Ep 132: A holistic approach to seasonal allergies, with integrative pediatrician Elisa Song MD

Hi, Everybody. I am Dr. Jessica Hockman, pediatrician and mom of three. On this podcast, I like to talk about various pediatric health topics, sharing my knowledge not only as a doctor, but also as a parent. Ultimately, my hope is that when it comes to your children's health, you feel more confident, worry less, and enjoy your parenting experience as much as possible. Hello. Hello, everybody. Welcome Back to Ask Dr. Jessica. You are in for a real treat today. I am so happy to welcome back my favorite integrative pediatrician, Dr. Elisa Song. Now, as many of you may have already noticed, allergy season is here and in full effect. Now, I've talked about the treatment of seasonal allergies on past episodes. For example, episode 88 with allergist Dr. Yasharpur for your reference. But I must say, I do get a lot of questions from patients about alternative allergy treatments. So I thought it would be helpful to hear from Dr. Song about how to treat allergies from an integrative perspective. You are going to love Dr. Song. Not only does she have amazing credentials, she went to Stanford, nyu, and she trained in pediatrics at UC San Francisco, but she also is a warm, lovely person. She's so easy to talk to, and she has a great laugh. Without further ado, Dr. Elisa Song. Dr. Elisa Song, I am such a fan of yours. I'm so grateful that you are here on my podcast. Thank you so much for taking the time to come on today.

Oh, thank you, Dr. Jessica. I love being on Ask Dr. Jessica. Is this my second time? Second time. Okay. I love it. I love your podcast. So great for parents and. And for other pediatricians.

Thank you. I'm so lucky to know about you, to know who you are. You're such a wealth of information and such a rarity, I think, to find someone that knows the typical traditional medicine as well as alternative medicine. So how lucky for your patients. How lucky for my guests that are listening.

Thank you.

So can you explain, first of all, what is exactly integrative medicine?

You know, it's funny because when I first started in this, I guess, field, it's not really a field, but, you know, practicing in this way, it wasn't called integrative medicine. It was called alternative medicine. Right. I mean, this whole, you know, realm of non Western, non conventional, I guess, was considered alternative. And now more and more people, and I am using the word more integrative, even over when I first opened my practice, I called it a holistic pediatric practice. But, you know, really and truly, you know, for pediatricians, I mean, we're all holistic, right? We all take kids in the context of their families and their friends and their schools. So looking at the whole child is really what we should be doing. So integrative is more, more accurate because I integrate, I have a very conventional, you know, training background at NYU and ucsf, like super conventional. And then I can take and weave in, you know, through the decades what, what I've found to be helpful in, you know, functional medicine, nutrition, homeopathy, herbs, acupressure points, essential oils. So it's not an either or. It's, you know, what for this child in front of me in this moment, with what they're going through uniquely, what, what combination of treatments is going to be the most effective. So I mean, that's what, that's why I love the integrative. Because it's not like we're not throwing the baby out with, with the bathwater, you know, for instance, like conventional medicine, we're not saying, oh never ever take medications, but we are saying is there might be a place for medications, but a lot of these medications have unintended side effects and consequences. So how do we, if they are absolutely necessary, mitigate those adverse reactions for the short term and the long term, or if maybe there's some wiggle room, are there other things we can do that might actually help the body get stronger, the brain gets stronger and you know, get at some of the root causes of what's going on? Going on.

I think it's so great that you have such knowledge in integrative medicine because myself, I've never taken any courses in integrative medicine and I feel like it's such a gap in my knowledge because the truth is so many of my patients do seek care from alternative sources, from integrative medicine sources. And I wish I knew more, I wish I could help them more. So I'm always open to learning and I'm always, I always tell my patients when they go see an integrative doctor, please tell me about it. I'm happy to read about it, to learn more, but I genuinely appreciate learning from you. So thank you so much.

Well, you know what I, what I appreciate is just, you know, I mean, just how open minded you are. I mean really, I feel like in a way the older you get, I think this is true in life, right? The older you get, the more you realize you don't know. And, but you know, and I think maintaining that level of inquisitiveness and just scientific inquiry and open mindedness, it just makes us all better. Doctors. Right. I mean, no matter what field we're in. And so I appreciate you because I have to say, it's funny, I was talking with a friend who is a pediatrician and you know, as I was starting off my career in this, you know, not very non traditional way and going more online and you know, writing a book and doing like putting myself out there, it was the most daunting thing to share what I was doing with my pediatric friends.

Right.

Because I'm like, oh my gosh, are they going to judge me? Is this so different? So, yes, you know, to be judged by your peers. But I just so appreciate because there are obviously amazing open minded doctors out there. And then on the flip side, there are some who are not. Right. Who are not. And I think for me, I just learned so much from my patients too. When they bring in something new to me, I'm like, what? Like, where'd you hear that? I'm gonna look up some of the research and see because sometimes it's fascinating, you know, what, what they bring to us.

Yes. No, I agree. I think asking questions, staying humble, and definitely recognizing that no one can know everything. I mean, not even, not even know. Close to everything. Yeah, I think that's so important, especially in medicine. I work with my dad, actually. My dad's been practicing pediatrics for over 40 years. I know, it's so, I'm so lucky. We've been working together now close to 13 years. But what I really appreciate about him is that he still, he never acts like he knows everything. We have very natural conversations where he'll ask questions, I'll ask questions. But I so appreciate doctors that know how to put their ego to the side.

Yeah, yeah, absolutely.

So I thought it would be really helpful to talk to you about allergies because we're coming up on allergy season or we're in allergy season.

It's here already, right? We're like, oh, so many patients are suffering already.

It's spring and so many of my patients will show me, they'll ask about alternative medicine sources to treat their allergies. And I don't know that much about it. And so I wanted to talk to you to see what you think is helpful. I would love to hear from you where you feel like integrative medicine can help patients in the context of treating allergies. So first let me ask you how, how do you feel like conventional medicine is helpful when it comes to treating allergies? How you were taught in medical school? Where do you feel like we Got it. Right.

Yeah. Well, I mean, so I would say, yeah, that's a conventional pediatric approach. And sometimes when you're miserable and you're swimming in histamine, I mean, you need an antihistamine, right. If your child is, you know, snoring, can't sleep, they're stuffy. I mean, this is even for adults too, right? You know how fuzzy headed you feel when you have. When you have really bad allergies and it's just. It's miserable. Right. And so we do need symptomatic relief. I mean, absolutely. There's a time for that. So I think in that sense, I mean, that's what conventional pediatrics, Conventional medicine, That's a lot of what it does, right. It kind of squashes your symptoms. And so, great. I mean, no more symptoms, but temporarily. Right. And so if we want to figure out, is there a way to get things under even better control? Because, you know, even with antihistamines, kids and adults, I mean, they get some. But not full relief. So even then, like, even if you're using Zyrtec or Allegra or Claritin or whatever every day, day, then you can also use a lot of these other sort of integrative tools to really get even better.

I'm so glad to hear that you support use of an antihistamine to some degree, because my daughter uses antihistamines for her. For her allergies and she feels immediate relief. So I. I can definitely see the role in the benefit of antihistamines.

Oh, yeah. I mean, my daughter, she's. She's now at the age where she's. She's old enough to start reffing soccer games, which she is all about, because she gets paid cash on the spot. Except in these. In these, you know, on these grass fields with. Surrounded by trees. I mean, she's just. She's a mess, right? So last weekend when she had three games to ref and she came home from her first one, and she was like, you know, I'm kind of stuffy. My head hurts a little bit. And I said, just, you know, take the Zyrtec and you know, we'll just for the rest of the afternoon because, I mean, you need to be functional for the reffing. So that's the beauty of integrative. It's like, yeah, we know there's a time and a place, but. But, you know, we also know these medications with anticholinergic properties, there's a link with an increased risk for Alzheimer's and cognitive decline after prolonged use. And some of the top anticholinergic medicines are some of our antihistamine medicines. So I thought, hmm, well, what are we trading here? Right. And so if we can use our antihistamines over the counter antihistamines when we really that symptomatic relief and find other ways to manage symptoms at baseline so that we don't maybe need it every day, but when we might need it when we're, you know, reffing three soccer games or, you know, whatever it is.

Right, absolutely. Yeah, I agree with that. Not, not depending on something every day, but when you, when you need it seems to be very sensible. What about advice about nasal saline sprays? I'm sure that's something that you would wholeheartedly agree with as well.

Oh, absolutely. I mean, if we think about it and, you know, some of the, some of the things that I recommend for my patients, they're not necessarily, I wouldn't necessarily necessarily call them, you know, holistic or integrative approaches. They're just kind of more common sense, common sense stuff.

Right.

Because what happens right when, when we're outside, the pollen gets onto our hair, onto our eyebrows and our eyelashes, into our nostrils, the hair pushes it back into our nose and so just literally mechanically removing the pollen. And so for my kids who have, you know, really bad grass allergies or tree allergies, and they're outside playing sports, um, I have them just carry, you know, like water wipes or wet wipes in their backpacks. And when they're taking a water break, go ahead, take that. Like, wipe your eye, eyebrows, you know, eyelashes wet down your hair, spray your nose. Or if, and if you don't want to spray your nose in front of your friends, fine, but at least below your nose, you know. Oh, I actually got a tip from a patient and he said it's made a huge difference for him. He started putting Vaseline just around his, his nostrils and a little inside his nostrils, so it traps the pollen and prevents it from in. And he's like, that has made a huge difference. And even just, you know, on a high pollen count day, keep your windows closed, right? Don't, don't have your windows open so that the pond blows in. And then, you know, for me growing up, it was second nature for me to take my shoes off at the door. But taking your shoes off at the door, so you're not tracking pollen in all over your house and, you know, definitely not on your bed, right. Where you're going to lay down later. And Even changing for the kids who are really bad, I just say, just take your shirt off, your jacket off at the door, you know, run like, rinse off and then. And then go on with your day. But last thing you want is to come in, you know, full of pollen, and then you plop down on your couch and you, you know, lay there, you know, reading or watching TV for the rest of the afternoon.

No, it's so smart. I think that makes so much sense if you can keep the world around you clean. So, for example, when you come into your house or you're in your room, if you can keep that area clean, that seems like a very simple and helpful way to prevent allergies from getting worse. Yeah, the same with filters, right? I mean, do you recommend.

Yeah, for sure. I mean, I do. You know, and, you know, for us in California, right, you're southern, I'm northern. I mean, a lot of us had filters because of the. The fires, right? I mean, the air purifiers. But even. Even for people who have really, you know, significant environmental allergens, then yes. And running an air purifier can be really helpful. So air purifier, keeping the windows closed and using a HEPA filter, just a vacuum. So just, you know, vac. Vacuum up the pollen or, you know, if it's dust mites, even for that. That's helpful if you know what your kid is allergic to, like for pollens right now, with allergy season, then yes, I think an air purifier is really helpful.

Are there any other medications that come to mind that you use to treat symptomatic allergies?

You know, not so much. I mean, definitely the antihistamines. I mean, I have on occasion, and this again is a conventional thing, but what's very interesting is I'll notice that, you know, kids, when they. When they're having really bad allerg, they'll start to get some reflux symptoms, which. Which makes sense because your H2 histamine type 2 receptors are in your stomach and they're going to increase acid production. So. So if. If they're having, you know, really bad symptoms, then I might do an over the counter H1 blocker, like, you know, Zyrtec, and an over the counter H2 like Pepcid, and pair those, which is right when we're in the emergency room. That's what we do. If kids come in with. With, you know, really bad hives or a severe allergic reaction, even if they're hay fever, you. Or, you know, reflux Symptoms, you're going to give both an H1 and an H2 blocker. So I will reach for that. I have had, even for, you know, kids who have lingering coughs after viral infections, I do think sometimes that actually is more histamine mediated. And so I've had kids were just starting some Pepcid, and it's like the cough goes away. So, I mean, histamine is fascinating because, you know, we think of histamine as allergies, but we have histamine receptors on every single cell in our body. Like, there's not a single organ system that's not affected by histamine. So your gut, your immune cells, your skin, your respiratory tract, your brain. I mean, all of that. And so it makes sense that even if, you know, we're not having outright, you know, typical allergy symptoms, if we have a lot of histamine going around, it may not manifest in your nose, but you might have the brain fog or the irritability or some other kind of brain symptom. I do look for histamine a lot.

That's really interesting because as you're explaining this, I feel like a light bulb's going off because I can think of a number of patients that have allergies but also have reflux symptoms.

Yeah.

So thank you for giving me that to think about.

Yeah. I mean, because. Yeah, because a lot of my kids, like the springtime, that's when the reflux kicks in. And, you know, it wasn't there at one point, that same light bulb moment, I'm like, oh, that makes sense, right? I mean, yeah, histamine, of course. I mean, if you have a histamine, you know, released from an allergen, why would it make sense that the histamine is only going to stay in your nose and your sinuses? Right. I mean, it's like it goes all over.

Right, True. Very true. Okay, so just to summarize. So for people that have that experience seasonal allergies, the things to think about are when you come in the house, take off your shoes, think about sailing in the nose, washing your body, you can consider antihistamines for symptomatic relief. And is there anything else that I'm missing? H2 blockers.

H2 blockers. Oh, and, you know, if the nasal turbinates. So, Right, right, guys, the little bumpies in your nostril, I mean, if they're super swollen, then. Then, you know, I will sometimes use a steroid nasal spray. You know, we'll use flonase temporarily, but not for the whole season. I might try like, because I'm also incorpor, other tools, more natural treatments. So then I, I might try to do nasal steroid spray for, you know, maybe five days a week just to get things under control as we're allowing the, the other, other supplements, tools to try to kick in.

Do you recommend anything for itchy eyes?

Yes. So itchy eyes and this is where we're getting more into the more integrative tools because I mean the itchy eyes are terrible. But what works so well I think is two things. So if you take, you know, brew a cup of chamomile tea and a lot of people have chamomile tea in their house. So brew a cup of chamomile tea and then you could also put in if you have calendula oil. Calendula is marigold but has really great anti inflammatory soothing properties. You might even have some marigold in your yard. Right. You could actually just crush some flowers and put that into your tea. Or you can get some calendula oil, not, not the alcohol tincture, but the oil base. Put like half a teaspoon or a teaspoon into that tea. Take a compress and just hold it to your eyes because it'll be soothing, anti inflammatory. This is really good also for pink eye conjunctivitis. So conjunctivitis, whether it's allergic or infectious, I find that it can be really helpful. And calendula also has antimicrobial properties. So whether you have like a bacteria or a virus going on with your pink eye or if it's allergies, it's all going to help. So, so that's one thing. There's a, there are a few different homeopathic ones that I find really helpful. They're general. They're called the homeopathic antihistamine. So they're going to be good for the eyes. But. And also your other histamine symptoms. But you know, APIs malifica and one called histaminem. So there are two homeopathic medicines that are. And histaminem, I mean just what that is, it's homeopathically diluted, like ultra dilutions of histamine.

Right.

So when you have these ultra dilutions and homeopathy is one of the forms of medicine that a lot of people have the hardest time wrapping their mind around. They're like, it's so dilute. Isn't it just. It's a sugar pill, it's, it's placebo. Well, there Are there are animal studies that animals really, you know, probably won't respond to placebo. Right. And some in vitro studies. So this one in vitro study took basophils. So for the listeners, basophils are one kind of white cell that can release histamine. And they sensitize these basophils to dust mites. And then they bathed the basophils at different ultra dilutions, different strengths, very, very dilute of, you know, histamineum or APIs malefica. And then they exposed them to dust mite. So they should have released histamine when exposed to the dust mites. And what they found was at every ultra dilution, basically a homeopathic preparation of it, there was inhibition of degranulation, meaning in lay terms, they. They didn't release as much histamine. I mean, fascinating, right? And that's in. That's like in a test tube, so. Or a petri dish, right. You know, there's not really. There's no placebo there. So. And I have had, like. I had a kiddo who, you know, was in my office, and he had just. He had just gotten a shot, and they were checking out, and the mom's like, Dr. Song, can you come to the front desk until I come out? And I'm. And I look at him, I'm like, huh? He had, like, these red little blotches on his face that he. I mean, they weren't there before. I'm looking at him like, are you feeling okay? And he's like, yeah. And then they started marching. They were hives, right? Kind of marching down his body. I was like. I was like, wait a second. Let me, you know, go to the back office. I'm going to get some Benadryl, right? Time and place, right? I'm like, okay, you need an antihistamine. But that was going to take me a little bit. So I said, look, in the meantime, I gave mom a tube of APIs mellifica. And I said, look, give him three pellets and then I'll be right back. But, you know, like, you can every couple minutes give him three pellets. So by the time I went back, you know, poured the Benadryl in the cup and brought it back, they had already started marching back up his body and disappearing. Like, I mean. And, you know, I can't make this stuff up right there. You know, I'm like, wow. Like, I saw it from my eyes. And so I told him, okay, he's. He's looking at I mean, no trouble with breathing. Of course, you have to. To always have to think about allergies. Okay, no respiratory distress. And I said, he looks good. You know, we observe him for a little bit longer. I said, go on home. Keep giving the APIs mellifica, maybe every hour and that. But if it gets worse at all, like, give him the Benadryl. Right. And so she calls me later that night. She's like, well, they all went away, right? You know, very quickly, within a few hours. And he never needed the Benadryl. So anyhow, I just wanted to share that because like I said, homeopathy is one of the most misunderstood, you know, kind of alternative integrative treatments, modalities. And so I definitely, from a clinical standpoint, I, I've seen the effects and sometimes, you know, very quickly, it's amazing.

And I, I also have to say I'm impressed with how you pronounce all these hard words. I think that would be.

I've been doing it for, like, part.

Of being an integrative doctor.

Yeah, all. It's very different lingo, for sure.

Okay, so I have to tell you, so I'm going to share a story. I met somebody who you were their physician, and it was a coincidence because we don't live in the same city. And I met somebody while I was visiting a friend in Arizona, and she told me a story about how she was not feeling well and you actually diagnosed her home with having a mold situation. And so I just wanted to ask more about this. Ask you, what are the symptoms that exist if somebody's exposed to mold? I just wanted to bring some awareness because this particular family suffered for a long time. It wasn't on their radar. And so I just wanted to hear from you, what are the symptoms of mold and what should we know about it? So, by the way, that was such a great story. I was so proud of you.

Thank you. So when we think about mold exposures, the kind of mold exposure I'm more concerned about is not necessarily mold allergy. It's very different. So similar to a pollen or, you know, allergy or dust mite allergy. Some people do have those kind of mold allergies that are mediated by IgE antibodies, and those, you know, cause the typical allergy symptoms. Right. The, the nose, the eyes, the cough. What I look at more when I think about mold is, you know, different species of mold in an effort to protect themselves. Right. In an effort to kind of defend themselves. I mean, they're. They're living organ organisms, and they want to survive just as much as we do. So they secrete these. They're called mycotoxins. They're different chemicals that are secreted, and some of them are benign, but some of them can cause really big inflammatory responses in susceptible people. And so they can trigger a lot of inflammation. They're typically due to. I mean, the ones that are more common due to some area of water damage in your house you may not even know about. Right. Maybe behind the dishwasher leaked, or maybe there was, you know, a roof leak behind one of your walls. So if you were to open the wall, you would see mold there, but not anything that you see inside your house. And, and, you know, it's inflammatory to most of your organ systems. But many, many people will have neurologic symptoms. So, you know, a little confusion, you know, brain fog, they'll actually feel depressed, some cognitive slowing, you know, poor focus, difficulty sleeping, you know, problems with mood. So there lot of people will have joint pains because of the inflammation. And then of course, you can have respiratory symptoms as well. So with mycotoxins, they're kind of. It is, though, I'm going to be totally honest. It's a. It's still a little bit of a wild west in terms of. How do you test for, like, the. An accurate way to test for, quote, toxic mold in your home sometimes. I mean, we have a ton of mold outdoors, right. And some of the mold that we test might be actually what we're measuring from outdoors. Not all mold is bad. And, you know, how do we know if. If the symptoms you're feeling really are specifically related to mold? So there are some urine tests that, you know, from a functional medicine standpoint can be helpful, some blood tests. But it is, I will say if you have. If you have symptoms that are really varied or your child has symptoms kind of unusual and your doctor's having a hard time putting the pieces together, maybe referring you to a few different specialists and, you know, there's just. It's a confusing picture. Or if you have, you know, some chronic issue that is persisting and, you know, let's say you're on the quote, right? Treatments, whether it's conventional or, you know, functional medicine, integrative treatments, and, you know, they should be working, but they're not moving the needle, then oftentimes I find mycotoxins are an underlying inflammatory part of the picture that prevents you from moving forward in healing. So once we do with that, then all the other things can fall into place.

Okay. So for myself, as a General pediatrician. If patients come in with symptoms as you described, where I should be sending them to test for mold, what would the advice for my. You know what, what would the advice.

Yeah, because we need the practical. Right, because. Yeah. And you. And, you know, what I would suggest is if you're, if you are, if you actually see any, like, mold spots in your house or, you know, I have one family who, they're dealing with mold, and she said literally, she'll put a house plant in her kitchen and like, by the next day, there's mold growing on the leaves. I'm like, okay, there's. That's a problem. Right. That shouldn't be happening. Right. And so there are tests that you can order online. One's called an ermi E R M I where they'll send you like a little dust cloth where you can swiffer different areas of your home to collect some of the dust and, and send it off. And they'll analyze it for different types of, of mold and mold toxins to see if the kind of mold that's growing is anything to be concern about. You can have home inspectors come, but unless they are knowledgeable about how to accurately assess for mold, sometimes they'll just take a few air samples and say it's fine. But, you know, mold is, you know, likes to be on the ground. So really, like those petri dishes that you can collect samples and send off are probably going to be more accurate. And then if you have a patient who has kind of like mystery symptoms or unusual symptoms, then there are some urine tests that you can order for mycotoxins. The problem with the urine tests is there's not any at the moment that I'm aware of that you can order at a conventional lab like Quest or LabCorp, so that it would be easy to get and also covered by insurance. So that is one of the blocks there. But. But there are some labs that I will use. My first go to is one called Mosaic, Mosaic Laboratories.

Okay. Now, thank you. This is helpful because I, I think it's just important to keep it on our radar in case somebody has symptoms like you described.

So. Yeah.

Is there anything else with allergy season that you think would be helpful for parents to know, especially when it comes to prevention of symptoms?

So, yes, because there's the prevention and then there's like, what do you do when you actually have the allergies? And prevention always is better if you can. Right. And part of that prevention is pollen season is ramping up. You just got to do the House measures that, you know, start running the HEPA filter or the air filter if you. If you're not, and vacuuming more frequently and things like that.

Local honey has actually been found to be helpful in preventing and reducing the severity of allergies. Now, why is that if you have to start before allergy season, Right, and why local? Because your local honeybees are going to be sampling from the flowers and plants whose pollen you're allergic to. It's almost like, you know, allergy desensitization, right. If you were to do allergy drops at the allergist, they give you a really low dose of the allergen in little drops, and you. And your body learns to tolerate it, right? That's the goal. And so if you started that local honey, you know, like a teaspoon a day, you know, just maybe a month before that, that can be helpful. Not everyone is going to be super into acupuncture, but it works, works amazingly well. If you start, like the month, maybe even two months before allergy season, that can be super helpful. And for kids with acupuncture, they're not sitting there for half an hour, you know, with, with needles in them. I mean, they're literally. It's like in, out, you know, while we're reading a book or, or singing a song or whatever it is. I mean, the whole treatment can be like, I mean, two minutes, right? Very, you know, very, very fast. And then, you know, in terms of diet, as we head towards, towards allergy season, we just want to think. If you think of an allergen, it's triggering inflammation in your body, right? I mean, that, that's why you have symptoms. And, you know, so there's, there's histamine, but there are also other, you know, prostaglandins and other immune chemicals that are being released. And so anything we can do in our diet and lifestyle to reduce the inflammation. So I'm going to point out sugar, like, you just got to keep the sugar down to, you know, healthier levels, you know, as you. As you approach allergy season. Same thing, as I would say, if your kiddo is the. Is the kid who, whenever they get a cold in the winter, it goes immediately to their chest and they get pneumonia, bronchitis. All right, well, then cut the sugar. For now, not necessarily 100%, but the number that the American Heart association says is no more than 25 grams of added sugar in a day, which is about six teaspoons of added sugar. But, you know, it adds up. I mean, your kid May be having upward if they're, especially if they're older kids, like, you know, our teenagers, if they're going out with their friends and they go and they get a cake pop from Starbucks and they get a boba tea and they get this or that, I mean, they could have had right then and there like, you know, 12 teaspoons of sugar in one sitting without even thinking about it. So just having them be aware and you being aware. So we know sugar is inflammatory. I don't have a lot of good data on the dairy piece, but, you know, so many people have the, have the experience that it just makes you more snotty. Right. I mean, just build it, kind of clear your throat and get more mucus. So. And in Chinese medicine, okay, in traditional Chinese medicine.

There are certain foods that cause more dampness, more stagnation, more, more phlegm accumulation. And two of the top ones are dairy. Well, three, Dairy, sugar and bananas. Right. And so bananas too. You know, I mean, if your kid's eating like 10 bananas a day or you're having a banana a day and a smoothie, well, maybe drop that in preparation for allergy season.

I love hearing this because I think a lot of doctors were on the quick side to recommend medication. So I love thinking about prevention. So this is really helpful and I don't think anyone can argue with this. Some honey every day. A little bit of honey. Tastes good. Not bad. A little acupuncture, I think, think in my view, what I've read about acupuncture, there really aren't any side effects. So if a child can tolerate it, sounds great. And then who can argue with a child reducing sugar? I think that's a very helpful.

Right. Yeah.

Well, very good. I like having those things on the forefront of my mind to think about to recommend for families as we come into allergy seasons.

Yes, for sure.

Thank you so much. Is there anything else that you want to impart before we part on the conversation about allergies?

Well, yeah, so, you know, I. So let's talk more about symptomatic relief too. Right. Because, you know, there are like, you know, know my strategy when kids have allergies, especially if they've already started with full blown allergy symptoms. I do, you know, have them take Zyrtec or whatever over the, over the counter histamine to. So the way I explain it is you have all this histamine floating around. We need to mop up that histamine. So your, your H1 blocker is going to mop up that histamine. But what can we do to prevent more histamine from being released or slowing it down? And there are actually lots of supplements that can do that. So one of my favorite is quercetin. So quercet. Quercetin is found in the skin of red apples. It's found in red onions. It's found in capers, you know, spinach. So quercetin is a natural mast cell stabilizer, meaning it stabilizes the cells that would release histamine when they encounter a pollen. So loading that in along with. Along with vitamin C. Now, in adults, a dose of 2000 milligrams a day has been found to reduce histamine release and mop up histamine. So for kids, you just don't dose it. Like, if you have a teenager, maybe they'll get a thousand milligrams. For a younger kid, a little bit lower. And other supplements that have been found to help reduce histamine are zinc omega 3s. And there are certain probiotics that can actually also reduce histamine release. So, I mean, any of those, like, why not take those are probably things that that many kids would benefit from anyway. But especially in terms of histamine, we want to. We want to layer those in. And my goal is, you know, you take the Zyrtec Claritin to mop up the histamine, then you do all these other things to reduce histamine release, and you get this sweet spot where you're feeling pretty good. And eventually you can wean off the antihistamine because now you're maintaining on your. Your histamine stabilizers. And you can then use the Zyrtec more on an as needed basis, just not every day. And then. Oh, I totally forgot. On a dietary standpoint, if you can focus on a diet that's really rich in quercetin, because we get all that from food, why not, right? And you can. You can search lists of quercetin foods that are high in quercetin. On the flip side, there are foods that are known to either trigger histamine release or are high in histamine. Like, you know, deli meats, aged cheeses, strawberries. Those seeds can trigger histamine release. So maybe not have a basket of strawberries every day. Like, you just limit it to a little bit. And as much as I love, love, love fermented foods, there are some kids who, when they're in the throes of allergy season, they may be sensitive to the histamine levels in fermented foods. So just playing with that and seeing how they respond.

And do you feel like the same goes for zinc? Can you try to encourage zinc rich foods for kids rather than taking a supplement?

Could that be you could. Yeah. I will say, you know, because I do, I do blood work. I'm going to guess more, more often than, than conventional pediatricians. Right on kids. And so when I check zinc levels, it is one of the most common nutrient deficiencies. Even for like quote. Well, kids, I think our bodies just use a lot, so much zinc. I mean, zinc is important for our immune health. If you're a picky eater, I mean, zinc changes your taste preferences. Zinc can cause, I want to say it's called gain, gain amplification. Anyhow, it makes sound sound a little louder if you're deficient in zinc. So those kids with auditory sensitivities, you know, closing their ears with the, with the vacuum or the blender, and there's.

Great data on it. Preventing colds.

Preventing colds. For boys who, who are prepubertal, zinc is really important for testosterone production. It can help really support healthy neurotransmitter levels. So I just, I think so many. We're probably using a lot more zinc than, than we can get from our diets. But yes, please, where do you get zinc? Zinc intake is highly correlated with animal protein intake. You know, the highest source of zinc is actually oysters. So if your kids like oysters and go for it. But shellfish is really high in zinc. But also you can, if you know, get it from vegetarian sources. Your nuts and seeds, especially pumpkin seeds, are going to be really high in zinc too.

Oh, yum. I love pumpkin seeds, especially during Halloween. All right, well, this is so helpful. I love hearing about how to avoid allergies. This has been really helpful. So thank you so much.

Oh, thank you. Thank you for having me.

Thank you for listening and I hope you enjoyed this week's episode of Ask doctor Jessica. Also, if you could take a moment and leave a five star review wherever it is you listen to podcasts, I would greatly appreciate it. It really makes a difference to help this podcast grow. You can also follow me on Instagram at askdrjessica. See you next Monday.