086: Allergies, Your Immune System & Skin Rashes w/ Dr. Maya Shetreat

In today's world, germs are the enemy. We are constantly washing our hands, wiping down surfaces, and slathering on the hand sanitizer. But what does this over-sanitization mean for our skin and overall health?

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Maya Shetreat, MD is a neurologist, herbalist, urban farmer, and author of The Dirt Cure: Healthy Food, Healthy Gut, Happy Child (Simon and Schuster, 2016), which has been translated into ten languages.

She has been featured in the New York Times, The Telegraph, NPR, Sky News, The Dr. Oz Show, and more. Dr. Maya is the founder of the Terrain Institute, where she teaches Terrain Medicine™, earth-based programs for transformational healing.

She works and studies with indigenous communities and healers in Ecuador, and is a lifelong student of ethnobotany, plant healing, and the sacred.

Has spending more time in nature improved your overall health? Let me know in the comments!

In this episode:

  • The problem with over-sanitization
  • How antibiotics affect the gut
  • Connection between the immune system and the skin
  • Does over-sanitization as children affect us as adults?


“Everything's connected in the body. And this is a thing I think that unfortunately is forgotten about by all doctors and especially by dermatologists. Dermatologists are always thinking topical. Like, what will I do topically rather than thinking that, you know, how we heal skin is from the inside out.” [5:51]

“The immune system is a remote system. So when something's activated in one place, like the gut, it can totally cause symptoms in another place like the skin.” [8:56]

“What you need for a healthy immune system, particularly in infancy and childhood but throughout life at any point in life, is you need small stressors. And that's a concept called hormesis, which is the idea that something that might be toxic in a large amount, in a very tiny amount it actually optimizes health.” [13:20]


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086: Allergies, Your Immune System & Skin Rashes w/ Dr. Maya Shetreat FULL TRANSCRIPT

Jennifer: Hi everyone. Welcome back to the Healthy Skin Show. Today's guest is someone who I'm very, very excited to introduce to you and in fact I've been like doing happy dances knowing that this interview is coming up because I was so excited to have her on the show. If you haven't heard of Dr Maya Shetreat, well, you are going to hear from her in a moment and I'm so grateful that she was able to make time in her schedule to share her knowledge and wisdom with us. She's a neurologist, herbalist, urban farmer and author of the dirt cure, healthy food, healthy, healthy food, healthy gut happy child, which has been translated into 10 languages. She's been featured in the New York times, the Telegraph, NPR, sky news, the dr Oz show and more. Dr Myron is the founder of the terrain Institute where she teaches terrain medicine, which is earth-based programs for transformational healing.

Jennifer: She works in studies with indigenous communities and healers in Ecuador and is a lifelong student of ethnobotany, plants healing and the sacred. Thank you so much for joining us, Dr Maya. So the reason that I wanted to have you here is because I feel like you are one of the experts that I have massive respect for as far as herbal knowledge is concerned. And then also too this understanding this deep wise understanding that the excessive amount of sanitisation in our society has had this incredibly detrimental impact on pretty much everything. So I'm just curious like why exactly did you start to become interested in this whole concept of sanitization?

Dr. Maya: Well, so I actually kind of came to it from the other direction because my son had gotten sick. And he had started to have asthma symptoms at a year of age and at the same time as he had these nonstop asthma symptoms, he started to also have a developmental plateau or really like a little bit of a regression and he was like falling but not catching himself. And it was, he wasn't gaining new words for a while. It was a very, it was a very stressful time and it turned out after 10 months and basically zero help from, you know, my colleagues, my physician colleagues who all were like, okay, well he's just, you know, a reactive kid. And you could hear the same thing about a kid with eczema too, or an adult. We realized through our own research that he was actually allergic to soy and so he had been though already once we stopped soy, his breathing got better, he was doing great, but being on antibiotics and oral steroids and all the medications that are given to people when they have you know, a chronic health problem ended up sterilizing his gut and really impacting his microbiome, which is the three to five pounds of micro organisms that live in and on our bodies and that are instrumental in our immune health, our skin health, our gut health, our mood, our brain, everything basically.

Dr. Maya: So my job at that point for him was to help repopulate, you know, help him recover essentially from this insult that happened. Not as much from the soy, which was its own problem, but from all the medications he'd gotten. And that ultimately had been a very sterilizing experience because things like steroids and antibiotics and, and you know, antibacterial soaps and all these different things do end up kind of sterilizing our bodies and the fact that we really don't spend nearly as much time outside as we used to as a society. So all of these different things drew me to well what can I do to recover not just his body but then of course my patients as well because so many of my patients had gone through something similar.

Jennifer: It's interesting too that you mentioned this concept of like chronic illness seems to have this similar track of antibiotics, steroids, and also too this over-clean environment where we don't go outside, we don't want to be in the dirt, we don't want to expose ourselves to germs and people end up getting sicker. So I'm curious, I mean, I know a lot of the the soaps, the antibacterial soaps, how are supposed to not be on the market anymore, but hand sanitizer, hand sanitizers are sold rampantly. And even handed out, we've got the dispensers all over the place in, in different areas and different establishments. Do you feel like the antibiotics, even if you take them orally, do you feel like that also is almost like a side effect of the bomb that goes off in your gut as to what happens on the skin? Is there a direct connection?

Dr. Maya: Yeah, I mean I think definitely so if you're taking it orally, of course it's going to impact the digestive tract first and foremost. But it changes, you know, it changes the microbiome of the body. So everything's connected in the body. And this is a thing I think that unfortunately is forgotten about by all doctors and especially by dermatologists. Dermatologists are always thinking topical. Like what, what will I do topically rather than thinking that, you know, how we heal skin is from the inside out, right? It's not like, you know, skin is sort of like a Sentinel of what's going on in the gut, for example. And the gut itself, the gut lining is actually a specialized skin. It is its own kind of skin because the gut is really outside the body even though we don't think of it that way.

Dr. Maya: So it's like open at the mouth and opened at the other end and everything inside is just a specialized form of skin essentially. And then we have our skin on the outside as well, and they really reflect each other, kind of like mirrors of each other. So very often when I see someone who has issues in their skin, I immediately start thinking about their gut and their immune system and what they're eating and if they've had antibiotics and all of those things because that they're very connected.

Jennifer: Okay. So I'm thinking a person who's coming from the dermatologist who's listening to this going, okay, I got it. So there's a connection between the gut and the skin, but then you mentioned the immune system. So could you tell us a little bit about what you mean and the connection between the immune system and skin?

Dr. Maya: Yeah, absolutely. So you know, like I said, everything's connected. So we think, you know, often because we have a doctor for skin, a doctor for the gut, a doctor for the immune system, doctor for the brain. But like all of these things are kind of separated, but they're all really connected. And so for example, the gut has a massive amount of like lymph nodes and immune cells basically that are, are working all the time as different microbes and foods and chemicals come through the gut. And then those immune cells activate and the activation happens through something called cytokines. And cytokines are the way immune cells talk to each other, but they travel. So let's say you have immune cells in the gut that are activated because you ate dairy for example. And dairy for some reason, activates your immune system.

Dr. Maya: Your immune system's thinking, Hmm, maybe this isn't so friendly for my body. You know, this isn't a friendly compound. It will start to send out an alarm and the alarm is the cytokines which travel through the body and activate immune cells all over the body. So it can happen in the skin and that will cause inflammation in the skin. It can happen in the brain, it can cause inflammation or kind of malfunctioning of neurons in the brain. It can happen in the lungs and cause asthma. It happens all throughout the body in different ways and causes different symptoms. But the immune system is a remote system. So when something's activated in one place, like the gut, it can totally cause symptoms in another place like the skin.

Jennifer: When you say that, I'm also thinking what does that mean though for somebody that develops like ton of allergies, like legit allergies, not an intolerance to something or a sensitivity, but all of a sudden they're allergic to everything in their environment. Like to some degree it's like they're on Zyrtec all the time and that's barely making a dent. What would you think about someone in that particular situation?

Dr. Maya: Well, typically it's because there's been some significant instigator of the immune system. And oftentimes if it's someone who has a lot of different legit allergies, IgE, testable allergies, I do it in the blood for food people we'll get skin. Allergists will always tell you skin, you know, kind of prick testing is the more valid. But for systemic symptoms, I find blood is a really important way to test. So when they have legit allergies and there are many, many for me it's very commonly a mold exposure

Jennifer: I love where we're going here. So mold exposure just in the home. Like, Hey, I have a leaky pipe and my bathroom is moldy. Or is this something where you could then, or instead actually have an infection inside your body itself?

Dr. Maya: Well, typically it's going to be an environmental exposure. So you know, what it would be is maybe there was a flood at one point, a leak at one point, and then mold grows in the wall. Usually it's often even invisible. And then it gets activated and spores are released every time there's another little leak. So even if you don't really see it, if there's ever been a flood, like there could be mold, you know, and then it gets into the environment. And that can be in someone who's vulnerable, it can trigger a multitude of allergies all at once. So if I see someone who has one allergy or two allergies, I'm less likely to think it's triggered by mold. It's not impossible. But if it's someone with an array of allergies or like they're allergic to every food even low level allergic to every food on blood testing, then I'm usually likely to investigate the mold question pretty carefully.

Jennifer: Interesting. And you know, it's funny because a lot of people who listen to this podcast really struggle with allergies. So I think that this is an awesome, I feel like it's all connected though. This isn't like a diversion from the topic because what you're essentially saying is that if we have all these exposures of of antibiotics, sanitizers, et cetera, things that impact the microbiome and then we have these other exterior environmental exposures that then introduce things like mold where our system is then going bonkers and haywire and now we have these other crazy symptoms. This can explain why you're sitting there going, how did this happen? How did I get here? How did I end up with all of these allergies? I don't know why I'm so allergic. So do you feel like when kids, especially if they're exposed to an environment that is incredibly steroid sterilized, so mom is constantly wiping everything down, she's like, you know, wash your hands with rubbing alcohol and constantly just making sure that everything is not dirty and then we're using antibiotics a ton for every little cold and sniffle and whatnot. Do you feel to some degree that that sort of sets the stage for kids and even those adults where the immune system doesn't exactly know how to operate normally?

Dr. Maya: Absolutely. I think really what it comes down to is resilience. So what you need for a healthy immune system, particularly in infancy and childhood but throughout life at any point in life, is you need small stressors. And that's a concept called hormesis, which is the idea that something that might be toxic in a large amount, in a very tiny amount is actually it actually optimizes health right and inspires health in the cell, let's say. So an example would be like you know, we think of germs as, or we have in the past a lot of germs as being bad. And now we know that we need some exposure to germs in order to be healthy. And it's a little, it's like a little bit of a stressor, right? A little dirt, a little exposure to germs, getting actually even infections, believe it or not, is really important to teach the immune system what to do in case of an invader, right?

Dr. Maya: I mean, so the important thing to know about the immune system is we think it's so terrible to get infections and that is definitely a sort of spin that's come, you know, from the medical establishment that sort of comes all the way back from Louis Pasteur and germ theory. And I go into that actually quite a bit in my book, which I won't now for the sake of time, but, but really what it comes down to is immune system is a very social system. So it's not just like an army ready to attack. That's actually only one aspect of the immune system. The immune system wants to meet and greet everything that comes through. So it wants to see different compounds, different microbes, and kind of check them out and say, okay, you're all right, I know you okay, you're okay. You know, and kind of it's really interactive.

Dr. Maya: And then that means that it's going to have so much experience identifying diverse microbes, diverse food compounds, et cetera. It's going to really know when to get up in arms, right. And kind of mobilize that army. And that's mobilizing the army is asthma. It's the eczema, it's, you know, psoriasis, it's celiac, it's on and on and on. All these autoimmune and allergic kinds of conditions. But if an immune system doesn't see a lot of different organisms and doesn't see, doesn't get challenged, right? Meaning getting the infections, meaning having the kid, the kids, right? Like there is a reason that babies, for example, start out crawling and putting everything in their mouths. It's literally for them to see their microbiome and get and, and challenge their immune system. That is developmentally and evolutionarily the way the immune system for even being born vaginally is another way, right?

Dr. Maya: Like being born vaginally, it's like quote unquote kind of dirty, right? I mean, there's, they're swallowing vaginal fluid, they're coming out of the perineum, right? We think of this as like, Ooh, because we're squeamish about that, but that's actually how we seed the gut, seed the microbiome, and really start out by challenging and stimulating the immune system in these small ways that the immune system is evolutionarily prepared to do so. When we take away these opportunities for infection, small infection, right? And we take away these opportunities, let's say being born vaginally which sometimes is obviously necessary and for safety and survival, but sometimes may not be, or we take away the opportunities for babies and children to be outside or kind of get dirty, right? Get in the dirt or even have recess or even have like, you know, that's not just on like a black top or turf and so on and so on and so on.

Dr. Maya: Then the immune system becomes kind of paranoid, right? Because it's only seeing a few different things. It's not seeing that very wide and diverse array of different organisms and different foods and different exposures. And then when it gets paranoid, it mobilizes the army all the time. It's always thinking someone's an enemy because it just hasn't had that much experience. And so that's the problem that the immune system needs these different stressors. They're really tiny stressors. Just like meeting new people can be a stressor, but then you kind of realize, Oh Hey, they're okay. Like this is maybe someone different than me. They don't look like me or they don't come from the same places that I do or whatever, you know, they might be, but they're actually fine. Like it turns out it's okay and then you know, the immune system can kind of manage it. Does that make sense?

Jennifer: That very much does. And I think this is one of the, this is a very unique conversation that we're having because I haven't had a guest really talk about how important it is to have these types of stressors in your life. Because you know, one of the hard things is when you develop skin rashes, like I had them on my hands, I couldn't even wash my hands. I didn't want to even get anything dirty cause I couldn't wash them because water burned and soap burned. Everything hurt even more. So it was this horribly vicious cycle of not wanting to be in contact with a world, which in some respects, as I'm saying this out loud and thinking about what we just talked about is really interesting in and of itself. However I feel like one of the best things that we can do at a young age and I feel like you will agree with this is, is that we need to be outside and we need to be in nature. We can't just sit in doors all of the time. And to be connected, to get plugged in, to see the sun, to be in the sun. Some of these very fundamentally simple concepts are so important to be able to live a healthy life. Whether you've got skin issues or not. What's your take on that?

Dr. Maya: Yeah, I mean, the only thing I would take issue with is I would say not just kids, right? But at any age, we need those exposures because we're in relationship with the natural world. We've evolved to be in relationship with soil and trees and you know seeds and plants and animals and that kind of whole world. Right? We're meant to get dirty. Our floors used to be dirt floors. We grew our own food. We spent most of our time outside doing the things that we needed to do to survive and celebrate and be in community. We're all really very couched in nature and it's very new and different that we're indoors. And it's interesting because for example, you know, there is a lot of fear about being outside, let's say for the sun. And what's, what's interesting is that at the Karolinska Institute, which is, you know, premier scientific Institute in Sweden, they're the ones who, who give the Nobel prize.

Dr. Maya: They actually did a 20 year study and women like something, I think it was something like 20,000 women or more, maybe it was 30,000 women. And looked at sun exposure among many things. And they found that women who assiduously avoided sun exposure were twice as likely die of any reason as women who had some sun exposure. And that's kind of the opposite of what we've always thought, right? Or what we've been told is that, you know, sun exposure is probably bad for you and should really avoid it, but they actually then analyze it differently. Published another study. Basicallys comparing, they said it's similar to the risk of smoking, avoiding the sun assiduously, like seriously avoiding the sun, is as big a risk to your health as smoking. Right? So it's really, really profound how much we've sort of internalized this idea that nature is the enemy and that we need to be afraid and separate ourselves from nature when really not just not just kids, but all of us need to get outside and, and you know, the data even around things like forest bathing, which is just really immersing yourselves in the beauty of the forest.

Dr. Maya: It's a Japanese term called Shinran Yoku. There are so many benefits beyond just the microbiome and the immune, you know, kind of stimulation and getting that diverse exposure. It also has been shown to help us sleep better, improved mood, improved focus and executive function and improve memory. And it's also been shown to actually boost anticancer proteins and what are called natural killer cells, which are very important part of the nonspecific immune system that helps just fight general infections. So even lowers cortisol levels. So our stress hormones drop when we go into the forest and have like a nice immersion in the forest for a few hours and we need, it's something we need to do regularly and there's really no drug and no treatment in the world that I'm aware of that does all of these things. And art is so noninvasive. In fact, it's usually very pleasurable, right? So it's really a win win on every level for us to immerse ourselves in the natural world.

Jennifer: And so for what, what about somebody who does have a lot of these environmental allergies? Like they're like, Oh, I'm allergic to all sorts of pollen and grasses and trees. I love what you're saying. Do you have any suggestions of how someone like that could possibly start enjoying getting outside when it is a struggle?

Dr. Maya: Yeah, absolutely. I actually work with many people on these kinds of issues. And what I will say is it's very rare. I'm not gonna say it's impossible, but it's very rare that a person who has a lot of environmental allergies does not have food as well and very commonly. And I will say usually the reason that they are part of the reason that their immune system is disrupted is because there's you know, their microbiome, right? Those organisms that live in their gut and on their body are also disrupted and there therefore their immune system has been disrupted. So for me, I will say on the one hand, I'm going to be looking at their diet. I'm going to be looking at foods like dairy or gluten or eggs or soy or corn or citrus, which are like the most common allergies.

Dr. Maya: And there's more, I mean, I don't think all of them, but I might choose one that may seem like it could be a trigger and say, Hey, why don't we do a trial off of this? I will tell you very commonly environmental allergies drops significantly when the foods there are trigger foods are taken out of the diet just as an example because they're sort of a total, a total load, you know. So the more that sort of stresses the immune system, the more reactive it may be. So there are things we can do also like probiotics and I'll use things like medicinal mushrooms if they tolerate mushrooms which can be very, very helpful to the immune system. But let's say outside of that you know, going outside and small doses, very small doses, right? And making sure that you kind of shower after, let's say like rinse off after you go outside just to kind of build that tolerance, you know, or maybe certain certain periods of time, like when pollen's crazy, you know, you may do less going outside, but in other times you find the times that maybe are a little more tolerable and the more you have these exposures over time, actually the more your body starts to accept it.

Jennifer: It's interesting what you're talking about essentially. Sounds like you gradually develop that, that tolerance, so to speak.

Dr. Maya: Yeah. It's kind of like exposure therapy, but I would almost take it even a little farther and it, you know, however, this may sound, but I would almost like think of it as trying to make friends with, you know, these different elements, right? Like if you're like, oak or maple or these are just trees. Right? I mean, there's no reason that just the way, there's no real reason that like we should be allergic to like dairy or peanuts. I mean, oftentimes it's actually things we've done to the food or our immune systems that causes these problems. The truth is allergies used to be really non-existent practically. It was a very rare to have these kinds of allergies and, you know, the whole sanitization from even that, you know, all the things we've talked about and the antibiotics, the steroids, even vaccines probably play some role in that. That we haven't yet really investigated. There's so many different ways that we're kind of sanitizing the body and the immune system including the not getting outdoors. But like if you go to indigenous populations and you, you know, go to communities of indigenous people who are living in a traditional way for their culture, allergies are really non-existent. They're just non-existent.

Jennifer: It's so interesting. It is so interesting. All of this stuff and I feel like we could go on and on and on for hours about it, but we don't have that time right now. So I think in the grand scheme of things, Dr Maya, we probably have to have you back sometime. I can keep talking about this because I think what you're bringing to the table is so different from what other people are talking about. And it's something that's also very missing from the conversation when we're oftentimes focused on like, just what can I avoid in my diet? Or what supplement can I take or what medication can I try? And instead it's looking at this picture from a much different perspective. And I think it's something that while yes, our skin is important in this very moment, this is also about the greater health of not just ourselves but our families and our communities and the world as a whole. And how do we get back to that?

Dr. Maya: Yeah. And I think also just knowing that this skin is just like signaling something bigger going on and that bigger thing can be, you know, just gut health or diet or, you know what I mean? Or there's all different ways like the way the body is, the way the body talks to us is through symptoms. So when skin is activated in some way, those symptoms are activated and it can feel incredibly consuming to be in pain or itchy or sensitive or uncomfortable in your skin and whatever way you know, that may happen. It's also often like, that's why I always go deeper, right? I don't just stop at the skin because it's telling us something. It's just communicating. And that communication might be, I need to get outside more. I mean that is one possible message or part of the message among other things. And I think that's, it seems so counterintuitive, but very often it's getting outside and having that dirt exposure that really can turn things around.

Jennifer: Awesome. Thank you so much for joining us and I just want to remind everyone that number one, they can find drmaya.com. You're also over on Instagram, which I love your Instagram and I follow you on Instagram feed everything that you put up and watch all of your stories, but you also have a really gift for everybody. It's your earth medicine transformation bundle. I will put a link to that in the show notes. So for anybody who's thinking about how can I take a step back from a lot of the go, go, go, I've got to figure everything out. And, and I think it's almost in a sense you're, you're taking a big sigh, a step back, figuring out how to ground yourself, how to take everything down and notch, which many of us need, who are struggling with skin issues. I think this is a great resource for everybody out there. And I just wanna thank you so much for your time and your expertise, and I hope that we can have you back sometime.

Dr. Maya: Yeah, I would love that. Thank you so much for having me. It was a pleasure.

“The immune system is a remote system. So when something's activated in one place, like the gut, it can totally cause symptoms in another place like the skin.”