Idedicatethisbooktomyfamily,myfriends,andmypatients.Thisbookwouldnothavebeenpossible

withoutyourlove,companionship,andconfidence.Thankyou.

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Contents

INTRODUCTION

1 AllergiesAreontheRise

2 What’sCausingYourAllergies

3 What’sHappeningBehindtheSneezes:ThePhysiologyofAllergies

4 OntheOriginofSneezes:CommonAllergies

5 WhenGoodThingsGoBad:AllergiesandInflammation

6 PreventingAge-AssociatedInflammation

7 TippingtheScale:TheAdditiveEffectsofInflammation

8 FiringYourselfUp:AnxietyandInflammation

9 WhenFoodsDon’tAgreewithYou:DietandInflammation

10 EatingforYourAllergies

11 TreatingAllergiestheNaturalWay:SupplementsandHerbs

12 AnAntiallergyWayofLife:ThePoweroftheLittleThingsYouDoEveryDay

13 WorkingOutYourAllergies:ExerciseandtheAllergicResponse

14 CountdowntoanAllergy-FreeYou:The4-WeekAllergySolutionPlanACKNOWLEDGMENTSENDNOTES

Introduction

ASANATUROPATHICDOCTOR, I walk intomy office each day armedwith natural ways to help people help themselves and their loved ones leadhappier,healthierlives.AndIhavetosay,IlovewhatIdo.

Inthemidstofthislaboroflove,about5yearsago,IstartedseeingmoreandmoreallergypatientsinmyArizonapractice.ManyofthemadmittedtohavingmovedtoArizonabecausetheyhearditwas“theplacetolive”toeaseallergies.But after amonth or two of fewer sniffles and sneezes, just as these patientswere getting used to their new desert environment, their allergies seemed toreturn and settle in full time. Many of them had tried various conventionalallergymedications,buttonoavail.Nothingtheirdoctorsprescribedworked.

WhatInoticedabouttheseallergypioneerswasthat,inadditiontoallergies,they frequently had other health concerns. They suffered from heart disease,wereoverweight,haddiabetes,orstruggledwithotherhealthproblemsthatwerewell-established diseases of lifestyle. (Lifestyle diseases are conditions peopledevelopwhentheyeatunhealthydiets,don’texercise,orhavetoomuchstress.)I began to think thatmaybe therewasmoreof a connectionbetweenallergiesandgeneralhealththanwe’dpreviouslythought.

So, Ididsomeexperimenting. I tried to treat thesepeople’sallergiesusingnaturalmeans.Modernmedicineisallaboutusingpills,sprays,drops,andevenpainfulshotstotreatallergysymptoms.Butveryfewofthesemedicationstreatthe causes of allergies, so symptoms continue to return. To try and break thecycleandpullfolksoutofthesedownwardallergyspirals,sotospeak,Itreatedthemholistically.

My findings?Healthful eating and hydration practices, the right herbs andsupplements,properweightmanagement,andavoidanceofstressandanxietyallworked wonders. The people who took my advice got healthier—not just intermsoftheirallergysymptoms,butacrosstheboard.

Since then, equipped with what I’ve learned about treating allergiesnaturally, I have created an easy-to-follow plan that you, too, can use to easeyour seasonal allergies—without having to make a single trip to your localdrugstore.Usingmythree-prongedapproach—foods,supplements,andexercise—you can say goodbye to the pesky runny nose, scratchy throat, and allergy

shots for good!As a bonus, if you followmy advice, you’ll be less likely todeveloponeofthechroniclifestylediseaseskillingsomanyAmericanstoday—cancer,diabetes,orheartdisease.

As a result of my work, I have become known in the naturopathiccommunityasanallergyguru.EverywhereIgo,peopleaskme,“Howcanyouhelpmewithmyallergies?”Using thisbook, Iamspreading thewordfarandwide:With the right natural remedies, you can escape your allergy downwardspiral, reverseyourallergic tendencies, andwardoffother lifestylediseasesatthesametime.

THEPROBLEMOFRISINGALLERGIES

Thereareatonofallergiesoutthere,andit’sonlygettingworse.Globally,30to40 percent of people now suffer from allergies such as rhinitis, asthma,anaphylaxis, and food and drug allergies, and cases are increasing fastest inchildren.What’sparticularlyscaryisthatwe’renotjustbecomingmoreallergicto respiratory allergens like pollens and grasses, we’re also becoming moreallergic to everyday things in our environment, frompaint on thewall to newfoods. Places likeArizona, once considered to be safe havens for peoplewithallergies,nowseesufferersinrecordnumbers.Andpeoplewhoneverbeforehadseasonal allergies now find themselves filling prescriptions for allergymedications.

Why? There are multiple theories, from a too-sterile society to unhealthydiets to pollution. (This book will delve into these and other possibleenvironmentalcausesinmoredetail).Andthenthere’stheroleofwhat’sgoingoninsideyourbody.Afterall,it’snotonlyenvironment,butalsolifestyle,thatpredisposesyoutobecomingallergic.

One of the key inside-the-body factors is inflammation. So many of thediseases thatplaguepeople today—diabetes,obesity,heartdisease,andcancer,justtonameafew—areinflammatoryinnature.Allergiesarealsotheresultofan inflammatory cycle. In fact, the allergic response and inflammation sharesome of the same chemical messengers; therefore, too much inflammationcoupled with too much of an allergic response can cause an exaggeratedresponse.Inshort, ifyourbodyisalreadyinastateofinflammationwhenyouenter allergy season, you’re likely to bemoremiserable than the noninflamedguy.Andon the flip side,byvirtueofhavingallergies,youmaysufferworsesymptomsofotherhealthconditionswhenallergyseasonhits.

WHYTREATALLERGIESNATURALLY?As a naturopathic physician, of course I gravitate toward holistic, naturalremedies. I have nothing against conventional medicine; it saves lives,undoubtedly.ButI think therearesomeinstancesaswellascertainconditionsthatpeopleshouldn’t—orwouldrathernot—treatwithconventionalmedicines.Basedonmyexperience,Ibelievesomeallergiesshouldbetreatedholistically.

Becausewe’rebecomingmoreallergicasasociety,we’dbefoolishtothinkthatwe’renotgoingtoseeincreasesinthenumberofchildrenandadultswhoare allergic to medications. When we throw medications at people who arehighly allergic to other substances in their environments, there will likely bemore allergic reactions and adverse drug reactions because these people arealreadyallergyprone.

Also,Ithinkit’sbesttosavemedicationsforwhenyouorsomeoneyouloveisreallysick—when,Godforbid,youreallyneedthem.Thiswillmaximizetheeffectivenessofthosemedicationswhentheneedforthemismostdire.Usinganapproach to treat your chronic allergies that doesn’t rely on medical dosagesgivesyouarealadvantage.

HOWTOBREAKFREEFROMSEASONALALLERGIESFORGOOD:INTRODUCINGMYPLANUsingtheplanoutlinedinthisbook,youwillbeabletoreversenegativecyclesofallergyandinflammationwithnatural,nontoxictreatments.Myplanisacorelifestyle program, fine-tuned for allergy sufferers like you. By “lifestyleprogram,”Idon’tmean thatyouwillhave to liveonwheatgrass. It’ssimplyaholistic,healthyapproachtoliving.

Herearethemaincomponents.Good food.Eatingwell doesn’t justmeaneating lotsofvegetables; it also

means limiting junk food. A healthy diet includes foods that naturally reduceinflammation and/or the allergic response, such aswatermelon, green tea, anddarkchocolate.

Herbs and supplements. There are a number of natural herbs andsupplementsthatcanreducetheinflammationcausingyourallergiesandlessenallergysymptoms’ impactonyourdaily life.Examples includestingingnettle,bromelain,quercetin,andfattyacids.

Physical activity. Put simply, our bodies are meant to move. We’re notdesignedtositinfrontofourcomputerscreensandtypeallday,butthat’swhatmanyofus—myselfincluded—do.Andwhenwedon’tdowhatourbodiesareintended to do, we see adverse effects. A healthy lifestyle means makingexerciseaprioritynearlyeverysingleday.

Leadinganeasierlife.Inadditiontothethreecomponentsabove,thisbookwill help you examine the roles of anxiety, stress, and adequate sleep inallergies, aswell as teachyou thebestways to relax and sleepwell forbetterhealth.

Inshort,withthehelpofthisbook,youwillbeableto:• Discoverwhichfoodsandsupplementscaneliminatetheeffectsofyourseasonalallergies

• Learnspecificexercisestocombatyourallergysymptoms• Gainthepeaceofmindofknowingthatyouwillbeahealthierpersonandwon’tbedestinedtoalifeonallergymedications.

Guidedbymy easy-to-followplan, not onlywill you learn how to controlyour allergies naturally, without medications, but you’ll also learn how toimproveyourlifestyleandbecomeahappier,healthierperson.Ilookforwardtotakingthisjourneywithyou.

Let’sgetstarted!

1AllergiesAreontheRise

THERE’SNOQUESTIONABOUTIT:Allergiesareskyrocketingacrosstheworld,especiallyinindustrializedcountries.

AsIthinkabouttheincreasingrateofallergies,aparticularpatientsticksoutinmymind:About2yearsago, I sawayoungboywhowoulddevelop large,swolleneyesandveryswollenlipswheneverhewasinhisbedroom.Hisparentswere smart people and had tried eliminating all of the common possible foodallergens. I also did laboratory testing to see if maybe he was allergic to thefamilydogorcatoranothercommonhouseholdallergen.Allofthetestscameback reporting the same thing: The boy’s reactions could not be traced to acommonallergy.

Puzzled,theboy’sparentsandIzeroedinonwheretheboymostfrequentlyexperiencedsymptoms.Wedetermined that theymostoftenoccurredwhenhewassittingathisdeskinhisroom,completinghishomework.Therewasnothingunusual about this space; he had pens, paper, pencils, and erasers—all thenormal stuff youwould find on a school-aged boy’s desk. But he also had asmall fishbowl that contained one Siamese fighting fish. It was actually hisbrother who suggested that maybe the fish was causing the reaction. It washighly unlikely that this boy would be allergic to a fish, especially oneswimminginabowl;butthebrother’stheorydidgettheballrollingintherightdirection.Ieventuallydiscoveredthattheboyhadanallergytothebloodwormshefedtohisfisheachnight.

Granted, thiswasanunusual case.Nine timesoutof10, it is thecommonallergens—pollen, dust mites, pet dander, ragweed—that cause reactions. Butthisboy’scasehighlights thatyoucanalsobeallergic to themostunexpectedthings.

THEORIGINSOFMYCLINICALFOCUSONALLERGIES

Allergies have been around since the dawn of pollen itself, but they areundoubtedly becoming more common. (There are many theories as to why,whichwewillexploreinChapter2.)Theaeroallergensreportrecentlyreleasedby the US Environmental Protection Agency (EPA) found that half of allAmericansnowsufferfromsomesymptomswhenexposedtoairborneallergenssuch as ragweed, pollen, or dust.1 According to the American College ofAllergy,Asthma, and Immunology (ACAAI), each allergy season seems tobesubsequentlyworsethantheonebefore,anindicationthatseasonalallergiesareon the rise.2 And not only are we seeing more people allergic to commonallergens,allergiestouncommonthings—paintonthewalls,foodsnottypicallyallergenic,andyes,bloodworms—arerisingaswell.

So it should comeasno surprise that about5years ago, I started seeingadramatic increase in the number of allergy patients coming into my office.Thanks to thedry climate, lowmold levels, and shorterbloomingperiods, theSouthwestwasforalongtimeconsideredasafehavenforallergysufferers;somany people moved here in hopes of easing their symptoms. (Of course, thepicturesquesceneryandbrightsundidn’thurt,either.)3

Fromthesepatients,Irepeatedlyheardthesamestory:“WhenIfirstmovedtoArizona,Iwasokayforawhile.Butthenmyallergiesjusttookoff.WhatwasonceamonthortwoblockoftimewhereIhadallergicsymptomsisnowyear-round.Andmyallergiesdon’tseemtobeimproving.Mydoctorhasputmeonseveralmedications,butnothingworks.”

After seeing more and more of these patients coming into my office,desperate for relief after their medications had failed them, I became veryinterestedintreatingallergiesnaturally.Itriedusinghealthfuleating,hydration,weight management, relaxation techniques, and herbs and supplements astreatmentprotocols.Iwaspleasedtofindthatthesetreatmentsworkedverywell,notjusttocureseasonalallergies,butalsotohelpthepatientsbecomehealthierindividualsoverall.

Today, about 60 percent of my patients have some sort of allergy orsensitivity, andmost of them respond extremelywell to thenatural treatmentsandlifestyleinterventionsIprescribe.Asyoureadonandstarttofollowtheplanoutlinedinthisbook,you,too,canlookforwardtoahealthier,happierlife,withfewersniffles,sneezes,andhives.

THEGROWINGALLERGYPROBLEM

Allergies are one of the fastest-growing chronic health problems in theworld.AccordingtotheAsthmaandAllergyFoundationofAmerica(AAFA),about50millionAmericans—or1in5—sufferfromallergies.Brokendown,thenumberslooklikethis:

• About8percentofAmericanadultshavehayfever• About13percentofadultshavesinusitis• About8percentofchildrenhavefoodallergies,andnearly38percentofthosehaveahistoryofseverereactions4

Allergiesalsotendtooccuringroups,hittingvictimsfrommultipleangles.Childrenwithfoodallergiesaretwotofourtimesmorelikelytohaveasthmaorotherallergiesthanthosewhodonothavefoodallergies,forexample.AndtheAAFAreports that30percentof the15millionpeoplewithasthmacanblametheirwheezinganddifficultybreathingonallergies.5

Wewill explore thephysiologymoredeeply inChapter3, but put simply,allergies are an overreaction of the immune system to substances in theenvironmentthatdon’tcauseareactioninnonallergicpeople.Thesesubstances,whichmay includepollen,dust,mold,orotherproteins,arecalledallergens.14Almost anything can cause an allergic reaction, and as evidenced by thealarming increase inallergyratesworldwide,wearebecomingmoreandmoreallergic.

The most common allergies result from pollen, dust, food, insect stings,animaldander,mold,medications,andlatex.Anyoftheseoffenderscansparkarangeofsymptomsaffectingnumerousareasofyourbody:yournose,sinuses,ears, throat, skin, lungs, and stomach. Some allergic reactions, like occasionalsneezingandrunnynose,arejustannoying.Butmoresevereresponses,suchasswellingoritchyrashes,caninterferewithwork,sleep,anddailyactivities.Andother reactions, such as anaphylaxis from food allergies, can be life-threatening.15 Nomatter what the cause or the specific reaction, no one whosuffersfromallergieswilldenythattheycantakearealtollonyourqualityoflife.

TheFoodAllergyEpidemicOneofthemostalarmingtrendsrelatedtotheriseinallergiesisthegrowingthreatofallergiestofoods.AccordingtoFoodAllergyResearchandEducation(FARE),anonprofitorganizationformedin2012asamergerbetweentheFoodAllergyandAnaphylaxis

NetworkandtheFoodAllergyInitiative,1in13childrenunderage18hasafoodallergy.

Thisequals2kidsineveryschoolclassroomtoday.6

Foodallergiesareconcerningbecausetheycanleadtothepotentiallylife-threateningwhole-bodyreactioncalledanaphylaxis.Thebiggestfearofeveryparentofachildwithafoodallergy,anaphylaxisinvolvesdifficultybreathing,swellingofthelipsandthroat,and,

potentially,death.7

Oneofthemostsevereandpotentiallylife-threateningfoodallergies—peanutallergy—isalsoontherise.AstudybyScottH.Sicherer,MD,professorofpediatricsandchiefoftheDivisionofAllergyandImmunologyattheJaffeFoodAllergyInstituteatMountSinaiSchoolofMedicineinNewYorkCity,foundthatpeanutallergieshaddoubledinAmericankids

between1997and2002.8Whentheylookedatthedataagainin2008,peanutallergyrates

hadtripled!9ResearchdoneinCanada,Australia,andtheUnitedKingdomhaveshownsimilarincreases.IntheUK,forexample,hospitaladmissionsforfoodallergieshavegone

up500percentsince1990.10

Andnotonlydomorechildrenhavefoodallergiesbutalsotheytendtobeallergictomorefoods.Inthepast,achildwithfoodallergieswastypicallyallergictoone,maybetwo

foods.Today,kidsaretypicallyallergictothreeorfourdifferentoffenders.11

Asaresult,teachers,administrators,andschoolnursescarrydevicestoinject

epinephrinesotheycansaveanallergicchild’slifeatanytime.12Classroomwallsdisplaylistsofkids’foodallergiesnexttotheirartwork.Nonediblepartyfavorshavereplacedcupcakesatbirthdaycelebrations,outoffearofexposinganallergicchildtoevenatraceofapeanut.Andexpertsintheallergyfieldbelievethatfoodallergiesareactually

underreported,sotheproblemisprobablyevenworsethanwethink.13Therefore,risingfoodallergiesareamajorhealthconcern.

Therearenowbloodtestsavailablethatcandeterminewhetherachildhasanallergytopeanutsthatwillproduceananaphylactic-typereactionoronethatwillnotbelifethreatening.Thetestsarewidelyavailableandarereferredtoascomponenttesting.Ifyouhaveachildwithknownorsuspectedallergies,youshouldaskyourpediatricianaboutthistypeoftesting.Knowingtheseverityofyourchild’sallergycouldreallyputyourmindateaseandalsopotentiallysaveyourchild’slife.

RISINGALLERGIES:THENUMBERSSPEAKFORTHEMSELVESThenumberofallergysufferershasbeensteadilyrisingfordecadesworldwide.According to the American Academy of Allergy, Asthma, and Immunology(AAAAI), allergies have been on the rise in industrialized countries formorethan50years.16Andallergyratesaren’tjustincreasing,theyareaccelerating.Amajor study by Quest Diagnostics found that overall sensitization rates forallergiesroseby6percentbetween2005and2008.Increasesinsomeindividualallergies are evenmore dramatic.Mold sensitivities, for example, rose by 12percent, and ragweed sensitivities increased by 15 percent during the same 3

years.17What’sparticularly troubling is therateatwhichallergiesare increasing in

children.Worldwide,40 to50percentofschoolchildrennowhavesensitivitiestoatleastoneallergen.That’snearlyoneoutofeverytwokids!Asanimportantnote, I see more adults than children in my practice, but I think that it’simportant to raise the issue of allergies in children. A lot of the research onincreasingallergieshasbeendoneonchildren,but these study findings reflectsimilar increases in adults. Plus, allergic children are much more likely thannonallergicchildrentobecomeallergicadults,sotherisingratesinchildrenareaconcernforpeopleofallages.Recognizingtheseriousnessofrisingallergiesinchildren,theU.S.CentersforDiseaseControlandPrevention(CDC)recentlytook a careful look at the numbers. Their National Health Interview Surveyfound that between 1997 and 2011, both food and skin allergies increased inchildren under age 18. And although there was no increase in respiratoryallergies in children, they remained themost common types of allergies, at ahigh17percentbetween2009and2011.18

Breaking itdownfurther, theCDCalsofound thatskinallergies rose from7.4percentbetween1997and1999to12.5percentbetween2009and2011.Andinchildrenuptoage17,foodallergiesincreasedfrom3.4percentbetween1997and1999to5.1percentbetween2009and2011.19

Researchersalsodiscoveredthatwhilesomeallergiesfadewithage,othersgetworse.Aschildrengetolder,skinallergyratesgodown(from14.2percentinchildrenfrombirthto4yearsoldto13.1percentinchildren5to9andfinallyto10.9percentinchildren10to17).Respiratoryallergies,ontheotherhand,getworsewithage, increasing from10.8percent inchildren frombirth to4yearsoldto17.4percentinchildren5to9andto20.8percentinchildren10to17.20Sothesoonerinlifeweniptheseallergiesinthebud,thebetter.

AreAllergyRatesRisingwithIncome?Interestingly,whenyoulookatallergystatistics,asincomelevelsrise,sodoallergies.Childrenwithfamilyincomesgreaterthanorequalto200percentofthepovertylevelhavethehighestratesoffoodandrespiratoryallergies.Here’sabreakdown.

• Inchildrenwithhouseholdincomesthatarelessthan100percentofthepovertylevel,14.9percenthaverespiratoryallergiesand4.4percenthavefoodallergies.

• Whentheincomelevelrisestobetween100and200percentofthepovertylevel,15.8haverespiratoryallergiesand5percenthavefoodallergies.

• Infamilieswithincomelevelsgreaterthan200percentofthepovertylevel,18.3percentofchildrenhaverespiratoryallergiesand5.4percenthavefoodallergies.21

Racealsoseemstoplayarole,butnooneissurewhy.Hispanicchildrenhavelowerratesoffood,skin,andrespiratoryallergiesthankidsofallotherracesandethnicities.Blackchildrenaremorelikelytohaveskinallergiesthanwhitechildren(17.4percentinblacks,comparedto12percentinwhites).However,blackchildrenarelesslikelythanwhitechildrentohaverespiratoryallergies(15.6percentinblacks,comparedto19.1

percentinwhites).22

Thesenumbersmaymakeitlooklikeincome,race,andallergyriskarerelated,butIdon’tthinkmoneyorracearetrulycausingthesedisparities.Foronething,thestudydonebyQuestDiagnosticsfoundthateconomicallydisadvantagedchildrenare18percentlesslikelytobetestedforallergiesbytheageof5thanchildrenwhoseparentshaveahigherincome.Therefore,thesechildrenmaynotactuallyhavefewerallergies—theyjusthave

fewerallergiesthathavebeendiagnosed.23Ithinktherealreasonbehindthesedifferencesismoreamatterofbetterprotectionin

peoplewholiveamoreagrarianlifestyle,whereagricultureisafocus.Afterall,scientistshavefoundthatchildrenwhogrowuponafarmorwholiveinafamilywithatleastone

othersiblingarelesslikelytohaveallergies.24Asincomelevelgoesup,peoplearelesslikelytoliveonfarmsortohavelargefamilies.Theyaremorelikelytohaveahousekeeperwhocomesinandscrubstheentirehouseandtosendtheirkidstoadaycarewheretheyprovidehandsanitizerfourtimesaday.Clearly,besidesincomeandrace,thereareotherthingsatplay,whichwewillexploremoreinChapter2.

WhyAreAllergiesSuchaProblem?On a day-to-day level, an allergy may force you to carry extra tissues or anEpiPenincaseofanemergency.Butallergieswreakhavoconabroaderscaleaswell,bothonourbodiesandonoursocietyasawhole.

Perhapsmostimportantly,andthisisoneofmybiggestreasonsforwritingthisbook,Ibelieveallergiesare linkedtosomeof thebiggesthealththreats inthe United States—obesity, diabetes, and heart disease. Many of my patientswhocome incomplainingofallergiesalsohaveoneormoreof these lifestylediseases,whichare currently the leadingcausesofdeath inAmerica.Amajorculpritbehindallofthesechronicconditions,allergiesincluded,isinflammationin the body. When people eat unhealthy diets full of processed foods, avoidexercise, and live a stressed life, they are setting the stage for excessiveinflammation. The more inflammation someone has in his or her body, thegreater the potential for allergies and the greater the likelihood of developingotherchronichealthconditions.

There’s also a strong connection between allergies and asthma, a chronicdisease that causes inflammation in the airways. If you have asthma, airborne

allergensarelikelytriggersforanattack.25In addition to the toll they take on health, allergies also cost billions of

dollars per year in medical treatments and lost productivity. The three mostcommonallergicconditions—hayfever,asthma,andeczema—ranksixthamongexpenditures for chronic health conditions, and allergy treatment as a wholecosts$21billionayear.26Employeeswithallergiesmissanaverageof1.7daysof work due to their symptoms and deal with these symptoms for nearly 10weekseachyear.Thisequalsatotalof4millionsickdaysandmorethan$700millioninlostwagesandprofits.27Withthesetollsinmind,it’sinallofourbestintereststoeliminateallergies,onceandforall.

CommonTheoriesBehindtheAllergyExplosionWithall of thesenumbers and facts inmind, thebigquestion looms:Why theincrease in allergies?We know that inflammation plays a role, but we don’tknowexactlywhat’sfuelingthatinflammation.Scientistshaven’tuncoveredanydefinitiveanswers,buttherearelotsoftheories.

Ibelievetheansweristwo-pronged,withonecausebeingourenvironmentand the other being our lifestyles. Here’s a brief overview of the theoriessurroundingthesetwoprongs.WewillexploretheseinmoredetailinChapter2.

CAUSE1:ENVIRONMENTPollution. Experts subscribing to this theory think that pollution is a majorcontributor to increasing allergiesworldwide.28 InArizona and the SouthwestUnitedStatesingeneral,theairusedtobemuchcleaner,butthat’snolongerthecase.IrecentlyreadanarticlethatlinkedchildrenplayingoutsideinthestateofCalifornia(whereairpollutionisabigproblem)toahigherriskofdevelopingallergies.Itsoundstotallyinsane,butit’sprobablytrue.

That said, I’m not sure those kidswould be any better off playing inside.“Pollution”isaverybroadterm.It’snotjustthesmogintheairyoubreatheonyour daily commute but also what you’re eating in your food, what you’reingestingwithyourcosmeticsandpersonalhygieneproducts, andwhatyou’reinhalingfromthematerialsusedtobuildyourhousethatputyouatanincreasedriskforillnessandallergy.

Globalization. Our horizons are expanding too far: The world is gettingsmaller. As a result, environments are changing. So the theory here is that

globalization isbringingforeigndietsandmoreexoticproducts intoourstoresand kitchens, and this may contribute to allergies.29 A century ago, my fish-owningyoungpatientmostlikelywouldn’thavehadaccesstothebloodwormshefeedshisfish,andtherefore,heneverwouldhavereactedtothem.

Arizonaisaprimeexampleofthisshrinking-worldphenomenon.Phoenixisstill dryandhotwithbeautiful scenery,but it’s adifferentplace than itwasafewdecadesago.Wherethereusedtobejustdesertandsand,peoplenowhaveplantsfromallovertheworldgrowingintheirgardens.Therearegolfcoursesoneveryotherblock,withsprinklersconstantlykeeping thegreens lush.Also,airpollutionlevelsareextremelyhigh.30Asaresult,“theplacetogo”forallergysufferersnowhasoneofthefastest-growingallergyratesinthecountry.31

The hygiene hypothesis. Formost of our evolution,we have had a closerelationship with dirt, pollen, and microbes. Now that we’ve emphasizedremoving ourselves from the natural world, we’ve eliminated a lot of thesebackground germs with antibiotics, hand sanitizers, and cleaning products.Consequently, when exposure does occur, the immune system doesn’t knowquite how to respond appropriately. As a result, your body can produce aninflammatoryresponse,whichinturncanheightenyourchancesofdevelopinganallergy.32Researchhasshownthat theyearsuptoage5areveryimportantfor immunesystemdevelopment.Untilchildrenreachthatpoint, it’s importanttofindtherightbalancebetweencleanlivingandhealthyliving.(Inmyopinion,kidsaremeanttogetdirty.)

Climate change. This theory states that global warming and resultingincreases in carbon dioxide and precipitation create more pollen. Plants usecarbondioxidetoproduceenergythroughphotosynthesis,socarbondioxideactslikeaplant fertilizer.Warmer temperaturescauseplants togrowfaster,bloomearlier,andproducemorepollen.Morepollen,inturn,canleadtomoreseasonalallergies.33,34

CAUSE2:LIFESTYLEStress.Toomuchstressdestroysour immunesystems.Ourbodiesaren’tbuiltfor long-term,unrelentingstress. Instead,we’rewiredforshortburstsofstressfollowedbylongperiodsofrestandrelaxation.

Imaginebeingahuman5,000yearsago.Mostofyourtimeisspentlookingforfoodandpickingfleasoffyourfamilymembers.Everynowandthen,asyouwalk through the woods, a big bear pops out and starts chasing you. At this

point,youhavetwochoices—runorfight(i.e.,thefight-or-flightresponse).Thestress hormones start flowing; epinephrine puts your body on high alert. Allavailable resources are directed toward running or fighting. Digestion andassimilation, immune function, and all other nonessential operations aresuspendeduntilthecoastisclear.Inmostcases,escapingfromthebeartookarelativelyshortperiodof time,andpretty soonyouwereback topicking fleasoffyoursister.

Now think about our fast-paced society.We’ve flip-flopped our stress andrelaxationtimes;younowhavelongperiodsofsustainedstressmorefrequentlythanyoudon’t.Asaresult,yourbodyfeels like it’sconstantlyrunningfromabearinthewoods(orreactingtoacellphoneringinginyourpocket).Accordingtothistheory,yourbodyisalmostconstantlyinastateofhighalert,expendingresources reacting toward the perceived emergencies. This sustained stressresponse can deplete your body’s resources.When you combine thiswith theunhealthydietswetendtoeatandourpoorsleephabitsandlackofrest,we’remuchmorevulnerabletodevelopingallergiesandotherhealthproblems.

Unhealthy diet. The Standard American Diet, or SAD, is not a health-promotingdiet—it is sad in the true senseof theword. It’s toohigh in sugar,saturatedfat,andprocessedingredientssuchastransfats—allthethingsthatcancreate excess inflammation in your body and make you more vulnerable toallergies. The SAD also robs your body of the vitamins, minerals, andantioxidantsitneedstoprotectitself.Forallofthesereasons,anunhealthydietincreasesyourriskofallergies.

Additionally,thereisatheoryinthemedicalcommunity—andsomestudiestoback itup—that the foodsanddrinksawomanconsumesduringpregnancyhelp determinewhether or not her childwill have allergies, both in childhoodandlaterinlife.Studiesshowthatsomefoods,suchasmargarineanddietsoda,increasetheriskofallergiesintheunbornchild.Otherfoods,suchasfishrichinomega-3fattyacids,helpprotectthechildagainstallergies.35,36

Nutrient deficiency. The theory here is that we’re undernourished andliterallystarvingforgoodnutrition.Forexample,over thepast15 to20years,lackofvitaminDhasbeenincreasinglyrecognizedasariskfactorforallergiesand other conditions.37 I testmost ofmy patients to evaluate their vitaminDlevels,andmostofthemaresuboptimal.Manypeoplethinkthattheyaregettingenoughfrombeinginthesunorfromtakingmultivitamins,butthisisapparentlynotthecase.Peopleneedmoreofit,forsure.

Forexample,a2013studypublishedintheAmericanJournalofRhinology

&Allergy found that Taiwanese patientswith chronic rhinosinusitis and nasalpolyposis were more likely to have low vitamin D than those without thecondition.ThisshowsapotentiallinkbetweenallergicrhinitisandlowvitaminD.38

All of the aforementioned theories have some merit. But we still lack adefinitive explanation for the rise in allergies at this point. The true reason islikelyacombinationofouroverlysterileenvironments,constantexposuretothetoxins in our increasingly pollutedworld, our habit of eating unhealthy foods,andouroverlystressfullivesthatultimatelysubtractfromourgoodhealth.

The explanations surrounding allergies may be in part theoretical, but thelifestyle changes you can use to prevent and treat allergies—the changes I’veseenmakesuchanamazingdifference inmypatients,andtheonesIwillgiveyou in the chapters that follow—are not. They are based on sound medicalresearch, andevenbetter, theyareachievablebyeveryone.So let theultimateseasonalallergysolution—andyourjourneytobetterhealth—begin.

Carlo’sStoryBeforeseeingDr.Psenkaforhisallergies,Carlo,a32-year-oldhairstylist,couldn’tbenearhiscatwithoutdevelopinganitchyneck,itchyeyes,sneezing,andshortnessofbreath.“Iamveryallergictocats,”hesays.

CarlotriedtakingBenadryltocontrolhissymptoms.“ButIdidn’tlikehowIfeltwhenItookit,”hesays.Notwantingtogiveuphispet,CarlodecidedtoseeDr.Psenka—andtodayheisveryhappyhedid.

InthemiddleofhistreatmentwithDr.Psenka’sall-naturalplan,Carlostartednoticingamarkedimprovementinhisallergy.“WhenIamaroundthecat,evenwhenheissittingrightnexttomeonthecouch,IamnotsneezingoritchingnearlyasmuchasIwas,ifatall,”hesays.

Carlohasbeenvegansince2010,sohiseatinghabitsdidn’tchangemuchunderDr.Psenka’sguidance.Butthesublingualimmunotherapy(SLIT)Dr.Psenkaprescribedhasmadeabigdifference.“IwishIwouldhaveknownaboutSLITearlier,”hesays.

Hehasalsolostafewpounds.“Overall,I’vebeenfeelingmuchbettersincestartingthetreatment,”Carlosays.Andbecausehedoesn’tworryaboutthecatbeingaround,Carlosayshisstresslevelhasgonedown.

Overall,afterseeinghiscatallergyclearuprightbeforehiseyes,CarlosayshewouldreferanyonewithseasonalorotherallergiestoDr.Psenka.

2What’sCausingYourAllergies

THE FIRST RECORDED ALLERGY appeared in an ancient Egyptianpublication in 3500BC. Fast-forward a few thousand years to 1906,when anAustrianpediatriciannamedClemensvonPirquetnoticedsomeoddsymptomsinhispatientsthathecouldn’tattributetoanyparticulardisease.Henamedthesesymptoms “allergy,” which is derived from twoGreek words: allos, meaning“other,”andergon,meaning“reaction.”

Despiteknowingof theirexistence for literally thousandsofyears,modernmedicinehasn’tbeenabletoeradicateallergies.Infact,they’remoreprevalentthanever.Studyafterstudyclearlyshowsthatmoreandmorepeopleareallergicto more and more things.What’s not so clear, however, are the reasonswhypeople throughout the world—especially those in developing nations—are somuchmoreallergicthantheywereonlydecadesago.

THEORIESBEHINDTHERISEINALLERGIES:ADETAILEDLOOKInChapter1,yougotanoverviewofsomeofthetheoriesonwhat’sdrivingtheincrease in allergies, including pollution, the hygiene hypothesis, unhealthydiets,poorlifestylechoices,andclimatechange.Inthischapter,you’llgetmorecomprehensiveinformationonthesciencefuelingthesetheories.

Whetherornotyouchoosetosupportthesetheories,onethemeiscommonthroughout:therapidshiftawayfromtheconditionsinwhichourhumanspeciesevolved. Consider this: For the grand majority of human evolution, our dietsweremuchdifferent than theyare today.Ourancestorsweren’texposed to thelevelsofsyntheticandtoxicchemicalsthatwearetoday.Theyalsohadalotlessstress and anxiety. Quite simply, the human body was not designed to runefficiently in themannermost humans do today—with high levels of anxietycombinedwithanutritionallydeficientdiet.

Becauseofthechemicalsweingest,theanxietywefeel,ourpoornutritional

status, and the unnatural shields we put around ourselves (think antibacterialsoapsandhandsanitizers),ourbodieshavebecomeconfused,overwhelmed,and—asaresult—chronicallyinflamed.Manyofthediseasesplaguingpeopletoday—heartdisease,cancer,anddiabetes,justtonameafew—arelargelydiseasesoflifestyleandarepromotedbyexaggeratedlevelsofinflammation.

Theinflammatoryprocessisatriggerforallergies,aswell.Infact,allergiesandinflammationsharesomeofthesamechemicalmessagingpathwayswithinyourbody.Whenyourbodyischronicallyinastateofheightenedinflammation,your immune system can become agitated and hyperreactive, promoting anamplified allergic response to new antigen exposures, potentially evendevelopinganallergytoasubstancethatwouldnothaveelicitedthisresponseiftheinflammationwasn’tpresent.

Thisexplanationaside,thescientifictheoriesbehindanincreaseinallergiesmayhelpyoubetterunderstandthepossiblereasonsfor theincreasedpotentialfor inflammation in your body and your potential to experience allergysymptoms.Here’samoredetailedlookatthesetheories.

PollutionAsmentionedinChapter1,pollutionmaybethesinglelargestcontributortotheincrease in allergies. Over the past 25 years, researchers have becomeincreasinglymoreinterestedintheeffectsofairpollutiononhealth,andthey’veuncovered some compelling links between pollution and increases in bothallergiesandasthma.1

OnestudypublishedintheJournalofAllergyandClinicalImmunology,forexample, found that children exposed to high levels of air pollution as infantswereabouttwotimesmorelikelytodeveloprespiratoryandfoodallergieslaterinlife.2,3

The most common air pollutants—ozone, sulfur dioxide, and nitrogendioxide—areprovenhazards topeoplewith allergies andasthma.Notonlydothese pollutants reduce lung function but also they irritate the airways andaggravateestablishedallergysymptoms.4

Other pollutants, called diesel exhaust particles (DEPs), actually have thepower to elicit allergic reactions, and there are a few reasons why. For one,DEPs are very tiny;more than80percent are classified as “ultrafine.”Due totheir small size, you can easily inhale them deeply into your lungs. Dieselexhaustalsoseems tosparkallergiesbystimulatingyourbody’sproductionofimmunoglobulin E (IgE), one of the antibodies produced by your immunesystem in response to allergens. (IgE iswhat triggers the release of histamineand other chemicals that ultimately cause allergic symptoms).5 Through theactionsofIgE,DEPscanmakeallergensmorepowerfulbyenhancingaprocesscalled mast cell granulation, through which mast cells release histamine.Because of this, pollens in areas heavily polluted with DEPsmay havemoreallergicpotentialthanpollensfloatinginareaswithlessairpollution.6

OnestudyfoundthatDEPscanmakeanallergen18timesmorepotentwhenitcrosses the lungmembranes—and this isat levels thatareconsideredwithintherangeofacceptableforhealthintheUnitedStates.IncitieslikePhoenixandLosAngeles,whichhavehighpollutionrates,peoplebreatheindieselpollutioneveryday,anditismakingtheirallergiesnearly20timesmoresevere.7

Airpollution containingDEPs isworst in industrialized,heavilypopulatedareas.Researchshowsthatthemoredevelopedanation,thehigheritslevelsofthese pollutants and the higher its allergy rates. Hay fever was rare in JapanbeforeWorldWarII, forexample.But today,as thecountryhasbecomemore

industrialized, hay fever is now common, especially in people who live nearcitiesandhighways.8NorthAmericaandEuropealsohavemuchbiggerallergyproblemsthanthird-worldcountries,andwithinthesedevelopednations,peoplewholiveincitieshavehigherratesofallergysymptomsthanthosewholiveinmoreagrarianareas.9Soclearlycities,andallthepollutiontheyproduce,areabigpartoftheproblem.

BeyondDEP and other outdoor pollutants, the definition of pollution alsoincludes indoor toxins. The additives and preservatives in food, the chemicals(suchasparabensandmethylparabens)intoothpasteandpersonal-careproducts,andthecarcinogensinsecond-handsmokecanbejustashealth-damagingastheenvironmentalpollutantsproducedbycarsandfactories.

The worst indoor pollutant is tobacco smoke; it has been shown to makeallergy and asthma symptomsworse in thosewho are exposed to it. Pregnantmothers who smoke are more likely to have children with allergic eczema.Additionally,kidswhohaveoneormoresmokingparentsareatahigherriskforrespiratoryillnessessuchasasthma,bronchitis,andchroniccough.10

Even if you don’t smoke, but you live with a smoker—or if you’re justcasually exposed—you can breathe in enough toxins from cigarettes to makeyou sick.Theparticles in tobacco smoke stick to clothing andhair, producingthatsmokersmell.Keepinmindthatifyoucansmellcigarettesmoke,eitherintheairoronsomeone,you’rebreathinginitstoxins.11

Besidestheobviouscigarettesmoke,there’sahostofotherhealth-detractingpollutants hiding inside our homes. If you can smell that new carpetingwhenyouwalkintoyourbedroom,forexample,youareslowlypoisoningyourselfasyoubreatheitinatnight.Ifyousmellthe“oceanbreeze”comingoutofaplug-inairfreshener,thestory’sthesame.(Thispleasantsmellcanhideoneormoreof a variety of unhealthy chemicals, including alcohols, esters, formaldehyde,limonene,andpetroleumdistillates.)Tomakemattersworse,manyhousesaretightly sealed these days, making it impossible for toxins to escape theywaytheydoinolderhomes.Thisleadstoanunhealthytoxicbuildup.

In addition to smaller-scale indoor pollution troubles, there’s somethingcalled sick building syndrome. This is a situation in which occupants of abuildingbecomeill,andtheillnessseemstobecorrelatedwithtimespentinthebuildingbutnospecific illnessorcausecanbeidentified.Peopleaffectedmayexperience a variety of symptoms, including headaches, dizziness, cough,irritatedthroats,andbreathingproblems.Irecentlymetamaninhisfortieswhohadbeenaprofessionalbodybuilderwhoneversmokedordrankandwhoatea

very healthy diet. He came into my office complaining of a recent onset ofheadaches,cough,andpoorsleep.Idiscoveredthathehadrecentlyrentedanewhomeandhis symptomshaddevelopedwithin justa fewweeksofmoving in.Hehasnootherknownhealthproblems,anditislikelyhisnewlivingspaceismakinghimill.

Thetake-homemessageisthatwhenitcomestopollutionandallergyrisk,bothoutdoorandindoorpollutantsareathreat.

TheHygieneHypothesisAccording to the hygiene hypothesis, a person’s immune system needs to“toughenup”earlyinlifebybeingexposedtoavarietyofantigens(microbes,bacteria, dander, etc.). In the past,most children lived in caves or ran aroundwith animals on farms,which allowed their immune systems to develop in anenvironmentfilledwithdust,dander,pollens,andsoon.Asaresultofthishighlevel of exposure to many different things in the environment, a person’simmune systemwas able to develop a tolerance tomany things. In a sense, itlearned that it didn’tneed to react to everything itwasexposed to.But today,kids in first-world countries grow up in ultra-clean environments full ofantibacterial soaps and bleach wipes. Granted, these modern advances incleanlinesshave savedmanypeople fromboutsof thecommoncoldandevensome deadly infections. But the trade-off comes in the form of confused,underexposed, hyperreactive immune systems that trigger allergic responses tootherwiseinnocentsubstancesaroundus.12

There’s research to support the hygiene hypothesis. In a study done atBrighamandWomen’sHospital inBostonandpublishedonline in the journalSciencein2012,scientiststestedthetheorybycomparing“germ-freemice,”ormice lacking bacteria or any other microbes, to mice living in a normalenvironment, complete with normal bacteria and microbes. The researchersuncoveredafewimportantfindings.Forone,theyfoundthatthegerm-freemicehadinflammation in their lungsandcolons that lookedlikeasthmaandcolitis.Thisinflammationwascausedbyabnormalactivityofaspecialclassofimmunecellspreviouslylinkedtobothasthmaandcolitisinmiceandhumans.Second,theresearchersfoundthatwhentheyintroducedmicrobestothegerm-freemiceduringthefirstfewweeksoftheirlives,thosemicedevelopednormalimmunesystemsandwereabletopreventdisease.Thiseffectwasnotseenifresearchersintroducedthemicrobestothemicelaterduringtheiradultyears.Therefore,thestudy results show that microbe exposure is important early in life and canprovidelong-lastingprotection,whichiswhatthehygienehypothesispredicts.13

I agree with the hygiene hypothesis in that I do think our overly sterilesociety contributes to increasing allergies. But I also think that timing isimportant,with“theearlier, thebetter”beingagoodmottoforbolsteringyourimmunesystem.

Here’showIlookatit:Whenyourmotherwaspregnantwithyou,youwere

in a nice, protected environment.A few ofmom’smicrobesmay have gotteninto your environment via the cord blood, but for themost part, itwas prettysterileinthere.Thenallofasudden,youcameflyingoutintotheworld.Evenbefore the moment you left your mother’s body, you were exposed to newmicrobes.Asyou traveled throughyourmother’sbirthcanal,youencounteredallkindsofbeneficialandsometimespathogenicbacteriaandyeasts.Thenyoumetallofthemicrobesflyingaroundinthedeliveryroomair.Althoughsterileby medical standards, the doctor and nurse were also covered with bacteria.Natureintendedforinfantstomeetallofthesenewmicrobesfromthedaytheywereborn.And thisonslaughtofexposure isnot just limited tonewborns,butcontinues as a child ages. Consider how often young children put things intotheir mouths. All of this exposure helps to develop and teach your immunesystem how to operate. In our society today, we’re fairly sheltered andgermaphobic,soourexposureisprettylimitedcomparedtothatofourancestors.

Comparethattomostofourevolution,wherepeoplelivedoutsideandrolledaround in the dirt—especially as children—and encountered microbes andpollensconstantly.Inthese“dirtier”times,thebodysawlotsofdifferentgerms,so the immune system developed a tolerance to them. But today, we’veeliminatedsomanybackgroundallergensandmicrobesthatwhentheydoshowup,yourimmunesystemdoesn’tquiteknowhowtoreact.

Ibelieveexposuretobackgroundmicrobesismostimportantduringthefirst5yearsoflife,whenyourimmunesystemisfeelingouttheworldandtryingtoadjust.Considerhowmanysmallchildrenpick theirnosesand taste it,despitetheirparents’attemptstostopthem.Nearlyeverysmallchildseemstodoit,andnobodyhastoshowthemhow;itjusthappens.Whatchildrenfindintheirnosesisdriedmucus,whichhastrappedairborneparticlessuchasdustandmicrobes.So,inessence,theyareinoculatingthemselves.

Inadditiontonose-picking,anotherfavoritetopicamongchildren—poop—mayhelpbolstertheimmunesystemagainstallergiesaswell.Onetheorylinkslow exposure to endotoxins, which consist of a family of molecules calledlipopolysaccharides(LPS),withhigherratesofallergies.LPSsaremoleculesonthe outer membrane of gram-negative bacteria. Kids who live on farms oraround animals get exposed to these endotoxins,which are contained in fecesandwhich seem to thenofferprotectionagainst allergies.Researchhas shownthatchildrenwiththehighestconcentrationofendotoxinsintheirmattressdusthave the lowest rates of hay fever, asthma, and allergen sensitivity. Similarly,kids who live in rural areas in southern Germany and Switzerland—where

samplesfromkitchenfloorsandmattressesareteemingwithendotoxins—haverelativelylowallergyrates.14

Fewer childhood infections may also be at play in rising allergy rates.Studies from a few different countries show that exposure to viral infectionsearly in lifemay be protective against allergies later on.Young kidswho arefrequentlyaroundothersickkids—eitheroldersiblingsorclassmatesindaycare—havelowerratesofallergiesandasthmaoncetheyreachschoolage.Childrenwhohavesufferedthroughanactualmeaslesinfectionhavehalftherateofdustmiteallergiesaskidsprotectedbythemeaslesvaccine.Anotherinterestingfactis thatbabiesbornpreterm,which isoften the resultofabacterial infection inthemother,15 tend to have lower rates of eczema than full-termbabies,whichmaymeanthatthebacteriaexposuretheygotsoearlyinlifehelpedprotectthemagainstskinallergieslateron.16

Inadditiontoalackofinfections,anotherelementtothehygienehypothesisis our use—or overuse—of antibiotics to combat these infections. It’s true—antibioticshavesavedmanylivessincetheywerefirstdevelopedin1929.17Butwe use them far too much. Some doctors in this country hand out antibioticprescriptionstoeverydesiringindividualwhowalksin,regardlessofwhetherornottheprescriptionismedicallyindicated.Theproblemwithantibioticsisthat,inadditiontokillingpotentiallydeadlybacteria,theyalsokillthe“goodguys”—theprobiotics,whicharemicrobesthathangoutinyourgastrointestinalsystemand help your immune system fight off invaders. Because disease-causingbacteria have been exposed to antibiotics so often, they are developing aresistance to these drugs and creating new “superbugs” that antibiotics can’teradicate.18

There are some researchers who support the hygiene hypothesis when itcomes to explaining the rise of allergies, and there are otherswho do not.19 Iagreewith thenotion thatweareway too sterile.Thereneeds tobeabalancebetweenhealthylivingandcleanliving.Insomeplaces,it’sprudenttousehandsanitizer—inpublicrestrooms,forexample.Butscrubbingdownwiththestuffevery15minutesislikelytakingittoofar.Weallneedtogetalittledirtynowandthen.Andweneedtoletourkidsgetalittledirtynowandthenaswell.Sodon’tbeafraidtoletyourkidsorgrandkidsplayinthedirt—bothforthesakeoftheirhappinessandfortheireventualimmunity.

TheStandardAmericanDietAs more people move away from farms and into cities, not only are theyencounteringfewerendotoxinsbutalsothey’reeatingfewerfreshfoods.Outofsight, out ofmind.20And in place of these nutrient-and antioxidant-rich fruitsandvegetables,manypeopleeattheStandardAmericanDiet(SAD).

Sad but true, the Standard American Diet is horrible. It’s terribly low innutrientsandhighinsugar,transfats,processedingredients,andotherchemicalsthatcanpromoteinflammationinyourbodyandpotentiallyleadtohigherlevelsofallergies.21Herearesomeofthemostimportantelements(andpitfalls)oftheSADwhenitcomestoallergyriskandoverallhealth.

• Omega-3EssentialFattyAcids.Onethingthat’swellestablishedinthehealthcommunityistheimportanceoftherightbalancebetweenomega-3andomega-6fattyacidsinthediet.Omega-3fattyacidsarepolyunsaturatedfattyacids.Yourbodyneedstheseomega-3sforimportantfunctions,andbecausetheyfightinflammation,theyalsoofferprotectionagainstheartdisease,cancer,andotherdiseases.Yourbodycan’tmakeomega-3sonitsown(hencetheir“essential”designation),soyoumustgetthemfromfood.Goodsourcesincludeoilyfish,walnuts,somegreenvegetables(suchasspinachandBrusselssprouts),andsoybeanandflaxseedoils.22

Omega-6fattyacidsarealsopolyunsaturatedfattyacidsthatyourbodygetsfromfood.Foodsourcesofomega-6sincludesoybean,safflower,corn,cottonseedoils,andredmeat.23Theproblemwithomega-6fattyacidsisthattheyarethebackboneofproinflammatorycytokines.Inotherwords,theyincreaseinflammationinyourbody.Omega-6saren’tbadinandofthemselves,butwhenyoueatthemoutofproportiontoomega-3s,theycanhavebadeffects.Mostexpertssuggesteatinga1:1or1:2ratioofomega-6stoomega-3s.Toogreataproportionofomega-6scanleadtoincreasedinflammationandallofthenegativityandallergyriskthatgoesalongwithit.

Toillustratetheimportanceofagoodomega-6toomega-3ratio,researchersattheAmericanSocietyforBiochemistryandMolecularBiologyfed27healthyadultsadietthatprovidedthegoal2:1ratioofomega-6toomega-3fattyacidsfor5weeks.After5weeksofeatingthis

way,theyfoundthatthelevelsofkeygenesthatpromoteinflammationweresignificantlylowerthaninpeopleeatinganormalAmericandiet.TheresearchersalsofoundthatlevelsofasignalinggeneforaproteincalledPl3K—whichisimportantforautoimmuneandallergicreactions—weremarkedlylowerinthepeopleeatingthehigheromega-6toomega-3ratioaswell.24

• Sugar.MostAmericanseatmassiveamountsofsugar.Infact,accordingtotheAmericanHeartAssociation,theaverageAmericanconsumesmorethantwicetheamountofrecommendedsugar—about22.2teaspoons,or355caloriesfromsugar—perday.(Therecommendationis100caloriesfromsugarperdayforwomenand150caloriesformen.25)

Sugaristoughtoavoid.Itisseeminglyineverythingthesedays,fromtheobvioussourceslikesodaandcandytothesneakieroneslikepastasauceandenergybars.Theproblemwithsugaristhat,overtime,largequantitiesofitcandamageyourpancreasandinflameyourbody.26Iamalsoseeingnonalcoholicfattyliverdiseaseinmypracticemoreandmorecommonly.Asthenameimplies,thisconditioncausesfatmarblingintheliverthatissometimesaccompaniedbymetabolicdysregulationandimpairedliverfunction.Eatingtoomuchfatandsugarcontributestononalcoholicfattyliverdisease,whichinitsmostsevereformcancauseaperson’slivertofail.

Asifsugarinitspureformweren’tbadenough,thesubstitutespeopleuseforsugarmaybeevenworse.Thecoaltarderivativeaspartame,forexample,turnsintoformaldehydeinyourbrain.Infact,itissuspectedthatmanyhealthproblemsarecausedbyaspartame,includinganimbalanceintheantioxidant/pro-oxidantstatusinthebrain.27ImbalancesincertainbrainantioxidantshavebeenlinkedtoAlzheimer’sdiseaseandotherage-relateddiseases.28

• Processedfoods.Sure,they’reconvenient.Youcanpopafrozenblockoffoodinthemicrowaveandhaveahotmealin3minutes.Butthisconveniencecomesatabighealthcost.Ihavetosay,Ithinkprocessedfoodsaretheabsoluteworstfoodspeoplecaneat.Forone,theycontainallsortsofchemicalsmeanttoincreasetheirshelflifeandmakethemtastebetter,includingsulfites,monosodiumglutamate(MSG),andnitrites.Theseadditivescancauseallergicreactions,andtheyalsocontributetoinflammationandahigherriskofallergies.29Someofthechemicalsadded

toprocessedfoodswillabsolutelyastoundyou.Recently,ithascometolightthatamajorfast-foodcompanyservesbreadthatcontainsachemicalusedtomakeyogamats.30

Sulfites,foundinwine,driedfruits,andfrozenpotatoes(amongotherfoods),causemildtolife-threateningreactionsinabout5percentofpeoplewithasthma.Butylatedhydroxytoluene(BHT),anadditivefoundinsomecerealsandgrainproducts,hasbeenlinkedtochronichivesandotherreactions.Tartrazine,adyeusedincandy,desserts,saladdressings,beverages,andprocessedcheese,hasbeenshowntocausehivesandswelling.Nitritesinhotdogs,bacon,andotherprocessedmeatsandfishcancauseheadachesandhives.MSGcancauseChineserestaurantsyndrome—headache,chesttightness,nausea,anddiarrhea.31It’snotjustsyntheticfoodchemicalsthatcauseproblems.Whilebeingnatural,red(carmine)andyellow(annatto)foodcoloringshavebeenlinkedtotheserious,potentiallydeadlyallergicreactionanaphylaxis.32

Processedfoodsarealsoloadedwithtransfats—byfartheworstfattype.Alsoknownastransfattyacidsorpartiallyhydrogenatedoils,transfatsareman-madefatscreatedbyaddinghydrogentoliquidvegetableoiltomakeitsolid.33Thesetransfatsdoallsortsofterriblethingsinyourbody,includingpromotingallergyandasthma.Ina2011studypublishedintheJournalofAllergyandClinicalImmunology,nonobeseasthmaticindividualsatethreetypesofmeals—alow-fatmeal,ahigh-fatmeal,andahigh–transfattyacidmeal.Researchersthenmeasuredtheirairwayinflammation4hoursaftertheyfinishedeatingeachmeal.Theresults:Asthmasufferersweremorelikelytohaveairwayinflammationafterthehigh-fatmeals,andthatairwayinflammationwassignificantlyworseafterthehigh–transfatmealthanitwasafterthetransfat–freemeal.34

• Lackofnutrients.Inadditiontoalloftheunhealthyelementsitprovides,alotofwhatissobadabouttheSADiswhatitlacksintermsofbasicnutrition.MuchoftheAmericandietistakenupbyprocessedfoodsandsugar,sothere’snotmuchroomleftforthenutrientsyourbodyneedstoprotectitself.IfyoueattheSAD,youdon’tgetthenecessaryvitamins,minerals,andantioxidantsfromfreshfruitsandvegetablesandleanmeats,soyoulacktheresourcesyouneedtofendoffallergiesandotherconditions.

DIETINPREGNANCYTheroleofdietinexpectantmothersisextremelyimportant,buttheadviceonwhatpregnantwomenshouldorshouldn’tbeeatingisn’talwaysveryclear(see“TheEver-ChangingDietaryGuidelinesforExpectantMothers”).Thereareallsorts of things that can happen to a baby in utero to predetermine his or herallergicprofilelaterinlife.(AsImentionedbefore, thisbookisforadults,butbecausesomanyof the thingsthatcansetpeopleupfora lifetimeofallergieshappen in childhood, I want to educate parents to be aware of how they canminimizeallergicriskintheirchildren.)

Somefoodsandingredientsseemtobeprotectiveagainstfutureallergiesinthe developing fetus, and other foods and ingredients appear to be potentiallyharmful.Ina2007GermanstudypublishedintheAmericanJournalofClinicalNutrition,researcherslookedatthedietsof2,541pregnantwomenduringtheirlast 4weeks of pregnancy and then analyzed their children for allergieswhentheyreachedage2.35

Interestingly, the researchers found thatwomenwhoatea lotofmargarineand vegetable oils were more likely to have kids with eczema. On the otherhand, thosewho ate plenty of fishwere less likely to have kidswith eczema.Pregnantmomswhoatealotofcitrusfruitsandceleryweremorelikelytohavechildren with allergies to foods. And women who ate a lot of deep-friedvegetablefat,rawsweetpeppers,andcitrusfruitsweremorelikelytohavekidswith respiratory allergies.Someof these findingsparallel the theory regardingomega-3 versus omega-6 fatty acids. Eating margarine, which is made fromproinflammatoryomega-6fattyacids,increasedallergyriskinoffspring;eatingoilyfish,whichisrichinanti-inflammatoryomega-3s,wasprotective.38

Anotheroffender,bothintermsofallergyriskandoverallhealth,isartificialsweetener. Ifamom-to-bedrinksa lotofdietbeverages,studiesshowthatherchildismorelikelytodevelopallergies.A2013studypublishedinthescientificjournal PLOS ONE looked at the relationship between pregnant mothers’consumption of artificially sweetened beverages and their children’s rates ofasthma and allergic rhinitis at 18months and 7 years of age.After looking at60,466 pregnant women and their intake of artificially sweetened drinks,researchers found that themomswho drank diet drinkswere 1.23 timesmorelikely tohavechildrenwithasthmaat18monthsand1.3 timesmore likely tohave children who developed allergic rhinitis in the first 7 years of life thanthosewhoabstained.39

TheEver-ChangingDietaryGuidelinesforExpectantMothersWhenitcomestowhatexpectantmothersshouldeatandwhattheyshouldavoidduringpregnancy,theadvicehasbeenalloverthemap.Backin2000,theAmericanAcademyofPediatricsreleasedguidelinessuggestingthatpregnantwomenshouldavoidpotentiallyallergenicfoods,useonlysoy-basedformula,andwaittogivetheirbabiessolidfoodsuntiltheywereatleast6monthsold.Iftheyhadkidswhowereatriskforallergies,breast-

feedingmomswereadvisedtoavoideggs,fish,peanuts,treenuts,andmilk.36

Buttimeshavechanged.Thelateststudy,publishedintheDecember2013issueoftheJournaloftheAmericanMedicalAssociation,tellswomentoeatoneofthemostallergenicfoods—peanuts—withoutrestraint.Thestudylookedattheeatinghabitsof8,200pregnantwomenandfoundthatexpectantmotherswhoatethemostpeanutsortreenuts—fiveservingsormoreaweek—hadthelowestriskofhavingachildwhowasallergictothesenuts.Infact,thesepeanut-eatingmomswere69percentlesslikelytohaveachildwithnutallergiesthanthemotherswhoateoneorfewerservingsofpeanutsamonthwhiletheywerepregnant.Theexplanation:Earlynutexposuremayprotectkidsfromdevelopinganut

allergy.37

Asanaturopathicdoctor,Itendtotakeamoreconservativestancewhenitcomestodietduringpregnancyandthefoodintroductionscheduleonceababyisborn.There’sahighpotentialforallergiestoeggs,bananas,avocados,tropicalfruits,andnuts,soIthinkparentsshouldholdoffongivingtheirkidsthesefoodsuntiltheyarealittleolder.Startwithblandfoodswithalowerallergenicpotentialandworkyourwayintomorecomplexfoods.

VitaminDDeficiencyVitamin D deficiency is quickly becoming recognized as a major healthproblem. Vitamin D is a fat-soluble vitamin responsible for many differentactions in the human body, from maintaining proper immune function toinhibiting depression and building healthy teeth and bones. Vitamin Ddeficiency is also a risk factor for many chronic diseases and conditions,includingcancer,heartdisease,diabetes,andallergies.40

IfrequentlyseevitaminDdeficiencyinmypatients.Becausethisvitaminisso important, I have begun testing nearly all of my patients to assess theirvitaminD levels.Mostof the time, I find thatpatientsaredeficient,andsomehave levels thatarevery low.Togiveyouan idea, thenormalreferencerangeforbloodlevelsofvitaminD3is30to100ng/mLintheblood(dependingonthelaboratory). I’veseen levelsas lowas9,andI routinelyseenumbers less than20. These low levels can put you at a greater risk for many different healthproblems,inadditiontoincreasingyourallergicpotential.

WhyaresomanypeopledeficientinvitaminD?Perhapsthebiggestreasonislackofsunlight.YourbodyneedssunlighttomakevitaminD.Butthesedays,we spendmost of our time indoors basking in the glow of computer screensinsteadofoutdoorsbaskinginthesun’srays.Whenwedoventureoutside,mostofuscoatourselveswith sunscreen.41Asa result,we’renotgettinganywhereneartherecommendeddailyallowance(RDA)of800internationalunits(IU)ofvitaminDperday.Toreachthisamount,youwouldhavetoexpose30percentofyourbodytothesunatamoderatelatitudefor30minutesperday.Unlessyouworkas a lifeguard, this just isn’tpractical.Most research says that800 IU ismuchlowerthanwhatweactuallyneed,anyway.Additionally,mostAmericans’dietsdon’tincludeenoughofthefoodsthataregoodsourcesofvitaminD,suchasfish-liveroil,sardines,andshrimp.(Fortifiedfoodslikemilkcontainroughly100IUper1-cupserving,whichisnotenough.)

ResearchsubstantiatesthelinkbetweenlowvitaminDandincreasedallergyrisk. A recent study published in the journal Annals of Allergy, Asthma, andImmunology found a link between low vitamin D levels and risk for allergicrhinitisinKoreanadults.42AndanearlierstudypublishedinAllergyandAsthmaProceedingslookedatdatafromtheNationalHealthandNutritionExaminationSurvey 2005–2006, done by the Centers for Disease Control and PreventionNationalCenterforHealthStatistics.Thestudyfoundthatpeoplewithvitamin

Ddeficiencyweremorelikelytosufferfromallergies,includingspecificallergysymptomslikerashes,sneezing,andsinusinfections.43

You can try to boost your vitamin D levels by eating D-rich foods—eggyolks, fortified milk, and fish-liver oils—or by taking supplements. And Irecommend having your levels tested as part of your yearly comprehensivehealth exam (along with other vitamin and mineral levels and markers ofnutrition and overall health, including omega-3 fatty acids) to see where youstand.

StressI think diet is themost important part of a healthy lifestyle.The secondmostimportantpartisyourlevelofstress.Peoplearewaytoostressed-outthesedays.Our bodies are not designed for the weeks-to-months-on-end of stress andanxiety we put them through.We’re not meant to be attached to cell phonesconstantly,withdeadlinesandmoneytroublesdanglingoverourheads.Instead,asaspecies,wewereoriginallydesignedtoexperienceshortburstsofanxiety—caused by, say, a wolf at the mouth of our cave—followed by much longerstretches spent picking berries or fetching water from the river. Our fight-or-flight response, as it is called, was designed for short responses to acuteproblems—for instance, until you escaped from the wolf. But these days, thewolf (let’scall itawolf indysfunctional lifestyle’sclothing)never reallygoesaway,sowe’reinthisunhealthy,high-adrenalinemodemostofthetime.

Letmeexplainhowstress takes its toll.On theoutside, stress looks likeafranticperson racing fromplace toplace, coffee inhand.On the inside, stresslookslikeanincreasinglyexhaustedadrenalglandbeingaskedtocontinuouslysecrete hormones in response to the perceived emergency. These hormones,often referred to as the fight-or-flight hormones, are named epinephrine andnorepinephrine. Your body’s response doesn’t really differentiate between thestress of having several must-be-met work deadlines, a parent-teacherconference,and150uncheckedemailsandthestressofalargepredatortryingtoeatyou;yourstressresponseisessentiallythesame.

Your adrenal glands fire off the fight-or-flight hormones,which shift yourbodyintoastateofhighalert.Whenyourbodyisreactingthisway,itdirectsallavailableresourcestothematterathand.Nonessentialactivitiestakeabackseat.For example, gastrointestinal function is inhibited during the fight-or-flightresponse,becauseproperlyabsorbingthatlastmealisn’tgoingtosaveyou.Onthe other hand, increases in heart rate and respiration, aswell as havingmoreavailable sugar in your bloodstream, may provide you with the energy andoxygentosuccessfullyfightofforrunawayfromthedanger.

To remain in this heightened, stressed-out state requires a lot of bodilyresources.Eventually,youradrenalgland’sabilitytokeepuptheproductionofhormones can rundry, andwhen it does, your bodyhas to look for energy inotherplaces.Yourthyroidglandmaybeabletokeepthingsgoingtemporarily,buteventuallyitalsobecomesunabletomeetyourbody’sdemands.Excitatory

neurotransmitters may then be called to duty, providing your depleted andexhaustedbodywithafinalcrutchformeetingitsenergyrequirements.It isatthis point that a person complains of being completely exhausted but also ofsuffering from insomnia because his or her brain can’t “shut off” due to theexcitatoryneurotransmitters.Overtime,thisextendedfight-or-flightmodetakesatollonyourentirebody.

ThinkofitasbeinglikedrivingyourFerrariat190milesperhourwithnooil in theengine.Eventually, theenginewillblow.Iseepeople in thisstate inmypracticefartoooften.Thegoodnewsis,therearethingspeoplecandotogetbackontrack.Wewillexplorethesetacticslaterinthisbook.

Focusingbackonallergies, thehormonecortisol,whichhasbeenshowntobeoneof thebiomarkersof stressandwhich is also secretedviayouradrenalgland, can alter the functioning of your immune system, possiblymaking youmoresensitivetoallergens.Cortisolhasalsobeencorrelatedwithspecifictypesofallergicdiseases,includingatopicdermatitis.44

Research also supports the link between allergies and stress. A studypublishedinthejournalPsychosomaticMedicinefoundacorrelationbetweenaperson’s score on the Minnesota Multiphasic Personality Inventory distress-related scale, a test thatmeasures stress levels resulting fromprevious trauma,andtheirreactivityinresponsetoanallergen.45

Anewer study done atOhio StateUniversity and published in the journalPsychoneuroendocrinology found that even low levels of stress and anxietymadepeoplemoresensitivetocommonallergens.Theyalsofoundthatthestresslingeredandmadetheseconddayofanallergyattackevenworse.46Researcherslookedat28menandwomenwithahistoryofhayfeverandseasonalallergies.They started by asking the participants to complete a psychologicalquestionnaire to determine their baseline anxiety levels. Then half of theparticipants performed a low-stress task—reading aloud from a magazine—while the other half had to give a 10-minute speech in front of a panel ofevaluators and then watch their videotaped performances. After their tasks,participants took a skin prick test to measure their response to an allergen.Researchers found that those with higher baseline anxiety had higherinflammatoryresponsestoallergytests,especiallythosewhohadtoperformthehigh-stressspeech.Theparticipantswithhigherbaselineanxietywhoperformedthe speech task had continued inflammation the next day, which shows thatstressandanxietycanalsoprolongallergicreactions.47

Howandwhydid stress andanxiety combine tomakeallergiesworseand

lingering?ThestudyauthorsproposethatstresshormonessuchascortisolmightstimulateIgE,theproteinthatcausesallergicreactions.48

Cortisolisindeedanimportantstresshormone,andIbelieveitcontributestoallergies.However, it is not theonly stresshormone (Imentioned epinephrineandnorepinephrine aswell), nor is it theonly chemical inyourbody that canpromote an allergic predisposition. Inflammatory cytokines and interleukins,whichwewillexplore,haveaninfluence,aswell.

ClimateChangeScientists have given us lots of reasons to fear climate change and globalwarming,andnowwehaveyetanother:increasedriskofallergies.Byburningoil,coal,andotherfossilfuels,industryhasreleasedtonsofcarbondioxideintothe atmosphere.Peoplemaynot like the effectsof all this carbondioxide,butplantsdo;carbondioxidehelpsthemtogrowfasterandtaller,andasaresult,toproducemorepollen.Morepollenflying throughtheairequalsmorepollen inourlungs—andmoresniffles,sneezes,andwateryeyesinpeoplewithseasonalallergies.49

Asidefromincreasingthepollencount,awarmertemperatureinandofitselfcan also make allergies worse. High summertime ozone levels can triggerreactions like chest pain, congestion, and throat irritation, and it can make itharder for all people, especially allergy and asthma sufferers, to breathe.(Depending onwhere in the country you live, you’ve probably seen “poor airquality”or“stayindoors”warningsfromyourlocalweathermanwhenthingsgetparticularlyhotandstickyoutside.)Hightemperaturesandhumidityduringthesummermonthsalsocreateabreedinggroundforindoorfungiandmolds.50

Large fluctuations in temperature also seem toplay a role.Thegreater thevariation in temperature in a single day (called diurnal temperature range, orDTR), the more likely an asthma sufferer is to experience a flare. A 2014Australian study published in theAnnals ofAllergy,Asthma, and Immunologyfound that childrenwith asthmawhowere exposed to unstableweather and agreaterDTRhadworselungfunctionandmorerespiratorysymptomsthanthosewhowereexposedtomorestabledailytemps.51

Another issue related to climate change is globalization. Not only are wechangingtheclimateofourworld,butthatworldisalsogettingsmaller.PeoplefromallovertheglobearecomingtotheUnitedStates,andwiththemthey’rebringing foreign diets and exotic products, whichwe take into our stores andhomes.Ontheonehand, thesenewpeopleandproductsarewonderfulforourculture,making itmore richanddiverse.On theotherhand, thenewproductsarechangingourenvironmentandpossiblycontributingtoallergies.RemembermyyoungpatientfromChapter1whowasallergictothebloodwormshefedhisSiamese fighting fish?His allergy provides good support for the globalizationexplanation for increasing allergies. We have exposure to things we neverpreviouslysaw.52Onehundredyearsago,theboywouldnothavehadaccessto

aSiamesefightingfish,muchlesstobloodwormstogivethepetasfood.Wealsobringoutsidethingsintoourhomestomakeourlivingroomsmore

pleasant and homey. Houseplants make good decorating pieces and can helpcleanindoorair,buttheycanalsochangeyourindoorenvironmentandpromoteallergies.ABelgianstudyfound thatmore than75percentofpeoplewithhayfeverareallergictoatleastonecommonhouseplant.Thereasonmaynotjustbethesapontheseplants,whichgetsintotheairandintoyourairways;itmaybethat these “common” houseplants are actually pretty foreign to your immunesystem.Thestudyshowedficus,yucca, ivy,andpalmtreeweremost likely tocausesnifflesandsneezes.53

From houseplants to hygiene, there are many theories surrounding theproblemof increasingallergies,allofwhichshareacommon theme:Theshiftawayfromthelifestyleandenvironmentsinwhichweevolved.Withinthisshift,there is stress, poor diet and lifestyle choices, and exposure to environmentaltoxins. It’s not a single thing causing allergies to rise, but a combination offactorsthatgoalongwithourindustrializedworld.

Because there is no single allergy cause, there is also no single allergytreatmentormedication.Weneedtogetawayfromquick-fixdrugsandcomeatthe complex problem of allergy relief from all angles, by adopting a healthylifestyleinallfacetsofourlives.

3What’sHappeningBehindtheSneezes:ThePhysiologyofAllergies

WHEN ITHINKOFTHEPHYSIOLOGYOFALLERGIES, a particularpatientcomestomind.Yearsago,Imetayoung,college-agewomanwhohadbeensufferingfromasevereskin rash formanyyears. Itwouldappearonherlegs,arms,orfaceandseemedtocomeandgofornoparticularreason.Shehadtried all kinds of medications, seen several dermatologists, and even tried anexhaustivenumberofhomeremedies,buttonoavail.

Shewas a great kid, and I could tell that having this conditionwas reallybotheringher.Isuggestedwedosomefoodallergyandsensitivitytestingtoseeifwecoulddeterminewhether shehadany issueswithherdiet, as there is aninteresting correlation between the health of your gastrointestinal (GI) systemandthehealthofyourskin. Ifpeoplesuffer fromsomesortofGIdisturbance,whetheritbechronicdiarrhea,constipation,orgasandbloating,addressingtheunderlyingcausesoftheseproblemsmayhelptoclearupskinproblems.

When I see a patientwith a skin complaint, oneofmy first thoughts is toconsiderafoodallergyorintolerance.Asmycollegestudentwiththeskinrashproved, food allergies or sensitivities are often to blame.When this patient’stestingcameback,wediscoveredthatshedidinfacthaveseveralfoodallergies.Likemostpeoplewithfoodallergies,sheknewthatcertainfoodscausedhertoexperienceGI issues,and the test results showed that shedidhaveallergies tosomeofthesesuspectfoods.Wedevelopedadietplanthathelpedheravoidthefoods that her lab results had shown she had an allergy. Her skin graduallycleared and her rash became less and less severe. Today, the rash is resolvedmostof thetimeandonlycomesbackwhensheeats thefoodssheknowswillcauseproblems.Andnow,when it does comeback, it is generally short-livedandmuchlesssevere.

This girl’s experience illustrates that allergies are not simply localizedreactionsthataffectonlyoneareaofyourbody.Mypatient’sskinreactionwasnotlimitedtojustherskinorhergastrointestinaltract;instead,itresultedfroma

complexchainofeventsthataffectedherinsideandout.Whetheryousufferfromapesky,embarrassingrashlikemypatientoryour

respiratory allergies are so bad that you’re forced to stay inside for the entirespring season, you would probably be happy if your allergy symptoms wentaway.Whenitcomes toallergies, thefirststep inwinning thewar isknowingyourenemy.Tobestridyourselfofallergiesonceandforall,youfirsthavetounderstandhowtheyoperate.

ALLERGIES101:ACRASHCOURSEINTHEPHYSIOLOGYSimply put, allergies are hypersensitivity disorders of the immune system.Allergic reactions occur when a person’s immune system reacts to normallyharmlesssubstancesintheirenvironment.Thesubstancethattriggerstheallergicreactioniscalledanallergen.Anallergenisatypeofantigen,andantigensaresubstances capable of inducing an antibody response by the immune system.(Antibodies are proteins that the immune system produces in response to aforeignsubstance,orantigen.)

In people with allergies, the immune system becomes overreactive, so inaddition to viruses, bacteria, and othermicrobes that pose a genuine threat, itattacks innocent substances in its environment—allergens. Through a fairlycomplex process that we will explore in more detail below, the misguidedimmune system launches an attack against allergens and unleashes someunpleasant—andinsomecases,potentiallylife-threatening—allergysymptoms.2

AswelearnedinChapter1,allergiescanresultfromsomethingasunlikelyasbloodwormsorascommonaspollens,animaldander,housedust,dustmites,molds,medications, and foods suchasnuts,milk, eggs, and fish.Reactions totheseallergensmaytakeavarietyofdifferentformsinyourbody,including:3

1.Respiratorysymptoms,whichcanrangefromamildrunnyorstuffynosetosevereasthmaattackswithsneezing,coughing,andwheezing.

2.Skinsymptoms,whichmaytaketheformofrashes(hives),swellinginthemouth,oralitching,facialswelling,orredness.

3.Gastrointestinalsymptoms,whichcanshowupasnausea,vomiting,cramps,diarrhea,orconstipation.

4.Cardiovascularsymptoms,whichmayleaveyoufeelinglightheadedand

faint.5.Anaphylaxis,whichisasevereandsometimesfatalreactioninvolvingdifficultybreathing,loweredbloodpressure,constrictionofairways,andlossofconsciousness.(Thisisusuallytheresultofafoodorchemicalallergy.)

Thesesymptomsarewhatapersoncouldexperiencewhenhavinganallergicreaction. Symptoms such as sneezing, blowing your nose, or scratching youritchy hives are the result of an extremely complex set of reactions happeningwithinyourbody.

Thesereactionsbegininnocentlyenough.Forinstance,youmaytakeadeepbreathandlayyourheaddownonyourpillow.Whatyoudon’tknowis thatatiny dustmite haswalked across your pillow, shedding amicroscopic particlealongtheway:theallergen.Yourdeepbreathcausesyoutoinhalethedustmiteallergen,whereitiscarriedintothemucousmembranesofyourmouth,nose,orlungs.Once there, the allergen is found by an immune cell called an antigen-presentingcell.Thisantigen-presentingcellthencarriesthedustmiteallergentothenearestlymphnodes,whereitisshowntotheTcells.TheTcellsreacttothedust mite allergen by releasing proinflammatory chemicals, which promptanothertypeofimmunecell,theBcells,tobeginproducinganantibodycalledimmunoglobulinE(IgE).

TheIgEantibody triggers themastcells to takeonwater,swell,andburst,releasingchemicals intoyourbloodstream.Thesechemicals includecytokines,leukotrienes, and a chemical called histamine, which causes the annoyingreactions in your eyes, skin, throat, lungs, nose, or gastrointestinal tract.4 Therelease of these proinflammatory chemicals causes you to begin experiencinglaboredbreathing,sneezing,andothersymptomsoftheallergicresponse.

Not even the most well-educated allergy experts fully understand whycertainpeoplereacttoparticularsubstancesandothersdonot.Obviously,notallpeople react to a particular allergen. For example, somepeople are allergic tocats and others are not. The lucky nonallergic people can handle large andrepeated exposures to potential allergens such as pollen or peanut butter andneverhaveahypersensitiveimmunereaction.

TheproductionofIgEplaysanimportantroleinthedevelopmentofallergicsymptoms, and it works in concert with mast cells.5 You have mast cellsthroughoutyourbody,andtheyareconcentratedincertainplaces,suchasyourskin, eyes, trachea, lungs, and gastrointestinal tract. It’s in these places, with

concentratednumbersofmastcells,thatallergicsymptomsarethestrongest.Onthesurfaceofthesemastcells,therearespecialreceptorsdesignedforbondingwith IgE.Like a key that fits into the right lock, these receptors are speciallydesigned tomatchupwith corresponding IgE antibodies. Pollen IgE receptorswill only fit togetherwith pollen IgE antibodies, dustmite IgE receptorswillonly fit together with dust mite IgE antibodies, and so on. Some unfortunatepeoplehavemanyIgEantibodies,sotheyreacttomultipleallergens.6

Regardlessofthetypeofallergen,therearethreemainphasestotheallergicresponse—sensitization to an allergen, early-phase response, and late-phaseresponse.

TheRelationshipBetweenGastrointestinalHealthandSkinHealthItshouldcomeasnosurprisethatthedigestivesystemisoneofthemostimportantsystemsinyourbody,andithasanimpactonmanyothersystemsinyourbody.

Conventionalmedicinehaslinkedskinhealthtogastrointestinalhealth.Ina2013studydoneattheUniversityofAlberta,researcherslookedattheconnectionbetweengastrointestinaldiseasesanddermatologicsymptoms.Theyfoundaconnectionbetweenskinmanifestationsandmorethan30differentgastrointestinaldiseases,including

pancreatitis,hepatitis,andCrohn’sdisease.1

Becauseoftheimportancethenaturopathiccommunityplacesondigestivehealth,naturopathicdoctorsarewellversedintreatingdigestivedisorderssuchasirritablebowelsyndrome,autoimmunediseases,andfoodallergiesaswellasinrecognizingtheconnectionbetweendigestiveupsetandotherhealthproblems.

Oneparticularlystrongconnectionisbetweenthegastrointestinalsystemandtheskin.Manytimes,whenapatienthasaskinproblem,suchasacneorarash,thatpersonturnsouttohaveaproblemrelatedtohisorherGItract,andit’softenasensitivitytoafood.

Acommonfoodsensitivitythatcanmanifestasskinproblemsisglutenorwheatintolerance.Wheatgluten,atypeofproteinfoundinpastas,breads,cereals,andotherwheatproducts,isoneofthemostcommoncausesofinflammationintheGIsystem,anditcanleadtorashesandothertypesofskinirritation.Othersymptomsofglutensensitivityincludelowenergyandweightgainorloss.

Phase1:SensitizationtoanAllergenInordertobecomesensitivetoanallergen,youmustfirstbeexposedtoit.Youmayinitiallycomeintocontactwithanallergenthroughoneofthefollowing:7

• Touch.Youencountersomeallergenswhenyoutouchthemwithyourskin.Theseincludepoisonivy,latex,oranallergenicmetalsuchasnickel.

• Inhalation.Someallergenscausereactionsafteryoubreathethemin.Theseincludepollen,mold,dander,anddustmites.

• Consumption.Thereareallergensthatcauseareactionwhenyouswallowthem.Theseincludesomefoodsandoralmedications.

• Injection.Certainallergensonlycausereactionsoncetheygetunderyourskin.Theseincludesomemedications,venomfrominsectstings,anddrugs.

Your first exposure to an allergen through one of these portals doesn’ttypically result in an outward reaction. In all likelihood, you probably had noidea you were exposed to an allergen. But inside your body, your immunesystemnoticedtheallergenand,throughtheseriesofreactionsdescribedabove,produced antibodies against it. This process is similar to how your immunesystemreactstoavirusorbacteriainavaccine:Asaresponsetotheallergen,itcreated specific IgE antibodies to defend against it the next time that allergencamearound.

More specifically,when your immune system first encounters an allergen,thefollowingchainreactionoccurs:

1.Theimmunesystem“sees”theallergen—let’ssaypollen.Itidentifiesthepollenasaninvader.Antigen-presentingcellsinternalize,process,andexpresstheallergensontheirsurface.

2.Theallergensarepresentedtootherimmunecells,particularlyTcells.3.TheTcellsjumpintoaction.ThepollensparkstheTcellstoactivateBcells,whichthenturnintocellscalledplasmacells,whichsecreteantibodies.

4.PlasmacellsreleaseIgEantibodiesthatspecificallytargetthepollen.DifferentallergenssparkproductionofcorrespondingspeciallytargetedIgEantibodies,sopollenstimulatesthereleaseofIgEantibodiesthatspecificallytargetpollen,moldstimulatesthereleaseofIgEantibodiesthatspecificallytargetmold,andsoon.

5.Onceformedandreleasedintoyourbody,theIgEbindstospecialreceptorsonmastcells.OncetheIgEhasboundwithamastcell,theallergenreceptorisleftopensoitisprimedforsubsequentexposurestothatallergen.

6.Theimmunesystemisnowsensitized.Themastcellsarenowreadyandwaitinglikelittlebombs,preparedtodetonatethenexttimethepollen

appears.8

Phase2:Early-PhaseResponseThe next time your body encounters an allergen—again, let’s say pollen—theearly-phase response kicks in. Each time your immune system encounters anallergen, it produces more antibodies than it did the time before—and itproduces them more quickly. That’s why, over time, allergic reactions canbecome more severe. In the early-phase response, within an hour ofencounteringtheallergen,yourimmunesystemgoesthroughthefollowing:9

1.ThepollenbondstoitscorrespondingIgEantibodiesonthemastcells,cross-linkingtheIgE.Cross-linkingmeansthatwhenitcomestoanallergicreaction,mastcells—muchlikeprotestersatarally—needtojoinforceswithothermastcellstomakethingshappen.Asmentioned,IgEantibodiesonmastcellsarelikekeysdesignedtofitperfectlywiththeallergen(lock)theyarereadytoattack.OncethepollenfindstheIgEkeywithwhichitfits,thetwobondtogetherandthenlinkupwithaneighboringIgEantibodyandpollenpair.Thispatterncontinues,andtherallygrows.

2.Onceenoughofthiscross-linkingtakesplaceandthenumberofcross-linkedIgEsreachescriticalmass,themastcellsdegranulate(explode)andreleasehistamineandotherinflammatorysubstancescalledmediators.

3.Mediatorsracethroughyourbodyandcausetheunpleasantsymptomsoftheallergicreaction—sneezing,sniffling,wheezing,hives,andsoon.

Phase3:Late-PhaseResponseIn some cases, there is an additional phase, called the late-phase allergicresponse. This response involves immune cells called eosinophils and occurshours after the first early-phase allergic response—usually between 3 and 10hours later—and itcan last for24hoursormorebeforesubsiding.During thislaterphase,symptomscanactuallybeworsethanthoseduringthefirstphase.10Iused to get this sort of late-phase, delayed allergic reaction when I cut theBermudagrassinmyyard.ThenightafterImowed,Iwouldwakeupandhavedifficulty breathing. But of course that was before I started taking my ownadvice.

THEPHYSIOLOGYOFFOODALLERGIES

FoodallergysymptomsresultfromasimilarphysiologicalresponsetotheoneIjust described, but they are important to address separately because thesymptomstheycausecanbemuchmoresevere.

ClassicfoodallergiesareIgEmediatedandinvolvecharacteristicsoftype1hypersensitivity reactions. Type 1 hypersensitivity reactions develop rapidly—usually within a few minutes of the allergen binding with the correct IgEantibodyon themastcells.Symptomsof this typeof reaction includeurticaria(hives), angioedema (swelling similar to hives, but under the skin), andanaphylaxis.Asareminder,anaphylaxisisaveryseveretypeofallergicreactionthat can cause constriction of airways, difficulty breathing, lowered bloodpressure,lossofconsciousnessand,potentially,death.11

Type 1 hypersensitivity reactions can be either local or systemic. Localreactionsdependontheportalofentry.Generally,thereactiontakesplaceontheareaof thebody that encountered the allergen.For example, if youbreathe inmoldsporesandareallergictomold,youwillexperienceswellingandirritationinyourrespiratorytract.

AswediscussedinChapter1,moreandmorepeoplethroughouttheUnitedStates and the world are developing food allergies. The most common foodallergens aremilk, eggs, peanuts, soy, wheat, tree nuts (such as cashews andwalnuts), fish, and shellfish. Within this list, the foods most likely to causesevereanaphylaxisaretreenuts,peanuts,fish,andshellfish(suchaslobsterandshrimp).Peoplewhohave food allergiesand asthma tend tobe at risk for themostseverereactions.13

Mostfoodallergiesdevelopduringchildhood,buttheycanbeginatanyage.Somechildhoodfoodallergiesarelikelytogoawayontheirown.Forexample,most childrenwho are allergic tomilk outgrow their allergy by the time theyreachage5.Other foodallergies, suchaspeanut allergies, aremore stubborn;onlyabout20percentofpeoplewithpeanutallergieseveroutgrowthem.14

Foodallergiescanalsomanifestasaconditioncalled foodprotein-inducedenterocolitissyndrome(FPIES).Generallyfirstseeninyoungchildren,FPIESisa non-IgE-mediated immune reaction that takes place in the GI system andcauses profuse vomiting and diarrhea. As a result, it is often mistaken for astomachbug.AnyfoodcantriggerFPIES,butthemostlikelyculpritsarecow’smilk and soy. Other possibilities include oats, barley, rice, peas, green beans,

squash,sweetpotatoes,turkey,andchicken.15Aswediscuss the physiologyof all allergy types, a criticalmessage—and

oneofthemostimportantpointsinthisbook—istheconnectionbetweenallergyandinflammation.Withoutinflammatorysignalstherewouldbenoallergies.Itis an inflammatory response that triggers your body’s immune cells to beginproducing the substances responsible for allergic symptoms, which arethemselves proinflammatory. In essence, inflammation causes moreinflammation.

Intoday’ssociety,ourbodiesarechronicallyinflamed.Thisislargelyduetounhealthy habits, such as consuming nutrient-deficient and highly processeddiets,a lackofphysicalactivity,andanepidemicofexcessanxiety.All inall,thisaddsuptopoorlifestylehabits.Thisinflammationoftenplaysaleadingrolein the development of the diseases of modern society, such as heart disease,cancer, and diabetes, all ofwhich are considered lifestyle diseases. It is likelythat thisexcessive stateof inflammation is acausative factor in the rise in thenumber of allergic people worldwide. By adopting a healthy lifestyle plan,peoplemayreducenotonlytheirpotentialforbecomingmoreallergic,butalsotheirpotentialfordevelopingtheotherdiseasesoflifestyle.

What’stheDifferenceBetweenanAllergyandaSensitivity?Inmypracticeandbeyond,thephrase“I’mallergicto...”getsusedfartoooften.Peoplefrequentlyconfuseallergiesandsensitivities,particularlywhenitcomestofoods.They’llsay,“I’mallergictowheat,”whenreally,they’rejustsensitivetowheatandgetgassyandbloatedshortlyaftereatingadoughybagel.

Whatcomplicatesthingsisthatallergicreactionsaredifficulttodifferentiatefromsimilarnonallergicsymptoms.Thesneezingandrunnynoseofhayfever,forexample,canlookverymuchlikethecommoncold.Otherallergicreactions,suchastheswellinganddifficultybreathingofanaphylaxis,aremucheasiertorecognize.

Iwillusetheexampleoflactoseintolerance,whichisasensitivity,notanallergy.Peoplewithlactoseintolerancesufferfromdiarrheaandgaswhentheyeatdairyproducts.Specifically,theyaresensitivetothelactose,orsugars,inmilk.Lactoseintoleranceisnotanallergytomilkanddairy.Rather,itisanenzymedeficiencythatcaneitherbegeneticoracquired.Becausealactose-intolerantpersoncannotbreakdownlactose,whenhegivesintoanicecreamcraving,heexperiencesaninfluxofwaterintohisintestinesviaosmosis.Soonafter,hepaysthepriceforhissplurge—thediarrheaandgaskickin.Onebasicdifferencebetweenallergiesandsensitivitiesisthis:Anallergicreactionismediatedbytheimmunesystem,andasensitivityorintoleranceisnot.

Unlikelactoseintolerance,foodallergiesaremediatedbytheimmunesystem.Alsocalledhypersensitivities,foodallergiesoccurwhenallergicsubstances,mostlyproteins,maketheirwaythroughthedefensesofyourdigestivetractandendupinyourbloodor

lymph,wheretheycanelicitantibodyresponses.12

Thereisalsoagrayareabetweenallergiesandsensitivities.Whenpeopleundergofoodallergytesting,somedoctorslookforlevelsofIgG.IgGisasubstanceyourbodyreleasesinordertoblockandreducelevelsofIgE.IfsomeoneshowsahighlevelofIgG,somephysicianswillsayheorshehasasensitivity,notanallergy.Thethinkingisthatifitwereanallergy,therewouldbehighlevelsofIgE.ButtheproblemisthatIgGisnotasinglemolecule—itisafamilyofmoleculeswithdifferentsubpopulations.ThereisIgG1,IgG2,IgG3,andsoon,andeachofthesesubclasseshasadifferentactioninyourbody.SoIgG1couldbesomethingproducedwhensomeoneishavingasensitivityorintolerance,butIgG4,whichisthoughtofasablockingantibody,couldbeproducedinordertolowerlevelsofIgEproducedinresponsetoanallergen.ButunlessthephysicianmeasuresspecifictypesofIgG,thelevelwillsimplycomebackashigh.

Here’sapracticalexample:Whenkidshaveanallergytotheproteinsineggwhite,thereactionisoftensomildthatparentsdon’tevennoticeit.Sotheykeepgivingthechildeggs.Then,whenwetestthechilddowntheroad,hisIgGlevelsmaybequitehigh,butwhenweinvestigatethesubpopulations,weseethatthereisactuallyalotmoreIgG4(thetypethatblocksIgE)thananyothertype.Thisshowsthatthechildhasbuiltupatolerancetoeggs.Basically,theparentshavedonehome-grownimmunotherapy.So,whentryingtodifferentiatebetweenallergiesandsensitivities,thelessonis,relyingsimplyonIgGlevelswithoutlookingatsubtypesisreallynotveryeffective.

ALESSONINALLERGYDIAGNOSIS

Oneof the reasons it’s so important tounderstand thephysiologybehindyourallergysymptomsisthatitisoftenthephysiologicalresponsetoanallergenthatismeasuredduringtheallergydiagnosticprocess.Whenitcomestodiagnosingallergies—anddeterminingwhichspecificallergensareatplay—there is someoverlapbetweennaturopathicmedicineandconventionalpractices.

Intheconventionalmedicalworld,theprocessmaygolikethis:Beththinksshemayhavea ragweedallergybecause she’sbeenmiserable for the last twofall seasons. So she talks to her primary care doctor, who refers her to hisfavorite allergist or immunologist. (Allergists and immunologists are medicaldoctors—usuallypediatriciansor internists—whohavegone throughat least 2yearsofextratraining.Theyspecializeintreatingpatientswithallergies,asthma,autoimmune diseases, and other immune system problems.) At Beth’s firstappointmentwiththeallergist,heconductsaphysicalexamandperformsallergytesting,whichmayinvolveskin tests,bloodtests,orboth.16The testsusedforallergyscreeningincludethefollowing:

Scratchtesting.Duringascratchtest,adoctorscratchesyourskinanddropsinatinydoseoftheallergeninquestion.(Alternatively,thedoctormayinjectasmallamountoftheallergenintotheskinonyourback.)After15to20minutes,

thedoctorchecksyourskin to see ifa roundwhealwitha flare (a red,angry-lookingwelt)hasformedaroundthearea.Ifthere’snowheal,there’slikelynoIgE sensitization, and likely no allergy. If the wheal appears, you are indeedallergictotheparticularallergenthatwasputinplace.17Basedonthedegreeofthereaction,thedoctormaythenrateyouasslightlyallergicorseverelyallergic.Scratch testing can also be used as a way to monitor the effectiveness of atreatment.Thisisdonebycomparingthesizesofthewhealsformedbeforeandafter treatment. If thewhealgot smallerwith the second test, thenpresumablythetreatmentisworking.

Scratch testing has been used for a long time, but it is notwithout certainlimitations.It’sfairlysubjective,asprovidersmustnotonlyinterpretthedegreeofyourallergicresponsebasedon thewheal, theymustalso latercompare thesizeofthefirstreactionwiththesizeofthesecondonetodeterminewhetheratreatmentisworking.

Blood testing. Inmypractice, I prefer to use blood tests to help diagnoseallergies. Blood tests for allergies look for antibodies—IgE or IgG—todeterminethe typeofreactionapersonishaving.18Theycanalsolookfor thetotalamountofantibodiesintheblood.Inotherwords,bloodtestscantellyounotonlywhetherornotyouareallergic,butalsowhatyouareallergic toandevenhowallergicyoumaybe.19These tests areveryprecise, and I like thembecauseIcangetquantitativeresultsandthencomebackandchecklevelsagaintoseeiflevelsofantibodiestospecificallergensaredropping.

Forexample,ifBethcomesinbecauseshethinkssheisallergictoragweed,we can use blood tests tomeasure the specific amount of ragweed IgE in herblood.Then,aftersometreatmentandlifestyleinterventions,wecanretestherinthe future to see if her levels of ragweed IgE have indeed gone down. Thatmeanswecantracktheeffectivenessofatreatmentwithbloodtestslikethese.It’s important tonotethat thesetestscanbeusedforbothfoodandrespiratoryallergies.

Foodchallenge.Totestforfoodallergies,thegoldstandardtest—especiallyfor nonanaphylactic food allergies, such as those experienced by people whocome inwith complaints of gastrointestinal problems—is a food challenge. Inpractice, I generally recommend the rotation eliminationdiet.Thisdiet,whichinvolveseatingbiologicallyrelatedfoodsduringasingledayandthenwaitingatleast 4 days before eating them again, is one of the most effective ways toidentifywhichofthefoodallergensinquestioniscausingyoursymptoms.20

Component testing. There’s also a newer type of testing available, called

componenttesting,whichmayhelpdeterminewhetherapersonwillhaveamildorseverereactiontoaparticularallergen.Componenttestingworksbylookingforspecificproteinswithinanallergicsubstance.Certainproteinsareassociatedwithmildreactionsandothersareknowntocausemoreseverereactions,suchasanaphylaxis.

Toputthetestintopracticalperspective,let’ssaythatyou’retheparentofakidwithapeanutallergy.Yourchildmayberequiredtositataspecialtableatschool and wear a medical alert bracelet wherever he goes. Naturally, as hisparent,youarealwaysafraidthathewillbeexposedtoapeanutorthatsomeonewillbringacupcakethatcontainspeanutstoschool.Componenttestingcanhelpdetermineexactlyhowyourchildwouldreactifaccidentalpeanutexposuredidoccur.Ifyoufoundoutthereactiontopeanutswouldonlybemild,itwouldtakeawayalotofunnecessaryanxiety,wouldn’tit?Componenttestingisbecomingmoreandmorecommonplace,andifyouthinkyoumaybenefitfromthistypeoftesting,Iencourageyoutoaskyourdoctoraboutit.

ANOVERVIEWOFSTANDARDALLERGYTREATMENTI’d like to reiterate that I am by no means against conventional medications.(The decision ofwhether or not to takemedications is a personal one.)Therehavebeenmanytimeswhenconventional treatmentmethodshavesuccessfullytreated a patient’s condition.However, thesemedications are overused. If youcan live a health-promoting lifestyle instead of a health-detracting one, thenthereisthepotentialforareductioninoreveneliminationofthemedicationsinyourlife.

When it comes to allergymedications, I appreciate their ability to controlpotentially life-threatening symptoms, but I am dismayed that they are reallyonly able to treat symptoms. The vast majority of medications really do notimproveoverall health. Itwouldbe fantastic ifwehadmedications that couldactuallycurediseases,butunfortunately,thisisnotthecase.Therearesimplynomagic medications for allergies. What these medications do is reduce thediscomfortofallergiesbyeasing their symptoms.Theymayoffera temporarysolution, but beneath them, the wound is deepening. And too often, patientsrequiremultiple allergymedications at once to control their symptoms,whichcanbeextremelytaxingtothebody.

For example, antihistamines work to block the histamine that unleashes

allergicreactions.They’redesignedtotreatisolatedallergicsymptoms,suchasrunnynose,sneezing,hives,orabdominalpain.21Antihistaminesshouldnotberoutinely prescribed as the only treatment for allergies because they do notpreventallergy;theyonlypreventhistaminefrombeingreleasedfrommastcellsonce theallergicprocesshasalreadygottenstarted.Theydonothelpapersonbecomelessallergicinthelongrun,nordotheyhelpmovethepersontowardabetter state of health. There are other things that can be used alongsideantihistamines that may be able to reduce a person’s dependence on thosemedications.Myplanwilldiscusssomeoftheseoptions.

Anotherpopularconventional treatment forallergies isallergyvaccination,orsubcutaneousimmunotherapy(SCIT).SCITinvolvesinjectingapatientwithincreasingamountsofanallergen tohelpher immunesystembuild resistance,and therefore lessen the allergic response. For example, if you’re allergic topollen,adoctormayinjectyouwithpolleninincreasingdosestostimulateyourimmunesystem’sprotectivemechanismsagainstpollenexposureuntilheorshedetermines the right maintenance dose. The eventual goal is to reduce thenumberofallergyattacksorstopthemaltogether.23

TiredofAllergyShots?There’sFinallyaGoodAlternative!Asanaturopathicdoctor,inadditiontothelifestyleinterventionsIpresentinmyplan,oneofmyfavoritetreatmentsforrespiratoryallergiesiswhat’scalledsublingualimmunotherapy(SLIT).Sublingualimmunotherapyworksinmuchthesamewaythatallergyshotsdo:Itcombatsallergiesbygivingtheallergicpersonasmalldoseofwhatheorsheisallergicto.Ifapersonisallergictopollen,yougiveheraverysmallamountofpollensoherimmunesystemgetsusedtoit(i.e.,buildsatolerance).Butunlikeinjectionimmunotherapy(allergyshots),patientstakeSLITpainlesslyadministeredundertheirtongues.Overtime,SLIT

retrainstheimmunesystemnottobeallergictothatspecificallergen.22

OneofthereasonsIrecommendSLITisthatitlinesupwithmyprofessionalphilosophy.Therearecertainprinciplesthatguidethenaturopathicprofessionasweseepatients,andoneofthoseprinciplesistomakesuretoalwaystreatthecauseofthedisease.ItrulyfeelthatSLITfitsthisbill.Ittreatstheimmunesystemdysfunctionthatleadstothedevelopmentofallergysymptoms,anditdoessoinawaythatiscompletelynatural—there’snomedicationinvolved.

Myproblemwithallergyshotsisnotthephilosophybehindthem—infact,Ithinkinsomepatients,immunotherapycanworkquitewell.However,let’sface

it:Noonereallylikesneedlesorpain.For food allergies, conventional treatment usually involves avoiding the

offending foods. This is sound advice. Inmy practice, once I identify a foodallergy inoneofmypatients, I help themcreate aplan to avoid theoffender.People with food allergies often become experts at scanning food labels.Allergenicfoodsfrequentlyaren’t listedby theircommonnames; forexample,peanutsmaytaketheformof“hydrolyzedvegetableprotein,”andtheingredient“albumin” comes from eggs. People with allergies to these foods learn torecognizethembehindthesedisguises.24

If you have a food allergy, you should also work with your health-careprofessional to develop an emergency action plan you can put in place in theevent that you accidentally encounter the food to which you are allergic. Iencourage patients with severe allergies with the potential for anaphylaxis tocarryanEpiPenwith themin theeventofanemergencyreaction.Epinephrineworks to offset the anaphylactic response by relaxing narrowed airways andconstrictingsmallbloodvesselstoincreasebloodpressure.

Tosumup,allergymedicationsonlytreatthesymptomsofthedisease;theydo not improve the patient’s health. Inmy practice, I have seen far toomanyallergic people who are fed up and desperate for a treatment that works, andyou’re probably in the same boat. After all, if your allergies were wellcontrolled,youwouldn’tbereadingthisbook.Soreadon,andwewillexploreeffectivealternativetreatmentstogether.

Marie’sStoryInadditiontopumpkincarvingandhayrides,eachfall,Marieusedtoexpectitchyeyes,sneezing,andastuffynose.

“Myseasonalallergiesweremiserable,especiallywhenitcametimeforthefallryegrass,”saysthe37-year-oldaccountant.

AsisthecasewithmanyofDr.Psenka’sseasonalallergypatients,Marie’sallergiesfirstappearedwhenshemovedtoArizona13yearsago.Notwantingtotakemedications,shemadeanappointmentwithDr.Psenka,whoprescribedsublingualimmunotherapy(SLIT),somesupplements,andahealthiereatingplan.

“BeforeIwenttoseeDr.Psenka,Iatelotsofmeatandpotatoesanddrankdietsoda.Now,Ieatmorefruitsandvegetablesanddrinklesssodaandmorewater,”shesays.

Aboutsixweeksintotheprogram,Mariebegantonoticeimprovementsinherallergysymptomsandoverallvitality.Today,shefeelswonderful.

“IfeellikeIhavemuchmoreenergy,andI’velostweight—abouteightpoundssofar,”shesays,addingshewouldencourageanyonewithseasonalallergiestotrySLIT.

“NotonlyhasDr.Psenkatreatedmyallergysymptomswithnaturalmethods,hehastaughtmehowtoleadahealthierlife,”shesays.“Heisgreat.”

taughtmehowtoleadahealthierlife,”shesays.“Heisgreat.”

4OntheOriginofSneezes:CommonAllergies

A FEW YEARS AGO, I treated a 12-year-old boy who came to mecomplainingofconstantnasalcongestion.HewasaseasonalresidentofArizonaand spent the other half of the year in Minnesota. His mother told me thatwhenever they would leave Arizona and head back up north, the boy would“seize up,” meaning his allergies got so bad they prevented him fromparticipatinginschoolorotheractivities.

Itestedtheboyforbothfoodandrespiratoryallergiesandfoundthathehada number of different allergies and sensitivities. I then tested his respiratoryallergiesusingtworespiratoryallergytestpanelsspecifictothegeographicareasinwhichthisboylived.Respiratoryallergytestpanelsarefrequentlyorganizedinto regional panels that contain themost commonly encountered allergens inthatarea—inthiscase,theSouthwestandtheMidwest.Ialsosuggestedthathetrya rotationandeliminationdiet toconfirm the resultsofhis foodsensitivitytesting.Theculprit turnedoutnot tobebasedonhis locationafterall.Hewasallergictodairyandhadasignificantnumberofrespiratoryallergies,mostlytothings in the Southwest and not the Midwest. I started him on sublingualimmunotherapy(SLIT),whichhe tookwhilebothavoiding thefoods towhichhe had an allergy and following my other recommendations, which includedsomegeneralantioxidants,anomega-3oilblend(see“TheRoleofOmega-3sinTreatingAllergies”),andagoodprobiotic.Afewmonthslater,hismothercalledme from Minnesota to tell me that his allergic symptoms were much, muchbetter.Infact,hewashavingnoproblemsatall.

Thereareafewlessonstotakeawayfromthisstory.First,allergiescanverymuch be based on where you live in the country, and a relocation can meanfewer allergy symptoms, more allergy symptoms, or a completely new set ofallergy symptoms. The second is that, inmost cases, allergy symptoms resultfromoneof themost commonallergens—pollen, pet dander, dust, dustmites,cockroaches,andcertainfoods.

There are thousands of substances that can cause allergies, which makesthoseofuswhodiagnosethoseallergiesdetectives,inaway.Whenweconsiderwhat may be causing a patient’s symptoms, we must take into account diet,environment, and region of the country (see “Different Region, DifferentAllergy”) because you never knowwhat could be causing someone’s allergicsymptoms.

TheRoleofOmega-3sinTreatingAllergiesWhenItreatedthedairy-allergicboyfromMinnesota,onethingthathelpedincontrollinghisfoodallergywasasupplementcontainingomega-3fattyacids.Omega-3fattyacidsarepolyunsaturatedfattyacidsyourbodyneedsbutcannotmake;youhavetogetthemfromfoodsorsupplements.Foodsourcesincludeflaxseedoilandoilyfish(suchassalmon,cod,andhaddock)aswellasflaxseedsandwalnuts.

Thereasonomega-3fattyacidscanbesoeffectiveagainstallergiesisthattheycontaineicosapentaenoicacid(EPA),whichisanaturalanti-inflammatory.Andthelowerthe

underlyinglevelsofinflammationinyourbody,theloweryourallergicpotential.1

DifferentRegion,DifferentAllergyMyyoungpatientwiththedairyallergyturnedoutnottobesensitivetohisyearlychangeinregion.However,hismother’sthoughtthatthisannualmigrationmightbeafactorwasawisehypothesis.Differentallergensarefoundindifferentenvironments;whatcausesseasonalallergiesinupstateNewYorkiscompletelydifferentfromwhatcausesseasonalallergiesinPhoenix—thetwoareashavenearlyoppositeclimatesandthereforegrowverydifferentplantspecies.So,naturally,peoplecanundergochangesintheirallergysymptomswhentheytravelfromoneareaofthecountrytoanother.Thesenewallergiescankickin

immediately,orafterafewmonthsoryears.2

COMMONSEASONALALLERGIES

Themostcommonseasonalallergiesincludethosetopollensfromtrees,pollensfromweeds, andmold.Althoughmold is not a seasonal allergy in the classicsense,somemoldshavepeakseasonsincertainareasofthecountry.Here’sanoverviewoftheseseasonalallergiesandtheirsymptoms.

PollenAllergy

Pollen isaveryfinepowdergivenoffbymanydifferentkindsofplants, fromthe grass in your backyard to theweeds and flowers in your garden.When afertileplantbegins to flower, it releases itspollen into theair.Pollengranulesare themalecellsof trees,grasses, and flowers, and they travel in searchofafemale plant to pollinate. Like matchmakers, in a sense, wind and—appropriately—birdsandbeeshelpthefertilizationprocess,carryingpollenfromoneplanttoanother.3

Partofthereasonpollenissoallergenicisthatmillionsofparticlescancomefromasingleplantandtravelupto200miles.Asaquickglanceatyouryellow-coatedwindshieldinMaywilltellyou,whenmostpollinationhappens,inspringandfall,tonsofpollenparticlescirculatethroughtheair.4

Pollen allergy symptoms can range from mild to severe and may includesneezing,itchythroat,itchinginsideyourears,itchyeyes,swolleneyelids,runnyorstuffynose,coughing,wheezing,andtroublebreathing.5Symptomscanalsogetbetterorworsebasedontheweather,withrainydaysbeinglessproblematicforpollenallergysufferers.(Precipitationliterallyrainsonpollen’sparade.)6

Oneof themostcommonallergicconditionscausedbypollen ishay fever(alsocalledallergicrhinitis),whichinvolvesitchinginyournose,ontheroofofyourmouth,andinyourthroatandeyes;sneezing;runnynose;wateryeyes;anddarkcirclesunderyoureyes.7

Somepeopleareallergictoonlyonekindofpollen,suchasragweed,whileotherunfortunateallergysufferersreacttomultiplepollensfrommanydifferentplants.Someoftheothermostcommonplantswhosepollencansparkallergiesincludethefollowing:8

TREESAshAspenBeechBirchBoxelderCedarCottonwoodElmMapleMulberryOak

Willow

WEEDSBurningbush(alsocalledsummercypress,Mexicanfireweed,orkochia)CockleburLambsquartersMugwortPigweedPlantainRed(sheep)sorrelRussianthistleSagebrushSaltbushTumbleweeds

GRASSESBermudaJohnsonKentuckybluegrassOrchardRedtopRyeSweetvernalTimothy

Interestingly,ingeneral,thelesscolorfultheplant,themorelikelyitistobeallergenic. Pollen from the most colorful flowers and plants rarely causessymptomsbecause it is carriedby insects andbirds,whichareattracted to theplants’vibranthues.Dullerplantsandweeds,ontheotherhand,relyonwindtospreadtheirseed.

In addition to followingTheAllergySolutionPlan, you can try to controlpollenallergiesbypayingattentiontothepollencountintheair(whichchangeson a daily basis) and then adjusting your schedule so you don’t have a lot ofoutside activities when the count is highest. Pollen count can largely affectwhether or not you have a reaction. You can find out the pollen count bychecking theweather sectionofyour localnewspaperorbyenteringyourZIPcodeononeofthepopularweatherinformationWebsites,suchasTheWeatherChannelsiteatweather.com.

AllergensandTheirSeasonsByseason,theoffendersare:9

• Spring(AprilandMay).Allergiesmostoftenresultfrompollenfromtrees,suchasoak,ash,birch,westernredcedar,hickory,maple,walnut,andsycamore.

• Summer(lateMaythroughJuly).Allergiesmostfrequentlyresultfrompollenfromgrassesandweeds,suchastimothy,redtop,Bermuda,orchard,sweetvernal,andbluegrass.

• Fall(lateAugustthroughthefirstfrost).Allergiesmostoftenresultfrompollenfromragweed,sagebrush,cocklebur,Russianthistle,tumbleweed,andpigweed.

MoldAllergyWe’veallheardofthescaryblackmoldthatcanlurkbehindbathroomwallsandmakeyouverysick.Butthere’salsoasomewhatless-threateningmoldformthatcancauseallergysymptomsinyournoseandthroat.10

Moldsarefungithatgiveoffspores.Thesesporesthenfloatthroughtheairandcangetintoyourmouth,nose,andthroat.Molditselfusuallygrowsindark,wetplaces,suchasbathrooms,kitchens,andbasementsaswellasoutdoorsonwetleavesandlogs,butitssporescantravelfastondry,breezydays.

Moldallergysymptomsaregenerallysimilartosymptomsofpollenallergyandmay include sneezing; congestion; itchy eyes, throat, or ears; swelling inyour eyelids; coughing; trouble breathing; or wheezing. They can also rangefrom mild annoyances to potentially severe anaphylactic reactions.11 (See“DecodingAllergyJargon”.)Unlikepollens,which tend tobe seasonal,moldscangrowthroughouttheyearifyouliveinaSouthernorWesternstate.Theydohavepeakseasonsinotherareasofthecountry,however;inwarmerstates,theypeakinJuly,andincolderstates,moldlevelspeakinOctober.12

COMMONANIMALALLERGIES

Themost commonanimal allergies are to householdpets, but people can alsodevelopallergiestooutsidepetslikehorses.Here’sanoverviewoftheseanimalallergiesandtheirsymptoms.

PetAllergy

Ironically, one of the most common causes of allergies is man’s best friend.Nearly two-thirds of American homes have a pet, and 161 million of theseanimalsarecatsanddogs.Someexpertsadvisethosewithpetallergiestooptfora fish or turtle, instead, butmillions of allergic pet lovers hold on toKitty orBarkleyanyway,fortheloveoftheirfurryfriends.13

Contrary to popular belief, fluffier pets are no more allergenic than theirshort-hairedcounterparts.Pethairorfurcancontributetoallergiesbytrappingotherallergens,suchaspollenormold,butit’snotthelengthofthedogorcathair thatmatters—it’s the dander, saliva, urine, and skin flakes that can sparkallergicreactionsoraggravateasthmainsomepeople.

Also contrary to popular belief, there are no cats or dogs that are trulyhypoallergenic.Allpetshavedander,saliva,andurine,and therefore, theycanallcauseallergiestosomedegree.

Another thing to keep in mind about pet allergies is that they can take awhile todevelop.Therefore, ifyouadoptedakitten lastweekandeveryone inyour family is still symptom-free, you’re not quite out of the woods yet. Petallergiestypicallytakebetween4and6monthstofullykickin.16

Forthosewithanestablishedpetallergy,however,symptomswillshowupshortly after exposure to a dog or cat—withinminutes, in some cases. Thesesymptoms may include itchy, watery eyes; sneezing; congestion; and runnynose.Lesscommonly,peoplewithpetallergiesmaygetitchyskinorhives.17

In addition to followingTheAllergy Solution Plan, you canminimize petallergiesbylimitingyoursnugglingtimewithyourdogorcat,keepingyourpetoutofyourbedroom,andbrushinghimorheroutdoors.Usingahigh-efficiencyparticulateair(HEPA)filterinyourvacuumcleaneroraHEPAaircleanercanalsohelp.

AllergicRhinitisversusNonallergicRhinitis:What’stheDifference?Atleastoneoutofthreepeoplewithallergicrhinitissymptoms—runnynose,nasalcongestion,sneezing—donot,infact,haveallergies.Instead,theyhavewhatiscallednonallergicrhinitis,anallergicrhinitisimposter.Thesetwoconditionsdifferinthatwithallergicrhinitis,yourimmunesystemoverreactstoanenvironmentalsubstancesuchaspollenormold,whereaswithnonallergicrhinitis,yourimmunesystemdoesnotgetinvolved.Anotherimportantdifference:Allergicrhinitistendstocomeandgowiththe

season,whilenonallergicrhinitishangsoutyear-round.14,15

HorseAllergyAhorseallergyislesscommonthananallergytodogsandcats,butitcanaffectsomepeople,especiallythosewholiveinstateswherehorsesmaybeapartofeveryday life, such as Texas, Wyoming, and Arizona. People may be trulyallergic tohorsesand theirhair,or theymayactuallybe reacting to themoldsandsporesgivenoffbythehayhorsessleeponandeat.18

Symptoms of horse allergy are usually mild and include allergic rhinitis,allergic conjunctivitis, itching, and hives. Horses may also spark asthmasymptomsinsomepeopleor—inrarecases—cancauseanaphylaxis,whichmayinvolve itching, hives, difficulty breathing, a drop in blood pressure, loss ofconsciousness,andpotentially,death.19

If you think you may have a horse allergy, allergy testing can help youdetermineyeaor“neigh.”

COMMONHOUSEHOLDALLERGIES

Americansspendmostoftheirtimeindoors,soit’snosurprisethatsomeofthemost common allergies are to household substances. Here’s an overview ofhouseholdallergiesandtheirsymptoms.

HouseDustAllergyHouse dust is like an allergen soup serving up a bunch of potentially allergy-aggravating ingredients. It can contain pet dander, fungi, dust mites, foodremnants,fibersfromdrapesandcarpeting,cockroachparts,andevendustfromoutsideconstructionsites—anythingyoucanthinkofthatmightbelurkinginoraroundyourhome.20

Symptoms of a house dust allergy depend on the particular allergens thatdust contains and may include sneezing; runny nose; itchy, watery eyes; andincreasedriskofasthmasymptoms(suchaswheezing,coughing,chesttightness,anddifficultybreathing)inthosewhohaveasthma.21

Although an excessive amount of house dustmaymake allergy symptomsmore likely to kick in, realize that in most cases, a dust allergy is not anindication that you’re doing a bad job cleaning your home. Normalhousecleaning simply isn’t sufficient to remove dust—and a dust allergy—completely.22When it comes to house dust allergies, dustmites are the house

dust component most likely to cause allergy symptoms. These little creaturesbelongto thearachnidfamily,whichalso includeschiggers, ticks,andspiders.Dustmiteseathumanandanimalskinanddander,so they tend tohangout inplaceswheretheycanfindpeopleandpets.Theyalsolovewarm,humidspots—above 70°Fwith greater than 75 percent relative humidity. In fact, one of thebestways tokill dustmites is todrop the relativehumiditybelow55percent;theycannotsurviveinconditionsthisdry.23

Dustmites are very small, so you can’t see themwith your naked eye. Infact,asinglegramofhousedust(abouttheweightofapaperclip)maycontainasmanyas19,000dustmites.Themites liveforaboutamonth,duringwhichtimeegg-layingfemalescanproduce25to30offspring.Eachmiteproduces10to 20waste particles per day.And in case you aren’t grossedout enoughyet,dust mites also eat their feces and coat those waste particles with evenmoreallergenicproteins.31

Besidesbeingthoroughlydisgusting,theproblemwithdustmitesisthattheproteins in their bodies and feces cause allergy symptoms. These dust miteparticlescan float through theair,whereyoucanbreathe them in,or theycanhideinpillows,mattresses,upholsteredfurniture,andcarpeting,wheretheycanbedisturbedwhensomeonevacuumsthefloororchangesthesheets.Sotomakealonganddisgustingstoryshort,dustmitesmultiplyquicklyandleavealotofallergenicfecesintheirwake.32

Tothosewhoareallergictothem,dustmitesandtheirwastecancauseitchy,wateryeyes;stuffynoseandears;sneezing;eczema;respiratoryproblems;andinsomecases,asthma.33Toeaseyourwilliesabit,youcanrestassuredthatdustmitesdon’tliveonyourbody,theydon’tspreaddiseases,andtheydon’tbite.Ifit weren’t for allergies to them, we probably wouldn’t even know they werethere.34 (Bedbugs,however,dobiteandarebecomingaproblemformoreandmorepeople.Whileitremainstobeseenwhattheallergicpotentialofbedbugsis,wedoknowthatpeopledevelopIgEantibodiestotheselittlecritters.)35

DecodingAllergyJargonSomeofthemostcommonallergicreactionsarehidingbehindsomeprettytechnical-soundingnames.Here’saquickoverviewofthesereactions.

• Allergiccontactdermatitis.Thisreactionoccurswhenyourskincomesintodirectcontactwithanallergen,suchaspoisonivy.Itconsistsofred,swollen,itchyskinthat

maycontainbumpsorscales.24

• Allergicconjunctivitis.Thisconditionoccurswhentheclearlayeroftissuecoveringthewhitesofyoureyesandyourlidsbecomesswollenandinflamedaspartofan

allergicreactiontomold,pollen,petdander,oranotherallergen.25

• Anaphylaxis.Alsocalledanaphylacticshock,anaphylaxisisasevere,sometimesfatalreactionthatbeginswithinsecondstominutesafterexposureandinvolvesswellingofthelips,tongue,andthroat;itchiness;adropinbloodpressure;difficulty

breathing;anddecreasedbloodflowtothebrain,heart,andlungs.26

• Angioedema.Similartohives,angioedemaisswellinginthedeeplayersoftheskin.Angioedemamayoccurwithhivesandoftenaffectstheskinoftheeyelids,mouth,or

genitals.27Itcanalsoaffectthehandsorfeet,ortheinsideofthebowelsorthroat.28

• Atopicdermatitis(eczema).Eczemaresultsfromleakinessintheskin’sbarrier,whichcausesskintobecomedryandthereforevulnerabletoirritationandinflammation.Eczematypicallyshowsupinthebendsofelbowsorknees,behindthe

ears,oronthehandsandfeet.29

• Uticaria(hives).Whenyourimmunesystemreleaseshistamineinresponsetoanallergen,smallbloodvesselsleak,leadingtoswellingandrednessonyourskin.Thesehivesmaybeitchyorpainful,andtheymayappearasredandwhiteraised

bumpsorwelts.30Theycanshowupanywhereonyourbody.

CockroachAllergyWhenyouhearthewordcockroach,youmaythinkofadirty,infested,inner-cityapartment. But actually, cockroaches have been around for an estimated 400millionyears, so they’ve lived in themost rusticof countryhomes; their longhistory also proves that they are extremely resilient creatures.36 Not only arecockroaches a stubborn nuisance but also they can cause allergy symptoms insomepeople.37

Cockroachestypicallyhangoutinwarm,dark,dampplaceswheretheycanfindsomethingtoeat.Theyliketomunchonhumanfood,buttheydifferfromus in that they also enjoy paint, newspaper, book-binding materials, andwallpaperpaste.Thebugstypicallyhideingrocerybags,instacksofbooks,inwallandfloorcracks,andundersinks.Ifyouseeacockroach,thereareprobablymanymore:Oneroachcanmeanupto800morearelurkingnearby.38

Althoughtheymaymakeyourskincrawl,cockroachesareprettyharmless,excepttothosewhoareallergictothem.Inallergicpeople,thebugs’wastecanspark reactions like a persistent stuffy nose, skin rash, and asthma symptoms,suchascoughing,wheezing,difficultybreathing,andchesttightness.Cockroachallergiesareaparticularlystrongriskfactorforasthmainchildren.

Inaddition to followingTheAllergySolutionPlan inChapter14,youcan

fight a cockroachallergybydoingwhatyoucan toget ridof thebugs:Don’tleavefoodoutinyourkitchen;covertrashcanstightlywithlids;avoidleavingbowls of pet foodon the floor;mopyour floors at least once aweek; and fixleakypipes,drippingfaucets,andothermoistureproblemsinyourhouse.

COMMONFOODALLERGIES

Food allergies resultwhenyour immune systemmistakes a foodyou’ve eatenforan invader. Insteadofdigesting the foodandusing itasnourishment,yourbodylaunchesanattack(seehere),whichcanleadtosymptomsthatrangefrommildlyunpleasant topotentially fatal. In theirmost severe form, foodallergiescancauselife-threateninganaphylaxis.39

Whenwe talkabout foodallergies, it’s important todistinguish themfromfoodintolerancesorsensitivities.Atruefoodallergyisahypersensitivityoftheimmunesystemtoafoodcomponent,usuallyaprotein.Withafoodsensitivity,on the other hand, the immune system is not usually involved. For example,lactose intolerance is a food sensitivity. People with the condition lack theenzymenecessary to break downmilk sugar (lactose), sowhen they eat dairyproducts, lactose intolerant peoplemay experience gas, bloating, and diarrhea.Althoughtheymaybeuncomfortableandembarrassed,thesesymptomsarenotlife-threatening,assometruefoodallergiescanbe.

Here’sarethemostcommonfoodallergies.

PeanutAllergyOneofthemostcommonfoodallergies,peanutallergyisalsooneofthemostpotentially dangerous. Peanuts are among the foods most likely to causeanaphylaxis,andpeanutallergiesareontherise.AccordingtotheFoodAllergyResearchandEducation(FARE)study,peanutallergiesmorethantripledintheUnitedStatesbetween1997and2008.40

Unlike most other food allergies, which kids typically outgrow, peanutallergiesarealifelongcondition—onlyabout20percentofpeoplewithallergiesto peanuts ever get rid of them. These allergies tend to run in families, withyoungersiblingsofkidswithpeanutallergiesatanincreasedriskofdevelopingthem,aswell.41

Peanuts are amember of the legume family; othermembers include peas,lentils, and soy. Legumes differ from their cousins, the tree nuts (walnuts,

cashews,andalmonds), in that theygrowin theground.Althoughpeoplewithpeanutallergiesarenomorelikelytobeallergictootherlegumes,theyaremorelikelytobeallergictotreenuts.Recentresearchshowsthatbetween24and40percentofpeoplewithpeanutallergiesalsohavetreenutallergies.42

Symptomsofapeanutallergymayincludehives;eczema;stomachcramps;diarrhea; vomiting; runny nose; sneezing; itchy, watery eyes; and asthmasymptoms, such as coughing, wheezing, and difficulty breathing. In its mostsevere form, peanut allergy can cause—within minutes—the sudden allergicreactionanaphylaxis.43

Anotherreasonpeanutallergiesaresuchaconcernisthatjustatinyamountofanutcantriggerabigreactioninsensitivepeople.Ifsomeonewithapeanutallergy touches a surface where a peanut or some peanut butter sat and thentoucheshisorhereyes,forexample,itcanbeenoughtosetoffaseriousallergicreaction.44

Becausetraceamountsofpeanutscansparkasevereresponse,andbecausepeanutscanlurkinmanyunsuspectingfoods,peoplewithapeanutallergy—orany true food allergy—simply can’t be too careful. If you have a severe foodallergy,youshouldcarryanEpiPenatall times,andmakesureyouand thosearoundyouknowhowtoadministeritandarepreparedtouseitatanytime.45

As a peanut allergy sufferer, youmust also be vigilant about reading foodlabels. The FoodAllergen Labeling and Consumer ProtectionAct (FALCPA)requiresallfoodscontainingpeanutsthataresoldintheUnitedStatestolisttheword“peanut”clearlyon the label.However,keep inmind that theuseof thephrase “may contain peanuts” is voluntary, so you still need to know whatyou’reeating.

It’s also important to be aware of foods and ingredients that may containpeanuts.Theseincludethefollowing:

• Artificialnuts• Bakedgoods• Candy• Chili• Eggrolls• Glazesandmarinades• Mandelonas(peanutssoakedinalmondflavoring)• Marzipan

• Nougat• Pancakes• Petfood• Specialtypizzas

TreeNutAllergyTree nuts are, as their name suggests, nuts that grow on trees. They includealmonds,walnuts,hazelnuts,pistachios,Brazilnuts,andcashews.46

Tree nut allergies are similar to peanut allergies in that they tend to causesevere reactions and usually last a lifetime. Even fewer kids with tree nutallergies thanwith peanut allergies ever outgrow them.Tree nut allergies alsotendtoruninfamilies,withyoungersiblingsofchildrenwithtreenutallergiesatanincreasedriskofdevelopingthem,too.47

Peoplewithtreenutallergiesarefrequentlyallergictomorethanonekindoftreenut, so they’re advised to avoid all nuts and to check all ingredients.TheFALCPAnowrequiresfoodcompaniestolistspecifictreenutsonalllabelsoffoodssoldintheUnitedStates.Evenso,thosewithallergiestotreenutsshouldbeawarethatthesenutscanpopupinthemostunusualplaces,suchasbarbecuesauces,flavoredcoffees,andalcoholicbeverages.(NotethatalcoholicbeveragesarenotrequiredbytheFALCPAtolistpotentialallergensontheirlabels.)48

If you have a severe tree nut allergy, you should also look out for thefollowingsubstances:

• Gianduja(chocolatewithhazelnutpasteasaningredient)• Litchi• Marzipan• Pesto

MilkAllergyCow’smilk is themost commonallergy in infants andyoungkids.About2.5percentofchildrenyoungerthanage3areallergictomilk.Thosewithanallergyto cow’s milk can also react to the milk of other animals, such as goats andsheep.49

Milkallergysymptomsarevariableandcanrangefrommildtosevere.Someindividualsreactafteringestingonlyatinybitofmilk,whileotherscandrinka

moderateamountandreactonlyslightly.Mildreactionstendtotaketheformofhives,andseverereactionscanincludeanaphylaxis.50

Thegoodnewsisthatmostkidswithmilkallergiesoutgrowthem.Therearealsoanumberofhealthydairy-freebabyformulasavailable,somothersofmilk-allergickidswhochoosenot tobreastfeedhaveotheroptions.Asyou’llsee in“Soy Allergy” on the opposite page, soy alternatives are not always a goodchoicebecausemanypeoplearealsoallergictosoy-basedfoods.

Luckily,theFALCPAnowrequiresthatallmilk-containingproductssoldintheUnitedStatesactuallylisttheword“milk”onthelabel.Evenso,it’shelpfulforparentsofkidswhoareallergictomilk—andforthekidsthemselves—tobeas educated as possible on hidden cow’s milk sources. It’s also important torealizethatmilkcanshowupinthemostunexpectedplaces,suchasindelimeat(whenmeatslicersareusedtocutbothmeatandcheese),meatsthatusecaseinasabinder,andmedicationsthatcontainmilkprotein.

Herearesomemilk-containingingredientstolookoutfor:51

• Casein• Caseinates• Curd• Diacetyl• Ghee• Lactalbumin• Lactoferrin• Lactose• Lactulose• Recaldent• Rennetcasein• Tagatose• Whey

EggAllergyEgg allergies are also common in kids, second only to milk. Luckily, mostchildrenoutgrowtheireggallergybyage5.Thosewhoaresensitivereacttotheproteins in thewhiteof theegg.Peoplewithchickeneggallergiesshouldalsoavoid eggs from ducks, geese, turkeys, and other birds, because they may

containsomeofthesameallergenicproteins.Symptomsofaneggallergyrangefrommildskinreactionstosevereanaphylaxis.52

Children who are most allergic to eggs can react after just smelling eggfumes or getting a tiny bit of eggwhite on their skin.Because eggs have thepotential tocauseanaphylaxis, thosewhoareatriskshouldcarryanEpiPentouseintheeventofaccidentalexposure.53

The FALCPA requires all egg or egg product–containing packaged foodsmeantfordistributionintheUnitedStatestosay“containseggs”ontheirlabels.But eggs can still show up in unexpected places, such as in surimi, the foamtoppingsofcoffeedrinksandonpretzels.(They’reintheeggwashusedbeforethepretzelsaredippedinsalt.)Therefore,youcan’tbetooeducatedabouteggs’many whereabouts. Some of the less-obvious names for egg-containingingredientsincludealbumin(oralbumen),meringue,andovalbumin.54

SoyAllergySoyisanothercommonfoodallergen,especiallyininfantsandchildren.About0.4percentofchildrenhaveasoyallergy.Somekidsoutgrowitbyage3,andthemajorityoutgrowitbyage10.55

Soybeansarelegumes(plantsthathaveseedsinpods;otherlegumesincludepeas, lentils,andpeanuts).Havingasoyallergydoesnotmakesomeonemorelikely tohaveanallergy toanother legume, suchaspeanuts,however.And inmostcases,soyallergiestendtobemuchmilderthanpeanutallergies.

Symptomsofasoyallergymayincludehives,itching,eczema,cankersores,abdominal pain, diarrhea, nausea, vomiting, or dizziness.56 More severeanaphylacticreactionstosoycanalsooccur,butthesearerare.Thosewhoareatrisk for an anaphylactic reaction from soy should carry an EpiPen. (You canlearn if you’re at risk through specialized testing.) The FALCPA requires allpackaged foods that contain soy and that are sold in theUnited States to say“soy”onthelabel.However,it’sstillhelpfultorecognizefoodsandingredientsthatmaycontainsoy.Theseincludethefollowing:57

• Edamame• Miso• Natto• Shoyu• Soya

• Tamari• Tempeh• Texturedvegetableprotein(TVP)Beyond the obvious soymilk and soy products like tofu, soy can also be

found in unexpected foods, including cannedmeats and fish, cereal, crackers,energybars,andinfantformula.58

FishandShellfishAllergyLikepeanutallergies,fishandshellfishallergiesoftenstickwithpeoplefortheirentirelives.Infact,seafoodallergyisoneofthetopfoodallergiesamongadults.Italsosendsmorepeopleage6andoldertotheemergencyroomthananyotherfoodallergybecauselikenutallergies,anallergytofishandshellfishcanbringonasevereanaphylacticreaction.59

When it comes to seafood, those with fins are the most allergenic, withsalmon,tuna,andhalibutbeingtheworstoffenders.Peoplewhoareallergictoone type of fish are frequently also allergic to another. However, fish andshellfishcomefromdifferentfamilies,sohavinganallergytoshellfishdoesn’tnecessarilymeanthatyou’llalsobeallergictofinnedfish,orviceversa.60

Intermsofshellfish,crustaceanswithintheshellfishfamilyaremostlikelyto cause allergic reactions. These include shrimp, lobsters, and crabs.Unfortunately, these are also some of themost popular shellfish for people toeat.61

Ifyouareallergictofishorshellfishandareatriskforanaphylaxis,youwillwant to avoid these foods at all costs. On a positive note, fish and shellfishhardlyeverhidebehindstrangeingredientnamesorinsurprisingfoods.Andifapackagedfoodcontainsshellfish,thelabelmustlistit.62

However, it’s important tokeep inmind thatdeep fryers in restaurants areoftenusedtofrymultiplekindsoffoods,soyourplateofinnocentFrenchfriesmayhavebeendippedinthesameoilassomeoneelse’sfriedseafoodsamplerHibachi restaurants are another danger zone for peoplewith seafood allergies,becausechefsuse thesameopengrill tocookeveryone’smeals. Ifyouhaveashellfishallergy,your safestbet is toavoid seafood restaurantsaltogether, andespeciallyanyfoodsthathavebeendeep-fried.63

In addition, because fish and shellfish allergies can cause anaphylaxis,carryinganEpiPenisagoodideaforthosewhohavetheseallergies.

WheatAllergyWheatallergiesmostcommonlyshowupinkids,whousuallyoutgrowthembyage3.Andjustasamilkallergyshouldnotbeconfusedwithlactoseintolerance,awheatallergyshouldnotbeconfusedwithceliacdiseaseorglutenintolerance,whichisasensitivitytothestickyprotein(calledgluten)that’sfoundinwheat.Wheatallergiesintheirtrueformarereactionstotheproteinsinwheatandaremediatedbytheimmunesystem;IgEantibodiesaresecretedwithinminutes tohours after a person eats a wheat-containing food.64 Symptoms of a wheatallergy can range from mild hives, rash, digestion problems, itching, andswellingtosevere,life-threateninganaphylacticreactionsthatinvolvewheezing,troublebreathing,andlossofconsciousness.65

Insomeonewithceliacdiseaseorwithwheatglutenintolerance,thereisanabnormal immune system reaction to gluten (but not a hypersensitivity,whichoccurswithallergy).Leftuntreated,celiacdiseasecanleadtomalnutritionandseriousdamagetotheintestines,soit’simportantforpeoplewhosufferfromittoavoidwheat.66

Whetheryouhaveawheatallergyoranintolerance,avoidingthisingredientcanbechallengingbecausewheatisAmerica’smostcommonlyusedgrain.It’salso used as a filler in many foods that you wouldn’t suspect, such as saladdressing,soysauce,lunchmeat,andicecream.Goodalternativestowheatflouritselfincludecorn,oats,quinoa,rice,barley,andamaranth.Tobestavoidwheat,you should also become educated on all of its imposters. These foods andingredientscontainwheat:• Bulgur

• Couscous• Crackermeal• Durum• Einkorn• Emmer• Farina• Kamut• Matzoh• Seitan• Semolina• Spelt

• Triticale

CornAllergyThemostprofitablecropinthecountry,cornisusedinalmosteverythingthesedays, including as a filler in processed meats and as a sweetener in candies,cereals,andjams.67It’snotyetconsideredacommonfoodallergenintheUnitedStates,butbasedonthepatientsI’veseeninmypractice,I thinkcornisonitsway to this list. In one study, 2 percent of people self-reported an allergy tocorn.68

OnereasonIthinkcornallergiesareunderrecognizedisbecausetheycanbesodifficulttodiagnose.Whenyouuseastandardskinorbloodtest,therecanbecross-reactionsbetweencornandothercommonallergens,suchasgrasspollens,grains,andseeds;therefore,acornallergycanbedifficulttoteaseout.69

When theydoshowup,cornallergiesmaycausesymptomssuchashives,rash, runnynose,nausea,vomiting,cramps,diarrhea,headaches,sneezing,andasthma.Somepeoplealsoexperiencesevereanaphylacticreactionstocornandcorn products, including the cornstarch used on surgical gloves. If you areseverelyallergictocorn,youshouldavoidbothrawandcookedcornandcarryanEpiPenincaseofareaction.

5WhenGoodThingsGoBad:AllergiesandInflammation

AFEWYEARSAGO,Isawa34-year-oldmotheroftwowhohadbeenhavingtrouble losing weight after giving birth to her second child. This wasn’t anunusual reason for an office visit in and of itself, but she also complained ofconstantly feeling gassy, bloated, and fatigued. She had previously gotten herhormonelevelscheckedandwastoldthateverythinglookedfine.Shehadalsoseenagastroenterologistwhohadorderedabatteryof tests thatallcamebacknormal.The lastdoctor she sawsuggested she takeananti-gas agent and sentheronherway.

Frustratedbecauseshewasn’tgettinganyrelief,thiswomanfoundherwaytomy office.We discussed her health history, including her diet and lifestylehabits.Shewasn’tawareofanyfoodallergies,butshedidsayshehadterriblespringtime allergies that were not well controlled with over-the-counterantihistamines.

So I performed some testing and determined that she had a sensitivity towheat.Sheadmittedthatbreadsandpastasweresomeofherfavoritefoodsandthatshehadbeenenjoyingthemwithoutrestraintforherentirelife.Iencouragedhertotryawheat-freedietforaweek.Shewasreluctantatfirst,believingthatbeing “wheat-free” was a fad and thinking that eliminating wheat would bedifficult. I assuredher thathavinga sensitivity towheatwas avery real thingand that those who had it generally described symptoms similar to hers. Wetalkedabouthowwheatcontainssubstances thatmaycauseher togainweightandalsoinhibitweightloss.Onesubstancefoundinwheat,gliadin,canactuallystimulateappetitebybindingtoopioidreceptors,whicharespecificreceptorsinthebrain.Ialsotalkedtoheraboutanothercomponentofwheat,amylopectinA,whichisahighlydigestiblecarbohydratewiththepotentialtocauseaperson’sbloodsugartobecomemarkedlyelevated.Ifurtherexplainedthatshewouldn’thave a tough time finding replacements for all herwheat-containing favorites.Shedecidedtogiveitatry.

Withinjustoneweekofbeingonthewheat-freediet,thiswomannoticedabigpositivechangeinthewayshefelt.Hergasandbloatingweregone,andshewas beginning to believe that wheat might actually be part of her problem.Because her respiratory allergy testing had also revealed several allergies tograssesandpollens, I recommendedstartingsublingual immunotherapy(SLIT)fortreatmentofherseasonalallergiesatthattime.Asthespringallergyseasonwasrightaroundthecorner,Ialsorecommendedthatshebegintakingquercetin,anaturalantihistaminefoundinonionsandgarlic,tohelpprovidesymptomaticrelief for her allergies while the SLIT started to work (see “SupplementHighlight:Quercetin”).

After a month or so of being wheat-free, my patient reported that herseasonalallergieshad improved.Herbodyhadbeenexperiencingan increaseddegree of inflammation as a result of her diet,which had beenworsening theseverityofherseasonalallergysymptoms.Inaddition,herfatiguehadimprovedandshehadalso losta fewpoundswithout increasingherexerciseor limitingherdietinanyotherway.Asabonus,shewaspleasantlysurprisedtofindthatbeingonawheat-freedietimprovedheracne.Weendedupusingacombinationherbal allergy formula along with the quercetin to alleviate her symptomsthroughouttheremainderofthespringallergyseason.Today,sheiscontinuingto lose weight, her allergy symptoms are dramatically improved, and she isworkingoncontinuingherfullcourseofSLIT.(SeehereformoreinformationonSLIT.)

Mypatient’sstoryillustratestheconnectionbetweenallergiesorsensitivitiesandotherhealthissuesthatmay,atfirst,seemcompletelyunrelated.Itislikelythatthelargeamountsofwheatshewasingestingandhercorrespondinglylargeintake of amylopectin A were promoting her weight gain. They were alsocausing her to have elevated levels of inflammation. Amylopectin A causesextremelyhigh levelsofblood sugar,whichcauseshigher-than-normal insulinsecretion.Excessive insulinsecretionpromotes inflammation.Furthermore,herdigestive symptoms were certainly a by-product of her wheat sensitivity. Herseasonalallergieswerealsolikelyworsenedbytheinflammationcausedbyherdiet.Whensheadoptedaless-inflammatorydiet,herseasonalallergysymptomsimproved.

Inflammationandallergieshavea lot in common.Theyboth result fromanumberofbiological,cellular,andimmunologicalprocessesinyourbody,someof which they share.5 In this chapter, we will explore the interdependentrelationship between allergies and inflammation and how the two immune

systemresponsescontributetooverallhealth.

QUERCETINInthestoryofmy34-year-oldpatientwhowashavingtroublemanagingherweightandcontrollingherseasonalallergies,oneoftheremediesthatworkedwellwasasupplementcalledquercetin.Flavonoidslikequercetinareantioxidants—moleculesthatneutralizeharmfulfreeradicals.(Throughaprocesscalledoxidativestress,freeradicalsdamageDNA,harmcellmembranes,andincreaseyourriskformanyhealthproblems,suchasheartdiseaseand

cancer.)1

Intermsofallergies,quercetinappearstofightsymptomslikesneezing,runnynose,hives,andswellingbecauseitactsasanaturalantihistamineandanti-inflammatory.Itstabilizesmastcells,theimmunesystemcellsthatreleasehistamine,whichisthechemicalthatcauses

theseallergicreactions.2

Quercetincomesinsupplementform(pillsorcapsules),whichiswhatmypatienttooktohelpwardoffherspringallergies.Quercetinsupplementssometimesalsocontainbromelain,

anenzymefoundinpineapplethatactsasanaturalanti-inflammatory.3

Youcanalsogetquercetinfromfruitsandvegetablessuchasapples,blackberries,blueberries,citrusfruits,darkcherries,onions,parsley,andsage.Oryoucandrinkadose,

sinceit’salsofoundinteaandredwine.4

INFLAMMATIONNATION

As scientists learn more about the physiology of disease, one commonperpetrator continues to emerge at the top of the “most wanted” list—inflammation.6 Inflammation is your immune system’s response to injury,irritation, or infection. It involves increased white blood cells, redness, pain,swelling,andheat. Inflammationcanaffectanypartofyourbodyand isoftendescribedwith“itis.”Forexample,rhinitisisinflammationofthenose,arthritisis inflammation of the joints, and sinusitis is inflammation of the sinuses.(However,asthmameansinflammationoftheairways,sothe“itis”ruledoesn’talwaysapply.)10

Manythingsinyourenvironmentcancauseinflammation;theworldwelivein these days is very proinflammatory. Environmental toxins; high-fat, high-

sugarprocessedfoods;stressfullifestyles—theyallcauseyourbodytobecomehyperinflamed. These stressors also change the way your body functions andheals, acting on receptors, enzymes, mediators, and cells involved in bothallergiesandinflammation.11

The problem is, once your body switches into a proinflammatory state, itdoesn’t operate in an optimal fashion. It’s in a state of high alert. There issomethingwrong,andyourbodyknowsit.Itwantstoeliminatetheproblem,butsometimes it has a hard timedoing so. It could be that it is hard to avoid theproblem(suchaspollution,ifyouliveinacity)orthatyourbodydoesn’thavethe resources to deal with the problem effectively (for example, due to anutrient-deficient diet). As a result, your body becomes increasingly inflamedand thus becomes vulnerable to even more breakdown and disease, whichultimatelycausesmoreinflammation.

Allergies are one of themany conditions that can result from this viciousinflammatory cycle. An inflamed body is more sensitive to things in itsenvironment, and is thereforemore likely to overreact to food, pollen, animaldander, and other allergens.Other conditions—such as diabetes, heart disease,cancer, obesity, and chronic pain—can also result from uncontrolledinflammation.12

ThePowerofAntioxidantsQuercetin,anaturalantihistamine,isanexampleofantioxidantsthatcanneutralizefree

radicals.7Freeradicalscanbesodamagingbecausewhentheyaccumulateinsidecells,theycausedamagetocellularcomponents,includingDNA.ThisdamagetotheDNAcanpromotedysfunctionthatleadstothedevelopmentoftumors.Becausetheyfightfreeradicals,antioxidantshelpcontrolthisdamageandpreventanumberofdiseasesand

conditions,includingallergies.8

SomeofthemostpowerfulantioxidantsarevitaminC(ascorbicacid),beta-carotene,and

vitaminE.Thereareplentyofgoodsourcesofeachoftheseantioxidants.9

VitaminC• Broccoli• Greenpeppers• Redpeppers• Oranges• Papaya• Strawberries

Beta-Carotene• Carrots• Collards• Spinach• Squash• Sweetpotatoes

VitaminE• Almonds• Brancereal• Hazelnuts• Peanuts• Sunfloweroil• Sunflowerseeds• Wheatgerm

ACrashCourseinInflammationTounderstandtheconnectionbetweeninflammationandallergies,youmustfirstunderstand the physiology of inflammation. The term “inflammation” comesfromtheLatinwordinflammo,whichmeans,“tosetalightorignite.”Similartoallergies, inflammation starts out as a well-intended immune response.Inflammation is often confused with infection, but the two are distinctlydifferent. Infection results from invading bacteria, viruses, or fungi.Inflammation,ontheotherhand,isyourbody’sresponsetotheseinfections.Itispart of a complex biological reaction to protect your body from potentiallyharmfulinvaders,betheyviruses,bacteria,trauma,orallergens,suchaspollenand mold. Without inflammation, wounds would never heal, tissue wouldbecomemoredamaged,andyourbodywouldeventuallydiefromanywounditreceived.21Interleukin-1(IL-1):IL-1isacytokine.Itisproducedbyplatelets,macrophages,andmonocytes.IL-1stimulatesanumberofresponses,includingbloodclotting,activatingTcellsduringthe

immuneresponse,decreasingbloodpressure,andinducingfever.16

Interleukin-6(IL-6):Aproteinthatactsasbothaproinflammatoryandananti-inflammatorycytokine.MacrophagesandTcellssecreteIL-6,usuallyinresponsetotrauma,suchasburnsor

tissuedamage.17

Leukotrienes(LT):Inflammatorysubstancesreleasedbymastcellsduringanallergicreactionor

anallergyattack.18

Naturalkillercells(NKs):Partoftheinnateimmunesystem,naturalkillercellsarewhitebloodcellsthatrejecttumorsandvirusesbyattackingand“killing”theinvaders.19

Prostaglandins:Prostaglandinsarefattyacidderivativesofarachidonicacidinvolvedinanumberofbodilyprocesses,includingpainsensation.Tumornecrosisfactor-alpha(TNF-alpha):Whenmastcellsarestimulated,theyquicklyreleaseTNF-alpha.AllcellsinvolvedininflammationhaveTNF-alphareceptors,orTNF-alphatellsthosecellstomakemoreTNF-alphaontheirown.AsmoreTNF-alphagetsproduced,theinflammatory

responseamplifies.20

Soinshortbursts,inflammationcanbeagoodthing.Butwhenitgoesontoolongandbecomeschronic,inflammationcanturnbadandputyouatriskforallkindsofdiseasesandhealthissues.

The inflammatory process is complicated, and it involves quite a fewchemicals.Here’soneexampleofhowinflammationoccursinthebody:Oneofthebigplayersintheinflammatoryprocessisanenzymecalledcyclooxygenase-2(COX-2).COX-2convertsarachidonicacid(anomega-6fattyacidandanotherbigplayerintheinflammatoryarena)intoaproteincalledtumornecrosisfactor-alpha(TNF-alpha)andthecytokinesinterleukin-1(IL-1)andinterleukin-6(IL-6).BothTNF-alphaandIL-1causeyourbodytoreleasefreeradicals;thesefreeradicals work to attack invaders, but they can also do major damage to yourbodybydestroyingcellsandDNA.22Thisdamage—whichisthemajorproblemwhen it comes to inflammation in your body and resultant disease—is calledoxidativestress.23

Tohelpmypatientsbettergrasptheconceptofinflammationwithouthavingto introduce complicated physiology, I often use the example of the drugcelecoxib (Celebrex), which is a COX-2 inhibitor. This prescription anti-inflammatorydrugdoesexactlyasadvertisedandreducesinflammationquickly.Italsocomeswithsomeseriouspotentialforsideeffects,includingriskofdeath.

CelebrexworksbyblockingtheactionofCOX-2—oneofthemostpowerfulenzymes for producing inflammation in your body.When you block COX-2,youliterallystoppaininits tracks.24Theopposite isalsotrue:WhenyouhelpfacilitateCOX-2, youmake inflammationmuchmore likely. Imentioned thatCOX-2 converts the omega-6 fatty acid arachidonic acid into inflammatorychemicals, which lead to free radicals and tissue damage. When you take inexcessive omega-6 fatty acids (by eating lots of foods that contain refinedvegetableoilssuchassnackfoods,cookies,andcrackers)without takinginanappropriate amount of anti-inflammatory omega-3 fatty acids (you should aimfora2:1ratioofomega-6 toomega-3fattyacids),yougiveCOX-2thatmuch

moreproinflammatorymaterial toworkwith.Eating toomanyomega-6 fatty-acid–richfoodsislikeaddingfueltotheinfla

mmationfire.25

INFLAMMATIONGLOSSARY:

TheBiggestPlayersintheInflammatoryProcessArachidonicacid(AA):AAisaproinflammatoryomega-6polyunsaturatedfattyacidmadefrommembranephospholipids.Cyclooxygenase(COX):COXisanenzymerequiredtoconvertarachidonicacidtoprostaglandins.13TherearetwodifferentformsofCOX,COX-1andCOX-2.BothCOX-1andCOX-2worktoinducepainbyallowingprostaglandinstocauseinflammation.Thesetwoenzymesaresimilar,butCOX-1promotesclotting,protectsyourstomach,andisinvolvedinpain,whileCOX-2ismoreinvolvedinthepainthatresultsfrominflammationin

yourbody.14

Cytokines:Amongthemostimportantplayersininflammation,cytokinesareproteinsthathelpimmunecellscommunicateandcoordinatetheinflammatoryresponse.Theyalsostimulatehematopoieticstemcellstomultiplyandturnintoimmunecells.Cytokinesinclude

IL-1,IL-6,andTNF-alpha.15

Dendriticcells(DCs):DCsarelikethepoliceoutonpatrolforcriminals.TheysearchforandpickoutcertainforeignantigensandtheytakethemtolocallymphnodestoactivateTcells,naturalkillercells(NKs),andBcells.Histamine:Whenmastcellsencounteranallergen,theyreleasehistamine,whichstartstheallergicreaction.Histamineincreasesbloodflowandencouragesfluidandproteintoleakintotissues,causingswellingandredness.

TheConnectionBetweenAllergiesandInflammationThereisaclearconnectionbetweenallergiesandinflammation;thetwoimmuneresponses are linked in several ways. For one thing, inflammation is animportantpartoftheallergicresponse.Inhayfever,mucousmembranesinyourears, nose, and throat become inflamed. In asthma, inflammation affects yourairways.Andduring the life-threateninganaphylactic allergic reaction that canresult from certain allergies, usually to foods, inflammation can affect yourentirebody.

In someone with allergies, the key chemical behind this allergicinflammationishistamine.Duringanacuteallergicreaction,theimmunesystem

reacts toa substance thatnonallergicpeople’s immunesystemswouldviewasharmless.Allergensbind to IgEantibodies,which triggermast cells to releasehistamine, which triggers allergy symptoms to set in. In the case of asthma,histamine causes the airways to become inflamed and to swell, which makesbreathingmoredifficult.26

Allergiesareprimeexamplesofchronicinflammationinthebody.Researchhasshownthatpeoplewithallergiesdon’tjustexperienceinflammationduringaflare; they actually have a higher baseline inflammation level all the time,particularly during the 2 months following allergy season. This minimalpersistent inflammation, as it is called, then makes allergy sufferers morevulnerabletoanallergyattack—andtohavingevenmoreinflammation—whenallergensdoshowup.27

Onadeeperlevel,allergicinflammationinvolvesanintricatecommunicationbetween several proinflammatory cells, including mast cells, lymphocytes,eosinophils,basophils,dendriticcells,andattimes,neutrophils.28

In terms of asthma, a few different inflammatory mediators, including T-helper cells, cytokines, prostaglandins, and leukotrienes, are involved in anasthmaattack.29Themastcells,“allergycells”inthebody,arekeyplayerswhenit comes to initiating inflammation. Here is a general overview of what mastcellsdo.

• Mastcells’cytoplasmisloadedwithgranulesthatmediatetheinflammatoryprocess.

• Thesemediatorsrecruitwhitebloodcells,including:• Themonocytesthatbecomemacrophageswhentheyleavethebloodandenterthetissue.30

• Neutrophils,whichhelpfightoffinfections,especiallythosecausedbyfungiandbacteria.31

• Eosinophils,proinflammatorycellsthatbecomeactiveinresponsetocertaininvaders,includingallergensandbacteria.32

• Lymphocytes,includingtheBcells,Tcells,andNKcells.Blymphocytesturnintocellsthatmakeantibodies,substancesthatattachtoantigensandhelpthebodydestroythem.Tlymphocytesdirectlyattackantigensandreleasecytokines,chemicalsthatcontroltheimmuneresponse.Together,BandTcellshelpcreateyourimmunesystem’smemory,soitcaneasilyattackinvadersithasseenbefore.33

Inadditiontorecruitingthesewhitebloodcells,mastcellsreleasetheirowninflammatorychemicals,oneofwhichishistamine.Histaminebringsonallergysymptomslikesneezing,runnynose,andhives,anditalsocausesinflammationbyincreasingbloodflowandencouragingfluidandproteintoleakintotissues.34

Thereareotherelementsoftheallergyandinflammationconnectionthataremorecomplicatedandlesswellunderstood.Researchersarestilllearningmore.In a2011 reviewpublished in the journal ImmunologicalReviews, researcherssaid people with allergies may have defective anti-inflammatory mechanismsandmolecules,includingproblemswithlipidsandcytokines.Soovertime,bothallergiesandinflammationgetworse.35

THEALLERGYANDOBESITYCONNECTION

Themorescientistslearnaboutallergyandobesity,themorethetwoseemtoberelated. Rates of both conditions are steadily climbing throughout the world,making researchers scratch their chins and consider a connection between thetwo.AccordingtotheWorldHealthOrganization,in2008,morethan1.4billionadults in the world were overweight and 500 million were obese, and thesenumbersarerising.Atthesametime,235millionpeoplehadasthma,andthosenumbers are going up as well.36 In addition to asthma, scientists have foundconnectionsbetweenobesityandavarietyofother allergicdiseases, includingallergicrhinitis,allergicconjunctivitis,andatopicdermatitis(eczema).37

InareviewpublishedintheSeptember2013issueofInternationalArchivesof Allergy and Immunology, researchers examined the connection betweenobesity and allergies. The review showed that overweight childrenweremorelikelytohaveeczema,andthemoreoverweighttheywere,theworsetheirskinconditionstendedtobe.38

They also found a clear connection between asthma and obesity. In onestudy, risk for wheezing went up steadily with increasing body mass index(BMI),showingthattheheavierapersonwas,theworsehisasthma.However,thequestionremainsastowhetherobesitycausesasthmaorthereverseistrue.(It’s theold“chickenoregg”puzzle.)Somethinkpeoplewithasthmaare lesslikely to exercise for fear of suffering an attack, and therefore, they’re morelikelytogainweight.However,therearemorestudiestosupportthenotionthattheoppositeistrue—obesityworsensasthma.

One such study lookedat17,316adults ages18 to65and10,700children

ages5to17,allofwhomhadpersistentasthmain2008.ThestudymembersfitintooneofthreedifferentcategoriesbasedontheirBMIs—normal,overweight,or obese. Researchers then looked at whether or not the participants had anasthmaattack in thespring, summer, fall,orwinterof2009.The results:BothBMIandseasonexacerbatedasthmasymptoms.HigherBMIincreasedriskforasthmaattacks in adults andkidswithpersistent asthma, especially in fall andwinter.39

AnotherstudypublishedintheBritishJournalofSportsMedicinelookedat452adultmenandfoundthatthosewithhigherBMIshadincreasedwhitebloodcellcounts(markersofinflammation)comparedtomenofanormalweight.Theresearchers looked at the individual types of white blood cells (neutrophils,lymphocytes,monocytes,basophils,andeosinophils)andfoundthatlevelsofallofthesewhitebloodcellswerehigherinoverweightmen.40

Butperhapsthebiggestlinkbetweenobesityandallergiesisinthearenaoffood allergies. We talked about the connection between food allergies andinflammation.Foodallergies,beingoverweight,andexcessiveinflammationallseemtobeinterconnectedaswell.Foronething,overweightpeopleseemtobemoresensitivetofoodallergens.41Ihaveseenpatientssteadilyloseweightaftertheyidentifyandcutoutafoodallergen,likethewheat-allergicmotheroftwo.Interestingly, underweight people seem tobemore sensitive to food allergens,too,butresearchersaren’tsurewhy.42

TypesofInflammation:TheGood,theBad,andtheUglyWhenyourimmunesystemspotsaninvader,inflammationisoneofthewaysinwhichitpreparesyourdefenses.Inflammationisanimportantfirststepinthefightagainstinvading

microorganismsorallergens,anditactivatesyourbody’shealingprocesses.43Therearetwomaintypesofinflammation—acuteandchronic.

Acuteinflammationhappensquicklyfollowinganinjuryorillness,suchasasorethroat,appendicitis,orascratchorcutontheskin.Itusuallylastsforafewdaysbutcangoonfor

aslongasafewweeks.44

Duringacuteinflammation,yourbodygoesthroughthefollowingsteps.

1.Yourbodysensesanirritant,let’ssayascratchontheskinofyourelbow.Thesmallbranchesofarteriesthatsupplybloodtoyourelbowskindilate,leadingtoincreasedbloodflow.Theareaaroundthescratchturnsred.

2.Yourcapillarieschangeandbecomemorepermeable,sofluidandbloodproteinscanmovethroughthespacesbetweencells(calledinterstitialspaces)andstartthehealingprocess.

Asyourbodygoesthroughthesestages,therearefivesignsofacuteinflammation:pain,

Asyourbodygoesthroughthesestages,therearefivesignsofacuteinflammation:pain,redness,immobility,swelling,andheat.

Pain.Inflammationusuallycausespain,whichresultsfromswellingpushingonnerves.Paincanalsoresultfromchemicalsreleasedspecificallytostimulatenerveendings.Weallknowpainisnofun,butitisanimportantwarningsignthattellsyousomethingisharming

yourbody.45

Redness.Asbloodvesselsdilateandcapillariesfillwithmoreblood,aninflamedareaturnsred.

Immobility.Dependingonthedegreeofinflammation,theaffectedareamaynotmoveorfunctionasitnormallywould.

Swelling.Inflammationcancauseabuildupoffluid,andtherefore,swelling.Heat.Excessfluidintheinflamedareacanmakeitfeelhot.46Chronicinflammation.Inflammationthatpersistsforseveralmonthsand,insome

cases,years.Incontrasttoacuteinflammation,chronicinflammationisharmfultoyourbody.Whenadiseaseorconditionpersistsfortoolong—suchasanautoimmunedisease,likemultiplesclerosisorrheumatoidarthritis;allergies;orasthma—theinflammatoryresponsecanbackfireandbecomemisdirected.Insteadofhealingtissue,theywayacuteinflammationdoes,chronicinflammationcanactuallyleadtotissuedestructionandcausemanymoreproblemsthantheinitialinvaderthatsparkeditinthefirstplace.Thisputssufferersatriskfordiseasesandconditionsthatincludehayfever,heartdisease,andsome

cancers.47,48,49

FoodAllergiesandInflammationNaturopathicphysiciansaretaughttoalwaysthinkaboutthefunctioningoftheliverandthegastrointestinal(GI)tractwhenassessingaperson’shealth.Ifeitherthe liver or the GI tract is not working well, then overcoming other healthproblemswillcertainlybemoredifficult.

As evidence of the influence that the GI tract may have on other organsystems, consider the GI-skin connection. People who have food allergiesleadingtoincreasedGIaggravationandinflammationwillfrequentlyalsohaveskinissues.Infact,whenpeopleareabletohealtheirGItracts,theirskinissuesoften resolveaswell. InChapter3, I talkedaboutacollege-agepatientwhoseskinclearedupwhenshe stoppedeating foods towhich shewasallergic. I’verepeatedly seen, in her case and in others, that when you heal the gut andfunctioningimproves,theskinclearsupaswell.

The idea that the GI tract is significant in determining the health of anindividualseems tobegainingsupport in theconventionalmedicalworld.Themorescientistslearnabouttheimmunesystemandinflammation,themoretheyuncover themany inflammatory reactions that takeplace in the digestive tractandcancausecramping,nausea,vomiting,andbloating.

There’s research to support this foodallergyand inflammationconnection.In a 2007 European study, researchers looked at two groups of kids—anoverweight group and a normal-weight group. They then measured threeindicatorsof inflammation:high-sensitivityC-reactiveprotein(CRP),amarkerof inflammation in the body; plaque in the carotid arteries; and levels ofimmunoglobulin G (IgG). All three of these markers indicate delayed foodallergies.50

They found that the overweight children had three times theCRP and 2½times theIgGas thenormalweightkids.Theoverweightkidsalsohadthickerarteries and early signs of atherosclerosis. These results suggest that foodallergies may actually cause inflammation and obesity, not vice versa.51 Ofcourse, itmaybeaviciouscircle:Theallergycauses the inflammation,whichpredisposesyoutoincreasedsensitivity.

One explanation for the study findings by the authors is something calledleaky gut syndrome, which is exactly what it sounds like. Food allergies andleakygutoftencoexist.Forvariouspossiblereasons,includingfoodallergies,apoor Standard American Diet, or microbial overgrowth, your GI tract canbecomeirritated—soirritatedthatitactuallybreaksdownanddevelops“cracks”initslining.Thesecracksallowfoodparticlestomoveoutofyourintestinesandinto your bloodstream. When these particles leave your gut, they areimmediately recognized by your immune system as a foreign substance. Inresponse,yourimmunesystemreactsbysettingoffaseriesofreactionsaimedateliminating this foreign substance, many of which are mediated byinflammation.Theseinflammatoryprocessescanbeverypowerful,astherearelargenumbersof immunecellssurroundingyourGIsystem.TheinflammationcanbesopowerfulthatitdoesnotstaycontainedwithinyourGItractbutrathercanbefeltthroughoutyourentirebody.52

Over time, the inflammation that results from a leaky gut can lead toconditionslikenonalcoholicfattyliverdiseaseandinsulinresistance,whichcancauseobesity.53This leakygut inflammationcanalsomakepeopleevenmoresusceptibletofoodallergies,thuscreatingmoreinflammation.54

Onewaytohelppreventleakygut—andtheinflammation,obesity,andotherconditionsthatitcanpromote—istocreateahealthybacterialecosysteminyourGI tract. You don’t realize it as you go through your daily life, but there areliterallymillionsofbacterialivingbothonandwithinyouatalltimes.Makingsurethey’retherighttypesofbacteriacanactuallyimproveyourhealth.Someofthe bacteria have names that you might recognize, such as Lactobacillus or

Bifidobacterium.Othershavenamesthatyoumightconsiderscary,likeE.coli.When these bacteria live in the right proportions, they promote optimal GIsystemhealth.It’swhenthebacterialsocietywithinyougetsdisruptedthatGIinflammationandillnessmayensue.

Thebacterialsocietywithinyourgutregulatesitselftoalargeextent.Eachstrainofmicroorganismiskeptincheckbythepresenceoftheotherstrainsalsolivingwithinyoursystem.Thetypeofbacteriaisalsoinfluencedbythetypesoffoods that are regularly processed through yourGI tract.A high-sugar diet, ahigh-proteindiet,andavegetariandietallfavordifferentstrainsofbacteria.

SomeofthebacteriainyourGIsystemhavethepotentialtobepathogenic,if their population gets large enough.This can occur for reasons such as poordietaryhabitsorantibioticuse.Changestotheinternalmilieu(orenvironment)canalsooccurwhenthewrongtypeofbacteriaisintroducedintoyoursystem,as in the case of food poisoning. If the undesirable bacteria dominate thegastrointestinal society for extended periods of time, damage can occur to thelining of the intestines, allowing partially digested food to enter yourbloodstreamandstimulatingyourimmunesystem.Andthatstimulatedimmunesystem can promote further inflammation throughout your body and increaseyourriskofobesity,heartdisease,autoimmunedisease...andallergies.55

Todemonstrate the importanceofgoodbacteria in thegut, researchers fedthinmiceahigh-fatdiettochangetheirintestinalbacteriafromgoodbacteriatothe bad type. (High-fat diets feed toxin-promoting bacteria in theGI tract andkillgoodbacteriathatfightoffinvaders.)56

Researchersfoundthatthemicethatatethehigh-fatStandardAmerican–likeDiet favored a bacterial population that produced a toxin calledlipopolysaccharide(LPS).Thistoxinwasthenabletoseepintothebloodstreamthroughtheleakygutthathadalsooccurredduetothepoordiet.Inpeople,LPSisknowntopromotetheproductionofproinflammatorymoleculessuchasIL-1,IL-6, andTNF-alpha.The resulting inflammation, especiallywhen it’s chronicinnature,cancauseinsulinresistance,fattyliver,andobesity.57

Furtherresearchsuggeststhataless-than-idealratioofgoodtobadbacteriamayalsopromotefoodallergies.Referringbacktothehygienehypothesis,somescientiststhinkthatourlackofexposuretoarangeofbacteriaearlyinlifeleavesourgutswithoutthebeneficialbacteriatheyneedtostaveofffoodallergies.58

A study published in Proceedings of the National Academy of Sciencessupports this. Researchers compared the gut bacteria of 14 kids from a ruralAfricanvillage inBurkinaFaso to thegutbacteriaof15children inFlorence,

Italy. They found that the bacteria in these two groups of childrenwere verydifferent.ThechildrenintheAfricanvillageliveinacommunitythatproducesitsownfood,andtheyeatamostlyvegetariandietsimilartotheonehumansate10,000yearsago.TheItaliankids,ontheotherhand,eatadietclosetotheSAD—high inanimal fat, sugar,andemptycalories.Thebacteria in theirgutswasless varied (or less biodiverse) than the bacteria in the guts of the Africanchildren.Thestudyauthorsconcludedthatthedifferenceinthebacterialflorainthetwogroupsofkidswasduetotheextremedifferencesintheirdiets.59

Childrenwholiveindevelopingthird-worldcountrieshavemuchlowerratesof food allergies, and their protective gut bacteriamay have something to dowith it.60 The moral of the story: Keeping your GI system and gut lining ashealthy as possible is vital not just for digestivewellness, but also for overallhealth.61

FightingInflammationandAllergies:GoingwithYourGutInstinctsWe’ve established that allergies and inflammation are connected, not justbecauseallergiescause inflammationbut alsobecause the twoprocesses sharesomeofthesameproinflammatorychemicalmessengers.Sothebigquestionis,canyoucontrolinflammationinyourbodyandstartcuringyourallergies?Theanswerisyes,andTheAllergySolutionPlaninthisbookwillprovideyouwithacomprehensiveprogramfordoingso.Atthisstage,Ijustwanttointroduceyoutosomeoftheimportantpartsoftheplan.

First, to stop the inflammatory process in its tracks, one of the mostimportant things you can do is maintain an optimal weight. I believe thatbreakingoutoftheviciouscycleofobesityandinflammationisoneofthebestthingsapersoncandotohelpcontrolinflammation.Thisisnotjustmyopinion,either;inonestudy,researchersfoundthatpostmenopausaloverweightorobesewomenwholostatleast5percentoftheirbodyweighthadfewerinflammatorymarkersthantheydidbeforetheydroppedthepounds.62

Second,youcanreduceyourintakeofproinflammatoryomega-6fattyacids(theonesthatcanbeconvertedtoTNF-alpha,IL-1,andIL-6)andincreaseyourintakeoftheanti-inflammatoryomega-3fattyacids.Foodsrichinomega-3fattyacids have great potential to reduce inflammatory cytokines and thus lowersystemic inflammation.Thebestomega-3fattyacidsareeicosapentaenoicacid

(EPA)anddocosahexaenoicacid(DHA);theycanactuallyhelpyourbodymakeanti-inflammatory prostaglandins and reduce its own inflammation.63 Thismeansthatyouneedtoeatlessvegetableoilandfewerprocessedfoods(whichcontain omega-6s) and eat more cold-water fish, nuts, and flaxseed (whichcontainomega-3s).AsI’vementioned,youshouldaimforanomega-6fattyacidtoomega-3fattyacidratioof2:1,orbetteryet,aratioof1:1.64

Andthird,youcanboostthenumberofbeneficialbacterialivinginyourgutby taking probiotics. You can get probiotics from foods like yogurt orsauerkraut, or you can take them in supplement form. If you choosesupplements, look for probiotics that contain Lactobacillus andBifidobacterium.65

Thisagainbringsme tooneof themain themesof thisbook:Treating thecauseofdisease.Toooftenpeopletreattheirallergiesthesamewaytheytreatalotofotherhealthconditions—byonlytreatingthesymptomsandignoringthecause. By looking at your body as a whole and addressing underlying riskfactors, such as chronic inflammation, it is possible not only to improve andeliminate allergic symptomsbut also to significantly reduceyour risk of otherdiseases as well. Essentially, it’s a two-for-one deal: Use a healthy lifestyleapproachtotreatyourallergies,andmakeadrasticimprovementtoyouroverallhealth.Afterall,whodoesn’twantthat?

PavingtheWaytoaNewDietwithProbioticsWhenIseepatientswhoaremakinganefforttoadoptahealthiervegetable-baseddiet,Ioftenhearthemcomplainofincreasedgas.Onereasonthisoccursisthatthebacterialpopulationsintheirdigestivesystemshaven’thadtimetoproperlyadapttotheirnewdiets.I’lloftenprescribeaprobioticandadigestiveenzymetohelpthemmoreeasilytransitiontotheirnewdiets.

6PreventingAge-AssociatedInflammation

ONEOFMYOLDESTPATIENTS,B.G.,isinhislate80s;he’salsooneofmymost inspirational patients.He’s lived a very rich life and is also a coloncancer survivor. Since his cancer diagnosis, this gentleman has been veryproactive about his health. He exercises every day, eats a healthy vegetable-based diet, and takes high-quality supplements specifically prescribed for himbasedonhisneeds.

Oneofthosesupplementsisanomega-3fattyacidsupplementderivedfrommolecularlydistilled fishoil.Aswe’vediscussedpreviously,omega-3 fats areanessentialcomponentofahealthylifestyle.Omega-3sdecreaseinflammation,improvecognitivefunction,and—importantforthispatient—canhelptoinhibitcoloncancergrowth.1IrecentlysawB.G.inmyofficeforhisyearlycheckup,and at that time, I ordered an omega-3 analysis to assess his body’s levels ofthesehealthyfats.Whenhisresultscameback,IwassurprisedbywhatIsaw.This80-plus-year-oldguyhadthebestomega-3fattyacidlevelsIhadeverseenin a patient. His overall levels were in the high-normal range, and he had anearlyperfectratioofomega-6toomega-3fats.

OneofthethingsthatIfindsoremarkableaboutthispatientishislevelofphysicalfitness.Inoneofmyconsultationrooms,Ihaveapairoffunky-lookingchairsthatweremadeinthe1960s.They’regreatchairs,buttheyaretruthfullyalittlelowandhardtogetinandoutof,sotheyprobablyaren’tthebestpatientchairs. Recently, B.G.was sitting in one of those low-slung chairswhilewetalked about his health.Hewas concerned thatmaybe he needed to be doingmoretopromotehishealth.Hethenproceededtoeffortlesslystandupandgetoutof thechairhehadbeen sitting in.At thatpoint I toldhim,“Youknow, Ihave40-year-oldpatientswhohavetroublegettingoutofthosechairs,andhereyouareclosinginon90,andyouget intoandoutof themwithoutaproblem.You’reanexampleofwhatweshouldallstrivefor.”

This patient is a shining example of the power of good lifestyle habits to

keepusyoung.Heisalsoanillustrationofhowmuchinflammation—oralackthereof—contributestooverallhealth.Asweage,wehaveanincreasedriskofdeveloping a number or diseases and adverse health conditions, such as heartdisease,arthritis,cancer,Alzheimer’s,andyes,allergies.Onereasonfor this istheaccumulationofinflammationthattypicallyaccompaniestheagingprocess.Whilesomedegreeofinflammationisaninevitablepartofaging,therearesomethings that you cando to set yourself up for less inflammation, bothnowandlaterinlife.

B. G. is the perfect example. He does everything in his power to combatinflammation—he eats well, exercises, and takes a variety of herbs andsupplements,includingthepowerfulanti-inflammatoryomega-3fattyacids.Healsomakes timeeveryday todosomething tosethismindateaseandreducestress.Hetellsmehehasvirtuallynoachesandpains.“Mybrother-in-lawcallsmealiarwhenIsaynothinghurts,butitreallydoesn’t,”hesays.He’salsohadno recurrence of the colon cancer that plagued him 15 years ago. And he isallergy-free.

Whenitcomestoaging,Idon’tthinkanyofuscanevercompletelyescapetheeffectsoftime.Wewillneverbeabletocompletelyfightallofthewrinklesandgrayhair,norwillwebeable to removeallof the inflammation fromourbodies. However, if you take care of yourself and make an effort to reduceinflammationandpromotehealth,youmightbeabletoeasilygetinandoutofsomecool,low-slung,retrochairswhenyoureachyournineties.Youwillalsobelesslikelytosufferfromdiseasesassociatedwiththeagingprocess,includingallergies.2

ANINTRODUCTIONTOAGINGANDINFLAMMATIONScientistsstillhavealottolearnabouttheagingprocessandwhysomepeopleage faster than others.3 One established reason for the inevitable physicalbreakdown that comes with age is that our bodies become increasingly moreinflamed as they get older. In general, elderly people have higher levels ofinflammatorychemicalsintheirbodies,suchasC-reactiveprotein(CRP),tumornecrosis factor-alpha (TNF-alpha), and interleukin 6 (IL-6). Once thatinflammationsetsin,researchshowsthatitmakesusageevenfaster.4,5

Anumber of studies support this link between increasing age and chronic

inflammation.6,7Ina2013studypublishedintheCanadianMedicalAssociationJournal, researchers looked at 3,044middle-age adultswho had no history ofstroke,heartattack,orcancerandmonitoredthemfor10years.Atthebeginningof the decade-long study, they measured participants’ levels of IL-6, animportantmarkerof inflammation.8 (IL-6 isagoodmarkerof inflammation inthebodybecauseithelpscontrolthereleaseofothercytokinesandinflammatorymoleculesthatdirectlyimpactyourmusclesandbrain.)9

After10years,721(23.7percent)oftheparticipantshadagedsuccessfully,based on the researchers’ criteria. Of the remaining participants, 321 (10.6percent)hadheartdisease,147(4.8percent)haddied,and1,855(60.9percent)fitthecriteriafornormalaging.10Themostimportantfinding:TheparticipantswiththehighestIL-6levelswere47percentlesslikelytoagesuccessfullywhencomparedtothosewithnormalIL-6levels.ThosewithelevatedIL-6werealsomorelikelytohavesufferedaheartattackortohavediedfromaconditionnotrelatedtoheartdisease.11

Based on these results, researchers concluded that chronic inflammationreduces your likelihood of disease-free aging. In otherwords, the higher yourinflammationlevels,the“older”youare.12

WhichCameFirst,theCandlesortheFlame?Scientists know for sure that most people becomemore inflamed as they getolder.But it’snotentirelyclearwhether inflammation levels increaseand thenconsequentlypromotedisease,orwhetherthediseasesandconditionscomefirst,causingpeopletobecomemoreinflamed.13

Somestudieshaveshown thatelderlypeoplehave inflammation regardlessofwhetherornottheyhaveanydiseases,whichwouldindicatethatagingaloneinvites theswellingand tenderness inour tissues.Onecontributing factormaybethatpeopletendtogainweightastheygainyears.AswelearnedinChapter5,obesitycertainlycontributes to inflammation.14However,otherstudieshavenotshownincreasedinflammatorymarkersinolderpeopleunless theyhaveanunderlying condition or disease, which would indicate that the diseases comefirst,thentheinflammation.15

Itmayalsobeacombination,whereagingmakesusmore inflamed,whileage-related inflammation then accelerates the aging process.16 For instance,researchersatAlbertEinsteinCollegeofMedicineinNewYorkCityhavefound

that as a particular area of the brain called the hypothalamus becomes moreinflamed with age, people are more likely to develop metabolic syndrome, agroup of risk factors that includes a largewaistline, high blood pressure, highbloodsugar, andhighcholesteroland triglycerides.Metabolic syndrome raisesyourriskofheartdiseaseandotherhealthproblems.17,18

To further explore this connection, researchers activated a specificbiochemicalpathway,calledtheNF-kBpathway,withinthehypothalamus.Thisstudywasperformedonmice,and theactivationof theNF-kBpathway led todecreasedmusclestrengthandskinthicknessinthemicetested.Italsomadeitmoredifficultforthosemicetolearn,anditdecreasedtheirlifespans.Inshort,whenresearchersstimulatedtheNF-kBpathway,themiceaged.Therefore,thehypothalamus and theNF-kBpathway appear to play an important role in theagingprocess.19Generallyspeaking,activationofthispathwayappearstoplayacentralroleininflammation,which,inturn,canacceleratetheagingprocess.20

There are a number of additional theories on the aging and inflammationconnection.Onepossibleexplanationissomethingcalledthefreeradicaltheoryof aging.Aswenoted inChapter 5, highly reactive atoms called free radicalscandestroycellsandDNAinaprocesscalledoxidativestress.21

This free radical–induced damage can make a person more vulnerable tomanyage-relateddiseases anddisorders, includingdiabetes, heart disease, andcancer.22(See“TheCancerConnection”.)Oxidativestressis,infact,oneofthemaincausesofdisease.Andingeneral,aspeopleage,theyhavemoreoxidativestressaswellaslessabilitytouseantioxidants(themoleculesthatcanstopfreeradicaldamage)asprotectionagainstthatstress.23

Anothertheoryisthataspeopleage,theirbodiesbecomelessabletorecoverfromperiodsofacuteinflammation.Togiveyouanexample,imaginethata70-year-oldwomancontractspneumonia.Tofighttheinfection,herbodybecomesacutely inflamed.Butonce the infectionclears, the inflammationdoesn’t fullygo away. Then, when the next threat comes along—say a cold virus or anallergen—her already-inflamed body overreacts and stays evenmore inflamedoncethecoldorallergicreactionisgone.Thisviciouscirclecontinuesandtheleftoverinflammationmounts.27

Yet another study points to a group of genes to explain the connectionbetween aging and inflammation. In a study that was funded by the NationalInstitutes of Health and published in the journalMolecular Cell, researchersdiscussedwhattheyfoundoutaboutafamilyofgenescalledAUF1.Afamilyof

four relatedgenes,AUF1controls the inflammatory response inyourbodybyturningoffinflammationtostoptheonsetofsepticshock.28(Septicshockislife-threateninglylowbloodpressurethatsetsinasaresultofaseriousinfection.)29WhenresearchersturnedoffAUF1,agingaccelerated,whichsuggestedthatthegenesactuallyhelpedslowtheagingprocess.AUF1alsoappearstohelpprotectchromosomes,thuspreventingrapidagingandcancer.30

TheCancerConnectionThelinkbetweenageandincreasedcancerriskhasbeenproven.Withalmosteverycancertype,ratessteadilyincreasewithage.Thereareprobablyafewreasonswhy.

Forone,immunefunctiondeclineswithageandputsolderpeopleatriskforcancerandautoimmunediseases.Putsimply,likeanoldcar,theagingimmunesystemdoesn’twork

aswellasitoncedid.Asaresult,itcan’tputthebrakesonaprogressingtumor.24ThebiggestfactorseemstobethedeclineinTcells,theimmunesystemcellsthatlookfor

fragmentsofantigensonthesurfacesofcellsthatareinfectedorcancerous.25

Foranother,researchhasalsolinkedcancerwithallergies,claimingthatpeoplewithallergiesaremorelikelytodevelopcertaintypesofcancer.Chronicinflammationisoneofafewdifferentexplanationsforthislink.Thethinkingisthattheongoinginflammationcausedbyallergiescausesoxidativestress,whichdamagestumor-suppressorgenes.Asaresult,thosegenescan’tinhibitcancercellgrowthaseffectivelyastheyshould.Moreresearchneedstobedone,butthetake-homemessageatthispointisthis:Doyourbesttokeepyourselfasinflammation-freeaspossible,andyouwillhelppreventmanydiseasesand

conditions.26Andifyoualsoreducethenumberoftoxinstowhichyouareexposedoveryourlifetime,you’resuretodecreaseinflammation.

ALLERGIESANDAGING

We’ve established the connection between aging and inflammation, but whatdoes all of that have to do with allergies, you ask? Put simply, the chronicinflammationthatincreaseswithageputspeopleatahigherriskofallergies.31Andwhenitcomestoallergies,let’sfaceit—thedarkcirclesunderyouritchy,wateryeyesandyourconstantrunnynose,not tomentiontheotherunpleasantsymptoms that go alongwith allergies, don’tmake you feel healthy or young(see“AnatomyandAllergiesintheElderly”).32

Allergies are often thought of as childhood conditions, and there’s a goodreasonforthat:Manychildrenoutgrowtheirallergies,especiallyfoodallergiestomilk and eggs. In addition, a number of studies have shown that levels of

immunoglobulin-E (IgE), the antibody responsible for releasing histamine,decreasewithage.Inonestudyof326peoplewithallergies,IgElevelspeakedinthetwentiesandthirtiesanddecreasedfromthereonout.Otherstudieshaveshown that as allergic people get older, they have gradually fewer allergensensitivities.33

But—and this is a big but—there are also a number of allergic conditionsthat persist into adulthood and the senior years aswell as some allergies thatmake their initial appearance later in life.35Allergiesandasthmacan showupforthefirsttimeatanyage,evenaslateas70or80yearsold.36

Additionally, as allergy rates are increasing in thegeneralpopulation, theyare also rising in the elderly. Doctors report seeing more older patients forallergysymptomsthaneverbefore.37Inonestudy,therateofallergiesinpeopleoverage60wasestimatedtobe4percent.38Otherstudiesputthenumberat5to10 percent. Considering the fact that people 65 years old and older are thefastest-growingsegmentofthepopulationindevelopedcountries,thenumberofelderlypeoplewithallergieswillbeanincreasinglyimportantpartoftheoverallallergypicture.39

Whenitcomestoasthma,accordingtotheCentersforDiseaseControlandPrevention,about10percentofthe14.5millionasthmasufferersareage65orolder.40 Considering the way that things are trending, the number of elderlypeoplesufferingfromasthmawilldoubleover thenext20years.Furthermore,experts think the numbers of older people with allergies and asthma areunderreported,so theactualnumberofelderlywithallergies isprobablymuchhigher. Unfortunately, there are fewer studies done on older people withallergies,andtherefore,fewerstatisticsonratesinthisgroup.41

Inaddition,symptomsofotherconditionsofolderage,suchasshortnessofbreath, wheezing, and chest tightness may mimic symptoms of allergies andasthma;asaresult,allergiesandasthmaaretoughfordoctorstopinpoint.Olderpeople are also more likely to take medications with side-effects similar toallergyandasthmasymptoms.Forexample,ACEinhibitors,whicharepopulardrugs for treatingdiabetes,highbloodpressure,andheartdisease,cancauseadrycough.Andthebeta-blockersusedtotreathighbloodpressureandglaucomacanconstricttheairwaysandleadtodifficultybreathing.42

Butallergiesandasthmainolderadultsarenothingtosneezeat.Whentheydoshowup later in life, theseconditions tend tobemore severe.Olderadultswithasthmaaremorelikelytosufferrespiratoryfailureandarelesslikelytogo

intoremissionthanyoungerpeoplewiththedisease.43Whydo allergies sometimeswait decades before rearing their ugly heads?

Thereareafewpossiblereasons.Foronething,itcantakeyearsofexposuretoan allergen before your body makes IgE antibodies and finally reacts to thatallergen.44Inaddition,aspeopleage,theyseemtobemoresensitivetoIgEthanthey were earlier in life, making them more likely to react to allergens likecockroaches,dust,andmold,evenifthesesubstanceshadneverbotheredthembefore.NotonlydoallergysymptomspersistinelderlypeoplewhoseIgElevelsremainrelativelyhigh,buttheyarealsomorelikelytoleadtoasthma.45

Second, some scientists think that the same hygiene hypothesis that mayexplainwhypeopleofallagesareexperiencingmoreallergiesmayalsoexplainwhyolderpeoplearemorevulnerabletofirst-timeallergysymptoms.Becauseofsmaller family size, increased sanitation, and less exposure to viruses andbacteria, people are suffering fewer infections; as a result, their relativelyinactive immunesystemsaremore likely to react toeveryday things likedust,pollen,andmold.Increasingairpollutioninourdevelopingworldmayalsoplayarole.46

Intermsofasthma,olderpeoplearealsomorelikelytosufferasthmaattacksinresponsetononallergenirritants,suchascoldair,potentperfumesandothersmells,andrespiratoryinfections.(Andwhenthoserespiratoryinfectionshitinolder asthmatics, they are more likely to be severe.) And older people withasthma are likely to suffer more severe declines in lung function than theirnonasthmaticfriendsofthesameage.47

Inaddition,havingallergiesearlier in lifeseems toputpeopleat increasedriskforasthmalateron.IntheNormativeAgingStudy,researchersfollowedalargegroupofpeopleages21 to80andfound that thosewhowereallergic tocatsweremorelikelytodevelopasthmainoldage.48

It works both ways: Researchers have also found that older adults withasthmaaremorelikelytohaveallergies.Ina2013studypublishedintheAnnalsof Allergy, Asthma, and Immunology, researchers looked at 2,573 peoplewhotookpartintheNationalHealthandNutritionExaminationSurvey(NHANES)2005–2006andcomparedallergicsensitizationoftwogroups—adultsages20to40andadultsage55yearsoldandolder.Intheyoungergroup,6.7percenthadasthma, and in the older group, 4.5 percent had asthma. Of the asthmatics,researchers found that 65.2 percent of the older group also had at least oneallergy,makingthemnearlythreetimesmorelikelytohaveanallergythanthe

participantswho didn’t have asthma. Themost common allergies in the olderpeoplewithasthmaweredustmitesandryegrass.Asan interestingsidenote,allergiesweremostcommoninwomen,especially thosewhowereoverweightorobese.49,50

Whichbringsmebacktooneofthemainthemesofthisbook:Byvirtueofbeingmoreinflamedthantheywereintheirtwenties,olderpeoplebecomemorevulnerable to all sorts of conditions, allergies included. The inflamed body ismore sensitive, and therefore has more potential to overreact to dust mites,pollen,andotherallergens.51

AnatomyandAllergiesintheElderlyInadditiontobattlingtheinflammationthatoftencomeswithage,olderpeopleundergoanatomicalchangesthatcanmakeallergysymptomsworse.AccordingtoanarticlepublishedinthejournalAllergy,Asthma,andClinicalImmunology,asyougetolder,thetipofyournosedroops,resultingindecreasedairflowthroughyournostrilsandworsenedhayfeversymptoms.Inaddition,nasalhairsarelessactiveinpostmenopausalwomen,soallergensaremorelikelytobuildupinthenoseandthroatandcausesymptomsinthese

individuals.34

ALLIUMCEPALatinfor“onion,”Alliumcepaisahomeopathicremedythattreatsallergysymptomsmimickingthoseyouwouldexperiencefromcuttingthepungentvegetable.PeoplewhobenefitmostfromAlliumcepaarethosewhosufferallergysymptomssuchaswaterydischargefromtheeyes,burningeyes,andburningacriddischargefromthenose.

DON’TTAKEINFLAMMATIONLYINGDOWNAsmypatientB.G.demonstrated,youshouldn’tshrugyourshoulders,putyourfeetup,andaccept inflammationand increasedriskofdiseaseasan inevitablepartofgettingolder.Thereareanumberofthingsyoucandotokeepyourselfhealthyandnimble.

Wewill delve into thismore inTheAllergySolutionPlan, but exercise isoneofthemosteffectivewayspeoplecanfightinflammationastheygetolder.52Intheshortterm,itistruethatexercisecanincreaseinflammation,especiallyifthat exercise is intense and prolonged. If you’ve everworked out particularlyhardonedayandthendreadedclimbingstairsthenext,you’veexperiencedthiskindofinflammation.

However,onceyourbodyadapts,regularaerobicexerciseseemstobeoneofthe best ways to reduce inflammation, especially as you age. At least ninestudies have shown that themore physical activity older people (average ageover60)report,thefewerinflammatorymarkerstheyhave.53

In a study published in the Journal of the American Geriatrics Society,researchers put half of 424 sedentary, overweight 70-to 89-year-olds on amoderate-intensitywalkingprogramandputtheotherhalfinahealtheducationprogram that didn’t include exercise. They then measured levels of twoinflammatory markers—CRP and IL-6. After 12 months on their respectiveprograms,levelsofbothinflammatorymarkerswentdownmoreintheexercisegroupthantheydidinthenonexercisegroup,especiallylevelsofIL-6.Similarstudies have shown the same results—regular aerobic exercise lowersinflammationinpeopleage60andolder.54,55

In addition to exercise, eating fewer calories may also help reduce age-related inflammation. Since the 1930s, studies done on mice have found thatrestricting calories helps decrease inflammation and slow the aging process.Whenrodentsarefedadiet thathas30percentfewercalories thanusual, theylive up to 40 percent longer than they normally would. Researchers at theNationalInstitutesofHealtharecurrentlylookingintowhetherthesameistrueinmonkeys and other nonhumanprimates.They have also started preliminarystudiestolookattheeffectsofcalorierestrictioninhumans.59,60,61

GREENTEAEXTRACTGreenteahassuperpowerswhenitcomestofightingallkindsofage-relatedconditionsandailments,allergiesincluded.Thelistofconditionsgreenteacanhelpcombatincludesnumerousformsofcancer,includingbreast,ovarian,prostate,pancreatic,andstomach;

diabetes;liverdisease;andinflammatoryboweldisease.There’salsoevidencethatgreentea

canhelpkeepyoutrim.56

Researchersthinkgreenteaissuchaneffectivemedicinebecauseitcontainschemicalscalledpolyphenols,whichactasantioxidants.Aswe’vediscussed,antioxidantsaremolecules

thatneutralizethefreeradicalsthatcancausedamagingoxidativestress.57

Intermsofallergies,inastudypublishedinScandinavianJournalofImmunology,researchersattheStateUniversityofNewYork(SUNY)DownstateMedicalCenterinBrooklynlookedatacomponentofgreenteaextractcalledepigallocatechingallate(EGCG)anditspowertosuppressimmunoglobulinE(IgE).(Torefreshyourmemory,IgEantibodiesareproteinsthebodymakeswhenexposedtoallergens.IgEantibodiesleadtoinflammation.)TheyfoundthattheEGCGingreenteaextractindeedhelpssuppressIgEinhumanallergic

reactions.58

Youcantakegreenteainstandardizedextractform,asdriedtealeavesmadeintotea,orincapsules.Itellmypatientstolookforadecaffeinatedgreenteaextractstandardizedtocontain90percentofthegreenteapolyphenols,whicharetheantiallergicportionoftheleaves.ThesupplementsIrecommendarealsostandardizedtocontainatleast40percentofEGCG—themostactivepartofthegreenteaplantthatsuppressedIgEintheSUNYstudy.Irecommendthatmostpeopleaimfor500to1,500milligramsofgreenteaextractperday,dependingonhowwellitworks.

Asasidenote,wheneveryoubuysupplements,keepinmindthattheyaren’tregulatedbytheFDA,soyouhavetodoyourhomeworktofindoutwhatyouarereallygetting.Lookforsupplementsthatareaspureaspossible,withnounnecessaryorextraneousingredients.Also,bewareoftermslike“proprietaryformula,”whichcouldmean30ingredientsbutnoefficaciousdosesofanybeneficialsupplementsorherbs.

Aswediscussed inChapter5,peoplewhoareoverweightorobese tendtohavemoreinflammationintheirbodiesbecausefattissue,especiallyabdominalfat,producescytokinesthatstimulateinflammation.Andthemoreyouexerciseandthefewercaloriesyoueat,thelessfattissueyouwillhave.62

Overall,we know that exercise and healthy eating are cornerstones of anystrong lifestyle routine. It’s not just the changes inmuscles andbreathing thatexercisebringsonbutalsothepositivementalchanges,theimprovedbodymassindex, and the decreased inflammation that help combat both the physicalbreakdownaccompanyingagingandtheincreasedallergyriskthatcanresult.

COQ10CoenzymeQ10(CoQ10)isasubstancefoundinyourbodythathelpswithcellgrowthandmaintenance.Italsofunctionsasanantioxidant,fightingthefreeradicalsthatcancauseoxidativestress.CoQ10levelstendtodecreasewithageandinpeoplewithcertain

conditions,includingcancer,diabetes,heartdisease,andallergies.63

CoQ10isagoodallergyremedybecauseitactsasanantihistamine;itquicklyworksto

combatallergysymptomslikesneezing,hives,andrunnynose.64Toboostlevelsofthisnaturalantihistamine,youcantakeCoQ10insupplementform.Personally,IlikethechewableCoQ10supplementsbecausetheytastelikechocolateandarealotbetterforyouthanacandybarorabrownie.Tohelppreventallergysymptoms,Irecommendtakingabout300milligramsofCoQ10aday.

Peg’sStoryManypeopledevelopallergiesinchildhood,butforPeg,52,theyfirstkickedinwhenshereachedmiddleage.

“Inmy40s,Idevelopedsneezing,rhinitis,andwateryeyesthatwouldlastformonthsoutofeveryyear,”saysthenurse.“Itriedseveralover-the-countermedicationswithnosuccess.”

Ontopofherallergies,Pegstruggledwithhighbloodpressure,whichshewasalsounabletocontrolwithconventionaldrugs.“Ivisitedmanydoctorsandtriedanumberofmedications,butnothingworked,”shesays.Withhighbloodpressurecombinedwithahighstressjob,shewasatickingtimebomb.

Soattherecommendationofafriend,PegwenttoseeDr.Psenka,whoprescribedsupplements—fishoil,curcumin,andvitaminD—aswellassublingualimmunotherapy(SLIT).HealsoencouragedPegtoexerciseregularly.

PegfoundDr.Psenka’splaneasytofollow,andshesawresultsrightaway.“Mybloodpressureimprovedimmediately,”shesays.“Withtheallergies,ittookacoupleofweeks,butmysymptomsaredefinitelybetter.”ShealsobegansleepingmoresoundlyunderDr.Psenka’scare.

ForPeg,Dr.Psenka’snaturalremediesfortreatingherallergiesandhighbloodpressureworked.“IwouldtellanyonesufferingfromseasonalallergiestotrynaturopathicmedicineandSLIT,”shesays.

7TippingtheScale:TheAdditiveEffectsofInflammation

IRECALLTREATINGAPARTICULAR50-YEAR-OLDprofessionalguyafewyearsago.Tosaythatthisgentlemanwasnotapictureofhealthwouldbeanunderstatement.Thisguywasoverweight,unhappy,andfatigued.Heclaimedthat in the past, around 30 years ago, he had been a heavy exerciser, but likemanymiddle-agemen,hehadfallenintoasedentarylifestyle.HewaseatinganunhealthyStandardAmericanDiet(SAD).Hisbloodpressure,bloodsugar,andcholesterolwereallelevated,andhehadproblemswithimpotencyandinsomniaas well. On top of all that, he complained about having tremendousgastrointestinal (GI) issues—gas, bloating, and diarrhea were the rule, ratherthantheexception,forhim.

This patient had seen another doctor, who had offered him prescriptionmedications to treat his hypertension and elevatedblood sugar and cholesterollevels. But the potential side-effects of these medications scared him, so hesoughtoutnaturopathiccare,lookingforamorenaturalapproachtoaddressinghishealthissues.

When this man came to me, we started slowly. I ordered some baselinelaboratorytests,includingfoodallergytesting,andIalsoinstructedhimonhowto begin eating a healthier diet. It turned out that he had awheat intolerance.Whenheremovedwheatfromhisdiet,hereportedthathisGIissuesdiminisheddramatically, andhe also feltmore energetic thanhehad in a longwhile.Wetalkedabouttheimportanceofregularexercise,andIpersuadedhimtogetbackintoaregularexerciseroutine.Onceheimplementedthis,henotedthathissleepimprovedandhisfatiguewentaway.

By the time about a year had passed,my patient had dropped close to 80pounds;hisGIissueswereresolved;hisbloodpressure,cholesterol,andbloodsugar all normalized; and his other symptoms were all greatly improved. Hishealth had completely turned around—and he never took one prescriptionmedication.

Thisman’sexperiencereinforcesmytheoryaboutthedownwardspiralthatcanresultfromunhealthyhabits.Asapersonsuccumbsmoreandmoretoastateof dis-ease and begins developing a number of lifestyle-related diseases andconditions, as my patient did, his or her levels of inflammation also risedramatically.Thisriseininflammationisadditiveandsystemic.Asyourlevelsof inflammation increase, your body becomes more and more vulnerable toadditionalhealthproblems.

So many of the conditions and diseases that are making people sick intoday’sworld—obesity,heartdisease,diabetes,cancer—arelargelydiseasesoflifestyle,meaningthattheyariseorbecomeworseduetopoordietary,exercise,and stress-management habits.1 Most of the aforementioned diseases havesubstantialinflammatorycomponents.Whenpeoplehavechronicallyunhealthyhabits, they stimulate their bodies to produce increasingly higher levels ofsystemic inflammation, which further increases their risk of developing thesediseases.

AswediscussedinChapter5,allergicdiseasesarealsopromotedthroughaninflammatory cycle. So as you becomemore andmore inflamed, you becomeevenmorelikelytooverreact,withallergicsymptomssuchassneezesandhives,tosubstancesinyourbody.Inshort,youbecomemoreallergic.2

TheInflammationCupSpillsOverWhen talking topatients, I oftenmake an analogybetween allergic symptomsandanoverflowingglass.Youcanonlyfillaglasswithsomuchfluidbeforeitgetsfilled to the topandbeginsspillingover.Thesameconceptholds trueforinflammation:Yourbodycanonlyadequatelycontrolsomuchbeforethelevelsgettoohigh,symptomsarefelt,anddiseaseriskiselevated.Whenitcomestoallergies, ifyourbody isalready feeling inflamedwhenallergyseasonarrives,thefirstspeckofpollenismorelikelytoleaveyousufferingswollen,itchyeyesandarunnynosethanitisforsomeonewithlowerlevelsofinflammation.

Backtotheglassanalogy:Let’ssayyouhaveanemptyglassinfrontofyouandyouhavefourknownallergens—dog,cat,ryegrass,andoaktree.Eachoneof thoseallergies causes theglass to fill upbyaquarter.Withexposure to allfourallergens,yourglassis100percentfull,righttothebrim.

Nowlet’ssayyoualsohaveawheatintolerance—notanallergytowheatorceliac disease, but an intolerance that makes your stomach hurt with gas andbloatingwheneveryouindulgeinawheat-containingfood.Yougooutforpizza

withyourfriendsandyoueatthreeslices—crustandall.Itisdelicious,butthenext morning you pay dearly with terrible gas and bloating. Your glass hasspilledover.

Thisisacommonscenario.Manyofusareatthebrimofourglassor,likemy50-year-oldpatientwith thewheat intolerance,alreadyhave liquidpouringover the top.One reason somanyof us are overflowingwith inflammation isthat there are proinflammatory substances all around us. The preservatives inyourmorningcereal,thechemicalsthatcausethe“newcarsmell”inyourbrandnewSUV,thefumescomingoutofthefactoriesyoupassontheroad,andtheanxietyyoufeelonceyouopenyourfulle-mail inbox—these thingsalladdtoyourinflammationglassandtakeawayfromyourhealth.

EUPHRASIAAlsocalledeyebrightbecauseofitsbenefitstotheeyes,Euphrasiaisapurple-floweredplant.Asahomeopathicremedy,Euphrasiaseemstoworkbestforeye-relatedallergysymptoms,includingburning,stinging,orwateryeyesaswellasnasaldischargethatgetsworsewhen

youliedown.3Igenerallyrecommenda30cdoseacoupleoftimesperdayforacuteeyeallergysymptoms.(Note:Homeopathicremediesaremeasuredonthecentesimal,or“c,”scale,whichrepresentsthedilution.)

TheCRPConnectionThenature of the relationship between inflammation and disease is somethingscientists continue to investigate. Some studies support the notion thatinflammationbuilds,leadingtoincreasedriskforbodydysfunctionanddisease.Onemarkerof this inflammatorybuildup isaproteincalledC-reactiveprotein(CRP),orHS-CRPforhighsensitivityCRP.4

Like inflammation itself, CRP does have some beneficial actions in yourbody. It triggers many immune system responses that help fight off fungi,viruses, and bacteria. Short-term bouts of increased CRP are fine; it’s whenthose CRP levels stay elevated due to chronic inflammation that they can doharm and cause tissue destruction.5 Some doctors now perform blood tests to

measureHS-CRPlevelsasameansofevaluatingapatient’sriskofdevelopingasuddenheartproblem,includingaheartattack.6

Some scientists think CRP levels slowly build in the body as peopleexperiencediseasesandinfections.Sothemoreillnessesapersonhasfoughtinhis or her lifetime, the higher the potential inflammation and resultant CRPlevels, and therefore the greater the risk of an untimely death. In the UnitedStates,peoplearemuch less likely todieatanearlyage today than theywere200yearsago.Onethoughtisthatpeoplewholivedhundredsofyearsagodiedatayoungagebecausetheyexperiencedmanymoreinfectionsandasaresult,theyhadhigherCRPlevels.7

One 2008 study published in the Journals of Gerontology, Series A:Biological Sciences and Medical Sciences explored this theory. Researcherscouldn’t re-create theunsanitaryconditionsofhundredsofyearsago,but theycould take a good look at a population that lives under similar circumstancestoday. Because of limited access to modernmedicine, the Tsimane people ofBolivia have high rates of infection and a low life expectancy. In fact, theircurrentmortality rate is the same as that of peoplewho lived in 19th-centuryEurope.8Topaintamorepracticalpicture,at the timeof thestudy,more thantwo-thirds of theTsimaneparticipantswere actively infectedwith at least onespeciesofintestinalparasite.9

What the researchers found was interesting: As a result of years ofinfections, the Tsimane had higher levels of the inflammatory marker CRPthroughout their lives. By age 35, the average Tsimane had spentmore yearswith high CRP than the average American has at age 55. The CRP levels ofyoungTsimanepeoplewerehigher than those inAmericansage65andolder.ThelifeexpectancyoftheTsimanewasabouthalfofthelifeexpectancyintheUnitedStates,whichatthetimeofthestudywas77.2years.10

So what do these findings really mean? We know that inflammationcontributes to many age-related diseases, including metabolic syndrome,diabetes, heart disease, and cancer. But the results of this study show thatinflammationcanalsoresultfrominfectionanddiseaseandcanbuildupinyourbodyovertime;therefore,themoreyourbodygoesthroughintermsofinfectionandillness,themoreinflameditmaybecome.Inasense,ifyourbodyfightsofftoomanybacteria,viruses,andparasites,itcanprematurelyage.Thetake-homemessage is this: The more you can do to protect yourself from illness andinfection, the less inflamed you will be. (One interesting footnote is that anumberofrecentstudieshavedemonstratedthatarangeofenvironmentaltoxins

can lead to increased risk for a number of diseases—including cardiovasculardisease—bypromotinginflammation.11)

DiseasesThatIncreaseInflammationWith theTsimane inmind, one important thing you can do to prevent excessinflammation—and therefore, allergy symptoms—in your body is to work tostayhealthy.Thereisonlysomuchyoucandotoavoidbacteriaandviruses,butthere are steps you can take to help prevent some common promoters ofinflammation.Many lifestyle-relateddiseasesnotonlymayarise in thefaceofchronic inflammation but also they actually increase inflammation once theyhavedeveloped.These include obesity, diabetes, heart disease, somedigestivedisorders, and cancer. In the next few chapters, Iwill teach you some simplestepstohelppreventandpotentiallyreversethesehealthproblems.Firstthough,let’sexploretherelationshipbetweenchronicinflammationandthediseasesoflifestyle.

OBESITYOne of the most important conditions to avoid is obesity, because thedevelopment of other lifestyle diseases can be hastened by carrying excessweight.12ObesityisthebiggesthealthproblemintheUnitedStates,withalmost155 million adult Americans now overweight or obese, according to 2013figures from the American Heart Association.13, 14 Scientists are constantlylearning more about obesity and what—other than simply eating too much—causes it. They do know it is a disorder of metabolism caused by numerousfactors,includinginflammationandoxidativestress.15

There is some debate among researchers about which comes first—theinflammationortheobesity.16(It’stheever-presentchicken-or-eggconundrum.)There’sactuallyresearchtosupportbothsidesofthedebate.Thosewhobelievethat the inflammation precedes the obesity describe a series of steps like this:Whenyoueatafoodtowhichyouareallergicorsensitive,yourbodybecomesinflamed.Thatinflammationthencausesyouradrenalglandstosecreteadrenalhormones thatdestabilizeyourbloodsugarand insulin levels,causing them tobecome elevated. High insulin levels affect the activity of two enzymes,lipoproteinlipaseandtriglyceridelipase,whichtellyourbodytostorefatratherthantoburnitforenergy.17Thehighinsulinlevelsalsopromoteinflammation.

Asaresult,overtime,yougainweight.Then,tomakemattersworse,havinga high-body-fat percentage makes your body even more inflamed. Peopleassume that fat tissue is just fat tissue and that other thanmaking your jeanstighter,itdoesn’tdoanything.However,fatis,infact,verymetabolicallyactiveandplays lotsofdifferent roles, bothgoodandbad, inyourbody.Oneof thebad:Itcausesothertissuestobehavedifferentlyandtobecomemoreinflamed—andmoreinflammationmeansevenmoresensitivitytoallergens.18

Let’s lookat this inmoredetail.Contrarytopopularbelief,whenyougainweight,youdonotgainmorefatcells.Youareactuallybornwithasetnumberoffatcells,andyoukeepthatfatcell totalforyourentire life.Whenyougainweight,thesecellsbecomelargerandfillwithmorefat;whenyouloseweight,they shrink. As you gain weight and your fat cells swell, they can becomestretched to thepointwhere theydevelopholesand they leak.Tocleanup themessyfatthatseepsout,yourimmunesystemsendsoutatypeofcellknownasamacrophage.Astheyclean,themacrophagesreleaseinflammatorychemicals.Theinflammationthatresultsfromthiscleanupprocessmaybethemechanismbehindalotofthenegativehealtheffectsofobesity.19

There’s more still: To counteract this inflammation, your body producesanti-inflammatory chemicals. Fighting inflammation is a good thing, but itcomes at a hefty price. Some anti-inflammatory chemicals appear to interferewithleptin—thehormoneresponsibleforkeepingyourbodyatahealthyweight.(Leptin is the reason some people can eat whatever they want and not gainweight;ifthesepeopleovereat,leptinkicksintoboostmetabolismanddecreaseappetite.) Inflammation can cause a condition called leptin resistance, whereleptin doesn’t work properly to control appetite and metabolism. As a result,peoplestruggletomaintainahealthyweight.20

TheprocessIjustdescribedisoneofthewayspeopledeveloptheconditioncalledmetabolic syndrome.Metabolic syndrome isagroupof five factors thatraiseyour risk for anumberofdiseases, includingheartdisease,diabetes, andstroke. The five risk factors are high blood pressure, high blood sugar, hightriglycerides, abdominal fat, and a low level of good (HDL) cholesterol.21Peoplewithmetabolic syndromeusuallyhavehigh levels of the inflammatorymarkerCRP,too.22

Most peoplewithmetabolic syndromegoon to develop insulin resistance,which changes the way the body processes sugar and fat. As such, insulinresistance is a precursor to diabetes and nonalcoholic fatty liver disease—acondition that limits the liver’s ability to perform its functions. Once people

develop nonalcoholic fatty liver disease, also known as nonalcoholicsteatohepatitis(NASH),theygetveryhighcholesterolandtriglyceridelevels,aswell as elevated blood sugar, and liver enzymes, potentially leading to severeliverdysfunction.Sothemoreyoucandotopreventinflammation,thebetter.

HEARTDISEASEIntermsofspecificdiseasestates,theonewithprobablytheclosestconnectiontoinflammationisheartdisease.Thesedays,fewerpeoplearedyingfromheartdiseaseinthiscountry,butmoreandmorepeoplearebeingdiagnosedwiththecondition.Infact,morethanoneinfourAmericanadultshassomeformofheartdisease.23

Althoughnoonehasproventhatinflammationdirectlycausesheartdisease,study after study on cardiovascular disease points to inflammation as amajorcontributingfactor,especiallytoatherosclerosis.24Atherosclerosisisaconditioninwhichfattydepositscalledplaquebuildupinsidethearteries.Atherosclerosiscanleadtoserioushealthproblems,includingheartattackandstroke.25

Itworkslikethis:Justlikeaknifecaninjurethetipofyourfingerwithacut,smoking, high-fat foods, and high blood pressure can damage yourcardiovascular system.As a response to these irritants, plaque is deposited inyour arteries, narrowing the lining of the vessels and potentially causing ablockage.26

Inaddition,yourbodyseesplaqueinyourarteriesasaforeigninvaderandtriestoprotectitselfbyseparatingthatplaquefromyourbloodstream.Oneresultofthisattemptedseparation:bloodclots,whichareoneofthebiggestcausesofheartattackandstroke.27

Researchers have also discovered that there may be a direct link betweenheart disease and allergies. Scientists at the Einstein Medical Center inPhiladelphia looked at health information on more than 8,600 adults whoparticipated in the National Health and Nutrition Examination Survey(NHANES).Theyfoundthatpeoplewithheartdiseaseoftenhadallergies.Theyalso discovered that people with wheezing had two times the risk of heartdisease,andpeoplewithstuffynoseanditchy,wateryeyes(rhinoconjunctivitis)were 40 percent more likely to have heart disease than people without theseallergic conditions. The researchers think allergies and the inflammation thatgoesalongwiththemmayleadtothickeningofarterywallsand,eventually,toheartdisease.28

More recently, researchers have connected allergic episodes to acutecoronarysyndromes.InaTurkishstudypublishedinInflammationandAllergy-DrugTargets,researcherslinkedtheinflammatorymediatorsreleasedduringanallergy attack—namely, histamine—to coronary artery spasms and plaqueerosionorrupture.29

DIABETESDiabetes,especiallytype2,whichisdirectlytiedtopoorlifestylechoices,isoneofthefastest-growingdiseasesintheworld.IntheUnitedStates,thenumberofpeoplewith diabetes went from 1.5million in 1958 to close to 19million in2010.Thisriseismainlyduetopoorlifestylehabits,suchaslackofexerciseandeating theStandardAmericanDiet (SAD).30These badhabits lead to obesity,whichisaprimaryriskfactorfordiabetes.Bothbadhabitsandextrafat tissuelead to more inflammation in the body, which researchers have also tied todiabetesrisk.

NewresearchfromDenmarklookedspecificallyattheinflammatorynatureoftype2diabetes.Inone2014study,researcherslookedathowtype2diabetesunfolds in mice. They found that during the early stages of the disease,macrophages invade thepancreas and, in theprocess, releaseproinflammatorycytokines. Those cytokines then destroy the beta cells that produce insulin,leadingtoinsulinresistanceanddiabetes.31

DEPRESSIONIt seems that inflammation is not only associatedwith physical conditions butalsocanariseasaconsequenceofaperson’smentalhealth.Forexample, inastudyattheUniversityofMiamiresearchersfoundthatdepressedpatientstakingselectiveserotoninreuptakeinhibitors(SSRIs)werelesslikelytoseebeneficialresults from the drugs if they’d experienced a negative event (or emotionaltrauma)earlyinlife.Patientswhohadn’texperiencedsuchaneventweremorelikely to respond to the drugs. Inflammation caused by the early life stressorappearstohaveinhibitedthedrugs’effects.32

There’s also a pretty clear link between depression, asthma, allergies, andinflammation.Onthesurface,dealingwithachronicconditionsuchasasthmaorallergiescan,inandofitself,bedepressing.AstudypublishedinPsychosomaticMedicineshowedthatpeoplewithhayfeverhadhigherratesofdepressionanddecreasedfeelingsofpleasureduringtheearlyfall ragweedseason.This is the

oppositeofthegeneralpopulation,whichtendstogetthebluesduringthewintermonths.34But the relationship seems togodeeper than that, tocytokines—thechemicalssecretedbyimmunesystemcells tostartorstopinflammation.Bothconditionsareconnected to increased levelsof theseproinflammatory typesofcytokines.35

VITAMINCAmericanchemistLinusPaulingthoughtvitaminCwasnature’sbestmedicine.Whenitcomestofightinginflammationandallergies,hemayhavebeenontosomething.

VitaminCisawater-solublevitaminfoundnaturallyincitrusfruits,tomatoes,andbroccoli.It’simportantforgrowthandrepairoftissues,especiallyskin,ligaments,tendons,andbloodvessels.VitaminCisalsoimportantforboneandtoothhealthaswellasforwoundhealing.

ThehealingpowerofvitaminCstemsfromthefactthatitisanantioxidant,andthereforeitcombatssomeofthedamagecausedbyfreeradicals.Becauseoftheseproperties,vitaminC

canhelptreatallergysymptomssuchashayfever,asthma,andeczema.33Whenyou’retreatingallergies,typicaldosesofvitaminCrangefrom1toseveralgramsperday,usuallyindivideddoses.

IRRITABLEBOWELSYNDROMEFor a long time, scientists didn’t think there was any connection betweenirritable bowel syndrome (IBS)—a chronic bowel disorder characterized byabdominal pain and intermittent diarrhea and constipation—and inflammation.Butthey’vechangedtheirtune.Thereseemstobesomelow-gradeinflammationinthedigestivetractsofsomepeoplewithIBS.36

SomepeoplemaydevelopIBSasaresultofgastroenteritis,oftenreferredtoas a stomach bug.37 Most of us have suffered the acute inflammation of astomachbug:Assoonasyougotinfected,mastcellsandcytokineswerequicklyrecruited into action to fight against the infection. The release of thesesubstancescausedabdominalpain,cramping,vomiting,ordiarrhea.Then,afteradayortwooffeelingpoorly,chancesareyoustartedtofeelbetter.38

Research points to the possibility that, in some people with IBS, theinflammatoryprocesspersistedlongafterthestomachinfectionresolved.Infact,

upto30percentofpeoplewithIBSclaimtheirsymptomsstartedafterastomachinfection or food poisoning. In these people, the mast cells continue to staymildlyactivated,causingongoingcrampsanddiarrhea.

Sincemastcellsare involved, thisresearchalsohelpssupportaconnectionbetweenIBSandallergiestofoodsandothersubstances.ManypeoplewithIBSreport that certain foodsmake their symptomsworse. Plus,many peoplewithIBSwho go on food elimination diets tend to feel better,which suggests thatfoodallergiesorsensitivitiesmaybeatplay.39

Besides food, research has shown a link between IBS and respiratory andskinallergiesaswell.A2008studyfoundthatpeoplewithhayfeverandeczemaweremuchmorelikelytohaveIBSthanpeoplewithouttheseallergies.Ontheflip side, IBS sufferers are more prone to eczema and hay fever than peoplewithoutIBS.40

CANCERScientistshave long recognized the linkbetweencancerand inflammation,buttheyhaveyettounderstandtheexactreasonsfortherelationship.41

Ina2007studypublishedinthejournalCell,researchersatTheUniversityofCalifornia,SanDiego,foundaspecificproteincalledp100,whichiscommontobothinflammationandcancer.Simplyput,p100helpsregulatethebalanceofinflammation and cellular development in your body. Someone with chronicinflammationmayhavetoomuchp100,whichleadstothedevelopmentofmorecells,includingcancercells.42

In a more recent review published in Clinical and Experimental Allergy,researcherstooktherelationshipbetweeninflammationandcancerabitfurtherandlookedathowallergiesfitinaswell.Amongothertheories,theyexaminedthe chronic inflammation hypothesis, which says that the inflammationconnectedtoallergiesmayincreasecancerriskbycausingoxidativestress.Thisoxidativestressdamages tumorsuppressorgenes, therebymakingcancermorelikelytogrow.43

I want to stress that theworldwe live in is very proinflammatory.We’reconstantlybeingbombardedwithsubstancesthatincreaseourinflammation,andbad habits like choosing the couch instead of a workout and supersizing ourmealscertainlyaren’thelping.Remembertheglassofinflammationanalogy:Itcanonlygetsofullbeforeitstartsrunningovertherimandcausingsymptomsor increasing disease risk. If you want to improve your health, not just with

respect to curing your allergies but also relating to your mental and physicalfitness, read on. TheAllergy Solution Plan inChapter 14will provide tips tohelpyoudojustthat.

8FiringYourselfUp:AnxietyandInflammation

AFEWYEARSAGO, Iconsultedwithaverynicewomanwhohadrecentlybeen diagnosed with metastatic breast cancer. She had been struggling withchronic anxiety even before her cancer diagnosis, and facing the conditionunderstandablymadeherallthatmuchmoreanxious.AswithallofthepatientsIsee,Iaskedthisladyhowsheperceivedheranxietylevels.Onascaleof1to10,with1beingthelowestanxietyleveland10beingthehighest,mostpeopleratetheiraverageanxietylevelsatabouta7oran8.Shewasn’tanydifferent,statingthatshewasnormallyaboutan8,butsinceherdiagnosisshehadbeena10-plus.

ThenextquestionIaskedwasmoreimportant:Whatdidshedoonadailybasis to compensate for the 10-plus stress level she was experiencing? HeranswerwasthesameasthatofmanyofthepeopleIsee.Shedidn’tdoanything,thoughshehadbeenusingAtivan tohelpherdealwithherdailystressand tohelpherfallasleepatnight.Iaskedherwhatshedidforfun.Shedidn’thaveananswer.Iaskedherifshepracticedanysortofreligionorengagedinanyartisticoutlets.Shedidnot.

I suggested that thispatient findsomethingshecoulddo tohelpoffsetheranxiety. We discussed many different options, such as meditation, guidedimagery, religion, exercise, and art. At one point, I suggested gardening. Shesaidshehadayard,butitwasmainlyjustdirtwithafewscragglyplantsonthesides.Shehadnevergivenmuchthoughttogardening,butbecauseshewassickofbeingconstantlyanxious,shedecidedtogiveitatry.

As time passed, this woman slowly but surely became less anxious, evenduringhercancertreatments.Alongtheway,Iwouldaskherhowthegardeningwasgoing;shewouldalwayssmileandsay,“Oh,it’scomingalong.”

A fewyears later, the samewomanwhohadcome intomyofficewithnohobbies and a chronic anxiety issue told me she was planning to host herparents’50thweddinganniversaryinthegardenshehadcreatedinherbackyard.

Onceshehad incorporateda littlestress-relievinggardening time intoherday,she became gradually less dependent on the antianxiety medication and waseventually able to stop taking it altogether. I’m happy to share that she alsoovercamethemetastaticbreastcancer.

This particular patient did not suffer from allergies, but she is a goodexampleofthepoweranxietyandstresshavetotakeoveryourlifeaswellastheimportance of including enjoyable, stress-relieving activities in your dailyroutine. Her story also illustrates the toll mental problems can take on yourphysicalhealth.Anxietyismorethanjustafeeling;ithasaverytangibleeffecton your body. Most notably, anxiety causes surges in the adrenal hormonescortisol(the“stresshormone”),epinephrine,andnorepinephrine,andchronicallyelevatedlevelsofthesehormonessetupyourbodyforinflammation.

Aswe’vediscussed, inflammationputsapersonatgreater risknot just forallergiesbutalso forawholehostofotherdisordersandconditions, includingheart disease, diabetes, obesity, and cancer.1 There is no way to determinewhether my patient’s chronically elevated anxiety level contributed to hercancer,butitcertainlydidn’thelp.OvertheyearsthatIhavebeeninpractice,Ihave visited with many women diagnosed with breast cancer, and the vastmajorityofthemreportedhavingsignificantlyelevatedstresslevelsjustpriortotheirdiagnoses.I’mveryhappythatmybreastcancerpatient,andmanyotherslike her, found an activity to help compensate for and treat their anxiety.Reducing anxiety levels can only improve your health, no matter what yourhealthchallengesmaybe.

Duringmyyearsinpractice,Ihavecometobelievethatanxietyisoneofthebiggesthealthproblemsaffectingoursociety.NearlyallofthepatientsIseeinmypracticereporthavingelevatedanxiety.Often,it’sunchecked,meaningthatthesepatientshaveanxietybutnomethod for relieving it. Imake it apoint toeducate all of my patients on how to incorporate relaxing, stress-relievingactivitiesintotheireverydayroutines.Doingsopromoteslivingahealthier,less-stressed lifestyle and reduces inflammation, and therefore improves overallhealth,includingallergysymptoms.WithTheAllergySolutionPlaninChapter14,Iwillhelpyoudothesame.

WhatAreAnxietyandDepression?AnxietydisordersareamongthemostcommonmentaldisordersintheUnitedStates.2In

fact,aboutoneinfiveAmericanssuffersfromanxietyinsomeform.3

Anxietyiscomplexandcanbedifficulttounderstand,evenforexperts.Insimpleterms,itisanabnormallevelofapprehensionaboutthefuture,especiallyconcerningchallengingtasks.Thereareanumberofcategoriesofanxietydisorders,includinggeneralizedanxietydisorder,socialanxietydisorder,phobia,post-traumaticstressdisorder(PTSD),and

obsessivecompulsivedisorder(OCD).4Eachdisorderhasitsownuniquesymptoms,buttheyallsharetwocommonelements:irrationalfearsandfeelingsofdread.Anxietydisordersoftenaccompanyothermentalorphysicalillnesses;substanceabuseand

depressionaretwoofthebiggies.5Andwhileanxietyisworryingaboutthefuture,

depressioncanbedefinedasoverthinkingthepast.6

Similartoanxiety,thereareanumberofdifferentdepressivedisorders,eachofwhichhasitsownuniquesymptoms.Butingeneral,symptomsofdepressioncanincludesadness,irritability,cryingspells,changesinsleepingandeatinghabits,difficultymakingdecisions,shorttemper,overeating,problemsconcentrating,pain,avoidanceofpeople,anddecreasedinterestinactivitiesyouusedtoenjoy.Inthemostseverecases,depressioncan

includethoughtsofsuicide.7NearlyasmanyAmericanssufferfromdepressionasfrom

anxiety.8

WHATISSTRESS?Inordertohaveanxiety,youmustfirsthaveoranticipatehavingstress.Stressisanyfactor inyourlife thatrequiresyoutoadaptandreact,eitherphysicallyormentally. It canbe emotional (losing a lovedone), physical (an injury), social(pressure to attend parties you’d rather skip), technological (your constantlybeeping and ringing cell phone), or economic (a layoff). In some cases, thesestressesarereal.Inothers,theyareexaggeratedinourownminds.9

Stresscanactasamotivator,soitcanbeagoodthinginsmalldoses.(Thispositivestressissometimesreferredtoaseustress.)Afterall,intheabsenceofanystress,we’dallstillbeinourpajamasatnoon,flippingthroughthechannelsinstead of halfway through a productive day. It’s when the stress starts andbecomes chronic and unrelenting, eventually taking over our lives, that itbecomesproblematic.10Unfortunately, stress seems tobe amajorproblem formost people in this country. According to the American PsychologicalAssociation,mostAmericansbelievetheyaremoderatelyorseverelystressed.11

The trouble stems from a mismatch between the way the human stressresponse was originally designed to operate and our current stress-riddledlifestyles.Intimespast,ourstressresponse,thefight-or-flightresponse,kickedintogearwhenwewereindanger.Thefight-or-flightresponseisorchestratedbyouradrenalglandsandthehormonesthattheyproduce,namelyepinephrineand

norepinephrine.Thesehormoneschangeourbodiesphysiologicallytoprepareustodooneoftwothings,fightorrun.Defendingoneselforbeingabletoescapefromdangerservedourancestorswellwhenwewerestilllivinginthewild.

Ioftenuseanexampletakenfromsomeofourclosestanimalrelatives,thechimpanzees, to help people more fully understand this concept. Everyone isfamiliar with chimps; they are social apes that live in tightly knit groups inAfrica.Most of a chimp’s day is spent foraging for food and reinforcing thestrong social bonds that tie their families together and keep things calm.Oneway that chimps reassure each other and promote a lowered stress level isthoughgrooming,andtheyhavebeenobserveddoingthisbehaviorformuchoftheday.Itisonlyeverynowandthenthatajaguarspringsoutofthebushesandsends the chimps into a frenzy, triggering their fight-or-flight responses. Thechimpsoperateinthisstateuntilthedangerhaspassed,likely10to15minutes,andthentheygorightbacktogroomingeachother.

Whilehaving the fight-or-flight response is helpful indangerous situations(suchasescapingfromahuntingjaguar),havingachronicallystimulatedfight-or-flightresponsecanleadtoproblems.Today,mostofusliveverybusyliveswith not nearly enough relaxation time, and that puts our bodies in a near-constant state of fight-or-flight. As a result, our bodies, acting under thedirectionof theadrenalglandsand the fight-or-flight response, are chronicallypreparingtoeitherfightorrun.Inthisstate,thereareveryfewbodilyresourcesdevotedtoessentialhealth-promotingfunctionssuchasdigestion,repairing,andrebuilding.Digestion is impaired, leading toproblemswithnutrientabsorptionand gastrointestinal function, which often lead to symptoms such as stomachcramps and diarrhea. Immune function is also lowered, making you moresusceptible to illness. Researchers have also found clear connections betweenchronic stress and chronic depression.12 Excessive anger and irritability arelinkedwith chronic stress states as well. In some people who are chronicallystressed,thereproductivesystemmayevenstopworkingasitshould.Basedonthis,it’sclearthatthestressandanxietylevelsexperiencedbymostpeopletodayarecontributingtothedevelopmentofdisease,andwhatweshouldbedoingisspendingmoretimepickingthefleasoffourfriends—figurativelyspeaking,ofcourse.

ARSENICUMALBUMMadefromwhitearsenicthatwillcauseseveregastroenteritisiftakenatahighdose,Arsenicumalbumtakeninhomeopathicdosescanhelpwithgastrointestinalsymptomsaswellasanxietyanddepression.Irecommendthistreatmenttomypatientswithfoodintolerancesormooddisordersymptoms.Igenerallyrecommenda30cdosetostart.

TheConnectionBetweenAnxietyandInflammationResearchers know that there’s a definitive connection between anxiety andinflammation in your body, and they are constantly learning more about thereasonswhy.Unlikeotherorgans,yourbrainhasnopainnerves.Soinsteadofpain, inflammation in your brain manifests as mental conditions like anxiety,depression, or fatigue.13 And chronic brain inflammation can be dangerous.Whenitgoesontoolong,thisinflammationcancausedecreasedcommunicationbetweenbraincellsandfewersignalsbetweennerves.14

ArecentstudydonebyresearchersatOhioStateUniversityhasfoundthatchronicstressmayactuallychangethewaygenesinimmunecellsbehavebeforetheyentertheblood.Bycomparingmiceandhumansinstressfulsituations,theresearch found that the two experience similar changes in their bone marrowwhenthey’reunderstress.15

Tocreatestressinthemice,researchersforcedagroupofmalemicetolivetogether in close quarters for enough time to create a hierarchy. They thenintroduced an aggressivemalemouse to thegroup for2hours at a time. (Themouse equivalent of social defeat, which put them in chronic fight-or-flightmode.) The human participants in the study had poor socioeconomic status,whichisastrongpredictorofchronicstress.16

Togiveyousomecontext,eachday,yourbonemarrowreleasesbillionsofredbloodcells andmanydifferent typesofwhitebloodcells. Ifyour immunesystem senses a threat, your bone marrow produces special energized whiteblood cells that are primed for an immediate andpowerful defensive responseevenwhen there is no actual infection or trauma present.These immune cellscanthencauseunwantedandexcessiveinflammation,evenifthesignalforthecellularactivationwasafaultyone.17

Whentheresearchersexaminedtheimmunecellstakenfromthebloodofthestressedmice, they found four times thenumberof immunecellscompared to

mice that weren’t stressed.18 The stressed humans hadmore proinflammatorycells as well, and some of the changes in the humans’ gene expression weresimilar to the changes seen in the mice. These results indicate clear linksbetweenmind andbody, and inparticular, between stress and inflammation.19Toput the findings inpractical terms, ifyouhaveprolongedperiodsof stress,youcanactually change thegeneexpression inyour immune system to createmoreinflammationinyourbody.20

Another study done atCarnegieMellonUniversity inPittsburgh showed asimilarconnectionbetweenpsychologicalstressandtheinflammatoryresponse.This study found that people with chronic stress can develop problemsregulatinginflammation,leadingtoanincreasedriskofdisease.21Thestudywasbuilt off of previous research concluding that people who experienced stressweremorelikelytocomedownwithacoldwhenexposedtoacoldvirus.22

In this follow-up study, researchers assessed 79 healthy people for theirabilitytocontroltheinflammatoryresponse.Theythenexposedthosepeopletoa cold virus and monitored their production of cytokines, the chemicalmessengers that trigger inflammation. The researchers found that those whowereworstatregulatinginflammationweremorelikelytocomedownwiththecold.23

Theresearchers’conclusionwasthattheimmunesystem’sabilitytoregulateinflammationhelpsexplainhowstresscanpromotedisease.Inflammationis inpartregulatedbythestresshormonecortisol,andwhencortisoldoesn’tfunctionlike it should, inflammation can go haywire.24 It works like this: Prolongedstress alters cortisol’s ability to regulate the inflammatory response because itmakestissueslesssensitivetothehormone.Becausecortisolalsohelpsregulatetheinflammatoryresponse,decreasedsensitivitytocortisolcancauseyourbodyto become more inflamed, and this uncontrolled inflammation promotes thedevelopmentofanumberofdiseases.25,26

Personalitycanalsoplayaroleinhowpeopledealwithstress,andthereforewhetherornottheirbodiesbecomeinflamedinthepresenceofadversity.Peoplewho dwell on negative events in their lives seem to be more vulnerable toinflammation,according toastudydoneatOhioStateUniversity.Whenstudyparticipantswereaskedtoruminateaboutastressfulincident,theirlevelsofC-reactiveproteinrose.32 (Togiveyouarefresher,C-reactiveprotein,orCRP,isanimportantmarkerofinflammationinthebody.Itisproducedbytheliverandrises as part of the immune system’s initial inflammatory response to trauma,

infection,orinjury.ElevatedCRPhasbeenlinkedtoheartdiseaseandanumberofotherchronicdiseasesandconditions).33

Togettotheirfindings,researchersasked34healthyyoungwomentogiveaspeechabout theirpotential jobcandidacy tostone-faced interviewers inwhitelab coats. Then half of the participants were asked to think about theirperformanceduringtheinterview,andtheotherhalfwereaskedtothinkaboutnonstressful,neutralactivities,likeatriptothegrocerystoreorsailingonaboat.Researchers measured CRP levels before the women completed the interviewand thenagainafter theywereasked to think the stressfulorneutral thoughts.Anhourlater,CRPlevelscontinuedtoriseinthewomenwhothoughtabouttheinterview. In those who thought about neutral things, CRP levels returned tonormal.34

Also linked to inflammation is anxiety’s cousin, depression. In a studypublished in the journal FuturePundit, researchers looked at 28 men, half ofwhom were diagnosed with major depression, and exposed them to mildlystressful situations for20minutes.Researchers took themen’sbloodevery15minutes, starting right before the stressful situation and for the 1½ hoursfollowing. In these blood samples, theymeasured the inflammatory cytokinesinterleukin-6 and a proinflammatory signaling molecule in white blood cellscallednuclearfactor-kB.Theresults:Boththedepressedandnondepressedmenshowedaninflammatoryresponsetothestressfultask,butthedepressedpatientshadthegreatestincreasesininflammation.35

In a related 2003 study,menwith depressive symptomswere found to bemore likely to have heart disease and increased mortality than men withoutdepression. And among people with cardiovascular disease, the study showedthat thosewhoweredepressedhad twice the riskofdeathcompared topeoplewithoutdepression.36

GenderandAgeDifferencesinAnxietyandDepressionandInflammationIngeneral,morewomenthanmensufferfromanxietyanddepression.27Buttherearesomeinterestingdifferencesinthewaythatmenandwomenrespondtochronicstressandanxiety.Forone,menwithanxietydisorderstendtohavelow-gradeinflammationintheir

bodies,andthereforetheyhavehigherlevelsofC-reactiveprotein(CRP).28

InastudypublishedinPsychosomaticMedicine,researcherslookedatdatafrom6,149peoplewhotookpartinthethirdNationalHealthandNutritionExaminationSurvey

(NHANES).TheyfoundthatmenwhohadahistoryofmajordepressionhadelevatedCRP,

butthatthesameresultswerenotfoundinwomen.29

InamorerecentstudypublishedintheJournalofOccupationalHealthPsychology,researcherslookedat933menand630womenandfoundthatonceagain,depressedmenhadhigherlevelsofCRPaswellaselevatedfibrinogen,anotherinflammatorymarkerforheartdisease.Theyalsouncoveredsomethingnew:Womensufferingfromburnout(definedasfatigue,emotionalexhaustion,andcognitiveweariness)weremorelikelytohaveelevatedCRPthanmenwithburnout.Scientiststhinkthatthesegenderdifferencesmayhavesomethingtodowithsexhormones.Anothertheoryisthatmenanswerinterviewquestionsandself-disclosurequestionnairesaboutdepressiondifferentlythanwomen

do.30

Asidefromgender,agealsoseemstoplayaroleinthedifferentrelationshipsbetweenmooddisordersandinflammation.ThehighestCRPlevelsoccurinbothmenandwomenwhodevelopedtheiranxietydisorderatanolderage,particularlyafterage50.Onepossibleexplanationisthatpsychologicalandphysicalstressbuildovertime,eventuallycausing

immunesystemchangesthatleadtoanxietyanddepression.31

ANXIETYANDALLERGIES

Sowhat’stheconnectionwithallergies,youask?Itallgoesbacktotheallergyandinflammationconnection.37Aswe’vediscussed,short-termanxietyislikelynot amajor issue; it’s when that anxiety persists and becomes chronic that itcausesproblems,namelythroughinflammation.Becauseanxietyanddepressionareproinflammatory, theymakepeoplemorevulnerabletoallergicreactions.41Stressnotonlyworsensasthmaandsomeallergiesbutalsoitcanstimulatemastcells in your coronary system (called coronarymast cells), which can lead toinflammation in your coronary arteries and contribute to heart disease.42Conversely, allergies seem toworsen anxiety anddepressionby triggering thereleaseofproinflammatorycytokinesintotheblood.43

A2011 research reviewpublished in Innovations inClinicalNeurosciencetookagood lookat the relationshipbetweenallergiesandmooddisordersandfound that themajorityof studies showedassociationsbetween theconditions.Thereviewproposedafewpossibleexplanationsfortheconnection.44

• Allergiesmayaffectpeople’sabilitytothinkclearlyandthereforeworsenmooddisorderslikedepressionandanxiety.

• Allergiesmaycauseinsomniabymakingitmoredifficultforsuffererstobreathe,andtheresultinglackofsleepthenmakesmentaldisorderslikeanxietyanddepressionmorepronounced.

• Somepeoplemayhavegeneticfactorsthatputthematincreasedriskforbothanxietyormooddisordersandallergies.

Studies have also been done to directly examine the relationship betweenallergiesandmooddisorders.Inastudyofmorethan85,000people,researchersfound that people with allergies had rates of depression that were 1.7 timeshigherthanthoseofpeoplewithoutallergies.45Asimilar,morerecentstudyof12,000 people found that people with nonfood allergies were more likely tosufferfrommajordepressionthanindividualswhowerenotallergic.46

Additionally, having a severe allergy or asthma can in and of itself bestressful, causing anxiety. A 2013 study published in the journal Annals ofAllergy, Asthma, and Immunology found that patients with asthma were 43.5percent more likely to suffer from anxiety than patients without asthma. Theresearchers concluded that all patients with asthma should be screened foranxiety.47

VITAMINB6VitaminB6,orpyridoxine,isoneoftheeightwater-solubleBvitaminsthathelpyourbodyconvertfoodintoenergy.TheBvitaminsassistwithmetabolismandalsosupporthealthyskin,hair,eyes,andliver.Theyalsosupportyournervoussystemandbrainfunction,helpingtopreventmentaldisorderslikeanxietyanddepression.Morespecifically,vitaminB6helps

yourbodymakethefeel-goodhormoneserotonin.38

SignificantB6deficienciesarerare,butsomepeoplecanbemildlydeficient,especiallykidsandolderpeople.Symptomsofadeficiencymayincludenervousness,depression,

problemsconcentrating,andmemoryloss.39

Intermsofstressandanxiety,vitaminB6canhelpassistinthetryptophan-serotoninpathway;lowlevelsofvitaminB6canlowerserotoninandthereforeincreaseaperson’sriskforanxietyanddepression.Ina2004studypublishedinPsychotherapyandPsychosomatics,researcherslookedattheassociationbetweendepressionandbloodlevelsofvitaminB6in140people.TheyfoundasignificantlinkbetweenlowplasmalevelsofB6andsymptomsofdepression.IrecommendthatyoutakevitaminB6aspartofaB-complexvitamin,whichcanprovidesignificanthelpforstressandanxiety.ItcanalsohelptocontrolPMS,some

neurologicalproblems,andacne.40

THEFATTYACIDFIGHT

Inadditiontoanxietyanddepression,anothercontributingfactorwhenitcomesto inflammation in the brain is the omega-6 fatty acid arachidonic acid (AA).Thisfattyacidproducesinflammatoryhormonescalledeicosanoids.48

ThebestwaytocounteractAAiswithitsantithesisfattyacids—theomega-3s. There are two omega-3 fatty acids in your brain: docosahexaenoic acid(DHA) and eicosapentaenoic acid (EPA). Together, these two fatty acids helpdecrease inflammation. When their levels drop too low, brain cells becomeinflamed,disruptingcommunicationbetweencellsandnerves.49

Severalstudiesbackthetheoryoftheanxiety-fightingpowerofomega-3s.Ina 2008 study that was published in the journal Progress in Neuro-Psychopharmacology and Biological Psychiatry, alcoholics and substanceabusers who took high doses of EPA (more than 2 grams per day) had lessanxiety than those who took a placebo. (Anxiety is one of the main reasonsalcoholics and substance abusers tend to relapse.) In addition, the substanceabusers with the best ratio of AA to EPA in their blood had the greatestreductions in anxiety. In other studies, taking EPA seemed to make peoplehappierandbetterabletorollwithstress.Soitseemstohelpwithdepressionaswell.50

In another study done at theUniversity ofMontreal, researchers looked atthe effectiveness of omega-3 fatty acids in treating major depression.Researchersgave432patientswithmajordepressionwithoutanxietyeitheranomega-3supplementcontaininghighconcentrationsofEPAoraplacebofor8weeks.Theresearchersfoundthat theomega-3supplementsworkedaswellasconventionalantidepressanttreatmentsfordepressioninthesepatients.51

In a 2009 review published in the journal CNS Neuroscience andTherapeutics,researcherslookedatthreestudiesonthetreatmentofdepressionand found that omega-3 fatty acids were more effective than a placebo fortreatingdepressioninbothadultsandkids.52

Another study done atOhioStateUniversity found that omega-3s reducedanxietyand inflammation inyoung,healthypeople.The research,published inthe journal Brain, Behavior, and Immunity, looked at a group of medicalstudents to see if omega-3 supplements would decrease their production ofproinflammatorycytokines.The study followedearlier research from the samescientists showing that stress from exams affected the medical students’immunity.53

Thistime,theresearcherstook68first-andsecond-yearmedicalstudentsanddividedthemintosixgroups.Multipletimesthroughoutthestudy,thestudents

took surveys to gauge their levels of stress, anxiety, and depression and gavebloodsamples thatmeasured their levelsof inflammation.Halfof thestudentsgotomega-3fattyacidsupplementscontainingfourorfivetimestheamountoffishoilinoneservingofsalmon,andtheotherhalfgotaplacebo.54

Duetoachangeincurriculum,thestudentsdidn’thavethelevelofstresstheresearchers had originally anticipated; however, researchers were still able tomeasure the students’ anxiety.What they foundwas interesting: The studentswho took theomega-3 fatty acid supplements reported20percent less anxietythanthestudentswhotooktheplacebo.Andwhentheymeasuredlevelsofthreemarkersof two importantproinflammatorycytokines—interleukin-6and tumornecrosisfactor-alpha—therewasa14percentreductioninthesecytokinesinthestudentstakingtheomega-3s.Thebottomline:Theomega-3fattyacidsreducedbothinflammationandanxietyinthesestudents.55

Tomakea longfattyacidstoryshort,oneof thebest thingsyoucando tocombatanxietyistoconsumelessomega-6fattyacidsandmoreoftheomega-3fattyacidsEPAandDHA.Intermsoffood,thatmeanseatinglessvegetableoil,processed foods, and refined carbohydrates. It also means eating more cold-waterfattyfish,likesalmonandmackerel.Idothinkthateatingmoreomega-3foods is good, butmost peoplewill benefit from taking a supplement aswell.Thedosages studiedarehigher thanwhat couldbeachievedbyadding fish toyourdietonceortwiceperweek.Again,Irecommenda2:1,orbetteryet,a1:1ratioofomega-6toomega-3fattyacids.

AnxietyandSleepOneofthemostcommonandpotentiallyserioussideeffectsofanxietyissleepdeprivation.Iseepatientswithinsomniaallthetimeinmypractice.Mostinsomniacsdonothaveanorganicdisorderthatpreventsthemfromsleeping;theycan’tsleepbecausetheyliedownatnight,puttheirheadsontheirpillows,andthewheelsstartturning.Theycan’tstopthinkingaboutthemeetingtheyhadwiththeirboss,thethingstheyhavetodotomorrow,orhowthey’llmakethatcarpayment.Thentheywakeupinthemorningandgetthemselvesbackintothesamebadroutinethatcontributedtotheinsomniainthefirstplace:Theyeatjunkfood,avoidexercisebecausetheyaretired,andmaybehaveafewextracupsofcoffeetohelpthemstayalert.

Meanwhile,thebodyisdoingwhateveritcantostayawake,too.Whenstressbecomeschronic,theadrenalglandscanactuallylosetheabilitytoproduceenoughstresshormonestomeetthedemandsofthebody.Asaresult,thebodyturnstootherplacesforenergy,oneofwhichmaybethebrain.Inresponse,yourbrainpumpsoutexcitatoryneurotransmitters;thesechemicalswillgiveyouenergyduringtheday,butunfortunately,theyalsokeepyouupatnight.Thisisacommonphenomenon.AccordingtotheAmericanPsychologicalAssociation,42percentofpeoplewhoreporthavingstresssaytheyfrequentlylieawakeat

night.56

There’salsoaconnectionbetweenallergies—specificallyfoodallergies—andinsomnia.Peoplewhohavethiscondition,calledfoodallergyinsomnia,havetroublefallingasleepandstayingasleepaftereatingcertainfoods.Theinsomniausuallyhappensaftereatinganewfoodordrink,forexample,cow’smilk(acommonculpritinadultswhodon’ttypically

consumedairyproducts).57

Nomatterthereasonforinsomnia,itisextremelydetrimentaltoyourhealth.Ifitgoesonforalongtime,sleeplosscanleadtoincreasedriskofhighbloodpressure,obesity,

diabetes,depression,heartattack,andstroke.58Soneedlesstosay,forthesakeofstaving

offallergiesandprotectingyourgeneralhealth,it’sveryimportanttogetyourZ’s.59

THEANXIETYSOLUTIONSo with all of this information on the relationship between anxiety andinflammation, what’s a stressed-out, potentially allergic person to do? Inmainstreammedicine,doctorsusuallyputpeoplewithanxietyordepressiononantidepressant or antianxiety prescription medications. In some cases, thesedrugs are agoodchoice, and theygivepeople amarked improvement in theirqualityoflife.Inothercases,thesemedicationsprovideonlytemporaryrelieforput patients in a permanent fog.60 No matter how a patient responds, theseprescription medications may not address the underlying causes fueling thementalconditionstheyaredesignedtotreat.

The Allergy Solution Plan will provide more information, but in themeantime,herearesomeofthethingsIadvisemyanxiouspatientstodotoeasetheirstressandhelpdecreaseinflammation.

Don’t ignore symptoms. Far too often, people with stress, anxiety, anddepression chalk up their symptoms to normal reactions to the inevitablefrustrations and challenges of life. Or, they may simply be in denial. Mygardeningpatientisaprimeexample.Sheignoredheranxietysymptomsforfartoo long.Onlyafter she facedher symptomscouldshestart to incorporate thechangesthathelpedhergobacktoenjoyinglife.

If you feel stressed, anxious, and depressed most of the time, you areprobablydoingsignificantharmtoyourhealth;youneedtotalktoyourhealth-careprofessionaloracounselorandaddressyoursymptomsassoonaspossible.

Findanoutlet.There’sasimplereasonwhysomanypeopleinthiscountryare stressed-out: We don’t handle stress well. According to the AmericanPsychological Association’s Stress in America Survey, 36 percent of peoplereporteatingunhealthyfoodsand27percentsaytheyskipmealsduetostress.61

Otherunhealthystressrelieversincludesmoking,usingdrugs,anddrinkingtoomuch. These bad habits are all proinflammatory and increase disease risk;therefore, by using these coping mechanisms, you are adding fuel to theinflammationandanxietyfire.62

Instead,oneofthebestwaystodealwithstressistospendtimedoingthingsyou enjoy, especially activities that make you feel like you’re making adifference in theworld.This doesn’tmean forcing yourself to participate in astress-relieving techniqueyoudon’tenjoy; thatwon’twork.Makesureyoudothingsthattrulygiveyoupleasure.TakealongbikerideonaSaturdaymorning.Volunteer at a local homeless shelter. Or, like my patient, create a masterfulgarden. Do something you enjoy every single day. You’ll be amazed at howmuchbetteryouwillfeel.

Change your perspective. In our fast-paced, competitive society, a lot ofour stress is self-imposed. We feel pressure to say yes to every socialengagement and request we get, we try to be too many things to too manypeople,andwespend toomuch timesweating the small stuff.Giveyourself abreaknowandthen.Taketimetothinkaboutallyouhavetobethankfulfor,andstep back to assess what’s really important. These simple switches in yourthinkingcandowondersforyourstresslevelandoverallhealth.

Exercise.Wewilldivemuchdeeper into this inChapter13,butweknowthatexercise is a cornerstoneofanyhealthy lifestyle routine.And it’snot justthe benefits in cardiovascular conditioning, muscle tone, and weight loss thatexercisebrings,but thepositivemental changesphysicalactivityprovides thatmakesuchanenormousdifference.Idon’tsuggestthatpeoplewithallergiesorasthmaexercisevigorously. In fact, thebest approach is slowand steady.Thebest forms of exercise are mind-body practices such as yoga and tai chi. Inadditiontocalmingyourmind,thesetime-testedexerciseformsdowondersforstavingoffallergiesandsupportinggoodphysicalhealth.

Balanceyouromegas.TogettheamountofEPAshowntoreduceanxietyin themedical student study, you would need to consume about 2 pounds ofsalmonperday.TheJapaneseareabletoeatthismuch,buttheyarethelargestfish consumers in the world. For you and me, that’s a difficult goal—not tomentiontheriskofmercuryexposureassociatedwitheatingthisquantityoffish.SoItellmypatientstoeatmoreomega-3saspartofananti-inflammatorydiet(seeChapter10tolearnexactlyhow)andtotakepurifiedfishoilsupplementsdaily.63

Kyle’sStory“Yourbodycanheal!Findsomeonewhounderstandsthis,andletthatpersonhelpyouhelp.”

SuchistheadvicefromKyleCass’smother,whohaswatchedher12-year-oldson’sallergyandasthmasymptomsgetbetterthankstoDr.Psenka’sall-naturalplan.“Iwishalldoctorswouldusethebody’snaturalabilitytohealinsteadofpills,andwheninterventionisnecessary,usethemostnaturalwaypossible,”shesays.

BeforetheywenttoseeDr.Psenka,notwantingtoputtheirsononsteroids,Kyle’sparentswatchedtheirson’sallergiesandasthmagetgraduallyworse.“Weusedhisprimarycaredoctorandlimpedalongwithjustaninhaler,”Kyle’smomsays.Asaresult,Kylehadtorestduringrecessorsportsandusehisrescueinhaleronaregularbasis.Hewouldalsooccasionallywakeupbreathlessinthemiddleofthenightandneedtoreachforhisinhalertogethisbreathingundercontrol.

BecauseKyle’sparentsbelieveinpreventioninsteadoftreatment,theytookhimtoDr.Psenka.

TheplanwasaneasyassimilationforKyle,whohadalreadystartedmakingsomenutritionalchanges.“WewereontherighttrackbeforewecametoDr.Psenka,butwehaveseenmuchbetterresultsunderhisguidance,”Kyle’smothersays.

Withthedietarychanges,Kylesawchangesinhisallergyandasthmasymptomswithinamonth.Healsostartedsublingualimmunotherapy(SLIT),whichleadtonoticeableimprovementsaftersixtoninemonths.

Asabonus,thewholefamilyhaschangedtheireatinghabitsalongwithKyle.“BeforewesawDr.Psenka,wewereeating50/50goodandbadfoods.Nowwecravethegoodfoodsandareatabout80/20healthfultounhealthfulfoods.Ourbodiesaredoinggreat,”Kyle’smothersays.

Today,Kyleismuchmoreactive,bothonandoffthesportsfield.Heisnolongerwakingupatnighttousehisinhaler,andhehasmuchmoreenergyduringtheday.“Andwearehopingtotrashtheinhaleraltogethersoon!”hismothersays.Toparentsofotherchildrenwithseasonalallergyandasthmasymptoms,shesays,“Getguidancewithnaturaltreatments.Eventhesmallestchangescanmakeahugedifference.”

9WhenFoodsDon’tAgreewithYou:DietandInflammation

WHENITHINKOFTHEADVERSEEFFECTSOFFOOD,Ithinkofa10-year-oldpatientIsawwhowashavingtroublepayingattention.

“Shecan’tsitstill,”herparentssaid.Thegirl’shyperactivity,combinedwiththeoccasionaloutburst,wasleadingtoproblemsinschool.Herparentstoldmethat theirdaughterhadalwaysbeen restless, and theywereconcerned thatherbehaviorwouldendupbeingadisadvantagetoheriftheydidn’tdosomethingaboutit.

Whilereviewingthisgirl’shistory,Idiscoveredthatherdietwasprobablyatleastpartiallyresponsibleforherbehavior.Bothparentsworked,andbecauseoftheir busy schedules, time for meal preparation wasminimal. Quick-and-easyfoodswerecommonplaceintheirhome,andprocessedfoodsand“juicedrinks”werethemainstaplesofthegirl’sdiet.

We sat down and discussed some food preservatives known to haveoverstimulating effects and that have also been linked to attention deficitdisorder(ADD).Wealsotalkedabouthowprocessedfoodsandrefinedsugarscancausekidstobehyperactive.Ifeltthatgettingthiskidonahealthydietplanwas paramount. I presented a strategy to her parents and gave them somesamplesofhealthymealsaswellasafewcookbookrecommendations.

When I saw the family back inmy office a fewmonths later, the parentswere very happywith the results theywere seeing in their daughter. Shewashaving fewer problems at school, and her teacher had remarked about theimprovementsshesaw.

This 10-year-old’s case is far from unusual. There is often a relationshipbetweenaperson’ssymptoms—inthiscase,behavior—andlifestylefactorssuchasdiet.Ifindthatmanypatientsandparentsofpatientseitherdon’tknowwhatreallyconstitutesahealthydietortheyfindthemselvestoocrunchedfortimetopreparehealthfulfood.

Myhope,inmypracticeandinthisbook,isthatbyeducatingbothchildren

andadults,Iwillteachthemhealthyhabitsthattheycanuseforalifetime.It’snevertoolatetostarteatingbetter,bothforthesakeofyourallergiesandyouroverallhealth.

CHANGINGOURDIETSFROMSADTOHAPPYThefoodyouputinyourbodyissoimportant.Inthedaysbeforemedications,doctorsusedfoodsasmedicine,andsomeofusstilldo.Manyfoodshavestronghealing powers, but what you eat can also trigger inflammation. Repeatedlyeatingthewrongfoodscancauseachronicinflammatorystatewithinyourcells,tissues, andorgans.Your immune system treats these junk foods like invadersand goes into attack mode, and with no virus or bacteria to zap, this causesinflammation.1

Aswe’ve discussed, the dietmostAmericans eat—the StandardAmericanDiet(SAD)—issad ineverysenseof theword.It’swaytoohighinprocessedfoodsandexcessive sugars, and it’sdeficient in fruits,vegetables, andhealthyproteinsources.

It’simportanttokeepinmindthatifyouhaveasensitivityorintolerancetoafoodandyouchoosetosplurgeandeatthatfood,itwillleadtoinflammation.Sowhilewalnutsmaybecompletelyanti-inflammatoryinanonallergicperson,they may cause lots of inflammation in someone with a walnut allergy orsensitivity.

Theexcessive levelsof inflammation thatcanresult fromeating thewrongfoodscancontributetoallkindsofproblemsinyourbody,evenputtingyouatriskfordiseaseslikeheartdisease,diabetes,andcancer.Notsurprisingly,eatingtheSADcanalsoleadtoweightgain.Inflammationcausesyouradrenalglandsto secrete hormones that can cause a dysregulation of your blood sugar andinsulinlevels.Chronicallyelevatedinsulinlevelsnotonlymakeyourbodyholdon to fat but also they lead to inflammation. If that weren’t bad enough,increasedbodyfatalsoleadsto—youguessedit—evenmoreinflammation.5

As we discussed, high insulin levels and inflammation can also lead to apotentiallyseriousconditioncallednonalcoholicsteatohepatitis(NASH),whichleadstofat,inflammation,anddamagetoyourliver.6Therefore,intermsofbothallergy and inflammation, it is imperative that you do whatever you can toincorporateahealthydietintoyourlifeandtoavoidthefoodstowhichyouaresensitiveorallergic.

Inthischapter,wewilldiscussthebestandworstfoodstoeatwhenitcomes

topreventinginflammationand,asaresult,allergies.Keepinmindasyoureadthat the central goal is to improve your entire diet plan, not necessarily tomaximizeyourintakeoforavoidoneparticularfood.It’swhatyoudomostofthetimethathasthegreatestimpact.

ThePowerofPrenatalDietsAllmedicalexpertsagree:Pregnantwomenshouldeatahealthful,nutrient-filled,toxin-freediettoensurethebestpossibleoutcomesfortheirbabies.Andofcourse,Iwholeheartedlyagreewiththisadvice.Assoonasawomanconceives,sheisliterallyeatingfortwo.

Butwhenitcomestoallergyrisk,theguidelinesforpregnantmomshavebeenanythingbutclear.Womenhavebeentoldtoavoidpotentialallergenstohelppreventfoodallergiesintheirbabies,andthey’vealsobeentoldtoeatthesefoodswithoutrestraint.

Thelatestresearchtellspregnantwomentoeatup.A2014studypublishedintheJournalofAllergyandClinicalImmunologylookedat1,277mother-childpairs.Researchersusedfoodfrequencyquestionnairestoassessthemothers’dietsduringtheirfirstandsecondtrimesters,specificallytheirintakesofcommonfoodallergens.Theythenassessedtheirkidsforfoodallergies,allergicrhinitis,andasthmabyusingquestionnairesandmeasuringIgElevelswhenthekidsreachedanaverageageof7.9.Theresults:Themomswhoatelotsofpeanutsduringtheirfirsttrimesterwere47percentlesslikelytohaveachildwithapeanutallergy.Themomswhodranklotsofmilkduringtheirfirsttrimesterwerelesslikelytohavekidswithasthmaandallergicrhinitis.Andthemomswhoatelotsofwheat

duringtheirsecondtrimesterwerelesslikelytohaveachildwitheczema.2

ArelatedstudypublishedintheBritishJournalofNutritionlookedatpregnantmoms’intakesoffattyacidsandtheriskofeczema,wheezing,andallergicrhinitisintheirchildrenoncetheyreachedage5.Resultssuggestthatahigherratioofomega-6toomega-3fattyacidsmaybelinkedtoincreasedriskofallergicrhinitis,andeatinglargeramountsof

omega-3fattyacidsmaydecreasetheriskofallergicrhinitisinkids.3

Theadvicetoeatlotsofdifferentfoodsseemstocontinueafterbirth.Newresearchalsoshowsthatencouragingkidstoeatavarietyoffoodsduringtheirfirstyearoflifemayhelp

preventthemfromdevelopingfoodallergies,asthma,andfoodsensitivitiesyearslater.4

THEGOODGUYS:ANTI-INFLAMMATORYFOODSANDNUTRIENTSThereareanumberoffoodsandnutrientsthatcanhelpdecreaseinflammation.Herearethemostnoteworthy.

Omega-3FattyAcidsAswe’vediscussed,thereisalotofresearchtosupportthebenefitsofomega-3

fattyacids,especiallywhenitcomestoinflammation.Inareviewofstudiesonomega-3fattyacidspublishedinAmericanFamilyPhysician,researchersfoundthatwhengivenindosesofat least3gramsaday,omega-3fattyacidshelpedreduceinflammation,stiffness,andpaininpeoplewithrheumatoidarthritis.7

Some of the foods highest in omega-3s are oily fish like mackerel, tuna,salmon,andsardines.Lookforsalmon(wildkinghasthemostomega-3s),wildor canned sockeye, sardines that are packed in water or olive oil, herring, orblackcod.Keepinmindthatfishcanbehighinmercury,sokeepyournumberofweeklyservingstothreeorfewer.11

Not a fish eater? Fish oil supplements also get the job done, without thepotential for mercury exposure. Look for a supplement that contains botheicosapentaenoicacid(EPA)anddocosahexaenoicacid(DHA)indailydosagesof2to3grams.12

Othergoodsourcesofomega-3fattyacidsincludeomega-3fortifiedorganicmilk and eggs, flaxseeds (freshly ground flaxseeds are the best), and hempseeds.13Notethatflaxonlycontainsalpha-linolenicacid(ALA)andnoEPAorDHA,soitshouldn’tbeconsideredagoodomega-3supplementallbyitself.

Asasidenote,dietaloneisofteninsufficienttoraiseaperson’somega-3stoahealthy level, and a supplementmay alsobeneeded. I use some specializedtestingtogetaclearpictureofwhataperson’somega-3levelsare(brokendownintoEPA,DHA,andALA).Thetestingalsotellsmeapatient’somega-6levels,sothathelpsdeterminehowmuchomega-3theyshouldhave.Irunthistestingon many allergic patients and also use it as part of a comprehensive healthassessmentpanelIrunonpatients.Formoreonomega-3fattyacidsupplements,seeChapter11.

GLYCYRRHIZAGLABRAForthousandsofyears,healersinbothEasternandWesternmedicinehaveusedGlycyrrhizaglabra(licorice)totreatanumberofdiseasesandconditions,includingthecommoncold,liverdisease,asthma,andsomeallergies.8Foreczema,a1to2percenttopicallicoricegelcan

helprelieveitching,swelling,andredness.9,10

ColorfulFruitsandVeggiesAgoodruleofthumb:Ingeneral,thebrighterthecolorofafruitorvegetable,the richer it is in anti-inflammatory antioxidants. In-season fresh fruits andvegetables are bestwhen it comes to retaining nutrients.But frozen fruits andveggiesareagoodalternativebecausetheyarefrozenatthepeakoffreshness,which means most of their nutrients are retained.17Within the bright-coloredvegetablesandfruits,therearesomeshiningstars.

SupplementsorFoods:What’stheBestWaytoGettheNutrientsYourBodyNeeds?Thefoodsversussupplementsdebateisahotlycontendedone.Mostresearchshowsthatsupplementsarehelpfulforpeoplewhoaredeficientinaspecificnutrient,butforpeople

whohaveagoodbaseline,it’spreferabletogetnutrientsfromwholefoods.14

Afterall,whenyougetnutrientsfromfoods,notonlyareyoulivingyourlifethewaynatureintendedbutalsoyoucancreatefantasticcombinations,bothintermsofnutrients

andtaste.15

Togetmorebangforyournutrientbuck,youcancombinecertainhealthfulfoods.Whenyoueatbroccoliandtomatoesatthesametime,forexample,thesulforaphaneinthebroccoliandthelycopeneinthetomatoeshavestrongertumor-preventingpowersthantheydowheneatenalone.Andyourbodywillabsorbbeta-carotenebestwhenyoueatitwithafat,socombinecarrotswithavocadoesoroliveoil.Othergoodcombinationsincludeapples

withblueberriesandspinachwithstrawberries.16

BERRIESWhether they’re blue, boysen, cran, black, or rasp, berries are great anti-inflammatory foods. Research done at Tufts University in MedfordMassachusetts, shows that berries help prevent age-related inflammation byturningoffproinflammatorysignalssentbycytokinesandtheproinflammatoryenzyme COX-2. Researchers think berries are so powerful because of theiranthocyanins, the antioxidants that give them their rich red, blue, or purplecolor.18

DARK,LEAFYGREENSWhen it comes to fighting inflammation, the rule is, thedarker thegreens, thebetter. Dark green veggies such as spinach, kale, collard greens, and broccoli

contain vitamin E, which has been shown to help protect the body againstproinflammatory cytokines. As a bonus, these greens serve up a bunch ofhealthfulvitaminsandminerals,includingcalcium,iron,andanti-inflammatoryphytochemicals.19They’realsoveryrichinantioxidants.

To measure the level of antioxidants in fruits, vegetables, and spices, theNational Institute onAging developed the oxygen radical absorbance capacity(ORAC)test.ORACassignsascoretoalonglistoffoods.Thehighest-scoringfoods include brightly colored fruits and vegetables, such as blueberries,raspberries,apples,beans,and,youguessedit:leafygreens.20

NUXVOMICANuxvomicaisahomeopathicremedyderivedfromseedsofthestrychninetree,whichisnativetoIndia.Itistraditionallyusedtotreatdigestiveupsetfromfoodintolerancessuchasheartburnandstomachdiscomfortaswellasnausea.Nuxvomicacanalsohelpwithotherallergysymptoms.21

Afewyearsago,nuxvomicawasrecognizedinthemedicaljournaltheLancetasoneof12homeopathicremediesthatcanhelpfighthayfeversymptoms.22Ioccasionallyusenuxvomicaforpatientswithallergies,andwhenIdo,Igenerallystartwitha30cdosage.

TARTCHERRIESAt a 2012 American College of SportsMedicine (ACSM) conference in SanFrancisco, researchers atOregonHealth&ScienceUniversity proclaimed thatcherrieshave“thehighestanti-inflammatorycontentofanyfood.”That’saboldstatement.Tocometothisconclusion,theresearchersstudiedwomenages40to70whohadinflammatoryosteoarthritis.Theyfoundthatwomenwhodranktartcherry juice two times a day for 3 weeks had decreases in importantinflammatory markers. The women who had the greatest inflammation at thebeginningof thestudyhad the largestdecreases in inflammationasa resultofdrinkingthecherryjuice.Theresearchersalsofoundthatyouneedtopuckertoprevent pain—sweet cherries don’t pack the anti-inflammatory punch of theirtartrelatives.24

BROMELAINAnenzymefoundinthefruitandstemofpineapple,bromelainisanaturalanti-inflammatorythat’softenusedtotreatinjuredordamagedtissuesandarthritispain.Bromelainisalsoused

tohelpcontrolallergysymptoms,suchasnasalandsinusswellingandthickmucus.23

Inmyexperience,theefficacyofbromelainseemstobedose-dependent.Somepeoplebenefitfrom150milligramsperday,whileothersmayneedtotakeupwardsof1,000milligramsdaily.Iusuallyrecommendthatmypatientstake150milligramsofbromelainthreeorfourtimesperday.

Animportantsidenote:Somepeopleareallergictobromelain,andinthesepeople,itcancauserespiratorysymptomssimilartothoseofarespiratoryallergy.Becausebromelaincomesfrompineapple,peoplewhoareallergictotropicalfruitsshouldusecautionwhentakingit.

Youshouldalwaystakebromelainonanemptystomachtomaximizeabsorption.

TOMATOESIf the rule of thumb with greens is, “the greener, the better,” the rule withtomatoes is, “the redder and juicier, the better.” Tomatoes contain a chemicalcalled lycopene, which reduces inflammation in the lungs and throughout thebody.Ina2013IranianstudypublishedintheBritishJournalofNutrition,obeseandoverweightwomenwhodranktomatojuicehadsignificantlylowerlevelsofinflammatory markers in their blood than overweight and obese women whodrankwater.25

NutsNuts are a big part of theMediterranean diet, which has been shown to helpreduceinflammationinamatterofweeks.Almondsandwalnutsareparticularlypackedwithanti-inflammatory fats.Othergoodnuts for fighting inflammationinclude pecans and Brazil nuts. In fact, a 2008 study published in the AsiaPacificJournalofClinicalNutrition foundthatpeoplewhofrequentlyatenutshaddecreasedconcentrationsofC-reactiveprotein(CRP),animportantmarkerofinflammationinthebody.Theyalsohadlowerlevelsofanotherinflammatorymarker,interleukin-6,intheirblood.

Nuts also contain antioxidants, which can help protect your body fromdamage caused by inflammation.26 Raw nuts—not roasted—provide the mostbenefits.Animportantnote:Avoideatingnutsifyouareallergictothem.

OliveOilWhen it comes to fighting inflammation,oliveoil isoneof themostpowerfulfoods;itactsasananti-inflammatoryelixirofsorts.Studieshaveshownthatacompoundinoliveoil,calledoleocanthal,workssimilarly tononsteroidalanti-inflammatorydrugs(NSAIDS)inthatitblockscyclooxygenase-2(COX-2),theenzyme that helps stimulate proinflammatory prostaglandins. By doing this,oliveoilstopsinflammationinitstracks.Thestrongertheoliveoil’sbitterbite,thehigheritsoleocanthallevelsandthemoreanti-inflammatoryitis.Oliveoilsfrom Tuscany or other regions that use the same variety of olives have thestrongestbiteandthereforethehighestoleocanthallevels.27

Inonestudy, researchers found that50millilitersofoliveoil,orabout3½tablespoons,isequaltoa200-milligramtabletofibuprofenintermsofreducingpainandinflammation.Thisamountofoliveoilservesupabout400calories,soto avoidweight gain, use olive oil in place of other fats in your diet, such asbutterormargarine.28,29

GarlicKnownforitsimmune-boostingproperties,garlicisalsoanti-inflammatory.Andit seems that in order to get the greatest reductions in inflammation, youwillhave toputupwitha littlegarlicbreath.A2013studypublished inFoodandChemicalToxicologyfoundthatfreshrawgarliccontainshigherlevelsofallicin,acompoundthatgivesgarlicitsanti-inflammatorypowersbyreducinglevelsofproinflammatorycytokines.Garlic thathasbeenheatedcontains lessodiferoussulfur,butalsolessallicin,andisthereforenotasstrongofananti-inflammatoryasgarlicinitsrawform.30

OtherGoodSpicesSome spices aren’t just good for adding zest and flavor; they can lowerinflammation as well. Ginger, a popular antinausea remedy, can reduceinflammationinyourintestineswhentakeninsupplementform.Likeoliveoil,

gingerinhibitsCOX-2andthereforeblocksproinflammatoryprostaglandinsthatareimportantforpainsensation.31

A relative of ginger, turmeric (the spice that gives curry its yellow color),fightsinflammationbyhelpingtoturnoffNF-B,aproteinthathelpsregulatetheinflammatoryresponseinyourimmunesystem.32Numerousstudieshaveshownthatcinnamoncanalsohelpreduceinflammation.InanIranianstudypublishedintheInternationalJournalofPreventiveMedicine,researchersgave60healthyfemale tae kwon do athletes either cinnamon, ginger, or a placebo daily for 6weeks.Attheendofthestudy,theathletestakingthecinnamonandgingerhadlessmusclesorenessthantheathletestakingtheplacebo.33

TheBadGuys:ProinflammatoryFoodsandNutrientsThere are a number of foods and nutrients in the SAD that may beproinflammatory.Herearesomeoftheworstoffenders.

OMEGA-6FATTYACIDSThroughafairlycomplexchainofevents,manyoftheomega-6fattyacidsareproinflammatory.Simplyput,omega-6fattyacidsactivatetheCOX-2enzymesthat cause inflammation. Eating a diet high in omega-6 fatty acids (found invegetableoil)andlowinomega-3fattyacidsisassociatedwithelevatedlevelsof cytokines, proteins in cells that trigger inflammation, according to a 2007studypublishedinPsychosomaticMedicine.34

Foods rich in omega-6 fatty acids include corn, sunflower, safflower,soybean,andcottonseedoils;processedsnackfoods;margarine;friedfoods;eggyolks;andmeats.Thesefoodstendtobetheonespeopleoverindulgein,leadingto weight gain. Remember that it’s very important to balance your intake ofomega-6fattyacidswithahealthyintakeofomega-3s.35

SUGAROne of the worst parts of the SAD is an overabundance of sugar.We eat anexcessive amountof sugar in this country, and it’s nowonder; the sweet stuffseems tobe ineverything, fromketchup tosoda to junk-food-in-health-food’s-clothing, like energy bars and sports drinks.To give you an idea, the averageAmericaneatsapproximately100gramsofsugaraday.Butyourbodycanonlytolerateabout50grams, so theexcess sugar triggers irritablebowel symptoms

likegasandbloatingaswellasinflammation.36There are basically three different forms of sugar—fructose, sucrose, and

high-fructosecorn syrup (HFCS).Fructose is anatural formof sugar found inhoneyandmanyfruits.Sucroseisanaturallyoccurringformofsugarmadeoffructose and glucose. It is found inmany plants but is usually extracted fromsugarcane and sugar beets to make table sugar. Sucrose (table sugar) is 50percentglucoseand50percentfructose.37

High-fructose corn syrup is corn syrup with added enzymes that changesomeoftheglucosetofructose.ThisprocessmakesHFCSsweeterthanregularcornsyrup. Itcan range from42 to55percent fructose.38 It isacost-effectivesweetenerusedinmanyproducts, includingcereal,bread,yogurt,ketchup,andfruitjuice.39Inthe40yearssinceHFCSwasintroducedinthiscountry,obesityrateshaveskyrocketedfrom15percentofthepopulationin1970tonearlyoneinthreeAmericanstoday.40

The results of a study done at Princeton University and published inPharmacologyBiochemistryandBehaviorarealarming.Researchersconductedtwoexperiments to testwhetherornotHFCSleads toweightgain. In the firstexperiment,theyfedmaleratswatersweetenedwithhigh-fructosecornsyruporwater sweetenedwith table sugar (sucrose) in addition to a standard rat-chowdiet.Theconcentrationofsweetenersinthetwodrinkswasthesame,buttheratsthatdranktheHFCSsolutiongainedsignificantlymoreweightthantheratsthatdrankthesucrosesolution.41

In the secondexperiment, researchers lookedatweightgain,body fat, andtriglyceridelevelsinratsthatconsumedHFCSfor6months.Comparedtoratsonastandarddiet,theHFCSratsdevelopedametabolicsyndromesimilartotheconditionfoundinhumans,completewithweightgain(theygained48percentmoreweight than the ratson thestandarddiet), increased triglycerides,andanabnormaldegreeofbellyfat.42

Fructose isn’t a much better option. While every cell in your body usesglucoseforenergy,fructoseisonlymetabolizedbyyourliver.Therefore,eatingtoomuchfructosecandamageyour liver just likealcoholandother toxinsdo.And like alcohol, fructose getsmetabolized into fat instead of energy. It getsstoredinyourfatcells,whichcanleadtomitochondrialdamageand,asaresult,inflammation.43

SODA

Ican’t talkaboutsugarwithoutbringinguponeof itsbiggestcustomers:sodamanufacturers. There is absolutely nothing good about soda (also called softdrinks). As if the piles of sugar it contains weren’t bad enough, soda is alsoproinflammatory.InaSwissstudypublishedintheAmericanJournalofClinicalNutrition,youngmenwhodrankabouttwocansofcolaperdayhadCRPlevelsthatrosebynearly110percentinonly3weeks.44

REFINEDCARBOHYDRATESWhenyoueatwhitebread,pasta, and rice,youmightaswellbeeating sugar.The effects of these refined carbs are similar to sugar, and they increase yourlevelsofproinflammatorycytokines.45

Asevidence,ina2010studypublishedintheAmericanJournalofClinicalNutrition, researchers looked at the carbohydrate intake of 1,490postmenopausalwomenand1,245menwhowere49yearsold.Theyfoundthatthewomenwith the highest intakes of refined carbohydrates had nearly threetimestheriskofdeathfrominflammatorydiseasecomparedtothewomenwhoatethefewestnumberofrefinedcarbohydrates.46

ProcessedFoodsMany processed foods are loadedwith all kinds of flavor-boosting, freshness-preserving chemicals with long, scary-sounding names. And we should befrightenedof these ingredientsbecausemanyof themarepotentially toxicandinflammatory.

Onesuchchemicalismonosodiumglutamate(MSG),aflavorenhancerandpreservative used in many processed foods, and traditionally used in Chinesefood. In a 2008 study published in the Journal of Autoimmunity, researchersinjectedMSGintomiceandfoundthat it led tosignificant liver inflammation.Themicealsodevelopedobesityandtype2diabetes.Bythetimetheyreached6and 12 months of age, all of the mice given MSG had developed liverinflammation, and some had developed lesions.47 Another preservativecommonlyusedinprocessedfoods,butylatedhydroxytoluene(BHT),hasbeenshowntocauselunginjuryandinflammationinmiceaswell.48

RedMeat

Organic, grass-fed redmeat eaten inmoderation is an acceptable protein (andiron)source.49Unfortunately,overconsumptionofunhealthytypesofredmeatisaseriousproblemandpromotesunnecessaryandunhealthyinflammationintheUnitedStates.

The fact is that redmeat in the formof steaks and burgers is loadedwithsaturatedfattyacids,whichcanleadtotheformationofarachidonicacid.Plus,red meat—especially when charred—may contain toxic substances likeheterocyclicamines,whichhavebeenlinkedtothedevelopmentofcancer.50

Case in point: Asian men have much lower rates of prostate cancer thanAmerican men, and they are much less prone to inflammation in general. InAsia, thedietconsistsof lotsof fishandvery little redmeat. Interestingly, thelonger Asian men live in the United States, the higher their risk for prostatecancer.AsianmenwholiveintheUnitedStatesfor25yearsormorehavehalftherateofprostatecancerofCaucasians.IftheirsonsareborninAmerica,theirprostatecancerriskrisestothesameasthatforCaucasianAmericanmen.51

WhythisdifferencebetweenAsiansandAmericans?Forone,AsianseatalotmorefishandalotlessredmeatandpoultrythanAmericansdo.Theremayalso be something to thewaywe prepare ourmeats in theUnited States.Weknowthatwhenmeatsarecookedacertainway, theycanproduce thosenastycarcinogens,heterocyclicamines.Itseemsthatthemorecharredameat,andthemoretimesitgetsflippedduringcooking,thehigheritslevelofthesedangerousamines.TheworstoftheseheterocyclicaminesiscalledPh1P.Whenlaboratoryanimalsatelargedosesofthischemical,themalesdevelopedcolonandprostatecancerandthefemalesdevelopedbreastcancer.52

Some researchers think the level of carcinogens consumed bymeat-eatingAmericanscomesclosetotheequivalentofsmokinghalfapackofcigarettesaday.Thebestthingyoucandoiseatredmeatonlyoccasionally,inmoderation.Ifandwhenyoudoeatthem,sticktoleancuts.53

AllergenicFoodsIn addition to foods that spark allergy symptoms byworsening inflammation,there are also foods that, in and of themselves, cause allergies.Going back toChapter4,thereareanumberofallergenicfoods.Themostcommonarewheat,peanuts,treenuts,milk,eggs,soy,fish,andshellfish.Somefoodallergiesfadewithtimeandothers,likenutallergies,tendtopersist.Theonesthathangonareusuallythosethatcarrytheriskofanaphylacticshock.Irecommendthatpeople

withtheseseriousfoodallergiesavoidtheoffendingfoodsaltogether.It’ssimplynotworththeriskortheresultantinflammationinyourbody.

Beyond classic food allergies, there are also a number of foods that canworsenotherallergysymptoms.Forexample, somepeoplewhoareallergic toragweedwill experience itchiness and swelling in theirmouthswhen they eatbananas,watermelon,orcantaloupe.Peoplewhoareallergictopollenmayfindthat cherries, peaches, potatoes, carrots, or apples may make their symptomsworse.Ifhoneycontainssomeallergenicpollen,itcancauseareactionaswell.Peoplewith thesecross-reactionsusuallygetsymptomsallyear long,but theirsymptomsoftengetworseattheheightofhayfeverseason.54

Aside fromavoiding the fruitsandvegetables thatcauseyou tosniffleandsneeze,there’sonlyonethingyoucandotodealwithacross-reaction:Cookthefoods that give you symptoms.Of course thisworks better for some produce,suchaspotatoesandcarrots,thanforothers,suchaswatermelon.55

Fruitsandveggiesaside,somepeoplewithhayfeveralsofindthatredwinecausestheirallergysymptomstokickin.A2011studyfoundthatalongwithabuzz, some red wine serves up histamine, the chemical that causes allergicreactions such as a runnynose and sneezing.56 If you already have hay fever,indulging in aglass or two can cause constriction inyourbronchial tubes anddifficultybreathing.57

SOMEHELPFULTIPSONINCORPORATINGANTI-INFLAMMATORYFOODSNowthatyouknowaboutthebenefitsofanti-inflammatoryfoods,here’showtoworkthemintoyoureatingroutine.

Planyourmeals.Scheduleallofyourweek’smealsaheadof timesoyoucanbuythe ingredientsyouneedinone trip to themarket.ConsiderpreparingallofyourmealsonSundayandkeepingtheminthefreezerorfridgeuntilyouneedthemlaterintheweek.

Bewaryofridiculoushealthclaims.Asageneralrule,ifaproductmakesaspecial point of saying it contains something like a vitamin or mineral, be askeptical consumer. For example, I recently saw a frozen drink that said,“ContainsvitaminC!”inbig,eye-catchinglettersonthelabel.Pureandsimple,itwasaSlurpee,andtherearezerohealthbenefitstodrinkingSlurpees.The10milligrams or so of vitamin C that come along with the bucket of sugar are

negligibleatbest.Anotheroneofmypetpeeves is thenotion that sportsdrinksaregood for

you.Unless you are an elite athlete or labor in the heat all day, youprobablydon’tneed to consumesportsdrinks.Theyare loadedwith sugar and theyarenotjuiceinanyway,shape,orform.

Overall,it’simportanttokeepinmindthatnotonlydoeseatingadietfullofhealthy,anti-inflammatoryfoodshelppreventallergiesandotherconditionsbutit also helps control your weight. As discussed, obesity is one of the biggestcontributorstoinflammation.

Eachof theanti-inflammatoryfoods listed in thischapter ishealthful in itsownright,but these foodsaremosteffectivewheneatenaspartofanentirelyanti-inflammatorydiet.Thathavingbeensaid,givingintoahamburgercravingeverynowandthenisn’tgoingtomakeyouinflamed.Readon,andI’lltellyoumoreabouthowananti-inflammatorydietcanimproveyourhealthandreduceallergies.

10

EatingforYourAllergies

ITISMYGOALASANATUROPATHICDOCTOR andas the authorofthisbooktoeducatepeopleabouthowtomakehealthylifestylechoices.Infact,oneofmyfavoritethingstodoasadoctoriseducatepeopleabouttheirhealth.Ibelievethatthisshouldbeanimportantpartofwhateveryphysiciandoeswithhisorherpatients,andthisconceptofthedoctoractingasateacherisoneoftheguiding principles of naturopathic medicine. The doctor’s role includeseducatingandencouraging thepatient to take responsibility forhisorherownhealth. The doctor should also empower and motivate the patient to make ahealthfulchange,as it is thepatientwhoultimatelycreates thehealing. Ihopethatyouwill use the information in this chapter as aguide forhow to changeyourdietanddailylifestylehabitstobehappier,healthier,andallergy-free.

Whetherornot theyhaveallergies, I alwaysencourage thosepatientswhomaybenefitfromweightlosstodosobyadoptingahealthyeatingandexerciseplan.Nearlyeveryonewhohasevertriedtoloseweightusinganythingelsehasexperiencedtemporaryresultsatbest.Yousimplycan’tchangeyoureatingandexercisehabitsforafewmonths,dropsomeweight,andthenexpecttogobacktoyouroldhabitsandkeep thosepoundsoff.Nomatterwhatany30-daydietclaims,itneverworksthatway.

That said, changinghabits isn’t alwaysaneasy thing todo.They’recalledhabitsforareason:They’reregulartendenciesthatarehardtogiveup.Thebestway to rewire your brain and change your habits is to replace themwith newones. The goal of making healthy lifestyle changes is all about creating newhabitstoachieveastateofsustainedwellness.

For most Americans who are overweight, there are a number of differentfactors contributing to their condition. The unhealthy StandardAmericanDiet(SAD), which is full of sugar and processed foods and is severely lacking invitamins,minerals,andantioxidants,certainlyplaysarole.Undeniably,alackofadequatephysicalactivityalsopredisposesyoutocarryingextraweight.Stressand anxiety are also common reasons people gain andmaintain an unhealthyweight, as there is a strong emotional attachment to food;many find it bringscomfortduringstressfuloranxioustimes.Ifanyofthissoundsfamiliar,thengetreadytomakesomechanges.You’llbegladyoudid!

THEHEAVYHEALTHBURDENOFOBESITYObesityisanepidemicinthiscountry.Amajorityofadults—nearly7in10—arecarryingenoughextraweighttoputthematincreasedriskofhealthproblems.1

Overweight andobesity are risk factors for all kindsofdiseases, includingheartdisease,stroke,arthritis,type2diabetes,andsomecancers.2Aswelearnedin Chapter 5, extra weight also increases your risk for allergies. Therefore,keeping yourself at a healthyweight is extremely important, not just for yourself-imagebutalsoforyourphysicalhealth.

Obesity doesn’t happen overnight; usually, the weight slowly accumulatesovermonthsoryearsasyoutipthebalancebytakinginmorecaloriesthanyouburn.Nomatterwhatfaddietsclaimabouttheratiooffattocarbohydratesyoushouldbeeating,pureandsimple,ifyouwanttoloseweight,youhavetoburnmorecaloriesthanyoutakeinfromfood.3Ifyouwanttomaintainyourweight,you need to balance the calories you eat with the calories you burn throughphysicalactivity.

Thecorrectbalancebetweencaloriesinandcaloriesoutdiffersfrompersontoperson.Differentpeoplehavedifferentbasalmetabolic rates (BMRs).YourBMR is theenergyyourbody requires tomaintainbodily functions,or just to“keepthelightson.”Somepeoplehavefastmetabolismsandothershaveslowerones.ThosewithslowerBMRsmayneedtoworkhardertokeeptheirweightinthehealthyrange.4

Losingweightcan seem likeanoverwhelming task, especially ifyouhavelots of extraweight or have failed at diets in the past. But youwill find thatgetting theweight off iswellworth the effort—losing just 5 to 10 percent ofyourbodyweightcanmakeabigdifferenceinyourallergysymptomsandyouroverall health.5 Remember, achieving a healthy weight seldom happensovernight.Losing1to3poundsperweekisagoodgoal;slowandsteadyistherecipeforsuccess.

TheStartingBlock:UnderstandingYourBMIAsidefromyoursocialsecuritynumber,oneofthemostimportantnumbersforyou to know is your bodymass index (BMI).Body fat can bemeasured in anumberofways,fromunderwaterweighingtocalipersthatmeasurefoldsoffat.The easiest and least-expensiveway tomeasure your body fat is to determineyourBMI.Althoughthisdoesn’tdirectlymeasureyourbodyfatpercentage, in

most cases, your BMI correlates closely and is a good screening tool todeterminewhetheryouareoverweightorobeseandneedtolosesomeweight.6

IntermsofBMIandallergyrisk,anumberofstudieshavedemonstratedaconnection.A2011 studypublished in theJournalofAsthma examined5,351Taiwanesechildrenages4 to18and lookedat theirBMIs, immunoglobulinE(IgE)levels,andhistoryofallergiesandasthma.Theyfoundthatthekidswithelevated BMIs were more likely to suffer from wheezing and eczema thanchildrenofanormalweight.7Anotherstudypublishedin2013intheJournalofAllergyandClinicalImmunology:InPracticefoundthatbothasthmaticchildrenand adults with BMIs that classified them as overweight or obeseweremorelikely to suffer an asthma attack, especially during the spring and fall allergyseasons.8

As we discussed in Chapter 5, the strongest link between obesity andallergies seems to be connectedwith food allergies. I have seen patients loseweight after determining which foods they are allergic to. Eliminating thesefoods from the diet can make losing stubborn weight much easier for somepeople.9

There is a mathematic calculation for determining your BMI: Take yourweight inpoundsanddivide itbyyourheight in inchessquared, thenmultiplythat number by 703. The resulting number is your BMI. If math is not yourstrong point, don’t be alarmed—there are many BMI calculators to be foundonline,andallyouneedtoknowisyourheightandweight.YoucantrytheonefromtheCentersforDiseaseControlandPrevention:byvisitingmyWebsite:seasonalallergysolution.com.10

Alternatively,manyphysiciansarestartingtoruntheirpatients’BMIsintheofficeaspartofroutinevisits.Thereareseveralmachinesavailablethatcandothisquicklyandefficiently.Itmightbeworthyourtimetoaskyourdoctorifshecandothisforyou.

OnceyouknowyourBMI,youcandeterminewhetheryouareclassifiedasunderweight, normal weight, overweight, or obese. To be at your healthiestweight,youwanttoaimforthenormalrange.

BMI WEIGHTSTATUS

Below18.5 Underweight

18.5–24.9 Normal

25.0–29.9 Overweight

25.0–29.9 Overweight

30.0andover Obese

AsImentioned,BMIcorrelatesprettystronglytoyouramountofbodyfat,but therearesomeexceptions.Forexample,highly trainedathletesmayweighmoredue to increasedmuscularity.TheirBMIsmay read as overweightwhenactuallytheirratiooffattomuscleislow.Conversely,womentendtohavemorebody fat thanmendoat thesameBMI. Inaddition,olderpeopleusuallyhavemorebodyfatatthesameBMIthantheiryoungercounterparts.11

Once you know your BMI, you can determine whether you need to loseweight,andifso,abouthowmuch.IfyourBMIis26,forexample,you’rejustoverthenormalweightcategoryandprobablywon’tneedtolosemorethan5or10 pounds. If your BMI is 30 or above, you have significant weight to lose.Eitherway,youcandoit,andmyplanwillshowyouhow.

Todetermine approximately howmany calories youwill need to cut fromyourdietorburnwithexerciseinordertoreachyourweight-lossgoal,youmustfirstdeterminethenumberofcaloriesyouuseeachday—yourbasalmetabolicrate, plus any calories you burnwith everyday activities. To access an onlinecalculator,visitseasonalallergysolution.com.

Ifyouhaveaspecificweight-lossgoalinmind,youcanprettyeasilycrunchthenumbersanddeterminehowmanycaloriesyoushouldbeeatingandburningeach day. Again, you can find an online calculator atseasonalallergysolution.comtohelpyouverifythatyourgoalweightishealthyandachievable.

EFFECTIVEEATING:THEMODIFIEDMEDITERRANEANDIETCountlessdietplanshavegoneinandoutofthelimelight,sometoutinghealthbenefitsandall claiming tohelppeople loseweight.Manyof thesedietshavebeen proven to be not only ineffective, but in some cases, also potentiallydangerous.

However,onediethasstoodthe testof timeandresearch,both in termsofhealthbenefitsandweightcontrol:ThemodifiedMediterraneandiet.BasedonthedieteatenforcenturiesbypeopleinMediterraneanSpainandItaly,thisdietisrichinplant-basedfoodsandhealthful,monounsaturatedfats.Itdiffersfromthe standardMediterranean diet in that it calls for reduced servings of meat,

wine,andstarches.Themainelementsofthedietare:12

• Plentyoffishandotherseafood• Verylittleredmeatandchicken• Useofanti-inflammatoryoliveoilasthemainsourceoffattoflavorandcookfoods

• Lotsofvegetablesandamoderateamountoffruit• Minimaluseofsaucesandgravies• Wholegrainsthatnaturallycontainahighamountoffiber• Veryfewsweetsorsugaryfoodsordrinks• VerylittlebutterandeggsInadditiontoitsheart-healthybenefits,theMediterraneandietseemstohelp

protect against allergies. In a 2007 British study, researchers assessed therespiratory symptoms and dietary habits of nearly 700 children who lived inCrete,Greece.Theyfoundthat80percentofthechildrenatefreshfruitandtwo-thirdsatefreshvegetablesatleasttwiceaday.Theseproduce-eatingkidswereless likely to develop airborne allergies, skin allergies, and asthma symptomsthankidswhodidn’t eat fruits andvegetables in these amounts.13Conversely,kids who ate margarine had increased levels of allergic rhinitis and asthma.Accordingtothestudy,theMediterraneandieteatenbytheseGreekkids,whichincludes antioxidant-rich grapes and tomatoes, had something to dowith theirlower rates of asthma and allergies. As we learned, antioxidants help fightdiseasebyneutralizingdangerousfreeradicals.14

The children in this study also consumed a lot of nuts that are rich inmagnesium, which seems to help protect the lungs and, as a result, preventasthma.Childrenwithahighintakeofnutshadlowerratesofasthma.15AnotherstudypublishedinthejournalAllergyandAsthmaProceedingsfoundthatbothkidsfromurbanAthensandruralareasofGreecewhoateaMediterraneandiethadlowerratesofasthmathankidswhodidnoteataMediterraneandiet.16

AmorerecentstudypublishedintheJournalofAsthmalookedattheeffectsof a Mediterranean diet on 38 adults with asthma. Researchers put theparticipants into three groups—a high-intervention group, a low-interventiongroup, and a control group. The first two groupswere encouraged to adopt aMediterraneandiet.Theyalsoreceivedconsultationsessionsfromanutritionist,vouchers for purchasing appropriate foods, and written advice. To measure

asthma symptoms, the researchers used asthma control questionnaires, foodfrequency questionnaires, asthma-related quality-of-life questionnaires, andspirometry (acommonoffice testused todiagnoseasthmaandotherbreathingconditions).Attheendof12weeks,thoseintheinterventiongroupshadsmallbut significant improvements in their spirometry andqualityof life, indicatingthattheMediterraneandietmaybeafeasibletreatmentforadultasthma.17

Additionally,researchshowsthatexpectantwomenwhoeataMediterraneandietduringpregnancyarelesslikelytogivebirthtoachildwholaterdevelopsasthma or allergies than are pregnantwomenwho do not eat aMediterraneandiet.18A2008studypublishedintheBritishjournalThoraxfollowed460Greekmotherandchildpairsfrompregnancyuntiltheirchildrenreachedtheageof6.Sixty-fourpercentofthepregnantwomenateaMediterraneandietrichinfruits,vegetables,andomega-3fats fromfishandnuts,and theremaining36percentdidnoteataMediterraneandiet.Researchers found thatpregnantwomenwhodid not eat aMediterranean diet weremore likely to have childrenwho laterdevelopedasthmaandallergies.19

TheMostPowerfulAntiallergyFoodsThereareanumberoffoodsthatcanhelpcurballergysymptoms.Here’saquicklookatafewofthemostpotent.

Onionsandgarlic.Theymightnotbethebestforyourbreath,butonionsandgarlicaregreatforallergycontrol.Bothflavorfulrootvegetablescontainquercetin,anaturalmastcellstabilizer(antihistamine).Becauseoftheseantihistamineproperties,quercetinhelpsfighttheinflammationthataccompaniestheallergicresponse.Otherfoodsthatcontainquercetin

includeapplesandtea.20

Citrusfruits.Similartoquercetin,thevitaminCinoranges,tangerines,andothercitrusfruitshasantihistamineeffectsthatcanhelpfightallergysymptoms.Othergoodsourcesof

vitaminCincludestrawberries,peppers,andtomatoes.21,22

Pineapple.Thetarttropicalfruitcontainsanenzymecalledbromelain,whichisapowerfulanti-inflammatory.Researchshowsthatitcaneasesorethroatsandirritated

sinuses.23Anda2012studypublishedinAlternativeTherapiesinHealthandMedicinefoundthatbromelainhelpedeaseairwayinflammationinmice,whichisevidencethatitmay

helpwithallergicasthma.24Plus,pineappleisagreatsourceoftheallergy-fighting

antioxidantvitaminC.Togetthemostfrompineapple,eatthefreshfruit.25

Broccolisprouts.RecentresearchpublishedinthejournalFoodandFunctionshowsthatbroccolisproutextract(BSE)mayactuallybeabletoprotectagainsttheallergy-andasthma-promotingeffectsofdieselexhaustparticles(DEPs),whicharepollutantsthat,forvariousreasons,actuallyhavethepowertoexacerbateallergicreactions(seehere).Researchersexposed29peopletoDEPsandthenmeasuredtheirinflammatoryresponsesintermsofincreasesinwhitebloodcellcounts.TestsubjectsthengotadoseofBSEinmangojuiceeverydayfor4days.WhenparticipantstooktheBSE,theirwhitebloodcellresponsetotheDEPswas54percentlowerthanwhentheydidn’tdrinktheBSE.Theresearchersconcludedthateatingbroccoliandbroccolisproutsmayhelplessentheimpact

ofparticulatepollutiononpeoplewithasthmaandallergies.26

Redgrapes,blueberries,andredwine.Thesedeeppurpletreatshaveoneimportantingredientincommon:apolyphenoliccompoundcalledresveratrol.Ina2013studypublishedintheJournalofNutrition,researchersfoundthatresveratrolhelpedsuppresstheIgE-mediatedallergicresponsesinmice.27

Watermelonandtomatoes.Bothofthesesummertimefruitsarehighinlycopene,whichhasbeenshowntodecreasetheallergicresponseandtheaccumulationofsymptom-

producingcelltypesinthelungs(specifically,thewhitebloodcellseosinophils).28Ina2007studypublishedintheJournalofAsthma,asthmaticswerefoundtohavelowerlevelsoflycopeneintheirbloodthanparticipantswithoutasthma.29

Chocolate(cocoa).Ifyouhaveasweettooth,I’vesavedthebestantiallergyfoodforlast.CocoahasbeenfoundtohavesomeantiallergypropertiesviareductioninIgEsynthesis.Ina2012studypublishedinthejournalPharmacologigalResearch,laboratoryanimalsfedacocoa-enricheddietfor4weekshadlowerlevelsofIgEthanratsfeda

standarddiet.30

ModifyingtheMediterraneanDietforYouIrecommendthemodifiedMediterraneandietformorethanjustitspotentialasan antiallergy diet. Aside from its antiallergy powers—which are great—Irecommendthisdiettomypatientsbecauseitisavaried,vegetable-richplan;ithasalowglycemicload,soitdoesn’tcauserapidelevationsinbloodsugar;andit provides adequate protein and fiber. Perhaps most important, the modifiedMediterraneandietisnotrestrictive—itprovideslotsoffoodchoices.Withalotofotherdiets,you’relimitedtoeatingcertainfoodsforadefinedperiodoftime,but the modified Mediterranean diet is an eating plan you can stay on—andenjoy—indefinitely.

Asanimportantsidenote,ifyouhaveanallergyorsensitivitytooneofthefoods in the modified Mediterranean diet, you will want to find appropriatesubstitutesforthatfood.Luckily,thiseatingplanisveryflexibleandofferslotsofhealthfulalternatives.

Tomake themodifiedMediterraneandiet evenmorepalatable,both in thetruesenseofthewordandintermsofyourlifestyle,herearesometipstotry.

Boost your omega-3s. The most important element of the modifiedMediterranean diet in terms of allergies, inflammation, and overall health isomega-3fattyacids.Asdiscussed,bothomega-3fattyacidsandomega-6fattyacidsareessential,meaningyourbodydoesn’tmakethem;instead,youhavetogetthemfromfoodorsupplements.Someomega-6fattyacids,likethosefoundin vegetable oil and many processed foods, are proinflammatory unless youbalancethemwiththeappropriateamountofomega-3fattyacids.Mostexpertsrecommendaimingforanomega-6toomega-3ratioof1:1or2:1.

Not only do omega-3 fatty acids help keep inflammation at bay bycounteractingomega-6s,butomega-3fattyacidsmayalsohelpfightallergies.31Oneofthebestsourcesofomega-3fattyacidsisoilyfish,butthere’salimittohowmuchfishyoucaneat.AccordingtotheEnvironmentalProtectionAgency,all fishandshellfishcontainsomemercury.Tobesafe, I recommend thatyoulimit yourself to no more than two servings of seafood per week. This isespeciallyimportantforchildrenandwomenofchildbearingage.32

Besidesoilyfish,thereareanumberofotherfoodsourcesofomega-3fattyacids. These include flaxseed, chia, and spirulina (a blue-green freshwateralgae). Recently, foodmanufacturers have beenmaking an effort to advertisetheirproductsasbeingfortifiedwithomega-3s.Products likecereal,milk,andeggs are often labeled as good sources.Thosewith allergies or sensitivities to

wheat, dairy, or eggs will obviously want to avoid these foods. Furthermore,how much beneficial omega-3 fatty acids these products really contain issometimes suspect, so I certainly wouldn’t rely on these foods to fulfill youromega-3quota.

Oneofthebestnonfishwaystogetsomeomega-3fattyacidsistoconsumeflaxseeds.Flaxseedsare rich inalpha-linolenicacid (ALA),a typeofomega-3fattyacidthathasbeenfoundtobeprotectiveagainstthesymptomsofasthma.33Youcanbuyflaxseedinbulkinmosthealthfoodgrocerystores.Inordertogetthemostoutofflaxseed,youshouldgrinditintoamealbeforeingestingit.(Theseeds are too small to be effectively broken down by your digestive tract andabsorbed.) I generally recommend that people use whole flax, rather than apregroundproduct,asthehealthyfatscontainedintheseedcanrapidlyoxidizewhen exposed to air, losing some of their healthiness.A simple solution is togrindacoupleofheapingtablespoonsofwholeflaxseedsinasmallcoffeebeangrinder justprior tousing them.Freshlygroundflaxmakesagreataddition tooatmeal or cereal; it adds a pleasant, nutty flavor to salads; and it is a goodaddition to a smoothie.A quickword of caution: If you add ground flax to asmoothie, make sure you add a little more liquid than usual, as the fibercontained in theseedscanmakeyourdrinkpretty thick. It’s important tonotethat flaxseedsdonotcontain theotheromega-3fattyacids,DHAandEPA,sotheyarenotacompletesourceofomegas.Thereisevidence,however,thattheALAfoundinflaxcanbeconvertedtoDHAandEPA.

As previously mentioned, most people are deficient in omega-3s and, inadditiontodietarymeasures,willbenefitfromtakingasupplementtobringtheirlevelsuptooptimal.Aqualityfishoilsupplementorspirulinaproductisagoodwaytocorrectthisdeficit.Thecurrentrecommendationsforomega-3fattyacidsare500milligramsperdayofEPAandDHAforhealthyadults.34

Ithinkthattheselevelsarealittlelowtorealisticallyachieveahealthyratioof omega-6 to omega-3 fatty acids unless you also drastically reduce youromega-6 intake and increase your omega-3 intake from food. In Japan, it hasbeen documented that people have eaten in excess of 1,200 milligrams ofcombinedDHAandEPA fordecadeswithout adverse effects.While I tend tousehigherdosesofomega-3s,Irecommendthatpeopleconsultwithaphysicianeducatedaboutsuchthingspriortousingsupplementstoboosttheiromega-3s.Personally,Ifeel theliquidis thebestform.Youmayhavetotakeuptoeightcapsulesofsomebrandstogetthe2,000milligramsIrecommend,butyoucangetthisamountinjust1teaspoonoftheliquid.

Useoliveoilwheneveryoucan.Thefat inoliveoil isamonounsaturatedfat,whichhasbeenshowntoreduceinflammation, lowercholesterol,andhelpprevent blood clots. Olive oil is also rich in antioxidants, which can reduceinflammationandhelppreventanumberofinflammation-relateddiseases.35Toreapall of thesebenefits, follow theguidelinesof themodifiedMediterraneandietanduseoliveoilasyourmainfat.Drizzleoliveoilonyoursaladinsteadoftoppingitwithranchdressing,anduseoliveoiltocookyourvegetablesinsteadofotherfatsandoils.36

Keep in mind that olive oil has a very low smoke point (defined as thetemperaturesomethingcanreachbeforeitstartstoburn,smoke,andeventuallycatchfire),soyoushouldonlyuseittocookatalowerheat—lessthan325°to400°F.Notonlycouldhigh-temperaturecookingwitholiveoilcauseafire,butwhen it reaches its smoke point, the oil starts to break down. It loses itsantioxidantsandcanactuallyrelease toxicchemicals in itssmoke,servingyoucarcinogenicfreeradicals—theveryfreeradicalsithelpsfightinitscoolerform.Soavoidusingoliveoiltosearfish,meat,orchicken;toroastvegetablesinanovenhotterthan400°F;whenyouarecookinginawokorstir-fryinginapan;orwhen you are deep-frying anything. When cooking in these higher-heatinstances,userefinedcoconutoilinstead.37

Getfourorfiveservingsofveggiesandtwoorthreeservingsoffruitperday. As discussed in Chapter 9, fruits and vegetables—especially brightlycoloredvarieties—aregreat sourcesofanti-inflammatoryantioxidants.38But ifyou’re not a natural fruits and veggies eater, don’t panic. You don’t have tomunch on carrots and celery all day. Aim for four to five ½-cup servings ofvegetablesandtwoorthree½-cupservingsoffruitperday.39Addstrawberries(see“TheImportanceofSpringingforOrganicStrawberries”)andblueberriestoyouroatmealorflaxcerealinthemorning,haveaspinachsaladwithtomatoesandavocadoforlunch,andeataservingofsteamedasparaguswithyourdinner,andyou’vemorethanmetyourdailygoal.

TheImportanceofSpringingforOrganicStrawberriesStrawberriesareoneofthemostdelicious,nutritiousfruitsyoucaneat,butunfortunately,theyarealsooneofthemostheavilycontaminatedfoods.Alongwithgrapes,apples,andpeaches,strawberriesareguiltyofbeingonthe“DirtyDozen”list.Andstrawberriesareonthislistforagoodreason:Theymaycontainupto371differentpesticidesapprovedbythe

EnvironmentalProtectionAgency,includingmethylbromide;chloropicrin;captan;malathion;Dibrom;Kelthane;andavermectin.Thesechemicalscancauseanumberofhealthproblems,includingnervedamage,respiratoryproblems,andcancer.

Becausenonorganicstrawberriesarepotentiallytoxic,it’sworthittoinvestinorganic

strawberriesifyoucan.41

Eatyourgrainswhole.Whole-grainbreads,cereals,andricearegoodforyoubecausetheycontaindietaryfiber.Thesolublefiberinwholegrainsformsastickygelthatprotectstheinsideofyourdigestivetractfromharmfulsubstancesin the foods you eat.40 Plus, a 2014 study shows that dietary fiber may helpprotectagainstallergicasthma.Swissresearchersfedmicetwodifferentdiets—onewith4percentfiberandonewith0.3percentfiber.Whentheyexposedbothsetsofmicetodustmiteextract,themiceeatingthelower-fiberdiethadtwicethe number of immune cells associated with allergic inflammation in theirairwayscomparedwiththemiceeatingthehigh-fiberdiet.42

Ifyouhaveanallergyorsensitivity,or justageneraldesire toavoidgrainproducts,youcanget soluble fiber fromother foods, too. Inaddition towholegrains, nature provides a number of alternative sources of soluble fiber,including lentils, apples, beans, blueberries, carrots, celery, cucumbers, driedpeas,nuts,oranges,pears,andstrawberries.43

Don’t rely on redmeat and chicken as your primary protein sources.Red meat and chicken both contain proinflammatory arachidonic acid. Thatdoesn’tmeanyouhavetocutthemoutcompletely,buttheyshouldn’tbeatthecenterofyourdiet.

Tohelpminimizeyourdependenceonthesemeats,considertryingsomeofthereallygoodmeatsubstitutesavailable.Texturedvegetableprotein(TVP)isadefattedsoyflourproductthathasasimilarproteincontentasmeat.(There’sarestaurant down the street frommy house that servesmeatless chickenwingsmade from textured vegetable protein, and you literally cannot tell thedifference.)Youcanalsousequinoaasagroundmeatsubstitute in things likemeatballs and vegetarian stuffed peppers. Veggie burgers and portobellomushroom burgers are also tasty alternatives to beef. Other good alternativeproteinsourcesincludebeans,lentils,nuts,andseeds.

I also want to highlight the importance of getting complete proteins—proteins thatcontainallnineof theessentialaminoacidsnecessary forhumandietary needs—in the correct proportions.Most animal proteins, such as eggs,dairyproducts,meat,andfish,arecompleteproteins. Ifyouarecuttingoneor

more of these animal products from your diet, add quinoa; it’s also a goodcompleteproteinsource.44

Part of changing your eating habits to reduce your meat consumptioninvolvesgivingyourpalate some time toadjust.Substitutes formeat,chicken,and other fattening and inflammation-promoting foods take some getting usedto.Asyoustarttoadoptaless-meat-dependentdiet,notonlywillyoufindthatyou feel better but also your taste budswill change and youwill crave thosefoodslessandless.

GeneticallyModifiedFoodsandAllergiesAsdiscussedinChapter2,thereareanumberoftheoriestoexplaintheriseinallergiesindevelopedcountries—particularlyfoodallergies—rangingfromoursterilesocietytotheincreaseinpollution.Oneadditionalpotentialexplanationforthisincreaseisgeneticallymodified(GM)foods.Geneticallymodifiedfoods(alsocalledgeneticallyengineeredfoods)arefoodsthatcontaingenesfromotheranimalsorplantsintheirgeneticcodes.Justlikedogbreedershaveworkedtocreatebreedsthataremoredocileanddomesticated,scientistshavetriedtocreatethe“perfectfood”inappearanceandtastebymovingdesired

genesfromoneplantoroneanimaltoanother.45

Geneticallyengineeredfoodsdohavesomebenefits.Theymaybemorenutritious,requirefewerpesticides,growfaster,havealongershelflife,orhaveincreasedmedicinal

propertiesthatallowthemtobeusedinvaccinesanddrugs.46Thesebenefitscomewithsomesignificantrisks,however,includingunexpectedgeneticchangesthatmaybeharmful.Forexample,afoodcancontainagenefromanotherallergenicfood,whichcouldcausepeopleallergictoBrazilnutstoreacttosoybeans,becausetheBrazilnutproteinwastransferredtothesoybeanaspartofthegeneticengineeringprocess.Inaddition,geneticallymodifiedfoodsmayinterbreedwithnaturalorganismsandcreatehybrids,

potentiallyleadingtothegeneticextinctionoftheoriginalanimalorfood.47

AccordingtotheAmericanAcademyofEnvironmentalMedicine(AAEM),geneticallymodifiedfoodsposeaseriousthreattohumanhealth.TheAAEMbelievesthatintroducinggeneticallymodifiedfoodsintothefoodsupplyhascorrelatedwithrisesindiseasesand

allergies,particularlyallergiestofoods.48Themainreasongeneticallymodifiedfoodsarecontributingtofoodallergiesisthat,asaresultofbeingmanufactured,geneticallymodifiedfoodsmaycontainmorefoodsthanthefoodtheyweremeanttobecome,asisthecaseof

theBrazilnutandsoybeanjustexplained.49

Myadvicetopeoplewithallergiesistoavoidgeneticallymodifiedfoodsasmuchastheycan.Thebestwaytoavoidgeneticallymodifiedfoodsistoeatorganicwheneverpossible.Thatmeansvegetables,fruits,fish,and—ifyoueatthem—poultry,meat,anddairy.Eatinganall-organicdietcanbecost-prohibitive.Ioftentellpeopletovisittheirlocalfarmer’smarket,asorganicfoodsareoftenlessexpensivewhenyoubuythemstraightfromthefarmer.Ipersonallytrytoeatonlyorganicanimalproducts.Asforproduce,IusemydollarstobuyonlythosefoodsthatarenotontheEnvironmentalWorkingGroup’s“DirtyDozen”

list.50Thesearethefoodsthataremostlikelytocontainpotentiallyharmfulchemicals.The“DirtyDozen”includesthefollowing12fruitsandvegetables:

1.Apples2.Grapes3.Strawberries4.Spinach5.Peaches6.Cherrytomatoes7.Importedsnappeas8.Sweetbellpeppers9.Cucumbers

10.Celery11.Importednectarines12.Potatoes

DIETARYCHANGESANDYOURDIGESTIVESYSTEMThisbringsmetomynextpoint:Anytimeyouaremakingsignificantchangestoyourdietaryhabits,yourdigestive tractwill likelyneedsometimetoadapt.To digest high-fiber fruits, vegetables, and nuts, you will require differentenzymesthanyoudidwhileeatingameat-baseddiet.Asaresult,whenyou’resuddenly eating more produce, you may experience an increased amount ofbloating and gas. A good digestive enzyme supplement can help you throughthistransition.

Digestive enzymes are produced by your pancreas and secreted into yoursmall intestine to help you break down the foods you eat. These enzymes areveryimportant,astheyworktodigestfoodintoastateinwhichitcanbeeasilyabsorbedbyyourbody.Quiteoften,patientswithgastrointestinalsymptomswillremark that their symptoms dramatically improved once they started taking adigestive enzyme. There are many good digestive enzyme supplementsavailable,andforthosepeoplemovingtowardamorevegetable-heavydiet,anenzyme formulation containing alpha-galactosidase may help reduce thesymptoms of gas and bloating. Digestive enzymes are generally taken rightbeforemeals.

All-PowerfulProbioticsI think justabouteveryoneshould try to incorporateprobiotics into theirdailyplan. Regardless of whether you are making a significant dietary change,fighting allergies, or trying to improve gastrointestinal health, probiotics willlikelybeofbenefit.

Probiotics, the health-promoting symbiotic bacteria that live on and in us,canhelpmaintainahealthybalanceofgoodtobadmicroorganisms.Toillustratethebenefitsofprobiotics,considerthisexample:Mostwomenhaveexperienceda urinary tract infection (UTI) at one time or another in their lives.Generallyspeaking, the usual treatment for a UTI is an antibiotic. The antibiotic will

eliminatetheoffendingbacteriafromtheurinarysystem,butitoftenpredisposesthewomantoasubsequentyeastinfection.Thisisbecausewhiletheantibioticdestroysthebacteriaresponsiblefortheinfection,italsodamagesthepopulationofhealthy,protective,goodbacteria,calledbeneficialflora,intheurinarytract.With these good bacteria diminished, it creates an opportunity for yeastovergrowth,asyeastsarenotaffectedbyantibiotics.Takingaprobioticduringacourse of antibiotics, and especially immediately afterward, can nearly alwayspreventtheyeastovergrowth.

Intermsofallergies,researchhasshownthattherightbalanceofbeneficialtobadbacteriacanhelppreventyourimmunesystemfromoverreactingandcanthereforepreventallergicreactions.51AsmentionedinChapter2,kidswhoareexposedtoawidervarietyofbacteriaearly in life tendtohavefewerallergiesthankidswhoaremoreprotectedfromgerms.52Plus,becauseofourwidespreaduseofantibiotics,we’reunintentionallydestroyingsomeofthegood,protectivebacteria along with the bad ones, and that loss of good bacteria inhibits ourimmunesystemsfromfunctioningproperly.53

There’sresearchtosupportthepotentiallyprotectiveeffectsofprobioticsinpeoplewithallergysymptoms.Ina2013reviewpublishedinthejournalCurrentOpinion inAllergyandClinical Immunology, researchers found thatprobioticsmayhelppreventeczemaaswellasrespiratoryallergies.54

Herearesomeguidelinesontakingprobiotics.• Don’tfallfortheprobioticmarketinghype.Makesuretolookforproductsthatcontainmultiplestrainsofprobiotics.Lactobacillusandacidophilusarecommonstrainsfoundinfoodslikeyogurt.

• Findtherightprobioticsupplement.Mostprobioticsupplementsshouldberefrigerated.Becausetheyarelivingthings,probioticsaresensitiveandcanloseefficacyifexposedtotemperatureextremes.Thereareafewprobioticsupplementsthatdon’tneedtoberefrigerated(lookfortheminhealthfoodstores),buttheyarefewandfarbetween.Alsolookforsupplementsthathavethefollowing:• Agoodrangeofbacteria,notjustonekind.Yoursupplementshouldcontainacidophilus,bifidobacterium,andlactobacillus.

• Enoughbacteria.Probioticsaremeasuredincolonyformingunits(CFUs).Lookforasupplementthathasatleast5billionCFUs.

• Somevariety.Ithinkit’sagoodideatoswitchyourprobioticsupplementeverysooften,becausetheyallcontainslightlydifferent

strainsofbacteria.Youdon’twantthesamebacteriaoverandover.Instead,mixituptoaddsomefreshgeneticstothegenepool,sotospeak.

Additionally, there are some foods that are naturally good sources ofprobiotics,suchasmisosoup,sauerkraut,yogurtwith“live,activecultures,”andkefir(acrossbetweenmilkandyogurt).

THEIMPORTANCEOFHYDRATIONDrinkingwaterisoneofthebestthingsyoucandoforyourself.Afterall,morethan half of your body ismade ofwater—itmakes up your interstitial fluids,intracellular liquid, and cerebrospinal fluid as well as other important liquids.Blood,forinstance,is83percentwater.55

Justasyouhavetochangetheoil inyourcar,forgoodhealth, it isagoodidea to continuously flush your system with fresh water in order to promotehealth.Youareconstantly losingwater throughurine,sweat,breath,andstool,soyouneedtoreplenishyoursuppliesconstantly.56Unfortunately,manyofusare walking around semi-or completely dehydrated.Most of us are busy, anddrinkingwater doesn’tmake it onto our to-do lists.We confuse sensations ofthirst with hunger and reach for a snack, rather than for the water we reallyneed.57

Making sure you get enough water is imperative. Without enough water,your blood can’t deliver oxygen, nutrients, and other important substances toyourtissues.58Dehydrationcanleadtoallkindsofproblems,includingdigestiveupset, especially acid reflux and constipation, as well as depression andirritability. Anyone who has ever had a hangover knows the mental fog thatdehydrationcanbring.Infact,whendehydrationpersists,bloodvolumecangetso low that it can temporarily reduceblood flow to thebrain and impair clearthinking.60

In terms of allergies, dehydration can cause an immune system imbalanceandincreasedhistaminelevels.Therefore,ifyoudoencounteranallergen,suchas fromamoldor a cat,whenyou are thirsty, your allergic reaction couldbeexaggerated.61 Hydration, on the other hand, can also protect against allergysymptomsbythinningmucusandhelpingyoursinusesdrain.Sincecongestionalsoleadstoadrymouthandlessenstheprotectivepropertiesofsaliva,drinkinglotsofwatercanhelpboostyourimmunity.62

To stay hydrated, I recommend you drink water. My generalrecommendation ishalfofyourbodyweight inouncesofwatereachday.Forme,a200-poundguy, thisequates toabout100ouncesperday.Activities thatcauseyoutosweatwillobviouslyincreaseyourwaterneeds.Tostayhydrated:

• Drinkwaterthroughouttheday.Don’twaituntil6:00p.m.todrinkyourdailyrequirement;nobodylikestobeupallnightgoingtothebathroom.

• Keepwaterwithyouatalltimes.Oneofthebiggestobstaclestodrinkingwaterisnothavingaccesstoit.Ifyouhaveawaterbottleonyourdeskorinyourcar,youwilldrinkfromit.Getagoodwaterbottleandtakeitwithyouwhereveryougo.LookforacontainerthatisfreeofharmfulchemicalssuchasbisphenolA(BPA).

• Makesureyouhavegoodwaterinyourhome.Considerinstallingaqualitydrinkingwaterfilter(see“DrinkingandDrugging?”).It’snotabadideatoinstallchlorinefiltersonyourshowerheads,too.Bothofthesetypesoffiltersarereadilyavailablefromavarietyofsources.

• Forgobottledwater.TheFDAdoesn’trequirewater-bottlingcompaniestoundergowater-qualitytests.Inthepastfewyears,somebottledwaterhasbeenrecalledduetocontaminationwithbacteria,mold,arsenic,andevensomecleaningcompounds.63

• Makesureyourwaterisn’ttoopure.Reverseosmosisisawater-purificationprocessthatconvertssaltwaterintofreshdrinkingwater.Itissuchapowerfulcleansingtoolthatitstripsallofthemineralsoutofthewater,too,soyou’releftwithpureH2O.Withnothingtobufferit,waterpurifiedthroughreverseosmosiscanbequiteacidic,anddrinkingitcanactuallyremovesomeofthemineralsfromyourbody.Tobuffertheacidity,Irecommendthatpeoplewhodrinkthiswaterheadtothehealthfoodstoreandpurchaseliquidminerals.Addafewdropstoyourwaterbottletobuffertheacidity,andyou’regoodtogo.

DrinkingandDrugging?Ifyoudrinkmunicipalwater,youmaybegettingmorethanyoubargainedfor.Anumberofstudieshavefoundhighlevelsofpharmaceuticaldrugsindrinkingwater.Infact,accordingtoanAssociatedPressstudyof24majorUScities,41millionAmericansmaybegettingdrugsintheirdrinkingwater.Thesemedicationsincludedrugsforpain,asthma,mentalillness,highcholesterol,andinfections.

Tohelpprotectyourselfandyourfamilyfromtheseunwanteddrugtreatments,consider

ahomewater-purificationsystemorwaterfilter.Also,makesuretoengageinlifestyleactivitiesthatpromotegoodhealth,suchashealthfuleatingandexercise,whichwillhelpflushthingsthroughyoursystemandpreventaccumulationofthesedrugsaswellas

unwantedtoxicity.59

SLOWANDSTEADYWINSTHERACEChanging your lifestyle to lose weight—or just to become healthier and lessallergic—is a big commitment. In order to succeed, you have to be kind toyourselfandtakethingsslowly.

Beflexible.OneofthegreatthingsaboutthemodifiedMediterraneandietisthat there are somany foods you can eat as part of it, whichmeans you caneliminatefoodsyoucan’teatordon’tlike.Ifyoudislikeeggplantoravocados,forexample,youcan substitute inotherhealthfulvegetablesandnuts, suchassquash and chickpeas. If you don’t like seafood or are allergic to fish orshellfish, you can still enjoy a healthful, anti-inflammatory eating plan. Somesuggestions for shellfish substitutes in recipes include green leafy vegetables,likespinach;walnuts,Brazilnuts,hazelnuts,andpecans;flaxseedoil;canolaoil;eggs;sesamebutter(tahini);soybeansandsoybeanoil;soymilk;andtofu.64

Be accountable. To stick to healthy lifestyle changes, it can help to beaccountable to someoneor something,be it a trainer at yourgym, anexercisebuddy,oranonline journal—whateverworksbest foryou.Whenit’s justyou,it’s really easy to talk yourself into or out of something.Walking through thegrocerystore,youcouldbedoinggreat,pushingacartfuloforganicgreensandfish.Then,forwhateverreason,youheaddownthefrozenfoodaisleandthereisyourfavoritemacadamianutcrunchicecream.Itfeelsgoodtoeaticecream,soyoureachout,grabit,andthrowitintoyourcartwithoutreallythinking.Ifitisinyourfreezer,youhaveahigherprobabilityofeatingit.Now,ifyoumadeapoint of bringing a friendwith you to the grocery store, or you just promisedyourselfyouwouldtellafriendallofthethingsyoubought,youwouldbealotlesslikelytogiveinandtosstheicecreamintoyourotherwisehealthfularrayofpurchases.

Anotherexample:Manyofmypatientscomplainabouthavingtofitexerciseinto their busy schedules. It usually requires a change in routine—getting upearlierinthemorningorgoingtothegymlateratnight.Soyoutellyourselfyouaregoingtogetupat6:00a.m.torun.Butwhenthatalarmgoesoff,yousmackit,rollover,andgorightbacktosleep.Ifyouhaveafriendwaitingonthecorner

torunwithyou,itwillbeawholedifferentstory.Notonlywillyoufeelguiltyforlettingyourselfdownifyouskiptherunbutalsoyouwillhavetolivewithknowingyouletyourfrienddown,too.Sothepointis,whetherit’sforexerciseor weight loss or anymajor lifestyle and habit change, accountability is veryimportant.

Ialsoliketheideaofkeepingafoodjournal.Writingdownwhatyoueatandwhen you eat it not only provides positive feedback about how great you’redoing,butitcanalsohelpidentifyfoodsthatmightbecausingGIupset.Ithinkit’ssmarttokeepafoodjournalforaboutthefirst2weeksofanynewdietplan.

Makeitafamilyaffair.Iseethisalot:Onememberofafamilydecidestoloseweightorjuststarttomakehealthiereatingchoices(usuallythewife),andthe other family members (usually the husband and the children) choose tocontinuetoeattheirregulardiets.Typically,thewifeisthecookinthefamily,sonowshehastocooktwomeals,nottomentiondealingwiththetemptationofcontinuing to have unhealthy foods around the house. So I think it is reallyimportantforpeopleundergoingalifestylechangetomakesuretheyhaveareal,honest discussionwith their familymembers about their plansbefore they getstarted. Spell out how you plan to improve your health, and encourage yourfamilymemberstoadoptthesamehabits—notonlytogiveyousupportbutforthesakeoftheirownhealthaswell.That’soneofthebeautifulthingsaboutthisplan:It’snotjustforallergies,it’sforgoodhealthingeneral!

Don’tgocoldturkey.Justliketryingtoquitsmoking,mostpeoplehavetoweanthemselvesoffoftheirolddietsandeaseintoatheirnewones.Switchingtoaneweatingplanovernightisarecipeforfailure.Myadvice:Takeaweekorsoandmentallyeaseintotheideaofyourneweatingplan.ConsiderdoingsomeresearchandfindingsomerecipesforthemodifiedMediterraneandiet.Lookforsome cookbooks with ideas for healthy meals (I like Asian, and specificallyThai, cookbooks myself), because these recipes are typically in line withMediterraneandietfoodchoices.

Set small goals. The safestway to loseweight and keep it off is to do itslowly,losingnomorethan2to3poundsinasingleweek.Monitoryourweightloss closely,weighingyourself a few times throughout theweek tomake sureyouarelosingatagoodpace.Also,keeparecordsoyoucanseeyourprogressover time.This is great positive feedback thatwill help keep you enthusiasticandontrack.

Spencer’sStoryEversincehewasakid,Spencersufferedfromsevereallergysymptoms—eyewatering,puffy,itchyeyeshecouldbarelykeepopen,sneezing,runningnose,andfoodallergiesthatinterferedwithhisqualityoflife.“Asakid,Imissedalotofschoolduetomyallergies,”hesays.

Later,asanadult,hemissedworkandactivitiesheenjoyed.“Workingorridingmotocrossaretheonlytwoplacesyou’llfindme.BothwereimpossiblewhenIcouldn’tseeandfeltmiserable,”saysthe22-year-old.

Inaddition,Spencersufferedstomachunrestgastroenterologistscouldn’tfix.Aftertryingnumerousanti-anxietymedicationstohelpwithserotoninlevels,aswellasarangeofantibiotics,Spencerdidnotfeelanyrelief.“TheGIdoctorsdidn’tsupporttheideaofbacterialovergrowthorleakyintestinallining.Theyweren’twillingtoconsideritasanactualcondition,”Spencersays.

Fedup,hedecidedtovisitsomeonewhowouldtakehissymptomsseriously:Dr.Psenka.

“Iwasneverabelieverin‘naturaltreatments.’Ifelttherewasapillforeverything,”saysSpencer,apersonaltraineratOrangeTheoryFitness.FortheoldSpencer,energydrinks,stress,andbingedrinkingwerearegularoccurrence.Healsoatewhateverhewanted.“Somehow,thosehabitscoupledwithabacterialinfectionishowthewholemessstarted.IwishIwouldhavealwaysbeeneatinghealthfullylikeIdonow.”

This‘eatinghealthfully’meansfollowingtheSpecificCarbohydrateDiet(SCD),whicheliminatescarbohydratesthataredifficulttodigestandcauseinflammationinthegut—primarilygrains,starches,sugarsanddairy.

Inaddition,Spencerisnowusingsublingualimmunotherapy(SLIT)tofighthisseasonalnasalandocularallergies.WithinthefirsttwoweeksonSLIT,hestartedfeelingbetter.“SinceIstartedusingtheSLIT,Ihaven’thadonebaddaylikeIusedtohave,”hesays.“Mylifeisnowallergy-andworry-free.”

TheSCDisworkingwell,too.“Ittookabouttwomonthsforthediettoeradicatethebacterialovergrowth,butInowfeelIamonthepathtohealingmyintestinallining,”hesays.“Whenmystomachfeelsgood,Iamafarhappierandmoreoutgoingperson,andIfeellessstressed.”

Spencerhasalsolostweight.“Idroppedfroma34waistsizetoa30to32,andIwentfrom200to185pounds,”hesays.Andhisweightdroppedfrom200poundsto185.

AllthisthankstoDr.Psenka’splan,whichSpencersayswaseasytofollowandwelllaidout.

Forallthesereasons,today,theoncenaturalremediesskepticisnowafirstbeliever.“Ihavelearnedkeepingyourbodyhealthycanfixalotmoreproblemsthanonemedicinecan,”hesays.“IwillnowseeDr.PsenkafirstforwhateverproblemsIamhaving.”

11TreatingAllergiestheNaturalWay:SupplementsandHerbs

DURING THE 12 YEARS THAT I HAVE BEEN PRACTICING as alicensednaturopathicphysician,Ihaveuseddietarysupplementstohelpagreatnumber of people. When used correctly, supplements can help improve aperson’shealthinavarietyofways.Forexample,peoplewhoarejustbeginningto eat a healthy diet can use supplements to give their bodies a boost of aparticularsubstance,likeomega-3fattyacids,andquicklycorrectanynutritionaldeficiencies thatmay exist.Once these deficiencies have been corrected, thendietalonecanbeusedtomaintainhealthylevels.

It’s important to note that physicianswill often suggest using supplementsalongwithconventionalmedicationsinhopesthatthissynergisticapproachwilldeliverbetterresultsthaneithertreatmentcouldalone.Specialattentionshouldbepaid in thesecases,becausenotallsupplementsandmedicationsworkwelltogether.Sometimessupplementscanbeusedbythemselvestoaddressspecificsymptomsinmuchthesamewaythatprescriptionmedicationsare.Ifanaturalsupplementcanalleviatesymptomsjustaswellasamedication,butwithoutthepotential for adverse effects, then my recommendation is to use the naturalsupplement.

It’salsoagoodideatousefoodtoimproveyourhealthwheneverpossible.Iwouldmuchratherseepeopleeatingwholesomefoodsthantakingahandfulofsupplements.Foodasmedicineisalwaystheideal,butasyou’lldiscoverinthischapter,it’ssometimeshelpfultousesupplementstoaidhealingandfindrelieffromallergies.

Now,Iamnotrecommendingthatyouimmediatelydiscontinueprescriptionmedications forallergiesorasthma,but rather I’mhoping toencourageyou tolearnhowyoucansafelyintegratemedicationsandsupplements.But—andthisisabigbut—keepinmindthatjustbecausesomethingisnaturaldoesn’tmeanitissafe.Poisonivy,forexample,isnatural,butweallknowitisn’tsafetotouch.It’salsoimportanttorememberthatherbsandsupplementsarenotregulatedby

theFDAthewayothermedicationsare,sotheydon’thavetoundergothesametypeoftestingbeforetheyhittheshelves.

It’s a good idea to consult with a physician experienced in using naturalsupplements before taking anything new. This is especially true if you havehealth issues, are pregnant, or are taking any pharmaceutical medications.Consultingwith a doctor can not only help you avoid any unpleasant adverseeffectsthatmayarisebutalsoitcanhelpensurethatyourdosageiscorrectandthattheproductyouaretakingisofhighquality.

In addition, some supplements may actually aggravate allergy symptoms.Echinacea,forexample,belongstothesamefamilyasragweed,soitcanmakehayfeverworse.Thesamegoesforchamomile.1

Supplementsandherbsmayalsocross-reactwithsomeprescriptionorover-the-counter medications.2 For all of these reasons, it’s important to followdosage recommendations and directions whenever you take any herb,supplement, or medication. And always talk to your health-care provider andpharmacistbeforeyoustarttakinganynewsubstance.

SUPPLEMENTSANDHERBSFORALLERGIESANDASTHMAWith all of the above information in mind, here are some of my favoritesupplementsandherbsfor treatingallergies,asthma,andtheinflammationthatcanexacerbatetheseandotherconditions.

SNEEZE-STIFLINGSUPPLEMENTS

BromelainBromelain,whichwasfirstproducedinHawaiiandJapan,isaprotein-digestingenzyme (akaaproteolytic enzyme) that can significantly reduce inflammation.Asananti-inflammatory,bromelainhas thepotential tohelpmanyconditions,suchasstrains,sprains,arthritis,backpain,andofcourse,allergies.3

HOWITFIGHTSALLERGYORASTHMASYMPTOMSBromelainhasbeenshowntodecreaseinflammationintherespiratorytract,andthereforeitcanhelpreduceallergysymptoms,suchasnasalandsinusswelling.4,5 Bromelain can also thinmucus, easing nasal congestion. There’s also someevidencethatitcanboostyourimmunesystem.

In a 2005 study published in the journal In Vivo, researchers found thatchildrenunderage11whowerediagnosedwithacutesinusitisrespondedwelltobromelain. The participants got one of three different treatments—bromelain(200 milligram tablet), bromelain combined with a standard treatment, or thestandardtreatmentbyitself.Thegrouptreatedwiththebromelainalonehadthefastest recovery—6.66 days, compared to 9.06 days for the kids treated onlywith the standard therapy.6 It is also important to point out that none of thechildren in the study experienced any serious adverse reactions to bromelain.However, one child did have an allergic reaction, and itwas later determinedthatthischildhadapineappleallergy.

HOWTOGETITWhileyoucangetbromelainfromeatingfreshpineapple,mostoftheenzymeisfoundwithinthepineapplestem,whichisn’tagoodpartofthepineappletoeat.Thebestwaytousebromelainistotakeitasasupplement.7

Bromelain is usually measured in gelatin dissolving units (GDUs), milkclotting units (MCUs), International Pharmaceutical Federation units (FIP), ormilligrams(mg).(ToconvertmilligramstoFIPs,simplymultiplythemby2.5.)It’sagoodideatolookforabromelainsupplementthatisentericcoated,whichprotectsthebromelainfrombecomingactiveinyourstomach.Whenbromelainbecomesactiveinyourstomach,theenzymeworkstodigestanyfoodthatisinthere.Therefore,itisbesttotakebromelainsupplementsonanemptystomach.

TheGermanCommissionEmonographforbromelainsuggestsadosageof80 to 320 milligrams. The effectiveness of bromelain seems to be dose-

dependent and, for many, dosages up to 1,000milligrams per day have beenused. It is best to take bromelain three or four times per day, rather than as asingledose.Iusuallyrecommendthatmypatientstake150milligramsthreeorfourtimesaday.

CONTRAINDICATIONSANDTHINGSTOCONSIDERBromelainhasagoodsafetyprofileandiswell-toleratedbymostpeople.Thatsaid, itdoeshave thepotential tobeanallergen itself,especially in thosewhosuspect that they may have a pineapple allergy. It can also cause some mildgastrointestinal side effects, including heartburn and diarrhea.8 There is someevidence that bromelain can increase the action of certain blood-thinningmedications aswell as antibiotics known as tetracyclines. If you are currentlytaking these drugs, consult with your doctor before starting a bromelainsupplement.

VitaminB6Vitamin B6 (pyridoxine) is an important vitamin that helps your body makeproteins, hormones, and neurotransmitters. It’s particularly critical for properfunctioning of your brain, nerves, and skin.9 In your body, vitamin B6 isabsorbed in your small intestine and transported to your liver, where it isconvertedtoitsmetabolicallyactiveform,pyridoxal5'-phosphate.

HOWITFIGHTSALLERGYORASTHMASYMPTOMSAfewstudieshavesuggestedthatvitaminB6mayhelppeoplewithasthma.Onestudy on 76 children with asthma found that kids who took a vitamin B6supplement for 2 months were able to reduce their doses of asthmamedications.10

AnothersmallstudypublishedintheAmericanJournalofClinicalNutritionfound that adult asthmatics had significantly lower levels of vitamin B6 thancontrols. The study subjects with asthma were then given 50 milligrams ofvitamin B6 twice daily and noted a dramatic decrease in the frequency andseverityofwheezingandasthmaattackswhiletakingthesupplement.11

Also,peoplewithhighlevelsofinflammationoftenhavedepressedvitaminB6 levels.As discussed, inflammation sets the stage for the development of a

rangeofdiseases, fromheartdisease toallergies. Ina2012studypublished intheJournalofNutrition,researcherslookedatvitaminB6levelsand13differentmarkersofinflammationin2,229adults.Theresearchersfoundthatthosewiththe highest levels of inflammation had the lowest levels of vitamin B6.Conversely, those with the highest levels of B6 had the lowest levels ofinflammation.12

Another interesting studypublished in the same journal found thatvitaminB6–deficient rats had an impaired ability to convert dietary proinflammatoryomega-6fattyacidsintoanti-inflammatoryomega-3fats.Theresearchersfoundthattheanimalshadan80percentreductionintheactivityoftheenzymeacyl-CoAoxidase,which is responsible for fattyacidmetabolism.13Granted,we’renot rats, but one thing is becoming clear in themedical literature: There is adefinitelinkbetweenvitaminB6deficiencyandinflammation.

HOWTOGETITWhileyou canget vitaminB6 from some foods, including avocados, bananas,poultry, soybeans, sunflower seeds, andwatermelon, it can also be taken as asupplement.Currently,therecommendeddailyallowance(RDA)ofvitaminB6isbetween1and2milligramsperday.However,mostoftheresearchregardingB6fortherapeuticpurposeshasuseddosagesrangingfrom50to200milligramsperday.Irecommendtaking50milligramseachday.

VitaminB6 is awater-soluble vitamin and is generally recognized as safe.However, in the past there has been some concern about this vitamin beingneurotoxic at high doses. Most cases of neurotoxicity and vitamin B6 haveinvolveddosagesofatleast500milligramsperdayfor2years.14,15

CONTRAINDICATIONSANDTHINGSTOCONSIDERManyprescriptionmedicationshavetheabilitytocauseadeficiencyinvitaminB6.Eating adiet rich invitaminB6 canhelp to improveyourbody’s stores. Irecommend that you have your vitamin B6 levels checked prior to taking thevitamin in large doses.Also, because vitaminB6 has the potential to interferewith some types ofmedications (cycloserine, hydralazine, levodopa, isoniazid,penicillamine,and theophylline), it isagood idea todiscuss takingvitaminB6withaphysicianexperiencedwithitsuse.16

VitaminB12Vitamin B12 (cobalamin) is an important cofactor in DNA synthesis, nervehealth, and carbohydratemetabolism. This vitamin is foundmainly in animalproductssuchasbeefliver,clams,salmon,lamb,andcheese.NonanimalsourcesofvitaminB12includebrewer’syeast,seavegetables,chlorella,andspirulina.17

HOWITFIGHTSALLERGYORASTHMASYMPTOMSThereissomeevidencethatvitaminB12mayhelpwithasthma.Ina2010studypublished in the journalAllergy, researchers lookedat4,516peopleages30 to60. They found that those deficient in B12 were more likely to suffer fromasthma attacks and shortness of breath over a 5-year period than people withadequatelevelsoftheBvitamin.18

A smaller study published in the Journal of Allergy and ClinicalImmunology reported that people who suffer from asthma caused by anintolerance to sulfites could be helped by vitamin B12. In this study, childrenwithconfirmedsulfiteintolerancesweregiven1,500microgramsofvitaminB12andthenexposedtosulfites.Themajorityofchildren(fouroutoffive)didnotdevelopbronchospasmaftersulfiteexposure.19Whilethiswasasmallstudy,itdoesshowthepotentialofvitaminB12inhelpingasthmatics.

HOWTOGETITThecurrentRDAforB12 isup to3microgramsdaily,whereas thedosage forclinical effect ranges from 1,500 to 6,000 micrograms per day.20 Formaintenance,youcantakeadoseof1,000microgramsdaily.B12comesinbothchewableandsublingualforms.

CONTRAINDICATIONSANDTHINGSTOCONSIDERVitaminB12hasexcellenttolerabilityandisrelativelysafe.Thisvitamincanbeadministered orally, intramuscularly, or intravenously, with all routes ofadministrationprovidingpositiveoutcomes.MyfavoriteformofvitaminB12ismethylcobalamin,asitappearstobebetterabsorbedandutilizedbythebody.

VitaminCVitaminC(ascorbicacid)isthemostpopularsupplementintheworld,andit’snowonder;itdoesmanygoodthingsforyourbody.SomeofvitaminC’smostimportantactionsincludeprotectingfat-solublevitaminsfromoxidativedamageand producing collagen to strengthen connective tissues. Vitamin C is also apowerfulantioxidant,and ithelpsprotectagainstdamagefromfree radicals. Itmay also prevent plaque buildup in the arteries by lowering LDL (bad)cholesterol. Vitamin C is also useful for regulating your immune system andhelpingyourbodydealwithstress,andithasanticancerpropertiesaswell.Oneof its most well-known powers is its ability to shorten the duration of thecommoncold.

HOWITFIGHTSALLERGYORASTHMASYMPTOMSNotsurprisingly,there’salsoevidencethatvitaminCcanhelpeaseasthmaandallergy symptoms.21 Research shows that vitamin C helps prevent histaminefrombeingreleasedbystabilizing themembranesofmastcells.Mastcellsarethe storage units for histamine, and when their cell membranes rupture,histamine is released, causing allergic symptoms. Vitamin C can also breakdownhistamineonceithasstartedcirculatinginyourbody.22Ina2013study,researchers found thatwhen they injectedallergicpeoplewithvitaminC, theirbloodlevelsofhistaminewentdown.23

In another 2013 study published in Allergy, Asthma, and ImmunologyResearch,Koreanchildrenages6to12withhighintakesofvitaminChadfewersymptoms of allergic rhinitis (hay fever) than kidswho did not increase theirdailyvitaminCintake.24

Vitamin C also appears to help reduce inflammation. In a 2006 cross-sectional study published in the American Journal of Clinical Nutrition,researchers looked at 3,258 men participating in the British Regional HeartStudyandfoundthatthosewithhigherintakesandbloodlevelsofvitaminChadlower levels of C-reactive protein (CRP), an important marker ofinflammation.25ThesamerelationshipbetweenhighervitaminCandlowerCRPwasnotedinaNationalHealthandNutritionExaminationSurvey,whichlookedatdatafrommorethan14,500adults.26Andyetanotherstudyfoundthatwhenhealthynonsmokerstook1,000milligramsofvitaminCfor2months,theirCRP

levelsdroppednearly17percent,comparedtoan8.6percentdropintheplacebogroup.27

HOWTOGETITYoucaneasilygetvitaminCfromfoods,andnearlyeveryoneshouldtrytoeatsome of this vitamin daily. Focus on foods like acerola berries, cauliflower,guavas, kiwis,mangoes,melons, oranges, peppers, strawberries, and tomatoes.ThecurrentRDAforvitaminCis60milligramsperday,andthisislikelyjustenoughtopreventapersonfromdevelopingadeficiency.Inmypractice,Ihaveuseddosagesexceeding50,000milligramswithoutadverseeffects.WhenusingvitaminCtherapeutically,dosagesofgreaterthan6gramsperdayarefrequentlyused.

ThereisalargevarietyofvitaminCsupplementsavailable,includingliquid,tablet, capsule,powderedcrystalline, andeffervescent forms.For allergies andasthma, I generally recommend taking vitamin C in divided dosages rangingfrom6 to 10 grams (6,000 to 10,000milligrams) per day. For somepeople, IfindthatusingintravenousvitaminCprovidesthequickestresults.

CONTRAINDICATIONSANDTHINGSTOCONSIDERIt is important to know that dosages of vitamin C greater than 3 to 4 grams(3,000 to 4,000 milligrams) taken at once may result in gastrointestinaldiscomfortanddiarrhea.Tohelppreventthis,vitaminCcanbetakenindivideddosesthroughouttheday.(Forexample,2,000milligrams,threetimesperday.)

Whiledietary intakesofvitaminCaregenerallysafe, theuseofvitaminCsupplements may produce unwanted reactions when combined with certainmedications. Blood-thinningmedications, such aswarfarin,may lose some oftheir effectiveness when combined with vitamin C, so people taking thosemedicationsshouldconsultwiththeirphysiciansbeforestartingtotakevitaminCorstartingtotakeanynewmedicationswhiletakingvitaminC.28,29,30

CoenzymeQ10First discovered by the Japanese in the 1960s, coenzyme Q10 (CoQ10) hasquickly become one of the most popular supplements in the United States.CoQ10 is an enzyme found in almost every cell in your body, and it is anecessary intermediary in the production of the cellular energy molecule

adenosine triphosphate (ATP). CoQ10 is also a powerful antioxidant and canbufferyourbodyagainstdamagingfreeradicals.AsaresultofitsinvolvementinATPproductionandasanantioxidant,CoQ10affectsthefunctioningofallofthe cells in your body and is essential for the health of all human tissues andorgans. Many diseases and health conditions—including heart disease,fibromyalgia,Parkinson’sdisease,diabetes,bronchitis,andallergy—havebeenlinkedwithdepletedlevelsofCoQ10.31

HOWITFIGHTSALLERGYORASTHMASYMPTOMSResearchhasshown thatpeoplewithasthmahave lower thannormal levelsofCoQ10, suggesting that the enzymemight help treat this condition. In a 2002Slovakianstudy,researcherslookedatthecoenzymeQ10levelsof56asthmaticadults and 25 adults without asthma. They found that the asthmatics hadsignificantlylowerlevelsofCoQ10thanthenonasthmaticparticipants.32

CoQ10mayalsoworkwellalongsideconventionalasthmamedications.33Infact,2005BritishresearchfoundthatasthmaticswhotookCoQ10supplementswereabletoreducetheirdosagesofthecorticosteroidstheytooktohelpcontrolasthmaattacks.34

Amore recent study examined the relationship between antioxidant levelsand airway inflammation in asthmatic children. The results of this studysuggestedthatantioxidantspositivelyinfluencedantioxidantlevelsandreducedairwayinflammationinasthmaticchildren.35

HOWTOGETITCoQ10comesinanumberofforms,includingchewablewafers,tablets,softgelcapsules, and powder-filled capsules. Typical dosages range from 30 to 300milligrams in divided doses daily, although higher dosages are also used.AbsorptionofCoQ10seemstoimprovewhenit’stakenwithfood.

CONTRAINDICATIONSANDTHINGSTOCONSIDERThereareseveraltypesofconventionalmedicationsthatcanlowerCoQ10levelsinyourbody.Theseincludethecholesterol-loweringdrugsknownasstatinsandbloodpressure–loweringdrugs likebeta-blockers.Peopleon thesemedicationsmay benefit from incorporating CoQ10 into their treatment plans. CoQ10 isgenerallyasafesupplementandadversereactionsarerare,buttherearereports

ofdosesgreaterthan200milligramsperdaycausingnauseainsomepeople.36

VitaminEVitaminEisactuallyafamilyofrelatedmoleculesthatexhibitsimilarbiologicalactivity. Alpha-tocopherol causes the most actions in the body, but beta-,gamma-,anddelta-tocopherolsaretheformsfoundnaturallyinfoods.VitaminEisoneofnature’smostpotentantioxidantsandhassignificantanti-inflammatoryactionsaswell.37

Vitamin E seems to be particularly powerful against free radical harm tobloodandtissuescausedbyvigorousexercise,anditmayhelpdecreasemuscleinjury and inflammation. It also appears to reduce the risk of some cancers,includingbreast,colon,prostate,liver,lung,andpancreatic.38

HOWITFIGHTSALLERGYORASTHMASYMPTOMSSomestudieshaveshownthatvitaminEcanhelpdampenallergiesbyregulatingthepartofyourimmunesysteminvolvedinallergicresponse.39Otherresearchhasshownthatdeficienciesinthevitamincanincreaseasthmasymptoms.

Inonestudypublished in theAnnalsofAllergy,Asthma,and Immunology,researchers looked at the effects of vitamin E on 112 men and women withallergic rhinitis (hay fever). For 10 weeks, participants took either 800internationalunitsofvitaminEperdayoraplacebo.Attheendofthe10weeks,thevitaminEgrouphadsignificantlyfewerallergysymptoms—especiallynasalcongestion—comparedtotheplacebogroup.40

Population-based British studies have also looked into the relationshipbetweenantioxidantintakeandasthmaandfoundthatlowlevelsofbothvitaminCandvitaminEmayincreaseasthmasymptoms,suchaswheezing.41

Ina2008studypublishedinFreeRadicalBiologyandMedicine,researchersfound that thegamma-tocopherol formofvitaminEhelped reducemarkersofinflammationandoxidativestressinpeoplewithasthma.42

Newer research has begun to shed light on themechanismbehind vitaminE’s ability to suppress allergic symptoms.A 2013 study found that vitaminEsuppressedthedegranulationofmastcellsandthusinhibitedhistaminerelease.43

HOWTOGETITYou can get vitamin E from food, includingwheat germ (the richest source),

asparagus,avocados,nuts(almondscontainthemostvitaminEofallnuts),andwhole-grainproducts.44 In addition,manydifferentvitaminE supplements areavailable.Thesesupplementscomeinnatural(d-alpha-tocopherol)andsynthetic(dl-alpha-tocopherol)forms,incapsules,softgels,tablets,andtopicaloils.Thenatural d-alpha-tocopherol form can potentially deplete gamma-tocopherollevels in your body, so supplements containing mixed tocopherols arepreferable.45

TherecommendeddailyallowanceforvitaminEisbasedsolelyond-alpha-tocopherol, and no official recommendations exist for the other naturallyoccurringformsofvitaminE.ThecurrentRDAis22.4internationalunits(IU),withasuggestedupperlimitof1,490IUdaily.Irecommend400to800IU,ifnocontraindicationsexist.

CONTRAINDICATIONSANDTHINGSTOCONSIDERVitaminEhasalowtoxicityprofile,butconcernsexistregardingtheinfluencethat vitamin E may have on blood-thinning medications. Consult with yourphysicianifyouaretakinganysuchmedications.

EveningPrimrose(Oenotherabiennis)True to its name, the flowers of the evening primrose plant open at dusk andcloseagainatdawn.Oilfromthisplant(Oenotherabeinnis)istraditionallyusedtohelptreatwomen’shealthissuessuchasPMSandhotflashesaswellassomeskinconditionslikerashes,eczema,andhives.46

HOWITFIGHTSALLERGYORASTHMASYMPTOMSInadditiontoitsotheruses,eveningprimroseoil(EPO)hasanti-inflammatoryproperties,whichmakes it agood remedy for arthritis andother inflammatoryconditions.47More than 30 studies have shown that evening primrose oil canhelp ease eczema and dermatitis. One 2006 review of 26 studies thatencompassed a total of 1,207 people found that EPO helped ease redness,itching,crusting,andswellingfromskinconditions.48

HOWTOGETITLook for EPO that is standardized to contain 8 percent gammalinolenic acid(GLA),andalwaystakeitwithfood.StudieshavesuggestedthatitistheGLA

found ineveningprimroseoil that is responsible formostof itsability to treatatopicdermatitis.49CommondosagesofEPOrangebetween2and6gramsperdaytakenindivideddoses.

CONTRAINDICATIONSANDTHINGSTOCONSIDEREPOrarelycausessideeffects,butitmaysometimesleadtoheadaches,nausea,andabdominalpain.50Alsokeepinmindthateveningprimroseoilcaninterferewithsomemedications,includingantibiotics,chemotherapydrugs,nonsteroidalanti-inflammatory drugs (NSAIDS), anesthetics, anticonvulsant medications,andcyclosporine.51

MagnesiumThisisaveryimportantmineralinvolvedinmetabolismandenergyproductionas well as muscle, heart, and lung function.Magnesiummay help prevent ortreat a whole list of other common health problems, from sleep issues to hotflashes to constipation.52 A magnesium deficiency is quite common, as thismineral is not generally found in processed foods,whichmost people eat toomuchof.53

HOWITFIGHTSALLERGYORASTHMASYMPTOMSMagnesium can help relieve lung constriction in people who have asthma byrelaxing the smoothmuscles of the bronchioles,which are the airwayswithinyour lungs.Onestudyshowed thatmagnesium-deficient labanimalshadmorehistamineintheirbloodwhenexposedtoallergensthananimalswithsufficientmagnesium levels.54Other studieshave shown thatmagnesiummayhelp treatacute asthma attacks and that peoplewith asthmawho have goodmagnesiumintakesmayhavedecreasedwheezingandbetter lungfunction thanasthmaticswhohavelowermagnesiumlevels.55

HOWTOGETITAswithmostminerals,thebestandsafestwaytogetmoremagnesiumistoeatfoods containing it.Magnesium is found inmany foods, including buckwheatandwhole-wheatflours,almonds,avocados,bananas,beans,Brazilnuts,brownrice,cocoa,anddriedfigs.56 Incaseswherea littleextramagnesiumwouldbe

helpful,asupplementcanmakegettingmagnesiumeasier.The daily dose varies based on age and gender. While the RDA is 350

milligramsperdayformenand280milligramsperdayforwomen,thedosagesusedinclinicalpracticemaybehigher.Dosagesashighas1,200milligramsindivided doses are sometimes used. Magnesium intakes greater than 800milligramsperdayareassociatedwithariskofdiarrhea,althoughsomepeoplecanhandle thesedoseswithout aproblem.Tobegin, Iwould recommend400milligrams per day.Magnesiummay also cause a calciumdeficiency, so highdoses should be used with caution in people with low calcium. One studyinvestigatingmagnesium’s effect on allergic rhinitis found 365milligrams perdaytobeaneffectivetreatment.57

CONTRAINDICATIONSANDTHINGSTOCONSIDERTalktoyourhealth-careproviderbeforeyoustarttakingmagnesium,especiallyif you have heart or kidney disease or are taking amiloride, tetracyclineantibiotics,heartmedications,ororaldiabetesdrugs.58

ProbioticsWediscussedthepowerofprobioticsinChapter10.IthinkitisworthrepeatingthatIbelieveeveryoneshouldtakeprobiotics.

HOWITFIGHTSALLERGYORASTHMASYMPTOMSNotonlycanprobioticssuchasacidophilus,bifidobacterium,and lactobacillushelp strengthen your immune system but also they can help control yourallergies. Research shows that probiotics may regulate the immune systemoverreactionthatoccursinallergysufferers.59

Infact,oneimportanttheoryonwhydevelopedcountrieshavehigherratesof allergies is that we have fewer “good” probiotics in our flora. When yourepopulate with the good guys, you can bolster your body’s defenses againstallergens.60

There’s research to back up these potentially protective effects. In a 2013review published in the journal Current Opinion in Allergy and ClinicalImmunology,researchersfoundthatprobioticsmayhelppreventeczemaaswellasrespiratoryallergies.61

HOWTOGETITYoucangetprobioticsfromfoodssuchasmisosoup,someyogurts,sauerkraut,andkefir, but sinceyou can’t get toomuchof a good thingwhen it comes toprobiotics,Ialsorecommendyoutakesupplements.

Avarietyofproductsclaimtocontainprobioticsthesedays,soyouhavetochoosecarefully.Lookforaprobioticsupplementthatneedstoberefrigerated.(Thereareafewshelf-stableprobioticbrandsonthemarket,butmostneedtoberefrigeratedorthebacteriawilldie.)Aqualityprobioticsupplementshouldalsocontain a range of different species of good bacteria, including acidophilus,bifidobacterium, and lactobacillus. Probiotics aremeasured in colony formingunits(CFUs);lookforasupplementthatprovidesatleast5billionCFUs.Ialsorecommendthatyouswitchyourprobioticbrandeveryonceinawhile.Theyallcontain slightlydifferent strainsofbacteria, and it canneverhurt to add freshDNAtoyourbeneficialbacteriagenepool.

CONTRAINDICATIONSANDTHINGSTOCONSIDEROnewordofcautionregardingprobiotics:Ifyouhaveacompromisedimmunesystem, you need to exercise caution whenever you introduce any sort ofbacteriaintoyoursystem.Evenbacterialstrainsthatarenormallyfoundonandin us have the potential to be pathogenic in people with poorly functioningimmune systems. Immuno-compromised individuals can greatly benefit fromtakingprobiotics,buttheyneedtoconsultwiththeirphysicianstoconfirmthatthey’re using probiotic supplements that contain no potentially pathogenicbacteria.

PycnogenolPycnogenolisaregisteredtrademarkforaplantantioxidantthatcomesfromthebarkof thePinuspinaster tree.It isalsofoundingrapeseed,peanutskin,andwitchhazelbark.62

HOWITFIGHTSALLERGYORASTHMASYMPTOMSSome research shows that pycnogenol may help reduce allergy symptoms inpeoplewithbirchallergies.63Ina2010study,researchersfoundthatpycnogenolimproved symptoms of hay fever. Researchers gave 39 birch allergy suffererspycnogenolfor5to8weeksbeforethestartofthe2009allergyseason.Oncethe

seasonkickedin,participantshad35percentlowerscoresforallergysymptomspertaining to their eyes and 20.5 percent lower scores concerning their nasalallergy symptoms compared to peoplewho took a placebo. In addition, thosewho took the pycnogenol had a 19.4 percent increase in their birch-specificimmunoglobulinE(IgE),comparedwitha31.9percentincreaseintheplacebogroup. The participants with the best results in terms of improved allergysymptomsstartedtakingthepycnogenol7to8weeksbeforetheallergyseasonkickedin.64

Pycnogenolhasalsobeenshowntohelppeoplewithasthma,specificallybydecreasing levels of inflammatory leukotrienes. In a 2013 study published inFoodandChemicalToxicology,pycnogenolwasreportedtohelpprotectallergicasthmasufferersfromattacks.65

A2002reviewofstudiesonpycnogenolfoundthatitmayreducesymptomsandimprovelungfunctioninpeoplewithasthma.Anotherstudyfoundthatthesupplement could help children with asthma use their rescue inhalers lessfrequentlytomanagetheirconditions.66

HOWTOGETITTo treat allergies, take50 to200milligramsof pycnogenol, twicedaily.67 It’savailableinpillformandcanbefoundathealthfoodstoresandonline.

CONTRAINDICATIONSANDTHINGSTOCONSIDERAs always, talk to your health-care provider before you start taking thissupplement. Pycnogenol may cause some side effects, including headaches,stomachupset,dizziness,andmouthulcers. Ithasnotbeenprovensafeduringpregnancyorbreastfeeding.Andbecauseitcanstimulateyourimmunesystem,youshouldavoidtakingitifyouhaveanautoimmunediseasesuchasmultiplesclerosis, lupus, or rheumatoid arthritis. Also avoid it if you are taking animmunosuppressantmedicationorbloodthinners.68

N-acetylcysteineN-acetylcysteine (NAC) is a derivative of the amino acid cysteine. It is apowerful antioxidant itself, and it’s also a precursor molecule to one of yourbody’sstrongestantioxidants,glutathione.Inadditiontoitsantioxidantabilities,it is also helpful in treating respiratory conditions due to its mucus-thinning

ability.Morespecifically,n-acetylcysteinehelpsbreakdownmucusandmakeitlesssticky.Itiscommonlyusedtohelppeoplewithcysticfibrosis,aconditioninwhichpeople lack the tiny,hairlikestructurescalledcilia that sweepmucusawayfromthelungs.NAChelpsclearthemucusfromthelungsofthesepeoplesothattheycanbreathemoreeasily.69Itcanalsohelpreduceinflammationandpreventheartdisease,cancer,andotherdiseasesrelatedtoaging.70

HOWITFIGHTSALLERGYORASTHMASYMPTOMSResearchshowsthatn-acetylcysteinealsohelpspreventallergysymptoms.71Ina 2007 study, researchers found that n-acetylcysteine inhibited eosinophils, atypeofwhitebloodcell thatplaysacrucialpart inallergicinflammation.Asaresult, they concluded that n-acetylcysteine may be a useful treatment forinflammationresultingfromallergicreactions.72

Interestingly,NAC’s role as a precursor to glutathione is also likely to behelpful in addressing allergic inflammation. Recent research has found thatincreasing glutathione stores usingNAC counteracted allergen-induced airwayreactivity and inflammation and restored the balance between oxidants andantioxidants.73

HOWTOGETITInpeoplewithallergiesandotherrespiratoryproblems,NACdosesrangefrom600to1,500milligramsperday,takeninthreedivideddoses.NACisavailableinaliquidformoraerosolspraybyprescription,oroverthecounterastabletsorcapsules.74

CONTRAINDICATIONSANDTHINGSTOCONSIDERSideeffectsofNACarerare,buttheymayincludenauseaandvomiting.ThosewithpepticulcersshouldnottakeNAC.Also,talktoyourhealth-careproviderbeforetakingNACifyouareonimmunosuppressiveorantifungalmedications,ifyouarepregnant.75

Omega-3FattyAcidsOmega-3 fatty acids are essential fatty acids that help fight inflammation bybalancingouttheirproinflammatorycousins,theomega-6fattyacids.76

Inareviewofstudiesonomega-3spublishedinAmericanFamilyPhysician,researchersfoundthat,whengivenindosesofatleast3gramsaday,omega-3fatty acids helped lower inflammation, stiffness, and pain in people withrheumatoidarthritis.Omega3scanalsohelpfightheartdiseaseandcancerandprotectyourbrainfromdepressionanddementia.77,78

HOWITFIGHTSALLERGYORASTHMASYMPTOMSIn a 2005German study, researchers looked at 325women and 243men andfound that thosewith a high content of omega-3 fatty acids in their redbloodcells—particularlyeicosapentaenoicacid(EPA)andalpha-linolenicacid(ALA)—hadfewerhayfeversymptomsthanpeoplewithlowerlevelsofomega-3s.79

Ina2010studypublishedinRespiratoryMedicine,researchersexaminedthedietaryintakeoffishoilin38peoplewithallergicasthmaand19peoplewithoutasthma. They then exposed the participants to grass pollen. The researchersfound that the asthmatics hadhigher ratios of omega-6 to omega-3 fatty acidsthan those without asthma and that those with the lowest intakes of omega-3fatty acids had the strongest allergic reactions during the grass pollenchallenge.80

Researchershavealso found thatomega-3 fattyacidsseem tohelppreventallergiesasearlyastheprenatalstage.Ina2011studypublishedinthejournalBJOG: An International Journal of Obstetrics and Gynaecology, researchersfoundthatwomenwhotookomega-3fattyacidsupplementsduringpregnancywere less likely to have children who went on to suffer from asthma andallergiesthanpregnantwomenwhodidnottakeomega-3supplements.81

HOWTOGETITYou can get omega-3 fatty acids from foods, such as flaxseed, soybeans,spinach,walnuts, and oily fish.Anchovies, bluefish, herring,Atlantic salmon,Atlantic halibut, black cod, and sardines are the best fish sources.82However,there’salimittohowmuchfishyoucaneatbecauseofthepotentialformercurycontamination.As discussed, limit your fish servings to one to two perweek.Different species of fish are known to have higher levels of environmentalcontaminants; the worst offenders are shark, swordfish, king mackerel, andtilefish.83

Becauseof thepossibilityofmercurycontamination in fresh fish,omega-3supplementsmaybeabetterbet,asmostqualityfish-oilproductsgothrougha

moleculardistillationprocesstoremoveenvironmentaltoxins.Lookforomega-3 supplements that contain both eicosapentaenoic acid (EPA) anddocosahexaenoic acid (DHA).Most supplements contain 12percentDHAand18 percent EPA, or a total of 30 percent omega-3 fatty acids.84 Therecommended dosage of fish oil varieswidely, from1 to 10 grams daily. Formost conditions, 3 grams daily is a good place to begin. You may have toswallowalotofcapsulestogetthisamount,soasanalternative,lookforfishoilina liquidform,wherea largerdosecanbeachievedby takingas littleas1½teaspoonsperday.

CONTRAINDICATIONSANDTHINGSTOCONSIDEROmega-3 fatty acids are generally considered safe. The most frequently seenadverse effects are gastrointestinal upset and the notorious “fish burps”experiencedbysome.Somepeoplehavefoundthatfreezingfish-oilcapsulesortaking them prior to a meal can help reduce the incidence of burping.Additionally,researchhasfoundthatfishoilhasablood-thinningeffectthatcancompound the effects of blood-thinning medications such as warfarin andaspirin.85

QuercetinAtypeofantioxidantcalleda flavonoid,quercetin is found insome fruitsandvegetables, suchas apples, berries, broccoli, capers, garlic, lettuce, redgrapes,redonions,andtomatoesaswellasinblackteaandwine.

HOWITFIGHTSALLERGYORASTHMASYMPTOMSQuercetinisoneofmyfavoritesupplementsforallergies.Itseemstoworkasamast cell stabilizer, blocking the histamine that unleashes the swelling anditching of allergic reactions.86 In addition to its antihistamine properties,quercetin also appears to block tumor necrosis factor-alpha (TNF-alpha) andprostaglandins,thusfightinginflammation.87

With respect to allergies, in a2012 study, researchers found that quercetinwasmoreeffectivethantheallergydrugcromolynsodiuminblockingmastcellcytokinesandhelping topreventcontactdermatitisandphotosensitivity.Thesearetwoallergicskinconditionsthatdon’tusuallyrespondwelltoconventionalmedications.88

InanearlierstudypublishedintheIranianJournalofAllergy,Asthma,andImmunology,researchersfoundthatquercetinmayhelpdecreasethepotentiallydeadlyanaphylacticreactionassociatedwithpeanutallergies.89Additionally,ina 2007 study, mice that ate a quercetin-rich diet had lower levels ofinflammatorymarkerslinkedtoallergiesthanmicewhoateastandarddiet.90

HOWTOGETITQuercetin typically comes in 250-, 300-, or 500-milligram capsules. Forallergies,theusualdoseisbetween200and500milligrams,threetimesaday.91

CONTRAINDICATIONSANDTHINGSTOCONSIDERTherearenone,soyoucanfeelcompletelyateasetakingthissupplement,evenifyou’recurrently takingothermedications.That said,alwaysconsultwithanexperiencedphysician,justtobesafe.

SeleniumOneofthebestantioxidantmineralsoutthere,seleniumcanhelpfightdamagefrom free radicals, reduce inflammation, andboostyour immune system.Asaresult, it may help prevent a number of diseases and conditions, includingcancer,maculardegeneration,eczema,andasthma.92

HOWITFIGHTSALLERGYORASTHMASYMPTOMSAfewstudieshave shown thatpeoplewhoaredeficient in seleniumaremorelikely to suffer from asthma attacks than people with adequate levels of themineral.93A 2013German study looked at 35 asthmatic kids and 21 childrenwithoutasthmaandfoundthatthosewithasthmahadsignificantlylowerlevelsofseleniumaswellaslowlevelsoftheantioxidantsvitaminA,vitaminE,andcoenzyme Q10.94 Other research has suggested that seleniummay inhibit thereleaseofmastcellsthatunleashtheallergicresponse.95

HOWTOGETITYou can get selenium from some foods, including barley, Brazil nuts, brownrice, dairy, garlic, oats, orange juice, turnips, wheat germ, and seafood. Theactualamountofseleniumyougetdependsonhowmuchofthemineralwasin

the soil in which your food was grown. Most crop land today is selenium-deficient,soaseleniumsupplementisprobablythebestwaytogo.96

Seleniumsupplementscomeinorganicandinorganicforms,andincapsules,extended-release tablets, and regular tablets. Research shows that organicsupplementsmaybepreferredbecausetheyareeasierforyourbodytoabsorb.Atypicalsafedoseforadultsisupto200micrograms.97

CONTRAINDICATIONSANDTHINGSTOCONSIDERSeleniumisoneofthemosttoxicoftheessentialminerals,andalthoughdosesgreater than 200 micrograms per day have been used in the research setting,takinglargerdosesisonlyadvisableunderthecareofanexperiencedphysician.

ZincOne of the most important trace minerals in your body, zinc is consideredessential, meaning that you must get it from your diet. It’s also essential fornormalgrowth,development,andreproduction.Zincplaysasignificantrole inimmunity,whichiswhyzinclozengeshelpfightthecommoncold.98

HOWITFIGHTSALLERGYORASTHMASYMPTOMSZinc is an antioxidant that can help combat inflammation. Low levels of zinchave been linked with an increased risk of asthma symptoms, such as chesttightness, wheezing, shortness of breath, and chronic cough.99 A 1997 studypublishedinthejournalThoraxlinkedzincdeficiencywithanincreasedriskofasthmaandallergies.100Anda2011reviewdoneattheUniversityofEdinburghMedical School in Scotland examined 62 studies and concluded that zincdeficiency,amongdeficienciesofothernutrients,wasassociatedwithincreasedriskofasthmaandallergies.101

Other research has shown the benefits of zinc supplementation in asthmapatients.Ina2009studypublishedinthejournalActaPaediatrica,researchersgave60children7to10yearsoldwhohadmildtomoderateasthmaeither1,000milligrams of fish oil, 15milligrams of zinc, 200milligrams of vitamin C, acombinationofallthreesupplements,oraplacebo.After6weeks,thechildrentakingthezinc,fishoil,orvitaminCallhadbetterscoresontheirasthmacontroland standard pulmonary function tests. They also had lower levels of severalmarkers of inflammation. The childrenwho took the combination of all three

supplementshadevenbetterresults.102

HOWTOGETITZinc sulfate is themost common zinc supplement. This is the least-expensiveform of zinc, but it is also the least absorbed by the body. It can also causenausea in some people. The better forms are zinc citrate, zinc glycerate, zincmonomethionine,andzincacetate.Forzinc-responsiveconditions,dosagesof20to30milligramsone to three timesperdayfor1 to2monthshavebeenused.Afterthisinitialperiod,thedosageshouldbereducedtoamaintenancedoseof10 to 20milligrams daily.103 Zinc can also be found in foods such as grains,legumes,meats,seafood,wheatbran,wheatgerm,nuts,andseeds.

CONTRAINDICATIONSANDTHINGSTOCONSIDERPotential side effects of zinc include nausea, vomiting, and ametallic taste inyour mouth. Zinc can be toxic in large doses, so remember that more is notnecessarilybetter.Oneconcernisthattakingtoomuchzinccandepletecopperlevels in your body.Zinc can also interferewith the absorptionof someotherminerals,suchascalcium,magnesium,andiron.

Talk toyourhealth-careproviderbefore taking largedosesofzinc throughsupplements, especially if you are taking blood pressuremedication, hormonereplacement therapy, diuretics, drugs to reduce stomach acid,immunosuppressants, nonsteroidal anti-inflammatory drugs (NSAIDS), musclerelaxants,orantibiotics.104

HEALINGHERBS

BoswelliaBoswelliaisagummybarkfromtheBoswelliatree(Boswelliaserrata),whichisnative to India, the Middle East, and North Africa. Boswellia has anti-inflammatory properties; some studies have shown it to be as effective asibuprofen and aspirin at reducing swelling. It’s also been used in Chinesemedicinetotreatpainandinflammationinthemouth,throat,andgums,anditisoftenusedinnaturalmouthwashes.105

HOWITFIGHTSALLERGYORASTHMASYMPTOMSThe active ingredient in boswellia is boswellic acid, which seems to reduceinflammation by inhibiting inflammatory enzymes called leukotrienes. Studiesshow that boswellia can help treat a number of inflammatory conditions,includingosteoarthritis,Crohn’sdisease,tendonitis,andasthma.106

Inadouble-blind,placebo-controlledstudy,40peoplewithasthmatook300milligramsofboswelliathreetimesadayfor6weeks.Attheendofthestudy,70percentofthepeoplewhotookboswelliashowedimprovementsintheirlungfunction,comparedwithonly27percentofthepeoplewhotooktheplacebo.107

HOWTOGETITBoswelliaisavailableintabletsandcapsules.Toreduceinflammationortotreatasthmatic conditions, a typical dose is 300 to 400 milligrams of a standardextractcontaining60percentboswellicacids,threetimesadayasneeded.

CONTRAINDICATIONSANDTHINGSTOCONSIDERIt’sbesttotakeboswelliawithafattymealtomaximizeabsorption.Whentakenatnormaldoses,assuggestedabove,therearenotoxicityconcerns.108

GinkgoBilobaGinkgobiloba is thought tobe theoldest surviving treeonEarth—around200millionyearsold.Healerswereusingginkgoforasthmaandbronchitisaslongagoas2600BC,109andgingkobilobaextract(GBE)isstillusedtoday.Infact,itis one of themost popular herbal supplements in bothEurope and theUnitedStates.110

GBE is especially used for boostingmemory, but it also has a long list of

other uses, from treating depression to improving vision to treating asthma. Ithasantioxidanteffectsandcanthereforehelpbufferyourbodyfromfreeradicaldamage. It also seems to improve blood flow to the brain and boost cellmetabolism.111

HOWITFIGHTSALLERGYORASTHMASYMPTOMSIn a 2007 Chinese study, researchers looked at the effects of ginkgo bilobaextract on asthma. They gave 75 asthmatics either fluticasone propionate (astandard glucocorticosteroid asthma treatment) for 2 weeks or 4 weeks orfluticasonepropionateplusGBE for2weeksor4weeks.Theyalso lookedatthesetreatmentsin15healthycontrols.Attheendofthestudy,theresearchersconcluded thatGBE significantly decreased the number of inflammatory cellsand relievedairway inflammation.Therefore, inaddition tobeingagoodanti-inflammatoryonitsown,ginkomayalsobeagoodcomplementarytreatmenttoglucocorticosteroidtherapiesforasthma.112

HOWTOGETITGinkgo biloba is available in capsules, tablets, and tinctures, but it is mostcommonlyusedasconcentratedginkgobilobaextract(GBE)that’sstandardizedtocontain24percentflavonoidsand6percentterpenoids.Thedoserangesfrom40to80milligramstwoorthreetimesperday.113

CONTRAINDICATIONSANDTHINGSTOCONSIDERTalktoyourhealth-careproviderbeforeyoustarttakingginkgobiloba.It’ssafein small doses but can occasionally cause side effects such as stomach upset,headaches, heart palpitations, dizziness, or skin rashes.You should avoid it ifyouhaveliverorkidneyproblems,arepregnantorbreastfeeding,orifyouhavea history of seizures. Ginkgo biloba can also have blood-thinning effects, soavoidtakingitwithin2weeksofascheduledsurgery.114

GreenTeaExtractNexttowater,greenteaisthemostpopularbeverageintheworld.Andforgoodreason:Arichsourceofantioxidantscalledpolyphenols,greenteahasalonglistofhealthbenefits.Mostnotably, itmayhelppreventcertaincancers, includingbreast, prostate, cervical, and digestive as well as some types of leukemia.

Becauseofitsantioxidantpowers,greenteamayalsohelpprotectyourimmunesystem,decreaseinflammation,andfightallergies.115

HOWITFIGHTSALLERGYORASTHMASYMPTOMSIn a 2002 Japanese study published in the Journal of Agriculture and FoodChemistry,researchersfoundthatoneofthemostabundantcompoundsingreentea—epigallocatechin gallate (EGCG)—can fight allergy symptoms, such assneezing and runnynose.The researchers foundEGCGblockedproductionofbothhistamineandIgE,twoofthemostimportantchemicalsinvolvedinallergicreactions.116Additionally, in a 2010 studypublished in theAnnals ofClinicalandLaboratoryScience,researchersfoundthatgreenteaextracthelpedsuppressIgE,andthehigherthedoseofgreenteaextract,thelowertheIgElevels.117

HOWTOGETITYoucanmakegreenteawithdriedtealeavesorteabags,oryoucanbuyitascapsulesorintheformofanextractmadefromtheleavesandleafbudsofthetea plant. Drinking green tea is a great way to get a nice dose of the activeingredients,butitshouldbenotedthatthelevelsofEGCGindecaffeinatedteaare significantly less. Supplement dosages used in clinical practice rangebetween100 and750milligramsper day. If you take an extract, look for onestandardized to contain a minimum of 90 percent total tea catechins and aminimumof70percentEGCG.118

CONTRAINDICATIONSANDTHINGSTOCONSIDERGreenteaisgenerallyprettyharmless,especiallyinpeoplewhoarenotsensitivetocaffeine.Infact,studiesshowthatyoucansafelydrinkasmanyas20cupsaday.Most of the side effects of green tea come from the caffeine and includerestlessness,insomnia,irritability,heartpalpitations,anddizziness.119

LicoriceRootLicoriceRoot(Glycyrrhizaglabra)isthescientificnameofthelicoriceplant,ofwhichtherootsandundergroundstemsareused.Becauseitisatleast50timessweeterthantablesugar,licoriceroothasgottenthenickname“sweetroot.”120

Licorice root can help prevent and treat a number of conditions, including

stomach ulcers, heartburn, gas, respiratory infections, and cough. It may alsohelplowercholesterolandtriglycerides,loweringriskofheartdisease.121

HOWITFIGHTSALLERGYORASTHMASYMPTOMSThe active ingredient glycyrrhizin has been shown in studies to decreaseinflammation; soothe the throat, bronchial membranes, and lungs; promotemucussecretion;andstimulatetheadrenalglands.122Ina2010study,63asthmapatientstookeitheraplacebooranherbalcombinationcontaininglicoriceroot,turmeric, and boswellia for 4weeks.At the end of the study, the participantstaking the herbal combination containing licorice root had lower levels ofinflammatorymarkers and improvedpulmonary function than those taking theplacebo.123Ina2007studypublishedinPlantaMedica,micegivenglycyrrhizinhad lower levels of IgE, suggesting that the compoundmay help relieve IgE-inducedallergiessuchaseczemaandallergicasthma.124

HOWTOGETITYoucantakelicoricerootinafewdifferentforms,includingcapsules,chewabletablets, teas, or oral drops. There are two types—whole licorice and thechemically modified form deglycyrrhizinated licorice (DGL), which doesn’tcontainmorethan3percentglycyrrhizin.Thedosageforlicoricerootis2to6milliliters of a 1:1 liquid extract or 1.2 to 4.6 grams per day of DGL. TheGermanCommissionEmonographadvisesadosageof5 to15gramsperdaybut states that treatment undertaken without medical supervision should bediscontinuedafter6weeksduetotheriskofadverseeffects.125,126Teaisagreatwaytouselicorice,andinadditiontoprovidingtheanti-inflammatoryeffects,italsotastesgreat!

CONTRAINDICATIONSANDTHINGSTOCONSIDERTalk toyourhealth-careproviderbefore taking licorice. Inhighdoses, licoricecan also cause more serious side effects, including a condition calledpseudoaldosteronism,whichcanleadtoheartattack.Donottakelicoricerootifyouhavehighbloodpressure,kidneyorliverproblems,obesity,heartdisease,ordiabetes.

Butterbur

(Petasiteshybridus) is a shrublikeplant thatgrows inpartsofNorthAmerica,Europe,andAsia,andseems towork likea leukotriene inhibitor,blocking thechemicals that triggernasal swelling.Oneof the extracts inbutterbur root,Ze339, isparticularlyeffectivewhen itcomes tocontrollingcoughs,asthma,andallergies.127

HOWITFIGHTSALLERGYORASTHMASYMPTOMSIn a 2013 study published in the Journal of Ethnopharmacology, researcherslookedintotheanti-inflammatoryandantiallergiceffectsofPetasitesleavesandfound that a particular compound in the leaves called bakkenolide B helpedinhibit mast cell degranulation and also helped suppress the inflammatoryresponse. The researchers concluded that it could potentially be used as anasthmatreatment.128

In an earlier, 2010 study,Ze 339 helped prevent airway inflammation andairway hyperresponsiveness in mice exposed to allergens. More specifically,researchersfoundthatZe339producedtheseantiallergyeffectsbysuppressingproinflammatorycytokinesinthemice.129

And in a related 2005 study, 330 people with hay fever got one of threedifferent treatments—one tablet three times a day of butterbur extract, theantihistamine drug fexofenadine (Allegra), or a placebo.The peoplewho tookthe butterbur extract had the same reduction in their symptoms as the peoplewho took the Allegra. Both treatments were more effective than the placebo.Therefore,butterburmaybeaseffectiveastakingthepopularantiallergydrug,withoutAllegra’ssedatingsideeffects.130

Additionally, in another study, Ze 339 was found to help prevent allergicasthmainasthmaticmiceexposedtohousedustmites.131

HOWTOGETITYoucanfindthisherbincapsuleform.Intermsofarecommendeddosage,staybetween50and100milligramsperday.

CONTRAINDICATIONSANDTHINGSTOCONSIDERTalktoyourhealth-careproviderbeforetakingbutterbur.Possiblesideeffectsofbutterbur extract include headaches, fatigue, indigestion, nausea, vomiting,diarrhea,andconstipation.Nevereatunprocessed,rawbutterburroot,whichcan

betoxic.132

StingingNettleAplantwhoseleavesandstemsarecoveredwithfinehairsthatcontainirritatingchemicals, stinging nettle (Urtica dioica) has been used for centuries as adiureticandtotreatjointpain.Thehairsontheplantarepainfultothetouch,butwhentheycomeintocontactwithaninflamed,painfulareaofthebody,theycanactuallydecreasepain.Scientiststhinktheplantdoesthisbyinterferingwiththetransmissionofpainsignals.133

HOWITFIGHTSALLERGYORASTHMASYMPTOMSAfewstudieshavefoundthatstingingnettlemayhaveantihistamineproperties;therefore, it canhelp calm itching and sneezing in hay fever sufferers.134 In adouble-blind study done at the National College of NaturopathicMedicine inPortland,Oregon, researchers found that freeze-dried stinging nettlewas as ormore effective at relieving allergy symptoms than conventional allergymedicationswere.135Alsoina2009studypublishedinthejournalPhytotherapyResearch, researchers found that stinging nettle may help fight allergies byreducinginflammation.136

HOWTOGETITFortreatingallergies,typicaldosagesrangefrom200to800milligramsperdayofthedriedherb,althoughdosagesupto10gramsperdayhavebeenused.Fortincturesofnettleleaf,recommendeddosagesrangefrom7to14millilitersperdayof a 1:5 tincture.Anddon’t forget about nettle leaf tea!Nettle tea canbefoundatmostshopsthatdealinherbs.Forallergies,makesuretouseaproductthat ismadeupof thenettle leaf, rather than theroot. (Nettle root isprimarilyusedfortreatingaconditionknownasbenignprostatichyperplasiaandisnotaseffectiveastheleafintreatingallergies.)137

CONTRAINDICATIONSANDTHINGSTOCONSIDERStingingnettleisaprettysafeherb,butitmaycausesomesideeffects,suchasstomach upset, diarrhea, sweating, fluid retention, or hives or rash when it isusedtopically.Neverapplystingingnettletoanopenwound.138

Also,talktoyourhealth-careproviderbeforeyoustartusingstingingnettle.Theherbcaninterferewithseveralmedications,includingbloodthinners,drugsforhighbloodpressure,diabetesdrugs,diuretics,lithium,andnonsteroidalanti-inflammatorydrugs(NSAIDs).139

TylophoraTylophora(Tylophoraindica)isaclimbingvinethatgrowsinIndia.Ithasbeenused as a treatment for asthma since the 1800s. It has also been used to treatallergies, bronchitis, and the common cold as well as osteoarthritis pain,constipation,andstomachupset.140

HOWITFIGHTSALLERGYORASTHMASYMPTOMSAfewstudieshavetoutedtylophoraasatreatmentforallergiesandasthma,butmostofthemareold,fromthe1960sand1970s.Inoneofthemostnoteworthy,published in theJournalofAllergy in1969,asthmasuffererswhochewedandswallowed150milligramsoftylophoraleafdailyintheearlymorningfor6dayssawmoderatetototalreliefoftheirasthmasymptoms.141

In a similar study done in 1972, 195 asthma sufferers took either 40milligramsoftylophoraalcoholextractoraplacebofor6days.Thegrouptakingthe tylophora had fewer asthma symptoms, and their symptoms remainedcontrolled formonths after they stopped taking the herb.142 Tylophora can befoundathealthfoodstoresandonline.

HOWTOGETITTheusualdoseoftylophoraforasthmais250milligrams,onetothreetimesperday.143

CONTRAINDICATIONSANDTHINGSTOCONSIDERTylophora is relatively safe, but it can have potentially serious side effects athighdoses,sotalktoyourhealth-careprofessionalbeforetakingit.Also,keepinmindthatyoushouldn’ttaketylophoraifyouarepregnantorbreastfeeding,orifyouhavehighbloodpressure,diabetes,orcongestiveheartfailure.144

Guduchi

Anherb longused inAyurvedicmedicine to treatavarietyofconditionsfromliverdiseasetoarthritistodiarrhea,Guduchi(Tinosporacordifolia)isthoughttoremovetoxinsfromthebody.Itisstillusedtodayforits“adaptogenic”effects,meaningitcanhelpyourbodyadapttostress.145

HOWITFIGHTSALLERGYORASTHMASYMPTOMSSomeherbalistsandnaturopathicdoctors,myselfincluded,alsouseGuduchitohelptreatallergies.146Ina2004study,researchersgave75allergypatientseitherguduchi or a placebo for 8weeks.At the end of the study, 83 percent of theparticipants who had taken the guduchi experienced complete relief fromsneezing;71percentexperiencedrelieffromnasalpruritus(dry,itchynose);69percent experienced relief from nasal discharge; and 61 percent experiencedrelief from nasal obstruction. In other words, most of the people taking theguduchi saw relief fromall of their allergic rhinitis symptoms.Of theplacebogroup,79percentexperiencednorelieffromsneezing;85percenthadnorelieffrom nasal discharge; 88 percent had no relief from nasal pruritus; and 83percenthadnorelieffromnasalobstruction.147

HOWTOGETITA typical dose of guduchi is 300milligrams of an aqueous stem extract threetimesperday.148

CONTRAINDICATIONSANDTHINGSTOCONSIDERTalk to your health-care provider before you take guduchi for allergies. Itappearstobeaprettysafeherb,butithasn’tbeenstudiedthoroughly.Onestudysuggested that itmightdecreasemale fertility,and ithasnotbeenprovensafeforpregnantor breastfeedingwomen.149 It ismost commonly available inpillformandcanbefoundinmosthealthfoodstoresandonline.

Nowthatyou’velearnedaboutthesupplementsandherbsthatcanhelptreatallergies,asthma,andcontributinginflammation,youarebetterequippedtostartusingoneormoreofthemaspartofTheAllergySolutionPlan.Readon,andIwillhelpyouappropriatelyincorporateherbsandsupplementsintoyourlife.

12AnAntiallergyWayofLife:ThePoweroftheLittleThingsYouDoEveryDay

ONCEWHILEVOLUNTEERINGONAMEDICALMISSIONinMexico,Itreatedanindigenouswomanfromthesouthernpartofthecountry.Throughaninterpreter,shecomplainedofhavingdevelopedarashabout3monthspriortoour meeting. This rash was on her torso, upper arms, back, and legs. It wasslightly raised, red, and itchy, and shehadno ideawhatmighthavecaused it.WhileIwasconsultingwithher, Iaskedher ifshehadstartedeatinganynewfoods or taking any new medications that could have contributed to thedevelopment of this rash. She had not.During the timewe talked, it came tolightthatshehadstartedusinganewlaundrydetergentaroundthetimetherashdeveloped.Astherashwasreallyonlypresentonherbodyinareasthatcameincontact with her clothing, we deduced that this new detergent might be thecause.Onceshestoppedusingthedetergent,therashwentaway.

The lesson here is twofold. First, it illustrates that you have to considereverythinginyourenvironmentwhenyou’retryingtofigureoutwhat’scausinganallergicreaction.Second,it’sareminderthatyoushouldstopandthinkaboutalltheproductsandchemicalsyoucomeintocontactwithonadailybasisandhowthosesubstancesmaybeaffectingyourhealth.

When it comes to the connection between lifestyle and health, it’s usuallynot one bad habit or chemical exposure that kills us or one good habit thatextendsourlives.(Thereareafewexceptions,ofcourse,suchasheavysmokingorasbestosexposure.)It’sthecollectionofgoodandbadhabits—thethingsyoudohereand there—that addup toyour total routine.Maybeyou smokea fewcigarettesnowandthen,youhavesomeplug-inairfreshenersinyourbedroom(more to come on these), and you indulge in a doughnut for breakfast on theweekends.Ontheflipside,youtakeyourvitaminseveryday,exercise5daysaweek, andkeep stress to aminimum. It’s really all about balance.These littlehabits have a big additive effect over months, years, and your lifetime. Theycontributetoorimproveyourinflammation;theyaffectwhetherornotyouwill

have a particularly bad allergy season; and they ultimately determine thediseasesyouwilldevelopandthelengthandqualityofyourlife.

Myadvicetoyouisthis:Tryeverysingledaytomakesureyourgoodhabitsoutweighyourbadones.IgaveyousomedietarytipsinChapter10,andwewilltalkaboutexerciseinChapter13.Inthischapter,Ioffersomethingsyoucandotomakeyourhomeenvironmentlessinvitingtoallergensandmoreconducivetoclean,healthyliving.

HOMEISWHERETHEHARMISNomatterhowmuchwelovefreshairandtheoutdoors,mostofusspendmostof our time inside, in an office or at home. We are sometimes under theimpression that our homes are healthier than they really are. The fact is, youneedtothinkabouthowhealthyyourhomereallyis.

As discussed in Chapter 2, outside of our homes, we are constantlysurroundedbytoxicfumescomingfromallsortsofplaces,suchasvehiclesandfactories.Oneoftheworstoffendersidentifiedsofarforasthmaandallergiesisdieselexhaustparticulates(DEPs).ButwhatmaybeevenmoreharmfulthantheDEPsfloatingaroundintheoutsideairarethetoxinsyouareexposedtoinsideyourhomeonadailybasis.Yes, theplaceyoucallyour sanctuarycanbe themostpoisonousofall.Fromthepaintonthewallstothegluesinthefloorstothechemicals inyour cleaningproducts, there are lotsof toxic substances inyourhome.(See“TheToxicBigBoys—RadonandLead.”)

TheToxicBigBoys—RadonandLeadWhenitcomestodust,dustmites,andpetdander,youcanprobablyhandlethecleaningyourself.Whenitcomestoremovingmoreharmfulsubstances,suchasleadandradon,youshouldhireaprofessional.

Leadisatoxicelementthatwasusedinpaintsuntil1978andinplumbinguntil1988.Itcandamageyourbrainandnervoussystemandisparticularlydangerousforyoungchildren,whoexposethemselvestoitbyputtingpaintchipsintheirmouths.Youshouldhaveyourpainttestedforleadifyourhomewasbuiltbefore1978,andyoushouldtestyourwaterforleadifyourhomewasbuiltbefore1988.Formoreinformationonlead,callthe

NationalLeadInformationCenterat800-424-5323.1

Radonisanodorless,colorlessgasthatcomesfromsoilanddecayingrocks.Itcangetintoyourhomethroughcracksinyourbasementfloor.Thisradioactivegascancauselungcancerinpeopleexposedtohighlevelsforyears.Infact,itisthesecondleadingcauseoflungcancerintheUnitedStates.Luckily,evenifyourhomehasahighradonlevel,youcangetridofthegasbyinstallingaradonremediationsystem.Formoreinformationonradon

andhowtogetyourhometested,gotoepa.gov/radon/radontest.xhtml.2

In addition to the toxins, there are also a number of potential allergenslurking in your home, including dust, dustmites, animal dander, cockroaches,andmold,nottomentionthepollenandotheroutdoorallergensyoubringinonyour clothing and hair. In fact, according to the Environmental ProtectionAgency (EPA), the levels of indoor air pollutants may be two to five timeshigherthanthelevelsofpollutantsoutside.Indoorairpollutionisamongthetopfive environmental threats to human health. Considering thatmost Americansspend90percentoftheirtimeindoors,thisisamajorconcern.3

Sowithallofthisinmind,here’ssomeadviceonhowtoallergy-proofyourhomeandmakeitamorehealthfulplacetobe.

Filter the air youbreathe.When it comes to air, quality counts.To helpmakeyourairascleanaspossible,considerinvestinginahigh-qualityairfilter.Thereareafewdifferentkindsofair filters. It’sadvisable to lookforone thatfiltersoutnotonlyparticulatematter,likedustanddander,butchemicalmatteras well. You don’t have to get a complicated air filtration system. I havefreestandingairfiltersinmyofficeandhome,andtheyworkquitewell.Thebestkinds of filters for people with allergies are high-efficiency particulate air(HEPA)filters,whicharespeciallydesignedtoremoveallergensfromtheair.4Themostimportantplacetorunanairfilterisinyourbedroom,whichiswhereyou spend most of your time and which is also frequently the most pollutedroominthehouse.Itisagoodideatotryandadjustthefiltersoitdirectscleanairtowardyouasyousleep.5

Youcanalsohelpremovedebris fromtheairby installinga furnacefilter,which traps pollen and dust before these allergens have a chance to circulatethroughoutyourhouse.Furnace filtersareeasy to installand they’re relativelyinexpensive.6 Ifyou live in anarid region suchas thedesertSouthwest,makesure thatyouregularlycleanorreplaceyourairductorfurnacefilters. I try tochangethefiltersinmyhomeonamonthlyorbimonthlyschedule.

Anotherthingtokeepinmindwhenitcomestocleanairisthestateofyourairconditioning(AC)unit.Acleanunitcanactasanair filter,butadirtyonecontaminatedwithmoldorothersubstancesinthedriptrayorfiltercanactuallypump new allergens into your home. To truly condition your air, hire aprofessionaltoinspectyourACsystemonceayear,andhaveyourductscleanedatleastonceevery5years.7

Makeyourhomelesscomfortableforpests.Frommicetobatstoants,lotsofcreatures like to invadeourhomes.Someof themare justnuisances;otherscan cause allergy symptoms or threaten your health in otherways.You can’tcompletely eliminate all critters from your home, but you can make it lessinvitingtothem.

• Deterdustmites.Microscopicdustmitesareacommonasthmaandallergytrigger.Theyfeedonsloughed-offskincellsandlurkinbedding,stuffedanimals,storageboxes,carpeting,andupholsteredfurniture.Todiscouragethem,dothefollowing:• Encaseyourmattresses,boxsprings,andpillowsinallergy-prooforairtightzipperedplasticcovers.Youcanfindthesecoversatspecialtystoresandonline.

• Washallbeddingweeklyinwaterthatisatleast130°F,anddryeverythingonyourdryer’shottestsetting.8

• KeepyourhomecoolbyturningdowntheheatorturninguptheAC;dustmitesdon’treproduceintemperaturescolderthanabout77°F.

• Togaugetheseverityofyourdustmiteproblem,considerpurchasingadustmitedetectionkit,whichmeasuresthelevelofdustmitesinyourenvironment.9

• Kickcockroachestothecurb.Cockroaches,whosedroppingsandcast-offskinscanstimulateallergysymptomsandasthma,aremostoftenaproblemindenselypopulatedareas,buttheycanshowupalmostanywhere.Tomakeyourenvironmentlessroach-friendly,dothefollowing:• Blockareaswhereroachescancomein,includingwindows,wallcracks,andcrevices.

• Realizethatlikeus,cockroachesneedwater,sotheyseekoutdrippingfaucetsandpipes.Fixandsealanyleaks.10

• Keepyourkitchenclean.Inadditiontowater,cockroachesloveandneedfood,socleanitup,putitincoveredcontainers,andvacuumandmopanycrumbsorspillsquickly.Don’tforgettocleantheareaswherecrumbshide,suchasunderthestoveandrefrigerator.Wipedownyourcountertopsandcupboardsregularly.11

• Avoideatinginroomsotherthanthekitchenanddiningroom.Themoreplacesyoueatanddropcrumbs,themoreattractionsyoucreatefor

cockroaches.• Changeyourkittylitteratleastonceeveryfewdays,asroachesareattractedtothedroppings.

• Putgrocerystorebagsoutsideinrecyclingbinsassoonasyougethomefromfoodshopping.Asgrossasitsounds,roachesoftenhangoutingrocerystoresandhavebeenknowntohitcharidehomeinshoppers’grocerybags.12

• Ifroachesarestillpresentafteryoutrythesetips,installtrapsfromyourhardwarestore.13

• Ifthingsgetoutofcontrol,hireanexterminator.Keepinmindthatifyouseeoneroachinyourhome,especiallyifyouseeitduringtheday,hundredsmoreareprobablylurkingbehindthewalls,soyoudon’twanttoletaroachinfestationgo.14Lookforapest-controlcompanythatusestheleast-toxicchemicalspossibletocontrolcockroaches.

Make your home clean and comfortable for yourself. Not only does acleanhousemakeforamorepleasantandenjoyablelivingenvironmentforall,italso helps keep allergens under control. If you can, try to clean your homeweekly.Mopallofyourfloorswithadampmopandvacuumallcarpetingandrugs with a vacuum cleaner that has a small-particle or HEPA filter. (Don’tforget tovacuum thebacksofchairsandcouches,wheredust,dustmites,andmoldcanhide.)15Wipethedustfromwindowsills,furniture,andothersurfaces.Ifyouhaveallergies,wearadustmaskwhileyouclean,oraskafamilymemberwhodoesn’thaveallergiestodothesechores.16

Think twice about pets. No cats or dogs are completely hypoallergenic,even the hairless varieties. After all, it’s not the hair that causes allergysymptoms,buttheproteinsindogandcatsaliva,urine,anddander.17

Alsokeepinmindthatwhiledogsandcatstendtogetthemostblamewhenitcomestopetallergies,rabbits,mice,hamsters,andguineapigscanalsosetoffallergy symptoms—even Siamese fighting fish have been known to indirectlycause allergic reactions!18 Clothingmade from animal fur, such as cashmere,goathair,mohair,andalpacasweaterscantriggerallergiesaswell.19

Ifyouoroneofyourfamilymembershasaknownpetallergy,theverybestthingyoucandoisnotgetananimalinthefirstplace.Ifyoualreadyhaveapetthatispartofyourfamily,trytokeepthatpetoutdoorsasmuchaspossible.Inaddition,dothefollowing:

• Keeptheanimaloutofyourbedroomandotherroomswhereyouspendalotoftime.

• Vacuumcarpetsandrugsoften.• Askanonallergicfamilymembertobrushthepetorcleanitscageorcrate.• Bathethepetweekly,orbetteryet,twiceaweektominimizedander.Askanonallergicfamilymembertowashthepet.

• Ifpossible,replacecarpetingwithhardwoodflooring,tile,orlinoleum.Keepinmindthatevenafterapetisnolongerinahouse,petdandercanremainonfabricsandincarpeting,triggeringallergiesforuptoayearorlonger.20

Lowerhumidity.Ingeneral,whenitcomestofosteringaclean,allergy-freeenvironment, the rule is, “the dryer, the better.” Mold loves moisture, as doallergenicpests.Soaimtokeeptherelativehumiditylevelinyourhomeat30to50 percent or lower by running a dehumidifier.21 On humid days, keep yourwindowsclosedandrunyourairconditioner.Tomeasurethehumidityinyourhomeandmakesureyou’restayingintherightrange,youcanbuyatoolcalledahygrometeratyourlocalhardwarestore.22

Asasidenote,ifyourunadehumidifier,makesuretokeepitclean.Rinseandscrub thewater tankat leastonceaweek,anddust thegrillswith thesoftbrushattachmentofyourvacuumcleaner.23

Use the less-is-more style of decorating. The more knickknacks,ornaments, books,magazines, and general clutter you have in your house, themoreplacesthereareforallergenstoparkthemselves.Solimitingthenumberofpictureframes,figurines,andotherdusttrapsinyourhomewillhelpyoubreathebetter.24

Also,keep fibers toaminimum.Clothandcarpetscreate surfaces fordustandallergeniccritterstohide.Oldshagcarpetingistheworstbecauseitnotonlytrapsdust,but it alsoproducesnewdust as the fibersbreakdown.Removeasmuch wall-to-wall carpeting as possible and replace it with hardwood floors.Throwrugsareokayifyouwashordry-cleanthemregularly.25Ifyoumusthavecarpeting,chooselow-napinsteadofthehigh-napvariety,andvacuumitatleastonceaweek(ordaily, ifyoucan),preferablywithavacuumthathasaHEPAfilter.Also,shampoocarpetsregularlyusinganontoxicproduct.

Onwindows,heavydrapesandhorizontalblindsareadditionaltrapsfordustandotherallergens.Instead,goforwashablerollershadesorcottonorsyntheticcurtains.Orbetteryet,forgowindowtreatmentsentirely.

Intermsoffurniture,upholsteredpiecestrapdustmitesandotherallergens.Thebest furniturematerials forpeoplewithallergiesare those thatareeasy toclean:wood,leather,metal,andplastic.26

Getridofmold,pronto.Notonlycanmoldtriggerallergysymptomssuchaswateryeyes,runnynose,headaches,andcoughing,butsomeformscanalsoreleasedangerous toxins.Topreventmoldgrowth, lower thehumidity inyourhome(runadehumidifiertoeliminateexcessmoisture)andfixallleaks.Ifyousee visible mold, wash it with soap and water and, if necessary, a 5 percentbleachsolutionbeforedrying theareacompletely. Ifyoucan’twashanddryamoldyitem,throwitaway.Alsogetridofanyoldrags,carpeting,orfurniturethat could harbormold. Ifmold covers a significant area of your home, thinkabouthiringamoldremovalspecialisttogetridofit.27

Keepinmindthatyourkitchenisoneofmold’sfavoriteplacestogrow.Todeter it, wipe up excessive moisture in your refrigerator and clean drip pansunderappliancesaswellasrubbersealsaroundappliancesoften.28

Mold also loves bathrooms and basements. To keep it at bay in yourbathrooms,alwaysrunyourexhaustfanwhileyoutakeashowerorbath;don’tput carpeting in your bathroom; swap out any wallpaper for tile or drywallpainted with mold-resistant enamel paint; replace moldy shower curtains andbathmats;anduseableachsolutiontoscrubanyvisiblemoldfromyourtoiletsandsinks.29

Inyourbasement,paint thewallswithmold-resistantpaint,whichcontainschemicals that helpdestroy any remainingmold.Thepaint alsohelps seal theareatodiscouragefuturemoldgrowth.30Lowvolatileorganiccompound(low-VOC)mold-resistantpaints arealsoavailable.31Researchhas shown thathighlevelsofVOCs,whicharefoundinmanycommercialpaints,havebeenlinkedto increased rates of asthma and rhinitis in adults and worsened asthma inchildren.32,33

Pay special attention to your bedroom. You spend more time in yourbedroomthananyotherroominyourhouse.Unfortunately,inmanycases,thisroomisthemostpollutedandinvitingforallergenssuchasmold,pollen,animaldander,dustmites,andcockroaches.Soclearoutknickknacksandclutter,avoidstoring things under your bed, and remove drapes from your windows. Also,keepyourbedawayfromairventsifyoucan,soyoudon’tbreatheindustthatcomesoutofthemasyousleep.Getbeddingandpillowsyoucanmachinewash,andavoiddownpillowsandcomforters,whichcan’tbewashedeasily.Thebest

choicesforpeoplewithallergiesarehypoallergenicbeddingandpillowsthatcanbewashedoftenwithoutfallingapart.34

Inkids’bedrooms,keepstuffedanimalstoaminimum—theyaredusttraps.Ifyourkidscan’tpartwiththem,washstuffedtoyseverysooftentoremovethedust. Use a damp cloth to wipe those that can’t bemachine-washed, and drythemonyourdryer’shottestsettingtokilldustmites.

Keepyourselfclean.Duringallergyseason,pollensarerampant.Whenyougooutside, thatpollencollectsonyourclothingandinyourhair.Tominimizetheallergensyoudraginside,changeintofreshclothesassoonasyougethome,andtakeashowerandwashyourhairbeforeyougotobed.35

Useplantstocleanyourair.Plantsactlikenaturalairfilters;theyproduceoxygenandactuallyhelpcleantheair.Asabonus,theylookpretty.Someplantsarebetterair filters thanothers.Accordingto theNationalInstitutesofHealth,thetop10air-cleaninghouseplantsareasfollow:36

1.Arecapalm(Chrysalidocarpuslutescens)2.Ladypalm(Rhapisexcelsa)3.Bamboopalm(Chamaedoreaerumpens)4.Rubberplant(Ficuselastica)5.Dracaena(Dracaenaderemensis)6.Englishivy(Hederahelix)7.Pygmydatepalm(Phoenixroebelenii)8.Banana-leafficus(Ficusmaclellandii‘Alii’)9.Bostonfern(Nephrolepisexaltata‘Bostoniensis’)10.Peacelily(Spathiphyllumwallisii)Themoreofthesefilteringplantsyoucanputinyourhomeandoffice,the

healthier your airwill be.Houseplantsmay not be a good idea if you have amold allergy or sensitivity, however; mold can grow in moist dirt, triggeringyour allergy symptoms.37 To help controlmold growth in your potted plants,spreadaquariumstonesoverthesoil.38

Freshen your air naturally. There are lots of things people use in theirhomes tomake the air smell good that are, ironically, quite toxic. Plug-in airfresheners, spray air fresheners, and scented candles all give off syntheticchemicals in the fragrances thatpermeateyourhome.So ifyouareconcernedaboutyourrespiratoryhealth,avoidanyproductswithaddedfragrancesorthat

have“fragrance”listedasaningredient.39If you want your home to smell good but you don’t want the potentially

poisonous effects that comewith the chemicals, one option is to use essentialoils.Pureessentialoilsaresafeandcomeinavarietyofscents,someofwhichare energizing or soothing, to boot. To use them, put a few drops of pureessential oil into a spray bottle filled with water and spray it on absorbentsurfaces, such as the toilet paper in your bathroom. Or dip cotton balls intoessentialoilsandplacetheminopenjars.Or,ifnooneinyourhomehaspollenallergies, simplyopenup thewindowsand let thenaturalbreezesweetenyourair. Modern homes are very airtight. This is great for keeping heat and airconditioninginandloweringenergybills,butitalsokeepsallergenstrappedandcirculatingthroughyourindoorair.

Clean green. Many of the cleaning products we use in our homes andoffices, including soaps, polishes, and personal grooming supplies, containchemicals that can cause health problems.40 Some of theworst ingredients inhousehold products are the volatile organic compounds (VOCs) used in anumber of products, including chlorine bleach, detergent, dishwashing liquid,dry-cleaning chemicals, rug and upholstery cleaners, furniture polishes, ovencleaners, floor polish, air fresheners, and aerosol sprays.41 In addition toirritating your throat, nose, and eyes and worsening asthma and allergysymptoms,theseVOCsmaycauselungdamage.42

Luckily, you have alternatives. There are a number of nontoxic,environmentally friendly, and hypoallergenic detergents and cleaners availablefor carpeting, upholstery, and other areas of your home. Some brands includeEarth Friendly Products, SimpleGreen, andNaturallyYours.43 Keep inmindthatnotallproducts labeled“green,”“environmentallyfriendly,”or“ecosafe”are truly harmless; check the ingredients lists.Whenever possible, clean withsafer,alternativecleaningsolutions,suchasbakingsodaoramixtureofvinegarandwater.44 A good place to learn about which products are safe to use andwhichyoushouldavoidistheEnvironmentalWorkingGrouppageatewg.org.(CheckouttheirConsumerGuidesforarankingofcommoncleaningproducts.)Andnomatterwhich cleaningproducts youuse, always open thewindows tokeeptheareayouarecleaningwell-ventilated.45

Minimizetoxicmaterials.Alotofbuildingmaterialsoff-gas,meaningtheyreleasetoxicgassesintotheair,whichyouthenbreathein.Onesuchchemicalisformaldehyde,whichisusedasanadhesiveandbondingagentinmanyproducts

such as plywood, pressed wood products, and some foam insulation.Formaldehydeisclassifiedasavolatileorganiccompound.Besidesbeingtoxic,VOCs are chemicals that becomegasses at room temperature (in otherwords,theyoff-gas).Intheshortterm,formaldehydecausescoughing,headaches,andirritation of the nose, eyes, and throat. Long term, the exact effects offormaldehyde aren’t known, but the EPA has classified the chemical as“carcinogenictohumans.”46

ToavoidVOCsduringarenovation,youcanhirea“green”contractoranduseallenvironmentallyfriendlymaterials.Inouroffice,wehaveamanufacturedwoodfloor(notrealwood)thatdoesn’toff-gasatall;thereisnosolventcomingout of the glue. We also painted the walls with VOC-free paint, which hasvirtuallynoodor.

Manypeoplecan’taffordtouseenvironmentallyfriendlybuildingmaterials,sincetheyaremoreexpensive.Analternativetogoinggreenfromthestartistoopenup thewindows,crankup theheat,and try tobake thesmelloutofyourhouseafteryourrenovationisoverbutbeforeyoustart livingin therenovatedspace.

Dryyourlaundrytheold-fashionedway.Wantfresh-smellinglinens?Drythem on a clothesline outside in the breeze (pollen allergies permitting, ofcourse).Whateveryoudo, try toavoidusingdryer sheetsand scented laundrydetergents.A2011studydoneattheUniversityofWashingtonfoundmorethan25VOCsemitted fromdryervents, twoofwhichareconsideredcarcinogenic.The culprit: the fragrances in detergents and fabric softener sheets. The studyauthors noted that unlike factory smokestacks or car tailpipes, emissions fromdryerventsaren’tregulated.Plus,companiesthatmakehouseholdproductssuchas laundry detergents and fabric softeners aren’t required to list all of theiringredients on their labels, so it’s tough to knowwhether or not they containharmfulchemicals.Thebestthingyoucandotoavoidtoxiclaundryistogoforunscenteddetergentandskipthedryersheetsentirely.48

LifestyleTipsforFoodAllergiesThere’sadifferencebetweenfoodallergiesandfoodsensitivities.Ifyouhaveafoodsensitivity,youshouldavoidthefoodthatcausessymptoms,butyouknowitwon’tbetheendoftheworldifyoucomeincontactwithit.Ifyouhaveatruefoodallergy—particularlyifitisonethatcancauselife-threateninganaphylacticshock—youneedtobeespeciallycarefultoavoidanythingthatmaycontainthatfood.Soinkeepingwiththischapterfullofeverydaytips,herearesomethingsyoushoulddotoprotectyourselfonadailybasisifyou

haveafoodallergy.47

• Alwayscheckingredientslistsandlabelsbeforeyoueatapackagedfood;youmayfindallergenicfoodswhereyouleastexpectthem.

• Ifyouareeatingatarestaurant,tellyourserveraboutyourfoodallergyandstressthatyoucannoteatanythingthatcontainsthatfood.

• Avoidclosecontactwithsomeonewhohasrecentlyeatenthefoodtowhichyouareallergic.Kissingsomeonewhohasrecentlyeatenyourfoodallergenisparticularlydangerous.

• Donotshareutensilswithsomeonewhoiseatingafoodtowhichyouareallergic.• Ifyouhaveapotentiallyseriousfoodallergy,alwayswearaMedicAlertbraceletornecklaceandcarryanEpiPen.

Justsay“no”tosmoke.Smoke,whether itcomesfromtobaccoproducts,wood-burningfireplaces,orbonfires,canworsenallergyandasthmasymptoms.Sogoforagasfireplaceinsteadofawood-burningoneifyouhavethechoice.Italsogoeswithoutsaying:Ifyousmokecigarettesorcigars,quit.Ifsomeoneinyourhomesmokes,encouragehimorhertogiveitup,andinthemeantime,askthesmokertotaketheirsmokeoutside.

Watchoutforothertoxinslurkinginyourhome.InadditiontoVOCsincleaningproductsandbuildingmaterials,therearehealth-damagingchemicalsinsomeofyourbeautyproductsandhouseholdcontainers.

• Parabensaresyntheticpreservativesfoundinpersonal-careproductsandcosmetics,includingdeodorants,skincreams,shampoo(includingbabyshampoo),andhairgels.Parabenshavebeenlinkedtoanumberofconditions,includingcancer,reproductiveproblems,skinirritation,neurotoxicity,immunotoxicity,andhormonedisruption.Theyhavealsobeenfoundinbreasttumors,butsofar,nodirectlinkbetweenparabensandcancerhasbeenestablished.However,itseemsthatparabensmayactonestrogen-sensitivetissuebymimickingtheactionofthathormone.To

avoidparabens,choosecertifiedorganicproductsandthosewithoutsyntheticpreservatives.Keepinmindthatproductsthatclaimtobe“natural”aren’talwaysso.Alwaysreadlabelsandlookoutforthewords“butylparaben,”“ethylparaben,”“propylparaben,”and“methylparaben.”49

• BisphenolA(BPA)isachemicalusedmainlyinplastics,includingfoodanddrinkpackagingsuchaswaterbottles,babybottles,andsomemedicaldevices.YoucaningestBPAthroughairanddust,butmostexposurecomesthroughdiet;BPAcanseepintofoodsanddrinksfromplasticcontainers.MostpeoplehavebeenexposedtosomeBPA.The2003–2004NationalHealthandNutritionExaminationSurvey(NHANES)foundBPAin93percentofthe2,517peoplestudied,includinganumberofchildren.ToavoidBPA,don’tmicrowaveplastic;steerclearofplasticcontainerswithrecyclecodes3or7printedonthem;keepyourconsumptionofcannedfoodstoaminimum;andstoreleftoversinglass,stainlesssteel,orporcelaincontainersinsteadofplastic.Additionally,newerresearchhasfoundthatBPAexposureinuterocanpredisposepeopletofoodallergieslaterinlife.50

Drinkcleanwater.There isn’tmuchofadirectconnectionwithallergies,butintermsofpromotingyouroverallhealth,cleandrinkingwaterisextremelyimportant.After all, your body ismademostly ofwater, so if you put taintedwaterinyourbody,youwillliterallycontaminateyourself.Weareluckyenoughtoliveinacountrywithcleandrinkingwaterdevoidofpathogensthatcanmakeyou acutely ill. But some of the chemicals lurking in tapwater (chlorine, forexample)canharmyouovertime.Tohelppurifyyourwater,andthereforeyourbody,trythefollowing:

• Getagoodwaterfilter.Waterfilterscomeinanumberofforms,frompitchersyouputinyourfridgetofull-housefiltrationsystems.Anyfilterisbetterthannothing.Ihaveasimplewaterfilterundermysinkathome.Iinstalleditmyself,anditworksgreat.

• Putachlorinefilteronyourshowerhead.Ifyouhavepublicwater,yourwaterprobablycontainschlorinetokillbacteriaandviruses.Butchlorine’spowertokillpathogenscomesatacost:Thechemicaldriesoutyourskinandhair,anditispotentiallytoxic.Severalstudieshavelinkedittocancer.Inone2005studypublishedintheJournalofEpidemiologyandCommunityHealth,menwhodrankchlorinatedwaterwerefoundtohaveanincreasedriskofbladdercancer.Achlorinefilterwillhelpreduceyour

exposure.51

Landscapeappropriately.Getridofanyweedsgrowingrightnexttoyourhouse—theyarejustanothersourceofpollenandallergens.Ifyouhavepollenallergies,asksomeoneelsetodotheweeding.Also,avoidplantingflowersthatarerelativesofragweed—mums,sunflowers,dahlias,andzinnias.52

Getawayfromitall.Ifyouhavehayfever,trytoplanavacationinamorepollen-freearea,suchasthebeach,atthepeakofallergyseason.Yourbodywillenjoythebreak.

Inconclusion,remember:Thechemicalsandproductsyousurroundyourselfwith—both indoors and outdoors—play a large role in your level ofinflammation, allergy risk, and general health. So minimize the potentiallyharmfulsubstancesinyourenvironment;increasethenumberoftinygoodhabitsyouperformdailysotheyoutnumberthebadones;andmakeyourenvironmentascleanasyoupossiblycan.

Beth’sStoryBeth,a40-year-oldstay-at-homemom,wasingreatshapewhenshefirstvisitedDr.Psenka.Shewasexercising,eatingwell,andtakingbeneficialsupplements.

However,eversincemovingtoArizonafromWashington,DC,Bethhadbeensufferingwithallergysymptoms,includingarunnynose,sneezing,andpluggedears—symptomsthatweregettinginthewayofherotherwisehealthylifestyle.Bethhasachildwithadairyallergy,sosomegeneticfactorsmayalsohavebeenatplay.

Notwantingtotakesyntheticdrugs,BethwasinterestedinwhatDr.Psenkacouldofferherintermsofnaturalremediesforherallergies.

“MuchofwhatDr.PsenkarecommendedIwasalreadydoing,soheaddedafewsupplementstomyregimenandrecommendedItrysublingualimmunotherapy(SLIT),”shesays.

AsaresultofDr.Psenka’streatments,thenextallergyseason,Bethfeltmuchbetter.“Myfamilyhasalsonoticedmyallergysymptomshaveimproved,”shesays.

Beth’sonlyregret:notseeingDr.Psenkaandstartingtreatmentearlier.“Dr.Psenkataughtmenaturalremediescanworktotreatallergies.”

13WorkingOutYourAllergies:ExerciseandtheAllergicResponse

AFEWYEARSAGO,Imetawomaninherearlyseventieswhohaddecideditwas timetomakehealthychanges inher life.Shewasmoderatelyoverweight,fatigued, and was having trouble sleeping. Her diet was poor, and she didn’texercise at all. I counseled her on healthy eating, proper hydration, and howimportant it is for all people, regardless of age, to find a way to incorporateexerciseintotheirdailylives.Shedecidedthatinsteadofgoingtothegymandwalkingonthetreadmillorliftingweights,shewouldliketotryyoga.Inashortperiodof time, she found thatyoganotonly improvedherphysicalhealthbutalsomadeherfeelbettermentally.Sheno longerhad troublesleepingandshedevelopedanoverallbettersenseofwell-being.

Now in her mid-seventies, this woman has become a yoga instructor andteaches yoga classes three or four times aweek. It’s been amazing to see herprogress. Inherseventies,she is inbetterphysicalshape thanmanyof the30-year-oldsIsee.She’salsomuchhappierandisfullofvitality.Thisspunkyladydid not have allergies or asthma, but she is a wonderful example of theimportanceofregularexerciseformentalandphysicalhealth.

Iamafirmbelieverinexercise,andIenjoyitmyself.Itrytoexerciseforatleastanhouraday,andIthinkeveryone,whethertheyhaveallergiesorasthmaor not, should exercise for 30 to 45 minutes almost every day, if possible.Exercisepromotesgoodhealthandhelpspreventdiabetes,heartdisease,cancer,andotherdiseases.Italsopromotesstressreductionandamoregroundedsenseofbeing.Anyonewhohas incorporatedexercise intoher lifewill tellyou thatshefeelsbetterandmorerelaxedafteraworkout.1

If youhave allergiesor asthma,whichyouprobablydo if you are readingthis book, you still need to exercise.However, you need to bemore cautiousaboutthetypeofexerciseyoudo.Inmostcases,exercisecanbebeneficialforthosewith allergies and asthmawhen the right types of exercise are chosen. Iwill tellyoumoreabouthowtosafelyworkoutwithallergiesandasthma,but

firstlet’scoversomebasicsregardingtheimportanceofexercise.

WEAREMEANTTOMOVE

Regular exercise is vital to good health. Everyone needs to incorporate somekind of physical activity into his or her life.Your body ismeant to run; it ismeant tomove.You’renotmeant to sit in frontof a computer screenall day,which is unfortunately what many of us do. And while we can’t completelyremoveourselvesfromourcomputers,wecanandshouldmaketheefforttogoforawalkorabikerideoncewestepawayfromthem.

According to the Centers for Disease Control and Prevention (CDC),engaginginregularphysicalactivityisoneofthemostimportantthingsyoucandoforyourhealth.Amongitsmostpowerfuleffects,exercise:

• Lowersyourriskofheartdisease• Reducesyourchancesofdevelopingtype2diabetesandmetabolicsyndrome

• Lowersyourriskofsomecancers• Strengthensyourbonesandmuscles• Improvesyourchancesoflivinglonger• Improvesyourabilitytogothroughyourdailyactivitiesaswellasyouroverallqualityoflife

• Reducesstressandbolstersyourmentalhealth2

Additionally, regular exercise lowers chronic inflammation in your body,and as discussed, inflammation puts you at risk for a number of diseases andconditions. In a 2012 study published in Current Pharmaceutical Design,researchers found that regular exercise helped increase anti-inflammatorycytokinesandchemokines,therebyreducingchronicinflammation.3

In another 2012 study published in the journal Circulation, researcherslookedattheself-reportedactivityof4,289adultsandmeasuredtheirlevelsoftwo inflammatorymarkers—C-reactive protein (CRP) and interleukin-6 (IL-6)—over a 10-year period. The adults who reported exercising for at least 2.5hoursperweekhadlowerlevelsofbothCRPandIL-6atthe10-yearfollowupthanthosewhoreportedlowerlevelsofphysicalactivity.4

Exercisealsoburnscaloriesandhelpsyouloseweightormaintainahealthyweightifyourbodymassindex(BMI)isalreadygood.(TocalculateyourBMI

orlearnmoreaboutit,seehere.)As noted, maintaining your BMI within the normal range is extremely

important forgoodhealth.Obesityputsyouat increasedriskforheartdisease,high blood pressure, stroke, high cholesterol and triglycerides, metabolicsyndrome, cancer, osteoarthritis, gallstones, fertility issues, sleep apnea, andotherpotentiallyserioushealthproblems.5

KeepingyourBMIwithin the suggestednormal rangeof18.5 to24.9alsoappears to help control your risk of asthma. In a 2014 study published in theAmerican Journal of Epidemiology, researchers examined the relationshipbetween asthma and BMI. They looked at the risk of adult-onset asthma in76,470 women without asthma who were participants in the Nurses’ HealthStudy between 1988 and 1998. They assessed asthma risk in four differentscenarios:(1)womenwhohadnointervention,(2)womenwhohada5percentreductioninBMIover2yearsiftheywereoverweightorobese,(3)womenwhoexercisedatamoderateorvigorouspaceforatleast2.5hoursperweek,and(4)womenwhoexercisedforatleast2.5hoursperweekandreducedtheirBMIsby5percent.Theresearchersfoundthatthewomenwhoexercisedandlostweighthadthelowestriskforasthmaofallfourgroups.6

ThelinkbetweenasthmaandBMIseemstobepresentearlyinlife—asearlyas the preschool years. In a 2009 study published in the Journal of Asthma,researchers looked at BMI and the presence of asthma, allergic rhinitis, andeczema in 1,509 children who were 4 and 5 years old. They found a clearrelationship between asthma symptoms and obesity in these preschool kids;thosewithhigherBMIsweremuchmorelikelytoreporteverhavinghadasthmasymptomsorhavinghadtheminthepast12monthsthankidswhoseBMIswerenormal.7

AsdiscussedinChapter10,tomaintainahealthyBMI,youhavetobalancethe calories you take in from foods and beverageswith the calories you burnthroughphysicalactivity.8ThecurrentexerciserecommendationsfromtheU.S.DepartmentofHealthandHumanServices (HHS)areas follows:Tomaintainyourweight,aimforatotalof150minutesofmoderate-intensityaerobicactivity(equivalent to a briskwalk), 75minutes of vigorous-intensity aerobic activity(equivalent to a run), or 75 to 150minutes of a combination ofmoderate andvigorousactivityeveryweek.Becauseourbodiesandmetabolismsaredifferent,youmayneedtodomorethantherecommended75to150minutes,especiallyifyouaretryingtoloseandnotjustmaintainyourweight.Somepeopleneedupto300minutesof physical activityperweek to stay slim.Youmayalsoneed to

combineexercisewithchangesinyourdietinordertodroppounds.9,10Butnomatter what your weight-loss requirements, the more you exercise, the morehealthbenefitsyouwillreap.11

In addition to aerobic activity, you should also incorporate some strengthtraining into your exercise routine. The HHS guidelines recommend that youengageinstrengthtraining2ormoredaysaweekandthatyouworkallmajormusclegroups, includingyourabdomen,chest,hips, legs,back,shoulders,andarms.12

While I agree with the HHS recommendations, I think you should try toexerciseforatleast30minuteseveryday,oralmosteveryday.Alotofpeoplehear30 to45minutes adayand their knee-jerk reaction is, “I just don’t havetimeforthat.”Butyoudohavetime—youjusthavetomakethattime,andyouhavetorealizethatyoudon’thavetoexercisefor30to45minutesstraight.Youcanbreakitupintoafew10-minuteintervalsyoufitinthroughoutyourday.Gofora10-minutewalkrightbeforebreakfastinthemorning;getoutduringyourlunchhourforanother10minutesandwalkaroundyourbuildingorforafewblocks,ifyouworkintown.Thenwalkfor10minutesafterdinner.Whenyoubreaktheactivitydownintosmallerchunks, itdoesn’tseemsooverwhelming.Once you have incorporated these activity breaks into your daily routine, youwill look forward to them. After all, they are good excuses to get out of theofficeandintothefreshairtodosomethingjustforyou.

You don’t have to choose walking for your exercise—biking, swimming,spinning, aerobics, yoga, Pilates, tai chi—they are all great for you. In fact,swimming and yoga are particularly good for people with allergies andasthma.13,14,15,16Aslongasyougetmovingandincreaseyourheartrate,youaredoingyourbodygood.

Inaddition,andthisisvery important:Ifyouhaveallergiesorasthma,youcanexercise,butyouneedtobeverycarefulandtakespecialprecautionsasyoustart—andasyoucontinue—yourexerciseroutine.Ifyouarestartinganexerciseprogramforthefirsttime,talktoyourhealth-careproviderbeforeyougetgoing.Onceyou’vegottenthegreenlight,startslowly,especiallyifithasbeenalongtimesinceyou’veexercisedregularly.It’salsoimportanttorealizethatyoucanoverexercise. If exercise is new for you, consider enlisting the assistance of aprofessional.

EXERCISINGSAFELYWITHALLERGIESANDASTHMA

ASTHMAExercisingwith allergies or asthmapresents someunique challenges. Physicalactivitycanbemoredifficult,unpleasant,and insomecases,dangerous ifyouhaveoneorbothoftheseconditions.Youmayalsohavelessenergywhenyourallergies or asthma are acting up. If your allergies or asthma are properlymanagedandyouhave the right tools,youcanworkoutwithoutcausingyourbodyanyharm.17

If you are among the 20millionAmericanswho suffer from asthma, youshouldbeawareofthepossibilityofexercise-inducedasthmaattacks.Exercise-inducedasthmais justwhat itsounds like:asthmathat is triggeredspecificallybyexercise,usuallyvigorousactivitiessuchasrunningorfastbiking.Whileitiscommoninpeoplewithasthma(inindividualswithallergicasthmaaswellasinthosewithasthma thatoccursseparately), itcanalsostrikepeoplewhodonothave asthmaunder anyother conditions. In these cases, it is sometimes calledexercise-inducedbronchoconstriction(see“AWarningAboutExercise-InducedAnaphylaxis”).23

Peoplewith asthma and parents of childrenwith asthmamayworry aboutexercise triggering an asthma attack, but research shows that in the long run,aerobic exercise is good for peoplewith asthma and improves their quality oflife.24Toexercisesafelywithallergiesorasthma,knowledgeisyourbesttool.First, realize that therearesomeactivities thatarebetter thanothers.Running,biking,andbasketballaremore likely tocauseexercise-inducedasthma,whileless-intense forms of exercise such as swimming, baseball, and resistancetrainingarelesslikelytobringiton.25Yogaandtaichi,whichwewillexplorelaterinthischapter,arealsoexcellentoptions.

If you have allergies or asthma and are thinking of starting an exerciseprogram,consultwithyourhealth-careprovider first.This isvitally important.Yourdoctorcanhelpyoufindthebestactivityforyourconditionandgiveyoutipsonhowtoexercisesafely.

AWarningAboutExercise-InducedAnaphylaxisPeopleatriskforallergiesshouldbeawareofaconditioncalledexercise-inducedanaphylaxis(EIA).Anaphylaxisisasevere,life-threateningreactionthatinvolveshives,troublebreathing,dizziness,lowbloodpressure,fainting,andinsomecases,death.EIAisdistinctlydifferentfromfoodallergies,buteatinganallergenicfoodbeforeexercisecan

makeEIAmorelikelytokickin.18ThemechanismsbehindEIAaren’tfullyunderstood,but

scientistsknowitisananaphylacticreactionthathappensasaresultofphysicalactivity,mostoftenrunning,cycling,orswimming.Itseemsthatinsomepeople,exercisecanstimulatemastcellstoreleaseIgE.

Accordingtoa2013studypublishedinNutritionResearchandPractice,theworstoffenderswhenitcomestoEIAarewheat,eggs,shellfish,shrimp,nuts,fruits,and

vegetables.19Itdoesn’toccureverytimeasuffererexercises,anditissometimeslinkedtotheexerciserhavingeatenaspecificfoodbeforeheorshestartedtheactivity.Takingcertainmedications,suchasaspirin,togetherwithoneofthesefoodsfurtherincreasestheriskofanattack,asdoeshigh-intensityandfrequentexercise.Low-intensityandless-

frequentphysicalactivities,ontheotherhand,arelesslikelytotriggerEIA.20EIAismorelikelytooccurinextremetemperatures,inpeoplewithafamilyhistoryofEIA,andinwomen

whoarehavingtheirmenstrualperiods.21EIAisprettyrare;somestatisticssayitonlyaffects1to3peoplein10,000,andothersourcessaybetween1and15percentofthepopulationisatriskofsufferinganexercise-relatedanaphylacticattack.Thebestthingto

doifyouhaveriskfactorsistocarryanEpiPenwithyouwheneveryouworkout.22

TipsforExercisingSafelywithAsthmaandAllergiesTo exercise safely with allergies or asthma, here are some importantguidelines.26,27

• Talktoyourhealth-careproviderfirst.Ihaverepeatedthisafewtimesthroughoutthischapter,andthat’sbecauseItrulywantittosinkin:Beforeyoumakeanymajorchangeinyourlifestyle,whetheritistakinganewsupplementorstartinganexerciseprogram,talktoyourhealth-careprovider.Yousimplycan’tbetoocautious.

• Takeallofyourallergyandasthmamedicationsasyourdoctorhasprescribedthem.Yourdoctormaytellyoutotakeyourmedicationshortlybeforeyoustartexercising.Ifheorsheinstructsyoutodothis,listen.

• Ifyouhavethepotentialforexercise-inducedanaphylaxisorifyouareallergictoinsectstings,alwaysexercisewithafriend(neveralone),wearyourmedicalalertbraceletornecklace,andcarryyourEpiPenatalltimes.

• Ifyouareallergictoinsectstingsandyouplantoexerciseoutside,avoidwearingbrightlycoloredclothing,perfume,cologne,orscentedlotion.Alsoavoidareaswherebeesliketohide,suchastrashcansandflowerbeds.

• Ifyouhaveasthma,alwayscarryyourrescueinhalerwithyouwhenyouexercise.

• Checkthetemperaturebeforeyouheadoutsideforarunorbikeride.

Avoidworkingoutinextremeheatorcold(coldistheworst,becausecold,dryaircanbeveryirritatingtoyourbronchialtubes;thebestairtoexerciseiniswarmandmoist)orwhenpollencountsarehigh(usuallyinthemorningandthemiddleoftheafternoon).

• Ifyouareexercisingindoors,workoutonmatsinsteadofcarpeting,andkeepyourwindowsclosedifpollencountsarehigh.Also,avoidexercisingwheretherearefumesfromrecentrenovations.

• Ifyouareexercisingoutdoors,avoidfields,busyroads,andfactories,tokeepallergensandirritantsoutofyourlungs.

• Whenyouexercise,breathethroughyournoseasmuchasyoucan.Yournasalpassagesarenaturalairfilters,andtheytrapsomeoftheallergens,irritants,andpollutantsbeforetheyhaveachancetoenteryourlungs.Breathingthroughyournosealsohelpskeeptheairyoubreathemoistandatthepropertemperature.

• Ifyouhaveasthma,topreventanexercise-inducedattack,alwaysdoalong,15-minutewarmupbeforeyoustartthemainpartofyourexerciseroutine,andthencooldownforanother15minutesonceyou’vefinishedyouractivity.

• Neverexercisewhenyouhaveacoldorrespiratoryinfection.Waituntilyoursymptomshavesubsidedtoresumeyourroutine.

• Ifyouhaveallergiesorasthma,don’tpushyourselfduringexercise.

CanRunningEaseAllergySymptoms?Doyoutakeofffromexerciseonthedaysyourallergysymptomsareattheirworst?Youmightwanttothinktwiceaboutthat.AstudydoneinThailandfoundthatrunningmayhelprelievesomeallergysymptoms,suchassneezingandrunnynose.Ina2012studypublishedintheAsianPacificJournalofAllergyandImmunology,afterallergysufferersranfor30minutes,theirnasalcongestion,sneezing,runnynose,andnasalitchingdecreasedbymorethan70percent.Itseemsthatexercisemayworkbycalminginflammatoryproteinsinyournasalpassagesthatsparkallergysymptoms.

Thestudyauthorsrecommendexercisingatamoderatepace,at65to70percentofyour

heartratereserve.28Tocalculatethisnumber,firstfindyourmaximumheartratebymultiplyingyourageby0.7andthensubtractingtheresultingnumberfrom207.(Forexample,ifyouare40,40x0.7=28.Now,207−28=179.Yourmaximumheartrateis179.)Then,tofindtheheartrateyoushouldaimforinordertostaywithin65to70percentofyourheartratereserve,subtractyourrestingheartrate(thenumberofbeatsperminute)fromyourmaximumheartrate.Ifyourrestingheartrateis60,179−60=119.Youwould

thenaimforaheartrateof119beatsperminutewhileyouareexercising.29

TOCALMYOURALLERGIES,RELAXYOURBODYANDMINDAllergiesandasthmanotonlyaffecthowyoufeelphysicallybutalsotheycancauseemotionalstress.Knowingthatyouwillspendthewholespringsnifflingand sneezing is anxiety-provoking, and to make matters worse, stress canexacerbatetheallergicresponse.AsdiscussedinChapter7,thestresshormonecortisol increases inflammation in your body and triggers the release ofhistamine,thechemicalthatbringsonallergysymptoms.Conversely,whenyouaremore relaxed, your immune system is less likely to overreact to allergenswithinflammation,increasedmucus,itching,andotherunpleasantsymptoms.Inthesamewaythatapersonwhoisinacalm,relaxedstateofmindislesslikelytooverreact tocriticismorpickafight,acalm,relaxedimmunesystemis lesslikely to respond in an exaggerated manner when it’s exposed to pollen ordust.30

Thereareafewrelaxation-typeexercisesthatcanhelpcombatthe“fight-or-flight”modewegointowhenwe’restressedandfightallergiesandhelppreventasthma symptoms at the same time, thus allowing you to metaphorically killmultiplebirdswithoneworkout.31Plus,asyogaistypicallydoneindoors,youwillavoidexposingyourselftopollenandotherallergensandirritantsfloatingintheoutsideair.32

TheBenefitsofTaiChiOne form of exercise that will relax you and can help combat allergies andasthma is tai chi. Similar in nature, qigong and tai chi are a group of ancientexercisescomprisedofslowmovementsthatspecificallypromoterelaxation.Taichi has been shown to improve immune-system function, thereby helping topreventallergiesandasthma.33

The goal of tai chi and qigong is to cultivate the qi, which is defined inWestern terms as the energy found within all living things. By cultivating,nourishing,balancing,andchannelingtheqiintherightdirections,doingtheseancientformsofmartialartscanhelpyourbodyheal.Inaddition,qigonghelpspeoplewhopracticeittoconcentrateonandcontroltheirbreathing.Thismakesitgreatforpeoplewithrespiratoryconditions, includingsometypesofchronic

allergies.35In a study done in Thailand and presented at the annual meeting of the

American College of Chest Physicians, researchers looked at 17 people withpersistent asthma and enrolled them in a 6-week tai chi program. Participantsattended a supervised tai chi class once aweek and did home-based exercisesusinganaudiovisualguide.Attheendoftheir6weeksoftaichi,theparticipantshadbetteroxygenconsumptionandexerciseendurancethantheydidbeforetheystarted.36,37

In a related study published in the Journal ofMicrobiology, Immunology,and Infection, researchers looked at the pulmonary function of 30 asthmaticchildrenat rest,afterexercise,andafterexerciseplusdrinking icewater.Theythenenrolledhalfofthekidsina12-weektaichiprogram.Theotherhalfmadeup the control group and performed no exercise routine. After 12 weeks, thechildren in the tai chi group had significant improvements in their overallpulmonaryfunctioncomparedtothecontrolgroup.Underthestrongerchallengeofexerciseplusdrinkingicewater,thechildreninthetaichigrouphadmilderasthmasymptomsthanthekidsinthecontrolgroupdid.38

Tofindagoodtaichi instructor,askyourhealth-careprovider ifheorshecanrecommendoneorconsulttheAmericanTaiChiandQigongAssociationatamericantaichi.net/taichiqigongclass.asp.39

PutDowntheSaltshakertoReduceLungConstrictionHere’sanotherbenefittoalow-saltdiet:alowerriskforexercise-inducedasthma.Ina2010study,researchersgaveadultswithasthmaalow-sodiumdietfor1to2weeksandfoundthatitdecreasedtheirbronchoconstrictionwhentheyexercised.Soalthoughitcannottaketheplaceofasthmamedications,alow-sodiumdietmaybebeneficialforpeoplewhosuffer

fromexercise-inducedasthma.34

TheBenefitsofYogaAnotherrelaxationexercisethatisgoodforpeoplewithallergiesandasthmaisyoga. In a 2012 study published in the Indian Journal of Physiology andPharmacology,researcherscomparedlungfunctionanddiffusioncapacity(howwell the lungsprocessair)ofpeoplewithasthmabeforeandafter2monthsof

practicing yoga. They found that pranayama yoga breathing and stretchingposturesincreasedrespiratorystamina,relaxedthechestmuscles,expandedthelungs,improvedenergylevels,andhelpedcalmthebody.40

A related 2012 study published in the Journal of Alternative andComplementaryMedicine assessed theeffectsof10weeksofyoga trainingonqualityoflifeandheartratevariability(HRV),thevariationinthetimebetweenheartbeats.Theresearchersrandomlyassigned19womenwithmildtomoderateasthmatoeitherayogagrouporacontrolgroup.Theparticipantsallcompletedquality-of-life questionnaires and underwent isometric handgrip tests to assesstheir HRV. After 10 weeks, the yoga group saw significant improvements intheirqualityoflife;infact,theirqualityoflifewasrated45percenthigherthanthat of the control group. The yoga group also saw improvements in theirHRV.41

Ina2009 randomizedcontrolled trial, researchers lookedat57adultswithmildormoderateasthmaandputthemintoayogagrouporacontrolgroup.Theyoga group received conventional care as well as yoga instruction, and thecontrol group just got conventional care. More specifically, the yoga groupreceived 2 weeks of supervised training on lifestyle, medication, and stressmanagementbasedonyoga,followedbyacloselymonitoredcontinuationoftheprogram at home for 6weeks. The researchers looked at the progress of bothgroupsatthebeginningofthestudyand2weeks,4weeks,and8weeksintothestudy.Intheyogagroup,theyfoundasteady,progressiveimprovementinlungfunction. The yoga group also saw a reduction in exercise-inducedbronchoconstrictionandimprovementsinqualityoflife.42

Whenyoupracticeyoga,especiallyoneoftheless-vigorousforms,yourelaxyourmindandyourimmunesystem.AccordingtoYogaJournal,thebestwaytouse yoga for relaxation is to perform it smoothly and slowly.43 Further, yogainstructors discourage allergy and asthma sufferers from engaging in certainyogaforms,includingBikramor“hotyoga,”whichisdoneinaroomthatisatleast105°Fandat60percentrelativehumidity,aswellasAshtangayoga,whichisanintenseandphysicalyogaform.44,45,46

Asyou practice yoga, try to steer clear of forceful breathing through yournostrils,whichcanbeuncomfortableanddifficultifyouarecongested.Instead,doashortinhalationfollowedbyalong,slowexhalation,whichismorecalmingforyourbodyandmind.47

THEBESTYOGAPOSESFORALLERGYANDASTHMASUFFERERSIngeneral,standingposesthatinvolveforwardandbackwardbendsandtwists,like the Shoulder Stand Pose and the Plow Pose (described on the followingpages), massage your spine and thoracic cage and help condition your lungs,thus strengthening your immune system.48 There are also a few specific yogaposesthatcanhelpwithasthmaandallergysymptoms.

WARRIOR1POSEThisposehelpsyourchestand lungstoopenandusesgravity todrainmucusoutofyournoseandlungs.Toperformthepose:

1.Standwithyourfeettogetherandarmsatyoursides.2.Stepforwardwithyourrightfootsoyourfeetare3feetapart,and

bendyourrightkneeuntilyourthighisparalleltothefloor.Trytokeepyourbackleftheelpressedtothefloor.

3.Asyou’rebendingyourrightknee,raiseyourarmsaboveyourhead,keepingthemshoulder-widthapart,withyourarmsstraightandyourpalmsfacingeachother.(Yourarmsshouldbenexttoyourears.)

4.Inhaleandexhaleslowly.Holdthisposefor3to10slow,deepbreaths.

5.Comebacktostandingandrepeattheposeonyourleftside.

HALFMOONPOSEThisposeeasesbreathingbyopeningyourribcageandlungs,soitwillhelpclearyourheadifyouhavehayfeversymptomssuchassneezing,runnynose,andwateryeyes.Toperformthepose:

1.Standwithyourfeetshoulder-widthapartandarmsatyoursides.2.Placeyourlefthandonyourlefthipandturnyourrightleg90

degreesouttotheright.3.Extendyourrightarmstraightouttoyoursideatshoulder-height.4.Bendingatyourwaist,reachdownwithyourrighthandandplace

yourfingertipsonthefloorafewinchesinfrontofyourrightfoot.5.Liftyourleftlegstraightbehindyousothatitisparalleltothefloor,

andopenyourhipstotheleft.Extendyourleftarmsothatitisinlinewithyourrightarm.Turnyourheadandlookupatyourlefthand.Holdfor3to5breaths.

6.Slowlyloweryourleftarmbacktoyourlefthipandlooktowardthefloor.Slightlybendyourrightkneeandgentlyloweryourleftleg.Straightenyourrightknee.

7.Comebacktostandingandrepeattheposeontheoppositeside.

SHOULDERSTANDPOSEBoththeShoulderStandPoseandthePlowPoseareusedtoopennasalpassagesandhelpdrain the sinuses.49 Fold twoormoreblankets intorectanglesandstackthemtocreateyoursupport.Youmaywanttoplaceastickymatontopoftheblanketstohelpyourupperarmsstayinplacewhileyouareperformingthepose.Toperformthepose:

1.Liedownsoyourheadisonthefloorandyourshoulderbladesareontheblankets.(Theshortedgeoftheblanketshouldbeparalleltoyourarms.)Placeyourarmsflatonthefloorsotheyareparalleltoyourtorso,bendyourknees,andputyourfeetflatonthefloor.

2.Asyouexhale,pressyourarmsagainstthefloorandpushyourkneesawayfromthefloor.Drawyourthighsintowardyourtorso.

3.Continuetoliftyourlegsupwardbycurlingyourpelvis,andpushthebackofyourtorsoawayfromthefloorsoyourkneescometowardyourface.Putyourarmsoutsotheyareparalleltotheedgeoftheblanket,andturnthemsoyourthumbsarebehindyouandyourfingerspressagainstthefloor.

4.Bendyourarmsanddrawyourelbowstowardeachother,thenplaceyourpalmsflatonyourlowerbackandthebacksofyourupperarmsontheblanket.Raiseyourpelvisoveryourshoulderssoyourtorsoisperpendiculartothefloor.Walkyourhandsupyourbackanddowntowardthefloor,keepingyourelbowsshoulder-widthapart.

5.Asyouinhale,liftyourbentkneestowardtheceiling,bringyourthighsinlinewithyourtorso,andletyourheelshangdownbyyourbuttocks.Pressyourtailbonetowardyourpubicboneandturnyourupperthighsslightlyinward.Asyouinhale,straightenyourlegs

andpressyourheelsuptowardtheceiling.Oncethebacksofyourlegsarefullyextended,pushyourfeetupwardthroughtheballsofyourbigtoessoyourinnerlegsareslightlylongerthanyourouterlegs.

6.Pushyourshoulderbladesandthebacksofyourarmsintotheblanketsupportandmoveyourchintowardyoursternum.Inthisposition,yourforeheadshouldbeparalleltothefloor,andyourchinshouldbeperpendiculartothefloor.Trytoliftyourupperspineawayfromthefloorandlookatyourchest.

7.Holdtheposefor30seconds.Asyougetstronger,graduallyadd5to10secondstotheposeuntilyoucandoitcomfortablyfor3minutes.Toexitthepose,asyouexhale,bendyourkneestowardyourtorsoandkeepthebackofyourheadagainstthefloorasyourollyourbackslowlydownontothefloor.YoumayalsomoverightintothePlowPosewithoutexitingtheShoulderStandPose.

THEPLOWPOSEThePlowPose isusuallyperformedafter theShoulderStandPose, foranywherebetween1and5minutes.Toperformthepose:

1.FromtheShoulderStandPose,exhaleandbendfromyourhipjoints,andslowlyloweryourtoestothefloorsotheyareaboveandbehindyourheadandyourthighsareinfrontofyourface.Yourtorsoshouldbeperpendiculartothefloorandyourlegsshouldbestraightandcompletelyextended.

2.Keepingyourtoesonthefloor,liftthetopofyourthighsandyourtailbonetowardtheceiling,drawingyourinnergroinintoyourpelvis.Imaginethatyourtorsoishangingdownfromyourgroin.Drawyourchinawayfromyoursternumandsoftenyourthroat.

3.Pressyourhandsagainstthebackofyourtorso,pushinguptowardtheceilingasyoupressthebacksofyourupperarmsdownontothefloor.Activelypressyourarmsdownonthefloorbehindyourbackasyouliftyourthighstowardtheceiling.

4.Toexitthepose,bringyourhandsontoyourbackandrolloutoftheposeasyouexhale.

MAKINGEXERCISEAPARTOFYOURLIFE

MAKINGEXERCISEAPARTOFYOURLIFEThemostdifficultpartofgettingintoanexerciseroutineis . . .gettingintoanexerciseroutine.Onceyoufindanactivityyouenjoyandmakeitapartofyourdailylife,thehardestpart’sover.Atthatpoint,youcanjusthavefunexercisingandreapthebenefits,bothintermsofyourhealthandyourappearance.Inthemeantime,therearesomethingsyoucandototransformyourselfintosomeonewholooksforwardtoexercising.

Schedule your time for exercise. The excuse I hear most often when itcomestoexerciseis,“Idon’thavethetime.”Butifyouscheduleexercisetimelikeyoudoahalf-hourbusinessmeeting,assomethingthatcannotbeoverriddenorremoved,youwillbemuchmorelikelytodoit.Likemostpeople,Iamverybusy.Ihaveabusinesstorun,Iseepatientseveryday,Idoresearch,andIamafatheroftwowithawifeandahouse.TherearenotalotofhoursinthedaytoaccomplishallofthethingsIneedtodo,butIstillfindtimetoexercisefor1to2hoursalmosteverydaybyschedulingtimeformyactivity.

Forexample,Ioftenkeepmybikeatmyoffice.IfIhaveabreakinmyday,evena shortone, Ioften jumpon thebikeandgo for aquick ride.Takinganexercisebreaknotonlyhelpstokeepmephysicallyfitbutalsoit’sagreatwaytostaymentallysharpthroughouttheday.Sowrite“exercise”inyourplanner,blockofftimeinyoursmartphonecalendarforayogaclass,orbookadatewithyourexercisepartner—whateveryouneed todo tomakeexerciseapriority inyourday.

Find an activity you enjoy.When I ask patients about exercise, a lot ofthem tell me they have this great treadmill in their bedroom. I sometimesjokingly askhowmanypiecesof clothingarehangingon that treadmill.Mostpeoplechuckleandadmitthattheirtreadmillgetsmoreuseasahangerthanasapieceofexerciseequipment.Ithinkthatoneofthereasonsbedroomtreadmillsdon’tgetenoughuseisbecausetheyarenotveryexciting.

Exerciseshouldbefun;itshouldbethesortofthingthatyoulookforwardtodoing.Forme,ridingmymountainbikeisfun,andIlookforwardtomyrides.However,evenbikinglosessomeofitsappealeverysooften,andwhenitdoes,IsimplystartdoingsomethingelseIenjoy,suchasswimming.Soifyou’renotexercisingenough,askyourselfwhynot,andifyoufindthereasonisalackofenthusiasm about your routine, think about what you might find fun andexciting.

Thebestwaytofindanexerciseyouloveistotrydifferentthings.Signupfor a tai chi class or two, join a friendon a hike, or pay for a few swimming

sessionsatyourlocalYMCA.Chancesare,whenyou’vefoundagoodactivityforyou,you’llknowit.Somepeople(myselfincluded)don’tenjoyengaginginjustonetypeofexercise.Theyrunoneday,hike thenext,andride theirbikesthedayafterthat.Notonlydoesswitchingactivitiespreventboredom,itkeepsyourmuscleschallengedaswell,whichisgreatforfitnessandoverallhealth.

Findanexercisepartner.Thispersoncanbeagoodfriend,anot-so-goodfriend,orapersonaltrainer.Itdoesn’tmatter—aslongasyouhavesomeonetokeepyou accountable.Whenyou areonly accountable toyourself, it’s far tooeasytomakeexcuses,likeI’mtootiredorIdon’thavetime,andthenskipyourworkout.Whenyouknowyourexercisepartneriswaitingforyouonthecornerat6:00a.m.togoforawalk,youwillbealotlesslikelytohitthesnoozebuttonandalotmorelikelytogetupandputonyourshoeswhenthealarmgoesoff.

Ialsorecommendthatyouconsiderusingtheservicesofaqualifiedpersonaltrainer.Using a personal trainer hasmany advantages, especiallywhen you’rebeginninganexerciseprogram.Agoodpersonal trainerwill encourageyou tostickwithyourexerciseroutineandwillbeyourcheerleader.Personal trainerswillalsokeepyouaccountabletoyourworkouts,asyou’lllikelybepayingfortheir services. Most important, a trainer will help you work out safely. I seemanypeople,especiallymenin their thirtiesandforties,whotry to jumprightintoaworkoutroutinesimilartowhattheyweredoingwhentheywere18yearsold.Unfortunately,thisoftenresultsinaninjurythatderailstheentireexerciseeffort. A qualified personal trainer will work with you to exercise safely,whetheryouhaveallergiesorasthmaornot.Consider itasmart investment inyourself.

With these tips,youhavea recipe forexercise success.Aswemoveon toTheAllergySolutionPlan,remembertheimportanceofregularexercise,notjustforallergiesandasthma,butforloweringinflammation,keepingweightoff,andimprovingyouroverallhealth.

14CountdowntoanAllergy-FreeYou:The4-WeekAllergySolutionPlan

AFEWYEARSAGO, IWASTALKINGWITHAFELLOWDOCTORwho is in her thirties, and she told me about her terrible allergies. She hadseveralconfirmedfoodallergies,significantseasonalallergies,andwasallergictocatsanddogs.Sheknewhowtodealwithherfoodallergiesandshehadtakenmeasures to clean up the environment in her home. In other words, she wasdoingeverythinginherpowertocontrolherallergies.Shedidn’thaveanypets,butshehadstartedaseriousrelationshipwithaguywhohadbothcatsanddogs.Becauseofherexposuretothepets,shehadtodoseherselfwithantihistaminesmultipletimesadaytocontrolherallergysymptoms.

Inaddition to the lifestyle factors shehadalready initiated,wediscussedanewertreatmentcalledsublingualimmunotherapy(SLIT)asapossibletreatmentoption. As discussed, SLIT is an allergy treatment that involves giving theallergysufferersmalldosesofwhatheorsheisallergictoinordertoincreasehisorhertolerancetothatallergen.SLITdiffersfrominjectionimmunotherapy(allergy shots) in that it is givenorally via a sprayor a dissolvable tablet, notthroughaninjection.1

Iorderedsomebloodtestsandfoundthatshewas,infact,severelyallergic—more than15antigensshoweduponherblood test, including thoseforcatsanddogs, so itwasnowondershewassufferingafterstartingher relationshipwiththeanimallover.

The SLIT took a fewmonths to begin alleviating her symptoms,which istypical for immunotherapy, butwhen it did, she experienced dramatic results.Her seasonal allergieswere for themost part eliminated, and shewas able tomoveinwithherboyfriend(whoisnowherhusband).Shecantoleratethedogsandcats,sohewasabletokeephispets.MypatientissohappywiththeresultsofSLITthatshenowusesitinherownpractice.

Aswe launch into the 4-weekAllergySolutionPlan, Imust note that thiswomanwasaseverecase,andherstoryillustratesthatinsomeinstances,people

must try several different measures before they find the right combination ofthings, be they lifestyle changes or supplements, that work for them. In hersituation, it was the combination of eating a healthy, noninflammatory diet;removing all feasible allergy risk factors from her home; taking specificsupplements;andusingSLITthatprovidedherallergysolution.Itmayseemlikeherplanentailsquitealotjusttogetridofherallergies—especiallywhenmanytakeonlyasmallnumberofpillstoachievesimilarresults.However,thebeautyofanaturalapproachtoallergies is that itnotonlytreatsyourallergiesbut,aswe’ve discussed throughout this book, it can also dramatically improve youroverallhealth.

Most allergy sufferers are less allergic than this patient, however, andthereforemightnotneedto takeallof thesamestepsasshedid.Manypeoplerespond well to simple changes like eliminating certain foods and allergy-proofingtheirhomes.

BEGINNINGTHEALLERGYSOLUTIONPLAN

Asour journey comes to a close, theAllergySolutionPlanwill put all of theknowledgeandtipsyou’vegainedsofarintoplay.Theplanwilltellyou,step-by-step,what todoasallergyseasonapproaches tobothstrengthenyourbodyandtopreventthedevelopmentofallergies.Itwillalsoinstructyouonthebestpracticestoemployatthepeakofyourallergyseason.

MostoftheadviceIhavegiventhusfarinvolveshealthylifestylehabitsyoushouldbeengaging in allof the time. It’s important to incorporate thesegoodhabits intoyour routineallyear long, and it is especiallycritical tomake sureyoupracticethemasmuchaspossibleheadingintoallergyseason.

The Allergy Solution Plan is separated into 4 different weeks, withcorresponding steps and phases occurringwithin eachweek. That’s because afewweeksbeforeallergyseasonstarts—orbetteryet,afewmonthsbefore—isthe time to start reducing the inflammation in your body.You can do this bycleaningyourhometolowerthelevelsofdustmites,mold,andotherallergens;by eating anti-inflammatory foods like walnuts, flax, and cold-water fish; bysteering clear of proinflammatory foods like dairy and red meat; and byexercising for at least 30minutes every day.Of course you could, and likelyshould, make these things part of your normal daily routine anyway, all yearlong.

If you’re reading this book at the end of allergy season or when allergy

seasonisstillmonthsandmonthsaway,youcanstillgetstartedwiththeAllergySolution Plan. That way, once allergy season does roll around, yourinflammationwillbeevenlowerandyouwillbebetterarmedandreadytokeepyourallergysymptomsatbay.Onceyouhavethispreparationunderway,itwillbecomepartofyourroutine,andthenfurtherdowntheroad,itwillbecomeyourwayof life.Thebest time tostartusingallof the tipsyou’ve learnedsofar isnow.

WEEK1:PROMOTEANALLERGY-FREEHOMETwoweeksbeforeallergyseason,yourfocusshouldbeonallergy-proofingyourhome.Most of us spend themajority of our time indoors, so it’s important tomakethisenvironmentaspureandallergen-freeaspossible.

Phase1:CleanYourIn-HomeAirAs noted in Chapter 12, the pollution and allergens lurking in your indoorenvironments can be even worse than the substances floating around in theoutside air.Therefore, the cleaneryoucanmake the air insideyourhomeandoffice,thebetteryouwillbreathe.

One of the bestways to purify your air iswith an air filter, amechanicaldevicethattrapsandremovesdust,pollen,andotherparticlesfromtheairbeforetheymaketheirwayintoyourlungs.Inadditiontoremovingparticulatematter,high-quality air filters will also remove chemicals from the air. There are anumberof different typesof air filters, fromwhole-house filtration systems tofreestanding, single-room filters. They range in price from about $50 for afreestandingairfiltertothousandsofdollarsforwhole-housefiltrationsystems.Nomatterwhatkindyouchoose, look for theUnderwritersLaboratories (UL)seal,whichindicatesthatthefilterissafe,aswellasastatementfromtheFDAindicatingthatthefilterhasmettheFDA’sClassIIapproval,whichmeansthedevicehasalegitimatemedicalbenefit.2

Personally,Iusefreestandingairfiltersinbothmyofficeandmyhome,andthey work great. There are a few different types of single-room air filters tochoosefrom.

• Mechanicalaircleaners.Theseincludefan-drivenhigh-efficiencyparticulateair(HEPA)filters,whichforceairthroughaspecialmeshthatphysicallytrapsparticlessuchasdust,pollen,petdander,andtobacco

smoke.• Electronicaircleaners.Theseincludeion-typecleanersanduseanelectricalchargetoattractandgetridofirritantsandallergens.

• Hybridaircleaners.Thesefiltershaveelementsofbothmechanicalandelectronicairfilters.

• Gas-phaseaircleaners.Thesefiltersdonotremoveallergens,buttheyaregoodforeliminatinggaspollutantssuchascookinggas,perfumes,andfumesreleasedbybuildingmaterialsandpaint.3

It’sparticularlyimportanttorunanairfilterinyourbedroomandtopointittowardyourbodyasyousleep.Youspendmoretimeinyourbedroomthananyotherroominyourhouse,butunfortunately, this roomisoften thedirtiestandmost ladenwithallergens, includingdustmites,dust, andmold. Inaddition torunning an air filter in your bedroom, go with a minimalist style of decor toreducethenumberofplacesallergenscanhide—eliminateknickknacks,pictureframes, window dressings, and other clutter. Also avoid storing things underyour bed, and keep your bed away from vents, so you’re not breathing inparticlesthatblowoutofthemasyousleep.4

Nomatterwhatkindofairfilteryouuse,asallergyseasonapproaches,kickitintohighgear.Ifyounormallyonlyrunitatnight,startrunningitalldaylong.Ifyounormallyrunitonlow,pushittohigh.Thisisthetimetopulloutallthestopsandmakesureyouaredoingeverythingyoucantocleanuptheairinyourhouse.

Phase2:IncreasetheOxygeninYourHomeAirOneof thebestways to increase theamountofoxygen inyourhomeis togetair-cleaning houseplants. Because they produce oxygen, houseplants act likenatural air filters and can actually help clean the air. Some can also absorballergens.5 Plants make great air filters because they are simple, safe, andinexpensive.Plus,they’redecorative.Ifyouorsomeoneinyourhouseholdhasallergies,lookforplantsthataregoodairfiltersbutthatdon’tproducealotofpollenorotherallergens.Foralistofair-cleaninghouseplants,seehere.

Phase3:MinimizeYourExposuretoEnvironmentalToxins

Asidefrommovingtoaremoteareaofthecountry,whichisn’tfeasibleformostofus,thereisn’tawholelotyoucandotoavoidenvironmentaltoxinsthatcomefrom outside pollution—sources like vehicle exhaust and by-products fromplantsandfactories.Buttherearethingsyoucandotoreduceyourexposuretoenvironmental toxins inside your own home. From paint to glues used inflooringandotherbuildingmaterials tocausticcleaningproducts,anumberofchemicalsinyourindoorworkandhomeenvironmentscancauseyouharm.Asyou close in on allergy season, it’s particularly important to minimize yourexposure to these toxinsbecause they can increase inflammation inyourbodyand therefore make you even more vulnerable to allergy symptoms once theseasonkicksin.6

Aswe discussed inChapter 12, some of theworst offenders in householdproductsarevolatileorganiccompounds (VOCs),whicharechemicalsused indetergents,dishwashingliquids,furniturepolishes,rugandupholsterycleaners,floor polishes, chlorine bleach, air fresheners, and aerosol sprays.7 To avoidVOCs,youcancleantheold-fashionedwaywitheverydayhouseholdproducts.Baking soda is a great carpet cleaner—just sprinkle it on your carpet andvacuumitup toeliminateodors.8Youcanalsomakeahomemadeall-purposecleaningsolutionbymixingequalpartswhitevinegarandwater.9Or,youcanlook for green cleaning products. Remember, reputable brands include EarthFriendlyProducts,SimpleGreen,andNaturallyYours.10

Anotherthingtowatchoutforisdry-cleaningchemicals.Mostconventionaldrycleanersuseperchloroethylene (sometimes referred to as “perc”),which istoxictohumansandcontributestoenvironmentalpollutionintheformofsmog.Look foradrycleanerwhousesgreenmethods—the twomostcommonareapatentedprocesscalledGreenEarthCleaningandcarbondioxidecleaning.Or,ifyoumust use a conventional dry cleaner, take your clothing out of the plasticbagassoonasyougetithome,andhangitoutsidetoairoutbeforeyouwearit.Thiswon’t helpwith environmental pollution, but it will help keep the air inyourhomeclean.11

Anotherway to reduce thenumberof toxins inyour living space is to askpeople to take off their shoes at the door. Along with dirt that you have tovacuum, sweep, and mop, shoes bring animal waste, particulate pollution,pollen,antifreeze,oil,andotherpotentiallyharmfulchemicalsintoyourhome.12

If you have a home cleaning service,make sure that they are using greencleaningproductsinyourhome.Iftheyarenot,considerprovidingthecleaning

suppliesforthem,orlookforaservicethatusesthem.13

WEEK2:CHANGEYOURRISKFACTORSMakethesechangesbeginningatleast1weekbeforeallergyseason.Youcan’tchangesomeofyourriskfactorsforallergies,suchasfamilyhistory,buttherearesomeriskfactorsforallergiesthatyoucanchange.Theseincludeyoureatinghabitsandyourlevelofphysicalactivity.

Phase1:AssessandEliminateDietaryOffendersIfyouhaveafoodallergy,itgoeswithoutsayingthatyoushouldstayawayfromfoods to which you are allergic—not just going into allergy season, butthroughouttheyear.Thisisparticularlyimportantifyouhaveafoodallergythatcouldcauseapotentiallylife-threateninganaphylacticreaction.

But even if your allergies aren’t food-related, you should be careful aboutwhatyoueat,especiallyleadingintoallergyseason.Mostimportant,avoidfoodsthat can increase inflammation inyourbody.After all, themore inflammationyouhavegoingintoallergyseason,themorelikelyyouwillbetoreacttoyourtriggers(ragweed,pollen,dust,oranothersubstance towhichyouareallergic)oncetheyappear.

The worst foods when it comes to inflammation—and therefore, the onesyouwanttobemostdiligentaboutavoidinggoingintoallergyseason—areredmeat, excessive sugar, and dairy products. These foods are especially bad forallergiesbecausetheycontainarachidonicacid,whichstimulatestheproductionof leukotrienes, fatty molecules in your immune system that areproinflammatory. Now, I am not promoting a strict vegetarian diet. It isacceptable tohaveanorganiccarnivorous treatonce inawhile throughout theyear.ButIdothinkthatduringthefewweeksbeforeallergyseason,youshouldcompletely abstain. To satisfy yourmeat craving, you can use substitutes liketexturedvegetableprotein(TVP),veggieburgers,portobellamushroomburgers,andquinoa(inplaceofgroundbeef).

Asallergyseasonapproaches,you’dalsobewisetoavoidfoodsthatcontainexcess calcium, including fortified orange juice; sardines; green, leafyvegetables; and bananas. Eating these foods can perpetuate the production ofphospholipase, another enzyme that produces inflammatory enzymes in yourbody.

Phase2:StartEatinganAntiallergyDietJust as important as avoiding proinflammatory foods at the dawn of allergyseason is eating their anti-inflammatory counterparts. Increase your intake offoodsrichintheomega-3fattyacidsEPAandDHA,suchasflaxseed,walnuts,and cold-water fish like salmon. These omega-3–rich foods can help decreasethe leukotrienes that contribute to the bronchoconstriction involved in someallergicreactionsandallergicasthmaattacks.

In addition, boost your intake of foods that contain flavonoids such asquercetin and beta-carotene aswell as vitaminC.To getmore flavonoids, eatmoreapples,berries,broccoli, celery,cranberries, endive,grapes,greenbeans,kale,onions,strawberries,sweetredpeppers,andtomatoes.14Toincreaseyourintake of the flavonoid quercetin,which is a natural antihistamine, eat lots ofapples (with the skin), cherries, cranberries, currants, garlic, andonions.15 Foradded beta-carotene, go for apricots, broccoli, cantaloupe, carrots, mangoes,pumpkin, spinach, squash, sweet peppers, and sweet potatoes.16 And to boostyourintakeofvitaminC,whichisanotherofnature’spowerfulantihistamines,eatmorecitrusfruits,peppers,strawberries,andtomatoes.17,18

I have to point out that one of themost powerful foodswhen it comes toallergy-fighting potential is broccoli sprouts. A study published in Food andFunctionshowedthatbroccolisproutextractcouldactuallylessentheimpactofdiesel exhaust particles (DEPs), one of theworst environmental pollutants, inpeoplewith allergies and asthma.19As an addedbonus, broccoli sprouts are agreatsourceofvitaminC,sothisistrulyasuperfoodwhenitcomestoallergyandasthmaprevention.20

Ifyouare feelingextragungho,youmaywant to consider switching to avegandietintheweeksleadinguptoallergyseason.Byeliminatingallanimalproducts, youwill lower your levels of proinflammatory arachidonic acid andtherefore decrease the leukotrienes that get released as part of the allergicresponse. In a landmark Swedish study done in 1985, researchers found thatasthmaticswho followed a vegan diet saw a 71 percent improvement in theirasthmasymptomsafter4monthsanda92percentimprovementafterayear.21

In addition to getting the right nutrients and eliminating proinflammatoryfoods,youshouldalsobevigilantaboutstayingadequatelyhydratedatthistime.Your body is mostly made of water, so you need H2O to keep your systemsfunctioningsmoothly.Also,stayingadequatelyhydratedasyouheadintoallergyseason will help thin your mucus and prevent congestion. Hydration also

promotes general detoxification in your body, so it will help flush outproinflammatorymarkersthatcanworsenanallergicresponse.22

Tostayhydrated,Irecommendthatyoudrinkwater(notsoda,juice,coffee,or caffeinated tea).Youcan substitutedecaffeinatedherbal teahere and there,butmostofyourbeveragesshouldbeH2O.Youshoulddrinkhalfofyourbodyweightinouncesofwateraday,soifyouweigh150pounds,drink75ouncesofwater. That’s a lot, but it is doable, especially if youmake it a point to keepwaterwithyouatalltimesandyoudrinkitsteadilythroughouttheday.

Phase3:ExerciseforPhysicalandMentalHealthAsImentionedinChapter13,Iamafirmbelieverinexercise,andIthinkthateveryone shouldmake time for at least 30minutes of physical activity everysingle day. If you have asthma or the potential for exercise-inducedbronchoconstriction or exercise-induced anaphylaxis, you should still exercise,butyoumayneedtobea littlemorecautiouswithyourexerciseroutine.Idealactivitiesforyouwillincludegentleyoga,qigong,andtaichi.Asabonus,theseactivitieshelpbolsteryourbodyagainstallergiesandasthma.23

By harnessing the energy, or qi, tai chi and qigong can improve yourimmune system function and help prevent allergies and asthma. Research hasshownthattaichicanhelpimproveoxygenconsumptionandexerciseenduranceaswellasdecreaseasthmasymptoms.24,25

Yogaisalsobeneficialforasthmaandallergysufferers.Studieshaveshownthat the practice can help calm the body, increase respiratory stamina, boostenergy levels, improve lung function, reduce exercise-inducedbronchoconstriction, and improveoverall qualityof life inpeoplewith asthmaandallergies.26,27,28

In addition to their physical benefits, yoga and tai chi are also wonderfulstress-relievers.Anyonewhohassufferedfromallergiesorasthmaknowshowstressfultheseconditionscanbe.Asallergyseasonloomsandyouanticipatethesnifflingandsneezing,youmayfeelyouranxietybuilding.Sothemoreyoucandotokeepyourbodyrelaxedduringthistime,thebetter.WelearnedinChapter8thatstressandanxietycontributetoinflammation,soasyouloweryourstresslevels, youwill lower your inflammation levels, too, and thereforemake yourbodylesssusceptibletoallergysymptoms.29

Allformsofexercise—notjustyogaandtaichi—havesomestress-relievingeffectsandaregreatformentalhealth.30Andifyoucanaddsomemeditationto

yourroutineasallergyseasonapproaches,evenbetter.Ina2011studypublishedin Alternative Therapies in Health and Medicine, researchers found thatindividuals who meditated for 15 minutes once or twice a day for 4 weeksshowed improvements in their levels of stress and anxiety as well as in theiroverallqualityoflife.31

WEEK3:INCORPORATEANTIALLERGYSUPPLEMENTSANDHERBALMEDICINEAsallergy seasonbegins, it is important to keepupwith the lifestyle changesyou’ve implemented—cleaning up your environment and air, eating anti-inflammatory foods, avoiding proinflammatory foods, and exercising on aregular basis, with an emphasis on stress-relieving workouts. Some peoplerespondwell to these lifestyle interventions alone; thesepeopleget substantialrelieffromtheirallergiesjustbyloweringtheirinflammationlevels.Othersneedtodomore.

If you havemilder allergy symptoms, I suggest that at this time you alsobegin taking supplements thatwillmake your body stronger, allowing you tobetterstaveoffallergysymptoms.Ifyouarealittlemoreallergic,Irecommendyou start taking a few antiallergy herbs andmaybe homeopathic treatments inadditiontothosebasicsupplements.Ifyouarehighlyallergicoryouknowfrompastexperiencethatyourallergiesarestubborn,youmaywanttoconsiderSLITatthispoint.

Everyoneisdifferent,andittakessomepeoplelongerthanotherstoachievethe same results using lifestyle interventions. That’s where supplementation,herbs,homeopathy,andSLITcanhelp.Theseremediescanloweryourallergicpotential and stabilize mast cells so you don’t get the histamine release andresultingallergysymptoms(suchasitchingandsneezing)thatcanmakethefewmonthsofallergyseasonsomiserableforyou.

All of the herbs and supplements here are generally regarded as safe.However,everyone’sbodyisdifferent,andherbscaninterferewithsomedrugsand medical conditions, so you should always talk to a health-care providerexperiencedinprescribingsupplementsandherbalmedicinesbeforestartinganynewherborsupplement.

Supplements

At the very beginning of allergy season, you can start with the most basicsupplementsforimprovingoverallhealth.Theseincludethefollowing:

VitaminC (ascorbicacid).This is agoodsupplement to start rightat thebeginning of allergy season. Ideally, you should be taking vitamin C all yearlong, as it does a number of things for your body: It’s a natural anti-inflammatoryand ithelpspreventhistaminerelease,so itcaneaseasthmaandallergysymptoms.Take2to3gramsaday.32,33

BVitamins. I recommendyou takevitaminB6 andvitaminB12 aspartofyoursupplementrepertoire.B6(pyridoxine)mayhelppreventinflammationandease asthma symptoms,34, 35, 36 and studies show that B12 can help stave offasthmaattacksaswell.37

HerbalRemediesYou can bolster your immune system at the start of allergy season by takingherbs thathaveantiallergiceffects. Ifyou’vealreadystartedexperiencingmildsymptoms, these herbs can help prevent your allergies from becoming full-blown.

Here’sarefresheronsomeofthebestherbsforallergies.Ifyouwanttomixa few of these remedies, there are some products on themarket that combinemultiple herbs and supplements in one pill, so you don’t have to purchase orswallowmultipleproducts.

Youcanalsomakean“allergy remedy”herbal teausinga combinationofthelooseleavesofafewoftheherbsbelow;drinkafewcupsadaystartingatthebeginningofallergyseason.Or,ifyourherbalremediesareintinctureform,mixseveralofthemtogethertomakethemeasiertotake.38

Intermsofdosagesofthefollowingherbs,I’vegiventheusualranges,butyou may want to start off with a higher loading dose and then take a lowermaintenancedosefortherestofallergyseason.Generallyspeaking,peoplecanoften find relief using only one or two of these herbs at a time. Remember,naturaldoesnotequalsafe,andeverypersonisunique,somakesuretotalktoaqualified physician before taking herbal medicines. (For more detailedinformationontheseherbs,includingsideeffectsandwarnings,seeChapter11.)

Boswellia. This bark has anti-inflammatory properties. The typical dose is150to400milligramsofastandardizedextract,threetimesadayasneeded.39

Butterbur. A shrublike plant, butterbur (or Petasites) works like a

leukotriene inhibitor,blocking thechemicals thatcan triggerallergysymptomssuch as nasal swelling.40, 41 The typical dose for treating hay fever is 50milligramsofbutterburrootextract,twotimesaday.42

Gingkobilobaextract(GBE).GBEhasantioxidantpropertiesandhasbeenshowninsomestudiestohelpfightasthma.43Thedoserangesfrom120to160milligramsperday.44

Greenteaextract.Oneofthemostabundantcompoundsingreentea,calledepigallocatechingallate(EGCG),canhelpfightallergysymptomssuchasrunnynoseandsneezing.Thedoseisaround100milligramsperday.

Licoriceroot.Licoriceroot,orGlycyrrhizaglabra,helpswithallergiesbyfightinginflammation;soothingthethroat,bronchialmembranes,andlungs;andpromotingmucussecretion.Thedoserangesfrom5to15milligramsperday.45

Stinging nettle. A few studies have shown that stinging nettle hasantihistamine properties and therefore may help ease sneezing and itching inpeoplewithhayfever.46Thedosefortreatingallergiesisabout500milligrams,threetimesaday.47

Guduchi.AnherblongusedinAyurvedicmedicinetoremovetoxinsfromthebody,guduchicanalsohelptreatallergies,specificallyhayfever.48Thedoseisabout300milligrams,threetimesaday,forthecourseofallergyseason.49

Tylophora.AclimbingvinethatgrowsinIndia,tylophorahasbeenshowntohelptreatbothallergiesandasthma.Thedoseisaround250milligrams,onetothreetimesperday.50

WEEK4:LIVEALLERGY-FREEAt theheightof allergy season,you shouldbedoingallyoucan tokeepyourcurrentallergysymptomsatbayaswellasplanningaheadfornextyear’sallergyseason.Thetypesofremediesyoutry—andthedosages—willdependonyourindividualsymptomsandthedegreeofyourallergies.Ifyouhaveanumberofallergies,or ifyourallergiesareparticularlystubborn, inaddition to followingthelifestylerecommendationsofWeeks1through3,youwillprobablyneedtokickthingsupanotch,perhapswithSLIT.

Phase1:ControlPersistentSymptomsUsingNaturalSupplements

If your allergy symptoms have persisted after you have employed the basicsupplements recommended during Week 3, you can try some other naturalremedieswithantiallergyeffects.Aswasthecasewiththeherbs,ifyoufindthatyou have to take several different supplements, you may want to reduce thenumberofpillsyouneedtoswallowbylookingforasupplementthatcombinesafewdifferentremedies.Thebestantiallergysupplementsincludethefollowing.(For detailed information on these supplements, including side effects andwarnings,seeChapter11.)

Bromelain.Theusualdoseis3,000milkclottingunits(MCU),threetimesadayforafewdays,thenamaintenancedoseof2,000MCUthreetimesaday.

CoenzymeQ10.Therecommendeddoseofthispowerfulantioxidantrangesfrom30to300milligramsperday,dividedintotwoorthreedoses.

Eveningprimrose.Thedoserangesfrom3to6gramsperday.Magnesium.Thetypicaldosagerangeformagnesiumisbetween30and400

milligramsperday.N-acetylcysteine: Inpeoplewithallergiesandother respiratoryconditions,

the dose ranges from 600 to 1,500milligrams per day, taken in three divideddoses.

Omega-3fattyacids.Irecommendtakingabout3gramseachoftheomega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).Youmayhavetoswallowalotofcapsulestogetthisamount,solookforitinliquidform.

Probiotics. Ihavesaid ita few times throughout thisbook: I think thatallpeople should take a probiotic supplement daily. Look for a supplement thatprovidesatleast5billionCFUs,andswitchyourbrandeveryonceinawhiletokeepthebacteriacoloniesfresh.

Pycnogenol.Forallergies,take50milligrams,twotimesaday.Forasthmainchildren,thedailydoseis1milligramperpoundofbodyweight,givenintwodivideddoses.

Quercetin.Forallergies,thedoserangesfrom200to400milligrams,threetimesaday.

Selenium.Takeabout400microgramsofthisantioxidantperday.VitaminE.Thedose for treating allergies and asthma is 400 international

units of a natural supplement containing mixed tocopherols and d-alpha-tocopherol.

Zinc.Irecommend10to15milligramsofzincdailyformostpeople.

Phase2:KeepAllergySymptomsatBaywithHomeopathicRemediesTocontrolanyallergysymptoms thatpersist into theheightofallergyseason,youcantrysomehomeopathicremedies.Iwanttostartbysayingthattherearetwo schools of thought on homeopathy. The first school includes classicallytrained homeopathic physicians who sit down with patients for detailedinterviewstodiscoveralloftheirindividualized,specificsymptomssotheycanthen prescribe very targeted homeopathy. In the second school, there arephysicians likemyselfwho prescribe homeopathic remedies acutely, based oncurrentsymptoms.

Forexample,ifyoucomeinwithrunnyeyesandanacridnasaldischarge,Imaysay,“TryAlliumcepa.”Thathavingbeensaid,thefollowinghomeopathicremediesarebestused tocurbexistingallergysymptomsorasthmasymptomsyou know you can expect once the season really ramps up.Here are the besthomeopathicremediesforallergiesandasthma,alongwithalistofthespecificsymptomstheytreat.

Thestandarddosageforacutesymptomsisthreepelletsof30cevery4hoursuntil symptoms resolve. Stop using the remedy if you fail to notice anyimprovementafterthreedoses.51

• Alliumcepa:Hayfever,profuselytearingeyes,irritatingandpainfulnasaldischargethatturnsskinred

• Agaricus:Hayfever,especiallywithitchyearsandmouth• Ammoniumcarbonicum:Sneezingatnightorinthemorninguponwaking• Apis:Swellingaroundtheeyes,swollenfacethatgetsbetterwithcold• Arsenicumalbum:watery,acrid,drippingnosewithnasalobstruction;swollenlowereyelids;dry,itchyeczema

• Arundomauritanica:Profusesalivationwithrhinitis• Blattaorientalis:Troublebreathingwithshortnessofbreathonexertion,asthma,allergytomoldandmildew

• Causticum:Constantdesiretoclearthroat,hoarseness• Dulcamara:Hayfeverattheendofsummerorbeginningoffall• Euphrasiaofficinalis:Runnynoseandprofuselywateryeyes,burningeyes,sensitivitytolight

• Iodum:Hayfeverwithacridnasaldischargethatworsenswithheat

• Kaliarsenicosum:Allergythatgetsworseinthecold,asthmathatgetsworseatnight(1:00to3:00a.m.),psoriasis,eczema,burninganditchingskineruptions

• Kaliiodatum:Swellingoftheeyelids,edemaofconjunctiva,thicknasaldischarge,asthmaintheearlymorning,sinusitis

• Natrumcarbonicum:Foodallergies,especiallytomilkanddairy;diarrhea• Nuxvomica:Sneezingandrhinitisuponwaking,hayfever• Psorinum:Hayfever,eczemawithitchingatnight,itchinguntilitbleeds• Pulsatilla:Hayfeverwithrhinitis,hayfeverthatgetsworseoutsideandintheevening,greenishnasaldischarge

• Sabadilla:Hayfever,rhinitiswithtremendoussneezing• Sanguinaria:Hayfever;sensitivitytoodorsandpollens;frequentsneezing;wateryrhinitis;burningnose,mouth,andthroat;allergicasthma

• Sticta:Verystuffynosewithurgetoblowthatisn’tproductive,crustinginthenose,nasalobstruction,paininthenoseandforehead,allergicasthma

• Sulphur:Red,itchyeyeswiththesensationofhavingsandintheeyes• Sulphicumacidum:Aggravationsfromfumesorexhaust,asthmafromfumes,smoke,ordust

• Wyethia:Hayfever;tremendousitchinginthenose,throat,orpalate;theurgetoscratchthetongue

Phase3:PlanAheadtoReduceSymptomsDuringtheNextAllergySeasonwithSLITTo plan ahead for the next allergy season, you should continue eating well,exercisingregularly,andkeepingyourenvironmentascleanandallergen-freeaspossible.

You might also start receiving SLIT. Before I start SLIT, I confirm apatient’s allergieswith a blood test thatmeasures levels of immunoglobulinEagainst specific allergens, such as pollen, dust.52 I then custom-compound theSLITpreparationbasedoneachpatient’sallergies.Thefirst3monthsofSLITareconsideredtheescalation,orbuildupphase;duringthis time, thedosageoftheallergensgraduallyincreases.After3months,themaintenancephasebegins,andthepatienttakesthesamedoseeachday.53

SLITisalong-termtreatmentforallergies,andpatientsusuallytakeadaily

doseforupto3yearstohelptheirbodiesbecomedesensitizedtotheirallergies.Thetreatmentisverysafe,anditisconvenient;patientscantaketheirtreatmentathome, insteadofhaving togo to thedoctor everyweek for immunotherapyinjections.54SLITisnotjustanallergytreatment—ithasthepotentialtoactuallycure a person of his or her allergies. This is done by retraining the immunesystem to no longer produce elevated levels of IgE when it’s exposed toallergens.

Intheresearchcommunityandinclinicalpractice,SLITisshowingagreatdealofpromiseforthetreatmentofallergies.InastudypublishedintheJournalofAllergyandClinicalImmunology:InPractice,SLITwasfoundtobeasafeandeffectivetreatmentforpeoplewithrespiratoryallergies.55

Personally, I believe that when SLIT is used correctly and under theguidanceofanexperiencedphysician,itcanwipeoutallergies.SLITisoneoftheareasofmedicinewherewecanactuallyusetheword“cure”becauseitdoeshave the potential to cure, rather than just cover up the symptoms, likeconventionalallergymedicationsdo.

Tosummarize,herearethemainpointsofthe4-weekAllergySolutionPlan.Overall, you should incorporate the lifestyle tips you’ve learned into your

everydayroutine,includingdailyphysicalactivityandhealthfuleating.Ideally,youwillstarttheselifestylechangesafewmonthsbeforeallergyseason,butifyou’re just picking up this book a few weeks before the season starts, that’sokay,too.

• Week1(2weeksbeforeallergyseason):Cleanyourin-homeairbyrunninganairfilter,eliminateyourexposuretotoxicchemicals,anduseair-cleaninghouseplantstonaturallyfilteryourair.

• Week2(1weekbeforeallergyseason):Eliminateproinflammatoryfoods,suchasredmeat,dairy,andexcessivesugarBoostyourintakeofanti-inflammatoryfoods,suchasflaxseed,cold-waterfish,andwalnuts,andmakesuretodrinkatleasthalfyourbodyweightinouncesofwatereveryday.Starteatingfoodsrichinquercetin,beta-carotene,andvitaminC.Alsostartengaginginexercisesthatboostyourenergylevelandreducestress,suchasyogaandtaichi.Ifyoucan,startameditationprogram.

• Week3(atthestartofallergyseason):Starttakingantiallergyherbs,suchasstingingnettle,butterbur,andboswelliaaswellasbasicsupplementsthatboostyourhealthandimmunity,likevitaminsB6,B12,andC.

• Week4(duringallergyseason):Ifyoursymptomshavepersisteddespitehavingincorporatedtherecommendedlifestyleinterventionsandtakingbasicsupplementsorantiallergyherbs,youcanstartusingsupplementswithallergy-fightingpropertiesandhomeopathicremediesthatcombatyourspecificallergysymptoms.Thisisalsothetimetoplanaheadfornextallergyseasonbycontinuingyourhealthyexerciseandeatingplanand,ifnecessary,startingSLITtobuildyourallergentolerancesoitisextrastrongthefollowingyear.

Aswedrawtoaclose,youshouldfeelequippedwithpractical,effectivetipsthat will not only fight your allergies but will also make you healthier, lessinflamed, andbetter armed to staveoff someof theotherbig chronic lifestylediseases,suchastype2diabetes,heartdisease,andcancer.

Mygoalasanaturopathicphysicianandastheauthorofthisbookistohelpguideyoutowardlivingahealthierlifefreeofallergies,andtoputyouinbettershapeoverall,bothphysicallyandmentally,soyouhavethefreedomtopursueallthatyouenjoy.It’sbeenmypleasuretojoinyouonthisjourney.Mayitbejustthebeginning—notjustofanallergy-freeseason,butofahappier,healthieryou.

AcknowledgmentsIWOULDLIKETOSAYTHANKYOUtosomeofthepeoplewhoplayedaroleinhelpingmewritethisbook.First,tomyverybeautiful,veryloving,andverysupportivewifeMissy,wordscannotdescribehowmuchIloveandcherishyou.Tomychildren,IlliaandRocco,whoarebothboundlesssourcesofjoyandinspiration.AlsotomyparentsJoeandAlice,andmysiblingsCharlesandLisa,fortheirloveandencouragementinbelievingthatanythingispossible.

Ialsowish toexpressmysinceregratitude tomyagentTrinaBeckstedforhertirelessworkandalsoforbeingtheonewhosuggestedIwritethisbook!Abigthankyoutomyeditor,LoraSickora,forallherexcellenthelpandguidancethough thewritingprocess (not tomentionherpatience!).And, avery specialthank you to Elizabeth Shimer Bowers, as this book simply wouldn’t havehappenedwithoutherhelp.

Iwouldalso like to thankall the staff inmyoffice:Katie,Sanchez,Tami,andTracey,andthedocs,Tamburri,Marchese,Retz,andDiCampli.Youareall

greatpeopleandIappreciateyoursupport,help,andfriendshipmore thanyouknow.Iwouldalsoliketosaythankyoutoallmyfriendsformakingsurethereare plenty of fun times. Lastly, a special thanks to friendsBrian andLars forignitingmyinterestinallergy.

Endnotes

CHAPTER11“AllergiesGettingWorse?”EnvironmentalProtectionAgency,February2011,epa.gov/research/gems/scinews_aeroallergens.htm.

2L.F.Wangetal.,“Serum25-HydroxyvitaminDLevelsareLowerinChronicRhinosinusitiswithNasalPolyposisandAreCorrelatedwithDiseaseSeverityinTaiwanesePatients,”AmericanJournalofRhinologyandAllergy27,no.6(November–December2013):e162–65.doi:10.2500/ajra.2013.27.3948.

3“TrendsinAllergicConditionsamongChildren:UnitedStates,1997–2011,”CentersforDiseaseControlandPrevention,NCHSDataBriefNumber121,May2013,cdc.gov/nchs/data/databriefs/db121.htm.

4“AllergyStatistics,”AmericanAcademyofAllergy,Asthma,andImmunology,aaaai.org/about-the-aaaai/newsroom/allergy-statistics.aspx.

5“AllergyFactsandFigures,”AsthmaandAllergyFoundationofAmerica,aafa.org/display.cfm?id=9&sub=36.

6“FactsandStatistics,”FoodAllergyResearchandEducation,foodallergy.org/facts-and-stats.7Ibid.8C.Hadley,“FoodAllergiesontheRise?DeterminingthePrevalenceofFoodAllergies,andHowQuicklyItIsIncreasing,IstheFirstStepinTacklingtheProblem,”EMBOReports7,no.11(November2006):1080–83.ncbi.nlm.nih.gov/pmc/articles/pmc1679775/.

9“PeanutAllergy,”FoodAllergyResearchandEducation,foodallergy.org/allergens/peanut-allergy.10C.Hadley,“FoodAllergiesontheRise?DeterminingthePrevalenceofFoodAllergies,andHow

QuicklyItIsIncreasing,IstheFirstStepinTacklingtheProblem,”EMBOReports7,no.11(November2006):1080–83.ncbi.nlm.nih.gov/pmc/articles/pmc1679775/.

11Ibid.12“FactsandStatistics,”FoodAllergyResearchandEducation,foodallergy.org/facts-and-stats.13C.Hadley,“FoodAllergiesontheRise?DeterminingthePrevalenceofFoodAllergies,andHow

QuicklyItIsIncreasing,IstheFirstStepinTacklingtheProblem,”EMBOReports7,no.11(November2006):1080–83.ncbi.nlm.nih.gov/pmc/articles/pmc1679775/.

14“Allergy,”NationalInstitutesofHealth,nlm.nih.gov/medlineplus/allergy.xhtml.15“Allergies,”AmericanAcademyofAllergy,Asthma,andImmunology,aaaai.org/conditions-and-

treatments/allergies.aspx.16“AllergyFactsandFigures,”AsthmaandAllergyFoundationofAmerica,aafa.org/display.cfm?

id=9&sub=30.17“AllergiesacrossAmerica:TheLargestStudyofAllergyTestingintheUnitedStates,”Quest

Diagnostics,2011,questdiagnostics.com/dms/Documents/Other/2011_QD_AllergyReport.pdf.18“TrendsinAllergicConditionsamongChildren:UnitedStates,1997–2011,”CentersforDiseaseControl

andPrevention,NCHSDataBriefNumber121,May2013,cdc.gov/nchs/data/databriefs/db121.htm.19Ibid.20Ibid.21Ibid.22Ibid.23“AllergiesacrossAmerica:TheLargestStudyofAllergyTestingintheUnitedStates,”Quest

Diagnostics,2011,questdiagnostics.com/dms/Documents/Other/2011_QD_AllergyReport.pdf.24“PreventionofAllergiesandAsthmainChildren:TipstoRemember,”AmericanAcademyofAllergy,

Asthma,andImmunology,2013,aaaai.org/conditions-and-treatments/library/at-a-glance/prevention-of-

allergiesand-asthma-in-children.aspx.25“Asthma,”NationalInstitutesofHealth,nlm.nih.gov/medlineplus/asthma.xhtml.26“AllergiesGettingWorse?”EnvironmentalProtectionAgency,February2011,

epa.gov/research/gems/scinews_aeroallergens.htm.27“AllergiesacrossAmerica:TheLargestStudyofAllergyTestingintheUnitedStates,”Quest

Diagnostics,2011,questdiagnostics.com/dms/Documents/Other/2011_QD_AllergyReport.pdf.28J.Bartaetal.,“AirPollutionandAllergens,”JournalofInvestigationalAllergologyandClinicalImmunology17,sup.2(2007):3–8.

29C.Hadley,“FoodAllergiesontheRise?DeterminingthePrevalenceofFoodAllergies,andHowQuicklyItIsIncreasing,IstheFirstStepinTacklingtheProblem,”EMBOReports7,no.11(November2006):1080–83.ncbi.nlm.nih.gov/pmc/articles/pmc1679775/.

30“StateofAir2013:MostPollutedCities,”AmericanLungAssociation,stateoftheair.org/2013/city-rankings/mobile/most-polluted-cities.xhtml.

31“AllergiesacrossAmerica:TheLargestStudyofAllergyTestingintheUnitedStates,”QuestDiagnostics,2011,questdiagnostics.com/dms/Documents/Other/2011_QD_AllergyReport.pdf.

32“WhyAreAllergiesIncreasing?”UCLAFoodandDrugAllergyCareCenter,fooddrugallergy.ucla.edu/body.cfm?id=40.

33“AllergiesGettingWorse?”EnvironmentalProtectionAgency,February2011,epa.gov/research/gems/scinews_aeroallergens.htm.

34“TheRiseofSpringAllergies:FactorFiction?”AmericanCollegeofAllergy,Asthma,andImmunology,March6,2014,acaai.org/allergist/news/New/Pages/TheRiseofSpringAllergiesFactorFiction.aspx.

35S.Sausenthaleretal.,“MaternalDietduringPregnancyinRelationtoEczemaandAllergicSensitizationintheOffspringat2yofAge,”TheAmericanJournalofClinicalNutrition85,no.2(February2007):530–37,ajcn.nutrition.org/content/85/2/530.full.

36E.Maslovaetal.,“ConsumptionofArtificially-SweetenedSoftDrinksinPregnancyandRiskofChildAsthmaandAllergicRhinitis,”PLOSONE8,no.2(2013):e57261.doi:10.1371/journal.pone.0057261.

37M.Cantornaetal.,“VitaminDStatus,1,25-DihydroxyvitaminD3,andtheImmuneSystem,”TheAmericanJournalofClinicalNutrition80,no.6(December2004):1717S–1720S,ajcn.nutrition.org/content/80/6/1717S.full.

38L.F.Wangetal.,“Serum25-HydroxyvitaminDLevelsareLowerinChronicRhinosinusitiswithNasalPolyposisandAreCorrelatedwithDiseaseSeverityinTaiwanesePatients,”AmericanJournalofRhinologyandAllergy27,no.6(November–December2013):e162-65.doi:10.2500/ajra.2013.27.3948.

CHAPTER2

1G.D’Amatoetal.,“EnvironmentalRiskFactorsandAllergicBronchialAsthma,”ClinicalandExperimentalAllergy35,no.9(September2005):1113–24.

2“TheInternationalScientificForumonHomeHygiene.ActivityReview2013,”HomeHygieneandHealth,ifh-homehygiene.org/public-leaflet/international-scientific-forum-home-hygiene-activity-review-2013.

3O.Gruzievaetal.,“Traffic-RelatedAirPollutionandDevelopmentofAllergicSensitizationinChildrenduringtheFirst8YearsofLife,”JournalofAllergyandClinicalImmunology129,no.1(January2012):240–46.doi:10.1016/j.jaci.2011.11.001.

4E.Levetinetal.,“EnvironmentalContributionstoAllergicDisease,”CurrentAllergyandAsthmaReports1,no.6(November2001):506–14.

5“AirPollutionandAllergies:AConnection?”Medicinenet.com,March2007,medicinenet.com/script/main/art.asp?articlekey=17112.

6D.Jenerowiczetal.,“EnvironmentalFactorsandAllergicDiseases,”AnnalsofAgriculturalandEnvironmentalMedicine19,no.3(2012):475–81.

7G.D’Amato,“EffectsofClimacticChangesandUrbanAirPollutionontheRisingTrendsofRespiratory

AllergyandAsthma,”MultidisciplinaryRespiratoryMedicine6,no.1(2011):28–37.8“AirPollutionandAllergies:AConnection?”Medicinenet.com,March2007,medicinenet.com/script/main/art.asp?articlekey=17112.

9G.D’Amato,“OutdoorAirPollutioninUrbanAreasandAllergicRespiratoryDiseases,”MonaldiArchivesforChestDisease54,no.6(1999):470–74.

10“AirPollutionandAllergies:AConnection?”Medicinenet.com,March2007,medicinenet.com/script/main/art.asp?articlekey=17112.

11“5ThingsThatMakeYourAllergiesWorse,HealthyWomen.org,healthywomen.org/print/node/9322.12“WhyIsAllergyIncreasing?”AllergyUK,November2013,allergyuk.org/why-is-allergy-increasing.13T.Olszaketal.,“MicrobialExposureduringEarlyLifeHasPersistentEffectsonNaturalKillerTCell

Function,”Science336,no.6080(April27,2012):489–93.14“TheAllergicMarch,”WorldAllergyOrganization,September2007,

worldallergy.org/professional/allergic_diseases_center/allergic_march.15R.Goldbergetal.,“IntrauterineInfectionandPretermDelivery,”NewEnglandJournalofMedicine342

(May18,2000):1500–507.doi:10.1056/NEJM200005183422007.16“TheAllergicMarch,”WorldAllergyOrganization,September2007,

worldallergy.org/professional/allergic_diseases_center/allergic_march.17J.Davies,“WhereHaveAlltheAntibioticsGone?”CanadianJournalofInfectiousDiseaseandMedicalMicrobiology17,no.5(September–October2006):287–90.

18“TheInternationalScientificForumonHomeHygiene.ActivityReview2013,”HomeHygieneandHealth,ifh-homehygiene.org/public-leaflet/international-scientific-forum-home-hygiene-activity-review-2013.

19Ibid.20“WhyIsAllergyIncreasing?”AllergyUK,November2013,allergyuk.org/why-is-allergy-increasing.21D.Blyweiss,“TheSilentKiller,”AdvancedNaturalMedicineHealthNewsletter2010,

advancednaturalmedicine.com/heart-health/the-silent-killer.xhtml.22F.Sacks,“AskTheExpert:Omega-3FattyAcids,”HarvardSchoolofPublicHealth,TheNutritionSource.hsph.harvard.edu/nutritionsource/omega-3.

23Ibid.24K.Weaveretal.,“EffectofDietaryFattyAcidsonInflammatoryGeneExpressioninHealthyHumans,”TheJournalofBiologicalChemistry284,no.23(June5,2009):15400–407.

25“Sugar101,”AmericanHeartAssociation,2014,heart.org/HEARTORG/GettingHealthy/NutritionCenter/Sugars-101_UCM_306024_Article.jsp.

26“ThePancreasandPancreatitis,”MIMS,mims.co.uk/news/882288/Pancreas-Pancreatitis.27M.Abhilashetal.,“Long-TermConsumptionofAspartameandBrainAntioxidantDefenseStatus,”DrugandChemicalToxicology36,no.2(April2013):135–40.doi:10.3109/01480545.2012.658403.

28J.M.Mercola,“Aspertame:IsThisFDA-ApprovedSweetenerCausingBrainDamage?”,March24,2012,articles.mercola.com/sites/articles/archive/2012/03/24/aspartame-affects-brain-health.aspx.

29“FoodAdditiveIntolerance,”AmericanCollegeofAllergy,Asthma,andImmunology,2012,acaai.org/allergist/allergies/types/foodallergies/types/pages/food-additive-intolerance.aspx.

30A.Aubrey,“Almost500FoodsContainthe‘YogaMat’Compound.ShouldWeCare?”NationalPublicRadio,March6,2014,npr.org/blogs/thesalt/2014/03/06/286886095/almost-500-foods-contain-the-yoga-mat-compound-should-we-care-keep.

31“FoodAdditives,”AsthmaandAllergyFoundationofAmerica,2005,aafa.org/display.cfm?id=9&sub=20&cont=285.

32“FoodAdditiveIntolerance,”AmericanCollegeofAllergy,Asthma,andImmunology,2012,acaai.org/allergist/allergies/types/foodallergies/types/pages/food-additive-intolerance.aspx.

33“TransFats,”AmericanHeartAssociation,2014,heart.org/HEARTORG/GettingHealthy/FatsAndOils/Fats101/Trans-Fats_UCM_301120_Article.jsp.

34L.G.Woodetal.,“AHigh-FatChallengeIncreasesAirwayInflammationandImpairsBronchodilator

RecoveryinAsthma,”JournalofAllergyandClinicalImmunology127,no.5(May2011):1133–40.doi:10.1016/j.jaci.2011.01.036.

35S.Sausenthaleretal.,“MaternalDietduringPregnancyinRelationtoEczemaandAllergicSensitizationintheOffspringat2yofAge,”TheAmericanJournalofClinicalNutrition85,no.2(February2007):530–37.ajcn.nutrition.org/content/85/2/530.full.

36“FoodforThought:PreventingFoodAllergies,”KidswithFoodAllergies.org,December2013,kidswithfoodallergies.org/resourcespre.php?id=108.

37“PregnancyandPeanuts:TheEndoftheAvoidanceTheory,”BostonChildren’sHospital,December2013,childrenshospital.org/health-topics/thriving/2013/december-2013/12-23-2013-peanuts-and-pregnancy.

38S.Sausenthaleretal.,“MaternalDietduringPregnancyinRelationtoEczemaandAllergicSensitizationintheOffspringat2yofAge,”TheAmericanJournalofClinicalNutrition85,no.2(February2007):530–37.ajcn.nutrition.org/content/85/2/530.full.

39E.Maslovaetal.,“ConsumptionofArtificially-SweetenedSoftDrinksinPregnancyandRiskofChildAsthmaandAllergicRhinitis,”PLOSONE8,no.2(2013):e57261.doi:10.1371/journal.pone.0057261.

40M.Frierietal.,“VitaminDDeficiencyasaRiskFactorforAllergicDisordersandImmuneMechanisms,”AllergyandAsthmaProceedings32,no.6(November–December2011):438–44.doi:10.2500/aap.2011.32.3485.

41“IncreasingRatesofAllergiesandAsthma,”AmericanAcademyofAllergy,Asthma,andImmunology,2014,aaaai.org/conditions-and-treatments/library/allergy-library/prevalence-of-allergiesand-asthma.aspx.

42J.W.Jungetal.,“AllergicRhinitisandSerum25-HydroxyvitaminDLevelinKoreanAdults,”AnnalsofAllergy,Asthma,andImmunology111,no.5(November2013):352–57.doi:10.1016/j.anai.2013.08.018.

43M.Frierietal.,“VitaminDDeficiencyasaRiskFactorforAllergicDisordersandImmuneMechanisms,”AllergyandAsthmaProceedings32,no.6(November–December2011):438–44.doi:10.2500/aap.2011.32.3485.

44J.Arndtetal.,“StressandAtopicDermatitis,”CurrentAllergyandAsthmaReports8,no.4(July2008):312–17.

45M.Gaucietal.,“AMinnesotaMultiphasicPersonalityInventoryProfileofWomenwithAllergicRhinitis,”PsychosomaticMedicine55,no.6(November–December1993):533–40.

46J.K.Kiecolt–Glaseretal.,“HowStressandAnxietyCanAlterImmediateandLatePhaseSkinTestResponsesinAllergicRhinitis,”Psychoneuroendocrinology34,no.5(June2009):670–80.doi:10.1016/j.psyneuen.2008.11.010.

47Ibid.48“9HabitsThatMakeAllergiesWorse,”Prevention,2014,prevention.com/health/health-concerns/9-

habits-make-allergies-worse.49“AReviewoftheImpactofClimateVariabilityandChangeonAeroallergensandTheirAssociated

Effects,”UnitedStatesEnvironmentalProtectionAgency,July2009,cfpub.epa.gov/ncea/cfm/recordisplay.cfm?deid=190306.

50“Asthma,RespiratoryAllergiesandAirwayDiseases,andClimateChange,”NationalInstituteofEnvironmentalHealthSciences,March2013,niehs.nih.gov/research/programs/geh/climatechange/health_impacts/asthma/index.cfm.

51S.Lietal.,“AnAustralianNationalPanelStudyofDiurnalTemperatureRangeandChildren’sRespiratoryHealth,”AnnalsofAllergy,Asthma,andImmunology112,no.4(April2014):348–53.e1–8.doi:10.1016/j.anai.2014.01.007.

52C.Hadley,“FoodAllergiesontheRise?DeterminingthePrevalenceofFoodAllergies,andHowQuicklyItIsIncreasing,IstheFirstStepinTacklingtheProblem,”EMBOReports7,no.11(November2006):1080–83.ncbi.nlm.nih.gov/pmc/articles/pmc1679775/.

53V.Mahillonetal.,“HighIncidenceofSensitizationtoOrnamentalPlantsinAllergicRhinitis,”Allergy61,no.19(September2006):1138–40.

CHAPTER3

1J.Raoetal.,“DermatologicManifestationsofGastrointestinalDisease,”Medscape.com,November2013,emedicine.medscape.com/article/1093801-overview.

2“FrequentlyAskedQuestions,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,acaai.org/allergist/resources/pages/frequently-asked-questions.aspx.

3“FoodAllergies,”TheNemoursFoundation,November2011,kidshealth.org/teen/food_fitness/nutrition/food_allergies.xhtml.

4Ibid.5“AllergicReactions:TipstoRemember,”AmericanAcademyofAllergy,Asthma,andImmunology,2013,aaaai.org/conditions-and-treatments/library/at-a-glance/allergic-reactions.aspx.

6“IgE’sRoleinAllergicAsthma,”AsthmaandAllergyFoundationofAmerica,2005,aafa.org/display.cfm?id=8&sub=16&cont=54.

7Ibid.8P.M.EhrlichandE.S.Bowers,TeenGuides:LivingwithAllergies(NewYork:FactsonFile,2008).9“IgE’sRoleinAllergicAsthma,”AsthmaandAllergyFoundationofAmerica,2005,aafa.org/display.cfm?id=8&sub=16&cont=54.

10“FrequentlyAskedQuestions,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,acaai.org/allergist/resources/pages/frequently-asked-questions.aspx.

11“FoodAllergies,”TheNemoursFoundation,November2011,kidshealth.org/teen/food_fitness/nutrition/food_allergies.xhtml.

12“FoodAllergies,”TheNemoursFoundation,November2011,kidshealth.org/teen/food_fitness/nutrition/food_allergies.xhtml.

13“Allergies:NothingtoSneezeAt,”TheUniversityofIllinoisMcKinleyHealthCenter,2011,mckinley.illinois.edu/handouts/allergies.htm.

14“FoodAllergies,”TheNemoursFoundation,November2011,kidshealth.org/teen/food_fitness/nutrition/food_allergies.xhtml.

15“FPIES:FoodProteinInducedEnterocolitisSyndrome,”KidswithFoodAllergies.org,February2008,kidswithfoodallergies.org/resourcespre.php?id=99.

16“BloodTest:Allergen-SpecificImmunoglobulinE(IgE),”TheNemoursFoundation,February2011,kidshealth.org/parent/system/medical/test_ige.xhtml.

17Ibid.18Ibid.19“Allergies:NothingtoSneezeAt,”TheUniversityofIllinoisMcKinleyHealthCenter,2011,

mckinley.illinois.edu/handouts/allergies.htm.20“HowtoUseaRotationDiet,”FoodAllergy.org,2007,foodallergy.org/rotation.xhtml.21“FoodAllergies,”TheNemoursFoundation,November2011,

kidshealth.org/teen/food_fitness/nutrition/food_allergies.xhtml.22“SublingualImmunotherapy,”TheJohnsHopkinsSinusCenter,2008,

hopkinsmedicine.org/sinus/allergy/sublingual_immunotherapy.xhtml.23“FrequentlyAskedQuestions,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/resources/pages/frequently-asked-questions.aspx.24“FoodAllergies,”TheNemoursFoundation,November2011,

kidshealth.org/teen/food_fitness/nutrition/food_allergies.xhtml.

CHAPTER4

1“FoodsThatAggravateAllergiesandFoodsThatFightAllergies,”AchooAllergy.com,June2007,achooallergy.com/foods-aggravate-fight-allergies.asp.

2“PollenandMoldCounts,”AsthmaandAllergyFoundationofAmerica,2005,aafa.org/display.cfm?id=9&sub=19&cont=264.

3Ibid.

4P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.5“PollenandMoldCounts,”AsthmaandAllergyFoundationofAmerica,acaai.org/display.cfm?id=9&sub=19&cont=264.

6P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.7“RhinitisOverview,”AmericanAcademyofAllergy,Asthma,andImmunology,2014,aaaai.org/conditions-and-treatments/allergies/rhinitis.aspx.

8“PollenandMoldCounts,”AsthmaandAllergyFoundationofAmerica,acaai.org/display.cfm?id=9&sub=19&cont=264.

9P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.10“PollenandMoldCounts,”AsthmaandAllergyFoundationofAmerica,2005,aafa.org/display.cfm?

id=9&sub=19&cont=264.11Ibid.12P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactonFile,2008.13“PetAllergyOverview,”AmericanAcademyofAllergy,Asthma,andImmunology,2014,

aaaai.org/conditions-and-treatments/allergies/pet-allergy.aspx.14“RhinitisOverview,”AmericanAcademyofAllergy,Asthma,andImmunology,2014,

acaai.org/conditions-and-treatments/allergies/rhinitus.aspx.15“PollenandMoldCounts,”AsthmaandAllergyFoundationofAmerica,2005,aafa.org/display.cfm?

id=9&sub=19&cont=264.16“PetAllergyOverview,”AmericanAcademyofAllergy,Asthma,andImmunology,2014,

aaaai.org/conditions-and-treatments/allergies/pet-allergy.aspx.17Ibid.18G.Robertsetal.,“HorseAllergyinChildren,”BMJ321,no.7256(July29,2000):286–87.19Ibid.20“HouseDustAllergy,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/allergies/types/dust-allergy-information/pages/default.aspx.21Ibid.22Ibid.23Ibid.24“SkinAllergyOverview,”AmericanAcademyofAllergy,Asthma,andImmunology,2014,

aaaai.org/conditions-and-treatments/allergies/skin-allergy.aspx.25“AllergicConjunctivitis,”NationalInstitutesofHealth,May2014,

nlm.nih.gov/medlineplus/ency/article/001031.htm.26P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.27“SkinAllergyOverview,”AmericanAcademyofAllergy,Asthma,andImmunology,2014,

aaaai.org/conditions-and-treatments/allergies/skin-allergy.aspx.28Ibid.29Ibid.30Ibid.31P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.32“HouseDustAllergy,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/allergies/types/dust-allergy-information/pages/default.aspx.33P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.34“HouseDustAllergy,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/allergies/types/dust-allergy-information/pages/default.aspx.35J.B.Priceetal.,“IgEagainstBedBug(Cimexlectularius)AllergensIsCommonamongAdultsBitten

byBedBugs,”JournalofAllergyandClinicalImmunology129,no.3(March2012):863–65.e2.doi:10.1016/j.jaci.2012.01.034.

36P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.37“CockroachAllergyInformation,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/allergies/types/pages/cockroach-allergies.aspx.

38Ibid.39P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.40“PeanutAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/peanut-allergy.41Ibid.42Ibid.43P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.44“PeanutAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/peanut-allergy.45Ibid.46“TreeNutAllergies,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/tree-nut-

allergy.47Ibid.48Ibid.49“MilkAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/milk-allergy.50Ibid.51Ibid.52“EggAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/egg-allergy.53Ibid.54Ibid.55“SoyAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/soy-allergy.56“AllergicConjunctivitis,”NationalInstitutesofHealth,May2014,

nlm.nih.gov/medlineplus/ency/article/001031.htm.57“SoyAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/soy-allergy.58Ibid.59“ShellfishAllergy,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/allergies/types/foodallergies/types/pages/shellfish-allergy.aspx.60“FishAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/fish-allergy.61“ShellfishAllergy,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/allergies/types/foodallergies/types/pages/shellfish-allergy.aspx.62Ibid.63Ibid.64“WheatAllergy,”FoodAllergyResearchandEducation,2014,foodallergy.org/allergens/wheat-allergy.65Ibid.66Ibid.67“CornAllergy,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/allergies/Types/foodallergies/types/Pages/corn-allergy.aspx.68Ibid.69Ibid.

CHAPTER51“Quercetin,”UniversityofMarylandMedicalCenter,May2013,umm.edu/health/medical/altmed/supplement/quercetin.

2Ibid.3Ibid.4S.R.Naik,“Inflammation,Allergy,andAsthma,ComplexImmuneOriginDiseases:MechanismsandTherapeuticAgents,”RecentPatentsonInflammationandAllergyDrugDiscovery7,no.1(January1,2013):62–95.

5Ibid.6E.Moilanen,“TwoFacesofInflammation:AnImmunopharmacologicalView,”BasicandClinicalPharmacologyandToxicology114,no.1(January2014):2–6.

7S.R.Naik,“Inflammation,Allergy,andAsthma,ComplexImmuneOriginDiseases:MechanismsandTherapeuticAgents,”RecentPatentsonInflammationandAllergyDrugDiscovery7,no.1(January1,2013):62–95.

8“Phytochemicals,Antioxidants,andOmega-3FattyAcids,”StanfordMedicine,2014,cancer.stanford.edu/information/nutritionAndCancer/reduceRisk/phyto.htm.

9M.Schatzetal.,“Overweight/ObesityandRiskofSeasonalAsthmaExacerbations,”JournalofAllergyandClinicalImmunology:InPractice1,no.6(November–December2013):618–22.doi:10.1016/j.jaip.2013.07.009.

10“ChronicInflammationandChronicDisease,”AchooAllergy.com,February2007,achooallergy.com/chronic-inflammation-disease.asp.

11S.R.Naik,“Inflammation,Allergy,andAsthma,ComplexImmuneOriginDiseases:MechanismsandTherapeuticAgents,”RecentPatentsonInflammationandAllergyDrugDiscovery7,no.1(January2013):62–95.

12“WhatIsInflammation?WhatCausesInflammation?”MedicalNewsToday,May2014,medicalnewstoday.com/articles/248423.php.

13R.N.Duboisetal.,“CyclooxygenaseinBiologyandDisease,”FASEBJournal12,no.12(September1998):1063–73.

14“Inflammation,”November2013,users.rcn.com/jkimball.ma.ultranet/BiologyPages/I/Inflammation.xhtml.

15M.Shih,Biocarta,“CytokinesandInflammatoryResponse,”biocarta.com/pathfiles/h_inflampathway.asp.

16“Inflammation,”November2013,users.rcn.com/jkimball.ma.ultranet/BiologyPages/I/Inflammation.xhtml.

17“Interleukin-6—WhatisInterleukin-6?”News-Medical.net,2014,news-medical.net/health/Interleukin-6-What-is-Interleukin-6.aspx.

18P.M.EhrlichandE.S.Bowers,Teen’sGuides:LivingwithAllergies.NewYork:FactsonFile,2008.19E.Moilanen,“TwoFacesofInflammation:AnImmunopharmacologicalView,”BasicandClinicalPharmacologyandToxicology114,no.1(January2014):2–6.

20Ibid.21“WhatIsInflammation?WhatCausesInflammation?”MedicalNewsToday,May2014,

medicalnewstoday.com/articles/248423.php.22“NaturalKillerCell,”ScienceDaily,2014,sciencedaily.com/articles/n/natural_killer_cell.htm.23S.R.Naik,“Inflammation,Allergy,andAsthma,ComplexImmuneOriginDiseases:Mechanismsand

TherapeuticAgents,”RecentPatentsonInflammationandAllergyDrugDiscovery7,no.1(January2013):62–95.

24Ibid.25Ibid.26“ChronicInflammationandChronicDisease,”AchooAllergy.com,February2007,

achooallergy.com/chronic-inflammation-disease.asp.27G.W.CanonicaandE.Compalati,“MinimalPersistentInflammationinAllergicRhinitis:Implications

forCurrentTreatmentStrategies,”ClinicalandExperimentalImmunology158,no.3(December2009):260–71.doi:10.1111/j.1365-2249.2009.04017.x.

28P.J.Barnes,“PathophysiologyofAllergicInflammation,”ImmunologicalReviews242,no.1(July2011):31–50.

29S.R.Naik,“Inflammation,Allergy,andAsthma,ComplexImmuneOriginDiseases:MechanismsandTherapeuticAgents,”RecentPatentsonInflammationandAllergyDrugDiscovery7,no.1(January2013):62–95.

30“ImmuneResponse,”TheNationalInstitutesofHealth,Medline.com,May2012,nlm.nih.gov/medlineplus/ency/article/000821.htm.

31“Neutrophil,”EncyclopediaBritannica,britannica.com/EBchecked/topic/410999/neutrophil.32“EosinophilCount—Absolute,”NationalInstitutesofHealth,Medline.com,May2014,

nlm.nih.gov/medlineplus/ency/article/003649.htm.33“ImmuneResponse,”TheNationalInstitutesofHealth,Medline.com,May2012,

nlm.nih.gov/medlineplus/ency/article/000821.htm.34B.OzbenandO.Erdogan,“TheRoleofInflammationandAllergyinAcuteCoronarySyndromes,”InflammationandAllergy-DrugTargets7,no.3(September2008):136–44.

35P.J.Barnes,“PathophysiologyofAllergicInflammation,”ImmunologicalReviews242,no.1(July2011):31–50.

36S.Baumannetal.,“Obesity:APromoterofAllergy?”InternationalArchivesofAllergyandImmunology162,no.3(2013):205–13.doi:10.1159/000353972.

37Ibid.38Ibid.39M.Schatzetal.,“Overweight/ObesityandRiskofSeasonalAsthmaExacerbations,”JournalofAllergyandClinicalImmunology:InPractice1,no.6(November–December2013):618–22.doi:10.1016/j.jaip.2013.07.009.

40N.M.Johannsenetal.,“AssociationofWhiteBloodCellSubfractionConcentrationwithFitnessandFatness,”BritishJournalofSportsMedicine44,no.8(June2010):588–93.doi:10.1136/bjsm.2008.050682.

41S.Baumannetal.,“Obesity:APromoterofAllergy?”InternationalArchivesofAllergyandImmunology162,no.3(2013):205–13.doi:10.1159/000353972.

42Ibid.43“ChronicInflammationandChronicDisease,”AchooAllergy.com,February2007,

achooallergy.com/chronic-inflammation-disease.asp.44“WhatIsInflammation?WhatCausesInflammation?”MedicalNewsToday,May2014,

medicalnewstoday.com/articles/248423.php.45Ibid.46Ibid.47Ibid.48“NaturalKillerCell,”ScienceDaily,2014,sciencedaily.com/articles/n/natural_killer_cell.htm.49S.R.Naik,“Inflammation,Allergy,andAsthma,ComplexImmuneOriginDiseases:Mechanismsand

TherapeuticAgents,”RecentPatentsonInflammationandAllergyDrugDiscovery7,no.1(January2013):62–95.

50M.Wilders-Truchnigetal.,“IgGAntibodiesagainstFoodAntigensareCorrelatedwithInflammationandIntimaMediaThicknessinObeseJuveniles,”ExperimentalandClinicalEndocrinologyandDiabetes116,no.4(April2008):241–45.

51Ibid.52G.W.CanonicaandE.Compalati,“MinimalPersistentInflammationinAllergicRhinitis:Implications

forCurrentTreatmentStrategies,”ClinicalandExperimentalImmunology158,no.3(December2009):260–71.doi:10.1111/j.1365-2249.2009.04017.x.

53Ibid.54“LeakyGutSyndrome:Allergies,”leakygut.co.uk/Allergies.htm.55M.Hyman,“AreYourFoodAllergiesMakingYouFat?”2014,drhyman.com/blog/2010/04/20/are-

your-foodallergies-making-you-fat/.56P.Canietal.,“ChangesinGutMicrobiotaControlMetabolicEndotoxemia-InducedInflammationin

High-FatDiet–InducedObesityandDiabetesinMice,”Diabetes57,no.6(June2008):1470–81.doi:10.2337/db07-1403.

57Ibid.58S.Bischoffetal.,“FoodAllergyandtheGastrointestinalTract,”CurrentOpinioninGastroenterology

20,no.2(March2004):156–61.59C.DeFilipoetal.,“ImpactofDietinShapingGutMicrobiotaRevealedbyaComparativeStudyin

ChildrenfromEuropeandRuralAfrica,”ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica107,no.33(August17,2010):14691–96.doi:10.1073/pnas.1005963107.

60L.VanderPoeletal.,“FoodAllergyEpidemic:IsItOnlyaWesternPhenomenon?”CurrentAllergyandClinicalImmunology22,no.3(August2009):121–26.

61M.Hyman,“AreYourFoodAllergiesMakingYouFat?”2014,drhyman.com/blog/2010/04/20/are-your-foodallergies-making-you-fat/.

62Imayama,Y.etal.,“EffectsofaCaloricRestrictionWeightLossDietandExerciseonInflammatory

BiomarkersinOverweight/ObesePostmenopausalWomen:ARandomizedControlledTrial,”CancerResearch72,no.9(May1,2012):2314–26.doi:10.1158/0008-5472.CAN-11-3092.

63“Allergies,Inflammation,andWeightControl,”FoodAllergyResearchandEducation,2011,foodallergy.org/inflammation.xhtml.

64“NaturalKillerCell,”ScienceDaily,2014,sciencedaily.com/articles/n/natural_killer_cell.htm.65M.Hyman,“AreYourFoodAllergiesMakingYouFat?”2014,drhyman.com/blog/2010/04/20/are-

your-foodallergies-making-you-fat/.

CHAPTER61“LinkbetweenOmega-3FattyAcidsandIncreasedProstateCancerRiskConfirmed,”FredHutchinsonCancerResearchCenter,ScienceDaily,July10,2013,sciencedaily.com/releases/2013/07/130710183637.htm.

2H.Eyreetal.,“PreventingCancer,CardiovascularDisease,andDiabetes,”DiabetesCare27,no.7(July2004):1812–24.

3“HypothalamusandAging,”AlbertEinsteinCollegeofMedicine,2014,einstein.yu.edu/news/releases/894/brain-region-may-hold-key-to-aging/.

4T.W.McDadeetal.,“PsychosocialandBehavioralPredictorsofInflammationinMiddle-AgedandOlderAdults:TheChicagoHealth,Aging,andSocialRelationsStudy,”PsychosomaticMedicine68,no.3(May–Jun2006):376–81.

5J.Woodsetal.,“Exercise,Inflammation,andAging,”AgingandDisease3,no.1(February2012):130–40.

6T.W.McDadeetal.,“PsychosocialandBehavioralPredictorsofInflammationinMiddle-AgedandOlderAdults:TheChicagoHealth,Aging,andSocialRelationsStudy,”PsychosomaticMedicine68,no.3(May–Jun2006):376–81.

7J.Woodsetal.,“Exercise,Inflammation,andAging,”AgingandDisease3,no.1(February2012):130–40.

8T.NAkbaraly,“ChronicInflammationasaDeterminantofFutureAgingPhenotypes,”CMAJ185,no.16(November5,2013):E763–70.doi:10.1503/cmaj.122072.

9T.W.McDadeetal.,“PsychosocialandBehavioralPredictorsofInflammationinMiddle-AgedandOlderAdults:TheChicagoHealth,Aging,andSocialRelationsStudy,”PsychosomaticMedicine68,no.3(May–Jun2006):376–81.

10Ibid.11Ibid.12T.NAkbaraly,“ChronicInflammationasaDeterminantofFutureAgingPhenotypes,”CMAJ185,no.

16(November5,2013):E763–70.doi:10.1503/cmaj.122072.13J.Woodsetal.,“Exercise,Inflammation,andAging,”AgingandDisease3,no.1(February2012):130–

40.14Ibid.15Ibid.16“HypothalamusandAging,”AlbertEinsteinCollegeofMedicine,2014,

einstein.yu.edu/news/releases/894/brain-region-may-hold-key-to-aging/.17Ibid.18“WhatisMetabolicSyndrome?”NationalHeart,LungandBloodInstitute,November2011,

nhlbi.nih.gov/health/health-topics/topics/ms/.19“HypothalamusandAging,”AlbertEinsteinCollegeofMedicine,2014,

einstein.yu.edu/news/releases/894/brain-region-may-hold-key-to-aging/.20P.Taketal.,“NF-KB:AKeyRoleinInflammatoryDiseases,”JournalofClinicalInvestigation107,no.

1(January1,2001):7–11.doi:10.1172/JCI11830.21“AntioxidantsandFreeRadicals,”RiceUniversity,June1996,rice.edu/~jenky/sports/antiox.xhtml.22N.Khansarietal.,“ChronicInflammationandOxidativeStressasaMajorCauseofAge-Related

DiseasesandCancer,”RecentPatentsonInflammatoryandAllergyDrugDiscovery3,no.1(January

2009):73–80.23J.Woodsetal.,“Exercise,Inflammation,andAging,”AgingandDisease3,no.1(February2012):130–

40.24“SepticShock,”NationalInstitutesofHealth,Medline.com,May2014,

nlm.nih.gov/medlineplus/ency/article/000668.htm.25“TCells,”NationalInstituteofAllergyandInfectiousDiseases,October2008,

niaid.nih.gov/topics/immunesystem/immunecells/pages/tcells.aspx.26D.H.Josephsetal.,“EpidemiologicalAssociationsofAllergy,IgE,andCancer,”ClinicalandExperimentalAllergy43,no.10(October2013):1110–23.doi:10.1111/cea.12178.

27J.Woodsetal.,“Exercise,Inflammation,andAging,”AgingandDisease3,no.1(February2012):130–40.

28“KeyGeneFoundResponsibleforChronicInflammation,AcceleratedAgingandCancer,”NYULangone,May2012,communications.med.nyu.edu/media-relations/news/key-gene-found-responsible-chronic-inflammation-accelerated-aging-and-cancer.

29“SepticShock,”NationalInstitutesofHealth,Medline.com,May2014,nlm.nih.gov/medlineplus/ency/article/000668.htm.

30“KeyGeneFoundResponsibleforChronicInflammation,AcceleratedAgingandCancer,”NYULangone,May2012,communications.med.nyu.edu/media-relations/news/key-gene-found-responsible-chronic-inflammation-accelerated-aging-and-cancer.

31S.K.Mathur,“AllergyandAsthmaintheElderly,”SeminarsinRespiratoryandCriticalCareMedicine31,no.5(October2010):587–95.doi:10.1055/s-0030-1265899.

32J.M.Pinto,“RhinitisintheGeriatricPopulation,”Allergy,Asthma,andClinicalImmunology6,no.1(May13,2010):10.doi:10.1186/1710-1492-6-10.

33S.K.Mathur,“AllergyandAsthmaintheElderly,”SeminarsinRespiratoryandCriticalCareMedicine31,no.5(October2010):587–95.doi:10.1055/s-0030-1265899.

34J.M.Pinto,“RhinitisintheGeriatricPopulation,”Allergy,Asthma,andClinicalImmunology6,no.1(May13,2010):10.doi:10.1186/1710-1492-6-10.

35S.K.Mathur,“AllergyandAsthmaintheElderly,”SeminarsinRespiratoryandCriticalCareMedicine31,no.5(October2010):587–95.doi:10.1055/s-0030-1265899.

36“Older-AdultsandAsthma,”AllergyandAsthmaFoundationofAmerica,2005,aafa.org/display.cfm?id=8&sub=17&cont=173.

37J.Graham,“Allergies—AtYourAge?”BetterHomesandGardens,2014,bhg.com/health-family/conditions/allergies/adult-allergies/.

38M.D.D’ArcyLittle,“AllergiesintheAging,”GeriatricsandAging8,no.5(2005):52–53.39V.Cardonaetal.,“AllergicDiseasesintheElderly,”ClinicalandTranslationalAllergy1(2011):11.40“Older-AdultsandAsthma,”AllergyandAsthmaFoundationofAmerica,2005,aafa.org/display.cfm?

id=8&sub=17&cont=173.41M.D.D’ArcyLittle,“AllergiesintheAging,”GeriatricsandAging8,no.5(2005):52–53.42J.M.Pinto,“RhinitisintheGeriatricPopulation,”Allergy,Asthma,andClinicalImmunology6,no.1

(May13,2010):10.doi:10.1186/1710-1492-6-10.43“Older-AdultsandAsthma,”AllergyandAsthmaFoundationofAmerica,2005,aafa.org/display.cfm?

id=8&sub=17&cont=173.44J.Graham,“Allergies—AtYourAge?”BetterHomesandGardens,2014,bhg.com/health-

family/conditions/allergies/adult-allergies/.45S.K.Mathur,“AllergyandAsthmaintheElderly,”SeminarsinRespiratoryandCriticalCareMedicine

31,no.5(October2010):587–95.doi:10.1055/s-0030-1265899.46J.Graham,“Allergies—AtYourAge?”BetterHomesandGardens,2014,bhg.com/health-

family/conditions/allergies/adult-allergies/.47S.K.Mathur,“AllergyandAsthmaintheElderly,”SeminarsinRespiratoryandCriticalCareMedicine

31,no.5(October2010):587–95.doi:10.1055/s-0030-1265899.

48Ibid.49L.Handetal.,“OlderAdultAsthmaPatientsOftenAlsoHaveAllergies,”AnnalsofAllergy,Asthma,andImmunology110(2013):247–52.

50P.J.Busseetal.,“CharacteristicsofAllergicSensitizationamongAsthmaticAdultsOlderThan55Years:ResultsfromtheNationalHealthandNutritionExaminationSurvey,2005-2006,”AnnalsofAllergy,Asthma,andImmunology110,no.4(April2013):247–52.doi:10.1016/j.anai.2013.01.016.

51“WhatIsInflammation?WhatCausesInflammation?”MedicalNewsToday,May2014,medicalnewstoday.com/articles/248423.php.

52J.Woodsetal.,“Exercise,Inflammation,andAging,”AgingandDisease3,no.1(February2012):130–40.

53Ibid.54Ibid.55B.J.Niklas,“ExerciseTrainingandPlasmaCReactiveProteinandInterleukin-6inElderlyPeople,”JournaloftheAmericanGeriatricsSociety56,no.11(November2008):2045–52.doi:10.1111/j.1532-5415.2008.01994.x.

56“GreenTea,”UniversityofMarylandMedicalCenter,July2013,umm.edu/health/medical/altmed/herb/green-tea.

57Ibid.58S.YWuetal.,“GreenTea(Camelliasinensis)MediatedSuppressionofIgEProductionbyPeripheral

BloodMononuclearCellsofAllergicAsthmaticHumans,”ScandinavianJournalofImmunology76,no.3(September2012):306–10.doi:10.1111/j.1365-3083.2012.02729.x.

59M.ElAssaretal.,“OxidativeStressandVascularInflammationinAging,”FreeRadicalBiologyinMedicine65(December2013):380–401.doi:10.1016/j.freeradbiomed.2013.07.003.

60M.Masternaketal.,“GrowthHormone,Inflammation,andAging,”PathobiologyofAgingandAge-RelatedDiseases(2012):2.doi:10.3402/pba.v2i0.17293.

61“TopicsofInterest:CalorieRestriction,”NationalInstituteonAging,nia.nih.gov/newsroom/topics/calorie-restriction.

62J.Woodsetal.,“Exercise,Inflammation,andAging,”AgingandDisease3,no.1(February2012):130–40.

63“CoenzymeQ10,”MayoClinic,2014,mayoclinic.org/drugs-supplements/coenzyme-q10/background/hrb-20059019.

64Ibid.

CHAPTER71N.Khansarietal.,“ChronicInflammationandOxidativeStressasaMajorCauseofAge-RelatedDiseasesandCancer,”RecentPatentsonInflammationandAllergyDrugDiscovery3,no.1(January2009):73–80.

2“BeyondAllergensandTriggers:GettingtotheRootCauseofAllergiesandAsthma,”TotalHealthMagazine,April2009,totalhealthmagazine.com/articles/allergies-asthma/beyond-allergens-and-triggers-getting-to-the-root-cause-of-allergiesand-asthma.xhtml.

3“Euphrasia/Eyebright,”Herbwisdom.com,2014,herbwisdom.com/herb-euphrasia.xhtml.4M.Gurvenetal.,“AgingandInflammationinTwoEpidemiologicalWorlds,”JournalsofGerontologySeriesA:BiologicalSciencesandMedicalSciences63,no.2(February2008):196–99.

5D.Johnson,TheOptimalHealthRevolution(Dallas:BenBellaBooks,2009),38,39.6“WhatisaCReactiveProtein(CRP)BloodTest?”MDJunction,May2014,mdjunction.com/forums/chronic-pain-discussions/general-support/247023-what-is-a-creactive-protein-crp-blood-test.

7M.Gurvenetal.,“AgingandInflammationinTwoEpidemiologicalWorlds,”JournalsofGerontologySeriesA:BiologicalSciencesandMedicalSciences63,no.2(February2008):196–99.

8Ibid.

9Ibid.10Ibid.11A.Bhatnagaretal.,“StudyingMechanisticLinksbetweenPollutionandHeartDisease,”CirculationResearch99(2006):692–705.

12“ObesityandOverweight,”CentersforDiseaseControlandPrevention,May2014,cdc.gov/nchs/fastats/obesity-overweight.htm.

13Ibid.14“OverweightandObesityStatisticalFactSheet2013,”AmericanHeartAssociation,

heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319588.pdf.15A.Ruperezetal.,“GeneticsofOxidativeStressinObesity,”InternationalJournalofMolecularSciences15,no.2(February20,2014):3118–44.doi:10.3390/ijms15023118.

16G.W.Canonica,“MinimalPersistentInflammationinAllergicRhinitis:ImplicationsforCurrentTreatmentStrategies,”ClinicalandExperimentalImmunology158,no.3(December2009):260–71.doi:10.1111/j.1365-2249.2009.04017.x.

17“Allergies,Inflammation,andWeightControl,”FoodAllergyResearchandEducation,2011,foodallergy.org/inflammation.xhtml.

18Ibid.19Ibid.20Ibid.21“WhatisMetabolicSyndrome?”NationalHeart,Lung,andBloodInstitute,November2011,

nhlbi.nih.gov/health/health-topics/topics/ms/.22“PhysicalActivityandHypokineticDisease,”WesternWashingtonUniversity,

wwu.edu/depts/healthyliving/PE511info/infection/Diseases.xhtml.23“HeartDisease,”CentersforDiseaseControlandPrevention,May2014,cdc.gov/nchs/fastats/heart-

disease.htm.24“InflammationandHeartDisease,”AmericanHeartAssociation,September2013,

heart.org/HEARTORG/Conditions/Inflammation-and-Heart-Disease_UCM_432150_Article.jsp.25“WhatisAtherosclerosis?”NationalHeart,Lung,andBloodInstitute,July2011,

nhlbi.nih.gov/health/health-topics/topics/atherosclerosis/.26“InflammationandHeartDisease,”AmericanHeartAssociation,September2013,

heart.org/HEARTORG/Conditions/Inflammation-and-Heart-Disease_UCM_432150_Article.jsp.27Ibid.28J.Kimetal.,“RelationbetweenCommonAllergicSymptomsandCoronaryHeartDiseaseamong

NHANESIIIParticipants,”AmericanJournalofCardiology106,no.7(October1,2010):984–87.doi:10.1016/j.amjcard.2010.05.029.

29B.Ozben,“TheRoleofInflammationandAllergyinAcuteCoronarySyndromes,”InflammationandAllergy-DrugTargets7,no.3(September2008):136–44.

30“TheFactsaboutDiabetes:ALeadingCauseofDeathintheUS,”NationalDiabetesEducationProgram,ndep.nih.gov/diabetes-facts/.

31H.Cucaketal.,“MacrophageContactDependentandIndependentTLR4MechanismsInduceβ-CellDysfunctionandApoptosisinaMouseModelofType2Diabetes,”PLOSONE9,no.3(March3,2014):e90685.doi:10.1371/journal.pone.0090685.

32C.B.Nemeroffetal.,“DifferentialResponsestoPsychotherapyversusPharmacotherapyinPatientswithChronicFormsofMajorDepressionandChildhoodTrauma,”ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica100,no.24(November25,2003):14293–96.

33“VitaminC(Ascorbicacid),”UniversityofMarylandMedicalCenter,June2013,umm.edu/health/medical/altmed/supplement/vitamin-c-ascorbic-acid.

34P.S.Marshalletal.,“EffectsofSeasonalAllergicRhinitisonFatigueLevelsandMood,”PsychosomaticMedicine64,no.4(July–August2002):684–91.

35J.Engelman,“Cytokines—AMissingLinkinInternalDiseases?”2006,serendip.brynmawr.edu/bb/neuro/neuro06/web1/jengelman.xhtml.

36S.M.Collinsetal.,“ThePutativeRoleofInflammationintheIrritableBowelSyndrome,”Gut49(2001):743–745.doi:10.1136/gut.49.6.743.

37“WhatIsIrritableBowelDisease?”Everydayhealth.com,2014,everydayhealth.com/digestive-health/ibs/index.aspx.

38S.M.Collinsetal.,“ThePutativeRoleofInflammationintheIrritableBowelSyndrome,”Gut49(2001):743–745.doi:10.1136/gut.49.6.743.

39E.Isolaurietal.,“FoodAllergyinIrritableBowelSyndrome:NewFactsandOldFallacies,”Gut53,no.10(October2004):1391–93.

40M.C.Tobinetal.,“AtopicIrritableBowelSyndrome:ANovelSubgroupofIrritableBowelSyndromewithAllergicManifestations,”AnnalsofAllergy,Asthma,andImmunology100,no.1(January2008):49–53.doi:10.1016/S1081-1206(10)60404-8.

41S.Rakoff-Nahoum,“WhyCancerandInflammation?”YaleJournalofBiologyandMedicine79,no.3–4(December2006):123–30.

42S.Seethaler,“MolecularLinkbetweenInflammationandCancerDiscovered,”UniversityofCalifornia,SanDiego,January2007,ucsdnews.ucsd.edu/archive/newsrel/science/cancer07.asp.

43D.H.Josephsetal.,“EpidemiologicalAssociationsofAllergy,IgE,andCancer,”ClinicalandExperimentalAllergy43,no.10(October2013):1110-23.doi:10.1111/cea.12178.

CHAPTER8

1“StressedinAmerica,”AmericanPsychologicalAssociation,2011,apa.orgmonitor201101/stressed-america.aspx.

2N.Vogelzangsetal.,“AnxietyDisordersandInflammationinaLargeAdultCohort,”TranslationalPsychiatry3(April23,2013):e249.doi:10.1038/tp.2013.27.

3B.Sears,“AnxietyandOmega-3FattyAcids,”Psychologytoday.com,January2012,psychologytoday.com/blog/in-the-zone/201201/anxiety-and-omega-3-fatty-acids.

4Ibid.5“WhatIsAnxietyDisorder?”NationalInstituteofMentalHealth,nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.

6B.Sears,“AnxietyandOmega-3FattyAcids,”Psychologytoday.com,January2012,psychologytoday.com/blog/in-the-zone/201201/anxiety-and-omega-3-fatty-acids.

7“WhatIsDepression?”NationalInstituteofMentalHealth,nimh.nih.gov/health/publications/depression/index.shtml.

8B.Sears,“AnxietyandOmega-3FattyAcids,”Psychologytoday.com,January2012,psychologytoday.com/blog/in-the-zone/201201/anxiety-and-omega-3-fatty-acids.

9“Q&AonStressforAdults:HowItAffectsYourHealthandWhatYouCanDoaboutIt,”NationalInstituteofMentalHealth,nimh.nih.gov/health/publications/stress/index.shtml.

10Ibid.11“StressedinAmerica,”AmericanPsychologicalAssociation,2011,apa.orgmonitor201101/stressed-

america.aspx.12N.Volgelzangsetal.,“AnxietyDisordersandInflammationinaLargeAdultCohort,”TranslationalPsychiatry3(April23,2013):e249.doi:10.1038/tp.2013.27.

13W.Cole,“IsYourMoodSufferingbecauseYourBrainIsInflamed?”Mindbodygreen.com,December2013,mindbodygreen.com/0-12037/is-your-mood-suffering-because-your-brain-is-inflamed.xhtml.

14B.Sears,“AnxietyandOmega-3FattyAcids,”PsychologyToday,January2012,psychologytoday.com/blog/in-the-zone/201201/anxiety-and-omega-3-fatty-acids.

15N.D.Powelletal.,“SocialStressUp-RegulatesInflammatoryGeneExpressionintheLeukocyteTranscriptomeviaβ-AdrenergicInductionofMyelopoiesis,”ProceedingsoftheNationalAcademyofSciences110,no.41(October8,2013):16574-9.doi:10.1073/pnas.1310655110.

16Ibid.17“EffectsofChronicStressCanBeTracedtoYourGenes,”OhioStateUniversity,November2013,

researchnews.osu.edu/archive/stressgenes.htm.18Ibid.19N.D.Powelletal.,“SocialStressUp-RegulatesInflammatoryGeneExpressionintheLeukocyte

Transcriptomeviaβ-AdrenergicInductionofMyelopoiesis,”ProceedingsoftheNationalAcademyofSciences110,no.41(October8,2013):16574-9.doi:10.1073/pnas.1310655110.

20“EffectsofChronicStressCanbeTracedtoYourGenes,”OhioStateUniversity,November2013,researchnews.osu.edu/archive/stressgenes.htm.

21S.Cohenetal.,“ChronicStress,GlucocorticoidReceptorResistance,Inflammation,andDiseaseRisk,”ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica109,no.16(April17,2012):5995–99.doi:10.1073/pnas.1118355109.

22Ibid.23Ibid.24“HowStressInfluencesDisease:StudyRevealsInflammationastheCulprit,”CarnegieMellon

University,April2012,sciencedaily.com/releases/2012/04/120402162546.htm.25S.Cohenetal.,“ChronicStress,GlucocorticoidReceptorResistance,Inflammation,andDiseaseRisk,”ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica109,no.16(April17,2012):5995–99.doi:10.1073/pnas.1118355109.

26“HowStressInfluencesDisease:StudyRevealsInflammationastheCulprit,”CarnegieMellonUniversity,April2012,sciencedaily.com/releases/2012/04/120402162546.htm.

27“WomenandDepression,”NationalAllianceonMentalIllness,October2009,nami.org/Template.cfm?Section=Women_and_Depression&Template=/ContentManagement/ContentDisplay.cfm&ContentID=89194

28N.Vogelzangsetal.,“AnxietyDisordersandInflammationinaLargeAdultCohort,”TranslationalPsychiatry3(April23,2013):e249.doi:10.1038/tp.2013.27.

29M.Danneretal.,“AssociationbetweenDepressionandElevatedCReactiveProtein,”PsychosomaticMedicine65,no.3(May–June2003):347–56.

30S.Tokeretal.,“TheAssociationbetweenBurnout,Depression,Anxiety,andInflammationBiomarkers:CReactiveProteinandFibrinogeninMenandWomen,”JournalofOccupationalHealthPsychology10,no4(October2005):344–62.

31N.Vogelzangsetal.,“AnxietyDisordersandInflammationinaLargeAdultCohort,”TranslationalPsychiatry3(April23,2013):e249.doi:10.1038/tp.2013.27.

32“DwellingonStressfulEventsCanIncreaseInflammationintheBody,StudyFinds,”OhioUniversity,March2013,ohio.edu/research/communications/zoccola.cfm.

33D.Johnson,TheOptimalHealthRevolution(Dallas:BenBellaBooks,2009),24.34“DwellingonStressfulEventsCanIncreaseInflammationintheBody,StudyFinds,”OhioUniversity,

March2013,ohio.edu/research/communications/zoccola.cfm.35“DepressionIncreasesStressInflammationResponse,”FuturePundit,September2006,

futurepundit.com/archives/003698.xhtml.36J.Barthetal.,“DepressionAsaRiskFactorforMortalityinPatientswithCoronaryHeartDisease:A

Meta-Analysis,”PsychosomaticMedicine66,no.6(November–December2004):802–13.37R.Sansoneetal.,“AllergicRhinitis:RelationshipswithAnxietyandMoodSyndromes,”InnovationsinClinicalNeuroscience8,no.7(July2011):12–17.

38“VitaminB6(Pyridoxine),”UniversityofMarylandMedicalCenter,June2013,umm.edu/health/medical/altmed/supplement/vitamin-b6-pyridoxine.

39Ibid.40A.M.Hvasetal.,“VitaminB6LevelisAssociatedwithSymptomsofDepression,”PsychotherapyandPsychosomatics73,no.6(November–December2004):340–43.

41R.Sansoneetal.,“AllergicRhinitis:RelationshipswithAnxietyandMoodSyndromes,”InnovationsinClinicalNeuroscience8,no.7(July2011):12–17.

42M.Alevizos,“StressTriggersCoronaryMastCellsLeadingtoCardiacEvents,”AnnalsofAllergy,Asthma&Immunology112,no.4(April2014):309–16.doi:10.1016/j.anai.2013.09.017.

43R.Sansoneetal.,“AllergicRhinitis:RelationshipswithAnxietyandMoodSyndromes,”Innovationsin

ClinicalNeuroscience8,no.7(July2011):12–17.44Ibid.45B.Cuffeletal.,“EconomicConsequencesofComorbidDepression,Anxiety,andAllergicRhinitis,”Psychosomatics40,no.6(November–December1999):491–96.

46S.B.Pattenetal.,“AllergiesandMajorDepression:ALongitudinalCommunityStudy,”BiopsychosocialMedicine3(January26,2009):3.doi:10.1186/1751-0759-3-3.

47E.Gadaetal.,“TheRelationshipbetweenAsthmaandSelf-ReportedAnxietyinaPredominantlyHealthyAdultPopulation,”AnnalsofAllergy,Asthma,andImmunology112,no.4(April2014):329–32.doi:10.1016/j.anai.2013.08.027.

48B.Sears,“AnxietyandOmega-3FattyAcids,”Psychologytoday.com,January2012,psychologytoday.com/blog/in-the-zone/201201/anxiety-and-omega-3-fatty-acids.

49Ibid.50L.Buydens-Brancheyetal.,“AssociationsbetweenIncreasesinPlasman-3PolyunsaturatedFattyAcids

FollowingSupplementationandDecreasesinAngerandAnxietyinSubstanceAbusers,”ProgressinNeuro-PsychopharmacologyandBiologicalPsychiatry32,no.2(February15,2008):568–75.

51F.Lespéranceetal.,“TheEfficacyofOmega-3SupplementationforMajorDepression:ARandomizedControlledTrial,”JournalofClinicalPsychiatry72,no.8(August2011):1054–62.doi:10.4088/JCP.10m05966blu.

52Y.Osheretal.,“Omega-3FattyAcidsinDepression:AReviewofThreeStudies.”CNSNeuroscienceandTherapeutics15,no.2(Summer2009):128–33.

53J.K.Kiecolt-Glaseretal.,“Omega-3SupplementationLowersInflammationandAnxietyinMedicalStudents:ARandomizedControlledTrial,”Brain,Behavior,andImmunity25,no.8(November2011):1725–34.doi:10.1016/j.bbi.2011.07.229.

54Ibid.55J.K.Kiecolt-Glaseretal.,“Omega-3SupplementationLowersInflammationandAnxietyinMedical

Students:ARandomizedControlledTrial,”Brain,Behavior,andImmunity25,no.8(November2011):1725–34.doi:10.1016/j.bbi.2011.07.229.

56“ImpactofStress,”AmericanPsychologicalAssociation,2012,apa.org/news/press/releases/stress/2012/impact.aspx.

57“InsomniaInformation”,StanfordUniversity,1999,stanford.edu/~dement/insomnia.xhtml.58“ExtentandHealthConsequencesofChronicSleepLossandSleepDisorders,”NationalInstitutesof

Health,2006,ncbi.nlm.nih.gov/books/NBK19961/.59Ibid.60W.Cole,“IsYourMoodSufferingbecauseYourBrainisInflamed?”Mindbodygreen.com,December

2013,mindbodygreen.com/0-12037/is-your-mood-suffering-because-your-brain-is-inflamed.xhtml.61G.Tett,“Stressed?It’stheNewNormal.”FTMagazine,January27,2012.FT.com/cms/s/2/18cc0240-

47cc-11e1-b646-00144feabdc0.xhtml#axzz3G2VP1g08.62D.Johnson,TheOptimalHealthRevolution,(Dallas:BenBellaBooks,2009),24.63J.K.Kiecolt-Glaseretal.,“Omega-3SupplementationLowersInflammationandAnxietyinMedical

Students:ARandomizedControlledTrial,”Brain,Behavior,andImmunity25,no.8(November2011):1725–34.doi:10.1016/j.bbi.2011.07.229.

CHAPTER91M.Edelson,“TakeTwoCarrotsandCallMeintheMorning,”HopkinsMedicine,Winter2010,hopkinsmedicine.org/hmn/w10/feature2.cfm.

2S.Bunyavanichetal.,“Peanut,Milk,andWheatIntakeduringPregnancyIsAssociatedwithReducedAllergyandAsthmainChildren,”JournalofAllergyandClinicalImmunology133,no.5(May2014):1373–82.doi:10.1016/j.jaci.2013.11.040.

3B.Nwaruetal.,“MaternalIntakeofFattyAcidsduringPregnancyandAllergiesintheOffspring,”BritishJournalofNutrition108,no.4(August2012):720–32.doi:10.1017/S0007114511005940.

4C.Ronduitetal.,“IncreasedFoodDiversityintheFirstYearofLifeIsInverselyAssociatedwith

AllergicDiseases,”JournalofAllergyandClinicalImmunology133,no.4(April2014):1056–64.doi:10.1016/j.jaci.2013.12.1044.

5“Allergies,Inflammation,andWeightControl,”FoodAllergyandResearchEducation,2011,foodallergy.org/inflammation.xhtml.

6“NonalcoholicSteatohepatitis,”NationalDigestiveDiseasesInformationClearinghouse,May2014,digestive.niddk.nih.gov/ddiseases/pubs/nash/.

7M.Covington,“Omega-3FattyAcids,”AmericanFamilyPhysician70,no.1(July1,2004):133–140.8“Licorice,”UniversityofMarylandMedicalCenter,May2013,umm.edu/health/medical/altmed/herb/licorice.

9Ibid.10M.Saeedietal.,“TheTreatmentofAtopicDermatitiswithLicoriceGel,”JournalofDermatologicalTreatment14,no.3(September2003):153–57.

11“BalancingOmega-3andOmega-6?,”Dr.Weil.com,February2007,drweil.com/drw/u/QAA400149/balancing-omega-3-and-omega-6.xhtml.

12Ibid.13Ibid.14M.Edelson,“TakeTwoCarrotsandCallMeintheMorning,”HopkinsMedicine,Winter2010,

hopkinsmedicine.org/hmn/w10/feature2.cfm.15Ibid.16Ibid.17Ibid.18“TheBenefitsofBerries,”ArthritisFoundation,2014,arthritistoday.org/what-you-can-do/eating-

well/benefits-of-eating-well/berries-benefits.php.19“DarkGreenLeafyVegetables,”UnitedStatesDepartmentofAgriculture,March2013,

ars.usda.gov/News/docs.htm?docid=23199.20“ORAC:ScoringAntioxidants?”Dr.Weil.com,December2010,drweil.com/drw/u/QAA400852/ORAC-

Scoring-Antioxidants.xhtml.21D.Reilly,“IsHomoeopathyaPlaceboResponse?ControlledTrialofHomoeopathicPotency,with

PolleninHayfeverasModel,”TheLancet(October18,1986):885.22Ibid.23“Bromelain,”AmericanCancerSociety,April2011,

cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/bromelain24“ResearchersSayTartCherriesHave‘TheHighestAnti-InflammatoryContentofAnyFood,’”May

2012,eurekalert.org/pub_releases/2012-05/wsw-rst052912.php.25E.A.Drokeetal.,“SoyIsoflavonesAvertChronicInflammation-InducedBoneLossandVascular

Disease,”JournalofInflammation4(September7,2007):17.26J.Salas-Salvado,“TheEffectofNutsonInflammation,”AsiaPacificJournalofClinicalNutrition17,

sup.1(2008):333–36.27“OliveOilReducesInflammation,”ArthritisFoundation,2014,arthritistoday.org/what-you-can-

do/eating-well/arthritis-diet/olive-oil-inflammation.php.28Ibid.29L.Lucasetal.,“MolecularMechanismsofInflammation.Anti-InflammatoryBenefitsofVirginOlive

OilandthePhenolicCompoundOleocanthal,”CurrentPharmaceuticalDesign17,no.8(2011):754–68.

30J.H.Shinetal.,“Short-TermHeatingReducestheAnti-InflammatoryEffectsofFreshRawGarlicExtractsontheLPS-InducedProductionofNOandPro-InflammatoryCytokinesbyDownregulatingAllicinActivityinRAW264.7Macrophages,”FoodandChemicalToxicology58(August2013):545–51.doi:10.1016/j.fct.2013.04.002.

31R.Grzannaetal.,“Ginger—AnHerbalMedicinalProductwithBroadAnti-InflammatoryActions,”JournalofMedicinalFood8,no.2(Summer2005):125–32.

32Y.Fuetal.,“CurcuminAttenuatesInflammatoryResponsesbySuppressingTLR4-MediatedNF-κB

SignalingPathwayinLipopolysaccharide-InducedMastitisinMice,”InternationalImmunopharmacology20,no.1(May2014):54–58.doi:10.1016/j.intimp.2014.01.024.

33N.S.Mashhadietal.,“InfluenceofGingerandCinnamonIntakeonInflammationandMuscleSorenessEnduedbyExerciseinIranianFemaleAthletes,”InternationalJournalofPreventiveMedicine4,sup.1(April2013):S11–15.

34J.K.Kiecolt-Glaseretal.,“DepressiveSymptoms,Omega-6:Omega-3FattyAcids,andInflammationinOlderAdults,”PsychosomaticMedicine69,no.3(April2007):217–24.

35“FoodsThatFightInflammation,”ArthritisFoundation,2014,arthritistoday.org/what-you-can-do/eating-well/arthritis-diet/eat-to-beat-inflammation.php.

36M.Edelson,“TakeTwoCarrotsandCallMeintheMorning,”HopkinsMedicine,Winter2010,hopkinsmedicine.org/hmn/w10/feature2.cfm.

37“FructoseAttacksYourLiverLikeAlcohol—IsThisWhat’sMakingYouFlabbyandSick?”May2012,articles.mercola.com/sites/articles/archive/2012/05/07/the-sweetener-that-is-more-dangerous-than-alcohol.aspx.

38Ibid.39H.Parker,“ASweetProblem:PrincetonResearchersFindThatHigh-FructoseCornSyrupPrompts

ConsiderablyMoreWeightGain,”NewsatPrinceton,March2010,princeton.edu/main/news/archive/S26/91/22K07/.

40Ibid.41Ibid.42Ibid.43“FructoseAttacksYourLiverLikeAlcohol—IsThisWhat’sMakingYouFlabbyandSick?”May2012,

articles.mercola.com/sites/articles/archive/2012/05/07/the-sweetener-that-is-more-dangerous-than-alcohol.aspx.

44I.Aeberlietal.,“LowtoModerateSugar-SweetenedBeverageConsumptionImpairsGlucoseandLipidMetabolismandPromotesInflammationinHealthyYoungMen:ARandomizedControlledTrial,”AmericanJournalofClinicalNutrition94,no.2(August2011):479–85.doi:10.3945/ajcn.111.013540.

45“WhatYouEatCanFuelorCoolInflammation,aKeyDriverofHeartDisease,Diabetes,andOtherChronicConditions,”TheHarvardMedicalSchoolFamilyHealthGuide,February2007,health.harvard.edu/fhg/updates/What-you-eat-can-fuel-or-cool-inflammation-a-key-driver-of-heart-disease-diabetes-and-other-chronic-conditions.shtml.

46A.Buykenetal.,“CarbohydrateNutritionandInflammatoryDiseaseMortalityinOlderAdults,”AmericanJournalofClinicalNutrition92,no.3(September2010):634–43.

47Y.Nakanishietal.,“MonosodiumGlutamate(MSG):AVillainandPromoterofLiverInflammationandDysplasia,”JournalofAutoimmunity30,no.1–2(February–March2008):42–50.doi:10.1016/j.jaut.2007.11.016.

48A.K.Baueretal.,“ButylatedHydroxytoluene(BHT)InductionofPulmonaryInflammation:ARoleinTumorPromotion,”ExperimentalLungResearch27,no.3(April–May2001):197–216.

49“IronRichFoods,”AmericanRedCross,2014,redcrossblood.org/learn-about-blood/health-and-wellness/iron-rich-foods.

50M.Edelson,“TakeTwoCarrotsandCallMeintheMorning,”HopkinsMedicine,Winter2010,hopkinsmedicine.org/hmn/w10/feature2.cfm.

51Ibid.52Ibid.53Ibid.54S.YeagerandtheeditorsofPrevention,TheDoctorsBookofFoodRemedies(Emmaus,PA:Rodale

Inc.,2008).55Ibid.56V.Konakovsky,.“LevelsofHistamineandOtherBiogenicAminesinHigh-QualityRedWines,”FoodAdditivesandContaminants:PartA:Chemistry,Analysis,Control,Exposure,andRiskAssessment28,no.4(April2011):408–16.doi:10.1080/19440049.2010.551421.

57S.YeagerandtheeditorsofPrevention,TheDoctorsBookofFoodRemedies(Emmaus,PA:RodaleInc.,2008).

CHAPTER101“ObesityandOverweight,”CentersforDiseaseControlandPrevention,May2014,cdc.gov/nchs/fastats/obesity-overweight.htm.

2“Obesity,”NationalInstitutesofHealth,MedlinePlus.com,May2014,nlm.nih.gov/medlineplus/obesity.xhtml.

3Ibid.4Ibid.5Ibid.6“BMI,”CentersforDiseaseControlandPrevention,December2013,cdc.gov/healthyweight/assessing/bmi/index.xhtml.

7F.Huang,“EndothelialActivationandSystemicInflammationinObeseAsthmaticChildren,”AllergyandAsthmaProceedings29,no.5(September–October2008):453–60.doi:10.2500/aap.2008.29.3149.

8M.Schatz,“Overweight/ObesityandRiskofSeasonalAsthmaExacerbations,”JournalofAllergyandClinicalImmunology1,no.6(November–December2013):618–22.doi:10.1016/j.jaip.2013.07.009.

9S.Baumann,“Obesity—APromoterofAllergy?”InternationalArchivesofAllergyandImmunology162,no.3(2013):205–13.doi:10.1159/000353972.

10“AdultBMICalculator:English,”CentersforDiseaseControlandPrevention,May2011,cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.xhtml.

11Ibid.12“MediterraneanDiet,”NationalInstitutesofHealth,MedlinePlus.com,May2014,

nlm.nih.gov/medlineplus/ency/patientinstructions/000110.htm.13L.Chatzietal.,“ProtectiveEffectofFruits,Vegetables,andtheMediterraneanDietonAsthmaand

AllergiesamongChildreninCrete,”Thorax62(2007):677–83.doi:10.1136/thx.2006.069419.14Ibid.15Ibid.16D.Grigoropoulou,“UrbanEnvironmentAdherencetotheMediterraneanDietandPrevalenceofAsthma

Symptomsamong10-to12-Year-OldChildren:ThePhysicalActivity,Nutrition,andAllergiesinChildrenExaminedinAthensStudy,”AllergyandAsthmaProceedings32,no.5(September–October2011):351–58.doi:10.2500/aap.2011.32.3463.

17P.Sextonetal.,“InfluenceofMediterraneanDietonAsthmaSymptoms,LungFunction,andSystemicInflammation:ARandomizedControlledTrial,”JournalofAsthma50,no.1(February2013):75–81.doi:10.3109/02770903.2012.740120.

18D.Sewelletal.,“InvestigatingtheEffectivenessoftheMediterraneanDietinPregnantWomenforthePrimaryPreventionofAsthmaandAllergyinHigh-RiskInfants:ProtocolforaPilotRandomisedControlledTrial,”JournalofAnimalScienceandBiotechnology14(2013):173.doi:10.1186/1745-6215-14-173.

19L.Chatzietal.,“MediterraneanDietinPregnancyIsProtectiveforWheezeandAtopyinChildhood,”Thorax63,no.6(June2008):507–13.doi:10.1136/thx.2007.081745.

20S.YeagerandtheeditorsofPrevention,TheDoctor’sBookofFoodRemedies(Emmaus,PA:RodaleInc.,2008).

21Ibid.22“VitaminC,”NationalInstitutesofHealth,MedlinePlus.com,February2013,

nlm.nih.gov/medlineplus/ency/article/002404.htm.23“GMOAlert:Top10GeneticallyModifiedFoodstoAvoidEating,”May2012,

naturalnews.com/035734_GMOs_foods_dangers.xhtml.24E.R.Secor,Jr.,etal.,“BromelainLimitsAirwayInflammationinanOvalbumin-InducedMurineModel

ofEstablishedAsthma,”AlternativeTherapiesinHealthandMedicine18,no.5(September–October2012):9–17.

25“GMOAlert:Top10GeneticallyModifiedFoodstoAvoidEating,”May2012,naturalnews.com/035734_GMOs_foods_dangers.xhtml.

26D.Herberetal.,“Sulforaphane-RichBroccoliSproutExtractAttenuatesNasalAllergicResponsetoDieselExhaustParticles,”FoodandFunction5,no.1(January2014):35–41.doi:10.1039/c3fo60277j.

27S.Y.Hanetal.,“ResveratrolInhibitsIgE-MediatedBasophilicMastCellDegranulationandPassiveCutaneousAnaphylaxisinMice,”JournalofNutrition143,no.5(May2013):632–39.doi:10.3945/jn.112.173302.

28L.C.Hazelwoodetal.,“DietaryLycopeneSupplementationSuppressesTh2ResponsesandLungEosinophiliainaMouseModelofAllergicAsthma,”JournalofNutritionalBiochemistry22,no.1(January2011):95–100.doi:10.1016/j.jnutbio.2009.12.003.

29G.Riccioni,.“PlasmaLycopeneandAntioxidantVitaminsinAsthma:ThePLAVAStudy,”JournalofAsthma44,no.6(July–August2007):429–32.

30S.Baumann,“Obesity—APromoterofAllergy?”InternationalArchivesofAllergyandImmunology162,no.3(2013):205–13.doi:10.1159/000353972.

31C.M.Clemensetal.,“TheEffectofPerinatalOmega-3FattyAcidSupplementationonInflammatoryMarkersandAllergicDiseases:ASystematicReview,”BJOG118,no.8(July2011):916–25.doi:10.1111/j.1471-0528.2010.02846.x.

32“WhatYouNeedtoKnowaboutMercuryinFishandShellfish,”UnitedStatesEnvironmentalProtectionAgency,November2013,water.epa.gov/scitech/swguidance/fishshellfish/outreach/advice_index.cfm.

33R.Barrosetal.,“DietaryIntakeofα-LinolenicAcidandLowRatioofn-6:n-3PUFAareAssociatedwithDecreasedExhaledNOandImprovedAsthmaControl,”BritishJournalofNutrition106,no.3(August2011):441–50.doi:10.1017/S0007114511000328.

34“WhatIstheRecommendedIntakeofDHA+EPAperDay?”DHAEPAInstitute,2013,dhaomega3.org/FAQ/WHat-is-the-recommended-intake-of-DHA+EPA-per-day.

35“OliveOilReducesInflammation,”ArthritisFoundation,2014,arthritistoday.org/what-you-can-do/eating-well/arthritis-diet/olive-oil-inflammation.php.

36“HowtoChooseaQualityOliveOil,”Dr.Weil.com,2014,drweil.com/drw/u/ART02970/Olive-Oil.xhtml.

37“12ThingsYouShouldn’tBeCookingwithOliveOil,”BuzzFeedFood,August2013,buzzfeed.com/christinebyrne/things-you-shouldnt-be-cooking-with-olive-oil?bffbfood#1t5duqn.

38M.Edelson,“TakeTwoCarrotsandCallMeintheMorning,”HopkinsMedicine,Winter2010,hopkinsmedicine.org/hmn/w10/feature2.cfm.

39“CanAntioxidantsinFruitsandVegetablesProtectYourHeart?”AmericanHeartAssociation,February2014,heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Can-antioxidants-in-fruits-and-vegetables-protect-you-and-your-heart_UCM_454424_Article.jsp.

40S.YeagerandtheeditorsofPrevention,TheDoctor’sBookofFoodRemedies(Emmaus,PA:RodaleInc.,2008).

41NaturopathicFamilyCareNewsMarchNewsletter,February24,2009,naturopathicfamilycare.blogspot.com/2009/02/nfc-march-newsletter.xhtml.

42S.Bushwick,“Fiber-MunchingMiceAvoidAsthma,”ScientificAmerican,January2014,scientificamerican.com/podcast/episode/fiber-munching-mice-avoid-asthma-14-01-08/.

43S.YeagerandtheeditorsofPrevention,TheDoctor’sBookofFoodRemedies(Emmaus,PA:RodaleInc.,2008).

44J.Brusco,“WhatFoodsMixedwithLentilsProvideaCompleteSourceofAminoAcids?”SFGate,healthyeating.sfgate.com/foods-mixed-lentils-provide-complete-source-amino-acids-1195.xhtml.

45“GeneticallyEngineeredFoods,”TheNationalInstitutesofHealth,MedlinePlus.com,May2014,nlm.nih.gov/medlineplus/ency/article/002432.htm.

46Ibid.47Ibid.48“GMOAlert:Top10GeneticallyModifiedFoodstoAvoidEating,”May2012,

naturalnews.com/035734_GMOs_foods_dangers.xhtml.49B.Buchanan,“GeneticEngineeringandtheAllergyIssue,”PlantPhysiology126,no.1(May2001):5–

7.plantphysiol.org/content/126/1/5.full.50EWG’sShopper’sGuidetoPesticidesinProduce.ewg.org/foodnews/summary.php.51B.Björkstén,“EvidenceofProbioticsinPreventionofAllergyandAsthma,”CurrentDrugTargets—InflammationandAllergy4,no.5(October2005):599–604.

52“TheAllergicMarch,”WorldAllergyOrganization,September2007,worldallergy.org/professional/allergic_diseases_center/allergic_march/.

53“TheInternationalScientificForumonHomeHygiene.ActivityReview2013,”HomeHygieneandHealth,February2013,ifh-homehygiene.org/public-leaflet/international-scientific-forum-home-hygiene-activity-review-2013.

54M.Kuitunen,“ProbioticsandPrebioticsinPreventingFoodAllergyandEczema,”CurrentOpinioninAllergyandClinicalImmunology13,no.3(June2013):280–86.doi:10.1097/ACI.0b013e328360ed66.

55I.Eliaz,“AreYouChronicallyDehydrated?”RodaleNews,August2012,rodalenews.com/chronic-dehydration.

56Ibid.57ibid.58Ibid.59NaturopathicFamilyCareNews,February2010,

naturopathicfamilycare.blogspot.com/2010_02_01_archive.xhtml60I.Eliaz,“AreYouChronicallyDehydrated?”RodaleNews,August2012,rodalenews.com/chronic-

dehydration.61Ibid.62G.P.Curatola,“TopTipstoSmilethroughSpringAllergySeason!”TheDr.OzShow,April2011,

doctoroz.com/blog/gerald-p-curatola-dds/top-tips-smile-through-spring-allergy-season.63I.Eliaz,“AreYouChronicallyDehydrated?”RodaleNews,August2012,rodalenews.com/chronic-

dehydration.64T.Harlan,“WhatCanISubstituteforFishandShellfish,ifIAmAllergictoThem?”AskDr.Gourmet,

drgourmet.com/askdrgourmet/foods/fishsubstitute.shtml#.VDL-c2d0y70.

CHAPTER11

1K.McCoy,“VitaminsandSupplementsforAllergyTreatment:DoTheyWork?”Everydayhealth.com,October2012,everydayhealth.com/allergies/vitaminsand-supplements.aspx.

2R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).3Ibid.4Ibid.5J.M.Braun,“TherapeuticUse,Efficiency,andSafetyoftheProteolyticPineappleEnzymeBromelain-POSinChildrenwithAcuteSinusitisinGermany,”InVivo19,no.2(March–April2005):417–21.

6Ibid.7R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).8Ibid.9“VitaminB6(Pyridoxine),”UniversityofMarylandMedicalCenter,June2013,umm.edu/health/medical/altmed/supplement/vitamin-b6-pyridoxine.

10“VitaminB6,”NYULangoneMedicalCenter,August2013,med.nyu.edu/content?ChunkIID=21852#REF43.

11R.D.Reynoldsetal.,“DepressedPlasmaPyridoxalPhosphateConcentrationsinAdultAsthmatics,”AmericanJournalofClinicalNutrition41,no.4(April1985):684–88.

12L.Sakakeenyetal.,“PlasmaPyridoxal-5-PhosphateIsInverselyAssociatedwithSystemicMarkersofInflammationinaPopulationofUSAdults,”JournalofNutrition142,no.7(July2012):1280–85.doi:10.3945/jn.111.153056.

13H.Tsugeetal.,“EffectsofVitaminB-6on(n-3)PolyunsaturatedFattyAcidMetabolism,”JournalofNutrition130,no.2(February1,2000):333.

14“Pyridoxine(VitaminB6),”NationalInstitutesofHealth,MedlinePlus.com,July2011,nlm.nih.gov/medlineplus/druginfo/natural/934.xhtml.

15A.Bendichetal.,“VitaminB6SafetyIssues,”AnnalsoftheNewYorkAcademyofSciences585(1990):321–30.

16“VitaminB6(Pyridoxine),”UniversityofMarylandMedicalCenter,June2013,umm.edu/health/medical/altmed/supplement/vitamin-b6-pyridoxine.

17R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).18B.H.Theusenetal.,“Atopy,Asthma,andLungFunctioninRelationtoFolateandVitaminB(12)in

Adults,”Allergy65,no.11(November2010):1446–54.doi:10.1111/j.1398-9995.2010.02378.x.19B.Añíbarroetal.,“AsthmawithSulfiteIntoleranceinChildren:ABlockingStudywith

Cyanocobalamin,”JournalofAllergyandClinicalImmunology90,no.1(July1992):103–9.20R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).21“VitaminC(AscorbicAcid),”UniversityofMarylandMedicalCenter,June2013,

umm.edu/health/medical/altmed/supplement/vitamin-c-ascorbic-acid.22J.Galloway,“NaturalSolutionsLetYouBreatheDeeply,withoutSneezingorSideEffects,”The

AmericanAssociationofNaturopathicPhysicians,2012,naturopathic.org/pdf/757_111105934.pdf.23A.F.Hageletal.,“IntravenousInfusionofAscorbicAcidDecreasesSerumHistamineConcentrationsin

PatientswithAllergicandNonallergicDiseases,”Naunyn-Schmiedeberg’sArchivesofPharmacology386,no.9(September2013):789–93.doi:10.1007/s00210-013-0880-1.

24J.H.Seoetal.,“AssociationofAntioxidantswithAllergicRhinitisinChildrenfromSeoul,”Allergy,Asthma,andImmunologyResearch5,no.2(March2013):81–87.doi:10.4168/aair.2013.5.2.81.

25S.G.Wannametheeetal.,“AssociationsofVitaminCStatus,FruitandVegetableIntakes,andMarkersofInflammationandHemostasis,”AmericanJournalofClinicalNutrition83,no.3(March2006):567–74;quiz726–27.

26E.S.Fordetal.,“CReactiveProteinConcentrationandConcentrationsofBloodVitamins,Carotenoids,andSeleniumamongUnitedStatesAdults,”EuropeanJournalofClinicalNutrition57,no.9(September2003):1157–63.

27G.Blocketal.,“VitaminCTreatmentReducesElevatedCReactiveProtein,”FreeRadicalBiologyandMedicine46,no.1(January2009):70–77.doi:10.1016/j.freeradbiomed.2008.09.030.

28R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).29“3SupplementsforAllergies,”Prevention,November2011,prevention.com/health/health-concerns/3-

supplements-allergies.30A.Sataretal.,“PossibleWarfarinResistanceDuetoInteractionwithAscorbicAcid:CaseReportand

LiteratureReview,”AmericanJournalofHealth-SystemPharmacy70,no.9(May1,2013):782–86.doi:10.2146/ajhp110704.

31R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).32F.Gazdik,“LevelsofCoenzymeQ10inAsthmatics,”BratislavaMedicalJournal103,no.10(2002):

353–56.33R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).34A.Gvozdjákováetal.,“CoenzymeQ10SupplementationReducesCorticosteroidsDosageinPatients

withBronchialAsthma,”BioFactors25,no.1–4(2005):235–40.35E.Fabianetal.,“NutritionalSupplementsandPlasmaAntioxidantsinChildhoodAsthma,”WienerKlinischeWochenschrift125,no.11–12(June2013):309–15.doi:10.1007/s00508-013-0359-6.

36R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).37Ibid.38Ibid.39“FightAllergieswithVitaminE,”BastyrCenterforNaturalHealth,2014,

bastyrcenter.org/content/view/319/.40E.Shaharetal.,“EffectofVitaminESupplementationontheRegularTreatmentofSeasonalAllergic

Rhinitis,”AnnalsofAllergy,Asthma,andImmunology92,no.6(June2004):654–58.41R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).42“StudySuggestsVitaminEMayHelpPeoplewithAsthma,”NationalCenterforComplementaryand

AlternativeMedicine,July2008,nccam.nih.gov/research/results/spotlight/070208.htm.43T.Tsudukietal.,“Tocotrienol(UnsaturatedVitaminE)SuppressesDegranulationofMastCellsand

ReducesAllergicDermatitisinMice,”JournalofOleoScience62,no.10(2013):825–34.44R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).45Ibid.46Ibid.47Ibid.48N.L.Morseetal.,“AMeta-AnalysisofRandomized,Placebo-ControlledClinicalTrialsofEfamol

EveningPrimroseOilinAtopicEczema.WhereDoWeGofromHereinLightofMoreRecentDiscoveries?”CurrentPharmaceuticalBiotechnology7,no.6(December2006):503–24.

49D.Simonetal.,“Gamma-LinolenicAcidLevelsCorrelatewithClinicalEfficacyofEveningPrimroseOilinPatientswithAtopicDermatitis,”AdvancesinTherapy31,no.2(February2014):180–88.doi:10.1007/s12325-014-0093-0.

50R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).51Ibid.52Ibid.53Ibid.54“3SupplementsforAllergies,”Prevention,November2011,prevention.com/health/health-concerns/3-

supplements-allergies.55R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).56Ibid.57C.Cipollaetal.,“MagnesiumPidolateintheTreatmentofSeasonalAllergicRhinitis.Preliminary

Data,”MagnesiumResearch3,no.2(June1990):109–12.58R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).59J.Galloway,“NaturalSolutionsLetYouBreatheDeeply,withoutSneezingorSideEffects,”The

AmericanAssociationofNaturopathicPhysicians,2012,naturopathic.org/pdf/757_111105934.pdf.60B.Björkstén,“EvidenceofProbioticsinPreventionofAllergyandAsthma,”CurrentDrugTargets—InflammationandAllergy4,no.5(October2005):599–604.

61M.Kuitunen,“ProbioticsandPrebioticsinPreventingFoodAllergyandEczema,”CurrentOpinioninAllergyandClinicalImmunology13,no.3(June2013):280–86.doi:10.1097/ACI.0b013e328360ed66.

62“Pycnogenol,”TheNationalInstitutesofHealth,MedlinePlus.com,August2011,nlm.nih.gov/medlineplus/druginfo/natural/1019.xhtml.

63Ibid.64D.Wilsonetal.,“ARandomized,Double-Blind,Placebo-ControlledExploratoryStudytoEvaluatethe

PotentialofPycnogenolforImprovingAllergicRhinitisSymptoms,”PhytotherapyResearch24,no.8(August2010):1115–19.doi:10.1002/ptr.3232.

65I.S.Shinetal.,“InhibitoryEffectsofPycnogenol(FrenchMaritimePineBarkExtract)onAirwayInflammationinOvalbumin-InducedAllergicAsthma,”FoodandChemicalToxicology62(December2013):681–86.doi:10.1016/j.fct.2013.09.032.

66“Asthma,”UniversityofMarylandMedicalCenter,June2013,umm.edu/health/medical/altmed/condition/asthma.

67“Pycnogenol,”TheNationalInstitutesofHealth,MedlinePlus.com,August2011,nlm.nih.gov/medlineplus/druginfo/natural/1019.xhtml.

68Ibid.69R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).70Ibid.71M.Martinez-Losaetal.,“InhibitoryEffectsofN-AcetylcysteineontheFunctionalResponsesofHuman

EosinophilsinVitro,”ClinicalandExperimentalAllergy37,no.5(May2007):714–22.

72Ibid.73A.Nadeemetal.,“GlutathioneModulationduringSensitizationaswellasChallengePhaseRegulates

AirwayReactivityandInflammationinMouseModelofAllergicAsthma,”Biochimie103(August2014):61–70.doi:10.1016/j.biochi.2014.04.001.

74R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).75Ibid.76P.C.Calder,“n-3PolyunsaturatedFattyAcids,Inflammation,andInflammatoryDiseases,”AmericanJournalofClinicalNutrition83,sup.6(June2006):1505S–1519S.

77R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).78M.Covingtonetal.,“Omega-3FattyAcids,”AmericanFamilyPhysician70,no.1(July1,2004):133–

140.79S.Hoffetal.,“AllergicSensitisationandAllergicRhinitisAreAssociatedwithn-3Polyunsaturated

FattyAcidsintheDietandinRedBloodCellMembranes,”EuropeanJournalofClinicalNutrition59,no.9(September2005):1071–80.

80R.Kitzetal.,“Omega-3PolyunsaturatedFattyAcidsandBronchialInflammationinGrassPollenAllergyafterAllergenChallenge,”RespiratoryMedicine104,no.12(December2010):1793–98.doi:10.1016/j.rmed.2010.06.019.

81C.M.Klemensetal.,“TheEffectofPerinatalOmega-3FattyAcidSupplementationonInflammatoryMarkersandAllergicDiseases:ASystematicReview,”BJOG118,no.8(July2011):916–25.doi:10.1111/j.1471-0528.2010.02846.x.

82R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).83“WhatYouNeedtoKnowaboutMercuryinFishandShellfish,”UnitedStatesEnvironmental

ProtectionAgency,November2013,water.epa.gov/scitech/swguidance/fishshellfish/outreach/advice_index.cfm.

84R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).85C.Wong,ND,“NaturalAllergyRemedies,”About.com,May2011,

altmedicine.about.com/od/healthconditionsatod/a/allergies.htm.86R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).87L.Bielory,“ComplementaryandAlternativeTherapiesforAllergicRhinitisandConjunctivitis,”

Uptodate.com,May2014,uptodate.com/contents/complementaryand-alternative-therapies-for-allergic-rhinitis-and-conjunctivitis.

88Z.Wengetal.,“QuercetinIsMoreEffectiveThanCromolyninBlockingHumanMastCellCytokineReleaseandInhibitsContactDermatitisandPhotosensitivityinHumans,”PLOSONE7,no.3(2012):e33805.doi:10.1371/journal.pone.0033805.

89F.Shishehboretal.,“QuercetinEffectivelyQuellsPeanut-InducedAnaphylacticReactionsinthePeanutSensitizedRats,”IranianJournalofAllergy,Asthma,andImmunology9,no.1(March2010):27–34.doi:09.01/ijaai.2734.

90A.P.Rogerioetal.,“Anti-InflammatoryActivityofQuercetinandIsoquercitrininExperimentalMurineAllergicAsthma,”InflammationResearch56,no.10(October2007):402–8.

91C.Wong,ND,“NaturalAllergyRemedies,”About.com,May2011,altmedicine.about.com/od/healthconditionsatod/a/allergies.htm.

92R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).93M.F.Carneiro,.“LowConcentrationsofSeleniumandZincinNailsAreAssociatedwithChildhood

Asthma,”BiologicalTraceElementResearch144,no.1–3(December2011):244–52.doi:10.1007/s12011-011-9080-3.

94E.Fabianetal.,“NutritionalSupplementsandPlasmaAntioxidantsinChildhoodAsthma,”WienerKlinischeWochenschrift125,no.11–12(June2013):309–15.doi:10.1007/s00508-013-0359-6.

95R.Safaralizadeh,.“InfluenceofSeleniumonMastCellMediatorRelease,”BiologicalTraceElementResearch154,no.2(August2013):299–303.doi:10.1007/s12011-013-9712-x.

96R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).97Ibid.

98Ibid.99P.Bass,MD,“ZincandAsthma,”About.com,October2011,

asthma.about.com/od/preventioncontrol/a/Zinc-And-Asthma.htm.100A.Soutaretal.,“BronchialReactivityandDietaryAntioxidants,”Thorax52,no.2(February1997):

166–70.101U.Nurmatovetal.,“NutrientsandFoodsforthePrimaryPreventionofAsthmaandAllergy:

SystematicReviewandMeta-Analysis,”JournalofAllergyandClinicalImmunology127,no.3(March2011):724–33.e1-30.doi:10.1016/j.jaci.2010.11.001.

102M.A.Biltagietal.,“Omega-3FattyAcids,VitaminC,andZnSupplementationinAsthmaticChildren:ARandomizedSelf-ControlledStudy,”ActaPaediatrica98,no.4(April2009):737–42.

103A.Gaby,NutritionalMedicine(Concord:FritzPerlbergPublishing,2011).104R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).105Ibid.106Ibid.107I.Guptaetal.,“EffectsofBoswelliaSerrataGumResininPatientswithBronchialAsthma:Resultsof

aDouble-Blind,Placebo-Controlled,6-WeekClinicalStudy,”EuropeanJournalofMedicalResearch3,no.11(November17,1998):511–14.

108R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).109“Gingko,”NationalInstitutesofHealth,MedlinePlus.com,August2013,

nlm.nih.gov/medlineplus/druginfo/natural/333.xhtml.110R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).111Ibid.112Y.Tangetal.,“TheEffectofGinkgoBilobaExtractontheExpressionofPKCalphainthe

InflammatoryCellsandtheLevelofIL-5inInducedSputumofAsthmaticPatients,”JournalofHuazhongUniversityofScienceandTecnholog[MedicalSciences]27,no.4(August2007):375–80.

113R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).114Ibid.115Ibid.116“GreenTeaMayFightAllergies,”ScienceDaily.com,September2002,

sciencedaily.com/releases/2002/09/020919071413.htm.117E.Hassanainetal.,“GreenTea(Camelliasinensis)SuppressesBCellProductionofIgEwithout

InducingApoptosis,”AnnalsofClinicalandLaboratoryScience40,no.2(Spring2010):135–43.118R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).119Ibid.120Ibid.121Ibid.122Ibid.123M.Houssenetal.,“NaturalAnti-InflammatoryProductsandLeukotrieneInhibitorsasComplementary

TherapyforBronchialAsthma,”ClinicalBiochemistry43,no.10–11(July2010):887–90.doi:10.1016/j.clinbiochem.2010.04.061.

124Y.W.Shinetal.,“InVitroandinVivoAntiallergicEffectsofGlycyrrhizaglabraandItsComponents,”PlantaMedica73,no.3(March2007):257–61.

125R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).126K.BoneandS.Mills,PrinciplesandPracticeofPhytotherapy(London:ChurchillLivingstone,2000).127C.Wong,ND,“NaturalAllergyRemedies,”About.com,May2011,

altmedicine.about.com/od/healthconditionsatod/a/allergies.htm.128K.P.Leeetal.,“Anti-AllergicandAnti-InflammatoryEffectsofBakkenolideBIsolatedfrom

PetasitesjaponicusLeaves,”JournalofEthnopharmacology148,no.3(July30,2013):890–94.doi:10.1016/j.jep.2013.05.037.

129A.Brattstrometal.,“PetasitesExtractZe339(PET)InhibitsAllergen-InducedTh2Responses,AirwayInflammation,andAirwayHyperreactivityinMice,”PhytotherapyResearch24,no.5(May2010):

680–85.doi:10.1002/ptr.2972.130A.Schapowaletal.,“TreatingIntermittentAllergicRhinitis:AProspective,Randomized,Placeboand

Antihistamine-ControlledStudyofButterburExtractZe339,”PhytotherapyResearch19,no.6(June2005):530–37.

131J.S.Leeetal.,“SuppressiveEffectofPetasitesjaponicusExtractonOvalbumin-InducedAirwayInflammationinanAsthmaticMouseModel,”JournalofEthnopharmacology133,no.2(January27,2011):551–57.doi:10.1016/j.jep.2010.10.038.

132C.Wong,ND,“NaturalAllergyRemedies,”About.com,May2011,altmedicine.about.com/od/healthconditionsatod/a/allergies.htm.

133“StingingNettle,”UniversityofMarylandMedicalCenter,May2011,umm.edu/health/medical/altmed/herb/stinging-nettle.

134B.Roschek,Jr,etal.,“NettleExtract(Urticadioica)AffectsKeyReceptorsandEnzymesAssociatedwithAllergicRhinitis,”PhytotherapyResearch23,no.7(July2009):920–26.doi:10.1002/ptr.2763.

135P.Mittlman,“Randomized,Double-BlindStudyofFreeze-DriedUrticadioicaintheTreatmentofAllergicRhinitis,”PlantaMedica56,no.1(February1990):44–47.

136B.Roschek,Jr,etal.,“NettleExtract(Urticadioica)AffectsKeyReceptorsandEnzymesAssociatedwithAllergicRhinitis,”PhytotherapyResearch23,no.7(July2009):920–26.doi:10.1002/ptr.2763.

137KerryBoneandSimonMills,PrinciplesandPracticeofPhytotherapy(London:ChurchillLivingstone,2000).

138“StingingNettle,”UniversityofMarylandMedicalCenter,May2011,umm.edu/health/medical/altmed/herb/stinging-nettle.

139Ibid.140“Tylophora,”NYULangoneMedicalCenter,August2013,med.nyu.edu/content?ChunkIID=21875.141“Tylophora,”2001(informationunlikelytochange)

ip.aaas.org/tekindex.nsf/2a9c4e44835b04ea85256a7200577a64/75641188d67fb97685256c33004fbd79/Body/M1?OpenElement.

142“Tylophora,”NYULangoneMedicalCenter,August2013,med.nyu.edu/content?ChunkIID=21875.143“Asthma,”UniversityofMarylandMedicalCenter,June2013,

umm.edu/health/medical/altmed/condition/asthma.144Ibid.145“Tinosporacordifolia,”NYULangoneMedicalCenter,med.nyu.edu/content?ChunkIID=111811.146Ibid.147V.A.Badar,“EfficacyofTinosporacordifoliainAllergicRhinitis,”JournalofEthnopharmacology

96,no.3(January15,2005):445–49.148Ibid.149“Tinosporacordifolia,”NYULangoneMedicalCenter,med.nyu.edu/content?ChunkIID=111811.

CHAPTER12

1P.Greco,“HowtoDetoxYourHouse,”GoodHousekeeping,2014,goodhousekeeping.com/home/cleaning-organizing/house-cleaning-hazards-apr07?click=main_sr.

2Ibid.3“QuestionsaboutYourCommunity:IndoorAir,”UnitedStatesEnvironmentalProtectionAgency,September2013,epa.gov/region1/communities/indoorair.xhtml.

4“7TipsforanAllergy-ProofBedroom,”WebMD.com,October2012,webmd.com/allergies/tips-for-an-allergy-proof-bedroom.

5“DiseasesandConditions:Allergies,”MayoClinic,April2014,mayoclinic.org/diseases-conditions/allergies/in-depth/allergy/art-20049365?pg=2.

6P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).7P.Greco,“HowtoDetoxYourHouse,”GoodHousekeeping,2014,goodhousekeeping.com/home/cleaning-organizing/house-cleaning-hazards-apr07?click=main_sr.

8“TheAllergen-FreeBedroom,”GreenAmerica,January/February2006,greenamerica.org/livinggreen/bedrooms.cfm.

9P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).10“IndoorAllergens:TipstoRemember,”AmericanAcademyofAllergy,Asthma,andImmunology,

2013,aaaai.org/conditions-and-treatments/library/at-a-glance/indoor-allergens.11Ibid.12P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).13“IndoorAllergens:TipstoRemember,”AmericanAcademyofAllergy,Asthma,andImmunology,

2013,aaaai.org/conditions-and-treatments/library/at-a-glance/indoor-allergens.14Ibid.15P.Greco,“HowtoDetoxYourHouse,”GoodHousekeeping,2014,

goodhousekeeping.com/home/cleaning-organizing/house-cleaning-hazards-apr07?click=main_sr.16“IndoorAllergens:TipstoRemember,”AmericanAcademyofAllergy,Asthma,andImmunology,

2013,aaaai.org/conditions-and-treatments/library/at-a-glance/indoor-allergens.17Ibid.18Ibid.19P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).20“TheAllergen-FreeBedroom,”GreenAmerica,January/February2006,

greenamerica.org/livinggreen/bedrooms.cfm.21“IndoorAllergens:TipstoRemember,”AmericanAcademyofAllergy,Asthma,andImmunology,

2013,aaaai.org/conditions-and-treatments/library/at-a-glance/indoor-allergens.22P.Greco,“HowtoDetoxYourHouse,”GoodHousekeeping,2014,

goodhousekeeping.com/home/cleaning-organizing/house-cleaning-hazards-apr07?click=main_sr.23Ibid.24“7TipsforanAllergy-ProofBedroom,”WebMD.com,October2012,webmd.com/allergies/tips-for-an-

allergy-proof-bedroom.25“IndoorAllergens:TipstoRemember,”AmericanAcademyofAllergy,Asthma,andImmunology,

2013,aaaai.org/conditions-and-treatments/library/at-a-glance/indoor-allergens.26“DiseasesandConditions:Allergies,”MayoClinic,April2014,mayoclinic.org/diseases-

conditions/allergies/in-depth/allergy/art-20049365?pg=2.27“IndoorAllergens:TipstoRemember,”AmericanAcademyofAllergy,Asthma,andImmunology,

2013,aaaai.org/conditions-and-treatments/library/at-a-glance/indoor-allergens.28“DiseasesandConditions:Allergies,”MayoClinic,April2014,mayoclinic.org/diseases-

conditions/allergies/in-depth/allergy/art-20049365?pg=2.29Ibid.30S.McEvoy,“Mold-ResistantPaint,”HGTV,hgtvremodels.com/interiors/mold-resistant-

paint/index.xhtml.31“InteriorPaintProblems:MoldandMildew,”benjaminmoore.com/en-us/for-contractors/mildew-paint-

problem.32C.Billionnet,“QuantitativeAssessmentsofIndoorAirPollutionandRespiratoryHealthinaPopulation-

BasedSampleofFrenchDwellings,”EnvironmentalResearch111,no.3(April2011):425–34.doi:10.1016/j.envres.2011.02.008.

33C.M.Robroeks,“ExhaledVolatileOrganicCompoundsPredictExacerbationsofChildhoodAsthmaina1-YearProspectiveStudy,”EuropeanRespiratoryJournal42,no.1(July2013):98–106.doi:10.1183/09031936.00010712.

34P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).35Ibid.36L.Claudio,“PlantingHealthierIndoorAir,”EnvironmentalHealthPerspectives119,no.10(October

2011):a426–a427.doi:10.1289/ehp.119-a426.37“TheAllergen-FreeBedroom,”GreenAmerica,January/February2006,

greenamerica.org/livinggreen/bedrooms.cfm.

38“DiseasesandConditions:Allergies,”MayoClinic,April2014,mayoclinic.org/diseases-conditions/allergies/in-depth/allergy/art-20049365?pg=2.

39B.Burmeier,“NaturalWaystoFreshenYourHome,”EverydayHealth,January2012,everydayhealth.com/asthma-pictures/natural-ways-to-freshen-your-home.aspx.

40“CleaningSuppliesandHouseholdChemicals,”AmericanLungAssociation,2014,lung.org/healthy-air/home/resources/cleaning-supplies.xhtml.

41Ibid.42P.Greco,“HowtoDetoxYourHouse,”GoodHousekeeping,2014,

goodhousekeeping.com/home/cleaning-organizing/house-cleaning-hazards-apr07?click=main_sr.43N.Martin,“BetterSleepStrategiesforAsthmaSufferers,”RealSimple,2014,

realsimple.com/health/better-sleep-strategies-for-allergy-sufferers.44“CleaningSuppliesandHouseholdChemicals,”AmericanLungAssociation,2014,lung.org/healthy-

air/home/resources/cleaning-supplies.xhtml.45Ibid.46“FormaldehydeinYourHome,”MinnesotaDepartmentofHealth,

health.state.mn.us/divs/eh/indoorair/voc/formaldehyde.htm.47P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).48H.Hickey,“ScentedLaundryProductsEmitHazardousChemicalsthroughDryerVents,”Universityof

Washington,August2011,washington.edu/news201108/24/scented-laundry-products-emit-hazardous-chemicals-through-dryer-vents/.

49“UsePrecautionwithParabens,”HealthyChildHealthyWorld,January30,2013,healthychild.org/easy-steps/use-precaution-with-parabens/.

50“BisphenolA(BPA),”NationalInstituteofEnvironmentalHealthSciences,niehs.nih.gov/health/topics/agents/sya-bpa/.

51C.M.Villanueva,“Meta-AnalysisofStudiesonIndividualConsumptionofChlorinatedDrinkingWaterandBladderCancer,”JournalofEpidemiologyandCommunityHealth57,no.3(March2003):166–73.

52P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).

CHAPTER131“PhysicalActivityandHealth,”CentersforDiseaseControlandPrevention,February2011,cdc.gov/physicalactivity/everyone/health/index.xhtml.

2Ibid.3A.Pintoetal.,“EffectsofPhysicalExerciseonInflammatoryMarkersofAtherosclerosis,”CurrentPharmaceuticalDesign18,no.28(2012):4326–49.

4M.Hameretal.,“PhysicalActivityandInflammatoryMarkersOver10Years:Follow-UpinMenandWomenfromtheWhitehallIICohortStudy,”Circulation,publishedelectronicallyAugust13,2012.doi:10.1161/CIRCULATIONAHA.112.103879.

5“WhatAretheHealthRisksofOverweightandObesity?”NationalHeart,Lung,andBloodInstitute,July2012,nhlbi.nih.gov/health/health-topics/topics/obe/risks.xhtml.

6J.Garcia-Aymerichetal.,“IncidenceofAdult-OnsetAsthmaafterHypotheticalInterventionsonBodyMassIndexandPhysicalActivity:AnApplicationoftheParametricG-Formula,”AmericanJournalofEpidemiology179,no.1(January1,2014):20–26.doi:10.1093/aje/kwt229.

7A.Taietal.,“AssociationbetweenAsthmaSymptomsandObesityinPreschool(4–5YearOld)Children,”JournalofAsthma46,no.4(May2009):362–65.doi:10.1080/02770900902759260.

8“PhysicalActivityandHealth,”CentersforDiseaseControlandPrevention,February2011,cdc.gov/physicalactivity/everyone/health/index.xhtml.

9Ibid.10“DietaryGuidelinesforAmericans,2010,”UnitedStatesDepartmentofHealthandHumanServices,

June2014,health.gov/dietaryguidelines/2010.asp.11“2008PhysicalActivityGuidelinesforAmericansSummary,”UnitedStatesDepartmentofHealthand

HumanServices,June2014,health.gov/paguidelines/guidelines/summary.aspx.12“PhysicalActivity:FrequentlyAskedQuestions,”CentersforDiseaseControlandPrevention,February

2011,cdc.gov/physicalactivity/growingstronger/faq/index.xhtml13“ExercisingwithAllergiesandAsthma,”TheAmericanCollegeofSportsMedicine,

acsm.org/docs/current-comments/allergiesandasthmatemp.pdf.14A.Mantica,“AttackAllergieswithYoga,”Prevention,November2011,

prevention.com/fitness/yoga/yoga-hay-fever-and-allergies.15S.Singhetal.,“EffectofYogaPracticesonPulmonaryFunctionTestsIncludingTransferFactorof

LungforCarbonMonoxide(TLCO)inAsthmaPatients,”IndianJournalofPhysiologyandPharmacology56,no.1(January–March2012):63–68.

16A.J.Bidwelletal.,“YogaTrainingImprovesQualityofLifeinWomenwithAsthma,”JournalofAlternativeandComplementaryMedicine18,no.8(August2012):749–55.doi:10.1089/acm.2011.0079.

17“ExercisingwithAllergiesandAsthma,”TheAmericanCollegeofSportsMedicine,acsm.org/docs/current-comments/allergiesandasthmatemp.pdf.

18“PhysicalActivityandHealth,”CentersforDiseaseControlandPrevention,February2011,cdc.gov/physicalactivity/everyone/health/index.xhtml.

19C.W.Kim,“CombinedEffectsofFoodandExerciseonAnaphylaxis,”NutritionResearchandPractice7,no.5(October2013):347–51.

20Ibid.21“ExercisingwithAllergiesandAsthma,”TheAmericanCollegeofSportsMedicine,

acsm.org/docs/current-comments/allergiesandasthmatemp.pdf.22Ibid.23“ExercisingwithAllergiesandAsthma,”TheAmericanCollegeofSportsMedicine,

acsm.org/docs/current-comments/allergiesandasthmatemp.pdf.24D.Silvaetal.,“PhysicalTrainingImprovesQualityofLifeBothinAsthmaticChildrenandTheir

Caregivers,”AnnalsofAsthma,Allergy,andImmunology111,no.5(November2013):427–28.doi:10.1016/j.anai.2013.08.016.

25“ExercisingwithAllergiesandAsthma,”TheAmericanCollegeofSportsMedicine,acsm.org/docs/current-comments/allergiesandasthmatemp.pdf.

26Ibid.27“ExercisingwithAllergiesandAsthma,”AmericanCollegeofAllergy,Asthma,andImmunology,2010,

acaai.org/allergist/asthma/asthma-treatment/management/pages/exercising-with-allergies-asthma.aspx.28W.Tontako,“TheEffectofAcuteExhaustiveandModerateIntensityExercisesonNasalCytokine

SecretionandClinicalSymptomsinAllergicRhinitisPatients,”AsianPacificJournalofAllergyandImmunology30,no.3(September2012):185–92.

29J.Stewart,“RunAwayfromYourAllergies,”Men’sHealth,March2013,menshealth.com/health/run-away-from-your-allergies.

30A.Pirisi,“CalmingYogaforAllergies,”YogaJournal,2014,yogajournal.com/article/health/allergy-antidote/.

31Ibid.32A.Mantica,“AttackAllergieswithYoga,”Prevention,November2011,

prevention.com/fitness/yoga/yoga-hay-fever-and-allergies.33“QiGongandTaiChiforAllergies,”2014,altmd.com/Articles/Qi-Gong-and-Tai-Chi-for-Allergies.34T.D.Mickleborough,“SaltIntake,Asthma,andExercise-InducedBronchoconstriction:AReview,”ThePhysicianandSportsmedicine38,no1(April2010):118–31.doi:10.3810/psm.2010.04.1769.

35“QiGongandTaiChiforAllergies,”2014,altmd.com/Articles/Qi-Gong-and-Tai-Chi-for-Allergies.36T.Neale,“CHEST:AsthmaPatientsMayDeriveExtraBenefitfromTaiChi,”MedPageToday,October

2008,medpagetoday.com/MeetingCoverage/CHEST/11533.37B.Hendrick,“TaiChiMayHelpControlAsthma,”October2008,

webmd.com/asthma/news/20081028/tai-chi-may-help-control-asthma.

38Y.F.Changetal.,“TaiChiChuanTrainingImprovesthePulmonaryFunctionofAsthmaticChildren,”JournalofMicrobiology,Immunology,andInfection41,no.1(February2008):88–95.

39SupremeChiLiving:AnOnlineJournalbyAmericanTaiChiandQigongAssociation.LocateTaiChiorQigongClasses.americantaichi.net/TaiChiQigongClass.asp.

40S.Singhetal.,“EffectofYogaPracticesonPulmonaryFunctionTestsIncludingTransferFactorofLungforCarbonMonoxide(TLCO)inAsthmaPatients.”IndianJournalofPhysiologyandPharmacology56,no.1(January–March2012):63–68.

41A.J.Bidwelletal.,“YogaTrainingImprovesQualityofLifeinWomenwithAsthma,”JournalofAlternativeandComplementaryMedicine18,no.8(August2012):749–55.doi:10.1089/acm.2011.0079.

42R.Vempatietal.,“TheEfficacyofaComprehensiveLifestyleModificationProgrammeBasedonYogaintheManagementofBronchialAsthma:ARandomizedControlledTrial,”BMCPulmonaryMedicine9(July30,2009):37.doi:10.1186/1471-2466-9-37.

43A.Pirisi,“CalmingYogaforAllergies,”YogaJournal,2014,yogajournal.com/article/health/allergy-antidote/.

44Ibid.45S.Waxman,“6TipstoStaySafeinHotYoga,”YogaJournal,2007,yogajournal.com/article/yoga-

101/facing-the-heat/.46YogaJournal,“StyleProfile:AshtangaYoga,”yogajournal.com/article/beginners/spotlight-on-ashtanga-

yoga/.47A.Pirisi,“CalmingYogaforAllergies,”YogaJournal,2014,yogajournal.com/article/health/allergy-

antidote/.48Ibid.49Ibid.

CHAPTER141“SublingualImmunotherapy,”TheJohnHopkinsSinusCenter,2008,hopkinsmedicine.org/sinus/allergy/sublingual_immunotherapy.xhtml.

2“PortableAirCleaners,”AsthmaandAllergyFoundationofAmerica,aafa.org/display.cfm?id=8&sub=17&cont=158.

3Ibid.4P.M.EhrlichandE.S.Bowers,LivingwithAllergies(NewYork:FactsonFile,2008).5“FiveBestAllergyFriendlyHousePlants,”Zyrtec.com,2014,zyrtec.com/passion/gardening/allergy-friendly-house-plants.

6“CleaningSuppliesandHouseholdChemicals,”AmericanLungAssociation,lung.org/healthy-air/home/resources/cleaning-supplies.xhtml

7Ibid.8“HowtoGreenYourCleaningRoutine,”Treehugger,June27,2014,treehugger.com/htgg/how-to-go-green-cleaning.xhtml.

9“95+HouseholdUsesforVinegar,”Reader’sDigest,rd.com/home/150-household-uses-for-vinegar/.10N.Martin,“BetterSleepStrategiesforAllergySufferers,”RealSimple,realsimple.com/health/better-

sleep-strategies-for-allergy-sufferers.11“HowtoGreenYourCleaningRoutine,”Treehugger,June27,2014,treehugger.com/htgg/how-to-go-

green-cleaning.xhtml.12Ibid.13Ibid.14S.YeagerandtheeditorsofPrevention,TheDoctors’BookofFoodRemedies(Emmaus,PA:Rodale,

2008).15Ibid.16Ibid.17Ibid.

18“VitaminC,”NationalInstitutesofHealth,MedlinePlus.com,May2014,nlm.nih.gov/medlineplus/ency/article/002404.htm.

19D.Heberetal.,“Sulforaphane-RichBroccoliSproutExtractAttenuatesNasalAllergicResponsetoDieselExhaustParticles,”FoodandFunction5,no.1(January2014):35–41.doi:10.1039/c3fo60277j.

20“What’sNewandBeneficialaboutBroccoli,”World’sHealthiestFoods,2014,whfoods.com/genpage.php?tname=foodspice&dbid=9.

21O.Lindahl,“VeganRegimenwithReducedMedicationintheTreatmentofBronchialAsthma,”JournalofAsthma22,no.1(1985):45–55.

22I.Eliaz,“AreYouChronicallyDehydrated?”,RodaleNews,2012,rodalenews.com/chronic-dehydration.23“QiGongandTaiChiforAllergies,”2014,altmd.com/Articles/Qi-Gong-and-Tai-Chi-for-Allergies.24T.Neale,“CHEST:AsthmaPatientsMayDeriveExtraBenefitfromTaiChi,”MedPageToday,October

2008,medpagetoday.com/MeetingCoverage/CHEST/11533.25Y.F.Changetal.,“TaiChiChuanTrainingImprovesthePulmonaryFunctionofAsthmaticChildren,”JournalofMicrobiology,Immunology,andInfection41,no.1(February2008):88–95.

26A.Tai,“AssociationbetweenAsthmaSymptomsandObesityinPreschool(4–5YearOld)Children,”JournalofAsthma46,no.4(May2009):362–65.doi:10.1080/02770900902759260.

27“PhysicalActivity:FrequentlyAskedQuestions,”CentersforDiseaseControlandPrevention,February2011,cdc.gov/physicalactivity/growingstronger/faq/index.xhtml.

28“DietaryGuidelinesforAmericans,2010,”UnitedStatesDepartmentofHealthandHumanServices,2010,health.gov/dietaryguidelines/2010.asp.

29S.Cohenetal.,“ChronicStress,GlucocorticoidReceptorResistance,Inflammation,andDiseaseRisk,”ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica109,no.16(April17,2012):5995–99.doi:10.1073/pnas.1118355109.

30“PhysicalActivityandHealth,”CentersforDiseaseControlandPrevention,February2011,cdc.gov/physicalactivity/everyone/health/index.xhtml.

31K.Prasadetal.,“EffectofaSingle-SessionMeditationTrainingtoReduceStressandImproveQualityofLifeamongHealthCareProfessionals:A“Dose-Ranging”FeasibilityStudy,”AlternativeTherapiesinHealthandMedicine17,no.3(May–June2011):46–49.

32“VitaminC(Ascorbicacid),”UniversityofMarylandMedicalCenter,June2013,umm.edu/health/medical/altmed/supplement/vitamin-c-ascorbic-acid.

33A.F.Hageletal.,“IntravenousInfusionofAscorbicAcidDecreasesSerumHistamineConcentrationsinPatientswithAllergicandNon-AllergicDiseases,”Naunyn-Schmiedeberg’sArchivesofPharmacology386,no.9(September2013):789–93.doi:10.1007/s00210-013-0880-1.

34“VitaminB6,”NYULangoneMedicalCenter,August2013,med.nyu.edu/content?ChunkIID=21852.35L.Sakakeenyetal.,“PlasmaPyridoxal-5-PhosphateIsInverselyAssociatedwithSystemicMarkersof

InflammationinaPopulationofUSAdults,”JournalofNutrition142,no.7(July2012):1280–85.doi:10.3945/jn.111.153056.

36“Pyridoxine(VitaminB6),”NationalInstitutesofHealth,MedlinePlus.com,March2014,nlm.nih.gov/medlineplus/druginfo/natural/934.xhtml.

37B.H.Thuesen,“Atopy,Asthma,andLungFunctioninRelationtoFolateandVitaminB(12)inAdults,”Allergy65,no.11(November2010):1446–54.doi:10.1111/j.1398-9995.2010.02378.x.

38L.Lewis,ND,“NaturalTreatmentsforYourSeasonalAllergies,”TheAmericanAssociationofNaturopathicPhysicians,2014,naturopathic.org/content.asp?contentid=117.

39R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).40“Butterbur,”NationalCenterforComplementaryandAlternativeMedicine,April2012,

nccam.nih.gov/health/butterbur.41C.Wong,“NaturalAllergyRemedies,”altmedicine.about.com/od/healthconditionsatod/a/allergies.htm.42“FindaVitaminorSupplement:Butterbur,”2014,webmd.com/vitamins-supplements/ingredientmono-

649-butterbur.aspx?activeIngredientId=649&activeIngredientName=butterbur.43Y.Tang,“TheEffectofGinkgoBilobaExtractontheExpressionofPKCalphaintheInflammatory

CellsandtheLevelofIL-5inInducedSputumofAsthmaticPatients,”JournalofHuazhongUniversity

ofScienceandTechnology,27,no.4(August2007):375–80.44R.Schulman,SolveItwithSupplements(Emmaus,PA:RodaleInc.,2007).45Ibid.46B.Roschek,Jr,etal.,“NettleExtract(Urticadioica)AffectsKeyReceptorsandEnzymesAssociated

withAllergicRhinitis,”PhytotherapyResearch23,no.7(July2009):920–26.doi:10.1002/ptr.2763.47EditorsofReader’sDigest.1,801HomeRemedies.NewYork:Reader’sDigest,2004.48V.A.Badaretal.,“EfficacyofTinosporacordifoliainAllergicRhinitis,”JournalofEthnopharmacology96,no.3(January15,2005):445–49.

49“TinosporaCordifolia,”RXList,2014,rxlist.com/tinospora_cordifolia/supplements.htm.50“Tylophora,”NYULangoneMedicalCenter,August2013,med.nyu.edu/content?ChunkIID=21875.51L.Lewis,ND,“NaturalTreatmentsforYourSeasonalAllergies,”TheAmericanAssociationof

NaturopathicPhysicians,2014,naturopathic.org/content.asp?contentid=117.52J.Sunetal.,“EfficacyofAllergen-SpecificImmunotherapyforPeanutAllergy:AMeta-Analysisof

RandomizedControlledTrials,”AllergyandAsthmaProceedings35,no.2(March–April2014):171–77.doi:10.2500/aap.2014.35.3730.

53“SublingualImmunotherapy,”TheJohnsHopkinsSinusCenter,2008,hopkinsmedicine.org/sinus/allergy/sublingual_immunotherapy.xhtml.

54Ibid.55P.Moingeon,“UpdateonImmuneMechanismsAssociatedwithSublingualImmunotherapy:Practical

ImplicationsfortheClinician,”JournalofAllergyandClinicalImmunology:InPractice1,no.3(May–June2013):228–41.doi:10.1016/j.jaip.2013.03.013.

DR.JONATHANPSENKA is a licensed naturopathic physician and theowner and chiefmedical officer of LongevityMedicalHealthCenter—one ofthe longest-lived and most successful naturopathic medical offices in thecountry. Dr. Psenka has served as adjunct faculty at several universities, is afrequent lecturer, andwasvoteda“topdoctor”byPhoenixmagazine in2010.HeresidesinPhoenix,AZ.

Thisbookisintendedasareferencevolumeonly,notasamedicalmanual.Theinformationgivenhereisdesignedtohelpyoumakeinformeddecisionsaboutyourhealth.Itisnotintendedasasubstituteforanytreatmentthatmayhavebeenprescribedbyyourdoctor.Ifyoususpectthatyouhaveamedicalproblem,

weurgeyoutoseekcompetentmedicalhelp.

Mentionofspecificcompanies,organizations,orauthoritiesinthisbookdoesnotimplyendorsementbytheauthororpublisher,nordoesmentionofspecificcompanies,organizations,orauthoritiesimplythatthey

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©2014byJonathanPsenka,ND

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