Most of us don’t think about prostate health until a man receives a diagnosis of prostate cancer. This is unfortunate because men can make thoughtful choices about lab testing, food choices and lifestyle to support prostate health and/or to support the prostate—even after a cancer diagnosis.

June is Men’s Health month, and we are taking a deeper dive into prostate health and how it affects a man’s quality of life.

For vital prostate health insights: get the Testosterone and Prostate Health Panel…on sale now for $169 (from $199). It includes important testosterone makers, PSA, estradiol and a Complete Blood Count (for a snapshot of your blood health). Buy now…and you can schedule the blood draw at any time—up to 1 year from date of purchase.

Where is the prostate gland—and what does it do?

Roughly the size and shape of a walnut, the prostate gland is located in front of the rectum and just below the bladder. A healthy prostate gland (i.e., one that is not enlarged) weighs between 20 and 30 grams.  The urethra, a thin tube that delivers urine and semen through the penis, runs through the center of the prostate gland (1, 2).

The prostate is an essential gland in the male sexual and reproductive system. Its main function is to produce most of the fluid in semen, including a liquid protein known as prostate-specific antigen (PSA). Given its proximity to the bladder and urethra, the prostate also helps regulate urine flow and plays an important role in male hormone balance (3). PSA liquefies and protects semen on its way through the uterus to the female egg.

PSA serves as the basis of PSA tests for prostate cancer screening. An elevated PSA level can also be indicative of an enlarged prostate and/or a potential, non-cancerous prostate issue, like benign prostate hyperplasia or prostatitis as discussed below (4).

 Your PSA level is a good marker of current prostate cancer risk. That said…it is possible to have a “normal” PSA (<4.0 ng/mL) and still have cancer, or to have an elevated PSA (>10.0 ng/mL), yet be cancer-free (5).

Conventional PSA ranges and prostate cancer risk are listed below (6, 7):

• <4.0 ng/mL: Considered “Normal”; you have a 15% risk of prostate cancer.
• 4.1 to 10 ng/mL: You have a 25% risk of prostate cancer
• >10 ng/mL: You have 42 to 64% risk of prostate cancer
• >20 ng/mL: 80% of men are typically diagnosed with prostate cancer.

Keep in mind: being in a “normal” PSA range does not ensure prostate health. A PSA in an optimal range is a more accurate indicator of prostate health. From a functional medicine perspective, optimal PSA levels are more narrowly defined; SEE BELOW (8),

Men, aged 40 to 59:

• • Abnormal: >/=2.5 ng/mL
  • OPTIMAL: 0.6 to 0.7 ng/mL

Men, aged 60+:

• • Abnormal: >/=4.0 ng/mL
  • OPTIMAL: 1.0 to 1.5 ng/mL

Testosterone and the prostate

The prostate requires androgens (steroid hormones that trigger the development of male physical traits), especially testosterone, to function optimally. Both women and men have androgens, but men naturally have more; in particular, testosterone.

Not only is it important for prostate health, an optimal level of testosterone is vital for men with regards to their heart health, liver function, mental health and overall male organ system function (9).

 Conventional vs. Optimal Levels for Testosterone

Total Testosterone:

>300 ng/mL = “Normal”  (Conventional lab standards)

700 to 900 ng/mL = “Optimal” (Functional health standards)

Studies have shown that testosterone is important for maintaining functional integrity of the prostate.

In a 2021 study published by Scientific Reports, researchers found a significant association between low testosterone and increased prostate volume (i.e., enlarged prostate)—even after 4 years of follow-up—compared to male study participants who had normal levels of testosterone (10)

Low testosterone in men doesn’t happen in a vacuum. Yes, as men and women age, hormone levels naturally decline. However, poor metabolic health—for example, overweight/obesity; high fasting blood sugar and/or high insulin levels—can accelerate or intensify hormonal imbalance, contributing to significantly lower testosterone levels in men, which can affect prostate health (11). It’s all connected.

An Enlarged Prostate: What does it mean?

The good news is that an enlarged prostate does NOT necessarily mean “cancer”. What it can mean includes the following:

1.  Benign Prostatic Hyperplasia (BPH).

This is a non-cancerous enlargement of the prostate gland.

The risk for BPH increases both with age and as the size of a man’s prostate increases (12). By age 50, apx. 50% of men are diagnosed with BPH; by age 80, 90% of men are diagnosed with BPH (13, 14).

Other risk factors for BPH include: Obesity, history of diabetes, metabolic syndrome, a family history of BPH, and Black race (15).

Food choices and lifestyle factors that can affect the progression of BPH (in other words, contribute to increased prostate size) include (16, 17):

• A diet high in starches and processed / factory farm meats
• Excessive alcohol consumption
• Lack of physical activity
• Systemic inflammation (i.e., metabolic syndrome promotes inflammation in the body)

Men with BPH often experience discomfort with urination. Symptoms may include (18, 19):

• Difficulty starting a urine stream or emptying your bladder
• Difficulty maintaining a steady urine stream
• Weak urine stream
• Dribbling at the end of urination
• Nocturia (Waking up more than 1x / night to pee)
• Frequent urination
• Urinary urgency
• Pain during urination

Left unaddressed, complications may develop over time, including hematuria (blood in the urine), recurrent urinary tract infections (UTIs), kidney disease and bladder stones (20, 21).

2.  Prostatitis.

This is a non-cancerous condition of the prostate. The affix “itis” means “inflammation”; therefore, prostat-“itis” refers to inflammation of the prostate gland, where the tissue in and around the prostate gland is swollen, tender and/or irritated.

Prostatitis affects urinary and sexual health. It can be caused by an acute or chronic bacterial infection OR it can stem from non-infectious causes.

Although men can experience prostatitis at any age…

Prostatitis is the most common urinary tract issue in men under age 50 (22). Prostatitis is the third most common issue for men over age 50 (23).

Common symptoms of prostatitis can include (24, 25):

• Pain or burning when urinating
• Trouble urinating: dribbling, or unable to start/maintain urine stream
• Frequent need to urinate
• Cloudy urine or blood in urine
• Blood in semen
• Pain in the belly, groin or lower back
• Pain in the perineum, the area between the rectum and scrotum
• Pain or discomfort in the testicles or penis
• Painful ejaculation
• Erectile dysfunction
• Fever, chills, sweating and other flu-like symptoms (for acute bacterial prostatitis)
• Infertility (for chronic prostatitis, a.k.a., chronic pelvic pain syndrome)

Bacterial prostatitis can occur when bacteria gets into your blood.  Pathogenic bacteria, such as E coli, Klebsiella, Pseudomonas and Serratia, as well as Staphylococcus and Chlamydia, often cause acute or chronic bacterial prostatitis (26).

Risk factors for bacterial prostatitis include (27, 28):

• Age (under 50): Most common from young adulthood to midlife
• Urinary tract infection (UTI)
• Bladder stones or bladder infection
• Sexually transmitted infection (STI)
• HIV infection or AIDS
• Having had surgery or a biopsy that requires a catheter
• Use of a catheter, a tube inserted into the urethra to drain the bladder

Chronic Prostatitis, a.k.a., Chronic Pelvic Pain Syndrome (CP/CPPS), is a form of non-bacterial prostatitis that affects apx. 10 to 15 percent of men (29). In other words, this type of prostatitis is NOT caused by pathogenic bacteria.

Unfortunately, this condition is largely unresponsive to conventional medical treatment (e.g., antibiotics). Characterized by pain in the perineum (the area between the rectum and the scrotum), pelvic area, and/or genitalia, CP/CPPS is associated with a significantly reduced quality of life (30). Men with CP/CPPS are more likely to report higher levels of (chronic) pain, as well as greater rates of psychological distress, including depression, anxiety and catastrophizing (31).

Research suggests that the following factors may trigger or worsen chronic prostatitis: 1) having an autoimmune disease (e.g., rheumatoid arthritis, psoriasis, lupus, Hashimoto’s, Ménière’s,, etc.); 2) pelvic nerve irritation; 3) pelvic inflammation; 4) pelvic floor damage; 5) psychological stress; and/or 6) hormonal imbalance (32, 33).

Because of its complex nature, CP/CPPS can be difficult to treat and may require a more holistic and nuanced physical and cognitive behavioral approach to treatment.

Risk factors for chronic prostatitis or chronic pelvic pain syndrome include (34):

• Nerve damage or trauma to the pelvic area
• Previous urinary tract infection (UTI)
• Past injury or infection to which the body is reacting

3.  Prostate Cancer

Prostate cancer is the second most common cancer in men, behind lung cancer.

The good news? When detected early, the 5-year survival rate of men with prostate cancer is 99% (35)!

 Initially, prostate cancer may present without any symptoms. Therefore, early detection is key. The first step begins with a PSA (prostate specific antigen) blood test. Your PSA results may be paired with other blood or urine medical tests and/or MRI imaging for more detail.

Keep in mind: a biopsy is considered the “gold standard” for confirming a prostate cancer diagnosis. A biopsy involves extracting samples of prostate tissue (analyzed in a lab) to detect the presence—or absence—of cancer cells.

The American Cancer Society recommends that men at the “highest risk” begin prostate health screening at age 40; men at ”high risk” should begin screening at age 45; and, men at “average risk” should screen beginning at age 50 (36).

Men deemed to be at “high risk” include: 1) Black men; 2) Men with one 1st-degree relative diagnosed with prostate cancer at an early age; 3) Men who have had MORE than one 1st-degree relative diagnosed with prostate cancer at an early age; 4) Men with a strong family medical history of cancer with genetic risks, including prostate, breast, ovarian, colorectal and pancreatic (37, 38, 39).

What You Can Do

1. Be proactive about prostate cancer screening. Starting from age 40 (to establish a baseline), check your PSA and testosterone levels. You can do this HERE.

2. Maintain a healthy weight. Overweight and obesity are associated with low testosterone levels and increased risk of prostate cancer (40).

3. Eat unprocessed, anti-inflammatory, nutrient-dense whole foods in a way that is sustainable for YOU.

4. Eat enough unprocessed high-quality protein, including fish, to build muscle.

5. Practice intermittent fasting. For example, eat your last meal early, allowing 12 hours (or more) to pass—including sleep time—before your next meal. This is ideal, specifically, for prostate cancer (41).

6. Move your body—every day. More time spent sitting is associated with increased cancer incidence, including prostate cancer, as well as cancer death (42, 43, 43).

7. Lift weights.

8. Manage stress.

9. Get enough quality sleep. Sleep disorders (e.g., too little, poor quality and insomnia) are associated with increased risk of prostate cancer (45).

10. Get support in making food choices and lifestyle practices that support prostate heath. Schedule a 1:1 30-minute consultation with Kathryn HERE.

Sources

1, 3, 5, 6, 38 Espinosa, Geo. Thrive: Don’t Only Survive! Dr. Geo’s Guide to Living Your Best Life Before & After Prostate Cancer. New York. Riverdale Publisher. 2016.

2  Male Reproductive System. Cleveland Clinic. 5/8/23.

4, 14, 15, 18, 20  Skinder, Danielle PA-C; Zacharia, Ilana PA-C; Studin, Jillian PA-C; Covino, Jean DHSc, MPA, PA-C. Benign prostatic hyperplasia: A clinical review. Journal of the American Academy of Physician Assistants, 29(8): p 19-23, August 2016.

7  “Elevated PSA (Prostate-Specific Antigen) Level.” Cleveland Clinic. 4/21/24.

8  Christie, Jessica. “The Integrative Practitioner’s Guide to Prostate Health: Integrative Approaches to Prevention and Healing.” Rupa Health. Jan. 14, 2025.

9, 10, 11  Xia, BW., Zhao, SC., Chen, ZP. et al. Relationship between serum total testosterone and prostate volume in aging men. Sci Rep, 11, 14122 (2021).

12, 13  Sausville, J. and Naslund, M. (2010), Benign prostatic hyperplasia and prostate cancer: an overview for primary care physicians. International Journal of Clinical Practice, 64: 1740-1745.

17 Parsons, J.K. Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors. Curr Bladder Dysfunct Rep 5, 212–218 (2010).

19  “What is Nocturia?” Urology Care Foundation. American Urological Association. August 2023.

21  “Prostate Problems: Enlarged Prostate (Benign Prostatic Hyperplasia)” NIH: National Institute of Diabetes and Digestive and Kidney Diseases. June 2024.

22  “10 Prostatitis Symptoms You Should Know.” Oregon Urology Institute.

23, 25, 32 “Prostatitis.” Cleveland Clinic.  11/14/23.

24, 27, 33 “Prostatitis.”  Mayo Clinic. Feb. 22, 2025.

26 Davis NG, Silberman M. Acute Bacterial Prostatitis. [Updated 2023 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.

28, 34 Benisek, Alexandra. “Prostatitis vs. Prostate Cancer.” WebMD. June 7, 2024.

29  “Prostatitis: Inflammation of the Prostate.” NIH: National Institute of Diabetes and Digestive and Kidney Diseases. July 2014.

30, 31  Krsmanovic A, Tripp DA, Nickel JC, Shoskes DA, Pontari M, Litwin MS, McNaughton-Collins MF. Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Can Urol Assoc J. 2014 Nov;8(11-12):403-8.

35, 37  McCormick, Brooke. “Men’s Health Month 2025: Spotlight on Prostate Cancer, Lifelong Health”. AJMC. June 3, 2025.

36 “American Cancer Society Recommendations for Prostate Cancer Early Detection.” American Cancer Society. Nov. 22, 2023.

39  Worthington, Janet Farrar. “Understanding Family Cancer History.” Prostate Cancer Foundation. Nov. 15, 2021.

40 Freedland SJ, Aronson WJ. Examining the relationship between obesity and prostate cancer. Rev Urol. 2004 Spring;6(2):73-81.

41  Espinosa, Geo, Host. “The Impact of Meat, Dairy, and Eggs on Prostate Cancer.” Dr. Geo Prostate Podcast [EP 52]. 13, June 2023.

42 Mctiernan, Annne; Friedenreich, Christine M.; Katzmarzyk, Peter T.; Powell, Kenneth E.; Macko, Richard; Buchner, David; Pescatello, Linda S.; Bloodgood, Bonny; Tennant, Bethany; Vaux-Bjerke, Alison; George, Stephanie M.; Troiano, Richard P.; Piercy, Katrina L. Physical Activity in Cancer Prevention and Survival: A Systematic Review. Medicine & Science in Sports & Exercise 51(6):p 1252-1261, June 2019.

43 Hermelink, R., Leitzmann, M.F., Markozannes, G. et al. Sedentary behavior and cancer–an umbrella review and meta-analysis. Eur J Epidemiol 37, 447–460 (2022).

44  Worthington, Janet Farrar. “Monkey Wrench in the Works: How Exercise Helps Sabotage Prostate Cancer.” Prostate Cancer Foundation. Feb. 10, 2023.

45  Chung, WS., Lin, CL. Sleep disorders associated with risk of prostate cancer: a population-based cohort study. BMC Cancer 19, 146 (2019).

Are you feeling sluggish, low energy, bloated, constipated, or exhausted—moreso than usual?

If yes…your body is likely signaling that it would welcome a whole foods-based spring cleanse. My DIY whole foods-based spring cleanse includes a program guide that walks you through the process, recipes, shopping list and suggested meals. Use coupon code MayDay10 for $10 off through May 31st.

Spring is an ideal time to do a cleanse and help the body rid itself of “heaviness” accumulated over the winter. This “heaviness” can manifest physically as extra weight; emotionally as depression, overwhelm, anger or irritability; or mentally as brain fog or a sense of stagnation or inertia.

In this post, we will be talking specifically about the benefits of a whole foods-based cleanse (versus a detox). While the terms “cleanse” and “detox” are often used interchangeably—I’m guilty of this myself!—there are subtle differences that distinguish a cleanse from a detox.

Cleanse vs. Detox

Where they are similar…

Both a cleanse and detox are short-term (ranging from a few days, up to 1 to 3 weeks) dietary and lifestyle interventions to help eliminate toxins from the body. 

Both a cleanse and a detox focus on hydrating well; eating less overall (volume-wise); eating foods that are lighter, clean (e.g., unprocessed) and nutrient-dense; and engaging in lifestyle practices that promote rest and relaxation.

After doing either a cleanse or detox, people often report having more energy, clearer skin, improved sleep, less cravings, less bloating, modest weight loss, and/or balanced mood. 

Where they differ…

A cleanse is a way to support and enhance the body’s detoxification organs and natural pathways and systems. 

This involves abstaining from certain foods; prioritizing sleep, rest, and relaxation; engaging in gentle exercise; and, optionally, using herbal supplements if and when necessary to help your body remove toxins more efficiently. A typical cleanse will eliminate primary “trigger foods” that contribute to allergies, food sensitivities, and digestive distress, including gluten, dairy, eggs, soy, corn, sugar, refined carbohydrates, caffeine (coffee, tea, soda), processed foods and alcohol.

If you follow a simple, whole foods-based cleanse—one that omits common trigger foods—you will be eating less food overall (in terms of volume), but more nutrient-dense foods. You are also less likely to experience intense hunger and/or symptoms of low blood sugar that can accompany a detox (see below), especially if you are doing a detox for the first time; if you are a fasting neophyte; or, if you have blood sugar issues, like hypoglycemia.

The goal of a detox is to facilitate the release of toxins from fat cells and to enhance the body’s detoxification pathways, particularly the liver, the main organ of detoxification, located just beneath your right rib cage. 

Think of a detox as a next-level cleanse. It is deeper and more intense. A detox is typically more restrictive than a cleanse. A detox can involve one or more of the following elements: some form of fasting (e.g., extended intermittent fasting, water fast); a liquids-only intake (e.g., juicing, Master Cleanse, vegetable or bone broth); therapeutic sweating; detox-supportive supplements and/or teas; colonic irrigation and/or enemas.

Word of caution: If you are pregnant or breast-feeding, you should NOT do a detox (as described above). 

Most environmental toxins are fat-soluble, which means that toxins are stored in our fat cells. During a detox, toxins are knocked loose from their fat storage cells and released into the bloodstream, where they are carried to the liver, then filtered out of the body. Since blood passes through the placenta and provides nutrients to your breast milk (essentially, all fat), a flood of toxins released during a detox could potentially be transferred from mother to baby through the placenta or through breast milk.

Is a cleanse or detox really necessary?

Conventional medicine often poo-poos the notion of cleansing or detoxing, the argument being that our bodies are well-equipped to eliminate toxins on their own.

It is true that our bodies are ingeniously designed to handle day-to-day detoxification.

However…we are no longer eating, hydrating, moving, sleeping or communing the same way that our ancestors did—as evidenced by the current obesity epidemic with 73.6% of America adults (aged 20 and over) now overweight, of whom 42% are obese (1).

Unlike our ancestors, we also live in a world (over)saturated with chemicals.

For example, within a mere 25-year period—between 1970 and 1995—the volume of synthetic chemicals that were produced in the U.S. tripled from about 50 million tons to approximately 150 million tons (2)! Of course, it is much more today.

As of 2018, there were over 86,000 chemicals available for commercial production and use in the U.S.—with an estimated 40,655 chemicals in commerce (3).

In our daily life, these chemicals pummel us from all sides.

• Inhale. The air we breathe. This includes—but is not limited to—the following, carbon monoxide (e.g., automobile emissions); ozone (e.g., VOCs from industrial emissions gasoline vapors, etc.); particulate matter (e.g., the 2023 Canadian and 2025 L.A. wildfires); and geoengineering, a.k.a. toxic chemical aerosol trails in the sky (4, 5).

• Absorb. The products we knowingly—or unknowingly—put ON our bodies. This includes make-up, anti-perspirant, soap, shampoo, moisturizers and other personal care products, tattoos, perfume/cologne, among others (6). If we play or walk barefoot on public grass, we may inadvertently absorb herbicides, like Round-up (deemed a probable carcinogen by the International Agency for Research on Cancer), which is sprayed in many public parks, trails and playgrounds, as well as golf courses (7).

• Ingest.  What we eat and drink significantly affects how efficiently—or not—our bodies are able to eliminate toxins. What we consume—including pesticide-sprayed produce, factory farmed meats, farm-raised fish, processed foods, fast foods, restaurant/convenience-based foods, commercial snack foods (e.g., chips, cookies, crackers), highly refined seed oils, high sugar foods, alcohol, cigarette smoke, vaping, and all medications—contribute to the body’s cumulative toxic burden.

Unfortunately, modern Americans are inflamed… Remember: Toxins are stored in our body fat. These toxins create inflammation in the body that can negatively affect metabolic health, contributing to insulin resistance, diabetes and/or overweight/obesity (8). Accumulated toxins in the body can also stoke other chronic inflammatory states, including rheumatoid arthritis, heart disease, infertility, Alzheimer’s and cancer (9).

I would argue that…

…intentional cleansing on a regular basis is essential for optimal health. 

For me, personally, mindful detoxification through my food choices and lifestyle practices is a way of life—it is not a fad, a quick fix way to lose weight, or a temporary intervention.

That said…even a short-term cleanse can help reduce the body burden from our daily overexposure to environmental toxins, including pesticides, GMOs (genetic modified organisms), xenoestrogens, plastics, medications, pharmaceutical injections, heavy metals (via our food, water, air, pharmaceutical drugs, cigarettes and vaping) as well as a myriad of synthetic chemicals in our personal care and household products (10, 11).

Keep in mind: many chemicals are considered endocrine-disrupting chemicals (EDCs), meaning that they interfere with our natural hormone balance and function. Exposure to EDCs can contribute to health problems, including fertility issues, overweight/obesity, Type 2 diabetes, cancer and autoimmune disease (12, 13).

Xenoestrogens, in particular, are problematic. Xenoestrogens (e.g, bisphenol A, synthetic fragrance) are man-made chemicals that act like estrogen in the body. Chronic xenoestrogen exposure can create a state of estrogen dominance in both women and men. Xenoestrogens are linked to reproductive dysfunction, which can affect fertility, pregnancy, and fetal development in women and can result in low sperm count or poor sperm quality in men. Being in a chronically estrogen dominant state is also associated with an increased risk of hormone-dependent cancers, like breast cancer, as well as ovarian and uterine cancers. Here is a list of common everyday sources of xenoestrogens.

Signs that indicate it’s time for a cleanse…

How does toxicity manifest in the body?

Signs that your body may be overwhelmed by toxins and will likely benefit from a cleanse:

• • Fatigue / Exhaustion.
  • Tired, but wired.
  • Weight gain and/or redistribution of weight caused by chronic xenoestrogen exposure. In women, this can manifest as carrying more weight around the hips, buttocks and thighs; and, in men, think “man breasts” and more fat deposition around a man’s hips.
  • Depression.
  • Anxiety.
  • Brain fog.
  • Mood imbalances, including irritability and quick to anger.
  • Headaches.
  • Food sensitivities or intolerances.
  • Seasonal allergies.
  • High blood pressure.
  • Muscle aches.
  • Joint pain.
  • Frequent colds.
  • Sleep issues: Problems falling or staying asleep; poor sleep.
  • Digestive distress: constipation, bloating and gas (flatulence).
  • Persistent skin conditions: acne, itchy skin, rashes, rosacea.
  • Hormonal imbalances and fertility issues.
  • Intolerance to fragrance.
  • Multiple chemical sensitivities.

Understanding your organs of detoxification

One of the main purposes of a cleanse is to support our organs of detoxification. These include the following…and I’ve included tips on how to best support each:

–Liver (Cleansing site for all toxins and converts harmful substances to excretable forms). One of the hardest-working organs in your body, the liver helps support metabolism, immunity, digestion, and vitamin storage, especially Vitamin A and iron (14). The liver is a primary organ of detoxification. In addition to cleansing your blood, the liver is responsible for filtering out toxins, like alcohol, medications, and other harmful substances, from your body. Acting like a “transformer”, your liver converts harmful fat-loving substances to a water-soluble form for eventual excretion (15).

How to support: Remove inflammatory foods, such as processed foods, refined carbohydrates, processed oils, high sugar foods. Abstain from alcohol. Include cruciferous vegetables (e.g., broccoli, cabbage, arugula, bok choy), which support the liver’s ability to clear chemicals from the body. Eat dandelion greens or drink dandelion root tea to help detoxify the liver. Consider supplementing with milk thistle, which aids the liver in eliminating toxins, and/or turmeric, which supports healthy liver tissue.

–Kidneys (Urine). The kidneys are an extension of detoxification that takes place in the liver. Like a sieve, the kidneys filter your blood, keeping it free of waste products and excess fluid. Your kidneys are responsible for processing and separating out byproducts your body makes naturally (e.g., acid, urea, metabolic waste); heavy metals (e.g., mercury, lead) that you may ingest; and any medications you take into what eventually becomes urine (16).

How to support: Hydrate well with clean, filtered water. No water filter? Try drinking water from glass bottles (versus plastic).

–Skin (Sweat).  Your skin helps detoxify your body through sweat.  Working up a good sweat has been an age-old practice of cleansing or “purifying” the body in many native cultures around the world. Studies suggest that sweating—by way of heat or exercise—can help eliminate heavy metals, such as arsenic, cadmium, lead and mercury (17, 18). Sweating can also help release hormone-disrupting chemicals from the body, like Bisphenol-A, also known as BPA (an industrial chemical and xenoestrogen used to manufacture polycarbonate plastics for a wide variety of consumer products) and some PCBs, or polychlorinated biphenyls, man-made organic chemicals that have been linked to adverse health effects, including cancer (19, 20, 21).

How to support: Sauna. Steam. Vigorous exercise.

–Colon (Poop). The large intestine comprises most of your colon. Its detoxification role involves reabsorbing water from waste material; storing solid waste; then, moving waste material toward the rectum, where it is eliminated via stool (22). Regular elimination of solid waste (poop) ensures that toxins are not recirculated in the bloodstream.

How to support: Increase fiber intake; in particular, dark leafy greens. If you have digestive issues, try eating cooked leafy greens (versus raw greens, like salads). Or, try blended greens—raw or cooked—in a smoothie or warm “soup”. Other high fiber, antioxidant-rich foods include low-sugar fruits (berries), seeds (hemp, flax, chia) and nuts (not recommended if you have digestive issues). If you include animal protein, eat a smaller portion (3-4 oz.), stick with mostly fish and lean cuts of poultry, and choose high-quality—meaning organic, grass-fed and grass-finished meats, or wild-caught, low mercury fish.

–Lungs (Breath). The primary organ of the respiratory system, your lungs transport oxygen throughout your body. The lungs play an important role in detoxification by filtering out carbon dioxide, allergens and airborne toxins.

How to support: Engage in mindful deep breathing: Inhale 4 counts; hold 4 counts; exhale 4 counts. Avoid mucous-producing dairy foods. Avoid foods to which you are intolerant as this stimulates mucous production.

–Lymph (Internal watery fluid). A watery fluid that flows throughout the body, lymph delivers proteins and nutrients to your blood. Lymph plays a role in detoxification by helping dispose of cellular debris, such as viruses, bacteria and cancer cells. Your liver and digestive system produce 80% of your lymph (23).

How to support: Move your body every day. (p.s. A sedentary lifestyle promotes swelling, a common symptom of lymphedema, where lymph fluid is blocked and begins building up in nearby soft tissue.). Dry skin brush: use a natural stiff bristle brush to brush your skin in a circular motion from your feet to your heart, then from your neck to your heart. Get a massage or do a self-massage.

FOR MORE SPRING CLEANSE TIPS…Don’t miss my interview with Ashala Yardley! CLICK HERE FOR VIDEO.

Sources

1  CDC/National Center for Health Statistics. Obesity and Overweight. Jan. 5, 2023.

2   Roundtable on Environmental Health Sciences, Research, and Medicine; Board on Population Health and Public Health Practice; Institute of Medicine. Identifying and Reducing Environmental Health Risks of Chemicals in Our Society: Workshop Summary. Washington (DC): National Academies Press (US); 2014 Oct 2. 2, The Challenge: Chemicals in Today’s Society.

3  Environmental Protection Agency (EPA). EPA Releases First Major Update to Chemicals List in 40 Years. Feb. 19, 2019.

4  Nathanson, Jerry A. “Air Pollution.” Brittanica. May 17, 2025.

5  Herndon, J.. (2015). Aluminum poisoning of humanity and Earth’s biota by clandestine geoengineering activity: Implications for India. Current Science. 108. 2173-2177.

6  Negi S, Bala L, Shukla S, Chopra D. Tattoo inks are toxicological risks to human health: A systematic review of their ingredients, fate inside skin, toxicity due to polycyclic aromatic hydrocarbons, primary aromatic amines, metals, and overview of regulatory frameworks. Toxicol Ind Health. 2022 Jul;38(7):417-434.

7  International Agency for Research on Cancer (WHO). “IARC Monograph on Glyphosate.”  IARC WHO Int.

8  Jackson E, Shoemaker R, Larian N, Cassis L. Adipose Tissue as a Site of Toxin Accumulation. Compr Physiol. 2017 Sep 12;7(4):1085-1135. doi: 10.1002/cphy.c160038. Erratum in: Compr Physiol. 2018 Jun 18;8(3):1251.

9  Parke DV, Parke AL. Chemical-induced inflammation and inflammatory diseases. Int J Occup Med Environ Health. 1996;9(3):211-7.

10  Nessa F, Khan SA, Abu Shawish KY. Lead, Cadmium and Nickel Contents of Some Medicinal Agents. Indian J Pharm Sci. 2016 Jan-Feb;78(1):111-9

11  Broadfoot, M. E-cigarettes expose users to toxic metal such as arsenic, lead. National Institute of Environmental Health Sciences. Feb. 2022.

12  Paterni I, Granchi C, Minutolo F. Risks and benefits related to alimentary exposure to xenoestrogens. Crit Rev Food Sci Nutr. 2017 Nov 2;57(16):3384-3404.

13  Comhaire, Frank H. and Decleer, Wim A.E.  Chapter 8 – The Effects of Environmental Hormone Disrupters on Fertility, and a Strategy to Reverse their Impact, Editor(s): Ronald Ross Watson, Handbook of Fertility, Academic Press, 2015, Pages 89-97.

14  Kalra A, Yetiskul E, Wehrle CJ, et al. Physiology, Liver. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.

15  Grant DM. Detoxification pathways in the liver. J Inherit Metab Dis. 1991;14(4):421-30.

16  National Kidney Foundation. How Your Kidneys Work.

17  Sears ME, Kerr KJ, Bray RI. Arsenic, cadmium, lead, and mercury in sweat: a systematic review. J Environ Public Health. 2012; 2012:184745.

18   Sheng J, Qiu W, Xu B, Xu H, Tang C. Monitoring of heavy metal levels in the major rivers and in residents’ blood in Zhenjiang City, China, and assessment of heavy metal elimination via urine and sweat in humans. Environ Sci Pollut Res Int. 2016 Jun;23(11):11034-11045

19  Yaghoobi, Bianca. “The Original ‘Forever Chemicals’.” UC Davis Biotechnology Program. 3 March, 2021.

20  Genuis SJ, Beesoon S, Birkholz D, Lobo RA. Human excretion of bisphenol A: blood, urine, and sweat (BUS) study. J Environ Public Health. 2012; 2012:185731.

21  Genuis, S. J., Beesoon, S., Birkholz, D. “Biomonitoring and Elimination of Perfluorinated Compounds and Polycholorinated Biphenyls through Perspiration, Blood, Urine, and Sweat Study”, International Scholarly Research Notices, vol. 2013, Article ID 483832, 7 pages, 2013.

22  Kahai P, Mandiga P, Wehrle CJ, et al. “Anatomy, Abdomen and Pelvis: Large Intestine.” [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

23  Cleveland Clinic, Lymph. 8/22/23.

According to a recent (May 2024) study published in the Annals of Internal Medicine…

Low testosterone in men was associated with an increased risk for all-cause mortality (death) while very low testosterone levels were associated with increased risk of cardiovascular death (1, 2).

In a systemic review and meta-analysis, researchers included 11 studies with more than 24,000 participants to analyze the associations of sex hormones with mortality and heart disease risk in aging men. According to the study authors, their data supported the hypothesis—and provided much-needed clarity—that hypogonadism (a condition where the male body is unable to produce normal amounts of testosterone, resulting in low testosterone) is associated with higher cardiovascular and all-cause mortality (3).

This is yet another reason why men—no matter their age—should know their testosterone level—even if it is to establish a baseline for future reference. Simply order your own testosterone and prostate panel—no doctor’s visit required—on sale until July 31st for $149.

In my article Testosterone and Men’s Health, I highlighted the vital role that testosterone plays in men’s health. I also discussed the physicatl and mental health consequences for men with low testosterone; why low testosterone is so prevalent—even among young men; and how to boost testosterone naturally.

Cause or Consequence?

When it comes to testosterone and men’s heart health…

Does having low testosterone cause increased risk of adverse cardiovascular events in men? Or is low testosterone a consequence of having coronary artery disease (CAD)?

Studies have suggested evidence for both.

However, the relationship between low testosterone and an increased risk of developing—or dying from—heart disease is neither simple nor direct. It is a complex and multi-factorial relationship.

One of the main causes of low testosterone levels is male hypogonadism, where the body is unable to produce normal amounts of testosterone, resulting in low testosterone,because of abnormal signaling hormones being released from the brain. For young, healthy men in their 20s, this signaling hormone rapidly messages the testes to make more sperm and testosterone. However, as men age and/or they experience chronic stress, their signaling hormones can lose speed, reducing the amount of testosterone being produced. Low testosterone symptoms can present as low libido (sex drive), changes in sleep patterns, difficulty concentrating, reduced muscle strength/muscle mass, decreased bone density, depression and fatigue.

Hypogonadism, characterized by low testosterone, is categorized as one of two types (4):

Primary. This type of hypogonadism is generally associated with a problem in the testicles, whether a congenital or genetic defect, testicular injury or trauma, autoimmune disorder or an infection affecting the testes (5).

Secondary. This type of hypogonadism is where low testosterone levels can be attributed to a problem in the hypothalamus or the pituitary gland, parts of the brain that signal the testicles to produce testosterone. This is a signaling issue, like a faltering Internet connection.

Secondary hypogonadism can be caused by pituitary disorders or by lifestyle factors, such as taking certain medications (e.g., opioids, anti-psychotics, antidepressants, etc.) that suppress testosterone production and/or having a chronic disease, like Type 2 diabetes, hypertension and/or obesity. (6)

Why Metabolic Health Matters

A common theme that underlines the association between low testosterone and increased cardiovascular risk in men is poor metabolic health.

“Metabolic health” is a term that describes how well we generate and process energy in the body (7). When we are metabolically healthy, the following 5 metabolic markers are at optimal levels—without the use of medications:

1. 1. 1. Blood sugar
      2. Triglycerides
      3. HDL “good” cholesterol
      4. Blood pressure
      5. Waist circumference

Metabolic health is also defined as the absence of “metabolic syndrome” (described below).

Each one of the conditions listed below individually increases your cardiovascular risk. However, “metabolic syndrome” consists of a group of conditions that, together, significantly increase your risk of heart disease, Type 2 diabetes and stroke.

If you have 3 or more of the following conditions, you are considered to have metabolic syndrome (8):

1. 1. 1. High blood sugar. Your fasting blood sugar is 100 mg/dL or higher.

1. 1. 2. Hypertriglyceridemia (high triglycerides). Your triglycerides are 150 mg/dL or greater.

1. 1. 3. Low HDL “good” cholesterol: For men, “low” HDL is less than 40 mg/dL; for women, “low” HDL is less than 50 mg/dL.

1. 1. 4. High blood pressure: Your systolic (top number) is 130 mmHg or higher and your diastolic (bottom number) is 85 mmHg or higher.

1. 1. 5. Large waist circumference. Greater than 40 inches (for men). Greater than 35 inches (for women).

In a 2018 study, published in Metabolic Syndrome and Related Disorders, researchers from the University of North Carolina at Chapel Hill analyzed data from 8,721 adults—consisting of men and women aged 20 and older—from the 2009 to 2016 National Health and Nutrition Examination Survey (NHANES).

What they found:  only 1 in 8 adults in the US—(just 12%!)—have optimal metabolic health (9).  Post-COVID, that percentage is likely even less.

 *Keep in mind: you can still be metabolically unhealthy even if you are at a “normal” weight.

 That said, poor metabolic health often goes hand-in-hand with being overweight or obese, which also increases risk of heart disease. According to the latest NIH statistics, among men aged 20 or older, 34% are overweight and 43% are obese (10).

And…being overweight or obese can lower testosterone levels in men.

How? There are two ways…

First, a large waist circumference (greater than 40 inches for men) indicates excess abdominal fat. An enzyme called “5-aromatase” is present in belly fat; and this enzyme is responsible for converting testosterone into estrogen (the female sex hormone). More belly fat = increased aromatase activity, which leads to an undesirable hormonal imbalance for men: less testosterone and more estrogen. This is why obese men typically have higher levels of estrogen than men who are of normal weight.

.

What you can do

The best defense is a good offense. If you discover that your testosterone is less than optimal…that good news is that lifestyle modifications can help you raise testosterone levels naturally.

1.  Start by getting tested. Click here to order your own testosterone and prostate panel—no doctor’s visit required—on sale until July 31st for $149.

2.  Maintain a healthy weight or lose weight.

3.  Commit to lifestyle modifications that support metabolic health, including:

1. 1. 1. Food choices. Reduce consumption of ultra-processed foods; choose whole foods; reduce intake of refined carbohydrates, seed oils and sugar.
      2. Movement. Sit less. Lift weights. Interval train.
      3. Stress. Reduce!
      4. Sleep. Prioritize!
      5. Supplement. As appropriate.
      6. Endocrine-disrupting toxins.

4.  Get support. Feeling overwhelmed or confused about how to start making better food choices? Click here to schedule a FREE 15-minute Discovery phone consultation with me to see how I can best support you.

Sources

1, 3  “Low testosterone levels in men associated with mortality risk.” I.M. Matters from American College of Physicians (ACP). Endocrinology. May 14, 2024.

2   Yeap, B. B. et al. “Associations of Testosterone and Related Hormones with All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men: Individual Participant Data Meta-analyses”. Annals of Internal Medicine. Vol. 177, No. 6, pp. 768-781. June 2024.

4, 5, 6  Kumar P, Kumar N, Thakur DS, Patidar A. Male hypogonadism: Symptoms and treatment. J Adv Pharm Technol Res. 2010 Jul;1(3):297-301.

7  Means, C. (2020, June 18). “The Ultimate Guide to Metabolic Health”. Levels | Metabolic Insights.

8  “Metabolic Syndrome”. Cleveland Clinic. 9/13/23.

9  Araújo, J., Cai, J. and Stevens, J. “Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016.” Metabolic Syndrome and Related Disorders. Vol. 17, Issue 1, pp. 46-52. Feb. 2019.

10  NIH, National Institute of Diabetes and Digestive and Kidney Diseases. Overweight & Obesity Statistics.

11  Arnarson, A. “Can Boosting Your Testosterone Help You Lose Fat?” Healthline. June 13, 2023.

12  George JT, Millar RP, Anderson RA. Hypothesis: kisspeptin mediates male hypogonadism in obesity and type 2 diabetes. Neuroendocrinology. 2010; 91 (4):302-7.

13   Lee HK, Lee JK, Cho B. The role of androgen in the adipose tissue of males. World J Mens Health. 2013 Aug;31(2):136-40.

For men, it is having a healthy (optimal) level of testosterone.

Unfortunately—as I have experienced both as a practitioner and personally—men rarely prioritize self-care. Men tend to ignore, dismiss or “power through” symptoms of potential health problems that are completely reversible if caught in time.

An important way that men can stay on top of their health is to know what their testosterone level is. It’s as easy as ordering a testosterone panel yourself—no doctor’s visit required—on sale now for just $149!  More info below.

Why testosterone matters

Testosterone is the major sex hormone for men. Testosterone is what makes men “men” and is essential for male growth and masculine characteristics.

Testosterone contributes to important bodily functions including (1):

• • Development of the penis and testes
  • Deepening of the voice during puberty
  • Appearance of facial and pubic hair
  • Muscle mass
  • Body fat distribution
  • Strength
  • Bone mineral density (2)
  • Regulation of red blood cell production (3)
  • Balanced mood
  • Healthy sex drive
  • Normal erections
  • Sperm production
  • Urinary health (4, 5)

Over the last 40-plus years, low testosterone—also referred to as “low T” and “testosterone deficiency”—has become widespread among men of ALL ages in the U.S..

While declining levels of testosterone are typically associated with aging males, starting from around age 40…results from the 2020 American Urological Association Virtual Experience (and later published in the European Urology Focus) revealed that:

Testosterone deficiency has a prevalence of 20% among adolescent and young adult males, aged 15 to 39 (6, 7).

This would explain why, 10 years ago, I found myself working with several male clients, between their late 20s and early 30s, who had low testosterone levels and struggled with their metabolic health.

As it turns out…testosterone levels have been declining over the last 40 years. In fact, several studies, but one retrospective study, in particular, that was published in the British Medical Journal in 1992, suggested that sperm quality had declined over the last 50 years, from around the early 1940s (8, 9).

The Massachusetts Male Aging Study, a landmark study, highlighted a significant decline in testosterone levels among men over a nearly two-decade period and across different generations.  Study participants consisted of a random sample of men, between ages 45 to 79 (born between 1916 and 1945), who lived in the greater Boston area. The data was collected in three waves. In each wave, researchers took blood samples and conducted extensive interviews. The men were first interviewed between 1987 to 1989, establishing a data baseline. Two follow-up interviews took place between 1995 to 1997 and between 2002 to 2004 (10).

What the researchers found (11, 12):

–There was a substantial decline in testosterone among U.S. men from when the baseline data was first drawn (1987 to 1989) to the final data collection (2002 to 2004).

–The decrease in testosterone concentrations was independent of age. In other words, declining testosterone was not just an “old man” phenomenon. There were notable declines in testosterone levels across all age groups sampled.

Why has low testosterone become so prevalent—even among young men?

Several potential causes for this low T trend include (13):

—Poor metabolic health as evidenced by the dramatic rise in overweight and obesity: approximately 43% of American men, aged 20 and older, are obese; 34% of American men are overweight (14).

—An increasingly sedentary lifestyle with little to no physical activity.

–Engaging in habitual (heavy, chronic) marijuana use (15). A Danish study of 1,215 men, between the ages of 18 and 28, reported that sperm concentration, total sperm count, percentage of mobile sperm and percentage of morphologically normal forms were all lower among men smoking marijuana more than once per week.

—Heavy alcohol consumption (16). Since the early 1980s, alcohol has been known to lower testosterone in men. In a study published in Pharmacological Biochemical Behavior, healthy men were given the equivalent of a pint of whiskey to drink every day for 30 days. Their testosterone levels were then compared to those of men with chronic alcoholism. (By the way, virtually all the alcoholic men had “low-normal” to “low” levels of testosterone). The testosterone levels of the healthy men began dropping after just 72 hours (3 days). By Day 30, the healthy men had testosterone levels similar to those of the alcoholic men (17).

–A dramatic rise in the use or abuse of opioids, including fentanyl, heroin and morphine(18).

—Use or abuse of anabolic steroids, synthetic derivates of testosterone (19).

—Eating a Western-style diet, also known as the “Standard American Diet” (SAD for short), which consists primarily of ultra-processed foods, including refined carbohydrates, fried foods, inflammatory seed oils, high-sugar foods and a low overall nutrient intake (20).

–Having greater exposure to environmental toxins, many of which are endocrine-disrupting chemicals (EDCs). They include xenoestrogens, synthetic compounds that have estrogen-like effects in the body (21, 22). Xenoestrogens are in plastics, pesticides, tap water, personal care products, household products, in our conventionally grown food supply as well as in ultra-processed foods, including food packaging (23).

Men: be mindful of overconsuming soy, especially conventionally grown, highly processed soy “foods”. Keep in mind that, as of 2020, 94% of soybean crops were genetically modified (24). Considered a “natural” plant-derived xenoestrogen, soy is a phytoestrogen that can exert estrogenic effects (25).

Estrogen, especially estradiol (the most potent form of estrogen), is the primary sex hormone that defines a woman. Estrogen gives women their hips and breasts and is responsible for the first half of a woman’s menstrual cycle.

However, men, too, produce a small, but critical, amount of estrogen (estradiol).

In men, regular exposure to xenoestrogens can disrupt the normal male testosterone (high)-to-estrogen (low) ratio; and, instead, create a state of “estrogen dominance”, where the ratio of a man’s estrogen level is high—relative to his testosterone level.

What does “estrogen dominance” look like in men?

Estrogen dominance in men can manifest as decreased testosterone production; lower sperm counts; and may contribute to the development of prostate cancer. High estrogen levels in men can have a physically feminizing effect, presenting as: weight gain; less muscle mass (softer and flabbier); higher overall body fat and fat deposits (think love handles); excess belly fat and enlarged breast tissue (26).

Back to testosterone… Low testosterone is often associated with co-morbidities such as (27):

• • Obesity
  • Belly fat (abdominal obesity)
  • Metabolic syndrome
  • Type 2 diabetes
  • Hypertension
  • Heart disease
  • Chronic kidney disease

As men age, testosterone levels decline at the rate of 1% to 2% every year, starting around age 40 (28).

However, younger men are not immune from having low T. Even from age 30, testosterone levels can drop in men who have a chronic disease (e.g., diabetes, obesity); experience prolonged emotional stress; or take medications, such as statins, anti-anxiety, anti-depressants, opioids, chemotherapy, hypertension and beta-blockers, where lowered testosterone levels are often a side effect (29, 30).

For men, having low testosterone can significantly diminish quality of life; affect the functionality of multiple organs; and impact fertility.

Symptoms of low testosterone include (31, 32):

• • Low libido (sex drive)
  • Erectile dysfunction / impotence
  • Oligospermia (low sperm count) or azoospermia (zero sperm count), which causes male infertility
  • Low energy
  • Lack of drive / motivation
  • Difficulty concentrating
  • Depression
  • Mood swings
  • Irritability (as in “Grumpy Old Man Syndrome”)
  • Changes (for the negative) in sleep patterns or disrupted sleep
  • Fatigue
  • Increased frailty
  • Decreased bone density
  • Decreased muscle strength and mass
  • Low stamina / endurance
  • Gynecomastia, colloquially known as “moobs” (male boobs), characterized by enlarged breast tissue in men (33)
  • Difficulty building muscle—even when working out
  • Excess belly fat (34)

What you can do

The good news? It is possible to raise testosterone levels naturally.

First and foremost, get tested! Consider ordering the Testosterone and Prostate Health panel, which I love for men, because it enables a more insightful takeaway of male hormonal balance (e.g., testosterone to estrogen ratio).

The Testosterone and Prostate Health panel will accurately measure your bioavailable testosterone and also measures your level of estradiol (estrogen), which can be created by excess belly fat. This panel includes a comprehensive testosterone panel (including total, free and bioavailable testosterone and sex hormone binding globulin), estradiol, prostate specific antigen (PSA) as well as a Complete Blood Count.

* The sale ($149) ends on Wednesday, July 31st, 2024. You can purchase the panel now—and schedule your blood draw later—up to 1 year from date of purchase.

***Note: This is direct lab testing. Meaning…you order your own labs online. No doctor’s visit required. IF you live in New York or New Jersey, you will NOT be able to access direct lab testing in these states. However, you CAN order your labs online, then travel to Connecticut, Pennsylvania or Massachusetts (this is where I go) for your blood draw. You will be emailed your results 1 week from your blood draw. You can then take your labs to the healthcare practitioner of your choice. OR, you can choose to do one of my Lab Review packages, where I review your labs with you, highlight potential red flags and give suggested action steps to improve testosterone levels.

Knowing your testosterone level can be highly motivating to make lifestyle changes that support hormone balance. To naturally boost testosterone levels, key lifestyle modifications include:

1. Prioritizing sleep.

2. Eating nutrient-dense whole foods vs. ultra-processed foods.

3. Weight training. Building muscle.

4. Sitting less. Moving more.

5. Engaging in a regular relaxation practice.

6. Cutting out or mindfully reducing alcohol consumption and/or recreational drug use, including marijuana.

7. Reducing exposure to endocrine-disrupting chemicals, like plastics, pesticides and other xenoestrogens.

Sources:

1  Harvard Health Publishing, Harvard Medical School. “Testosterone: What it is and how it affects your health”. June 22, 2023.

2 Snyder PJ, Kopperdahl DL, Stephens-Shields AJ, et al. Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone: A Controlled Clinical Trial. JAMA Intern Med. 2017;177(4):471–479.

3  Bachman E, Travison TG, Basaria S, Davda MN, Guo W, Li M, Connor Westfall J, Bae H, Gordeuk V, Bhasin S. Testosterone induces erythrocytosis via increased erythropoietin and suppressed hepcidin: evidence for a new erythropoietin/hemoglobin set point. J Gerontol A Biol Sci Med Sci. 2014 Jun;69(6):725-35.

4  Yang, TK., Chang, CC., Chang, HC. et al. Factors Associated with Bothersome Lower Urinary Tract Symptoms in Middle-Aged Men Receiving Health Checkup. Sci Rep 9, 901 (2019).

5  Haider KS, Haider A, Doros G, Traish A. Long-Term Testosterone Therapy Improves Urinary and Sexual Function, and Quality of Life in Men with Hypogonadism: Results from a Propensity Matched Subgroup of a Controlled Registry Study. Journal of Urology [Internet]. 2018 Jan 1; 199(1):257–65.

6, 13  Kahl, K L. Testosterone levels show steady decrease among U.S. men. Urology Times Journal. Vol. 48. Issue 7. July 3, 2020.

7  Lokeshwar SD, Patel P, Fantus RJ, Halpern J, Chang C, Kargi AY, Ramasamy R. Decline in Serum Testosterone Levels Among Adolescent and Young Adult Men in the USA. Eur Urol Focus. 2021 Jul;7(4):886-889.

8  Shalender Bhasin, Secular Decline in Male Reproductive Function: Is Manliness Threatened?, The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 1, January 2007, Pages 44–45.

9  Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. BMJ. 1992 Sep 12;305(6854):609-13.

10, 11  Thomas G. Travison, Andre B. Araujo, Amy B. O’Donnell, Varant Kupelian, John B. McKinlay, A Population-Level Decline in Serum Testosterone Levels in American Men, The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 1, January 2007, Pages 196–202

12  Kalvaitis, Katie. “Generational decline in testosterone levels observed.”  Healio.com. 2 Oct. 2023.

14  NIH, National Institute of Diabetes and Digestive and Kidney Diseases. Overweight & Obesity Statistics.

15  Tina Djernis Gundersen, Niels Jørgensen, Anna-Maria Andersson, Anne Kirstine Bang, Loa Nordkap, Niels E. Skakkebæk, Lærke Priskorn, Anders Juul, Tina Kold Jensen, Association Between Use of Marijuana and Male Reproductive Hormones and Semen Quality: A Study Among 1,215 Healthy Young Men, American Journal of Epidemiology, Volume 182, Issue 6, 15 September 2015, Pages 473–481.

16, 17  Emanuele MA, Emanuele NV. Alcohol’s effects on male reproduction. Alcohol Health Res World. 1998;22(3):195-201.

18, 19, 29  Cohen J, Nassau DE, Patel P, Ramasamy R. Low Testosterone in Adolescents & Young Adults. Front Endocrinol (Lausanne). 2020 Jan 10;10: 916.

20  Hu TY, Chen YC, Lin P, Shih CK, Bai CH, Yuan KC, Lee SY, Chang JS. Testosterone-Associated Dietary Pattern Predicts Low Testosterone Levels and Hypogonadism. Nutrients. 2018 Nov 16;10(11):1786.

21  Toppari J, Larsen JC, Christiansen P, Giwercman A, Grandjean P, Guillette LJ Jr, Jégou B, Jensen TK, Jouannet P, Keiding N, Leffers H, McLachlan JA, Meyer O, Müller J, Rajpert-De Meyts E, Scheike T, Sharpe R, Sumpter J, Skakkebaek NE. Male reproductive health and environmental xenoestrogens. Environ Health Perspect. 1996 Aug;104 Suppl 4(Suppl 4):741-803.

22  Anna Katrina Loomis, Peter Thomas, Effects of Estrogens and Xenoestrogens on Androgen Production by Atlantic Croaker Testes In Vitro: Evidence for a Nongenomic Action Mediated by an Estrogen Membrane Receptor, Biology of Reproduction, Volume 62, Issue 4, 1 April 2000, Pages 995–1004.

23, 25  Paterni I, Granchi C, Minutolo F. Risks and benefits related to alimentary exposure to xenoestrogens. Crit Rev Food Sci Nutr. 2017 Nov 2;57(16):3384-3404.

24  Shahbendah, M. Percentage of genetically modified crops in the US by type 1997, 2018, 2019 and 2020. Statista.  16 Dec. 2022.

26  Gottfried, S. (2014). The Hormone Cure. Scribner.

27  Institute for Functional Medicine. Insights. Testosterone Deficiency: Lifestyle-Based Approaches.

28  Singh P. Andropause: Current concepts. Indian J Endocrinol Metab. 2013 Dec;17 (Suppl 3):S621-9.

30  Samadi, David. “Beware, these prescription medications may lower testosterone levels”. Prostate Cancer 911. 14 June 2021.

31  Goodale T, Sadhu A, Petak S, Robbins R. Testosterone and the Heart. Methodist Debakey Cardiovasc J. 2017 Apr-Jun;13(2):68-72.

32  Low Testosterone (Male Hypogonadism). Cleveland Clinic. 2 Sept. 2022.

33  Swerdloff RS, Ng JCM. Gynecomastia: Etiology, Diagnosis, and Treatment. [Updated 2023 Jan 6]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.

34   Fillo J, Levcikova M, Ondrusova M, Breza J, Labas P. Importance of Different Grades of Abdominal Obesity on Testosterone Level, Erectile Dysfunction, and Clinical Coincidence. Am J Mens Health. 2017 Mar;11(2):240-245. 

1 bunch of dried organic kelp, torn into smaller pieces
1 pound of wild-caught Gulf shrimp, peeled, deveined and well rinsed in filtered water
6 cups of filtered water
2 tablespoons organic red miso, placed in a medium-sized bowl
1/2 cup button mushrooms, sliced thin
1 bunch scallions, sliced into thin rounds

In a large stockpot or Dutch oven, bring 6 cups of water to a roiling boil.

Using a stainless steel ladle, scoop up a generous ladle of the boiling water and add to the bowl with the miso; whisk together well.

Add the kelp to the boiling water in the stockpot or Dutch oven.

Allow the water to come to a boil again, then turn heat to low. Cover stockpot or Dutch oven and simmer about 5 minutes.

Raise heat to high and when the water comes to a boil, add the shrimp to the stockpot. Reduce heat to low, cover, and cook shrimp about 2 minutes.

Add miso mixture to the pot and stir until well combined. Add sliced mushrooms and a handful of scallion rounds. Cover pot and simmer mixture apx. 5 minutes. Turn off heat.

Ladle soup into individual bowls. Garnish with scallions.

Serve warm.

Enjoy!

Eating more of the following foods is key to supporting your breast health.
 

1.  Organic Leafy Greens

Leafy greens are a rich source of vitamins, like mood-balancing folate; hard-to-get minerals, like magnesium; high in fiber and phytonutrients. Lettuce greens, from mesclun and Bibb, to red leaf and butter lettuces, are high in water and a good source of folate and vitamins A and K. Dark leafy greens, like spinach, kale, romaine, green and red leaf lettuce, mustard greens, chicory, and Swiss chard, are rich in fiber, folate and carotenoids.

A higher consumption of leafy green vegetables was associated with a lower risk of estrogen receptor-negative (ER-) breast cancer in an analysis of 20 observational human studies (46).

What you may not know…  Nearly 75% of conventionally grown produce sold in the U.S. contains pesticide residues. Any type of leafy green, including salad greens, is highly suspect. Spinach is #2, and kale, collard and mustard greens tie for #3 on the Environmental Working Group’s 2023 Dirty Dozen ranking of pesticide residue-contaminated produce.

In 2016, the USDA collected 642 conventional spinach samples for a pesticide analysis. What they found: each spinach sample contained, on average, 7 pesticides—with a maximum of 19 different pesticides on a single sample. Seventy-six percent of the samples contained permethrin, a neurotoxic insecticide, which, at high doses, affects the nervous system and can cause tremors and seizures (47). A study published in Environmental Health found that children with detectable permethrin levels in their urine were twice as likely to be diagnosed with ADHD (48).

Kale is another high pesticide residue leafy green. Multiple samples of conventionally grown kale indicated 18 different pesticides. And, nearly 60% of conventionally grown kale samples sold in the U.S. were sprayed with DCPA (or “Dacthal”), a pesticide classified as a potential carcinogen in 1995 (49).

In addition to kale, more than 35 percent of collard greens and mustard green samples analyzed by the USDA in 2019 contained detectable levels of DCPA (50).

You want to eat leafy greens to prevent cancer—not to increase your risk of getting it! It really is worth choosing organic.

Support breast health:  Buy organic leafy greens! Try incorporating raw and/or cooked leafy greens at most meals. In addition to salads, drink your greens in green juices, or add 1 or 2 large handfuls to smoothies.  Aim to eat 8 to 12 servings daily. For recipe inspiration, click here and here. Try a DIY 7 Day Body Reset Cleanse as a way to introduce more greens into meals. Bolster your immune system with this nutrient-dense greens powder, which provides nutrient, antioxidant and detoxification support.
 

2.  Cruciferous Vegetables

Research shows that regularly eating cruciferous vegetables is associated with lower breast cancer risk.

Cruciferous vegetables are in the brassica family: broccoli, cabbage, cauliflower, Brussels sprouts, turnip, rutabaga and radis). Cruciferous leafy greens include arugula, collard greens, mustard greens, bok choy, watercress and many varieties of Asian greens.

Why do they have such potent anti-cancer protective effects?

Cruciferous vegetables are a nutrition powerhouse: a rich source of vitamins C, E, K; folate; minerals; antioxidants; flavonoids; and high in fiber. They also contain glucosinolates, sulfur-containing chemicals, that give cruciferous vegetables their distinct, pungent smell and bitter taste. Glucosinolates also help the liver produce detoxifying enzymes.

When you chop, chew and digest cauliflower, the glucosinolates break down into biologically active compounds—indoles, nitriles, thiocyanates, and isothiocyanates (ICTs)—that prevent cancer cell growth. Laboratory studies have found that indoles and ICTS can prevent cancer in the breast (as well as other organs) in mice and rats (51).

What about humans? A study of 337 Chinese women found that those who ate the most cruciferous vegetables had significantly reduced breast cancer risk (52).

Your liver and your gut play important roles in helping your body get rid of extra (bad) estrogen. Your liver converts estrogen into metabolites that are excreted through the kidneys and gut. Your estrogen is also “packaged” in your liver, so that it can exit (in bile) via your poop. Eating cruciferous vegetables helps your liver perform more efficiently.

Support breast health:  Eating fiber-rich foods every day—especially cruciferous vegetables and leafy greens—helps promote healthy bowel movements. You need to poop every day in order to get rid of excess (harmful) estrogen.  You want to be in a state of estrogen balance, NOT estrogen dominance, which can contribute to increased breast cancer risk. Eat a minimum of 3 to 5 servings of cruciferous vegetables per week. Recipes for my favorite cruciferous-themed dishes are here. You can also try reaping the benefits of cruciferous (sulforaphane glucosinolate) in a capsule; I like this one as it supports liver detoxification.
 

3.  Wild-caught fish and fish oil

Chronic inflammation is linked with breast cancer development, its metastasis (spreading), recurrence, and lower survival rates. Being overweight or obese creates an environment that encourages chronic inflammation, insulin resistance and an overproduction of estrogen in the body  (53, 54).

A nutrient that can help fight chronic inflammation? Omega-3 fatty acids. They help reduce the production of substances that promote inflammation, like inflammatory cytokines. Higher omega 3 intake has consistently been linked with lower inflammation levels—and with reduced risk of breast cancer in women (55).

Not all omega-3 fatty acids are created equal. Alpha linolenic acid (ALA), a plant-based omega 3 fatty acid, is found in soy, canola oil, flax seed, chi seeds and walnuts. In order for your body to use it, ALA has to first be converted into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—and this conversion process is very inefficient.

Wild-caught fish, like salmon, mackerel and sardines naturally contain the anti-inflammatory omega-3 fatty acids, EPA and DHA.  Studies suggest that omega 3 fatty acids—from fish and fish oil—are more effective in preventing breast cancer than plant-based omega 3 fatty acid.

In a 2018 study, researchers compared the effects of three types of omega 3s—ALA, DHA and EPA—on breast tumor development in mice bred to develop breast cancer that was HER2-positive (this is an aggressive form of breast cancer that tests positive for a protein called Human Epidermal Growth Factor Receptor 2). Mice exposed to fish-derived omega 3s (EPA and DHA) experienced a 60-70% reduction in tumor size and 30% less breast tumors. When the same dose of plant-based ALA was given to mice, it did not have the same protective effect against breast cancer tumors; it was only 1/8 as potent as DHA and EPA. Researchers concluded that fish oil-based DHA and EPA omega 3s were 8 times more effective than ALA in preventing the growth of breast cancer tumors (56).

Support breast health:  Eat 12 to 16 ounces of wild-caught, cold water, fatty fish (like salmon, sardines, cod or mackerel) every week. Some of home-cooked favorite fish preparations are here.  Supplement with high quality fish oil capsules or a high quality (liquid) fish oil.  I like both.

Continue Reading About Breast Cancer Prevention (below):

Your Breasts: What You Need to Know  (Part 1)
Understanding Estrogen: How It Affects Breast Health  (Part 2)
Protect Your Breasts:  Avoid / Limit the Big 3  (Part 3)

Sources

46  American Institute for Cancer Research (AICR). AICR Food Facts. April 6, 2021.
47  Environmental Working Group (EWG).
48  Wagner-Schuman M, Richardson JR, Auinger P, Braun JM, Lanphear BP, Epstein JN, Yolton K, Froehlich TE. Association of pyrethroid pesticide exposure with attention-deficit/hyperactivity disorder in a nationally representative sample of U.S. children. Environ Health. 2015 May 28;14:44.
49, 50  Environmental Working Group (EWG).
51  National Cancer Institute.
52  Cancer Research. 2003. July 15; 63(14):3980-6
53  Am Soc Clin Oncol Educ Book. 2013; 33: 46–51
54  Journal of Clinical Oncology. 2009
55  Breast Cancer Research.  17, Article number: 62 (2015)
56  Journal of Nutritional Biochemistry. Vol. 55. May 2018, Pages 41-52

The Big 3 | Avoid or Minimize

1.  Alcohol

Many women remain unaware that alcohol is a significant breast cancer risk factor.

Depending on dose, alcohol consumption accounts for up to 11% of breast cancer cases in women (29).

In fact, a recent British Medical Journal study, conducted among female patients of mammogram facilities and breast clinics—as well as staff—in the U.K., found that only 19.5% of female patients (and 48.5% of staff) were able to identify alcohol as a breast cancer risk factor (30)!

Alcohol is not a health food—especially for women. Back in 1988, the World Health Organization (WHO) classified alcohol as a Group 1 (human) carcinogen (31).Research (over 30-plus years) establishes a strong causal link between alcohol and breast cancer.

Heavy drinking can also increase breast cancer risk in men. Excess alcohol can hurt the liver, which helps balance sex hormones.

Men with liver disease (like cirrhosis) may end up having higher levels of estrogen, increasing their risk of developing breast cancer (32).

Compared to other organs, the female breast is more vulnerable to the carcinogenic effects of alcohol. Women metabolize alcohol differently than men: they absorb it more quickly, and alcohol takes longer to break down and exit their bodies. As a result, alcohol of any kind (beer, wine, spirits) can increase estrogen levels and increase risk of hormone receptor-positive breast cancer. Alcohol damages DNA in cells, which also increases breast cancer risk (33).
 

Disturbing trends: Girls, Women and Alcohol

Across the board, alcohol disorders and alcohol abuse among women—and girls—have risen in recent years.

Consider the following:

Among adolescents, aged 12-17, more than double the amount of girls (4.7%) than boys (2.2%) had alcohol use disorder (AUD), according to the 2021 National Survey on Drug Use and Health, or NSDUH (34).

» Among those aged 12 to 20, 12% of males and 11.9% of females reported “binge drinking”, a pattern of drinking alcohol that brings blood alcohol concentration to 0.08%—or more. This blood alcohol concentration level is typically reached after consuming 4 or more alcoholic drinks for females and 5 or more alcoholic drinks for males on the same occasion, typically within 2 hours—or less (35).

» 1 in 5 high school girls binge drinks (36).

Approximately 13% of adult women report binge drinking. Among this group, 25% binge-drink weekly, and 25% will consume at least 6 alcoholic drinks during one binge drinking occasion (37).

» Approximately 1 in 2 women of child-bearing age (i.e., aged 18–44 years) drink alcohol; and, among those (aged 18 to 44) who consume alcohol, 18% binge drink (38).

Some consequences of chronic excess consumption of alcohol?

Liver disease. Cognitive decline. Heart damage. Cancer of various types: mouth, throat, esophagus, liver, colon and, of course, breast cancer (39).

Specific to women, reproductive health consequences may include: irregular menstrual cycles. Increased risk of infertility, miscarriage, stillbirth and premature delivery.

One study, conducted on healthy, pre-menopausal (regularly menstruating) women, aged 18-44, recorded increased levels of hormones—estrogen, testosterone and luteinizing hormone—after participants consumed just one alcoholic drink! Hormone levels increased, including total estradiol by 5.26%; free estradiol by 5.82%; total testosterone by 1.56%; free testosterone by 1.42%; and luteinizing hormone by 6.18% (40).

 

On the other hand, binge drinking, defined as consuming 4 or more alcoholic drinks (for women), was associated with a dramatic increase in estrogen levels: total estradiol increased by 64.35% and free estradiol increased by 63.53% (41).

How much is “too much”?

It doesn’t take much!

There is a 7 to 10% increase in breast cancer risk for each 10 grams of alcohol (less than 1 drink) consumed daily by adult women; this applies to both pre-menopausal (women who have regular periods) and post-menopausal women who no longer menstruate (42).

» Compared to women who do not drink at all, women who have 3 alcoholic drinks per week have a 15% higher risk of breast cancer. Experts estimate that the risk of breast cancer goes up 10% for each additional drink woman regularly have each day (43).

Support breast health: Say “no” to alcohol OR limit to 2 alcoholic drinks— or less—per week, as recommended by breastcancer.org. Assess your relationship with alcohol: is it your main (or only) go-to for coping with stress or to unwind? Try swapping alcohol out for mineral water. Consider doing a DIY 7-Day Body Reset Cleanse.  If you regularly consume alcohol, support liver detoxification.
 

2.  Sugar

A high sugar diet, which includes simple sugars, refined grains and refined starch carbohydrates, is associated with increased breast cancer risk.

In a 2016 study, researchers found that when mice were fed high-sugar diets, specifically sucrose or fructose, 50 to 58% of these mice developed breast cancer tumor; they also had significantly more tumors on their lungs, suggesting that high sugar consumption accelerates breast cancer spreading elsewhere (44).

Regularly eating high sugar foods leads to overweight and obesity. The more fat cells you have, the more estrogen you make; this contributes to estrogen dominance—and a greater risk of breast cancer.

Eating high sugar foods also raises your blood sugar—in a big way. Your pancreas releases the hormone insulin to bring your blood sugar back down. Insulin escorts sugar (as glucose) out of your bloodstream and into the cells of your liver and muscles. When you keep eating sugar, your liver and muscle cells eventually run out of room to store glucose.

Insulin resistance happens when your cells get “burned out” from insulin always “knocking on their door”, asking if glucose can enter. When your cells stop responding to insulin, this is called insulin resistance. From this point, any excess glucose typically ends up being stored in fat cells, mostly around your waist. As a result, you can end up having high insulin and high blood sugar levels.

Studies show that excess body fat, high estrogen and high insulin levels increase your risk for breast cancer. Higher insulin means that your body becomes efficient at storing fat. Again, excess body fat means that you produce more estrogen. Higher insulin levels are also thought to help breast cancer cells develop and grow.

Support breast health:  Eat more quality protein and high fiber vegetables. Eat less white starch carbs (e.g., rice, pasta, bread,.flour-based foods, etc.). Consume more home-cooked whole foods; eat less processed foods. Avoid colas, sodas, “flavored” drinks; commercial fruit juices; and beverages with added sugars. Replace artificial sweeteners with natural sweeteners, like maple syrup, coconut sugar or raw honey—and use sweeteners judiciously.Consider doing a DIY 7-Day whole foods-based cleanse. Invest in a one-time Comprehensive Wellness Assessment as a launchpad for making different food and lifestyle choices.
 

3. Ultra-processed foods, including refined carbohydrates

Processed foods are convenient—and they aren’t all bad. Especially if they are minimally processed: pre-cut vegetables, bagged lettuce, roasted nuts, frozen vegetables or canned tuna. Americans eat plenty of processed foods; however, about 60% of processed foods consumed are ultra-processed.

Ultra-processed foods are “foods” that undergo multiple industrial processes, like hydrogenation, extrusion, and molding, to create the final product. They contain many added ingredients not used in traditional cooking  (e.g., salt, sugar, artificial sweeteners, highly refined oils, unhealthy fats, artificial colors, preservatives, flavorings, emulsifiers, etc.) to manipulate appearance, taste and texture and to extend shelf life.

Designed so that you will crave them, ultra-processed foods include: store-bought breads and buns, breakfast cereals, fruit yogurt, ice cream, packaged soups, snack foods, cookies, chips, soda, energy drinks, energy bars and French fries, to name a few.

 

Eating ultra-processed foods can increase a woman’s risk of breast cancer by 11%, according to a 2018 study published in the British Medical Journal.

When the dietary intake of 105,000 French male and female participants  was analyzed, researchers found that, for both men and women, 18% of their diet consisted of ultra-processed foods. Each 10% increase in ultra-processed foods raised overall cancer rate by 12%. And, for women, the risk of breast cancer, specifically, increased by 11%. Sugary ultra-processed foods were most strongly associated with increased breast cancer risk (45).

Support breast health: Eat fresh, whole foods. Cook simple, real food meals from scratch instead of eating ready-to-heat prepared meals.For anti-inflammatory recipe inspiration, click here, here and here. Reduce your toxic load with my DIY 7 Day Body Reset Cleanse. Consider doing a one-time Food & Lifestyle Review for insights on where you can start making healthier choices.
 

Continue Reading About Breast Cancer Prevention (below):

Your Breasts: What You Need to Know  (Part 1)
Understanding Estrogen: How It Affects Breast Health  (Part 2)
Better Breast Health: Eat These 3 Foods  (Part 4)
 
 
 
 
 
Sources
29, 30  BMJ Open. June 2019.
31  International Agency for Research on Cancer.
32  American Cancer Society
33  BreastCancer.org
34  NIH: National Institute on Alcohol Abuse and Alcoholism. Alcohol Use Disorder. 2023.
35 NIH. Alcohol’s Effects of Health. Binge Drinking.
36  Drink: The Intimate Relationship Between Women & Alcohol. Ann Dowsett Johnson. Harper Wave. 2013.
37, 38, 39  Centers for Disease Control and Prevention (CDC).
40, 41  Schliep KC, Zarek SM, Schisterman EF, Wactawski-Wende J, Trevisan M, Sjaarda LA, Perkins NJ, Mumford SL. Alcohol intake, reproductive hormones, and menstrual cycle function: a prospective cohort study. Am J Clin Nutr. 2015 Oct;102(4):933-42.
42  Women’s Health.  January 1, 2015
43  BreastCancer.org
44  Cancer Research. Jan. 2016
45  British Medical Journal. February 14, 2018

Breasts have been glorified for their beauty and ability to nourish new life. Breasts have also been vilified (e.g., breastfeeding in public). And, from bustiers and push-up bras, to silicone and saline implants, breasts have been objectified.

Yet…while breasts seemingly have a life of their own, they are a vital part of an integrated body system that reflects overall health.

Most of us know a friend or family member who has had breast cancer—or soon will. Yes, we should be aware of breast cancer. But it is even more important to understand how to keep your breasts healthy. Being pro-active about breast health can significantly lower your breast cancer risk or prevent you from getting breast cancer ever again (if you have already had it).

Breast Cancer: The Big Picture

In 2023:

» Among women: 297,790 new cases of invasive breast cancer are predicted (1). And an estimated 43,170 women will die from breast cancer (2).

» Among men, 2,800 new cases of invasive breast cancer are expected to be diagnosed (3).

» In the U.S., apx. 1 in 8 women versus 1 in 883 men will be diagnosed with invasive breast cancer over the course of her or his lifetime (4).

The statistics can sound daunting. And, if a family member has had breast cancer, it’s easy to feel anxious or fearful that you may be “next”.

The good news? Only 5 to 10% of breast cancer cases are linked to genetic mutations, like BRCA1 and BRCA2.

The vast majority (85%) of breast cancers occur in women (and men) who have NO FAMILY HISTORY of breast cancer (5).

This means that breast cancer risk can be mostly attributed to lifestyle, food choices and exposure to environmental toxins. Prevention is key! By making mindful choices about food, lifestyle habits, non-toxic products and ways of coping with stress, you can take charge of your breast health NOW.

If you’re unsure of your risk status, click on this link to check out The National Institute of Health’s breast cancer risk assessment tool.

Who Is At Risk

Personal factors that increase risk 

The following are personal factors that can potentially increase breast cancer risk (6):

» First-degree relative with breast cancer. Having a first-degree relative (mother, sister or daughter) with breast cancer. One in 5 men with breast cancer have a close relative—male or female—with breast cancer.

» Father or brother. Having a father or brother who has had breast cancer increases breast cancer risk for women. For men, too.

» Having a personal history of breast cancer. If a woman has had cancer in one breast, she has a higher risk of developing a new cancer in the other breast or in another part of the same breast.

» Early onset of menses and/or late onset of menopause. Getting periods early (especially before age 12) OR going through menopause after age 55; in both cases, a woman has a longer lifetime exposure to estrogen and progesterone.

» Having dense breasts. it can be harder to see a tumor on a mammogram.

Lifestyle risk factors

» Oral birth control pills. Past or present use of hormonal birth control pills.  *Risk increases the longer a woman has been using oral contraception, especially after 5 years (7).

» Hormone replacement therapy. Long-term use of combination hormone therapy featuring synthetic versions of estrogen and/or progesterone, such as Premarin and Provera (8, 9).

» Smoking.  Includes former and current smokers, as well as those who are exposed to secondhand smoke (10).

» Overweight and obesity, especially if a woman gains weight as an adult. Having more fat tissue raises estrogen levels, increasing risk of breast cancer, especially in post-menopausal women. Being overweight or obese is also associated with unhealthy (high) levels of insulin (a fat storage hormone), linked with increased risk of breast cancer (11).  Obesity is a risk factor for men, too. As of 2023, 42.4% of American adults (age 20+) are obese: 41.9% women and 43% men (12).

» Alcohol. Drinking alcoholic beverages of any kind—beer, wine, and spirts—increases a woman’s risk of hormone-receptor-positive breast cancer (13).

Compared to women who don’t drink at all, women who have three alcoholic drinks per week have a 15% higher risk of breast cancer. Experts estimate that the risk of breast cancer goes up another 10% for each additional drink women regularly have each day (14).

» Older age at birth of first child. The older a woman is when she has her first full-term pregnancy, the higher her risk of breast cancer (15).

» DDT (dichlorodiphenyltrichloroethane).  A pesticide (synthetic insecticide), DDT was widely used from 1945 until it was banned in 1972; DDT is positively associated with breast cancer (16, 17).

» Exposure to agricultural pesticides.  Historically, research has been inconsistent. However, recent studies find an association between exposure to organophosphate insecticides and increased risk of breast cancer.

One study and its follow-up found that the wives of agricultural workers who used pesticides had an increased risk of developing of breast cancer, especially pre-menopausal breast cancer (18).  (Pre-menopausal refers to women who are still getting their periods regularly.)

Another study, published in International Journal of Cancer, found that women living in Long Island who had high levels of organochlorine insecticides in their bloodstream when they were diagnosed with breast cancer, were more likely to die 5 and 15 years after their diagnosis (19).

» Exposure to environmental breast carcinogens. Certain chemicals are linked to breast cancer: chemicals in gasoline, diesel, and other vehicle fuel; lawn equipment, tobacco smoke and burned or charred food; chemicals in food and drinking water; flame retardants, stain-resistant textiles and paint removers, among others (20).

Continue Reading About Breast Cancer Prevention (below):

Understanding Estrogen: How It Affects Breast Health (Part 2)
Protect Your Breasts: Limit / Avoid the Big 3  (Part 3)
Better Breast Health: Eat These 3 Foods  (Part 4)

Sources

1, 3, 4  BreastCancer.org.
2  National Cancer Institute: Surveillance, Epidemiology and End Results Program. Cancer Stat Facts: Female Breast Cancer.
5, 6  Cancer.org.
7  American Journal of Lifestyle Medicine. 2018 Jan. 13.
8  Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer. The Lancet. 1997 Oct 11;350(9084):1047-59.
9  Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Collaborative Group on Hormonal Factors in Breast Cancer. The Lancet. 2019 Sept. 29. Vol. 394. Issue 10204. pp: 1159-1168.
10  Breast Cancer. 2017; 9: 127–132.
11  Cancer Research. 2015 Jan. 15; 75(2): 270-274.
12  State of Childhood Obesity. Robert Wood Johnson Foundation.
13, 14  BreastCancer.org.
15  National Cancer Institute. Reproductive History and Cancer Risk. Nov. 9, 2016.
16  Asian Pacific Journal of Cancer Prevention. 2010;11(1):173-80.
17  The Journal of Clinical Endocrinology and Metabolism. Volume 100, Issue 8, 1 August 2015, pgs. 2865–2872.
18  Environmental Health Perspective. 2017 Sep 6;125(9):097002.
19  International Journal of Cancer. 2016 Feb 1;138(3):565-75.
20  Environmental Health Perspectives. 1 Sept. 2014, Vol. 122, No. 9.

Progesterone keeps estrogen in check. These two hormones counterbalance each other. Estrogen causes you to retain salt and water; progesterone is a natural diuretic.  When it comes to the breast, estrogen stimulates breast cells to grow; progesterone prevents cysts from developing in painful breasts (21).

Estrogen is a primary female sex hormone, and it is the hormone that defines women. However, estrogen can become problematic when it is high relative to progesterone. In today’s highly toxic, modern world, this very common hormone imbalance is known as “estrogen dominance”.

Estrogen also plays a role in most breast cancers. About 80% of breast cancers are “ER-positive”, or “estrogen receptor-positive”. This means that the cancer cells in the breast are growing in response to estrogen (22).

Two routes to estrogen dominance (for women):

1. You have high estrogen relative to a normal progesterone level. This type of estrogen dominance is common in overweight or obese women because, in addition to the ovaries making estrogen, fat cells also make estrogen. More fat cells means higher estrogen levels. Women of normal weight who have been exposed to xenoestrogens (synthetic chemicals that have estrogen-like effects) can also be estrogen dominant. Xenoestrogens are present in combination hormone birth control pills, skin care products, cosmetics, plastics, artificial food colorings, preservatives, insecticides, building materials, chlorine and chlorine by-products, among others (23).

2. You have high estrogen relative to low progesterone. This often happens, naturally, from age 35, as a woman’s fertility begins to slow somewhat. During periods of hormonal transition, like perimenopause, which typically starts around age 40 and can last up to 15 years before a woman has her final period (menopause), estrogen levels can spike wildly.

Men can also have high estrogen levels…

Factors that contribute to men having high estrogen levels include (24, 25):

» Being overweight or obese. Fat cells in the body convert male hormones (androgens) into estrogen, resulting in higher estrogen levels.

» Exposure to environmental estrogens. For example, regularly consuming conventionally raised meats.

» Heavy alcohol consumption. A study that explored the role of alcohol consumption in 74 European male breast cancer patients, ages 35 to 70 years, suggests that the risk of developing breast cancer in men increased by 16% with each additional 10 grams of alcohol consumed per day. Higher alcohol consumption levels (above 60 grams per day) was linked with increased male breast cancer risk (26).

Keep in mind: a “standard” drink contains 14 grams (0.6 ounces) of alcohol. Typical examples include a 12 oz. beer (5% alcohol by volume), a 5-ounce glass of table wine (12% alcohol by volume),  and a 1.5 oz shot of distilled spirits (40% alcohol by volume)—whiskey, rum, gin, vodka, tequila (27) .

» Liver disease. A malfunctioning liver upsets hormonal balance, causing lowered androgens (male hormones) and increased estrogen. In general, people who drink more alcohol are at higher risk for alcohol-related liver disease.

For men, drinking more than 2 standard drinks per day (for women, drinking more than 1 standard drink per day) increases risk of alcohol-related liver disease, which can contribute to elevated estrogen levels (28).

» Having Klinefelter syndrome. Men with this congenital condition have lower levels of androgens (male hormones) and higher levels of estrogen, and they often develop gynecomastia (male breast tissue). Men with Klinefelter syndrome can have a 20 to 60 times increased risk of breast cancer compared to other men.

» Radiation exposure, especially in the chest area.

Continue Reading About Breast Cancer Prevention (below):

Your Breasts: What You Need to Know  (Part 1)
Protect Your Breasts: Limit / Avoid the Big 3  (Part 3)
Better Breast Health: Eat These 3 Foods  (Part 4)

Sources

21  The Hormone Cure. Sara Gottfried, MD, Scribner. 2013. pp. 150-153
22  BreastCancer.org.
23  WomeninBalance.org.
24  BreastCancer.org.
25  Cancer.org.
26  Ahrens W, Baumgardt-Elms C, Ménégoz F, Olsson H, Paulsen S, Simonato L, Wingren G. Alcohol drinking may increase risk of breast cancer in men: a European population-based case-control study. Cancer Causes Control. 2004 Aug;15(6):571-80.
27, 28  Yale Medicine. Alcohol-related liver disease.

Environmental toxins have been top-of-mind for many people after a Norfolk Southern train, loaded with hazardous materials, derailed in East Palestine, Ohio on February 3rd. East Palestine residents were understandably distressed that toxic chemicals were released during the derailment—and the short- and long-term health consequences. Nationwide, the derailment raised questions about the frequency of such incidents, the soundness of our infrastructure, a sluggish Federal response, and our vulnerability—as Americans—to being unwittingly exposed to toxic chemicals that affect our health and well-being.

Yet, as sobering as this derailment incident has been, the vast majority of toxins to which we are exposed, are through the products we choose to use EVERY DAY.

Did you know…

The Environmental Protection Agency (EPA) has over 85,000 chemicals listed on its inventory of substances that fall under the Toxic Substances Control Act (TSCA)? But…even the EPA is unable to ascertain which chemicals are in the marketplace now and how they are actually being used (1)!

That said…while we cannot control external events, like toxic train derailments, lax EPA standards or corporate negligence—we can be mindful of making different choices for ourselves. Spring, a season of renewal and rebirth, is a perfect time to do an external “spring cleanse” that lessens our body burden, the amount of chemical toxins accumulated in the body via ingestion, inhalation or absorption through the skin (2).

I know…the thought of changing out our favorite foods and/or products can feel overwhelming. But when you know better, the goal, hopefully, is to do better. For me, personally, integrating non-toxic choices into my lifestyle has been an ongoing decade-plus journey. Educating yourself is the first step. Then, start small—with basic, everyday items—and build from there.

1. Pesticides | Food

What they are:

Pesticides are chemical substances—in the form of herbicides, insecticides, and fungicides, rodenticides, bactericides and larvicides—used in commercial agriculture to protect plants from weeds, pests or diseases.

Types + Potential Adverse Effects:

Conventionally raised crops are often sprayed with synthetic pesticides, including:

1. Organochlorines. The most infamous organochlorine pesticide? DDT. Used after World War II, DDT was officially banned in 1972 because it caused human health harms: breast cancer and other cancers; male infertility, developmental delays, and nervous system and liver damage (3). However, DDT is a forever chemical that persists to this day—and it is still used in some countries.

Considered an endocrine disruptor, other organochlorine pesticides include dieldrin, endosulfan, heptachlor, dicofol and methoxychlor (4, 5). Chronic exposure to organochlorine pesticides is associated with adverse effects on the liver and kidneys (6).

2. Organophosphates. This class of pesticides includes malathion, parathion and dimethoate, some known for their endocrine-disrupting potential (7).

One of best known and widely used organophosphates is glyphosphate, a.k.a., Roundup, which is widely sprayed on commercial crops, like wheat, as well as on golf courses and home lawns and gardens.

Glyphosphate (Roundup) is linked to many adverse health effects, including: ADHD, gluten intolerance, hypertension, diabetes, heart disease, stroke, autism, kidney failure, Parkinson’s and Alzheimer’s diseases and cancer (8). As an endocrine disruptor, glyphosphate mimics estrogen and is associated with increased risk of breast cancer (9).

3. Carbamates. A class that includes aldicarb, carbofuran and ziram, carbamates demonstrate endocrine-disrupting activity, and they are associated with reproductive disorders, increased risk for dementia and non-Hodgkins lymphoma (10)

4. Triazines. This category of pesticides, which includes atrazine, simazine and ametryn, is associated endocrine-disrupting effects and reproductive toxicity, including increased breast cancer incidence (11).

5. Pyrethroids. These include fenvalerate, permethrin and sumithrin. Studies suggest negative reproductive effects including DNA damages in sperm (12). Exposure to pyrethroids, like fenvalerate and sumithrin, may be linked to reproductive dysfunction, developmental impairment and cancer (13).

6. Neonicotinoids. This relatively new class of systemic insecticides—imidacloprid, thiacloprid and thiamethoxam—has negatively affected honeybees and is associated with reproductive dysfunction in birds and mammals. Researchers have found that neonicotinoids also increase the expression of the enzyme aromatase, which contributes to breast cancer (14).

Where they are:

Pesticide residue can be found in:
–Conventionally grown fruits and vegetables
–Conventionally raised meats
–Dairy products, like milk, cheese, butter, sour cream, yogurt (15)
–Processed foods
–Fast food

What YOU can do:

–Eat organic produce. Leafy greens, like spinach, kale, collards, mustard greens and lettuces are highest in pesticide residue.
–Eat organic fruit. Strawberries (and other berries), apples and peaches retain the highest levels of pesticide residue.
–Eat organic and/or 100% grass-fed and grass-finished meats and poultry as much as possible.
–Rethink the amount of dairy you consume.
–Eat more organic whole foods (and I’m not talking about “organic” Oreos!)—and less fast food and processed foods out of bags, boxes and cans.
–Get support around making healthier, toxin-free food and lifestyle choices. Schedule a free consult HERE.

2. Sulfates | Shampoo

What they are:
Sulfates are made of sulfur-containing mineral salts. Sulfates are surfactants, molecules that can attract both oil and water. One end of the molecule attaches to oily dirt; the other end attaches to water. Sulfates can lift grease and grime off our skin and scalp, creating an “emulsion” that enables an easy rinse and leaves our hair and skin feeling “clean” (16). The two most widely used sulfates are SLS and SLES. Both are inexpensive and pervasive surfactants, synthetic detergents that serve as cleansers, degreasers and foaming agents.

Types:

Sodium Lauryl Sulfate (SLS). Sodium Laureth sulfate (SLES). There are more, but these are the two most commonly used sulfates.

SLS and SLES are chemically similar. SLES is derived from SLS and further undergoes a process called ethoxylation to become SLES. ‌

The result of ethoxylation is two-fold: SLES is a less harsh chemical than SLS. However, the same ethoxylation process that makes SLES less irritating also exposes it to 1,4-dioxane, a carcinogen (because of its ability to damage DNA); 1, 4-dioxane is also a known by-product of ethoxylation (17).

Although SLES must be purified to remove 1,4-dioxane, there is no way of actually knowing if SLES has been purified or not (because this process is not legislated).

Where they are:

Marketing campaigns have programmed us to believe that a “good” shampoo produces a foamy lather, but that foaminess is created by SLS or SLES.

In addition to shampoo, you’ll also find SLS and SLES in the following:

Hair conditioners. Soaps (bar and liquid). Bubble bath. Bath bombs. Facial cleansers. Shaving cream. Toothpaste. Mouthwash. Body wash. Laundry soap. Dish soap. Household cleaning products. Beware of greenwashing terms like “derived from coconuts” or “comes from coconuts”—it’s still SLS/SLES!

Potential Adverse Effects:

The skin is our largest organ and serves as our first line of defense. This is where surfactants, like SLS and SLES, can be problematic, especially in susceptible individuals.

In one study, German researchers found that among 1,600 patients who were tested for reactivity to SLS, 42% (668 subjects) had an irritant skin reaction (18). A small sample study found that regular exposure to SLS over 6 non-consecutive weeks (103 days) caused contact dermatitis; once participants were no longer exposed to SLS, their skin irritation stopped (19).

The European Medicines Agency acknowledges that while sensitivity to SLS can vary based on concentration, contact time and patient population: “SLS is a moderately toxic material with acute toxic effects including irritation to the skin, eyes, mucous membranes, upper respiratory tract, and stomach.” (20).

Who should avoid SLS / SLES?

Personally, I avoid all shampoos, soaps and toothpastes containing SLS and SLES. The Cosmetic Ingredient Review (CIR) deems SLS and SLES generally “safe”. But we are all physiologically different: let your body be your guide.

Consider avoiding if you have:

–Sensitive skin
–Eczema
–Rosacea
–Psoriasis
–Dry, itchy and/or flaking scalp
–Color-treated hair, damaged hair
–Hair loss

What YOU can do:

–Go native. Wash your hair with baking soda as a “shampoo”—there will be no “lather”! Rinse hair with a mixture of 1-2 tablespoons raw apple cider vinegar in 1 cup filtered water.
–Choose sulfate-free shampoos, conditioners, and other personal care products.
–Get support around making healthier, toxin-free food and lifestyle choices. Schedule a free consult HERE.

3. Parabens | Lotions

What they are:

Parabens are a family of related chemicals that are commonly used in cosmetics as preservatives to prevent the growth of bacteria, fungus and mold. Parabens may also be used in foods and drugs (21).

Types:

Methylparaben. Propylparaben. Butylparaben. Ethylparaben. Isobutylparaben. Isopropylparaben. “Parahydroxybenzoate” is another name for “paraben”.

Where they are (22, 23):

Lotions. Moisturizers. Eye creams. Makeup. Hair care products. Shaving products. Processed foods (to prevent spoilage). Processed food packaging (to prevent spoilage; think fast food wrapping and takeout food containers).

Potential Adverse Effects:

Parabens are classified as an endocrine- disrupting chemical (EDC) and have been linked to reproductive harm. Why? As a xenoestrogen, parabens are synthetic compound(s) that mimic the hormone estrogen by binding to—and activating—estrogen receptors (24). As a result, your body reacts negatively to this fake “estrogen”. Parabens can disrupt both female and male reproductive system functioning.

Parabens are easily and quickly absorbed into the skin (25). Parabens are linked with:

–In women: Decreased fertility (26).
–In women: Interference with birth outcomes, including increased risk of pre-term birth and low birth weight (27).
–In men: Decline in sperm count and motility (28, 29).
–In men: Increase in sperm DNA damage (30).
–In men: Lower testosterone levels (31).
–Skin irritation / reactivity. An allergy or sensitivity to parabens can manifest as itchy skin, redness, redness, flaking or hives (32).
–Increased risk of developing malignant melanoma due to estrogenic effects of parabens (33).
–Increased risk of certain cancers; in particular, breast cancer (34).
–Accelerated growth of breast cancer cells (35).

*Note: In a 2004 British study that tested for parabens in human breast cancer tumors, researchers found traces of 5 different parabens in 19 out of 20 tumors (36). Although this did not prove a definitively causal relationship between parabens and breast cancer, this study was significant in that it revealed how parabens can penetrate skin and remain in breast tissue (37, 38).

In a 2019 study of Iranian women with breast cancer, researchers reported that some risk factors were stimulated by parabens. The study found that the amount of parabens consumed increased breast cancer risk—this was an especially significant association for women with a family history of breast cancer (39).

Who should avoid parabens?

–Pregnant women
–Couples trying to get pregnant
–Anyone struggling with hormone imbalances (that’s virtually everyone today)

What YOU can do:

–Use unrefined, organic coconut oil to moisturize your body.

*In the past, I had tried using “dermatologist recommended” Cetaphil for my dry skin, but it always felt slick with an icky chemical feel. When I began reading the labels of personal care products, I realized that, in using Cetaphil, I was saturating my body in synthetic chemicals. Plus, I never felt truly moisturized. I have now been using organic coconut oil as my all-over body “moisturizer” for over a decade and have found it soothing and effective. It’s also toxin-free and half the price that Cetaphil was!

–Choose organic, plant-based oils to moisturize your skin. Jojoba oil, sweet almond oil and evening primrose oil are all excellent choices. I like this one HERE.
–Choose paraben-free skincare and personal care products.
–Eat more home-cooked whole foods; avoid / limit processed foods.
–Get support around making healthier, toxin-free food and lifestyle choices. Schedule a free consult HERE.

4. Phthalates / Fragrance | Soap (Bar and Liquid)

What they are:

Phthalates are a common industrial chemical, derived from a family of man-made chemical compounds, used in the manufacture of plastics, solvents and personal care products.

Types of Phthalates (40):

BBP (butyl benzyl phthalate). *DEP (diethyl phthalate). *DBP (di-n-butyl phthalate). DEHP (di-(2-ethylhexyl) phthalate. DiDP (di-isodecyl phthalate). *DiNP (di-isononyll phthalate). DnHP (di-n-hexyl phthalate). DnOP (di-n-octyl phthalate).

*DEP: Commonly added to personal care products to enhance fragrance.
*DBP: Commonly added to nail polish
*DiNP: Commonly added as a softener in the manufacture of toys and bath toys.

In plastic products, phthalates act as a “plasticizer” making plastic more flexible and harder to break; think of commercial bottled waters. Phthalates are used to soften vinyl plastic; for example, shower curtains and IV tubing.

In personal care products and household cleaners…where you smell fragrance, there are phthalates. Guaranteed! One exception is if a product label specifies that it uses essential oils. Otherwise, if “fragrance” or “parfum” is listed as an ingredient (even alongside essential oils), or if a product is labeled “Scented”, assume it contains phthalates.

In personal care products, phthalates are used as a fixative in synthetic fragrances to help “hold” scent. This is why the scent of someone’s soap, shampoo or perfume lingers—long after they have long left a room. And why you can smell your laundered clothes a week after washing.

Where they are (41):

Soaps. Shampoos. Colognes. Perfumes. Nail polish. Sunscreen. Make-up. Any personal care or household product (e.g., all-purpose household spray cleaners, bathroom disinfectants, laundry detergents) that lists “fragrance” as an ingredient. Air fresheners. Vinyl (e.g., lawn furniture, garden hoses, building materials, shower curtains, raincoats, vinyl toys, vinyl floor coverings, etc.). Coatings on some medications. Plastics. Paint. Plastic medical devices (e.g., IV tubing, catheters, chest tubes, etc.). Foods packaged in plastic. Food processing materials.

Potential Adverse Effects:

Like parabens, phthalates are endocrine disruptors, meaning that they mimic and/or interfere with your body’s hormones. As synthetic chemicals, phthalates are linked with developmental, reproductive, brain, immune system and other problems. Phthalates can affect the functioning of multiple organs (42, 43).

Phthalates are also obesogens, chemicals that cause weight gain by interfering with your metabolism and hormones. Obesogens can increase the size / number of fat cells and/or the storage of fat in existing fat cells.

Obesogens indirectly promote obesity by altering energy balance to favor weight gain. How? By altering your basal metabolic rate (the number of calories your body needs to maintain basic functions); by altering your gut microbiome so that you are storing (vs. burning) calories; and by altering the hormones that regulate your hunger, appetite, satiety and insulin sensitivity (44, 45).

Exposure to obesogens early in life (in utero, childhood) may also increase risk of obesity later in life.

In human studies, exposure to phthalates have been strongly associated with negative health, metabolic and reproductive outcomes in both men and women, including (46):

–Type 2 diabetes
–Insulin resistance
–Overweight / obesity
–Allergy (especially in children)
–Asthma
–Poor semen quality (47)
–Impaired sperm motility (48)
–Infertility in men with significant exposure to phthalates, like DEP (49).
–Infertility in women with significant exposure to phthalates, like DEP and DBP (50).

Phthalates are an endocrine disruptor, and they interfere with estrogen receptors. Some phthalates also mimic estrogen. As a result, exposure to phthalates can cause:

–Early onset of breast development in girls (51)
–Ovulation problems (52)
–Endometriosis (53)
–Hot flashes  *Some phthalates and phthalate metabolites may affect the severity of hot flashes in midlife women (54)
–Growth of uterine fibroids (55)

Studies also suggest that exposure to phthalates increases breast cancer risk (56):

–In a 2022 study of Indian women, published in Cancer Epidemiology, researchers found a significant association between urinary concentrations of phthalates (DBP and DEHP) and increased risk of invasive breast cancer (57).

–When Danish researchers conducted a long-term study of phthalate exposure (via redeemed prescriptions for phthalate-containing drugs) on 1.12 million women at risk for a first cancer diagnosis, they found that high-level exposure to the phthalate DBT was associated with double the rate of estrogen-positive receptive cancer. Lower levels of exposure were not associated with breast cancer incidence (58).

Who should avoid phthalates?

EVERYONE! But, especially:
–Pregnant women
–Children, especially those under age 3
–Teenagers

What YOU can do:

–Read labels. Read labels. Read labels!
–Avoid all products marketed as “Scented” or where the label lists “Fragrance” or “Parfum” as an ingredient.
–Avoid products, where scent is marketed as a benefit. For example, scented candles or Lemon Pledge (“fragrance” is included in the label).

–Get support around making healthier, toxin-free food and lifestyle choices. Schedule a free consult HERE.

–Rethink the soap you use! We have intimate daily contact (hands, face, body) with soap, which enables multiple exposures to endocrine-disrupting chemicals, like parabens and phthalates (synthetic fragrance).

The labels of conventional brand-name soaps often read like a chemistry experiment. According to the FDA, most body cleansers (liquid and solid) are actually “synthetic detergent products” because they foam and make suds easily (59). Commercial soaps can potentially contain various endocrine-disrupting chemicals, including synthetic fragrance (phthalates) and/or antibacterial agents, like triclosan.

A true soap is made by combining fats or oils (from animal, vegetable or mineral sources) and an alkali (e.g., lye). The lye reacts with the oils and liquid turns into a block of soap. When made properly, no lye remains in the finished product (60).

–Buy local or choose small soap-making companies. Check out vendors who make soap at your local farmers’ market or choose small companies that make, for example, goat’s milk soap or tallow soap.

–Choose a pure glycerin soap that is fragrance-free and SLS-free, like this one.

*Note: Glycerin is a natural compound derived from vegetable oils or animal fats. It is clear and naturally fragrance-free. However, many OTC glycerin soaps can contain additives, including fragrance and other chemicals that can irritate the skin. Always read the label.

–Choose pure castile soap, which is a vegetable oil-based soap. A widely accessible brand that is SLS-free, paraben-free and fragrance-free (hence, phthalate-free)—and my longtime go-to favorite soap (both bar and liquid) is THIS ONE. This is one brand committed to high quality, well-sourced ingredients and all of its soaps (except for the Unscented bar and liquid soaps) contain scent derived from organic essential oils.

–Choose nail products that are free of phthalates (DBP).
–Avoid plastic as much as possible—and never heat your food in plastic!
–Avoid plastic products with recycling codes “1”, “3” and “7”. Recycling codes “2”, “4” and “5” are safer.
–Limit or avoid your use of or avoid processed and packaged foods.

Sources:

1 Chemical & Engineering News. Vol. 9, Issue 9. Feb. 27, 2017. Britt E. Erikson. How Many Chemicals Are In Use Today?

2  Koch HM, Calafat AM. Human body burdens of chemicals used in plastic manufacture. Philosophical Transactions of The Royal Society B, Biological Sciences. 2009 Jul 27;364(1526):2063-78.

3  Pesticide Action Network. The DDT Story.

4, 7, 8, 10, 11  Nicolopoulu-Stamati P, Maipas  S, Kotampasi C, Stamatis P, Hens, L. Chemical Pesticides and Human Health. Frontiers Public Health. 18 July 2016. Sec. Environmental Health and Exposome. Vol. 4.

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6  Carmen Freire, Rosalina Jorge Koifman & Sergio Koifman (2015) Hematological and Hepatic Alterations in Brazilian Population Heavily Exposed to Organochlorine Pesticides, Journal of Toxicology and Environmental Health, Part A,78:8, 534-548.

9  Juan P. Muñoz, Rocío Araya-Osorio, Raúl Mera-Adasme, Gloria M. Calaf. Glyphosate mimics 17β-estradiol effects promoting estrogen receptor alpha activity in breast cancer cells. Chemosphere, Volume 313, 2023, 137201.

12  Joanna Jurewicz, Michał Radwan, Bartosz Wielgomas, Wojciech Sobala, Marta Piskunowicz, Paweł Radwan, Michał Bochenek & Wojciech Hanke (2015) The effect of environmental exposure to pyrethroids and DNA damage in human sperm, Systems Biology in Reproductive Medicine, 61:1, 37-43.

13  Joan Garey, Mary S. Wolff, Estrogenic and Antiprogestagenic Activities of Pyrethroid Insecticides, Biochemical and Biophysical Research Communications, Volume 251, Issue 3, 1998, Pages 855-859.

14  Élyse Caron-Beaudoin, Michael S. Denison, J. Thomas Sanderson, Effects of Neonicotinoids on Promoter-Specific Expression and Activity of Aromatase (CYP19) in Human Adrenocortical Carcinoma (H295R) and Primary Umbilical Vein Endothelial (HUVEC) Cells, Toxicological Sciences, Volume 149, Issue 1, January 2016, Pages 134–144.

15  Schopf MF, Pierezan MD, Rocha R, Pimentel TC, Esmerino EA, Marsico ET, De Dea Lindner J, Cruz AGD, Verruck S. Pesticide residues in milk and dairy products: An overview of processing degradation and trends in mitigating approaches. Crit Rev Food Sci Nutr. 2022 Jul 23:1-15.

16  Medicinenet.com. What Is Sulfate Used For?

17  National Cancer Institute. Ethylene Oxide. Dec. 5, 2022.

18  Geier J, Uter W, Pirker C, Frosch PJ. Patch testing with the irritant sodium lauryl sulfate (SLS) is useful in interpreting weak reactions to contact allergens as allergic or irritant. Contact Dermatitis. 9 Apr 2003. Pages 99-107.

19 Branco N, Lee I, Zhai H, Maibach HI. Long-term repetitive sodium lauryl sulfate-induced irritation of the skin: an in vivo study. Contact Dermatitis. 2005 Nov;53(5):278-84

20  European Medicines Agency. 9 Oct. 2017. Committee for Human Medicinal Products. Sodium laurilsulfate used as an excipient.

21, 22  FDA. Parabens in Cosmetics. 2/5/22.

23  Environmental Working Group. April 8, 2015

24  Pan S, Yuan C, Tagmount A, Rudel RA, Ackerman JM, Yaswen P, Vulpe CD, Leitman DC. Parabens and Human Epidermal Growth Factor Receptor Ligand Cross-Talk in Breast Cancer Cells. Environ Health Perspect. 2016 May;124(5):563-9.

25  Nowak K, Ratajczak-Wrona W, Górska M, Jabłońska E. Parabens and their effects on the endocrine system. Mol Cell Endocrinol. 2018 Oct 15; 474:238-251.

26, 27, 34, 35  Environmental Working Group. Tasha Stoiber, PhD. What Are Parabens and Why Don’t They Belong in Cosmetics? April 9, 2019.

28  Jurewicz J, Radwan M, Wielgomas B, Dziewirska E, Klimowska A et al. Human Semen Quality, Sperm DNA Damage, and the Level of Reproductive Hormones in Relation to Urinary Concentrations of Parabens. Journal of Occupational and Environmental Medicine, Vol. 59, No. 11, Nov. 2017, pp. 1034-1040 (7).

29, 30, 31 Virant-Klun I, Imamovic-Kumalic S, Pinter B. From Oxidative Stress to Male Infertility: Review of the Associations of Endocrine-Disrupting Chemicals (Bisphenols, Phthalates, and Parabens) with Human Semen Quality. Antioxidants. 2022; 11(8):1617

32  Healthline.com. June 16, 2020.

33  Darbre PD, Harvey PW. Paraben esters: review of recent studies of endocrine toxicity, absorption, esterase and human exposure, and discussion of potential human health risks. J Appl Toxicol. 2008 Jul;28(5):561-78.

36, 37  Darbre PD, Aljarrah A, Miller WR, Coldham NG, Sauer MJ, Pope GS. Concentrations of parabens in human breast tumours. J Appl Toxicol. 2004 Jan-Feb;24(1):5-13.

38  Campaign for Safe Cosmetics. Parabens.

39  Amin MM, Tabatabaeian M, Chavoshani A, Amjadi E, Hashemi M, Ebrahimpour K, Klishadi R, Khazaei S, Mansourian M. Paraben Content in Adjacent Normal-malignant Breast Tissues from Women with Breast Cancer. Biomed Environ Sci. 2019 Dec;32(12):893-904.

40  Zero Breast Cancer. Phthalates.

41  Environmental Working Group. May 5, 2008.

42  National Institute of Environmental Health Sciences. NIH.

43  Wang Y, Qian H. Phthalates and Their Impacts on Human Health. Healthcare (Basel). 2021 May 18;9(5):603.

44  Darbre, Philippa D. Endocrine Disruption and Human Health. 2015

45  Heindel JJ, Blumberg B, Cave M, Machtinger R, Mantovani A, Mendez MA, Nadal A, Palanza P, Panzica G, Sargis R, Vandenberg LN, Vom Saal F. Metabolism disrupting chemicals and metabolic disorders. Reprod Toxicol. 2017 Mar;68:3-33.

46, 47  Wang Y, Zhu H, Kannan K. A Review of Biomonitoring of Phthalate Exposures. Toxics. 2019 Apr 5;7(2):21

48, 49, 50 Campaign for Safe Cosmetics. Phthalates.

51, 52, 53 Endocrineweb.com. Lisa Marie Basile. The Everyday Chemicals That Could Be Harming Your Hormone Health. Feb. 17, 2002.

54 Ziv-Gal A, Gallicchio L, Chiang C, Ther SN, Miller SR, Zacur HA, Dills RL, Flaws JA. Phthalate metabolite levels and menopausal hot flashes in midlife women. Reprod Toxicol. 2016 Apr;60:76-81.

55  Iizuka T, Yin P, Zuberi A. Mono-(2-ethyl-5-hydroxyhexyl) phthalate promotes uterine leiomyoma cell survival through tryptophan-kynurenine-AHR pathway activation. Proceedings of the National Academy of Sciences. Vol. 119, No. 47, Nov. 14, 2022.

56  Wu, A.H., Franke, A.A., Wilkens, L.R. et al. Urinary phthalate exposures and risk of breast cancer: the Multiethnic Cohort study. Breast Cancer Res 23, 44 (2021).

57  Mukherjee Das A, Gogia A, Garg M, Elaiyaraja A, Arambam P, Mathur S, Babu-Rajendran R, Deo SVS, Kumar L, Das BC, Janardhanan R. Urinary concentration of endocrine-disrupting phthalates and breast cancer risk in Indian women: A case-control study with a focus on mutations in phthalate-responsive genes. Cancer Epidemiol. 2022 Aug; 79:102188.

58  Ahern TP, Broe A, Lash TL, Cronin-Fenton DP, Ulrichsen SP, Christiansen PM, Cole BF, Tamimi RM, Sørensen HT, Damkier P. Phthalate Exposure and Breast Cancer Incidence: A Danish Nationwide Cohort Study. J Clin Oncol. 2019 Jul 20;37(21):1800-1809.

59, 60  FDA.