"Dr. Hyman, I've been suffering from seasonal allergies for years," writes this week's house call. "Is there anything that I can do to make these go away or am I doomed forever?"
You are definitely not doomed; however, I do know how miserable seasonal allergies can be, especially in the spring and summer.
Conventional medicine treats seasonal allergies with injections and pills, which unfortunately creates side effects and fails to address the root problem. If you don't address the root cause, then the allergies will never go away.
I've seen countless patients arrive complaining about gut issues. Once we fixed their diets and healed their guts, their seasonal allergies also disappeared. When the immune system (60 percent of which is in the gut) is irritated, it reacts to everything—kind of like when you don't get enough sleep everything makes you more irritable.
One patient struggled with allergies, asthma and hives. She almost nearly died twice from anaphylaxis. She arrived in my office on 42 different pills, sprays and inhalers; yet, she still felt awful. These drugs were suppressing and inhibiting her immune function, causing her body to attack everything. None of her doctors had questioned why her immune system was so compromised in the first place. But due to my Functional Medicine approach, that's the first question I asked.
Turned out, she had leaky gut that was triggered by celiac disease, a gluten-related autoimmune disease. Until that point, nobody had actually tested her for this condition. When we eliminated gluten and other dietary allergens, we healed her leaky gut and calmed down her allergies. Thankfully, after six weeks she was able to stop the 42 medications she used daily.
For her and countless other patients, a key strategy involves getting your gut healthy. After all, an unhealthy, inflamed gut can't fight off potential allergens. To do that and eliminate seasonal allergies, I've found these four strategies incredibly helpful:
1. Replace bad with good. An elimination diet becomes the first step for a healthy gut. The simple foundation of Functional Medicine is taking out the bad and putting in the good. Eliminate common toxic triggers like wheat, corn, dairy, soy and alcohol. Eat a whole foods, high-fiber diet that is rich in anti-inflammatory plant chemicals called phytonutrients. Avoid anything that contains sugar or trans fats. Focus on eating healthy fats from extra virgin olive oil, nuts, avocados and omega-3 fats like those found in small fish (sardines, herring, sable, wild-caught salmon). I provide an easy-to-implement plan in my book Eat Fat, Get Thin.
2. Use powerful gut-healing nutrients—including probiotics, which provide good bacteria to improve digestion and reduce inflammation. Other gut-healing nutrients include glutamine, zinc, curcumin and fish oil. I always recommend a high-quality multivitamin. Quercetin (which has anti-inflammatory and anti-histamine properties) and nettles can also relieve symptoms from allergies. You can find these and other allergy-relieving supplements in my store.
3. Manage stress. A mind-body disconnect can mean being stressed out, wired and tired and can really damage your gut and worsen seasonal allergies. Practice relaxation techniques like yoga or meditation every day.
4. Get adequate sleep. Optimal sleep is crucial for gut health and overall health. Research shows inadequate sleep shortens your lifespan and increases inflammation, which can lead to chronic disease. Insufficient sleep can also increase your risk for diabetes through insulin resistance, paving the way for diabesity. Aim for at least eight hours of uninterrupted, deep sleep every night. To help meet that quota, check out my eight simple hacks for a better night's sleep.
Occasionally, I'll have a patient who has tried all these things and still suffers. In those cases, we need to dig a little deeper for other causes such as food additives, pesticides, chemicals and pollution in their environment. You should also check for mold in your home or work—check out this site to learn more.
Also, consider a very important blood test called C-reactive protein, which measures the degree of hidden inflammation in your body. Almost every modern disease is caused by or affected by hidden inflammation, including heart disease, cancer, obesity, dementia, arthritis, autoimmune disease, allergies and digestive disorders.
Chronic inflammation that contributes to seasonal allergies and much more can come from many sources, including:
- A high-sugar, processed-foods diet
- Inflammatory fats like omega 6 fats found in processed vegetable oils and trans fat
- Lack of exercise
- Hidden or chronic infections, such as viruses, bacteria, yeasts or parasites, mold and other environmental allergens
- Toxicity from an overload of environmental toxins
Ultimately, lifestyle choices and how we care for our bodies and souls is not part of our education, values or even our daily planning; yet, these basic skills form the root cause of our happiness and health.
While these principles are disarmingly simple, even the best and brightest people fail to make the connection between how we treat our bodies and how we feel. Most of us never learned how to care for and feed our bodies and souls. A few simple acts implemented into your daily life could change everything, including seasonal allergies.
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When hurricanes and other extreme storms unleash downpours like Tropical Storm Beta has been doing in the South, the floodwater doesn't always stay within the government's flood risk zones.
New research suggests that nearly twice as many properties are at risk from a 100-year flood today than the Federal Emergency Management Agency's flood maps indicate.
Flooding Outside the Zones<p>About <a href="https://furmancenter.org/files/Floodplain_PopulationBrief_12DEC2017.pdf" target="_blank">15 million</a> Americans live in FEMA's current 100-year flood zones. The designation warns them that their properties face a 1% risk of flooding in any given year. They must obtain flood insurance if they want a federally ensured loan – insurance that helps them recover from flooding.</p><p>In Greater Houston, however, <a href="https://doi.org/10.1111/j.1539-6924.2012.01840.x" target="_blank">47% of claims</a> made to FEMA across three decades before Hurricane Harvey were outside of the 100-year flood zones. Harris County, recognizing that FEMA flood maps don't capture the full risk, now <a href="https://www.hcfcd.org/floodinsurance" target="_blank" rel="noopener noreferrer">recommends that every household</a> in Houston and the rest of the county have flood insurance.</p><p>New risk models point to a similar conclusion: Flood risk in these areas outstrips expectations in the current FEMA flood maps.</p><p>One of those models, from the <a href="https://firststreet.org/flood-lab/research/2020-national-flood-risk-assessment-highlights/" target="_blank">First Street Foundation</a>, estimates that the number of properties at risk in a 100-year storm is 1.7 times higher than the FEMA maps suggest. Other <a href="https://doi.org/10.1088/1748-9326/aaac65" target="_blank" rel="noopener noreferrer">researchers</a> find an even higher margin, with 2.6 to 3.1 times more people exposed to serious flooding in a 100-year storm than FEMA estimates.</p>
What FEMA’s Flood Maps Miss<p>Understanding why areas outside the 100-year flood zones are flooding more often than the FEMA maps suggest involves larger social and environmental issues. Three reasons stand out.</p><p>First, some places rely on relatively old FEMA maps that don't account for recent urbanization.</p><p>Urbanization matters because impervious surfaces – think pavement and buildings – are not effective sponges like natural landscapes can be. Moreover, the process for updating floodplain maps is locally variable and can take years to complete. Famously, New York City was updating its maps when Hurricane Sandy hit in 2012 but hadn't finished, meaning flood maps in effect <a href="https://projects.propublica.org/nyc-flood/" target="_blank">were from 1983</a>. FEMA is required to assess whether updates are needed every five years, but the <a href="https://www.fema.gov/cis/nation.html" target="_blank" rel="noopener noreferrer">majority of maps</a> <a href="https://www.oig.dhs.gov/sites/default/files/assets/2017/OIG-17-110-Sep17.pdf" target="_blank" rel="noopener noreferrer">are older</a>.</p><p>Second, binary thinking can lead people to an underaccounting of risk, and that can mean communities fail to take steps that could protect a neighborhood from flooding. The logic goes: if I'm not in the 100-year floodplain, then I'm not at risk. Risk perception <a href="https://doi.org/10.1088/1748-9326/ab195a" target="_blank" rel="noopener noreferrer">research</a> backs this up. FEMA-delineated flood zones are the major factor shaping flood mitigation behaviors.</p><p>Third, the era of climate change scuttles conventional assumptions.</p><p>As the planet warms, extreme storms are becoming <a href="https://nca2018.globalchange.gov/" target="_blank">more common and severe</a>. If greenhouse gas emissions continue to increase at a high rate, computer models suggest that the chances of a severe storm dropping 20 inches of rain on Texas in any given year will increase from about 1% at the end of the last century to 18% at the end of this one, a chance of <a href="https://doi.org/10.1073/pnas.1716222114" target="_blank" rel="noopener noreferrer">once every 5.5 years</a>. So far, <a href="https://www.rstreet.org/wp-content/uploads/2020/02/195.pdf" target="_blank" rel="noopener noreferrer">FEMA hasn't taken into account the impact climate change is having</a> on extreme weather and sea level rise.</p>
Racial Disparities in Flooding Outside the Zones<p>So, who is at risk?</p><p>Years of research and evidence from storms have highlighted social inequalities in areas with a high risk of flooding. But most local governments have less understanding of the social and demographic composition of communities that experience flood impacts outside of flood zones.</p><p>In analyzing the damage from Hurricane Harvey in the Houston area, I found that <a href="https://doi.org/10.1088/1748-9326/aba0fe" target="_blank">Black and Hispanic residents disproportionately experienced flooding</a> in areas beyond FEMA's 100-year flood zones.</p><p>With the majority of flooding from Hurricane Harvey occurring outside of 100-year flood zones, this meant that the overall impact of Harvey was racially unequal too.</p><p>Research into where flooding occurs in Baltimore, Chicago and Phoenix points to some of the potential causes. <a href="https://www.nap.edu/read/25381/chapter/4#16" target="_blank" rel="noopener noreferrer">In Baltimore and Chicago</a>, for example, aging storm and sewer infrastructure, poor construction and insufficient efforts to mitigate flooding are part of the flooding problem in some predominantly Black neighborhoods.</p>
What Can Be Done About It<p>Better accounting for those three reasons could substantively improve risk assessments and help cities prioritize infrastructure improvements and flood mitigation projects in these at-risk neighborhoods.</p><p>For example, First Street Foundation's risk maps account for <a href="https://firststreet.org/flood-lab/research/flood-model-methodology_overview/" target="_blank">climate change</a> and present <a href="https://floodfactor.com/" target="_blank" rel="noopener noreferrer">ratings</a> on a scale from 1 to 10. FEMA, which works with communities to update flood maps, is <a href="https://www.fema.gov/media-library-data/1521054297905-ca85d066dddb84c975b165db653c9049/TMAC_2017_Annual_Report_Final508(v8)_03-12-2018.pdf" target="_blank" rel="noopener noreferrer">exploring rating systems</a>. And the National Academies of Sciences, Engineering and Medicine recently <a href="https://www.nationalacademies.org/news/2019/03/new-report-calls-for-different-approaches-to-predict-and-understand-urban-flooding" target="_blank" rel="noopener noreferrer">called for a new generation of flood maps</a> that takes climate change into account.</p><p>Including recent urbanization in those assessments will matter too, especially in fast-growing cities like Houston, where <a href="https://authors.elsevier.com/a/1boBRyDvMFW6W" target="_blank" rel="noopener noreferrer">386 new square miles</a> of impervious surfaces were created in the last 20 years. That's greater than the land area of New York City. New construction in one area can also <a href="https://scalawagmagazine.org/2018/01/city-in-a-swamp-as-houston-booms-its-flood-problems-are-only-getting-worse/" target="_blank" rel="noopener noreferrer">impact older neighborhoods downhill</a> during a flood, as some Houston communities discovered in Hurricane Harvey.</p><p>Improving risk assessments is needed not just to better prepare communities for major flood events, but also to prevent racial inequalities – in housing and beyond – from <a href="https://www.npr.org/2019/03/05/688786177/how-federal-disaster-money-favors-the-rich" target="_blank" rel="noopener noreferrer">growing</a> after the unequal impacts of disasters.</p>
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