Endocrine Disruptors: Unveiling the Impact of Environmental Factors on Hormonal Health

Since the 1940s, chemical manufacturing has increased exponentially, leading to 84,000 human-made chemicals now in existence. The Endocrine Society estimates that 1,000 or more of these chemicals can be considered endocrine-disrupting chemicals (EDCs) based on their properties. Exposure to these chemicals can occur through the air we breathe, the water we drink, the food we eat, and the various household materials and products we come into physical contact with each day.

Alongside increased exposure to chemicals, there have been increased rates of endocrine-related diseases and disorders. Exposure begins as early as the womb, where chemicals can pass through the umbilical cord to the fetus. This exposure during development not only risks potential harm to the individual exposed, but can also pass health risks onto future generations (52). In this article, we will discuss what EDCs are, their impact on our health, and how functional medicine labs and treatments help identify and eliminate exposures.

[signup]

What Are Endocrine Disruptors?

Our endocrine system produces hormones, which are chemical messengers responsible for regulating hundreds of bodily processes, including growth, reproduction, metabolism, blood pressure, blood sugar, sleep, and mood. Endocrine disruptors are compounds that can mimic or interfere with the normal function of the body’s hormones. Endocrine-disrupting compounds can be naturally occurring substances found in foods we eat or man-made, synthetic substances. Some synthetic compounds, such as pesticides, are released intentionally into our environment, while others are byproducts of industrial and combustion processes, like dioxins.

EDCs can enter the body through multiple routes: air, water, food, and skin contact. Some individuals’ professions, industries such as coal, steel, rubber, or textile manufacturing, put them into more frequent contact with potentially hazardous compounds (occupational exposures). However, other environmental exposures, such as through ambient air or drinking water, can be sources of low-grade, chronic exposure to the general population as well. Nearly all individuals have some level of EDCs in their bodies. As awareness has grown about the risk of EDCs, some steps have been taken to regulate and limit their use, but they remain pervasive in our environment.

What Is The Impact on Hormonal Health?

EDCs interfere with our endocrine systems in multiple ways. They can increase or decrease hormone production, mimic the action of a hormone, or change the production or metabolism of a hormone. One way in which they alter hormone signaling is by binding to hormones’ receptors. They can either bind to a receptor and block activation, preventing that hormonal process from taking place, or they can mimic the hormone’s action, triggering an inappropriate hormonal response. Since the body’s endocrine system responds to very small changes in hormone levels, even low doses of endocrine-disrupting chemicals can be disruptive to our health.

Exposure to EDCs during important developmental periods can also change the epigenome, increasing the risk of disease later in life. Research shows that EDCs are most damaging to developing bodies, so pregnant women and young children are especially vulnerable to negative health outcomes. Epidemiological data suggests that EDC exposure is higher in people of color and low-income individuals. (20, 21) 

Since EDCs can disrupt many different hormones, they are associated with numerous health conditions, including infertility, abnormalities in reproductive hormones, endometriosis, early puberty, cancers, diabetes, obesity, cardiovascular disease, neurodegenerative diseases, immune system dysfunction, and neurological and learning disabilities. A study done in 2016 estimated that the costs of diseases related to EDC exposure in the United States were around $340 billion. (2, 24)

What Are Some Common Endocrine Disruptors? 

Endocrine disruptors are a diverse group of compounds that can be classified as plant-derived, industrial chemicals, manufactured household goods and consumables, medical supplies, or pharmaceuticals. Common endocrine disruptors include: (20)

Bisphenol A (BPA)

There are over 140 hazardous chemicals found in plastics, including BPA. BPA can leach into our food and drinks from canned foods, tableware, Tupperware, water bottles, and baby bottles. 

Pesticides

There are over 800 pesticides registered for use in the US. Herbicides are commonly used on lawns to prevent the growth of weeds, insecticides are used in homes and agriculture to control insects, and fungicides are used to protect crops from mold. Due to the variety of ways we use pesticides, we can be exposed through oral consumption, breathing, and skin contact.

Phthalates

Phthalates are used to make plastics more durable. They are found in lots of products, including food packaging, personal care products, and children’s toys. 

Dioxins

‍Dioxins are usually produced as byproducts of industrial incineration processes. They can also be released into the air during fires. They are one type of persistent organic pollutants (POPs), which are a class of chemicals that are resistant to degradation and accumulate in the environment.  

Polychlorinated Biphenyls (PCB)

PCBs were used as coolants and lubricants in electrical equipment until they were banned in 1977. They are another type of POP.

Heavy Metals

Heavy metals, such as lead and Mercury, demonstrate endocrine-disrupting effects. Most commonly, we are exposed to Mercury through the consumption of seafood, but other routes of exposure are also possible, like through dental amalgams. We are most commonly exposed to lead through old pipes and lead-based paints.

Functional Medicine Labs to Test for Endocrine Disruptor Exposures and Hormonal Effects

Functional medicine labs allow practitioners to identify patients with significant environmental exposures as well as those who are experiencing hormone imbalances.

Toxin Testing

The Environmental Toxins test measures 39 toxicants in the urine to determine the presence of excess environmental exposures. Some of the important EDCs it can detect include herbicides, pesticides, phthalates, and BPA.

Hormone Testing

Thyroid function is assessed in a blood test. Often, TSH alone is used as a screening tool for thyroid disorders, but relying on just TSH can miss 7% of patients with a thyroid dysfunction. A complete thyroid panel measures TSH, T4, T3, free T4, free T3, and thyroid antibodies. 

To assess adrenal and reproductive hormones, blood, urine, and/or saliva testing can be used. 

A DUTCH Complete test is a great option because it uses a non-invasive urine collection to measure adrenal hormones, including the diurnal pattern of cortisol, as well as reproductive hormones and their metabolites. This provides a complete picture not only of hormone production but also of hormone metabolism. An additional biomarker, 8-hydroxy-2' -deoxyguanosine (8-OHdG), is a marker of DNA damage and oxidative stress, which can be useful in the case of suspected toxic exposures.

Functional Medicine Labs to Test How Well Your Body Can Rid Endocrine Disruptors

In addition to identifying EDC exposure, functional medicine labs can also provide insight into patients’ abilities to metabolize and eliminate those compounds.

Liver Function

The liver plays an important role in detoxification, the process of removing harmful compounds from the body. Detoxification in the liver consists of two phases. In Phase I, cytochrome P450 enzymes transform compounds into water-soluble metabolites that are reactive and potentially harmful to the body. Phase II detoxification then neutralizes these Phase I end-products into metabolites that can be eliminated either through the urine or stool. The Hepatic Function Panel measures important markers of liver function to assess overall liver health. The Hepatic Detox Profile is a urine test that measures D-glucaric acid, a byproduct of Phase I detoxification, and mercapturic acid, which is an end-product of Phase II detoxification. These markers provide information both on exposure as well as the efficiency of Phase I and II detoxification. 

Kidney Function

The Renal Function Panel measures multiple biomarkers associated with kidney function to ensure that urinary waste products can be eliminated properly.

Comprehensive Stool Test

The GI Effects comprehensive stool test analyzes digestive function, intestinal inflammation, and the microbiome. Since some toxic compounds are eliminated through the stool after liver detoxification, proper digestive function is crucial to complete the detoxification process. Dysbiosis and intestinal permeability have been associated with liver dysfunction.

[signup]

Reducing Exposure to Endocrine Disruptors

EDCs are pervasive in our environment and not completely avoidable. However, there are some tips we can follow to help reduce our exposure: (24)

• Avoid eating and drinking out of plastic containers. Instead, use glass, porcelain, or stainless-steel containers whenever possible.
• Reduce consumption of packaged and processed foods.
• Replace non-stick cookware with non-toxic ceramic pans.
• Purchase organic meat, dairy, and produce when possible. The EWG’s Dirty Dozen is a list of fruits and vegetables with the highest level of pesticides to prioritize which produce we should try to buy organic.
• Consider using air and/or water filters in the home.
• Avoid fragrances and read the labels of personal care products. Try to find products that are phthalate-free, BPA-free, and paraben-free. The EWG’s Skin Deep database can be a useful tool in finding non-toxic products. 

Nutritional Recommendations to Detoxify and Rebalance Hormones

Proper functioning of the liver, gastrointestinal tract, and kidneys is important to support the detoxification of EDCs. The liver uses vitamins, minerals, amino acids, and antioxidants as cofactors in Phase I and Phase II detoxification. Adopting a whole-foods diet with plenty of fruits and vegetables helps to ensure you consume the nutrients and phytonutrients that support detoxification (30). Consuming adequate amounts of fiber supports regular bowel movements, healthy microbiome diversity, and liver health (33). Drinking water to stay hydrated prevents constipation and helps the kidneys to remove waste products more efficiently (5, 35).

Supplements & Herbs to Detoxify and Rebalance Hormones

These supplements are helpful for assisting the body in the detoxification process:

Milk Thistle

The active constituent in milk thistle is called silymarin. It provides antioxidant protection to the liver against free radicals produced during the detoxification of toxic substances. It also stimulates enzymes that are critical in the liver’s detoxification pathways.

NAC

N-acetyl cysteine (NAC) is a supplement form of the amino acid cysteine. Cysteine is a precursor to glutathione, an important antioxidant in the liver that is involved in detoxification reactions. It also has chelating properties that can support the elimination of heavy metals. 

Probiotics

Probiotic supplementation improves the gastrointestinal microbiome and regulates bowel movements, aiding in elimination. Probiotics also reduce intestinal permeability, preventing bacterial translocation and excess LPS exposure (endotoxemia) that can cause liver inflammation and damage.

Resveratrol

Resveratrol is a nonflavonoid polyphenol found in foods such as grapes, apples, blueberries, and plums. Resveratrol modulates Phase II detoxification enzymes in the liver. It also stimulates important antioxidant enzymes in the body and has been used in the treatment of hormone imbalances.

Lifestyle Practices to Detoxify and Rebalance Hormones

Sweating, either through therapies such as sauna or physical activity, can help with eliminating of toxic exposures. Supporting the liver-gut axis through exercise aids detoxification and hormone balance. Exercise improves microbiome composition, regulates gastrointestinal motility, and modulates liver detoxification enzymes. (18, 49, 58)

Our sleep-wake cycle affects important bodily functions like digestion and hormone release. Sleep deprivation is associated with liver dysfunction, gastrointestinal conditions, and hormone imbalances. Implementing a sleep hygiene routine is an important first step in improving sleep quality. (3, 34, 53, 60) Good sleep hygiene practices include things like incorporating daily physical activity, maintaining similar sleep and wake times each day, keeping the bedroom cool and dark, and avoiding distractions before bed like TV and cell phones. 

Psychological stress negatively impacts the health of both the liver and the gut (32). Stress management techniques like yoga, mindfulness meditation, and breathing exercises can be helpful in regulating our physiological responses to stress to counteract negative impacts on the gut and liver, which could hinder their ability to efficiently remove unwanted exposures.

[signup]

Summary

Endocrine-disrupting compounds are pervasive in our environment. These compounds not only impact our own well-being but can also impact the well-being of future generations. The tips and tools discussed in this article can assist patients in preventing exposure to these compounds and eliminating them when they occur. Functional medicine practitioners can also order labs when needed to assess toxic exposure and the function of the organs of detoxification and elimination.