What if we said that our understanding of what clean and dirty needs to be turned upside down? What could that possibly have to do with allergic diseases? Our Nutrition Programs Director, Romilly Hodges, explains why. For readers who would like more support with managing hay fever or other allergic conditions, consider my Seasonal Allergy Relief Program or working with one of our Functional Medicine practitioners. Allergic diseases are my area of focus in my work on faculty with IFM and our clinic does good work here.
– DrKF
The Meteoric Rise of all Things Allergic
Allergies of all kinds continue to be a pressing health problem. Worldwide, the prevalence of allergic diseases continues to rise. Sensitization to at least one common allergen is approaching 40-50% amongst school children globally. Allergic diseases manifest in a variety of different ways – from hay fever, rhinitis, post-nasal drip, and eczema, to food allergy, urticaria, asthma, mast cell, and eosinophilic disorders.
Allergies are also a relatively new thing. The first cases of allergy appeared only just over 150 years ago. In 1859 Dr. Charles Harrison Blackley, in Manchester England, puzzled over his summer cold. He went on to prove, mostly by experimenting on himself, that his symptoms were caused by pollen. The term ‘allergy’ was coined only in 1906 by an Austrian pediatrician, Clemens von Pirquet. In 1967, immunoglobulin E (IgE) was identified as the antibody responsible for most allergic reactions. Over the rest of the twentieth century, the incidence of allergies and asthma simply exploded – the floodgates opened, although many doctors resisted acknowledging allergies as anything more than a passing fad.
Fast forward only a short time to today, and here are some more allergy facts:
- Allergies are the 6th leading cause of chronic illness in the US
- Allergic conditions, including hay fever, are the most common health issues affecting children in the US
- The annual cost of allergies in the US exceeds $18 billion
A Toxic Clean
What could possibly be contributing to the meteoric rise in allergies? The answer is unfortunately complex and difficult to pin down scientifically, but the likelihood of industrialization and post-industrial living practices playing a role seems unequivocal.
And here is where we turn to hygiene, and a tale of two threads. 1. Our willingness to bathe ourselves in all kinds of environmental toxins, often in the name of hygiene itself, and 2. Our determination to exterminate all microbes, again in the name of hygiene. Both these directions have not served us well when it comes to appropriate immune tolerance.
Here’s how to approach things differently and start restoring our immune health…
Resetting our Thinking – The Right Kind of ‘Clean’
Toxins turn on allergies.
To underscore the toxin-equals-allergy equation – it’s believed that those first reports of pollen sensitization hay fever, 150 years ago, were caused by all of the mercury and petroleum in the industrial air.
We’re all exposed to environmental toxins to varying degrees. We also all have different capacities to detoxify those toxins based on our genetics, nutrient status, and other metabolic factors. Our immune system is especially (sometimes exquisitely) sensitive to toxins so that a toxic burden beyond that which our body can handle exerts constant immune stress that can easily tip it out of balance.
Observational data correlate the increase in exposure to environmental toxins, such as pesticides solvents, and air pollutants, with the rise in all kinds of allergic disease and asthma. Here’s a smattering of their observations:
- Prenatal exposure to BPA increases risk for allergic disease later in life
- Urinary BPA levels correlate with higher levels of asthma in children
- Prenatal phthalate and BPA exposure increases odds for asthma
- Ambient exposure to metals (nickel, vanadium and zinc) and elemental carbon from exhaust fumes associated with wheezing
Side note: Quality of evidence is always an important question. Many naysayers attempt to confuse the issue by asserting that these observational data don’t represent categorical proof. They may argue that there isn’t the highest quality of evidence on the potential harms of environmental toxins – a randomized, controlled trial (RCT). Association is not causation, we wholeheartedly agree. However, there are NO RCTs in the field of toxicology since, for ethical reasons, a research review board would never approve a study where the hypothesis tested potential harm. Observational studies are the highest level of evidence we can hope for here (as those links above are), together with animal/lab studies (those links below) where such hypotheses are allowed. Animal and cell studies can help to tease out potential mechanisms. Remember, the US Environmental Protection Agency has made its own determinations of chemical safety based on short-term animal and cell studies. There shouldn’t be different standards to suit different arguments.
Here is a sampling of animal studies suggesting negative impacts on immune regulation:
- Surfactants in household and personal care products promote allergic lung inflammation
- Phthalates promote and aggravate allergic asthma
- Phthalate exposure exacerbates the allergic milieu in the nose (rhinitis), skin and lungs
- Exposure to mercury increases IgE production, promoting allergic responses
- Household pesticide used against cockroaches and vermin shown promotes an inappropriate immune response to allergens in the environment – note that this study is published on the EPA website itself, although the EPA allows its use.
Fascinating fact: Genetically leaky skin (more common than you might think) leads to increased toxin absorption.
Some individuals with a tendency towards eczema (including allergic dermatitis) have a genetic predisposition towards loss of skin integrity. The gene at fault here is called the filaggrin gene, which is crucial for normal skin barrier function. Even without the filaggrin gene mutation, skin inflammation through allergic dermatitis also reduces the filaggrin concentration of the skin.
Recent research has shown that individuals with this gene carry a higher toxic burden which is thought to be due to the increased permeability of the skin and therefore increased absorption of chemicals (including certain phenols, parabens, and phthalates) and metals.
Loss of skin barrier integrity, such as in eczema, is also a risk factor for sensitization to allergens including to foods, pollens, dander, dust mites and more. If you have eczema, it’s a good idea to work with a Functional Medicine provider to help address that and reduce the risk of sensitization.
What to do?
When combatting seasonal allergies, it pays to live as free of environmental toxins as possible. And if you’re someone with eczema or extra dry skin you could have the filaggrin mutation making it doubly important for you to use clean skin products.
Choose non-toxic personal care products, home and yard care products, building materials and organic foods as much as you can. Get an air purifier for your home, especially in areas that you spend a lot of time in such as living rooms and bedrooms – one study conducted in California showed significant improvements in nasal symptoms following the use of air purifiers for 12 weeks. Air purifiers also help to remove indoor air toxins as well as pollens.
The Environmental Working Group is a great resource for choosing less toxic home and personal care items. We love their Skin Deep cosmetics database!
In addition, and since we can never live fully toxin-free, support your body’s natural detoxification systems by eating nutrient-dense, whole foods that include plenty of colorful immune-balancing phytonutrients. Don’t forget about adequate protein too – detoxification is a protein-intense process which is why we don’t recommend fasting or raw-plant food only for first-time detoxers.
Don’t forget about exercise, and in particular the kind of exercise where you work up a good sweat. Perspiration is a great way to eliminate toxins through the skin (research exists here – for instance with excretion of BPA, flame retardants, aluminum, and other heavy metals). Just make sure you shower after so they’re not reabsorbed. Saunas and steam rooms, if you’re medically cleared for them, can help with toxin elimination through the skin too.
Resetting our Thinking – The Right Kind of ‘Dirty’
The right microbes turn down allergies
Our microbiomes, the collective term for our symbiotic microbial species, predominantly resides in our gastrointestinal tracts, where around 2-6 lbs of bacteria act almost as an additional organ. They produce nutrients that our body uses, signaling molecules that change our own cell gene expression, metabolic and immune responses, and help to ‘crowd out’ potentially harmful microbial species that could make us ill. In fact, our microbiomes have been described as ‘critical for human survival’ according to a consortium of researchers organized by the US National Institutes of Health. We also have important microbial populations elsewhere on and in our bodies – including on our skin, in our nasal passages and in our lungs.
What happens when our microbiome isn’t functioning well? When the right interplay between healthy microbes and host immune system doesn’t happen, the immune system responds inappropriately to substances that should be safe. It’s likely this important relationship that is behind the research findings that children who grew up on farms have 70% fewer allergies and asthma than those who don’t.
Here are some studies that support the relevance of our microbiomes in allergic disease:
- Probiotics improve quality of life in individuals with seasonal allergies (this is an ‘RCT’ in humans – the highest quality of evidence available)
- Probiotics improved seasonal allergy and allergic asthma symptoms (another RCT)
- Probiotics improved systemic nickel allergy syndrome including eczema, hives, and itch (another RCT)
- Probiotics improved allergic eczema (another RCT)
- Arabinogalactans (prebiotic polysaccharides) protect against allergic airway inflammation (animal study)
In our modern society, we have for a long time been focused on total germ elimination. Antimicrobial soap, hand sanitizer, and bleach use are still unwaveringly common. Antibiotics are so commonly prescribed that it’s hard to find anyone who hasn’t had them. Yes, antibiotics can be crucially life-saving in some circumstances, but their overuse leads to dramatically deficient microbial health in and on our bodies.
Toxins in our environment, such as pesticides in foods, have also been implicated in disturbing the balance of our gut ecosystem. Less time spent in nature, poor diets that don’t nourish our gut bugs, and stress, are more reasons for deficient microbiomes.
What to do?
Probiotics that help to ‘reinocculate’ a depleted microbiome are commonly-used in Functional Medicine for many applications including allergic disease. However, the food we eat can have even more dramatic impacts on the microbiome, even within days.
To start eating to nourish your microbiome, incorporate plenty of plant foods rich in natural fiber. Especially helpful foods include onions, leeks, lentils, jicama, asparagus, and Jerusalem artichokes*. Incorporate live fermented foods, such as sauerkraut, yogurt, kefir, miso, and kimchi. You may wish to explore this article to find out more about cultured foods: https://www.drkarafitzgerald.com/2018/09/26/when-do-cultured-foods-outperform-probiotic-supplements/
Check your stress response. Are you constantly ‘on alert’? Do you allow yourself downtime? Chronically elevated stress levels directly alter our microbiomes.
Minimize the use of antibacterial soaps too**, since our surface microbiome is an important regulator of skin barrier health and our immune responses to external compounds.
*If you feel worse on these foods, consult with a Functional Medicine practitioner as you may have other underlying issues that need addressing.
**This doesn’t mean forgoing handwashing with non-toxic soap, or essential food hygiene practices – these are still important for preventing the transmission of harmful species.
What has been your experience with allergies? Perhaps you’ve already taken steps to improve your allergies naturally? Let us and others know by commenting below.
Are Seasonal Allergies getting you down?
Discover how to comprehensively balance your immune system through food and living recommendations and targeted nutraceutical supplements, all within the DrKF Seasonal Allergy Relief Program. Our experienced team is also available to help you with personalized protocols and designing protocols for children.