Is the Exposome the Future of Medicine?

Creator: Robin Berzin MD
Published: 2026-11-10T13:00:00.000Z

Your environment may shape your health more than your genes. Here’s how to measure your exposome and lower the exposures you can control.

By Robin Berzin MDColumbia-trained physician · Founder of Parsley HealthPublished November 10, 2026·8 min read

Robin's Short Version

In a study of nearly 500,000 people, measured environmental and lifestyle exposures explained substantially more variation in premature death than genetic risk for 22 major diseases.
Your exposome includes chemicals, air, water and household products—as well as factors such as smoking, exercise and living conditions.
Testing remains fragmented, but urine panels, water reports and home mold testing can help identify specific exposures worth addressing.
The highest-impact first steps include filtering drinking water, replacing frequently used fragranced products and reducing contact with mercury, pesticides and heated plastics.

I just got back from Eudēmonia in West Palm Beach. My third year going. The biggest one yet.

The expo hall there is called the EXPOSŌME. Cute name. This year, it felt more like a prediction.

The companies that caught my eye weren't selling another supplement. They were measuring what we're all swimming in. Lution, an always-on home air system that tracks mold, bacteria, VOCs, formaldehyde and more down to the species, far more sophisticated than old-school tests like ERMI. And TEAL Science, which is building testing for nearly 1,000 toxins, from metals and plastics to PFAS and phthalates, in your blood, urine and home, tracked over time to find where they're coming from.

Everywhere I turned, people were talking about the exposome. (Not exosomes, the tiny vesicles in your skincare. One letter, totally different thing.)

The exposome is everything you're exposed to. Air, water, food, your shampoo, your couch, your office carpet. It always sounded too big to measure. Not anymore.

Tired, foggy, headachy and not sure why? Your environment is one of the first places I look. Let's find out what you're carrying →

This week: what the exposome is, how to measure yours and how to clean it up without losing your mind.

⚡ Forward this protocol

💡 Forward this protocol

Two swaps that cut your toxic load fast:

Filter your drinking water. Put an under-sink reverse osmosis filter on the tap you use most.
Swap the product you use most. Lotion, body wash, shampoo. Go fragrance-free, phthalate-free and paraben-free.

👉 Forward this to the friend who's been meaning to test her house for mold for two years.

What to know: Your environment shapes your health more than your genes.

❌ The old assumption: Your genes are your destiny. Good genes, long life.

✅ The new reality: For most of what ages us, the exposome wins. Researchers followed nearly 500,000 people to see what predicts dying early. Age and sex explained the most. On top of that, genetic risk for 22 major diseases added less than 2 percentage points. The exposome added 17 ^[1]. The rest? Chance, and things no one has yet measured. The environment mattered most for lung, heart and liver disease.

And the biggest exposures weren't only chemicals. Smoking, exercise, income and whether you live with a partner all made the list. Your exposome is how you live.

❝ Your genes aren't your destiny. Your exposome has more say.

☠️ It's already in us. We spend about 87% of our time indoors ^[2]. That's a lot of air, furniture and cleaning spray.

PFAS "forever chemicals" showed up in more than 98% of Americans the CDC tested ^[3].
Pollution causes about 9 million deaths a year, 1 in 6 worldwide ^[4].
Microplastics turned up in the neck-artery plaque of 58% of surgery patients. Those people had 4.5x the risk of heart attack, stroke or death over about 3 years ^[5]. It's observational. But it got my attention.

🔬 How we measure it today. In pieces. A urine panel for metals and chemicals. A dust test for mold. A water report for your tap. Every result is a snapshot.

That's changing. In 2025, the NIH helped launch a global human exposome initiative, the sequel to the Human Genome Project ^[6]. The goal: combine lab samples, sensors, satellites and AI into one picture.

My prediction? Companies like TEAL and Lution will change how we build homes, how we clean and what we buy. Our understanding of the exposome is going to transform medicine the way mapping the genome did.

What to do: Test what matters. Then cut your biggest exposures.

1️⃣ Test your body and your home.

You can't fix what you can't see.

Your body: at Parsley, we use Vibrant America's Total Tox Burden panel. One at-home urine sample, 87 toxins: mycotoxins, heavy metals and chemicals like phthalates and pesticides.
Heavy metals: a dedicated panel from Genova Diagnostics or Doctor's Data.
Your home: an at-home ERMI dust test for mold, if you have symptoms. Some people live with mold and feel totally fine. Fix water damage no matter what. But if you're not reacting, you may not want to go down that rabbit hole.

2️⃣ Filter your water.

One of the fastest wins. Every under-sink reverse osmosis and two-stage filter tested removed nearly all PFAS. Pitcher and fridge filters were hit or miss ^[7].

3️⃣ Clean up your products.

Check labels for parabens, phthalates and "fragrance," which can hide a whole mix of ingredients that don't have to be listed.

Beauty: I love Merit. At Eudēmonia I found Crunchi. I wore their lip gloss on stage for my last panel and really liked it.
Cleaning: Branch Basics or Seventh Generation. Or white vinegar and water in a spray bottle.
swap as you run out, not all at once

4️⃣ Mind your fish and your produce.

Fish: skip swordfish, shark, king mackerel, marlin, orange roughy, tilefish and bigeye tuna, the highest in mercury (FDA/EPA). Canned light tuna is a better pick than albacore. EWG's seafood guide is a great cheat sheet.
Produce: soak it in 1 teaspoon of baking soda per 2 cups of water for 12–15 minutes. It removed 80–96% of two surface pesticides from apples, way more than tap water ^[8].

Full disclosure: I also bought the PurePod Produce Cleaner on Amazon, a little gadget you drop in a bowl of water with your produce to help release pesticide residue. I can't vouch for it. But it seemed worth a shot.

5️⃣ Look around your home (and your hotel room).

store food in glass, and never heat plastic
living in a home built before 1978? Test for lead paint before you sand or renovate
choose low-VOC paint, and ask what new carpets are treated with
when you travel, pick places that use non-toxic products

Listen, I'm not a psycho. I'm not going to stop traveling. But at Eudēmonia, I did two workouts in the conference center: Primal Moves, which I love (check out their LA studio), and yoga with Janet Stone. Both times my face was pressed against wall-to-wall carpet. I was not super stoked about whatever I was inhaling. I think about it every time I stay in a hotel. A lot of big chains use the cheapest products they can. Often, that means a lot of chemicals.

The goal: Not to be paranoid. To be aware of what you're swimming in, and lower what you can control.

Living Longevity

I loved the whole Eudēmonia experience: the positivity, the excitement, the new companies. They sold over 5,000 tickets this year, and the number and quality of speakers was remarkable. Serena Williams even bought a ticket as an attendee, just to check it out, and was posting about it on her Instagram.

There was great music, fun workouts, and Sofi Tukker played in downtown West Palm Beach where anyone in the community could go, even if they weren't attending.

I got to have dinner with some of my favorite friends in health and wellness, people I've known for a long time: Gabby Bernstein, Dr. Will Cole, Dr. Jeffrey Bland (considered the father of functional medicine) and Rich Roll. I even got to hang out with Andrew Huberman and get to know him personally for the first time. Not to mention countless founders, investors, doctors and creators in the space.

I was also really proud of how I showed up.

I had spent the whole week grieving the loss of my friend and his family in the plane crash the weekend before, which went down in Palm Beach. I was nervous about flying there and how I would feel. But I decided the best thing I could do was show up as fully as possible. To be of service, and to educate and inspire wherever I could, whether 5 people showed up to my talks or 500.

On Saturday, I gave my keynote on female longevity in the grand ballroom, the largest space at the conference, with nearly 1,200 seats. We were at 98% capacity, with people standing around the edges. All weekend, people came up to tell me it was one of the best talks of the weekend. I was really proud of that.

It was a reminder that longevity is so much about how we live now. How we show up. How we hold ourselves, even in moments of stress or grief. Being fully present that weekend was what my friend would have wanted. It was the best way to honor him, and the best thing I could do for myself.

One more thing...

Curious what's in your exposome? At Parsley, we test for heavy metals, mold toxins and environmental chemicals. Then we help you find where they're coming from and what to fix first. Book with a Parsley clinician →

Stay strong, stay curious, and breathe,
Robin

References

Originally published in the Off Script newsletter. Join Robin’s readers for weekly functional medicine insights.

As always, this newsletter is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any health decisions or changes to your treatment plan.

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