This week I sit down with Dr. Stan Gabryszewski to discuss allergies from multiple angles. Dr. Gabryszewski graduated from Princeton University with a degree in Molecular Biology before attending Columbia University for his MD as well as a PhD degree in Cellular, Molecular and Biomedical Studies. He then completed his pediatric residency and is a senior allergy immunology fellow at the Children's Hospital of Philadelphia where he now teaches and performs research in the lab of Dr. David Hall. His research is focused on better understanding the epidemiologic and immunologic features among pediatric allergic disorders, in particular the food allergies IgE-mediated food allergy and eosinophilic esophagitis. In this conversation, Stan and I sit down to discuss his recent paper in Pediatrics entitled, Patterns in the Development of Pediatric Allergy. This article is a much needed look at the true prevalence of allergy and allergic diseases in children. We discuss the statistics as well as the thoughts behind the why this is occurring. The upstream reasons are very important, hard to tease out but worthy of discussion. Please enjoy my conversation with Stan Gabryszewski, Dr. M His recent paper in pediatrics.

Teenagers and tweens are a challenge to any parent as they embark on their identity development. These are years filled with angst, joy, love and pain, as our kids develop physically, mentally, and emotionally. As we attempt to guide but not control, we struggle watching them make and maybe repeat obvious mistakes. We, so dearly, want them to make the right choices (in our mind) and respect their bodies. What can we do to help? Dictating to teens will never work. They are more likely to sabotage their own lives in order to prove that they are in control. The tighter parents squeeze, the more the adolescent rebels. I think of this stage of parenting as motivational interviewing.... and a literature review. Enjoy, Dr. M

Micro/nano-plastics (MNP) - the new ultra threat to our health In a first of its kind study, a group out of Italy has found quite disturbing results in the hearts of a few hundred tested individuals. From the study: 257 patients completed a 35 month study where they detected polyethylene in the 59% of the patient's heart's carotid artery plaque. In addition, 12% of the patients had detectable amounts of polyvinyl chloride. "Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine." (Marfella et. al. 2024) Individuals with micro/nanoplastics in the carotid atheroma were at significantly higher risk for myocardial infarction, stroke, or death than those without detectable MNP. The hazard ratio is 4.5 which is to say that the risk is 4.5 X higher for the plastic exposed people.....plus a literature review. Enjoy, Dr. M

This week I sit down with Dr. Stephen Porges, He is a Distinguished University Scientist at Indiana University where he is the founding director of the Traumatic Stress Research Consortium. He is Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland. He served as president of the Society for Psychophysiological Research and the Federation of Associations in Behavioral & Brain Sciences and is a former recipient of a National Institute of Mental Health Research Scientist Development Award. He has published more than 400 peer-reviewed papers across several disciplines including anesthesiology, biomedical engineering, critical care medicine, ergonomics, exercise physiology, gerontology, neurology, neuroscience, obstetrics, pediatrics, psychiatry, psychology, psychometrics, space medicine, and substance abuse. In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders. ​ He is the author of multiple books on his Polyvagal Theory: including the Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation, as well as Polyvagal Safety: Attachment, Communication, Self-Regulation. His newest book cowritten with his son is called Our Polyvagal World, How Safety and Trauma Change Us. Dr. Porges is the creator of a music-based intervention, the Safe and Sound Protocol ™ (SSP), which is used by therapists to improve social engagement, language processing, and state regulation, as well as to reduce hearing sensitivities. This is such a fascinating conversation. He brings the worlds of psychiatry and anthropological physiology into union for us to understand the why of trauma reactions and the future unwinding that is now possible. This is a must listen to conversation if you know anyone with trauma history. Please enjoy my conversation with Professor Porges, Dr. M His recent paper in Frontiers in Integrative Neuroscience Website for Dr. Porges Newest Book - Our Polyvagal World

Allergy Season and School - What is your plan? Spring is coming and maybe even here already in Carolina. School is in full swing for kids and they are filled with joy and excitement. They are back outside enjoying sports and play. For the parents of allergy suffering kids, this is a time for check ups, medicines and the countless forms required by school. I know! What a pain! The goal for parents and educators is to limit missed or unproductive school days due to asthma and allergies and to get the most out of the learning environment for all children. My goal is to help children be symptom free or as close as possible while also focusing on reducing mucous development which is a direct precursor to bacterial sinus and ear infections....and more Enjoy, Dr. M

To Forgive The act as defined as I see it - to release consciously another person from your negative feelings based on an event that was hurtful toward you from them whether it is perceived on your part or known by both parties. What I find fascinating is that often the act of forgiveness may have to push past an unconscious threat injury in order to take root. This is to say that we can be harmed at a conscious and an unconscious level. The unconscious harm is understood at the vagal nerve level which is a primitive emotional safety response state that all mammals have that developed a long time ago. This is the essence of polyvagal theory which states that when humans feel safe, their nervous system supports the homeostatic functions of health, growth and restoration, while simultaneously become accessible to others without feeling or expressing threat and vulnerability. (Porges S. 2022) Thus, the opposite exists, when humans are threatened, their nervous system supports a break in homeostasis that can be short lived or long persistent based on the severity and chronicity of the harm. This break can lead to persistent mental and physical health challenges..... and a section on sleep followed by the recipe of the week. Enjoy, Dr. M

This week we sit down with Dr.  John Warner, an Emeritus professor of Pediatrics at the Imperial College of London in the United Kingdom and also at the University of Cape Town in South Africa. We discuss his recent paper entitled: Strategies and Future Opportunities for the Prevention, Diagnosis, and Management of Cow Milk Allergy. Dr. Warner completed his undergraduate medical training in the School of Medicine, University of Sheffield and his initial pediatric experience was at the Children''s Hospital, Sheffield in the United Kingdom. He moved to London as Professor of Pediatrics and Head of Department at Imperial College St Mary's hospital campus.  He is also Hon Professor of Pediatrics in the University of Cape Town. In 2008 he became Director of Research for the Women and Children's Clinical Programme Group, Imperial College Healthcare NHS Trust (ICHT). He was the lead for pediatrics in both the Biomedical Research Centre in ICHT and the NW London CLAHRC (Collaboration for Applied Health Research and Care) and was President of the Academic Pediatrics Association. Professor Warner's research has focused on the early life origins of asthma and related allergic and respiratory disorders.  He has published over 500 papers in scientific journals on these topics.  He was Editor in Chief of the journal Paediatric Allergy and Immunology from 1997-2010 and chairman of the paediatric section of the British Society for Allergy and Clinical Immunology for 5 years until 2010.  He was also a member of the Speciality and Training committee of the World Allergy Organisation and a past Trustee of the charity known as The Anaphylaxis Campaign.  He was a member of the Advisory Committee for Novel Foods and Processes of the Food Standards Agency for 12 years until 2012 and was recognised for his work in food allergy research by the award of an OBE in 2013.   Please enjoy my conversation with Professor Warner, Dr. M  

Pregnancy is a super important time. Do not take by inhalation, ingestion or other exposure anything that is a potential toxin for the body. Things to avoid: 1) Caffeine - in low to minimal doses, it is clear that caffeine is safe for pregnant women and their offspring. Caffeine easily crosses into the placenta and thus the baby's circulation. In utero babies cannot metabolize caffeine well putting them at risk with increasing exposure. The data does not support the same reality for more moderate to high doses. Caffeine is known to raise blood pressure and heart rate in all users in variable numbers based on metabolism capabilities...... plus a literature review and a recipe. Enjoy, Dr. M

Measles Overview Again From the CDC: As of this week, there have been 35 cases of measles, the Centers for Disease Control and Prevention (CDC) reported including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of these cases were among children and adolescents who had not received a measles-containing vaccine (MMR or MMRV), even if age eligible. (Site) In 2023, there were 58 total cases. A far cry from the 1274 cases in 2019, but still a sign that risk persists for some unvaccinated and immune compromised people. What is measles - a refresher? Measles is a serious, highly contagious and potentially deadly viral infection. It is caused by an RNA paramyxovirus. It is spread by contact with droplets from an infected person's nose, mouth or throat. Sneezing and coughing can aerosolize the droplets and increase the range of infectious spread. Enjoy, Dr. M

Dr. Kate Kresge is the Head of Medical Education at RUPA Health and host of the Root Cause Medicine Podcast. Dr. Kate collaborates with clinicians to bring leading-edge root-cause medicine information to the world through bootcamps, courses, podcasts, articles and more. Before joining RUPA, Dr. Kate was the founding Director of Functional Medicine at Sanare Today, a multi-location practice on the east coast of the U.S. that combines therapy, coaching, natural medicine and more to help people thrive. Dr. Kate’s training in naturopathic medicine began at Bastyr University where she learned how to approach a patient through a prevention focused lens. She focuses on therapies like biofeedback, micronutrient cofactor support and nutrition, allowing her to emphasize root-cause treatments that are both low-cost and effective in order to help keep functional medicine accessible to all. Today, we look at ADHD and the upstream levers that can be pulled on to help reduce the symptom burden. What are the nutritional, lifestyle and other mitigating factors for symptom amelioration? How does Dr. Kate approach a child and the family? What is a meal plan and so much more. Please enjoy my conversation with Kate Kresge. Dr. M

APOE4 and the history of human disease Apolipoprotein E, discovered in 1973, is derived from a polymorphic gene called ApoE that encodes for a signaling protein on a class of fatty proteins that primarily carry cholesterol and other molecules around the body. We find ApoE primarily on VLDL, very low-density lipoproteins and HDL, High density lipoproteins. It primarily helps to shuttle cholesterol from the periphery of the body back to the liver. ApoE proteins are also involved in neuronal signaling, neuroinflammation and glucose metabolism making them especially critical for brain activity. This is becoming a critical part of the story for understanding dementia and neurodegeneration. (Williams T. 2020) ApoE is most famous for an isoform, APOE4/4, being highly associated with Alzheimer’s dementia in modernity. Unfortunately, as we do with many things in medicine, we have been focused on this genetic protein variant as a net negative in humans because we look at things as black and white. Either good or bad. A binary choice. Rubish! ..... Enjoy, Dr. M