Dr. Cindy Geyer:
If somebody has a lot of histamine symptoms and are struggling, it’s also worth a trial of a low histamine diet.
Dr. Mark Hyman:
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman. That’s Farmacy with an F. A place for conversations that matter. If you’ve ever suffered from allergies or you’re struggling with seasonal allergies, you better listen up because you’re going to learn a lot about how to deal with this problem in a way that you probably never heard before. It can really help you. And today we have, as our guest, none of them, Dr. Cindy Geyer, who’s joined our practice at the UltraWellness Center recently. I’ve worked with her for over 20 years. She was the medical director at Canyon Ranch. She’s an extraordinary physician. I’d go see her any day for me. And we’re so lucky to talk to her today about allergies. Not food allergies, but seasonal allergies, which we’ve covered a lot about food allergies or sensitivities. But I think this is a vexing problem that affects so many people.
Dr. Mark Hyman:
These over the counter drugs, people are buying like candy. And I think most of us think we’re doomed to just have allergies. We get allergy shots. But the truth is there’s so much that’s driving this overactive immune response that we can modify once we understand what’s going on underneath. And I know you’ve had your own experiences with allergies, and I certainly have seen many, many patients who struggle with and had just remarkable benefits by adjusting some of their lifestyle habits, diet and also improving their other factors, which we’re going to talk about, like the gut, for example. So welcome Cindy.
Dr. Cindy Geyer:
Thank you Mark. It’s good to be here as always.
Dr. Mark Hyman:
What is the problem with allergies we’re having in this country? How prevalent is it? What are the symptoms that most people get? What causes it, and how does traditional medicine typically deal with this problem?
Dr. Cindy Geyer:
Well, allergies have been around for a long time, so it’s not a new problem. It’s when your immune system makes antibodies, usually called IgE antibodies, to something that you’re breathing in or exposed to in the environment, like a dust allergy or a pollen allergy or a grass allergy. And when that happens, these mast cells, that contain histamine, dump their histamine and cause all the symptoms that we recognize as allergy symptoms, congestion, sneezing, itchy nose, itchy eyes, watery eyes, sometimes wheezing, tightness in the chest. It can contribute to asthma. And one of the things that gets overlooked is just how exhausted people who have active allergies can feel. They’re a really common contributor to just low level lethargy and fatigue. So those are the classic symptoms.
Dr. Cindy Geyer:
Even though it’s not new, the prevalence is unfortunately increasing. There are a lot more people nowadays with allergies, actual allergies, than there were 50 years ago, 100 years ago. And we can talk about some of the reasons why that happens. And typically, going to treat it, or in traditional medicine, you treat it with identifying the allergen, trying to remove it, treating the symptoms with anti-histamines, maybe nasal steroids, maybe an inhaler for your lungs or trying desensitization shots or drops to try to down-regulate that response.
Dr. Mark Hyman:
And what we see often is this resignation that, “Oh, I’ve got allergies. It’s just what I got, and there’s nothing I can do about it.” So like Eeyore, right? “I had to take these medications, these nasal sprays.” And the truth is, most of the allergy medicines, they’re pretty benign. But the steroids are not, and they’re often used pretty aggressively, like Flonase and Nasonex, all these hailed steroids that may reduce symptoms, but then cause osteoporosis and cause other immune suppressing issues. People really suffer from these problems. And the question is, why are we so over-reactive to things that are just part of our normal environment, right? That’s the question nobody’s really asking.
Dr. Mark Hyman:
It’s like, well allergies are something humans get. Well, guess what? Not necessarily. When you look at populations in indigenous cultures, when you look at even kids who grew up in America, on farms and are in the dirt. I thought about this. I don’t have any allergies and I’m like, why don’t I have allergies? And I realized, when I was a kid, every summer I went and lived on a ranch with 50 horses, shoveling horse manure and getting really dirty and sleeping in the dirt. I don’t even think I washed my hands all summer. I think there is a lot of data on this and the science of why we have allergies. So I’d like to go into that a little bit with you. Why? Are there prenatal reasons? Are there early childhood reasons that set people up for allergies? What are the things that tend to predispose people and how do we begin to think about that? Because that’s really about a prevention strategy, right?
Dr. Cindy Geyer:
So that’s a great question. Our immune system is designed to be able to respond to things that it needs to respond to, but not react to airborne pollens or foods that we bring into our bodies. And it turns out that there may be early life influences that help educate or train that immune system to learn what warrants a reaction, like a parasite, for example, and what doesn’t warrant a reaction, like the pollens. So what’s emerging is some of the factors that are making people more likely to develop allergies now could be related to more C-sections as opposed to vaginal deliveries, more antibiotic use in childhood, more frequent hand-washing, being indoors. Some of the things that you mentioned about your own life, that exposure to certain microbes early on that are friendly and beneficial, help teach the immune system that that’s what it’s going to be quiet and react to, whereas it shouldn’t be reacting to the things that we breathe in.
Dr. Cindy Geyer:
There’s even evidence before delivery that a mom who has allergies and asthma, so there’s a genetic component, her diet in pregnancy may also impact her offspring’s future risk of developing allergies and asthma. So there’s evidence that we can put things in place that might lower somebody’s risk in the first place with a healthy diet and pregnancy. Some women have to have a C-section, so I think what’s really fascinating is research going on now that you’ve probably heard of, vaginal seeding or bacterial baptism, it has a couple of different names to it. Don’t do it at home.
Dr. Mark Hyman:
That’s where you take the vaginal fluids and you put it in the baby’s mouth to inoculate the baby’s-
Dr. Cindy Geyer:
Yes. Yes, yes. Because that vaginal delivery is swallowing all those lactobacilli and getting coated in the lactobacilli of the mom that helped train the really immature immune system, that this is a healthy microbiome. Baby’s born by C-section, their first exposure to bacteria is going to be the delivery room nurses’ skin flora, very different populations than what we normally colonize as healthy gut. There is a higher prevalence of allergies and asthma in those kids. You mentioned growing up on a farm, having multiple siblings, playing in the dirt, having pets, paradoxically decrease the risk of allergies and asthma, as opposed to-
Dr. Mark Hyman:
The dog licks you all over your face and you’re less likely to have allergies, right?
Dr. Cindy Geyer:
Believe it or not, yes. Yes.
Dr. Mark Hyman:
It’s interesting, I think there’s a whole theory of these missing microbes in a book called Missing Microbes by a professor, I think he’s at Columbia or Cornell, NYU, [inaudible 00:07:52], and he talks about the fact that we have lost so many of these indigenous microbes that help us regulate our response to foreign substances, right? So we should not be having an overreactive response to things that normally shouldn’t bother us. We should be tolerating them, they shouldn’t be effecting us. And we’ve seen a lot of other books like the Epidemic of Absence, and this goes for allergy, for autoimmunity and more.
Dr. Mark Hyman:
And I think one of the most striking things that I’ve seen as a study years ago, was way back when we were just starting doing this work in Canyon Ranch, there was a paper published. It showed if you gave pregnant women lactobacillus while they were pregnant, and then you give the babies lactobacillus after they were born, or even if you didn’t, the babies would have far less eczema and asthma and allergies just by virtue of that. And it turns out that there’s a bacteria that’s so important for helping regulate immune function and reduce inflammation and help with development we call oral tolerance, which is why don’t you, when you eat a chicken, you don’t become a chicken or you don’t react. It’s because your body knows what to do. There’s a company called Evivo that’s created a bacteria strain that’s called bifidobacterium infantis. And this is infant, right? So this is a very important bacteria that should be in every baby’s gut. And it also should be in every mom’s system.
Dr. Mark Hyman:
And the problem is that one, our overuse of antibiotics during pregnancy, during delivery and even before, there isn’t probably a woman on the planet, pretty much, who hasn’t had an antibiotics sometime in their life. And these bacteria are super sensitive to antibiotics and you will literally wipe them out. And so there’s a whole generation of kids being born with increased allergy and autoimmunity and inflammation and asthma. And it may be in part due to this widespread genocide of this particular bacteria. But now you can take as a supplement and they’re giving it to pregnant women. They’re giving it to babies in the first 100 days. What they’re seeing is dramatic reductions in the consequences that we typically see in these kids, such as allergies and autoimmunity. So I think this whole field, how do we reset the gut? How do we reset the immune system? How do we calm things down? So, so important.
Dr. Cindy Geyer:
Yeah. There’s another piece related to that, Mark and that’s what’s been fairly recently recognized that another advantage of breastfeeding your baby is breast milk is rich in prebiotics that actually allow a bloom of beneficial bacteria in the baby’s gut. So if they’re being bottle fed, they’re missing another opportunity to help develop a resilience ecosystem in the gut.
Dr. Mark Hyman:
Yeah. Absolutely. I think that’s so important. But the problem with it, the breast milk, is that not everybody gets it. And we need to think about how do we put the oligosaccharides, these [inaudible 00:10:56] starch in breast milk into formula, kids are drinking formula. And what’s interesting in terms of this bifidobacterium infantis is that it really loves this particular food. It loves the oligosaccharides that’s in breast milk, and it feeds on it. But the problem is if the baby or the mother doesn’t have it, even if they get the oligosaccharides, it won’t feed it because it’s just not there.
Dr. Cindy Geyer:
It’s just not there, yeah.
Dr. Mark Hyman:
Yeah. So it’s really important. Let’s go into your story because this is not just an abstract medical thing you’re doing with your patients. This is something you’ve really suffer from and you’ve learned about. Tell us about what happened to you and what you found, how you dealt with it and what changed?
Dr. Cindy Geyer:
Yeah. We often use the term of peeling the onion, right? And Mark, it’s interesting because I was born vaginally. My mom breastfed me, so she was kind of an outlier back in her generation. I grew up in South Carolina, played in the woods. I remember getting, this is kind of gross, but we would get hookworm and pinworm. I had certainly had some parasite exposure. Played in the dirt, had pets, but I developed pretty significant dust allergy and cat allergy. So lived most of my adult life with chronic congestion, sneezing, itchy eyes, itchy nose. And I did the usual. I took loratadine and nasal sprays to keep it at bay. And as you mentioned at the very beginning, I thought that was just my lot, runs in my family, I’ve got allergies, right?
Dr. Cindy Geyer:
I also noticed early on, but didn’t know what it meant, I never liked fermented foods. I didn’t like pickles, I didn’t like vinegar. I didn’t like any of that food. I don’t remember having a reaction, I just had an aversion to them, did not like them. That’s a clue that we’ll come back to in a moment. And over the years, as we looked at different types of testing, sometimes at Canyon Ranch, we would vet a test before we brought it on and we would often do it on ourselves.
Dr. Cindy Geyer:
The one thing that kept showing up for me with food sensitivities is lots of antibodies to dairy. I’m not allergic to dairy, but I had IgG and IgA antibodies to dairy. So I did experiments off and on, I’d cut my dairy out, I’d put it back in, I’d cut it out, I’d put it back in. And the only symptom I really noticed was some joint aching. Long story short, I finally cut it out for other reasons, along with some other things. I don’t have as many allergy symptoms anymore. My environmental allergies are quieted down. I’m not on medications. So it’s really interesting how, when we empty the bucket of triggers to histamine, it may make us less reactive to things that we have a true allergy to, if that makes sense.
Dr. Mark Hyman:
Yeah. I think that’s right. I think this is an important concept that you’re talking about, Cindy, is that I’ve seen this in my practice over and over, is that when I have patients who have allergies, when I fix everything else, their allergies get better or go away.
Dr. Cindy Geyer:
Right.
Dr. Mark Hyman:
And what I mean by fix everything else is getting their gut healthy, making sure they don’t have a leaky gut and fixing that and making sure their microbiome is optimized, making sure we get rid of all the bad bugs, put in the good bugs, give them prebiotics, help nourish the gut. And that really helps so many people. And then of course, trying to minimize your exposure, if there’s things like dust or cats. But even those things that are environmental allergies will go way down once we fix the food.
Dr. Mark Hyman:
Often people will have corresponding food sensitivities. So they’re not necessarily related to the environmental allergies. But when their immune system is just pissed off about everything, it just reacts worse. So they end up having, for example, and maybe food sensitivity to dairy, like you said, or gluten or something else. And they have environmental allergies, the environmental allergies will be a lot worse if you don’t deal with those oral allergies that are really causing them also to suffer. And then sometimes, there’s some really amazing things you can do around histamine too, right? So you mentioned histamine and you had a low enzyme, DAO, that is important in neutralizing histamine. But you can’t do that so well. So you have to actually potentially supplement with that, right?
Dr. Cindy Geyer:
Right. And it’s interesting, Mark, that you say that because I only found that out this past year, with one of the new genetic tests that both copies of my gene that codes for the DAO enzyme that breaks down histamine, it codes for a slow version of it. So even without allergies, I may be more prone to having histamine-like reactions because some foods have histamine, those fermented foods, they tend to be really high in histamine. And in retrospect, the fact that I have difficulty genetically breaking them down might explain my body’s own wisdom in not liking those foods. It’s a story, but it makes sense. It makes a lot of sense to me.
Dr. Mark Hyman:
Yeah. And I think it makes total sense. And then we treat people by one, removing the foods they’re reacting to, two, by optimizing their gut and healing leaky gut. By three, helping them support histamine breakdown with histamine breakdown enzymes. We can also give herbs and supplements that can help, like vitamin C and quercetin that really help a lot. So can you talk a little bit about the supplementation? They’re all certain things that can help reduce allergies and allergy symptoms.
Dr. Cindy Geyer:
Sure. So you mentioned DAO. For people who are really symptomatic, that can make a big, big difference. We want to make sure, if somebody has a lot of histamine symptoms and are struggling, it’s also worth a trial of a low histamine diet, which is interestingly, it’s not just fermented foods. There are other foods that we tend to think of as being healthy foods that have high histamine, foods that I happen to love, things like avocados and spinach. Some people respond dramatically to a low histamine diet, and it’s one of those dietary approaches that you really have to partner with a good dietician because this is a complicated approach. Histamines accumulate when food sit as leftovers. So even foods that have been in the refrigerator for three days might have more histamine buildup than not. And any time you’re thinking about cutting foods out, you need to make sure that you’re putting enough things in that you feel nourished and satisfied, and you’re meeting all your needs for critical nutrients. So this is an important one to partner with a good dietician, emptying that histamine bucket.
Dr. Mark Hyman:
Yeah.
Dr. Cindy Geyer:
We know that some probiotic strains can also help reduce histamines. Some may actually make it worse. So it’s also important to get some guidance about which probiotic might be the best for you, if you’re trying to improve your gut function and not cause harm, not cause things to get worse. For example, Lacticaseibacillus casei is one of the ones that’s been associated with possibly making issues worse. And probiotics, you know Mark, it’s a dizzying array. People go stare at the supermarket and say, “Oh my gosh, there’s so many. What do I take?” There’s high quality ones that are specifically designed to only give you the strains that are going to lower histamine, not increase it. But if you’re just taking a random one off the shelf, you may not know. May thinking you’re doing good and you’re doing harm.
Dr. Cindy Geyer:
You mentioned quercetin. I think that’s a great nutraceutical that’s a natural histamine down regulator. Resveratrol may also lower histamine. Vitamin C, even food sources of vitamin C like red peppers and broccoli, those can all down regulate histamine. So there’s a lot we can do. And you mentioned the gut. The other thing to keep in mind is those histamine releasing cells, those mast cells, they cluster behind every place that our body has a natural barrier to the outside world. So they predominate under the skin, they predominate the lining of the respiratory tract and they predominate in the wall of the gut. So we have to keep our skin barrier healthy and resilient, no breaks in the skin and not dry. We want to keep our respiratory tract healthy, not smoking and vaping, that’d be the best way to do it. But air pollution can negatively impact it as well. And then keeping the health of the gut lining really, really in tip top shape. And that also decreases the burden of those mast cells.
Dr. Mark Hyman:
Yeah. And I think just getting everything out, like heavy metals and dealing with any nutritional deficiencies and zinc is common to be low in people, and vitamin D is low. So you basically just stabilize the immune system by helping to optimize all the systems in the body. And the immune system is also influenced by our thoughts and feelings, right? There’s a whole field of psychoneuroimmunology. And we know that your immune system is listening to your thoughts. And so stress can often inflame your emotions, inflame your immune system. And I think that’s really underappreciated. And another doorway is through your autonomic nervous system. Can you talk a little bit about that?
Dr. Cindy Geyer:
Yeah. I think that’s great, Mark. There was a study a few years ago in people with asthma and they found that people who started journaling, so a way to get some of their stresses out on paper and manage them, they had fewer asthma flares and less significant symptoms. Meditation, biofeedback, quieting down that sympathetic arousal upregulated nervous system can also quiet the immune system. Acupuncture, many people find that acupuncture is another way to help quiet everything down. It can make a big, big difference. So it’s a critically important piece that often gets overlooked.
Dr. Mark Hyman:
So important. And I think that the bottom line here, Cindy, is that we don’t have to suffer like we thought we did from allergies, with just constant seasonal allergies and struggling and having difficulty with congestion and runny eyes and being a mess. And I can tell you just how shocking it is to me. Even people with very high levels of allergies, like IgE levels that are really high, which is the part of your immune system that fights with the allergy response, they can get better, that can come down. What’s really striking is that it’s really not something you get from your traditional allergist or your traditional [crosstalk 00:21:23]. They have to struggle.
Dr. Mark Hyman:
And the other thing that is an interesting therapy that it was written about in a book called the Epidemic of Absence, or Missing Microbes is the other book, but they’re all basically the same idea that we’ve messed up our gut flora, that we are not exposed to the same things we’re exposed to. And often, our immune systems don’t know what to do, so they create autoimmunity or they create allergy. So autoimmunity is you’re overreacting to something inside yourself and allergy is you’re overreacting to something outside yourself. And what they found was that there’s cultures, like I mentioned earlier, where they don’t have these problems. But they also have other issues. They have gut issues such as parasites and worms. It turns out that these worms and parasites were keeping our immune system busy. And when those go away, because we’ve been so hygienic, that our immune systems are looking for something to do and they get busy doing autoimmunity or allergy.
Dr. Mark Hyman:
There’s actually some studies looking at worms for the treatment of allergy. And I particularly and personally use some of these. One of the product is called the HDCs, which is a rat tapeworm. And as our friend, Sid Baker calls them, little dudes. It sounds really weird and a little crazy, but there is a lot of scientific data about this and evidence that it could be helpful. And it’s very harmless. They don’t pick up residence in there. And I actually treated a number of patients who’ve had IgE levels of 1,000. Normally, they should be like 100. And I’ve seen levels come down to normal and allergies basically go away.
Dr. Mark Hyman:
So I don’t start with that treatment, it was for these other things we have to do anyway first to stabilize and improve the overall health of the patient. But if people get stuck, there’s a lot of cool tricks we have in functional medicine.
Dr. Cindy Geyer:
I’ve not tried that one, Mark.
Dr. Mark Hyman:
No, it’s great. I learned it from Sid Baker. It’s very impressive. And it’s shocking when you see an IgE level go from 1,000 to 100. That’s shocking and you go, “Okay, well there’s something there.” It makes sense that there’s a biological plausibility to it. It’s inexpensive, it’s safe. There’s evidence that it works. And so sometimes these things that we’re trying, even though they’re not mainstream. Cindy, what other wisdom you have about people suffering from allergies? Because you’re in it with them, right?
Dr. Cindy Geyer:
I’m in it with them. Well, I wish the pinworms and hookworms had served me a little bit better. They did not, as a kid.
Dr. Mark Hyman:
You didn’t take, but you haven’t taken them.
Dr. Cindy Geyer:
I was exposed to them. I grew up playing up the dirt in South Carolina. Yeah. It’s interesting, I loved this study, it’s a very small proof of concept study that came out last year in Finland. We’re talking about prevention, right? In half of the daycares, playgrounds, they created a mimicking of the forest flora, the things that would grow in the forest flora in Finland. And the other was just a regular daycare and they let the kids just do their normal playing in the playground. And after two months, the kids who were using the playground that mimicked the forest flora, they had a more resilient, diverse skin microbiome and gut microbiome and their inflammatory markers were downregulated. So that to me is yet more evidence that man, we are healthier when we’re outside in the woods and playing in the dirt. Even after the fact, there’s a rebounder improvement in our skin and gut micro flora.
Dr. Mark Hyman:
Yeah. It’s all about getting the bugs balanced, right?
Dr. Cindy Geyer:
Getting the bugs balanced. Yes, absolutely.
Dr. Mark Hyman:
Well Cindy, this has been such a great conversation about a very vexing problem for so many millions of people. But have hope, by using a functional medicine approach, by getting your gut healthy, by dealing with the root causes, by addressing things like histamine and addressing underlying heavy metal toxins and other factors, you can restabilize your immune system and calm down the allergic responses and maybe even get rid of your allergies. I’ve seen it in a number of patients. And maybe who knows, maybe worms will help you. I know it sounds crazy, but you definitely look it up, it’s a thing. We’ll put it in the show notes. If you know people suffering from seasonal allergies that have been struggling, please share this podcast with them. I know they’d love to hear it. Maybe they’ll learn something that’ll help them. And subscribe wherever you get your podcasts. Leave a comment, we’d love to hear how you’ve managed your health analogies. And next week, we’ll see you again on another episode of The Doctor’s Farmacy.
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