This is part six in a series covering autoimmune disease. Don’t miss the upcoming article covering mind body medicine. Check out previous articles covering Loneliness, GI health, nutrition part 1 and nutrition part 2, and hormones.
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Autoimmune disease occurs when our immune system starts attacking our own tissues. Autoimmune diseases are complex illnesses that develop when there is just the right combination of genetics, epigenetic factors, and environmental triggers (infections, chemicals, stressors, etc). In this article I will focus on a few chemical or xenobiotic exposures that are linked to the development of autoimmune disease. I want to start by saying it’s very challenging to conduct research trying to link specific chemicals to any disease. Humans are exposed to a myriad of chemicals daily and there is likely a compounding effect happening. There can also be a long delay between exposure and the onset of disease. For example, someone could work in a hair salon touching and inhaling chemicals for 10 years before they finally develop an autoimmune disease. Drug (ie medication) induced autoimmunity is well known and most associated with SLE (lupus) like disease. I will skip that in this article. I want to focus on chemicals in our environment that we can control.
Endocrine Disruptors
Arguably the most notorious endocrine disruptors we are exposed to are bisphenols with BPA being the most well known. Unfortunately, when the dangers of BPA were brought into public awareness we saw a boom in ‘BPA free’ products that are quite misleading. Many of these products just replaced BPA with it’s cousins BPF and BPS which are also estrogen like compounds. Bisphenols are used in the production of polycarbonate plastics and at this point are ubiquitous in our environment. Research from 2003 found that more than 90% of the US population has detectable levels of BPA in their urine and females BPA levels were at higher concentration than males. Growing concern about the impact on children from bisphenol exposure has caused BPA to be banned in baby products in Canada and the European Union. BPA is a known endocrine disruptor but it’s role in autoimmunity has not been elucidated yet. What happens to our bodies from BPA exposure is quite similar to the autoimmune process. More research is needed but I am concerned that this could be a potential trigger and the people who already have an autoimmune disease may see a worsening in their pathology with higher exposure to bisphenols.
Some of the products where bisphenols are found include:
One relatively easy change is to avoid plastic containers for food or water and opt instead for glass or stainless steel.
Phthalates are another endocrine and immune disruptor that are ubiquitous in our environment. Phthalates help make plastic soft and to dissolve raw materials when making fragrances. In the US, chemicals such as phthalates are considered safe until they are proven dangerous. Unfortunately, most of the research on phthalates has been done on animals. A 2019 study in rats found that a particular phthalate exacerbates the most common autoimmune disease, an autoimmune thyroiditis called Hashimoto’s.
Below is an example of products that may contain phthalates.
There is no easy way to tell if a product has added phthalates. There are numerous compounds and are identified on labels often as acronyms (BBP, DBP, DEHP, DEP, etc). Dust may also contain phthalates so consider washing your hands before preparing food and eating, cleaning your floors regularly using a wet mop and using a vacuum with an HEPA filter.
Solvents
A meta-analysis in 2012 reviewed research studies that explored the potential link between exposure to solvents and autoimmune disease. Common routes of exposure to organic solvents include:
Many of the studies the authors reviewed look at occupations that have a higher exposure risk such as nurse anesthetists, painters, people who frequently use hair dye and nail polish, and textile workers. Their findings indicate that organic solvent exposure is a risk factor in developing autoimmune disease. The researchers recommended that people with genetic risk factors avoid organic solvents. I think it might be wise for all of us to avoid organic solvents as much as possible.
I find two free apps helpful when trying to avoid chemicals in the products that we use daily, Think Dirty and ‘Healthy Living’ by The Environmental Working Group. Both apps contain a barcode scanner so you don’t have to memorize the thousands of chemicals that might be a concern for you- you can just scan the barcode and see the product's score.
There are so many more chemicals we could talk about in relation to autoimmune disease but instead I want to finish this article with some ideas to support healthy detoxification.
Our detoxification system is quite complex and the major players are our liver, kidneys and GI tract. Our liver processes not just the chemicals we are exposed to daily but also things we produce naturally such as hormones and bilirubin. Some of what the liver processes goes back into our bloodstream to be filtered through our kidneys and excreted through our urine. Other substances are deposited into bile to be dumped into the intestines. Our liver produces roughly 3.5 cups of bile every day! Here is an important piece- when that bile binds to fiber it leaves our body through our stool. Regular bowel movements are a very important part of our detoxification system. Laxatives are not the answer, a healthy diet rich in fiber is!
Some practical ways to enhance your natural detoxification process include:
We are all exposed to chemicals on a daily basis. So I recommend taking small steps to both reduce your exposure to chemicals and support your natural detoxification system.
References:
Toxicology of Autoimmune Diseases
Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis
A Potential Link between Environmental Triggers and Autoimmunity
Exposure of the U.S. Population to Bisphenol A and 4-tertiary-Octylphenol: 2003–2004
The Potential Roles of Bisphenol A (BPA) Pathogenesis in Autoimmunity
DINP aggravates autoimmune thyroid disease through activation of the Akt/mTOR pathway and suppression of autophagy in Wistar rats
Endocrine Disruptors
Arguably the most notorious endocrine disruptors we are exposed to are bisphenols with BPA being the most well known. Unfortunately, when the dangers of BPA were brought into public awareness we saw a boom in ‘BPA free’ products that are quite misleading. Many of these products just replaced BPA with it’s cousins BPF and BPS which are also estrogen like compounds. Bisphenols are used in the production of polycarbonate plastics and at this point are ubiquitous in our environment. Research from 2003 found that more than 90% of the US population has detectable levels of BPA in their urine and females BPA levels were at higher concentration than males. Growing concern about the impact on children from bisphenol exposure has caused BPA to be banned in baby products in Canada and the European Union. BPA is a known endocrine disruptor but it’s role in autoimmunity has not been elucidated yet. What happens to our bodies from BPA exposure is quite similar to the autoimmune process. More research is needed but I am concerned that this could be a potential trigger and the people who already have an autoimmune disease may see a worsening in their pathology with higher exposure to bisphenols.
Some of the products where bisphenols are found include:
- Food packaged in cans or tetra packs
- Beverage cans
- Hard translucent plastic marked #3, 6 or #7
- Cash register receipts
- Plastic food wrap
- Frozen meals in plastic trays
- Heating or microwaving plastic
- Placing plastic in the dishwasher
One relatively easy change is to avoid plastic containers for food or water and opt instead for glass or stainless steel.
Phthalates are another endocrine and immune disruptor that are ubiquitous in our environment. Phthalates help make plastic soft and to dissolve raw materials when making fragrances. In the US, chemicals such as phthalates are considered safe until they are proven dangerous. Unfortunately, most of the research on phthalates has been done on animals. A 2019 study in rats found that a particular phthalate exacerbates the most common autoimmune disease, an autoimmune thyroiditis called Hashimoto’s.
Below is an example of products that may contain phthalates.
- Plastics both PVC and #3
- Children’s toys
- Cosmetics
- Nail polish
- Perfumes
- Almost anything with fragrance
- Detergents
- Solvents
- IV tubing
There is no easy way to tell if a product has added phthalates. There are numerous compounds and are identified on labels often as acronyms (BBP, DBP, DEHP, DEP, etc). Dust may also contain phthalates so consider washing your hands before preparing food and eating, cleaning your floors regularly using a wet mop and using a vacuum with an HEPA filter.
Solvents
A meta-analysis in 2012 reviewed research studies that explored the potential link between exposure to solvents and autoimmune disease. Common routes of exposure to organic solvents include:
- Nail polish
- Nail polish remover
- Perfumes
- Dry cleaning
- Paint thinners
- Spot removers.
Many of the studies the authors reviewed look at occupations that have a higher exposure risk such as nurse anesthetists, painters, people who frequently use hair dye and nail polish, and textile workers. Their findings indicate that organic solvent exposure is a risk factor in developing autoimmune disease. The researchers recommended that people with genetic risk factors avoid organic solvents. I think it might be wise for all of us to avoid organic solvents as much as possible.
I find two free apps helpful when trying to avoid chemicals in the products that we use daily, Think Dirty and ‘Healthy Living’ by The Environmental Working Group. Both apps contain a barcode scanner so you don’t have to memorize the thousands of chemicals that might be a concern for you- you can just scan the barcode and see the product's score.
There are so many more chemicals we could talk about in relation to autoimmune disease but instead I want to finish this article with some ideas to support healthy detoxification.
Our detoxification system is quite complex and the major players are our liver, kidneys and GI tract. Our liver processes not just the chemicals we are exposed to daily but also things we produce naturally such as hormones and bilirubin. Some of what the liver processes goes back into our bloodstream to be filtered through our kidneys and excreted through our urine. Other substances are deposited into bile to be dumped into the intestines. Our liver produces roughly 3.5 cups of bile every day! Here is an important piece- when that bile binds to fiber it leaves our body through our stool. Regular bowel movements are a very important part of our detoxification system. Laxatives are not the answer, a healthy diet rich in fiber is!
Some practical ways to enhance your natural detoxification process include:
- Drink ½ body weight (lbs) in ounces of water daily
- Consume a diet rich in vegetables, especially vegetables in the brassica family such as broccoli, cauliflower, cabbage, and brussels sprouts.
- Get your body moving. Physical activity moves our lymphatic system which helps remove waste. Bonus if you work up a nice sweat!
- Eat 25+ grams of fiber daily. Excellent fiber sources include legumes, avocado, chia, flaxseed, artichoke hearts and oats.
- Have 1 bowel movement per day. If you struggle with constipation consuming adequate fiber and water is a good place to start.
We are all exposed to chemicals on a daily basis. So I recommend taking small steps to both reduce your exposure to chemicals and support your natural detoxification system.
References:
Toxicology of Autoimmune Diseases
Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis
A Potential Link between Environmental Triggers and Autoimmunity
Exposure of the U.S. Population to Bisphenol A and 4-tertiary-Octylphenol: 2003–2004
The Potential Roles of Bisphenol A (BPA) Pathogenesis in Autoimmunity
DINP aggravates autoimmune thyroid disease through activation of the Akt/mTOR pathway and suppression of autophagy in Wistar rats
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