Healthy Living with Dr. EE

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[00:05:01]Good morning everyone. I'm Eli. Welcome to Healthy Living with Dr. E. Although we may be in different cities and time zones, there's one thing many of us are probably familiar with, and that is allergies. Some people sneeze or experience an itchy nose whenever the seasons change. Others might feel uncomfortable after eating certain foods. Some people may also react to dust, pollen, or pets, which can cause reactions in the skin, eyes, or even the respiratory system. Now, allergies may seem very common, but they can affect our daily lives in many ways. Today, we'll learn more about them and discover how we can better protect ourselves and our families. Before we begin, just a quick reminder, this content is copyrighted, so please refrain from recording or sharing it. And now, let's give a warm welcome to our special guest, Dr. Eie Tong.

[00:05:55]Hey everyone, and thank you so much for spending your Saturday morning listening to me talk. I'm always really really thankful that everyone has made the choice when there is so much so many other things you could be doing to spend this time with me and to learn new new things about health and how we can help ourselves.

[00:06:17]Every year, allergy season reminds us how sensitive our immune system can be to harmless environmental triggers like pollen, dust, and certain foods. It's a good thing our immune system has a complex way of learning and responding to what it encounters. So, Dr. E, what actually happens in the body during an allergic reaction? And what steps can we take to help keep allergic responses under better control?

[00:06:42]So I feel like in order to fully answer this question, I think that firstly we need to build a really good foundation, we need to first understand allergies like why do they happen before we can really dive into what we can do about it. So let's spend some time first talking about allergies. Now have you noticed that allergies have becoming have been becoming more and more common?

[00:07:06]And perhaps, you know, once you've noticed this, the next thought would be, well, if they're so common now, then what are some practical things we can do to support a healthier immune system?

[00:07:19]Now, when most people think about allergies, you know, they think about sneezing during springtime, carrying tissues everywhere they go, or maybe things like avoiding peanuts at a restaurant. But allergies are actually much more complicated, much more fascinating than that. They are actually telling us a story about how our immune system works, how our modern lifestyle has changed or even how the tiny microbes living inside of us on our skin on our digestive tract may influence our health in general are is influencing our health in ways that scientists are only beginning to understand.

[00:07:59]So before we really dive into the preventative strategies, let's start with a simple question. How many of you know someone out there with allergies?

[00:08:09]Maybe it's you, maybe it's your spouse, your child, a coworker, a friend.

[00:08:14]Chances are nearly everyone here will know someone with some sort of allergy.

[00:08:21]And that's not surprising because allergies are incredibly incredibly common. According to data from the CDC, about one in three adults has some form of allergy. Now, seasonal allergies affect roughly one quarter of adults.

[00:08:39]Food allergies can affect millions of people and conditions like eczema and allergic asthma continue to increase all over the world. In fact, allergies have become one of the most common chronic health conditions in the modern world.

[00:08:55]Now, according to the American CDC, um all of these things are becoming far far far more common. So, just think about it. If there are 30 people sitting in the room right now, statistically about 10 of them will have some form of allergy. So, that's a lot of sneezing.

[00:09:15]That's a lot of itching. That's a lot of antihistamines. And then there's a lot of people out there who will wonder why their body seems to be fighting a war against flowers, peanuts, dust, cats, etc. And now what's even more interesting than this, well I think it's interesting is that allergies are much more common today than they were a few generations ago. If you talk to your grandparents, many of them might have grown up in environments where allergies were pretty uncommon. You know, like think back to your childhood. You probably had someone in your classroom who was really allergic to something or another. I remember when I was a kid, I had a classmate who was so allergic to peanuts, he couldn't eat a Snickers bar in their vicinity, right? Cuz that's all it took. Okay? But if you ask your grandparents about this, they might say, "Okay, yeah, like they know allergies existed, but they don't have that memory of allergies or some people with allergies being all around them." Okay.

[00:10:22]So, because today it seems like every classroom has a child with a food allergy or every pharmacy has an aisle dedicated to allergy medications and then every spring you have millions of people out there just bracing themselves for that seasonal battle against nature.

[00:10:42]So then you have to ask yourselves or what researchers are asking now is like what has changed? Why are allergies so much more common today than they were, you know, generations ago? And you can't say, oh, it's our genetics, you know, our genetics have changed because it's not that. Our genetics have not changed that significantly in 50 years. Okay?

[00:11:05]Human evolution takes much longer than that. So, it's got to be something else.

[00:11:11]All right? And they think that it may be something to do with the environment.

[00:11:16]Okay? Okay. So, first what is an allergy? Okay. An allergy is when the immune system overreacts to something.

[00:11:25]Okay. Firstly, we have to understand what the immune system is actually supposed to do. So, think of your immune system as your body's security department. Its job is to constantly patrol the body looking for threats and then responding appropriately.

[00:11:43]So every day we're exposed to things like viruses, bacteria, fungi, you know, all sorts of, you know, scary things, but that doesn't really matter because our immune system is around to get rid of it. So you will come into contact with all sorts of viruses, all sorts of bacteria, but you won't even notice because your immune system just gets rid of the threat before it has time to ever become a problem. So imagine you were in charge of security at a large stadium that holds like I don't know how many thousands and thousands of people. So every day people will enter and exit the building and most of them harmless, you know, but it's still your job to keep an eye out for someone that could pose a genuine threat.

[00:12:32]So the security team's job is to look over everyone to identify the dangerous individuals and then intervene when necessary. If they do that job correctly, everyone is safe. The event proceeds smoothly. You know, there are no hiccups. Now imagine security is a little bit overenthusiastic.

[00:12:55]Now, instead of identifying genuine threats, they start treating everyone as suspicious. You know, they'll tackle the elderly grandma with a crochet kit in her bag. They call the bomb squad because someone brought a sandwich.

[00:13:10]They're they're interrogating children carrying balloons.

[00:13:14]You know, that's essentially what happens during an allergic reaction. the immune system become becomes overreactive to otherwise harmless substances. Things like, you know, pollen, cat hair, peanuts, all of these things that should cause no problem. So, all of these things, you know, inherently they're not actually dangerous to the body. It's the immune system's overreaction to it that causes an allergy. So allergies will differ from person to person. The key point to understand in allergies is that the allergen itself is not necessarily dangerous.

[00:13:57]Okay? A peanut's not toxic. A cat is not some biological weapon. Pollen is not the same thing as radioactive fallout.

[00:14:06]But the immune system will react as if it is something super scary that you need to get rid of immediately right then and now. It's that overreaction to this allergen that causes all of the symptoms that you feel and an allergic reaction. So the triggers for an allergy can vary from person to person and every person can have you know different you might think okay so someone who has a peanut allergy will always react in the same way but that's not true actually everyone has their own special little reactions to everything and it's really you know it depends on not the allergen which an allergen is something that is going to trigger an allergic reaction and allergen can be really anything on earth, right? So, and really you have the exact same peanut.

[00:15:03]To one person, they enjoy that Snickers bar in peace. You know, nothing's happening to them. To another person, they might say, "Okay, yeah, I can like I can watch you eat a Snickers bar." And that's fine. And then another person is like, "Okay, um I cannot be in the vicinity of peanuts whatsoever, otherwise I start getting reactions." So everyone is a little bit different. The triggers can be a little bit different. The severity of the reaction can be a little bit different. But the difference there is not the allergen but the reaction of their immune system.

[00:15:38]All right. So what happens during a normal immune response? When harmful bacteria or viruses enter the body, the immune system recognizes them as dangerous as it should and then activates a complex network of cells, chemicals, antibodies designed to eliminate this threat. And one of the ways it does this is by producing antibodies like IGM and IGG.

[00:16:06]These antibodies help identify harmful invaders and then sort of communicate with all the different cells out there to coordinate this appropriate response. So think of them like experienced detectives who know exactly who they're looking for and how to deal with the problem. Now allergic reactions are a little bit different. They involve a different type of antibbody called Ig.

[00:16:35]Now, if IGG and IGM antibodies are experienced detectives, IG antibodies are more like an overexited mall cop who's had maybe six cups of coffee before work. Everything is suspicious.

[00:16:50]Every situation feels urgent. Every harmless visitor looks like a potential threat.

[00:16:57]So when someone with allergies encounters the allergen, these Ig antibodies recognize that substance and trigger specialized immune cells called mass cells. And these mass cells can release a variety of inflammatory chemicals. The most famous of which is histamine. You know the anti-histamines that a lot of people with allergies will take is targeting the histamine.

[00:17:25]Histamine is responsible for a lot of the symptoms that people will associate with allergies. It causes things like blood vessels to expand, increased mucus production, stimulates nerve endings that you know create the itching feeling, and it contributes to a lot of the swelling and inflammation that you get with allergic reactions. And that's why people who are have an allergy and when they're exposed to an allergen they get, you know, they get sneezing attacks. They get itchy eyes, itchy skin, a runny nose, they get hives, they get, you know, difficulties breathing, etc. All of this is from the reaction of the immune system. It's from an overreaction of the immune system believing it's got good intentions. Okay? It's trying to defend yourself against the threat. it believes it is doing its good appropriate job but it's not. Okay. So, you know, seasonal allergies are pretty much one of the most dramatic overreactions that your body can make because every spring plants will release pollen. It's normal. It's natural. You know, the flowers are just trying to make more flowers. Trees are trying to make more trees. It's totally fine. But millions of people's immune systems will interpret this like some sort of a biological war. One person will walk through a field of flowers and then they'll just look around and wonder being like, "This is beautiful. This is amazing." And then the second person walks through and then they're just like, "This is the worst thing ever."

[00:19:00]They're digging tissues out. They got snot dripping everywhere. The eyes are red and itchy. they're walking around like this cuz they can't even open their eyes. And also like the same environmental exposure can trigger vastly different responses in different people and it's just because their immune system has been programmed a little bit wonky. Okay, so there are a lot a lot of allergy triggers out there.

[00:19:29]Okay, so one reason allergies can be sort of confusing is that they don't all look the same. The symptoms depend largely on where in the body the reaction occurs. Now if the reaction occurs you know mostly in the nose and sinuses then you get congestion, sneezing, you get you know drippy noses, runny noses. If the reaction occurs in the eyes then you get red eyes, you get you know puffiness you get a lot of tearing.

[00:19:57]If the skin is involved, people can develop things like hives, eczema, rashes, intense itching, and then if the airways are affected, symptoms can include wheezing, coughing, chest tightness, asthma-like symptoms, or in the worst cases, things like anaphylactic shock. Food allergies will involve the digestive system, and you can get things like nausea, vomiting, abdominal pain, diarrhea, etc. So that's why two people can both have allergies and then have completely different experiences. So one person's allergy will look like a box of tissues and constant sneezing. Another person's allergy might just be like a really itchy rash. Another person's might be okay, I just need an inhaler. And then a third person and then even more people will be like, okay, my allergy gives me a lot of diarrhea. different symptoms, different body systems, but that same underlying process of an immune overreaction.

[00:21:02]Okay? So, you can have things like skin contact like latex, nickel, fragrances, cosmetics, or even other things like insect stings or medications can trigger allergies as well. The most common of which can be things like antibiotics or even some painkillers known as non-steroidal anti-inflammatory drugs.

[00:21:21]These are also really really common.

[00:21:23]They cause a lot of allergies in people.

[00:21:26]So when it comes down to all of these things, you know, people can actually be allergic to anything, okay? You can even be allergic to things like water and sunlight because it's not so much about this allergen, but about the immune system being really malfunctioning.

[00:21:47]All right? Because normal people, you know, they walk into the sunlight. And although I wouldn't recommend someone be sunbathing for hours and hours at a time, most of us, you know, we walk out and it's perfectly fine. You know, at at the worst part, we might get a little bit of a tan. We might get a bit of a sun sunburn if you're out there for too long. But people with a sunlight allergy, it's not actually allergy to sunlight.

[00:22:12]They're allergic to the UV radiation.

[00:22:14]They react very, very badly. Okay? they re they have super severe reactions. It can cause lasting um skin damage. It increases the risk of melanoma dramatically. All right. So, people with this sort of allergy, they it's it's it's a tough it's really tough to deal with it because you have to install specialized, you know, UV filters on your windows or you have to live in a windowless room. But I feel like that's that's not reasonable. I feel like that's, you know, a form of torture. So they have to go through lengths of installing specialized UV filters over their windows so they get no UV light in and they have to do it in their cars every time they go out. They have to wear specialized outfits. Every single bit of them has to be covered from head to toe. So it's it's it's a really it's a really serious problem.

[00:23:06]And then people can be allergic to water as well in which when they come into contact with water they get you know really really itchy hives. they get really itchy skin. It's it's it can even get into painful territory. So again, it is very very troublesome reaction to these normal things that you and I can manage perfectly fine. And it's just an example of how we can be allergic to literally anything on earth and really and so you know I see people doing a lot of things like oh they eat a certain thing or you know they come into contact with something else and they get reaction to it and their first instinct is to blame this the thing they ate or to blame the thing they came into contact with as if you know the peanut or the soybean or you know whatever it is that they came into contact with that was the thing that was in the wrong.

[00:24:01]That is the thing that was harming them when in reality the allergen itself is perfectly harmless. It has done no wrong. The only thing it's done is exist. What is going wrong here is the immune system. The immune system is going haywire.

[00:24:18]Okay. So instead of focusing on the allergens, we have to, you know, look back within ourselves and look at our immune system.

[00:24:28]Okay. So, what are the sort of risk factors that can increase the risk of allergic reactions? So, now that we have a better understanding of what allergies are and why they happen, let's talk about one of the more exciting developments in modern allergy research.

[00:24:46]Now, if you had attended an allergy lecture maybe like 20, 30 years ago, it was all about things like, oh yeah, we're looking at the allergens, pollen, antihistamines, asthma, inhalers, other triggers, etc., etc., etc. Now, these things are important.

[00:25:02]Okay. But lately, it's been a sort of shift in the mentality asking sort of different questions like what I mentioned before. Why are allergies more common now than they were before?

[00:25:16]Because, you know, our genes have not changed that dramatically in the last 50 years. And yet, the rates of asthma, eczema, seasonal allergies, food allergies, etc. They have been increasing significantly all around the world. So, that means if it's not our genes, then it's got to be something in our environment has changed. And now, you know, researchers have been looking into this more and more and more, trying to figure out, okay, what is it? And one clue comes from looking at how dramatically our lifestyles have changed compared to those with our grandparents or our greatgrandparents.

[00:25:57]We encounter fewer natural environments.

[00:26:00]You know, we're exposed to fewer microbes from soil, animals, and plants.

[00:26:05]We use a lot more antibiotics than previous generations. were exposed to more pollution.

[00:26:12]Now, each of these little changes might seem small on their own, but together they have fundamentally altered the environment in which our immune systems developed. And that brings us to one of the most important concepts in modern medicine and that is the microbiome.

[00:26:34]Right? So, one of the huge huge changes in our diets compared to generations ago is our amount of fiber. Okay, a lot of people will think, "Oh, yeah, I know. I have enough fiber a day." You probably do not. Okay, meat does not contain any fiber. I know people will say, "Oh, yeah, like f like meat has these little fibrous things and that's not fiber."

[00:27:02]All right. only plant foods like fruits and vegetables and so forth. Only those things have actual fiber.

[00:27:10]Okay? So less fiber and more processed foods will affect our gut health because our gut health really really loves fiber. So when we're talking about things like the microbiome, we're referring to that enormous community of microorganisms that live inside and outside of our bodies. Right now, as you're sitting here listening to me, you have trillions of microorganisms living in you, around you. We're exposed to them constantly.

[00:27:41]Now, most of these microbiomes are located in your digestive tract. And in fact, your gut contains one of the most dense microbial microbial ecosystems found anywhere on Earth. But of course, you know, when people hear the word bacteria, the first thing they think of is disease. They think of infections.

[00:28:02]They think of food poisoning. They think of those commercials that, you know, show a spray and it goes, "Our spray can kill 99.9% of germs." You know, that's what they think of. But that's only part of the story. A lot of the bacteria that are living in us, they're not enemies.

[00:28:22]They're just living there. You know, there a lot of them can be neutral. Some of them can even be bene beneficial to us. And some of them are so so important to us that we would have a hard time taking care of our health without them.

[00:28:40]So for years and years and years, scientists have viewed these microbiomes as micro microbes as sort of passengers.

[00:28:48]They're just there. They don't really do anything. That's how a lot of scientists thought of them at first. They're just hitchhikers that happen to live inside of us. But today, we understand that they are much more important than just that. They are active participants in human health. And one researcher has famously described the microbiome as an organ that we didn't even know we had.

[00:29:15]And like any organ, when it's functioning well, our health tends to improve. And when it's not functioning well, when it's disrupted, then a lot of health problems can arise. Now, one reason the microbiome is so important is because of this very close relationship it has with the immune system.

[00:29:38]And in fact, a lot of experts will estimate that even up to 70% of immune tissue can be associated with the digestive tract, which when you think about it makes a lot of sense. You know, when people think about the immune system, they think, "Oh, yeah. It's all about these, you know, little white blood cells that will, you know, run through our bloodstream and look for viruses, look for bacteria, look for all sorts of things to get rid of it. You know, it's all, you know, there that sort of mental imagery. But from the immune system's perspective, the digestive tract is one of the busiest locations in the body because every day you're eating a lot of food. You know, you get food coming in, you get water coming in, you will get microorganisms coming in because you know the things we eat are not sterile. But that's not an issue because the immune system is constantly constantly monitoring the things that go through our digestive tract, monitoring it to make sure that it is not letting anything really dangerous through. So it's asking itself, okay, should this be ignored? Should this be tolerated?

[00:30:54]Should this be attacked? These are all really, really important decisions and it's happening constantly inside of our gut because there's so many things going through there, right? It's like airport security. You know, thousands of people will go through your checkpoint every day. Most of them totally harmless. You know, not an issue at all. Some of them may look suspicious, but if you're well trained, you know that they don't actually pose a threat. So a tiny tiny number actually poses a actual threat.

[00:31:29]So their job is to identify these dangerous individuals without accidentally arresting innocent tourists. And this is essentially what the immune system is doing every single day. So a healthy immune system doesn't attack everything. a healthy immune system will be able to look at all of these, you know, bacteria and other things going through your gut and being like, "Okay, yeah, I know that's a bacteria, but I also know that this is something that is safe to be tolerated because it's not going to cause me an issue." And it just lets it through.

[00:32:04]Okay? So, a lot of people will have this idea in their brain that a healthy immune system is one that is really, really strong. But that's not it. Okay?

[00:32:14]A healthy immune system is about having an immune system that is wellbalanced, that has a lot of checks and balances in place. Because you can't have an immune system that is attacking everything willy-nilly. You have to have a smart immune system. You have to have one that actually knows what it's doing.

[00:32:36]Okay? You have to have one that is responding appropriately to threats. So that because that's what an allergic reaction is. Allergic reaction is the result of your immune system being too active against the wrong targets. Okay?

[00:32:53]So the problem there isn't the immune system being too strong or too weak, but the immune system lacking control. It's like having a smoke detector in your house that is so sensitive that it activates every time someone makes toast. Okay. Technically, yes, it's doing its job. It's detecting smoke, but it's responding inappropriately. And by doing that, it's causing you problems.

[00:33:23]Okay? So, the microbiome in the gut, it appears to be helping to educate the immune system. Okay? So, think back to childhood. You know, when you're a kid, you get taught stranger danger or, you know, you want to teach your kids stranger danger. All right? They learned through and when they're born, children don't know this. You know, they're they're they're such innocent souls.

[00:33:47]Everyone is great, right? But you have to teach them about stranger danger. You got to teach them about these sort of things. The same thing with our immune system. Our immune system comes out, it is formed and it doesn't know anything.

[00:34:00]It's a blank slate. So, it comes out and then has to undergo this training. And how does it undergo this training? It underos this training by interacting with a lot of things. And by interacting with these microbes in our gut which are not harmful is starting to learn, oh okay, these things are bacteria. These things are things that could be harmful but are not and I will learn to recognize these things as things to be tolerated as things to be left alone.

[00:34:31]Okay. So, so then you get into researchers going into okay, all right, so if you have less variety of bacteria in your environment and bodies, then your immune system is lacking that sort of training. It's lacking that sort of indepth, that diversity to learn exactly what things it should be attacking and what things it can just leave alone.

[00:34:58]And then you dig a little bit further and then you find okay then what about you know what what exactly how does this translate into realw world effects because it's one thing to have theory it's another thing to see it reflected in real life. Okay. So what does it mean when you don't have enough microbes to help train the immune system. It means that you have, you know, a lot of kids who will be growing up and having a lot of allergies because they have found that children exposed to more microbes tend to have a lower risk of allergies and asthma.

[00:35:35]Okay. So, so you know a lot of parents especially, you know, helicopter parents, it's it's very much ingrained in our mentality that we want everything to be super nice and clean. Okay, we want especially our babies, you know, you want to take care of them. So, you think to yourself, okay, okay, to take care of my kids, you know, one of the best things I can do is to, you know, keep everything clean around them. I want to protect them from the bacteria, the viruses. I don't want them to come into contact with these things. And the intentions are pure, okay? And they don't they don't want their kids to be playing in the dirt and getting all dirty because it feels like, oh, you know, I should be keeping my kids very hygienic and clean when in reality, you may actually be doing them harm by not allowing them to get themselves dirty, by not allowing them to roll around in the soil or like get into touch with nature. Okay? Because when you allow your kids to be exposed to a lot of these different microbes, you're actually giving their immune system a chance to be trained because as kids are growing up, they're learning so many new things about their environment. And it's the same thing with their immune system.

[00:36:55]Their immune system is also born knowing absolutely nothing. So, it also has to undergo training. And to undergo the best sort of training, you need to be exposed to all sorts of different microbes.

[00:37:11]So by doing this, it's learning, okay, what sort of microbes are living around me? You know, what sort of microbes would I see on food? What sort of things would truly require a defensive response? And what sort of things do not require a, you know, defensive response?

[00:37:29]So, think of it like training a new employee. You know, the first few months on the job are critical.

[00:37:37]If they're trained really well, they make good decisions. But if you have a trainee and you just shut them in an office all day every day, you never actually bring them out into the world and show them in real life what the sort of things they need to deal with and then you just let them out of the office months later and go, "Okay, go do your job." Are they actually going to be able to do their job fully, correctly, appropriately? No, of course not. And the same thing applies to the immune system.

[00:38:11]Okay? So, you know, children who grow up with pets are actually less likely to develop allergies. Children who grow up, you know, exposed to more soil, more grass are less likely to develop allergies. A Finnish study found that replacing pavement in artificial play, you know, artificial playgrounds, right?

[00:38:34]I don't know why. It's a very very modern thing, you know, like they all they're always coming with these little spongy artificial floors which on the surface seem really great because you don't want kids to be falling over onto a hard floor and hurting themselves, right? But there's more and more research showing that if you replace that sort of artificial flooring with things like soil, plants, gardens, they actually the children's immune health is actually improved. And the research shows that it can improve in just 28 days because children exposed to natural environments will ex will have more diverse um skin microbes and showed immune changes associated with better immune regulation because the immune system is again coming into contact with different microbes and having better training.

[00:39:31]So these sort of findings support the idea that regular contact with nature helps train the immune system and can actually reduce the risk of allergies or even other immunereated diseases. So kids should not just be placed indoors.

[00:39:47]You can't just have you know parents being like a robot vacuum cleaning every single surface around them. You know you got to let them go out touch grass a little bit. Okay. And if you have pets, you know, have you ever noticed that if you have a cold, your pet does not get the cold? You know, if your pets have a cold, they do not transfer the cold to you, right? That's because a lot of viruses and bacteria, they're very specific.

[00:40:13]You know, the sort of virus that causes a cold in a dog is not going to cause a cold in a human. The sort of virus that causes a cold in a human, it's not going to cause a cold in a dog.

[00:40:23]Right? So if your kids are in contact with a lot of these sort of different microbes, it actually causes no harm to them, but it's like giving their immune system a play thing, you know? You're you're giving your immune system a totally harmless thing. It's not going to it's not going to cause them sickness, and it's just going like, oh yeah, like here's this thing. You can have a look at it, interact with it a little bit. And that's another form of training. So research has found that children who grow up with pets often have lower rates of allergic disease.

[00:40:57]Children with multiple siblings also have lower allergy rates. Children attending daycare can experience lower rates of certain allergic conditions. At first glance, the finding seems strange because it's so ingrained in us to think, okay, more exposure to bacteria, more exposure to viruses is something that will increase health problems. But that's not true. Okay? And I know I know a lot of parents will be like, "Okay, yes, but like my kid gets sick all the time. What do I do about this? Does this mean that their immune system is weak?

[00:41:35]Do I need to boost their immune system?

[00:41:37]I'm here to tell you that you don't need to worry. Okay? I know in our adult lives, we get sick like maybe once or twice a year. Kids, they get sick on average 6 to 12 times a year. And that is normal. Okay? That is normal for them. I know. I know it makes their heart hurt to see your kids sick. But please be assured that it's actually really, really, really, really normal for kids to get sick all the time. It's because their immune system is still learning. Okay, did you know that every time you catch a cold, your immune system will have immunity against that specific virus that caused the cold?

[00:42:23]Now, you might say, "Okay, then why do I keep getting the cold?" It's because there are thousands of viruses out there that will cause the cold. Okay? But every single time it's because as we grow, you know, our immune system gets stronger. It has, you know, better training, so we get sick less often. But kids, their immune system is still training. They're still learning just like the kid themselves. So, they get sick all the time. But you don't need to worry about the frequency of illnesses because it is something that is very very normal and very expected for kids.

[00:42:57]Okay? So, not something you have to be too worried about.

[00:43:02]Okay. So, of course, you know, kids who have more siblings, kids who go to daycare because they're exposed to other kids who are also carrying a lot of microbes, you know, they're they're coming into contact. They may get sick more often, but that's okay. You know, their immune system is still learning.

[00:43:20]Okay. So you might have noticed that the common theme here is exposure. The immune system needs to learn through experience. Just as a person becomes wiser through encountering different scenarios, different situations, the immune system is the same way and it becomes better regulated through encountering a wide variety of these different microbes. Okay. So now these things are super super important. Okay?

[00:43:55]So you have to let go of the apron strings a little bit. Let the kids get a little bit dirty and it'll be totally fine. Now another thing that has changed over the years is this recommendation.

[00:44:11]Now in the past it used to be recommended that you avoid giving children you know very allergenic foods like things like peanuts. But now that recommendation has changed and it is now recommended to introduce these allergenic foods around 4 to 6 months of age. Basically, you know, when you start weeding them off breast milk, you can start introducing them to all of these food like peanuts, milk, eggs, soy, all of these things that are very commonly cause food allergies because it can actually reduce the risk of food allergies developing later on in life.

[00:44:47]So, you know, that previous recommendation to delay introduction, that is no longer given because it's wrong. Research has found that early appropriate exposure can actually promote tolerance. Tolerance meaning that your immune system will look at this thing and then tolerate it. It won't have a reaction against it. Okay.

[00:45:12]So if you have a kid now you know this new recommendation.

[00:45:18]Another thing is that like there's so much research going into this and they have found that another area of research focuses on the birth itself. Now during a vaginal delivery babies are exposed to a large number of microbes from their mom's birth canal. Now these microbes will become some of the earliest settlers in their in you know in baby's microbiome. Now think of a newborn as a sort of an empty field. Okay. The first microbiomes that arrive will help determine what the future ecosystem looks like. Just like the first plants in a garden can influence everything that grows there afterwards. So the first microbiomes can have a very strong influence on the development of the immune system. And babies born by cesareian section C-section encounter a different micro microbial environment.

[00:46:14]Now, their earliest exposure tends to come from things like skin microbes of mom or even healthcare workers and the surrounding environment rather than mom's, you know, birth canal or from the mom's, you know, microbiome. And studies have found that babies born via C-section have a slightly higher risk of allergies, eczema, asthma later on in life. Now, of course, this doesn't mean that C-sections are entirely bad. Far from it. You know, C-sections are medically necessary in a lot of the cases and can be lifesaving for both mom and baby. Okay? So, it's not something that you have to absolutely avoid. If you need it, you need it. And I want people to, you know, be able to have this sort of procedure done when they need it without feeling that sort of guilt cuz if you need it, you need it.

[00:47:05]Okay. Now this research is simply looking into simply highlighting how important this early microbial exposure can be for immune development. Okay. Now of course you know this also leads into other things as well mostly from people who will read this sort of research and then um misunderstand it a little bit because I know that now there is this procedure that a lot of people will do because they believe that it's going to help them which is something called vaginal seating or microbial seating in which they will wipe the baby's mouth, face, skin with vaginal fluids after a caset. ction to sort of stimulate a natural birth, but this doesn't actually help. Okay, so this can actually introduce bacteria and viruses that can make the newborn baby sick. Okay, and there isn't a lot of data about how safe or beneficial this can be because it's not the same thing. Okay? And in fact, there's a lot of leading healthc care groups that will actively recommend against this outside of, of course, you know, clinical trials where they're trying to get more research about it to see why exactly is this not quite the same? What exactly can we do to perhaps improve the process, etc., etc., etc. So, don't I know I know a lot of people will think, okay, yeah, like if I have a C-section, then maybe I can do. It's not the same thing. So you know it would I the current recommendation is to avoid doing this.

[00:48:45]Another thing that we want to avoid is things like antibiotics. Okay. And what I mean by this is we want to avoid unnecessary antibiotic use. If you need it again you need it. Okay. Now I want to be super clear here. Okay. Antibiotics are one of the greatest medical discoveries in human history. before antibiotics, infections that are super minor today could be fatal. Okay, antibiotics are directly responsible for saving millions and millions of lives. However, antibiotics have their own sort of challenges. They are very very good at killing bacteria, but they don't really distinguish between the harmful bacteria and the beneficial bacteria.

[00:49:36]So when you take antibiotics, yes, you're getting rid of the harmful bacteria, but you are also reducing the population of beneficial bacteria as well. So if you have a lot of antibiotic exposure, especially during infancy and childhood, you're absolutely destroying that population of healthy friendly bacteria. And this can be associated with increased risk of asthma, eczema, hay fever, food allergies, etc. Now, this does not mean that antibiotics should be totally avoided. Okay? It's like a C-section. If you need it, you need it and you should use it. Okay? If you have a serious bacterial infection, antibiotics, they can be lifesaving.

[00:50:21]But the lesson here isn't fear. It's about appropriate use.

[00:50:27]A lot of people, you know, they'll be like, "Okay, I feel a little bit unwell." Then they just take antibiotics or I have a little bit of diarrhea. And they just take antibiotics, right?

[00:50:37]Unless you have a piece of paper, you're holding a piece of paper that says, "Yes, you have a bacterial infection, you do not need antibiotics."

[00:50:47]Okay? You do not need to take antibiotics willy-nilly. It's actually better for you, better for everything, better for your own, you know, healthy microbiome that you only take antibiotics when absolutely necessary.

[00:51:04]Okay? Because a healthy microbiome can you need that diversity for a healthy microbiome. And antibiotics, yes, they are super useful and very necessary in a lot of cases, but they also absolutely destroy that diversity.

[00:51:22]Okay, so the so the lesson here is not just to take them willy-nilly, okay? You have to be a lot more discerning about when you want to take your antibiotics.

[00:51:36]All right? And scientists have actually sort of looked at this as one of many factors as to why allergies or allergic diseases are more and more common in the modern world because we've become much more lax about our antibiotic use. Now another factor here is obesity. A lot of people think of fat as just stored energy when in reality fat tissue is biologically active. It doesn't just sit there. It produces hormones. It produces inflammatory signals that can influence the immune system. So, researchers have found that children with obesity are more likely to have food allergies and adults who become obese have a higher risk of developing allergic diseases like asthma because you have a lot of chronic lowgrade inflammation happening there.

[00:52:30]Okay. So physical activity, it can actually have a very protective effect.

[00:52:36]Exercise isn't just about getting stronger muscles or burning calories.

[00:52:40]Regular movement helps regulate inflammation. It helps support your metabolic health. It helps support your heart health, your heart function, and can even influence the composition of your microbiome. Okay? So you don't need to be a marathon runner. Okay? Okay, the immune system isn't demanding that everyone, you know, complete the Iron Man triathlon. All you have to do is just get up, move a little bit more. You know, if you have to go up one story, you don't have to take the escalator or the elevator. You can take the stairs and that's perfectly fine, right? Just a little bit of movement more and more and more and it can help our immune system.

[00:53:21]Now, another really, really, really important thing that people do not do enough of is eating more fiber. Now, fiber is incredibly important. Okay?

[00:53:31]People think that probiotics are the way to go, but probiotics don't actually encourage a healthy gut microbiome. The only thing that does that is fiber. And the only way you can get more fiber is by eating more plant foods. Okay?

[00:53:49]Because in this modern world, I feel like, oh yeah, everyone has has a focus on protein in foods. It's all over my social media. They've got like protein ramen now. They have protein chips. They have protein everything. I even see DIY recipes for like high protein brownies.

[00:54:09]And it's like everything is about protein. People will post on social media, I had this and this much protein today. And they are so proud of themselves. And you know what? good for them. But I feel like people can also use this energy and pour it into fiber as well because yes, you know, having a lot of protein is great, but having a lot of fiber is also really great, but no one pays attention to fiber. It's really, really sad. Okay, so I feel like fiber is also one of those things that's really, really great for you, but fiber just isn't very glamorous. You know, people associate fiber with things like, "Oh, yeah, I have, you know, fiber to get regular bathroom habits." And that's not very glamorous. It's not very fancy.

[00:54:53]It's not very Instagrammable because no one wants to hear about your bathroom habits, okay? But that's what in their minds people link these two together.

[00:55:01]But in reality, fiber has profound effects on our metabolism, on inflammation, on our immune regulation, and even on our allergy risk. So, it is something that is super important for us to get more of. Now, why is this? It's because fiber helps nourish the beneficial bacteria inside of our gut.

[00:55:24]It's one of the only things that we can do to encourage a healthy and diverse microbial population. Probiotics don't do this. Probiotics don't help with diversity because probiotics are usually just one or two strains, you know, so you don't get that diversity.

[00:55:44]The only thing that helps us here is fiber. So when these beneficial bacteria, they digest fiber, they produce compounds known as shortchain fatty acids. And among these things, you know, it's it's important to understand the role that this plays. Now, these short- chain fatty acids, they appear to act as messengers between the microbiome and the immune system, and they help maintain the intestinal barrier. They help regulate inflammation. They help support immune balance. And perhaps most importantly, they help promote immune tolerance. And tolerance is one of the most important concepts in allergy science. So that's what we're really looking for, tolerance.

[00:56:33]And one of the best ways to do this is by eating more fiber. And it is something that every single one of us can absolutely manage. Okay? All we need to do is eat more plants and vegetables, which is something that we should be doing to begin with. Okay? Another thing is that link between stress and allergies. Okay, I feel like for those of you who have allergies, like even eczema, you know this already, right?

[00:57:06]Every time you know you're super stressed about something, maybe it's exam season, maybe you, you know, you're hitting a rough patch in work or life, but when this happens, you know, the symptoms of eczema just flare up.

[00:57:20]Sometimes you don't even know why. you can't think of a trigger. The only thing that happens is that you're a little bit more stressed. So, everything flares up.

[00:57:26]You know, your skin gets super red and itchy. The eczema gets worse. People with asthma might find that, you know, it's much more easy to, you know, trigger difficulties breathing or other things. You know the all of these things can be all linked together because people think of allergies as something that is triggered purely by external factors when in reality the immune system does not operate in isolation like that. Okay. It's constantly receiving input yes from the outside world but also from the world within our bodies. Okay. Okay. So, it's listening not only to the signals from the outside, but also to how you live, how your brain is perceiving the world, how your different hormones or different other chemicals in your body are being produced at different levels there.

[00:58:15]Okay? So, your immune system is a very sensitive home security system and like all home security systems looking at the outside but a lot of them also monitor the inside. Okay. So stress is really strongly associated with allergic flare-ups especially in conditions like eczema, hives, asthma. So that's because when your body experiences stress, it's activating what is also called the stress response system. And this includes the release of hormones like cortisol and adrenaline. Both hormones that are released in times of stress.

[00:58:54]Now in short bursts this system is helpful because it improves focus. It helps increase energy, helps to respond to immediate challenges.

[00:59:05]So it's essentially the body's emergency mode. But in our modern world, you know, we're not really needing this to help fight off a tiger or help defend our territory. What happens is that it is looking at different things >> and it is looking at things like um so when you're actually having this these sort of stress responses, you're looking at things like chronic inflammation over time and this can cause a lot of effects on our immune system. Because when you're going through this sort of chronic inflammation, this chronic stress response, your immune system is reacting to it as if you were fighting something out there. But over a long period of time, it has it has this dampening effect on your immune system. It has negative effects on your immune regulation. And this is why a lot of the times, you know, researchers will look at this immune system and the nervous system and look at them together because they're constantly talking to each other through chemical signals, nerve pathways or hormones as well. So it is very very strongly linked together. So when you're looking at controlling allergic diseases, you can't just look at the triggers or the environment. You also have to look at the inner world as well.

[01:00:28]Now another thing we want to look at is the difference between food allergy and food intolerance because a lot of the times it can be very very very food allergies versus food intolerance you know they're very very different, but people can actually have a lot of difficulty telling them apart. So, the main point here is that food allergies involve the immune system. Okay? But food intolerance is actually something that has nothing to do with the immune system and it's all about a mechanical process. Okay? So, they can have very similar symptoms, but they are very very different. And this distinction matters because a lot of people will end up avoiding foods based solely on you know their symptoms. And you know when you have this reduced dietary diversity you it can also be linked to a reduced microbiome diversity which in turn can influence immune regulation.

[01:01:43]So ironically overrestriction of the diet can work against that goal of improving immune health. All right. So we do want to be able to understand this difference and once we understand this difference we can have a more appropriate management strategy. So generally food allergies tend to happen very quickly. The symptoms can involve you know the very typical allergic symptoms. And the important thing about food allergy is that even tiny amounts can trigger a reaction. Trace amounts can trigger a reaction. And this is really important because I know some people will try to do this themselves at home in which they will eat tiny tiny amounts of it and think that it improves their tolerance but it does not. If you repeatedly expose yourself to things, especially without medical intervention, what happens then is that you make the allergy worse and worse and worse. Okay, that's the that's the that's just how allergies work, how our immune system works because our immune system has a memory. Okay, so if you repeatedly expose your immune system to this, it has a stronger and stronger response every time. A food tolerance is different. Got nothing to do with the immune system, everything to do with the mechanical process of digestion. And symptoms can be slower, milder. Okay, they can include things like bloating, gas, stomach discomfort, can still get like diarrhea, nausea, etc. But the thing about a food intolerance is that it is very dose dependent.

[01:03:24]Okay, you might know someone with lactose intolerance. Some people with lactose intolerance, which is a true food intolerance, some people with lactose intolerance, they can eat cheese, they can have butter, they can have cream, and they're okay. Whereas someone else with, you know, lactose intolerance will not be able to have these things. Or, you know, someone with lactose intolerance, they can have cheese, but then if they drink straight up milk, they're in trouble. Okay? So, food intolerance or food sensitivity is about the dose. And the beauty about this one is is that if you work on it, small portions can be tolerated over time. You can improve your tolerance over time.

[01:04:07]So, how are allergies detected?

[01:04:10]Allergies are there's a lot of tests out there. For example, you have a skin prick test which determines whether the immune system has been sensitized to an allergen. Now, remember that word sensitized. All that means is that your immune system has encountered this allergen before. And remember, your immune system has memory. So, it remembers this. So when you get a positive test for a skin prick test, it does not indicate a true allergy. It only shows that your immune system has encountered this thing before. So you have to encount you have to interpret these sort of test results together with the symptoms. Now another thing that's also really popular is a blood test. Now these blood tests, they throw out false positives all the time. They measure allergy related antibodies in the blood.

[01:05:05]And again, it's like the skin prick test. A positive test does not mean a true allergy. It only means that your immune system has been sensitized against it. Meaning that your immune system has encountered it before and remembers it. Okay. I have a friend who did this test and showed that she was allergic to tuna.

[01:05:27]Does she still go out with me to Japanese restaurants and eat tuna?

[01:05:32]Absolutely. Because it's not a true allergy. So, do you know what the gold standard is for diagnosing an allergy? I know it seems really medieval, but literally the gold standard is that you sit there in the office with a doctor and you eat the thing that is suspected to be causing you an allergy and then your doctor can observe your symptoms and responses. Now, why do you do this in the office? It's because if you have anaphylactic shot, they can save you.

[01:06:03]Okay, seems really medieval but it is the gold standard because the most important thing about food allergies, food sensitivities, food intolerances is the symptoms. Okay, you can do all of these tests and is not a true diagnostic test. It only shows that hey, your immune system has seen this thing before. So, I know people will do all these tests and they'll be like, oh my gosh, it shows I'm allergic to everything. But you're not actually allergic to everything. Okay, if you don't have the symptoms of an allergic reaction, it's not a true allergy. Okay, so how do you manage allergies? Then the most important thing for managing an allergy is to avoid it unfortunately.

[01:06:49]Okay, that is the most important thing because every time you come into contact with something that causes an allergy, your immune system will have a stronger and stronger and stronger response every single time. So you have to avoid it.

[01:07:03]The most important thing, avoid it. If you have very mild allergies like hay fever, pollen, etc., there's a lot of medications that can help you relieve and control the symptoms because unfortunately for things like hay fever, pollen, etc. It can be really, really difficult to avoid the triggers because the trigger is the world, right?

[01:07:26]There is also amunotherapy in which you have controlled gradual exposure under medical supervision. This is super important under a medical supervision.

[01:07:38]Okay. And the thing about immuno theapy is that it is not a cure. Okay. For things like an intolerance, you can actually achieve a cure in that they can eat this food in the future and no longer have symptoms. But for an allergy, it is entirely different. What they're aiming to build here is tolerance. So I want to set expectations straight. Okay. The sort of therapy in which you very very carefully expose them to the allergen over a period of time. It is to build tolerance. The goal here is for example with someone with a peanut allergy. The goal here is so that if they ever accidentally come into pe come into contact with peanuts, they're not going to go into anaphylactic shock and die.

[01:08:27]Okay? It does not mean that they can enjoy a peanut butter sandwich. That's not the goal here, okay? It's to pro to protect them against accidental exposure so that they can have a life more free of that sort of anxiety. But you still need to check labels. You still need to check for warnings. Still need to carry around an EpiPen. Okay. It's more about having that another protective layer.

[01:08:55]Okay. And the thing about this sort of oral exposure to things is that you have to keep it up for life. Often times if people achieve that sort of tolerance and then they slack off and they don't eat it again, all of that can reverse back. So it is something that has to be built up very very slowly over a very very long period of time and kept up over a very long period of time. Okay.

[01:09:21]So what else do we need to do? We want to you know it's also important to zoom out and look at the bigger picture.

[01:09:29]Allergies are not just a localized issue in the nose, the skin or the gut. It's the result of a complex immune system interacting with the genetics, with the environment, with the microbiome, with the diet, with stress levels, with overall health status. So, it's all sorts of things all linking together into one. And this is why modern allergy research is increasingly moving beyond simply just treating the symptoms, okay?

[01:09:56]You're looking at all sorts of things as well. you're diving deeper and deeper and deeper because ultimately, you know, the goal here is not to suppress the allergic reaction. The goal here is to help the immune system make better decision to recognize real threats when they appear and to ignore harmless substances when they are present. So, it's that building that really strong foundation there. Okay? And to be able to build that strong foundation, you have to target it from all sorts of avenues. So you want to be able to support your immune health through a balanced diet full of a variety of whole foods of fiber richch foods. You want to support your healthy gut microbiome. And remember what I said before, the best thing to do this is not through probiotics, but through eating a lot of fiber. Next up, you also want to have a lot of regular physical activity. Okay?

[01:10:51]And you don't have to run a marathon, but just get up, move a little bit more, and slowly slowly build up over time.

[01:10:58]You want to maintain a healthy weight as well because this helps support immune balance and reduces inflammation. So just remember when it comes to allergic diseases, it's not just about the allergen, but it's about all sorts of things all interlinking together to help support our health in general.

[01:11:21]It's time for our Q&A session. If you have a question, please drop it in the live chat. Kindly avoid asking personal medical questions and please ask each question only once. Thank you. Dr. E.

[01:11:35]World Cup 2026 features a record eight athletes aged 40 plus. It should be attributed to better sports science and nutrition. any tips to improve performance, boost recovery, and reduce inflammation after exercise?

[01:11:51]>> All right, so when it comes to exercising, firstly, I feel like we have to control our expectations a little bit, okay?

[01:11:59]Because when you're looking at these athletes on the world stage, you have to remember cuz I feel like a lot of people will hold themselves up to these impossible standards and then once they can't achieve them, they feel very discouraged and they don't really follow they don't they lose that motivation to follow through with these sort of things. Okay. So firstly in the world cup these are worldclass athletes. Okay.

[01:12:26]Their sport is literally their job. They spend all day every day working at this.

[01:12:33]Okay. And number two, they are genetically blessed.

[01:12:37]A lot of the times when it comes to these sports, you got to have that talent, you got to have that motivation, that drive, but you got to have those genetics, too. Okay.

[01:12:48]All right. So another thing is that like they also have an entire team behind them, you know, really really focusing on making sure that they have the very best possible. They got the best nutrition. They have, you know, the best recovery, you know, they have all the time in the world to do only this. Okay?

[01:13:05]So we got to set those expectations for the normal human being.

[01:13:10]When it comes to recovering after sports, when it comes to, you know, when it comes to getting the best sort of benefits out of sports, it really comes down to a lot of the time it comes down to the diet. Okay, a lot of us will think, oh yeah, we do have or I am eating enough protein every day. You aren't probably not eating enough protein every day. Okay, for for a lot of athletes out there, the amount of protein they eat is huge.

[01:13:37]Okay, it's a lot of lot of effort to eat that amount of protein. But it's not just about the protein. It is also about the healthiness of the food in general because you can have a lot of protein in very unhealthy ways. And if you eat that sort of protein and in healthy ways, then what was the point of all your exercise? Okay? Because you can't outrun a bad diet. The two have to go together.

[01:14:03]So you have to have a lot of protein in a very healthy way. So I would recommend personally that you know for a lot of people you can look into something like plant proteins okay like soybeans. A lot of people will think oh yeah you know plant proteins are not as good as animal proteins but that's just not true. Okay soy protein is just as easily absorbed as animal protein. It's got every single essential amino acid that you need. So it is a super super viable and super healthy choice because unlike animal protein it doesn't have that sort of excess unhealthy fats and excess amounts of cholesterol.

[01:14:45]Okay, so it is a very very valid choice.

[01:14:48]Now another thing that people also think of when it comes to these sort of exercises is that you don't want to be a weekend warrior. Okay, what this means is that people who do absolutely nothing all throughout the week and then on the weekend they're just like, you know what, I'm gonna go out. I'm gonna run a marathon. Okay, so when you do this, you can actually cause yourself more harm than good. So when you're doing these sort of things, you know, you want to build up gradually over time. You don't want to so you don't want to push yourself so hard that you push yourself into injury. Okay? So, it's building up a little a little bit over time. And we also want to get enough rest. A lot of people will exercise super super hard and then they just don't take enough rest because I also feel like again they're looking at these, you know, fitness influencers. They're looking at the athletes on the world stage and they think to themselves, well, this person can work out every day for like 3 hours a day and they're perfectly fine. Why can't I do the same? It's because they built up to that. Okay? And for some people, you know, you have to be able to give yourself a little bit of time. Give yourself time for your body to repair itself. And maybe, you know, if you're super consistent with it, you can build up to that level. Okay? So, it really does come down to diet and getting enough rest.

[01:16:17]Dr. E, if one is deficient in vitamin D, is it recommended to sunbathe for an hour after 10:30 a.m., will doing so cause skin cancer? And is it true that no food contains vitamin D?

[01:16:31]So, when you're looking at, you know, vitamin D for the amount of time you need to spend in the sun to get adequate amounts of vitamin D depends on the strength of the sunlight we are in. For example, people in the up up way up north will have to spend more time outdoors because they don't get as much sunlight as we do. Okay. But we are practically on the equator. Okay. It also depends on the time of the day as well.

[01:17:04]Okay. So, if you're trying to sunbathe super early in the morning, you may need a little bit more time. Whereas, if you're trying to do it in the middle of the afternoon when sunlight is the strongest, you will need a little bit less time. Another factor that matters is your skin tone. The more tan you are, the more time you're going to need in the sun to get adequate amounts of vitamin D. The more pale you are, the less time you need in the sun to get adequate amounts of vitamin D. So, it really depends on what time of the day you're going out, where in the world we are. If you're in Singapore, you don't need that much time. We got a lot of strong sun here and also your skin tone.

[01:17:42]Okay. So, when it comes to vitamin D, Yeah. Yeah. Yeah. Um, the best way to get that is through sunlight, but again, you have to be able to balance it with the risk of skin cancer. Okay. So, spending a little bit amount of time in the sun is fine. It's natural. We will we'll be able to deal with it perfectly fine. But you have to balance it correctly so you don't get to the point of, you know, having a sunburn or having too much sun damage because that can increase the amount of increase the risk of melanoma. And all of these things will depend on all of the factors I listed before. So, it's not so much a hard and fast rule of, you know, you have to sunbathe for an hour every day after 10:30 a.m. It really depends on you and like what exactly you're doing here. All these individual factors.

[01:18:39]Dr. E, may I ask if tick disorder is related to the nervous system, allergies, or perhaps both? For children with tick disorder, is it possible for the condition to gradually improve as they grow?

[01:18:53]>> So when you're talking about things like tick disorders or I think you have Tourette's disorder, Tourette's. So a lot of these things, scientists, doctors, we don't actually know what causes it. Okay? So there's a lot of research going into it trying to figure out what exactly is causing the sort of disorder, but we don't actually know yet. So we don't actually know if it's from the nervous system, if it's from an allergy, or even if it's both.

[01:19:22]We don't actually know. But what we do know is that there are a lot of management strategies that children can use to help manage this disorder. And then for some kids, they can get better over time. For other kids, it does not get better over time. It really comes down to the individual. I wish I could give you a more specific answer, but unfortunately, we just don't know enough about it yet. And hopefully in the future with more and more research, we can have a better understanding of why these things happen. And then once we have that better understanding, we can come up with a better management strategies.

[01:20:01]Dr. E for women who experience pmenopause or menopause symptoms what can they do to improve their symptoms and quality of life.

[01:20:11]All right so women with pmenopause menopausal symptoms it can have a lot of very disruptive symptoms. For example, hot flashes are one that I have a lot of people complaining to me about all the time. So one of the things that you can do is take hormone replacement therapy.

[01:20:28]But a lot of people don't want to take this medication for for you know reasons of their own cuz it does have its own side effects. So outside of this medication, what can you do to help these symptoms? Now there's a lot of research showing that if you eat more soy, it can help manage the symptoms of pmenopause or menopausal symptoms.

[01:20:51]That's because soy contains phytoestrogen. And phytoestrogen is not the same as estrogen. I know it's got the name estrogen in it, but people always see estrogen. They ignore the phyto in front of it. Okay? It's not the same thing. Phytoestrogen has similar effects in the body as estrogen, but it's not the same thing in which that it can it can attach to the receptors of estrogen. So a lot of these permenopausal or menopausal symptoms is because of as we get older as you know we enter into menopause the estrogen levels will drop. That's natural but that's what causes a lot of the symptoms. Okay. So phytoestrogen can attach to these estrogen receptors in such a way in that it helps relieve some of the symptoms of permenopause but without you know without having a true estrogen-like effect. Okay. So, to help out with these symptoms, researchers have found that increasing the amount of soy in the diet can actually have measurable benefits. Another thing that can help is also just more exercise. I know, I know I keep going on about it, but it is something that helps a lot of people in a lot of different ways. And it's something that's so so simple that each of us can manage. Okay, so two really easy things to do is eat more soy products and get moving a little bit more.

[01:22:21]Dr. E, people with psoriasis rely on topical steroids but worry about TSW, topical steroid withdrawal, when trying to stop treatment. What alternative treatments and long-term strategies are available beyond topical steroids?

[01:22:39]Okay. So, when it comes to topical steroids, most people do not have to worry about topical steroid withdrawal syndrome if they do not use very strong steroids over a very prolonged period of time. Okay? You need both of those together in order to be to be more at risk of this sort of um syndrome. So, with the thing about psoriasis is that these topical steroid treatments are the gold standard. Um, it is one of the most effective things that can help manage psoriasis symptoms. But the key point here is that you can only use it for a very short period of time.

[01:23:19]Okay? So it's as with everything in medicine, there is a balance. Okay? You want to as a because all treatments they come with risks. So the so the balance is does the benefits of using this treatment outweigh the risks for me?

[01:23:36]Okay, you can't speak for everyone. You got to speak for the individual and have them decide for themselves. Some people will say yes. Okay, like the the effects of the steroid treatment is worth the risks for me because it helps get rid of my psoriasis symptoms, you know, it helps me live a more comfortable life.

[01:23:56]All right, it depends on them. But for other people, they would go, "Hey, I'm not comfortable using this steroid treatment because I don't I don't want to potentially suffer any of these side effects." Which is perfectly valid because everyone is a little bit different. Okay. So, outside of these steroid treatments for psoriasis, there are also a lot of different treatments as well. For example, these newer treatments called um biologic treatments in which it can come in the form of injections that will help modulate the immune system so that it doesn't go into this overdrive of attacking the skin.

[01:24:31]Because psoriasis is at its core an autoimmune disorder, which is why medications like steroids will work because it suppresses the immune system and by suppressing that you help improve the symptoms.

[01:24:46]But a lot of these new u medications like these biologic pins biologics can also work in a similar way in that it helps modulate the immune system so that you have that control of this overreactive immune system. Um but not everyone is suitable to be on this sort of medication. So it so you can look into that but you have to go into your doctor have them evaluate you and see which one would be more suitable. All right. So there's a lot of options out there. Steroids are not the only option.

[01:25:19]There are a lot of options out there. So you have to go into your doctor, have them have a have a good look at your symptoms, have a good look at the severity of the disease and all the other factors and see if you're if you're a good candidate for these other medications.

[01:25:36]Dr. E, why are cancer patients often advised to avoid antioxidant supplements during chemotherapy treatment?

[01:25:46]So a lot of cancer patients are advised against these sort of antioxidant supplements during chemotherapy treatment. It's because a lot of chemotherapy will kill cancer cells via oxidation. That's the method of killing these cancer cells because chemotherapy is a it is a poison. Okay. So the idea of it is that the chemotherapy will target cancer cells and leave normal cells mostly alone. Okay, it's a hit or miss. Sometimes it does the job really well. The newer chemotherapies are really really good at this. Um but it really depends on the chemotherapy itself. Okay.

[01:26:27]So a lot of doctors will be like you know what just to be absolutely safe I'm going to recommend against these sort of things. But then I also feel like people will go okay so if it's down to this and this means that I can't have a healthy diet because a lot of foods in a healthy diet like plant foods a lot of you know vegetables fruits they all have antioxidant properties. So I feel like oh yeah people will take this way way too far in the opposite direction and they'll be like I'm not going to eat any blueberries. I can't have any sort of, you know, any sort of vegetables because it's got too many antioxidants in it.

[01:27:04]And I feel like that is doing yourself a um doing yourself harm. You know, you're not doing yourself any favors there. So, yes, the doctors are trying to cover all their bases because their goal here is to like maximize the treatments, maximize killing off the cancer cells.

[01:27:23]But when it comes to you as an individual, your goal is to take care of your health as a whole. Okay? And part of taking your care of your health as a whole is to put in the effort to have a healthy diet. And a healthy diet does absolutely include foods that have antioxidant properties. So, I feel like yes, it's perfectly fine to do that because who am I to tell a cancer patient you can't have a healthy diet?

[01:27:52]you can't have vegetables, you can't have fruits, can't have these sort of foods. You know, who am I to say that because that would be I feel like that's just wrong advice.

[01:28:01]You know, you are advocating for something that is going to do them harm in the long run. Okay? So, if you have a healthy diet, I don't want people who are have cancer, who are on chemotherapy to be avoiding these foods because they're scared it's going to interfere with their chemotherapy treatment. Okay, don't think that way. All right, your foods, the blueberries you eat, all the other foods that you eat, it's going to bring it to you so many other nutrients, it's going to help your healthy cells, you know, get through this chemotherapy because chemotherapy is very, very strong. Okay, the amount of blueberries that you eat is not going to undo the work that chemotherapy is going to do.

[01:28:48]That stuff is that stuff is effective.

[01:28:51]Okay. It's it's it's it's it's really strong stuff. Okay. So, I don't want you to worry too much about that. I want you to have the doctors worry about the chemotherapy. Have the doctors worry about, you know, killing off your cancer cells. I want the patients to focus on making sure that they're taking care of their body as a whole. And this does include a healthy diet that will include antioxidants. So, don't don't worry about that.

[01:29:21]Dr. E, if we have low IG, will we have less reactions to allergens? How can we lower?

[01:29:30]All right. So, the goal to improving allergies or allergens is not to mess about with the immune system.

[01:29:40]Okay. A lot of people have this mentality in which when they're looking at, you know, improving things like diseases, allergies, even autoimmune diseases, their focus is to, okay, I'm going to go in and mess about with immune system. I want to go in and mess about with all of these, you know, different different levels of different things when that is not the goal. That is also not advisable because who are we to say, "Oh yeah, I know better than the immune system. Our immune system is so complicated that scientists, researchers, doctors, even people who have spent their entire life researching it still do not fully understand it."

[01:30:21]Okay?

[01:30:22]And even then, if you have these high levels of it, it is also not it's not the root cause of the problem.

[01:30:31]The root cause of the problem here is not the IG levels. The root cause of the problem here is that the immune system is reacting inappropriately to something that is otherwise harmless because in and of itself is not a problem. Okay?

[01:30:45]You still need essential roles. For example, levels will go up if you're fighting against parasites. Okay? So, it's not that's not the problem. Ig levels are not the problem. It is a symptom of the problem.

[01:30:59]It is a result of the problem and the problem is our immune system going haywire.

[01:31:06]Okay, that's the problem. And as uh as I already went through, one of the best ways to take care of our immune system is to also take care of things like our healthy microbiome. All right? And one of the best ways to do that is to eat more fiber. A lot of people will go, okay, if I eat a lot of probiotics, you know, I will be fine. you know, I'll eat a lot of kombucha. I'll eat more kimchi. I'll eat more fermented foods and all of this will mean that I have a great microbiome. But that's not exactly the case. Okay? Because for a lot of these probiotic supplements, so what they do is that they will have I don't know how many thousands of colonies.

[01:31:47]They always advertise, you know, I've got like this many thousands of colonies of like lactobacillus or budtoacterium.

[01:31:55]It's always one of those two. Um but it's actually you know yes these things are beneficial bacteria but it's only one or two strains it's not giving you that diversity that is important.

[01:32:08]Okay, so probiotics, yes, they give you a massive dose of otherwise friendly bacteria, but it is not a replacement for fiber because it does not build diversity, which is the important thing about our microbiome. And fiber does help build diversity.

[01:32:29]Okay. So, for a lot of people with allergies or even for a lot of people with autoimmune diseases, which is also the immune system going haywire, but in a slightly different way, um they find that if they eat more fiber in their diet, their allergic symptoms or even the autoimmune symptoms can improve. So for people with allergies who are really struggling with allergies or allergic diseases, one of the things that I would recommend for them which is also something that everyone can manage is to eat more fiber.

[01:33:06]As we are running short on time, the next question will be our last question.

[01:33:11]Dr. E for severe eczema issues. What are the evidences on efficacy and safety data available on amunotherapy in managing it? Also, is amunotherapy good for kids with nose allergies and eczema.

[01:33:28]All right. So, the thing about these imunotherapies is that they are relatively new. Okay. But again, as with everything in medicine, it is about the risk and benefits. Okay. So for things like eczema, the very very core like the very basic treatment that we would recommend to everyone with eczema is to keep the skin very very moisturized.

[01:33:51]Okay? You want to apply moisturizer all the time because the thing about eczema is that it is it is interfering with the skin's barrier function. So the one of the main purposes of the skin is to be a barrier between you and the outside world. All right? But in eczema, this barrier function is compromised, which means that a lot of the other things like environmental triggers, pollutants, bacteria, viruses, they can penetrate the skin deeper. because it is has this compromised barrier function.

[01:34:28]Once it penetrates deeper, you can also have that reaction to it, which is why it's so easy for kids with eczema to have, you know, very sensitive skin, to have a lot of things that will trigger these sort of eczema reactions. So, at the at the very very basic level, we ask certain things of parents and children and that is to avoid known triggers, right? And for every person, it can be a little bit different. So you got to figure that out on your own. Okay. Some common ones can be things like detergents. It can be like cold air. It can be sweat. It can be all sorts of things. Even different foods can have different triggers. But everyone's a little different. Okay. The other thing we ask of them is that they have to keep their skin very very moisturized. I'm talking like, you know, no hot showers, you know, no prolonged hot showers. Of course, you can still shower using hot water, but you can't just soak in the shower, okay? It's a quick shower as as long as you need to get to get clean, but I don't want you to be like standing there under the shower contemplating life, okay? Or singing a musical. No, none of that. Okay? So, quick shower to get clean and then you come out and then moisturize. Okay? In the middle of the day, moisturize. You know, after you eat, moist, you remember to moisturize.

[01:35:45]Okay? It's important. super important.

[01:35:48]Okay, next up is that if they ever get a flare up of eczema, then the next thing they should just step up is like steroid cream just to control the reaction so they're more comfortable over time. But of course, some people don't want to use steroids. So there are these imunotherap these imunotherapy um treatments like different biologics to help manage allergic diseases like eczema or even psoriasis or even other diseases like um autoimmune disease can use them as well.

[01:36:17]But the thing is that these sort of treatments are usually reserved for people who have very severe cases of eczema. these sort of cases that do not respond to the other treatments like steroids either topical or oral steroids or the other sort of management strategies because at this point they're going like okay in order to control the eczema in order for them to have cuz you know bad eczema it's it's terrible you know it's a miserable existence so at that point they're thinking okay the risks of these treatments is worth it to in in order to control this disease process in order to allow them to have a more comfortable life. All right? So, at that point, they're saying, "Okay, we're going to use this because it's still relatively new. There's still a lot of research going on to it. You know, there's still a lot of research going on into the long-term effects as well. But what the research has shown so far is that it can be very effective in controlling these sort of allergic or autoimmune diseases. But of course, because it's new, because it's because there's more research going on about it, they're sort of reserving it for the more severe cases. So, the research is ongoing, but so far it's very, very promising. And I'm glad that people who have, you know, very difficult to control diseases have another method in order to help them live a more comfortable life.

[01:37:49]>> A big thank you to Dr. E for sharing such valuable knowledge today and thank you everyone for joining us.

[01:37:57]>> This video will be accessible until June 24th 900 a.m. Until then, stay healthy, take care, and we look forward to seeing you again at the next Healthy Living with Dr. E. Bye.