Sep 19, 2017
I remember clearly the first time I came across the reality that our consumer products expose us to toxic exposures--which include chemicals, heavy metals, and electromagnetic fields. It was ten years ago, when my first born was just a few weeks old.
I had just ended my maternity leave. And after a demanding day at work, I climbed into bed at a little after midnight with a pile of books to skim. The books were about how to take care of a baby: how often she should eat, what she should eat, what her sleep patterns should be, and how to keep her safe.
On p73 of a book by an accomplished pediatrician, I encountered a sentence about nitrosamines—compounds that can cause cancer—in some baby bottle nipples, and BPA—a hormone disruptor—in some baby bottles. I thought,
What?! That just can’t be true. That doesn’t make any sense: toxic chemicals in baby products? That doesn’t happen in America. And, if that were true, then someone, like my pediatrician or OBGYN, would have told me this sooner.
Turns out, there's a meaningful body of science that proves that this is true: what we buy and do have a meaningful impact on our toxic exposures.
My maternal instincts were extra heightened during my daughter's infancy. Her biological vulnerability was obvious to me. I would later learn how wise this is, because, biologically, infancy is one of our most vulnerable, and important, stages of development.
So it was much more upsetting for me to learn about the health risks from toxic exposures while as a mother to an infant than if I learned about the topic if my children were older. Ideally, I would have learned about this before having children.
Difficult times, however, can be opportunities.
I was so upset by what I was learning that I harnessed my anger and indignation into creating a book that I wish I had sooner. I became determined to protect my growing family from the toxic exposures from what I buy and do.
My husband and I have been blessed with a total of three beautiful daughters. It has been during their pre- and post-natal periods, breastfeeding, and early childhood that I studied the toxic exposures of an average family. I never would have imagined that it would end up taking me eight years to complete my research and the book. But it did because information is conflicting, facts are challenging to verify, credible sources are substantial but come from various sources, and our toxic exposures are pervasive.
My book, titled A to Z of D-Toxing, was published in October 2015. I created it to make it easier for others to learn about the toxic exposures that we can influence, which is an important, and overlooked, pillar of health.
While the prenatal and postnatal periods are the most critical stages to protect, our toxic exposures are always relevant to us because some can affect biological processes, like metabolism, menstruation, aging, human development, and more.
Throughout this stressful learning period, I often desperately wished for a doctor like Dr. Hugh Taylor.
Dr. Hugh S. Taylor serves in varied and impressive roles:
What I cherish in Dr. Taylor is that, in addition to his impressive expertise and accomplishments, he also has a holistic perspective on reproductive health. He is informed about the current science on risks that toxic exposures may pose on fertility, and their potential influences on IVF- and pregnancy- outcomes.
Dr. Taylor and I recently recorded a conversation that I think every individual should listen to. If you, or someone you know, cares about fertility, having healthy children, and optimizing your health, then you should listen to this important conversation that includes simple tips that are easy to incorporate. And, remember, as always, you can find podcast show notes on my website at www.NontoxicLiving.tips. Also, please share this podcast because we are interconnected by the health of our planet. So, the more we can work collaboratively, the better off we, and our future, will be.
Click above to listen to the podcast. Below is a transcript of the podcast with Dr. Hugh Taylor. It has been edited and sometimes modified to make it more reader-friendly. Please also listen to the conversation by clicking below. You can subscribe to this podcast on popular podcast platforms, like Overcast, Stitcher, and iTunes.
SRG: In writing and researching my book over eight years, I learned a lot about the science on toxic exposures from household products, and the body burdens (the load of chemicals) we're finding not just in humans but also in wildlife, and their possible associations with reproductive health.
I developed many questions that I haven't been able to figure out from my research. So it's especially exciting for me to be able to have this conversation with you.
HT: Me too. Hopefully we can talk about some of the research I've done. I can't say that I'm an expert on every toxic substance or the type of general things that you have written about. So I think you probably know more about some of them than I do, but I'm glad to be of help where I can.
SRG: I would love to hear more about your research, your perspective on fertility, and how certain environmental factors we do have control over can either help or hurt our reproductive health.
First, I'm not clear on whether fertility is more challenged than ever. Recently, in early July, The New York Times published an article about fertility in the US being at an all time low. The numbers say that fertility, for those under age 30, is at an all time low, and fertility for birth rates for women from 30 to 40 years old has increased. And so, I realized that it's hard to tell whether fertility has increased or decreased, or whether women are more educated and just choosing to have children later.
HT: I think that is part of it. But I think that's a complex issue. There are so many things that go into fertility. Some of it is social, and some of it is biological. I think you really have to think about both.
Clearly women are spending more time pursuing careers and doing a lot of great things. And delaying childbearing. And that always will make fertility more difficult the older you are, especially over 35, fertility starts going down naturally in everyone. And it varies from person to person. But the longer we wait, the more that becomes a challenge.
But we also have introduced better and better fertility treatments. They've improved dramatically recently so we can overcome some of those.
I wouldn't be surprised if we saw decreasing fertility as women delayed childbearing till later for good reasons, and then improving fertility as in that same age group as fertility therapies (IVF) has become better, more efficient, more effective. And I think we'll see more improvement.
Now, the latest trend is for people who want to delay their family. We can freeze eggs, stop the clock from ticking, and bring those eggs back at a later time. So we really don't have that same sort of age restriction on it.
SRG: That is pretty exciting.
HT: It's very exciting. I think you're seeing fertility decreasing for those social factors. And we're seeing fertility increasing due to the medical improvements.
HT: But in the younger women, where it's not age-related, I think we do see things going on in society that are decreasing fertility. One of which is how we eat.
HT: The obesity epidemic is potentially decreasing fertility, making more women in-ovulatory. They're not having regular cycles and ovulating every month. So that very well could decrease fertility. We see more polycystic ovaries syndrome, and that has largely to do with diet, and some of the things that we have in our diet. Not just overeating, but problems with some of the carb heavy diets that we have today, that are really bad for for our metabolism and obesity.
And we also see more access to better contraception. For example, IUD has been rising in popularity, there are implantable contraceptive devices that are more reliable: You can't forget to take your pill if you're on an implantable device. There are more consistent birth control methods that may have decreased the number of unintended pregnancies, and about half of all pregnancies in this country are unintended. So that may artificially look like we're decreasing our fertility rate when, in fact, we are just better at using contraception, and have better access to contraceptive devices.
SRG: So, do you still see patients? Are you still a practicing physician?
HT: I am. I'm a reproductive endocrinologist, which is a sub-specialty of OBGYN.
SRG: With patients who are in their 20s, who are actively trying to become pregnant, do you notice if that demographic has more reproductive challenges than in the past?
HT: It's hard for me to say. I hate to extrapolate from my experience. I haven't really noticed that. But, on a larger macro scale, it may very well be happening. Again, I think diet plays an important role, and we didn't mention the main point of our conversation today: these toxic exposures, which I think play a role.
SRG: You do?
HT: Yes. And somewhat in fertility in an individual. But I think the more important point we're missing is how it affects the fertility of our offspring. What you do when you're pregnant may affect your child's fertility, and our fertility right now may have been programmed by what our mothers did when they were pregnant. I think that's an important piece that we're missing.
So toxic exposures twenty years ago, 20-30 years ago, when there was less awareness of the implications of some of these agents, may have influenced us when we were still in the womb as a fetus or a young child. And may be impacting our fertility now, 20-30 years later. That's one of the biggest challenges: How do you connect the dots? How do you link those two together?
Most people aren't even aware of some of the exposures that were out there, back then. Our moms didn't know that they were doing something that would be of concern. And it's almost impossible to go back now and recreate what our mothers did when they were pregnant to see if that impacted our fertility.
SRG: Would you speak more about what we now know, as a scientific and medical community, about how our mother's, or even grandmother's, exposures may affect our fertility today?
HT: The classic example, the one that is the sort of established paradigm that everyone agrees about, is diethylstilbestrol, or DES.
That is the model in humans, and it parallels very nicely with what happens in animal experimental models, is DES. It was a hormone given to women during pregnancy, that was intended to be helpful, that was intended to reduce miscarriage, pregnancy loss, make for a healthier pregnancy. In reality, it did not do that. But had, instead, devastating consequences to female fetuses that were exposed.
So a baby exposed inside the mother's womb to the DES the mother was taking, supposedly to help with the pregnancy, resulted in her baby's reproductive tract developing inappropriately, abnormally.
And nothing obvious: When these children were born, they weren't born with birth defects. Even as they got older, there was nothing obvious that would be detected, that told us that they had birth defects.
But when we went back and looked at women whose mothers had DES during pregnancy, we found that they had a higher risk of miscarriage, pregnancy loss, more infertility, more ectopic pregnancies, misshapen uteri, early deliveries, premature babies, a lot of pregnancy problems. If we really looked with various X-rays, we could have seen that the uterus may have had some sort of abnormality, may have been misshapen, may have been damaged by the DES, but that's something you don't see. It's inside. You don't see that unless you're really doing testing, looking for it.
But, the thing about DES. that helped establish the paradigm was that we knew, because it was prescribed, we knew exactly who got DES, and who didn't.
So we can say, your mom had DES, and you have a much higher likelihood of having this problem.
Think about all the other chemicals we're exposed to that we don't even know if we're getting them or not. Or, they may be so widely disseminated, everybody is exposed to a little bit. You can't sort it out into two groups, and say this group with exposure has a problem. This group doesn't.
It's almost impossible to know. When you don't know what you were exposed to, it's going to be impossible to trace back any medical problem, any problem with pregnancy, any problem with fertility, to some sort of exposure that you didn't even know you had, that may have happened 30 years ago. It just doesn't happen.
HT: So we have to rely on animal models for much of this study. It's very clear. You give an animal DES, and they'll have the same exact same sort of problems that humans have. And you can model it nicely.
And we're finding that unfortunately the same is true for many environmental agents that, some of which, thankfully, we're now no longer exposed to the same degree, but many environmental agents can have the same type of effect. Again, especially when exposure occurs during pregnancy, when we're still a fetus, when our organs are just developing, that's when we're so vulnerable, we're at our most vulnerable stage.
And the DES was an estrogen-like compound, and we know that environmental hormones can have the same types of effect. There are many chemicals in the environment right now that function like estrogens. And there are some that function like testosterone, the male hormone. And we know that these can be harmful from our animal models. We give an animal one of these hormones, or one of these chemicals that functions like a hormone, and it has some pretty bad effects.
If you think about it, how hormones are supposed to work, the biology: we evolved over millions of years to make sure that hormones in our body really weren't influenced by the environment. Otherwise, it would wreck havoc on our bodies.
We needed to make a specific chemical that would send a signal from one part of our body to another, that's what a hormone does: it's made in one gland, and it sends a signal to another organ in our body. And we designed those, we evolved, to have them not be interfered with a bunch of, essentially hormones equivalents, or other agents in the environment that would trigger the same response. We evolved very specific one-to-one signals so we wouldn't have to have that interference with the environment.
It's not surprising now, as we make thousands and thousands and thousands of chemicals that we're exposed to in our food and the environment, that some of those, just by accident, might interfere with those pathways.
We haven't had millions of years to test and evolve to make sure that we have very specific responses that just sort of randomly, some of them are going to interfere with our normal body responses. And that's exactly what's happened. If you throw 10-20,000 chemicals at someone, it's bound to interfere with something, it's bound to interfere with normal biologic processes in the body. So, it's a mess.
SRG: Would you talk more about how the chemical can interfere in our body at extremely low doses? And also comment on the potential cocktail effect there can be from the mixture of chemicals?
HT: Yeah. That's really important. I think both of those points are very, very important.
Even very low doses of some of these chemicals can have profound effects, especially in the developing fetus, especially in children and the fetus. If a pregnant woman is exposed, her baby is at bigger risk because it doesn't take much during these particularly vulnerable sensitive times.
Some of the research that we've done also show that, although we think about these chemicals as not being very potent hormones, sometimes, the way they work during pregnancy with the fetus is a little different
The mechanism at work in a fetus or a young child is different than in an adult. The baby is designed to respond to lower doses of certain hormones and respond in a different way that programs them for life.
HT: This is a time of development where we are being programmed to develop appropriately, to grow appropriately. And these implications are that whatever happens during that period, we are carrying with us for the rest of our lives, and these hormones and environmental chemicals, by interfering with hormones, are doing it in a different way than they might in an adult, because there's really very different biology going on.
And even very low doses of these chemicals, or that mimic very low doses of hormones, can have profound effects. So just because something is too low a dose to have a profound effect on you or I, doesn't mean that it might not have a very profound effect at a different stage of life. Very important.
Another point you mentioned is the cocktail that we're exposed to. None of us are exposed to one single agent at a time. Most of our animal experiments are done just that way. We give one agent and say this has an effect or not.
But many of these things interact and have a much more profound effect in the real world, when we don't isolate them one at a time. It's kind of silly to think that we would ever be able to see the totality of the effect of chemicals on our body by looking at them one at a time, when many of them are falling into the same sort of classes, work together, or work on the same pathways, and they have multiple effects.
I think some of the best examples to show just how profound these effects are come from studying wildlife. In some of the very polluted areas, I like to quote the work of the late Lou Gillette, who was a biologist who studied alligators. He went wading in the swamps of Florida, and captured alligators. Pretty heroic.
What he found was comparing this sort of more pristine lakes and waterways to those that were near, or in, polluted areas where there might be a lot of pesticides running off farm lands into ponds and swamps, or near industrial plants that have a lot of chemicals, that when you are exposed to higher doses of these chemicals, or various mixtures of these chemicals that might naturally occur, that these animals had tremendous abnormalities. And most of them had to do with reproduction.
HT: They saw animals that had sex reversed. They had a male that had certain female components and vice versa. The females would be infertile, the eggs would be abnormal, the males would have small testicles, or small penises, and low sperm counts, or, even again, some sex reversal. They had much lower success rates at laying eggs, at those eggs hatching, and reproducing. The biggest effects on these animals were reproductive effects. And this was, again, representative of the type of mixed exposures that you'd see out in the environment.
So I think reproduction is one of the most concerning factors when we talk about toxic exposures, and especially about these environmental chemicals, many of which are our hormone mimics or endocrine disrupters as we call them.
The reproductive tract is one of the most sensitive, one of the most important hormonally-regulated organ systems, very sensitive to perturbations in hormone levels or blocking hormones, and especially sensitive again during development when we're a fetus or a young child. It's crucial.
SRG: It seems like we have a lot more data on, not necessarily a cause-effect relationship between a high body burden and reproductive challenges and wildlife, but there are some studies that show a high body burden of certain chemicals with certain reproductive deformities or other things. But is the data on humans starting to mirror the trends that we have outlined in wildlife?
HT: Oh, exactly they do. I mean you can find a few more extremes in wildlife because you go to a very polluted areas where we wouldn't be drinking water. And we can give animals these toxic chemicals that we would never obviously expose humans to.
But, they do. And the problem we have is that people are out there saying those are only animals, they're not the same as people, how can you extrapolate to people? How can you know, how can you extrapolate to people?
And we're never going to give people these toxic compounds, and then wait 30 years to see how their children came out. I mean, that's ridiculous. So what we have are these correlations in people, between maybe a level of some chemical in the blood, or in the eggs, or some other tissue. But not a real cause and effect proof. The higher the level and more likely we are to have some adverse outcome.
But people dismiss that saying it doesn't prove that it's cause and effect, the same way people said, well, most smokers don't get lung cancer, just because you get lung cancer how do you know that tobacco actually caused that. And we're sort of at the same point in some of these toxic exposures now, and people argue that just because higher levels are associated with disease doesn't mean that everybody who has the high exposure gets the disease, how do we know it's cause and effect?
But then we have the same correlations in animals, and we can prove it in animals by giving the chemical and showing that you have that toxic effect. And I think when the human and the animal data all line up perfectly to tell us the same thing, that's very good proof that it really is cause and effect in humans as well. I'm convinced.
SRG: I am too.
SRG: A few years ago, the World Health Organization released an excellent report about endocrine disrupting chemicals, State of the Science. In it, they outlined trends that science has identified in wildlife and the body burdens of certain chemicals, like we've just discussed. But they also noted that in certain parts of the world there tends to be decreasing semen quality. There seems to be good data on that... I don't know if that's outside your scope?
HT: No, I mean, it's not what I study personally, but there are reports that show decrease sperm quality, more recently. And, again, we know we can mimic that in animal models with certain toxic exposures. The phthalates, for example, interfere with testosterone action. Testosterone is important for male sperm production. So there are chemicals out there that we know can have those effects that are commonly used today.
And phthalates are in almost everything. Fragrances and some makeup are particularly important sources of the phthalates that we put on our skin and absorb pretty readily.
But it's in most flexible plastics, and there are certain agents we know of that are certainly capable of doing this, that we're exposed to.
SRG: I was really really happy that you spoke about how cell phone radiation may impair the developing brain.
HT: Yeah. So actually I'm a fertility expert by background. My intent wasn't to see how it affected the developing brain. We stumbled on this by accident.
HT: We wanted to know if cell phone exposure could affect fertility. There have been many studies that have linked cell phone exposure to lower sperm counts. And we wanted to test that out in a mouse model. There are a lot of studies that have shown that cell phone exposure might be linked to brain tumors, might have a link to, especially when children are pregnant women are exposed, might have a link to behavioral problems. But many of those have been dismissed.
The behavioral problem studies have been dismissed saying, Well, of course, if the mother is talking on her cell phone all the time and ignoring that kid, of course they're going to have behavioral problems. But we wanted to see if there was really any biologic basis to the fertility aspect of this. And what we found were behavioral problems.
We exposed mice to cell phones during pregnancy, and we looked at their offspring. We thought, again, going back to the idea that the fetus is the most sensitive of these types of exposures, that when we're developing when we're very small, and just starting to grow, and the organ systems are forming, that, for most things, is the most vulnerable sensitive time. So, we exposed mice to cell phones, and we just took the simple cell phone, the one that was most readily used at that time, and we took half the pregnant mice and put an active cellphone on the cage that was muted and silent so the mouse did not know if the cell phone was on or not. And then in another another room, we had other mice that had a cell phone on the cage that wasn't active. It was turned off so it wasn't sending out a signal.
So the only difference really was the radiation exposure coming from the cell phone. And, I'm a fertility expert, so we were interested in fertility.
There were no differences in fertility. They were reproducing male and female. Both reproduced well. They had normal fertility.
HT: But we also tested behavior more, because if they weren't getting pregnant, we wanted to determine whether it was a low sperm count, a low egg count, or whether they just weren't behaving properly and mating. So we put behavioral tests there, more to find out about why they weren't getting pregnant. Contrary to what we expected, they were getting pregnant.
The key finding was that they were not behaving normally: They were more active, anxious, but they were not worried about it. They were sort of hyperactive, bouncing off the walls. Their memory was a little impaired, but they weren't anxious or worried about that abnormal behavior.
So the cell phone exposure to the fetus had this effect on the brain that led to abnormal development as these mice grew up. And that behavior persisted as they became adults. It was not just immediately after exposure. The mice were exposed only during pregnancy when they were a fetus. We waited till after they were born, and let them grow up, and tested them at several different time points, and their behavior was persistently abnormal in adulthood.
So that programming early on, during fetal development, they carried the consequences of that with them for the rest of their lives. So that exposure for the time of roughly two weeks, during a three week mouse pregnancy, was enough to permanently alter their behavior.
Now when we expose them later on in life, we didn't see those same type of effects. Again, going back to the point that the brain is particularly sensitive, as most organs are, to toxic exposures very early on in life, when we're still developing. That's when it's most vulnerable, when it's small, and just starting to form. That's when any perturbation can do the most harm. And often programs the brain, the brain develops abnormally, and is stuck that way for the rest of our lives.
Same thing with other organ systems as well. If we don't get it right in the beginning, if we don't form those organs appropriately and properly, we'll carry an abnormally developed organ with us for the rest of our lives.
HT: So the mice were behaving abnormally, and this mirrored exactly what people have found in humans. Again, as I mentioned, large European studies have shown that women who use cell phones a lot, high cell phone exposure during pregnancy, are more likely to have children with behavioral problems, very much mimicking what we were able to see in mice.
Again those studies were dismissed, of course: If everybody is talking on a cell phone, maybe that's why she has a child with behavioral problems because she's not paying attention to the kid. No, that wasn't it. We were able to prove that this is really a cause and effect phenomenon.
So this goes back to what we're saying earlier. Sometimes you can only find a correlation in humans, and you might attribute it to lots of different things that are related. But with the mouse studies, we knew exactly that this was cause and effect. There was no difference between those two groups, other than the phone was on. The mice didn't even know which ones were exposed or not.
We also took their brains out, and showed that they had differences in electrical conductivity in the brain, and we really showed those were functioning differently. Again, based on that early life exposure, that brief early life exposure during pregnancy, they were programmed differently. And that same thing did not happen when the exposure occurred as an adult. Vulnerable time.
There was a dose-response effect. If we cut back the exposure, we had the cell phone on transmitting a signal from a certain point in the pregnancy all the way to just before they were born, 24 hours a day. As we cut that back to fewer hours a day, we could see that effect lessen as well. So a clear dose-response. But it tells us that we can really start to mitigate this.
The beauty of all the things we've talked about here is that you can really do things to limit your exposure. And it's hard in this day and age to get down to zero exposure, but, by cutting back, by reducing exposure, you can have a profound effect.
Again, these mice, if you cut back from 24/7 to just a few hours a day, there was no discernible effect. So we really can change our lifestyle and have an impact on development.
And, again, especially I would caution women out there who are pregnant, or thinking of becoming pregnant, to know that that is really a very vulnerable time. This is the time to educate yourself, and to learn about what exposures might be harmful, those that are clearly known to be harmful, and even those that might be. Start to think about eliminating those for the duration of pregnancy, and early childhood exposure as well.
SRG: I agree.
My feeling has been, and I don't know that there are any signs to prove it, but my feeling has been that in this world where we can't avoid electromagnetic fields, including cell phone radiation, completely, and we can't avoid other toxic exposures, completely, allowing your yourself breaks, so your body can recover, is extremely helpful. It sounds like, with the mice studies, when you were talking about the dose-relationship, it seems that idea carries through. So, for anyone listening, who's thinking, Oh no, but, at work, I can't control it... But, at home, they can.
HT: There are some very simple things you can do too. I mean, the cell phone, is the one that is most concerning to me. I know we're worried about all sorts of different types of electromagnetic fields and radiation exposure. But the amount of exposure that comes from a cell phone is huge compared to most other exposures.
That little transmitter, that we hold right up against our heads, is sending out a signal, has to broadcast out a signal, that's going to go to a cell phone tower miles away. It has to send out a huge powerful signal, as opposed to other signals that are in the air around us, that are very diffuse, it has to send out a huge pulse that's going to reach that tower. It's going to be spread out over miles but still hit that tower. It has to be a huge signal at its source. And if we hold that source of that signal, where the energy coming out is very intense, right next to our body, that's when we get the greatest exposure.
So I really think that the cell phones are probably the biggest concern, far bigger than anything else, than the Bluetooth, which doesn't transmit a signal very far, or being in a area where there's wireless, where we're far away from the transmission of the signal, and where those wireless signals usually aren't powerful enough to go long distances. It's our phone that's programmed to give out a very powerful signal that it'll make it to a tower miles away, sends it out in all directions, and hopes to get enough that will hit that tower. It has to give out a massive amount of energy, and we hold that right up next to our heads. That, I think, is the one thing where we can make a difference, that using the bluetooth is probably a great idea, using an earpiece rather than have the transmitter right next to our ear...
When we're not talking on the phone, move it away from you. If you're pregnant, especially, don't put it on your belt and put it in your front pocket, or leave it on your lap. That's worse. Put it on the other side of the room.
The intensity of that radiation, it goes from a single point on the phone, it spreads out in all directions. So it's really the square of the distance from the phone that determines how much exposure you have. So as you move further away from your phone, that signal dissipates pretty rapidly. It doesn't take a lot of movement away from the phone to make a big big difference.
So when you're driving your car, don't leave your cell phone on your body, stick it on the same seat next to you. When you're in bed, don't sleep with it on your pillow. Move your phones to the other side of the room, or, even if you're in your office, don't leave it clipped to your body. Put it on the far end of your desk. Even that type of small movement can make a big big difference.
Again most concerning is during pregnancy, when you're most vulnerable, I think, of all these electromagnetic fields I think the cell phone is the most worrisome, especially in pregnancy. And it's easy enough to limit your exposure.
Again, with the wired device that you plug into your phone, the old fashion head set, or even the bluetooth, is lower energy. You could move that transmitter, which sends out most of the energy, away from you and be a lot safer.
SRG: Excellent advice. Have you noticed any influences that toxic exposures may have on the outcome of IVF?
HT: Yeah, there's a lot of data, especially on Bisphenol A, the estrogen-like plastic. It suggests that it may interfere with egg quality and IVF performance.
HT: So I advise that women trying to get pregnant, or who are pregnant, a lot of our studies have been looking at BPA, bisphenol-A, exposure and the effect on the fetus. So if you're either pregnant, or thinking about trying to become pregnant, avoid Bisphenol-A.
Now it's the same type of comment I made before. You can't avoid it all. But you can reduce it.
Now bisphenol-A is in plastics. It is the agent that makes plastics very rigid. So it is found in those, not the crunchy water bottles that we get at most convenience stores or supermarkets today, but it's more the hard rigid water bottles that are more the permanent ones that you keep and reuse, the water cooler bottles, the hard bottles that you might put in your bike.
Many of those manufacturers, because of this publicity, have removed the BPA from the bottles. But they've been replaced by other plastics that we just haven't tested yet so I'm not sure how safe that is. And bisphenol-A, or BPA, is found in the epoxy linings of anything that comes in a can, essentially.
So if you eat out in a restaurant, you're probably eating something that came out of a can at one point, and has BPA in it.
So avoiding eating things out of plastics, avoiding eating out to get fresh fruits and vegetables, instead of canned goods, is easy enough to do, especially, again, when you're pregnant, or thinking of becoming pregnant. It's easy to do, and probably has a whole lot of other health benefits other than just getting rid of that BPA, just a good healthy lifestyle for many reasons. It's never a bad idea to do that.
SRG: Yeah, I agree. Generally speaking, there's still a lot of differing opinions on the risks of BPA. But it seems like, from your perspective as a fertility specialist, you're clear that BPA poses risks for someone who is trying to conceive or who is pregnant.
HT: Yes, I believe it does. It is a controversial field. And some of the controversy comes from, again, studies that have been correlative in humans without, and not every animal study looks at the same timing, the same conditions. Again, my own feeling is that pregnancy is the most vulnerable time, and probably the worst BPA exposure is when you're exposed as a baby or fetus, and how it affects your reproduction 30 years later. We just don't have answers to those kind of questions yet because of the time delay it would take.
As I said before, eliminating BPA, or at least dramatically reducing it, is so easy. And, even, let's say I'm wrong, and BPA isn't harmful at all, I don't believe that, but, let's say it is, think of all the other benefits you get from eating fresh fruits and vegetables; and not getting everything out of cans or plastics. Yeah. Eating high quality foods has so many other health benefits, that it's the right thing to do. Either way.
So I think there's really no downside to doing that. I'm a strong advocate for that. And why not be cautious. There's something out there called the precautionary principle that just says that if, even if we're unsure, why not avoid things that we can easily avoid without disrupting our lives in a major way, that may be harmful, even if there are people who aren't 100% sure they are harmful, you might as well avoid them, especially at times in your life that are crucial, like when you're trying to get pregnant or during pregnancy. Really, no downside to avoiding them, living a healthier lifestyle.
There are probably things we're not even looking at yet that may be implicated in future generations as harmful, that if we that we avoid by eliminating a lot of this artificial material, or are exposed to pesticides, the additives, the packing in the containers, shipping containers that contaminate some of our food, why not go back to eating more healthy organic natural unprocessed food. There's really no downside to that.
Other than a little more expense. That's always an issue for those who have trouble affording it. It's a problem. And hopefully we can find ways to help encourage that, and subsidize that for those who can't afford it.
SRG: Well, I think it's an important investment in trying to reduce more serious problems down the road. The upside can be life-changing.
HT: Absolutely. I think as a society it is a very smart investment. We will save much more by not exposing, not suffering the consequences of these toxic exposures. So if you can work together as a group to make sure we recognize that, and provide these investments for people who can afford it early on, to save society a greater expense later, it will not only be good for people, but it will be a smart investment, a wise financial move for mankind.
SRG: Would you comment on whether precocious puberty is becoming more common, whether you think toxic exposures is interfering with menopause? I haven't read anything about that, but I'm just curious.
HT: Well, I think puberty is happening earlier. And it's hard to know how much of that is nutrition, obesity. If you are undernourished, you certainly can go through puberty later. As we get better nourishment, maybe, now, too much to the point we're getting to obesity, that does tend to encourage early puberty. So that's part of it.
But there is some evidence that these reproductive hormones-like chemicals in the environment, the endocrine disruptors, can lead to early puberty. So there is no question that puberty is occurring earlier in the world. How much of it's due to environmental exposures isn't exactly clear. But, I think at least part of it is
There's less data on menopause. But we know toxic exposures, that many of them can lead to early menppause and early infertility. Cigarettes are the classic example. We know that people go through menopause a year or two earlier, if they've been smokers. They become infertile. They lose their natural fertility at a little younger age. It may not harm fertility when they're in their 20s, their ovaries won't shut down then. But they will, in general, lose the ability to become pregnant at an earlier age.
We all do at some point in life as we as we hit our peak fertility in our 20s, and it declines in our later 30s, and then drops off to zero somewhere in 40s, or early 40s. But smokers, on average, that transition to no longer producing good viable fertile eggs happens a year or two earlier, and they hit menopause a year or two earlier.
SRG: Would you talk about the potential risks with precocious puberty? I read that the earlier a girl goes through puberty, the longer she's been exposed to estrogen, and that may increase their risks for certain things later on.
HT: There are a lot of, and all the hormonally-related diseases, breast cancer, and some others, the longer you're exposed to hormones, your own natural hormones, the higher the risk. Although that change is small.
The toxic exposures, we didn't even talk about this, but they may have some impact on breast cancer as well, speaking of breast cancer.
The couple of big problems with precocious puberty is, one, in women, when they go through puberty, estrogen stops bone growth, so they'll often be short, and never reach their full height.
And, second, the breast development, and others that come on, they will be out of sync with their peers, it is often very limiting socially, or problematic socially, if they are going through puberty, and have apparent changes of pubertal changes much earlier than all their peers. It's very difficult for these children. And socially, something needs to be dealt with. So a lot of negative implications with precocious puberty.
SRG: We hadn't even talked about breast cancer. But the reality is when we're talking about endocrine disrupting chemical, they are being associated with a really long list of potential health complications, not just breast cancer, like ovarian cancer and many other things.
HT: ...obesity, heart disease, all sorts of things, not just the typical traditional hormone-related diseases. You might expect breast cancer as the breast is very hormonally sensitive. But the other diseases that we may not normally think of as hormonal, but that really plays a role.
So increasing obesity, I'm sure EDCs play a role. BPA has been implicated. Heart disease, breast cancer, reproductive tract diseases, that I'm particularly studying, endometriosis being one. It's a disease where the uterine lining grows in the abdomen and outside of the uterus, that can cause pain and infertility. And we've got some evidence that early life exposure to Bisphenol A and some other environmental estrogens that can be found in pesticides and other agents can lead to an increase in that disease and many other diseases that are classically related to hormones, and even some that aren't.
Again, the organs that are most sensitive to female hormones the estrogens or the reproductive track. So you'd expect it would affect fertility, pregnancy, but also the breast, and have implications for breast cancer.
SRG: How did you end up focusing on this area?
HT: Well, it's a it's a long story. I was always interested in medicine and biology. I was particularly concerned about the idea of developmental programming.
The theme that we've talked about throughout this conversation, that certain things that happened early on in life, program the rest of our lives. So that something that happens as a fetus or a child may shape the way an organ or tissue forms, that it remains that way for the rest of our lives. So very important, and something that I think isn't paid attention to enough. As an obstetrician who cares a lot about pregnancy, it's not just a healthy delivery, it's making sure that that baby isn't exposed to anything that may make that development go awry.
Now thankfully we've found most of the horrible things out there that cause terrible birth defects that are obvious as soon as the baby is born, that the baby has some horrific birth defect. We've eliminated most of the really bad agents that can cause that sort of obvious harm.
But it's the more subtleties that I think we were ignoring, that may actually have a very profound effect. It's just not as obvious and immediate. But if agents that we're exposed to are influencing our fertility later, are influencing our cancer risk later, are influencing the risk of heart disease later in life, that's something that we really need to focus on. You really need to prevent, before we're even born, to optimize. Huge diseases that have a huge impact on society that affect nearly everyone, and a much more profound effect, much more common and prevalent effect than simple birth defects, these are things that affect all of us, or will affect all of us at some point, that are influenced by our development as a fetus. And I think that's an aspect of medicine that isn't studied well enough now, and needs a lot more attention.
Like everything else in medicine, once the damage is done, once the disease is there, it's hard to fix it. But if we can keep things healthy, prevent disease, we are doing a much better job, much more likely to keep people healthy, and have them living longer, healthier lives.
I think this is an area that's neglected, and an area that's of great interest to me, and where I think there's still a lot of room to have a big impact.
SRG: You have communicated so many things that I have felt are so important, but there hasn't been a voice to communicate from an informed perspective, and grounded perspective, about being conservative about our exposures. And I'm encouraging the public to take the topic more seriously, and that there's so much we can do, by being more informed. There are so many choices we make that can be healthier. So I am so grateful that you do what you do. It's so important.
SRG: Do you feel that there's more lack of awareness in the United States, or do you think it's worldwide?
HT: I see growing awareness. I see people being proactive about this. I mean there is never enough awareness. I wish everyone would be more knowledgeable, and we need more research, to allow us to give accurate information.
But I've seen legislatures in Europe and Canada pass laws eliminating BPA and other toxic agents in many food, and in baby products. I've seen consumers vote with their feet. In the United States, we see things labeled as BPA-free. And Wal-Mart have taken the BPA out of their products.
I think people are informed. People are demanding healthier foods and containers, and eliminating chemicals from the things that we're exposed to every day. I see this as going in the right direction. It's never fast enough for me, and we can always do more. But I see this, as, especially in the US, being driven by the consumer. It is things like what you're doing here today, informing people, that are moving this forward.
I wish we could do more. And there is a lot more to be done to identify all the effects. And I think there's a lot of, we focused on BPA, consumers are well aware of that, but there are so many other chemicals that people aren't aware of. And again so many cosmetics and air fresheners and a lot of what we buy I think might be the next step to educate people more about a lot of these other common exposures that they haven't heard as much about yet.
But I think this is the right way to do it. By educating, informing people, they're listening. And I think they'll vote with their feet. They'll get things done.
I think that's more effective than, and certainly faster and less controversial than, trying to do it through legislation.
SRG: Yes, I agree. We are very much on the same page. And I studied all my household products because I wanted to do everything I could to protect my children. And I found some common denominators, which I call household repeat offenders, because there have been over 84,000 chemicals introduced into the United States since World War II. We can't study all of them. But there are general themes, like plastic is one, and polyurethane foam is another. So there there can be a simple approach for consumers to make smarter choices.
SRG: I'm just wondering, when my friends have struggled with fertility, they've looked into alternative therapies, like acupuncture and herbal medicine. Do you find that there are alternative therapies that can help with fertility?
HT: Well, acupuncture has been fairly controversial. There is a large study that's just out from one of my colleagues here at Yale, that's very well done, really showing that there is no benefit from acupuncture. Like so many of these things, it's complicated.
Things like stress play a big role in fertility, exercise, weight, there are a lot of natural things you can do. And things like acupuncture may work for some people to reduce stress, and people enjoy it. But if you do a medical study, where you randomized half the people that get acupuncture, and they're afraid of the needles, stressed out over it, that's not going to work.
So I think it's hard to know what works in the right setting, where it's naturally applied. But I haven't seen evidence that I consider good evidence that acupuncture is really helpful.
But other things are, like exercising the right amount, maintaining a good body weight, avoiding obesity, and not to be too thin either, to eat right, and eliminate these chemicals, to detoxify, I think are important things you can do. Those things really do matter.
Pay attention to what your body's telling you. If you are feeling particularly tired, maybe you should have that checked out. If you're not having normal menstrual cycles. If you're finding that there may be other things related to hormonal imbalances that are affecting your metabolism... All those things should be checked out by a medical professional, or are things that you can work on... For example, the stress, the exercise, diet, are all things you could work on... that can have a profound effect on fertility.
So I think you want to optimize all those things before you get to the point where you need some sort of artificial fertility care. Often, that's helpful.
There are other things that just do need medical treatment. If your tubes are scarred closed, and there's no sort of remedy that's going to work. But people who have slightly irregular cycles, or aren't ovulating properly, things like stress reduction, maintaining the proper body weight, eliminating toxic exposures, I think make a big difference.
SRG: Great. That's really helpful for many women to hear. Are more women getting IVF than before?
HT: Yes, it's growing. IVF is very successful. It works well, and the success rates are better than ever, and getting better and better.
SRG: What are they now?
HT: On a woman under the age of 35, any reasonable IVF program these days should have a better than 50 percent chance of pregnancy per cycle per attempt. Usually that's with putting only one, or two, embryos back, and without the risk of the multiple gestations. Often it's much higher than that at the top programs.
And so within a couple cycles, one or two cycles, most people should get pregnant, assuming they're not having waited to the point where their egg count is diminished. If you come in your mid-forties, there's not a whole lot we can do with IVF to overcome egg loss. That's something we still haven't found a way to correct. There are groups working on stem cell therapies, or stem cell derived products, to try and improve that. But as of right now, there's no routine therapy that can reverse that age-related decline in egg production.
But, aside from that, IVF is exceedingly successful. Again, for certain fertility problems, IVF is a great solution, and the only solution. But, as we talked about, there are a lot of other simple natural things you could do prior to that that can really help.
SRG: We started this conversation touching upon freezing eggs. How good is the science now?
HT: Great. That's an area that's been rapidly progressing over the last few years. You know it wasn't too long ago when it was first brought up on Sex and the City, I think is the first place that it was mentioned in public.
SRG: I know Oprah has said that every woman should freeze their eggs.
HT: Back then, when it first came out on Sex and the City, it wasn't really a reality, there were only a few places doing it. The success rates were poor. These days, the success rates are pretty good. And a lot of places are offering it.
So, absolutely, I think anybody who's thinking of delaying having children, it's a wonderful option to let you do that, for whatever reason you do not want to have children, whether it's to invest in your career, or your education, or take more time to find the right partner, it's a real option now that is successful as, again, as long as you don't wait until you're nearly deplete of eggs that are high quality. You want to put those eggs away when you're young and they're still viable.
But you can expect, if you freeze a reasonable number of eggs, that you'll have a very good chance of using them for a successful pregnancy later on. We usually stimulate someone to produce lots of eggs in one cycle. It's not like we collect one egg every month. We use the same type of medications we would use for IVF to stimulate the production of multiple eggs, and we get enough frozen that you have a good chance of a baby.
Not every egg will resolve the baby, by far. That doesn't happen naturally, when we're not freezing eggs, so it's certainly not going to happen when we freeze eggs. But freeze enough, and you can really count on it, as long as you do it when you're young your eggs are still healthy and viable.
SRG: Is it painful or expensive?
HT: The price varies quite a bit. It is fairly expensive and most places insurance does not cover it, but it is typically several thousand dollars for egg freezing.
It does involve putting a needle into the ovary, which is done with some sedation. Most people are given some sedation, enough that it's not painful, but if you weren't given something for sedation, it would be painful. But, again, there it's done under some sedation to eliminate the pain. But it is putting a needle in the ovary.
SRG: I want to be mindful of your time. I so appreciate talking to you. Is there anything I didn't ask you that you would like to share before we wrap up?
HT: I think we covered all the important things. We could probably talk about this probably for many hours, but I think we've covered a lot of important highlights. We packed a lot of information in this time.
SRG: Yeah. Well, thank you again. I really am so grateful you're doing what you're doing.
HT: Well, I'm grateful that you're getting the word out there. Again, as I said, that's the best way we can make a difference. If I do this research, and the consumer, the public, doesn't know about it, it's not going to make as much of an impact, so thank you for covering it. Thank you for all you do.
SRG: My pleasure. And I think you'll like the book. It's a detailed support of everything that we've talked about.
HT: I looking forward to reading it ,thanks for the copy.
SRG: My pleasure. Take care!
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