CHAPTER 10: T IS FOR TOXINS: DETOX YOUR MIND AND BODY

Toxicity is the primary driver of disease.

DR. JOSEPH PIZZORNO, NP, THE TOXIN SOLUTION

STEVEN

Steven, 32, was a firefighter who suffered from depression, brain fog, and symptoms of post-traumatic stress disorder (PTSD) when he first came to see me. I had already seen his brother for learning issues at school, his father for job-related anxiety, and his stepmother for depression. All of them had mentioned to me their concern for Steven, especially after learning about the connection between brain health and mental health. Firefighters are exposed to environmental toxins, head trauma, and emotional trauma.

Steven initially asked me, “How can I deal with the trauma? I wish I could forget what my eyes have seen, from children being burned to losing whole families in car crashes and fires.” His scan showed signs of PTSD, with his emotional brain working way too hard, plus he also had evidence of toxic exposure, likely from breathing in carbon monoxide and the poisonous chemicals often released by burning furniture. This toxic look is very common among the many firefighters we have seen. Seeing his scan caused Steven to get serious about brain health. Within six months, he felt much better and his brain was healthier.

Steven’s SPECT Scans Before and After Treatment

STEVEN’S SPECT SCANS BEFORE AND AFTER TREATMENT

Toxic: overall low blood flow

Healthier overall

Steven isn’t alone. The dangerous professions of firefighters, police officers, first responders, and other everyday heroes subject those workers to long-lasting negative impact on their brain function. They are exposed to environmental toxins such as carbon monoxide, benzene, asbestos, and diesel exhaust; head injuries; and emotional trauma. Studies show an elevated risk of PTSD, depression, heavy drinking, and suicide in first responders.[342] Unfortunately, they are less likely to seek help because of the stigma associated with having a mental illness, fearing they will be labeled as weak or unfit for duty. Their professions have convinced them that they are superheroes and nothing could or should get to them.[343]

TOXINS AND THE BRAIN

Your brain is the most metabolically active organ in your body. As such, it is vulnerable to damage from toxins. Toxins are one of the major causes of brain health/mental health issues that traditional psychiatrists almost completely ignore. During my first decade as a psychiatrist I ignored them too. But when I started our work with brain SPECT imaging, I quickly began to see toxic patterns on patients who were not substance abusers. Uh-oh, I thought to myself, there is much more to my patients’ problem than I have considered. I wonder, how many people with toxic exposure have I missed?

Toxins are one of the major causes of brain health/mental health issues that traditional psychiatrists almost completely ignore.

Environmental toxins impact nearly every aspect of your body and can damage the brain, leading to a variety of physical and psychiatric symptoms. On the physical side, issues can include autoimmune diseases, diabetes, cancer, fatigue, numbness, tingling, tremors, allergies, abdominal pain, diarrhea, smelly stools, bad breath, weight issues, skin rashes, sweats, and more. From a psychiatric standpoint, exposure to toxins can increase the risk of depression, suicide, attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD), learning problems, memory problems, brain fog, autism, temper outbursts, psychotic behavior, and dementia. Our biological systems get rid of toxins (through the gut, liver, kidneys, and skin), but when those natural detoxification processes are overwhelmed, we can experience brain fog, fatigue, and even life-threatening illnesses. And it can certainly disrupt our mental health.

TEN WAYS TOXINS POISON YOUR BRAIN AND CONTRIBUTE TO MENTAL ILLNESS

1. 1. Reduce cerebral blood flow, which on SPECT scans has been associated with depression, bipolar disorder, schizophrenia, ADD/ADHD, and more. As you learned in chapter 5, low blood flow is the number one brain-imaging predictor that a person will develop Alzheimer’s disease.[344]
2. 2. Disrupt the endocrine system, interfering with hormone production, causing serious imbalances, and increasing the risk of depression, anxiety, and panic attacks.
3. 3. Impair the immune system, increasing your risk of autoimmune disorders and cancer, as well as anxiety, depression, and even psychosis.
4. 4. Disrupt the gut microbiome, resulting in leaky gut and accompanying problems, such as mood and anxiety disorders, ADD/ADHD, Parkinson’s, and Alzheimer’s.
5. 5. Increase the likelihood of developing diabetes and obesity, since as toxic load rises, so does risk. Toxins are also called diabesogens and obesogens because they contribute to diabetes and obesity, which raise the risk for anxiety, depression, and Alzheimer’s disease.
6. 6. Damage DNA, which can accelerate aging of the brain and lead to problems with mood, anxiety, irritability, temper, and irrational behavior, as well as memory.
7. 7. Impair enzyme systems, which disrupts many biological processes, such as the ability to produce energy and fight free radicals.
8. 8. Harm organs, including the digestive tract, liver, kidneys, and brain. This damage reduces your detoxification system’s ability to do its job, creating an even greater buildup of toxins.
9. 9. Alter gene expression, possibly turning on harmful gene variants and/or turning off beneficial ones.
10. 10. Damage cell membranes and disrupt communication between cells.

How Toxic Is Your Brain? Toxins Exposure Quiz

Over the years, our clinic has developed a checklist to help patients determine how much contact they may have had with harmful substances. By answering the questions below, you can begin to determine your own risk —and begin taking steps to combat that exposure.

1. 1. Do you smoke, or are you around secondhand smoke?
2. 2. Do you smoke marijuana?
3. 3. Do you use conventional cleaning products and inadvertently breathe the fumes?
4. 4. Have you been exposed to carbon monoxide?
5. 5. Do you travel on planes more than six times a year?
6. 6. Do you pump your own gas or breathe automobile exhaust?
7. 7. Do you live in an area with moderate to high air pollution?[345]
8. 8. Have you lived or worked in a building that had water damage and mold in it?
9. 9. Do you come in contact with flame-resistant clothing or carpet, or with furnishings sprayed with chemicals to prevent stains?
10. 10. Do you spray your garden, farm, or orchard with pesticides or live near an area with pesticides?[346]
11. 11. Do you paint indoors without ventilation?
12. 12. Do you have more than four glasses of alcohol a week?
13. 13. Do you regularly eat processed or fast foods?
14. 14. Do you regularly eat conventionally raised produce, meat, or dairy, or farm-raised fish?
15. 15. Do you eat large (i.e., mercury-contaminated) fish, such as swordfish?
16. 16. Do you eat nonorganic fruits and vegetables on a regular basis?
17. 17. Do you consume foods with artificial colors or sweeteners, such as diet sodas, or use artificial sweeteners, such as aspartame (NutraSweet), sucralose (Splenda), or saccharin (Sweet’N Low)?
18. 18. Do you use more than two health and/or beauty products per day? (Most people never read the labels or understand how many chemicals are included.)
19. 19. Do you live in a house that contains lead pipes or copper plumbing soldered with lead (built prior to 1978)?
20. 20. Do you wear lipstick or kiss someone with lipstick made with lead? (Sixty percent of the lipstick sold in the United States has lead in it.[347])
21. 21. Do you have mercury amalgam fillings? How many?
22. 22. Do you work in a job where you are exposed to environmental toxins, such as firefighting, painting, welding, longshoreman?
23. 23. Have you had general anesthesia? How many times?[348]

TOXINS

THE EVIL RULER WOULD . . .

1. 1. Repeal laws that ensure clean air, clean water, and safe buildings.
2. 2. Ignore companies that dump toxic waste.
3. 3. Promote chemically laden foods.
4. 4. Highlight research that touts the health benefits of alcohol and marijuana.
5. 5. Encourage teens to start smoking cannabis, because it has been found to increase the risk of depression and suicide later in life. One study found that using the drug as a teen contributes to mental illness in over 500,000 people in adulthood.[349]
6. 6. Disallow labeling of the ingredients in personal care products, so people wouldn’t have to worry about the chemicals they are putting on their bodies.

THE BENEVOLENT RULER WOULD . . .

1. 1. Strengthen laws that ensure clean air, clean water, and safe buildings.
2. 2. Penalize companies that dump toxic waste.
3. 3. Expose the dangers of chemical-laden foods.
4. 4. Highlight research that reveals how alcohol and marijuana affect brain health.
5. 5. Discourage tweens and teens from smoking cannabis.
6. 6. Require truthful labeling of all ingredients in personal care products, so people can make an informed decision about what they are putting on their bodies.

HOW MODERN SOCIETY IS POISONING THE BRAIN AND CONTRIBUTING TO MENTAL ILLNESS

Every single day, we are exposed to a host of chemicals, pesticides, fumes, and products that poison the human brain. Common toxins in the air we breathe, the foods we eat, and the products we rub on our skin are absorbed into our bodies via our lungs, digestive system, and pores and can eventually impact the brain. The more exposure you have to these everyday toxins, the more you are putting your brain at risk and increasing your chances of brain health/mental health issues. Look at the following lists and check how many toxic substances you may have been exposed to, either currently or in the past.

You can’t avoid toxins, but you can limit your exposure and boost your natural ability to detoxify. Detoxifying your world will help you and everyone in your household, including children. My nieces, Alizé and Amelie, don’t need to increase their risk factors. So we do everything we can to clean up our environment.

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The more exposure you have to these everyday toxins, the more you are putting your brain at risk and increasing your chances of brain health/mental health issues.

 

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Common Toxins . . .

THAT CAN BE INHALED[350]

• Air pollution
• Asbestos
• Automobile exhaust
• Aviation fumes
• Carbon monoxide
• Cigarette smoke, secondhand smoke, marijuana smoke
• Cleaning chemicals
• Fireplace fumes
• Fire retardant fumes
• Fire toxins (inhaled by first responders fighting fires)
• Gasoline fumes
• Mold
• Paint and solvent fumes
• Pesticide or herbicide residues near farms (also backyard applications)
• Welding, soldering fumes

THAT CAN BE INGESTED OR ABSORBED THROUGH THE SKIN[351]

• Apples sprayed with diphenylamine, which makes them shiny but breaks down into cancer-causing nitrosamines,[352] associated with Parkinson’s and Alzheimer’s[353]
• Artificial food dyes, preservatives, and sweeteners
• BPA (or bisphenol A; found in plastics, food and drink containers, dental sealants, and the coating of cash-register receipts)
• Chemotherapy
• General anesthesia in some patients
• Heavy metals, such as
  • Mercury: in “silver” dental fillings (50 percent mercury) and contaminated fish. (The Environmental Protection Agency recommends pregnant women eat fish no more than twice a week and avoid the big four: king mackerel, swordfish, shark, and tilefish. Also limit grouper and albacore tuna.)
  • Lead: in paint, pipes, airline fuel, and lipstick (see pages 187–188)
  • Cadmium: in cigarettes; soils treated with synthetic fertilizers; and industrial and hazardous waste sites. It is highly toxic and accumulates in the liver and kidneys and damages your ability to detoxify. It is linked to osteoporosis, heart disease, cancer and diabetes. Once it is in your body, it takes 16 years to get rid of just half of it!
• Excessive alcohol
• Foods manufactured with plastic equipment, leaking plasticizers
• Health and beauty products (see chart on pages 190–191)
• Herbicides such as glyphosate —for example, Roundup (used in genetically modified crops) —disrupt the body’s endocrine or hormonal system, affecting both testosterone and estrogen,[354] and raise the risk of cancer by 41 percent.[355] Herbicides may also damage DNA, making cells age faster and increasing their susceptibility to cancer.
• Many medications, such as benzodiazepines (for anxiety, insomnia) or narcotic pain medications
• Marijuana
• MSG (monosodium glutamate)
• PCBs (polychlorinated biphenyls) (see “Gone but Not Forgotten” on page 193)
• Pesticides —such as organochlorines and organophosphates (neurotoxins) —stimulate enzymes that turn calories into fat, where toxins are stored. Those in the top 5 percent of organophosphate exposure have a 650 percent increase in dementia.[356]
• Polluted or tainted water (including lead and arsenic)
• Silicone breast implants that leaked

COMMON TOXINS AT THE ROOT OF MENTAL ILLNESS

As a psychiatrist, I have seen many patients with depression, brain fog, anxiety, poor memory and concentration, word confusion, headaches, vertigo, and cravings who all had the same thing in common: exposure to toxins. Here are eight of the most common toxic issues we see at Amen Clinics.

1. Alcohol: not a health food

Some large-scale studies have found that light-to-moderate alcohol use may benefit the heart and brain.[357] But I see alcohol from a different point of view. I worked as an ambulance driver and in emergency rooms where I witnessed the tragedy of lives lost due to drunk driving. As a psychiatrist for nearly 40 years, I have met with many patients whose lives and families have been wrecked by alcohol abuse. And as a brain imaging expert, I have seen thousands of SPECT scans of “moderate” drinkers, whose brains look terrible, and the scans of alcohol abusers that look even worse.

When it comes to the brain, alcohol is not necessarily the health food it’s reported to be. Alcohol can harm your cognitive function and psychological well-being, and alcohol abuse can contribute to mental illness. For example, did you know that people who drink every day have smaller brains?[358] When it comes to the brain, size matters! Heavy alcohol use can alter neurotransmitter and hormonal systems that are involved in mood and anxiety disorders.[359] And did you know that compared to nondrinkers and light drinkers, moderate-to-heavy drinkers increase their risk of dementia by 57 percent —and develop it earlier?[360] Alcohol can also decrease judgment and decision-making skills and increase cravings. And because alcohol lowers blood flow to the cerebellum, an amazing part of the brain that is associated with physical movement, it can make you less coordinated. In the United States, there are 30 million children of alcoholics, and many of them suffer from PTSD as a result of growing up in an unpredictable, abusive alcoholic home. Excessive alcohol use is also a major cause of divorce, incarceration, and financial problems, which can contribute to sadness, anxiety, and despair.

Alcohol is listed as the seventh leading preventable cause of death and is related to seven different types of cancer.[361] Why do nurses rub alcohol on your skin before they give you a shot or insert an IV needle? To kill bacteria. What is the reason alcohol is used to preserve dead specimens? To kill all the cells and tissues in the specimen. This should make you wonder what alcohol is doing to your gut. If you want a better brain, less is more. For people who want to drink and who do not have a history of addiction in their families, I recommend no more than two to four normal-size drinks a week.

Brain SPECT Scan of Heavy Alcohol Use

BRAIN SPECT SCAN OF HEAVY ALCOHOL USE

Overall low activity

2. Marijuana: reason for caution

A growing number of states are legalizing marijuana for medical and recreational use, which has boosted the interest in the drug as a potential therapy for physical and mental health issues. Some research suggests it may have some benefit for people dealing with depression, anxiety, and PTSD;[362] however, other studies have found that marijuana can have a negative impact on mental health. In 2016, we published the largest brain imaging study on marijuana users, showing the overall decreased blood flow of 982 users compared to a healthy group.[363] Blood flow was decreased the most in the right hippocampus, which is often involved with Alzheimer’s disease and all types of memory loss. A 2019 review of 11 studies involving more than 23,000 people found that using cannabis as an adolescent increased the risk of developing depression and suicidal thoughts or suicide attempts in young adulthood.[364] Other research shows marijuana impairs short-term memory, contributes to learning and attention problems, reduces focus and coordination, and increases the risk for psychosis. In fact, a 2019 study in The Lancet Psychiatry found that potent cannabis may be associated with 10 percent of new cases of psychosis.[365]

3. Smoking/vaping: more toxic than you thought

Cigarettes are some of the most toxic substances around. According to the American Lung Association, as cigarettes burn they create about 7,000 chemicals, many of which are poisonous.

Here are just 10 of the toxins found in cigarettes:

TOXINS	ALSO FOUND IN . . .
Acetic acid	Hair dye
Ammonia	Cleaning products
Arsenic	Rat poison
Benzene	Rubber cement
Butane	Lighter fluid
Cadmium	Battery acid
Formaldehyde	Embalming fluid
Methanol	Rocket fuel
Tar	Road materials
Toluene	Paint

It’s common knowledge that the tobacco industry has promoted smoking despite its serious negative health effects. But what you may not know is that it has also promoted the use of its products within psychiatric settings and has funded research suggesting people with schizophrenia can benefit from self-medicating with cigarettes.[366] Today, as many as 80 percent of people with schizophrenia smoke.[367] They aren’t alone. People with brain health/mental health or substance abuse issues are more likely to smoke cigarettes than the general population. In fact, they smoke nearly 40 percent of all cigarettes, according to the CDC.[368]

Although smoking rates have been going down for years, rates of vaping e-cigarettes are on the rise. A 2018 report involving more than 40,000 teens nationwide showed that more than 20 percent of twelfth graders said they had vaped nicotine in the previous month. That’s twice the number who had reported vaping in 2017. And 11 percent of eighth graders admit vaping nicotine in the past year.[369] The rate of young people vaping is rising so rapidly that in 2018, the US surgeon general called e-cigarette vaping among youth an epidemic.[370]

Cigarettes —tobacco and marijuana —as well as vaping nicotine and caffeine delivery systems cause you to inhale into your lungs a host of fine and ultrafine toxic junk that can also penetrate your brain. Does size matter? Yes! The smaller the particle you inhale, the greater its ability to cause inflammatory reactions and damage your brain.

I wanted to see what vaping caffeine does to the brain, so for an episode of The Dr. Oz Show, I scanned Dr. Oz before and after he vaped. The results weren’t pretty. After vaping, his scans showed increased activity in the occipital lobes (the area that makes you notice someone attractive) and decreased activity in the frontal lobes (the area that puts on the brakes to prevent bad behavior). This seems like a prescription for divorce!

4. Mold: a mental illness creator

One of the first lessons I learned from our brain imaging work is that many everyday things are toxic to brain function —and one of the worst is mold. Take it from Bulletproof Coffee CEO Dave Asprey. He had been struggling with focus and memory and was barely able to pass his classes at Wharton. Then, in 2003, after reading my book Change Your Brain, Change Your Life, he got a brain SPECT scan. He says it changed everything in his life. It turned out that Dave had been exposed to toxic mold in his home. His health dramatically improved after following specific healing protocols, and he went on to produce Moldy: The Toxic Mold Movie (watch it online at https://moldymovie.com).[371]

COMMON TOXIC MOLDS

MOLD VARIETY	DESCRIPTION AND CONSEQUENCE
Ochratoxin A	Foodborne mold; causes cancer
Aflatoxins	Foodborne mold; causes cancer, can stunt growth in children
Fumonisins	Contaminant in maize as well as wheat and other cereals; implicated in neural tube defects and stunted growth[372]
Zearalenone and other Fusarium mycotoxins	Crop contaminants; disrupts hormone balance (estrogenic)[373]
Aspergillus	Found indoors and outside; especially concerning in children[374]
Tricothecene, “black mold”	Crop contaminants that can also grow in damp indoor environments; inhibits protein synthesis; extremely dangerous to skin, kidneys, liver, and more[375]

Another patient, George, 32, came to see us complaining of anxiety, brain fog, memory problems, and sleep disturbance. From the detailed history we collected, it became clear that George’s symptoms began when he moved back home from college into his parents’ basement apartment. Mold diagnostic testing revealed George had high levels of mold toxins in his body. Only after seeing these lab results did George remember that the basement had flooded on several occasions.[376]

We recommended that George remove himself immediately from the moldy environment, which is the first step for anyone with mold toxicity. Next, we began treatment consisting of binding agents and other medications, such as antifungals, as well as metabolic support supplements. With proper treatment and remediation of the mold problem, George’s symptoms improved. He did not need psychiatric medications; he simply needed an accurate diagnosis and appropriate treatment. If no one had checked him for mold toxins, he probably would have been diagnosed with one or more mental illnesses and treated (unsuccessfully) with psychiatric medications. He could have gone years with worsening symptoms.

Six Common Symptoms of Mold Exposure

• Unexplained muscle problems
• Brain fog, memory problems
• Difficulty focusing
• Numbness or “pins and needles” feeling
• Digestive issues
• Breathing problems (chronic cough, sinus problems, wheezing)

5. Lead: a clear and present danger

Lead harms the brain, and lead exposure is associated with lower IQ, speech problems, cancer, cardiovascular problems, arthritis, seizures, headaches, anemia, kidney disease, a metallic taste, and death from all causes. Lead exposure is also related to a variety of mental health issues. In children, it has been associated with ADD/ADHD,[377] learning problems, irritability, aggression, fearfulness, anti-social behavior, and more.[378] It has also been linked to adult-onset schizophrenia.[379] In a 2010 study with nearly 2,000 young adults with low levels of lead exposure, higher blood levels of lead was associated with an increased risk of depression and panic disorder. The researchers concluded that even at levels generally considered safe, lead exposure could negatively affect mental health.[380]

The US government used to report that a “safe” level of lead in the bloodstream was less than 60 μg/dL (micrograms per deciliter). The current “safe” level is under 10 μg/dL, and in July 2012, the CDC reported that the range of 5.0–10.0 μg/dL is highly risky for children. Many scientists say that any level of lead is unsafe. Depending on your age, you may recall that the government dictated that lead be removed from gasoline and paint. Strangely, this didn’t apply to small aircraft aviation fuel. At the Amen Clinics, we scanned 100 pilots and saw significant brain toxicity in two-thirds of them. We suspected it was caused by lead and other toxins that they are exposed to when they fly. In regard to paint, any house painted white before 1978 has high levels of lead, and once it chips or peels, it exposes those in the home to lead. And houses built or remodeled before 1984 likely have lead in the pipe solder.

One of the most widely used cosmetics —lipstick —still contains lead since no regulation has required that lead be removed from it. Lead was found in 60 percent of national brands.[381] In 2013, researchers at the University of California, Berkeley, found lead in 24 of 32 lip products tested. Many of the products contained high levels of eight other metals, including cadmium and chromium.[382]

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To avoid buying and ingesting lead-contaminated lip products, know your lipstick brands and go to www.safecosmetics.org to learn more.

 

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6. General anesthesia: the risk surgeons don’t warn you about[383]

I first became aware of the potentially toxic risk of general anesthesia[384] when one of my patients called me in tears after having knee surgery. She told me she felt as if she had brain fog and was afraid she was developing Alzheimer’s disease. I had already done a SPECT scan on her, so I rescanned her to see if her brain had changed. On the new scan, her brain looked toxic. Her frontal and temporal lobes, which are both involved in memory and attention, looked dramatically worse. Something had negatively affected her brain after that first scan. With the BRIGHT MINDS approach in this book, she was able to clear the brain fog and regain her memory.

Some scientific studies show no lasting negative effects and others show toxic effects from general anesthesia, but two recent studies are notable. In one, children who had undergone general anesthesia before the age of four had lower IQ, diminished language comprehension, and decreased gray matter in the back of their brains.[385] Also, a before-and-after SPECT study of patients who underwent coronary artery bypass surgery showed that 68 percent had diminished blood flow, which was linked to decreased verbal and visual memory six months later.[386] As you’ve seen in this book, low blood flow is one of the BRIGHT MINDS risk factors that can contribute to mental illness. If you have to undergo surgery, I recommend local or spinal anesthesia whenever possible. If that is not an option, make sure you do everything you can to optimize your brain before going under the knife.

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If you have to undergo surgery, I recommend local or spinal anesthesia whenever possible. If that is not an option, make sure you do everything you can to optimize your brain before going under the knife.

 

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One of my treasured assistants, Karen, who is beloved by our patients, discovered she had an aortic aneurysm. We had a prior SPECT scan, one shortly after her aneurysm surgery, and then one after she worked hard to rehabilitate her brain. No doubt, the surgery had a very negative impact on her brain and mind, but that was recoverable with the right BRIGHT MINDS program.

Karen’s SPECT Scans Before, After Aortic Aneurysm Surgery, After BRIGHT MINDS

KAREN’S SPECT SCANS BEFORE, AFTER AORTIC ANEURYSM SURGERY, AFTER BRIGHT MINDS

Before

Overall lower blood flow after surgery

After rehabilitation

7. Chemotherapy and heavy metals: stealing your mind

At Amen Clinics, we see many patients who have treated cancer with chemotherapy. Chemotherapy kills cancer cells, but it unfortunately can kill healthy brain cells too.[387] High exposure to heavy metals (e.g., arsenic, mercury, iron, and aluminum) can also lead to memory problems. I recommend asking your physician to screen you for heavy metals, especially if you know you’ve been exposed to any.

8. Personal care products: the ugly side of health and beauty aids

How many personal care and cosmetic products do you use each day? If you’re like the average American woman, you apply about 12 products, or like the average man, about six.[388] According to Statista, the cosmetics, perfume, and other toilet preparations industry is expected to spend close to $19 billion on advertising in 2019 to encourage us to use more of these everyday items.[389] But the chemicals in these products are easily absorbed through your pores and can be transported to every organ in your body, including your brain. This means while trying to look better on the outside, you could be poisoning yourself on the inside and increasing your risk for brain health/mental health issues. The risk from these items is real. In 2016, Johnson & Johnson was ordered to pay $72 million to the family of a woman whose death from ovarian cancer was associated with the daily use of Johnson’s Baby Powder among other company products.[390]

If you have symptoms associated with brain health/mental health issues, I highly recommend that you ditch personal care products with harmful ingredients to lighten your toxic load. The Environmental Working Group’s Skin Deep database (http://www.ewg.org/skindeep/) can help. It offers information on many products with toxic ingredients and suggests healthier alternatives. The following chart lists chemicals commonly found in personal care products —along with a brief description of the damage they can do, and is from The Toxin Solution, an exceptional book by Joseph Pizzorno, ND, a founder of Bastyr University.

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What goes on your body goes in your body.

 

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COMMON CHEMICALS FOUND IN HEALTH AND BEAUTY AIDS

CHEMICAL	PURPOSE	TOXICITY
Acrylates	Artificial nails	Neurotoxins[391]
Aluminum	Antiperspirant	Potential connection to Alzheimer’s disease[392]
Formaldehyde	Shampoos, nail polish, hair gel, nail and eyelash glue, body wash, color cosmetics	Cancer,[393] allergic reactions[394]
Fragrance	Shampoos, liquid baby soap, nail polish, glues, hair smoothing, body wash, color cosmetics	Cancer, endocrine disruption, allergic reactions
Oxybenzone	Sunscreen	Hormone disruption, lowers sperm count, skin allergies
Parabens	Preservative, fragrance in cosmetics (eye shadow, foundation, mascara), shampoos, conditioners, lotions, facial/body cleansers	Hormone issues, breast cancer,[395] developmental problems in kids, reproductive problems, allergies
Phthalates (banned in Europe)	Fragrances in cosmetics Also used in plasticizers (plastic wrap, packaging)	Hormone disruption;[396] lower IQ;[397] decreases BDNF in males,[398] which helps neurons grow and connect
Polyethylene glycols (PEGs)	Create suds in shampoos, bubble baths, liquid soap	Cancer,[399] birth defects,[400] hair loss, allergies
Triclosan	Antimicrobial cleanser, toothpaste	Hormone disruption,[401] harmful to the microbiome[402]
Lead	Lipstick (kiss of death)	Neurotoxin, damage to hippocampus and prefrontal cortex[403]
Source: Dr. Joseph Pizzorno, ND, The Toxin Solution. Used with permission.

9. Household items: when home sweet home becomes “home toxic home”

Many of the common items in your home may harbor potentially harmful chemicals, and tackling DIY home projects can increase your exposure to toxic substances. For example, carpeting, flame-retardant bedding and furniture, flooring, and paints can have high concentrations of chemicals. In 2019, researchers from Duke University presented evidence showing that children who grow up in homes with a flame-retardant sofa had six times more polybrominated diphenyl ethers (PBDEs) in their blood serum.[404] These chemicals have been associated with neurodevelopmental delays, interference with the endocrine system, thyroid disruption, obesity, cancer, and other conditions.

Pamela: The Surprising Source of Her Depression, Migraines, and Memory Problems

Before coming to Amen Clinics, Pamela would spend most of each day in bed:

My kids would go out; I’d be lying in bed and missing out on everything. I would have migraines. I was down to 116 pounds. I couldn’t eat; I couldn’t think; I had memory loss. I couldn’t finish a sentence. I couldn’t come up with a word. There were times I couldn’t even remember my children’s names. Nobody could give me a reason for that. This just wasn’t the person I was before. I was vibrant. I was a successful businesswoman. I had it all together and then all of a sudden, I was falling apart and everything was getting progressively worse. . . .

I tried everything. You name it, I’ve tried it . . . but more things would keep happening. Something else would add to my list of illnesses. I’d end up getting depressed, because it didn’t seem like anybody really understood. I was on 21 prescription medications, because that’s all they would give me. “Well, if you feel this, that’s not working. Well, here, I’ll add this drug to you, and I’ll add that drug to you.” I felt that somewhere out there, there had to be an answer, and I just had to find the answer. A lot of times, some of these doctors would tell me it was in my head. I’m thinking, No, this is physical. I can’t breathe. I’ve got migraines. These are not mental issues. These are all physical problems. . . .

When I started having these memory issues, at that point, I thought, You know what, I need to go to Amen Clinics. When I went to Dr. [Muneer] Ali, I walked in with my 21 prescriptions: my 11 in the morning and my 10 in the evening. He said, “Oh, we’re not doing that anymore.” He got rid of all of my prescriptions but five of them.

Pamela spent three days at the Amen Clinic in Atlanta, where the staff took a thorough history and SPECT scans, and did extensive laboratory testing. Dr. Ali found a genetic abnormality that made it harder for Pamela to fight off viruses. Pamela also discovered she had Lyme. When Dr. Ali found out that Pamela had a leaky roof, he did a mold test, which came back positive for black mold, one of the worst kinds. The Lyme and mold explained a great deal about her symptoms.

When I walked in here, I was so sick, and I do not look like I do now. I’ve got a smile, and I’m sitting up. I have energy, and I’m completing my sentences. . . . I can remember everything. It’s like a rebirth. I wanted to be a better mom for my kids. That was my goal.

Disturbing Fact: One of the most effective ways for a woman to decrease her toxic load is through breastfeeding, which decreases breast cancer risk.[405] Unfortunately, the baby gets the brunt of it.

Gone but not Forgotten: PCBs and Their Lingering Effects on Brain/Mental Health

Polychlorinated biphenyls, better known as PCBs, were industrial chemicals used in electrical products and appliances. Though they were banned in 1979, they don’t break down well so they are still pervasive in our water, soil, and air. And because of this, they continue to cause problems. A 2014 study found that people with higher levels of work-related exposure to PCBs had an increased risk for developing depression.[406] Other studies show possible links to changes in the brain associated with autism, ADD/ADHD, schizophrenia, and learning problems.[407] PCBs also inhibit the workings of the thyroid, so you feel tired all the time. In addition, PCBs can build up in the fatty tissue of fish that live in contaminated rivers or coastal areas. Eating those fish cause a build-up of PCBs in your fatty tissue as well. Limit your exposure by trimming the skin and fat from raw and cooked fish and avoid fried fish.

CHECKUP FOR TOXIN ISSUES

Your detoxification organs include your gut, liver, kidneys, and skin. To operate as intended, they must be healthy. Your liver, for instance, filters blood to identify and hold toxins. Its enzyme systems break them down, and the liver produces bile to excrete them. Your liver has finite toxin-processing capacity, which means it is highly vulnerable to toxic overload.

Your kidneys filter all your blood 60 times per day. Because kidney function decreases with age —about 50 percent from age 20 to 85 —your support is critical.[408]

Chapter 7 offers ways to check up on your gut. For the other organs, keep reading.

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Note: If you have limited resources, skip the expensive lab tests and spend your money on high-quality, detoxifying food.

 

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Lab tests

LIVER FUNCTION

• ALT (SGPT) —normal range: 7–56 units per liter (U/L)
• AST (SGOT) —normal range: 5–40 U/L
• Bilirubin —normal range: 0.2–1.2 mg/dL
• Zinc —normal range: 60–110 mcg/dL (low zinc will limit detoxification in the liver)

If liver function tests are high, check for excessive sugar and simple carbohydrate intake, alcohol use/abuse, hepatitis or medications that raise liver enzymes, such as acetaminophen (Tylenol).

KIDNEY FUNCTION

• BUN —normal range: 7–20 mg/dL
• Creatinine —normal range: 0.5–1.2 mg/dL

SKIN

• Check for rashes, acne, and rosacea —may be signs of detoxification problems

If mold is suspected

• TGF Beta-1 —This blood test measures a protein found throughout the body that plays a role in immune system function and is often high in mold exposure (also called mycotoxin exposure). It can also be raised because of certain infections, such as Lyme disease. The normal level is below 2,380; 0 is optimal. Mold exposure can raise this to greater than 15,000.
• Real Time Labs mycotoxin test (http://www.realtimelab.com/home)

If heavy metals are suspected

• Hair sample and urinary “challenge” tests are common —for these urine tests, a chelating agent is administered prior to collecting the specimen

PRESCRIPTIONS FOR REDUCING YOUR TOXINS RISK FACTORS
(AND THE FOUR CIRCLES THEY REPRESENT)

The Strategies

You can reduce your toxic load with three simple strategies:

1. 1. Care about your detoxification organs.

1. 2. Avoid toxins as much as possible:
   • Quit smoking (social circle if you smoke because others are doing it, psychological circle because you have to believe you can quit, and spiritual circle because you have to know why you want to quit). Hypnosis, nicotine patches, or the medication bupropion can help you quit.
   • Address drug and/or alcohol abuse. What are the underlying causes of why you use? Determine if something such as anxiety or depression is leading you to self-medicate with drugs or alcohol. I recommend going off marijuana completely. (See explanation for social, psychological, and spiritual circles at the end of “Quit smoking” section above.)
   • Gradually replace “silver” dental fillings. Do not get any new silver amalgams; ask for ceramic fillings. Remove amalgam fillings as soon as possible, but not all at once because of the risk of releasing toxins into the bloodstream. Do just one or two at a time.
   • Avoid aluminum and Teflon cookware.
   • Buy and store foods in glass jars when possible; plastic containers may contain phthalates and BPAs. Never reheat foods in plastic containers.

1. 3. Reduce toxin-contaminated foods in your diet (social circle because your friends and family influence your eating habits).
   • Go organic (and always wash your produce). When a family switched to organic food for two weeks, a study found that the pesticides levels in their urine went down by 95 percent.[409] Another study revealed that children who ate conventionally grown foods had neurotoxic pesticide levels nine times higher than those who ate organic.[410] The Environmental Working Group publishes an annual list of the foods that have the highest/lowest pesticide levels; check it out at the EWG website (www.ewg.org).
   • Always read food labels. If you do not know what an ingredient is, don’t eat it or put it on your body. Here are chemicals, additives, and preservatives to avoid:
     • Potassium bromate —carcinogenic
     • BHA, BHT —linked to tumors
     • Sodium benzoate —may damage DNA
     • Sodium nitrate —linked to cancer
     • Tartrazine dye (makes cheese yellow) —linked to asthma
     • Monosodium glutamate (MSG) —linked to seizures and heart issues. (MSG is also called glutamic acid, hydrolyzed protein, autolyzed protein, autolyzed yeast extract, and textured protein.)
     • Red Dye #40
     • Artificial sweeteners —Aspartame (blue packets) and saccharin (pink packets) are both linked to obesity,[411] diabetes,[412] and cancer.[413] Sucralose (yellow packets) has the potential of direct toxic effects. It may also induce glucose intolerance by disrupting gut health.[414]
   • Ignore the word natural on labels. It means nothing. (After all, arsenic and cyanide are natural.)
   • Limit or eliminate produce grown with pesticides and herbicides; dairy raised with hormones and antibiotics; meats raised with hormones, antibiotics, or grain-fed; and farm-raised fish that is grain-fed or includes PCBs.
   • Avoid processed meats, such as bacon and deli meats (they contain nitrosamines, which cause the liver to produce fats that are toxic to the brain).
   • Drink no more than two to four normal-size alcoholic drinks a week; choose wine and beer over aged liquors.
   • Do a food detox. For two weeks, eliminate:[415]
     • Processed foods
     • Glutens (found in flour, triticale, triticum, semolina, durum, Kamut, wheat, rye, and barley, this substance can increase gut permeability —even in people who are not sensitive to them.)
     • Dairy
     • Nonorganic beef and chicken (to avoid hormones, antibiotics, and arsenic)
     • Farm-raised fish
     • “Dirty Dozen” produce items, designated by the EWG (go to https://www.ewg.org/foodnews/summary.php)
     • Soy (high levels of arsenic, cadmium; 96 percent in United States is genetically modified)
     • Artificial sweeteners
     • Alcohol and recreational drugs
     • Water that has not been purified or proven to be clean

1. 4. Purify your air.
   • Have your home tested for mold, and eliminate it whether or not you have any symptoms.
   • Avoid burning wood fires in fireplaces; they release toxic compounds.
   • Regularly swap out the filters on your heating and cooling systems.

1. 5. Reduce your use of unsafe health and beauty aids.[416]
   • Do a bathroom cleanse. Download the Think Dirty app (www.thinkdirtyapp.com), which rates products on a scale of 1–10 (10 = the most toxic), and scan all the products in your bathroom. If you love yourself, throw out toxic products. After downloading this app, I threw away more than 70 percent of the products in my bathroom.
   • Use natural products without fragrance that are low in chemicals and free of phthalates. This can really make a difference: 100 teenage girls who avoided these chemicals for just three days had significantly lower toxins in their urine.[417] These products may be more expensive in the short run, but they will be cheaper in the long run as you will spend less money on doctors and medicine.

1. 6. Really clean the house.
   • Install carbon monoxide alarms and nonradioactive smoke alarms.
   • Clean with fragrance-free, chemical-free, natural household cleansers.
   • Clean, dust, and vacuum regularly.
   • Do not Scotchgard anything in the home.
   • Periodically check for black mold in any part of your home that is exposed to water (e.g., under sinks).
   • Limit volatile organic compounds (VOCs) at home by using VOC-free cleaning products, no- or low-VOC bedding materials made from natural products, low-VOC paints, and throw rugs instead of new carpeting.

1. 7. Engage in habits to strengthen your detoxification systems.
   • Support your gut. (See chapter 7, “I is for Inflammation.”)
     • Add fiber and fiber-rich foods, which bind to toxins and help your gastrointestinal system get rid of them. In the past, humans ate 100–150 grams of fiber a day. Americans now eat an average of 15 grams.[418] Women should consume at least 25 grams; men, 30 grams.
   • Support your liver.
     • Limit alcohol and eat brassicas (detoxifying vegetables, such as brussels sprouts, cabbage, broccoli, and cauliflower).
     • Take the nutraceuticals that support your liver.
       • N-acetylcysteine (NAC) —NAC raises blood, liver, cellular, and mitochondrial levels of cysteine and the super-antioxidant glutathione. It also helps decrease the toxicity of chemotherapeutic drugs and antibiotics.[419]

         Dose suggestion: 600 mg twice a day

       • Vitamin C

         Dose suggestion: 1,000 mg twice a day

       • Artichoke extract —significantly increases bile excretion from the liver for two to three hours.[420]

         Dose suggestion: 500 mg twice a day

   • Support your kidneys.
     • Drink three to four quarts of clean water a day. “The solution to pollution is dilution.” Water helps flush toxins from your kidneys. Filter your water with charcoal or reverse osmosis. Check the purity of your local water supply with this EPA link: https://ofmpub.epa.gov/apex/safewater/f?p=136:102.
     • Take the nutraceuticals that support your kidneys.
       • Magnesium glycinate, citrate or malate

         Dose suggestion: 200 mg twice a day

       • Ginkgo biloba extract —increases blood flow to brain and kidneys[421] and helps protect against glyphosates.[422]

         Dose suggestion: 60–120 mg twice a day

   
   • Support your skin.

     Your skin is the largest organ in your body.[423] It reflects the health of your brain.

     • Work up a sweat during exercise. Sweating naturally cleanses your system. The concentration of most toxins —including arsenic, cadmium, lead, and mercury —is 2 to 10 times higher in sweat than in blood, which indicates that the body is effectively using sweating as a significant detoxification process.[424] The more you sweat with exercise,[425] the more you increase glutathione production, one of the most important detoxifiers;[426] protect against PCB exposure;[427] and eliminate phthalates[428] and BPA;[429] plus it keeps your skin healthy.
     • Take a sauna. Research shows that saunas lower toxins in firefighters.[430] In a follow-up study over 20 years, the findings revealed an inverse relationship between sauna bathing and serious memory problems. Men who only had one sauna session per week versus those who had two to seven saunas were, respectively, 22 percent or 66 percent less likely to have dementia.[431] In other research, those who had frequent sauna baths also had a lower incidence of sudden cardiac death and death from all causes,[432] reduced depression;[433] increased endorphins,[434] testosterone, and growth hormone; and lowered cortisol[435] and blood sugar.[436] When you take a sauna, sweat profusely for 20 to 30 minutes.[437]
     • Take the nutraceuticals that support your skin.
       • Vitamin D

         Dose suggestion: 2,000 IUs a day or more, depending on your level

       • Vitamin E

         Dose suggestion: 60 mg of mixed tocopherols

       • Omega-3 fatty acids

         Dose suggestion: 1,400 mg or more with a ratio of approximately 60/40 EPA to DHA

BRIGHT MINDS: TOXINS

STEPS TO CREATE MENTAL ILLNESS . . . AND MAKE MY NIECES, ALIZÉ AND AMELIE, SUFFER

1. 1. Don’t care about your detoxification organs.
2. 2. Engage in habits that increase your exposure to toxins.
   • Smoke cigarettes, use marijuana, and drink excessive amounts of alcohol.
   • Eat pesticide-laden foods.
   • Consume processed foods with chemicals, additives, and preservatives.
   • Eat meat and dairy treated with hormones and antibiotics.
   • Eat fish containing PCBs.
   • Use plastic food containers and reheat food in them.
   • Don’t bother thinking about how much water you drink.
   • Expose yourself to mold.
   • Routinely light a fire in the fireplace at home.
   • Don’t change the filters of your heating and cooling systems.
   • Use cleaning products and personal care products with chemicals and fragrances.
3. 3. Avoid the strategies that strengthen your detoxification systems.

STEPS TO END MENTAL ILLNESS . . . AND KEEP MY NIECES, ALIZÉ AND AMELIE, HEALTHY

1. 1. Care about your detoxification organs.
2. 2. Avoid toxins as much as possible.
3. 3. Engage in habits to strengthen your detoxification systems.
   • Quit smoking, stop using marijuana, and limit alcohol to two to four glasses a week.
   • Remove “silver” dental fillings.
   • Reduce your consumption of toxin-contaminated foods.
   • Choose organic foods when possible.
   • Always wash your fruits and vegetables.
   • Avoid processed foods and those with chemical ingredients.
   • Choose meat and dairy that is antibiotic and hormone-free.
   • Drink three to four quarts of clean water a day.
   • Check your home for mold and eliminate it.
   • Do a bathroom cleanse to eliminate unsafe cleaning and personal care products.
   • Support your gut (see chapter 7, “I is for Inflammation”).
   • Exercise to work up a sweat and detoxify your skin.
   • Consider nutraceuticals to support your liver, kidneys, and skin.

Pick One BRIGHT MINDS Toxins Tiny Habit to Start Today

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1. When I go grocery shopping, I will buy organic whenever possible.
2. When pumping gas, I will not stand at the pump and breathe in any fumes.
3. When I visit friends and family, I will avoid secondhand smoke.
4. When I drink alcohol, I will limit my intake to no more than two to four glasses a week.
5. When I take my supplements, I will include N-acetyl-cysteine (NAC).
6. When I make meals, I will include brassicas for their detoxifying ability.
7. When I go shopping, I will avoid handling cash register receipts (the BPA in their plastic coating can get through your skin).
8. When I drink, I won’t use plastic straws.
9. When I go to the store, I will not buy anything with MSG, artificial dyes, or preservatives.
10. When I am about to buy or use a cleaning or personal care product, I will scan it first on an app like Think Dirty or Healthy Living (ewg.org) and will not use any that contain toxins.

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Samuel B. Harvey et al., “The Mental Health of Fire-Fighters: An Examination of the Impact of Repeated Trauma Exposure,” Australian and New Zealand Journal of Psychiatry 50, no. 7 (July 2016): 649–58.

[343] Melanie A. Hom et al., “Mental Health Service Use among Firefighters with Suicidal Thoughts and Behaviors,” Psychiatric Services 67, no. 6 (June 1, 2016): 688–91.

[344] Yasser Iturria-Medina et al., “Early Role of Vascular Dysregulation on Late-Onset Alzheimer’s Disease Based on Multifactorial Data-Driven Analysis,” Nature Communications 7 (June 21, 2016): 11934.

[345] Eric Emerson et al., “Risk of Exposure to Air Pollution among British Children with and without Intellectual Disabilities,” Journal of Intellectual Disability Research 63, no. 2 (February 2019): 161–67.

[346] Tesifon Parrón et al., “Association between Environmental Exposure to Pesticides and Neurodegenerative Diseases,” Toxicology and Applied Pharmacology 256, no. 3 (November 1, 2011): 379–85.

[347] “Don’t Pucker Up: Lead in Lipstick,” Campaign for Safe Cosmetics, October 12, 2007, http://www.safecosmetics.org/about-us/media/news-coverage/dont-pucker-up-lead-in-lipstick/.

[348] This quiz also appears in Daniel G. Amen, Memory Rescue (Carol Stream, IL: Tyndale, 2017).

[349] Gabriella Gobbi et al., “Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis,” JAMA Psychiatry 76, no. 4 (April 2019), 426–34.

[350] Amen, Memory Rescue, 145–46.

[351] Ibid., 144–45.

[352] Curt T. DellaValle et al., “Dietary Nitrate and Nitrite Intake and Risk of Colorectal Cancer in the Shanghai Women’s Health Study,” International Journal of Cancer 134, no. 12 (June 15, 2014): 2917–26.

[353] Kim Harley, “The Health Costs of Beauty: EDCs in Personal Care Products and the HERMOSA Study,” Collaborative on Health and the Environment, March 22, 2016, www.healthandenvironment.org/partnership_calls/18271.

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[354] Céline Gasnier et al., “Glyphosate-Based Herbicides Are Toxic and Endocrine Disruptors in Human Cell Lines,” Toxicology 262, no. 3 (August 21, 2009): 184–91.

[355] Luoping Zhang et al., “Exposure to Glyphosate-Based Herbicides and Risk for Non-Hodgkin Lymphoma: A Meta-analysis and Supporting Evidence,” Mutation Research/Reviews in Mutation Research 781 (July–September 2019): 186–206.

[356] Ki-Su Kim et al., “Associations between Organochlorine Pesticides and Cognition in U.S. Elders: National Health and Nutrition Examination Survey 1999–2002,” Environment International 75 (February 2015): 87–92.

[357] Kaarin J. Anstey et al., “Alcohol Consumption as a Risk Factor for Dementia and Cognitive Decline: Meta-analysis of Prospective Studies,” American Journal of Geriatric Psychiatry 17, no. 7 (July 2009): 542–55.

Ruth Peters et al., “Alcohol, Dementia and Cognitive Decline in the Elderly: A Systematic Review,” Age and Ageing 37, no. 5 (September 2008): 505–12.

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[358] Jingzhong Ding et al., “Alcohol Intake and Cerebral Abnormalities on Magnetic Resonance Imaging in a Community-Based Population of Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study,” Stroke 35, no. 1 (January 2004): 16–21.

[359] George F. Koob, “Neurobiology of Addiction: Toward the Development of New Therapies,” Annals of the New York Academy of Sciences 909 (2000): 170–85.

[360] Elizabeth P. Handing et al., “Midlife Alcohol Consumption and Risk of Dementia over 43 Years of Follow-Up: A Population-Based Study from the Swedish Twin Registry,” Journals of Gerontology: Series A 70, no. 10 (October 2015): 1248–54.

[361] Jennie Connor, “Alcohol Consumption as a Cause of Cancer,” Addiction 112, no. 2 (February 2017): 222–28.

[362] Zach Walsh et al., “Medical Cannabis and Mental Health: A Guided Systematic Review,” Clinical Psychology Review 51 (February 2017): 15–29.

[363] Daniel G. Amen et al., “Discriminative Properties of Hippocampal Hypoperfusion in Marijuana Users Compared to Healthy Controls: Implications for Marijuana Administration in Alzheimer’s Dementia,” Journal of Alzheimer’s Disease 56, no. 1 (2017): 261–73.

[364] Gobbi et al., “Association of Cannabis Use in Adolescence,” 426–34.

[365] Marta Di Forti et al., “The Contribution of Cannabis Use to Variation in the Incidence of Psychotic Disorder across Europe (EU-GEI): A Multicentre Case-Control Study,” Lancet Psychiatry 6, no. 5 (May 2019): 427–36.

[366] Judith Prochaska et al., “Tobacco Use among Individuals with Schizophrenia: What Role Has the Tobacco Industry Played?” Schizophrenia Bulletin 34, no. 3 (May 2008): 555–67. Used with permission,

[367] Prochaska et al., “Tobacco Use among Individuals with Schizophrenia,” 555–67.

[368] “Tobacco Use among Adults with Mental Illness and Substance Use Disorders,” Centers for Disease Control and Prevention, last reviewed January 14, 2019, https://www.cdc.gov/tobacco/disparities/mental-illness-substance-use/index.htm.

[369] “Teens Using Vaping Devices in Record Numbers,” National Institute on Drug Abuse, December 17, 2018, https://www.drugabuse.gov/news-events/news-releases/2018/12/teens-using-vaping-devices-in-record-numbers.

[370] “Surgeon General’s Advisory on E-cigarette Use among Youth,” Office of the US Surgeon General, 2018, https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf.

[371] Amen, Memory Rescue, 152.

[372] World Health Organization, “Fumonisins,” Food Safety Digest series, Department of Food Safety and Zoonoses, February 2018, https://www.who.int/foodsafety/FSDigest_Fumonisins_EN.pdf.

[373] Silvia W. Gratz, Neil Havis, and Fiona Burnett, “Fusarium Mycotoxin Contamination in the Human Food Chain,” New Food, September 1, 2015, https://www.newfoodmagazine.com/article/19318/fusarium-mycotoxin-contamination-in-the-human-food-chain/.

[374] “About Aspergillosis,” Centers for Disease Control and Prevention, last reviewed January 2, 2019, https://www.cdc.gov/fungal/diseases/aspergillosis/definition.html.

[375] Susan P. McCormick et al., “Trichothecenes: From Simple to Complex Mycotoxins,” Toxins 3, no. 7 (July 2011): 802–14.

[376] Amen, Memory Rescue, 152–53.

[377] James S. Brown Jr., “Introduction: An Update on Psychiatric Effects of Toxic Exposures,” Psychiatric Times 33, no. 9 (October 1, 2016).

[378] Amanda Habermann, “Lead Poisoning’s Harmful Impact on Physical and Mental Health,” Sovereign Health, February 20, 2016, https://www.sovhealth.com/health-and-wellness/lead-poisonings-harmful-impact-on-physical-and-mental-health/.

[379] Brown, “Update on Psychiatric Effects of Toxic Exposures.”

[380] Maryse F. Bouchard et al., “Blood Lead Levels and Major Depressive Disorder, Panic Disorder, and Generalized Anxiety Disorder in US Young Adults,” Archives of General Psychiatry 66, no. 12 (December 2009): 1313–19.

[381] “Don’t Pucker Up,” Campaign for Safe Cosmetics.

[382] Sa Liu, Sally Katharine Hammond, and Ann Rojas-Cheatham, “Concentrations and Potential Health Risks of Metals in Lip Products,” Environmental Health Perspectives 121, no. 6 (June 2013): 705–10.

[383] Amen, Memory Rescue, 153.

[384] Edward A. Bittner, Yun Yue, and Zhongcong Xie, “Brief Review: Anesthetic Neurotoxicity in the Elderly, Cognitive Dysfunction and Alzheimer’s Disease,” Canadian Journal of Anesthesia 58, no. 2 (February 2011): 216–23.

Chia-Wen Chen et al., “Increased Risk of Dementia in People with Previous Exposure to General Anesthesia: A Nationwide Population-Based Case-Control Study,” Alzheimer’s and Dementia 10, no. 2 (March 2014): 196–204.

[385] Barynia Backeljauw et al., “Cognition and Brain Structure following Early Childhood Surgery with Anesthesia,” Pediatrics 136, no. 1 (July 2015): e1–12.

[386] N. Efimova et al., “Changes in Cerebral Blood Flow and Cognitive Function in Patients Undergoing Coronary Bypass Surgery with Cardiopulmonary Bypass,” Kardiologiia 55, no. 6 (June 2015): 40–46.

[387] University of Rochester Medical Center, “Chemotherapy’s Damage to the Brain Detailed,” ScienceDaily, April 22, 2008, https://www.sciencedaily.com/releases/2008/04/080422103947.htm.

[388] Harley, “Health Costs of Beauty.”

[389] A. Guttmann, “Advertising Spending in the Perfumes, Cosmetics, and Other Toilet Preparations Industry in the United States from 2010 to 2019 (in Million U.S. Dollars),” Statista, last edited November 29, 2018, https://www.statista.com/statistics/470467/perfumes-cosmetics-and-other-toilet-preparations-industry-ad-spend-usa/.

[390] Stacy Malkan, “Johnson & Johnson Is Just the Tip of the Toxic Iceberg,” Time, March 2, 2016, https://time.com/4239561/johnson-and-johnson-toxic-ingredients/.

[391] Gina L. LoSasso, Lisa J. Rapport, and Bradley Axelrod, “Neuropsychological Symptoms Associated with Low-Level Exposure to Solvents and (Meth)Acrylates among Nail Technicians,” Neuropsychiatry, Neuropsychology, and Behavioral Neurology 14, no. 3 (July–September 2001): 183–89.

[392] Masahiro Kawahara and Midori Kato-Negishi, “Link between Aluminum and the Pathogenesis of Alzheimer’s Disease: The Integration of the Aluminum and Amyloid Cascade Hypotheses,” International Journal of Alzheimer’s Disease 2011 (March 8, 2011): 276393.

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[393] Michael Fenech, Armen Nersesyan, and Siegfried Knasmueller, “A Systematic Review of the Association between Occupational Exposure to Formaldehyde and Effects on Chromosomal DNA Damage Measured Using the Cytokinesis-Block Micronucleus Assay in Lymphocytes,” Mutation Research/Reviews in Mutation Research 770, part A (October–December 2016): 46–57.

[394] Ann Pontén and Magnus Bruze, “Formaldehyde,” Dermatitis 26, no. 1 (January/February 2015): 3–6.

[395] Philippa D. Darbre and Philip W. Harvey, “Parabens Can Enable Hallmarks and Characteristics of Cancer in Human Breast Epithelial Cells: A Review of the Literature with Reference to New Exposure Data and Regulatory Status,” Journal of Applied Toxicology 34, no. 9 (September 2014): 925–38.

[396] Pinar Erkekoglu and Belma Kocer-Gumusel, “Genotoxicity of Phthalates,” Toxicology Mechanisms and Methods 24, no. 9 (December 2014): 616–26.

[397] Pam Factor-Litvak et al., “Persistent Associations between Maternal Prenatal Exposure to Phthalates on Child IQ at Age 7 Years,” PLOS One 9, no. 12 (December 10, 2014): e114003.

[398] Catherine A. Smith and Matthew R. Holahan, “Reduced Hippocampal Dendritic Spine Density and BDNF Expression following Acute Postnatal Exposure to Di(2-Ethylhexyl) Phthalate in Male Long Evans Rats,” PLOS One 9, no. 10 (October 8, 2014): e109522.

[399] Carcinogenic Potency Project, “Ethylene Glycol,” U.S. National Library of Medicine, last updated October 3, 2007, https://toxnet.nlm.nih.gov/cpdb/chempages/ETHYLENE%20GLYCOL.html.

[400] Allyson E. Kennedy et al., “E-cigarette Aerosol Exposure Can Cause Craniofacial Defects in Xenopus laevis Embryos and Mammalian Neural Crest Cells,” PLOS One 12, no. 9 (September 28, 2017): e0185729.

[401] “Five Things to Know about Triclosan,” U.S. Food and Drug Administration, last reviewed May 16, 2019, https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm205999.htm.

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[402] Alyson L. Yee and Jack A. Gilbert, “MICROBIOME. Is Triclosan Harming Your Microbiome?” Science 353, no. 6297 (July 22, 2016): 348–49.

[403] Kang-sheng Liu et al., “Neurotoxicity and Biomarkers of Lead Exposure: A Review,” Chinese Medical Sciences Journal 28, no. 3 (September 2013): 178–88.

[404] Duke University, “Children Carry Evidence of Toxins from Home Flooring and Furniture,” EurekAlert! American Association for the Advancement of Science (Heather M. Stapleton et al., “Children’s Exposure to Chemicals Emitted from the Home Environment,” presented at AAAS annual meeting, February 17, 2019), https://eurekalert.org/pub_releases/2019-02/du-cce021419.php.

[405] Joseph Pizzorno, The Toxin Solution: How Hidden Poisons in the Air, Water, Food, and Products We Use Are Destroying Our Health —And What We Can Do to Fix It (New York: HarperOne, 2018).

[406] Petra M. Gaum et al., “Prevalence and Incidence Rates of Mental Syndromes after Occupational Exposure to Polychlorinated Biphenyls,” International Journal of Hygiene and Environmental Health 217, no. 7 (May 27, 2014): 765–74.

[407] Dongren Yang et al., “Developmental Exposure to Polychlorinated Biphenyls Interferes with Experience-Dependent Dendritic Plasticity and Ryanodine Receptor Expression in Weanling Rats,” Environmental Health Perspectives 117, no. 3 (March 2009): 426–35.

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