The Whole View, Episode 498: Environmental Allergies

Welcome to episode 498 of The Whole View! This week, Dr. Sarah and Stacy break down the science behind environmental allergies to determine how and why they happen, and what you can do.

If you enjoy the show, please review it on iTunes!

Key Takeaways

  • Environmental allergies are immune responses to something in your surroundings that’s typically otherwise harmless. Symptoms are caused by histamine release by basal cells and mast cells, and reactions are mediated by IgE antibodies. If you have seasonal allergies, your symptoms might be worse during specific times of the year.
  • Environmental allergies are different than food allergies because you’re not reacting to something you’ve ingested. Instead, the response is triggered by something you come into contact with in your surroundings or inhale during your day-to-day activities.
  • The 4 most common environmental allergens are pollen, dust, pet dander, and mold. The fifth most common environmental allergy is cockroaches (ew).
  • Chemical intolerance (CI) is a condition where the sufferer experiences recurrent unspecific symptoms attributed to low-level chemical exposure most people find unproblematic. Multiple chemical sensitivity as a consequence of anxiety and is not the same as saying “it’s in your head! Possible triggers that set off people’s symptoms vary and is different than chemical-induced asthma, which is well described.
  • Symptoms of environmental allergies and MCS can be identical, so the best way is to see an allergist and get allergy testing. There is no diagnostic test that can confirm someone has MCS. It is a diagnosis of exclusion, what is left after ruling out a long list of possibilities.
  • MCAS is currently classified as autoinflammatory (rather than autoimmune), but mast cell overactivity is common in many autoimmune diseases. So, whether someone is diagnosed with idiopathic/primary MCAS versus an autoimmune disease that includes mast cell activation is a fine line.
  • Outdoor air pollution frequently occurs as a mixture of natural pollutants (e.g., from wildfires, volcanoes, biological decay, dust storms) and human-made pollutants (e.g., from motor vehicles, biomass burning, power plants, industrial facilities, waste incinerators, pesticides). Cigarette smoke also has been found to irritate and worsen environmental allergies in many people.
  • There are a lot of steps you can take to minimize your exposure that causes environmental allergies, whether they be outdoors, indoors, pets, etc. If mold spreads across an area of your home that’s bigger than 10 square feet, consider hiring a professional to clean it up.
  • Vitamin D deficiency has been blamed as a cause of increased incidence of asthma and allergy symptoms. There’s good research showing vitamin E can be very helpful for allergies and other histamine issues. There’s also some research showing a role for vitamin B6, vitamin C, and zinc, too, but just in the sense that you don’t want to be deficient.
  • Antihistamines have an very small impact on the gut microbiome, and not one that is clearly problematic, if anything, there may be a benefit, although more research is needed. Sedating antihistamines can cause many short-term effects like urinary retention, dry mouth, increased appetite, constipation, and worsen narrow-angle glaucoma via their action on cholinergic receptors. For non-sedating antihistamines, no serious side effects have been reported.
  • You may be a candidate for allergen immunotherapy, also called allergy shots. Allergen immunotherapy involves multiple shots given over the course of a few years, and can improve and reduce symptoms for an extended period of time.
  • Environmental allergies stop overnight. They usually improve during the first year of treatment, but the most noticeable improvement often happens during the second year. By the third year, most people are desensitized to the allergens contained in the shots and no longer have significant allergic reactions to those substances.

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Sarah’s Announcement

I have some bittersweet news and I’m going to read the announcement I wrote because I’m hoping having this prepared will help me not completely fall apart as I tell you that our upcoming episode 500 will be my last on The Whole View podcast.

I have loved creating this podcast with Stacy and Matt and our teams for the last nearly 10 years. I love what I’ve learned along the way, the amazing connection that this podcast has created with our listeners, the community that that has built, and most of all my favorite few hours of the entire week, when I get to hang out with Stacy. So realizing that it is time for me to move on, was really tough. And I say realization because this never felt like a decision.

Over this last year and a half building Nutrivore, I’ve been able to apply everything I’ve learned in the last decade to my vision for not just this website but all of the resources that will eventually accompany it, which is huge in scope and impact. And, what I realized is that in order for Nutrivore to achieve its potential, to have the impact on public health that it has the capacity to, I need to spend the next few years dedicating 100% of my energy towards it. The cost therefore is having to step back from this podcast, but please know that I do so with grief. Grief, but also pride.

I am so proud of the resource that Stacy and I have created together, of the lives it has touched, the difference we have made, and the conversation that we have led. And, I feel good moving on knowing that this resource will continue to exist for all of you, and in the knowledge that Stacy has amazing plans to continue creating a fantastic resource for all of you moving forward, and I know you are in great hands. I will miss you all terribly, but I will be back to visit as a guest co-host on The Whole View from time to time.

I know that every listener who has seen their health improve because of the information we have communicated on this podcast, or who has been able to get a friend or family member to take their first health journey steps because of being able to share a crucial episode, I know that you all, better than anyone, understand the value of me dedicating my energy now to having an even bigger impact on even more people. And, I hope you’ll keep up with me as I build Nutrivore by joining my newsletter. I send a brief recap of what’s new and noteworthy every Sunday and on Wednesdays, I deep dive answer a subscriber question.

You can sign up at And, I continue to hope we get to meet in person one day, when the world goes back to normal and I return to travel and events. Podcast listeners will always be my favorite people to meet! 

-Dr. Sarah

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