The Kitchen Health Review
Plain answers to what we cook with
What I tell patients who ask me about their nonstick pans
Every few weeks, someone in my office asks whether the coating on their frying pan is something to worry about. Here is the same answer I give them — what the research shows, what it doesn't, and the one change that makes the question go away.
I did not expect cookware to become a regular topic in my consulting room. But over the last couple of years it has, and the question is almost always the same: "Doctor, is my nonstick pan actually bad for me?" It's a fair question, and the honest answer is more nuanced than either the scare headlines or the reassuring marketing would suggest. So let me walk you through what I actually tell people.
First, what we are really talking about. The slick surface on most nonstick pans is PTFE — the material long sold as Teflon. Chemically, PTFE belongs to a large family called per- and polyfluoroalkyl substances, or PFAS: the synthetic compounds you'll have seen described as "forever chemicals." They're called that because they are built around an extremely stable bond that barely breaks down, either in the environment or in the human body.
That persistence is the heart of my concern as a clinician. These are not substances the body clears easily. Testing has found them in the blood of the great majority of people, from many sources — water, food packaging, textiles — so no single pan is "the" cause of anything. But the pan is one of the exposures a person can actually choose to remove, which is exactly why it comes up in my office.
What the evidence actually shows
I try to be careful here, because this is where patients most often hear either too much or too little. Let me give you the part that carries the most weight.
The WHO's cancer agency classified PFOA — one specific PFAS long used in nonstick manufacturing — as carcinogenic to humans (Group 1), and the related PFOS as possibly carcinogenic (Group 2B).
Group 1 describes how strong the evidence is that a substance can cause cancer — not how much risk you personally face at a given exposure. The human evidence is clearest for kidney and testicular cancer. I treat it as a solid reason for caution, not a cause for panic.
Beyond cancer, a large body of research has associated higher PFAS exposure with other effects I watch for: changes in cholesterol and hormone levels, reduced immune response, thyroid and liver effects, and developmental impacts in children. I want to be precise with my patients: most of these are associations, not proven cause-and-effect, and they depend heavily on dose and duration. But the pattern is consistent enough that regulators have stopped waiting for perfect certainty — and so have I, when a patient asks what they can do.
My job isn't to tell you a frying pan will make you ill. It's to help you lower avoidable exposures where the trade-off is easy. This is one of the easy ones.
The three situations I actually warn people about
For a pan that is in good condition and used at moderate heat, the risk is generally considered low, and I say so plainly. The trouble is that real kitchens don't stay ideal. Three ordinary things change my advice.
1. Scratches. Once the coating is chipped or worn, it can flake into food. One 2022 study found a single crack could shed thousands of microscopic particles, and consumer testing groups now simply advise discarding a scratched nonstick pan. When a patient tells me their pan is "a bit scratched but fine," that's the one I push back on.
2. Overheating. Left empty on a high flame or pushed past roughly 260°C (500°F), PTFE starts to break down and release fumes. There's even a recognized condition — "polymer fume fever," sometimes called Teflon flu — and those same fumes are well known to be fatal to pet birds. That detail tends to land.
3. Labels that don't tell the whole story. "PFOA-free" sounds reassuring, but it does not mean PFAS-free. Independent lab testing has found PFAS in pans marketed as PFOA-free, and other undisclosed coatings in products sold as safer. I tell patients they can't fully rely on the front of the box.
Lab testing found measurable PFAS in a pan whose packaging claimed to be PFOA-free; the group no longer treats "PFOA-free" as a meaningful safety signal for PTFE cookware.
The EPA set the first federal drinking-water limits on PFOA and PFOS, and from 1 January 2025 Minnesota became the first US state to ban the sale of cookware with intentionally added PFAS — with several states following through 2028.
The change I actually recommend
Here is where I try to be useful rather than alarming. You do not need to hunt for the "safest coating." The cleaner move is to cook on something that has no coating to begin with — because a surface that was never sprayed on can't scratch off, flake into food, or break down into fumes.
Professional kitchens have relied on uncoated materials for generations: stainless steel, cast iron, carbon steel. The one I find easiest to recommend to a home cook who is specifically worried about coatings is pure titanium. It's a bare, non-reactive metal — nothing layered on top, nothing to degrade — which means, by definition, no PFAS, no PTFE and no BPA. For the patient who just wants the question to go away, that's the simplest answer I can give.
None of this is medical advice for your specific situation, and I'd always rather you make a calm, informed choice than an anxious one. But if you were sitting across from me asking what I'd change first, this would be it — and it happens to be one of the least disruptive changes you can make in a kitchen.
Michael Ashford, MD
[ Specialty / credentials — to be completed with the real author's details ]
The coating-free titanium cookware referenced above is made by the sponsor of this article.