Show #379 The Allergy epidemic in our kids: Can we fix it? Dr Elisa Song says yes.


About this show:

Allergies – Nearly 1 in 5 kids has an environmental allergy today, and nearly 1 in 10 has a food allergy. While these differ from person to person in severity, they are a challenge on the mental load, in the home and even more so out and about. My good friend and one of my favourite doctors in the world – she’s SO DANG SMART – Dr Elisa Song @healthykids_happykids and I deep dive into the reason so many families are dealing with allergies and in this comprehensive show, we explore: 

  • The biggest factors playing into how we got here with allergies and poor gut health.
  • How the gut microbiome has changed in 100 years and what species we know are critical to healthy histamine and mast cell ‘flexibility’ as we grow. 
  • How to be better informed when it comes to antibiotics and how to talk to your doctor
  • Testing and screening options
  • Therapeutics – conventional and holistic
  • The SOS game vs the long game – building resilient health and regulated responses to what we eat and what we’re exposed to in our environments. 

It is PACKED. I usually say go for a walk in nature, but if your reality is dealing with allergies, it’s PAPER-AND-PEN day today! 

I hope it’s useful for you and people you love – share it far and wide + if you want to hear the first show we did together look up show #85 on the childhood epidemics of our times. It’s also a doozy full of practical wisdom.


Questions I asked Dr Elisa:

  • When we first talked on the podcast a few years ago, we discussed the childhood epidemics of our time – as pertinent today if not more so than when we recorded it… Today I want to discuss allergies and the immune system as so many families almost 10% in food, almost 20% in seasonal/environmental allergies… But before we go into allergies I want to talk gut health which will of course make more sense as we then explore allergies… 
  • I love how you share a section actually early in the book ‘but my kid doesn’t have gut health issues’ ue might not be complaining their tummy hurts, might be pooping daily etc… how can we know some signs to investigate further/there’s an issue? 
  • Gut-immune, gut-brain, and gut-epigenetic connections and what we can do to cover our bases for our kids’ gut health? 
  • How is gut health connected to allergic reactions? 
  • Can we start with an allergies 101: 1. What’s happening when someone has a reaction – 2. Which systems/cells are triggered 3. Why so much variety in severity, and why one person dust mites, next person cashews, next person only seasonal pollens or even a specific pollen/grass? 
  • Best way to test for allergies (maybe explaining the IGG?E?As and gut testing/stool and why that can be most relevant)? 
  • Now, my son has an Incaberry allergy – such a hippy kid allergy right? But basically, we took the food, did the skin prick, reaction got measured, it was labeled on its scale of severity, we were given an action plan to share with the school, and then had to spend $500 2 years later doing the same thing again and confirming the same thing/severity again – a great reason to involve your partners if they aren’t in the care of your child is going to that appointment and paying, so they get riled up enough about the cost to trust you to explore alternatives! Hehe. 
  • Can we reverse and heal allergies – what do we know now that we perhaps didn’t once realise when it comes to allergies? 
  • Issue with antihistamines long term and whipping out an epi pen a few times a year – without of course discounting life/death SOS = of course, amazing to have!? 
  • Therapies currently in the mix for allergies and how to find someone who is progressive and up to date to work with with your child’s allergies (or your own for that matter) 
  • Why does the Vagus nerve need to be in the mix of working on your child’s health? 
  • Holistic care for children is often out of reach for families – an hour with an integrative paed is upwards of $400 in Australia, not sure what it is in the US (feel free to interject there) and then the supplements and other potential testing and therapies that might be recommended from that appointment – what are some of the most accessible ways, lower cost options for caring for our kids’ health? 
  • Fave supplement recommendations for kids overall/general health in a world often with poor soils, multiple environmental toxins – do you have your ‘insurance policy go-tos? 
  • Fave foods for inclusion regularly in kids meals? 
  • You love Homeopathics – when did that love start and what have you found to be the most useful ones in allergies? 


And the link to pre-order Elisa’s truly excellent new book is in the bio – her work is seminal in the way she’s put everything together here. Bravo Doc! 

Connect with Dr Elisa on the following platforms;

Website — 

Instagram @healthykids_happykids

Facebook @DrElisaSongMD

Healthy Kids, Happy Kids

Her amazing book Health Kids, Happy Kids is now available for pre-order on Amazon and Booktopia: 




Thank you to this month’s show sponsor for helping you make your low tox swaps easier:

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Be sure to join me on Instagram @lowtoxlife and tag me with your shares and AHAs of this week’s episode.


Alexx Stuart

Founder of Low Tox Life and the Low Tox movement

Join me on Insta @lowtoxlife



About Dr Elisa Song:



Dr. Elisa Song, MD is a Stanford-, NYU-, UCSF-trained integrative paediatrician, pediatric functional medicine expert, and most importantly, a mom to 2 thriving children. She is the bestselling author of the Healthy Kids Happy Kids: An Integrative Pediatrician’s Guide to Whole Child Resilience. Dr. Song is on a mission to revolutionise the future of children’s health. She has dedicated her career to helping parents and practitioners bridge the gap between conventional and holistic paediatrics with an evidence-based, paediatrician-backed, parent-approved approach. Dr. Song has lectured around the world at leading integrative and functional medicine conferences and premier parenting events. She has also been featured in hundreds of top podcasts, print and online media outlets including the Wellness Mama podcast, BloomTV, Forbes, Healthline, MindBodyGreen, National Geographic, PopSugar, Parents, Motherly, Parade, Verywell Health, and New York Post.



More about this month’s sponsors:

Thank you to this month’s sponsors for partnering with our show and helping you make your swaps with their special offer:

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Title show track, by LIOR.

Love the podcast music? You will hear excerpts from Lior’s track “Caught Up”  – go check it out on iTunes or Spotify if you want to hear the whole song or album, Scattered Reflections. Co-written with Cameron Deyell, it’s a great song and I love the reflective energy of it – perfect for the show, right? Enjoy. Lior is always touring, so do check out his website. It is wonderful to hear him sing live, trust me.

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If you would love reading like me or you just simply want to go through the full transcript, you can check below.

[Alexx] (0:00 – 6:38)

Allergies. One in 10 kids have a food allergy. One in five have an environmental allergy of some kind, and today we unpack that with one of the world’s top pediatricians here on the Low Tox Life Podcast.


Hello and welcome to the Low Tox Life Podcast. I’m Alexx Stewart, your host and the founder of the Lowtox movement, and I could not be more thrilled that you have decided to press play and join me today because my guest is not only a dear friend, she is also one of the smartest dang pediatricians in the world, in my view, and I’ve made a fair few, and her name is Dr. Elisa Song. I’ve wanted to do a show on allergies that was really comprehensive and looked at all of the things plugging into the current epidemic levels of allergies, but also look at allergies as they pertain to immune health, nervous system health, dysregulation of various types of cells, and how we could look at the best kind of testing and screening, the best kind of monitoring, what does SOS look like, what does the long game look like, how do we build resilience and immune flexibility when it comes to exposures as we try to reduce allergic presentations and heal, and of course the gut is very much involved in that.


It is a fantastic nerd out and I know I usually send you guys out into nature on a walk to listen to the show, but it’s really, you know what, it’s a pen and paper show today. If you or someone you know has an allergy, I would just be so grateful if you pass this on because it is genuinely an amazing body of work in the next hour and 10 minutes or so as we unpack this topic so comprehensively, and for those of you who haven’t come across Dr. Elisa Song, we did a show a few years ago, show number 85, if you want to look it up, on global childhood epidemics, and we’ve been friends for years.


I had her whole family over to our house once when they were visiting from Australia, and we’ve done the Bondata Bronte walk, which is my standard friends from overseas show and tell of this beautiful city that I get to live in, and she is Stanford trained. I could tell you all the technical stuff. She’s got a fantastic book coming out that is far more important, though.


Healthy Kids, Happy Kids is her body of work and offering to parents all over the world. She obviously can’t consult with everybody, and it is a brilliant book. The Aussies are going to have to wait till September, although pre-orders will open up shortly.


You lucky, lucky people in the northern hemisphere over in America, Canada, you get to pre-order it right now if you’re listening live this week, and it’s coming out May 14th, just around the corner. I have all the details in the show notes for you. You can always head to forward slash podcast to check out not only the details of the show today and an overview of all the questions I asked and ways that you can connect with Elisa’s work or any show guest if you look back, but also the special offers. These are predominantly for our Aussie listeners, but we do every now and then have an international one, and they’re to help you with your low-tox swaps. Many of you would have heard of the brand Weleda, and so if it’s time for you to replenish a few of your favorites or maybe try some low-tox, high-performance and low-cost skincare and healthcare products for your family for the first time, we have 20% off with the code LOWTOXLIFE April 29 through to June 30, 2024. So that is a huge help towards making your low-tox swaps, and if things are a bit tight right now, it’s a great time to stock up.


I know I will be lathering myself in all things firming pomegranate as I work to maintain and promote skin elasticity in the midlife flux, but there are just so many things and actually someone who worked on my team for many years, the gorgeous Steph, naturopath, has just had a little bubba and I cannot wait to deliver her my usual food care package and of course some Weleda calendula products just as I used on my boy Seb when he was a bub.


We still have our major sponsor, all year through you can get 10% off with the code LOWTOXLIFE on all dehumidifiers and Winix air purifiers from Ausclimate. So your code there is LOWTOXLIFE. You can also call them if you have a floor plan that you’re just like, I don’t know what size to get, I don’t know what we need.


They can talk you through your climate, your floor space and make the best recommendation. But to give you an idea of what we have, I have two compact four stage air purifiers, one in each of our bedrooms and then we have the five stage in our living dining areas and we have a 50 litre dehumidifier that we run through the larger rooms in the house when it’s raining or when it’s a really humid season and we have the little compact 16 litre dehumidifier that we run between the bathroom and the laundry. That works great for a two bedroom apartment situation and then if you wanted to just extrapolate from there, go for it. So for that offer and of course for the huge 20% off you have now through the whole month of May. Enjoy and let us now unpack the monster topic of allergies and create some empowerment. There is no way you’re going to get to the end of this conversation without feeling like you have some proactive steps forward. I know I certainly did myself.




[Dr Elisa] (6:39 – 6:47)

Hello, Elisa. How are you? Oh, I’m so good, Alexx.


I just I love chatting with you. I love seeing you and I’m so glad so honoured to be back on again.


[Alexx] (6:48 – 8:27)

It is so exciting and I know we kind of just pretend hello but we’ve been like talking for half an hour because we haven’t for a while and I think when we did our first show and the beautiful friendship we’ve had since, we were really opening up the Pandora’s box of modern childhood epidemics and we touched on obviously each of them but I wanted to unpack one today which the numbers just keep creeping up and it’s on allergy. So I was looking as I was preparing for today’s chat and we are up to nearly 10% of people, kids with a food allergy and nearly 20% and when you just single out boys, it is 20% if you look at the CDC on environmental allergies.


So dust mite, grass, mould, etc. Oh my gosh. And so obviously there’s a correlation between like rising pollution, rising processed food, decreasing gut bugs and gut health and today you are here to help us unpack like some of the big questions around what can we do?


Am I stuck with this forever? Am I gonna have to be panicking about peanuts when my kid’s backpacking when he’s 19? Like, you know, like they’re big stressful questions and more stressful, the more intense and severe the presentation, it can really be quite anxiety ridden, right?


[Dr Elisa] (8:27 – 9:56)

Yeah, yeah, absolutely. I mean, allergies are it’s just, you know, even in my career as a pediatrician, I mean, I look back to when I was in medical school, now this was in the late 1990s and I mean, sure there was kind of the one off of a child who might need an EpiPen but I mean, fast forward, oh my gosh, I mean, you know, EpiPens are sort of, you know, when I look in my daughter’s classrooms and, you know, going on field trips and being one of the chaperones, I mean, so many kids have EpiPens that they’re carrying and, you know, it’s the anaphylactic food allergies but it’s also the less, you know, less severe but still, you know, severe food allergies and the environmental allergies, it’s just, you know, mounting at such an increasing rate and, you know, the number of kids now who from, it seems almost from the moment they’re born, you know, with cow’s muck allergies or egg allergies that break out into eczema when their moms even just have a tiny little bit, you know, while they’re nursing and so, you know, we need to recognize that there is this shift in the way our children’s, our infants and our children’s immune systems are developing and shaping that is informing their later risk of allergies of all sorts whether they develop when they’re infants or sometimes they show up years later but it really starts in that early infancy for most of us, you know, for most babies.


[Alexx] (9:57 – 10:07)

Yeah and so, what are we looking at here? What are the components that feed into this rising picture in your view? Like I shared some of the correlations you could point out.


[Dr Elisa] (10:07 – 12:28)

Are they causations as well? Yeah, I think absolutely, I think the number one thing that we need to look at is how our baby’s microbiomes develop. You know, our infant microbiome, we know that the infant microbiome now is so key to the future health potential of this child in front of you, this adolescent that they’re going to become, the adult that they’re going to become in terms of their immune health, their brain and mental health, their metabolic health, their hormone health, all of that really gets sort of imprinted by those first thousand days, you know, where the microbiome is taking shape really from, you know, preconception with mama’s microbiome vaginal and breast microbiomes and gut microbiomes but from the moment that baby is born until the first two and a half to three years of age, we have this critical window where the microbiome is communicating and housing 80% of your baby’s immune system and informing their blood’s immune system how to behave.


Are they going to develop, quote, tolerance to these different foods or environmental allergens that are coming their way? Or are they going to develop an inflammatory allergic response? And, you know, one of the things that, you know, through just digging in through what’s going on with their kids’ microbiomes, what’s really interesting is that our kids’ microbiomes, the composition has changed through the decades, through the centuries.


And, you know, there was a Scottish pathologist who, you know, had the wherewithal to test microbiomes of infants 100 years ago and compare the microbiomes of babies who were breastfed at the time and babies who received formula at the time. And, yes, you know, there were some babies who did need formula even a century ago. And what he found was that the babies who were breastfed had nearly 100% bifidobacteria in their gut microbiomes, nearly 100%, whereas the microbiomes of the formula-fed babies had many other bacteria that were in those initial stages.


We know bifidobacteria is really important for that tolerance, for building immune tolerance to foods and to environmental allergens.


[Alexx] (12:29 – 12:52)

They’re the calm the farm kind of bacteria as well. If you think about the antihistamine style probiotic formulas like that Ben Lynch has, or, you know, I know that those bifidobacteria, and I remember when I had mold illness and I did an advanced stool sample, the bifidobacteria were very scarce. And I had tons of lactose.


[Dr Elisa] (12:52 – 16:39)

That’s right. And, you know, as we get older, we have less bifidobacteria relative to other, we get more lacto and we get other species. But even for adults, as you noted, right, as you’re going through your mycotoxin illness, bifido is so important for our immune response.


And, you know, even during COVID, there was a microbiologist, Dr. Sabine Hazan in Southern California, right? And she found that you could correlate the adults who seem to have higher risks, you know, worse COVID outcomes, you could see that they had less bifidobacter in their microbiomes. And so fast forward now, you know, to nearly 100 years to our current infants microbiomes.


And even the breastfed baby of today has a gut microbiome that is much more similar to the formula fed baby of 100 years ago, because of that loss of bifidobacteria. And bifidobacteria, they are the species in our microbiome that feed on human milk oligosaccharides, these very special prebiotics that are found only in human breast milk, although now there are synthetic forms that are being put into infant formulas and into some infant probiotic blends and can be purchased individually, that are, you know, great benefits even for adults via the vagus nerve, right?


There’s this bifido loves to communicate with your brain via the vagus nerve, bifido or bifido species love to bring their friends along with them. So, you know, there’s a type of bacteria called F-prow, Fecalibacterium fasnitzae, which is responsible one of our butyrate producing microbes. So bifidor helps our butyrate producing buddies in our gut to flourish and butyrate is now considered one of our master regulators of health.


So you can see how just from this bifido, we can have this immune tolerance, this calm brain phenomena, this production of this short chain fatty acid, you know, butyrate that helps them to regulate our metabolism, our immune health, our brain health. So I think that, you know, if we can really think about, well, we see this disruption to our children’s microbiomes, even for babies who are vaginally birthed and breastfed. And so we have to think, well, what’s going on?


Why are our children’s microbiomes different? And if we can get to the crux of that, I think that we can really help to restore balance to our children’s microbiomes so that we don’t see the downstream effects when they’re older of allergic diseases. I mean, when we’re talking about allergies, we know disruption plays a big role.


There was a study, a very large study, a military study that looked at nearly 800,000 infants. And they looked at infants who received antibiotics or antacid medications within the first six months of life and found that those infants had a significantly increased risk, sometimes double the risk of virtually every single allergic disease by the time they were four years of age. And that includes anaphylactic food allergies, hay fever, hives, eczema, asthma, even autoimmunity later on.


And so, you know, doing everything we can to maintain microbiome resilience in our infants and our children and our teens and in us as adults is going to really be one of the most impactful, especially when we’re talking about allergic diseases. Mm.


[Alexx] (16:40 – 17:11)

And so let’s just say someone out there is listening. They’ve got a baby next week, baby, really sick. Antibiotics really, really the only option.


And of course, this is where we are very grateful for them. Now, what can that mom or dad do in the having to take of the course of the antibiotics to support the prevention, I guess, of the depletion of the microbiome?


[Dr Elisa] (17:12 – 17:29)

Yeah. So many things. So I love that question because first we have to recognize that, especially in children, some studies have found that up to 70 percent of antibiotics are inappropriately prescribed.


So for things like viral infections where they’re not going to do anything.


[Alexx] (17:29 – 17:38)

So can I just say, then, in that, should we be demanding swab testing every time antibiotics are put on the table in this day and age?


[Dr Elisa] (17:38 – 21:00)

So I think that we should be asking questions. Maybe demanding was too harsh a word. But in some cases, there are swabs available, like for strep throat.


One hundred percent. You know, if you if your child has a sore throat and even if you look and it’s a raging red sore throat with pus on the tonsils and it looks like strep, you still…I would demand a swab in that case. I would demand proof from a rapid test and a culture, a throat culture, to show that it actually is strep.


Because viral pharyngitis, like let’s say the monovirus, Epstein-Barr, can look exactly like strep throat. And there is zero way a clinician can look at your child’s throat or your throat if it’s the same situation and say, I know it’s strep. There’s just no way.


I don’t care how long you’ve been a doctor. You cannot look and tell it’s strep. Now, there might be some clinical clues.


You know, if it’s strep throat, usually there’s not really any other respiratory symptoms. You usually don’t get a runny nose or a cough or other things as opposed to a viral pharyngitis. They often do go along with other respiratory symptoms, but it doesn’t matter.


The look of it doesn’t matter. It can be the most severe, awful-looking sore throat and it could still be viral. In fact, some of the worst sore throats I’ve seen are viral, not strep throat, right?


So, yes, I would demand, you know, a swab for that. Now, something like an ear infection, you can’t really swab. Although, you know, if your child has a ruptured eardrum and there’s some material, some pus coming out, yes, I would swab that, right?


Because we know that most ear infections are kind of mixed. They can have virus and bacteria. Sometimes I’ve had fungus grow out from ear canals, right?


Which then, of course, fungus don’t respond to antibiotics. Viruses don’t respond to antibiotics. Then even most bacterial ear infections will resolve without antibiotics.


So I actually have a list of six questions in my book to ask the doctor before you start antibiotics. And the number one question, right? Because, you know, we don’t want to, you know, we don’t, as you said, sometimes they’re absolutely necessary.


And I tell everybody, both of my children received antibiotics when they were under two months of age. And my Kenzie had a urinary tract infection when she was two weeks of age. Bodie did have strep with pus coming out of his ear, right?


And I cultured that. So, and that was at five weeks of age. So, and we’re going to get to like, how do you restore your child’s microbiome?


But they were absolutely necessary. So sometimes they are. But the number one question to ask the prescribing physician, you have to ask, hey, doc, is this antibiotic really necessary?


I mean, it sounds so simplistic, but that some studies have found that, you know, like doctors are twice as likely to prescribe an antibiotic, even if they don’t think it’s going to be helpful, if they think that the patient wants a prescription. Right? So if you simply just ask the question, you know, hey, is it really necessary?


It lets the doctor know that you’re not one of the moms coming in that just wants to, you know, come in and leave out the door with a prescription in hand that, you know. To feel like you’ve done something.


[Alexx] (21:00 – 21:01)

That’s right.


[Dr Elisa] (21:01 – 22:03)

That’s right. You’ll use it if it’s necessary, but you want to be judicious about it. Right?


And so you just, you know, you have to ask the questions. It’s very, very important because we don’t want to, we want to use them when they’re necessary, but we also don’t want to overuse them because in this overuse, it’s your child’s microbiome, you know, that’s being disrupted or yours, if you’re on antibiotics, it’s also a public health concern, right? Because, you know, by 2050, there’s some estimates that antibiotic resistance is going to become a leading cause of death.


And that is frightening. I mean, antibiotics have been one of, you know, the most profound, you know, public health inventions of the 20th century. And now fast forward to the 21st century, could you imagine if a simple skin infection was something that could do you in?


Right? And so, you know, we just need to be good antibiotic stewards and understand that they can be necessary. Many times they’re not.


And then, you know, when, when they are necessary, how do we maintain your microbiome? Right. So that’s, those are, that’s really key.


[Alexx] (22:04 – 22:09)

It is Kate. So can we get some good ideas on that?


[Dr Elisa] (22:09 – 23:30)

Because I know everyone would be like, so tell me what I need to do. Yeah. And so, you know, for parents listening, the same thing can hold true.


Like, even if like, let’s say, you know, for Bodhi, he had antibiotics when he was five weeks of age. And I didn’t know, I didn’t know that, you know, that restoration of the microbiome was really important. And now he’s 12 and, you know, maybe, you know, knock on wood, he’s healthy.


But let’s say for instance, he had eczema or he had allergies, or maybe some ADHD attention focus issues stemming because of the intimate gut brain connection and the disruption that happened there. Right. We can, you can still recover your child’s microbiome.


So we can do all these steps, even many years down the road, it might take a little longer to recover. But, you know, all hopes not lost. We just have to know though, the first step is knowing, oh, okay, if my child has behavioral concerns, or they have skin concerns, or whatever it is, we want to look at the microbiome.


So ideally, ideally, if you are starting antibiotics, you would start a probiotic and a prebiotic supplement alongside the antibiotic. So start with the course, there are all sorts of fallacies, you know, these myths going around, I’ve had parents go to the ER and call me and ask me, oh, you know, the ER doc said, you know, I shouldn’t take a probiotic while my child’s on an antibiotic, because it will make the antibiotic not work. Oh, yeah, no, like, no, that doesn’t work.


[Alexx] (23:30 – 23:31)

We’re done with that. Right? Yeah.


[Dr Elisa] (23:32 – 23:52)

Now it is true, though, that antibiotics because they they’re not, you know, specific about what they kill, which is why they can kill all the good bacteria in your gut microbiome. We want to take the probiotics at a different time of day than the antibiotic, just so that you’re not taking the antibiotic right after your probiotic, and then it goes right in there and it kills the probiotics too.


[Alexx] (23:52 – 23:57)

Right? Yeah, you got to think about it like a binder, right? You would take it away from other medicines.


[Dr Elisa] (23:57 – 25:08)

Yeah, that’s right. Yeah. Now, you know, what probiotics?


Well, that’s a million dollar question, right? Because, you know, I used to say, and this is probably one of the biggest shifts in my practice, I used to say, you know, yeah, most people would benefit from taking a probiotic every single day. Well, not necessarily anymore, right?


Because there are thousands and thousands of different strains that are being identified, each with a different benefit. And not all probiotic strains are really that good at restoring your microbiome. Some of them may be really good at creating like serotonin and dopamine for you.


Some of them might be really good for your skin or for your vaginal flora, right? So, you know, we want to really think about the different strains that we’re using. But, you know, we’re not quite there yet in terms of really getting amazing, you know, strain-specific combinations.


I think, you know, that’s where the future is going to head. So for now, you choose a broad-spectrum probiotic. You know, you can use, you know, what does broad-spectrum mean?


A variety of different bifidobacteria species, lactobacillus species. You can choose, you can also add in Saccharomyces boulardii, which is actually a yeast probiotic, not a bacterial one. One of my faves.


[Alexx] (25:08 – 25:09)

I love that one.


[Dr Elisa] (25:09 – 25:45)

And Saccharomyces boulardii can actually enhance your immune capacity in your gut. It improves something called secretory IgA antibody in your gut. It also has been shown to reduce antibiotic induced diarrhea.


So also another big, very common side effect, right? And now there are, you know, more and more availability of these spore-based, you know, bacillus, you know, coagulans and Klausi that are available as well. There’s not, I’m going to be totally honest.


I think spores are great. There’s not great research in children with spores.


[Alexx] (25:45 – 25:54)

Okay. So spore-based probiotics could just be a little faddish to jump on the bandwagon at this point when you look at the research.


[Dr Elisa] (25:54 – 26:46)

At this point, there’s just, yeah, there’s not. I mean, there is, there’s one, there’s one bacillus Klausi strain out of India that’s been well-studied in infants. It’s not as commercially available.


So the spore-based strain, you know, there are some studies in adults that are promising, but you know, we know kids’ microbiomes are not the same as adult microbiomes and they don’t respond necessarily the same as adult microbiomes. So I’ve kind of, I, you know, I have used some spores in kids, but I’ve reserved sort of blanketly saying, oh, every child should be on a spore-based probiotic now. But, you know, so we start the probiotic alongside.


We want to make sure though, that we understand that just throwing in trillions or, you know, let’s say billions of, of, you know, colonies into your gut, kind of throwing them down there doesn’t necessarily make them stick.


[Alexx] (26:47 – 26:48)

More is more is not true.


[Dr Elisa] (26:49 – 28:18)

It is not true. More than always better. That’s a very Western thing, right?


You know, that, you know, oh, you need more. Well, let’s, instead of, you know, 25 billion, why we throw like 450 billion at it, or maybe 900. So more isn’t always better, right?


Because there are some studies showing that if we throw in a ton of different probiotics into your gut microbiome, it can sometimes crowd out the return of your native flora, the flora that wants to be in your microbiome. All of us have a different microbiome. So when we ask the question, what’s the perfect microbiome?


We have to ask, well, for whom, right? Because it’ll vary depending on your sex, your age, your race and ethnicity. And so, you know, there’s not one perfect microbiome.


I mean, even when we’re thinking about fecal transplants, that’s the problem with it, right? I mean, it’s like, well, how are you matching the person who’s, you know, basically donating their poop? You know, because it’s got to be specific for you.


I mean, the ideal, I’ve spoken with some microbiologists who think before antibiotics or before surgery or before anything that we know can immediately disrupt the microbiome, the ideal thing would be to take your own poop sample, right? Cultivate that. And then when you, after the surgery, when you take the antibiotics, you re-inoculate with your own flora.


That’s called an autologous fecal microbiome transplant, right? That is fabulously noted.


[Alexx] (28:18 – 28:19)

It’s fabulous. I love that.


[Dr Elisa] (28:19 – 30:30)

We’re not there yet, right? And then the question is also, did you have the healthiest microbiome to begin with, right? I mean, if you have ADHD or autoimmunity or something like that, you know, or if you have metabolic syndrome, diabetes, maybe there’s some optimization that could happen.


But anyhow, it’s not just about throwing more. It’s also about creating an ecosystem, an environment in your microbiome where these beneficial bacteria, yeast, even beneficial viruses want to come back and create a community again, right? They want to come back and call your gut their home.


And so that’s where you can pair prebiotics with the probiotic so that you have the food to fuel the probiotics and help them thrive. But even beyond that, this is the time to double down on all of the nourishing factors for your gut microbiome because we want this place to be, I mean, like the best neighborhood that these microbes could want to move into, right? And so that means, you know, when we’re thinking about the things that nourish your microbiome, it has to include fiber from real fruits and vegetables and whole grains and legumes, you know, if you can tolerate them.


It has to include all the colorful phytonutrients that act as prebiotics and also interact with your microbial genes to modify our genes, right? Fermented foods were found in one study to restore microbial diversity and composition better than fiber, whereas fiber was really helpful for microbiome functioning. So production of, you know, short chain fatty acids like butyrate.


So we get in all the things that nourish your microbiome. And it’s really equally important that, you know, when we’re trying to rebuild, it’s sort of like, you know, after a forest fire, right? Imagine your gut microbiome has just been raised, you know, by these antibiotics.


And so if we’re trying to rebuild the forest, I mean, how do we do that? We don’t just throw sapling seeds on the ground, right?


[Alexx] (30:30 – 30:31)

Yeah, yeah.


[Dr Elisa] (30:31 – 32:49)

We’re throwing in- You prepare the soil. Prepare the soil and the sunlight and the water. And we try to keep away, you know, chemicals and, you know, pests that are going to really eat away, you know, at the forest that we’re trying to cultivate.


So we want to keep away all of the factors in our modern world that are acting to every single day disrupt our microbiome and can literally directly trigger leaky gut and zonulin release, preferentially preserve, you know, the bad bacteria relative to the beneficial flora. And so that means you got to get out, you know, the artificial food dyes, the food additives, especially food emulsifiers that are found in a lot of packaged foods that can disrupt the gut microbiome. You know, we want to really watch all the added sugars and, you know, glyphosate, you know, herbicides that are used, pesticides, many of them, glyphosate was initially patented as an antibiotic.


And so, you know, we want to make sure let’s eat as organically as possible, let’s cultivate this resilience in our microbiome. And so, you know, doing all of those things at that time will help to restore your child’s microbiome and also help it to stay there, right? Because, you know, we could, I mean, you could, for instance, take a probiotic supplement, a prebiotic supplement.


We want to make sure some antibiotics will directly trigger leaky gut as well. So you could, you know, think about taking an extra omega-3, you know, fish oil supplement, zinc, glutamine to make sure the intestinal lining stays really intact. But when you stop that after a month or two, okay, your microbiome is restored.


But if you go back to all the ways of, you know, maybe, you know, eating out of packaged foods, stress, stress, stress, you know, busy, busy, busy, not getting enough sleep, not moving your bodies, your microbiome is going to slowly shift back to a state that’s less resilient so that with the next round of antibiotics or next big stressor, it’s going to fall apart again, right? So we just, we want that solid, we want like, you know, the California redwoods that can withstand any fire, right?


[Alexx] (32:49 – 33:18)

I love the metaphor of like, you are trying to create the best neighborhood that they would just want to move into and set up house. I think those visuals really help you get in touch with the deeper work and feel a sense of purpose around the change, especially if it’s a big shift for your family, which it often is. You know, sadly, we often have those critical moments or the big allergy episode and then boom, that’s when you wake up and something has to change.


[Dr Elisa] (33:19 – 34:15)

Yeah. Or you get ear infection after ear infection and you’re like, okay, you’re on this kind of cycle. And so that can, you’re right, that can be the impetus for change.


So, and it doesn’t have to be all at once, but you know, it’s just really being aware of, okay, knowing now how important my child’s microbiome is to their overall, you know, health and resilience, how are we going to educate our kids first of all, so that they want to nourish their little buddies too. I mean, they need to really consider their microbiome as their best friends, their best allies, right? And, you know, really create a culture in our home that supports living in a way that just naturally supports our microbiome.


We don’t have to think about it, but all the, all the different ways that we can live is, you know, if it’s, if it’s done in a kind of a microbiome centric way, it’s the, that, that the magic in your microbiome is going to happen, right? We don’t have to think consciously about it.


[Alexx] (34:16 – 34:59)

Yes. And, and it’s about like really thinking of the stuff you do at home, like good bookends that kind of create the structure. And it doesn’t matter if a book falls off the shelf every now and then pick it back up, put it back in.


But if you’ve got the structure there, we’re going to the park in our free time, we’re going to the beach, getting a swim in, taking a forest hike, like all that nature stuff, all the no blue lights, you know, come on off the phones, off the iPads, off the TV, go read a book in bed with your red light and get sleepy. These things are, you know, if you’ve got those in place and most meals are from scratch, then the little hiccups are less likely to impact us in good ways.


[Dr Elisa] (35:00 – 35:10)

And, you know, when we think about it, because for, for a lot of us, right, I mean, think about us as parents, it’s so much easier to do things for our children than it is to practice self-care for ourselves. Right.


[Alexx] (35:11 – 35:12)

And so, right.


[Dr Elisa] (35:12 – 37:00)

And so, you know, if we, if we talk to our kids about these trillions of tiny little friends in our, in our microbiome and how much they take care of us and how much they rely on us to take care of them, it gives a different, it gives a different perspective on, you know, how we’re eating and how we’re living because all of that impacts. I mean, I, I talked to kids about, you know, finding Nemo, that clownfish and that anemone, they need each other. Right.


I mean, that’s just like you and your microbes in your gut. And so the fascinating thing about, you know, walking in nature, engaging your vagus nerve, getting a restorative sleep, exercising, all of those have been found in the literature to improve your gut microbiome. And all of these, like, let’s say, you know, improving heart rate variability and vagus nerve functioning through breath work or through laughing together or through, through gratitude.


So anything that improves your vagus nerve output and your heart rate variability will actually directly improve your gut microbiome diversity and functioning independent of diet. Because I know, you know, that’s right. It’s huge because diet for parents, I mean, especially, you know, in our world, such a focus.


Yeah. And, and it can be one of the most stressful things to change, especially if that’s not yet your family culture or, you know, your kids are like our kids are older and they’re at school and they’re seeing all of their friends with the package X, Y, and Z. And, you know, it’s, it’s, it’s tough.


It’s tough to, you know, really think about changing that. Or if your kids are really, really selective and you’re like, I don’t know, they’re not eating a single vegetable right now. And, you know, now you want me to eat a rainbow.


I’m like, okay, well then let’s not do that first. Right.


[Alexx] (37:00 – 37:00)



[Dr Elisa] (37:00 – 37:07)

Let’s work on breath work or let’s move our bodies. Let’s have fun together, you know, because all of that will make a difference. I love that.


[Alexx] (37:07 – 37:36)

You just said, let’s have fun together because I genuinely think when it’s the health conversation, we forget the fun part, the joy part. And it’s such a huge part of having a healthy vagus nerve, healthy gut brain connection, feeling a sense of lightness and joy. Like not everything has to be this serious undertaking for our health because you’ve got a big allergy and we can very easily be caught up in the stress of that situation.


[Dr Elisa] (37:36 – 38:35)

I get it. Yeah. Well, and then we just have to remember too, I mean, I let kids know that like, you know, when you measure your inflammatory cytokines and certain levels of different, you know, stress hormones, psychological stress sometimes has a bigger impact on that than infections or toxins or, you know, any physiologic stress.


And so, you know, it’s not that, so it’s not to paint all stress in a bad light because we need a certain stress. It’s just your physical response. But, but if it’s, if it’s prolonged and unmanageable and just chronic.


And not flexible, like you can’t get back into relaxation easily. Yeah. I mean, that can be way more inflammatory than the actual problem that you’re trying to deal with.


Right. And so, you know, learning how to have that flexibility, have that balance is so important when we’re trying to recover from a health concern or just move towards a different state of health. So important.


[Alexx] (38:36 – 41:20)

And can I just paint a picture of the current situation a lot of families are in and I’ve actually experienced it myself with my son when it comes to an allergy diagnostic process and then what the future looks like for that. Because if, if you, like I remember we were eating a hippie piece of toast that I had made, I had brought because I wanted a grain-free option when we were staying with friends. And it had like a few different kinds of berries and things in it.


It was really dense and delicious, but Seb breaks out in a huge rash, big blotchy. And I’m like, oh my gosh, he’s never had this. Mom, my hands are stinging.


I can’t touch them. They’re too hot. And I was like, Jesus, what?


Okay. So go to doctor, get the referral to the allergist. A $500 appointment gets you the skin pricks, bring the piece of toast he had the issue with, and we’ll test the different ingredients.


And we get diagnosed, he gets diagnosed with an Inca berry allergy. I mean, we only live, we only live five kilometers from Bondi. It feels like the ultimate hippie Bondi allergy to be diagnosed with.


And, and so I was like, okay. And then we get given his allergy plan that gets shared with the school and we get told come back in two years and we’ll test it again. My husband happened to be the one who could take the appointment the second time around.


Now, luckily Inca berry is very easy to avoid. It’s pretty rare. And my husband calls me, he goes, did we just pay $500 for a nurse to prick his skin and tell us, yep, it’s still the same as last time we’ll see you again in two years.


And I was like, yeah, I believe we did. And I just think that’s insane as a, as a framework for dealing with an allergy. So I would love to spend our last 15 minutes unpacking the futility of that merry-go-round the, oh, well, this is how it is and how it would be better to step through an allergy experience as a family.


I feel like the things we’ve been talking about already, of course, play into what we could be doing differently. But like in our case where we are hitting a lot of those markers, is there some secret sauce? Is this some extra stuff we can do?


[Dr Elisa] (41:21 – 45:50)

Well, so when we think about allergies, I mean, and in this case, we’re thinking about allergies that are mediated by an antibody called IgE. I would love to unpack that, those differences. So that’s, so that’s important to distinguish because we have this IgE part of our immune system that really is involved in immediate allergic reactions.


And these are allergic reactions like with SEB typically happen within seconds of eating a food to maybe an hour. So they’re typically fairly obvious. They can be skin like hives, sometimes it’s more itchy tongue, swollen tongue or lips.


They can manifest as GI symptoms with immediate vomiting, like your body’s literally trying to purge it out or become the more serious respiratory anaphylactic reactions as well. What’s fascinating about the allergic reactions, the IgE reactions that are on the skin like the hives, they look really dramatic, but thankfully those typically don’t progress on to be the anaphylactic type allergies. If you have though, the internal, the tongue swelling, the vomiting, you know, the respiratory, then that, you know, that is, you know, a more serious where you probably do want to make sure that, you know, depending on what the allergen is, as you said, Incaberry is easy to avoid, but you, you know, avoiding peanuts or soy might be much more challenging, right?


And so, you know, having an EpiPen and having that allergy action plan at school can be really important. Now it’s many IgE allergies. Well, I shouldn’t say that, you know, used to be that if we thought about these anaphylactic or IgE food allergies, they were ones that, you know, kids were born with or presented early on in life with their first exposure to the food.


Interestingly, I’m finding a lot more and more kids who are developing these IgE allergies later on in life, or you get the story of these teenagers or these college kids where they’ve never been allergic to shellfish. And then all of a sudden, oh my gosh, they’re having this, you know, huge allergic reaction, right? So, and that I do think is as their microbiomes and immune systems are changing, they’re not responding appropriately to these foods that they’ve eaten tons of times before, right?


So we have these. Now there’s also the IgG, immunoglobulin type G arm of our immune system that is more involved in these, what are called delayed hypersensitivity reactions. So they are quote, allergies in a sense, but these reactions can happen sometimes within hours, but sometimes it can take three or four days for a reaction to occur.


And these non-IgE mediated IgG reactions can manifest pretty much anywhere in our body. So they can be joint pains, they can be mood behavior issues, they can be brain fog, they can be GI, like tummy issues and, you know, sometimes constipation, sometimes diarrhea, sometimes eczema, like eczema can often be associated with that. Now, these IgG reactions are a sign of a leaky gut.


They’re a sign that your intestines have lost, the intestinal lining has lost its integrity. And so they’re allowing these food antigens that you’re eating, you know, probably every day to get into your bloodstream and eventually your immune system can’t clear them away and they start developing these IgG reactions to them. Now, the good thing about IgG allergies, these delayed reactions are that they typically, if we can go through an elimination diet, a gut reset by sealing and healing the leaky gut, eliminating, you know, any organisms, dysbiotic organisms that shouldn’t be there, many of these can resolve, right?


The IgE allergies, sometimes it can resolve, but we’re a lot more cautious because once you’ve developed them, it’s a lot harder, you know, to quote, get rid of. Now, for some of the anaphylactic food allergies, we’re really fortunate now that out of Stanford and Duke University, there’s been a lot of research around oral desensitization. So these allergy drops where you can be desensitized to even the most severe anaphylactic, you know, cashew allergy, which is so great because as a parent and as a child growing up with a life-threatening allergy, it does, you know, make you, you know, oftentimes have a different relationship with food and the fear around…


[Alexx] (45:50 – 45:55)

Of course, it’s very hard to keep it healthy and relaxed when you’re terrified of an exposure.


[Dr Elisa] (45:55 – 49:00)

Yeah. So I feel like that desensitization can really help, you know, people breathe a little bit more easily. Now, here’s the thing though, I think that a lot of the allergies that do develop a little bit later on, because the IgE allergies are more histamine mediated and, you know, typically, I mean, there are many different kinds of cells that can release histamine, but there are mast cells and there are basophils.


If we can work on restoring the gut microbiome, making sure there’s plenty of bifidobacteria around, and also stabilizing the mast cells, stabilizing that overactive immune response, I have seen kids where these lesser IgE allergies on testing, those go away, right? Sometimes, you know, the larger, like the big peanut one or the big soy one, that, you know, that may stay, but it might get a little bit lower on the scratch testing or on blood testing. I actually prefer to do blood testing because with blood testing, you can test out many, many, many different kinds of foods or environmental allergens.


And you can also see there’s a number score. So you might see, oh my gosh, dust mites are through the roof, and maybe we target those first, you know, with our dust mite control measures, right? But the more things we can do to stabilize histamine responses, the more likely we are to support a healthier response the next time that allergen is faced, right?


Because if you think about it, if we can stabilize mast cells so that, you know, let’s say if you’re allergic to, you know, macadamia nuts and, you know, a piece of macadamia antigen attaches to your mast cell instead of exploding, you know, with, you know, this huge release of histamine, if the mast cells are stabilized, then that macadamia attaches, sure, there’s a little histamine release, but it’s more contained and more controlled.


So that’s what we want. And there are lots of different supplements that can do that. There’s quercetin, there’s luteolin, vitamin C and zinc can reduce histamine level, stabilize mast cells.


There are certain probiotics, like you mentioned, Ben Lynch’s, he’s got a probiotic histamine X that, you know, can help to degrade some of the histamine and not include some of the histamine-producing probiotic strains. And also DAO, so diamine oxidase enzymes, are great if you have food-related histamine reactions. Because sometimes when we’re allergic to something and our histamine is just floating around like crazy, we start reacting just randomly, maybe not even just to the macadamia nut, but like, well, I don’t know, there’s no macadamia nuts in here, but all of a sudden I’m really uncomfortable, right?


And so it just depends on the histamine load. So sometimes a DAO enzyme, which can break down histamine in your gut can help you tolerate a lot more foods too, with less, less discomfort.


[Alexx] (49:01 – 49:23)

So what I’m hearing is reminding me of what we were saying about stress in that you want stress flexibility. It’s not that you want no stress. And I kind of feels like what you’re saying is we want mast cell flexibility.


Like we want them to be able to come to the rescue when we need them, but we don’t want them freaking out about every tiny little thing and staying dysregulated.


[Dr Elisa] (49:24 – 50:30)

So key because mast cells should be activated in certain situations. Inflammation should occur in certain situations, but we’ve kind of, in our minds, many of us have put mast cells, inflammation bad. We don’t want any inflammation and that’s not true, right?


If we never mounted an inflammatory response, we probably wouldn’t get over viruses and our skin would never heal from a cut because you need inflammation. We just need a normal amount. And so, yes, we would like a healthy amount, but not an overshoot.


And I found for these overactive immune reactions, whether it’s an autoimmune phenomena going on, or this NIGE or mast cell overload, then there are immune modulating supplements that I love. I love these specialized pro-resolving mediators from fish oils, but you want to really have a supplement that specifically purifies out these SPMs or PRMs, pro-resolving mediators.


[Alexx] (50:30 – 50:45)

They’re incredible. I remember having one of my attacks, I think it was one of the moldy houses or whatever. And I said, Elissa, what can I do?


Double down on your SPMs. And they really did make a huge difference.


[Dr Elisa] (50:45 – 51:21)

I mean, they probably really are my favorite supplement that I think that everyone could benefit from. And then I don’t know if in Australia, low-dose naltrexone is available, but compounded low-dose naltrexone can be really, really helpful. I don’t use a lot of CBD for kids, but I think for some adults and teenagers, it could be appropriate and help also reduce that, that can help with immune modulation, right?


Same immune resilience, immune modulation. That’s what we want, that flexibility.


[Alexx] (51:22 – 52:34)

So we were just obviously talking about that stress flexibility, not only like, you know, relating it back to the nervous system, but also now thinking about mast cell flexibility and inflammatory response flexibility. And given there’s so much that traces back to the gut in everything you’re talking about, when it comes to testing, we obviously don’t just want to like, you know, go to an allergist and do that whole thing. We’ve kind of confirmed, but that’s not always going to produce the kind of data that helps us actually get to the root of what’s going on.


Is poop testing something like, you know, stool testing’s become so sophisticated these days and there are some tests that are really expensive, but is it something you consider super important to do? Medium? Like, I’d love for you to unpack that subject because often parents feel pressured to spend like literally their last dime on a $500 test.


And that’s fine if that’s what your kid needs, any parent will put themselves on the line like that, but let’s have a look at the options.


[Dr Elisa] (52:35 – 56:32)

Yeah. So I don’t necessarily initially start off with testing. It depends on, I mean, I guess it would really depend on how significant, how severe the symptoms are for a child.


If they are, you know, really suffering quite a bit, or let’s say they come in with a, you know, with a more, you know, serious chronic health concern, like an autoimmune condition, then I really do want to try to dive into some of the lab work. A stool analysis can be really helpful just because of the intimate connection between your child’s gut and their immune system. So when it comes to allergies, food sensitivities for sure.


I mean, we know food sensitivities are a hallmark of, you know, quote, leaky gut. So recognizing some of those imbalances can be helpful, but it’s not necessary at first. So, and even for blood testing, and I love doing something called a urine organic acid test, and sometimes it’s easier for kids to give urine samples, and sometimes they get blood work, and for sure, you know, your poop samples can be harder the older kids get, and the more they want that privacy.


But so each of those pieces of information is really helpful. Let’s take, you know, blood tests, for instance. There are clinical clues, there are different signs that your child might be telling us that they need more zinc, or they need more magnesium, or they need more vitamin D.


So we can go on those clinical clues. When blood testing is helpful is if we’re doing some supplementation kind of presumptively on those clinical clues, and we’re not kind of moving the needle, you know, as far as we’d like to, and I want to know, well, just how deficient are you? You know, sometimes it can be shocking how low kids are in their zinc levels, and how much needs to be supplemented.


The urine organic acid test, for instance, can give us clues as to are there some other imbalances going on that maybe we’re not addressing adequately that we need to support if we’re going to get true healing, like are there mitochondrial dysfunction issues going on, which is so common in, I mean, not just adults, but kids too. You know, any kid who has chronic immune stress of any sort, chronic psychological stress, chronic infections going on, chronic toxic exposures, those all stress out your mitochondria. And so we often think, oh, kids have enough energy, their cellular energy is fine, kids don’t get mitochondrial dysfunction, but we know that’s not true.


So sometimes that can give a clue. But again, there are clinical clues that your child might have some mitochondrial needs, like if they fatigue more easily than their peers, or they can go, go, go, go, go and be like the fastest runner on the soccer team. But then after the soccer game, or football in Australia, right?


After the football game, they can’t keep going. Like the rest of their friends are going out to have dinner together and a play date and jump on the trampoline. And your kid, they gave it their all, and now they have to go home and lay on the couch for a couple of hours, right?


So there can be some signs like that. So my preference initially would be to go with those clinical signs, and then also start on some supplements for allergies, for mast cells, for histamine control, modify the diet in the way that we can. And then if we get stuck, that’s when testing can be more worthwhile.


Now, there are some parents who come in and say, I just want to do the test, right? I just want to know, and I’ll do the test, and then we’ll start the supplements. That’s great.


But as you said, not every parent has access from an affordability standpoint, and also a practitioner standpoint, to be able to get those tests done. Yeah, 100%.


[Alexx] (56:32 – 57:13)

And so from that, like that really struck a chord there when you mentioned the kid who can go, go, go, but then they have to lie on the couch for a couple of hours. Because I’ve often wondered about the legacy impact of water damage on my own son, because he does fatigue more easily than his friends. And so if a parent is noticing that, is that some of the supplements we’ve already talked about, like the SPMs and that kind of stuff?


Or is it more bolstering energy-based supplements like ubiquinol and that kind of family of nutrients?


[Dr Elisa] (57:13 – 58:57)

Yeah, I mean, they would be more kind of mitochondrial support specific supplements. I mean, the SPMs, in the sense that if there’s inflammation that’s perpetuating the mitochondrial dysfunction, then SPMs are amazing. But I do give specific mitochondrial support.


So, you know, some of the other signs that there might be some mitochondrial issues, I mean, for sure, you know, when there’s been exposure to mycotoxins or environmental toxins, we know, I mean, just in the literature, I just did give a talk on endocrine disruptors and kids. And in the research, we find that virtually every environmental toxicant is associated with mitochondrial stress. Chronic infections, you know, whether it’s PANS, PANDAS or chronic Lyme or, you know, what chronic Epstein-Barr infections are known to be mitotoxic.


I mean, we know the SARS-CoV-2 virus is mitotoxic, which is, you know, why we can see in some people all the hallmarks of chronic fatigue syndrome. You know, is it a reactivation of your Epstein-Barr? I mean, probably in many people, but, you know, then you have the double whammy of this latent Epstein-Barr and then the SARS-CoV-2, both of which stress the mitochondria.


So you can have this lower, you know, either just outright lower energy levels or good energy but easy fatigue, right? We tend to also see lower muscle tone. So maybe they’re really strong, you know, from an extremity syndrome, but core muscle tone often tends to be a little weaker.


So kids who, you know, just tend to slump a little bit when they’re sitting, not because they’re on their screens necessarily. I mean, that is a factor.


[Alexx] (58:57 – 58:58)

It’s definitely a modern factor.


[Dr Elisa] (58:59 – 1:01:08)

Yeah. But really just because their core muscles are preventing them from being able to keep their core engaged and sit up nice and tall. In younger kids and even older kids, we might see either, you know, some sloppy handwriting because the pencil grip isn’t as strong and regulated, or we might see the pressure.


Some kids who the pressure of their pen or pencil is super light, so very light writing, or it’s really hard because they can’t regulate the strength of their arm. So they’re kind of breaking their pencil points. Another classic sign is the sitting in the W position.


So this is where, you know, you sit on the ground on your bottom and, you know, knees are in front of you, but lower legs, your calves and your feet are kind of splayed out to the side of you. So when you look down from up top, it looks like a W. That, you know, if you have really good muscle tone, that should be really challenging to do, right?


You shouldn’t have such loose hips and knee joints. So the supplements that I will… Another sign can be if you just have slower recovery from infections, right?


So slower recovery from illnesses, because you need your mitochondria and antioxidant reserve to recover quickly, or slower recovery from any like musculoskeletal stress, like, you know, workouts where, you know, you’re exercising or you go on a hike and you’re like, oh my gosh, my muscles are just cramping and so sore. Could be a magnesium thing, could also be a mitochondrial issue. So the supplements, I mean, you mentioned ubiquinol for sure.


There’s also ribose, D-ribose, which is, you know, it’s, I mean, essentially, I mean, like a natural sugar that enhances mitochondrial function that’s often paired with carnitine. So L-carnitine, really important for mitochondrial function, which we can see on a urine organic acid test. Well, I’ll see elevations.


Ah, that’s why I love that one.


[Alexx] (1:01:08 – 1:01:09)

That’s right.


[Dr Elisa] (1:01:09 – 1:02:05)

So I’ll see like, you know, little elevations in the subaric acid or the adipic acid. I’m like, okay, this kid is having some issues with fatty acid oxidation, not fat, you know, GI absorption and metabolism, but from a cellular standpoint. And then also, you know, with mitochondrial dysfunction, you need a lot of antioxidant support.


So you can choose, I mean, glutathione, vitamin C, vitamin A or E. I also love, you know, phospholipids. So there’s also some research that phosphatidylcholine and some of your phospholipids can also help support mitochondrial recovery.


So, I mean, and of course you can throw the kitchen sink at kids. I mean, you can start with a couple of them, but, and see how they do. I usually start with CoQ10, you know, ubiquinol and carnitine are my usual first starts.


And then I’ll kind of add on as needed.


[Alexx] (1:02:06 – 1:02:33)

Yeah. And a lot of that can come from food, right? Like if we get some chicken liver pate in there, that’s your A covered, vitamin C from fruits, like we can, we can definitely, like, I think we often think, oh crap.


And you do these beautiful visuals often I’ve seen in the past where it’s like, this is what those nutrients look like as food to really help parents, you know, focus on what could be on the plates to optimize.


[Dr Elisa] (1:02:33 – 1:03:35)

Well, and, and I love that because we really, I mean, the best, the best way to get your antioxidants is from the plant itself, right? Because if you’re eating, I mean, you know, that cliche, eat the rainbow, but, you know, vitamin C extracted from, you know, let’s say, you know, a cherry is not the same as eating the whole cherry or eating the pomegranate because it’s not just the vitamin C content. There’s so many other antioxidants and phytonutrients that support not just mitochondria recovery, but your microbiome.


And there’s a, there is a microbiome, mitochondria connection that needs to be supported, you know, that, that can really help influence, you know, your epigenetic profile. So, I mean, the, the whole, I mean, nature and its wisdom has all of these amazing nutrients found in, found in plants that, I mean, we can get some benefits from the supplements, but they’re not going to be nearly as much as what we can get from, from foods. And I mean, you know, so, so for sure, I mean, we always want to try to get in food as medicine first.


[Alexx] (1:03:36 – 1:03:45)

And to link the mitochondrial function back to allergy, what is, is there a relationship there that’s quite direct or no?


[Dr Elisa] (1:03:45 – 1:04:00)

I mean, you know, yes, in the sense that any stressor to the immune system is also going to stress the mitochondria. That’d be interesting to see, you know, how much, I mean, there is a mass cell mitochondria relationship, right? Is that a bit like chicken and the egg?


Like which one?


[Alexx] (1:04:00 – 1:04:01)

It is. Yeah.


[Dr Elisa] (1:04:01 – 1:05:27)

It is. Yeah. Because, you know, we often, I mean, for patients with, with chronic illnesses, we often see mitochondrial dysfunction and mass cell activation kind of hand in hand.


And, you know, I, I think it’s more whatever the initial trigger is, is likely triggering both. And now these are just sort of the kind of the canaries in a coal mine that, hey, hey, your body needs to get back into balance. But, you know, as we, as we, you know, because when we think about it, I mean, it’s, it’s a very normal physiologic process for our mass cells to become activated, you know, when we’re sick or, you know, when, I mean, just as a normal and, and, you know, we need our mass cell.


So it’s not like, you know, mass cell activation. We want that sometimes. It’s just, we don’t want to perpetually, right.


And oxidative stress, you know, the, the creation of free radicals and oxidative stress, that’s a very important part of detoxifying. So we need that to happen. It’s just that when we don’t have enough antioxidant reserve to mop up the oxidative stress, that’s when we get into trouble.


So all of these things, I mean, they’re very normal physiologic and cellular processes. It’s just that the way we’re living nowadays in our modern world and just the environment that we’re living in, you know, that we may not necessarily have control over, it’s, it’s causing us more to swing into a dysregulated state.


[Alexx] (1:05:28 – 1:05:56)

So many levels. Yeah, absolutely. And so when, you know, given we mentioned mold there, and we’ve talked a lot about food allergies, is there a difference between how you would test for and treat for environmental allergic responses like dust mite?


I mean, so many parents and families seem to struggle with dust mite. Then your food, food allergies?


[Dr Elisa] (1:05:57 – 1:09:31)

You know, I, I think that for, I do think it is worthwhile if you’re having any symptoms or the other interesting thing is sometimes what I’ll see for kids who have environmental allergies and, you know, right now, as we’re speaking, we’re in, in our springtime. And so, you know, seasonal allergies, springtime allergies are pretty rampant right now. And, you know, you have your classic, the sneezing, the itchy eyes, the scratchy throat and all of that.


But some kids don’t present with those classic quote allergy symptoms. What I’ll sometimes see is, you know, kids who are presenting more with kind of mood or behavioral changes that in retrospect, we look back and like, how this happens like every October or it seems like every spring something kicks up, right? So it’s a seasonal pattern or it could be GI symptoms.


So now, well, why those two? Well, we have histamine receptors in every single cell in our body, including our brain and histamine can act as a neurotransmitter. We have histamine type four receptors in our nervous system.


And then why the GI? Well, you know, histamine receptors are lining our entire GI tract, mostly histamine type two receptors. And so, but, you know, when we have histamine floating around from environmental allergies, histamine doesn’t just attach to, you know, selective histamine receptors, they’ll attach wherever the receptors on the cells are to bind to them.


And histamine type one receptors are going to be responsible for the itchy eyes, the sneezing, you know, the post-nasal drip. Your histamine type two receptors are responsible for increased acid production in your stomach and reflux symptoms or, you know, GI upset and diarrhea. And so I’ve had kids where it’s really this kind of heartburn, you know, symptoms and the GI symptoms that seem to be more seasonal, and that makes sense.


And so then, you know, I do like to check whether it’s on scratch skin testing or blood testing for an environmental respiratory allergy panel. Now, I mean, here, our lab’s called a respiratory allergy panel, but it’s kind of a misnomer. It’s really just an environmental allergy panel, just to see, because sometimes I’ve had kids, like I had one kiddo who, you know, he had PANDAS, so Pediatric Acute Onset Neuropsychiatric Disorders associated with strep, and he would get this surge in, you know, tics and anxieties and kind of OCD thoughts right around February, March.


And it happened, you know, it was like the second year it happened, and we’re kind of putting it together. And I’m like, hmm, okay, let’s check an allergy panel. He had through-the-roof oak tree blood IgE, so immunoglobulin type E levels, not any respiratory symptoms, right?


And he lived in a yard surrounded by beautiful oak trees, right? And so, yeah, so we’re like, oh my gosh. And so we loaded him up with the mast cell stabilizers and the antihistamines and antioxidants, and his neuropsychiatric symptoms improved, right?


And so the next year we knew we’re just going to, before allergy season even starts, we’re going to start these up so that we can, you know, prevent some of those non-classic allergy symptoms from happening.


[Alexx] (1:09:32 – 1:09:59)

And, you know, that’s why the timelining piece that we were talking about earlier is so important, you know, look in retrospect, what was happening around that time? Did you move house? Did a season change?


Did you have stressful exams to get into a special school? Like, was there anything that was out of the ordinary when you started to notice things for your kid? Because that’s something that the parents are obviously going to be much better at, like, reflecting on and sitting down and thinking about.


[Dr Elisa] (1:10:00 – 1:10:32)

But doing that timeline, you know, I think is so important because a lot of times we don’t necessarily connect the dots until we actually start talking about what’s going on. And then either a light bulb goes off for you as a parent or the practitioner you’re talking with, and you’re like, gosh, that maybe that’s related. And then you pursue the testing.


You pursue some, you know, presumptive treatments. And I mean, just really taking that history is so important in a really broad sense.


[Alexx] (1:10:33 – 1:11:20)

And you’re a huge fan of homeopathic. So I kind of want to finish here because I’d love to first ask you as a pediatrician, there must have obviously been a point where these came onto your radar because it’s not pediatricians that are pediatricians right now. You didn’t start as an integrative pediatrician, you know, right.


And so what was the point at which, yeah, I know, I know. Retrospect there it is again. Right.


But what was the point at which you thought these need a little bit of my investigation and then to kind of come into how homeopathics might fit into looking at allergies and supporting allergic reactions? Yeah.


[Dr Elisa] (1:11:20 – 1:16:35)

You know, what’s interesting, I actually did start in medical school wanting to learn more of an integrative approach, which is so unusual, right? I mean, this just it was sort of, you know, I don’t think there’s any such thing as coincidence, right? Life happens in the way it’s meant to.


But when I was in, you know, at Stanford University as an undergraduate, you know, thinking about what do I want to do with my life? It wasn’t medicine. It was actually law.


And so because I wanted to be a children’s advocate, but it was my junior year, my third year where I stumbled across this flyer on a big telephone pole. And it was a flyer for the American Holistic Medical Association. And I’m like, what is holistic medicine?


This is in the late 80s, right? Just to date myself, right? Well, that is totally groundbreaking.


I love it. So I’m like, what is this term? Because that was not a term being used at all, right?


And in fact, the CDC had an office, the NIH, the National Institutes of Health at that time had an Office of Complementary and Alternative Medicine, right? Which I mean, it shouldn’t be alternative, but anyhow, I went to this conference as an undergrad and I was like, let me see what it’s all about. And I mean, my mind was blown on like what this thing called holistic medicine.


This is amazing, right? We can actually, you know, heal people with food and you know, that there’s power in, you know, mindset. And so I heard from these docs who were just getting known at the time, like Andrew Weil and Deepak Chopra and Joan Borisenko.


And I remember at the time I told my mom, I was like, you know, mom, I think I want to be a naturopathic doctor. How did she go with that? You know, she was just like, what’s that?


Which was the common response, right? What’s that? Because it wasn’t as widely known then.


And I mean, she never discouraged me, but she was just like, I don’t know if, you know, if people are going to really know what that is, maybe you want to get your MD first. And so anyhow, that’s how I ended up going to conventional medical school, but I was completely, you know, disillusioned with everything I was learning. Although I am glad in retrospect now, having gone through the conventional medical route, I feel like, you know, there is a time and a place for things like antibiotics.


And, you know, if my child has, you know, acute trauma, I want them to be seen by a trauma surgeon or, you know, God forbid they develop some, you know, really life-threatening chronic illness. There may be some medications that are going to turn things around, right? At the same time, you know, we really do need to get to some of the root causes and underlying, you know, biochemical imbalances that got our kids there in the first place, and then, you know, learn how to kind of build back up that resilience from the ground up.


So, but anyhow, so that was always my interest. And then when I was at UCSF doing my residency, I actually asked if I could take, use my elective time a month to go all around San Francisco and go to these different like alternative practitioners and learn how to use complementary and alternative medicine to treat and manage juvenile, so childhood arthritis, autoimmune arthritis. So yeah, so they let me, and I’m like, this is so cool.


So I went into acupuncturist offices and chiropractor’s offices. And, you know, I shadowed a homeopath who was also a medically trained doc and, you know, just got to see all sorts of different ways of incorporating different modalities into a child’s care. And so that’s how I got into homeopathy.


I’m like, this is really interesting. It doesn’t make sense, right? Didn’t make sense to me, but now, you know, seeing more and more of the data coming out.


And what I remind people is that the definition of evidence-based medicine, which was really, you know, not even a term until I was in residency, right? There was, because there was this, right. I mean, it wasn’t, it was not a phrase.


And now everyone now would say, oh, I want evidence-based medicine. Well, guess what? It was a term that was coined in the late 1990s, right?


Not that new. And when I think it was Dr. Eisenberg first coined the phrase, the phrase was meant to really be this triad. Okay.


So yes, you rely on the current best existing scientific literature, knowing that there’s a lot more literature research that hasn’t been done, right? So the best existing scientific evidence with clinical evidence, right? Your clinical experience and your patient’s preference, right?


I mean, that your patient’s cultural background and heritage all play into also what the best care is for them. So it’s this triad of the art and the science and personalization of that is truly evidence-based medicine.


[Alexx] (1:16:36 – 1:16:57)

Wow. And that really plays into why doctors like take that Hippocratic oath, right? First do no harm.


And let’s have a look at the whole picture. And what does this person in front of me presenting with want? What do I know about what I’ve done in the past?


And what do we know up to the minute? Like that’s how we should practice.


[Dr Elisa] (1:16:57 – 1:20:36)

We should. And that’s where, you know, I think through the pandemic, you know, follow the science and evidence-based medicine. It just, it became this mantra for just looking at what the research was.


And guess what? Who funds the research? Who decides who gets researched and what gets researched, right?


I mean, there’s no such thing as unbiased research. So that’s why we can only take, you know, the evidence, the research that we have, and then take that with a grain of salt and bring in the clinical experience of doctors and, you know, practitioners, integrated practitioners who have decades of experience and clinical successes. So, so anyhow, long story short, that’s how I came to homeopathy.


And I love homeopathy, especially for children, you know, infants, children. I mean, even for, you know, women who are nursing or, or maybe pregnant. When you use a homeopathic medicine from a reputable company, there really should be no interactions with any other medications that you’re on.


They’re so quote infinitesimally diluted that there should be really no risk for harmful side effects. And I say reputable because you want to use a company that you know is really diluting the remedies in the most appropriate way. But that’s why I think homeopathy gets such a, it’s the least well-understood, you know, integrative modality because, you know, a lot of people think, oh, it’s just, just placebo.


Oh, it’s just a sugar pill. Well, first of all, we know that there’s power in the placebo, right? Second, we also know, you know, from in vitro studies, like lab studies, you can’t make things up in a Petri dish, right?


And also even animal veterinarian studies that, and, and pediatric studies that there are some really significant, you know, positive outcomes with homeopathy, either compared with placebo or compared with conventional medicines. And for allergies in particular, there’s this one homeopathic medicine called the homeopathic antihistamine. Well, I guess there’s two.


There’s one called apis mellifica. So apis mellifica that in these ultra dilutions, there was a scientist, Dr. Ben Veniste, who took this homeopathic preparations of apis mellifica and also homeopathically diluted histamine, so histamine. And he surrounded these white blood cells called basophils, right?


In these different ultra dilutions of histamine or apis mellifica. Now these basophils were special basophils because they were already sensitized to, I believe it was dust mite, like an antigen, right? Where if they came into contact with the dust mite, they would release histamine, right?


However, when these particular basophils were bathed, surrounded by these ultra dilutions of apis mellifica or histamine, and then exposed to dust mites, the degranulation was significantly inhibited. So what does that mean? That they didn’t release histamine anymore, right?


And that was at multiple dilutions that were for all intents and purposes, you would think, well, it’s just water, right? But it’s not because now we can see it sort of this molecular level. I mean, this kind of electron microscopy level.


I mean, you can see that there are difference in the water structure, right?


[Alexx] (1:20:37 – 1:20:48)

It’s like, is it- So does it actually, is it better described then as an energetic medicine, given structures are changing? Like that’s pretty- Yeah, yeah.


[Dr Elisa] (1:20:48 – 1:22:18)

And I would say it’s interesting because when you speak about energetic medicine, a lot of times that gets kind of eye rolls, especially where I’m at in Silicon Valley, right? But now it’s a whole different meaning because we know there’s, I mean, on a quantum physics level, there are energetic changes that are happening at a cellular level, right? Even from what we’re thinking, right?


And so, you know, there’s so much, there is so much power to that. And I’m hoping that now with more and more research at that kind of quantum physics energetic level, we will be able to see more clearly how these different homeopathic medicines work. Because I can tell you from my clinical experience, they work amazingly well.


I had a kiddo in my waiting room who had started to develop hives all of a sudden out of the blue. And literally, as I was going back to get the Benadryl, the diphenhydramine, you know, in the back office, I gave the mom a tube of Apis Malefica. And I said, look, just give it to him like three pellets every five minutes, I’m going to be back.


And, you know, I was rifling around trying to find where the Benadryl was, right. And by the time I came back, the hives were disappearing back up his body. I mean, in all of, you know, I mean, that was probably, you know, like, six, seven minutes, right.


And so, and I have more stories like that, that if I didn’t see with my own eyes, I wouldn’t believe, right. But yet here I am, and I know that they work, which is why I recommend them.


[Alexx] (1:22:18 – 1:22:25)

Yeah. And such an easy, accessible, inexpensive thing to try. Nothing to lose, right?


[Dr Elisa] (1:22:25 – 1:23:23)

Yeah, nothing to lose, right? Because if it doesn’t work, you can always use your antihistamine, right? Your over-the-counter antihistamine, which, you know, we know that that antihistamine is the medication, the medicines, right?


Like, I don’t know what they’re called in Australia. We’ve got like Telfast, Zyrtec. Zyrtec is Cetirizine, Loratadine, which here is Claritin.


We have, in some of the studies, they found that your over-the-counter antihistamines can disrupt your gut microbiome pretty much similarly to an antibiotic, right? And so, we just want to be mindful. I’m not saying never, ever, but, you know, we just, if we can use our natural, you know, therapies that don’t have the same microbiome disrupting properties.


And also, by the way, if you use something like Quercetin, it has amazing phytonutrient and antioxidant properties, why not, right? Yeah.


[Alexx] (1:23:23 – 1:24:27)

And it really is like in the SOS bucket, like we do want to find out, which is everything we’ve talked about, why? And is there a mast cell inflexibility that we need to work on? Is there a gut microbiome situation that needs support to become less reactive?


So, I feel like we’ve covered pretty much all bases. So, and it’s not about shaming the SOS measures because they are so useful. And as we talked about with EpiPens, life-saving, but we also want to deal with the reasons these things are happening in the first place and play a long game.


Yeah, absolutely. Thank you so much for joining me to talk about allergies. I wanted to do this for ages and I just know it’s going to be so helpful to so many parents.


And of course, they now have your book to, at least in America, we’ve got to wait a little while in Australia, if you’re listening to this live, but very, very excited to, to be able to share that with people too.


[Dr Elisa] (1:24:28 – 1:24:35)

Oh, thank you, Alex. I always love chatting with you and I cannot wait to come to Australia and give you and Sab a huge hug in person.


[Alexx] (1:24:35 – 1:27:32)

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