Episode 46: Environmental Health with Dr. Aly Cohen

We’re joined by Dr. Aly Cohen, a nationally recognized expert in environmental health and integrative rheumatology. Dr. Cohen helps us unpack what “toxins” actually are, how everyday chemical exposures affect the immune and endocrine systems, and why vulnerable stages like pregnancy, childhood, and adolescence matter so much.

Drawing from over 20 years of clinical experience, Dr. Cohen explains how regulatory gaps in the U.S. allow harmful chemicals into our homes, food, water, and personal care products, and most importantly, what we can realistically do to protect ourselves and our families.

This conversation moves beyond fear and into practical, science-based prevention.

What We Cover in This Episode:

• What toxic chemicals are and why they matter for human health
• Why pregnancy and early development are critical windows of vulnerability
• Why most chemicals in the U.S. are not adequately tested for safety
• How household and personal care products can disrupt hormones and immunity
• The 4 A’s of Environmental Health Management
• How to choose safer baby products, skin care products, cosmetics, and household items

About Dr. Aly Cohen:

Dr. Aly Cohen is a board-certified rheumatologist and integrative medicine physician with national recognition for her work in environmental health, disease prevention, and medical education. She is the author of Detoxify: The Everyday Toxins Harming Your Immune System and How to Defend Against Them and co-author of Non-Toxic: Guide to Living Healthy in a Chemical World.

Dr. Cohen is the founder of TheSmartHuman.com, lectures nationally, serves as a legal medical expert for toxic exposure cases, and has received numerous awards including Top Docs NJ (2016–2025) and the Burton L. Eichler Award for Humanitarianism.

Connect with Dr. Cohen:

• Website: TheSmartHuman.com
• Social Media: @TheSmartHuman

Additional resources:
Environmental Working Group

Clearya

Yuka

Transcript

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Hi everyone. Welcome to the I Am Well MD podcast.

Today we have Dr. Aly Cohen joining us. Dr. Cohen is a board certified rheumatologist and integrative medicine physician recognized nationally for her expertise in environmental health and medical education. She's the author of Detoxified: The Everyday Toxins harming Your Immune System and how to Defend against them,

and this book connects the dots between everyday chemicals and the epidemic rise in immune disorders and autoimmune disease and it tells us what we can do about it. She continues to teach, lecture, and practice medicine in Princeton, New Jersey. And without further ado, here's Dr. Cohen.  Dr. Cohen, it's so good to have you on the show today, welcome. Thank you for having me  and talking to your audience I appreciate it.  So tell me a little bit about yourself and how you got to be where you are today.  Oh boy. Do you have all day? No, I just wanna keep it brief,  so I'm a practicing rheumatologist, and I went back to train in integrative medicine, which is kind of a holistic approach.

 To healing that brings in ancient, traditional,  you know, healing process like Ayurveda and Chinese medicine, but also nutrition, environmental health, sleep medicine.  So I really wanted that to add to many of the conditions I see in rheumatology, lupus, autoimmune diseases, those kind of things. And then I, you know, really learned about how chemicals affect human health, over a period of about

16, 18 years. My son's 18 now, so when he was a baby and it kind of snowballed. So now I'm really taking what I've learned, what I didn't learn in med school, unfortunately  and what I've picked up along the way from researchers that I work with,  and environmental health to add to better messaging to my patients and to colleagues. 

Hmm.  I'm in the same boat as you, so after I finished my residency is when I really started to dig my heels in.  I got a little bit of integrative medicine in  because I consciously planned my curriculum so that I would get some in during medical school, but it wasn't offered by my medical school per se.

I had to go out and search for it but when it came time for me to start having kids and we were doing some family planning, I was like, all right, well, let's just try to clean up some of the stuff that I use and I can't tell you how frustrating it was to find that literally every product I had, had something that was toxic in it.

 Whether it was my shampoo, my lotion,  I really leaned on the Environmental Working Group website to help me figure out what I could keep and what I had to toss in order to feel like I was going to be healthy enough for my pregnancy.  Yeah, I mean  look instinctively as parents, I will say this goes for any human, but for those who become pregnant, it's usually or often the very first moment that you start to think about, well, what do I really put in my body?

Because anthropologically and thinking about how we've evolved over millions of years at a very primal level, we're conscious that when you're creating a fetus. You start to think about what makes a fetus grow? What are the building blocks for bone, for blood, for tissue? And what perhaps, you know, instinctively in our modern day world, might we want to think about eating or drinking.

 Because we're in that state, as being a pregnant person. Now there's a lot of people doing this a lot earlier or independent of being pregnant. My middle schooler who is navigating the world of dating and being interested in girls who wants to wear cologne and smell really good with all his male personal care products, which, who knew that even would exist nowadays, right?

But the idea is that anywhere along the journey that people are looking to  think about what they put in their body, what they put on their body, so in, on and around their bodies. There's always a great opportunity to start the process and it doesn't mean you have to give up everything. I mean, I'm sitting here with colored hair, right?

I get my hair in foils, and I've been doing it since I was like probably 15 years old, 20 years old, I don't know but it's been a long time. And my kids play  lacrosse on, chopped up tire crumb in their turf fields that are,  touted as being the best athletic fields in this state or this, you know. So, there's a lot of messaging that we're given that doesn't always apply to the chemicals that we're exposed to.

I think number one we should learn what the problem is,  in terms of how we got here,  in terms of the chemicals that have been created, especially since World War II that are in food and water and cosmetics and personal care products. The second piece in the US is to know that they have not, for the vast majority of these 300,000 plus chemicals, been tested for safety or toxicity.

In particular in vulnerable populations like  pregnancy, during pregnancy, during childhood development, during teenage years, which is a lot of flux, and then even menopause too, so once you learn that we have a big problem with chemicals, new to the human experience, we don't have regulations on any real scientific level that really manages these chemicals for what we should and shouldn't be  taking or exposing ourselves to.

And then most importantly, what we can all do about it. And that took a long time to figure out and hopefully we'll get into some of that today of course.  I agree.  I think once I started learning about environmental medicine, I began to realize, gosh, we live in a world that has lots of toxic substances in it.

And you know, it's a matter of whether or not we take control over our immediate environment, so  we minimize or mitigate those effects  so yeah, I'm excited to dive into this. I think my eyes really first started to open up when I saw what the studies were like for how many toxins were in cord blood, right.

The blood that goes in the umbilical cord from mother to child, and I was floored.   That was a great study, that was 2005 in Environmental Working Group, which is one of the very well-known, well vetted resources, which I'll, I'm sure you'll share and  I'm sharing as well with my patients and in the public environmental, the environmental working group, basically looked at the cord blood, which next, like you said, mother to.

Fetus when the baby comes out, you clamp the cord, and then you know, you take care of the baby. But that cord blood is very important because it really identifies that connection, that communication between the fetus and the mom all throughout the pregnancy. And when they looked at the blood itself,

 and it was amongst 10  women and their babies, they looked at just 10 from across the country, moms with different habits, perhaps nothing specific. They looked at that blood and found over 175  industrial chemicals that could be found in solvents and paints that could be found in makeup,

those chemicals. And the, the real shocker of it was that there was no prediction of who would have more or less.  So moms that were eating super clean, perhaps felt they were versus  moms that weren't necessarily paying attention to  certain diets or that  what have you. It really  created humility,  and also made us really understand that we're all in this together.

 That expensive products don't always mean safer products, that cheaper products don't always mean unsafe products.   I do this with products I bring to high schools and let the kids look at them and you might think Chanel number, whatever versus  store brought nail polish at CVS or Walgreens, that they might be completely different by cost.

 In terms of safety,  not true. That's what we discovered when I throw these objects and these products to students to look up on  EWG's,  website and their app, Healthy Living. So, the idea that we all have access now to be able to look up a lot of these products, even if they're not government regulated before they go into the market, really gives me hope, gives me,   lot of empowerment and hopefully that gives people empowerment to have agency over their bodies and what they choose for products.   We have  access to these really great resources. Not just EWG, but Clearya,  Yuka, Think Dirty. These are all really great free apps on our phones that we could look at during our shopping experience.

And my son back to him, he's able to look up these products in two seconds, right? He's able to look out what he wants, what he think, you know, and then he makes a case for them to me to see whether he can buy them. But he's teaching his friends,  and his friends are learning how to look up these products, too.

 And it is really exciting because  they're looking at as gamifying the process, right? We're stuck in this pickle of exposure. We do have lots of stuff that has  harmful chemicals, but we can just as easily not only reduce how many we use in our life and on our skin and feminine care products and tampons and all that, but we can also, swap out to safer versions.

Not just reduce the overall, but even swap out.  So are you open to talking a little bit about brands during this conversation? Actually, I don't share brands. Part of what I do and what makes my messaging, I think much more, resonate amongst academic centers and places where I wanna get curriculum in and high schools and colleges is that I'm not 

going to share brands because it really, to me, muddies the, messaging to think that I might have a, biased reason to mention those endorsements or those brands, as if I get some kind of payback and to me, I've chosen all along not to do that. So I will, as I do with my books and my posts on the Smart Human, which is my social media, "the smart human,"

I post in a way that I'm hoping that will give people the tools to look at the labels and understand why labels for a couch that I just posted on how to find couches without flame retardants, I just literally,  posted that  to Instagram  how to look up produce in a supermarket and understanding which organics are labeled with a nine in front of their produce instead of without a nine,

 which identifies within the shopping market industry that that's organic,  how to look up on EWG. So all of the hacks that I'm sharing really don't require endorsements of brands. They're really about how to do the work simply and practically to get what you need. And that, that goes to the fact that many formulations change 

 Ingredients. Many brands change ingredients, so they're not always gonna stay the same in terms of maybe their level of toxicity or their rating on some of these apps and so you wanna be able to have the skillset to be able to game that problem and be able to choose no matter what happens to the market.

And so that's part of why I don't share brands.  That's good to know.  I'm glad that you shared that.  So let's dive into diet for a moment because I feel like I talk about this at  every doctor's visit, to be honest. Like, what's your kid eating? Are they eating their fruits and vegetables?

 Tell me a little bit about your thoughts on organic, non-organic pesticides, artificial flavors, colorings, you name it. Yeah, there's a lot to unpack here so  I kind of start to think about this in, in a more of a global, framework because look, it's hard enough for the messaging to say all right,  processed foods like fast foods and McDonald's and Burger King and packaged goods and,  sort of like what we know is junk, right?

You know, the chips and,  all that stuff.  That's a big lift, number one to say, let's try to move away from those processed foods into sort of a more whole, whole food diet, which is, you know, buying vegetables, whether it's at a local market or it's in your supermarket where you have the whole vegetable and you're gonna chop it up and cook it, or,

meat, that's real meat that you're getting from a store, turkey and fish and chicken, what have you, versus say,  a burger or fries or those kind of things so that's a big lift for many practitioners and I get it because the country loves that stuff and I certainly grew up on that stuff and love that stuff.

 But now the next level for people who get beyond just sort of processed and ultra processed versus Whole Foods  is, how are those whole foods looking in terms of their exposures to chemicals and what are they bringing into your diet  by not being  restricted from a variety of pesticides and farming chemicals that are allowed even in whole food  production, right?

Mm-hmm. Um, and so it's kind of a second layer that I'm realizing.   That's a whole nother lift. So I try to give people enough information not to overwhelm them, but the answer, the punchline I would say to you is first discussing why Whole Foods matters to a modern day body, human body. Because for millions of years we've had exposure to far less chemicals, more whole foods, less processed foods, and the human body and humans have evolved for over 4.5 million years.

Then you hit this sort of last 100 years of of our existence and we've had over 300,000 chemicals really added to our world, and to our food system and the food system is very limited in what it protects us from, okay. We've seen headlines about getting rid of red dye number three. Well, that's just one of thousands of chemicals that had been grandfathered in under what's called the  "generally regarded as safe" or GRAS designation, which really has so many loopholes,

it's kind of worthless.  To that point, the only thing that's ever really been created in the US food system that gives protection from a health perspective   is USDA organic certification or designation. And because it took 10 years to create and 10 years to implement, it's not a perfect system, but it is the best system we have in terms of having cleaner  food and restrictions on genetically modified ingredients, on a variety of farming chemicals that are used in fertilizers, and certainly pesticides- thousands of pesticides that are not allowed to be utilized in the soil, or even the products themselves when they're making those packaged organic foods.

So the idea that we have this one thing, hopefully will not be messed with in the next decade, it really is something that we can all hold onto. Now that being said, people might be thinking, oh, well maybe it's more expensive, or the access to organic foods, you know, that being said, it's healthier.

Maybe it's safer, maybe it's less chemicals, you know, can everyone have access to it? Well, the answer is, is that frozen USDA organic foods that are packaged, you know, primarily produce, right? Organic corn, organic asparagus, organic broccoli heads, organic berries, if it has that USDA organic seal it is going to be under the designation of organic in the food system and when it's frozen, you have this added benefit, not just having less pesticides and chemicals, but you have this added beautiful benefit of being more nutritious in many cases because you're flash freezing that produce when it's picked from the ground, and that's how farmers work.

I live on a farm here in New Jersey and the spinach farmer is one of the biggest spinach farmers, conventional spinach farmers in the whole East Coast, and he said  the minute that they can pull that spinach, they run it over to the huge you know, containers, I mean, they're monstrous.

They're building- size where they're filled with ice and they throw that spinach right in to kind of flash, freeze it because every second counts to get it to the market. But being frozen, it really locks in a lot of that nutrient value, the B vitamins, the antioxidants really isn't good shape. Whereas fresh supermarket organic often travels for weeks or even months  to get to the supermarket into that organic section. It doesn't happen overnight. I just had blueberries in a, a little plastic container from Peru and I know they weren't  picked that morning. So, you know, the idea is that when it's not in season, that means it travels further and longer.

So you wanna go with in-season produce. 'cause it tends to be more nutritionally balance because it's been picked more readily and more locally.  You wanna go with organic whenever you find it, whenever you feel that you can afford it, whenever it's frozen, it's usually more accessible, and cheaper.

And then you can always wash conventional, non-organic produce that's always available to everyone and that means agitating and rinsing in warm, clean water with a little baking soda,  one part baking soda to three parts warm water. Um, you can do one part   white vinegar to three parts warm water.

So in other words, less of the baking soda or the vinegar and more of the water, but essentially that works to get off pesticide residues. So there's value in that too, even if it's not USDA organic, which is not always available even in my supermarket. So, you just make these choices, but it's nice to have options and frozen organic, I believe is underrated

and definitely more accessible and cheaper  than we previously thought.  That's great. I've always questioned how much nutrition is lost in the freezing process and the reheating process. Right. Do you know, is any nutrition lost in that process? Yeah, no, it's a really great question.

In fact, I identified that in one of my books. Not, uh, I think in the most recent book, but certainly,  Non-Toxic was the middle book that had a lot more about food cooking and preparation  but the most recent book Detoxify has, has that in there as well, as far as I can remember. But  here's the 

the, information on that. So when you microwave, you tend to not ruin your food, but you tend to break down some of that nutrient value, even though we're all in a rush and we have multiple jobs and kids, and I get it. But microwaving in and of itself might break down some of that nutrient value. It won't hurt the food, it won't hurt you, but it does have a, a possible role in breaking down and denaturing some of those bonds, whereas steaming

really is probably the best way to cook food, especially raw food like broccoli and asparagus. 'cause now you're absorbing clean, fresh, hopefully filtered water. If you're considering that into the produce that you're gonna be eating, which is gonna contain the water you cook it in. Stir fry also could be very helpful,  in terms of keeping that nutrient

balance.  I think defrosting is a really good way to not denature anything, and then heating up lightly is a really great way if you have the time to do it. Sometimes even letting, um, like frozen wild caught berries from, you know, ShopRite, Stop and Shop. These are national big box brands, even Target, you can let them defrost overnight and put them in your breakfast foods in the morning if that's something you choose or have it as a snack.

So the idea is that if you get into a routine that makes sense, that you're  keeping in mind what's the best way to prepare this food that I,  thought so carefully about. Let's prepare it properly. Let's store it in glass and stainless steel instead of plastics. Let's not heat up plastics 'cause we are trying to avoid microplastics.

'cause that's hard to do, but certainly you don't wanna do with heating.  And so yeah, these are things that are not really cost prohibitive in terms of food storage, food cooking, using stainless steel instead of non-stick pans. That's a one pan swap.  And that's available at any, stores that you can, you know, locally.

So the idea is that once you put some thought into each of these pieces, and once you swap them out, you're done.  You really keep moving. And that's what I teach in the book Detoxify, and give it a 21 day plan, because some people don't wanna know all the nuances and all the science behind it.

They just wanna get started. So I get that too.  I think there's beauty to that and then there's beauty to having the rationale to like what  what is the benefit of what I'm doing if I'm putting a little extra effort forth? It's kind of nice to know what the outcome might look like down the line. Maybe it means,  a reduced risk of cancer down the line.

Maybe it means healthier progeny.  It's having that big picture in mind as we're making these changes. I think it's just so much more motivating because I find that sometimes when things get a little bit tough, um, we tend to slide back into our old habits.  For sure. And this so shows that when we do these behavioral changes, and this is in the book, you know, I try to give people not just what to do, but why it matters.

There's wonderful studies that show when people switch from a conventional to an organic diet, that the actual urine and blood levels of many of those most common,  agricultural farming pesticides are actually reduced. Mm-hmm. And,  life and health is about a kind of a dance between our genetics, which predisposes us to anything, right?

But along with lifestyle,  running, sleeping, sauna, sweating, toxic people, emotional stress, you know, all of the things that are lifestyle related and environment, which are the chemicals, that I talk about, synthetic, you know, um, when we, we take those three components, genetics, lifestyle, and environmental health.

You can control pretty well two of those three things.  I think that it's really important to know what you can control. Kind of like the Serenity Prayer, which I live for. It's knowing what is changeable, what you can modify, what you can have an effect on. Knowing what you can't, and having sort of this wisdom to know the difference so you don't waste really good energy or even money.

I want people to spend their money not on testing.  Even though I tell people what happens when people change certain lifestyles in terms of their blood concentrations, I'd rather people take my word for it. Take the study word for it. The studies are really what I emphasized. And then just  use your money wisely.

Use it towards the solutions. Like buying foods that you think are higher quality or getting a really reasonable water filter, swapping out personal care products to other things.  That's where you wanna spend your money. So, very practical, and really about doing the best you can.

 

 Life can feel like a constant balancing act, work deadlines, family responsibilities, and everything in between.

It's really easy to get stuck in "go mode" without ever stopping to ask,  "what do I really want?"  Imagine if you could set boundaries with confidence, say no without guilt, and start doing more of the things that light you up. That's what life coaching is all about, helping you get clear on what matters most and giving you the tools to make it happen. 

Your life is unique, your journey's unique, and your solutions should be too. If you're ready to stop surviving and start living with intention, let's talk.  Visit me at iamwellmd.com  and click on the link to contact me.  Send me a little message and we'll get you started with an introductory call.  I hope to see you soon.  

It's an 80 20, you know, this is a progress, not perfection we're going for. So that's what I  want people to think about.  Totally agree. Totally agree. I mean, the, one of the big swaps that I made, before I had my first child was swapping out the plastic Tupperware for glass Tupperware,  and avoiding heating my things up in the microwave in plastic.

Sure.  And, and that's different from how I grew up.  It's different. There's that. Oh, I grew up with junk. I mean, I, my first,   my first, the introduction to all the books that I write, I talk about, you know, I grew up on Flintstone vitamins, which were colors and preserved. You know, I grew up on every sugared cereal with every color you can think of.

I, I grew up with a lot of stuff. Now look, you could say, well you look fine. What's the big deal? Right. But you know, the question is not about the actual concentration of these chemicals entirely. It's about reducing risk for the development of things that are associated with these chemicals in labs and even some human studies for sure, which I talk about.

So the ideas that we have enough information about many, many of the chemicals that are very common to our life that  are associated with the development of illness of one kind to another. I talk about hormone effects. I talk about immune system effects, but the idea is that if you can reduce those exposures,

you are therefore reducing your risk on some level, and you're essentially  potentially changing the destiny of your health throughout your life and even through, you know, for your offspring. So it's not judgment, it's not shame, it's not, you know, you did this to get that disease, or your kid might have some disabilities and it's your fault.

I never talk about that. I talk about the fact that  when we know better, we do better and we can all play a role in our own exposures  and shape our own health outcomes as best we can.  I mean, this has been huge in my, my pediatric career: BPA- free baby bottles, BPA- free teething toys.

So I was in medical school, I think around the time that people really starting to study BPA and the effect of BPA, and then it finally got pulled off the market.  Can you talk a little bit more about that? What happened?  Yeah, so what's so interesting is that BPA was one of the first chemicals that was stumbled upon, that was shown to have hormone effects, essentially a mimicker for estrogen. 

This is in the 1930s, actually even in the 1890s. But, but the idea was that BPA was capable as a chemical, as a synthetic compound that was created in the lab to create bonds and structure that made plastics hard. But it also was known, again as an estrogen  mimicker. And it was actually given to chickens to fatten them up because they knew that it was an obesogenic component.

 Hormonally, it could affect these chickens  by its ability to mimic variety of hormones. And so it was actually used in the farming industry. It was also something very similar, was Diethylstilbestrol, which was similar to BPA, which was given to women in the seventies to help prevent miscarriage.

And it was given worldwide, but a lot in the US and subsequently found to be an endocrine disrupting chemical medication that had subsequent effects that were not good in terms of vaginal cancers and a variety of other health issues. So we've known about BPA being a  estrogenic- like chemical  for a very long time and when it had enough data to show that it works like hormones in, in, just very little bits, amounts, parts per billion parts per trillion, that it had all these physiologic potential capabilities

it was removed from plastic baby bottles in 2012. After,  somewhat like, I guess 15, 20 years of research that was accumulating around the world, robust studies that were well done, particularly by one of the smartest persons I know, Frederick vom Saal, who,  was really one of the first researchers to start studying how these environmental chemicals work different than toxicology area where  the dose makes the poison.

The more you're exposed to, the more likely you're gonna see problems. Well, with this kind of chemistry, it works at such small levels that it's underneath detection for those harmful levels. So it kind of, worked very differently than what our conventional 300 year perception of toxicology was.

So he had to fight against the tide and so did his colleagues. But Frederick vom Saal was one of the first people to discover how BPA works. And, since that time he's written over a thousand papers. He's partnered with me for two books  and he's just an, a brilliant person, but his colleagues and him from around the world felt that this was such an important issue, and they fought very hard to have BPA taken out of baby bottles because of its estrogenic hormonal effects that could potentially harm a fetus.

The problem is that once that was taken out in such a small area of the product market, right, sippy cups.   Plastic  baby bottles, very narrow area. There was all sorts of, what are called regrettable substitutions that were developed to be replacements. So  BPSIP, BPF, BPF, uh, fp, there's just so many of them.

Uh, BPS being one that was found to  even have more potential problems than BPA that's now still in our market in all our plastics and our canned foods and all those things. So when it says BPA free, it doesn't necessarily mean that it's not BPA free. It may very well be BPA free, but then there's all these other compounds that were substituted that could do the same function, but also have the same health effects, if not more.

So  the answer, the punchline is try to get away from plastic, bottles, baby bottles in particular, they have glass bottles now  with silicone nipples, which are fine. You know, silicone is considered the safest plastic if you're going to use plastics, and there's very little that can recreate,  a human female breast nipple for a baby.

And so we wanna be very clear that it's better to feed your child than to be worried about plastics in the nipple.  But  that being said, there's so many more products and so many more,  options than there were when I was even pregnant, you know, uh, 18 years ago. So, um, the regrettable substitutions you're never gonna know about.

So the punchline is really stick to glass. Stick to stainless steel things that have a very strong matrix, and the chemicals within those products don't leach into the food  and water that they're either carrying, storing, or cooking in cooking with. Excellent points. Yeah, I, I remember having such concern about,  about the plastics leaching into. 

The bottles that even when it came to pumping, I didn't wanna pump into breast milk bags.  I pumped into glass bottles that I managed to find that fitted to my breast pump. Was it fun? No, not at all. Yeah,  I mean, I had plastic drop-ins.  Mean, I had what was available at the time and I certainly wasn't into any of this stuff.

 I was rolling up to McDonald's and getting the deluxe  hot breakfast, on  plastic trays every morning of my pregnancy. So, you know, you live and you learn and  you go, as you go along, you see what's available and you start to see whether or not things matter to you.

And I think that has a big, there's a big piece of any kind of change we make in our lives for any reason. It has to matter to you and that doesn't come easily. I think it has to come with over time and so, you know, again, it's a journey. This was not  my choice of career, I walked into it by accident with my dog getting sick and really trying to why he got sick back 18 years ago

and it led to this world of education and trying to teach people what are the simple steps they can make to kind of reduce those exposures  and try to be healthier. Yeah.  And I think that's for a lot of us, right? We have a strong family history of autoimmunity in my family.

And so trying to figure out, okay, what can I do to reduce the risk of autoimmunity for myself, you know? Um, time will tell how much and, and  look tomorrow with a big problem and be like, all right, guess you don't wanna listen to me anymore but the fact of the matter  is, you know, we're all trying to have some control 

 over aspects of our life. When it comes to health. Again, anyone could wake up with a problem, but you take the science that's well done, if it's well done. You incorporate what we've learned into our daily actions in a way that makes sense, that doesn't overstress us, that doesn't make us, you know, um, go broke.

 These are just simple changes that anyone can make and I do, I do weigh that out. Like for instance, I posted on couches,  choosing couches that are safer. So literally for like three, four years,  I knew a lot about flame retardants couches. I knew that they had  started to put flame retardant chemicals, which are not great for the human body.

Back in the seventies in California, and it became a national way of managing fires. If there was a cigarette left on a couch back then you would have this 12 extra seconds of burn time if you dropped a cigarette, right? Cigarette in the seventies, more so than now, onto a couch. And this is really a big  push by the

 Tobacco industry, by the way. So there's a great Pulitzer prize winning story through the Chicago Tribune that I talk about in the books, but essentially this was,  in order to not change the formulations of cigarettes or to bash cigarettes, it was all a push to put these chemicals into couches and home furnishings in the seventies

to create this 12 second burn time that people could run out of a house if you, if your couch caught on fire. So that's the backstory. What ended up happening is that these chemicals turned out to be pretty, not only pervasive, you could measure them in the blood of almost every human being in the US.  In large doses, particularly children, because children had flame retardant pajamas back then and a bunch of other products that were used to sort of sell this idea that we had to  get out of the home and be fire resistant.

 Instead of dealing with the upstream issue of cigarettes and fire,  and having to manage that.  Long story short, it took a lot of years to figure out that not only those chemicals in us, but they also can cause harm:  developmental harm, you know, risk for breast cancer, cancers themselves a variety.

Certainly, you know, firefighters we know who wear a lot of clothing that have these chemicals. So the point was to say, well, what can we do better? And eventually the law was turned over in California in 2013, and now flame retardant chemicals are not required to be in home furnishings, particularly couches, right? 

Well, that was a voluntary law for manufacturers to follow. It was not mandated. And what ended up happening is that the manufacturers who jumped on board, they would grab the market share for people who were more concerned with these flame retardants. Right. And really in order to phase this out, it had to be a manufacturer's choice.

But turns out that the label that we now have available to us will say, TB117- 2013,   and that means that couch is no longer made with flame retardant chemicals. So we have the ability to look at our couches if we're changing up couches. And the reason  I say that changing up couches, because  they're expensive items, they're not cheap.

And so I knew about flame retardant chemicals, some of the risks of them, the health issues. And meanwhile, my kids are jumping on top of  this couch, and I'm thinking, I'm like Twitch twitching, you know, because I wanna get rid of it. But we didn't have the money to just get a new couch.  And it turned out that after about two years of watching this couch and watching my kids bounce all over it, I finally swapped out my couch.

But it wasn't an easy decision and it took time to figure out if that was something we could figure into our budget. So I want people to think like that. You know, think about what's the most.  What's your priority? What can you afford? And don't beat yourself up over it because you're fearful.  And I think that's a really important thing to message, you know, in terms of restraint  and understanding of your c, your circumstances.

 And it turns out that there's now many great companies, which I can't share here, but guess, guess what? It's green science policy.org. Can share that information as I posted because I'm giving you the resources to look it up to people who do this work. They have lists of brands that you can buy couches without flame retardants.

So again, it's a matter of having good, vetted resources that manage  this, information. They do it well, they change it up, it's evergreen, they can manage it. I can't do that because I don't keep on top of the markets. It's not my area  but people can really be more in control of the things in their lives and in their home than they think. 

I think that's great information.  You mentioned your kids jumping up and down on the furniture, and I think about that with my kids. I mean, they still jump up and down on the furniture, but even carpeting and things like that, where literally these like little tiny pieces of particular matter are now  aerosolizing, essentially, like we're breathing them in.  So I think a lot of people think flame retardants stay on the fabric.  Right. Or are embedded in the fabric and that might not necessarily be true. Is that correct? Correct. And here's the thing. Febreze and air fresheners and plugin air fresheners and cleaning products and the perfumes and shampoos that we use in our daily lives, even the cables on our computers have flame retardants.

So I mean, all of these chemicals that come from all of our products, they're happening, right? But they're not just staying, you know where we use them. And here's the punchline, a lot of this stuff just becomes dust in our house. In corners,  on couches, in carpeting. So the punchline really is until you're able to work through all those different areas that you wanna work through in a timely manner, the number one thing is to dust more regularly.

Because studies show that dust itself has some of the most harmful chemicals left over from all of our products and our personal care and our furniture. So one of the best ways to keep these dust chemicals from our pets,  from our children who have hand to mouth behavior is really to clean more regularly with water wipes, no chemical wipes,  to vacuum with a HEPA filter, which doesn't, you know, shed that air out again.

It kind of recirculates and collects. So Hepa, HEPA is really, um, useful, uh, vacuum type. Mm-hmm. Um, and so there's lots of different ways that you can fix or work on the problem while you're still in progress of making those changes without any regret and fear. And so that's what I'm all about is what can you do now That makes sense,

that's helpful, that's not a stretch while you're still working on the long-term goals.  Fabulous. This is such a wealth of information, and I would love to talk to you more about it but I don't wanna overload everybody. I think there are some really great pieces here that we can start  getting on top of so that we can create

a cleaner environment for ourselves, for our kids, for our grandkids. Even for those folks who are thinking about pregnancy or planning to get pregnant, I had this interesting conversation with my kids,  because I do try to eat organic and I do try to point out, hey, like, let's talk about this choice that we're about to make here to eat Twizzlers versus, you know, what have you. 

 For my daughter, she's six. So I have to like really bring it down to an age appropriate level  but I was like, you have little egg in your belly that one day might become babies and then that might make me a grandma. But did you know that when I was pregnant with you, your egg were right there with me?

 And my son just jumped in. He was like, it's like those nesting dolls. And I was like, yes it's like those nesting dolls, like yeah, what we do matters even generations down the line. Yeah. So super cool. Yeah, it's, look, it's a big topic, you know, I try to,  break it down.

I even have the four A's of environmental health, which are part of the book Detoxify, which is how I teach high school and college, and other doctors really have to have some easy framework. The first A of environmental health navigation is Assess.  You always wanna know where you're starting from so, you know, having a 50 question, you know,  survey where you put a one or a zero and you kind of see where you're starting from on this journey is really helpful to a lot of people who don't even know the right questions to ask.

For doctors, I want them to at least ask like five questions.  Where do you get your water from? Is it filtered? Is it not? You know, what kind of food do you eat?  What kind of job are you in where you might be exposed to chemicals and not be thinking about it and bringing them home.

There's a lot of  simple questions that doctors can ask, but for all of us mere mortals, you know, understanding "assess" is a good place to start without fear or shame.  The second A is "avoid" or swap so that goes to the conversation of do I need all these, you know, bathroom cleaners and surface cleaners and oven cleaner and,  carpet cleaner, all these cleaners we've been marketed to as an example, can we lower that total amount and or can we swap out to safer versions of what we like and wanna keep in our lives?

So that's the second A, the third A is "add." As humans, and I bring in a lot of anthropology to the work I do as human beings, we really wanna think about,  what makes human beings thrive independently of the chemicals that come into our lives? We need nutrition. How does nutrition affect these chemicals that come into our lives?

Don't we know that chemicals, that certain nutritional components actually offset the harm? What about sweating? Is sweating gonna help us remove what we can't control? Yes, of course. How about sauna? How about good sleep? And understanding that when we sleep well and appropriately and have good sleep hygiene, we're actually reducing chemicals that we're exposed to during the daytime.

That's our lymphatic system. Um, how about adding in,  mental health improvements? How about adding in movement? All of those things are adding in to help our bodies thrive. Even certain supplements I talk about called human fertilizer.  What are the basics that we need to get as a supplement if we can't get it from our diet on a routine basis,  and at the right quality and quantity.

So that's add. And then the last A of the four A's is "allow," and the allow is my colored hair is my kids on the turf, you know, playing lacrosse for years, it's the Gatorade, they're grabbing for. You know it's travel when you don't have access to the stuff you can control at home, it's the water bottles that are plastic that you can't get, you know, whatever it is.

There's an allow so that you can keep moving, even if you have to adjust, you know your choices and that's life. You know, it's birthday cake, it's whatever. So I need the allow for most people and for myself in order to keep moving on the stuff that has longer, longer term benefits in my opinion. So it's about perspective and hopefully that helps people think about this topic as well. 

Beautiful. I love this. I agree. I think we just need to at least take baby steps,  in the right direction and not drive ourselves insane like I did before getting pregnant with my first 'cause I really did. I looked up everything, everything. Yeah.  Yeah. And it's stressful and stress is a toxin technically.

So you really don't wanna be in a position where you're more stressed about the topic than, you know, taking a deep breath, knowing it's a process and,  doing what you can in a reasonable way. I really can't stress that enough and, you got through it and now look at you educating others.

So it's, a lot of it is sharing your experience  and kind of helping people to do better, you know?  Agree.  Aly, this was such a great conversation. Where can our listeners find you?  Well, I practice in Princeton, New Jersey, so if someone needs to see me or wants to see me via, you know, even in person, or even through telemedicine, I do a lot of consulting and second opinions and that kind of thing online.

So that's always available. And, uh, I would love people to follow my Smart Human, it's called the smart human.com, the Smart Human on TikTok, Instagram, the Smart Human Podcast. So everything was about anthropology and evolution, and so it's called the Smart Human. And, uh, that's available to everybody in YouTube as well.

And I even have courses that are on, uh, the Smart Human Academy and I have a summit.  In case people wanna jump on the summit, which I'll have a bunch of 11 practitioners coming up in April  but that can be accessed through social media and then,  gosh, what else? The book Detoxify is the book that I came out with in May that is really a culmination of like five years of work and really pulling together rheumatology, integrative medicine, and environmental health in a really accessible, I hope, accessible way

of learning this material. So you know, any of the above. I appreciate that. This is so great. Thank you so much, so much for being here and for your time. I really appreciate it.  My pleasure. Thank you so much for having me.

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