Heavy Metals, Chemicals and Mycotoxins: A Root Cause of Intractable Gut Health Issues

Adapted from episode 70 of The Perfect Stool podcast and edited for readability.

Wendie Trubow, M.D., MBA is a functional medicine gynecologist with a thriving practice at Five Journeys, and is passionate about helping women optimize their health and lives. Through her struggles with mold and metal toxicity, Celiac disease, and other health issues, Dr. Trubow has developed a deep sense of compassion and expertise for what her patients are facing. She is the co-author of Dirty Girl: Ditch the Toxins, Look Great, and Feel Freaking Amazing!

Lindsey: 

So I understand that you started your career focusing on gut health. So I’m wondering what got you into gut health, and then what moved you towards a focus on toxins?

Dr. Wendie Trubow: 

I think at the end of this conversation, you’re going to think that I’m completely self-focused. But as a celiac who was undiagnosed for many years, my gut was a hot mess and so I really naturally gravitated toward that, because I wanted to fix my own struggles. Then I saw the impact of how much of a difference it made for my patients and then simultaneously, I fell into the toxins hole because I was full of them and had a sort of second health crisis in my late 40s. So that really then served as the jumping board, springboard, for developing all my toxins expertise, because, again, I was struggling really badly and had to learn about it so I can fix myself, so I can take care of people.

Lindsey: 

Interesting. Now, when you say your gut was a hot mess from celiac, so that other people who might have celiac could potentially hear their symptoms called out and go, “Oh, maybe that’s what I’m going through.” What might that look like?

Dr. Wendie Trubow: 

Sure. And I think I would broaden it to not just celiac because you can have gut dysfunction, and not have the autoimmune component of it. If you think about it, a gluten allergy doesn’t just develop overnight for most people; it’s slow and steady and goes from no reaction to a little reaction, which could be some gas or bloating after eating. Then you maybe get constipated or maybe you have some diarrhea, or maybe then you get an irritable bowel. So it’s this whole progression of symptoms. I kind of had all of the above: I had stinky gas, bloating, constipation some days, and then some days, same day constipation and diarrhea, or maybe back and forth between them in any given day. Then the celiac part, the part where I had the autoimmune issue, was where it started to impact outside of my gut. So because of the celiac, it causes this degradation of the lining of the gut, you don’t absorb your minerals and nutrients properly. So I had mineral, nutrient deficiencies and that was ranging from iron to magnesium to B12 and folate; often celiacs have osteoporosis because they don’t absorb the calcium and the vitamin D. So I kind of had all of the above without the osteoporosis; and then head to toe issues so brain fog. I’m not an anxious person, but I had anxiety and difficulty synthesizing information: so executive function was impaired, I had thyroid disorder, I had heart palpitations, asthma, all the gut stuff, fertility challenges, bad periods, heavy periods, the wasting… I was wasting, like I was about 10 pounds lighter than I am now.

Lindsey: 

So a lack of nutrients will kind of destroy your body all over?

Dr. Wendie Trubow: 

Yes, yes. Head to toe. It was a mess.

Lindsey: 

Okay. And I imagine with all that, lack of B-12 and iron, you must have had some fatigue?

Dr. Wendie Trubow: 

Oh, yeah, I didn’t mention that.

Lindsey: 

I didn’t hear that one.

Dr. Wendie Trubow: 

Sorry, I got out of bed because I was the primary breadwinner and otherwise I would have been quite happy to stay all day in my bed curled up.

Lindsey: 

Yeah. Well, I have to say I had one client who came just for one appointment. And he had not been diagnosed with celiac until he was in his 60s. So you can imagine the fatigue that builds up over that many years of poor absorption of your nutrients?

Dr. Wendie Trubow: 

Yeah, yeah.

Lindsey: 

Okay, so tell me what the connection is between toxins and gut health?

Dr. Wendie Trubow: 

Sure. It’s so great. It’s creepy, but it’s awesome. So there’s a million levels at which this occurs. So toxins themselves irritate the gut: just flat out irritate the gut. If you do quote unquote everything right and you just can’t get a handle on your gut, it’s often because there’s this underlying thing called a toxin, which I’m referring to heavy metals, mycotoxins, which are the mold that when mold gets in you, it puts out these toxins called mycotoxins, or others like gasoline fumes, nail polish, phthalates, BPA, all that stuff that in the other category, so that flat out irritates the gut, A. B, if you’re somebody who has toxins, it’s creating this enormous pull on the body to detox and in order to detox you need to have your adrenals, your liver and your gut in good shape because your liver is responsible for in some way converting the toxins into a water soluble form that you most often poop out. But if you have dysfunctional poop, so say you’re constipated, and the poop is just sitting there and your gut not moving properly. You have you have these enzymes called beta glucuronidase and their job is throughout the body, but in the gut, what they’re doing is taking the toxins that your body has already packaged up nicely with a binder and they’re separating it from the binder. Now remember, I told you it’s water soluble to go be pooped out; the minute you separate it from that binder, it becomes fat soluble; it can’t stay in the gut; it gets recycled into your body; it’s super toxic. Your body freaks when it sees it; you put it in your fat. So if you have any dysfunctional processes in the gut, and by the way, any gut dysbiosis can have inappropriate secretion for beta glucuronidation for some of these nasty bacteria, so it’s like circling the drain, right? You know, you have this toxin that irritates the gut, the gut gets thrown off and then it doesn’t properly function and then you can’t get rid of your toxins. You just keep going around in circles.

Lindsey:

So the beta glucuronidase when elevated is an indication of some improper processes and the toxins are becoming recirculated?

Dr. Wendie Trubow: 

Yep and by the way, Lindsey, it’s not just toxins that you think of like bleach; its toxins like hormones, which can be toxic.

Lindsey: 

Right, of course, and a potential cause of breast cancer is elevated.

Dr. Wendie Trubow: 

Yep.

Lindsey: 

Recycling of estrogen.

Dr. Wendie Trubow: 

Yeah, yes.

Lindsey: 

I know, I have a client in this very situation.

Lindsey: 

Oh, no. No, I’m sorry to hear that.

Lindsey: 

Post breast cancer situation: elevated beta glucuronidase, but we’re bringing it down.

Dr. Wendie Trubow: 

We’re going to fix that, right?

Lindsey: 

Yeah. Okay, so are there specific conditions that have their root in toxins? Like, does it tend to to be more one condition than another or could it be any of the IBDs, IBSs etc.?

Dr. Wendie Trubow: 

Yeah, can really be any of them because it’s just how your body is responding to that particular stressor. You know, I get this question a lot. Why? Why is this my symptom and not that, or why am I having any symptoms? And I’m like, well, that’s just how your body’s processing it. So you really can run the gamut from just bloating, just gassiness. You could have poor digestion of stools or IBD, IBS, etc. I mean, it runs the gamut; you can develop anything from exposure to toxins.

Lindsey: 

Oh, speaking of which, I’m wondering, do regular doctors test beta glucuronidase? Or is this only within functional medicine?

Dr. Wendie Trubow: 

No, ma’am. That is a functional medicine test.

Lindsey: 

Okay. And I was just curious if it was the kind of thing that you could get an easy follow-up at the doctors, but obviously not.

Dr. Wendie Trubow: 

Nope, nope.

Lindsey: 

And so do toxins have an impact on your hormones?

Dr. Wendie Trubow: 

Yeah. So again, it’s like circling the drain. So some of these xenoestrogens that we get from plastics, they mimic the estrogen in your body and they look kind of like estrogen enough that your body goes down the let’s process you like estrogen pathway. And so it all ties together. So if you have these toxins, they look like your estrogens, then you’re not processing your estrogens properly. You can also go down the harmful processing of estrogens pathway with these xenoestrogens, when they wind up in your gut and they confuse the body. So that’s one part to it. But then, if your hormones are not properly processing, that can make it more difficult to deal with your toxins. And because a lot of it winds up in the gut, it throws the gut off. It really is this big circle of dysfunction.

Lindsey: 

So when you have the xenoestrogens in your diet, does that then increase your estrogen? Decrease your estrogen? How does that work?

Dr. Wendie Trubow: 

Yeah, so if you imagine that there’s 100 people in a room and the door is a foot and a half wide. So basically, one person can go through that door at any one time. Say now there’s a fire in the room and everyone’s trying to get out of that door but still that door is only a foot and a half wide. You have essentially people building up in the room trying to get out; that’s like your hormones. So your body can deal only with what it can deal with. But when you start to pile on,  there’s xenoestrogens in the room, there’s estrogen in the room, there’s testosterone, there’s progesterone; they’re all piling on. Essentially you’ve flooded your body’s ability to take care of it so one can increase the other and vice versa. So they’re tied in together.

Lindsey: 

Okay. And then what are your sources of xenoestrogens typically? I mean, you mentioned the plastics, but how far do you have to go in trying to eliminate that? What’s a reasonable way to work on that particular problem?

Dr. Wendie Trubow: 

Yeah, I mean this is not just limited to xenoestrogens. I think the question is, how can we systematically decrease our exposure to things that really increase the risk of making us quite sick, right?

Lindsey: 

That’s right.

Dr. Wendie Trubow: 

So when you take it from this big picture, look, you go, “Okay.” Really easy, low hanging fruit for a lot of people is how do you level up on your food: start with food, it’s foundational. You do it every day, multiple times a day. So aim for food that’s minimally processed, organic, if possible, local, and in season. That’s sort of the basis and then with that goes your drinks. So don’t drink anything from a plastic bottle because that’s a source of the xenoestrogens. Don’t drink alcohol because alcohol is straight up a toxin. And so that makes it harder for your liver to deal with the other stuff it’s being presented with because it’s busy dealing with a more important toxin, essentially. Alcohol will directly kill you if you don’t deal with it so your body knows we have to deal with this and get rid of it. So that’s the easiest way. And then all of us through our lives have exposure to hundreds of chemicals throughout the day. So what I say to people is, pick the thing you’re running out of, I don’t care what that is, whatever you’re running out of: be that house cleaner, weed killer, makeup, deodorant, hair products; it doesn’t matter. That’s an ideal moment to go to either Think Dirty, or EWG.org and look to see, what’s a better option here? What’s something where I can get three steps better, or 10 steps better? Depending on how bad it is, right? Maybe it’s really bad and you want to go a lot or maybe it’s not so bad. And you go, you know what, this isn’t a priority right now. But to systematically do that throughout your life as you start to run out of things.

Lindsey: 

Okay and so we’ll get back to the toxins and getting rid of them in a minute, but I wanted to ask first, what is the best and most economical way to test for the various toxins?

Dr. Wendie Trubow: 

Sure. So I’m not clear that I can say it’s necessarily economical straight up. The testing is a little bit pricey so, we use urine testing. You can test in the blood, but for metals, that’s only indicating if you had an acute exposure. You know, like the kids in Flint, Michigan, they have acute exposure; their lead levels are elevated, but for the rest of us, we’re not getting acute exposures, so blood’s not that accurate for that reason. We use urine, and the metals testing is not that expensive to test for. The system we use, it’s $69 for the test; you do two of them, because you always do a baseline and then you do a provoked test, and the provoking agents cost like, I don’t know, 35 bucks, so it’s not that expensive.

Lindsey: 

And what do you provoke with?

Dr. Wendie Trubow: 

We provoke with DMSA. And that’s pretty cheap to test because there’s so many prongs to treating metals, the treatments more expensive, but the testing is cheap. And then we usually do a urine test also, for the mycotoxins, the other environmental toxins and the pesticides and glyphosate. You can break those up or you can do them all together. So if you do them all together, it’s 500, just under six, $560, basically, which is not cheap. You can break them up, so it’s like 300, 201 and 100; you can do them piece meal, but you are going to need to see a functional medicine provider because your conventional doctor doesn’t have these tools in the office. It’s like going to the mechanic and asking for a haircut. Right? It’s just the wrong access.

Lindsey: 

So the $69 test is that urine for metals.

Dr. Wendie Trubow: 

Yeah, that’s urine for metals. It’s a cheap test.

Lindsey: 

Okay, what about hair testing?

Dr. Wendie Trubow: 

I’m not a huge fan of hair testing, personally, because hair testing is showing what your body’s basically voluntarily getting rid of, and this is for metals not for mycotoxins; you’re not going to see it there. For metals, it’s really only looking at water you’re kind of voluntarily excreting; it’s not looking at what’s stored, because 95% of your lead in particular is stored in your bones. You’re not going to see that in your hair. You know, it’s like a fraction of what’s really present.

Lindsey: 

But it would be in the urine.

Dr. Wendie Trubow: 

Yes. Well, when you provoke it.

Lindsey: 

Right. Okay, so you take the DMSA that prompts your body to start releasing toxins and then you see.

Dr. Wendie Trubow: 

Yep.

Lindsey: 

Okay, got it. How far apart? Or how long will you treat with DMSA before you do a provoked test?

Dr. Wendie Trubow: 

It’s the same day: what we do is we say to people, we need a baseline, “Get up and pee”. That’s the test. That’s the first $69 test. And then as soon as you’ve emptied your bladder, you’re starting with a clean slate. So take your DMSA and we collect for six hours; for six hours, collect that information and then at the end of six hours, empty your bladder so you complete the test at six hours. And that’s what we’re comparing against. We treat people if they have high levels; we treat over eight, which is just the reference range for that lab. Say someone comes in and for example, they have no hair anywhere on their body. I’m sure we’re going to see high levels, but say we didn’t; say their detox is so shut down, you don’t see it. We’re going to treat them anyway and keep monitoring them.

Lindsey: 

Okay, so no hair would be a sign of toxins.

Dr. Wendie Trubow: 

Yes.

Lindsey: 

Okay. And so how much DMSA will you give them then?

Dr. Wendie Trubow: 

It depends on how big you are and how old you are. So I don’t treat kids so I won’t speak to the dosing for that; for our adults as long as they’re a normal weight, we’re going to give them 1500 milligrams, and then we have that compounded by a pharmacy.

Lindsey: 

Okay, so you mentioned there’s the metals, then the mycotoxins, and then there’s also the all the pesticides right?

Dr. Wendie Trubow: 

Yep.

Lindsey: 

Are these Great Plains tests*?

Dr. Wendie Trubow: 

Yes. This is who we use. Yeah.

Lindsey: 

Okay. And then other… is that a whole separate one?

Dr. Wendie Trubow: 

Well, it’s on the same Great Plains test, but that’s all the stuff that we’re exposed to throughout our life. So the MTBE which is the gasoline fumes, the styrene plastics, asparagine, the burnt foods, tobacco, smoke; all of the chemicals in all of these things: makeup, nail polish, hair products; all of these things are captured in this test. And so it’s looking at all of them and really, I typically look for a level of 75 percentile or above, at around the 75th percentile and like, “Hey, we got to treat this.”

Lindsey: 

Got it. Okay, and what kind of gut conditions might prompt you to think that there could be a toxin issue?

Dr. Wendie Trubow: 

So we do a ton of toxins work in our practice, because we get a lot of people who say, “Okay, I eat right, I’ve done a stool test, I fixed my dysbiosis; I fixed my SIBO; I don’t eat gluten, do everything right. And I’m still not right. You know, I have this irritable bowel or bloating, gas, diarrhea, any of the above, right?” So if you do everything, right, and you’re still having symptoms, that deserves a toxins look, because what else is it; unless you’re so super stressed that your body can’t process? It’s a toxins issue.

Lindsey: 

And so talking about getting down to the level of specific toxins, what are the most common sources say of lead?

Dr. Wendie Trubow: 

This is great. So for lead, the most common sources are lead pipes, living in a house built before 1978, because almost all of them had lead in the paint. And everyone says to me, “Dr. T., I’m not licking the walls.” I’m like, dude, I know. I know, you’re not licking the walls. However, as that house settles down, you’re getting exposed to all of the lead dust and you absorb it in your skin; you breathe it and you touch it; you eat it, so you’re absorbing it in various ways. The most likely causes are living in homes built before 1978 or lead pipes. However, there’s lots more causes and one of the other really subtle ones is being born to someone who had lead in their system who also nursed you, because it will cross the placenta and it does come out in breast milk. My poor kids, right? I’ve got four kids; I nursed them all and I was like, “Nursing is a detox event for the mother.” And tox up event for the kids.

Lindsey: 

Perfect example of this: I have a friend who got really sick at a workplace she was at. I’m not sure what ultimately contributed to it, but during her pregnancy, she felt healthy. And then her son ended up with all these food sensitivities and allergies. And then as soon as he was out, you know, then she was really sick again. She was just transferring all those toxins to the baby the whole time.

Dr. Wendie Trubow: 

We’re so generous to our children, right?

Lindsey: 

Exactly. Okay, how about aluminum? What are sources of aluminum?

Dr. Wendie Trubow: 

Aluminum is usually just aluminum foil and that’s actually one I look at less. I usually focus on lead, mercury, cadmium, thallium and arsenic. The big five. Mercury… it’s so funny, Lindsey. So Mercury is fish and fillings. The fillings are the mercury amalgam silver fillings and even having one in you is enough to create problems for some people, and then the heavy mercury fish. So what’s horrifying is that as wildfires occur, say in California, they release all of the stored mercury in the forests. That mercury gets into the water system, which gets converted to methyl mercury, which the fish eat, it hangs out in their bodies. They can’t excrete it any better than we can. Then we eat the fish. So one serving of a heavy metal fish such as Mahi Mahi, tuna, swordfish, tilefish, Chilean sea bass; one serving, theoretically, it has enough for like a month’s supply of mercury. But if you’re someone like me, who’s not the best detoxer, I say to my patients, you should not be eating that period. It’s not like, “Oh, once a week.” It’s like no; we’re not going to eat that. It will make you sick.

Lindsey: 

I think I literally had just Chilean sea bass last night. I never thought of that.

Dr. Wendie Trubow: 

 I know, right? All the super yummy fish are high in mercury.

Lindsey: 

I think that is what I had last night.

Dr. Wendie Trubow: 

Oh, can I tell you a story? So we have a patient in our practice who had no hair when she came to our practice. And she was just told by… of course people see 20 doctors. If you have no hair, you keep going to doctors. So she came to us and she had seen 10 doctors. All of them had said to her, “Oh, you just have autoimmune alopecia. Nothing to do. Sorry.” So she came to us and she saw my husband first. I stole her from him. She saw my husband and he looked at her. He said, “You have heavy metals.” She had really high levels of lead. So this was about just under two years ago, just as the pandemic was starting she came in to us. She has been successively working on her hair and last year her hair started to grow back. I saw her two weeks ago in my practice; and she said to me, “I feel like I’ve plateaued.” Now by the way, what I will say is she has about two inches of hair growth all over her hair and she now has to go back to waxing and shaving and plucking because she’s grown hair in all the places women tried to get rid of it. But I was like, you know it’s a mixed bag, buddy. No hair on your head, but you didn’t have to wax, but now it’s the reverse. So she’s growing hair on her head but she said, “I feel like I plateaued.” And I said, “So what’s going on? Let’s drill into it.” Well, she was down at a remote job. And as a treat, one to two times a week, she was eating sushi. And I said, “Okay, well, what kind of sushi? Are you eating? You know, what are you having? Are you having salmon? What are you having?” She said, “I’m having tuna.” I was like, “Oh, no. We just got all this metal out of you. You can’t do that. You don’t have good detox.” So I said to her, “That’s it. Like, I hope you enjoyed your last meal. Because no more of that. It’s too much.”

Lindsey: 

Yeah and so do you think you can get away with the safe canned tuna though?

Dr. Wendie Trubow: 

Yeah. As long as they’re testing for mercury, there’s a number of brands that will test for mercury and canned tuna. So yeah, that’s reasonable.

Lindsey: 

It’s Vital Choice* and Safe Catch* that I know… Okay, so yeah, I had my last mercury fillings removed. And I was glad I went to the dentist I went to, although it cost me a pretty penny, I had it replaced with gold. I’ve got two gold fillings and I feel like I’ve got my bling in the mouth.

Dr. Wendie Trubow: 

The price of gold; you’re kind of like a kidnapping risk.

Lindsey: 

I know, seriously, they’re each like $1,000. But I mean, given the number of years I have left to live and you know, the composites are not supposed to last that long. So I had to make my choice. If somebody is getting their mercury fillings removed, I know you should go see the biological dentists and all that. But say you can’t afford that; you can’t do that. What could you ask your regular dentist to do to just keep you safer or what can you do yourself?

Dr. Wendie Trubow: 

Let’s look at things you can do yourself, because I can’t really speak for whether your dentist is going to say yes or no, but I can make some recommendations. So things you can do yourself: one, don’t eat any high mercury fish period. Okay. Particularly as you’re approaching this. Two, on the days preceding the mercury, I would take activated charcoal; especially the day of, take a couple of tabs of activated charcoal in the morning. Then when you get home, take a couple of tabs of activated charcoal and ideally fast so that you’re not bothering your body. It has to digest foods; you’re just focusing on binding the metals because a charcoal will bind to your food too. So don’t take it with your food. So take the charcoal, eat lightly, increase glutathione for a couple of days before and at least a couple of weeks afterwards.

Lindsey: 

By taking glutathione?

Dr. Wendie Trubow: 

Correct, Yeah.

Lindsey: 

Like liposomal?

Dr. Wendie Trubow: 

Yeah, the best one is by Quicksilver, which is a liposomal form. We have another one, it’s called SafeCell glutathione (find both in my Fullscript Dispensary*). It’s a liposomal in a gel, which is easier for people who don’t want to refrigerate it or can’t remember to take it.

Lindsey: 

It’s a Tesseract product, isn’t it?

Dr. Wendie Trubow: 

Yep, yep. So that’s a great product and then you can also do simple things like cilantro, parsley and chlorella help. All these things are super helpful, so I would say load up on those for the days preceding, the days after and the day of so that you give your body every opportunity to bind those metals. By the way, don’t drink any alcohol because your liver can’t deal with metals and alcohol. Yeah, too much. Do all those things. Then if you can find a functional medicine doctor who will give you metal binding IVs. A couple of weeks afterwards, you can get some IVs to bind up those metals so that you’re not just letting them float around and go back into your bones and your fat. So that’s for you to do and manage your stress because if you’re stressed, you’re not going to detox anyway. A lot of layers, right? 

That’s just for you; then what you say to your doctor is, “Hey, can you give me oxygen while you’re doing this? Because oxygen can help…” I’m not sure of the mechanism. It either binds to the metals or it prevents you from absorbing metals. But oxygen helps, A. B, Can you put a dam on the tooth you’re working on so that nothing falls down my throat. You know how they work in those little chips and you swallow them? You want them to not fall down your throat so could you put a dam on the tooth that you’re working on? Most dentists if they’re not comfortable with this are going to be like, “No thank you. And by the way, you can find another dentist.”

Lindsey: 

Yeah, my dentist was not like trained as a biological dentist, but it’s a very simple piece of plastic that you just surround the tooth with. It covers the rest of the mouth and he put that on. He had like a vacuum cleaner under my mouth. Yes. Yeah. I mean, very low tech, but like it did the job.

Dr. Wendie Trubow: 

Yeah, low tech and make sure they irrigate a lot, give you oxygen and keep it from swallowing it. So it’s not rocket science, right? I just can’t vouch for whether they’re going to say yes to doing that. Then the other part to that is, if you have a mouthful of fillings, do not get them all done in a week, period. You’re going to be really sick.

Lindsey: 

Yeah, yeah. So how many at once reasonably?

Dr. Wendie Trubow: 

Not more than two. Unless they’re tiny, you could do three but I was really reluctant to get my mercury fillings out because I said to my biologic dentist, “They’d been here for over 40 years. What difference are they making really?” She said to me a lot. It’s 50% mercury weight, A. It never stops off gassing, B. C, just so you know when we take that out of you, we can’t throw it in the trash. It’s considered toxic hazard. We have to put it in special trash. It’s so toxic. She said, “So that’s in you.” And I was like, “Oh, okay. Persuaded. Let’s get it out.” I got them taken out; but I was pretty resistant. You don’t want to do more than two and you want to give yourself two weeks between every two, at least so that if you have a reaction, don’t go back to get more done if you’re still reacting, right? Don’t pile it on.

Lindsey: 

Keep taking the activated charcoal or…

Dr. Wendie Trubow: 

Yes, and glutathione, it’s really weird: Metals deplete your glutathione and you need glutathione to get rid of your metal. So another case in which you’re circling the drain, if you have metals constantly depleting your glutathione. Okay and now that I see that, I just realized I didn’t take it this morning before I left the house. How aggravating.

Lindsey: 

And in this case, would NAC also do the job as a replacement for the glutathione?

Dr. Wendie Trubow: 

Yeah, so NAC and Alpha Lipoic Acid are precursors for glutathione. They help your body make the glutathione so you can give your body these things and they can help get you where you need to be for the substances your body needs to get rid of the metals.

Lindsey: 

Okay, so we talked about mercury, how about arsenic?

Dr. Wendie Trubow: 

Yeah, rice. No good deed goes unpunished. So… you eat brown rice, because you’re like, “Oh, I’ve got to get the fiber.” Except the whole seems to have more arsenic in it, so white rice, organic Jasmine, white rice has less. It’s unfortunate but you have to pick your battles. If you’re someone who’s really dealing with blood sugar issues and cardiovascular things and when you eat rice, you’re going to want to do the brown rice but be aware that you want to monitor your arsenic. Then otherwise, I would go for white rice and go for a smaller portion so that you don’t have a spike in your blood sugar, but then you don’t get the arsenic.

Lindsey: 

My parents, I had them both do an ION profile and both of them came up with high levels of arsenic. They barely ever eat rice.

Dr. Wendie Trubow: 

I’ll have to look up other sources. It’s not the only source but rice is like far and away the biggest source.

Lindsey: 

I mean, it can come from other grains I think too.

Dr. Wendie Trubow: 

You know, I don’t know the answer to that. I always think about glyphosate from other grains. So I’ll have to look at that. I’m not sure.

Lindsey:

Okay, fair enough. How about cadmium?

Dr. Wendie Trubow: 

Cadmium is west coast oysters, tobacco and I think there’s a couple more that I’m totally blanking on, but really the big ones are West Coast oysters and tobacco smoke.

Lindsey: 

Okay, so don’t get your oysters from the West Coast.

Dr. Wendie Trubow: 

No, ma’am.

Lindsey: 

Get them from somewhere else or avoid them altogether?

Dr. Wendie Trubow: 

Correct, Yeah.

Lindsey: 

Get them from somewhere else. Okay. And how about chromium?

Dr. Wendie Trubow: 

Thallium was the next one I focus on and this is back to the no good deed goes unpunished. So you’re doing a good job, you’re eating organic. A lot of it comes from California. You’re happy because it’s in the United States, you’re buying you’re buying American. However, California soil is contaminated with thallium. The organic vegetables happen to be particularly high so if you’re someone who eats a lot of green leafy vegetables from California, you’re at risk for getting high levels of thallium. Thallium can cause hair loss in high doses and maybe even constant doses. I always say to people, let’s work on improving your detox because I would vote that it’s better for you to eat organic, we’ll deal with thallium rather than eat non organic and then we have all these pesticides, which have even other consequences. It’s pick your poison here, right?

Lindsey: 

Well, if you get your vegetables locally and you don’t live in California, then you’re good, right? So I guess that’s the eat local part.

Dr. Wendie Trubow: 

Yes. Yeah.

Lindsey: 

Or grow them yourself.

Dr. Wendie Trubow: 

We should talk about mycotoxins too.

Lindsey: 

Let’s talk about mycotoxins.

Dr. Wendie Trubow: 

There’s a lot of layers to this. Water damaged buildings are probably the biggest source for people of mycotoxin exposure. Then food is another source; the foods that are the biggest ones – and by the way, I had a patient whose car was moldy kind of randomly. When I diagnosed her, she said, “My car’s moldy.” I was like, “Really?” She goes,”Yeah.” She had her car tested when she had her house tested and yeah, it was moldy. So she sold it. So anyway, foods that can increase your mycotoxin burden: coffee is a big culprit and grains are a culprit because, you know, they sit in these big sills and silos and they’re wet. One way that they dry them out is with glyphosate. Glyphosate was originally developed as an antibiotic and then was converted into agricultural use. In 2014, I don’t have stats beyond 2014; couldn’t find them. But in 2014, there were over 250 million pounds used in the United States, which is just ridiculous.

Lindsey: 

It’s banned in Europe, isn’t it?

Dr. Wendie Trubow: 

I don’t know the answer to that actually.

Lindsey: 

I’m going to Google that while we are talking.

Dr. Wendie Trubow: 

So it’s a probable carcinogen according to the World Health Organization. It wouldn’t surprise me if it was banned in the EU because they actually do a lot better job at preventing harmful things. So only about 500 different items have been specifically tested for whether they’re toxic. And then there’s another 150,000 things that haven’t been tested, specifically. So now we rely on just studies. So it’s pretty horrifying because they don’t have to prove that it’s not harmful, they have to prove that it’s not directly harmful in large doses. It’s a little bit of a nuance but the combined cumulative effect of lots of toxins in small amounts can be just as bad as one major exposure. So back to the mycotoxins, a lot of them are ochratoxins, which comes from grains that are wet.

Lindsey: 

Okay.

Dr. Wendie Trubow: 

Did you find it?

Lindsey: 

I did actually find the answer. Yeah, so it’s currently approved for use in the European Union until December 15, 2022. But Austria already banned it in July 2019. And Germany is going to start phasing it out by 2023. That’s what I got in my quick search.

Dr. Wendie Trubow: 

I mean, it’s pretty nasty. Back to gut health, it disrupts the microbiome because it was developed as an antibiotic. The World Health Organization has classified it as a probable carcinogen, because there are a number of cancers that are associated with it; most of which are lymphocytic, like non-Hodgkin’s lymphoma, things like that. It’s again just sort of horrifying. So I want the listeners to think, “Okay, I have control over this, right?” Because you can take control of the narrative and sometimes you have to get that horrified in order to make a change. When you’re eating the grains, even organic grains are sometimes contaminated with glyphosate because of the drift that occurs. It’s sprayed on these massive farms. And then the wind carries it to adjacent farms, which happen to be organic. There you go, your organic grains are now contaminated, as are like all of the garbanzo beans in the United States are contaminated with glyphosate.

Lindsey: 

Even the organic ones?

Dr. Wendie Trubow 

Yep but eat the hummus. Eat the hummus; it’s better than not eating it, right. It’s good for you. It’s just when you balance it.

Lindsey: 

Okay, so I know there are people out there who are just like, “Well, I don’t eat organic, and I’m okay.” Correct this line of thinking.

Dr. Wendie Trubow: 

Yeah, I think you have to look at that moment in time. So a lot of disease is from the cumulative effect of abuse. Meaning over the course of years, you get exposed to different things. I didn’t have celiac when I was 15 but I had certainly gluten sensitivity. I just didn’t know it. 20 years later, I had celiac. So it’s really about at what point do you want to intervene in the disease process. So there are certainly people I call them strong like bull; nothing impacts them, right? They can take a beating and nothing fazes them, they can eat anything, stay up all night, drink all night and the next day, they’re chipper. I’m not like them. There are some people like that cool. If you’re a bull, cool. It’s going to take a lot to bring you to your knees. The rest of us are generally not strong like bull, we’re more like a mouse. We can be brought to our knees a little bit faster than the like bulls and basically, everyone’s eventually going to break down with things. 

When you look into your optimal health, you can start to see the dysfunction at a cellular level before you see it at an organ level. When I was 15, I had iron deficiency and B-12 deficiency that didn’t respond to supplementation. By the time I was 35, I had wasting, right? So it was a 20 year process. I’m sure I had celiac earlier than 35. I just wasn’t tested. Nobody knew. So when you talk to these people who say I have nothing wrong, well I’m not so sure about that. Maybe you just don’t know about what you have wrong. Have you tested and the other part of it is: humans are very quick to explain things away, right? So when I hit the skids with all my toxins, exposure stuff, I was like, “Well, 48, perimenopause is terrible. Hate it. This is the worst, right?” Except it wasn’t perimenopause. It was a toxins exposure. But in the absence of knowledge, you might assume or chalk it up to something else. Oh, that’s how my family is; everyone in my family has insulin resistance or diabetes or everyone in my family can’t lose that 10 pounds or everyone in my family goes bald, whatever that is, right? We’re very quick to say that’s just how my genes are, as opposed to something’s turning on those genes.

Lindsey: 

So you’ve piqued my curiosity by mentioning perimenopause. Tell me what symptoms you think were associated with toxins that went away after you detoxed.

Dr. Wendie Trubow: 

I was losing hair at a very rapid clip and you can lose your hair in perimenopause. I gained almost 10 pounds and you can have weight shifts in perimenopause. I got a rash which wasn’t really perimenopause, but I was like, I don’t know what else it is so… right. I’m having a terrible perimenopause. So yeah, it was the weight and the hair loss.

Lindsey: 

And what toxins were you particularly high in? And where were they coming from in your life?

Dr. Wendie Trubow: 

Yeah, well sit down, okay, because it’s a long list. So I had lead. I was born in 1970 so I grew up in homes that were built with lead paint. We did construction on homes that have lead paint. We had lead pipes when I was a child, so those exposures. I had mercury from both fish and fillings. I had four strains of mycotoxins. I had seven or eight different environmental things such as nail polish, toxins, gasoline, fumes and plastics, styrenes. I had a whole bunch of those in me. That was really the impetus for writing the book because I got all this tests. I mean, Lindsey, for the last 16 years, I’ve eaten gluten free. I don’t eat gluten substitutes. So I’m eating like no processed food, no sugar; I don’t drink alcohol. I’m really boring on paper. I don’t do anything fun. I exercise to get enough sleep.

Lindsey:

I am sure you do something fun.

Dr. Wendie Trubow: 

But like, I’m not fun. People aren’t like, “Oh, let’s go to her house and have like an ice cream sundae.” No. I’m not that person. So there’s nothing fun in my diet, basically. And yet, I had all these toxins. That was the impetus for the book. When I got all this data, I said to my husband, “I am such a dirty girl.” And then he went, “Oh, that’s the book we need to write because don’t do what I did.” Right? Let’s provide a roadmap so you can avert getting to where I got to where I could not lose weight, hair was falling out, brain fog, fatigue, rash on my face, like all these problems. It’s preventable.

Lindsey: 

Yeah, yeah.

Dr. Wendie Trubow: 

And something else. I forgot to tell you because this is about poop, right? I used to be the canary in the coal mine for gluten. So if we went out to eat, and it had any trace of gluten, I was sick. The worst exposure I got, I was sick for three months and it was awful with brain fog, emotional problems, anxiety and really being sensitive. You look at me funny, I start crying and then got stuff like super sensitive diarrhea all the time, no matter what. It was awful. What was really amazing was when I started to treat the mycotoxins in particular, I only noticed this in retrospect, because you only notice when you don’t have a problem when you have a problem, I guess. So I used to have 6 to 12 weeks of problems with a gluten exposure. Then I noticed, it was like 4 weeks and then I noticed it was 10 days. Then I noticed it was 24 hours and then I noticed it was just overnight. Being someone who couldn’t eat at a restaurant at all, converting that to someone who can now, I’m not indiscriminate, but going to restaurants that are careful. I can eat out. That has transformed my life because my gut is no longer this raging torrent of reaction. It’s a lot quieter. Just an unexpected benefit, but that goes back to that these are all very irritating to the gut and when you start to pull them off, the gut can relax.

Lindsey: 

Your detox systems can handle the gluten because it’s not all preoccupied with everything else.

Dr. Wendie Trubow: 

Exactly.

Lindsey: 

Yeah. Mycotoxins. If somebody, they have no obvious exposure to them in their life. So they’ve never lived in a moldy house that they know of. They’re not having extreme reactions. They’re not losing hair. They’re not, you know, that kind of stuff. Is it worth still worth testing?

Dr. Wendie Trubow: 

Yes and no. So this depends on what your philosophy is. So if your philosophy is, I feel fine; I’m going to wait for a problem to develop and then I’ll deal with it, then no, you should not test. Right? Because there’s no problem that you’re treating. If you take a step back and you’re someone who says I really want to have optimal health. I understand that these mycotoxins are associated with degenerative diseases such as, as Alzheimer’s, dementia, Parkinson’s, cancers. I understand that these are a risk factor and I want to pull off any risk factors that I have, or I’m having symptoms, then yes, I would test. But it depends on your philosophy. It’s very upsetting for people when their philosophy is: I’m going to wait till it gets worse and you try to make them change. They’re not ready because there’s not a problem that they can react to.

Lindsey: 

Okay. So in terms of treating each of these and detoxing, is it specific for each toxin how you detox or is it more general?

Dr. Wendie Trubow: 

It’s both. So there’s basically three buckets. The metals fall into one treatment category and that includes improving the liver’s ability to remove the toxins, binding to them specifically and then replacing the minerals and nutrients that you pull out when you bind the toxins. So that’s the metals. The mycotoxins are specific binders based on what strain you have. So that’s really targeted therapy. You have to test because actually. There is a fiber, propolmannan fiber will bind to all the mycotoxins. But basically, you do want to know what you’re treating to know when you’re done even. Then the environmental toxins and pesticides almost universally trickle down into responding to a smaller group of things that include glutathione, NAC, sauna, B-12, niacin and things to improve phase two. So it’s a lot smaller but again, you want to know like what are you treating? But it would never harm you if you took glutathione, NAC, B-12, cilantro, parsley and did a sauna every day. That would not harm you.

Lindsey: 

Right and can you just explain phase two detoxification a little bit?

Dr. Wendie Trubow: 

Yes, it’s horrifying. I remember when I learned it in the context of hormones. Your liver’s responsible for doing the majority of work to get rid of anything that your body doesn’t need or is harming it. So that largely falls into toxins and hormones. Although alcohol too or medications; I guess I could keep going on. So your liver is responsible for doing lots of work. In phase one, you take this substance and you convert it into what’s called a toxic intermediary. It’s a middle ground substance that’s even more toxic than what it started out as. Don’t ask me why; it doesn’t make any sense to me but that’s what your body does. Then in phase two, there are six different detox pathways you can go down: you can bind it to a methyl group, you can put it on a glucuronic group, you can put it on a sulfur group, there’s lots of things you do to it, but you basically bind it, make it water soluble and poop or pee it out. Phase one is generally pretty fast, especially for women. Phase two is generally slower. So your body, it’s really good at making these toxic intermediates and then it’s like, “Oh, crap. Wait, now what do I do with it?” So it puts it in your storage units, which are your bones and your fat. It hangs out of there, out there until phase two is ready to actually pull it out and deal with it and excrete it. This is why when your gut has overactive beta glucuronidase and you’re recycling these toxic hormones it’s so harmful because not only do you now need to deal with what you’re already dealing with, but now you’ve just piled on more and your body can’t deal with the volume.

Lindsey: 

Is it better then to support phase two detoxification before doing anything with phase one?

Dr. Wendie Trubow: 

You want to do them together and there’s a lot of overlap actually.

Lindsey: 

And phase one supports are things like…

Dr. Wendie Trubow: 

Minerals, nutrients, curcumin, ginger… that’s funny. I’m less versed in phase one, because I’m like, everyone’s fine with phase one, right?

Lindsey: 

Generally, people have that under wraps. It’s the phase two they need help with.

Dr. Wendie Trubow: 

Yeah, they’re generally better. If they need help, I’m like, go to my nutritionist. She’ll take care of you. But then phase two, it’s actually very hard for vegans to do effective phase two, because a lot of support for phase two comes from flesh: meat, chicken, other poultry, fish, eggs, and dairy. So it’s harder for vegans. It’s not impossible, but it’s harder.

Lindsey: 

So they might be more inclined to have a buildup of toxins.

Dr. Wendie Trubow: 

Yeah, counter intuitively, because they eat much healthier.

Lindsey: 

Great. Well, so tell me about your book.

Dr. Wendie Trubow: 

It’s a fun read. Reading our book is like talking to me. So it’s pretty much like a conversation, well conversational. It’s all about: how are the ways that we’re getting exposed to various toxins and what are the things that we can do to control the narrative before you ever get to a functional medicine provider. There’s so many things that you can do to take control of your health: how you eat, how you live, how you drink, how you stress, how you exercise, the supplements you’re taking, all of these play a role and you really can alter it. There are a lot of things people can do on their own until we go through that in the book. We talk about what would make you even think that maybe you have toxins? Because some people don’t even have the awareness that it’s a toxins issue.

Lindsey: 

Yeah, so the things that should make them suspicious of toxins we’ve talked about, like hair falling out, weight gain… any other sort of big red flags?

Dr. Wendie Trubow: 

Unremitting fatigue. Really pronounced issues with any hormone stuff, you know, really bad periods, fertility challenges. Any type of cardiovascular disease or metabolic disease, so high blood pressure, heart disease, diabetes, and pre-diabetes; all those indicate toxins, bad cholesterol profile. Those indicate toxins.

Lindsey: 

Even if you have a genetic predisposition to have high cholesterol?

Dr. Wendie Trubow: 

Yep because your genetics are only one facet of the conversation. Your genetics aren’t your  determinant for life, they just make you more likely, but when you pile on the toxins, it makes it 10 times harder to deal with.

Lindsey: 

So tell me, I understand you have a free gift for my listeners.

Dr. Wendie Trubow: 

I do. I mean, after listening to this podcast, you may be saying to yourself, “Okay, I really need to clean up all the products around me, at least so I can stop being exposed.” Because this was my passion play and I had all these problems, we spent hours looking for products. Then we were like we’ll put it together in a guide, so that people don’t have to do as many hours of research as we did, because we did like… I don’t even know, I stopped counting, actually. So it’s the “Nontoxic Guide to Healthy Living.” It’s meant to really go with the book, but you can also use it alone. And that’s on our website

Lindsey: 

Okay, great. I will link to that in the show notes and all the other places and your different social media.

Dr. Wendie Trubow: 

Yep. We also have a podcast. It’s the Five Journeys Podcast. So people can also find us there.

Lindsey: 

Ok, great, wonderful.

Dr. Wendie Trubow: 

Because there’s probably a lot of overlap between us and people who like you, probably like me and lots of other people. So we do that, too. It’s somewhat fledgling, but yeah. Instagram, Facebook, Twitter, LinkedIn is all Wendie Trubow MD.

Lindsey: 

Great. Well, this was really informative and interesting, and I think will be useful to a lot of people who have kind of gotten to the stuck place after trying to fix the gut stuff and are not getting anywhere.

Dr. Wendie Trubow: 

Right. Yeah, definitely. It’s definitely helpful for people.

Lindsey: 

Awesome. Thank you so much for sharing your knowledge with us.

Dr. Wendie Trubow: 

My pleasure, Lindsey. Thanks for having me here.

If you’re struggling with your gut health, you’re welcome to set up a free, 30-minute breakthrough session with me (Lindsey). We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.

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