Episode 208 — Brain Allergies Are In the Way
Guest: Dr. Pejman Katiraei • Date: June 13, 2024
Episode Overview
Dr. Pejman Katiraei is one of the nation's top integrative pediatricians specializing in children's learning and behavioral challenges since 2008. His holistic approach has transformed thousands of lives, drawing from his own journey overcoming anxiety, ADHD, and depression.
About Dr. Pejman Katiraei
Dr. Pejman Katiraei is a board-certified pediatrician who is also boarded and fellowship-trained in integrative and holistic medicine. He completed his undergraduate at UCLA and then obtained his osteopathic medical degree at Western University of Health Sciences. He then went on to complete a pediatric residency at Loma Linda University, where he stayed on as teaching faculty for over 4 years. Dr. Katiraei has also completed two fellowships in integrative medicine, one with the University of Arizona and another under Dr. Kamyar Hedayat in a French model of integrative medicine called Endobiogeny. Dr. Katiraei is now in private practice in Santa Monica, where he focuses on helping children with severe behavioral challenges. He is also working with an amazing team to build Wholistic Minds, an online portal that helps parents understand the root cause of their child’s behavioral issues and what steps they can take to help resolve them.
You’ll Discover
A BIG Truth (7:33)
The Vicious Cycle To Avoid (8:23)
How High Histamine Wreaks Havoc (13:32)
The Relationship Between MAST Cells & Microglia (19:44)
“Sickness Behavior” (23:45)
A Possible Explanation for Regression (28:36)
Specific Supplements That Calm (36:18)
A Primary Cause Of Mast Cell Activation (42:26)
Useful Tests To Consider (50:08)
Referenced in This Episode
Autism Parenting Secrets - Episode 95: MOLD Is A Bigger Threat Than You Think
Algonot Neuroprotek developed by Theoharis Theoharides MS, PhD, MD, FAAAAI
Full Transcript
Dr. Pejman Katiraei | 00:00
How often do children or individuals with autism spectrum get overwhelmed in the world because their sensory experience is just so intense, right? They can't handle the auditory. They can't handle the tactile, the smells, right?
Some children can't be in the room where there's food being cooked because the smell. So we don't take these things into account to put that into context of why the children are And individuals experience what they do. And the beautiful part of it is these are all things we can actually do. I want to say easily treat, but relatively easily do something to change and improve.
Cass Arcuri | 00:43
Want to truly be the best parent you can be and help your child thrive after their autism diagnosis? This podcast is for all in parents like you who know more is possible for your child.
Len Arcuri | 00:54
- With each episode, we reveal a secret that empowers you to be the parent your child needs now, saving you time, energy, and money, and helping you focus on what truly matters most, your child.
Cass Arcuri | 01:05
- I'm Cass. - And I'm Len. - Welcome to Autism Parenting Secrets.
Len Arcuri | 01:21
Hello and welcome. It's Len and I'm thrilled to welcome back to the show Dr. Pejman Katiraei, or Dr. K as he is known, And he last appeared in episode 95 of Mold is a bigger threat than you think. Check that out if you haven't already. It's a dynamite episode. And today we're going to be diving into some different topics. But first, some background on Dr. K. He is one of the most highly trained integrated pediatricians in the country. Focused on helping children with learning and behavioral challenges. Since 2008, Dr. K has been practicing integrative and holistic medicine help children with complex health challenges And he has now helped thousands of children. Dr. K knows what children with learning and behavioral challenges go through because he was one of them. And until he learned how to heal himself, He was limited by anxiety. ADHD and depression Dr. K created holistic minds, to use his unique background and experience to help change the world for kids just like him. The secret this week is brain allergies are in the way. Welcome, Dr. K.
Dr. Pejman Katiraei | 02:31
Thank you for having me, Len. Pleasure to be.
Len Arcuri | 02:33
Here. Well, always good to have you. And you have lots of topics I know you are passionate about talking about.
So brain allergy, when I first heard this term from you, I was really intrigued. Can you explain a little bit more about what you mean by brain allergies?
Dr. Pejman Katiraei | 02:48
Yeah, you know... A lot of times, especially with children with autism, and with children with pans and pandas, they have these constellation of challenges that We can't really put into context in terms of why they're happening. And the term brain allergy was termed or coined by this brilliant researcher, Dr. Theo Haredes. And Dr. Theo Haredes has pioneered this domain of mast cell activity and how it impacts cognition and mood. And one of the things that we don't often talk put into context is how these allergy responses, and we know with children with autism, their rates of allergies and asthma and various other types of atopic diseases are much higher, two to 300% higher than conventional or normal to big children. We don't oftentimes take that allergy response and say, well, how does that impact my child's mood and behavior? And for instance, the constellation of sensory issues that these children have, the fear responses, right? They get overwhelmed by the world and everything sometimes becomes a trigger that causes them to feel anxious and they're scared and they're overwhelmed. And We don't look at that and say, well, gosh, what is driving that? And it turns out that this brain allergy phenomenon, which is Kind of an oversimplification of what's actually happening is actually a beautiful mechanism that describes a lot of these different things that I touched on.
Len Arcuri | 04:28
Yep. No, and the reason it resonated with me is because allergies are extremely relevant for our son, Rye. And Cass and I think navigating autism was somewhat not as difficult as navigating my son's life-threatening allergies, particularly peanuts and soy, which are truly the highest level possible.
So the term allergy is very familiar to me. That's why hearing it with respect to the brain, I think is a very simple. But a very useful way of looking at what might be happening and therefore what, you know, might, be available to a parent to help reduce that overreaction or that negative reaction.
Dr. Pejman Katiraei | 05:08
Yeah. And just improve your child's quality of life, improve your, how comfortable they are in the world. And the reason why I went down this road is as I was treating the children that I was taking care of, I started modulating inflammatory responses for sometimes other reasons.
And then I would notice like, God, this child's sensory overwhelm has calmed down substantially. I'll give you one example. There was this sweet little girl who was normal typic, but had PANS-PANDAS. Her sensory issues were so over the top that she literally could not wear one item of clothing, not even underwear, because the experience of clothing would just completely set her off the rails. We calmed down her inflammatory response.
And then three weeks later, this child is going to school wearing clothing like she's not happy wearing the clothes, but she was wearing the clothes. And like, how often do children or individuals with autism spectrum get overwhelmed in the world because their sensory experience is just so intense, right? They can't handle the auditory. They can't handle the tactile, the smells, right?
Some children can't be in a room where there's food being cooked because the smell. So we don't take these things into account to put that into context of why the children are And individuals experience what they do. And the beautiful part of it is these are all things we can actually do. I want to say easily treat, but relatively easily do something to change and improve.
Len Arcuri | 06:46
Right. It's within the ability to influence and control to some degree. And, you know, with that kind of insight and that that's exciting. Right. Because there's so much that seems.
Like it's fixed that there's nothing you can really do about it. But if you're looking at it from this perspective that it's this allergy, And therefore there's a root cause as to why the body is reacting that way with that type of curiosity and root cause focus. Many options open up that might seem ridiculous initially until you really look at it. From this perspective that the body's responding in a way that it wasn't designed to. And there's a reason why it's responding the way it is, correct?
Dr. Pejman Katiraei | 07:28
Yes. Yes. I think you hit the nail on the head. There's always a reason. Why things happen.
I mean, I, every day I become even more firmly convinced of that. Now, are we smart enough to understand all the different reasons? No. But yeah, The body, everything that happens in the body, everything that happens in the nervous system happens for a reason. It's just a matter of can we get to a level of sophistication where we can understand this in a comprehensive and appropriate way?
Len Arcuri | 08:00
Right. And that's, again, that's the job of a dynamite practitioner to be able to help advise and guide a parent But again, it all starts with this different a way of looking at what might be happening. And I'm guessing the last episode we did write mold. That's a piece of this puzzle, right? In terms of, Why the brain may be reacting, what may be extremely inflamed, number one, and may be reacting and manifesting in behaviors and symptoms that a parent's not wanting for their child.
Dr. Pejman Katiraei | 08:30
Yeah. You know, as time has passed since our last recording, what I've really become clear about is. I'll Moldemul toxins and frankly, all toxins, right? Glyphosates, plastics, antibiotics in embedded in our food supply, so you can look at them as a toxin, they all start disrupting the microbiome. And what I've started really putting together is how this cumulative effect, and for some children, it's an excess of glyphosates. For other children, it's an excess of metals, which can disrupt the microbiome. For some children, it's mold. But there's a tipping point where the gastrointestinal tract and the bacteria, and most importantly, the fungus that live in the gastrointestinal tract, it reaches a tipping point where it enters this dysfunctional state And it turns out that when you get inflammation in the gut, that inflammatory response further disrupts the microbiome. And because the microbiome gets disrupted, that triggers an inflammatory response. And you get this vicious cycle that essentially does not end of just one thing triggering another, which triggers another. The inflammation changes the makeup of the fungus in the gut.
So it activates candida. It's really interesting, this inflammation.
So everyone has candida, regardless to what people think. Everyone has candida. In healthy people, that candida is called a commensal. It's just kind of hanging out. It's polite. It's kind. It's not. Causing any problems. But when there's inflammation, specifically with these mast cells, this allergy response, the mast cells trigger a reaction within the candida to change its invasive nature. It becomes invasive, starts spreading these hyphae and hyphae. Candida actually then becomes problematic.
So for all these families that are saying my kid has a Candida problem, it's not that they suddenly got Candida. It's the Candida that was within their gut now has become problematic, has become aggressive, and that is triggering an inflammatory response.
So It's just literally this vicious cycle where one thing triggers another, which triggers another. And that cumulative cycle, response leads to this chronic activation of these mast cells that literally could linger for years upon years. And that activation then comes up here. To cause all kinds of really unfortunate reactions, if you want to say.
Len Arcuri | 11:18
Got it. Yeah, no, that's very helpful. And I guess for my, in my simple. Way of like, or my way of trying to simplify this You're suggesting that within the gut, which the goal is to have a balanced gut because all this stuff is designed to be in the gut, including yeast, but just... Not in a excessive way.
So I'm wondering, is it that the yeast levels within the gut Are you saying that the nature of that yeast is changing or is it actually increasing where there's an excess amount? Of candida and or yeast Within the gut, or is it.
Dr. Pejman Katiraei | 11:51
Both? It's both, but look at it as...
You know, if you've got, look at it as a community, let's say you're in your town, right? 99% of the people are good, kind, law abiding, just nice people, right? The kind of town you would want to live in.
And then there's the 1% of the bad actors, but those bad actors are kept in check because the 99%, you know, if that 1% starts acting out, the 99 are like, what are you doing? We don't do that here. Now, When you get toxicity, toxin exposure, when you get inflammation, What happens is these beneficial bacteria, these good community members actually start dying off.
So inflammation actually creates an environment that's hostile for these, we call them commensals, these beneficial bacteria. So the counts of these beneficial bacteria start dropping off. And when that happens simultaneously, that inflammation actually triggers the bad actors to start either becoming more invasive or start replicating.
So the ratios start changing. And that town where 99% were all kind and happy and law abiding is now 60%, let's say 70% law abiding. But now there's 20 or 30% of the bad actors, which is way too high. And now these bad actors are far more aggressive. They're causing, they're looting, you know, they're, breaking into homes, they're becoming invasive. And that further triggers the inflammation, which then causes this endless cycle of dysfunction. Now, one of the things like. We oftentimes, when it comes to allergies, right, just histamine. When you think of histamine, what do you think of?
Len Arcuri | 13:42
Yeah, well, I'm thinking for me, it's an allergic reaction. You know, it's the, I think of commercials talking about histamine and the like.
So I'm thinking about it, an allergic response.
Dr. Pejman Katiraei | 13:53
Yeah. And that's what everyone, including most physicians, think of, right? Runny nose, you get a rash, you get things like that. But- Think about what happens when you take Benadryl, which is an antihistamine, right? Benadryl is an allergy medication. When most people take Benadryl, what happens? You fall asleep. Right.
So how does an allergy medication cause you to fall asleep? It turns out that histamine, and this is a discussion that Theo Herades doesn't talk about so much. Histamine is one of the two primary issues modulators of the sympathetic response.
So there's glutamate, right? GABA glutamate. And we know that children with autism spectrum or individuals with autism spectrum have abnormalities with glutamate, but we don't ever talk about abnormalities in histamines.
So histamine is the other thing that modulates the sympathetic nervous system. And when histamine is too low, like when you've taken Benadryl, we pass out. When histamine is too high, That's an area that very few people are touching on. And that's why I was happy to join you on this podcast. But... The elevated histamine can show up as sleep disturbance.
So all those poor kids that fall asleep and then they're up at three o'clock in the morning and they cannot sleep for multiple hours, they get like six hours of sleep and they're just wired. That's a histamine response. The children who have very poor appetite If you think about if this nervous system, so think of when you've had way too much coffee in a day, what happens? Your appetite gets suppressed, right? Histamine can cause that kind of appetite suppression.
So you get all of these things that when you look at children on the spectrum, you're like, God, that sure looks like a lot of these presentations that these poor children have that do not make their life easy or for that matter, the family's life easy. But there's something beyond this.
So not only does histamine... Really keep the tone of the nervous system up at like 150 miles an hour where that child cannot slow down. It starts impacting their sensory pathways. And there's this beautiful article, I think it was published in 2008 by this brilliant guy, Haas, H-A-A-S, Helmut Haas. And Dr. Haas talks about, and it's like an 80-page paper, he gets into all of these fascinating ways in which histamine affects the nervous system. And how histamine changes vestibular.
So the balance, right? A lot of these kids are constantly pacing back and forth and they're constantly moving. And we see that with ADHD.
So those are all vestibular findings, but it's more than that. You get auditory issues.
Right. Or they're toe walking. A lot of these things are all the sensory pathways that get changed. And when you add to that, for instance, the change in smell, the change in texture, right, tactile sensitivity.
So why do some of these kids on the spectrum only eat two foods, right? Chicken nugget, peanut butter and jelly, or, you know, it's just bread and pasta. Why do they eat that way? It's not because they're trying to be a pain in the butt. Their appetite is suppressed.
So one, they're just not even sensing their hunger. And two, The experience of the food is distorted to them. And some of the normal type of kids that I have that have these changes and they can articulate what they experience. They're like, yeah, steak is gross to me. Mushrooms feel gross. And some of these kids can't express that, but they experience that. And we as normal adults are like, you know, why would a child not want to eat that delicious piece of salmon or whatever else, right, from our kind of normal judgy place? And we don't. Have the ability to understand that for this poor child, they just, the experience of the food is essentially grotesque.
So what do? They gravitate towards the foods. That feel okay to them and that happens to sadly be the very foods that trigger more inflammation right there's no fiber there are no nutrients which further causes the gut issues which then further exacerbates the inflammatory response and adds just one more vicious loop to this cascade of events.
Len Arcuri | 18:35
Yeah, I appreciate that expansive overview and I can relate to all of it. And especially for our for a lot of the people who are listening and their child fits in that category. What you're suggesting is that it might be, you know, the texture that might be something that's why they go to the junk food. But I have to imagine it's the fact that the processed foods, the fast foods, have such a crazy number of additives to increase the flavor in some way. In addition to the texture that these foods are just designed to be addictive. Again, it's not that your child's being difficult. It just might be that they really are addicted to these foods. And maybe getting some payoff with the texture or the taste or the saltiness or whatever it might be.
So yeah, it's really not your child's fault because those foods are designed to be quite addictive and to be pleasing to kids compared to more nutritious foods. That just aren't that exciting.
Dr. Pejman Katiraei | 19:36
Yeah, absolutely. Are you okay with us taking the conversation a step further?
Len Arcuri | 19:42
Yeah, keep going.
Dr. Pejman Katiraei | 19:44
Math cells. Happened to Have a very close relationship bond or tie with these other cells that sit in our brain called the microglia.
So imagine two sisters that are best friends and they text and talk multiple times per day. And the behavior of one sister affects the other Intimately. And when one sister gets very thrown off, the other sister gets completely thrown off. Mass cells and microglia are like this. They are intimately tied together and when mass cells become activated through multiple different pathways, they trigger the microglia to become activated. The microglia are the primary, they call them immune sentinels of the brain. They're there to protect the brain. They're there to clean. Things up and just, they're kind of like the guard dogs of the brain. Now, normally when everything is, you know, fine, the microglia are just not doing a whole lot. When you get mast cell activation, first of all, the blood brain barrier gets disrupted.
So now there's all of these foreign antigens coming into the brain, which triggers the microglia. The microglia are directly activated by the mast cells and It turns out that there are other processes from within the gut, like these bacterial toxins that are released into the bloodstream that activate the microglia. And when the microglia get activated, so you've got all this stuff we talked about with the mast cells and the histamine and the sensory distortions. When the microglia get activated, they cause a whole other layer of, if you want to say, a mess within the nervous system. And one of the first things that the microglia have been tied to is causing, and Dr. Theo Haredes gets into this in some of his papers, is it starts changing the amygdala.
So it literally causes a rewiring in the amygdala, which is one of our primary kind of limbic primary primal sense processing. So at the core level, the amygdala is influences our fear response. And I'll give you my own personal experience with this because it turns out. I didn't know this was a problem for me, but I've always had just this underlying sense of Everything being a small level of threat. There's always like, my God, what about this? What about that? And I'm guessing at some point I've been exposed to something in that trigger, this inflammatory response. And I took a supplement and we're talk about that in literally within two weeks like that. Background buzzing of Warty. Just was gone. It was the weirdest thing. And what I've seen in a lot of the children is the same thing.
Like all of a sudden their fear response. And since fear drives anger, That anger, aggression, constant just exploding anger. Palms down. When the amygdala gets distorted The child's perception of what is safe and what is not and what is a threat and what is not gets completely skewed in at a very early primal, certainly not conscious level, their nervous system starts misinterpreting what is a threat in the environment and what is not.
So if you can imagine your sensory pathways are distorted, so everything is amplified, everything is overwhelming from a sensory standpoint. And then you add to that your brain's perception of what is safe and not is completely skewed.
And then on top of that, The microglia and the inflammatory response they cause change all kinds of different circuits within the brain, and we won't get into that. But one of the things that they can cause and have been clearly shown to cause is this weird thing called sickness behavior. And sickness behavior is exactly what it sounds like. Sickness behavior is when you had the flu. You felt sick, right? You had no motivation. You felt tired. You felt depressed. You had brain fog. You were exhausted. You just feel sick. Imagine if every moment of your life You feel that way. And imagine when you compound all of these things together, there's the sickness response, you're tired, you don't feel good.
And then I'm sure you've talked about, you know, on top of this, we've got the mitochondrial issues and like all the things we won't talk about. So you have all of these things together. Compounding together And how would that if let's say that was happening to you, just stand back and for our audience, just I want all of you to just take a moment and just think of like, if I had this sickness behavior in the entire world. World felt like a threat and my sensory experiences were off and I just felt cruddy all the time. How would I behave? How would you behave like? How would that experience be for you? It wouldn't be pleasant. Right. And when we look at things like, for instance, social engagement. Right. Which is one of the hallmarks of autism spectrum. It turns out that sickness behavior and a lot of these things ultimately influence The child's ability to socialize. And I've seen this where as I've modulated these inflammatory responses and so forth, all of a sudden, these children that were not engaging with other kids are now engaging with other kids and their sociability, their engagement, their eye contact. A lot of these things change. Because some of the fundamental physiological factors that were impacting the child's experience of the world Suddenly started changing in there as a result, their experience in the world started changing.
Len Arcuri | 26:00
You know, it can explain a lot of behaviors, whether it's irritability, picky eating, you know, again, anger, tantrums. Yeah, no, it doesn't take much for me to imagine what it's what it would be like to be in that sickness state. Kind of perpetually And that's where, again, if you can really put yourself as a parent inside your child's mind, inside their body of what might be going on, Appreciating that this may very well be what's happening for him kind of gives you a little bit of a grace. And more of an acceptance as opposed to being annoyed by their behaviors, really looking at it with hey, curiosity-wise, there's something behind this It's something that if I can ascertain what's behind it, there's something I can do about it. And again, just in the heat of the moment, not necessarily going to frustration, anger, and annoyance with what your child's doing.
Dr. Pejman Katiraei | 26:57
Yeah. Yeah, it creates space for compassion. And as you said, understanding. And part of why I feel so passionate to you know, be in this world and to do the work is, you know, It breaks my heart to think... What is the experience of these poor children, right? And I mean, all the parents out there that are living with this know this better than anyone, but it's heartbreaking when you start thinking. Taking it and translating it into, wow, these are all the things that these children experience on an everyday basis. We as a society, we as a community sometimes fail to understand these things. It creates a lot of space and a lot of opportunity to ultimately help.
Len Arcuri | 27:48
And sometimes just that little bit of space is all that's needed. So I love that we're going deeper into this. Because that perspective really is important. And I love that you gave a little bit more of a detail on the connection of how the gut, what's going on in the gut, this inflammatory state in the gut, I think a lot of parents might be like me wondering, well, how does the gut ultimately influence the brain? And you talked about the different factors of how that would be the case that. What starts in the gut ultimately does yield a brain function. That basically is you know, just not, responding or operating the way it was intended because of this chronic inflammation and this overreactive state.
Dr. Pejman Katiraei | 28:34
Yeah. Yeah. It really begs the question of with regressive autism, right? That this phenomenon where overnight, it seems that these children, you know, sadly just deteriorate and they lose all of these, you know, beautiful, abilities that they had. One of the hypotheses that we're entertaining is, with whatever environmental load Is there a tipping point where the gastrointestinal tract is kind of working, it's kind of working? And when you pay very close attention to all these children, a lot of them had subtle things before that point, right? Bunch of ear infections, severe colic, digestive issues, early allergies. Their history was usually not perfectly normal. It's There were little things, right? Little things that from a conventional lens, we don't pay attention to.
Like, why would you pay attention to a two month old having severe colic for the first six months of their life and then having regression later on? Or, child having multiple rounds of ear infections or whatever digestive issues or allergies. But When you put all of this in context, it creates a storyline. The child's system was struggling from the early days. And It was compensating. It was trying to make it work. It was keeping it together.
And then it reaches a point where it can't keep it together. And that's when I believe this vicious cycle, there's a tipping point where the gut hits a place where now everything starts falling apart. And once it enters into that space, it cannot repair itself until someone comes in and actually intervenes. And I'm happy to touch on that. But again, This is part of the hypothesis that we are forming that. There's essentially this tipping point that these children get. And that tipping point happens within the gastrointestinal tract. And that's when you get a chronic state of toxicity and a chronic state of inflammation, which then causes some of the things we talked about.
Len Arcuri | 31:02
Yeah, no, I'd like to go even deeper on that. You know, in that tipping point, I think, as you alluded. Is not one thing. It's this cumulative load, this cumulative effect. And it may be a particular event that is the tipping point that kind of pushes your child over the edge. But for every child, that's going to be they all have different histories. It's going to be a different, you know, cumulative effect of a number of different stressors, right? That there won't be the same story for each child.
Dr. Pejman Katiraei | 31:31
You're right. With every child, the story is different. For some children, it was that one antibiotic that caused them to fall apart. For some children, it's a virus. That causes them to fall apart. For some children, we know that inoculations But it all takes us back to... The vulnerability was probably there. And one of the things that I encourage all my families to do is, yes, we need to understand what was trigger. But the trigger is only one part of the total equation. And, you know, analogy I share with families is whatever the trigger was, that's like having a match. Let's say you've got a big match. You throw that match. Now, where that match gets thrown. Probably matters a hell of a lot more than the match because you can throw a thousand matches onto a concrete asphalt parking lot. Nothing is going to happen, right? You're not going to harm the asphalt or the concrete with a match. You take that match and go into a dry forest with obscene amounts of tinder, one match, horrendous forest fire that will have no end. We need to step beyond the match and look at the environment in which that match lands. And if we can understand what caused that environment to have the equivalent of all that tinder. What caused that environment to be so vulnerable? That it then fell apart. We can then take that information to understand essentially how to reverse engineer. Okay, well, these were the things that created the vulnerability. And in my world, you know, mold and mold toxins are one of several important factors. And I know in certain parts of the world, you know, where people are living in the farming belt, like, gallons of glyphosates are getting sprayed into everyone's face.
Like that's a really big trigger. You know, heavy metals can do it. But when you can reverse engineer like, okay, this was present, that was present, this was present. These cumulative things created the vulnerability.
And then cause the gut to fall apart. Now we can get to a point of addressing that root cause to then. Hopefully bring the child into a healthy place where You know, it's not I mean, everyone says this, like I look at autism. As the beautiful part of the child. The dysfunction, the physiological dysfunction that causes them to suffer is the part that we have the ability to undo.
So the beautiful, radiant, magical part of that child can shine through. And that beautiful human being that wants to connect and could be present could actually show up in a way that's enjoyable to them. And allows them to really shine in the world. And I think that's really what this conversation is about. And I know that's what your work is about.
Len Arcuri | 34:40
Absolutely. I love how you framed it because If you do look at it, in this different way that what's going on with your child isn't fixed, isn't permanent, isn't some disease that that's permanent It is about reverse engineering in terms of, okay, whatever's happening within my child's body, If I understand why, in this case, There's allergies. The brain's allergic. The gut, there's allergies.
Something's off. Then it does give you that ability to look to reverse engineer it. And 99% of the time, there are things you can do, which I think Yeah, I love this approach. I love what you do. And a lot of practitioners like you who take this root cause approach. And yes, similarly, The work my wife and I do is about helping the parent to basically reverse engineer and to operate in a way that helps them thrive as they're trying to help their child thrive.
So yeah, the concept's not at all lost on me. And I love that you're sharing this more hopeful and pragmatic way that there's so much more a parent can do. And I know even something as simple as supplements, a lot of parents get overwhelmed with They go see a doctor, particularly functional medicine doctor, and it's supplement after supplement. But the reality is supplements can be a really powerful way of helping a child, right, with anxiety with whatever they may be wrestling with. Can you talk a little bit about that?
Dr. Pejman Katiraei | 36:14
Yeah, absolutely. Sue. A lot of providers that I see Use supplements at kind of a symptomatic level.
Like, your child has anxiety. Let me give you L-theanine or magnesium or, you know, whatever. The...
Root physiological processes that are then causing all of these other things. Like for instance, if you have mast cell activation and microglial activation, trying to throw magnesium or GABA or whatever to calm down that anxiety without addressing where that anxiety is coming from, it's like Your house is on fire and you show up with a watering can and you're wondering, like, why? Why? I'm pouring water. Why is this not working? You need to do a helicopter drop. So two of the supplements that I have found helpful, and everyone should talk to their provider first, because I said this, don't just jump and do this. But there are two supplements in combination. We can talk about a third that I found to be generally very helpful in calming down some of the symptoms that and the overwhelm that these children experience.
So the first one is this product called Myrica, and I have no affiliation with either any of these companies that I'm mentioning. I don't make a dollar for saying this. M-I-R-I-C-A. Myrica is this combination of this compound called luteolin, which is This bioflavonoid that has some really cool properties in reducing mast cell activity. And microglial activation. And Dr. Theorades has actually looked at luteolin in some of his studies, and they have found it to be very beneficial. Now, Dr. Theo Aredes has this product called NeuroProtect that he promotes and I have different thoughts about that. But what I have found with Mirica to be awesome is it has this other compound called PEA and it's thalamidoate.
Something or other. And I've tried memorizing this thing a million times, and my brain apparently has an allergic reaction to that term. The PEA is a fat derived from eggs. And PEA happens to be really good at chilling out the microglia.
So you've got these two compounds in this supplement called Myrica, and the taste profile is benign. It mixes in with most things. As far as we know, it's actually quite safe. And that combination starts calming down the mast cells and especially starts calming down the microglia. Now, when you add to this an enzyme called DAO, diamine oxidase, and you can get it from a bunch of different companies. One of them is Seeking Health. They've got this thing called Histamine Digest. There's this product. Company called Natura, They have this thing called Nature DAO. I forgot which company makes it, but that's another great product. There's multiple different products out there. These diamine oxidase enzymes basically start digesting histamine that is being generated within the gut. Which is where a lot of histamine originates from.
So when you add the Myrica in this enzyme, you start bringing down histamine levels, you start chilling out the microglia and mast cells. So far, what I have seen is about 50-60% of children, you can see at least a 25-30 plus percent improvement in sensory issues, in their agitation, which is oftentimes part of that neuroinflammation, and everything just starts settling down for them.
Sometimes in addition to this, there's an herb called cat's claw, and there's multiple companies that make that. One of the cool things about cat's claw is that it's highly effective at calming down this cytokine, this inflammatory chemical called TNF-alpha. And it turns out that TNF-alpha, from what we understand, is a very effective is one of the primary signaling triggers between mast cells in the microglia.
So it's one of the chemicals that they pass back and forth that irritates the both of them. So sometimes when you add cat's claw to the myrica and histamine block, it kind of supercharges the effect and further enhances that anti-inflammatory effect. Now, In some children, we find that these supplements do not work. And I'd say 30-50 percent of the time depending on the population. Generally speaking, when these supplements do not work, it is because there's something there that is completely unproductive. Even off the immune system.
So it's like having that flying on the chalkboard and you happen to be very sensitive to that sound, There's something constantly irritating the immune system, whether it's ongoing mold exposure. So I've seen some cases where the kids don't respond.
And then we find that there's a horrific amount of mold in the child's bedroom or something like that. So when there's that kind of exposure, you can't calm down the immune system. Kids who have food allergies or high food sensitivities. We're not talking a little, but like they're highly reactive to certain foods and they continue to eat those foods. They're nervous. Their immune system would not calm down. Kids who have parasites.
So let's say that they have some kind of gnarly parasite that's irritating the immune system from within the gut. You can't calm that down.
So it almost becomes a little bit of a diagnostic tool, believe it or not. And this is one of the things I'm teaching to some of the providers that I work with, where by doing this, if this child's system calms down, you can say, gosh, OK, there isn't something horrendous causing inflammation. If it doesn't calm down, you need to go back to the drawing board and say, what are we missing? What is going on that's continuously driving this inflammatory response?
Len Arcuri | 42:50
Yeah. Yep. No, I appreciate that. And I think I'll echo what you were saying. Where Have a practitioner you're working with. We're not throwing out medical advice, go buy these three supplements and try them out on your child. Work in concert with a really good practitioner who has this more root cause approach. But it's ironic that the three that you did mention, they've all been in my household. My son has Myrica each morning, and that was identified for him through, you know, detailed DNA type sequencing, functional genomic work that we had done that indicated that was something that specifically would be really useful for him. But yeah, all three of you mentioned have made their way into our household.
So yes, no medical advice here, just for your education to better understand that There are supplements out there and they can be very targeted. You know, work with the right practitioner and take your guidance from that. From that person.
Dr. Pejman Katiraei | 43:47
I'm curious, what change did you see when you started America?
Len Arcuri | 43:52
I think Yeah, I think we've seen, because we know mast cell histamine is a huge, again, allergies are a major issue. I took my son for blood labs yesterday, so we're going to see if his IgE allergies have come down at all. Because literally, it's been kind of like Charlie Brown and Lucy with the football where no matter what we've done, homeopathy has been huge for my son, saved his life. And there's been a lot of things that have helped him, but we've never seen those allergy levels come down.
So we're hopeful that over time, his overactive immune system, seeing any of these foods as invaders will diminish. But I think since we've been taking the, he's been taken to America, I feel like, yeah, he's, you know a little bit more chill calmer in his skin less perhaps ramped up you know so i think we've noticed differences But we've been at this game long enough to know that sometimes you won't see the benefits until... Down the road and just got to be consistent and stay the course. We didn't notice anything significant right away from taking it, in other words.
Dr. Pejman Katiraei | 44:58
Yeah. Yeah. And I think that's a really important point to highlight. This is not, you give the supplement and tomorrow your child wakes up, you know, comfortable and calm. I typically find it takes about three or four weeks for the results to really start showing up.
So do, if you do work with your practitioner to start them, keep it going for a little while. Would you like to talk about one... Primary source of this mast cell activity So, I'm sure most you and most people in your audience are now aware of that, case report by Dr.
Len Arcuri | 45:28
Absolutely.
Dr. Pejman Katiraei | 45:37
Sid Baker, where he described the use of itraconazole. So.
You know, when we last spoke, I had been taught to look at mold toxicity as a primarily toxin-related issue with the mold toxins. And Since then, what I've really come to open my eyes to is mold toxicity and exposure. Yes, these mycotoxins are present, but they're not the primary reasons that are causing the issues. These mycotoxins, because they... You can substitute mycotoxins for glyphosates and metals. They all sadly behave very similarly. Disrupt the gut and kind of what we talked about One of the things that I'm starting to become more and more clear about, which is in line with what Dr. Baker published, is you get this state of dysbiosis, this... Microbial imbalance within the gut. And I'm starting to become fairly convinced that at least in some substantial part of children who have ASD, that the microbiome, the fungal makeup of the gut, which is sadly very hard to assess, is one of the primary drivers of this mast cell activity. And part of that is because it turns out that the fungus in the gut play a really important role, and I can't underline that enough, a really important role in mediating the allergy response. And they perhaps, even though they're not The large part of the total gut makeup, they're less than 1%. They're a very small percentage of all the bacteria that are there. But when you look at the studies reveal that the fungus in the gut is what actually can control the allergy response. And they may be responsible for inducing the allergy response early in life that then leads to food allergies and a host of other things. And one of the things that I've started doing in the last, nine months or so is more aggressively using antifungals So starting off with nystatin, going into fluconazole and ultimately itraconazole. Nystatin is kind of the garden hose. It kind of calms down candida. It doesn't touch anything else. Fluconazole is like the super-powered garden hose. It starts killing off Candida. It doesn't touch anything else. And itraconazole is like bringing in the fire department where you're now killing off any excess mold that may be there. And one of the hypotheses we have is when Candida and these molds get completely out of control and parasites and everything else included in this, that is one of the triggers that causes this constant allergy response, which then causes the inflammation. And so far, touch wood, what I've started seeing in a lot of the kids is as I've started going down this road, and honestly, I've been using less and less binders like charcoal and clay and these things, like they're a very minor part of what I'm doing now. I'm seeing some rather remarkable results where sociability, expressive language, eye contact, just the irritability that these children have are all calming down, which is kind of supporting this hypothesis that perhaps this fungal makeup of the gut is part of what is triggering this constant allergy response that we see on the outside. And I have had some cases where these poor children Not necessarily on the spectrum, but children with like severe eczema, head to toe, like awful scaly symptoms. They're scratching themselves, bleeding kind of eczema. Their eczema starts calming down, like to the point where it's almost gone. It's almost... A little bit too good to be true. And if I didn't see it with my own eyes, I probably wouldn't believe it. But we're seeing some rather remarkable changes in these kids, all hinting to that possibility. Now, should you go run and put your kid on intraconisole? No. Absolutely talk to your provider. If you're a parent, and I'm sure a lot of families who have children on the spectrum have run an organic acid. If you see that tartaric acid, which is one of the fungal markers that either Genova Diagnostics or now Mosaic have, if that tartaric acid is kind of above the reference range, it is one clue. It's not 100% slam dunk my God, this is fungus, I need to go after it. It is a clue that perhaps this fungal dysbiosis is more real than it is. Now, With that, I want to highlight that 50% of the time in my experience, you can have a total distortion of the microbiome and the organic acids look completely normal.
So just because it's normal, it doesn't rule it out. But if it's positive, it's one clue that's hinting, you know, kind of like wink, like, hey, maybe there's something here. Go talk to someone about it.
Len Arcuri | 51:07
Yep. No, that makes sense. And yeah, so tartaric acid being one biomarker that very well might be relevant, might be indicative. And that organic acids test Yes, it's mosaic now. It used to be great planes and people are familiar hearing that particular test. Is there any other tests that a parent can be aware of? Maybe to talk to their practitioner about? Other than an organic acids test, Would any stool test like a CDSA be something that would indicate the fungal presence in the gut? Is there anything of that nature?
Dr. Pejman Katiraei | 51:42
No, sadly, this is really one of the greatest limitations. That we face right now. I'm sure you will I'm guessing you saw the Flintstones when you were little.
Len Arcuri | 51:57
Yeah, I'm that.
Dr. Pejman Katiraei | 51:58
Old. So remember that they had the car with the two stones and they were pedaling? Sure.
So that's essentially where we are in terms of our diagnostic capacity of understanding the microbiome. We think we're really advanced. We think we're in a really sophisticated stage. We're absolutely not. Pretty much, actually not pretty much, all commercially available stool studies, including the fancy ones that claim they can assess the microbiome, have zero ability to pick this up. If you do a stool study, And all of a sudden, candida is showing its ugly face where there's a positive candida effect. And it's elevated. That candida may be hinting at the possibility of a larger distortion within the microbiome. And the reason why I say that is all commercially available stool studies currently have very poor ability to pick up aspergillus and some of these other molds.
So that entire picture is essentially completely missed. There are some antibody tests you can do. There's a company called Alletess, A-L-L-E-T-E-S-S. They can do IgG antibodies against aspergillus, penicillium, some of these molds. Now, what we don't know, and this is the part where there's a big question mark here. We don't know if this IgG reaction is a reaction from... The immune system reacting to foods because foods have mold in them? Is it a reaction to the environment? And I typically do see when these antibodies are elevated, these children have been exposed. Or is it in reaction because those molds are now in the gut and the gut is compromised and the immune system is reacting to the molds within the gut? We don't know. But Sometimes I use these antibody tests as another way to assess what is irritating the immune system with the notion of we don't know where the immune reaction will be coming from.
Len Arcuri | 54:08
And that's very helpful. And yeah, I think we can talk at length about so many of the topics you've already introduced. But I think everything we have covered has been... It does come under this banner of there's a brain that's allergic that's responding in this way. And again, if you look at it from that perspective, whether it's mold, fungal overgrowth, yeast, The list goes on and on. There's going to be some reason, as you mentioned at the top of this discussion earlier, there's a reason for everything.
So to the extent that there's this allergic reaction, it's being driven by something. And again, with curiosity and the right practitioner, Parents, there's so much you can do to better understand what's going on with your child. And once you have that greater awareness, There's lots of options. And you talked about some antifungals, Dr. K. If for whatever reason a parent doesn't want to use those, I'm sure there's more natural herbal approaches as well. There's a lot of different possibilities depending on what you're using. What your guidelines are and what you think is right for your child. There's usually many options to be able to choose from.
Dr. Pejman Katiraei | 55:21
Absolutely. There's so many solutions, so many tools. It's just getting to a place where we understand. How do you use the right tool for the right child at the right time? When you put that together, really cool things can happen.
Len Arcuri | 55:36
That's amazing. I mean, I can't think of a more uplifting statement than that.
So thank you for taking the time to share your wisdom with our listeners. And again, we look forward to having you on again down the road.
Dr. Pejman Katiraei | 55:48
It was my pleasure to be here. I hope that what I shared is helping some of the families out there. I know that it breaks my heart that we have so many kids who are struggling and these beautiful children that. Are limited in their ability to enjoy life and be in the world. And if this conversation helps even a handful of families be able to Just create a brighter, happier, more productive life for their children. This conversation was well worth it.
Cass Arcuri | 56:21
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