Protect Your Children From Autoimmunity

Elisa Song, MD

I am so honored to be here, Terry. We are just talking offline and it is so great to always be connected. Hopefully, we can do that in person soon. For our listeners, I am an integrative pediatrician and pediatric functional medicine expert. I have been doing this for a long time, over 20 years now. And I integrate conventional pediatrics with several other healing modalities, functional medicine as a core piece but I also incorporate homeopathy, acupuncture, herbal medicine, and essential oils into practice. I love teaching parents and kids how to understand the foundations of health and to help them thrive for their lifetime.

Terry Wahls, MD

Okay. Well, let us talk about children and autoimmunity. How common is this?

Elisa Song, MD

Unfortunately, we know that chronic childhood disease in general is skyrocketing in kids. And at the moment, we have just a little over one in two kids diagnosed with some chronic health concern and that may range from chronic constipation and eczema to more serious concerns like autoimmunity. And that number, that one and two number is rapidly increasing. Now, with autoimmunity, we do not have specific numbers. We know that autoimmunity in adults is also rapidly on the rise and children seem to be mirroring that. I have middle schoolers with Hashimoto’s thyroiditis, toddlers with juvenile arthritis, and infants with Crohn’s disease and we have this epidemic of autoimmune encephalitis in children called pans pandas. And one of the findings that was really alarming to me, this was a study from last year, looking at ANA levels and for listeners ANA, your antinuclear antibody is a very nonspecific autoimmune marker. 

And following the US overall in five different age groups, the researchers found that there was a significant increase in the number of people in general with a positive ANA  biomarker. However, the age group who had the largest proportions of increase in a positive ANA were our teenagers from 12 to 19 years of age. I am just looking at the numbers on my screen right now. They looked at the late 80s as a baseline, by the early 2000, the rate of ANA in teenagers had doubled. And by 2012, the rate of positive ANA in teenagers had tripled and now we are already ten years from that. Our kids’ genes have not changed in the last 30, 40 years. And this is why this discussion and your summit is so important because we have to understand what factors have changed and how do we reverse this trend, this alarming trend of an increase in autoimmunity in our kids.

Terry Wahls, MD

And everyone who is listening, those positive ANA that comes years before the damage has accumulated to be severe enough to get an autoimmune diagnosis that will have neurologic or psychiatric symptoms hence the neuroimmune component. And this is why I am so glad we have you here. Now, what are some of the foundational issues? I am thinking of Hippocrates. You are talking about the gut health and food. Do you have any comments about Hippocrates’ perspectives there?

Elisa Song, MD

Yeah, absolutely. When I think about the foundations of optimal health and in particular the foundations of optimal immune health and as I think about, how do we reverse this trend, how do we try to prevent autoimmunity as possible in our kids and chronic disease? There are three key areas of mastery for our kids and for our families. And that is your microbiome, your mitochondria, and your mindset. Those are the three M’s that I focus on. And Hippocrates is credited with saying that all disease starts in the gut. We know that that is especially true for children and especially when it comes to their immune systems. The 70 to 100 trillion microbes in our gut, microbiome, they set the foundation, they meaning our microbes, set the foundation for over 70% of our immune system. And for a child, an infant whose immune system is just developing and learning how to deal with all of the antigens in the world, the toxins in the world, foods in the world, their gut microbes, their gut microbial composition informs their immune system how to respond, do they categorize a certain food or a toxin as friend and let it by, do they identify that antigen as a foe and create inflammation? And here is a thing when our immune system identifies that antigen as a foe sometimes the immune system can act in the wrong way and start attacking our own cells and that is when we have autoimmunity. And we know that the gut and the gut microbiome is intimately linked with how this occurs. In fact, gut dysbiosis or abnormal balance of bacteria, parasites, and yeast viruses in your gut microbiome can increase the risk of developing autoimmunity. And there are specific bacteria that I look at when I do functional stool analysis in children, especially when they have a personal or family history of autoimmunity that I do not want in their gut, especially bacteria like klebsiella or citra bacteria or proteus that have been specifically linked with certain autoimmune diseases.

Terry Wahls, MD

What are the big stressors as to why this imbalanced microbiome can develop in our infants, toddlers, children, and adolescents?

Elisa Song, MD

Yeah. There are many, many stressors. And just by virtue of living in our modern ultra-processed, ultra-fast world, you have so many. What I have been telling patients are what we would consider microbiome mischief makers. And unfortunately, one of the key factors in setting the stage for your child’s gut microbiome is as a mom, your vaginal, and your own gut microbiome when you are pregnant and when you deliver your baby. Now, we can not go back in time and change what is happened, but if you are going to have a baby I would say that optimizing your gut microbiome before you conceive is one of the best ways you can start your baby off with a healthy gut microbiome from birth. But from the moment they are born the biggest disruptor to our gut microbiome as children and even adults are antibiotics. 

And we have to really understand how to use those antibiotics judiciously. And understand that antibiotics wipe out not just the bad bacteria that we have but really all the good bacteria. And certain antibodies actually have a preference for killing some of the beneficial flora in your gut while preserving some of the more pathogenic or abnormal flora in your gut. And with that understanding, when our children and our teenagers are on antibiotics for not just ear infections but chronic long-term for things like acne, we need to understand how to do that mop up. The other key factors in our modern world in how we are living are the ultra-processed food with all of those FDA-approved, natural, and artificial food additives that have been shown in the literature, many of them, especially this category of food additives called emulsifiers, that directly can cause gut dysbiosis, can directly harm the gut lining and the gut barrier function and trigger leaky gut and have been correlated with a significant rise in autoimmunity in various countries. 

And we can not forget one of our biggest toxins of all is our modern world’s psychological stress. Because of psychological stress, that persistent elevated levels of chronic psychologic stress can directly change the gut microbes that want to live in our gut. And that balance of gut microbes also can affect how we manage our stress. It becomes this perpetual, this vicious cycle because we know that our gut microbes are responsible for making the vast majority of our neurotransmitters like serotonin and which is our feel-good kind of calming neurotransmitter. If we have an imbalanced gut it leads to worsening symptoms of anxiety, depression. And when we have anxiety and depression we have a worsening gut dysbiosis.

Terry Wahls, MD

I want to go back to the word emulsifier and we are going to go back to some of the psychological stress. I do not know that people know what emulsifiers are and how they would find them in their food. It is not going to show up as the word emulsifier on the food label.

Elisa Song, MD

It is true. An emulsifier is, if you think about an emulsion and an emulsifier in a packaged food as a food additive is the ingredient that keeps that food together. If you think about, if you buy. What was the ice cream I was looking at the other day? I think it was Breyers. If you look at ice cream, you do not want your ice cream when you open it up to be this goopy, soggy mess, you want to stay that nice ice cream shape, certain food manufacturers will put in emulsifiers to keep that food together. Emulsifiers are also used in infant formulas, the ready-to-feed liquid formulas. They are found in protein bars, in peanut butters. They are not fads in all and you will notice that the foods, for instance, your peanut butter that has oil on top that you have just stir, that is because it does not have an emulsifier, but you buy the Jiffy that is that perfect creamy shape that has an emulsifier. But what will you see on the labels? And this is really important because emulsifiers are one of the most gut-harming food additives. You will likely see mono or diglycerides, okay, that is a very common emulsifier. You might see carrageenan, you might see guar gum which is not as bad as a lot of diglycerides. Polysorbate also acts as an emulsifier. Just being savvy you can look up. Actually, the FDA has a complete list of food additives that I should put in my book so parents can see what is going to be on the label. But you can look that up yourself, it is really important to be a savvy food label reader. Because there are foods and I am not going to say I never eat out of a package, this is the modern world and we were busy, getting breakfast ready, busy packing the kids’ lunches, but when you buy packaged foods or jarred foods you need to make sure that you are reading that label and making sure that it is as clean as possible. Whole Foods really not having any of these gut-disrupting food additives in them.

Terry Wahls, MD

What a simpler way to think about the food they will be. If it is a word I do not recognize immediately as food that my grandmother would have recognized as food. It is probably a new compound that is not so good for my microbes.

Elisa Song, MD

100%. If you can not pronounce it. If you have to.

Terry Wahls, MD

Your grandmother would not recognize it.

Elisa Song, MD

Yeah, your grandmother would have recognized it. If you have to google what it does or what it is that is not something that you want in your kids’ bellies or in any of your family’s bellies for that matter.

Terry Wahls, MD

Okay. That is a simple measure we could all use. Now, let us get back to psychological stress. And I am going to hold up my phone as I talk. And I am worried about the impact these phones are having on our microbiome. Do you want to comment on that?

Elisa Song, MD

Yeah. Well, we know that, I mean, there are many things with this that are problematic. There is for our kids who are too young in age really are have access to phones, to constant texting, and social media, we know that that directly plays a role in negativity, reduced self-esteem, and lower ability to manage stress. In fact, a study just came out and I believe they just asked teenagers to reduce their screen time by one hour which most kids are spending seven, eight, nine hours of screen time a day, where on earth is that screen time, but think about what kids are not doing when they are on their screens, they are not exercising, they are not sleeping, they are not having family meals which are so important for our health, they are not having face to face interactions with their friends and with their community. And just reducing that screen time can reduce psychological stress and significantly improve your sensation of well-being which is so important when we have this crisis of mental health in our youth right now. 

And then we have the electromagnetic frequencies, the EMFs which some people are more sensitive to than others. But we are electromagnetic beings. And it makes sense that when you have this EMF that is bathing you and bathing these developing cells in your kids’ brains and in their guts and in their immune systems, that EMF can have a potentially profound impact on how their cells actually function and interact with the cells next to them and interact with the extracellular matrix around them. A lot of concerns with them. And I am not saying that we need to, in fact, we can not get rid of this. I mean, this is how we text each other, “Hey, are you on Zoom? Let’s get ready.”. But we need to be smart about the exposures that our kids have, how early they have them, and understand what they are doing on their phones and how to reduce the negative impact that the phone can have for them.

Terry Wahls, MD

Well, you and I could talk for hours about that. But I guess we should probably move on to mitochondria.

Elisa Song, MD

Yeah. Well, mitochondria are, I mean, everyone who follows Dr. Wahls knows that mitochondria are really important to optimize and support really no matter what is going on with your health, but especially if you have an autoimmune and neuroimmune chronic concern and this is really true for kids too. And it is an area that a lot of practitioners, even functional medicine practitioners who work with children, do not really look at closely enough. We know that mitochondrial dysfunction can be triggered by many different factors including infections like Epstein-Barr, even the SARS-CoV-2 virus can cause mitochondrial dysfunction. There are environmental toxins that are mitotoxin to really directly impacting that the health of our mitochondria and our lifestyle factors, lack of sleep, being dehydrated, eating a sad ascending wrecking diet, all of those de-stressing our mitochondria and children with chronic conditions, especially kids with neurodevelopmental concerns and immune dysfunction. When I look from a lab standpoint and also when I ask them questions from a clinical standpoint, virtually across the board, they have signs of mitochondrial dysfunction which would be low muscle tone, and sometimes fatigue but it is mostly poor endurance, these kids can play soccer and run around on the field but then they come home and crash and parents, no more playdates, no more anything the rest of the day which is not normal for kids, it should not be. Many, many kids are on medications to over-the-counter medications that we know are mitotoxin like Tylenol.

Terry Wahls, MD

Wait a minute. Tylenol? Mitotoxic? The drug that we are thinking is okay to give our kids for their aches and pains or after a vaccine is a problem?

Elisa Song, MD

Yeah. This is hugely important for parents to know. There are a couple of reasons. I mean, Tylenol, acetaminophen, I mean, what is the first thing that most parents and actually nurses and doctors reach for when kids have a fever? It is a Tylenol, without even looking at the kid even in the emergency room. The triage is to reach for Tylenol if the kid has a fever. But we want to, first of all, step back and understand the actual benefits of fever and fighting infections. When we reach for the Tylenol, Tylenol can be directly mitotoxic. It also does a very important thing that we need to understand. It depletes our levels of glutathione which is our master antioxidant. Now, when we are sick, or when we have pain, or when we have inflammation our mitochondria become stressed, I mean, that is the normal way of things and they create free radicals and produce something called oxidative stress. 

When we have oxidative stress we need antioxidants to quickly mop up those free radicals so that we can heal, recover and stay well. Tylenol, by depleting glutathione, our master antioxidant, directly impedes our ability to reduce oxidative stress and restore mitochondrial function. This is really important for parents to understand that there are options from an integrative natural standpoint when your kids have fever, when your kids have pain, and if your kids do need the Tylenol or that is the option that you have. Make sure that you are supporting your child’s glutathione levels with Epsom salt baths, and cruciferous vegetables, make sure you are supporting their mitochondria during those times. And please, when your kids are getting vaccines do not give them Tylenol at the same time. Tylenol is going to impede your child’s ability.

Terry Wahls, MD

Okay, let us stop and repeat that one more time because I think that is a super important message. Slowly, carefully.

Elisa Song, MD

Yes. Please, when your children are getting vaccines please do not give Acetaminophen or Tylenol concurrently if your child needs a fever reducer or pain management if you got the tetanus and the arm is really sore ibuprofen would be a better choice of those times. However, oftentimes we can do a cool bath, we can do a cool compress, we can maybe try some adding essential oils and not need to use these medications in the first place because, as I mentioned, Acetaminophen also can stress the mitochondria.

Terry Wahls, MD

Would this be a good time for an Epsom salts bath?

Elisa Song, MD

This would be a perfect time for Epsom salt baths. because Epsom salts are magnesium sulfate which first of all, the magnesium so many of us are deficient or insufficient or magnesium helps us stay calm and relax. And the sulfate in the magnesium sulfate, the Epsom salts will enhance our own body’s ability to produce glutathione. That is amazing. I love Epsom salt baths when kids are sick, when kids have an asthma flare when kids are taking medications that need to go through the liver, and certainly around the time of vaccines for sure.

Terry Wahls, MD

I think they are really helpful when we are having difficulty with insomnia when we are having difficulty with anxiety. I look at so many young people stressed with their social anxiety that Epsom salts are really very helpful. And I know in our family we use that, for everybody in the family we all love our Epsom salts baths. We are going to remodel our bathroom and the contractor when we get rid of the bathtub and spray the shower like, no, I love my Epsom salt bath, I am not giving that up.

Elisa Song, MD

Yeah. That Epsom salt bath is so amazing. And children, even infants and toddlers can have Epsom salt that just a little less of that.

Terry Wahls, MD

Okay. Let us talk about mindset because. And I talk about mindset a lot with my adult practice that healing begins first in the mind. What is your perspective on all of this?

Elisa Song, MD

Yeah, absolutely. What is fascinating about mindset, I mean, in conventional medicine, we have separated our body into different systems and the mind has been placed over here, it is separate from our body which does a huge disservice to, as you said, is really, I think the critical piece of healing that most people and practitioners are missing or maybe paying some lip service to but not really putting their money where their mouth is, not really embracing it as equally or even more important than medicine as what you can take by mouth. And we know that psychological stress by itself can alter our gut microbiome, their gut microbiome. And its status affects how we manage psychological stress. And the way the gut and the brain communicate in this way is via the vagus nerve which many of you listeners are familiar with. 

Just as a side note, 80% of that communication occurs from our brain to our gut, not from our gut to our brains. We have to think of who is the most important to support here. But the function of our vagus nerve, when our biggest nerve is functioning optimally, and what is called our parasympathetic nervous system or rest digest and heal part of our autonomic nervous system is a really good balance. And in good balance, with that sympathetic fight or flight part of our nervous system, we have something called optimal heart rate variability. And many studies = have looked at optimal heart rate variability as one of the most important biomarkers for a predictor of health or disease. And when we optimize our heart rate variability we are setting the stage in our children to have that foundation to always get back to health, to always know how to recover no matter what is going on. And with improving heart rate variability, improving your mindset, improving your vagal tone, almost everything you do to improve your vagal tone is 100% free. It takes your time but it does not cost anything to learn how to belly breathe and diaphragmatic breathing in the right way. It does not cost any money to have a mindful moment and do a five-sense meditation.

Terry Wahls, MD

Hang on. What is a five senses meditation?

Elisa Song, MD

I love the five-sense meditation. This is something that I talk with my kids and my patients about. And I call it stop, look, and listen because all kids when they first learn to cross the street they learn, okay, they just stop, look around the cars, listen, and then they can go and it is taken that mindful moment. And when we stop, we give ourselves permission to stop whatever we are doing at this moment whether we are walking on our way to school or in doing our homework and getting stressed about it, we stop and give yourself permission to take this mindful moment. And then we look and the looking means using all of your five senses to notice what you notice. And it is first really very helpful to close your eyes because our visual input is the strongest and what we absorb and takes over our other senses. You close your eyes and you first notice what you are hearing. And you might notice at that moment that you hear a bird chirp that you had not heard before or you really notice the sounds of the cars on the highway just down the street or you really notice, wow, I hear my neighbor mowing the lawn and I had not even noticed that before. 

And then we move on to our taste and we notice, what do you taste in your mouth? Now I can taste the minty toothpaste that I just brush my teeth with or maybe I did brush my teeth, I can taste that little piece of bacon that I chomped on at breakfast. Then we notice what we are feeling on our skin, do you feel the wind blowing the hair on the back of your neck? Or maybe the weight of the backpack on your shoulders? That we notice finally what we want to say to our hearing is, oh, snap this massive, and what do we notice that we are smelling, now you notice the fresh cut grass that your neighbor just cut or do you notice the smell of the smoke coming from your neighbor’s chimney on a cold brisk morning? Finally, we open our eyes and we notice what we see, and when you do that if your eyes close this entire time the world seems just a little brighter and you will notice colors you have noticed before, you will notice maybe the little hummingbird nest you had not seen before. It is basically, what you can see when you allow your other senses first to take over. And then the listen part of the stop, look, and listen is now listening to how your body and your brain feel in that moment to just sit and ingrain that positive moment. Because we need to sit with our positivity a lot longer than the negativity because our brain tends to stick to the negative. And that takes maybe five minutes of your time. And it is such an approach for kids to be able to stop and regulate and listen to their bodies. That is one of the keys to success into adulthood. And learning that is so powerful.

Terry Wahls, MD

That is wonderful. And that could be a very interesting family activity that the family could do that together in the evening as part of storytime with your kids to stop and have a meditative experience whether it is a breathing exercise or this beautiful sensory exercise you just guided us through. Elisa, I could talk for hours with you. It always gives me so much joy. I have so much insight. And I still want to come have a kimchi with you. It is been much too long since we have been able to share kimchi together. What is the one key message that you invite all the parents and grandparents, aunts and uncles to take from our conversation?

Elisa Song, MD

I would say that the key message that I want parents, grandparents, and practitioners to walk away from is that no matter what stage of health your child is in right now or no matter what stage of health you are in and you are worried that your child is going to have that same way it is never too late to shift how your child’s brain immune system and gut is working for them. We have the power, your kids have the power to change their epigenetic futures by how they live and how they breathe, and how they think. And this is a message of a power because I know that many listening has been suffering with autoimmunity or know a family member who is been suffering with autoimmunity for a very long time and you are here listening because you do not want that to happen to your children. And nothing is set in stone. And even if your kids already have an autoimmune concern cropping up it is never too late, you can always get your kids back to a much healthier vibrant place.

Terry Wahls, MD

That is wonderful. And I certainly endorse and support that. There are always things that we can be doing to make our circumstances better for ourselves and the people that we love. Elisa, where do people find you?

Elisa Song, MD

The best place to find me is going to be on my blog site that is healthykidshappykids.com where I have blogs, and if you send a friend for my newsletter, I send out information periodically, promise I got ten out of ten, and then also on Instagram. If you follow Terry on Instagram just hop on over to healthykids_happykids.com And that is where you will find me and some of my latest information.

Terry Wahls, MD

Okay. One more time slowly for people. Again.

Elisa Song, MD

It is healthykids_happykids, it is my Instagram username. And my website is healthykidshappykids.com

Terry Wahls, MD

Okay. This has been wonderful. Now much love to you and your family.

Elisa Song, MD

Yes, you too, Terry. Thank you so much for having me.