Below is the full transcript of Episode 103 of the Autoimmune Wellness Podcast. This transcript is provided for accessibility and reference.

Title: Environmental Toxins: What Actually Matters with Lara Adler (Ep 103)

Mickey: Spend a few minutes online learning about environmental toxins, and pretty quickly it can start to feel like everything around you is a problem.

The water you drink, the food you eat, your cookware, your cleaning products, skincare, all of those plastic containers we all have in our kitchen, even the couch that you might be sitting on.

And those of us living with autoimmune disease, this can be especially overwhelming. We are already paying attention to our food, our sleep, managing our stress, getting enough exercise, taking medications, all of these other pieces that can influence our health. And of us are wondering, do we really need to worry about every chemical that we are exposed to in addition?

And the reality is that environmental chemical exposures are an important part of the conversation about human health, but it doesn’t mean we need to live in fear of our environment or spend thousands of dollars trying to create this perfectly non-toxic life. You guys, I’ve, I’ve been there, trust me.

So how do we separate meaningful exposure reduction from fear and wellness noise? Which exposures actually deserve our attention? And if we want to make some changes and those changes are accessible to us, where do we even start? That’s what we’re going to dig into today.

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Mickey: Welcome back to the Autoimmune Wellness Podcast. I’m your host, Mickey Trescott, and today we’re talking about environmental toxins, what the science actually tells us, where the conversation can get oversimplified, how to take a practical approach to reducing exposure without being completely overwhelmed.

And before we get started, a quick reminder that this podcast is for educational and informational purposes only, and not intended to diagnose, treat, or provide individualized medical advice. Definitely see your qualified healthcare provider for that.

[00:01:52] Introducing Lara Adler, Environmental Health Educator & Consultant

Mickey: My guest today is Lara Adler, an environmental health educator and consultant who has spent more than 14 years helping health professionals understand the science of environmental chemical exposures and translate that into practical evidence-based guidance. She’s trained and supported more than 5,000 health professionals across 35 countries, and her work focuses on bringing nuance to a topic that is so often presented in extremes. Rather than labeling everything as either safe or toxic, she helps people understand what the research actually shows, where uncertainty exists, and how factors like dose, timing, and route of exposure shape risk.

Today, Lara works with practitioners, organizations, product teams, educators, and nonprofits on environmental health education, communication strategy, and research, and she is currently pursuing her Master of Public Health. One of the things that I appreciate the most about her work is that she takes environmental exposures seriously without resorting to fear. You guys, this is such an important thing, and I know this is exactly the conversation I wanted to have today, not just how to eliminate every possible exposure, but how to understand what actually matters and make reasonable changes that support our health.

So Lara, welcome to the Autoimmune Wellness Podcast.

Lara Adler: Thank you, Mickey, for having me.

Mickey: Yeah, I appreciate you so much. I’ve been following you for a very long time on social media, and I’m really excited to dig in and talk about some of these topics in a little more depth so that everyone can maybe gain a little bit of a starting point.

Lara Adler: Yeah.

Mickey: If they’ve already made some of those changes, they can take the next step without just feeling scared or overwhelmed.

[00:03:35] How environmental exposures affect human health

Mickey: So let’s start with the big why. What do we know about how environmental chemical exposures affect human health, and where does immune health or autoimmune disease fit into the picture?

Lara Adler: So we know both a lot and in some instances very little about how environmental exposures impact human health, and there’s kind of a couple of different reasons for that. We have been studying the effects of toxic substances since the origination of human beings by eating poisonous mushrooms and finding out that that’s maybe not a good thing to eat.

And so that sort of has evolved over the centuries. In the 19th and 20th century, really looking more at the chemicals or substances, including ones that are natural, so poisons, heavy metals, things like that, and how they impact our health.

And the research now has moved into really looking at more granular exposures, these teeny, tiny exposures that we’re getting every single day. A lot of the data that we have for earlier centuries is on, like, acute exposure, so occupational exposures. What happens if you fall into a vat of toxic chemicals?

What happens then? But that’s not really representative of how most of us are interacting with chemicals and substances in our daily lives. And so over the last couple of decades, the research has really started to focus in on what’s happening with all these low-dose exposures? The chemicals that we’re exposed to that on their own, like one exposure, doesn’t mean anything. It’s meaningless. It doesn’t have any impact.

But over time and cumulatively, we can see that there is a vast array of health impacts. There is no organ system that is not touched by some exposure. Lead impacts every single organ system. Not all of them behave in that way, but every single organ system is impacted in some capacity.

And pretty much every chronic disease and sometimes non-chronic diseases, have some environmental component because we are not just genetic beings, right? We live in an environment. And people sometimes like to have the conversation of like, is it nature or is it nurture? Is it genetics? Is it environment?

And it’s like, it’s always both. It is always, always both, because our genetics predispose us to one thing or another, and then what’s happening in our environment can send us down one path or another. And that environment is changing all the time. Name any sort of chronic illness or health issue, whether it’s like, eczema or cardiovascular disease or developmental issues in children or neurodegenerative conditions like Alzheimer’s and dementia there are always environmental components to that.

For the most part, within the context of the low-dose everyday chemicals that we’re all getting, it’s very unlikely that it’s just that exposure that’s leading to some health outcome. It’s a piece of the bigger puzzle. There’s a sort of cascade of events that lead someone to a health issue, and environmental exposures, for the most part, is not the thing, it is a thing in a cascade.

So when people are talking about toxins online, they’re often kind of framing it as if this thing is the thing that’s causing that thing. “Don’t wear leggings because they cause cancer.” Well, that’s not how that works. And so there’s this sort of oversim- simplification of the concepts that is making people, I think unnecessarily stressed out and anxious and overwhelmed.

Yeah. So in terms of immune and autoimmune, there is a substantial amount of evidence, whether it’s, lead exposure or PFAS exposure, or other heavy metals, endocrine-disrupting chemicals that can have an impact on our immune system.

PFAS exposure in infancy or prenatal PFAS exposure can, can alter our immune responses to vaccines that we get in infancy, making them less effective. So that is, like, already an immune shift right out of the gate. And so there’s lots of small things like that. Also there are environmental exposures that maybe they didn’t participate in the cause of your autoimmune, right?

We know there’s no single cause of autoimmune. It’s kind of a moving target that we’re still learning about with lots of little layers. But often, and this has been the experience of the practitioners that I’ve worked with, is that these exposures are amplifying the symptoms. So they might not be causing it, but they might be making those symptoms worse, in ways that we could mitigate if we lower those exposures.

Mickey: Yeah. Such an elegant way to describe really all of the multifactorial risk factors that go into developing chronic illness, and I love that you just mentioned something that I want to highlight again. It’s very, very unlikely that is there is one exposure. Just as we know from autoimmune disease, there is no one gene,

Lara Adler: Right

Mickey: a collection, a family of genes. And some of these intersection, I mean, you could even have a genetics that makes your body’s way of detoxifying something that you’re capable of being exposed to in low doses, just lower. And then for you, you might have a different response. So, that is a really important concept.

Thank you so much for explaining that because it is really tempting to want to go back in our histories and find that one thing. It is so tempting, but I love that you really educated us on just how interconnected and diverse that is, and how the spectrum of exposures can be kind of like low-grade things that are not so problematic to a single exposure of something that is high-grade, very problematic, which we’ll talk about all of that.

[00:09:15] How to interpret and evaluate exposures and health incomes

Mickey: But when we hear about a specific chemical has been associated with a health outcome, talk to us about how we can interpret that and evaluate that, things like dose, timing, duration, cumulative exposure. What does this all mean as we navigate the real world?

Lara Adler: So in the real world, we are all exposed to a complex mixture of chemicals that we don’t actually know what this complex mixture of chemicals together does. When we’re studying chemicals and the health effects, we are studying them one at a time, for the most part, because it’s easier. There’s less variables to try to have to adjust for.

There is a newer field of research called exposomics, which is trying to look at the totality of exposures through our entire lifespan and how those things impact us. And that is very data-heavy research that we’re still in the very early stages of identifying. We also don’t have good data on chemical mixtures.

We think we know what happens when we’re exposed to something like phthalates, which is an endocrine-disrupting chemical found in plastics and fragrances. But what happens when we’re exposed to phthalates and BPA, or bisphenol A, which is also an endocrine-disrupting chemical?

And the research has found, although we don’t have, super solid data on this, it’s just kind of we’re trying to figure it out, is that the impact or the effect of multiple endocrine-disrupting chemicals is not additive, it’s amplified. So one plus one doesn’t equal two. One plus one might equal five.

So we have different types of exposures, and we are still learning about how they impact us at a population level. When we study medicine, we have randomized control trials. We don’t test chemicals on people for ethical reasons, so we don’t have the same type of data, gold standard science is this randomized control trial, but we don’t have that in environmental exposures.

What we have is animal model studies and cell studies that are trying to identify what is the effect and then what is the mechanism? How does that effect happen? What is happening biologically that leads from this exposure to that outcome in a mouse or in a Petri dish? And then we have human epidemiological data, so population-wide studies where we’re looking at patterns and we’re seeing do the patterns, these population level patterns of, this many people have, lead exposure at this level and how does that lead exposure correlate with IQ or behavioral issues, et cetera.

And do those mirror what we’re seeing in the animal studies? This is imperfect science is what I’m saying. And so where people are kind of demanding the level of evidence that exists in other fields, we don’t quite have that, but epidemiology data is very strong. It is very important, and in some cases it can show causation in relationships.

So there’s a lot we don’t know and there’s a lot that we are kind of making inferences, but informed, educated inferences in terms of how we are exposed and what are the potential impacts of that.

[00:12:26] The issue with “the dose makes the poision”

Lara Adler: In terms of our daily lives, When we’re looking at the dose of exposures, which is one of the sort of frameworks within toxicology, people have probably often heard the dose makes the poison. This is often shared online. Anytime anybody’s talking about the harm of some kind of chemical, there’s always somebody in the comments on social media saying the dose makes the poison.

In other words, if you have a small amount, it’s not that big of a deal. It’s really large doses that are problematic. And this is true, for sure. Absolutely. Radiation is a really good example. Too much radiation, you will die. Could be instantly, in some instances if the radiation is high enough. But small amounts of radiation, like we get from walking around and eating food is tolerable. Our bodies can tolerate that.

And so this is an example of how the dose makes the poison. At a very high level is what makes it a poison, and a low level, our bodies can tolerate that. And so that’s the framework that most people look through, when talking about environmental chemicals. And that’s true, but it’s not always true, and this is where the kind of line gets fuzzy.

So where that’s not true or not always true is when it comes to chemicals that interfere with our hormones. Because our hormones are already functioning and communicating at extraordinarily low levels, right? Ones that would be the equivalent of, like, parts per trillion as opposed to parts per million or parts per billion.

Extraordinarily low levels. And so many of the chemicals that we interact with every single day at very low doses can be biologically active at very low doses, and this is where a lot of the concern is around environmental chemicals. And this field, this area of research around endocrine-disrupting chemicals kind of turns this foundational concept of toxicology that’s been around since the 16th century, on its head a little bit.

There’s some conflict in the disagreement on how solid that science is. But we have decades of research now on endocrine-disrupting chemicals. I always say talk to an endocrinologist and talk to a pharmacologist, and they will tell you absolutely that extraordinarily low levels of substances can be bio-biologically active and cause harm. Toxicology tends to not look at that same level of the exposure spectrum as endocrinology and pharmacology.

Mickey: Mm-hmm.

Lara Adler: So that’s the dose situation, where in our regular everyday lives, the doses that we are getting to most chemicals is extraordinarily low. For some chemicals like BPA and phthalates, these endocrine-disrupting chemicals, they’re not cumulative. They don’t build up in our bodies.

So we’re exposed to a little bit every day. We pee them out pretty quickly within like, you know, twelve, twenty-four hours. Our bodies metabolize them and pee them out. That’s great. It’s amazing. That’s what our bodies are supposed to do. But we’re exposed constantly, so the levels in the body never actually get to empty. And so that’s how those are concerning because the exposure is constant.

Then we have exposures that are bioaccumulative, that do build up in the body. So lead, PFAS, pretty much all heavy metals. And those are concerning in different ways because those are stacking. Every exposure stacks. This is why people that are older have higher levels of metals in their body than children, because children haven’t lived long enough to accumulate all that lead exposure. And so this is kind of another one of these lenses to look at dose through, is that the dose matters, but also is it cumulative? Does it bioaccumulate, or do we metabolize it out quickly? Because the interventions shift there.

Mickey: Hmm. Mm-hmm.

Lara Adler: Timing is also an incredibly big deal because exposures during fetal development are far more damaging than those when people are already fully formed in adulthood. It doesn’t mean that adult exposures don’t have impact. It often just means that it manifests differently in terms of symptoms.

But prenatal exposure and early childhood exposure is the most important because our bodies are still being built, and those chemicals that are interfering bioactively with the process of human development, those sometimes are irreversible changes, which is why that timing matters so much. So if anybody is listening that is wanting to have a family, is trying to get pregnant, is pregnant, has small children, the conversation is most important for that audience, I believe.

The route of exposure also matters. I don’t want to get too much into the weeds in this, but the route of exposure, there’s four ways that you can be exposed. Inhalation, you breathe it in, ingestion, you eat it, absorption through your skin, and injection. The fastest way for a substance to enter your bloodstream outside of injection is inhalation, the things that we breathe. And so this is where in your kinda opening intro, it’s like, well, how do we prioritize these things?

To me, the air quality is one of the most important things. But that’s not as interesting or sexy as talking about, like, PFAS in your leggings on social media. And so the attention to the more important thing is often in the wrong place.

Mickey: Mm, mm-hmm. Thank you so much for all of that. One thing I want to circle back to that I found just, profoundly interesting was just the low-grade exposures, affecting hormones. One of the things that I’m thinking about maybe that’s missing in toxicology research, it’s just really hard to pinpoint, that hormones are about having the right levels,

Lara Adler: Yeah.

Mickey: And optimization is so much different than having a sign that is like, obviously this chemical or this toxin or something is causing a problem. Hormone balance is often just so hard to reach for so many people anyways that just my comment of where my mind was going.

Also, thinking about the microbiome, all these things that we take in, they affect our microbiome. The microbiome is such a mediator of health and our hormones that it’s like, how could we even really begin to know how things are affecting that downstream when something is in the middle, like hormones or microbiome or anything?

So just, just my thoughts.

Lara Adler: Yeah, I mean, it’s a, it is a, it’s like this huge tangled knot and, you know, we just sequenced the human genome not that long ago, and now we’re looking at metabolomics and all of these different omics And we’re still learning. And so

Mickey: much

[00:18:45] How the environmental toxin conversation gets flattened on social media

Lara Adler: know a lot, but there’s also a lot of, empty space that we’re trying to fill with understanding, and I think that we don’t do well with uncertainty, and we like to have both certainty and simple answers, which is why the conversation gets flattened,

Mickey: Hmm.

Lara Adler: Because those algorithms reward content that is simple and sensational and outrageous, and this is where people lean into the conversation. What I find so interesting about the way that the conversation is had in social media, where there is such, heavy argument between these different sides, where you have people saying everything is toxic and, and, you know, sunscreen is toxic, and the sun doesn’t give you cancer, sunscreen does.

People that are very, very, very interested and, and, and passionate about these very small exposures to things, and they’re saying every pesticide is toxic and terrible and bad. And then on the other side, you have highly credentialed individuals that are just overly dismissive of this and saying things like all pesticides are safe, and anybody who says anything otherwise is as, you know, a grifter, and all this stuff, and that’s also not true.

And so online, I’ve been watching this argument unfold and get more complicated over the years and, and more heated and more vicious in a way.

Mickey: Mm-hmm.

Lara Adler: And then I talk to scientists that are doing research in this field, academics, people in my MPH program professors and whatnot, and they’re shocked to hear this because that’s not how it is in academia. That’s not how it is in the sciences. And so there’s the perception of the conversation is not reflective of the reality, which is frustrating to kind of try to push against.

[00:20:30] Taking exposures seriously without engaging with fear-based messaging

Mickey: Hmm. Yeah, I mean, that’s actually kind of hits a little bit on my next question, which is really about the fear-based messaging. We’re all exposed to this. How do we take environmental exposure seriously without just becoming afraid of everything?

Lara Adler: I can just start by saying it is serious. It is concerning. It is a social determinant of health is our environment. You know, this is a major contributor to our health and how we exist and, and survive and live in the world. As I said, there’s no organ system that’s unaffected in some way.

Some of the associations or relationships between chemical exposure and disease are far clearer. There’s less steps along the way, so smoking and lung cancer, for example, radon exposure and lung cancer. These are very distinct causative effects where the, the daisy chain from exposure to disease outcome is short, is shorter.

We don’t have h- all these different factors contributing. To say that we have been studying this for decades, this is a concern. It’s a growing concern. The more we learn, the more concerned we are about whether it’s air pollution or PFAS or microplastics, this is something that we all should be concerned about.

I think that we don’t need to be anxious, and we don’t need to be overwhelmed. There’s a difference. You can approach something level-headed with concern and say, “Okay, I cannot do everything. I cannot avoid every exposure. I can’t throw out everything in my house and start all over again with, you know, quote, “non-toxic products”. So what can I do?”

So I always encourage people to start with the things that are small, that are free, that are really easy to do in terms of lowering exposure. And if they are seeing or encountering information online that makes them feel if their first reaction is, like, a gasp and anxiety and, and anxious, overwhelm, or fear, to just take a step back.

Because the reality is we can be concerned. I don’t think we need to be scared for our individual health. From a population standpoint, yes, I think the level of concern and the level of urgency to address it is bigger, but that’s a population level. On the individual level, yes, we should be concerned, and yes, we should take action, but no, we don’t need to turn ourselves inside out to do that, and no, we don’t need to be stressed out.

People always ask me, because I know a lot about the materials out in the world, you know, even driving in your car, I’m like, “Well, your steering wheel is not made with leather. It’s made with PVC, and that probably has lead in it, and it probably has phthalates in it.” But I also need to drive my car.

We have to learn to live in the world with this information. And people ask me, how do I do that given all the things that I know? And I say, “Well, I, I have put in the effort that I can put in in my own personal life and in my own home environment, and beyond that I can’t change everything”. And so I’m not going to try.

For myself, I may advocate for policy changes and be vocal in those ways, but I think the fear-based perspective has gone off the rails. We have lost the plot in this conversation. And that’s true for all areas of health and wellness. The social media landscape in the wellness space has become almost cartoonish in its missing the point entirely.

Mickey: Mm-hmm. Mm-hmm. When you have information, you know better, you do better. Having some knowledge about one of these specific things, and then being faced with the opportunity to, like, swap out some of your cookware. You know, you’re not, like, starting over from scratch.

Lara Adler: Yes

Mickey: buy a different one.” You know? I- I’m going to make a different decision based on something that I know feels like a very reasonable way to use the information that we know, the things that we’ve gathered, instead of just, like, doing non-toxic everything.

And one thing that I just want to mention about this fear-based marketing is that if at the end of it you find a very expensive pitch

Lara Adler: Yes.

Mickey: that is the biggest

Lara Adler: Yeah, that’s…

Mickey: right?

[00:24:33] Avoiding scammy wellness products in this area

Lara Adler: And I would even say the price tag doesn’t have to be high, right? I have seen low-cost things, but these are volume businesses, right? Where they’re selling thousands and thousands of units of whatever the gadget is or whatever the supplement is or whatever, and it’s still not a solution. There are so many grifter products out there, scammy products out there, that if you don’t know any better, the person who’s selling it, who sounds super confident and has some type of credential behind their name, you might easily think, “Yeah, this is a great idea.”

I’ll give you the a ridiculous example or two of them, in the water space, because there’s a lot in the water filtration or treatment space, is water wands, which are like glass or crystal wands, literally like a little stick, that you swirl in your water, and people claim that it makes your water coherent and that it is more hydrating.

There’s literally absolutely no science that supports any of that. Same thing with vortex water. There are people selling machines that will spin your water in a bottle and say, “Well, water moves in nature, and therefore, this vortex nature that water moves in,” or whatever, provides some special qualities that regular water doesn’t have, which is complete bullshit.

Like, that’s just what it is. And it’s infuriating for me because, again, it’s missing the point. If we have contaminants in our water that we should be addressing, and we have a limited amount of income, maybe we shouldn’t be spending it on a glass water wand or a water vortex machine, and maybe we should spend it on a filter that actually removes the thing that is impacting our health.

So I see this kind of distraction marketing happening so often, and it is the most frustrating thing about having this conversation in sort of a public sphere.

Mickey: Yeah. And really, a lot of the things that we can do, and I mean, I’m speaking for myself as someone who, like I’ve been interested in this in 15 years, I’ve been making a lot of these changes in my own life from a place of just wanting to keep my health, maintain my health, but not from fear.

And I will say, the most impactful things are not super expensive, right? They’re just tiny little choices that add up.

Lara Adler: A lot of them are free.

Mickey: exactly, to

Lara Adler: Yeah

Mickey: your exposure. And a lot for me of that opportunity just comes up when I’m, like, getting some new clothes or something. It’s like, I’m not throwing out my clothes, I’m just like, “Can I get this in natural fibers?”

You know? If I can’t afford that new, then I shop on Poshmark, which by the way, is a great

Lara Adler: It’s great. Yeah.

Mickey: used natural fiber clothes.

Lara Adler: Yes.

[00:27:09] A smart approach to managing indoor air quality

Mickey: So, so with that energy, let’s talk about some of these major areas. I’d love to leave everybody with just some ideas. You mentioned air as the first route of exposure, one that we really need to worry about. Let’s talk about our indoor air and things that we can do about managing that.

Lara Adler: Yeah. I mean, indoor air is regularly consistently more polluted than outdoor air in the average home, and that’s because we don’t open our windows and our homes are built energy efficient and airtight. And so we don’t have the air exchange that we need to allow the things that have off-gassed, the chemicals that have released from the materials in our home to escape.

And so all of the things that we bring into a modern home release chemicals. Your carpet, your flooring, the paint on your walls, the couch that you just bought has flame retardants and, maybe even PFAS chemicals if it’s stain-resistant. So there’s all these chemicals that are released into our home environment.

There’s also particulate matter, so even from cooking, but also burning incense or cigarette smoke for sure, and fragrances, scented candles, diffusers, all of these things are adding pollutants to your air inside your home. And because the home is more tight, those pollutants aren’t escaping.

The first thing that I encourage people to do is just open the windows. Like, open the windows every single day, even if it’s for five minutes or 10 minutes. If you can open them all and then close them all, then at least you have some good airflow that has allowed for air exchange. So that’s, like, the free intervention.

The second free intervention that I think not everybody has access to, but many do, is that when you’re cooking, especially if you’re on a gas stove, but even if you’re not on a gas stove, use the vent hood. Use the hood over your range. If it vents outside. Not all of them vent outside. I actually live in a home where it doesn’t vent outside, it just blows the air up into the kitchen. So I don’t use it because there’s no point in my using it, but I try to open a window.

And so if you have a vent that vents outside, please use it. I know they’re noisy, but it makes a huge difference, not only in particulate matter, but in some of the gases that are released from gas stoves, which are respiratory irritants, asthma triggers air pollutants, et cetera. And so even just cooking a couple of burners on your stove can result in air pollution inside our home that would actually be a violation if it was outdoor air.

So one, open your windows. Two, use your vent hood. Three, don’t use air fresheners, scented candles, diffusers, incense, all of these products because you are simply adding pollutants to your home. I get that they smell nice. I think a lot of people use them to cover up smells that are, like, maybe musty or whatever, which is, that’s a Band-Aid on It’s not the right kind of Band-Aid to use on that problem.

And so that actually will save you money because you just don’t need to buy those. Even having a scented candle that’s not being burned, it’s not burned, still releases chemicals into the air. So if you can smell it, it’s volatizing. So those are the free things.

Then we’re looking at using some kind of air filtration system, and air filters are expensive. You know, on the cheap end they may be 2 or $300, but they can go all the way up to, like, $1,100 for an air purification unit, which not everybody can afford. So I’ll say two things. If you’re looking for an air filter, highly recommend people get air filters if they can afford it.

Look for one that has HEPA filters, like actual true HEPA filters, and that has carbon filtration. The more carbon, the better. HEPA captures particulate matter, so the particles coming from cooking or from incense or from wildfire smoke, for example. But carbon captures gases, and so a lot of the pollutants are a mix of, of particulate and gases.

And so HEPA will only capture particulate. HEPA and carbon will capture both, and the more carbon, the better. If you can afford one, great. Please go out and get one. Have it running constantly. That can be a easy way to make a huge improvement on your indoor air. If you can’t afford that, and you are dealing with poor indoor air quality, either because you live in a city or you are in an area where there might be wildfire smoke, which is kind of everywhere now, unfortunately, if you’re on a real tight budget, build what’s called a Corsi-Rosenthal box. You can just Google that name, Corsi-Rosenthal, Corsi hyphen Rosenthal. And it is a DIY air filter that you can make using, like, a $20, $25 window box fan and between three and five, 20-by-20 inch furnace filters that you can get at the hardware store for a couple bucks each.

And you kinda build this contraption and turn it on, and it’s actually an incredibly effective air filter. So you can build a DIY air filter for, like, 60 bucks, that is super powerful and like, I say anybody who’s living in any area where there is the potential for a wildfire, at least have those materials in your closet or in your garage so that when necessary to set it up. It’s ugly and it’s big, but it’s an important thing that I think that everybody have access to something like that, like an air filter.

Mickey: Yeah. Thank you so much for mentioning that, and actually I’ve used those because I live in Oregon, and

Lara Adler: Yep.

Mickey: to a firefighter, and so he,

Lara Adler: Yeah

Mickey: all about it. We get them on sale, whenever we find them 20, 30% off, we stick them in the garage. And I can tell you I know that they work because I have an air filtration system that gives me the AQI in my

Lara Adler: Yep

Mickey: there have been times where outside where I live in Oregon, the AQI has been like 500 plus,

Lara Adler: Mm-hmm.

Mickey: you guys, that is like, it

Lara Adler: It’s terrible.

Mickey: It is awful.

Lara Adler: Mm-hmm

Mickey: When I started using those, it really brought down the indoor air quality because, like, my air purifier could not keep up. So don’t sleep on that. If you

Lara Adler: yeah.

Mickey: Most people have a box fan, and all you need to do is get a couple,

Lara Adler: And some duct tape and you’re good. Yeah.

Mickey: You’re good, you’re good to go, and

Lara Adler: Yeah.

Mickey: works.

Lara Adler: Yeah, I remember my last year that I lived in Oregon, right when we had those in, I guess it was 2021, when those terrible wildfires were coming closer to the city of Portland than it ever had before. The air quality index in my house was 461, and my cat started coughing and I was like, “Oh, no. No, we’re not doing this.” So I locked us both in my small bedroom with her, like, litter box and her food and turned on my air purifier, and within about 20 minutes it was great. And I was like, “Okay, well, we’re just staying in here until this passes.”

Mickey: Well, that’s a good thing to mention too. So prioritization wise, I have some air purifiers. I did not always have as many as I do now, because I’ve collected them over the years.

Lara Adler: Sure, yeah.

Mickey: On sale, and I budgeted for them. But initially my priority was, bedrooms are usually small and

Lara Adler: Yep

Mickey: my bedroom, a smaller unit. You close the door, you’re in there 8 to 10 hours a night. And then I expanded to the other areas in my house that I spend time in, to the point where, I had enough to cover my house. But that, that is a really big expense,

Lara Adler: Yep

Mickey: all at once. I probably got mine over the course of 10 years,

Lara Adler: yeah.

Mickey: As things went on, and then using the box fan for backup during wildfires.

[00:34:24] A practical approach to water filtration

Mickey: So let’s talk about water. Water quality, it changes depending on where we’re talking about, but what are the basics people need to know about water filtration?

Lara Adler: So I’ll start by saying generally speaking, the water in the United States is good water. Like, we are not getting communicable disease from our drinking water. We’re not getting dysentery or cholera or typhoid, right? We don’t have that, because we have disinfection in our water system that uses things like chlorine or chloramine. Those are great.

We need to have disinfection, so we’re not poo-pooing disinfected water and we can acknowledge also that those disinfectants carry their own risks as well. And so from a acute illness standpoint, our water in the United States is fine. We are not getting diseases through our drinking water.

What we do have is a large number of chemical and microbial and radioactive contaminants, disinfection byproduct contaminants in our drinking water and that profile of what types of contaminants and how much contaminants differs from location to location. So somebody who’s living in an agricultural region that has a lot of pesticide use and pesticide runoff and nitrates in the water is going to have a different profile than somebody who’s living upstream or downstream from like an factory on the coast and that might have higher levels of industrial chemicals in their water and less pesticides.

So everyone’s water is different. One of the biggest bones I have to pick on the social media side of things is influencers, wellness influencers, lifestyle influencers, whatever, that are promoting water filters. And they’re, “This is the greatest, this is the best water filter you should get.” Well, how do they know it’s the best?

The reasoning that they give, the justification is, “My water tastes really great.” Well, that taste is no reflection on how contaminated your water is because a lot of contaminants have no color, they have no odor, and they have no taste, so you wouldn’t know if there’s PFAS or lead in your drinking water just because it tastes good.

They’re also buying filters and promoting them just because they’re an affiliate, not because they know that the filter is appropriate for everyone. And so I see people spending a lot of money on a filter that’s probably not the right one for their situation. And now they’ve sunk, you know, $500 into this thing, and they’re like, “Well, I gotta keep using it because I’m not going to buy another system.” And so then they feel frustrated and annoyed that they bought the wrong thing. So, don’t ever buy a water filter based on somebody else’s recommendation because they don’t know what’s in your water.

So there are lots of different types of filters on the market. There’s lots of different filter media, and by media I mean like activated carbon or KDF media, or reverse osmosis, which is not a media, but it’s a membrane that the water gets pushed through, is one of the different technologies.

And there’s no one system that’s perfect for all contaminants. With one exception, which is reverse osmosis, which removes almost everything that we need it to remove, including beneficial minerals, so we’d want to add those back in, but reverse osmosis is wasteful. I now live in the desert. I live in a drought-stricken area. I live in New Mexico. And so the idea of all of my water being reverse osmosis, if I didn’t need it to be, would be so wasteful.

So for reverse osmosis systems, you usually need at least one to two gallons of water to produce drinkable water. If you want to produce one gallon of drinking water, you need two gallons of tap water to produce it, and the other gallon gets poured down the drain as waste.

That’s just the way that the system works. And so it’s the best filter except for if we want to waste water or if we want our water bills to go up, ’cause you’re doubling the amount of water that you use for drinking and cooking, for example. So what I encourage people to do is two things.

One, if you can afford it, if it’s in within your budget, test your water. Test the water at your tap, because that’s going to give you the most accurate picture of exactly what type of contaminants are in your water. The company that I recommend people use is Tap Score. It’s just T-A-P S-C-O-R-E. They have excellent systems for testing your water.

They give you a really comprehensive report at the end that tells you, based on your contaminants, here’s the type of filtration system you need. Not, “Here’s the brand, and here’s my affiliate code.” It’s an unassociated recommendation of the type of filter that you would want to get. If you don’t have the budget for that, because that testing starts at like two hundred dollars and goes upwards, look at your free water quality report, which your municipality is required to produce every year.

Usually comes out around June or July for the previous year. And you can just look that up online. Just put in your city and water quality report. It’s sometimes called a consumer confidence report. And that’s going to give you the most information for free about what regulated contaminants are in your water. It’s going to give you a little bit of a storybook of where your water comes from, how it was treated, how it got from whatever aquifer or surface water system to your tap. And it tells you about that journey, or should.

And then it tells you about here are the contaminants that we found that are regulated by the federal government that we have to test for and report on. And then from there, you can at least find some more of a path to say, “Okay, well, I have this which has exceeded the federal guidelines or it’s, it’s kind of high. I’m going to see if I can find a filter that removes those specific contaminants.”

Mickey: So smart, yeah. And I have some experience, because I’ve actually done this and had my water tested, and I just used a local company. Of course they don’t give you the reporting that that probably $200 report, but I think I paid, like, $80.

Lara Adler: Yeah.

Mickey: And it was actually really helpful in finding my own water filter. And actually, I just wanted to put this out there. This might be a kinda new thing. My husband is kind of a nerd about this type of stuff, but he found a reverse osmosis filter that is actually powered, so

Lara Adler: Oh.

Mickey: waste

Lara Adler: Ah.

Mickey: one-fifth of the gallon that you

Lara Adler: Yes

Mickey: it uses electricity to push the

Lara Adler: push the water through.

Mickey: So just, just to

Lara Adler: Yeah

Mickey: like, there are so many pros and cons. We, we had a different unit that was actually wasting like five to one, and we

Lara Adler: yeah.

Mickey: That, that out. It is a very individual thing, and just as everything, you gotta find out what works for you, not, the best thing, which I know is so frustrating. Everybody wants to know what is

Lara Adler: I know. It’s… I know. And I am, I am working on a guide or a resource for people to, if they can’t afford to test, to help them understand everything they need to know about water, but more importantly, how to extract the most valuable information from that free water quality report. Because it’s, again, not everybody has the budget to go, especially now, to go out and buy, you know, a 200 or a $500 water system.

Mickey: Mm-hmm.

Lara Adler: And I’ll say anything is better than nothing. So if you don’t have any water filter, get…

Mickey: the crystal

Lara Adler: Yeah, but that’s not even, that’s not even a filter, right? That’s not… That’s just… You’re just… That’s just make believe. That is make believe.

Mickey: yeah.

Lara Adler: But, like, get a Brita filter, a carbon simple pitcher filter. If you don’t have anything, at least get that because at least then you know that if there’s lead in the water, it’s going to be reduced or removed. It’s going to taste better ’cause the chlorine will come out. There are some contaminants that, like, a Brita filter can do a pretty decent job at. You just have to remember to change the filter all the time.

Mickey: Great.

[00:42:11] Reducing environemental exposures through diet

Mickey: So food is another big area. Where do environmental chemical exposure show up in the food supply, and how do we think about things like, you know, pesticides, packaging, without feeling like everything has to be organic or perfect?

Lara Adler: Yeah. All of our food has some degree of contamination. And again eating, one single type of food that has this X contamination, you know, PFAS or BPA or phthalates, isn’t going to be the problem. It is eating the same food or having these same exposures consistently every day over our lifetimes. So we do the best that we can.

All of this conversation exists within a “we do the best that we can” because we’re just exposed to chemicals all the time. And by chemicals, again, I mean the harmful ones. So with food we have, fresh produce and meat and dairy and eggs, and those carry their own layer of potential contamination, usually with pesticides.

And the residues are low and there is some epidemiological data that is suggesting that people who eat conventional produce have higher risk of certain types of health outcomes that we would ideally want to avoid. But the most important thing in food, this is counter to what a lot of people say in the space that I’m in, is that we just want you to eat fruits and vegetables period, period.

I don’t care if it’s organic. If you’re not eating fruits and vegetables because you can’t afford organic, that’s wrong. The majority of people, 95% of the people in this country don’t eat enough fiber. I think it’s 90% don’t eat fruits and vegetables, period. This is again one of those sort of distraction things if we’re zooming out and looking at a population health, public health standpoint.

We need to get people to eat fruits and vegetables. So do I want those fruits and vegetables to be organic and have the least amount of pesticides of concern? Yes. But the more important thing is that we’re eating fruits and vegetables. So don’t let non-organic food be something that you scoff at if you don’t have the funds to buy everything organic.

I don’t buy everything organic and I haven’t for a very long time. So that’s kind of how I’ll say that with food. I don’t think that people need to put stock into the EWG’s Dirty Dozen and Clean 15 list because what they’re looking at is the amount of pesticides, not the toxicity of those pesticides.

Different pesticides have different toxicity levels, meaning a small amount might be a little bit harmful of one pesticides, and that same amount of another pesticide might be extraordinarily toxic. So it’s not apples and apples the way that they’re doing their review. I think it’s a great tool to get people into the work that they do, which I do support the work that they do, but I don’t encourage people to lean on that directly.

They’re also not testing anything directly. They are just pulling from USDA reporting data, and not every fruit and vegetable is tested every year. So it’s kind of a hodgepodge of information. So if you can eat organic, eat organic. If you can’t, just make sure that you’re eating your fruits and vegetables.

So outside of the sort of pesticide issue, then we roll into the packaging issue and that is things that are canned or boxed or bagged or sealed in plastic. All of our food is going to have, for the most part, unless it’s like a apple, right, if it doesn’t have pesticides, then it’s a apple and it’s hasn’t gone through any sort of production facility, is less likely to have any contamination.

Anything that’s been through a conveyor belt, a tube, a funnel, anything like that is likely to have picked up contaminants along the way. So there’s all these sort of citizen scientist groups online that test random foods for say phthalates and they say, “Oh, all these foods have phthalates.” Well, almost all food that has been processed to some degree is likely to have phthalates because phthalates are used in soft plastics and there is a lot of soft plastics that’s used in food production.

Even the tubes, if you’re milking a dairy cow and you’re not doing it by hand, the tubes that get attached to the udders, that is a plastic, soft plastic tubing. Milk is a high-fat substance. These chemicals are lipophilic, so they’ll be attracted to the fat in these foods and they’re right from the cow is how we start getting phthalates in our food.

So this is a thing that I don’t think beyond the advice of eat as little processed and heavily processed foods as possible. The effort that we want to put forth is not on our policing our own food. It is on advocating at the policy level for changes. That means calling your representatives and saying, “What are we doing in our state?

What are we doing about contamination of PFAS and phthalates and bisphenols, et cetera, in our food supply? What are you doing to advocate for us on that topic?” Because this is not a problem that we as individuals can solve. I mean, all of these problems are generally not ones that we as individuals can solve. These are all policy related.

Mickey: I like being encouraged to instead of hone in on more perfectionism on my part as a consumer, using some of that worry to actually get something done and make my voice known at a bigger level because, again, this is affecting all of us together, and we need to figure something out. One thought that I have, ’cause I know somebody’s going to ask this, our fruits and vegetables, which thank you so much for just saying we need to eat fruits and vegetables, whether or not they are organic you… cosign.

Lara Adler: Yeah.

[00:48:04] Can washing and peeleing minimize risk with non-organic produce?

Mickey: What about washing and peeling? What, what kind of strategizing can we do there just to minimize some of that risk? Especially with the, the contact of things, you know,

Lara Adler: yes.

Mickey: don’t know where,

Lara Adler: Yes, exactly.

Mickey: through, even if it’s a whole food.

Lara Adler: Yeah, I mean, you know, cyclospora is affecting whole foods, right? And lettuces in particular are so challenging because we eat them raw. We can’t cook them. So all these bacteria that we could, kill by cooking doesn’t work with lettuce because we don’t cook lettuce.

We eat it raw. That’s a separate challenge. In terms of washing your produce, first, just wash it. Water does actually remove some amount of surface level pesticides and bacteria, et cetera. So it’s just a general practice. It’s a good idea to wash all your fruits and vegetables.

There are a lot of pesticides that are known as systemics. So they’re not sitting on the surface of the food. They’ve actually been taken up by the plant and are distributed in the tissue of the food itself. So there’s no amount of peeling that would eliminate those. And a lot of the pesticides and herbicides we use in the United States are systemics.

So there’s only so much that we can do. We can reduce some pesticides or remove some specific pesticides, but we can’t remove all pesticides from foods in general. So this is where washing comes in beyond just using water. I don’t recommend anybody use those, like, veggie soaks or veggie sprays. They’re really not worth your money.

There’s been quite a bit of research on sort of home interventions on reducing pesticides in foods. And the best one really is baking soda. I don’t remember what the exact ratio is, but it’s, like a teaspoon of baking soda for four quarts of water.

Mickey: Okay.

Lara Adler: A gallon, right? So, so basically clean your sink, put the stopper in, fill it up with water, maybe a gallon or two, lob a tablespoon of baking soda in there, let it soak. You want to let it sit for about 10 to 15 minutes, and then you just rinse it off. And that actually has shown to reduce a significant amount of pesticides.

When these studies are done, they are not looking at every pesticide residue. They’re really saying, like, “We’re going to look at these five pesticides, and does this method remove or reduce these five pesticides?” So again, these are not representative of how all pesticides behave. So It’s better than nothing.

So yeah, the baking soda wash is the soak is the easiest. And that is the most effective, and it’s the cheapest. So do that. Yeah

[00:50:30] Minimizing plastic-related exposures

Mickey: I love it. All right, let’s talk a little bit about plastics.

Lara Adler: Yes.

Mickey: I think it’s worth it to just talk a little bit about plastic-related chemical exposure and where reducing plastic makes the biggest difference?

Lara Adler: Yeah. So I mean, I think the biggest place where you want to avoid plastics is ones that are in contact with food, food and water. So that means not drinking out of bottled water, which you wouldn’t want to do anyway because it’s oftentimes just treated municipal tap water that they’re selling to you at a 9,000% premium.

It’s such a waste. It’s such a scam. It’s such a scam. Anyway so no plastic bottled water if you can help it. So when I fly, if I happen to forget my water bottle at home, I also don’t want to be dehydrated, so I will buy a plastic bottle at the airport. Sue me. You know, like, this is one of those things where I’m like, you know, we have to be a little bit flexible,

Mickey: gotta

Lara Adler: in our lives.

Yes. So the other place that we have more control over in terms of plastics in contact with our food is how we store our leftovers. Do we store them in plastic Tupperware? Are we heating our food in plastic, whether that’s a frozen meal that comes in a plastic tray, or we just are heating up our lunch because in the microwave in our plastic container?

Those ones are easily avoidable. We can change those instantly. You can just put your food on a plate, a non-plastic plate, and put it in the microwave. You can get glass containers or stainless steel containers that are really inexpensive to store your food in, in the fridge or in the freezer that aren’t plastic.

So those are the easiest things. Beyond that, a lot of our food is packaged in plastic. I can’t change the way that certain foods are packaged. They only come in plastic containers. Okay. Or if there’s a glass version, maybe it’s more expensive and not everybody can afford that.

So again, we’re navigating an imperfect system. I think the biggest things in terms of ingestion, is not storing food in plastic. If you can buy the glass version of something, know, glass jarred peanut butter versus plastic jar, great. If you can’t, then that’s just an exposure that we can’t avoid.

And then just, like, minimizing your plastic utensils. You go in your kitchen and look at all the plastic stuff that you have. Your pasta strainer where you’re boiling water through. Your kitchen utensils, your measuring cups, your mixing bowls. All of these materials that don’t have to be plastic that are available in stainless steel or glass or wood or bamboo.

If it’s cutting boards, another one, don’t use a plastic cutting board. We’re literally just slicing, shaving microplastics into our food. So these are small but, I think, impactful change. Microplastic is a huge topic because it’s in the air that we breathe. It’s in the dust in our homes. It’s really hard to escape it at this point, but we can make it less bad by reducing the exposures that we have control over, and those are the places that I would would start.

The health effects of microplastics, we’re just on the cusp of figuring that out. Like, we don’t know. We know that they’re in all these human tissues, but we don’t know what the consequences of that are. There was a New England Journal of Medicine paper that came out, I think it was like two years ago, saying there’s a strong association between microplastic levels and cardiovascular disease and strokes and heart attacks. And so that’s concerning.

And microplastics pose a problem in two different ways. One, the plastic particles themselves, which are problematic, and the chemicals that come out of those plastics. But also, microplastics act as sponges for other chemicals that it interacts with. This is the problem with ocean plastics. I mean, all plastics also. In our drinking water, microplastics in our drinking water, again, are not just the plastic particles and the chemicals that, leaching from those. They also attract other toxic substances that they interact with in the water system, so they’re like little sponges of chemicals.

So we still don’t know what the health implications are. It’ll probably be another 5 or 10 years before we have more solid, data supporting, you know, a statement about an, a stronger association. But the, whatever we can do to reduce our exposure to plastics or microplastics to get ahead of it is great.

Mickey: Yeah. This is really relevant for our community because we are cooking from home, cooking from scratch, storing food, batch cooking, and so you guys have lots of ideas in how you can make some easy wins in swapping out, especially those utensils. I mean, that’s

Lara Adler: Yeah, those are easy. Yeah, those are easy.

Mickey: Food storage.

[00:55:01] All the details on best options for cookware

Mickey: Before we wrap up, let’s just touch on cookware really quickly because I know a lot of people have questions. What’s the best idea that you have for safe cookware?

Lara Adler: Yeah, I mean, the biggest no-no for me is just PFAS non-stick coated. There’s an unavoidable source of PFAS exposure in our lives. Especially if they’re old and scratched, it’s time to say goodbye to those, I think. We’re not donating these, by the way. We are unfortunately throwing them out because we’re not passing the buck to somebody else, and leaving them with the only choice of being is a crappy, scratched up non-stick pan.

We want to avoid those. We want to take caution, with the ceramic non-stick coated, the GreenPan, the Our Place, all of those Always pans. They’re very beautiful. They’re very pretty. They’re very aesthetic, which is why they sell so well. But the ceramic coatings, which are supposed to be an alternative to non-stick PFAS coatings, they don’t last very long, so it’s a colossal waste of money.

I have posted about these before, and I was shocked to see the hundreds plus comments of people saying, “Mine lasted three months. My… I bought a whole set, had to replace it six months later. Mine only lasted eight months. I had to throw out the whole set, replace it.” I’m like, why are we spending money on a cookware that frequently?

Mickey: And

Lara Adler: using the same… Yeah, I’m using the same stuff that I bought when I was in college. And so the things that what you would want to look out for are cast iron is what you want, or enameled cast iron, carbon steel, if you have joint issues, if it’s too heavy for you to lift cast iron.

Carbon steel is great. I love carbon steel. Think of your traditional Chinese wok. That is made very thin, made of carbon steel. It behaves exactly the same way as cast iron, so you have to cook with it and care for it the same way. But it’s very lightweight, and pretty inexpensive. And then you have stainless steel, which is great, and those are sort of the foundational surface and materials to choose from.

So cast iron, enameled cast iron, carbon steel, stainless steel, and then glass for things like bakeware, you know, your roasting pan or your casserole pan can just be glass. So those are the types of cookware that I recommend people look out for. And you know what’s great is that stores like Marshalls and HomeGoods, they have really excellent options, sometimes of these top brands that are just discounted.

Mickey: Mm-hmm

Lara Adler: That are stainless steel, cast iron, enameled cast iron, et cetera. So you can get them pretty inexpensively. Lodge cast iron is not fancy like all the kind of new cast irons. Lodge has been around for hundred plus years. I mean, you can get like a flat skillet for $18. I still have my $18 flat skillet that I bought in the early 2000s.

Mickey: It, that will last for

Lara Adler: you know, will last for generations. You just have to learn how to care for it. So there is a learning curve. I recommend people spend half an hour on YouTube just watching different videos of how people care for, and clean, and cook with. So people, you know, you can have stainless steel. You can fry an egg on a stainless steel pan and have it slide off.

It is a skills issue- When it doesn’t work … yeah, it’s a technique. It’s a technique. So learn the technique. Spend some time on YouTube, and you’ll, it takes a little trial and error. But you too can have non-stick stainless steel and cast iron.

Mickey: And, shout-out for carbon

Lara Adler: Oh, I love it

Mickey: I started maybe 10 years ago, if you season it correctly, which it’s kind of a living thing.

Lara Adler: It is.

Mickey: go nuclear and, like, take it down to

Lara Adler: Yep

Mickey: start re-seasoning it, but you can get it completely non-stick,

Lara Adler: non-stick

Mickey: with the practice of just knowing how to care for it, and there are many brands. I think I paid $80 for the

Lara Adler: Yeah.

Mickey: For the last 10 years, and it is perfectly functioning as new. So don’t be afraid of that.

[00:58:42] Wrap-Up and Closing

Mickey: Well thank you so much, Lara. I really appreciate you joining me today and bringing nuance to this topic. We covered a lot, and I know we could probably have talked for another whole hour, I think the biggest takeaway for me is that reducing our exposure doesn’t have to mean trying to create this perfectly toxin-free life. It’s about understanding where the evidence is strongest, prioritizing these areas that matter the most, many of which we talked about today, and making changes over time without fear or overwhelm.

So for people who want to learn more from you and continue this conversation, where can they find you and follow your work?

Lara Adler: So my Instagram is @environmentaltoxinsnerd. I have a Substack called Talking Toxins, and my website, which is just my name, lauraadler.com.

Mickey: Awesome. Well, we will link to all of those resources in the show notes, and for everybody listening, thank you for joining us. If you found this conversation helpful, please share it with somebody who could use more practical and a grounded approach to environmental health. I’ll see you next time on the Autoimmune Wellness Podcast.