FAQs

Perfluoroalkyl and polyfluoroalkyl substances, or PFAS, are a class of approximately 14,000 fluorine-based chemicals, all synthesized by man, that are widely used in such products as non-stick cookware, water and stain repellent fabrics, fire-fighting foam, dental floss, and food packaging. Because they have properties that repel oil and water, reduce friction, and resist temperature changes they are used in many sectors of manufacturing.

Because they do not readily breakdown in the environment they have been accumulating for decades in the environment. PFAS have been found in water, air, soil, fish, animals at locations across the nation and the globe. They get into the environment at the many manufacturing sites making and using them, at military bases using them as firefighting foam, at disposal sites such as landfills, as run-off from consumer products, or at spill sites.

Communities where there are manufacturers of PFAS, military bases, or industries that use PFAS in their processing, are at risk for drinking water (tap water), soil, and air contamination.

Elevated levels of PFAS in a person’s bloodstream are associated with serious illnesses that significantly affect the length and quality of a person’s life, such as thyroid cancer, kidney cancer, testicular cancer, breast cancer, ulcerative colitis, thyroid disease, immune suppression, high cholesterol, and serious pregnancy complications.

Blood testing is the only way to quantify one’s risk for PFAS-associated diseases, and reducing high blood levels of PFAS by identifying and eliminating exposure sources is the way to lower one’s risk for PFAS-associated illness.

It is estimated that 200 million people in the U.S. are drinking tap water known to be contaminated with PFAS, and 97% of us have PFAS in our blood from our drinking water and other sources such as consumer products, manufacturing pollution, and contaminated food.

The Environmental Protection Agency (EPA) notes that when their drinking water regulations of PFAS are fully implemented they “will prevent tens of thousands of serious PFAS-attributable illnesses or deaths.”  However, these regulations will not be in effect for at least 6 years. And because PFAS remains in the blood for years after exposure, this means at least 10 more years of exposure for the 200 million people in the U.S. who are drinking tap water known to be contaminated with PFAS.

With 200 million people in the U.S. drinking PFAS contaminated tap water, and all of us being exposed through other sources, it is imperative to know now, not in ten years, which of us has high levels of PFAS in our blood so that our exposure can be stopped immediately and we can work to minimize risks for disease and protect our health.

After your initial consultation to identify your exposure risk and answer your questions, Votary, MD will drop ship directly to you an at-home finger prick blood testing kit from EmpowerDX, which is a subsidiary of Eurofins, a global leader in analytical testing.  Once you have completed and returned the test, we will notify you when your results are ready.  Then you can schedule your follow-up consultation to receive and discuss the following:

1. A determination of your individual health risk based on your serum (blood) PFAS concentration. Your serum PFAS concentration is a calculation developed by the NAESM and CDC that takes into account your blood levels of the 7 most common PFAS chemicals in the blood of people in the U.S.
2. Individualized recommendations for health testing, monitoring and follow-up based on your calculated serum PFAS concentration, based on clinical guidelines developed by the National Academies of Sciences, Engineering, and Medicine (NASEM). Your primary care physician can then assess and discuss your plan with you, and carry out the NASEM’s recommended medical screenings as decided upon by you and your physician.
3. A detailed assessment and identification of your PFAS exposure source(s).
4. Detailed recommendations as to how to stop or minimize your PFAS exposure, including understanding water filters, finding the cleanest consumer products, and PFAS-free food sourcing.
5. Information about minimizing other toxin exposures that can impede good health.

We are happy to speak with you about your blood test results.  Just schedule a 30 or 60 minute “consultation only” appointment.

 Anyone can have their PFAS blood level tested and improve their health by understanding and reducing the toxin exposures in their life.

People who are at high risk for having elevated blood levels of PFAS include the following, and thus testing is highly recommended for people who:

• live in a community with known contamination of its public drinking water (tap water).
• live in a community where the tap water has not yet been tested for PFAS
• live in a community at risk for PFAS contamination due to manufacturers using or producing PFAS.
• live, or have lived, on or near a military installation.
• are, or have previously been, a firefighter.
• work or have worked at a manufacturing facility that uses chemicals.
• work or have worked in the carpeting, painting, or electroplating industry.
• regularly consume fast food or work in a fast-food restaurant
• regularly wear stain, iron, or water-resistant clothing, including uniforms and outdoor gear
• work, or have worked in construction or the food packaging industry.
• use non-stick cookware.
• have bought stain-resistant furniture, or treated their carpets, shoes, or furniture with stain-resistant, or water-resistant coatings.
• Consume processed foods or beverages such as fast food, pizza, microwave popcorn, or juices in plastic containers.
• are farmers or gardeners who are using, or have used, soil amendments such as biosolids or home fertilizers labeled “eco” or “natural”.
• work with ski wax, including surfboard and snow ski wax.
• work regularly on cars or bicycles.
• children or athletes who play sports on artificial turf

You might also want to consider PFAS testing if you:

• are pregnant or plan to become pregnant in the next 2 years.
• have cardiovascular disease (coronary artery disease)
• are breastfeeding.
• have high cholesterol.
• have or have had kidney cancer.
• have ulcerative colitis.
• have thyroid disease
• have ever been diagnosed with breast cancer or prostate cancer.

Over 20 years of scientific research has shown that PFAS exposure is associated with an increased risk for the following diseases:

• Thyroid disease
• Breast cancer
• Ulcerative colitis
• Kidney cancer
• Testicular cancer
• Pregnancy-induced hypertension (gestational hypertension and preeclampsia)
• Lower antibody response to vaccines in adults and children
• High cholesterol
• Elevated liver enzymes
• Low birth weight and growth rate in babies

PFAS testing is complex and requires special laboratory environments and equipment.  Turnaround time for EmpowerDX is between 2 and 6 weeks.

PFAS chemicals are often referred to as “forever chemicals” because they can persist for years in the environment, and in the human body.  On average, PFAS chemicals stay in the body for 2 to 8 years after exposure. This makes them particularly toxic because it gives them lots of time to interact with many different organ systems and cause many different diseases by disrupting hormone levels, changing cell metabolism, altering immune function, and altering DNA, among other things.

PFAS blood test results cannot tell you if PFAS exposure has caused a specific health condition, or if your PFAS exposure will affect your health in the future. 

If you have been diagnosed with one or more of the diseases known to be associated with PFAS exposure, or with any chronic disease, minimizing your toxin exposures can improve your overall health and help your body fight and heal from chronic illnesses.

Environmental Working Group (EWG) published an interactive map showing the U.S. communities whose tap water is contaminated with PFAS.  Not all communities in the U.S. have been tested for PFAS.  EPA will complete testing for all public water utilities serving 3,300 people or more by December 2025.

Ingestion is the most common route of exposure to PFAS. PFAS can be ingested by drinking contaminated water but also by eating contaminated seafood or other contaminated foods, such as wild game, or dairy products from areas contaminated with PFAS. PFAS are often used in cookware and food contact materials, such as microwave popcorn bags and packaging of fast foods and processed foods.

PFAS can cross the placenta, and PFAS from the mother’s body can be passed to her developing baby. PFAS can also pass from mother to child through breast milk, although this does not necessarily mean women with PFAS in their blood should not breastfeed their baby.

Certain occupations also may lead to increased PFAS exposure. These include firefighters, military workers, and occupations in facilities used to manufacture PFAS, or to produce PFAS-containing products, such as textiles or food contact materials. Other jobs with a known increased risk of exposure to PFAS include electroplating, painting, carpet installation and treatment, and jobs that require prolonged work with ski wax. In addition, food workers and others in the hospitality industry may have elevated exposure if they handle PFAS-containing food packaging as part of their job.

The benefits of knowing your PFAS blood level include:

• Opportunity to identify if you are at increased risk for certain health outcomes so you can minimize that risk.
• increasing your awareness of PFAS exposure so you can reduce that exposure.
• identification of the potential risk for health conditions that you can then monitor for and work to prevent.
• relief from not knowing your exposure level, and help in monitoring whether your efforts to reduce your exposure are working by comparing initial blood levels to subsequent levels.

The risks or PFAS blood testing include:

• the small risk of infection at the finger-prick site,
• stress about the health effects of PFAS exposure,
• unforeseen consequences from any clinical testing you do with your doctor as a result of your elevated PFAS levels.

PFAS are currently not regulated under the Safe Drinking Water Act, and there are no federal drinking water standards for PFAS, therefore public water supplies do not have to test or treat their water for PFAS under federal law. 

In March of 2023 the EPA announced the proposed National Primary Drinking Water Regulation (NPDWR) for six PFAS including perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), hexafluoropropylene oxide dimer acid (HFPO-DA, commonly known as GenX Chemicals), perfluorohexane sulfonic acid (PFHxS), and perfluorobutane sulfonic acid (PFBS). While this is a good step forward, these proposed regulations do not require any enforceable reduction of PFAS in our drinking water for at least 6 years.

The EPA notes that when these regulations are fully implemented, they “will prevent tens of thousands of serious PFAS-attributable illnesses or deaths.”   In the meantime, thousands of us are getting sick from PFAS exposure. 

Therefore, it is up to us as individuals to protect our health from PFAS and other toxin exposures. At Votary, M.D. we are committed to helping people identify and stop their PFAS exposure to protect their health.

Until recently, PFAS blood testing was only available to research scientists and laboratories. When testing initially became available to the public it was very expensive at $600-$900 dollars per test.  In the last year Direct-to-Consumer testing has become available, which lowers the price and also makes in-home testing possible.  At Votary we get a small wholesale discount for each test and only charge you the amount we pay for the test, which is $239.00.  Hopefully over time, as more and more people use the test, the price will drop.

In New Hampshire the legislature passed a law requiring insurance companies to pay for PFAS blood testing.  But this is not the case in other states.  However, we do advise you to call your insurance company and ask if they will by chance cover the test.  If they do, they may require you to use a certain lab for testing.  That is no problem. When your results are back, schedule a “consultation only” appointment and we can still provide a detailed exposure assessment, and prepare an individualized health risk assessment and plan.

At Votary, M.D. we are working with others to secure funding for testing of groups of people in high-risk areas.  Check back in 2024 for more information about this. If you have a group of at-risk people in your community, please contact us and we will add you to our list to contact when/if funding becomes available.

There are many great PFAS resources on the web. Here are some to get started:

• EPA
• EWG
• Federal Government 
• Societal implications of PFAS contamination

Yes, there are a multitude of chemicals to which we are exposed to daily through air pollution, consumer products, water, food, body care products, household cleaners, furniture, and our work. Many of these are known to be carcinogenic and associated with cancers such as breast cancer, lymphoma, leukemia, thyroid cancer, testicular cancer, and prostate cancer.  Many of them are known to disrupt hormones and cause chronic illnesses such as infertility, diabetes, neurologic disorders, Parkinsons disease, autoimmune diseases, and thyroid disease. 

Votary, MD is committed to heightening awareness about the importance of toxin avoidance to stay healthy. We are experts in the health effects of toxins, and offer consultations to identify your specific exposures and help you reduce them.

Environmental Working Group (EWG) published a tap water database interactive map showing contamination of drinking water with contaminates other than PFAS. You can enter your zip code and learn more about the water you are drinking.

Toxin exposures happen to individuals, communities, neighborhoods, workers, and randomly due to spills and accidents.  If you are part of a group that has experienced a toxic exposure that might affect your health, please email us and we can help you get information and support.

At Votary, M.D., while we specialize in PFAS exposure, we also provide testing (if available) and medical consultation for many chronic toxic exposures, including but not limited to, lead, Glyphosate, Arsenic, Atrazine, and Cadmium.  Please email us with a brief description of your exposure and we will let you know if and how we might can help.