Allergies, Inflammation, Dryness, and Lifestyle Medicine with Kara Wade EP#79


Allergies, Inflammation, Dryness, and Lifestyle Medicine with Kara Wade EP#79

Hey everybody. Welcome to the habits and humor podcast. I'm Suzi B and I'm joined here today by an incredible guest today. We've got Dr. Kara Wada.

 Welcome to the show Kara.

Thanks so much for having me, Suzi. It's great to connect again.

Yes, for sure. So Kara and I just did a summit together for.

Inflammation and how to decrease the stress on the body, whether that be physical, mental, emotional, or otherwise. And it was so powerful. You guys are, this woman is such a wealth of knowledge and we're just so excited and happy to have you here. So we're going to jump right into your story. So not your personal story of where you got to here, but your embarrassing story.

If you guys are new to the Habits and Humor podcast, we use funny and embarrassing stories to be relatable, to make it so that you understand and. So that it's memorable, but this story in particular, I think is so pertinent to what so many of us deal with. So Tara, tell us a little bit about your embarrassing story.

It's not so

Much as it is just Ooh, yeah. So I was newly married. I at the time was a medical resident, so I was in my early thirties seemingly, should have been like, hitting my prime when it comes to love life stuff, right? You awesome. Love my husband. Totally smitten with him.

And, but the problem we were, there were some problems. So I went to see my ob, G y n, who I had known for many years at that point. She was the doctor I had known for the longest period of time and, I was frozen. I was so embarrassed to bring up the fact that it was really painful, uncomfortable when we were having sex.

It seemed very odd. I, I'm a medical professional, though that area of the body is not generally my purview. And it seemed like everything should be working fine but it was uncomfortable and it, Things essentially I felt like I was a menopausal woman in my thirties with vaginal dryness, I hadn't had babies yet.

I hadn't breastfed. I hadn't done any of those things that like I later would understand can have those consequences. But here I was in the office with the person that I should have, medically trusted both for, that's her area of expertise, but also I knew pretty well. And here I was for my appointment.

And I waited until the very, very end of the visit, her hand is on the door, ready to leave to mention why I actually needed to be there. And my real concern for the appointment

right there. So many of us have been there where we're like, we need this help. We need this thing, but we're too afraid to ask.

And if they don't ask the question, it's okay, we're just going to let it go. So what did you

do? I asked and I said, Hey, it's uncomfortable. And I actually, at the time this is like extra, I'm feeling extra TMI, but tell us all. I within maybe 20 minutes or so after, after intercourse.

I would have swelling and itching and uncomfortableness in that area. And I said, I know I'm going into allergy and this doesn't make sense, but could I be allergic to my husband? And she's yes, but no, and she's just use more, she's just use more lubricant. You'll be fine.

And that was that. And the re the reality is, and in hindsight, I now recognize that the symptoms I was having were related to an underlying autoimmune condition that I would be diagnosed with many years later. And I also recognize and understand that by the time the doctor has their hand on the door to leave, their mind is already on to the next patient.

Shins. And the moral of the story is sometimes you just have to rip the bandaid off and try to like, get to that point where you can share earlier in the visit to really get your questions answered, or write things down or do other things to help arm yourself with a little more courage.

I think that's so hard for so many of us to get right. We want to read around the point, especially if it's an uncomfortable point. So we're getting into this room. We're like, all right, we're going to go through all the normal stuff. And then at some point it will just come up, and we're

ready to make it happen.

Yeah. My, my annual, my pop, I had already, like been there, fully, fully exposed and everything. And yet still there was that. That sense of the emotional kind of vulnerability that I think went along with it. So

how did you eventually get to what helped you?

So this wasn't the help that you needed her telling you just use more lube and sent you on your way. It wasn't obviously what you needed.

In the short term that was helpful for that particular issue, it actually wasn't until after I had my second child and I went to see the dentist that the hygienist mentioned my mouth look dry and that was the key of oh gosh, okay, I have dry eyes, dry mouth.

I had that appointment with, Dr. G years ago. Shoot, I think it's this condition that I knew about from my training called Sjogren's that really is characterized for many patients by dryness. So that was the tipping point. Yeah,

interesting. So listen to the feedback you're getting, would be lesson number one.

If you're a dental hygienist tells you something so that was another example of this is my hairdresser is the one that put the idea in my head that I have maybe some ADHD tendencies. And got me into, moving into that realm of mental health, my hairdresser, she's like the way that you pull your hair out.

This is probably an indicator of hyperactivity. And I was like what are you on about? And then it's totally what it was. So listen to the feedback, even if it's. Maybe, not coming from a place that you would expect, but then also know if that feedback is helpful. So there's going to be so many people that are like, Oh, you have this or you have that, or, you Google search yourself and then you're like, I'm going to die tomorrow.

Yes.

So I think part of it was putting the pieces together with my own story and kind of my own hunch or inclination that. Something wasn't right about my health. I had been really fatigued. I hurt a lot. I had a lot of stiffness. And I also had some labs that had been off in the prior years that we never quite got to the bottom of or the root of.

And so for me in that situation, I also realized a dental hygienist is looking at mouths all day long. It must have been pretty apparent to her To say something

so fascinating. So good on her for saying something good on you for listening. And then what did you do from there? What was the next step?

You're like, okay, I have this thing. What do I do?

So I I ended up making an appointment with my primary care physician the millennial that I am. I, of course, went online to make that appointment because you never want to actually pick up the phone. Those are scary. Yeah. I also though this seems so silly in hindsight, but I think it's important to share that just that as physicians, we're humans too.

Like I had to get my courage off to Asked for what I needed from my primary care doc to which I knew the labs I needed. I had that knowledge piece. But I still had that people pleasing I don't know, like fear of even though I know this. I knew this doctor. We had teaching responsibilities together.

We were about the same age, like all the power dynamics that should have been like pretty equal or equalized. I still felt it. uncomfortable asking for what I needed. And I don't think it was unwarranted because the response I got was, Oh, I'm sure you're fine. But if you really think so, yeah, we can check it.

Which knowing the person, I think, I'd like to give her the benefit of the doubt that it was also her trying to reassure me, hoping that everything was okay. But at the same right in that moment, what I really needed was just to be feel heard and feel validated that. Yeah, let's just check it.

Let's you know, hopefully it will be fine, but let's check it if you're worried about it. And I think that has really informed. I'm not perfect with how I use my words in my visits with my patients, but I think I certainly come into appointments, taking a little bit more of that pause and trying to at least help people feel that they're validated as we're making a plan together.

But their concerns are really concerns. That's beautiful. You are a medical doctor. Tell us a little bit about your background and your where you are and why you're in the space you're

in. Yeah. So I went to medical school thinking that I was going to be a surgeon. I am now the furthest from, turns out I had really loved immunology as an undergraduate student and little breadcrumbs were left along the way.

So I did internal medicine and pediatrics. I'm boarded to take care of both adults and children and then did an additional two years of training in allergy and immunology so i'm able to take care of kids through adults with immune Misbehaving immune systems, and in particular in allergy immunology, we certainly of course care for allergies like seasonal allergies, asthma, food allergies, but also some conditions that are a little beyond that.

So immune deficiency. So people who are born with immune systems that don't fight off infections very well. And then some segments of like autoimmune conditions. So for many people, things like chronic hives and swelling and some other related conditions fall sometimes more under the purview of autoimmune.

And with my own diagnosis about two years into my my, my first big girl job, my attending job my practice has shifted where I do tend to take care of I think a bigger portion of autoimmune conditions are people who are maybe on their way towards a diagnosis, but haven't quite checked all those boxes yet.

Just as the nature of of being open about my diagnosis and talking about it and some of the issues with the healthcare system.

So you're taking a different approach to it because of your own experience. How many of us have had something like that where you're like, you know what, this just wasn't right the way that it happened and now we want to make it better.

I feel like the world has taken such a shift in the right direction, especially in the world of health in the past, I don't know, four or five years. That we're focused on the right things. Finally, we're no longer focused on the numbers or, the amounts of stuff or whatever, but we're focused on how you feel your intuition from inside yourself is what told you something was off.

Yeah. Your labs didn't look quite right. Or there were things that weren't quite right, but your experience, the way you felt and how you felt inside your gut is what told you to take some action. So how do we get to that point where we trust our gut, where we can, okay, is this really a concern or am I making this up in my head?

I'm a hypochondriac, so I deal with this every day.

Quite honestly, for me, this has been very much a An unlearning of, I feel like almost everything that was ingrained and taught from the time I was little for so long and especially I think through medical training and I'm sure similar career paths where Excellence and perfection is rewarded our physical, our physical signs and symptoms, our hunger cues, our need to go to the bathroom, our need for sleep.

is ignored on purpose, time and time and time and time again. And doing that is rewarded. I think it has, it is taken and it's continued to take a lot of deliberate practice. To learn, to trust my body and my brain and that intuition all over again.

It takes practice. Some of the things that you mentioned along the way here were like that you were in pain or that you had consistent fatigue that wasn't related to a specific instance.

One thing that I have a lot of my clients do is to journal related to. The experience. So whether it's a emotional ups and downs or whether it's anxiety or whether it is emotional eating, whatever it is, I just have you recognize what happened right before that, or what's about to happen right after that.

Maybe you're feeling anxiety about something that hasn't happened yet, or maybe you're feeling guilt or stress or overwhelmed from something that just happened. And if you can figure out what those triggers are, that can absolutely help with that process. In detecting, maybe experiences and things that are help or are causing issue, what other sort of things can we look for?

What other symptoms can we look for that maybe would alert us to autoimmune or allergies or inflammation?

Yeah. So at its core, inflammation tends to cause. pain, swelling it can cause redness, especially if it's like an acute situation or like a more immediate situation. And throbbing. Those are the things you think about if you cut your finger, right?

But when inflammation sticks around too long, which is the hallmark of chronic illness and most of our modern diseases, it can look and feel a little differently. And that depends on the part of your body that's being affected. So for instance, in asthma, asthma could show up as, a really persistent cough.

It could show up as chest tightness or wheezing. Other things that, would be worrisome if you're getting more short of breath. When you previously hadn't.

Other things that... Something like food allergies.

Yeah, so food, and I would say food, so food allergies is allergists, we get a little prickly about in that food allergy at its, in its strictest definition is it like a kiddo with a peanut allergy where you eat something and pretty immediately you're going to either be throwing up or having hives or wheezing and need to treat that with an IV pen.

But what we have seen with onset of autoimmune conditions very commonly Is an increase in digestive problems, usually similar to, what may be attributed to irritable bowel, or, you're just not able to digest food like you used to. So maybe foods are making you gassy or bloated or giving you headaches or maybe seem to like, just.

just don't agree with you like they used to. That is actually really common. And can many times precede or happen before you see onset of, a true autoimmune diagnosis. And I will say personally, I noticed that back in college, I couldn't digest onions anymore. Raw peppers. I was always having like digestive issues, belly aches, chronic constipation, no fun.

Okay. So we're now seeing some of these symptoms with or without a diagnosis. What do we do? What actions can we take to immediately alleviate these symptoms? And as a lifestyle, this is what you do, lifestyle medicine, how can we get immediate relief and keep it going in the future?

Yeah. I think first and foremost, checking in with your health care team to make sure see where things are.

It can be helpful to, check your blood count, your kidney function, maybe some autoimmune labs or in some inflammatory lab just to make sure things are okay. The other thing I would suggest if you're going to be making significant dietary changes or considering a trial away from gluten, which for, a number of people may be something that they want to try is like gluten free, is to be checked for celiac disease.

So celiac is an autoimmune condition. It sometimes can have very minimal, sometimes some people are very symptomatic, other people. They're like quite surprised. But it affects one in 100 people. And and the labs can go turn negative if you are strictly avoiding gluten.

So it's important. To check before you're gluten free for more than a few weeks. Is

that one of those things? I know that with some other allergies, like my daughter had a dairy issue about a year ago. Yeah, we eliminated dairy from her diet. We totally went off of it for probably five months and then we started introducing it back and now she's okay with it.

Is that one of those things that you can do short term, heal yourself, and then it will be okay.

She's still a lot of people. Yeah. For me, like I will say that was my experience and but it's helpful because if you do have celiac right as of right now, the treatment for celiac is you need to avoid gluten.

And really it's very important to minimize risks of other downstream consequences that can happen from. That ongoing inflammation you would have if you're still eating gluten and have celiac. So it's just helpful to Get that information beforehand because then you have better Information to guide things for the long term.

And yeah, so As we're looking at, these underlying root causes of allergies of autoimmunity in these other inflammatory conditions how we think about how they're occurring has changed. So there's some folks listening may have heard of the hygiene hypothesis, this idea that we are, the reason we're having all these issues is because we're more clean, we have more antibiotics, and that's part of it.

But we've taken a bigger view, which is called, it's a mouthful, the epithelial barrier hypothesis. It's this idea that our skin, our respiratory tract, and our gut are all of the surfaces that interact with our outside world. And many of the things that these surfaces come in contact with in everyday modern living can put chinks in our armor.

Now these surfaces aren't supposed to be like, full don't let anything in, don't let anything out. They're supposed to be somewhat permeable, like letting air in, we need oxygen or letting nutrients in through our gut. But when these barriers get damaged or leaky, as the term that will sometimes come up with the gut in particular, our outside or the outside is that scene.

in ways that it hadn't been before by our immune system. It also changes the microbiome that is on those surfaces as well, which can, add to the complexity of what's going on. And it's some of the downstream effects from our insides, seeing more of the outsides and our exposure to these different substances and things that damage our barriers that we think is in large part driving this problem.

So we think about, healing. So minimizing, so gluten for many people is something that can increase the permeability or the leakiness in the junctions in our gut. Having a diet that's low in fiber decreases the amount of mucus that covers our gut lining and helps, add a protective layer.

Some of the additives and emulsifiers that make our breads and our different real processed yogurts and things have great texture those are also damaging to the gut lining. air pollution, super damaging, obviously to our respiratory tract, but actually to our skin as well.

It's a implicated in adult eczema. So we still have a whole ton to learn about, what are all of these different factors. But we're starting to learn more and more about what are those factors that are out there. And then I think as we learn, as we're able to, know better, do better, slowly but surely, if we can decrease our exposure to those through healthy habits.

Then we can work on healing in particular from the ground up.

So glad you brought up healthy habits. Anyone that drops that term in my face is my friend. We're talking about consistency here. So when people are like, Oh no there's an emulsifier in my bread panic. You know what? You only need to panic if it's the bread you eat every day.

If it's something that you're having consistently more days on than off. Yeah. Then it's probably something that you should look into. If it's a one time deal, occasional.

If you want the Hawaiian roll at Thanksgiving. As long as you have celiac, enjoy the Hawaiian roll.

Beautiful.

So my next question then for you is we're doing a sugar challenge next week. How does sugar, I know you're mentioning gluten, how does sugar affect inflammation, allergy, gut, biome, all of this stuff?

Yeah it's interesting. So looking at some of the statistics of how much sugar has increased in our diet over the last 100 years is absolutely incredible.

I think, one of them, right? So one of the examples that I find so fascinating my, so I have three kiddos, my older two are my girls, and we, in the last year, read the first Laura Ingall Wilder's book, A Little House in the Big Woods. And in the book Laura is only four years old, and the only time of year this little kiddo gets sugar is when they tap the maple trees.

And so we think about wow, vast majority of human history, the only time we really were exposed to sugar was when fruit was right. If you found a honey, the honey hole or what have you, high . Or, if you lived in an area maybe that you could tap the maple tree, like this was a pretty rare exposure.

When we think about this steep increase in the amount, especially if added sugar into our diet it really sets us up for changes in the microbiome a shift towards less healthy or less, beneficial gut bugs and can really set the stage for insulin resistance which it falls under this bigger terminology of dysmetabolism.

So essentially our metabolism being

beautiful. So it's not. That you can never have it. It's just that you shouldn't be having it every day.

Yeah. Yeah. And I think, I struggle with this too. I have a sweet tooth. I love a good pastry or a piece of cake, I think when we think back to even evolutionarily where we came from and where we are.

And see that stark difference. I think it is helpful for me to be like, okay, maybe I'll choose fruit tonight instead of the ice cream.

So let's talk about that. Compare added sugar to sugar that is a natural carbohydrate. How do we

process those differently? Yeah. So when you eat fruit, for instance, yes, it has a significant amount of sugar.

But it comes along with fiber. It comes along with the antioxidants, all of the nutrition Along with it and especially when you're eating, a piece of fresh fruit or maybe some frozen berries or you know Something along those lines One you're getting the whole package of it. You're also getting the water content and filling up with it So that's one reason a lot of folks will say just be conscientious with dried fruit because you can easily eat quite a bit of it but you're getting there And it's a filling factor too, that you don't get necessarily when you're eating a cupcake or a cookie.

That's the

difference right there is how it feels back to that whole how it feels thing. Yeah. Eat a candy bar you generally want another candy bar. When you eat some fruit you generally love to eat the fruit and then you realize there's an end point, or,

We all eat so many apples in a row.

Although. We did get a little a generous supply of honeycrisp. We went apple picking maybe three weekends ago and I looked in the fridge and we're already like down to the bottom of the

bag. We love fruit in our house, man. We can't even keep it. I could buy a giant. We need a fruit plunger.

We had two giant laundry baskets. We went picking the other day, too. And we had two giant laundry baskets full of apples, and they are gone. That's amazing. This has been such an enlightening conversation. You guys, those of you that have questions, go ahead and start dropping them in the comments, dropping them in the chat.

If you're joining us on Facebook, We are going to continue this in a live Q and a session. If you're live here with us, there is a link in the comments right here that you can click on to join the call. If you are not live with us and you're not able to catch the Q and A right now, but you're like, this sounds like a really interesting conversation that I have questions about.

Realize that you can be part of these conversations in the Habitize Health program. And all of the replays from all of our past 40 plus guests are in Habitize Health. That's part of the program. So if you're like, this sounds fascinating, I need more information on this, please reach out to me. I would be happy to talk to you more about it.

Kara everyone here has been enlightened by your goodness and we all need a little bit more. So how can we get a hold of you and find more of what you

teach? Yeah I have a website, Dr. Kara, K A R A, W A D A dot com. I have lots of goodies there. I have a little helpful guide on how to go non tox without the nonsense.

So 25 of the simple things that I was able to do with our family over the last few years to decrease some of the exposures to, some of those some of those things in our environment we were talking about that can lead towards immune system issues. I have a podcast called the becoming immune confident podcast that's available in the same place as you listen to Susie's where we talk about Allergies, autoimmunity, anti inflammatory, loving, awesome,

wonderful.

I love the non toxic without the nonsense. That's brilliant. Love it. So good. So succinct and clear. All right, you guys, thank you for being here. If you want to join us live, go ahead and click on the link in the comments. If you're here with us live, if you're needing the replay, feel free to reach out to me and we can keep this conversation going.

If you have questions for Kara, you know where to find her. Karawada. com. All right. Thanks everybody for being here. Facebook. We'll see you later. Those of you that are here with us in the zoom room, stay here.

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