OneMedicine Podcast

Rob Lutz 00:02
Hello and welcome to the OneMedicine Podcast with Today's Practitioner. In each episode, we share the expertise of a respected thought leader, some you will know and others you'll probably meet for the first time. We cover topics important to you, always with a focus on improving the health outcomes of the patients you treat, while expanding your understanding of the many healing modalities being used today.

Rob Lutz 00:24
Welcome to the OneMedicine Podcast. I'm Rob Lutz, your host and with me today is Chris Meletis for our second time. Chris joined us earlier in the year talking about CBD and the endocannabinoid system. Today we're going to discuss allergies and the immune system with an overview or focus on strategies for seasonal allergies. Before we get started, I just want you to know a little bit more about Chris. Chris Meletis is an educator, international author, and lecturer. His personal mission is changing America's health one person at a time. Chris Meletis has authored 18 books in over 200 national scientific articles and journals including Natural Health, Alternative and Complementary Therapies, Townsend Letter for Doctors and Patients, Life Extension, Natural Pharmacy, NDNR, and several journal articles on pubmed.gov. Dr. Meletis served as Dean of Naturopathic Medicine and Chief Medical Officer for seven years for the National College of Naturopathic Medicine, now called the National University of Natural Medicine. He was awarded the 2003 Physician of the Year by the American Association of Naturopathic Physicians. He has a deep passion for helping the underprivileged and spearheaded the creation of 16 free natural medicine health care clinics in the Portland metropolitan area of Oregon. Welcome, Chris .I really appreciate you coming on the show again, loved what we did last time. And this is such a great topic, I think, for a number of reasons as we head into allergy season. And what we're going to talk about, and I'll let you jump in here just a moment. But we're going to spend time talking about the immune system, and how that impacts allergies in general, and then some strategies and so forth. And just other information that I think our audience of other medical professionals will find helpful and interesting as they also treat patients dealing with with allergies in general, but seasonal allergies specifically. So welcome, Chris, and appreciate you coming on.

Dr. Chris Meletis 02:25
Well, thank you, Rob. And unfortunately achoo-achoo. 'Tis the season. It is allergy season and my wife and I are committed to doing lots more walking this spring and summer. But I can tell you that trees out in Oregon have my number. My eyes are itching; my poor wife's nose is running during our walks. But we're going to plow through.

Rob Lutz 02:45
But they sure are pretty. So, what do you guys do? What are some of your strategies personally, and we could dig into some of the science and things like that. But I'm just curious, what do you personally do? What do you and your wife do?

Dr. Chris Meletis 02:56
Well, sadly enough, we're not quick enough to dodge each pollen molecule. And for those that know me, I don't have a whole lot of hair. But even I have to wash my hair before I go to bed after being outside because my bald head, the little fur I still have on my body and my face, I have to wash it off. Otherwise, I'm going to go to bed with the pollen on my pillow, and then I'm going to flop around on my pillow for two, three, or four days until I change it. So I might as well just sleep outside at that juncture. So whatever hits us while we go to the car or exercise outside lands on us and lands on us in a much larger quantity. So I use quercetin, I use immune supportive products, like astragalus and EpiCor, which we'll chat about, I'm sure. Make sure my vitamin C levels are dialed up. And I just hydrate, hydrate, hydrate. So we'll go into those details. But it's all about susceptibility and immune competence. And so it's a philosophical thing. When I graduated in 1992, we didn't know about TH1 and TH2 and allergy immune competence like we did. We were very proud to know that we had CD4 and CD8 helper and suppressor cells. But now we know why in part we are more susceptible to allergies. But I think the other thing which I realized is if I'm going to be outside and you might have experienced this, I need to be really good on my diet. And for example, I have birch tree issues. And right now here in Oregon, if you go to pollen.com--and there's many of them, but pollen.com is by far my favorite--you're going to actually see the one-day and the five-day forecast for allergies. And so birch trees are right now my nemesis. I learned that during spring break when my kids were young; they're now 26 and 30. But I went down to the Oregon coast and we went to a little boutique chocolate place; I had dark chocolate with hazelnut so I said: My mouth is a little itchy. I've never had this problem before, but it was right in the throes of the season. So I need to make sure like with birch trees that there's cross-reactivities. And same thing with melons. Melons, for example, if it's ragweed season, melons and cucumbers, not your friend. Well, during birch season, nuts, peaches, lettuce, carrots, celery are all pulling up at cross reactivity. So I mind my P's and Q's before I go into my allergy season, which is right now. And as a result, I'm not basically being the cream of the Oreo cookie, sandwiching myself between "I just ate a problem nd now I just inhaled a problem" and it's a straw on a camel's back.

Rob Lutz 05:37
That's interesting. So something that I've thought about, and I didn't realize it was probably cross-reactivity, I've suffered from seasonal allergies my entire life. As a kid, it was always runny nose in the springtime and it was always such a challenge for me. And I tried everything, of course, I did the over the counter stuff. And I think back in the mid '90s, I took high desert bee pollen, and for some reason you've got to take so many of them, but that really seemed to help. But nothing really changed until I realized one spring after I'd stopped eating dairy--I'd figured out that dairy really just wasn't working for me, and so I stopped eating dairy--that was the first springtime where I just never really had the symptoms that I'd always had. And so is that an example of cross-reactivity, or...?

Dr. Chris Meletis 06:31
Yes, exactly.

Rob Lutz 06:32
Okay.

Dr. Chris Meletis 06:33
Cross-reactivity and total burden. So the dairy could have been cross-reacting with the various things in your environment. Plus, if we use the concept of the straw that broke the camel's back, and right here in Beaverton, Oregon, High-techville, Nike, very, very brilliant people. And I'll actually have three or four little stones in my office, one will say Peace and Health and Tranquility and Harmony, whatever. They're little positive affirmation stones and so I'll put my hand on the desk and all my fingers extended and pretend it's a little camel. I say: This is a camel. I put the stones on there. And I say: Can I put Harmony, Peace, Love, and Health? And the last stone is Health. Which one broke the camel's back? And 80% of the folks say: Well, it's the last one, which in this case was Love. And I say: No, no, no. Okay, let's rematch, reposition the stones. So let's put Love first, Health, Wisdom and then Peace. And then they say: Well, Peace broke the camel's back. I say: No, it's total burden. So in your case, Hunter, your problem was that it was already preloading the scale towards: Okay, I'm tipping, tipping, and over the top we go. And so that's probably what was going on with you. And if it was an IgG food sensitivity, that has a half-life of 25 days, give or take. So you eat a food, and then up to 25 days later, you still have half of that immune reaction in your body. So you can imagine the stacking effect. Now if it was an IgE, through allergy, it's a much shorter half life. But once again, it's a rolling boil. So you're at 200 degrees and the water is not boiling. You're on 212 degrees, and you're in a rolling boil. So it's the same concept here with our immune response, and then throw on some inflammation and maybe a little altered microbiome and then all of a sudden, voila, we're miserable inside and out.

Rob Lutz 08:30
So susceptibility in immune competence, how does that play into this? How do those pieces...?

Dr. Chris Meletis 08:36
Well, susceptibility is an interesting one philosophically. Because if you and I went to a conference and five people shook both of our hands, but you didn't get ill, and I got ill, because people don't wash their hands and they shook a thousand other people's hands. So we had cumulous promiscuous hands. And so but why did you not get ill? Because in part, you were not susceptible; you weren't worn down, you were sleeping better, you have a potentially more competent immune system. So that's susceptibility is when we're worn down is usually when things happen to us. I remember when I was much younger fellow and I was a Dean at the Naturopathic University, I would finally carve out from my 70- to 80-hour work week, well, let's see here: So, susceptibility. Too much work, too much stress, too little sleep. And at the time, I had very young children. So I was playing soccer mom of driving them here and driving them there while working until the eons of the morning. And so I was very susceptible. So whenever I would take a vacation, I would always make this very non-scientific example. I slowed down long enough that the germs caught up with me.

Rob Lutz 09:45
Yeah, and I've noticed that with my son who is just finishing up his master's, and he'll be working his tail off during the semester. And then he's like: I always seem to get sick on my break. So is it that kind of a situation where he's been stressing his body out and finally it just all caught up to him?

Dr. Chris Meletis 10:05
And it's much like for you, I know you're a big bicyclist. So you're all in for the race, you muster all your energy, and then you left it all on the road. And now it's like your body says: Okay, I need to get ill. And illness is by chance not a bad thing. In fact, some of my patients over the last 32 years, I end up with some very bad health conditions. And well, I haven't had a cold for over 20 years. Actually, a cold kind of tunes up and runs you through the paces every once in a while. So being too well is not necessarily a good thing, either. You want to hit that threshold of tuning yourself up every once in a while with a little cold or a little whatever.

Rob Lutz 10:42
Yeah, maybe a little cold, where you kind of ramp it back up and tune things back up and not so much where you're down for the count for a week.

Dr. Chris Meletis 10:48
Yeah, because then you're more stressed and like: Oh my goodness, all my work is piling up. And for us healthcare providers: Okay, no one's seeing my patients and there's all these questions, and I have to call it prescriptions, or there's all these little crises, while I'm there and feeling like you're on your deathbed. You don't want to be on your deathbed.

Rob Lutz 11:04
So it's your body just saying: Hey, it's time to slow down a little bit. Let's take a break. Otherwise, it's going to get worse.

Dr. Chris Meletis 11:09
It's either going to take a break, or I'm going to force you to take a break.

Rob Lutz 11:13
What I think I'm hearing you say is: Someone who's suffering from seasonal allergies, it's more than probably just the birch tree; it's this whole other list of things that they can be doing to support their immune system or inflammation or some of these other things that will make them less susceptible to experiencing the seasonal allergy symptoms. Is that--am I on track a little bit there, or...?

Dr. Chris Meletis 11:38
In large part. Okay, you and I go outside during seasonal allergies, and we might beat preordained. Ever since I was a little kid, I had allergy shots, I had a reactive airway. And I was on lots of antibiotics because I was a sickly little kid. So that threw off my microbiome. But now the question is you and I go outside or somebody in the audience goes outside and you got a little itchy eye. Okay, fair enough. You got a foreign molecule, it's an antigen, it's a protein. It goes in your eye and then there are sharp little barbs and you rub your eye, and now of course it hurt. But much like we were saying about a cold, it's a passing thing. But when it lingers, that's when you know your susceptibility has hit that threshold where you're too susceptible. And something which when I was lecturing for the Institute for Functional Medicine, I brought up this concept that if we have our natural given 20 milligrams of hydrocortisone a day, so our adrenal glands makes hydrocortisone. And once again, I'm speaking to my colleagues here, but I describe it this way to my patients: If I have a rash, it's not going away. I could put hydrocortisone cream on it and the rash will go away. You can argue that might be suppressive, or I'm meeting and backfilling what my body was able to otherwise do because maybe I'm only making 12 milligrams and for those of us that do salivary cortisol, or even serum cortisol levels, cortisol and cortisone cross-exchange from a molecular perspective, so we don't have enough anti-inflammatory capacity because we're running adrenal fatigue, or adrenal burnout or something. We'll probably chat about later on endocannabinoid deficiency. When we're worn out, we're not able to quench our own fire. So once again, peaceful, mindful, and so like with your son, he's finishing up his master's degree and so of course, he's all in. He wants to finish on a good stride; he had a lot of workload. And of course, that comes with an adrenal burden. And with that adrenal burden, we shift our immune system. Back in the day before all the biological drugs were advertised on television. I'm not picking on them, but you see all the small print can cause all the following side effects. But what did we have as our primary only too? Either an immunosuppressive like cyclosporine or prednisone or methylprednisolone. And why? Because when we have more steroids on board, artificially exogenous in this case, or enough steroid made by our body, because our adrenals are not tapping out, then we're actually able to quench our own fire and not come to all these symptoms. So susceptibility comes to adrenal burnout, immunological stress. My undergraduate thesis at Reed College was on psychosocial stress and immunosuppression. And hey, you get stressed out, you are going to leave yourself wide open for all kinds of problems. So the question is, how do we zen ourselves as healthcare providers? While we are helping everybody else, we all hear these stories all day long of suffering and torment and anguish, and we have our great success stories, but then we have those three to five patients or more, that no matter what we throw out there, they're just not beating it around. And all that eats on us as human beings because we can't separate our providerness from our humanity or our humanness.

Rob Lutz 14:44
Right. So it sounds like it's, again, it's more than just treating a symptom. It's really looking at how to support the entire body, the entire person with a number of things that we'll probably talk about that may focus more on supporting the immune system. Am I on track with that?

Dr. Chris Meletis 15:02
Basically trying to Scotchguard or waterproof ourself and have the innate and natural zen-like state of resilience. It just bounces off us. Walking across the hot coals, laying on the bed of nails. We all do that in our own way throughout the day, but eventually we can no longer tolerate it.

Rob Lutz 15:20
Okay, that sounds good. I think I get where we're going with that. So how does one fortify or support immune competence? What would you say are some key things for us to be thinking about?

Dr. Chris Meletis 15:32
I love to do a little wordplay on the word "restoration" or "restore." The first four letters of "restore" or "restoration" is "rest," making sure we have quality sleep and we have tools now. We have our Apple watches; we have our aura rings, where you see how well we're putting together our sleep cycle. But that's when our downtime is, when our body does our recycling of things. So it's not only quantity as I share with my patients, but also the quality. Am I hitting that REM cycle? Am I going through two or three cycles of that? Am I in a totally dark room? Am I supporting my circadian rhythm by not being in front of any blue screen television or tablet phone two or three hours before bed because that's of course, back in the day from an ancestral perspective, we have either an oil lamp that's more of an amber red hue, or a fire or fire pit in a cave someplace. And now we have all this blue spectrum and LED lighting and all of this, so we're throwing ourselves out. So some people are wearing amber glasses. Some people will put their devices on night mode and to try to lessen that. So I think the circadian rhythm of cortisol and melatonin, so I think doing a melatonin test, doing a cortisol salivary test, ideally. Salivary--for the conventional-minded providers will say: Well that seems very obtuse. Well, one of my patients over a decade ago, he was a very high level executive. And I diagnosed him; he was having about 100,000 irregular heartbeats in four days. And it was making him tired and weak and all of this, but he still walked all the way to McDonald's--his choice-- for his senior cup of coffee. But I said: I think something's going on. So I had diagnosed him with an adrenal tumor. So he been very smart, went off to the Mayo Clinic. He goes to have his adrenal gland resected, removed. And what did they do in the middle of the night around midnight for him? They said: Hey, wake up, wake up. Spit in this. They were majoring in salivary cortisol s even at the Mayo Clinic. Because the moment I stick my arm out, put a tourniquet on, I'm going to have an altered non-native response. And so sometimes the non-intrusive measurements of things, we have to quantify it of course with a standard testing methodology. It's a reference of ranges, but it gives us a lot of data. So, I think rest is important. And if not our body will force us to rest; it tends to get ill. On stress reduction--and if we think about stress in the Holmes-Rahe Stress Chart, getting fired from work and retired from work or virtually equivocal. Getting a mortgage and losing your home are equivocal in terms of what are stressors. So we often think: Well, stress is bad. It's like: I got a letter from the IRS or I got detained at the airport by TSA, and I'm running late for my... Well, those are stressors that we like to avoid and we do our best to do that. But then there are stressors that are good; Hey, I have a new baby, or I have a new grandbaby or I have, for instance, something which our body, any thing that alters our status quo is a stressor, which adds to what we term the allostatic load. And so we have the justice individual with the two weights, scales, and we have homeostasis and we have allostatic load and they're going up and down, up and down. But if all of a sudden, like a teeter-totter, allostatic load becomes too high, it's where so much of our homeostasis is out of balance, then our body once again becomes susceptible and you get allergies and immune competency issues. So that's why we work on the stress, we work on the hydration, we work on making sure we're sleeping well. But then that's where we'll supplement a good diet and lifestyle, which I'm sure we'll chat about today. But it's like we all need a little nudge or a little help. And the question is, first off, do the basic diet and lifestyle things and then we go from there.

Rob Lutz 19:25
Yeah, that's so one thing I'm going to ask you about, it sounds like those stressors are bad for us; we need to eliminate those or reduce them. But I've also heard that it's good for us to periodically do some intermittent fasting that's a challenge to the body or to plunge in a cold bath. Very uncomfortable but it's good for you, probably in small doses. How does that work? Or does any of that play into this somehow?

Dr. Chris Meletis 19:55
It's interesting that you brought up cold water plunges and so forth. Of course, it comes back to the mitochondria, which is one of my favorite topics. It stimulates mitochondria, mitogenesis. And so that's an important thing. And if you think about it, any aspect of our body requires the mitochondria. So our thinking, our talking, our heart, and even thermogenesis or losing weight. So if you and I go into an ice plunge bath, and we start shivering and it's cold, well that's the same thing we do when we go outside and we're underdressed, and it's 11 degrees outside like it was in Oregon this winter. We start shivering; that's called thermogenesis. Our large-scale muscles are actually inducing the creation of heat. And so as a result, thermogenesis is wonderful. The mitochondrial stimulation is wonderful, assuming that your heart can take the plunge. And it's like, wow, but that concept of intermittent fasting helps with sirtuin levels. And this is where also we come into the Krebs cycle--the citric acid cycle is how it's also known--and making sure we have enough NAD coming off that cycle, to go to electron transport chain to induce the ATP production. And so I'm approaching the 60 years of age vintage--I suppose I'm supposed to be a finer wine at this juncture; I'm not sure how fine I feel--but as a result my ATP productions diminish. If I was 30--the average person in the peer-reviewed literature--they estimate that we make about 60 kilograms, about 130 pounds of ATP per day. And so for every decade past that, we make about 10% less. We also, coincidentally, make less nitric oxide; we also make a lot less NAD. So we start seeing everything slipping from a biochemical perspective. And so making sure we're dotting our I's and crossing our T's where we are with the aging process, or with chronic illness is so vital.

Rob Lutz 21:54
That makes sense. Thanks for going into that for me. Let's talk a little bit about supplementation, this concept of mitigating susceptibility. Let's go there; tell me what that makes you think about? What do you want to share?

Dr. Chris Meletis 22:14
From a philosophical perspective, the first thing we want to do is support sleep. So if we're having trouble getting asleep or staying asleep this is where a professional will use herbals, Valerian or a hormone like melatonin. Or we will work on vagal nerve, sympathetic/parasympathetic heart rhythm, aspects to just getting more zen like, or just being really mindful and making sure we're not doing anything stimulating. We're creating a safe environment for us to cocoon for hopefully close seven to eight hours. A super dark room, the right temperature, quiet, all of the above. And knowing that by doing that, we're also supporting the adrenalines on the tail end. So when our melatonin levels surge from midnight past and start quieting down, the moment our adrenals start kicking in around 5-7am. We need to help support that natural circadian rhythm. So it's just a basic, non scientific but extremely scientific, simple thing which support diet and lifestyle, but then we have to take care of the adrenal glands. And so once again, if you think about a person with really bad asthma, they probably will end up somewhere along the way unless we do a phenomenal job of addressing the proverbial splinter. And I often ask the question, well, what hurts more? A large splinter or a little splinter. Have you ever had one of those little microscopic splinters, they can really hurt a lot. But we must remove the cause of the problem, the tolle causam as we say in Latin. And so by looking at the adrenal glands and our ability to quench that fire. But thinking about an asthmatic, a steroidal inhaler or at the very least a rescue inhaler unless we qualified and contained their problems. If you have really bad allergies, guess what used to be a prescription and now, of course, it went into the mass markets? Steroidal nasal sprays. That turns back to are my adrenal glands making enough to quench it and should I take care of my adrenals? And that's one of the reasons I like to use adaptogens even during allergy season, to help support that adrenal ability to quench things. I have a patient, I ended up diagnosing her with a pituitary adenoma. She was a phenomenally and still is--she's 82 years old now but she broke glass ceiling before glass ceilings were known. She was a Navy officer back in the '50s and '60s, and she was just phenomenal. Absolutely phenomenal. But they all thought she was a neurotic or histrionic, largely because she was a woman in a very male dominated environment. But lo and behold, this whole time she had Cushing's disease, and she was really really feeling poorly. So she opted to have her total adrenal or total pituitary gland removed, because she had a pituitary adenoma making too much ACTH. She had it scooped out, and I participate in controlling and managing her hydrocortisone, her desmopressin/vasopressin, her thyroid and all the other hormones controlled by that master gland. But if she has a little bit of a fever, we have to go up 5 or 10 milligrams of hydrocortisone. Well, what happens when we get a little sinusitis? When she just recently had sinusitis, since we're talking about allergies, I had to bump it up because the body naturally would have produced more hydrocortisone to quench that fire. So just listening to the body and what's going on. I'm giving an extreme example; I'm not proposing we try hydrocortisone for everybody. This is a person with the inability to adapt, since there's no regulator for the pituitary. And I think the other thing to do is--what happens when we get mucus in our body? If we get mucus in our eye, we could get an eye infection. We get mucus in our nose, we can, of course, go from an allergy or a virus where if it's clear mucus it starts turning yellow or green. Well, if I was a bacteria or a fungi, I want a warm environment, I want sugar, and I want moisture. Well, that's our sinuses, that's other parts in our GI tract as well as pelvic regions. So it's like we have to control mucus production. And whether it be tears in our eyes, or nasal secretions, or other secretions in the body, they all serve a purpose. But all of a sudden, they increase our susceptibility when they're excessive, because things say: Ooh! Warm, moist, sugar...we're petri dishes! Glorified, wonderful human being petri dishes. And so as a result, we want to control some of those symptoms. And this is where things like N-acetyl-L-cysteine come in, which we'll talk about, which is a mucolytic and increases glutathione levels and so forth and so on.

Rob Lutz 26:41
Before we jump into that, what are your opinions about a neti pot? I've used those in the past when I have sinus infections or are afraid of getting a sinus infection or I'm very congested. What are your opinions on that?

Dr. Chris Meletis 26:53
As long as it's not tap water. I don't know if have you heard about the case many years ago now in the Seattle, Washington area where they actually ended up having parasitic items in the water. It was municipal water. So as long as it's distilled and you sterilize it properly, neti pots. And this is where the beauty of now being a melting pot, a cosmopolitan society--neti pots have existed for a very long time in cultures because they work. Going from the sauna and jumping into a frigid water if we're Norwegian folks or Swedish peoples, and now we have cold plunges. Well, they created that idea.

Rob Lutz 27:32
Yeah, yeah. No, that's true. So, I use distilled water because I had heard that horror story and didn't want to mess with that.

Dr. Chris Meletis 27:39
Yeah, a brain is a hard thing to replace.

Rob Lutz 27:41
Yeah, for sure. Okay, so let's talk a little bit about some of the supplements. You briefly touched on adaptogens. Are there any specific ones that you feel are the ones that the practitioner should look at first, in this context of seasonal allergies and your immune system?

Dr. Chris Meletis 27:59
I would say the star is astragalus. And the reason is it's an adaptogenic herb, but it's an immunological adaptogenic herb. It helps the body adapt during immunologically challenging times while still being an adaptogen. And so astragulus is my go-to with my patients that have oncological issues, patients that have ongoing autoimmune issues. I want to help the body adapt, and at the same time support and nurture without stimuli.

Rob Lutz 28:29
OK. So you like astragalus.

Dr. Chris Meletis 28:32
I like my astragalus. And of course we can get throw in maca and rhodiola and ginseng, and ashwagandha. Those are my other big go-tos.

Rob Lutz 28:39
But they're not specifically targeted for the immune support.

Dr. Chris Meletis 28:42
Yeah, astragalus is my go-to for the immune.

Rob Lutz 28:44
OK. One thing we haven't talked about is hydration. I think you mentioned it briefly in the beginning. Why is that important?

Dr. Chris Meletis 28:55
Specifically with allergies and immune competence. Think of dried chapped skin; say we have chapped lips. It's been cold, it's been wintertime and so we have dried chapped lips. Well, doesn't anything that we pass by those lips hurt more, sting more? Yes, the answer is yes. Anytime we have broken skin, we're going to have a greater susceptibility or portal for things to enter. Now we think of our eyes, our nose, our throat, our lungs, and our GI tract; non-moist tissues will not have that same layer of what I call "slime": Secretory IgA. Secretory IgA is, of course, part of our immune competence. It drops with stress and Secretory IgA is our first layer of film, what I once again--bad examples, but--our Scotchguard or waterproofing of our body, and so if we have dry mucus membranes, we're going to have wide open portals to greater problems.

Rob Lutz 29:52
So nothing gets caught when it's being inhaled if it's if it's all dried out.

Dr. Chris Meletis 29:56
Yeah, and that's why we have developed sinuses. We breathe through our nose. Now we know breathing through our nose as opposed to our mouth increases nitric oxide levels. Surprise, surprise. But once again, all those warm and moist turbinates create a moister air that hits our lungs as opposed to having dry, arid air. And so once again, we're designed phenomenally to survive, but with basic things like hydration. The statistic I read about 15 or 20 years ago is that 31% of the population has such a low thirst drive, that we actually end up eating instead of drinking and it's like: Hmm, well, I know I went into the kitchen for something. Was it the chocolate chip cookie? Or, no I think it was the water.

Rob Lutz 30:41
I'll have a chocolate chip cookie anyway.

Dr. Chris Meletis 30:43
Yeah, well, but lots of water.

Rob Lutz 30:45
Yeah, that's right. Okay, so hydration is key for everything, probably any topic we're going to cover.

Dr. Chris Meletis 30:53
And even if you think about what the neti pot is doing. It's hyperhydrating and wiping out or washing away, whether it be tears or a snotty nose or vomit or diarrhea, our body has aids and strategies built in. It requires hydration in order for those.

Rob Lutz 31:10
Yeah, the runny nose is an annoyance, but it's built into the system to keep us from having more of those annoying allergens in our in our system.

Dr. Chris Meletis 31:22
Along the way you'd like to imagine every time the rain goes, say: Thank you for the rain, nose. It's taking out pollen molecules that either otherwise would go deeper into my body.

Rob Lutz 31:33
Okay, so I think you had mentioned another time and I want to ask this question: Classical music. Mozart. You've mentioned that as a potential strategy here. How does that work? And why, and where did you hear about that?

Dr. Chris Meletis 31:47
Yeah, well, sadly enough, I do not have a pocket protector, but I love reading the scientific literature. And I was coming across how to control allergies. I've suffered from allergies all my entire life. And so Dr. Kamate, an MD PhD--this is peer-reviewed literature--did a study. I don't know who funded it. I didn't go that deep. And he said: Well, we see that classical music can help, but there's a caveat. He compared Beethoven to Mozart. Beethoven failed to alter TH1 and TH2, whereas Mozart did. Mozart actually helped. About three or four years ago, my wife comes into my office and I have a very diverse listening profile. But Mozart was not one of them. But my wife's a pianist, and so she said: You're listening to classical music. Is that Mozart? I said: Yes. She said: Why? I have a window open, I have a fan blowing, and my arms were itchy and it's birch season. And I think it's actually healthy. So there's Mozart for babies, there's Mozart for concentrating while we're doing deadlines, which now I've adopted even year round, just listening to Mozart whenever I'm on a deadline, as opposed to some hard rock or something much more visceral. And it's like: Hmm. So Mozart actually, if you type in "Mozart allergies," it was shown to alter TH1, TH2 and just type that into PubMed. It pops up. Oh my goodness. So not everything has to cost money for patients' hydration; if you have a clean source of water, wonderful. Stress reduction, mindfulness, an attitude of gratitude. And like you've pointed out saying: Let's see whether I avoid a couple of foods i've been having a question mark, or a discernment about, like the dairy. Wow, good call.

Rob Lutz 33:36
So question around Mozart, as opposed to some other classical music. Mozart is very calming, I think,most of what I've heard. So is your breathing, adapting to the music? Is it becoming slower and more rhythmic? Are you stimulating your vagal nerve by using that music that's actually bringing you into a more relaxed state? Is that...Sorry to interrupt; I know you're going to answer that question, but with the vagal nerve, if you're stimulating that, is that doing the same thing to your thyroid? Anyway, so if you can answer a couple of those questions, I'm just interested in what your thoughts are on that.

Dr. Chris Meletis 34:17
You're brilliant. So the question is, How does Mozart work? It's really honestly the same question on how do all of these herbs work or how do all these nutrients work? We in 2024 here know many things about mechanisms of action. And because, as scientists, we're reductionist if you want to know all these things. I don't think we really know how Mozart works in totality, but the concept of calming, more hospitable, more sustainable. But then that difference between sympathetic nerve and run, run, run, stress, stress, stress, survive, survive. And I think when we were all young and more naive, if we had a reasonable childhood, we were kind of like: Okay, well, I knew what stress was, I had no idea what mom and dad were going through, because of adult responsibilities. But then all of a sudden stress entered our lives. We thought: Okay, it's all going to be perfect. We had this picturesque existence as adult human beings. But the difference between sympathetic and parasympathetic, we ignore parasympathetic. In most of the action films, most of the films on television, YouTube, Netflix, are all fighting for a sympathetic or visceral, response. We're supposed to be calm, meditative. So I think you're correct there. And I think that's a good supposition that you probably are bringing balance and harmony to the body when listening to Mozart, no pun intended on Mozart with harmony. That's another bad dad joke. So I think that's part of it. And it's just creating a little bubble for us mentally. And it was Thomas Edison that said: The prime function of the body is to carry around the brain. Okay, well, so if we tend to our brain, and we don't have brain strain, everything else will come into balance. And we know the vagal nerve, which you brought up--once again, brilliantly--80% of his sensory and we look at the word vagabond: One that wanders. Well, the 80% is actually wandering down our esophagus, past our heart and to our heart, and it goes down into our GI tract, our kidneys, our liver, our colon, our spleen, and then it's coming back with all that feedback to our brain. So the more calm and mindful we can be. And when I went to my allergist, a medical doctor allergist, when I was a young fellow--39 years old, 37 years old--he said: Chris, are you doing tai chi? Are you doing yoga? How many salads are you eating? I, being the naturopathic doctor, I'm like: What is this guy? I came here because my I've got tonsil issues. Way ahead of the curve, a wonderful brilliant guy named Dr. Wesley Lewis. Also he married a naturopathic doctor. I wonder why, because he put out the vibe: Hey, I'm a naturopath. Medical doctor, focused functional medicine before it was popular. And so he was living it, breathing it and proselytizing. I think Mozart probably does affect the vagal nerve. And now we even know that our level of stress also affects our microbiome. If we're stressed, we're not only throwing out all these pheromones that are a hospitable environment for a hundred trillion visitors and it took our GI tract. In my book The MMM Theory we speak about the microbiome throughout the entirety of the body, the skin, the prostate, of course the pelvic region for a female, and even now the brain--and leaky gut, leaky brain--a whole other conversation for another day. I think you're right on the money. I think it's the vagal nerve, and we're creating the hospitable environment. But he doesn't really delineate sufficiently what the mechanism of action is, but more was observational, that being around Wi Fi and cellular and even holding a tablet will actually increase your chance for atopic dermatitis, or eczema. So once again, the helter-skelterness of the world which we've created, we're as human beings creating a world built on sand and not the rock.

Rob Lutz 38:06
Yeah. Well, it's that mind-body connection that we hear a lot of talk about, I think there's this feedback loop. And we're able to maybe interrupt that feedback loop and direct it the way that we want, whether we're listening to Mozart, or using a vagal nerve stimulator, or deep breathing. And so if you're then raising your heart rate variability, and some of these other things, you're probably reducing inflammation. And other neuro chemicals are being released. And so you're getting that feedback loop to start to work in the direction you want it to, by doing some of these things. Same with probably hydrating, eating the right foods, getting good sleep, you're getting that feedback loop to work for you as opposed to potentially runaway.

Dr. Chris Meletis 38:53
Right on the money. And even thinking about food in the past, we often will sit at our desk--or I will; I'm guilty...I can't speak to you--and eat while watching a webinar or doing something. How about we sit like every culture around the world and show gratitude for the food, create an environment for that food to be digested properly: digestive enzymes lessens food, allergens and food reactivity because now we're digesting, we have the gas for cephalic reflex. And all of a sudden, it's like we're more mindful and we have a greater attitude of gratitude. So once again, we've lost some of our mindful practices as we've gotten too attached to technology. And yeah, I don't think AI is going to solve that; we have to solve our own problem when it comes to mindfulness.

Rob Lutz 39:39
Yeah, I think you're right. It's just putting the time in. That's really what it's about.

Dr. Chris Meletis 39:44
Keep simple. Just slow down and say what would my ancestors 300 or 400 years ago--they worked really hard on the hunting and gathering, they were very happy to have that food, and they were celebratory.

Rob Lutz 39:58
That was a great side track; I loved it. Let's dig again more maybe into the supplements; I think it's an easier one. There are lots of good supplements out there that can boost your immune system and probably make you less susceptible to an allergic reaction to some of these seasonal things. So we've talked about astragalus; why don't you list off a few of the others that you think come top of mind, things you might recommend to a patient who's trying to support their immune system?

Dr. Chris Meletis 40:29
Well, something I learned about in 2005 was discovered from a process of serendipity. There's an Iowa animal manufacturing feed factory--and this is right when health insurance premiums started really rising and utilization increased--and they did an epidemiological study about why this particular animal feed factory was not utilizing their health care. And lo and behold--and I heard this directly from the president of the company at the time, which has now been rolled up into other companies, as a lot of our nutraceuticals have been--and what they were doing is blue collar workers were packaging the food and the vitamins and they had a nutritional yeast--that nutritional yeast is Saccharomyces Cerevisiae, actually was metabolizing the special sauce in their animal feed factory product, and they were inhaling it and was then post-nasal drip we swallow. And EpiCor now actually has clinical studies showing it's helping with sinusitis, immune competence, helping augment Secretory IgA. And so this, once again, a yeast ferment from a naturally occurring environment, actually now supplement it at 500 milligrams a day or even less--milligrams is the claimed level and I don't work for that company. And it's like: Wow. So EpiCor is something I incorporate routinely because it helps with the mucus membranes, it helps with the immune competence and it's peer-reviewed literature. So it's E-P-I-C-O-R. Very simple. The other big one, once again, N-acetylcysteine, cut up our mucus, and I always will share with my patients: I put my two fists up and I put my two index fingers together, I put my two middle fingers together, I say: That's a disulfide bond. I say: Now, good luck trying to rotate the rest of your hands around those two fingers stuck together. But if you cleave one of those fingers and just have your index fingers, you're going to have more liquid mucus. NAC, of course, became quite popular and controversial during the COVID era. And I'll leave it there, if you look at the controversy around that in the peer-reviewed literature, that's when the FDA was thinking about banning it for a while and tried to make some moves in that direction. But it increases glutathione levels, but it cuts mucus. And we know in the drug world, it's known as a mucomyst. It actually is used for lung and other congestion. And then olive leaf and berberine, of course, those are our go-tos, which we know have antimicrobial and antiviral property, especially the olive leaf. Once again, I'm not making a claim but that's what the traditional utilizations have been. And then vitamin C, human beings don't make vitamin C. Your cat does, your dog does, your goat in the back 40 does. But human beings don't and primates don't. So we forget Vitamin C is more than just that RDA prevents scurvy. We need it for adrenal function, we need it for other functions. And both vitamin C and bioflavonoids, of course, help with immune competence, particularly during allergy season. So I use those in concert in a formula. And it just works well, along with the hydration, along with the sleep, along with a good diet and lifestyle, because once again, we call them supplements, we don't call them substitutes. "Well, I've got a bottle of substitutes here." No, you've got a bottle of supplements.

Dr. Chris Meletis 43:45
Sure, so those are things that you can recommend to your patients to boost their immune system, help with allergies, and things like that. Any kind of lifestyle hacks or things like that? You've touched on a few but if you were going to list--these are the few things I'm going to recommend to my patients and you should recommend to yours--what comes to mind?

Dr. Chris Meletis 44:06
Well, I always tell my patients once they start having any symptoms, figure out which environmentals are out there that have your name on them. So I go to pollen.com and the moment you identify which pollens are out there that most likely are triggering your problem, especially acutely during our seasonal cycles, then you can just go to cross-reactivity lists and I have multiple cross-reactivity lists I've created--which, if any of the providers want, I'll be more than glad to share--and it's like: Okay cross-reactions, so birch, I avoid my nuts, my celery, my carrots, and my pit fruits during the season. So knowing what is out there, which we can't really control--but we can, I'll share how--and then we go ahead and just know: I'm not going to eat those foods and double down on that level of reactivity because of cross-reaction. The other one is keeping your home doors and windows closed. We all like fresh air. Here in my very small office at home--I've got maybe a 200sf office, where I just do all my consultations virtually these days--I have two HEPA filters, right. And so sometimes I will open my window, but then I want to make sure it's filtered right away. And then the other thing is when we're driving along on the road. First off, I think we've all sat behind one of those diesel trucks or other vehicles that just smell terrible, and now our cabin is full of who knows--benzenes and toluenes or whatnot. So always keep your car in recirculate during the allergy season, that little circular picture there, and sometimes I'll find out: Well, darn, how did that turn off? So I turn it back on and so I can, if I have it on in the recirculate, I don't smell the person mowing the lawn, and I don't smell that nearly as much. So once again, lessening the burden. And then the other thing is, on windy days, not only do we have a geography or zip code we live in. On a windy day, we get the two or three circular zip codes around us. We're getting their pollen on top of whatever our pollen was. So windy days, not a good thing. And then the other thing is showering before bed. Easy for me to say as a bald fellow, because my bad hair day starts with: If I don't push my side hair down in 10 seconds, I've got a bad hair day. So if we have a lot of hair, it's like: Well, okay, do I really want to do that? And then I make a joke with my patients: Well, you can wear a "Little House on teh Prairie" bonnet, but the whole idea is to cover your head so you're not flopping around all night. Wash your face; if you have facial hair at all, wash your face. And I think those are the big ones.

Dr. Chris Meletis 46:35
Don't have your fluffy dog in bed with you. That's another one, I'm sure.

Dr. Chris Meletis 46:39
A fluffy dog is actually probably therapeutic at many levels, but the fluffy dog vacuum cleaner. But now I have fluffy cats. And vacuum cleaners and cats don't get along very well, if you want to survive as their human companion.

Rob Lutz 46:54
Yeah, makes sense. So most of the hacks are really intended to reduce the load, so not as much pollen in your house or in your car, because that's what you're reacting to. We talked about the foundational things that we can do to support the immune system in general and your body in general. So hydration, quality sleep, reduce anything that causes what you think is inflammation, so foods that you think could be culprits--reduce those. It sounds fairly simple. And it sounds a lot more--go ahead, what were you going to say?

Dr. Chris Meletis 47:32
I think it's all about making it doable. I think it can be simple. And then, of course, never forgetting our microbiome. I think our microbiome--I have a free book on Kindle Unlimited on Amazon, so no charge, not making money off it--and it discusses the microbiome. So a healthy gut, healthy us, knowing that we have so much immunological aspects of our being and if we have a leaky gut, we have gut inflammation, then all of a sudden, our allergies or our food reactivities, including food sensitivities will be worse. But I think it's keep it simple. Keep it straightforward. And realizing that good science is there. Just report the fact that keep it simple.

Rob Lutz 48:11
Well, sounds great. This was really interesting and I think timely with a lot of folks. Kind of a late spring here in New England, but the trees are starting to bloom, and I know a lot of people are starting to experience it. So this is good timing for that. And I really appreciate you coming back on the show. And another great episode. I'm sure we've got more in our future.

Dr. Chris Meletis 48:32
Thank you, Rob, and thanks for everything you do. And I love the fact that you pulled in the vagal nerve, to never forget our vagal nerve. Those twelve cranial nerves and the vagal nerve is the vagabond nerve and it does so much more. Or sometimes causes it to go a little wayward. So yeah, vagal nerve controlling mindfulness for sure.

Rob Lutz 48:49
Well, thank you. And in the show notes, I'll have a bunch of links. I know you mentioned you have some resources you're happy to share. So I have your email address and website and some of the things that you and I will add to the show notes just to make this more useful for the practitioners who are listening.

Dr. Chris Meletis 49:04
Wonderful. Sounds great.

Rob Lutz 49:05
Thanks again. I really do appreciate it.

Dr. Chris Meletis 49:07
Thank you.

Rob Lutz 49:08
Take care.

Rob Lutz 49:10
Thanks for listening to the OneMedicine Podcast. I hope you found today's episode interesting and came away with a few insights you can apply to your practice. If you're looking for the show notes, they can be found in the link below. If you want to go deeper on this topic or anything else, please visit todayspractitioner.com and consider registering for our weekly newsletter as well. Thanks again, and I hope you'll join us next time.