In this article

Meet the experts

Lisa Lavine Nagy, MD, FAAEM, is an environmental health physician, board-certified by the American Academy of Environmental Medicine. Dr. Nagy, who herself recovered from severe environmental illness, is the leader of the American Medical Women’s Association’s HEAL (Health and Environment Alliance) workgroup. Her clinic, the Environmental Health Center of Martha’s Vineyard, focuses on treating patients with environmental illnesses, including those with hormonal and neurological manifestations.

Olalekan Otulana, MBChB, DRCOG, MRCGP, DFSRH, FRSPH, MBA, is a physician with advanced expertise in detoxification and a background in reproductive health and substance addiction conditions.

The exposome is quietly disrupting your hormones

These days, “the exposome” is having a moment. Scroll through wellness blogs, listen to health podcasts, or visit your local integrative medicine clinic, and you’re likely to hear the term tossed around with increasing frequency. From TikTok influencers warning about “toxic load” to respected physicians urging cleaner living, the exposome has become a buzzword in health and wellness circles. But while it might sound like just another trend, the science behind the exposome is solid—and deeply relevant to anyone struggling with hormonal issues, thyroid dysfunction, or stubborn weight gain.

The environment we live in, the food we eat, and the products we use daily shape our hormonal health in ways we might not realize. Let’s explore how the invisible web of lifelong exposures to toxic chemicals, electromagnetic fields (EMFs), radiation, and mold – collectively known as the exposome – influences our hormones and affects our health, and what it means in your quest for better health.

The exposome refers to the complete sum of all non-genetic influences and environmental exposures you encounter from conception through old age, shaping your health across every stage. It encompasses a wide range of external and internal factors, including:

• Toxic chemicals
• Air pollution
• Heavy metals
• Microplastics
• Pathogens
• Electromagnetic fields (EMFs)
• Radiation (ionizing and non-ionizing)
• Mold and mycotoxins
• Hormonal exposures (e.g., endocrine-disrupting compounds and exogenous hormones)
• Medications (prescription, over-the-counter, recreational, and medical treatments)
• Biological processes (e.g., gut microbiome activity, inflammation, oxidative stress, and metabolic function)
• Lifestyle factors (e.g., diet, nutrition, physical activity, sleep, substance use, and stress management)
• Social determinants of health (e.g., economic status, education, occupation, healthcare access, and community environment)

Together, these factors interact with your genes and physiology, significantly influencing your risk for chronic conditions, including hormonal imbalances like hypothyroidism, Hashimoto’s, perimenopause symptoms, and obesity.

Unlike your fixed genetic code, your exposome constantly changes based on where you live, work, and play. Research shows that the exposome accounts for almost 20% of health outcomes related to aging and chronic disease, far exceeding the 2% effect attributed to genetics.

While your genes may load the gun, the exposome often pulls the trigger, especially when it comes to your hormonal health.

The exposome has even inspired a new scientific field – exposomics – dedicated to studying the concept of the exposome. Exposomic research extends far beyond simply measuring a single toxin or pollutant; instead, exposomics aims to understand how all the factors we’re exposed to—such as chemicals, germs, stress, and our surroundings—interact over time to affect our health.

Let’s look at many of the exposome factors and endocrine disruptors that we encounter daily and how they affect key hormones.

Toxic chemicals

• Bisphenol A (BPA) and derivatives: Found in polycarbonate plastics (e.g., water bottles, food containers), epoxy resins lining canned goods, thermal paper receipts, and toys. BPA disrupts thyroid hormone signaling and may worsen Hashimoto’s and weight gain due to its estrogenic effects.

• Phthalates: These chemical substances are used as plasticizers in PVC products, food packaging, vinyl flooring, and personal care items (e.g., nail polish, fragrances, shampoos, lotions). Phthalates interfere with thyroid function and estrogen balance, potentially worsening perimenopausal symptoms and promoting fat accumulation.

• Per- and polyfluoroalkyl substances (PFAS): These synthetic chemicals are also known as the “forever chemicals” because they do not break down easily in the environment or the human body, leading to persistent contamination. They are present in non-stick cookware, stain-resistant fabrics, food packaging, firefighting foam, and waterproof cosmetics. PFAS exposure is linked to reduced thyroid hormone levels and metabolic disruption, contributing to hypothyroidism and obesity.

• Parabens: Preservatives in cosmetics (e.g., moisturizers, makeup), baby wipes, and cleaning products. Parabens mimic estrogen, potentially affecting hormone balance during perimenopause and menopause and influencing weight gain.

• Flame retardants (e.g., PBDEs): Added to furniture foam, mattresses, carpets, electronics, and children’s products like car seats. PBDEs impair thyroid function and are associated with altered metabolism and increased obesity risk.

• Pesticides and herbicides
  
  - Atrazine: An herbicide contaminating water supplies via agricultural runoff. Atrazine may disrupt estrogen and thyroid pathways, increasing the risk for hormonal imbalance in perimenopausal women.
  
  - Glyphosate: A weed killer used in farming and lawn care. Glyphosate exposure is linked to microbiome and immune disruption, potentially exacerbating Hashimoto’s and metabolic issues.
  
  - DDT: Banned but persistent in ecosystems; still used in some regions. DDT persists in fat tissue, disrupting thyroid and estrogen systems, and is linked to obesity and menopausal hormone dysregulation.

• Dioxins: Industrial byproducts from waste incineration that accumulate in meat, dairy, and fish. Dioxins impair thyroid hormone metabolism and estrogen function, influencing menopause timing and weight regulation.

• Triclosan: Formerly in antibacterial soaps and toothpaste; persists in some cosmetics. Triclosan can interfere with thyroid hormone synthesis, possibly aggravating hypothyroidism and autoimmune thyroid disease.

• Perchlorate: An industrial chemical in rocket fuel that contaminates groundwater and food. Perchlorate blocks iodine uptake in the thyroid, directly impairing hormone production and increasing hypothyroidism risk.
• UV filters (e.g., oxybenzone): Commonly used in sunscreens and some cosmetics/fragrances to absorb UV rays and protect skin from sun damage. Studies suggest it may affect thyroid function and reproductive hormones
• Chlorine and Chloramine: Disinfectants used in municipal water supplies, pools, and cleaning products. Have been linked to hormonal disruption and reproductive health issues with chronic exposure (primarily through inhalation or skin absorption).

• Benzene: Found in industrial solvents, cigarette smoke, vehicle emissions, and some personal care products. Some studies suggest benzene may also affect reproductive hormones and endocrine signaling.
• Formaldehyde: Present in pressed-wood products (e.g., particleboard, plywood), building materials, cigarette smoke, disinfectants, cosmetics, textiles, and as a preservative in some vaccines. Formaldehyde exposure may disrupt thyroid function and immune response, potentially contributing to Hashimoto’s and metabolic imbalance linked to obesity.

Air pollutants

• Particulate matter 2.5 (PM2.5): Tiny airborne particles with a diameter of 2.5 micrometers or smaller that come from vehicle exhaust, industrial emissions, wildfires, woodsmoke, and other sources of air pollution. PM2.5 exposure is associated with thyroid hormone disruption, systemic inflammation, and an increased risk of obesity and autoimmune thyroid disease.
• Nitrogen dioxide (NO₂): A toxic gas formed primarily from the combustion of fossil fuels. Exposure mainly comes from car and truck emissions, power plants, industrial activity, and indoor gas stoves. NO₂ may impair thyroid hormone production and increase oxidative stress, exacerbating hypothyroidism and weight gain.
• Volatile organic compounds (VOCs): Volatile organic compounds (VOCs) are chemicals that easily become gases at room temperature, commonly released (“off-gassed”) from products like paints, cleaning supplies, carpets, furniture, and building materials. VOCs can interfere with endocrine function, potentially worsening perimenopausal symptoms and contributing to thyroid dysfunction and metabolic issues.
• Synthetic fragrances: These are commonly found in many household and personal care products, as well as air fresheners and scented candles. These fragrances often contain undisclosed mixtures of phthalates and other VOCs that lower indoor air quality and may disrupt thyroid and hormonal function.

Heavy metals

• Lead: It’s found in old paint (in homes built before 1978), contaminated soil, drinking water from lead pipes, imported spices and cosmetics, and certain canned goods or ceramic dishes with lead-based glazes. Lead disrupts thyroid hormone production and may worsen autoimmune conditions like Hashimoto’s, while also contributing to metabolic and cognitive dysfunction.
• Mercury: It’s primarily ingested through large, predatory fish such as tuna, swordfish, shark, king mackerel, and tilefish. Also found in some dental amalgams, skin-lightening creams, and contaminated water sources. Mercury accumulates in the thyroid gland and impairs hormone synthesis, increasing the risk of hypothyroidism and autoimmune thyroid disease.
• Cadmium: Cadmium is found in cigarette smoke (active and secondhand), leafy vegetables grown in contaminated soil, shellfish, liver and kidney meats, and grains like rice. It can also leach into food from metal containers or industrial pollution. Cadmium mimics estrogen and interferes with thyroid function, potentially intensifying perimenopausal symptoms and increasing obesity risk.
• Arsenic: Arsenic is present in contaminated groundwater (common in some private wells), rice and rice-based products, apple juice, seafood, and certain imported foods or herbs. Arsenic-based pesticides used in the past can persist in soil and contaminate crops. Arsenic exposure disrupts thyroid signaling and metabolic regulation, contributing to weight gain and thyroid hormone imbalances.

Microplastics

Microplastics are tiny plastic particles less than 5 millimeters in size that originate either from products made to be small—like microbeads in cosmetics and plastic pellets used in manufacturing—or from the breakdown of larger plastic items such as bags, bottles, and synthetic clothing. Microplastics are everywhere in food, water, and soil, and you’re exposed to microplastics primarily by consuming contaminated food and beverages (including seafood, salt, fruits, and bottled water), drinking tap water, and inhaling airborne particles and fibers from dust, especially indoors. Microplastics can act as carriers for endocrine-disrupting chemicals, such as phthalates and BPA, which interfere with thyroid hormone signaling and disrupt estrogen balance. This disruption may exacerbate conditions such as hypothyroidism, Hashimoto’s, and hormonal weight gain, especially during perimenopause and menopause.

Pathogens

This category includes bacteria like E. coli, Salmonella, and Listeria, viruses such as norovirus, rotavirus, and hepatitis A, as well as protozoa and parasites like Giardia and Cryptosporidium. Exposure to these pathogens typically occurs through contaminated food or water supplies. Exposure to food- and waterborne pathogens can trigger systemic inflammation and immune system activation, which may worsen autoimmune conditions such as Hashimoto’s thyroiditis. Additionally, chronic infections and inflammation can disrupt metabolic balance, potentially complicating weight management and hormonal changes during perimenopause and menopause.

Electromagnetic fields (EMFs)

EMFs are emitted by power lines, WiFi routers, cell phones, Bluetooth devices, and household appliances. EMFs have several effects, including:

• Altered melatonin secretion, which regulates sleep and reproductive hormone cycles

• Disrupted pituitary hormones (TSH, FSH, LH, ACTH, GH) that influence thyroid and reproductive health

• Possible impacts on menopause timing and fertility

• Disrupted insulin and glucose metabolism, potentially influencing weight

Radiation

UV radiation is a form of radiation resulting from sun exposure and artificial sources, such as tanning beds. Ionizing radiation comes from X-rays, CT scans, radioactive materials, nuclear fallout, and cosmic rays (primarily at high altitudes). Ionizing radiation is particularly harmful to the thyroid, increasing the risk of thyroid cancer and hypothyroidism. Radiation from frequent CT scans or X-rays can also damage DNA and cells involved in hormone production.

Mold and mycotoxins

Indoor mold, often hidden behind walls or under flooring, produces mycotoxins that can:

• Disrupt estrogen, progesterone, and thyroid hormone signaling.

• Trigger chronic inflammation and immune dysregulation.

• Make weight loss more difficult by promoting fatigue, brain fog, and metabolic slowdown.

• Worsen thyroid dysfunction and autoimmune conditions like Hashimoto’s.

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Hormones

Various forms of estrogen, testosterone, and progesterone are given to cattle to promote faster growth and leaner meat. Exposure to hormone residues from cattle treated with synthetic estrogen, testosterone, and progesterone can disrupt human endocrine function, potentially interfering with thyroid hormone balance and worsening autoimmune thyroid conditions like Hashimoto’s. These hormonal imbalances may also exacerbate symptoms during perimenopause and menopause, while promoting weight gain and metabolic disturbances.

Medications

Medications are part of the exposome. This category includes prescription, over-the-counter, and recreational drugs, chemotherapy, radiation therapy, antibiotic exposure, and vaccinations. Medications—including antibiotics, chemotherapy, and hormonal treatments—can alter the gut microbiome, immune function, and hormone metabolism, potentially triggering or exacerbating conditions like hypothyroidism and Hashimoto’s. Some drugs may also disrupt estrogen and thyroid pathways, influencing weight gain and intensifying symptoms during perimenopause and menopause.

Biological processes

Biological processes represent internal aspects of the exposome that play a central role in shaping hormonal and metabolic health. These include gut microbiome activity, which influences nutrient absorption, immune regulation, and even the conversion of thyroid hormones. Chronic inflammation and oxidative stress, often triggered by poor diet, environmental toxins, or infections, can impair hormone signaling, damage tissues, and promote autoimmune reactions. Additionally, disruptions in hormonal and metabolic pathways can exacerbate weight gain, insulin resistance, and estrogen imbalances, particularly during perimenopause and menopause. These internal exposures reflect a dynamic interplay between the body’s physiological systems and external influences, making them critical in understanding disease risk and progression.

Lifestyle factors

Lifestyle choices are among the most modifiable elements of the exposome, directly influencing hormonal balance, immune health, and metabolic function. A nutrient-rich diet supports thyroid hormone production and detoxification, while regular physical activity can enhance insulin sensitivity, reduce inflammation, and aid in weight regulation. Poor sleep and chronic stress, on the other hand, elevate cortisol levels, disrupt thyroid function, and intensify symptoms of perimenopause and menopause. Substance use, including alcohol and tobacco, has been linked to hormone disruption and increased risk for autoimmune and metabolic disorders. When consistently practiced, healthy lifestyle habits can buffer the impact of environmental toxins and reduce vulnerability to conditions such as obesity, Hashimoto’s disease, and hormonal imbalances.

Social determinants of health

Psychosocial factors and determinants of health—such as socioeconomic status, education, occupation, access to care, and neighborhood environment—profoundly shape an individual’s exposure to both risks and protective factors. People with limited economic resources often face higher exposure to environmental toxins (e.g., industrial pollution, substandard housing), reduced access to nutritious food, and barriers to quality healthcare, all of which can contribute to thyroid dysfunction, unmanaged autoimmune conditions, and weight-related issues. Educational attainment and occupational stress also influence health behaviors and resilience against environmental and biological stressors. Moreover, a lack of community support and healthcare access can delay diagnosis or management of hormonal conditions, exacerbating disparities in outcomes.

The exposome plays a powerful role in shaping your hormonal and reproductive health. Dr. Olalekan Otulan sums it up: “The concept of the exposome reflects the cumulative impact of everything we’re exposed to in our environment over a lifetime. Chemicals, air and water pollutants, EMFs -- even stress and sleep disruption – all can subtly or significantly influence our hormonal health.”

From endocrine-disrupting chemicals in plastics, pesticides, and personal care products to chronic stress, poor sleep, and diet, these exposures can interfere with your body’s delicate hormonal balance. As noted, various toxins can mimic or block natural hormones such as estrogen, testosterone, and thyroid hormones, leading to disruptions in your metabolism, fertility, and mood. Even low-level, chronic exposures can accumulate over time, particularly when combined with lifestyle and occupational stressors. Let’s take a more in-depth look at the effect of the exposome on hypothyroidism and Hashimoto’s, perimenopause and menopause, and hormonal weight gain and obesity.

Hypothyroidism and Hashimoto’s

A growing body of research demonstrates that the exposome plays a significant role in the development and progression of hypothyroidism and Hashimoto’s thyroiditis. Your thyroid is extremely sensitive to environmental toxins. For example, flame retardants, heavy metals, and plastics can suppress thyroid hormone production; fluoride competes with iodine, a critical building block for thyroid hormone; and pesticides can trigger or worsen autoimmune thyroid disease. 

Endocrine-disrupting chemicals – including PCBs, BPA, phthalates, pesticides, PFAS, and heavy metals – can interfere with thyroid hormone synthesis, transport, metabolism, and receptor binding. These chemicals may damage thyroid tissue, disrupt the hypothalamic-pituitary-thyroid (HPT) axis, and change your immune function, increasing the risk of both hypothyroidism and autoimmune thyroid diseases like Hashimoto’s. 

For example, PFAS have been shown to bind to thyroid hormone receptors, disrupt iodine uptake, and increase oxidative stress in thyroid tissues, all of which can contribute to thyroid dysfunction and autoimmunity. Epidemiological studies have found that people with higher blood levels of PFAS and other endocrine disruptors have a significantly increased risk of hypothyroidism, with women being particularly vulnerable. These findings underscore the importance of reducing toxic exposures to support optimal thyroid health.
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The perimenopausal/menopausal transition

The exposome plays a significant role in the perimenopausal and menopausal transition, a period marked by dramatic hormonal fluctuations and increased vulnerability to external stressors. During this time, women experience a wide range of symptoms, including hot flashes, night sweats, mood changes, sleep disturbances, metabolic alterations, and cognitive shifts, all of which can significantly impair quality of life.

Endocrine-disrupting chemicals such as BPA, phthalates, parabens, PCBs, pesticides, PFAS, and polycyclic aromatic hydrocarbons (PAHs) are prevalent in everyday products, including plastics, cosmetics, cookware, and household goods. According to research, these chemicals can mimic or block estrogen and other sex hormones, disrupt hormone production and metabolism, and alter the epigenetic regulation of genes related to hormones. Such disruptions are especially concerning during perimenopause and menopause, when natural declines in estrogen and progesterone make the body more susceptible to hormonal imbalances.

The key effects of endocrine-disrupting chemicals (EDCs) during perimenopause and menopause include:

• Accelerated reproductive aging: Exposure to EDCs is linked to earlier onset of menopause by as much as 1–4 years, which increases the risk of cardiovascular disease, osteoporosis, depression, and premature mortality.
• Intensified vasomotor symptoms: Xenoestrogens (chemical compounds that mimic estrogen) can cause unpredictable estrogen fluctuations, worsening hot flashes, and night sweats.
• Mood and cognitive effects: Certain EDCs interfere with neurotransmitters like serotonin and dopamine, heightening susceptibility to anxiety, depression, mood swings, and cognitive decline.
• Bone health: EDCs can reduce bone density by altering calcium metabolism, increasing the risk of osteoporosis.

Other environmental stressors that have an effect during this hormonal transition include:

• Electromagnetic fields (EMFs): EMF exposure has been shown to alter reproductive hormone cycles and melatonin secretion, potentially influencing the timing and severity of menopausal symptoms, including sleep disruption and hot flashes.
• Mold toxins: Mycotoxins from indoor mold can disrupt the balance of estrogen and progesterone, further exacerbating hormonal symptoms and reproductive health problems.

Toxic exposures can also induce oxidative stress and inflammation, compounding the physiological stress of the menopausal transition. Toxin overload may also impair liver detoxification, leading to estrogen dominance—even in menopause—further worsening symptoms like weight gain, mood swings, and hot flashes.

Difficulty losing weight

Difficulty losing weight is increasingly linked to environmental exposures that disrupt metabolic and hormonal regulation. Endocrine-disrupting chemicals, such as BPA, phthalates, PCBs, and polycyclic aromatic hydrocarbons (PAHs), can interfere with thyroid hormone regulation, insulin signaling, and sex hormone balance—processes critical for maintaining a healthy metabolism and body weight. Notably, some endocrine disruptors activate receptors that regulate fat storage and glucose metabolism, leading to increased fat accumulation and insulin resistance. Endocrine disruptors can also disrupt your gut microbiome, promote chronic inflammation, and alter appetite-regulating hormones like leptin and ghrelin, further complicating weight loss efforts.

While diet and exercise are foundational, exposome factors explain why some people struggle disproportionately with weight loss. Key factors include:

• Sleep deprivation: Reduces leptin (the satiety hormone) by up to 18%, increasing hunger and calorie intake.
• Night shift work: Disrupts circadian cortisol rhythms, which can impair metabolic regulation.
• Thermogenic stress: Chronic heat exposure may lower metabolic rate, reducing calorie expenditure.
• Microplastics: Have been shown to alter gut bacteria linked to fat storage and metabolic health.
• EMFs: Can disrupt insulin secretion and glucose metabolism, potentially contributing to weight gain and metabolic syndrome .
• Mold exposure: Chronic exposure may trigger inflammation and hormonal imbalances that make weight loss harder.
• Radiation: High exposures (such as from cancer therapy) can damage glands involved in metabolic control.

If you’re struggling to lose weight despite “doing everything right,” your exposome is often a hidden obstacle, for several reasons:

• Toxins are stored in fat cells: Your body may resist burning fat to avoid releasing these toxins into circulation.
• Endocrine disruptors: Affect metabolism, hunger hormones, and fat storage.
• Mitochondrial dysfunction: Chronic exposures can reduce your energy levels and fat-burning ability.
• Cortisol imbalances: Poor sleep, stress, or mold exposure can imbalance cortisol levels and lead to increased belly fat.

Your hormones don’t exist in isolation—they’re shaped by the air you breathe, the products you bring home, and the foods you choose. By viewing health through the exposome lens, you gain new tools to protect your endocrine system through every life stage.

Emerging research suggests that reducing exposure to endocrine-disrupting chemicals can improve your hormonal health and reduce symptom severity. While complete avoidance is impossible, strategic reductions can significantly lower risks.

You don’t need to live in a bubble, but small changes can add up to a big difference. According to Dr. Nagy, “Your toxic load is a driver for inflammation. And inflammation can lead to insulin resistance, metabolic syndrome, type 2 diabetes, obesity, and a host of other health complications. The key question, then, is: ‘How do I reduce my total toxic load?’”

Here are practical, science-backed recommendations to help reduce your exposure to toxins in the exposome and protect your hormonal health.

Clean your air

• Use a HEPA air filter/purifier in bedrooms and main living areas to reduce your indoor air pollution. HEPA filters reduce PM2.5 by 50–60%

• Open windows regularly to keep your home well-ventilated.

• Avoid burning candles or using plug-in air fresheners.

• Stay indoors when the air quality index is low.

Dr. Nagy also recommends some commonsense measures you can take to minimize your exposure to toxins in the air. “If you’re in your car and you smell diesel exhaust, immediately close your windows and use the recirculate button. And I always tell my patients to avoid the detergent aisle in the grocery store!”

Filter your water

• Install a reverse osmosis or carbon block filter. Activated carbon removes 70% of endocrine disruptors.

• Avoid plastic water bottles; opt for stainless steel or glass instead.

• Test your water annually if your water comes from a well. 

Choose clean food

• Buy organic produce when possible (especially from the Environmental Working Group’s Dirty Dozen list of the 12 fruits and vegetables found to have the highest pesticide residues).
• Choose hormone-free and free-range meats.
• Limit canned foods unless labeled BPA-free.
• Use glass or stainless steel containers instead of plastic.
• Avoid plastic-wrapped hot foods where chemicals leach easily.
• Never microwave plastic containers.
• Increase fiber intake: Binds to toxins in the digestive tract.
• Avoid processed foods and added sugars.

Detox your home environment

• Choose non-toxic cleaning products (e.g., vinegar, baking soda, or natural brands).

• Remove shoes at the door to avoid tracking in pollutants.

• Vacuum with HEPA weekly—dust harbors flame retardants and mold spores.

• Avoid air fresheners and scented candles.

Choose personal care products carefully

• Read labels: avoid parabens, phthalates, “fragrances,” and triclosan.

• Switch to natural deodorants, toothpaste, makeup, sunscreens, and hair and body care products.

• Avoid synthetic perfumes and products with added fragrance.

• Choose natural fabrics: Synthetic clothing sheds microplastics when washed.

The Environmental Working Group’s Skin Deep® Database lets you search thousands of personal care products for their chemical ingredients. Another helpful resource is Think Dirty Shop Clean. They have an app, as well as a list of verified brands. 

Reduce your EMF and radiation exposure

• Use speakerphone or wired headphones instead of Bluetooth when possible.

• Turn off WiFi at night or use a WiFi timer plug.

• Don’t wear your phone on your body.

• Don’t sleep with your phone near your head or in your bed.

• Limit unnecessary medical imaging.

Address mold

• Check regularly for signs of water damage, musty smells, condensation, or visible mold.

• Proactively prevent mold by fixing leaks promptly and using dehumidifiers.

• Use a humidity monitor to keep indoor levels below 50%.

• Hire professionals for mold testing and remediation.

• Work with a functional medicine provider with knowledge of mold treatment.

Support your body’s detox pathways

• Drink plenty of filtered water.

• Eat cruciferous vegetables (broccoli, cabbage, arugula) for liver support.

• Move daily—exercise and sweating help eliminate toxins.

• Dry brushing, sauna use, and Epsom salt baths can aid in detoxification.

• Get enough fiber to support healthy bowel movements.

Sleep and de-stress

Dr. Otulana wants to remind readers that an essential element of reducing your toxic load is to “prioritize consistent sleep and restorative downtime. And stress management is not a luxury; it is a medical necessity when it comes to hormone balance.”

Several priority actions include the following:

• Get 7 to 9 hours of quality sleep nightly
• Practice some form of stress reduction – breathwork, meditation, gentle yoga, Tai Chi – 10 to 15 minutes per day.

Test and track

Ask your doctor for tests to evaluate:

• TSH, Free T3, Free T4, and thyroid antibodies

• Salivary or DUTCH hormone panels to test estrogen, progesterone, and cortisol levels

• Heavy metals, mycotoxins, and chemical exposures

Finally, what if the exposome has already made you ill? How can you tell? According to Dr. Nagy, “Around 25% of people are environmentally sensitive, but most don’t know it. Especially if they wear perfumes, or are regularly exposed to strong scents, they often aren’t able to tell that they’re sensitive.”

For a more systematic approach, Dr. Nagy recommends starting by completing the Brief Environmental Exposure and Sensitivity Inventory (BREESI). This three-question screening tool helps determine whether you should pursue a more detailed assessment of environmental illness.

Answer yes or no to the following questions:

“1. Do you feel sick when you are exposed to tobacco smoke, certain fragrances, nail polish/remover, engine exhaust, gasoline, air fresheners, pesticides, paint/thinner, fresh tar/asphalt, cleaning supplies, new carpet or furnishings? By sick we mean: headache, difficulty thinking, difficulty breathing, weakness, dizziness, upset stomach, etc.

2. Are you unable to tolerate or do you have adverse or allergic reactions to any drugs or medications (such as antibiotics, anesthetics, pain relievers, X-ray contrast dye, vaccines or birth control pills), or to an implant, prosthesis, contraceptive chemical or device, or other medical/surgical/dental material or procedure?

3. Are you unable to tolerate or do you have adverse reactions to any foods such as dairy products, wheat, corn, eggs, caffeine, alcoholic beverages, or food additives (e.g., MSG, food dye)?”

If you answer yes to even one of the three BREESI questions, your next step, according to Dr. Nagy, is to take the complete 50-question QEESI^© assessment, which is available online. This more comprehensive self-assessment questionnaire accurately helps identify environmental illness and chemical sensitivity.

Treatment of environmental illness typically involves a comprehensive, integrative approach that focuses on identifying and reducing or eliminating exposure to environmental triggers while supporting the body’s natural detoxification and healing processes. (Dr. Nagy has a helpful guide to environmental illness diagnosis and treatment for patients and practitioners that’s available for free download.)

Treatment for environmental illness also can include medications to manage symptoms like inflammation, allergies, or neurological effects, and environmental health practitioners often recommend dietary changes (such as an anti-inflammatory or elimination diets), supplementation to support liver function and antioxidant defenses, and lifestyle adjustments to reduce toxin exposure—like using air purifiers, switching to non-toxic personal care products, and avoiding mold-prone environments. Stress management techniques such as mindfulness, yoga, and adequate sleep are also emphasized, as chronic stress can worsen the effects of environmental toxins. Ultimately, successful treatment requires personalized medicine—a plan that addresses both the root causes and the systemic effects of environmental exposures.

Dr. Otulana sums it up: “In cases where environmental factors are suspected to be driving symptoms, take a functional approach, identifying and reducing likely exposures while supporting nutritionally and hormonally, sometimes with the help of targeted supplements or medications where appropriate. We’re still uncovering just how significant the exposome is, but it’s clear that our environment and our hormones are far more intertwined than we used to believe.”

If you’re experiencing hormonal chaos, stubborn weight gain, or chronic fatigue, it’s not your fault, and you’re not alone. The modern world exposes us to more chemicals and stressors than any previous generation, creating a significant burden. However, understanding the exposome empowers you to make informed choices, reduce your body’s toxic load, and begin to restore balance.

It’s not about being perfect. It’s about creating a cleaner, safer environment that allows your body to do what it was designed to do: thrive.

It’s also essential to identify and treat underlying hormonal imbalances, and that’s where Paloma Health can be your trusted ally. By offering comprehensive at-home thyroid testing, personalized telemedicine consultations, and evidence-based treatment plans, Paloma Health’s team empowers you to take control of your hormonal health at every stage of life. Whether you’re navigating the complexities of hypothyroidism or experiencing the shifts of the peri- and menopausal transition, Paloma’s expert clinicians provide tailored support that considers not only your symptoms and lab results, but also the environmental and lifestyle factors that shape your unique exposome. 

With Paloma Health, you gain a partner dedicated to helping you understand and optimize your hormonal health so that you can feel your best today and in the years ahead.

• The exposome encompasses all non-genetic environmental exposures—from pollutants and chemicals to lifestyle and social factors—that influence health and hormones throughout life.
• Endocrine-disrupting chemicals (EDCs) like BPA, phthalates, and PFAS interfere with thyroid, estrogen, and metabolic pathways, contributing to conditions such as Hashimoto’s, early menopause, and obesity.
• Air pollution, EMFs, microplastics, mold, and pathogens further disrupt hormonal health by promoting inflammation, immune dysfunction, and metabolic imbalance.
• During perimenopause and menopause, toxic exposures intensify symptoms like hot flashes, mood shifts, and weight gain by disrupting hormonal regulation and detoxification.
• Persistent environmental exposures can make it difficult to lose weight by disrupting appetite hormones, fat metabolism, and mitochondrial function, even with healthy habits.
• Reducing your toxic load through clean air, water, food, and products, along with supporting detox pathways, can protect and restore hormonal health at every life stage.

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