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Episode 23
The Doctor's Farmacy: House Call

The One Factor That Determines 90% Of Your Risk For Disease with Dr. Todd LePine

Open the Podcasts app and search for The Doctor’s Farmacy. If you’re viewing this site on your phone, you can just tap on the

Tap the subscribe button and new shows will be added to your library.

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You’ve probably never heard of the exposome, yet it’s one of the most important things that determines your health, your gene expression, and your risk of disease. The exposome is the term for the sum total of all the exposures in our lifetime, starting in utero. These exposures include everything from the food we eat, environmental toxin exposure, the air that we breath, the water we drink, heavy metal exposure, and even our thoughts and emotions.

In this episode, Dr. Hyman sits down with Dr. Todd LePine to discuss the Functional Medicine approach to the exposome, and together they explore how they assess the way that patient exposomes may be contributing to their overall health.

Dr. LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders and the neurobiology of mood and cognitive disorders. Dr. LePine teaches around the world, and has given lectures to doctors and patients at American College for Advancement in Medicine (ACAM), Age Management Medicine Group (AMMG), the University of Miami Integrative Medicine Conference, The Kripalu Center in Lenox, MA, and is on the faculty for American Academy of Anti-Aging Medicine (A4M). Dr. LePine is the head of the Scientific Advisory Board for Designs for Health and a consultant for Diagnostic Solutions Laboratory. He enjoys skiing, kayaking, hiking, camping and golfing in the beautiful Berkshires, and is a fitness enthusiast.

This episode is sponsored by Uqora. If you’ve struggled with urinary tract infections, check out Uqora’s potent line of products to promote better urinary health. Right now they’re offering Doctor’s Farmacy listeners 30% off when you go to and use the code Hyman30 at checkout.

In this episode, Dr. Hyman and Dr. LePine discuss:

  • All the elements that make up the exposome
  • Air pollution and water contamination
  • Endocrine disrupting properties of BPA and atrazine
  • How your thoughts influence your microbiome
  • Why your DNA is not your destiny
  • Heavy metal toxicity (i.e. iron, arsenic, mercury, lead, cadmium, aluminum, and more)
  • Types of testing for heavy metals, including hair, blood, urine, and challenge testing
  • Pesticides and herbicides
  • Autism and gut health
  • Supporting the detoxification system
  • The link between environmental toxins, obesity, and diabetes
  • EMF pollution

For more information visit

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD


Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

Dr. Todd LePine

Dr. LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine,
specializing in Integrative Functional Medicine, and has advanced clinical training through the Institute for Functional Medicine.  He has been practicing Functional Medicine for over 15 years focusing on Optimal Aging, Bio-Detoxification, Gastrointestinal Health, Systemic Inflammation, Autoimmune disorders and the Neurobiology of mood and cognitive disorders.

Show Notes

  1. Environmental Working Group (EWG)
  2. EWG’s 2020 Dirty 12
  3. Lesson 1: Environmental Inputs
  4. Lesson 5: Detoxification
  5. How Toxins Make You Fat: 4 Steps to Get Rid of Toxic Weight
  6. A Functional Medicine Approach to Autism

Transcript Note: Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Todd LePine (00:00):
The water that you drink, the air that you breathe, the food that you put in and where you live in the United States, it can have a big impact on your overall health.

Dr. Mark Hyman (00:09):
It’s huge.

Dr. Mark Hyman (00:13):
Welcome to Doctors Farmacy. I’m Dr. Mark Hyman. That’s Farmacy with an F. F-a-r-m-a-c-y, a place for conversations that matter. If you’re wondering why you have some chronic ailment and nobody can figure it out, this is a podcast you want to listen to because it’s about something called the exposome, which you probably never heard of but it’s probably the most important thing that determines your health.

Dr. Mark Hyman (00:33):
It’s with none other than my colleague and friend, Dr. Todd LePine who is joining us for this special episode in the Doctors Farmacy called House Call where we, at the UltraWellness Center, discuss patients and diseases and mysteries that no one can figure out and how we treat these patients every single day in our practice.

Dr. Mark Hyman (00:53):
Todd and I have worked together for decades and we were together at Canyon Ranch years ago. He went to Dartmouth Medical School and is Board Certified Internal Medicine. He’s a leader in many aspects in the world of functional medicine training physicians all over the world and is on the faculty of many groups, including the Institute For Functional Medicine, ACAM and A4M and many other medical groups.

Dr. Mark Hyman (01:16):
I’m just so excited, Todd, to have you here again to talk about something that nobody heard about but is probably the most important thing that determines whether you’re sick or not and it’s called the exposome. Todd, what is the exposome?

Dr. Todd LePine (01:28):
The exposome, okay. The exposome is the term for the sum total of all the toxic exposures that we get in our environment and they can be both internal and external toxins.

Dr. Mark Hyman (01:43):
A thought can be a toxin, right?

Dr. Todd LePine (01:45):

Dr. Mark Hyman (01:46):
If you have a bad inner dialogue that’s literally talking to every aspect of your body.

Dr. Todd LePine (01:53):
Excellent point. I didn’t actually have that in my outline, but [crosstalk 00:01:58]

Dr. Mark Hyman (01:57):
It’s literally everything that happens to you and watches over you your whole life is what you’re exposed to throughout your life.

Dr. Todd LePine (02:03):
Exactly, yeah. Even the stuff you that you don’t even know which is the in utero exposure. Some of the children who have parents, or the mother who’s in a very stressful environment. Those stress hormones where the mother actually gets, the epigenetics gets transmitted to the child. These kids who are born in war torn countries they actually have epigenetic stressors. They’ve actually shown that. The epigenetic methylation of people that are brought up in war countries have a different genetic exposure.

Dr. Todd LePine (02:39):
The exposome, there’s a paper in science that goes over this. When I first read this paper it sort of put a light bulb on me to really sort of change the way of how I think of how is it that we interact with all these environmental toxins. The good news is that our body is able to detoxify. That’s a good thing. In fact, a lot of studies have shown that the people who age well and longevity is often times associated with how our body deals with toxins. I call that the George Burns gene.

Dr. Todd LePine (03:11):
George Burns had two martinis and a cigar and he lived to 100. He had good ability to detoxify. My father is a dentist and he’s like George Burns, he liked his martinis and his cigars. He was exposed to mercury as a dentist and he lived to 94 and he was actually quite healthy.

Dr. Mark Hyman (03:26):
Wow. That reminds me of Eubie Blake was a famous musician who lived to be well over 100. He said, “If I had known I was going to live so long I would have taken better care of myself.”

Dr. Todd LePine (03:35):
Right, exactly. Right. We define the exposome as that sum total of both internal and external toxins. Unfortunately, today we take the environment [crosstalk 00:03:45]

Dr. Mark Hyman (03:45):
Or influences, not just toxins. People think of toxins like pesticides and it’s really everything that happens to you.

Dr. Todd LePine (03:51):
Everything that happens to you, exactly.

Dr. Mark Hyman (03:54):
Inside and out.

Dr. Todd LePine (03:55):
Inside and out. Endotoxins and exotoxins. We actually live in a pretty toxic environment now. There’s a lot of air pollution, so depending on where you live will determine your risk for asthma. When you live in more of a city where there’s particulate matter from cars and diesel fumes you are going to be more susceptible breathing issues.

Dr. Todd LePine (04:18):
Your water. Very, very important. I mean our body is 60-70% water, so what type of water are you drinking? Does it have some of the chemicals that leach in. Over in New York there’s a case where they had some flame retardant that was being used by the military that seeped into the water systems. Now the people have to get bottled water.

Dr. Mark Hyman (04:44):
Most tap water in America is full of all those toxins.

Dr. Todd LePine (04:47):
Michigan had that big scandal with the lead in the water.

Dr. Mark Hyman (04:49):
Yeah, Flint, Michigan. But you know, just the average water in America there’s 38 contaminates according to one study. Including everything from pesticides, flame retardants, antibiotics, hormones, [crosstalk 00:05:02] medication. When you take the birth control where do you think that goes when that metabolizes? Into your urine. Where does that go? Then it gets all cleaned up and used again as your water supply. We are definitely exposed to enormous amounts of these compounds.

Dr. Todd LePine (05:16):
Right. The concept in mainstream medicine is the way they study toxicology is that you’ve got to give a certain dose to get cancer. If you give that dose, or if you give a dose and you don’t get cancer then it’s safe. We can use it, right? That’s an old way of viewing toxicology.

Dr. Todd LePine (05:37):
We’re finding out now is that toxins at very low doses, things like BPA, which is Bisphenol A, are actually endocrine disruptors. Two of the compounds that I find that potentially have the biggest impact in terms of very small amounts having a big impact are things like Atrazine [crosstalk 00:05:58]

Dr. Mark Hyman (05:59):
That’s a pesticide.

Dr. Todd LePine (06:01):
Atrazine is actually an herbicide.

Dr. Mark Hyman (06:02):
Oh, herbicide.

Dr. Todd LePine (06:03):
Atrazine is an herbicide and there’s some fantastic work. If you go onto the Internet and you Google Tyrone Hayes and Atrazine. He did some work showing that low doses of Atrazine, which is used in corn, actually has endocrine disrupting molecules and it can actually cause a male frog to turn into a female frog. That’s not normal.

Dr. Mark Hyman (06:26):
I wonder if that’s why we’re seeing decreased male fertility. A lot of these are estrogen molecules. We send them to a lab and you get one chemical and you se if it’s safe, but things combined together and become synergistic. [crosstalk 00:06:42]

Dr. Todd LePine (06:41):
Yeah, absolutely.

Dr. Mark Hyman (06:42):
It’s not like one plus one equals two, it’s one plus one equals 100. If you take Tylenol, that might be okay. If you drink alcohol, that might be okay. If you drink alcohol and take Tylenol at the same time, even the normal amount, you get liver failure.

Dr. Todd LePine (06:53):
Exactly. It’s a case report. I remember reading that in the New England Journal of Medicine. The guy was having one or two martinis and popping Tylenol and he had liver failure.

Dr. Mark Hyman (07:01):
In the normal dose. Not like overdosing, right?

Dr. Todd LePine (07:03):

Dr. Mark Hyman (07:04):
It’s one of the most common reasons for admission to the hospital with liver failure. I think we have to be really conscious of all these combinations of exposures. When I think about the exposome I think of our diet, I think of our thoughts and feelings and our emotional brain speaking to every cell in our body and our immune system.

Dr. Todd LePine (07:21):
Our perception.

Dr. Mark Hyman (07:23):
Yeah, perception. Even your thoughts influence your microbiome, so those little bugs in your gut are changing and listening to what you’re thinking. Not to put pressure on you but if you have a negative inner dialogue, it’s probably not benefiting your health. Of course, there’s your environmental exposures, right? Which we talked about. All these environmental toxins both from pesticides and chemicals in our food and the air and the water and more.

Dr. Mark Hyman (07:52):
Then, of course, there’s our internal toxins, right? Which can be produced by bad bugs in the gut so you’re microbiome influences everything then. I think what I learned in medical school is that your health is sort of determined by your genes. You’re at risk for diabetes, you’re at risk for alzheimer’s, you’re at risk for this and that autoimmune disease. Turns out it’s the exposome that is the thing that determines 95% of what happens with your health in terms of chronic disease. It’s not your DNA.

Dr. Todd LePine (08:20):
Exactly. [crosstalk 00:08:20]

Dr. Mark Hyman (08:20):
It’s what your DNA is exposed to.

Dr. Todd LePine (08:25):
We do the genetic testing here and there is this concept, or this idea that your DNA is your destiny. Heart disease runs in my family. Diabetes runs in my family. Alzheimer’s runs in my family. There may be a genetic predisposition and my analogy to this is a loaded gun. Genes can be a loaded gun if you have genes that maybe push you in the direction of one biochemical pathway. It’s good to know that.

Dr. Todd LePine (08:56):
A loaded gun doesn’t kill anyone until you pull the trigger.

Dr. Mark Hyman (08:59):
Yes and environment loads it [crosstalk 00:09:01]

Dr. Todd LePine (09:01):
Environment pulls the trigger.

Dr. Mark Hyman (09:02):
Environment pulls the trigger …

Dr. Todd LePine (09:02):

Dr. Mark Hyman (09:02):
… and the genes load the gun.

Dr. Todd LePine (09:03):
Absolutely. What we’ve also found, and this is really interesting is that things that we thought were [inaudible 00:09:08] genetics like Huntington’s Chorea. They’ve actually studied the genes of people who have Huntington’s genes and they do not clinically manifest Huntington’s Disease.

Dr. Todd LePine (09:19):
There’s more to it than we really fully understand. Genes are important but they’re not the main thing. I would venture to say when you look at things from a numbers standpoint, it’s probably 70-80% is environment and 20-30% are genes.

Dr. Mark Hyman (09:35):
Yeah, and in one of the studies I read on the exposome they said 95% of chronic disease is driven by exposome. I heard a guy say recently it’s not your DNA, it’s your dinner that matters most. That is a great quote because it sort of speaks to the fact that we can’t change our genes, but we can change how those genes are turned on or off or expressed.

Dr. Mark Hyman (09:59):
The exposome essentially is talking about what our biology and our genes are exposed to over the course of our lifetime and how that influences the course of our health. In functional medicine, and here at the UltraWellness Center, the things that we do really well are look at the exposome. Tell us more about what are the kinds of things you think of when you’re looking at patients to assess their exposome and how that’s contributing to their health or disease.

Dr. Todd LePine (10:22):
Well, you know, you mentioned earlier about your experience with heavy metal. Heavy metals can be disruptive. Often times we’ll look and assess for heavy metal toxicity, heavy metal burden. When we check for heavy metals guess what? Everyone has them. We all have exposure. I don’t think I’ve ever seen a negative heavy metal [crosstalk 00:10:43]

Dr. Mark Hyman (10:42):
I did a few times. People who are Vegans and never eat fish and they’ve always done that and have no fillings. And are probably good detoxifiers. Almost everybody else has some level.

Dr. Todd LePine (10:55):
A small amount, a small amount.

Dr. Mark Hyman (10:57):
Some have a lot.

Dr. Todd LePine (10:57):
They’re in the environment, so burning with coal. Coal gives off mercury and it gets into the water.

Dr. Mark Hyman (11:04):
And lead.

Dr. Todd LePine (11:04):
And lead, yeah, so you get some exposure. Heavy metals disrupt enzymes in the body. They disrupt detoxification enzymes. Things like mercury, lead, aluminum, arsenic, cadmium for cigarette smokers. In fact, the first time I actually learned that is when I had a patient who was a heavy cigarette smoker. I checked heavy metals and the cadmium was off the charts. I’m saying where’s this coming from? It turns out that cigarettes, tobacco for whatever reason it accumulates cadmium and you see heavy cadmium in cigarette smokers.

Dr. Todd LePine (11:39):
Heavy metals can be a source of toxicity.

Dr. Mark Hyman (11:43):
That can cause all kinds of symptoms, right? Give us some general symptoms that you’d see in a patient with heavy metal toxicity. When you go to your regular doctor they’re like well what is your lead, mercury, arsenic, cadmium and aluminum levels? They’re not checking that, right?

Dr. Todd LePine (11:59):
Yeah, yeah. The other thing that’s also interesting is that when you look at metals there’s this whole theory now about neurodegenerative conditions. It’s thought that metals play a role in what’s called metallosis. Metals disrupt the folding of protein. When you have excess amounts of metals in the body it causes proteins to misfold. Misfolded proteins are tied in with a lot of neurodegenerative conditions including things like ALS, things like Alzheimers.

Dr. Todd LePine (12:30):
There’s an interesting study that just came out this past week and I’ll send you the paper, Mark, about the role of excess iron. We think iron is good. Well guess what? [crosstalk 00:12:40]

Dr. Mark Hyman (12:40):
Not too much.

Dr. Todd LePine (12:40):
Too much iron is not good. Especially free iron. Iron is a very reactive metal. I was a chemistry major so I always liked to look at the chemistry.

Dr. Mark Hyman (12:50):
That explains it all now.

Dr. Todd LePine (12:51):
Yeah, yeah, right. I’m a science nerd. When you look at metal … [crosstalk 00:12:56]

Dr. Mark Hyman (12:56):
I was a Buddhism major.

Dr. Todd LePine (12:59):
Iron is reactive and it reacts with oxygen. When you leave something metallic outside it rusts because it oxidizes when it interacts with oxygen. Our bodies actually keep iron wrapped up and we keep that in the molecule called hemoglobin. We wrap up iron. If you have free iron in the body you get the Fenton Reaction. Basically, your body starts to rust.

Dr. Todd LePine (13:23):
I’ve seen this in patients with hemochromatosis. When you have hemachromatosis, which is a genetic condition that causes you to not be able to get rid of your iron, which is a metal. [crosstalk 00:13:34]

Dr. Mark Hyman (13:33):
10% of the population has some degree of that.

Dr. Todd LePine (13:36):
Exactly, yeah. What happens is iron is found in all tissues because blood is in all tissues. When that iron can’t get detoxified you build up iron in your liver, your heart, your pancreas and your brain.

Dr. Mark Hyman (13:49):
And your joints.

Dr. Todd LePine (13:50):
And guess what? You rust. [crosstalk 00:13:52]

Dr. Mark Hyman (13:52):
Yeah. Like the tin man. A rusted tin man. [crosstalk 00:13:55]

Dr. Todd LePine (13:55):
You get a rusty brain. Exactly, you can develop … In fact, the first time I [crosstalk 00:13:57]

Dr. Mark Hyman (13:56):
You get diabetes.

Dr. Todd LePine (13:58):
You get diabetes, liver failure, cardiomyopathy, you name it.

Dr. Mark Hyman (14:02):
Heart failure.

Dr. Todd LePine (14:03):

Dr. Mark Hyman (14:03):

Dr. Todd LePine (14:05):
Dementia, exactly.

Dr. Mark Hyman (14:06):
Arthritis. It’s a mess.

Dr. Todd LePine (14:09):
We call it metal trafficking and looking at the role of metals is really important. Aluminum, also. Excess amount of aluminum has been associated with increased risk for Alzheimers. Again, it’s probably related to these metals actually causing proteins to [crosstalk 00:14:24]

Dr. Mark Hyman (14:24):
So we shouldn’t be using that aluminum deodorant or cooking from those aluminum cans.

Dr. Todd LePine (14:28):
No, or aluminum soda cans.

Dr. Mark Hyman (14:32):
Antacids. Yeah, but like the [crosstalk 00:14:32]

Dr. Todd LePine (14:32):
Yes, oh yes.

Dr. Mark Hyman (14:35):
Antacids often have aluminum.

Dr. Todd LePine (14:37):

Dr. Mark Hyman (14:37):
Yeah, there’s a lot of aluminum in us. Heavy metal, we see heavy metal is one of the exposome areas. How, for example, would we assess someone’s heavy metals?

Dr. Todd LePine (14:47):
We do the, you can do the urine provocation testing for heavy metals, which is what we do a lot in patients with [inaudible 00:14:55] DMPS.

Dr. Mark Hyman (14:54):

Dr. Todd LePine (14:57):
Or DMSA, exactly. Yeah, you can do that. You can also assess it in the blood. There’s different, when you check mercury, there’s two different forms of mercury. Mercury takes organic and inorganic mercury and organic mercury tends to accumulate in the hair, so you can actually assess hair.

Dr. Mark Hyman (15:16):
That’s more from fish, for example.

Dr. Todd LePine (15:17):
From fish, yeah.

Dr. Mark Hyman (15:18):
Like methyl mercury.

Dr. Todd LePine (15:19):
Right, so you can assess it in the hair, you can assess it in the blood, and you can also assess things in the urine. Each of them give you a different perspective.

Dr. Mark Hyman (15:26):
Inorganic is from your fillings.

Dr. Todd LePine (15:28):
From fillings.

Dr. Mark Hyman (15:29):
And from pollution.

Dr. Todd LePine (15:31):

Dr. Mark Hyman (15:32):
The thing is, people say oh, you got these silver fillings. The dentist say they’re great. But you and I both know that when we see these patients they do have high levels of inorganic mercury and look at their tests and it does affect their health. You remove the fillings and the mercury levels come way down. I’ve seen this over and over again and then patients feel better.

Dr. Mark Hyman (15:51):
Now, this is not well accepted as a thing in dentistry except look at what most dentists do now. They moved all away from these “silver fillings” which are mostly mercury. Without saying they’re bad it’s like, “Well, they’re not bad we just don’t do it anymore.”

Dr. Todd LePine (16:06):
There’s too much of reliability. It’s a can of worms. Basically, if they were to admit that there’s a problem … Because once you remove mercury from the tooth it now becomes a toxic waste product and it’s fully regulated. Fully regulated.

Dr. Mark Hyman (16:19):
Yeah, yeah. That’s interesting. Ask your dentist.

Dr. Todd LePine (16:21):
It’s fine in your mouth but remove it and now it’s a toxic product.

Dr. Mark Hyman (16:24):
Yeah, that’s interesting. Ask your dentist if mercury is so safe then why can’t you throw it in the garbage? Why do you have dispose of it by the regulations set forth by the EPA as a toxic waste? I always thought that’s an interesting point. If you can’t answer that then you shouldn’t be putting it in your mouth.

Dr. Mark Hyman (16:41):
We can look at the blood and we can look at the urine. The problem with the typical blood test is if you haven’t had a current exposure, your body clears it after 90 days. It doesn’t necessarily get rid of it. It might store it in your tissues, in your liver, in your muscles, in your brain. You can’t really tell, and so that’s why this challenge test can help pull it out. Then we get a more accurate view of what’s happened over the course or your life.

Dr. Todd LePine (17:02):
The big thing, this is a clinical quote. I’m sure you’ve seen this is lead. We tend to have less lead toxicity now because we’re not using lead paint. We don’t use lead in gasoline. We don’t have lead pipes, unless you have old, old buildings.

Dr. Todd LePine (17:17):
I have seen this in a few patients, especially in women, where in menopausal women after menopause they’ll have accelerated bone loss. Lead gets stored where?

Dr. Mark Hyman (17:29):
In the bones.

Dr. Todd LePine (17:30):
In the bones. As a woman goes through menopause and she’s had a body burden of lead and it’s sort of sitting in the bones and all of the sudden you’re now digging up the bones and you’re peeing, when you go through menopause you pee out your bones. That’s how you do it. You can do a test called bone reabsorption testing which checks for the collagen breakdown products of bone. When you see increased bone reabsorption you know that they are peeing out their bones. When you see high levels of lead, you know that they are actually getting exposed. It’s like dripping lead out of the body.

Dr. Mark Hyman (18:03):
Not actual bones coming out of your urinary tract. It’s just a break down. [crosstalk 00:18:09]

Dr. Todd LePine (18:16):
When you get osteoporosis where do your bones go? Literally, you pee them out.

Dr. Mark Hyman (18:20):
Speaking about the bones, digging up the bones, there was a study I read years ago that they had to dig up this graveyard in Europe and they had to remove the bones and put them somewhere else. What they did was they decided to check the bones for lead and they compared that to today and they found that there was a thousand times more lead in the bones of modern people than there were 300 years ago.

Dr. Todd LePine (18:45):
Wow. Wow.

Dr. Mark Hyman (18:47):
It’s in there. That’s incredible. I think mercury is also one of those factors that it’s just so common because it comes in our diet, it comes in our fillings, it comes in pollution and it’s probably one of the most undiagnosed things I’ve ever seen. I certainly became an expert in it not by design but because I got really sick from mercury poisoning. That’s what led me to have this chronic fatigue syndrome and kind of figure this whole thing out.

Dr. Todd LePine (19:13):
Then, you know, the old term is the Mad Hatter. Remember in Alice and Wonderland the Mad Hatter? They used to use mercury when they made hats. What they found out is that you got mad. If you had enough mercury it affected your brain. You’d have delirium and others symptoms because it has a brain affect.

Dr. Mark Hyman (19:33):
The other thing about these problems with toxins is that they don’t manifest the same in everybody, right?

Dr. Todd LePine (19:37):

Dr. Mark Hyman (19:38):
They might make you crazy, they might give you autism, they might give you alzheimer’s, they might give you chronic fatigue syndrome, they might give you an autoimmune disease. The might cause weight gain. I had a woman who was a fitness trainer and ate perfectly and she had these 40 pounds she couldn’t lose. I took her history and thought she might have some mercury issues and we tested her. She had very, very high levels and we treated her. Over the course of a number of months without doing anything else just by treating her mercury her weight dropped 40 pounds.

Dr. Todd LePine (20:09):
Wow, wow.

Dr. Mark Hyman (20:12):
We know that there’s these compounds called obesogens which are environmental toxins that cause obesity. They interrupt your mitochondrial function, your energy production, your hormones and metabolism. Really, it’s important to really dig deep.

Dr. Mark Hyman (20:23):
Hey everybody, it’s Dr. Hyman. Thanks for tuning into the Doctors Farmacy. I hope you’re loving this podcast. It’s one of my favorite things to do and introduce to you all the experts that I know and I love and that I’ve learned so much from. I want to tell you about something else I’m doing which is called Mark’s Picks. It’s my weekly newsletter and in it I share my favorite stuff from foods to supplements, to gadgets, to tools to enhance your health. It’s all the cool stuff that I use and that my team uses to optimize and enhance our health.

Dr. Mark Hyman (20:52):
I’d love you to sign up for the weekly newsletter. I’ll only send it to you once a week on Fridays, nothing else, I promise. All you do is go to to sign up. That’s P-i-c-k-s. Sign up for the newsletter and I’ll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now back to this weeks episode.

Dr. Mark Hyman (21:19):
Beside these heavy metals what other things can we look for that most physicians don’t look for?

Dr. Todd LePine (21:24):

Dr. Mark Hyman (21:25):

Dr. Todd LePine (21:26):
Big one, big one.

Dr. Mark Hyman (21:27):
Herbicides, pesticides.

Dr. Todd LePine (21:28):
Yeah, yeah. Pesticides are the compounds that we use on plants to keep the bugs from eating them. There’s a whole bunch of them. You can measure them. There’s labs that will actually measure pesticide levels. One of the pesticides, which is a real bad one and it’s actually been banned in Europe, is the neonicotinoids. That’s the one they associate with bee colony collapse.

Dr. Todd LePine (21:56):
Pesticides, interestingly, are also associated with ADD and … I think, yeah, that study where they looked at the children who lived downstream from pesticide exposure. They checked how they would draw and such. There was a big difference between those who had high levels of pesticides and how their brains worked … [crosstalk 00:22:17]

Dr. Mark Hyman (22:17):
Oh, for sure. For sure.

Dr. Todd LePine (22:17):
… versus those who had low levels of pesticides. They’re neuro toxins. Basically, a pesticide works on the nervous system of insects. Our nervous system is not that different than an insect. High levels of pesticides are not good things.

Dr. Mark Hyman (22:31):
The other thing is farm workers and their kids. The kids through various diagnostics and neurologic testing they’ve found they’ve lost 41 million IQ points being exposed to pesticides.

Dr. Todd LePine (22:45):
Yeah, yeah, exactly. There’s an interesting study that looked at pesticides in Japanese populations. The interesting one is they found higher levels of pesticides in people who ate more fruits and vegetables. That’s counterintuitive, right? But it’s not counterintuitive because if you have pesticide laden fruits and vegetables you’re going to have high levels of pesticides. It’s not just don’t eat your fruits and vegetables, eat your organic fruits and vegetables.

Dr. Mark Hyman (23:11):
Yeah, I mean there was a paper recently published linking pretty clearly the fact that organic food eaters had much less cancer than people who ate traditional fruits and vegetables. The dirty dozen is a great guide from the working group of one of the 12 most contaminated foods. Strawberries I love, but I would never eat a conventional strawberry because it’s one of the most pesticide laden things.

Dr. Mark Hyman (23:32):
Glyphosate, which is another compound. It’s not a pesticide it’s an herbicide sprayed on 70% of our crops. It’s the most abundant agro chemical used around the world and it destroys our microbiome. It’s literally like an antibiotic that kills your own microbiome as well as the microbiome of the soil and that leads to all these other complications.

Dr. Mark Hyman (23:52):
When you go to your doctor they’re not mentioning your glyphosate, they’re not mentioning your pesticide levels, they’re not mentioning your heavy metals and you’re coming in with all these symptoms that could be related. Part of the difference with functional medicine is we actually start to think about these things and we have methods of diagnosing them and we have methods of treating them. Right?

Dr. Mark Hyman (24:07):
How do you begin to start thinking about treating these things?

Dr. Todd LePine (24:10):
You talk about Glyphosate, I think that’s a big one and that’s sort of the elephant in the room because it’s ubiquitous. It’s so prevalent and we do testing for that now. I don’t know if you’ve been measuring your [crosstalk 00:24:22]

Dr. Mark Hyman (24:22):
I do. I measured mine. I was shocked. I eat clean, I try not to eat GMO, I do travel, although not anymore, but I eat organic and I really am focused on detoxification and my Glyphosate levels were in the 50th percentile which is pretty high considering I’m on the extreme end of paying attention to this. It’s in everything and if you don’t know where your food is coming from it likely has it because it’s on everything.

Dr. Todd LePine (24:50):
You mentioned because the Glyphosate is actually an herbicide which is supposed to not affect the human system because it works on a different pathway, the shikimate pathway and that pathway is actually in bacteria. When you ingest Glyphosate it actually has an adverse effect on the gut microbiome. There’s some interesting work by Stephanie Sena and she has a whole bunch of data linking the increased use of Glyphosate with, linking it, not necessarily causing it [crosstalk 00:25:24]

Dr. Mark Hyman (25:24):
Correlating it.

Dr. Todd LePine (25:24):
Correlating it with Autism. I think there’s some truth to that because what you’re doing is if you’re having higher levels, especially early on, that you may be disrupting the microbiome which is in turn affecting the gut brain access. [crosstalk 00:25:38]

Dr. Mark Hyman (25:39):
We know that most kids with Autism have terrible guts. By helping their gut they get better. There’s studies showing just giving a kid a fecal transplant who’s got Autism helps fix her Autism.

Dr. Todd LePine (25:50):
The other interesting thing about Autism is that we talk about kids with Autism and their social interaction. A lot of the social hormone is oxytocin. It’s the love molecule. What we found out is that the gut bacteria actually produce oxytocin.

Dr. Mark Hyman (26:05):
Oh, the good ones.

Dr. Todd LePine (26:06):
The good ones.

Dr. Mark Hyman (26:07):
The good bugs.

Dr. Todd LePine (26:08):
It makes sense that when you have disruption of the microbiome you may be disrupting the social network of your gut which may be playing a role, one of many factors, in this Autism spectrum condition that we’re seeing.

Dr. Mark Hyman (26:24):
If you want to have happy, healthy relationships you’ve got to fix your gut, too.

Dr. Todd LePine (26:27):
Yeah, exactly. Happy gut. Exactly.

Dr. Mark Hyman (26:31):
Let’s talk about once we’ve started to identify all the factors in the exposome, right? Your diet, stress levels, the air you’re breathing, the water you’re drinking, the light you’re exposed to. These are also influences on your gene expression.

Dr. Todd LePine (26:48):
Light pollution.

Dr. Mark Hyman (26:50):
Light pollution. Environmental toxins. All these factors, your microbiome are influencing your genes and your gene expression and your health. But when we see a traditional doctor, not here at the UltraWellness Center or a functional medicine doctor, you’re not really getting evaluated for all these things, right? Here we’re able to test and measure these things and we know which ones to look for depending on the patients story.

Dr. Mark Hyman (27:14):
Once we find these things what can we do to relieve that burden? It’s kind of depressing. It’s like well, what can I do? I’ve got all these exposures, all these toxins, but you related to me before a story about a woman who had a significant exposure to pesticides and you treated her and she got better.

Dr. Todd LePine (27:31):
It was actually PCBs.

Dr. Mark Hyman (27:33):
Oh, PCBs.

Dr. Todd LePine (27:36):
Yeah, and up in the Berkshire’s with General Electric we have the whole PCB saga up here. PCBs are these persistent organic pollutants. They basically stay in the body. In general, I’m going to make a generalization here, a lot of environmental toxins are lipid soluble which means they love fat. They get stored in fat. When they get stored in fat your body is not able to detoxify them, as well.

Dr. Todd LePine (28:02):
As they accumulate, they can disrupt the endocrine system and cause insulin resistance and PCBs have been known to do this. They affect the thyroid, they affect insulin resistance. This lady wanted to be tested for it. I went ahead and tested her for it and she had high levels of PCBs.

Dr. Todd LePine (28:20):
I started to support her detoxification for fat soluble PCBs with Cholestyramine.

Dr. Mark Hyman (28:28):
What’s that?

Dr. Todd LePine (28:29):
It’s a molecule that prevents … It was originally used for cholesterol. Cholesterol gets recycled in the body, your body eliminates cholesterol [crosstalk 00:28:39]

Dr. Mark Hyman (28:38):
Through your bile.

Dr. Todd LePine (28:39):
Through your bile. Exactly, because cholesterol is a good molecule. Cholesterol is the building block of all our hormones for cellular membranes. Cholesterol gets a bad rap, but cholesterol can be a very good molecule. But the compound Cholestyramine was originally designed to lower your cholesterol to prevent the recycling of your cholesterol. It works for other things. I think some of the work with Richie Shoemaker with his use of … It’s an interesting story that he has how he was using it for microtoxins and how it helps the body to eliminate microtoxins.

Dr. Mark Hyman (29:14):
Those mold related toxins they just recirculate and create chronic inflammation. You might have been exposed to mold 10 years ago, but the mold toxins keep in your body and keep causing your inflammation which is why people have brain fog and fatigue. That’s another one of those things in the exposome is mold. We didn’t even talk about that. That’s another huge one.

Dr. Todd LePine (29:36):
Microtoxins, they’re definitely. But this lady we treated her with lifestyle changes but also I used Cholestyramine and I did it sequentially over about a year. Slowly her levels came down and as she did that guess what? She started being able to lose weight. She was very, very happy. She helped to reverse her pre diabetes and just felt so much better. When you’re carrying around an extra 30-40 pounds that’s like a backpack all day. It wears on you.

Dr. Mark Hyman (30:08):
I mean you’re right. You just mentioned diabetes but we know for sure that environmental toxins cause obesity and diabetes. The data is very clear on this. Whether it’s arsenic and diabetes or persistent organic pollutants. It’s not trivial to think about these toxins.

Dr. Mark Hyman (30:25):
You know, if you look at fat registry biopsy studies where they literally took, let’s say if you have a breast reconstruction and they take fat tissue and they send it to the lab or an autopsy they’ll take a bunch of fat tissue from people and they send it to the lab. Literally, everybody is a toxic waste dump. If we were food we wouldn’t be safe to eat. If you look at the kinds of things that are in there it’s dioxin, it’s DDT, it’s PCBs, it’s flame retardants, it’s heavy metal. I mean, these are the things that are stored in us.

Dr. Mark Hyman (30:56):
Traditional doctors are not trained in toxicology except for if you have an overdose of some toxin or an extreme acute exposure. But if you have a chronic exposure over a lifetime, there’s no model for how to deal with this. The good news is that with functional medicine there is a methodology. We’re helping people to upregulate their own detoxification system and to bind these toxins.

Dr. Mark Hyman (31:19):
Tell us about that. How do we do that in functional medicine?

Dr. Todd LePine (31:21):
You know, you bring up a really good point which is that fat is the storage depot. It’s a toxic waste dump. I often tell patients that if you want to lose weight you need to support detoxification.

Dr. Mark Hyman (31:34):

Dr. Todd LePine (31:35):
It’s a critical, critical thing. In the science of how our body detoxifies we sort of divvy it up into phase one and phase two detoxification pathways. Phase one is the oxidation process where your body sort of activates a molecule. Phase two is what we call the conjugation pathway where we stick molecules onto them like sulfate or glutathione to detoxify them.

Dr. Mark Hyman (32:02):
The first step gets it ready, the second step packages it up to get rid of it.

Dr. Todd LePine (32:06):
Yeah, so you think of it like taking out the garbage. You have garbage, you wrap it up in a plastic bag, or a trash bag, and then the guy comes out and takes it out.

Dr. Mark Hyman (32:15):

Dr. Todd LePine (32:16):
It has to be in balance. If you have too much of phase one and not enough of phase two it builds up and you get these reactive species. You have to have a balance in that phase one, phase two part of detoxification. Glutathione is one of the great molecules that our body has which is, it helps with detoxification. It’s an antioxidant and our bodies stick glutathione onto toxins. That’s one of the enzymes, one of the most important enzymes I think is Glutathione S-transferase.

Dr. Todd LePine (32:48):
A lot of people say well I’ll just take more glutathione. Well, it’s not just taking glutathione. You’ve got to stick the glutathione onto the toxin. That happens through Glutathione S-transferase. The cruciferous vegetables upregulate that enzyme. [crosstalk 00:33:02]

Dr. Mark Hyman (33:02):
Food, a lot of foods are, we use foods as medicine to upregulate these pathways. You just mentioned the broccoli family. But, any of those foods. Broccoli, cabbage, kohlrabi, brussel sprouts, watercress, arugula. Those are all foods which actually upregulate these pathways. Green tea dose, also. You need those. I find those, for me, are a staple in my daily diet. I eat those every single day because they’re so important.

Dr. Mark Hyman (33:27):
There’s a lot of other ways to upregulate these pathways. You need various nutrients to help like selenium and all the B vitamins. All these things that help these pathways. We really are focused on nutrition and nutritional detoxification as the first step. What other kinds of things can we do to help the body to get rid of toxins?

Dr. Todd LePine (33:48):
There’s also, traditionally there’s been the phase one, phase two parts of detoxification. There’s also a phase three, which Jeff Bland got me aware of, which is the urinary excretion of toxins. It’s very important to actually have an alkaline urine. Measuring your urinary Ph is important because having a Ph seven or above helps with the facilitation of detoxification.

Dr. Mark Hyman (34:12):
It’s not just drinking water, but you got to eat a diet that makes you more.

Dr. Todd LePine (34:15):
Right, and eating a more plant based diet, a heavier plant based diet will help to alkalize your urine.

Dr. Mark Hyman (34:20):
Plant rich diet.

Dr. Todd LePine (34:21):
Oh yeah, plant rich diet. Exactly.

Dr. Mark Hyman (34:25):
We have to take these foods in. Then fiber is also such a critical component. You mentioned cholestyramine but there are other binders that are naturally found in fiber that help you eliminate these toxins.

Dr. Todd LePine (34:36):
Oh absolutely. That’s why I call it, there’s phase one, phase two, phase three, which is the urinary detoxification and phase four is the gut. You’ve got to poop it out. That’s really, really important. Making sure that you’re moving your bowels one to three times a day is very, very important. Take out your garbage. People tell me, well how often are you moving your bowels? Well, every three days. I’m like no, you don’t want to do that.

Dr. Mark Hyman (34:58):
No, no, no. That’s bad news.

Dr. Todd LePine (34:59):
Bad gut.

Dr. Mark Hyman (35:00):
People with Parkinson’s we know very clearly is linked to environmental toxins but it’s also linked to constipation.

Dr. Todd LePine (35:06):
Absolutely. In fact, one of the key things is way before people develop Parkinson’s they actually have constipation issues. There’s strong evidence in the literature that Parkinson’s actually can begin in the gut.

Dr. Mark Hyman (35:19):
Yes, and it might be beginning in the gut but also if you’re not eliminating what’s in there, it’s exposing you to more toxins over time. We use food, we also use a lot of special nutrients to upregulate these pathways whether they’re herbs or vitamins, things like milk thistle, selenium, acetylcysteine, folic acid. We have a whole regimen in functional medicine to help your body detoxify. There’s other things, right?

Dr. Todd LePine (35:44):
Sauna sweating.

Dr. Mark Hyman (35:44):
Sauna’s, sweating, right? Sweating …

Dr. Todd LePine (35:46):

Dr. Mark Hyman (35:47):
Exercise, Yoga, right? All these things help to detoxify your body and move things around and move your lymph and your blood around and helps you detoxify. There’s a lot of strategies we use. Sometimes we even use intravenous therapies to help people, like IV Glutathione and Vitamin C and other things.

Dr. Mark Hyman (36:03):
We have a really comprehensive approach to helping identify what your exposome is, how that’s contributing to your issues and how to treat them very personally and specifically because it’s different for each one.

Dr. Todd LePine (36:14):
Yeah, absolutely. When you actually get into, you know, when you start reading the literature you really realize that this is a big problem and you can sort of become pessimistic, it’s like, what do I do? We’re living in this toxic world. Yes, that’s true. But the cockroaches that survive are the ones that can eat DDT and do okay.

Dr. Mark Hyman (36:35):
Don’t try that.

Dr. Todd LePine (36:36):
Being aware of the exposome I think is the first thing. Just sort of understanding that the water that you drink, the air that you breathe, the food that you put in and where you live in the United States. It can have a big impact on your overall health. You also mentioned your thoughts. It’s really important. I always go back to this. My understanding of the power of the mind and the power of thoughts was with Bruce Lipton’s book The Biology of Belief which is a fantastic book. If anybody’s not read it I highly recommend it. It sort of changed the way I understand how your thoughts can actually affect the expression of your genes and change your physiology.

Dr. Mark Hyman (37:22):
And your immune system and everything else.

Dr. Todd LePine (37:23):
Absolutely. It’s a game changer and I highly, highly recommend it. He’s on the Internet. You can read his book and even watch some of his videos. When you listen to how he explains it you really understand the importance of how you see the world and how you perceive the world and that whole internal dialogue that we have.

Dr. Todd LePine (37:41):
When you have happy thoughts you’ll be happy, when you have negative thoughts you’ll be negative.

Dr. Mark Hyman (37:46):
Thoughts can be toxins.

Dr. Todd LePine (37:48):
Absolutely. Absolutely.

Dr. Mark Hyman (37:49):
Relationships can be toxic.

Dr. Todd LePine (37:51):

Dr. Mark Hyman (37:52):
All that plays a role. I think the thing people should know is that there are ways to deal with this and to reduce your exposures. One of the best resources is the Environmental Working Group. I’m on the board. If you go to you can learn about how to reduce your exposures through what skin care products you use whether it’s face creams or sunblock. Household cleaning products, foods, all these things we have control over and you can’t eliminate everything but you can dramatically reduce your exposure. Then, using the principles of functional medicine you can help. That’s really what we do here at the UltraWellness Center. We’re like medical detectives. We help you identify what is going on. We deal with mystery illnesses.

Dr. Mark Hyman (38:38):
Todd and I used to work at Canyon Ranch, which is a health resort. They often call us the resort doctors because we’re the doctors of last resort. People come after they’ve seen everybody, done everything, tried everything and they can’t get better and then we figure it out. It’s not magic, it’s just science. We actually have a method and an operating model called functional medicine that helps us navigate to what the real issues are and have a very specific way of addressing them. Don’t fret, don’t fear, just realize that yes, we have to deal with the exposome, but there is a lot of science around how to do that effectively.

Dr. Todd LePine (39:12):
The last thing I’ll end with is what I call the silent toxin which is in the world that we live in is EMF pollution. It’s a real issue. You have continuous exposure to EMFs. Now, you have what’s called non native EMFs which is they’re not found in nature. They’re manmade things like WiFi and cell towers and stuff like that. There’s a lot of evidence that these non native EMFs at continuous exposure levels effect the immune system. There’s some really good stuff on this. I’ve had some patients who are “EMF sensitive.”

Dr. Todd LePine (39:50):
I really want to define that. They have a nervous system that actually picks up. We’re energetic beings. Our bodies are electric when we want to measure how our brain is working we do what? An EEG. That’s an electrical signal. When we want to check the heart we check an EKG. Those are electrical signals. It only makes sense that our bodies interact with bioenergetic fields.

Dr. Mark Hyman (40:11):

Dr. Todd LePine (40:12):
You can’t go to any mainstream doctor and get a test for EMFs so you’ve got to do it on your own. I turn my WiFi off at night.

Dr. Mark Hyman (40:20):
Yeah, we bought one of those EMF measuring devices.

Dr. Todd LePine (40:24):
Trifield meters.

Dr. Mark Hyman (40:25):
Put it next to my phone and it goes from like five to 5,000. In New York City we had an important and you know it was always in the extreme danger range even when nothing was going on. Everybody has WiFi in their own apartments. In our house in Massachusetts it’s much, much less.

Dr. Todd LePine (40:41):
Actually, there’s been some studies showing that actually when people go camping and they’re out in nature, they’re not surrounded by EMF fields they will actually reset their circadian rhythm and they will sleep better.

Dr. Mark Hyman (40:53):
Oh my God, I notice that every single time. I sleep like a baby.

Dr. Todd LePine (40:57):
There’s actually even some things that sounds a little crazy but there are things you can use in your house that are called Stetzerizers. They actually decrease dirty electricity. I don’t know if you’ve ever used those or heard of them, Mark.

Dr. Mark Hyman (41:07):
We created a Faraday cage over our bed in New York City. We basically created this tent that was made of this cloth, it’s EMF impervious.

Dr. Todd LePine (41:13):
It’s silver, it’s silver, yeah.

Dr. Mark Hyman (41:14):
And a little thing under the bed. It was the most interesting thing. You could go inside this tent in your bed. You couldn’t make a phone call with your cell phone. You couldn’t get WiFi. It was completely impervious. You put that around you went you sleep and it’s pretty cool.

Dr. Todd LePine (41:32):
There really is a science to that. We are affected by energetic fields. I always talk about some people give off good vibes and bad vibes. That’s energy, that’s energy. There is non native EMF and I think that’s one of the things that’s probably not well talked about in mainstream medicine. Even in alternative medicine.

Dr. Mark Hyman (41:53):
It’s hard to figure out what do to about it. I mean, you can reduce your exposures but how do you actually diagnose that, that’s the issue?

Dr. Todd LePine (41:58):
Yeah, yeah, exactly. But I just think being aware of it and minimizing is the important thing.

Dr. Mark Hyman (42:04):
Well, Todd, this has been a fascinating conversation about something probably people have never heard of called the exposome but it’s probably the most important thing determining your health or your risk of disease. It’s something that you can do something about because it’s an empowering idea that our genes are not our destiny. What is washing over those genes over the course of our life is determining our health or our risk of disease. It’s something we can do something about whether it’s our diet, whether it’s exposure to toxins, whether it’s our thoughts, it’s even our exposure to EMFs.

Dr. Mark Hyman (42:36):
We really covered a lot here, Todd. I think this has been an amazing conversation. Thank you so much for being on the Doctors Farmacy on this special episode, The House Call. If you love this podcast, please share with your friends and family. Please leave a comment. We’d love to hear from you. Subscribe wherever you get our podcasts and we’ll see you next time on the Doctors Farmacy.

Dr. Todd LePine (42:54):
Thanks, Mark.

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