gloves, and that the plastics can be super toxic, virtual magnets for heavy metals, poisons, and even radioactive materials as they float throughout the ocean and eventually end up on the beach, the wrack lines.

Homo sapiens pick through the wrack line for treasures like polished agates, whole shells, burled driftwood, and seeds from afar. These wrack lines, unfortunately, are now clogged with that deadline by-product of “better living with chemistry,” plastics. There is other rubbish from the by-products and by-processes of consumerism and industrialism, but by and far, plastics present the largest problem.

Plastics and Capitalism

The work of artist Chris Jordan on plastics and just on the consumer waste in our capitalist consumer society is amazing. His documentary, Albatross, stays with me as I walk the wrack lines on the Central Oregon Coast. I’ve walked wrack lines all over the world, and been in places where plastic bags and single-use plastic containers and bottles have destroyed ecosystems, on beaches, in harbors, and along riverways.

microplastic pollution birds

As a diver, an environmentalist, a deep green sustainability proponent, and as a journalist and teacher, and someone with a load of urban and regional planning under my belts, the reality for me is we have been at war with nature, with ourselves. Plastic is yet another symbolic manufactured element that is emblematic of our capitalism gone wild. Plastics are the thing of fossil fuels, and heavy natural gas consumption. Those fancy polymers are more than just a physical eyesore in the form of Pepsi bottles and single-serving ketchup packets. Every hour of every day, we touch plastic. Just imagine what teeny-tiny bits of plastic could do to our brains. This stuff is crossing the blood-brain barrier and is causing untold havoc on the human biological ecosystem. It is also linked to:

Deep Sea Plastics

Last year, I viewed online a Remote Operated Vehicle filming the deepest part of the globe, the Mariana Trench, with ghostly images of single-use plastic shopping bags floating by. It wasn’t a surprise, since I have been a scuba diver for more than 45 years. That revelation was, however, yet another cut in the 10,000 cuts of spiritual and intellectual death people like me have to steel themselves from.

deep sea plastic

The Consequences of All of This Plastic

Microplastics have been found in the liver, lungs, spleens, and other organs of humans and as one might expect, in feces too. BPA, also known as bisphenol A, is a chemical in the production of plastics. It is a reproductive, developmental, and systemic toxicant in animal and human studies. BPA levels in humans have been dramatically underestimated.

 It would be naïve to believe there is plastic everywhere but just not in us, said Rolf Halden at Arizona State University. We are now providing a research platform that will allow us and others to look for what is invisible – these particles too small for the naked eye to see. The risk [to health] resides in the small particles.

This bioaccumulation in tissues, that is, in the animals we eat, like tuna or salmon, is also part of the bioaccumulation of plastic particles in the food we eat, the air we breathe, and the water we drink. The US Environmental Protection Agency is concerned about BPA because “it is a reproductive, developmental and systemic toxicant in animal studies”. The researchers examined lung, liver, spleen, and kidney tissue as these organs are likely to be exposed to microplastics or collect them.

We never want to be alarmist, but it is concerning that these non-biodegradable materials that are present everywhere [may] enter and accumulate in human tissues, and we don’t know the possible health effects,” said Varun Kelkar of Arizona State University, part of the research team.

Just how is all of that plastic getting into our systems? With everything, we eat and drink. The latest research found:

Evaluating approximately 15% of Americans’ caloric intake, we estimate that annual microplastic consumption ranges from 39000 to 52000 particles depending on age and sex. These estimates increase to 74000 and 121000 when inhalation is considered. Additionally, individuals who meet their recommended water intake through only bottled sources may be ingesting an additional 90000 microplastics annually, compared to 4000 microplastics for those who consume only tap water.

The Great Pacific Garbage Patch: An Emblem of Plastic Pollution

The Great Pacific Garbage Patch is the largest accumulation of ocean plastic in the world and is located between Hawaii and California. It is the result of the billions of tons of plastic released into the environment since the 1950s. In total there are five large gyres around the world, so-called floating garbage patches where current and wave and wind conditions are set to harmonize where some of the refuse humans create end up as these dumps for anything that floats, plastic and its components being a large percentage of floating junk.

This is emblematic of the problem of throw-away societies and rampant consumerism that is predicated on disposability or one single-use product. As we can see, this is not just an eyesore – these plastics get ground down by wave action, wind, and sun, along with the chemical reactions of all of that combined. Hence, the very concept of micro-plastics ending up in the food chain, which ends up in humans as the apex predator or high on the food chain consumer. This article talks about how plastics and their components get to the human biome through more direct ways like plastic-lined canned foods, PFAS, and BPA. Breathing plastics from all the plastic fibers in clothes, furniture, carpeting, and other consumer sources is yet another vector that has created the Plastic Human.

The reality is we do not know all the possible negative health outcomes of microplastics alone, as opposed to microplastics mixing with all those nanoparticles and the other chemicals coming into play in human physiology. The convenience of plastic bottles and pipes in our homes represents the cancers of the future. Those plastics in the belly of whales, birds, and albacore are the bio-accumulated toxins in our daily meals. We don’t need to study the great Pacific plastic gyre to understand how plastics break down, unseen, or subsurface. We will at some point have more plastic particles in the oceans than all the organic biomass. These are not the fictions of Ursula La Guinn or Margaret Atwood. They are readily visible to anyone who looks, but there are especially visible at the wrack lines, where land and sea meet.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

This article was published originally on April 20, 2021.  

Share

Is Prenatal Dexamethasone Safe: The Baby Makers’ Hubris

15090 views

For some reason, maybe hubris, medical science seems doomed to repeat the sins of their fathers. The lessons of thalidomide and diethylstilbestrol (DES) of generations past (present and future because of transgenerational effects) have not been learned. Reproductive endocrinologist, obstetricians and others tasked with protecting maternal and fetal health are at it again; happily and blindly dosing pregnant women with synthetic steroids with neither the evidence to support their efficacy nor the research to prove safety.

Prenatal Dexamethasone and Congenital Adrenal Hyperplasia

Dexamethasone or DEX is a synthetic corticosteroid that mimics the anti-inflammatory and immunosuppressant effects of endogenous cortisol. DEX is used in the treatment of variety of conditions from arthritis to cancer. Since DEX easily crosses the placental barrier and can have detrimental effects to the developing fetus, it is considered unsafe for pregnant women. Per the FDA:

Dexamethasone is listed as a pregnancy Category C drug. Corticosteroids have been shown to be teratogenic (causes birth defects) in many species when given in doses equivalent to the human dose. Animal studies in which corticosteroids have been given to pregnant mice, rats, and rabbits have yielded an increased incidence of cleft palate in the offspring. There are no adequate and well-controlled studies in pregnant women

Despite the risk, dexamethasone has been given to pregnant women who are at risk of delivering a child with the congenital adrenal hyperplasia (CAH) for almost 30 years. CAH is a genetic disorder that involves the inability to appropriately metabolize certain hormones.

Female children with CAH are often more masculinized than their non-CAH counterparts, both in behavior and physiology. Sometimes the virilization extends to the genitalia with atypical clitorises and labia. High dose dexamethasone is given prenatally, as soon as the woman becomes pregnant, to ‘feminize’ the female genitalia of CAH babies. Prenatal DEX serves no other purpose but to change the appearance of the female genitalia. It neither prevents CAH nor does it promote the health of the developing fetus relative to CAH. It merely de-masculinizes female fetuses, feminizes her genitalia. Conversely, it also feminizes male genitalia.

The effective dose of DEX given from early pregnancy onward and elicits 60-100 times the normal physiological levels of cortisol. Because female sexual development happens very early in gestation, DEX is given to all women who might be carrying a female CAH child. With a previous history of delivering a CAH child, there is a 1 in 8 chance that a woman will have a second CAH child, who is female. So 7 of the 8 non-CAH babies are also exposed.

Previously, we reported animal research showing that DEX combined with common environmental endocrine exposures in early pregnancy is linked to significant reproductive abnormalities in male offspring. Moreover, the adrenal system is a critical component of our stress-response and regulates a variety of physiological functions from heart rate and blood pressure to insulin response and fat storage. Research on animals shows prenatal dexamethasone has significant adverse effects on each of these systems, many of which are likley to be transgenerational – affecting the offspring and the offspring’s ‘children’ in ways that have yet to be investigated.

The Hubris of the Baby Makers

As if dosing pregnant women with dexamethasone to somehow prevent the potential masculinization of female CAH babies without evidence or safety data isn’t bad enough, physicians who specialize in in vitro fertilization (IVF) are now also using DEX, again without sufficient evidence. One small and recent study suggests that DEX may augment ovarian response and increase follicle production for egg retrieval. There was no statistically significant improvement in fertilization, implantation or pregnancy rates. Miscarriage was not an outcome variable. There are no data about the long term safety of DEX for IVF or even any efficacy studies to support the use of DEX to prevent miscarriage. And yet, DEX is used to prevent miscarriage with IVF.

The physicians using dexamethasone have no idea if it works and appear to be operating on hunch versus hard evidence. Of course, they contend, using DEX in early pregnancy (pre-implantation through 10 weeks) couldn’t hurt and therein lay the hubris – that their talents, education and years of medical practice suffice. For these experts, no confirmatory analysis or evidence is needed to verify that their treatment protocols work. Trust us, they say.

As reported in the Atlantic, a prominent IVF specialist explains:

We tell our IVF patients that in our opinion it is by and large safe to take as prescribed, that there are no proven developmental risks to the baby [and] that side effects to the woman are infrequent, temporary in nature and reversible on proper withdrawal.” He went on, “We do not go into detail describing everything in the literature on what we consider to be safe treatments. That would be overly time consuming, impossible to accomplish thoroughly and comprehensively[,] and in my opinion [would] create unnecessary patient consternation.”

Well, of course there are no ‘proven’ risks, no one has ever done the appropriate research either for the DEX in CAH or the use of DEX in IVF.  After 30 years of being used off-label for CAH and potentially thousands, if not tens of thousands of babies exposed worldwide,  there are no controlled studies showing either its efficacy or its safety – no robust analyses of adverse events. This may be worse than either DES or thalidomide. A recent meta-analysis on the risks of prenatal DEX use for CAH found only four studies with marginally useful data. Most done by the same research team with a highly questionable history. Except the one study cited above, there are no studies, none, not even in animals, on the use of DEX to prevent miscarriage. Its use with IVF remains highly speculative and experimental.

Perhaps, one of the only studies on prenatal DEX worth examining was conducted in Sweden. The researchers reviewed 43 pregnancies from 1985 -1995 where prenatal DEX was used to treat CAH.  What they found was troubling; an excessively high rate of severe adverse events in the DEX pregnancies versus the control group.  In the prenatal dexamethasone group, researchers identified eight severe adverse events compared to only one in the control group. These included:

  • 3 children failed to thrive during the first year
  • 1 child with developmental delay and hypospadias (malformed male urinary tract opening)
  • 1 child had hydrocephalus
  • 2 girls were born small for gestational age; one was later diagnosed with mental retardation
  • 1 child had severe mood fluctuations resulting in hospitalizations

As a result of this study, researchers in Sweden petitioned their Regional Ethics Committee to put on hold a prospective study using DEX for CAH, citing the high risk of adverse events for what is essentially an elective treatment for reproductive cosmetics. In the US, despite petitions to the Office of Human Research Protection (OPRH – the oversight body tasked with approving human subjects research and protecting research subjects) and the FDA, there has been little oversight of the use of DEX in either CAH or IVF.

In both cases, these treatments are considered experimental and their use must be fully consented to and presumably monitored by OPRH and the FDA. Neither is happening with any rigor. Indeed, the fertility specialist’s claim – that there are no proven developmental risks to the baby [and] that side effects to the woman are infrequent, temporary in nature and reversible on proper withdrawal –  mirrors the unsubstantiated and dubious claims of the one research group funded continuously by NIH for the last dozen years who have failed to produce any robust or rigorous data on the topic but nevertheless continue to market the benefits of DEX, their practice and ‘research’.

Most recently, a prominent physician and researcher from UCSF has come out to state that risks do not outweigh the benefits and that “prenatal treatment of congenital adrenal hyperplasia with dexamethasone should only be done in prospective clinical research settings with institutional review board approval, and therefore is not appropriate for routine community practice.” No such review or research exists for prenatal dexamethasone and IVF.

Is Prenatal Dexamethasone Safe?

Probably not. Administering synthetic steroids during critical periods of fetal development- when physiological systems are organizing and developing – will impact system and organ functioning. Some of those effects will be seen early on and may be visible, like malformed reproductive tracts, but others will be more subtle and present as the child ages – cognitive deficits, heart disease, or cancer. Many effects will be epigenetic or transgenerational with the grandchildren suffering the consequences. We saw that with DES, we’re seeing that in animal studies with BPA and other endocrine disruptors. One has to assume, we will see the same effects with DEX given from pre-conception or early pregnancy onward. It’s just a matter of time.

Unfortunately, it may be years before the research catches up. Therefore, it is incumbent upon pregnant women educate themselves and make informed decisions.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

This article was published originally on April 15, 2013. 

More recent research (2018), reiterates much of the same.

Share

Promiscuous Hormones and Other Fun Facts

6147 views

Every time I read about an environmental endocrine disrupting chemical, a medication or even sometimes actual endocrine research, I am amazed, dumbfounded by the lack of up-to-date information about how hormones and receptors work. Indeed, much of the research still operates on what is called the ‘classical’ view of hormone-receptor activity. And while, those functions are still accurate, there is so much more going on that merits understanding and investigation. Here are some basics that will blow your mind.

Understanding Hormones and Receptors

Hormones are gods. Like the gods of Greek mythology, hormones control everything. There is a not a physiological system that a hormone does not impact in some manner or another.  And this is why ignoring hormones in health research is so bloody dangerous and just downright stupid.

Hormones bind to receptors. This isn’t mind-blowing, but is the basis for all endocrine and in fact chemical activity in the body – compound A has to talk to body part B. The conversation is mediated through receptor binding. The shape of the hormone determines which receptors and how strongly the hormone fits or binds. Much like a lock and key, only certain keys open certain locks.

Hormones are promiscuous. Hormones sleep around. Hormones like binding with other hormone receptors and are often similar enough in structure to do so, especially at higher concentrations. This means that estrogens will bind with estrogen receptors but also androgen receptors. Progesterone binds with estrogen receptors but also gluccocorticoid (cortisol) and mineralocorticoid receptors, and so on. Because of this cross-binding, the measure of interest becomes the hormone’s ‘affinity’ for a certain receptor. How much does hormone A like receptor B. The stronger the affinity, the longer it stays bound and the more intracellular effects it exerts.

The most shapely hormones bind more. Like mating, shape matters. The more shapely hormones bind to more receptors, more tightly. For example, the shape of MBP, the metabolite of BPA fits into the estrogen receptor better than BPA. In fact, MBP is a 1000 times stronger than BPA in its affinity for the estrogen receptors (ERs). If both MBP and BPA were competing for the affections an ER, MBP would win. This happens with all hormones and hormone-like chemicals, the more shapely the compound, the better it fits with a receptor and the longer it stays there.

Promiscuous hormones spread the love. The effects of an endocrine disruptor, even an estrogenic one may not be limited to the reproductive classics. Estrogen receptors are located all over the body and the brain, so too are androgen, progesterone, glucocorticoid, mineralocorticoid and thyroid receptors. So any time we talk about a hormone’s impact on health, we have to look at where its receptors are located. Ditto for chemical that binds to hormone receptors. And to make it even more complicated, because these hormones bind promiscuously, one also has to consider the fact that the hormone may act at other, non-similar receptors. Hormone promiscuity makes endocrine research infinitely more complex than asking whether hormone A binds to hormone receptor A or how long a substance takes to clear from the body.

Hormones beget more hormones. That’s right, hormones have babies and lots of them. Called metabolites, the offspring of one hormone can lead to a whole family of other hormones, each promiscuously binding with receptors. It’s a veritable orgy in there. How many and what type of hormone offspring depends entirely on the enzymes the hormone meets as it travels through the body. This means, it’s not enough to simply measure the effects of the parent hormone on health, but one has to look at its offspring or metabolites as well.

Take Home

Hormones systems are complicated. Hormone disrupting chemicals likely disrupt a myriad of physiological systems, often transgenerationally. One off, linear, cause-effect, dose-response studies cannot begin to understand the system changes involved with endocrine modulation. This requires large scale, data modeling tasks, that have yet to be designed.  For the time being, any study that claims to have proven that a man made, endocrine disrupting chemical  or hormone altering medication is completely safe or works only on the intended physiological system, is likely lying. They just haven’t found how or where the chemical is wreaking havoc. I’d err on the side of caution.

Image credit: Jan Saenredam, Public domain, via Wikimedia Commons

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

This article was first published May 3, 2013. 

Share

Evaluating Endocrine Disruptor Research

3390 views

Every now and again, we see a flurry of press releases flooding social media about new research purporting to prove that endocrine disruptors are safe. Most recently, the press has been focused Bisphenol A or BPA. New FDA proclamations suggest that it has no impact on health. When one reads the actual research upon which these statements are based, it says no such thing. Unless of course, the research is funded by industry, then it is almost always positive. A report in Newsweek found:

In 2013, for example, the American Chemistry Council spent more than $11 million on lobbying expenses, according to the Center for Responsive Politics. Industry groups have also funded, and in some cases written up, research done by governmental scientists. One 2008 investigation, by the Milwaukee Journal Sentinel, found that “a government report claiming that bisphenol-A is safe was written largely by the plastics industry and others with a financial stake in the controversial chemical.”

The report goes on to state that the FDA

…dismissed as irrelevant the vast majority of the BPA safety studies its own scientists reviewed in preparation for that official position statement. According to the FDA, for example, all of the 48 epidemiological studies reviewed had ‘no utility’ for the agency’s risk assessment, the formal process it undertakes to decide if a chemical is safe for human health or not.

With such contradictory claims about safety, who should we believe? How do we evaluate the safety research about endocrine disruptors? Here is a primer.

Industry Sponsored Research Is Biased

In a mini-review of research on bisphenol A (BPA) – the endocrine disruptor in plastics, of the 115 studies published on adverse effects of BPA 81.7% (94) reported significant adverse health effects (2004). However, upon review, it was found that 90% of the government funded, academic research found significant adverse effects while 100% of the industry-sponsored research found no ill-effects of BPA – none. This is a common theme across all industries – pharmaceutical included. When billions of dollars are on the line, industry sponsored studies will show favorable results more often than not. Always check the author’s conflict-of-interest disclosures at the back the article. If none are reported though, don’t assume they do not exist. Not all conflicts of interests are disclosed. You may have to do additional digging to identify conflicts.

FDA or EPA Approved Does not Mean Safe or Risk-Free

Both agencies have long histories of approving and then failing to recall dangerous chemicals, drugs and devices from the market. Their work is particularly incompetent in reproductive (endocrine) and women’s health: thalidomide, DES, Yasmin/Yaz, HRT, Mirena, Prolift to name but a few that have garnered the seal of approval by the FDA. Phthalates, BPA, Glyphosate for the EPA.  Remember the EPA doesn’t even study the female reproductive dangers unless research shows that a chemical impacts the male reproductive system.

Research Methods Matter

Perhaps more so than in any other field of science, endocrine research requires serious consideration of all aspects of the study protocol. This means that you cannot rely on a press release about the research to determine the study’s relevance. You must read the original research and evaluate the methods. (Reading original research is a good habit to have for all matters that affect your health and well-being). Once you pull the research, here are some things to consider.

  • Length of study. Most hormone reactions are longer term and span generations. If the study is short duration, as in the case with the industry sponsored GMO research or doesn’t include third generation effects, as with BPA research – question the results.
  • Population studied. Whether one is investigating a chemical or a drug in humans or in rodents, the sample population matters. Ascertaining safety of efficacy by testing only healthy young men, when the drug or chemical is meant for the real world where women, children, elderly, healthy and not so healthy individuals reside, is common practice and recipe for disaster. Same is true for rodent research – the strain, sex, age and health of the animal must be considered if the work is to be extrapolated to real humans. I read one study claiming that BPA was safe, but they used a strain of rats that was resistant to environmental estrogens. Of course, BPA’s estrogens would not affect these estrogen-resistant rodents.
  • Outcomes measured.  What does the study measure and how does it evaluate change? More often than not, industry sponsored research will not measure the appropriate endpoints or reproductive dangers. Sometimes this is sleight of hand, other times it is simply ignorance of the endocrine system’s far-reaching regulatory control. In either case, one has to evaluate what the study actually measures before determining its validity. Here, you can use a bit of personal experience – what systems, organs or behaviors are affected by your hormones? If the study didn’t measure any of these variables, then it’s probably not a very solid protocol.
  • ‘Gold-standard’ protocols are not always golden. It takes years, decades even for ‘gold-standards’ to become the accepted methods – often well after their utility has run out and newer, more sophisticated tools have reached the market. This has been the case for endocrine testing and endocrine disruptor evaluation. If a study rests all of its findings using a gold standard, it may not be using the most sensitive testing methods.
  • Clinical significance is not the same as statistical significance. Clinical significance means the chemical/drug has some meaningful impact on the health or well-being of the individual or animal. Statistical significance is just a math equation. A simple increase in sample size while limiting or ‘restructuring’ outcome variables is all it takes to derive statistical significance in most research. Does that mean the drug or chemical has clinically relevant health effects – not necessarily. The opposite is also true. Want to obfuscate the dangers of a drug/chemical? Do a huge study (preferably by combining dozens of poor quality individual studies into a meta analysis), throw everything but the kitchen sink into the analysis, do simple stats and highlight the lack of statistical significance in the death or injury rates. Only a small fraction of the study population died – but it wasn’t statistically significant, so the drug/chemical is considered safe. If the study does not study distinguish between clinical and statistical significance or downplays the death and injury rates as statistically insignificant, approach cautiously.
  • Hormone reactions do not conform to linear statistics. Damn it, how dare our complex physiology not conform to the simplicity of linear statistics. A common dose-response curve is highly linear, where a small dose elicits a similarly small response and a larger dose increase the response size. This is not case when dealing with endocrine disruptors. Hormone systems are complex and highly non-linear. Hormone dose-response curves are often in the shape of an inverted U where low doses elicit huge responses, mid-level doses elicit minimal responses and high doses again elicit huge responses. And so, any study measuring hormone effects using simple, linear, dose response calculations is bound to miss the effects entirely.
  • Hormones have metabolites (as does everything else). Metabolites evoke their own reactions. We know that some of the metabolites from BPA are stronger, 1000X stronger in fact, than BPA itself. Studies that don’t address the full complement of hormone products that circulate in our bodies as a result of exposure to something like BPA will severely underestimate the safety issues.

In a nutshell, we have to do our homework. There is no simple ‘Good Housekeeping Seal of Approval’ for products that impact health and well-being. We wouldn’t trust the marketing put out by car manufacturers or, worse yet, a car salesmen, about the safety, gas efficiency, repair history and comfort of a new/used car; why do we trust the makers of chemicals to give us the straight story. We shouldn’t. We have to become educated consumers of health research in order to protect ourselves.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

Photo by Markus Winkler on Unsplash.

This article was published previously in March 2013 and updated and edit for republication in 2015.

Share

BPA and Other Gender Bending Plastics

5010 views

An oft repeated theme in this journal is that measurement matters. From the basic concept that one cannot manage what is not measured to the more specific notion that research protocols in the lab should attempt to mimic real life as much as reasonably possible, we believe measurement is critical. In matters of health and hormones where complex systems with a myriad of ever-changing variables are the norm, this is difficult at best. Sometimes, however, the simple act of measuring these variables opens a world of insight. This is the case with BPA and other estrogenic plastics.

BPA and Estrogens

Bisphenol-A (BPA), the estrogenic activator leaching sperm from our men and damaging the ovaries of women came to the world’s attention several years ago after a vocal and strident outcry from moms. The FDA subsequently remitted, prohibiting BPA from baby bottles and sippy cups and a slew of newer ‘safer’ BPA-Free plastic products emerged, but are they really safer? Maybe not.

Simulating Real Life Usage: Measurement Matters

Until recently, no one had measured the estrogenic activity of the other compounds used to plasticize our food containers. Nor had anyone measured these compounds under real-world stressors, such as UV-radiation (sunlight), microwave radiation or in the dishwasher or with different types of solvent (to represent the food/drinks contained by these plastics). Indeed, as is often the case, we were lulled into a false sense of safety.  We believed that since BPA was removed from plastics, the endocrine disruptors were also removed, when in fact the other compounds had simply not been measured.

As one might expect, once those tests were conducted, researchers found that most plastic products on the market today release chemicals that are estrogenic – even those marketed as BPA-Free. Baby bottles, where much of the BPA outcry began, can leech as many as 100 different chemicals especially when exposed to real-life stressors, sunlight, microwaves and dishwashers, all estrogenic in nature.

Sunlight, in particular, was especially adept at maximizing the release of estrogenic chemicals into the solvent. Who hasn’t left their water bottle in the car? And when the plastics were tested in both polar and non-polar solvents (most foodstuffs/drinks are a combination of both), the majority showed reliably detectable estrogenic activity.

What to Do With All of These Estrogens

Not to worry, according to the authors of the study, there are ways to create plastics that don’t elicit estrogenic activity and they don’t cost any more or require different manufacturing than those that do. It’s simply matter of choosing to utilize those plasticizers and associated chemicals instead of what we currently use. The question is whether major plastics manufacturers will pay heed to these warnings and make the switch. Did I mention the man-boobs and infertility from the extra estrogens?

The study:  Most Plastic Products Release Estrogenic Chemicals: A Potential Health Problem That Can Be Solved 

Postscript

The article above was published originally in October 2012. Over two years later, I am sad to say that not much has changed. Industry has repeatedly denied the safety issues with BPA and the other, presumably safe, BPA-free plastics. The current campaigns, much like those of the tobacco industry, proffer industry financed research as proof of product safety while discrediting any scientist who brings evidence to the contrary. It’s a common script followed by all chemical manufacturers; one that has yet to be successfully curtailed.

 

Share

Navigating Health – A Video Talk about Endocrine Disruptors, Epigenetics and Energetics

3020 views

Last summer I was privileged to give a talk at a midwifery conference in Wisconsin, hosted by the wonderful people at Southwest Technical College and organized by my good friend Cynthia Caillagh.

The title of the talk was Endocrine Disruptors, Epigenetics and Energetics: Navigating Health in a Toxic World. It was weighty and depressing topic to be sure, but one that merits far more consideration than is recognized. The sheer number of environmental insults facing modern humans makes navigating health difficult at best and impossible for many.

The current generation is plagued with more chronic and complex health issues than any other in history. Why is that? The reasons for chronic illness are many, but the common pathway begins with pervasive toxicant exposures, poor nutrition, and limited exercise and ends with mitochondrial damage; damage that compounds generationally.

At some point, we have to break the pattern, for ourselves, our children and our grandchildren. Those in the birthing community are on the front lines of health and disease. Their influence and guidance can affect change for generations, and so, even though this topic is not one that would be typically presented at a childbirth conference, I thought it was important to provide a new framework through which to view the influence of midwifery.

Below is the video. It’s a little rough the first 8-10 minutes when I am pinned to podium mic, unable to see the computer and unable to move around, but after that, it’s pretty good. Enjoy.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Share

PCOS and Endocrine Disruptors

5736 views

Endocrine disruptors are chemicals that interfere with the body’s endocrine (hormonal) system. They can affect everything from normal development, reproductive fertility to neurological health. Unfortunately, endocrine disruptors are everywhere in our society. And there are many different types.

Some examples of endocrine disruptors include dioxin, PCBs, DDT, other pesticides and bisphenol A (BPA). Many of us have heard of the risks associated with various pesticides and the BPA in our plastics. These little guys can hide out everywhere – in our household cleaners, personal care products and cookware.

Endocrine Disruptors and Polycystic Ovarian Syndrome (PCOS)

PCOS is characterized by a group of signs and symptoms. These include excess androgens, insulin resistance, cysts on the ovaries, hirsutism (excess hair growth), acne, weight gain, irregular periods, depression and more. As PCOS is a hormonal disorder, anything that effects our production and/or filtration of hormones (like endocrine disruptors) will affect PCOS. Many studies have been conducted around this very topic.

Bisphenol A (BPA). Let’s talk about one of the most prevalent and widely-researched endocrine disruptors: bisphenol A. BPA is a chemical generally used in plastics and the lining of some metal items. For the consumer, BPA is found mostly in the lining of cans, plastic water bottles and containers. Now, this may not sound too bad but the BPA in these containers can seep into your food and drink- posing serious health risks.

Just a few of the many health risks associated with BPA exposure include:

  • Reduced number of oocytes (eggs in our ovaries)
  • Lowers successful number of births
  • Heightens stress response and anxiety
  • Increases testosterone
  • Reduces function of estrogen receptors
  • Developmental problems in fetuses and children
  • Impaired glucose metabolism (blood sugar problems)
  • Cancer

PCOS and BPA

Fetal Exposure. Several studies have been conducted to test the connection between BPA use or exposure and polycystic ovarian syndrome. What scientists have estimated is that a woman is much more likely to develop PCOS if there was BPA exposure as a fetus. This means that if your mother used canned foods lined with BPA or lots of BPA-containing plastic containers and bottles during her pregnancy, it could have contributed to your PCOS[i][ii].

Increased Testosterone. These studies have also show that BPA exposure leads to increased levels of testosterone. The reason for this is because BPA exposure is linked to decreased filtration of testosterone. A few studies have noticed this correlation.

Estrogen Dominance. Another connection between PCOS and BPA is an increase in estrogen production. Remember, there are many types of synthetic estrogens, but the most prominent endogenous (those made by the body) estrogens include: estrone, estradiol and estriol (high in pregnancy). Generally in PCOS, testosterone and estradiol reign high, with the body unable to produce enough progesterone. This can create what has been called estrogen dominance[iii]. This is bad news for women trying to balance their hormones.

BPA and other endocrine disrupting chemicals contain estrogen-mimicking compounds (xenoestrogens) that increase our body’s supply of the hormone. As we know, approximately 50% of women with PCOS are overweight. These xenoestrogens are fat-soluble, meaning that they get stored in fat. So, the more overweight a woman is, the more likely her symptoms of PCOS and estrogen dominance will be severe.

Glucose Metabolism. There is one more way that endocrine disruptors are bad for women with PCOS, and that is glucose metabolism. Insulin resistance and blood sugar issues are extremely common in women with PCOS[iv]. Scientists have discovered that endocrine disruptor exposure alters glucose metabolism and pancreatic function[v]. The pancreas is our blood-sugar-regulating hub, so this is bad news. Risk of developing diabetes is also heightened.

How to Avoid and Detox Endocrine Disruptors

Glass Cookware and Food Storage. Many of the endocrine disruptors we are exposed to are in some way related to our foods. Canned foods often have a BPA liner on the inside, which seeps into our food. We store our food in plastic containers and bottles that are made with BPA. It’s important to find alternatives to these storage methods to reduce our exposure.

Try using glass storage containers and bakeware instead of plastic. Glass is sturdy, easy-to-clean and can last a lifetime. A small investment in glass storage will go a long way to reducing your exposure. Another thing to try is avoiding cans lined with BPA. Generally, companies won’t tell you if a can is lined with BPA, but the ones that don’t use it will put it on the label. Not sure? Avoid canned foods altogether and only use fresh foods.

Whole Foods Diet. We all know we should eat for health and that whole foods are better than packaged foods, but how many of us are really doing this? We lead such busy lives it can be difficult to grasp the concept of cooking fresh, from scratch. If you are concerned about exposures to endocrine disruptors, eating fresh foods  will drastically reduce your exposure.  And for a bonus, – use organic fruits, vegetables, dairy products and meats wherever possible. Endocrine disruptors are also in the pesticides, hormones and antibiotics used to cultivate conventional foods[vi]. Still not sure? Why not try purchasing a share of a local farm that you trust. These are called CSAs, or community-supported agriculture. You pay a fee and get a weekly box of fresh goodies during the growing season.

Natural Remedies for Exposure to Endocrine Disruptors

Sweat. The skin is our largest organ. It’s also one of the ways our bodies detoxify. When you sweat regularly, the body is able to filter and release excess toxins, chemicals, hormones and other substances- this includes BPA. Sweat regularly through exercise, saunas and hot baths. But make sure to rehydrate your body with pure, clean water afterwards!

Lemon Water. Speaking of hydration, pure, filtered water is a huge helper for our bodies in filtering toxins. When we drink warm water with fresh lemon juice upon waking, it helps our bodies release toxins that is has filtered while we were sleeping. It also helps to set our digestion for the day, so we are better able to prevent toxins from getting into our bloodstream in the first place.

DIM. Diindolymethane (DIM) is an antioxidant and phytonutrient compound found in brassica family vegetables. These include broccoli, Brussel sprouts, cauliflower, cabbage and kale. Studies have shown DIM to have superior abilities to reduce excess estrogens and risk of some female cancers such as breast cancer[vii]. This is a supplement that could be useful for women with PCOS who have estrogen overload due to endocrine disruptors. DIM will safely bring the estrogens back into balance and restore healthy tissues. This can be helpful in hormonal weight gain, excess androgens and PMS issues.

Probiotics. Probiotics are “friendly” bacteria that reside in our gut. They help to regulate our immune system, digestion and so much more. They have become quite popular lately and are added to a variety of foods. Probiotics can also be taken in supplement form.

Probiotics detoxify endocrine disruptors like BPA because they are able to break them down[viii]. When this happens, those harmful chemicals are excreted through our bowels. Some examples of probiotic foods to include in your diet every day are plain, unsweetened yogurt, kefir, kombucha, raw, unpasteurized sauerkraut, kimchi or pickles, and raw apple cider vinegar.

BPA and other endocrine disruptors can wreak havoc on women with PCOS, and may even contribute to the syndrome developing in the first place. Prevent further complications from these chemicals by balancing your hormones, losing weight if necessary and enjoying a whole foods diet full of phytonutrients like DIM. And don’t forget to avoid sources of BPA like plastic containers and food cans as much as possible. When you take care to do these steps, PCOS may become more manageable.

References

[i] Eleni Kandaraki, Antonis Chatzigeorgiou, Sarantis Livadas, Eleni Palioura, Frangiscos Economou, Michael Koutsilieris, Sotiria Palimeri, Dimitrios Panidis, and Evanthia Diamanti-Kandarakis. Endocrine Disruptors and Polycystic Ovary Syndrome (PCOS): Elevated Serum Levels of Bisphenol A in Women with PCOS. The Journal of Clinical Endocrinology & Metabolism 2011 96:3 , E480-E484.

[ii] Evanthia Diamanti-Kandarakis, Jean-Pierre Bourguignon, Linda C. Giudice, Russ Hauser, Gail S. Prins, Ana M. Soto, R. Thomas Zoeller, and Andrea C. Gore. Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement. Endocrine Reviews 2009 30:4 , 293-342.

[iii] Slater, W. (n.d.). The Role of Estrogen Dominance in PCOS (Polycystic Ovarian Syndrome). Retrieved November 16, 2014, from http://www.ovarian-cysts-pcos.com/estrogen-dominance.html

[iv] Dach, J. (2014, May 19). PCOS, BPA and Endocrine Disruptors Part Three. Retrieved November 15, 2014, from http://jeffreydachmd.com/2014/05/pcos-bpa-endocrine-disruptors-part-three/

[v] Evanthia Diamanti-Kandarakis, Jean-Pierre Bourguignon, Linda C. Giudice, Russ Hauser, Gail S. Prins, Ana M. Soto, R. Thomas Zoeller, and Andrea C. Gore. Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement. Endocrine Reviews 2009 30:4 , 293-342.

[vi] Evanthia Diamanti-Kandarakis, Jean-Pierre Bourguignon, Linda C. Giudice, Russ Hauser, Gail S. Prins, Ana M. Soto, R. Thomas Zoeller, and Andrea C. Gore. Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement. Endocrine Reviews 2009 30:4 , 293-342.

[vii] A Super-supplement for Hormone Balance: DIM. (n.d.). Retrieved November 16, 2014, from http://blog.healthybynaturehwc.com/2013/08/06/a-super-supplement-for-hormone-balance-dim/

[viii] Gallaghan, H. (2013, December 5). 7 Ways to Drain BPA From the Body. Retrieved November 19, 2014, from http://www.activistpost.com/2013/12/7-ways-to-drain-bpa-from-body.html

About the Author. Robyn Srigley is the The Hormone Diva, holistic nutritionist, author and speaker. Robyn helps women replace anxiety with joy to open possibility in their lives and have a positive impact on the next generation. Robyn’s struggle with PCOS helps her with clients suffering from PMS, PCOS, Endometriosis and much more.

Web: http://www.thehormonediva.com

Facebook: http://www.facebook.com/thehormonediva

Twitter: http://www.twitter.com/thehormonediva

Pinterest: http://www.pinterest.com/thehormonediva

Share
1 2 3