Latest / In Moderation / Navigating the Allergy Maze: From Early Exposure to Alpha Gal Surprises with Dr. Rubin

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Navigating the Allergy Maze: From Early Exposure to Alpha Gal Surprises with Dr. Rubin · In Moderation

• 0:21
  Speaker 2: Welcome to In Moderation, the show where we give you a moderate dose of info sarcasm, and we already know we're not approved.
• 0:29
  Speaker 2: Hey everybody, welcome to the podcast in moderation episode.
• 0:41
  Speaker 2: Rob, help me out here a little bit.
• 0:43
  Speaker 1: I'm done helping you.
• 0:44
  Speaker 1: You're on your own.
• 0:45
  Speaker 1: I quit.
• 0:46
  Speaker 1: I know I'm not approved 16.
• 0:48
  Speaker 2: That's probably not right but we're going.
• 0:49
  Speaker 1: That's not right.
• 0:50
  Speaker 2: Today, it doesn't matter, we're still moving along.
• 0:53
  Speaker 2: We have our resident TikTok allergist, dr Rubin, on today.
• 0:57
  Speaker 2: Dr Rubin, how you doing.
• 0:59
  Speaker 3: I'm doing great Thanks for having me on again.
• 1:02
  Speaker 3: This is a lot of fun.
• 1:03
  Speaker 1: Well, this time you're actually a guest, last time you were the host.
• 1:06
  Speaker 3: I was the host.
• 1:07
  Speaker 3: Yes, because you two were in jail because you impersonated.
• 1:10
  Speaker 3: Bobby at Costco.
• 1:13
  Speaker 1: I just wanted to point out that our email got one of those spams from people trying to book onto the podcast for money.
• 1:22
  Speaker 1: The header was Dear Dr Rubin, Rob and Liam, you are officially one of the hosts of this show.
• 1:35
  Speaker 3: Wow, holy cow folks, I'm really excited.
• 1:39
  Speaker 2: Being a scammer has got to be great.
• 1:41
  Speaker 2: When people fall for it, you've got to be like really, but then you just take their money and it's awesome.
• 1:45
  Speaker 2: That's going to be fantastic.
• 1:48
  Speaker 1: By the time we're on episode 50, Liam's just going to have gone over to the dark side.
• 1:53
  Speaker 2: I don't know when we'll be on episode 50, so it doesn't matter that could be tomorrow.
• 1:57
  Speaker 3: That point.
• 1:58
  Speaker 3: You may be selling supplements, folks.
• 2:00
  Speaker 3: Let's be real.
• 2:02
  Speaker 2: Well, I mean, whatever it pays, come on, listen, come here.
• 2:05
  Speaker 2: But yeah, we figure we'd have Dr Rubin back on to talk about maybe some more serious things.
• 2:13
  Speaker 2: Dr Rubin, I've heard that allergies are a thing, that some people have them.
• 2:18
  Speaker 2: Am I correct in this?
• 2:20
  Speaker 3: You are absolutely 100% correct.
• 2:22
  Speaker 3: Considering what y'all do in terms of the nutrition field and wellness, it really overlaps quite a bit because there are unfortunately, millions of people in the United States living with the food allergy.
• 2:34
  Speaker 3: We're estimated now to be about 32 to 33 million people, which is roughly one in 10 to one in 13.
• 2:41
  Speaker 3: That's like saying two kids in a classroom and an average classroom size are going to have food allergies right now.
• 2:48
  Speaker 2: Does that mean like to a significant degree, or just like any amount?
• 2:50
  Speaker 2: I mean, I'm just kind of curious.
• 2:52
  Speaker 3: Correct.
• 2:52
  Speaker 3: When we're talking about food allergy, we're all going to say on the same page here.
• 2:56
  Speaker 3: This is potentially life-threatening situation where even the smallest amount for some people could develop a severe allergic reaction, also known as anaphylaxis.
• 3:06
  Speaker 3: That's what I'm saying.
• 3:07
  Speaker 3: That is a severe problem.
• 3:09
  Speaker 3: When we were kids, most of us didn't know anybody that had food allergies.
• 3:14
  Speaker 3: The rates have tripled in the last 30 years.
• 3:20
  Speaker 2: And there's some theories as to why.
• 3:21
  Speaker 2: Could you maybe give us like a couple as to like why we were thinking maybe food allergies are going up?
• 3:26
  Speaker 3: Sure.
• 3:26
  Speaker 3: So there's multiple potential reasons why this may be the case, so it's never one thing.
• 3:32
  Speaker 3: So if you ever look at a comment section when people are asking about this, they'll say oh, it's the water.
• 3:36
  Speaker 3: It's the chemtrails or the seed oils.
• 3:38
  Speaker 3: It's always that.
• 3:40
  Speaker 3: Or vaccines no, it's not one thing.
• 3:43
  Speaker 3: I'll give a few examples.
• 3:45
  Speaker 3: So the American Academy of Pediatrics for a long time had made a recommendation for babies to have peanuts.
• 3:53
  Speaker 3: Delayed introduction to like two to three years of age and we found that over the last 10 years there have been some really good studies comparing kids who were randomized to either getting peanut protein within the first six months of life to those who were delayed to five years of age.
• 4:08
  Speaker 3: And there's my years.
• 4:10
  Speaker 3: Yes, and there's an absolute risk reduction in the development of peanut allergy by about 80% when you do early introduction.
• 4:18
  Speaker 3: Wow, so 80% I would not have gotten Right so so those guidelines have changed About 10 years ago or so.
• 4:27
  Speaker 3: So we'll get more data in the next five to 10 years about where we are at with those guideline changes.
• 4:33
  Speaker 3: But it seems to be that many of these highly allergenic foods, such as peanut, it's better to introduce it during the first year of life, not delay it.
• 4:42
  Speaker 3: So the immune system we're still learning a lot about it.
• 4:44
  Speaker 3: It's rather malleable early on in life.
• 4:47
  Speaker 3: So if we can challenge the immune system early on to these foods, probably less likely to develop food allergies.
• 4:53
  Speaker 3: But we haven't eliminated food allergies just from that yet, which again shows you why it's not just one issue that we're talking about.
• 5:01
  Speaker 3: Another issue potentially is some of the early exposures to antibiotics and acid suppressor.
• 5:07
  Speaker 3: So if a baby has reflux, we often will give them a medication like an antacid to reduce the reflux that the baby has, and there have been some studies showing an association between these medications and potentially developing food allergies.
• 5:23
  Speaker 3: It doesn't mean that there's a link.
• 5:25
  Speaker 3: It's not necessarily causative, it's a possibility.
• 5:28
  Speaker 3: But again we have to think about everything involved with what we're trying to do here.
• 5:32
  Speaker 3: Early antibiotic use can be crucial if there's any concern for sepsis in a newborn.
• 5:38
  Speaker 3: So we're not going to say, because of food allergies, we're going to stop giving antibiotics to babies when they need it, but we want to have judicious use to make sure that we're not overusing it.
• 5:48
  Speaker 3: But it can still have its purpose.
• 5:50
  Speaker 3: Antibiotic usage could potentially change the gut microbiome, the bacterial milieu and how our immune system processes the food early on in life.
• 6:02
  Speaker 3: So that's another potential example.
• 6:05
  Speaker 3: Another issue is the fact that we're seeing more and more kids developing eczema.
• 6:09
  Speaker 3: It's this dry, itchy skin condition that has a lot of redness, a lot of irritation often is seen on the cheeks, and we see a strong association between those who have eczema and developing food allergy later in life, probably due to the fact that those who live with eczema have a skewing of their immune response to something called TH2 inflammation, which can generate a lot of allergy antibodies.
• 6:33
  Speaker 3: So oftentimes we could develop later in life.
• 6:38
  Speaker 3: I do think a small portion of it, though, is when parents bring their kids in to get potentially allergy tested.
• 6:45
  Speaker 3: They're given a whole panel of tests by a physician with all the different foods, and it'll show up that they're allergic to 10 different foods and they may unnecessarily avoid some of these foods.
• 6:55
  Speaker 3: So we have to be careful about food allergy testing because you could all have to have a little bit.
• 6:59
  Speaker 2: Oh, I would love to talk about that a little bit.
• 7:01
  Speaker 2: Yeah, we'll talk a bit more to it.
• 7:02
  Speaker 2: Yeah, the food allergy tests I know they're not, let's just say, super accurate, but I don't know to the extent, just kind of how bad it is I mean frankly?
• 7:10
  Speaker 2: I did want to quickly.
• 7:11
  Speaker 2: Yeah, sorry, I just wanted to quickly go back to the introducing it when they're younger.
• 7:15
  Speaker 2: So I've heard it's around six months you should try and introduce.
• 7:19
  Speaker 2: Is that correct, right?
• 7:20
  Speaker 2: So?
• 7:20
  Speaker 3: between four to six months.
• 7:22
  Speaker 3: It depends on how well the child is doing developmentally, if they're able to sit up, if they're not tonguing out too much because they have to be able to swallow solid foods.
• 7:33
  Speaker 3: That's something that you talk with your pediatrician about and have them assess them developmentally and have that conversation with them about is it appropriate to even introduce it at four months old?
• 7:41
  Speaker 2: I'm going to definitely talk about that with my pediatrician, because Oakley's about four months now and I refuse to her for her to be allergic to peanuts.
• 7:49
  Speaker 1: There's too many peanuts.
• 7:50
  Speaker 1: I could put peanuts.
• 7:51
  Speaker 1: He ended up being one of the allergic to peanuts when they dried up.
• 7:54
  Speaker 2: So I'm going to do everything I can.
• 7:55
  Speaker 2: So after I go, avoid that so a little bit of peanuts around four to six months I'm going to talk to.
• 8:01
  Speaker 1: But yeah, here's the real trick Liam Raw milk.
• 8:06
  Speaker 2: Okay, so do I give it to her now, or is that something that we wait till later to give the raw?
• 8:14
  Speaker 1: milk, you just bathe her in it.
• 8:15
  Speaker 1: How about now?
• 8:16
  Speaker 1: Oh, I bathe her in it, see, these are the questions.
• 8:18
  Speaker 2: This is why I have you around.
• 8:19
  Speaker 2: I was just going to have her drink it.
• 8:22
  Speaker 1: Oh God, don't drink raw milk.
• 8:23
  Speaker 1: You bathe in it, Okay.
• 8:26
  Speaker 2: Yeah, enema and bathing contracts, exactly.
• 8:31
  Speaker 3: So, to get back to the introduction issues, if a child has a history of egg allergy or they have what we call moderate to severe eczema, you definitely need to be talking with your doctor about whether or not you can safely introduce peanut, because those are the kids that are at highest risk and those are what the current evidence-based guidelines talk about.
• 8:51
  Speaker 3: You may need to get some testing for peanut allergy prior to introduction in those situations.
• 8:57
  Speaker 3: So those are all things that your pediatrician should be well-versed in start talking about because, yes, peanut is one of the prime examples, because it's one of the most common food allergens.
• 9:09
  Speaker 3: In the country, about 2% of people allergic to peanuts.
• 9:12
  Speaker 3: Now.
• 9:12
  Speaker 2: Could you run us through the top food out?
• 9:14
  Speaker 2: So I know peanuts, I know soy is up there Like wheat, wheat, cow's milk, tree nuts, fish, shellfish.
• 9:25
  Speaker 3: We also have sesame, wasn't sesame just added?
• 9:29
  Speaker 2: It was added as the ninth most common allergen Okay.
• 9:32
  Speaker 2: Yeah.
• 9:33
  Speaker 3: And now this is crazy.
• 9:35
  Speaker 3: So what might be number 10, the CDC recently reported last summer, is red meat Really.
• 9:42
  Speaker 2: Is it because of those ticks?
• 9:43
  Speaker 2: Yes, is it because of those ticks.
• 9:44
  Speaker 3: Yes, so it's something called Alpha Gal Syndrome, which I hope that your audience will start to get interested and know more about, because this is affecting a lot more people than we realize.
• 9:53
  Speaker 3: So there may be close to half a million people in the United States living with Alpha Gal Syndrome.
• 9:58
  Speaker 3: What we believe is happening is that there's a particular tick called the Lone Star tick, or Amblyoma Americanum.
• 10:04
  Speaker 3: It's mainly found in the East Coast, but it's gone further north.
• 10:08
  Speaker 3: It's also in the Midwest as well, and as we have rising temperatures, these ticks are traveling further north.
• 10:14
  Speaker 3: These ticks in their saliva they carry a sugar molecule called Galactose Alpha 1,3 Galactose, also known as Alpha Gal and when they bite you, Sounds like an anime.
• 10:27
  Speaker 3: It does actually Power up, power up.
• 10:29
  Speaker 3: Or you know, like we have Beta Bros and Alpha Gal right.
• 10:32
  Speaker 2: Oh, I get that comment all the time.
• 10:35
  Speaker 2: Look at the Stammy we got to start making animes.
• 10:39
  Speaker 3: So in the saliva of these ticks when they bite you they introduce the sugar molecule Alpha Gal into your bloodstream.
• 10:44
  Speaker 3: Humans and certain primates do not have Alpha Gal, but pretty much every other mammal has the sugar molecule.
• 10:51
  Speaker 3: So our immune system sees it as foreign and creates these allergy antibodies called IgE that are specific and combined to Alpha Gal.
• 10:59
  Speaker 3: And what's weird about this type of syndrome is it's not like a traditional food allergy where I eat the food and even the smallest amounts.
• 11:08
  Speaker 3: You get these kind of reproducible reactions of hives, swelling, problems, breathing, vomiting, combination of that, or drop in blood pressure, which can be life-threatening.
• 11:16
  Speaker 3: This is inconsistent and it can be delayed up to four to six hours.
• 11:22
  Speaker 3: So prior to noting this existed, there were many patients who would come in and say you know, I'd wake up at two, three in the morning and I'd be covered in hives and I have no idea why that's happening.
• 11:34
  Speaker 3: Or I'd wake up at two, three in the morning and I couldn't breathe.
• 11:37
  Speaker 3: I was wheezing, my chest was tight, my face is swollen.
• 11:40
  Speaker 3: They'd end up in the ER getting pumped with steroids and epinephrine and it would be called idiopathic anaphylaxis Idiopathic meaning, we just don't know the underlying issue Until a bunch of researchers out on the East Coast I believe it was at University of Virginia were able to connect the dots, because they were seeing a lot of these patients in that area, where the Lone Star tick was prevalent, there was also a colorectal cancer drug called Sintoximab that was causing similar reactions, and they found out that that sugar molecule was part of that medication, and so they were able to characterize this fairly recently, like over the last 10, 20 years or so, to really put things together, to come up with this, and a lot of physicians still don't know about this.
• 12:25
  Speaker 3: The majority of doctors still don't understand this condition or don't feel comfortable with it, so it's important for people to recognize this, as we now estimate a lot more people probably have this.
• 12:37
  Speaker 1: Is it permanent?
• 12:38
  Speaker 1: I know one doctor who definitely does not know anything about this Dr Salad, dr Salad.
• 12:45
  Speaker 3: Oh, Is it permanent?
• 12:47
  Speaker 3: You were asking.
• 12:49
  Speaker 2: Yeah, is it permanent so far?
• 12:50
  Speaker 3: So we don't have a ton of data on whether it's permanent or not, but we know that some people are able to outgrow it.
• 12:56
  Speaker 3: So I've actually have done oral food challenges for people, I suspect, in the past, where I'd say, you know, their allergy antibody to alpha-gal has gone down significantly.
• 13:07
  Speaker 3: What they would do is they would eat a steak dinner or you know a bunch of hamburgers in the morning and come into the clinic and sit there all day and just sit there all day because the reactions are delayed, and ideally you have to do this multiple times because it's inconsistent.
• 13:23
  Speaker 3: So people can sometimes have axial ingestion and not have a reaction, and other times they can get really, really sick.
• 13:30
  Speaker 3: And it's not just food.
• 13:31
  Speaker 3: This is an issue where there's a lot of you know, pills and medications, gelatin right as an example.
• 13:39
  Speaker 3: There's a whole list, way larger than you'd think.
• 13:42
  Speaker 3: You essentially have to go vegan.
• 13:43
  Speaker 3: If you have this issue, it's very, very difficult to live with.
• 13:48
  Speaker 2: So there's no like real treatments for it now or prevent anything.
• 13:51
  Speaker 2: It's just we're still figuring it out.
• 13:53
  Speaker 3: The best thing you can do, don't get bit by a tick.
• 13:55
  Speaker 1: Exactly, exactly, right.
• 13:57
  Speaker 3: You do not want to get bit by ticks, because ticks can resensitize you to the allergy potentially.
• 14:03
  Speaker 2: Oh, that's fast.
• 14:05
  Speaker 2: I find this fascinating.
• 14:06
  Speaker 2: It sounds like something in like a sci-fi novel series, something like that, where there's just you get bit and you can no longer eat these foods.
• 14:13
  Speaker 2: It sounds made up.
• 14:14
  Speaker 2: If you just told me, if somebody, if I saw it on TikTok they're like oh, that's fake, Like there's no way that's real.
• 14:18
  Speaker 2: But I did actually see it a while back and I was like that's it's, it's fascinating, it's crazy.
• 14:23
  Speaker 3: Yeah, Last summer I made one of the longest posts I've ever made about this and the history of it and it really does sound like you know, a documentary, sci-fi, you know type story and I even put like the moonlight sonata music in the background and made it kind of here because it's just, it is wild how they were able to come up with it.
• 14:41
  Speaker 3: But also a lot of people who have this don't feel heard and people think that they're crazy sometimes and it's just, it's far from the truth.
• 14:50
  Speaker 2: Yeah, this is a serious problem.
• 14:52
  Speaker 2: It's really so frustrating for the person because they're not being heard and other people are like there's just no way that can be true.
• 14:57
  Speaker 2: That has to be like made up.
• 14:59
  Speaker 2: So, yeah, I mean yeah.
• 15:02
  Speaker 3: There's, unfortunately, a lot of issues in in the patients I treat with allergic conditions that can be rare or becoming more recognized, where people are told ah, that's in your head, like I literally yesterday saw a patient who said don't call me crazy, but I'm pretty sure my child is allergic to the cold, and I said you're not crazy.
• 15:21
  Speaker 3: There is something called cold induced urticaria.
• 15:23
  Speaker 3: You can get hives just from the temperature, our immune system.
• 15:28
  Speaker 2: This is why it's so frustrating when people make up allergies.
• 15:30
  Speaker 2: That's why I have people like fake that, for whatever reasons they have, because that's stupid.
• 15:35
  Speaker 1: seed oil allergy card they print off the internet.
• 15:38
  Speaker 3: Yeah, this is a big challenge because, yes, some people want to use allergy as the term for potentially a lifestyle choice and that's caused a lot of confusion and anger that's now put towards people who actually having these lived experiences that are so challenging and potentially debilitating.
• 15:57
  Speaker 3: People who live with food allergies are at a significantly higher risk of developing anxiety and depression and may not be able to go out with friends as much as they want to because they have such anxiety or they're bullied for for having these issues.
• 16:11
  Speaker 3: There was a high school student in Texas who was on the varsity football team who, essentially, other players were hazing him they were putting like peanuts in his locker room and all sorts of peanut products and his stuff.
• 16:26
  Speaker 3: He got hives from it and the kids got kind of a slap on the wrist.
• 16:29
  Speaker 3: But now the parents have been speaking out and kids being bullied over this.
• 16:33
  Speaker 3: Even though he did nothing wrong, he was being picked on and he's being picked on even more.
• 16:38
  Speaker 2: For some Anything that makes you different it sucks.
• 16:40
  Speaker 2: It's just like anything that makes you different from other people.
• 16:43
  Speaker 2: They will they especially as teenagers they'll just latch onto that.
• 16:46
  Speaker 2: And when it's something like an allergy, you know it can be absolutely deadly.
• 16:49
  Speaker 2: And then not even just that, but all the psychological damage that can be done to someone in that situation.
• 16:56
  Speaker 3: Absolutely.
• 16:56
  Speaker 3: The media portrays allergies as people being weak, as looking like I mean, yes, I kind of have the stereotypical look that you'd see on TV of someone with allergies.
• 17:06
  Speaker 3: You know, I do fit some of that persona, so to speak.
• 17:09
  Speaker 3: I'll live it, I don't care, that's fine.
• 17:11
  Speaker 3: But anybody could have a severe, potentially life-threatening allergy, and it affects millions of people.
• 17:17
  Speaker 3: But doesn't mean you're weak, it just means that you have an immune system that is actually hyperactive to an extent.
• 17:23
  Speaker 3: It has these reactions that are really strong.
• 17:27
  Speaker 3: It just can cause these life-threatening situations.
• 17:30
  Speaker 3: If you actually look at how your body goes through these disease states, it's terrible, it really is, and so people need to be able to learn more about this so that they can take it more seriously and have more empathy towards it.
• 17:45
  Speaker 3: Where I'm at in Illinois, we actually passed a law where high school students at every public school have to learn how to use an epi-pen and identify anaphylaxis.
• 17:53
  Speaker 1: Now, Wow, I want to say, like it may be in the US, you look like the stereotypical allergy person for Canadians, you look like Mr Dress Up and that is like a big compliment.
• 18:08
  Speaker 1: Thank you, my friend, thank you.
• 18:12
  Speaker 2: I find it's interesting to me because people are interested in allergies.
• 18:17
  Speaker 2: Many people are suffering from health conditions and they want to improve their health.
• 18:22
  Speaker 2: So that leads to them to think maybe I do have an allergy, and that leads them to buying an allergy test and they get this thing and they take it and it turns out they're allergic to just everything, everything around them.
• 18:35
  Speaker 2: I see people post their results and they're like I'm allergic to 74 things, and usually it's just always the common stuff.
• 18:42
  Speaker 2: They're like I'm allergic to milk, I'm allergic to this.
• 18:45
  Speaker 2: So could you just give us a little bit on these allergy tests and how?
• 18:48
  Speaker 2: What's the deal with them?
• 18:52
  Speaker 3: Yeah, so I'm glad you're bringing this up because there is a lot of just like in the wellness industry.
• 18:59
  Speaker 3: This overlaps, where many companies try to profit off of people who are trying to find answers and it's not necessarily the best test, especially when there's not clinical context.
• 19:10
  Speaker 3: So just a little bit of background about medical testing.
• 19:14
  Speaker 3: There are so many different tests out there, but the question is what is the pre-test probability Meaning?
• 19:20
  Speaker 3: What's the likelihood that this particular person will get their question answered by having a positive test or having a negative test?
• 19:28
  Speaker 3: If the test has a low pre-test probability, in that person's situation, you probably don't want to do that test, and this happens in the allergy world all the time.
• 19:37
  Speaker 3: So I could do either a blood test or a skin test, which are both trying to measure that allergy antibody that I was talking about, called IgE or immunoglobulin E.
• 19:45
  Speaker 3: That's the classic allergy antibody that causes those potentially severe life-threatening situations.
• 19:51
  Speaker 3: And there are companies who will sell you a panel that you could look at 30 foods, 60 foods, 90 foods, whatever you want you could.
• 19:58
  Speaker 3: You could make an elaborate assay to any of those foods.
• 20:02
  Speaker 3: The immune system can make those antibodies and it can show up on a test.
• 20:07
  Speaker 3: But are you actually going to be reactive?
• 20:10
  Speaker 3: There's a difference between something we call sensitization meaning the antibody is present, and the allergy.
• 20:16
  Speaker 3: That's the clinical syndrome where you have symptoms after consuming it, and there's a huge disconnect between the test itself and the clinical syndrome.
• 20:26
  Speaker 3: So you need to have a good story before you get the test to improve that pre-test probability, the likelihood that it's going to tell you yes, I'm allergic to it.
• 20:38
  Speaker 3: A panel of testing for most people is not helpful.
• 20:42
  Speaker 3: So when a company goes and they sell that big test for allergy again, I'm only talking about this antibody, I'll get into another test in a second.
• 20:50
  Speaker 3: That's related to what you guys deal with all the time.
• 20:52
  Speaker 3: If you have that test that's sent by a company without a doctor interpreting it, then you get a lot of garbage information and you may end up false positives.
• 21:03
  Speaker 3: Exactly False positives, where you're unnecessarily avoiding food.
• 21:07
  Speaker 3: That can lead to nutritional problems, food aversion, especially if this is on children.
• 21:13
  Speaker 3: It's a lot of problems when you over test people with that one.
• 21:17
  Speaker 3: There's another test that I think you're going to ask about, called food sensitivity testing.
• 21:22
  Speaker 3: Yes, yes, that's kind of the overlap, so I talked about IgE antibody.
• 21:26
  Speaker 3: The other one is called food sensitivity testing, which is measuring a different antibody called IgG.
• 21:33
  Speaker 3: So when we eat food, how does our immune system know that it's not a germ?
• 21:42
  Speaker 2: Because we have some antibodies for antigens.
• 21:45
  Speaker 2: I'm assuming there's antigens, our antibodies, attached to the antigens.
• 21:49
  Speaker 2: Hey, this is bad.
• 21:50
  Speaker 1: I'm pretty sure the answer to everything on this podcast is magic Black magic, black magic, fairy dust.
• 21:57
  Speaker 3: So, besides the black magic and fairy dust, one of the ways it may tolerate food is through what we call a tolerance antibody, which is called IgG4.
• 22:05
  Speaker 3: Immunoglobulin G has four subclasses and IgG4 is one that may help induce a state of tolerance.
• 22:13
  Speaker 3: So it's like hey guys, rest of the immune system, don't worry about this, this guy can move along and get digested.
• 22:18
  Speaker 3: That's one way, potentially.
• 22:20
  Speaker 3: Another way is you're eating the food and you have all these digestive enzymes that break it down enough so that the molecules aren't big enough for the immune system to see.
• 22:30
  Speaker 3: It kind of just slides past.
• 22:31
  Speaker 3: Interesting For some people, and that's a big reason why sometimes you can have a positive allergy test and not necessarily get allergic reactions because you're digesting it before the immune system sees it.
• 22:43
  Speaker 3: That's potentially.
• 22:45
  Speaker 2: There's always the common ones.
• 22:46
  Speaker 2: Why people the food allergy test and whatnot are always like you're allergic, you have problems with these foods.
• 22:51
  Speaker 2: And it's always the common foods because those are just.
• 22:54
  Speaker 2: You know, maybe those are the most.
• 22:56
  Speaker 3: It might be.
• 22:56
  Speaker 3: It might be so with this IgG test, the companies will say, well, if you have a positive test to coffee on our food sensitivity test, you should avoid it, and if you feel better after two weeks and then you eat it again and it gets you feeling sick, then it's, you're sensitive to coffee.
• 23:15
  Speaker 3: Well, the reality is and I see this in my practice on a regular basis people will come in with a sensitivity test for like 90 foods, over 100 foods, and it'll say things like coffee, tea, vanilla, all these, all these you know obscure things.
• 23:30
  Speaker 3: And I'd say do you eat these things on a regular basis?
• 23:33
  Speaker 3: And almost every time they'll say, yeah, I do.
• 23:36
  Speaker 3: And the issue is is that that's the stuff that they're commonly eating?
• 23:40
  Speaker 3: So the immune system makes the antibody, that's all it's doing to tolerate it?
• 23:45
  Speaker 3: Okay, there's.
• 23:46
  Speaker 3: There's no validated way to say that IgG testing actually improves people's symptoms or whatever sensitivity means.
• 23:54
  Speaker 3: That term sensitivity is loosely defined.
• 23:56
  Speaker 3: We don't have an underlying mechanism of looking at the biochemical pathways in our body to say I eat this food.
• 24:03
  Speaker 3: It generates this process to cause these symptoms, unlike with food allergy.
• 24:07
  Speaker 3: I know your B cells produce IgG antibody.
• 24:11
  Speaker 3: There's.
• 24:11
  Speaker 3: They sensitize mass cells.
• 24:12
  Speaker 3: They sit on the mass cell surface.
• 24:14
  Speaker 3: Food comes in and cross links with those antibodies, releases chemicals in the mass cell called degranulation, like histamine, different cytokines, and those cause the symptoms I've described high swelling problems, breathing, vomiting, all that stuff.
• 24:59
  Speaker 3: So we can describe that and we have the test to describe that.
• 25:01
  Speaker 3: Igg testing or any food sensitivity tests where we pluck a hair out of your out of your head and measure that.
• 25:07
  Speaker 3: These sensitivity analyses there's.
• 25:09
  Speaker 3: There's no scientific proof that those actually really help people.
• 25:14
  Speaker 2: So you wouldn't recommend anyone get a food space basically anyone.
• 25:17
  Speaker 2: You would say, just skip the food sensitivity test.
• 25:19
  Speaker 2: I agree, yes.
• 25:21
  Speaker 3: Absolutely.
• 25:22
  Speaker 3: There's really no reason to do it, and I'm not the only one saying this.
• 25:25
  Speaker 3: This is endorsed by all the major allergy societies American College of Allergy Asthma Immunology, as well as the American Academy of Allergy Asthma Immunology.
• 25:33
  Speaker 3: These are unproven tests.
• 25:35
  Speaker 1: I just think that goes pretty much everybody who doesn't sell one.
• 25:40
  Speaker 2: Right, but that shows you the power of marketing, because I see these things like quite a bit I hear people talking about them and everything like that, and I think that really shows you the power of marketing.
• 25:48
  Speaker 2: And again it goes back to this we, a lot of us, are dealing with an issue and just be able to say, oh, it's this food you're eating.
• 25:55
  Speaker 2: Oh, that makes sense, because I always eat it, you know, and I and they play on that and that's really unfortunate.
• 26:01
  Speaker 3: Right, right.
• 26:02
  Speaker 3: My feeling on this is that you know you're spending all this money to give you things that don't necessarily help and it may appear to help some people, but that's anecdotal evidence.
• 26:12
  Speaker 3: That's the strongest force in marketing on the internet.
• 26:17
  Speaker 2: Yes, when people say Say that again, say that again, but louder.
• 26:20
  Speaker 2: Hey, I'm a parent.
• 26:21
  Speaker 3: You know when somebody comes on and says I'm a parent, I'm busy and I don't feel well, but I did this one thing that changed my life, oh gosh, that's not the basis of scientific evidence, folks, unfortunately so powerful, Like you said.
• 26:34
  Speaker 2: It's so powerful, Like it's more powerful than any meta analysis.
• 26:39
  Speaker 2: I could cite like five of those.
• 26:41
  Speaker 2: But a mother comes on and says we were struggling so hard and we had, we were at our wits end and we did this one thing.
• 26:49
  Speaker 2: And look at them now and you just see this before and after picture.
• 26:52
  Speaker 2: It's more powerful than anything, Like you tug on those heartstrings.
• 26:57
  Speaker 3: One of the ones that I'm trying to really confront right now, because we're shifting our guidelines from this from an evidence based standpoint is eliminating food to treat eczema, which has been a very common practice to do.
• 27:09
  Speaker 3: And so I see this where parents will go on and say my child is eczema and we've been struggling.
• 27:14
  Speaker 3: But you know, I got rid of dairy and in 24 hours their eczema was completely clear, it was fixed.
• 27:19
  Speaker 3: Is what?
• 27:20
  Speaker 3: I hear from time to time, and there's a lot of nuance that's lost in that that we're learning more about Eliminating foods at an early age unnecessarily could potentially increase the risk of developing a potentially permanent food allergy.
• 27:35
  Speaker 3: That could happen and notice how I'm trying to be very careful with my language because there's no absolutes it may.
• 27:42
  Speaker 2: Only the sex deals in absolutes.
• 27:44
  Speaker 1: It's almost like it's not black and white.
• 27:46
  Speaker 2: Joy, the dog side, yes, and you can then say this causes eczema.
• 27:53
  Speaker 3: Right.
• 27:53
  Speaker 3: But we found that in various studies when you eliminate foods to treat eczema, it doesn't significantly improve it for a population, a large population of kids, as an example, and the flip side is that there's potentially negative consequences.
• 28:11
  Speaker 3: So trying to focus on other ways to treat that skin condition, I think, is more important.
• 28:15
  Speaker 3: You could do a skin test and find that, yeah, they've got antibodies to these foods and maybe it might help their eczema Mildly.
• 28:23
  Speaker 3: I don't know.
• 28:24
  Speaker 3: But I'd rather not take that risk and create a problem that didn't exist before.
• 28:30
  Speaker 3: That's more likely to be permanent and potentially life-threatening.
• 28:34
  Speaker 3: I'm not downplaying eczema.
• 28:35
  Speaker 3: It's a terrible condition.
• 28:36
  Speaker 3: I grew up with eczema myself.
• 28:38
  Speaker 3: I didn't wear jeans for my entire childhood because it scratched my skin so badly I'd itch all day wearing those types of fabrics and I'd be itching all the time.
• 28:48
  Speaker 3: It was hard to focus.
• 28:49
  Speaker 3: So I can empathize with people living with eczema.
• 28:51
  Speaker 3: Fortunately, I mostly outgrew it when I became an adult, but I remember that feeling and so I empathize with that.
• 28:58
  Speaker 3: But knowing what I know now, I wouldn't.
• 29:01
  Speaker 3: For most people I'm not saying everybody, but for most I wouldn't go straight to avoiding food unless I was doing X, Y and Z things.
• 29:09
  Speaker 2: And I tell people that because I get asked what about acne?
• 29:12
  Speaker 2: A lot People ask me like, what's the deal with acne and food?
• 29:15
  Speaker 2: And I'm not an expert on it.
• 29:16
  Speaker 2: I'm from the experts that I see and talk to.
• 29:18
  Speaker 2: There may be a connection between acne and things like a high sugar diet.
• 29:25
  Speaker 2: Or they say maybe whey protein.
• 29:27
  Speaker 2: I hear that but we're not sure.
• 29:30
  Speaker 2: It's not likely.
• 29:31
  Speaker 2: Yeah, so, are you going to cut all that out of your diet, for maybe it possibly to help?
• 29:38
  Speaker 1: On the topic of acne quickly.
• 29:40
  Speaker 1: Before you even cut food out of your diet, change your bedding more often.
• 29:46
  Speaker 1: That is one of the biggest causes of acne.
• 29:50
  Speaker 3: Lifestyle changes in other ways besides.
• 29:53
  Speaker 3: Diet can be helpful in terms of having things that are a little bit more clean have a skincare routine.
• 29:59
  Speaker 3: There are so many other things.
• 30:00
  Speaker 3: We have medications that we can use for acne.
• 30:02
  Speaker 3: It's the same thing with eczema.
• 30:04
  Speaker 3: There are so many different things.
• 30:06
  Speaker 3: We can do the skincare now and there just has to be a lot more education and teaching and that's one of the big drivers for me going on social media to try to give general educational tips for people, to understand and debunk people who go out and say I have a food allergy and I'm going to eat the food and we're going to see what happens.
• 30:25
  Speaker 3: It's like no, don't do that.
• 30:27
  Speaker 2: Don't.
• 30:28
  Speaker 1: Yeah, no.
• 30:29
  Speaker 2: Especially with EpiPens being $800,000 or whatever they are.
• 30:32
  Speaker 3: It's crazy.
• 30:33
  Speaker 3: Now, it's been terrible.
• 30:33
  Speaker 3: What are the?
• 30:34
  Speaker 2: $600 now.
• 30:35
  Speaker 3: So they can, depending on the person, be as much as $600 to $700.
• 30:40
  Speaker 3: Most of the time with my patients it's like $200 to $300.
• 30:43
  Speaker 3: You can get generics for as low as $150.
• 30:47
  Speaker 3: But that's still ridiculous.
• 30:48
  Speaker 3: But then I have also some patients who are like, yeah, my insurance is great.
• 30:52
  Speaker 3: I only pay like $5 or it's free.
• 30:54
  Speaker 3: That's lucky.
• 30:56
  Speaker 3: I wish I had there at health insurance, because most insurance companies don't cover all of those costs for something like that even though it's a life saving medication.
• 31:04
  Speaker 3: So the expiration date is usually about a year, but they typically can last longer than that, especially if you're able to keep it in the right temperature conditions.
• 31:13
  Speaker 3: If you live in your car, you're going to ruin it faster than you think.
• 31:15
  Speaker 3: But if you're holding onto it and you look at it and, like I, have a trainer with me on my desk, I always have that to show people.
• 31:22
  Speaker 3: But the real device would have an indicator.
• 31:25
  Speaker 3: We can see the medication, you can look up to the light and if it's clear, not cloudy, not yellow, it probably will be helpful.
• 31:33
  Speaker 3: We just don't know how helpful it is.
• 31:35
  Speaker 3: It's better to use that than nothing.
• 31:37
  Speaker 3: But if it's yellow or cloudy you can't use it.
• 31:40
  Speaker 3: But soon we will have devices that will be needle free.
• 31:44
  Speaker 3: Within the next 12 months there should be a nasal spray containing epinectrum coming out.
• 31:48
  Speaker 2: I saw your video on the nasal spray.
• 31:49
  Speaker 2: That's fascinating.
• 31:50
  Speaker 2: That's so cool.
• 31:51
  Speaker 3: Yeah, it should have come out already, but the FDA asked for an additional dose repeating study and I'm not too happy about that.
• 31:57
  Speaker 3: They should have just approved it and let the physicians, like myself, just counsel patients very carefully on what's going on within what we know, what we don't know, Because in order to really know how these medicines work like EpiPen, same thing there is no randomized placebo-controlled trial to approve EpiPens.
• 32:14
  Speaker 3: It's not ethical to run those trials Because that would be saying hey, I want you to eat peanut butter and go into anaphylaxis and you may or may not get the real device, so you might die doing this.
• 32:28
  Speaker 3: That's OK.
• 32:30
  Speaker 2: That would be tough to give people the sign up.
• 32:31
  Speaker 2: No, no, it's unethical.
• 32:32
  Speaker 3: So they do something called pharmacokinetic, pharmacodynamic studies or PKPD studies, to look at secondary measures like blood pressure, heart rate, for example, and time that from when you get the medication.
• 32:44
  Speaker 3: So we see the physiological changes outside of anaphylactic conditions.
• 32:49
  Speaker 3: You see what I'm saying.
• 32:50
  Speaker 1: I'm just glad that stuff like that is a lot cheaper in Canada.
• 32:57
  Speaker 3: Yeah, a lot of times I hear from people outside of the US who are like, yeah, I get this for free or it's like it's $10.
• 33:02
  Speaker 2: No, here in America we jump out of ambulances because we know we're going to get charged $4,000 just for a ride to the hospital.
• 33:09
  Speaker 2: Yeah, I was talking to somebody about that and I was like what I've had friends jump out of ambulances like, no, I'm not going to go, you won't take, I won't pay $4,000 for a ride.
• 33:20
  Speaker 3: It's crazy how much the cost of health care could be.
• 33:22
  Speaker 3: One of the representatives from Florida introduced a bill to try to cap EpiPens and other related devices at $60 a TwinPak.
• 33:31
  Speaker 3: That would be federally Right now.
• 33:33
  Speaker 3: There's a few states, like in Illinois here, where they're capping it at $60, which is fairly reasonable because the device itself does take costs.
• 33:41
  Speaker 3: I think about $20, $30 to make.
• 33:44
  Speaker 2: So that's a fairly reasonable price for a life-saving medication, but $600.
• 33:48
  Speaker 2: Like $600 is crazy, it's gouging.
• 33:50
  Speaker 1: It's totally gouging, that is yeah.
• 33:53
  Speaker 3: So I'm hoping that gets passed.
• 33:55
  Speaker 3: It's called the EpiPen Act, and so anybody who's in the United States listening to this right to your local Congress people in support of what's called literally the EpiPen Act.
• 34:06
  Speaker 3: I don't remember the exact acronym, but I think it's important for people to be aware that we're trying to help.
• 34:11
  Speaker 3: It's not just for people living with food allergies.
• 34:13
  Speaker 3: You can have anaphylaxis, severe life-threatening situations to medications, to bee stings, latex, all sorts of things.
• 34:21
  Speaker 3: So this affects millions of people.
• 34:25
  Speaker 1: It'd be great for them to be more affordable, just so people who maybe not have allergies can even carry one around, just in case of emergency.
• 34:33
  Speaker 2: Absolutely, it is.
• 34:35
  Speaker 2: Yeah, that's very interesting.
• 34:36
  Speaker 2: Oh, so before, yeah, before we, I want to make sure I get to something, because I remember watching a video you did that I want to ask you about about Benadryl, because I you talked about how there's possibly a connection between Benadryl and like dementia.
• 34:52
  Speaker 2: If you take it, you know, consistently this isn't like once in a while thing, but you take it consistently.
• 34:57
  Speaker 2: I was fascinated by that.
• 34:58
  Speaker 2: I was kind of like looking it up, I was like wow, there's actually like a decent amount of research and the fact that this isn't more well known is very surprising, because you, uh, talk about that a little bit.
• 35:06
  Speaker 3: Yeah, so a lot of times people call me the Benadryl bogeyman because of the amount of posts.
• 35:12
  Speaker 3: I talked about it at one point.
• 35:14
  Speaker 2: I don't blame you, though, for you know.
• 35:15
  Speaker 3: Yeah, so.
• 35:16
  Speaker 3: So I remember a while ago there were several allerges who had written an editorial.
• 35:21
  Speaker 3: It was, but I think it was entitled like Diffin hydramine time to move on, or something like that.
• 35:26
  Speaker 3: Okay, and so Diffin hydramine is the generic name for branded Benadryl.
• 35:30
  Speaker 3: Benadryl is one of the oldest antihistamines.
• 35:33
  Speaker 3: It's been around, I think, since around the 40s.
• 35:35
  Speaker 3: It's part of the class of first generation antihistamines.
• 35:39
  Speaker 3: There's other similar ones, like chlorfeniramine, hydroxazine as examples.
• 35:45
  Speaker 3: These are medications that, yes, they block the chemical histamine from attaching to its receptor, but they also have properties called anti-cholinergic properties.
• 35:54
  Speaker 3: They block something called acetylcholine, which is a neurotransmitter.
• 35:58
  Speaker 3: That that is, you know, found all over the place.
• 36:01
  Speaker 3: And so Benadryl, when you take it, especially at higher doses, can have all sorts of side effects, such as you dry out, you can have constipation, urinary retention, it can actually cause sexual dysfunction, heart palpitations, seizures, coma and, yes, death.
• 36:19
  Speaker 3: People have died from taking Benadryl overdose.
• 36:22
  Speaker 3: There was, unfortunately, a teenager who passed away trying to do a benadryl challenge.
• 36:27
  Speaker 3: That there's been a social media challenge.
• 36:30
  Speaker 2: Where people try to take it.
• 36:32
  Speaker 3: And people and the FDA actually put out a warning for that.
• 36:34
  Speaker 3: Okay, so what you're talking about is there are some longitudinal data of similar medications, anticholinergic in nature, where they looked at several adults who would take these anticholinergic medications like benadryl For long periods of time and then say, okay, who developed dementia later in life, right, and there were significantly higher numbers of people Developing dementia who had taken these anticholinergic medications.
• 37:01
  Speaker 3: So we call that an association.
• 37:03
  Speaker 3: Can we say?
• 37:03
  Speaker 2: there's a direct mechanism of action like a.
• 37:06
  Speaker 2: Do we have any any ideas on how it could?
• 37:09
  Speaker 3: probably has to do with the Anticholinergic property and how it alters brain chemistry?
• 37:13
  Speaker 3: Most likely, but we don't fully understand this right.
• 37:16
  Speaker 3: This is an association, so whenever you see on the news someone saying, oh, this is linked to it, I don't like that word because that makes it sound like it's causing it.
• 37:24
  Speaker 3: This is an association where we see that some groups of people have these conditions and they also happen to have taken this, so I bring this up in a lot of my content because it's not like we don't have a lot of safer alternatives nowadays.
• 37:38
  Speaker 2: We have so many medications.
• 37:41
  Speaker 3: The second generation antihistamines like zirtech or satirazine, zizol, levosatirazine, claritin, which is loratidine, allegra, which is fexofenidine, these newer medications that have been around for a few decades now, since basically the 90s and early 2000s, that work basically the same.
• 37:59
  Speaker 3: They are antihistamines.
• 38:01
  Speaker 3: They work just about as quickly, they're just about as effective.
• 38:05
  Speaker 3: They last longer than benadryl usually, but they don't have those anticholinergic properties and they don't you.
• 38:11
  Speaker 3: You don't die from overdoses on them like you can with benadryl.
• 38:14
  Speaker 2: So those second generation, they don't cross the blood brain barrier, correct Is that's what I've.
• 38:19
  Speaker 3: They're engineered to not cross the blood brain barrier, but some people still have that issue.
• 38:24
  Speaker 3: So as an example for me, I I I offer zirtech to my patients all the time, but for me, if I take it, I'm tired for 12 hours, really tired.
• 38:33
  Speaker 3: But if I take Allegra I'm totally fine.
• 38:35
  Speaker 3: Everybody's brain chemistry is a little bit different and you have to, you know, check this out.
• 38:40
  Speaker 3: I have so many people asking me what's the best allergy medication and I can't answer that because everybody is different and I have to counsel you based on what are your specific symptoms, what you're allergic to, what is your overall medical history.
• 38:52
  Speaker 3: So I have to think about all those things before giving that as a recommendation but as a general broad stroke.
• 38:58
  Speaker 3: Most people don't need to take benadryl as their go-to, and if you're taking it as a sleep aid, which a lot of people do, like I was just about to start talking about that.
• 39:06
  Speaker 2: Yeah, because I work in sleep medicine and I people tell me like I take it to help me see them, like I really wouldn't recommend that, like there's other things you can do it is not a good thing.
• 39:14
  Speaker 3: It's like, basically, zik will is like drinking alcohol in terms of how it affects the brain.
• 39:20
  Speaker 3: You fall asleep more quickly, yes, but is your sleep quality actually improved and do you wake up refreshed?
• 39:26
  Speaker 3: Not usually, and one of the reasons why is because benadryl, just like alcohol, has similar properties.
• 39:32
  Speaker 3: It increases what we call the REM latency.
• 39:34
  Speaker 3: It's the time when you fall asleep to getting the first phase of your sleep cycle, when you first enter REM, rapid eye Move in sleep when you dream, and you have to go through several sleep cycles In order to get restful sleep.
• 39:46
  Speaker 3: And not everybody has to be exactly eight hours a day.
• 39:48
  Speaker 3: There's some.
• 39:49
  Speaker 3: There's some variation on it, but to get to the right number of sleep cycles by taking these medications you're disrupting that significant like again, I work in sleep medicine.
• 39:58
  Speaker 2: Like I see people every night with the, with their sleep and their brain waves.
• 40:01
  Speaker 2: Typically it's like you know, around 90 minutes after you fall asleep is your typical first REM cycle.
• 40:06
  Speaker 2: Each REM cycle is a little bit longer than the next, um, but I will tell you people who are on different medications, they're REM, it sucks.
• 40:12
  Speaker 2: Like I look at it and they're like up and down and they get maybe like 20 minutes of REM here and like, uh, 15 minutes there.
• 40:19
  Speaker 2: It's, it's awful.
• 40:19
  Speaker 2: So if you can reduce those and just try and get a solid, you know seven to eight hours Generally for most people is a good window.
• 40:26
  Speaker 2: You're doing great.
• 40:27
  Speaker 2: I know we all struggle, but do your best.
• 40:29
  Speaker 3: Yeah, some tips for general sleep hygiene, and people like you should say sleep hygiene like it's I wish it.
• 40:34
  Speaker 2: Yeah, whenever I say sleep hygiene, people like no, it's just for your routine.
• 40:38
  Speaker 2: Exactly so you're recently called that sleep hygiene.
• 40:41
  Speaker 3: Yeah, waking up at the same time every day helps start going to bed, waking up the same time, right, right, usually if you first start off saying I'm gonna wake up at 8 am Every day, then your your body will naturally eventually get you to fall asleep at the same time every day.
• 40:55
  Speaker 3: Um, we're all creatures of social media and like to be on our phones.
• 40:59
  Speaker 3: Really should not be on any electronic devices, for you know, ideally at least an hour before bed.
• 41:06
  Speaker 2: I will tell you what's kind of helped me, because I'm I used to do that a lot beyond my phone.
• 41:10
  Speaker 2: So now I find a podcast I like and I play that on the side of my bed and I just listen to it before bed and that kind of helps me relax.
• 41:17
  Speaker 2: Try something like that.
• 41:18
  Speaker 2: Listening something is great.
• 41:20
  Speaker 2: Having something you do before bed can be very helpful the same night.
• 41:23
  Speaker 2: Whether it's taking a shower, reading a book, walking, whatever it is, it just kind of lets sets your brain into that.
• 41:29
  Speaker 1: I'm about to go to sleep mode and it can help the biggest thing that helped me was Getting rid of lights in the room.
• 41:37
  Speaker 3: Yeah, like even just a little.
• 41:39
  Speaker 1: You know, You've got the the wall taps and they have that surge protector light.
• 41:42
  Speaker 1: I'd put a little bit of tape over them so they aren't projecting light all over the place.
• 41:49
  Speaker 3: So you don't have like the neon lights like in your background right now in your bedroom.
• 41:53
  Speaker 2: It's flashing all the time, man, I don't know why I can't sleep.
• 41:56
  Speaker 2: I don't know what's going on.
• 41:57
  Speaker 1: Right yeah, hey, google Office off.
• 42:03
  Speaker 3: Da-da.
• 42:05
  Speaker 2: Very nice, very nice.
• 42:06
  Speaker 2: Oh, that looks terrible.
• 42:07
  Speaker 2: Go back to the other way.
• 42:11
  Speaker 1: Hey Google Office on we truly live in the future.
• 42:19
  Speaker 3: Yeah, so it's just just to you know.
• 42:21
  Speaker 3: Make sure everybody's on the same page.
• 42:22
  Speaker 3: Who's listening?
• 42:22
  Speaker 3: When you see light at nighttime, that's not good for your circadian rhythms.
• 42:28
  Speaker 3: It really throws off your body sleep cycle.
• 42:30
  Speaker 3: That's why we keep saying put your phones down.
• 42:33
  Speaker 3: I like the idea of listening to podcasts because oftentimes you know this is a very entertaining podcast.
• 42:39
  Speaker 2: Obviously, Don't listen to ours.
• 42:40
  Speaker 2: You'll be awake for hours.
• 42:43
  Speaker 3: I know this is just riveting, riveting yes.
• 42:46
  Speaker 2: Yeah, but other boring podcasts that I've been told do exist.
• 42:51
  Speaker 2: Listen to those and you know relax.
• 42:55
  Speaker 1: Like every other fitness podcast, they all suck ours is the best.
• 42:58
  Speaker 2: All the others suck.
• 43:01
  Speaker 1: You can just put them on and at night we don't care.
• 43:03
  Speaker 1: Listen to ours in the gym, though.
• 43:05
  Speaker 3: Guys, it's always fun hanging out with you.
• 43:07
  Speaker 3: Thanks for having me on always.
• 43:09
  Speaker 1: Oh, I mean we had you tell everybody where to find you last time you were here.
• 43:14
  Speaker 1: But just refresh everyone.
• 43:16
  Speaker 3: Yeah, so I'm mainly on instagram and tiktok.
• 43:20
  Speaker 3: I've just recently started a youtube page.
• 43:22
  Speaker 3: It's all Ruben r u b I n underscore allergy.
• 43:26
  Speaker 1: Well, there you go.
• 43:27
  Speaker 1: Make sure you go follow dr Ruben, my my personal favorite thing.
• 43:31
  Speaker 1: Like I already knew this before you posted about it, but my personal favorite thing that you posted was about the Igy regarding cats.
• 43:40
  Speaker 1: If you know that I'm a big cat person.
• 43:44
  Speaker 2: Yes, yes, yeah, before.
• 43:45
  Speaker 2: Okay, so we were, we were talking about this before the podcast started, but I think we need to talk about.
• 43:49
  Speaker 2: We need to talk about this now.
• 43:50
  Speaker 2: Yes, why don't you Rob?
• 43:52
  Speaker 2: Yeah, give us the little thing about the eggs and the cats and the yeah.
• 43:56
  Speaker 3: So here's the, the cat eggs eggs thing.
• 43:58
  Speaker 3: Actually I think kind of propelled my my social media accounts I think I'm going to talk about this last spring because somebody had brought up they.
• 44:06
  Speaker 3: They looked at the bag of purina pro plan live clear and we're like wait, it says that it has egg yolk in it.
• 44:11
  Speaker 3: So like if I just put like Egg onto my cat's kibble, would that just be the same thing.
• 44:17
  Speaker 3: And I then went into the science of it, which I'm going to explain here for those who haven't heard before.
• 44:23
  Speaker 3: So what we know about cat allergies is that, though there are several proteins that cats make that humans could be allergic to, the one that 90 95 percent of people are allergic to is a protein found in their saliva, skin cells and urine, called Fel D1 and in the allergy nomenclature, which is actually an international classification system.
• 44:44
  Speaker 3: So any doctor, scientist will recognize this and say oh yeah, I know what Fel D1 is.
• 44:49
  Speaker 3: That's that's a shorthand for the latin word for for domesticated, cat felis domesticus, and the number is just the order of which we've identified it.
• 44:58
  Speaker 3: So Feldi1 is the protein that causes most people all of these different symptoms, even people who come into a house and they start wheezing, which used to be me.
• 45:07
  Speaker 3: I used to wheeze whenever I go to my brother's house and he has two cats and it would make me really sick.
• 45:11
  Speaker 3: So cat allergies can really make people really sick.
• 45:15
  Speaker 3: But besides, the point what scientists have discovered is that chickens, when they're exposed to cats, they make a specific neutralizing antibody called IgY.
• 45:25
  Speaker 3: Humans don't have that antibody, but chickens make that antibody in the presence of cats and, just like with humans and IgG antibodies, when someone is pregnant they pass IgG antibodies to the placenta.
• 45:39
  Speaker 3: Chickens will pass IgY antibodies to the egg yolk and so when the egg yolk is then sprinkled onto the cat food, cats will then eat that and that neutralizing antibody will coat the saliva and latch on to the Feldi1 proteins, making them functionally inert, so that when your immune system comes into contact with those proteins, it doesn't recognize it as anything.
• 46:06
  Speaker 3: It's just like whatever.
• 46:07
  Speaker 3: So with this food that they make, or the DIY approach where you take literally sprinkle the egg yolk onto the food from chickens exposed to cats, After a month, that has to be a chicken that has been exposed to cats.
• 46:25
  Speaker 3: Right.
• 46:25
  Speaker 3: If it's just a chicken that's never been exposed to cats for at least a few months, it's not going to work, Right?
• 46:31
  Speaker 3: You're just eating eggs After about a month of daily use.
• 46:36
  Speaker 3: Where these cats eat this food, the Feldi1 protein is reduced by almost 50%.
• 46:41
  Speaker 3: So for many people this new food that's by Purina, or those who've tried the DIY approach they've actually seen significant improvements in their allergy symptoms.
• 46:53
  Speaker 1: Then you combine that with stuff like air purifiers and constant cleaning, making sure you're vacuuming up after you're your cat.
• 47:00
  Speaker 1: This gives everybody who has a cat allergy.
• 47:04
  Speaker 1: You no longer have an excuse go get a cat.
• 47:06
  Speaker 1: Cats are awesome.
• 47:08
  Speaker 2: All I'm saying.
• 47:08
  Speaker 2: You know there is that option, but there's also the better option of being dogs for life.
• 47:13
  Speaker 1: Listen, I don't understand.
• 47:14
  Speaker 1: It's a controversial topic.
• 47:16
  Speaker 2: I've got four dogs.
• 47:17
  Speaker 2: I'm sticking up for them.
• 47:18
  Speaker 2: Man's best friend Cats aren't called man's best friend Dogs are called man's best friend.
• 47:23
  Speaker 3: Okay.
• 47:24
  Speaker 2: First domesticated like animal ever wolves, dogs.
• 47:27
  Speaker 2: I rest my case.
• 47:30
  Speaker 3: I love animals in general, but if you, if you ask me, which one I like better, I am a dog lover First.
• 47:35
  Speaker 2: Oh, no, oh, about the dogs.
• 47:37
  Speaker 2: You got all the different types of dogs.
• 47:39
  Speaker 2: You got a little big dog.
• 47:40
  Speaker 3: I will say the best, though, is when cats act like dogs, then you've got the best animal.
• 47:44
  Speaker 3: But that's what I'm saying is like what?
• 47:47
  Speaker 2: when you love a cat you say, acts like a dog, it's so good Like exactly.
• 47:50
  Speaker 1: So you're saying dogs are the best, you're like, you want to get the best.
• 47:53
  Speaker 1: A lot of people don't realize that you can train cats To some cats to a certain extent, but they are real.
• 48:03
  Speaker 2: They can be assholes.
• 48:03
  Speaker 1: Listen, there's a lot of tips and tricks to it and I could like I could literally do an entire episode on training.
• 48:09
  Speaker 2: We're going to do a whole episode on.
• 48:14
  Speaker 1: But the big thing is that cats do not respond to negative reinforcement like dogs do.
• 48:21
  Speaker 1: You have to use positive reinforcement, which is to say that shouting at a cat no, does not work.
• 48:28
  Speaker 1: But I try cats to like walk on leashes with me.
• 48:36
  Speaker 1: I take my cats camping.
• 48:37
  Speaker 1: I take my cats canoeing I take my cats.
• 48:39
  Speaker 1: My last one was kayaking with me.
• 48:43
  Speaker 2: Yeah, I mean that's really cool, but I'm sick, I'm just, I'm a dog, I love dogs Plus cats catch mice when you live out in the rural areas.
• 48:54
  Speaker 2: So if you're going to live in Canada in the middle of nowhere like Rob, get a cat.
• 49:00
  Speaker 3: Exactly.
• 49:01
  Speaker 3: You won't have any diet soda options, but you'll have a cat that can catch all the mice and lots of good snow to eat too, right.
• 49:11
  Speaker 1: Good old yellow snow.
• 49:12
  Speaker 1: The great.
• 49:19
  Speaker 1: The best part, though, is you know you?
• 49:21
  Speaker 1: Actually it's an actual thing.
• 49:22
  Speaker 1: You get maple syrup, you pour it into the snow, you get this maple syrupy snowball and you eat it, as long as it's not yellow.
• 49:33
  Speaker 3: That's what my followers were telling me.
• 49:35
  Speaker 3: Like.
• 49:35
  Speaker 3: All my Canadian followers are like, yeah, it's great, and I was trying to give like the most diplomatic approach in one of my recent posts and everybody was mad Like nobody was happy with it.
• 49:43
  Speaker 2: I saw you post about the snow, about like eating snow and everyone's like so upset in the comments.
• 49:47
  Speaker 2: Seriously, seriously, I was trying to get.
• 49:49
  Speaker 3: I was trying to be respectful of this person, not be a jerk, because some people like that's you know it's part of their memories and it's like that's not the worst thing if you do it like responsibly, and you know, try it once or whatever.
• 50:02
  Speaker 2: You know, like, and I see it like this stuff of like people like will like play with their kids and stuff and any sort of playing with their kids.
• 50:07
  Speaker 2: They're like don't do that, because the kid's going to break, he's fragile, he's got that, and they're just like everybody.
• 50:11
  Speaker 2: We all need to relax a little bit.
• 50:13
  Speaker 2: We need to eat a little snow, we need to play with our children.
• 50:16
  Speaker 2: It's going to be okay, obviously, like you know, it's within reason.
• 50:19
  Speaker 2: But, come on, yeah, you gotta form these memories and have some fun, right.
• 50:24
  Speaker 1: Yeah, have them in moderation.
• 50:27
  Speaker 1: Good night everybody.
• 50:28
  Speaker 2: In moderation.
• 50:29
  Speaker 2: Like I've heard, there's about a good podcast you should not listen to before bed.