Health & Fitness

Obesogens are chemicals that exert negative effects on your cells. You may recognize many on a list that contains bisphenol-A (BPA), parabens, flame retardants and pesticides.¹ The majority are known endocrine-disrupting chemicals (EDCs) that may be sabotaging your weight loss efforts.

Other obesogens include PFASs,² commonly found in food packaging, household cleaners, nonstick cookware, firefighting foam and stain-resistant carpets, rugs and furniture.

Exposure to this single chemical can happen through your food, indoor air and dust, drinking water and products used at home and at work. Aside from being an obesogen, according to Toxic-Free Culture, PFAS is also linked to liver and kidney toxicity, reproductive and developmental toxicity and cancer. This is just one chemical in a long list of compounds used in everyday materials.

Despite global recognition that obesity is pandemic and endless health campaigns being held to address the challenge, the trend is steadily rising. In 1960, just under 15% of the population were obese, as compared to 35% in 2005.³ This number had risen to 39.8% by 2016.⁴

Obesogens: Environmental Factors Contributing to Obesity

Professor Emeritus Philippa D. Darbre, from the University of Reading, U.K, is an expert in EDCs. In her book, “Endocrine Disorders and Human Health,”⁵ she describes the actions these chemicals take which disrupt your ability to maintain or lose weight.

The chemicals increase fat accumulation and promote the growth of fat cells, she explains. They also increase the number and size of adipose cells and alter hormones that regulate appetite. Additionally, obesogens change your metabolic rate and favor storing calories rather than burning them.

The idea was first published in 2002 by a researcher from Scotland in an obscure journal, but it caught the attention of a few scientists.⁶ The research began to build after a commentary on the study was published in a well-read toxicology journal.

Jerrold Heindel Ph.D., of the National Institute of Environmental Health Sciences (NIEHS), focused on the fact that toxicity testing for chemicals was conducted to see if it was related to weight loss, which is considered an effect of toxicity.

But, as reported by Newsweek, researchers “overlooked instances when the chemicals caused weight gain” — which Heindel noted is important, since “a number of chemicals caused weight gain — and at low doses,” such as the amount a fetus or infant would be exposed to.

Heindel also noted that research showed that exposing certain cells in a test tube to chemicals, including BPA, could stimulate the growth of fat cells. He wrote that if this could also happen in a living organism, "the result would be an animal [with] the tendency to become obese."

Only two years later, the leaders of an animal study demonstrated newborn mice exposed to a hormone-mimicking compound had 36% more body fat and were 20% heavier than the mice who were used in the control, Newsweek said.

In fact, results from more recent studies have continued to support the obesogen hypothesis.⁷ One additional issue is the mixture of EDCs you are exposed to over a lifetime. This is where years of mapping the human genome may be of benefit.

Experimental researchers and epidemiologists are analyzing levels of exposure to single and multiple chemicals using exposome studies. According to the CDC⁸ an exposome is “defined as the measure of all the exposures of an individual in a lifetime and how those exposures relate to health.” Researchers hope:

“This will inform and guide future laboratory and epidemiological approaches that will overcome the current limitations. In turn, this will allow us to assess the costs to society of EDC and obesogen exposure more accurately. In an optimistic view, this information might influence policy makers to take appropriate steps to protect the public health.”

Early Life Exposure to Trace Chemicals and Infant Obesity

Bruce Blumberg, Ph.D., was at the University of California Irvine when he read the 2002 published paper. He was not impressed by the hypothesis, however, so he decided to conduct his own experiments. By 2006 he had designed and executed an animal study in which pregnant mice were fed an endocrine-disrupting chemical known to enter the food chain and drinking water.

The offspring were born with more fat cells, and by adulthood were up to 20% heavier than those not exposed. Through genetic testing, he discovered the chemical activated a receptor to change the direction of fibroblast development. The change was so reliable that Blumberg coined the term “obesogen” to describe the effect.

This challenges the long-held belief that weight gain and loss are based solely on calories eaten versus calories burned. But, as intermittent fasting and ketogenic nutrition plans demonstrate, there is a difference in how efficiently calories might be burned.

In another demonstration of factors affecting weight loss and gain, results from an animal study⁹ showed what most night shift workers likely know instinctively: that eating food at night packs on more pounds than eating the same amount during the day.¹⁰

The authors of a literature review published in 2018 analyzed existing surveys and animal studies and found that the “most important sources of exposure to obesogens indoors are diet, house dust and everyday products such as cleaning chemicals, kitchenware or cosmetics.”¹¹

This ubiquitous exposure pattern is at the heart of prenatal and infant exposure to chemicals with the ability to change cell function and slow metabolic rates. The infant population over the past several decades has begun to grow.

CDC data show that from 1971 to 1974 as plastics became more popular and the use of endocrine-disrupting chemicals was growing, only 6.7% of infants ages 12 to 24 months were obese.¹² In the coming years the percentage of obese infants ages 6 to 24 months took an upward trajectory.

While the growth rate has varied, by 2000 10.4% of all infants were obese and in 2016 it was 9.9%. In a retrospective chart review¹³ of infant growth patterns, researchers found there were significantly different patterns that became evident as early as 2 to 6 months. The data showed a correlation between body mass index values at 4 months and 5 years.

Later support for these findings came from the University of Virginia, which showed that babies who are born overweight are likely to remain overweight.¹⁴ Further findings from animal research indicate that weight differences triggered by obesogenic chemicals may increase the potential for obesity in the following four generations.¹⁵

The Rising Challenge of Weight Management

The challenge of obesity and weight management presents a mental, emotional and financial burden. Being overweight or obese can increase the risk of a significant number of health challenges, including certain cancers, sleep apnea, heart disease and Type 2 diabetes.¹⁶ During pregnancy, it can raise blood sugar and blood pressure, resulting in an increased risk for cesarean delivery.

The effects can be long-lasting on individuals and communities.¹⁷ In those younger than 70, only tobacco is responsible for a greater number of deaths each year. Individuals who are overweight or obese may also suffer from discrimination, a lower quality of life and an increased risk of depression.

Using data from different states in America,¹⁸ one research team estimates the percentage of health care spending devoted to obesity rose from 6.13% in 2001 to 7.91% in 2015. This represents a 29% increase in spending for obesity-related health conditions.

Using BMI to assess your health risks may not give you the information you need to make safe life choices. The flaw with BMI is that it uses total weight to determine whether you’re overweight when it’s the total amount of body fat that represents the greater risk to your health.

By the same token, assuming you’re healthy, if you are within normal BMI limits is not an accurate assessment. For instance, an athlete or out-of-shape individual may have the same BMI or a muscular person could be categorized as overweight or obese when the only measurements used are weight and height.

Instead, your waist-to-hip ratio is a more reliable indicator of your future disease risk. A higher ratio suggests you have more visceral fat — the fat accumulation around your internal organs — which is far more hazardous than subcutaneous fat located just under your skin.

To determine your waist-to-hip ratio, get a tape measure and record your waist and hip circumference. Then divide your waist circumference by your hip circumference and compare the ratio to the values in the table below.

Waist-to-Hip Ratio	Men	Women
Ideal	0.8	0.7
Low Risk	<0.95	<0.8
Moderate Risk	0.96 - 0.99	0.81 - 0.84
High Risk	>1.0	>0.85

Where Are Obesogens at Home?

The increasing number of chemicals in your environment and diet are likely contributing to the obesity epidemic. There are some common places you can find these in your home including:^19,20

• Tap water — Pesticides make their way into the tap water, the primary of which is atrazine. Although it's been banned in Europe, it's continued to be used in the US. Another is tributyltin (TBT), a fungicide that stimulates fat cell production. This is found in vinyl products and a preservative in textiles and carpet.
• BPA and BPA replacement chemicals — These are infused in plastics and line many cans. They may increase insulin resistance.
• Nonstick coatings — PFOAs are used to create a nonstick barrier on luggage, carpet, Teflon, backpacks and clothing. It’s also found on food packaging, such as microwave popcorn bags.
• Flame-retardant chemicals — Some, like PCBs were banned in the U.S. but remain in the food supply. Replacement chemicals, such as PBDEs, have similar effects on the endocrine system. They can be found in treated carpeting and furniture, textiles, electronics and cars.

Commonsense Approach to Reducing Your Risk

Unfortunately, the number of places where you may be exposed to obesogens continues to grow. However, while troubling, you can take specific common sense steps to reduce your risk of exposure, as I’ve mentioned in numerous previous articles. Note that some endocrine disrupters are not strictly obesogens, but they do have an effect on your ability to manage your weight.

Avoid pesticides — Eat organic, non-GMO produce and grass fed, humanely raised meat and dairy products. Don’t use pesticides on your lawn, and always remove your shoes when you enter your house.

Get rid of all nonstick and fire retardant chemicals — Nonstick cookware releases chemicals when heated. Instead, cook with ceramic or glass. Purchase mattresses, carpet and furniture that are not treated with fire-retardant chemicals.

Avoid packaged food — Eliminate canned food products, microwave popcorn and take-out containers. Avoid buying processed and packaged foods as they may contain high fructose corn syrup, artificial sweeteners, pesticides and other obesogens. Artificial sweeteners can also be found in gum, soda and pancake syrup.

Avoid vinyl and plastic — Use a cloth shower curtain that can be machine washed. These stay cleaner and last longer than vinyl. Replace luggage and backpacks with products made of organic blend canvas. Use glass to store your food and reusable storage bags at home and to bring food home from the grocery store.

Filter your water — The number of toxins in tap water makes filtering a necessity. Find out more at “Why Filtering Your Water Is a Necessity.”

Use minimal antibiotics — You may be able to prevent most reasons for antibiotics by supporting a healthy gut bacterium and using natural remedies. Antibiotics alter your gut microbiome, which influences weight management for adults and children.

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Conventional guidance to avoid unprotected sun exposure at all costs has likely done public health a great disservice. The American Academy of Dermatology,¹ for example, stresses daily use of sunscreen to prevent skin cancer, regardless of weather conditions or skin pigmentation — two factors that simply cannot be overlooked when weighing the risks and benefits of sun exposure and sunscreen use.²

A direct result of this blanket recommendation is widespread vitamin D deficiency, which we now know is a risk factor for a wide variety of cancers and many other chronic diseases. Your vitamin D level even influences your risk of skin cancer.

For example, a 2010 study³ found elderly men with the highest quintile of vitamin D had a 47% lower risk of non-melanoma skin cancer compared to those with the lowest levels. Research⁴ has also shown vitamin D deficiency worsens your prognosis if you have metastatic melanoma.

What’s more, research^5,6 shows your risk of developing melanoma from sun exposure is exceedingly small to begin with — well below 1% — and your risk of developing melanoma does not disappear by avoiding sun exposure. It's just one-tenth of 1% lower than if you got frequent exposure.

The science is not cut and dry, however. You can certainly find studies to make an argument for both sides of the issue, i.e., that sun exposure can increase your risk of skin cancer, or lower it. A key argument that tends to get lost in the discussion, though, is the importance of vitamin D for overall health and disease prevention.

In my view, it seems foolish to prevent one disease using a strategy that will increase your risk of many others, including — most importantly — shortening your overall life span.^7,8 Aside from promoting vitamin D deficiency, daily sunscreen use is also a source of significant toxic exposure.

Your Body Absorbs Toxins From Sunscreens

In 2019, the U.S. Food and Drug Administration published a pilot study^9,10,11,12 showing four commonly used active ingredients in sunscreen — avobenzone, oxybenzone, octocrylene and ecamsule — are absorbed into your blood at levels that could potentially pose health risks.

Twenty-four participants were asked to apply 2 milligrams (mg) of sunscreen per square centimeter over 75% of their body, using either one of two sprays, a lotion or a cream. This amount equates to the maximum recommended dose recommended by most makers of sunscreen.

A total of 30 blood samples were collected from each participant over seven days of application. The geometric mean maximum plasma concentrations were as follows for each of the chemicals:¹³

• Oxybenzone — 209.6 nanograms per milliliter (ng/mL) for spray No. 1; 194.9 ng/mL for spray No. 2, and 169.3 ng/mL for lotion
• Avobenzone — 4 ng/mL for spray No.1; 3.4 ng/mL for spray No. 2; 4.3 ng/mL for lotion and 1.8 ng/mL for the cream
• Octocrylene, — 2.9 ng/mL for spray No. 1; 7.8 ng/mL for spray No. 2; 5.7 ng/mL for lotion, and 5.7 ng/mL for cream
• Ecamsule — 1.5 ng/mL for cream

As noted by the authors,¹⁴ systemic concentrations for all four products were greater than 0.5 ng/mL after four applications on the first day. Below this threshold of 0.5 ng/mL, the FDA will typically waive nonclinical toxicology studies for sunscreens. Since all four chemicals exceeded the safety threshold, the agency determined that additional toxicology assessment would be required.

Now, it bears mentioning that the safety threshold of 0.5 ng/mL is based on the FDA’s regulation of food packaging substances,¹⁵ not chemicals that are absorbed through your skin.

Chemicals that migrate from packaging into food are ingested, whereas sunscreen chemicals are absorbed through your skin directly into your bloodstream, bypassing your digestive tract, which has the ability to filter out some of the toxins. In short, there’s no telling whether the 0.5 ng/mL threshold is actually safe and appropriate for these (and other) sunscreen chemicals.

Follow-Up Research Confirms Previous Finding

January 21, 2020, the FDA research team published a follow-up study^16,17 on 48 adults using an expanded lineup of active sunscreen ingredients. This time, they looked at avobenzone, oxybenzone, octocrylene, homosalate, octisalate and octinoxate in lotion; aerosol spray; nonaerosol spray; and pump spray form.

Participants applied 2 mg of sunscreen per square centimeter over 75% of their body at two-hour intervals at baseline and on days 2, 3 and 4. Blood samples were collected over 21 days. Geometric mean maximum plasma concentrations for the various ingredients and products were as follows (listed from highest to lowest concentrations):

Oxybenzone
Lotion — 258.1 ng/mL	Aerosol spray — 180.1 ng/mL

Homosalate
Aerosol spray — 23.1 ng/mL	Nonaerosol spray — 17.9 ng/mL	Pump spray — 13.9 ng/mL

Octinoxate
Nonaerosol spray — 7.9 ng/mL	Pump spray — 5.2 ng/mL

Octocrylene
Lotion — 7.8 ng/mL	Aerosol spray — 6.6 ng/mL	Nonaerosol spray — 6.6 ng/mL

Avobenzone
Lotion — 7.1 ng/mL	Aerosol spray — 3.5 ng/mL
Nonaerosol spray — 3.5 ng/mL	Pump spray — 3.3 ng/mL

Octisalate
Aerosol spray — 5.1 ng/mL	Nonaerosol spray — 5.8 ng/mL	Pump spray — 4.6 ng/mL

As in the first study, oxybenzone concentrations were about 400 to 500 times higher than the presumed safety threshold after just a couple of days’ use. Despite that, the FDA continues to urge Americans to use sunscreen.

The justification for this recommendation, as noted by Drs. Adewole S. Adamson and Kanade Shinkai in an accompanying editorial,¹⁸ is the “absence of clear data demonstrating harm.” Alas, oxybenzone in particular has been linked to a variety of potential health problems, including allergies, hormone disruption and cell damage.¹⁹

Oxybenzone Is Far From Harmless

Importantly, research shows oxybenzone and several other active ingredients in sunscreens enhance the ability of other chemicals to penetrate your skin, including toxic herbicides, pesticides and insect repellants.

According to a study²⁰ published in 2004, oxybenzone, octyl methoxycinnamate, homosalate, octyl salicylate, padimate-o and sulisobenzone all significantly increased absorption of the herbicide 2,4-D, which can be a significant concern for agricultural workers in particular.

Oxybenzone (as well as at least eight other sunscreen ingredients^21,22) also acts as an endocrine disrupter, and research²³ published in 2018 warned it can induce changes in the breasts when used during pregnancy and lactation. According to the authors:

“These data suggest that oxybenzone, at doses relevant to human exposures, produces long-lasting alterations to mammary gland morphology and function. Further studies are needed to determine if exposure to this chemical during pregnancy and lactation will interfere with the known protection that pregnancy provides against breast cancer.”

Other studies have shown oxybenzone:

Is a phototoxicant, which means its adverse effects, and its ability to form harmful free radicals, are magnified when exposed to light,24 which of course is the primary use of the product	Is neurotoxic (toxic to your brain)25
Can “significantly lower” testosterone levels in adolescent boys26	Reduces sperm count in men27
Alters hormone levels in men, specifically testosterone, estradiol and inhibin B28	Is linked to endometriosis in women29
Increases male infertility by affecting calcium signaling in sperm, in part by exerting a progesterone-like effect30	Can result in lower male birth weight and decreased gestational age31
Is lethal to certain sea creatures, including horseshoe crab eggs, and poses a serious threat to coral reefs and sea life32,33,34

Considering the endocrine disrupting and neurotoxic effects of oxybenzone, its high absorbability, and the availability of safe sunscreens (those containing non-nanosized zinc oxide and titanium dioxide), it seems rather irrational to continue using oxybenzone-containing sunscreen to protect yourself against skin cancer.

Research³⁵ by the U.S. Centers for Disease Control and Prevention published in 2008 found 96.8% of the 2,517 urine samples collected as part of the 2003-2004 National Health and Nutrition Examination Survey had detectable levels of oxybenzone, which is a testament to just how much sunscreen people are using. And this data is 15 years old. It is likely far worse now.

Safer Sunscreens Are Available

When selecting a sunscreen, it’s important to realize there are only two known safe sunscreen ingredients — zinc oxide and titanium dioxide³⁶ — and they must not be nanosized, as nanoscale zinc oxide³⁷ and titanium dioxide³⁸ have their own health risks.

Your safest choice is a lotion or cream with non-nanoscale zinc oxide, as it is stable in sunlight and provides the best protection from UVA rays.³⁹ Your next best option is non-nanoscale titanium dioxide.

Also keep in mind that the sun protection factor (SPF) only tells you the level of protection you get from UVB rays (the rays within the ultraviolet spectrum that allow your skin to produce vitamin D), not UVA (which penetrate deeper and are responsible for much of the skin damage associated with excessive sun exposure.

So, make sure the product you select is labeled “broad spectrum SPF,” which indicates the product protects against both UVA and UVB. As a general rule, avoid sunscreens with an SPF above 50. While not intrinsically harmful, the higher SPF tends to provide a false sense of security, encouraging you to stay in the sun longer than you should.

Moreover, higher SPF typically does not provide much greater protection. In fact, research suggests people using high-SPF sunscreens get the same or similar exposure to UV rays as those using lower-SPF products.

What’s more, an analysis⁴⁰ by Consumer Reports found many sunscreens are far less effective than claimed on the label; 32 of the 82 products evaluated for 2019 offered less than half the protection promised by their stated SPF. Consumer Reports said they’d seen “a similar pattern in previous years’ sunscreen tests.”

The Environmental Working Group’s Skin Deep Database is a good resource when evaluating your sunscreen choices. Dr. Mercola Sunscreen SPF 30 received the EWG’s highest safety rating in 2017.⁴¹

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Many of the decisions you make each day have a compound effect on your overall health. Making small changes in what you eat and drink, how much you exercise and the quality of your sleep can pay big dividends. The same is true of some of the small unhealthy decisions you make.

For example, lifestyle choices affect your risk for high blood pressure, Type 2 diabetes and even heartburn. If you take medications to control these conditions, you need to know that some of them have been recalled due to contamination issues.

In July 2018 the FDA¹ announced a voluntary recall of Angiotensin II receptor blocker high blood pressure medications (ARBs) that contain the active ingredient valsartan; a month later the FDA updated its list to include those containing losartan and irbesartan, among others. It has continued to update the list through the end of 2019.²

The initial alert was generated after some of the products tested positive for N-nitrosodimethylamine (NDMA). To give an example of how many people were affected by this, in 2017 9.2 million prescriptions were written for valsartan; 51.9 million for losartan; and 2.3 million for irbesartan.³

Yet, when a second nitrosamine impurity was discovered in losartan, the FDA still did not stop distribution of the drug. Instead, they suggested that patients continue their prescriptions “until their pharmacist provides a replacement or their doctor prescribes a different medication.”⁴

Then, a new concern with a different drug arose, this time with an over-the-counter (OTC) medication for heartburn and other stomach issues: In September 2019 the FDA issued a warning that NDMA was also found in ranitidine (Zantac), a hystamine-2 (H2) blocker used to treat heartburn, saying:⁵

“Although NDMA may cause harm in large amounts, the levels the FDA is finding in ranitidine from preliminary tests barely exceed amounts you might expect to find in common foods.”

Next, test results revealed NDMA was in another heartburn drug, nizatidine⁶ (brand name Axid) and just days later those medications began being recalled. As of January 2020, the FDA was continuing to announce voluntary recalls because of unacceptable levels of NDMA. To give you an idea of how many people just the Zantac recall affected, in 2017 there were 16.3 million prescriptions written for Zantac.⁷

The saga of NDMA and other nitrosamine impurities in the U.S. medication supply doesn’t end there, however. Now, warnings include metformin, an oral medication for treatment of early Type 2 diabetes. In 2017 there were 78.6 million prescriptions for metformin written,⁸ representing the medication with the largest number of prescriptions affected by NDMA contamination thus far.

NDMA Is Deadly in Minute Amounts

NDMA was once used in the commercial production of rocket fuel.⁹ However, after animal testing demonstrated exposure to it significantly increases the risk of cancer, the chemical is now only used for research purposes. Since the compound may be absorbed from the environment, food, tobacco or medications, the FDA established an “acceptable intake” level.

The “acceptable” amount is 96 nanograms (ng). As a comparison, this is 0.000096 of 1 milligram (mg) and a grain of salt is about 1 mg.¹⁰ Some of the generic brands of the contaminated high blood pressure medications tested at 20 times this limit.

It’s important to remember these are drugs taken every day in addition to potential exposure from the environment and nitrite-preserved foods such as hot dogs, cured meat, malt beverages and salami — which, according to the University of Illinois Chicago, sometimes have “higher concentrations” of NDMA.¹¹

Even worse, the World Health Organization¹² writes “there is conclusive evidence that NDMA is a potent carcinogen in experimental animals.” With humans, WHO admits there is “no quantitative” measurement for the risk of NDMA causing cancer in humans, but they do say: “The results are supportive of the assumption that NDMA consumption is positively associated with either gastric or colorectal cancer.”

So just how bad is NDMA? Historically, there are several case studies in which NDMA was used as a poison.¹³ In 1978 a German teacher's wife died after he put NDMA in her jam. A Nebraska man was sentenced to death for spiking lemonade with it, and in 2013 a Chinese medical student died as a result of an April Fool's prank when NDMA was put into the water cooler.

FDA Ignored the Warning Signs

Novartis released valsartan (Diovan) in 1996. When the patent expired in 2012, generic drug companies began producing it, but reduced their costs by changing solvents. The change was designed to limit waste and increase the amount of drug produced, but it also produced NDMA impurities in the medication.¹⁴

Five years later an FDA inspection found the company had ignored their own test results demonstrating an “unidentified” impurity was present.¹⁵ However, instead of sending a warning letter, neither the FDA nor the Chinese manufacturing firm attempted to identify the impurity. Then, in May 2018, Novartis ordered the product during their research to make a generic drug, found the impurity and identified it as NDMA.

A few months later, in August 2018, Reuters¹⁶ reported drug recalls of NDMA-contaminated products in countries around the world, but not the U.S. — revealing dangerous holes in a medical safety net the American consumer relies on.

By this time Americans had been taking the drug for six years. Health regulators in Europe estimated 1 of every 3,390 people who were taking the contaminated pills could develop cancer. Subsequently, in the U.S., hundreds of patients with a diagnosis of cancer of the stomach, liver, colon and kidneys began filing claims with their lawyers.¹⁷

Metformin Use Rises With Incidence of Type 2 Diabetes

As I mentioned earlier, the newest medication to join the growing list of drugs contaminated with a component of rocket fuel is metformin. While metformin’s prescription numbers have gone down from the 86.1 million prescriptions written in 2014, another measurement of prescription popularity is rank, or frequency it’s prescribed compared to other drugs, and that number has vacillated from No. 6 in 2007 to remaining relatively stable at No. 4 since 2011.

As the diagnoses of prediabetes and diabetes have risen, so have the prescriptions for the oral antidiabetic medication, metformin. The drug works by limiting the amount of sugar released by your liver.¹⁸

Data from the CDC¹⁹ in 2017 showed there were 30.3 million with diabetes and 84.1 who had prediabetes. The CDC also notes that new cases are increasing in young people under 20 years. Factors that increase the risk of diagnosis include smoking, being overweight and being inactive.

Despite these enormous numbers, the good news is that in some areas of the world, Type 2 diabetes appears to be trending downward in specific populations, possibly due to preventive actions that include lifestyle changes.²⁰

On the downside, the American Diabetes Association believes this trend may potentially be an artifact of the data, suggesting improved screening and diagnosis have dramatically reduced the population of “susceptible individuals” and it is therefore premature to declare a victory.²¹

A Conflict With China Could Threaten Medication Supply Chain

When it comes to contamination issues, metformin generics were approved from 2004 to 2018, some of which are produced by companies distributing highly contaminated valsartan, such as Teva, Torrent and Prinston Pharmaceuticals.²²

Currently, many generic drugs are made either in India or China.²³ The voluntary recall of valsartan, ranitidine and metformin happened to drugs that were all originally manufactured in China.

Dr. Janet Woodcock, director of the FDA Center for Drug Evaluation and Research, staunchly supports the FDA’s capability of inspecting and monitoring consumer health. However, recent events have illustrated some of the challenges facing the organization’s staff as they regulate a market whose production is largely outsourced to other countries.

Rosemary Gibson from the Hastings Center is a health expert and author who believes the problem is exacerbated by the two countries’ differences in regulatory matters. She said, “China doesn't have anything like the consumer protection laws and product liability laws like the United States does.” But Woodcock countered with her belief that the FDA uses the same standards for drugs manufactured in the U.S. or any other country.

But still, that doesn’t address another challenge to the safety of the U.S. medication supply chain: the number of crucial medications manufactured in China. Mike Osterholm from the University of Minnesota is an expert in biosecurity. He commented on the vast number of medications manufactured in China:²⁴

“It’s a major national security risk for us in two ways. We are very concerned about the quality of these drugs. Now we are caught up in an economic war in the sense of tariffs. If we were ever in an international incident with China, they would literally have their hands around our necks in terms of critical drugs. They wouldn’t even have to fire a shot."

For example, the number of metformin prescriptions pales to the combined number of statins prescribed in 2017, which totaled 216.6 million.²⁵ The rank for the most popular statin prescribed, Atorvastin, has steadily risen from No. 10 in 2011 to No. 2 in 2017.

Seek a Natural Cure for Type 2 Diabetes

A diagnosis of diabetes often carries with it an increased potential risk for cardiovascular disease, high blood pressure and dementia, sometimes called Type 3 diabetes.²⁶

In some instances, your risk for getting diabetes goes up when you use specific medications, such as statins. Your risk of diabetes also rises with increasing weight, lack of activity and high carbohydrate intake that increases leptin and insulin resistance.

Many of my paternal relatives have a history of diabetes and my own experience with diabetes and review of the literature has made it clear that virtually every case is reversible and has nothing to do with drugs to control your blood sugar.

To recover from Type 2 diabetes, you must improve your body’s sensitivity to insulin and leptin through diet and exercise. I detail the process in my free nutrition plan, which addresses the guidelines in “Diabetes Has Become One of the Most Expensive and Lethal Diseases in the World” in great detail.

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Most anyone who has struggled with secondary infertility knows that it is an incredibly lonely experience. You may be blessed with one or two children — possibly more — but struggling to expand or complete your family. Surrounded by families with young children, you find yourself alone and in pain.

If you are a veteran of primary infertility, you may remember strategies you developed for shielding yourself from the pregnancies of others. Not so this second time around: pregnant women and moms with babies and toddlers surround you at preschool.

If you had your first child with ease and are new to infertility, you may feel even less equipped to deal with seemingly limitless fecundity. Primary infertility prepared your fellow travelers for the envy, anger, sadness, isolation, and awkwardness it brings. For you these feelings are new, and along with them comes the guilt of secondary infertility: “Why can’t I be happy with the child I have?” Today we’ll focus on ways you can cope with secondary infertility.

The first few steps to coping with secondary infertility

Seek good medical care. If you went through primary infertility, you know the ropes of the world of reproductive medicine. However, if this is all new to you, do not delay in seeking expert help. There is a lot to learn in reproductive medicine. Beginning to understand it may help you feel that you have some control of your situation. Don’t be reluctant to seek a second and even a third opinion — you will learn from each consult, and talking with a few physicians can help land you in the right place.

Try to avoid self-blame. It is tempting to blame yourself. You are a likely target if you feel you waited too long to have a second child, or perhaps blame yourself for not having your first child sooner. If you have two or more children and are struggling to complete your family, you may accuse yourself of greed. Another form of self-blame comes when parents feel they are being punished for not fully appreciating or enjoying the child they have, or worse still, being “bad” parents.

Take charge of the message. Although many people choose to have one child and feel confident with “one and done,” there is often the assumption that a family means two or more children. As a parent of one child, you are likely to frequently encounter the following questions: “Is she your only child?” or “Are you going to have more?”

It helps to figure out a short, direct, and containable message to give anyone who asks about family size. Something like, “We’re hoping to have a larger family, but it’s not been easy for us.” Or “___ is our first child, but we are hoping he/she will have a sibling before too long.”

Additional ways to cope with secondary infertility

Try not to focus on age. Many parents think a lot about the spacing of their children. Secondary infertility derails plans for ideal spacing — whatever that may mean to you. My advice to people is blunt: let it go. I remind clients that close or distant relationships with siblings are not defined by spacing. All of us know adults who cherish their sister or brother 10 or 15 years their junior, but argue constantly with the sibling who is within two years of their age.

Parents in their 40s worry also about their advancing age. Many will say, “I need to have a second child by the time I am X or it will be too late.” Here I remind people that they already have a child. Their future child will have an older sibling (or more than one) to share the challenges that may come from having older parents. One can’t turn back the clock.  If you are worried about age, all you can do is avoid unnecessary delays.

Explore other paths to parenthood. More people are becoming parents in their late 30s or early 40s. Many will face age-related infertility for a second child. Egg donation, and sometimes embryo donation or adoption, are options for expanding their families. It never hurts to look ahead to familiarize yourself with other paths to parenthood. Learning about them doesn’t mean you will end up pursuing them, but it enables you to be proactive and to feel some control over your situation.

Enjoy your child. At the risk of sounding preachy, I think it is important for you to take time to enjoy your child. Chances are that he or she will have a sibling at some point. And when that child arrives you will be busy with an infant. While another child (or more) may be your ultimate goal, certain pleasures come from having one child. Seize the sweetness of being with your little person without the distractions that are inevitable with a larger family.

Secondary infertility doesn’t just impact parents with young children; it also challenges people in second or third marriages or relationships, who had children earlier and now want to have a child with a new partner. And it affects those who had one or two children several years ago and decide, as adolescence — or even a departure for college — looms on the horizon, that they want to expand their family. As you make your way, best you can, to a larger family, remember that you have many fellow travelers. It may just be hard to recognize them.

The post Infertility the second time around appeared first on Harvard Health Blog.

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