a mother holding her bareskin baby

Protect Your Baby’s Health From Allergies Early

One of the best things an expecting mom can do to protect the health of her baby from all kinds of health problems, even before he or she is born, is to take a probiotic.

An extensive meta-analysis of studies by researchers at Imperial College London published recently in PLOS Medicine supports those benefits, showing how probiotics and fish oil may reduce problems in a baby’s early days with eczema and allergies.

Out of more than 400 studies that were examined, 28 trials determined moms who took a probiotic from the 36th week of their pregnancies, then for up to six months while breastfeeding, lowered by 22 percent their baby’s risks of eczema, a skin condition that causes the skin to be irritated or inflamed.

Overall, up to 20 percent of infants are affected eczema, which shows up as patches of red, dry or itchy skin.

Many of the probiotics identified by researchers in their meta-analysis contained Lactobacillus rhamnosus, one of 10 strains of beneficial bacteria found in EndoMune Advanced Probiotic.

A similar pre-birth benefit was discovered by moms who took fish oil daily. Starting from the 20th week of their pregnancies up to four months of breastfeeding, babies avoided common allergies to eggs by a nifty 30 percent.

Interestingly, a mom’s avoidance of foods like nuts, dairy and eggs during her pregnancy made no difference in her baby’s risks of experiencing allergies or eczema.

Your breastfeeding wakeup call

At this juncture, It’s good to remind moms that breastfeeding (along with natural delivery) does a great deal of good for the health of their newborns, as it gives them an extra gut health boost that helps their tiny bodies fight off diseases naturally.

While most experts recommend that moms breastfeed their newborns for as long as they’re able — the American Academy of Pediatrics recommends at least 12 months — even the best choices can fall by the wayside due to unexpected health concerns, like a caesarean (C-section) delivery.

However, moms who can’t breastfeed as long as they planned or at all can do a lot to protect the health of their babies, just by giving them a probiotic made just for them, like EndoMune Jr. Powder recommended for children up to age 3.

Like its “big brother,” EndoMune Jr. Chewable, EndoMune Jr. Powder contains four strains of beneficial bacteria from the Bifidobacteria and Lactobacillus families along with a prebiotic (FOS) that feeds the growing and diverse group of critters in your baby’s gut.

Probiotics: The New Treatment for Peanut Allergies

Allergies to peanuts have become such a big problem for adults and kids — from diarrhea and hives to shortness of breath and life-threatening anaphylaxis — many people avoid them altogether.

Despite federal regulations that ensure packaged foods list the presence of the eight major food allergens, including peanuts, paying attention to the fine print on food labels (especially foods bought in bulk) and restaurant menus requires consumers to be constantly vigilant.

You may recall the results of an Australian study conducted at the Murdoch Children’s Research Institute (MCRI) I posted a while back that found children taking probiotics containing Lactobacillus rhamnosus along with increasing amounts of peanut protein “trained” their immune systems to develop a tolerance to small amounts of peanuts without a problem.

Combining doses of Lactobacillus rhamnosus, one of the 10 strains of beneficial bacteria contained in EndoMune Advanced Probiotic, with peanut protein would shift the body’s allergic response to one of tolerance, researchers said.

At the time, all but five of the 28 children who received this treatment consumed peanuts with few problems. So, would this protection to severe allergic symptoms last?

Commonly, the benefits of such therapies extend for a short time, and very few patients enjoy this protection over the long term, according to medical experts.

The results of follow-up research with 48 children from the previous study (featured recently in The Lancet Child & Adolescent Health) were far better than many expected.

Two-thirds of the kids who were treated with probiotics four years ago and could eat peanuts safely back then were still able to do so.

Even better, more than half of those young patients in the probiotic group were eating 2 grams or more of peanuts at least once or twice a week.

“These children had been eating peanut[s] freely in their diet without having to follow any particular program of peanut intake in the years after treatment was completed,” says lead researcher Dr. Mimi Tang, according to a press release.

“The importance of this finding is that these children were able to eat peanut[s] like children who don’t have peanut [allergies] and still maintain their tolerant state, protected against reactions to peanut[s].”

Now, Australian researchers are hoping to duplicate these impressive results on a larger scale with a larger follow-up study already taking place, says Dr. Tang.

Still, rolling out an effective protocol for patients and doctors could take at least five years if not longer.

Until then, you’ll want to review my tips for avoiding peanut allergens and discuss any strategies to treat them with your family physician first.

Could probiotics be the answer for allergies?

As physicians steer patients away from drugs that can do more harm than good, like antibiotics, probiotics have attracted much attention as a safer way to treat allergies.

For example, giving patients a drink containing a proprietary strain of Lactobacillus casei was shown to boost the immune systems of patients, according to a 2013 PLOS One study we featured in a previous blog post.

Nevertheless, up to 30 percent of all American adults and 40 percent of children suffer from nasal allergies, leading to more than 13 million visits to the doctor, according to the American College of Allergy, Asthma & Immunology.

These numbers could explain why allergies are considered the sixth leading cause of chronic illness in America with an estimated annual price tag of more than $18 billion in healthcare costs, according to the CDC.

The latest study giving probiotics a four-star review was featured in the International Forum of Allergy & Rhinology. It took a look at 23 studies and all but six demonstrated some improvements in at least one aspect of a patient’s health after starting a probiotic regimen.

“When you look at all the studies combined, there was a statistically significant improvement in both the rhinitis-specific quality of life of those patients and in their nasal specific quality of life,” said lead author Dr. Justin Turner, an associate professor of otolaryngology at Vanderbilt University.

Here’s where the results get tricky. The studies that the researchers examined featured probiotics with very different mixes of bacteria and durations of treatments. Some probiotic bacteria were found in foods like yogurt or in supplements like EndoMune Advanced Probiotic.

Is it seasonal allergies or a cold?

Another potential complicating factor, based on a recent survey conducted by Doctor on Demand and Harris Interactive, is not knowing whether the symptoms experienced are derived from allergies or the common cold.

Some symptoms, such as a runny or stuffy nose and sneezing, are shared by colds and allergies. However, more than half of the Americans polled in the Doctor on Demand survey attributed some symptoms (itchy ears and watery and itchy eyes) to colds.

The obvious difference between colds and allergies is the duration. Allergies can go on for months while colds have an expiration date of up to 14 days.

No matter which sets of symptoms you’re experiencing, probiotics can help with allergies and colds by strengthening your immune system to prevent bad bugs and allergens from slowing you down.

Multi-species probiotics like EndoMune Advanced Probiotic or EndoMune Junior contains multiple strains of beneficial bacteria that can be a healthy improvement for your gut and body.

Could probiotics be a future treatment for peanut allergies?

Allergies that come with the flip of a calendar page to spring may be a nagging problem for 50 million Americans but seem very minor when compared to the seriousness of food sensitivities.

Of the eight foods or food groups that provoke 90 percent of the most serious responses, allergic reactions to peanuts are the most common.

Itchy eyes, a stomach ache or a tingling in or around your mouth are considered mild symptoms that may be treated by taking an antihistamine.

More severe symptoms, including breathing difficulties, a dramatic drop in blood pressure and dizziness, are considered life-threatening medical emergencies connected to anaphylaxis, a dangerous whole body reaction by the immune system to an allergen. Such serious reactions necessitate following a prescribed action plan by your doctor, which will likely include an emergency injection of epinephrine and a trip to the ER.

Unfortunately, the number of children under age 18 who are vulnerable to allergies to peanuts and tree nuts (walnuts, almonds, cashews) is growing, according to a 2010 study published in the Journal of Allergy and Clinical Immunology.

The Good News

A recent double-blind study that treated children with probiotics over 18 months offers some evidence of a safe, long-term solution to peanut allergies.

Australian researchers from the Murdoch Childrens Research Institute compared the effect of taking a probiotic containing a proprietary strain of Lactobacillus rhamnosus (also one of several beneficial strains of bacteria contained in EndoMune Advanced Probiotic) along with an increasing course of peanut protein in a double-blind, placebo-controlled trial of 60 children.

Of the 56 children who finished the 18-month trial, all but five of the 28 young patients who received probiotics could safely tolerate eating 4 grams of peanut protein without a problem, compared to only one of the placebo group. Also, the beneficial effect of the treatment lasted up to five weeks in some patients.

Researchers are planning a follow-up study that would measure the response of this treatment three to four years after giving patients probiotics.

More Research

Although some experts aren’t sure if probiotics were the answer, recent research with mice by scientists at the University of Chicago Medicine & Biological Sciences may provide some clues.

Two sets of mice (one was born germ-free while the other was treated with antibiotics at birth) with limited gut bacteria displayed a strong reaction to peanuts when compared to normal mice. Introducing a strain of Clostridia back into the guts of mice reversed these reactions, but a second group of intestinal bacteria tested by scientists (Bacteroides) failed.

“It’s exciting because we know what the bacteria are; we have a way to intervene,” says Dr. Cathryn Nagler, senior study author, in a news release. “There are of course no guarantees, but this is absolutely testable as a therapeutic against a disease for which there’s nothing. As a mom, I can imagine how frightening it must be to worry every time your child takes a bite of food.”

Tips to Avoid Peanut Allergens

Some tips you must consider to avoid allergic reactions to peanuts:

  1. Know what you’re eating, especially at restaurants, parties and the homes of friends. Don’t be afraid to ask about peanut ingredients in prepared foods if you have any doubt about their safety.
  2. Peanut allergens floating in the air can cause allergic reactions, so be cautious about your environment.
  3. Read food and product labels carefully before using them. Some shampoos, pet foods and lotions contain peanuts.
  4. Be prepared for the worst by taking an epinephrine shot with you at all times.

Additionally, despite this good news about probiotics and a healthy gut microbiome being a possible solution one day to lessening peanut allergies, I strongly recommend seeking the advice of your family doctor first to guide you in the treatment of peanut allergies.

10 safe, natural ways to stop allergies

With the warmth of spring comes the nagging irritation of allergies for 50 million Americans, according to the American College of Allergy, Asthma & Immunology.

Unfortunately, spring allergies could stretch long into the summer depending on where you live, and factors like the priming effect, climate change and hygiene hypothesis could influence their severity. Complicating the treatment of allergies further are the unexpected side effects that arise from relying too often on antihistamines.

National Asthma and Allergy Awareness month has come around at the ideal time to remind you of the many ways you can keep these pesky allergens from harming your health without drugs. What follows are 10 completely safe and effective ways to do just that.

Keep it clean

1. To prevent allergens from following you into your home, wash your body every day and change your clothes. And, don’t forget to leave your shoes at the front door too.

2. A 2013 study in the Annals of Internal Medicine found acupuncture, a natural treatment that brings pain relief to millions, may also be effective for allergy sufferers. Patients who received acupuncture showed greater improvements and didn’t use their antihistamines as often.

3. Cutting back on fast foods and eating at least three servings of fruit per day may reduce symptoms. Consuming fast food at least three times a week elevated the risks of severe asthma by up to 39 percent among young children and teens.

4. Checking local weather reports every day for pollen counts is crucial. You can also access online resources like The Weather Channel’s Allergies page or the National Allergy Bureau to get personalized forecasts for your area.

5. Closing your windows and running your air conditioner longer will add to your energy costs, but doing both will reduce pollen from swimming into your home.

Protect your bedroom from allergy invaders

6. You spend more time in your bedroom than any other place in your home, thus it’s important to wash all bed sheets, pillow cases and blankets in water heated to at least 130 degrees Fahrenheit every week, according to the Mayo Clinic.

7. Invest a little money by having professional cleaners do a deep cleaning of your entire home, including baseboards, window shades, tile floors and ceilings. And, don’t forget to change your home’s air filters promptly and wash your washing machines to remove extra surprises.

8. Although washing pets can be problematic — your cat will hate you for even considering it — create allergy-free zones in your home to restrict their access, according to the Humane Society of the United States.

9. Working to alleviate the stressors that flood your head may reduce the number of flare-ups with more intense symptoms, according to a recent Ohio State University study.

10. Because your body is under non-stop attack from allergens, taking a probiotic may help, as this recent PLOS ONE study showed in boosting the immunity of patients to hay fever.

With its multiple strains of beneficial bacteria, EndoMune Advanced Probiotic boosts your immune system naturally and safely while maintaining your good gut health.

More And More Research Affirms The Benefits Of Healthy Bacteria

Dear EndoMune subscribers,

This month’s newsletter looks at some of the recent research on the positive effects healthy bacteria can have on the digestive system.

When I went into medicine, we spent a long time studying how bacteria caused serious infectious diseases. We learned about the importance of antibiotics and when to use them.

We never had a lecture on how certain bacteria (microflora) have co-evolved with us and how they help maintain our health.

No one really knew much about these healthy bacteria. But it turns out that they are essential for human life. We need them in our gut to digest food, synthesize certain vitamins and form a barricade against disease-causing bacteria.

But what do they look like in healthy people, and how much do they vary from person to person?

“Studies have found that the healthy bacteria can inhibit intestinal immune system from producing immune reactions against food protein lessening the risk of asthma, eczema and other allergies.”

Human Microbiome Project

The National Institute of Medicine launched the Human Microbiome Project1 (HMP) in 2008. It’s a five-year program to better understand how the bacterial communities (microbiome) that live on and in the human body protect our health.

The HMP involves 200 scientists at 80 institutions. Using the latest genetic techniques, they collect samples of bacterial genetic material from 242 healthy people.

The samples have been collected from five areas of the body: the digestive tract, the mouth, the skin, the nose and the vagina.

The projects reveal some of the ways in which invisible or microscopic bacteria shape our lives from birth to death. The ultimate goal is to test whether changes in the human microbiome are associated with human health or disease.

Benefits of a Healthy Microbiome

For example, researchers2 at Baylor College of Medicine have found that the vaginal bacterial flora or microbiomes change during pregnancy. Particular species, like Lactobacillus johnsonii, become dominant. This bacteria is usually found in the human intestinal tract where it produces enzymes that promote digestion of milk and substances that destroy harmful bacteria.

These findings have implications for the newborn. Before birth, the infant is in a sterile environment. The initial exposure to the world of bacteria is during the passage through the birth canal. It has been speculated that the baby will ingest some of the Lactobacillus johnsonii which will aid in digesting breast milk.

Babies born by Caesarean section start out with different microbiomes, but it is not yet known whether their microbiomes remain different after they mature.

During infancy, the baby’s intestinal microbiome expands and is impacted by breastfeeding. A study of 16 lactating women3 found that human breast milk had up to 600 bacterial species and resistant starches. Breast milk helps to promote the healthy intestinal bacteria which aid in digestion, immune function and protection from harmful bacteria.

Studies have found that the healthy bacteria can inhibit intestinal immune systems from producing immune reactions against food protein lessening the risk of asthma, eczema and other allergies.

Future Research Projects

In addition to the above studies, the HMP is doing research on the how the skin microbiome may play a role in skin disorders like psoriasis and eczema.

Other research projects are evaluating the intestinal microbiome in obese versus normal weight individuals. Previous studies have found that there is a difference in the bacterial flora in obese and thin animals and humans. Hopefully, the flora can be manipulated to lessen obesity and the associated disorders of diabetes, hypertension and heart disease.

The point of this newsletter is that the scientific community now recognizes the importance of maintaining a healthy microbiome. The concern is that antibiotics can upset the healthy microbiome and can contribute to chronic disorders like Crohn’s disease, ulcerative colitis and allergies.

Take Home Message

Consider taking a high quality probiotic like EndoMune to maintain a healthy microbiome balance.

Remember, EndoMune contains 10 strains of bacteria, and it is the only probiotic on the market developed by a board certified gastroenterologist.

Eat healthy, exercise and live well!!!
Best Wishes,
Dr. Hoberman


1) Structure, function and diversity of the healthy human microbiome. Human Microbiome Project Consortium.Nature. 2012 Jun 13;486(7402):207-14. doi: 10.1038/nature11234.

2) A metagenomic approach to characterization of the vaginal microbiome signature in pregnancy. Aagaard K, Riehle K, Ma J, Segata N, Mistretta TA, Coarfa C, Raza S, Rosenbaum S, Van den Veyver I, Milosavljevic A, Gevers D, Huttenhower C, Petrosino J, Versalovic J. PLoS One. 2012;7(6):e36466. Epub 2012 Jun 13.

3) Characterization of the diversity and temporal stability of bacterial communities in human milk.Hunt KM, Foster JA, Forney LJ, Schütte UM, Beck DL, Abdo Z, Fox LK, Williams JE, McGuire MK, McGuire MA.PLoS One. 2011;6(6):e21313. Epub 2011 Jun 17.

Healthy Benefits of Probiotics for Children

As we start the New Year with resolutions for living healthy, I want to share with you an article(1) that assesses the healthy benefits of probiotics for children.

The December issue of Pediatrics included a report, “Clinical Report – Probiotics and Prebiotics in Pediatrics,” prepared by the Committee on Nutrition, a component of the American Academy of Pediatrics – an organization comprised of 60,000 pediatricians.

The purpose of the report was to provide guidance to pediatric health care providers on the usefulness and benefits of probiotics and prebiotics for children. In doing so, the committee:

  1. Reviewed published clinical studies that provided children with probiotics or prebiotics to prevent or treat a variety of health issues, and
  2. Analyzed the quality of the reports and determined whether there was enough evidence to recommend the use of probiotics for the specific disorders.

In the last five years there has been an explosion of clinical studies using probiotics. Most of the studies have proven efficacy or general positive benefits, leading to an increase in the recommendation of probiotics by mainstream medicine.

Committee on Nutrition: Probiotic Recommendations

After thoroughly reviewing and assessing previous studies, the American Academy of Pediatrics’ committee suggested probiotics and/or prebiotics may have a positive impact on the following conditions.

#1: Acute Infectious Diarrhea
The committee reviewed studies to determine if probiotics could prevent episodes of acute infectious diarrhea that occur in child care centers. Based on available studies, the committee did not recommend routine use of probiotics to prevent acute infectious diarrhea but did acknowledge there may be special circumstances that probiotics are beneficial.

#2: Viral Gastroenteritis
Trials of using probiotics to treat children with acute infectious diarrhea found that probiotics shortened the illness in children with viral gastroenteritis by one day. The conclusion stated “there is evidence to support the use of probiotics early in the course of childhood acute infectious diarrhea.”

#3: Antibiotic-Associated Diarrhea
Review of trials using probiotics to prevent antibiotic-associated diarrhea found that probiotics were beneficial. Antibiotics can decrease the healthy intestinal bacteria population and allow the unhealthy bacteria to overgrow and cause diarrhea. The conclusion was that probiotics can be used to reduce the incidence of antibiotic-associated diarrhea.

The committee reviewed numerous clinical trials that used probiotics to treat and prevent other pediatric medical disorders. While some of these studies found specific benefits, the general recommendation was that further studies were necessary to prove efficacy for the following conditions:

  • Irritable Bowel Syndrome
  • Infantile Colic
  • Ulcerative Colitis
  • Eczema

Prebiotics and Allergy Reduction

The committee also reviewed medical trials using prebiotics. Prebiotics refer to a special class of fiber in our diet that acts as “food” for the healthy bacteria, Lactobacillus and Bifidobacterium. These bacteria use the prebiotic as a source of nourishment for their growth and activity.

Studies of adding prebiotics to infant diets found reduced incidence of allergies. The conclusion of the committee was that “confirmatory studies of the benefits of prebiotics….are needed before recommendations cam be made…”

Safe and Promising Supplements

The committee also commented on the safety of both probiotic and prebiotic supplement. They stated “to date, these products seem to be safe for healthy infants and children.” Caution should be used in giving probiotics to children with compromised immune function.

The committee was generally positive about the use of probiotics in children. But, it was being very responsible in not making general recommendations. Although there are positive studies for the clinical use of probiotics, the committee wants to see more studies to confirm the benefits. Further confirmatory studies are being accomplished to prove the clinical health benefits. We await the next updated report.

In the meantime, if your child is suffering with one of the disorders mentioned above, it seems reasonable to consider a therapeutic trial with a probiotic like EndoMune – a safe supplement that contains both probiotics and a prebiotic.

Wishing you and your loved ones a very healthy 2011.

Eat healthy, exercise and stay well.
Dr. Hoberman


(1) Probiotics and prebiotics in pediatrics. Thomas DW, Greer FR; American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition. Pediatrics. 2010 Dec;126(6):1217-31.

Probiotics May Decrease Allergies

The increased sterilization and pasteurization of foods has led to a decrease in the amount of bacteria to which we are exposed. There is a potential this has led to the increase in allergies which today’s children are experiencing.

A Finnish team of researchers conducted a study with pregnant women; some received a probiotic while others received a placebo. From eight months pregnancy to delivery, these women took a daily dose of probiotics or its placebo counterpart.

The children were examined by pediatricians at 3, 6 and 24 months of age. The conclusion was that:

To read the article in its entirety, visit:

  • Key proteins associated with tissue inflammation were 50% higher on average in the blood of probiotic-treated infants than in the blood of placebo-treated infants. Inflammation is thought to stimulate the immune system, and so reduce allergic reaction.
  • Probiotic children were 30% less likely than their untreated counterparts to develop an itchy skin condition known as atopic eczema, which is often an early manifestation of allergies.

While more research is needed, it seems plausible that probiotics may be a key ingredient to decreasing the likelihood of your child developing allergies.

Probiotics and the Prevention of Food Allergies

Most of us are familiar with the term “food allergy.” Case in point, children with an allergy to peanuts can experience allergic reactions ranging from hives to coma, or even death. Sensitized children must have medication with them at all times to immediately treat reactions.

Strict avoidance of peanuts is their sole option to stay well. Schools have tried to create awareness for students and their parents to avoid bringing foods like peanut butter to school if there is a child with a peanut allergy.

In the last two weeks, there have been a number of news reports on the dramatic increase in food allergies experienced by children.

In the June issue of the medical journal Pediatrics(1), a study found that about eight percent of children under the age of 18 (almost 6 million) suffer from one or more food allergies. These numbers are twice as high as reported by the CDC in 2007, which reported a rate just below four percent. Additionally, the severity of the episodes has increased.

The lead author of the June study, Dr. Ruchi Gupta, reported that “based on our data, about one in 13 children has a food allergy. We are seeing a lot more cases in schools than we used to see. It does seem that food allergy is on the rise.” In addition, Dr. Gupta noted, “What’s more, nearly two out of every five affected children suffer from a severe food allergy. For these children, accidental ingestion of an allergenic food may lead to difficulty breathing, a sharp drop in blood pressure, and even death.”

With the growing severity of food allergies, how can probiotics help? There are some very interesting studies that suggest probiotics may lessen the risk of food allergies in children.

To get a better understanding of this topic, this newsletter will discuss:

  • What is a “food allergy”
  • What is the cause
  • How to diagnose a food allergy
  • How is a food allergy treated
  • Can probiotics help lessen the risk of developing a food allergy

What is food allergy?

Food allergy is a term used to describe an adverse immune response to a protein in some foods.

When we are born, our intestinal immune cells have to constantly survey what is being ingested. The immune cells determine if they have to mount a protective reaction to a potentially harmful virus, bacteria, parasite or toxin.

Sometimes, the immune cells react to harmless proteins in our food and produce antibodies that can result in allergic reactions like hives, eczema, asthma, rhinitis and gastrointestinal symptoms of cramps, nausea, vomiting and diarrhea.

The most serious reaction is called anaphylaxis, which causes severe breathing difficulty and a major drop in the blood pressure. Oxygen, epinephrine injections and IV fluids can be lifesaving.

Anaphylactic reactions due to food allergies account for 30,000 episodes annually and possibly 200 deaths each year.(2)

The CDC estimates that eight types of foods are responsible for 90 percent of all food allergies in children: milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.

What is the cause of a food allergy?

The exact cause of food allergies is not known. However, there have been several proposed explanations why food allergies occur and have been on the increase over the last 20-30 years.

Factors thought to contribute to food allergies include genetic predisposition and the introduction of foods too early in infancy.

The other major factor is the “Hygiene Theory”.(3) This theory is based on the idea that in the Western developed countries the exposure to harmful bacteria, parasites, viruses and other toxins has decreased due to our efforts at keeping everything sanitized. As a result, our immune system has more time to spend mounting a reaction to harmless proteins in our diet and other allergens like pollens.

Epidemiologic studies have found that the prevalence of allergies is highest in developed countries.

Over the last 30 years there has been a two-to-three fold increase in childhood allergies in developed countries when compared to those less developed.(4)

There have been a number of reports that have found children growing up on a farm have less allergies.(4) Playing with animals and in the dirt may actually be healthy.

How to diagnose food allergies?

A child might have a food allergy, if he/she has recurrent swelling of lips and face, hives, eczema, wheezing, stuffy nose, abdominal pain, diarrhea.

The best method for diagnosing food allergy is to be evaluated by an allergist. The allergist will review the patient’s history and the symptoms or reactions that have been noted after food ingestion. If the allergist feels the symptoms or reactions are consistent with food allergy, special tests can be performed.

Skin testing can aid in detecting the antibody(IgE) to the suspected food protein.

Blood tests can measure IgE antibodies

Sometimes it is necessary to perform a food challenge while being observed by the physician

How is a food allergy treated?

The only proven therapy is food elimination. All patients at risk for anaphylaxis must be trained to identify early symptoms and be prepared to use an auto-injectable epinephrine pen.

Can Probiotics lessen the risk of developing a food allergy?

To understand how probiotics may lessen the risk of food allergies requires a little primer on how the immune system in the intestines works.

Seventy percent of our immune system is in the intestines. Since the intestines serve as our window to our environment, it is important that the intestines monitor our exposure to harmful infections and toxins.

The lymphocytes (immune cells) in the intestines are of several types:

Th1 helps to fight infections due to bacteria and viruses

Th2 responds to infections caused by parasites

If an infant is not exposed to infectious bacteria and viruses, then Th1 will be less active, causing a shift in the balance of activity in favor of the Th2 lymphocytes, producing antibodies to parasites and also to harmless allergens.

Recently, another lymphocyte called a regulatory cell (Treg) has been identified(5). This lymphocyte can regulate the activity of both Th1 and Th2 lymphocytes.

Probiotics can modulate the immune response by acting on the Treg cells. Studies have shown that probiotics can decrease or down regulate the activity of the Th2 cells and lessen the immune reaction against proteins in foods. (6,7) The term “oral tolerance” is used to describe the process when the immune cells don’t mount a reaction.

Mice raised in a germ-free environment do not develop oral tolerance to food protein.(8) But when a mixture of oral probiotics were given to the mice, the IgE antibodies were not produced.

Since 1997, probiotics have been used in the management of food allergy. Infants with eczema due to cow’s milk had improvement when given a probiotic in their formula.(8)

In another study, either probiotics or a placebo were given to mothers during the last 4 weeks of their pregnancy. Their newborn infants were breast fed and given a probiotic supplement or a placebo for 6 months. The children who were exposed to probiotics had a 50% reduction in allergies compared to the placebo group.(9)

Not all clinical studies have shown that probiotics are able to lessen allergic diseases in children.(10) The good news is that the probiotics seem very safe. No serious adverse effects have been reported in the clinical studies.

There is no question that probiotics can influence the intestinal immune system to lessen allergic responses. Some of the future challenges include determining the most effective:

  • Probiotic strains
  • Combination of bacterial species and strains
  • Dose of bacteria in a serving size
  • Timing of introducing the probiotic to the infant/child
  • Duration of probiotic therapy

Take Home Message

If you don’t live on a farm or your child doesn’t include dirt in their diet, you might consider giving your child a probiotic. For women who are allergy prone, taking a probiotic like EndoMune may help prevent eczema in their offspring. In addition, giving EndoMune Junior to your child during infancy may help to lessen the risk of developing allergies. It is always recommended that you talk with your doctor before taking new medications and supplements.

Eat healthy, exercise and live well!

Dr. Hoberman

(1) The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States.Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL.Pediatrics. 2011 Jun 20

(2) Epidemiology of anaphylaxis in Olmsted County: A population-based study. Yocum MW, Butterfield JH,Klein JS, Volcheck GW, Schroeder DR, Silverstein MD.Yocum MW,Butterfield JH, Klein JS, Volcheck GW, Schroeder DR, Silverstein MD.

(3) The hygiene theory: fact or fiction? Sheikh A, Strachan DP.Curr Opin Otolaryngol Head Neck Surg. 2004Jun;12(3):232-6. Review.

(4) Exposure to environmental microorganisms and childhood asthma. Ege MJ, Mayer M, Normand AC, Genuneit J, Cookson WO, Braun-Fahrländer C, Heederik D, Piarroux R, von Mutius E; GABRIELA Transregio 22 Study Group. N Engl J Med. 2011 Feb 24;364(8):701-9.

(5) Hygiene theory and allergy and asthma prevention. Liu AH.Paediatr Perinat Epidemiol. 2007 Nov;21 Suppl 3

(6) Probiotics, prebiotics, and synbiotics: impact on the gut immune system and allergic reactions.Gourbeyre P, Denery S, Bodinier M. J Leukoc Biol. 2011 May;89(5):685-95.

(7) Food allergy and probiotics in childhood. del Giudice MM, Leonardi S, Maiello N, Brunese FP. J Clin Gastroenterol. 2010 Sep;44 Suppl 1:S22-5.

(8) Probiotics: a novel approach in the management of food allergy.Majamaa H, Isolauri E.J Allergy Clin Immunol. 1997 Feb;99(2):179-85

(9) Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial.Kalliomäki M, Salminen S, Poussa T, Arvilommi H, Isolauri E. Lancet. 2003 May 31;361

(10) Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial.Abrahamsson TR, Jakobsson T, Böttcher MF, Fredrikson M, Jenmalm MC, Björkstén B, Oldaeus G.J Allergy Clin Immunol. 2007 May;119(5)

Yale Workshop on Probiotics Presents New Research

I just returned from the 3rd Yale Workshop on “Advances in Probiotic Use” and am pleased to report there is a large amount of active research in the area of the intestinal bacteria. Namely, research is examining how bacteria impact human health and disease.

Among various findings, researchers presented new information about how probiotic bacteria can modulate the intestinal immune system. They have discovered how probiotic bacteria interact with the intestinal lining cells to improve the inflammatory conditions that occur due to infection colitis and ulcerative colitis.

In addition, there were a number of discussions about how the healthy intestinal bacteria can break down or ferment indigestible dietary starches. The breakdown products (short chain fatty acids) enhance the intestinal function, improve intestinal motility and lessen the risk of colon cancer. This is called a symbiotic relationship – mutually beneficial for the human host and the bacteria.

The conclusions from the various presentations are that probiotics can:

  • Lessen irritable bowel syndrome symptoms
  • Shorten the duration of infectious diarrhea in children
  • Aid in the prevention of antibiotic-associated diarrhea
  • Aid in the management of ulcerative colitis
  • Aid in the prevention of childhood allergies like eczema

Transplantation Therapy to Improve Bacteria Balance

An infection with a bacterium called Clostridia difficile can cause life-threatening colitis. The infection occurs when the healthy intestinal bacteria are reduced as a result of taking an antibiotic for something like a sinus infection.

There are special antibiotics that can destroy the Clostridia difficile infection. Unfortunately, there is a tendency for the infection to recur multiple times in the same person despite taking appropriate antibiotics to kill the Clostridia difficile organisms.

In an attempt to treat Clostridia difficile, a new innovative form of therapy was also discussed. The therapy involves the transplantation of stool from healthy individuals into patients as a means to re-establish a healthy intestinal bacterial balance.

There have been a few published case reports dating back to 1958 of transplanting healthy stool into patients who had recurrent Clostridia infections, and the results were very promising. Larger trials of infusing suspensions of healthy stool into ill patients have been recently done. The results have shown a cure rate of more than 90% within two days!!

This presentation was very thought provoking. To have this type of cure rate certainly indicates the importance of the healthy intestinal bacteria. The procedure is aesthetically unpleasing, but the alternative is to give the healthy bacteria in capsule form – accomplished when probiotics are prescribed.

Take Home Message

All of the presentations at the Yale Workshop provide further evidence of the importance of a healthy balance of intestinal bacteria. In addition, the studies confirm that probiotic bacteria have many beneficial benefits in helping to improve and maintain normal intestinal immune and digestive functions.

Please consider taking a high quality probiotic like EndoMune if you are going to take antibiotics or if you are struggling with ongoing GI symptoms despite medical evaluation.

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