How well do you know the ingredients in the foods you eat or products you use every day? A TikTok with more than 3 million views is raising questions about just that. One user shared her anger after learning that the tampons she’s been using contain titanium dioxide, a common coloring agent. She suggested that the tampons — from This Is L Inc — are causing ovarian cysts. Tens of thousands of users have flooded the comments, with many claiming to have had similar experiences. We all know social media is a breeding ground for misinformation and disinformation. But the video is raising important questions: What is titanium dioxide? Could it really be responsible for reproductive health issues? How can we learn more about the products we’re using? With all these questions, we turned to experts for answers — and heard from the company behind the tampons in question. What is titanium dioxide? Chemistry class was a long time ago. So here’s a refresher: Titanium dioxide is a naturally occurring mineral. It’s used as a coloring agent to brighten and whiten things like period products. It can also appear as Pigment White 6 and White Pigment in packaging. While there's concern over This Is L Inc’s tampons, the use of the ingredient in period products isn’t new. They’re actually in other brands like Always pads and Tampax tampons — and it doesn’t end there. It’s in plenty of other products you probably use in your day-to-day life. Including… Cosmetics Sunscreens Toothpastes Paints and plastics Certain medications Foods and candies What foods have titanium dioxide? This is where things get tricky. Food manufacturers aren’t always required to explicitly list titanium dioxide on their food labels. Which means there may be titanium dioxide in many more foods. But it could be found in… Candy Chewing gum Baked goods Sandwich spreads Cottage cheese Ice cream Coffee creamers That’s a lot. So is titanium dioxide safe? Titanium dioxide’s potential health effects depend on how it's used. Here’s what we know about the safety of… Titanium dioxide in sunscreen The FDA has found that regulated amounts of titanium dioxide are considered safe. Sunscreens can have a concentration of up to 25%. For context, the coloring agent in food items can't exceed 1% of the food's weight. Putting the different limits aside, it can be hard to find titanium dioxide on labels because not all companies are required to list it. Alexandra Scranton is the director of science and research at Women’s Voices for the Earth, an environmental nonprofit. Her job is to pore over ingredient lists and other scientific studies to find out what we know about the chemicals that are in our products and what their exposure could mean. She says that we don’t need to be particularly concerned with titanium dioxide in sunscreens. “The research that's been done has looked at how much titanium dioxide do you absorb through your skin when you put it on as a sunscreen? And the data seems to [indicate] that not very much gets into your body. So people are like, ‘Okay, it's doing a good thing. It's protecting you from UV rays,'” Scranton says. Titanium dioxide in food Consuming it orally appears to be a different story. Study after study has flagged concerns about the potential damaging effects of titanium dioxide on organs like the liver and kidney. Some linked it to cancer and damage to the immune system when certain amounts were ingested over a period of time. “The other thing that we know [about titanium dioxide is] you don't want to inhale it,” Scranton says. “Rats that inhale it are getting lung cancer.” Over the years, companies like Dunkin’ have announced they’re cutting ties with titanium dioxide (they used it for its powdered donuts). There’s even a lawsuit alleging that the candy company Mars, which makes Skittles, didn’t inform its customers about the potential ‘taste the rainbow’ dangers of titanium dioxide in its product. Meanwhile, other countries are cracking down on the coloring agent. The EU banned it on August 7, 2022 after food safety officials said it could damage DNA, which could lead to cancer. Titanium dioxide in tampons Experts’ resounding answer: We don’t have enough data. “There's just a lot of unknowns and I think it requires further investigation. I wouldn't raise the alarm. I would just be a very educated consumer, and I would be aware of what we're putting in our bodies. But, again, further study is needed,” says Dr. Olivia Dziadek, gynecologist with McGovern Medical School at UTHealth Houston. You might be racking your brain and thinking, ‘But what about all the studies you just mentioned?’ According to Dr. Aly Cohen, founder & medical director of The Smart Human LLC, all of these studies are different. Many of them are animal studies, and performed in ways that account for different titanium dioxide levels and time of exposure. “What we have now is some really interesting studies on titanium dioxide, showing that there's a disruption of the gut microbiome when you ingest it. What we need to think about is, if that's what can happen within the gut, there's a lot to be said for what can happen in the vaginal area,” Dr. Cohen says. “ Scranton is among the many experts who agree that it’s a topic that requires more investigation. “There’s been a lot of alarmist concern. Certainly, we don't have the data to support that alarmist concern. But we [also] don't have the data to support, ‘Don't worry about this. This is totally safe,’” she says. Meanwhile, Procter & Gamble, which carries the brands This Is L, Always, and Tampax, has responded to concerns surrounding titanium dioxide in its products. A company spokesperson told theSkimm in the summer of 2022 that the ingredient “represents much less than 0.1% of all ingredients used in a [P&G] tampon.” They also said it’s been used safely for years. “Our tampons are safe and all the ingredients that we use are rigorously tested to meet strict safety and government regulations around the world,” Erica Noble, spokesperson for Procter & Gamble, said. In an email statement to theSkimm around the same time, the FDA said it “has not received any medical device reports related to titanium dioxide and menstrual products.” They added that it requires manufacturers to evaluate their period products’ safety in a number of ways — including how tampons affect vaginal bacteria. Still, people’s stories on social media have left many shaken. It's important to note that individual experiences are valid. While many want to try and put two and two together, the bottom line is that there isn’t enough data to confirm the claims that titanium dioxide in tampons is causing the ovarian cysts and other issues people are describing. For many, the video has raised awareness about an important issue: The chemicals in our products, and the importance of questioning what we’re consuming on the daily. “What's great is that people are asking these questions. And that's a really good thing to drive science [and] safer products. This is what manufacturers need to know — that people are reading these things and asking these questions.” Scranton says. How can I make sure the products I’m using are safe? It can be frustrating when you don't have a clear picture of the ingredients in your tampons, toothpaste, chewing gum, and everything in between. So what can you do to stay healthy and safe? Here's what the experts suggest... Keep it simple. “Things like colorants, whiteners, and fragrances are not necessary to the product. If you can find products that don't have them, that's gonna lessen your exposure.” Scranton says. Follow the ‘less is more’ approach. Meaning “[the] lowest possible use of anything that has not been tested properly. And then look up and vet the products that we do have available.” Dr. Cohen says. Switch it up. “Try something different for a month — particularly if you're having some sort of acute reaction — and see how you feel,” Scranton suggested. Dr. Dziadek added that if people don’t feel comfortable with tampons, they can try menstrual cups. There’s also period underwear. Be cautious and meet with your doctor. “Always be vigilant and also don't get overwhelmed by what's on the internet. I think seeking solace and guidance from your physician is key because they may also help clarify [and] help with any anxieties that all this information can provoke.” Dr. Dziadek says. Plan for the future. Scranton encourages people to make calls, send emails, and write reviews to the companies or lawmakers in your life. Dr. Cohen agrees, and says it’s important to hold “legislators to a higher standard in making sure that they follow through with legislation that really does make sense, like the New York policy.” theSkimm TikTok is a powerful platform that’s influencing people’s lives — including their physical health. While experts agree more studies need to be done on titanium dioxide’s potential impact on reproductive health, one person's video is motivating millions of people to take control of their health — and question what they consume every day. Updated on Mar. 22 to reflect new information.