If all of the suppositions discussed over the last few weeks come to fruition as the science evolves, then we have actionable advice to give now. We do know a few things are for certain already from the research on autoimmunity and allergy.

The know:
1) Vaginal deliveries are better for the child’s immune system than C-sections.
2) Breast feeding is the best choice for new moms that are capable of nursing.
3) Living with animals like dogs and cats or on a farm is clearly beneficial.
4) Adequate levels of vitamin D are very important for immune function. The sun is the best source.
5) Overuse of antibiotics and antacid medicines are destroying our inner garden of beneficial microbes and altering the pH of the stomach which changes protein degradation thereby increasing immune activation.
6) The standard American diet is woefully deficient in fiber and micronutrients that are necessary to support a healthy gut and thus a healthy tolerant immune system.
7) Our environments are too clean and sterile. Chemicals used to sterilize our homes and workplaces are doing more harm than good; not to mention that many of these chemicals are toxic. Witness the data on triclosan as a hospital based cleaner that was used for years until toxicity was shown.
8) Pesticides and agrochemicals are scary for our gut microbiome. AVOID THEM.
9) Introducing food proteins between 6-12 months of age has been shown to reduce the risk of allergy. Do not introduce food before this critical period. Exclusively breastfeed until 6 months.
10) Fake sugars like aspartame and saccharine have been shown to damage the microbiome. Do not consume them.

The action based on the know and hypothesis:
1) Diet is a key piece of allergic and autoimmune disease amelioration. Adequate fiber is necessary to feed our friendly bacteria and we are not getting enough. Inflammatory type processed meats and foods increase circulating chemicals known as prostaglandins. All of these inflammatory chemicals worsen every disease state. Increasing omega 3 fats as fish, grass fed meats and flax is anti-inflammatory. Consider reading The Inside Tract by Dr. Gerry Mullin. It is the best book available for understanding the relationship of food to disease development.
2) Make sure that you have adequate amounts of micronutrients in your system. Pay special attention to vitamin D, zinc and magnesium which play unique roles in immune function and airway responsiveness. These nutrients help to maintain a healthy immune system and thus prevent infections from taking hold in your body, exacerbating asthma and making allergic symptoms more severe. Infections can also trip on an autoimmune disease. We need sufficient micronutrients for a strong gut lining and to keep our good Treg cells functional.
3) Expose your children to farm dust and animals from the beginnings of life. Visit a farm and keep a dog nearby. Learn about animal exposure safety from the CDC. Resist the desire to sterilize your house. Learn how and when to use cleaning agents, i.e. to clean countertops after cooking with raw meat. The biome depletion theory makes it very clear that the lack of bacterial exposure from animals is a problem.
4) Critical for allergy sufferers — avoid known triggers of allergic disease. If you do not know what you react to, get a blood test or skin test to ascertain potential triggers. Then go to www.aaaai.com for information on avoidance measures. This has been shown in recent studies to be as powerful as your steroid based asthma inhalers at controlling disease flairs. Visiting a quality allergist is worth every second of your time.
5) Control the air quality of your house by keeping air conditioners running through high efficiency filters to remove particulate matter that irritate the lungs and nose. Visit the Clean Air Carolina website for information. Add more air purifying plants to your living space.
6) Keep your nose and lungs humidified so that your allergen clearing mucous functions well. This can be achieved through nasal saline sprays, humidified saline and neti pots for irrigation.
7) Take a daily probiotic, consume fermented and prebiotic based foods. There is good evidence that this will decrease an allergy sufferer’s global symptoms. All three of these bacterial types are beneficial for the health of the micro biome which in turn decreases systemic inflammation and hopefully reduce autoimmune risks.
8) Avoid contact with all chemicals either in liquid or aerosol form. For example perfumes, aerosol plug ins, smoke, strong detergents and cleaning agents will irritate the nares, skin and lungs making disease worse. Consider having your detoxification genes analyzed for weakness. Add sulphur based foods and the amino acid cysteine from adequate protein intake to bolster your glutathione levels. Glutathione is the major detoxification chemical of every cell. Less toxicity means less cellular damage and in turn less disease.
9) Take your medicines as directed. People that do not take their anti-inflammatory medicines as directed suffer significantly more disease and sometimes death. The goal is to follow all of the other prevention techniques in order to not need the medicine, however, don’t fool yourself into believing that you may never need medicine if you already have disease. We have seen major nightmares based on non-adherence to recommendations.
10) Consider herbals to help with allergies. Quercetin, stinging nettles, bromelain are a few of the potent plant-based allergy inhibitors. A personal favorite is D Hist and D Hist Jr.
11) Reduce stress. Practice prayer, meditation and relaxing breath work to keep yourself centered and calm. Controlling stress in one’s life will reduce reactive oxygen species and inflammation.
12) Reduce exposure to excess heavy metals that are present in food. Mercury is an issue in large fish like tuna. Arsenic is becoming a problem in rice and apples. This means that a lot of gluten free foods are potential sources of arsenic. Also cadmium in e-cigarettes.

With great respect for Dr. Williams and his advice,
Drs. Chris Magryta and Aerik Williams

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com

https://evmedreview.com/reconstituting-the-depleted-biome-to-prevent-immune-disorders/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784904/

https://www.salisburypediatrics.com/patient-education/dr-magryta-s-newsletter/306-autoimmune-disease

https://www.salisburypediatrics.com/patient-education/dr-magryta-s-newsletter/238-hygiene-hypothesis