First Line Comprehensive Care. Part II: Anthropogenic Xenobiotics in Functional Medicine. Managing Persisting Bioaccumulating Pollutants: Toxic Minerals, Biocides, Hormone Mimics, Solvents, and Chemical Disruptors

First line comprehensive care is fundamental to integrative medicine, an emerging specialty within American healthcare. Primary focus is on functional and predictive tests to identify remediable causes of suffering and ill health. Integrative health professionals are learning a more functional language-it is both a language of causes and of deeper insights into more fundamental molecular and submolecular mechanisms of both our good health and our ill health. Anthropogenic xenobiotics, especially the bioaccumulating and bioconcentrating toxic minerals (TMs) and persistent organic pollutants (POPs) are the focus of this article as they are, in their more toxic forms, largely anthropogenic, human-sourced intoxicants. Bioconcentration operates in the following way: Ocean krill and algae convert less toxic, inorganic mercury to biotoxic organic mercury. Alga are ingested by small fish. Larger fish eat small fish, and humans, in turn, eat larger fish. The longer the lifespan, the more mercury accumulates in those people who have lost (phenotypic expression) or have innately impaired (genotypic expression) abilities to detoxify and eliminate these anthropogenic xenobiotic toxicants. Since accumulation of POPs takes place primarily in the fat while TM accumulates more prominently in muscle and bone cells and extracellular matrix, it follows that such toxins might contribute to the novel and more severe treatment-resistant musculoskeletal conditions observed in practice. Scientific evidence is also “bioaccumulating” for a clinical imperative to mitigate exposure where possible and to optimize innate host defenses, generally through strategic mental and functional, nutritional, and environmental adaptations. This article outlines the current standards of care for integrative medicine physicians incorporating the 2005 American Board of Clinical Metal Toxicology (ABCMT) training guidelines for practitioners. The practice of first line comprehensive care is emerging as outcome and cost effective compared with today's conventions in most chronic diseases as well as in the implementation of proactive, cost-effective, and outcome-effective health promotion approaches. If not now, when will we implement widely what we know that cost effectively and outcome effectively promotes sustainable good health and general well being?