Laurie Menk Otto, ND, MPH

Naturopathic Medicine | Portland, Oregon

Portland Allergy Naturopath Dr. Laurie Menk Otto

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Comprehensive allergy treatment and the “allergic load” – what does it mean?

Allergy treatment in my practice often extends beyond direct treatment of the allergy alone. Whether or not a person has allergy is determined by genetics, as well as environment and other factors about the person. The “allergic load” is a helpful concept to understand how I view comprehensive treatment of allergy and asthma, and how I get better results with patients who haven’t had relief in the past.

The most powerful direct tool I have for treating allergy is immunotherapy, which changes the way the immune system reacts in response to allergen exposures and relieve symptoms over time, directly addressing the genetic predisposition towards allergy. I also go deeper to address other factors that may trigger symptoms. The allergic load refers to the non-genetic factors that may lead to and influence overall inflammation in the body, and therefore increase expression of allergy and allergic symptoms. Addressing and understanding allergic load as a concept helps to minimize the influence of irritating factors that have the potential to make allergy symptoms worse.

Some patients come to see me having had allergy treatment in the past, usually through allergy shots, or medications to reduce symptoms, and they tell me that those therapies “helped a little bit,” or “ I think that helped mostly,” but their symptoms weren’t completely relieved. Why are treatments sometimes only partially effective? Why are symptoms worse some days than others, and sometimes inconsistent?

The answer is that there were likely some factors causing inflammation in the body that were not addressed as part of treatment – factors that weren’t addressed using allergy therapy alone, and only temporarily calmed by using medications for symptom control. This is where you gain the most benefit from working with me. We’ll go deeper, and here is what is different:

  • Trigger management. Irritating triggers such as dust, pet dander and hair, mold and pollens are removed or managed, and personal care measures to reduce exposures are addressed. Reducing trigger exposure by cleaning, air filtration, and avoidance is specifically important.
  • Other environmental factors are addressed. Irritant triggers like smoke, perfumes and other chemicals in the home or work environment are addressed when possible.
  • Individual health factors are addressed. Things like hormones and other chronic illnesses or low level infections can worsen allergy symptoms, although they have nothing to do with allergy technically, but aggravate inflammation and symptoms, are addressed or minimized as much as possible.
  • The role of diet. Diet is a very important intervention not only for allergy but also for overall health and longevity. Getting the right nutrients through diet, and reducing foods that are irritating to the system has the effect of reducing inflammation, improves nutritional status, and reducing allergy symptoms. Diet changes always include increasing vegetable consumption to increase intake of chemicals called flavinoids, which help manage inflammation and allergy expression.
  • Digestion and biome. Digestion, absorption of foods, and the intestinal biome influence allergy and inflammation. Elimination of food intolerances, where relevant, are important to decrease inflammatory load and support the biome in such a way that allergy and inflammation are minimized.
  • Chronic stressors such as stress, and sleep have a significant impact on allergy. High stress and poor sleep drive inflammation and tax all body systems, negatively influencing repair and immune balance.

What would it feel like to live with minimal allergy symptoms next year? With some work and investigation, along with carefully chosen therapies, it is possible.


Allergy choices website

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Immunotherapy FAQs

What is sublingual immunotherapy, and how does it work?
Sublingual immunotherapy is a treatment for hay fever type allergies.  Allergen extracts containing antigen are mixed with glycerin as a preservative and delivered in drops under the tongue. The formulation is specific to your allergy test results and symptom picture. Immunotherapy is used, in this case, to “re-train” the immune system away from the allergy-type reaction and towards a reaction that tolerates the same allergens without allergy symptoms.

How are allergy drops different from allergy shots or tablets?
SLIT works in a similar way to allergy shots, and use the same FDA-approved antigens, but the route of administration is drops under the tongue rather than shots. The main difference is that treatment is delivered at home on a daily basis, rather than at an allergist office. Allergy tablets treat single allergens or allergen types (grass, ragweed, dust) rather than multiple allergens and do not come in different dosages.

What kind of allergies are treated with allergy drops?
At our clinic, allergy to tree, grass and weed pollens, animals, dust, and mold are treated using SLIT. Your exact prescription is determined based upon the results of your allergy test. SLIT can treat allergy to multiple antigens at the same time.

Can food allergy be treated with SLIT?
Allergy to foods are treated with SLIT, and may be sought at an allergist’s office.

Who can be treated with SLIT?
At this clinic, anyone over age 3 is a good candidate for allergy treatment using SLIT. Some people may choose allergy drops over shots due to the convenience of in home administration, fewer doctor’s office visits, the safety profile, or if they don’t respond well to or tolerate shots well. Young children, people with asthma, highly sensitive people, and people with multiple allergies may choose to treat their allergies with SLIT rather than allergy shots. Anyone with uncontrolled asthma symptoms is not a good candidate for this type of allergy therapy.

How is the treatment managed?
There are two phases of treatment. The first phase of treatment is the “buildup phase” during which the dose of allergy drops is increased every week over a series of weeks or months. Appointments in buildup phase are held every 5 weeks. The second phase of treatment is the “maintenance phase,” where drops are at the highest dose and appointments are held every 10 weeks. Symptoms are monitored carefully to troubleshoot the best additional treatments.

Will medical insurance cover the costs?
At this time, most insurance companies cover the cost of diagnostic allergy testing and office visits. However, because allergy drops are an off-label use, they are not covered by insurance. Allergy drops often do qualify for HSA or flex spending reimbursement.

How long will I need to take allergy drops?
Most often, SLIT will be prescribed for 2-5 years, after which point the need for it will be reassessed. Benefits are often felt within in the first few months, with some variance among individuals. For the greatest symptom control (no reaction to what causes your allergy symptoms) 2-5 years is generally recommended. Please be aware that SLIT is intended for long-term use, and if discontinued early, benefits may not be experienced. This treatment “re-trains” the immune system over a period of time.

Are allergy drops safe? Are there studies that evaluate their effectiveness?
SLIT has been used in other countries for many years, and studies document their safety and effectiveness. The World Health Organization has endorsed SLIT as a viable alternative to allergy shots. The Cochrane Collaboration, which is the world’s most trusted international organization dedicated to reviewing health care treatment, concluded that allergy drop immunotherapy (SLIT) significantly reduced allergy symptoms and use of allergy medications.

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Why am I tired?

Do you have difficulty getting out of bed in the morning, or making it through the late afternoon hours? Do you find yourself reaching for that second, or third, cup of coffee mid-day just to get through? Fatigue can become such a usual feeling that it’s easy to assume that it is an expected part of a fast paced, demanding lifestyle. Fatigue is not normal, and I discuss with my patients why it’s important to discover underlying causes of fatigue. Here are some things to consider having evaluated if you feel frequently tired:

  • Sleep – not enough sleep, interrupted sleep, or sleep disorders such as sleep apnea are frequent causes of fatigue. For more information on sleep disorders see this article by the National Institutes of Health.

  • Stress – causes multiple chain reactions that contribute to fatigue. There is no avoiding stress in life. The work comes in with developing stress management strategies and continually adapting to change, because life will never be stress-free. This article by Success Magazine outlines several stress management strategies.

  • Nutrient deficiencies – Anemia is a common cause of fatigue in women, and low level of D or B vitamin may cause minor fatigue in anyone. Routine blood tests show whether you are deficient in any of these.

  • Blood sugar imbalance – Mid-day fatigue is a key indicator of blood sugar imbalance that can lead to afternoon energy crashes. Mental fog and fatigue after lunch or any meal can point to blood sugar issues as a potential cause. You don’t have to be overtly diabetic to have an issue here. Naturopathic physicians, excel at addressing dietary causes of fatigue, so you are best starting evaluation by consulting a licensed ND.

  • Health conditions – Low thyroid function can cause fatigue, so it’s good to have this checked out annually and especially if you have thinning hair, feel cold, and have dry skin.

  • Chronic health conditions and some medications can also cause fatigue. Your doctor can help you pinpoint potential causes.

The bottom line is that you should work closely with your doctor to investigate any unexplained fatigue. NDs are licensed as primary care physicians in Oregon.



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Pollen, pollen everywhere!

Portlanders, have you heard? There are record amounts of pollen in the air. Are you feeling it?

pollen count 6-12-17

The Willamette Valley typically has among the highest grass pollen levels in the world, and this year is exceptional. Even those who typically do not have allergy symptoms are feeling it. Sneezing, runny nose, itchy eyes, eyes feeling sandy, stuffiness at night are all symptom of grass allergy that are high this time of year.

What can be done to reduce exposure? 

  • Avoid outdoor exposure before noon when pollen levels are at their highest.
  • Change clothes when arriving home, and remove shoes. Rinse hair and face (entire head if you can) after being outdoors, and especially before going to bed.
  • Keep bedroom windows closed.
  • Use the filter function on your car fan settings if you have them, or use the air conditioning. Keep windows closed.
  • Nasal rinses and eye drops help wash away irritating pollens.
  • Do not dry clothing outside

What else can be done?

  • Get evaluated for allergy. Knowing what you are allergic to will allow you to take action to reduce exposure, and decide on appropriate treatment. An appointment at my clinic takes about 90 minutes and is usually covered by insurance.
  • Get treated. There are many effective treatments available for allergy that include any combination of: exposure reduction, immunotherapy (allergy drops – available at my clinic – or shots), dietary change, medications, and supplements.
  • Importantly, take all medications for asthma as directed by your doctor in addition to any allergy control medications or supplements.

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How to use a saline nasal rinse

Saline rinses are very effective at relieving allergy symptoms. A nasal rinse is like a shower for the mucous membranes of the nose. It helps to wash away dust and pollen that has accumulated throughout the day, reducing inflammation and allergy symptoms.

How to use a nasal saline rinse: 


  1. Neti pot or other nasal rinse bottle. Even a large needle-less syringe works great if you have one. For kids I recommend using a small 4mL syringe like the type that comes with medications. Kids can control these easily themselves and the volume is better for their size.
  2. 8mL warm water. Use distilled, filtered, or boiled and cooled water, re-warmed.
  3. Nasal saline rinse prepared packets like these or these can be purchased at any pharmacy. You can also make your own at home using 1/8-1/4 tsp sea salt or other non-iodized salt per cup of water.  (Use of iodized salt like Morton’s will cause irritation).

How to use: 
Place neti pot or bottle nozzle at the opening of one nostril and lean forward, tipping your head just slightly to the side to direct the water flow out of the other nostril.

Pour neti or squeeze bottle very gently, just to allow the water to enter the nose and come out the other nostril.

If your nasal passage is blocked and the water does not pass through, don’t worry about it. Just allow the water to enter and exit the same nostril.

Then, change nostrils, pouring in the other side using the same technique.


  • When tipping your head to the side, always keep the ear higher than the nose. Gravity will take the water through so you only need a slight head tilt.
  • Do not squeeze hard or use pressure to squeeze the water out of a Neil Med or other squeezable type of bottle. This can cause water to enter the middle ear, which can be very irritating.
  • Adjust the strength of the nasal rinse by adding more or less saline solution, to your comfort level. You should never experience burning or irritation when using a nasal rinse.

Challenge and Solution:

  • “I just need to remember to use it.”
    Set an alarm on your phone for about an hour before you go to bed, or an hour after you typically return home. Leave out the saline rinse setup on the bathroom counter so that you have a visual reminder.
  • “I have to boil water and let it cool each time.”
    Use an electric kettle and turn on for about 20 seconds to warm the water to the right temperature. Alternately, boil a large pot of water and store it in a larger gallon water container, and heat to warm the amount needed for each use.
  • “I’d rather use a nasal spray. It’s much easier.”
    Nasal rinses are more effective than nasal sprays which, even if they contain effective medications, can only spritz the interior nose, leaving much of the tissue untreated. 
  • “I can’t use it twice daily. It’s too hard.”
    Well, OK then. Use it once. It’s better than not at all! 
  • “I always feel like I get water in my ears.”
    See Tips #2 above.
  • “It burns when using the neti pot.”
    Adjust the strength of the saline by adding more or less until you find a comfortable amount for you.
  • “Someone told me that I can get a parasite in my brain when I use a neti pot.”
    Understand that this is a rare occurrence when people have submerged their head in or used a nasal rinse with infected water. However, to escape this risk completely, use filtered water, distilled water, or pre-boiled water. The CDC has full instructions here


Top Docs 2017

This year I have been included again in the select list of Portland Monthly’s Top Docs. I publish this very humbly – if you live in Portland you know that I am one among a large, smart, and talented medical community, of which I am fortunate to be a part. During the past year, the most gratifying work I have done is using immunotherapy to treat allergic disease, and providing comprehensive general primary health care with an emphasis on getting back to the basics of health. This includes using food as medicine, addressing the microbiome, and helping patients incorporate the foundational basics into treatment: exercise, sleep, and stress management. Maintaining a busy practice while raising small children has kept me busy, which is partly why you haven’t heard much from me recently. This year, I plan to expand my immunotherapy offerings, so stay tuned for more soon! In the meantime, be well, and eat your veggies!

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Antibiotic resistance—what is it, why does it matter?

Antibiotic resistance—what is it, and where are we now? This is such an important topic with implications for us all. We rely on antibiotics to treat infections that may overwhelm the body and cause serious illness. But the bacteria being fought have the capacity to evolve very quickly, developing defenses that render the antibiotics useless, even with the strongest antibiotics on the market.

This is a bad scenario not only because we need effective medicines, but we also need to rely on medicines with the best safety profile—meaning that stronger antibiotics can come with risks and side effects that are not seen with others.

Today’s edition of Science Friday provides an excellent overview. Take a listen and also hear about emerging science on the topic—antibodies and phages may be an important addition to the arsenal. Listen here!


Alternatives to antihistamines safer, equally effective

SLIT Allergy TreatmentWith spring allergies in full swing and summer allergies on the way, many turn to over-the-counter (OTC) medications for relief. Antihistamine use, however, often comes with undesired side effects such as drowsiness, loss of libido, increased appetite, and depression. Additionally, recent studies suggest that common allergy drugs with antihistamines may have more severe impacts on health, creating additional risks for allergy sufferers. I can help with options for allergy relief when OTC medications raise concerns.

Caution with antihistamines

Researchers at the University of Oregon discovered that muscle recovery and muscle gain after exercise may be blunted by over the counter drugs commonly used for allergy and acid reflux. After rigorous exercise, thousands of genes activate to help the body recover. But with elevated antihistamine levels, nearly 30 percent of genes don’t respond as effectively.
It turns out that histamine, the bodily substance most often associated with allergy symptoms, is also important for helping blood vessels relax, increasing blood flow, and ensuring the body recovers. Antihistamines, therefore, could create problems for those who exercise often or competitively.

Antihistamines have also been identified as problematic for people with restless legs syndrome, a condition that affects nearly 12 million people in the US. OTC medications such as Benadryl, taken to relieve allergies, or sleeping pills with antihistamines, can make the symptoms worse. This creates added difficulties during allergy season and the need for alternatives for sleep aid and allergy relief.

Another recent study from the University of Washington’s School of Pharmacy links diphenhydramine use (common for allergy relief) to increased rates of dementia. Tracking 3,500 men and women over the age of 65 for an average of seven years, the study found that the use of anticholinergic drugs, including some antihistamines and antidepressants, resulted in an increase risk for dementia. Findings indicated that, “Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less.” This finding adds to a growing body of research that says these drugs are not intended for long-term use.

Alternatives to antihistamines

Patients seeking alternatives to antihistamines for allergy relief have options at Heart Spring Health. I offer comprehensive allergy evaluation and testing followed by allergy treatment with a customized prescription of allergy drops tailored to address your specific allergic reactions. Also known as sublingual immunotherapy (SLIT), allergy drops are noninvasive, cost-effective, and convenient. No shots or antihistamines are necessary, and SLIT therapy is effective for people of all ages.

Over time, use of SLIT results in a decreased sensitivity to your allergens, decreased symptom severity, and decreased medication use when exposed to the allergens in the environment to which you are sensitive. SLIT works in a similar way to allergy shots, uses the same FDA-approved antigens, and is recognized internationally as safe and effective. By taking drops under the tongue, they are also easier to administer and result in fewer office visits.

If you are new to allergy drops, here’s how your treatment would begin:

  1. Initiate a comprehensive allergy evaluation to assess symptoms and exposures
  2. Complete allergy testing with skin prick or blood tests
  3. Begin using your customized prescription of liquid allergy drops, taken under the tongue
  4. Plan for long-term use for maximum relief (2-5 years)

Call 503-956-9396 to schedule with me for allergy evaluation and treatment today.

More reading

Sublingual Immunotherapy Allergy Treatment
Immunotherapy FAQs
When is the best time to start immunotherapy?

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Stress!! An important element of your health care

stressStress plays a large role in most of our lives. I talk with patients (and myself) about stress very frequently, and troubleshoot the best ways to manage the experience of stress. How do you manage stress? Journaling, reading, exercise, hobbies, meditation are frequently mentioned stress relief strategies.

This Wired magazine article summarizes nicely how the experience of consistent stress affects the entire body. Robert Sapolsky, whose research is featured in the article, is the author of the well known book Why Zebras Don’t Get Ulcers. Aside from the conversation about vaccine development, it’s very informative, well worth the read, and helps to explain why stress is, or should be, a primary focus of health care.

This 30-minute video outlines the major research on stress and its relationship to cardiovascular and digestive health, memory, and aging and provides a great synopsis of why recognizing and strategizing stress management is primary to health and health care.


Under Pressure: The Search for a Stress Vaccine


Stress, Portrait of a Killer




Beyond Allegra and Flonase: Naturopathic Tips for Portland’s Allergy Season

Allergy treatment from Dr. Laurie Menk OttoYou know that feeling…the little itch in your nose or eyes. That’s when you know allergy season is on its way. Last year in Portland we had what felt like a very long allergy season. Did you know that you don’t have to suffer from allergies forever?

Immunotherapy is the only treatment for allergy that changes the way immune system reacts to allergens, ultimately leading to fewer or no symptoms after treatment. In other words, immunotherapy re-trains your body to stop reacting. I use sublingual immunotherapy or “allergy drops” to treat allergy. This treatment is very convenient—it’s as easy as taking drops under your tongue each day, and it does not require frequent office visits or shots. Relief can be felt as early as several weeks into treatment.

Your allergy drops are mixed specifically for your allergy. This is important, because drops allow you to receive treatment for all of your environmental allergens. Treating for just one or two allergens would not bring about strong symptom relief. If you are allergic to trees, dust, and dogs, you can be treated for all of them at the same time.

Is this different from taking an antihistamine?

Yes. Antihistamines and nasal sprays are often recommended to control allergy symptoms, but many people don’t like the side effects or don’t want to rely on medications forever. That’s where I can help develop treatment that is very specific to your symptoms.

What else can be done?

Identifying what you are allergic to, controlling your environment to reduce exposure, and starting immunotherapy are your best bets to feel lasting relief and stop symptoms for good.

First, allergy testing is used to identify exactly what you are reacting to. It’s an easy test that takes one hour, and you have results by the time you walk out the door. You will leave the appointment that day with a list of actions that you can take to remove allergens from your environment, which alone will help to reduce symptoms. But it doesn’t stop there. Diet or other changes can help to reduce symptoms further, and if you are looking for alternatives for symptom control, I can help you with other options.

When should I start?

Ideally, start the process of identifying your allergies with skin or blood tests at least three months before your allergy season. Allergy evaluation and immunotherapy, however, can be started at any time.

Make this your year to start treatment to end your allergies. Stay tuned for future installments on my blog to learn about naturopathic allergy treatment options, or give me a call to schedule a consultation.


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Why see an ND for comprehensive allergy treatment

Comprehensive allergy treatment – what does this mean?

Naturopathic doctors are well known for addressing diet and lifestyle with every single patient, regardless of their underlying health condition. Treating allergy is no exception.

The most powerful direct tool I have for treating allergy is immunotherapy, which changes the immune system to relieve symptoms. But there might be more to the picture for complete symptom relief, and this is where working with me, or a naturopathic physician, will benefit you. We go deeper to figure it out.

Some patients come to see me to inquire about sublingual immunotherapy having had allergy treatment in the past, usually through allergy shots, or medications to reduce symptoms, and they tell me that those therapies “helped a little bit,” or “ I think that helped mostly,” but their symptoms weren’t completely relieved. Why is this? There must be an answer, right?

This is where you gain the most benefit from working with me, or a naturopathic physician. We’ll go deeper, and here is what is different:

  • We look at the local environment. Irritant triggers like smoke, perfumes and other chemicals in the environment, as well as hormones and weather changes can cause allergy-type symptoms that have nothing to do with allergy, so we find and reduce or minimize them as much as possible.
  • We pay attention to diet. What we eat and how our body uses the food is one of the foundations of health. Getting the right nutrients in and reducing foods that are irritating to the system reduces inflammation, improves nutritional status, and reduces allergy symptoms.
  • We make sure digestion is working well. Digestion and absorption must be strong in order to use all of the great foods that are being eaten. Elimination is also important, so we correct diarrhea, constipation, and other digestive disturbances.
  • We evaluate energy, stress, and sleep. All of these comprise the greater environment of the person. High stress and poor sleep cause inflammation and tax all body systems, and poor energy is a sign that something is out of balance. Think of it this way – will your garden produce with deficient, sandy, or nutrient deficient soil? No, it won’t. If your body has underlying inflammation or is depleted due to any of the above imbalances, or is deficient due to poor diet or high stress, or if the underlying environment is unhealthy, symptoms are an expression of this.

What would it feel like to live without allergy symptoms next spring? With some work and investigation, along with directed therapies, it is possible.

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Oral Allergy Syndrome

If you have seasonal or perennial allergies and experience itching in your mouth, throat, or ears when eating certain foods, your symptoms may have oral allergy syndrome. This is caused because the food and pollen to which you are reacting containing proteins that are similar enough that your body recognizes and reacts to them as if they are the same. So, if you have strong allergic symptoms to birch pollen, you may consider avoiding intake of the associated foods during the spring, as symptoms may be worse during allergy season.

Common sense note: if you have any unusual or strong symptoms after eating specific foods, consult a physician for full evaluation, as your symptoms could be due to a more serious form of allergy.

See the chart below (Source: UpToDate®) for foods that may cause oral allergy syndrome, listed by allergy causing pollen:





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Dr. Menk Otto discussing immunotherapy

Dr. Menk Otto discussing seasonal allergy treatment

I was contacted by the local news station to discuss with them information on non-pharmaceutical and innovative ways to treat seasonal allergy symptoms. You can hear the majority of what we discussed in the reporter’s opening statements. In this clip, I introduce sublingual immunotherapy, which is what I use in practice with patients suffering from seasonal allergy.

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When is the best time to treat allergies using immunotherapy?

Birch tree catkin is a common allergen.

Birch tree catkin is a common allergen.

People often ask me this question when discussing treatment for allergies. Any proactive steps towards treating allergy and reducing associated inflammation is a good time. Treatment can be started at any time, however, there are certain times that are ideal for starting immunotherapy, especially for seasonal allergies to tree, grass, or weed pollens. The rationale is that you will experience fewer allergy type symptoms if you start when the allergens are not in large doses in the air.

To avoid making allergy symptoms worse, immunotherapy should be started at least 3 months before your peak allergen season hits. If you have completed allergy testing and identified what you are allergic to, you will know the general season in which your symptoms flare. Then, you can plan to start immunotherapy 3-6 months earlier. Trees, grasses, and weeds pollinate the spring, summer, and fall, respectively, with windows of overlap, leaving many feeling miserable for a few months, especially in the case of multiple allergies. To get a head start without increasing your symptoms, starting immunotherapy during the early winter months is a good bet.

If your allergies are to dust, mold, or pets, which are present year-round, treatment can be started at any time. Medications and supplements used to alleviate allergy symptoms can still be taken while taking allergy drops.

Dr. Laurie Menk Otto does skin (intradermal and skin prick) allergy testing, and sublingual immunotherapy, or “allergy drops” at her practice at Heart Spring Health. With winter approaching, it is a good time to make an appointment for an allergy evaluation and to discuss your symptom picture. Wouldn’t it be nice to get through your next allergy season with less sneezing, runny nose, and itchy eyes?

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Change Is Possible

Change. It’s hard. It’s important. Do you agree?

Change requires introspection and pushing outside of comfort zones, and finding new ways to do things. When I suggest that patients make changes specific to treating their health complaints, I support them. If they are really ready, we start big. If they are not ready, we start small. Gathering information, recognizing thought patterns and outlining real and perceived barriers is all part of this process.

Last week, a patient who has hypertension and all of the lab markers for diabetes and increased cardiovascular risk told me that her doctor simply told her that she needs to lose weight. This patient is so highly motivated to improve her health, but she completely lacked the tools that she needed to make it happen. In 4 weeks, with a solid plan, she has already improved her lab values and reduced her metabolic syndrome risk factors, and we have the numbers to show it. Change doesn’t always come so quickly, but with determination, it’s possible.

The article linked below provides a teaser – what you think, you become. A solid plan is a necessity. Equally important are positive affirmations, re-framing negative and limiting thoughts, recognizing what is possible. Seek out a partner to whom you can become accountable, and who will be a mirror for you as you figure out what works and what does not work. I spend a lot of time with patients working on these plans and figuring out workable solutions.

What You Think You Become” from Success magazine.

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U.S. FDA bans trans fats in foods

cookieFDA: Partially Hydrogenated Oils Must Be Removed from Food Products Within 3 Years

Limiting trans fats in processed foods is a step in the right direction. Let’s all say it together though…processed foods as a category are not good for health. Limiting and ultimately removing processed foods from the diet is our most important action. 

In 2013, the FDA ruled that partially hydrogenated fats, or trans fats, were no longer generally recognized as safe (GRAS). This is the next step in reducing consumer exposure to this ingredient.

Trans fats, along with numerous chemicals, are used to prolong the shelf life of foods, in some cases for months or more. Currently, companies can claim that a product is free from trans fats if it contains less than 0.5 g per serving, so vigilance reading labels and a tad of elementary math (watch serving sizes) is necessary. It’s still in there, in amounts detrimental to health. For those who rely on processed foods as a staple in their diet, this will probably have no more than a modest effect on health.

I think that the strongest impact of this ruling will be on childrens’ health. I have 2 young kids, and it seems that every time I turn around, someone is throwing some sort of processed snack food containing trans fats and other poor quality fats their way, always sugar-filled as well. This happens at school, soccer games, some businesses, and from well-intending acquaintances. I think of it this way: children are actively building every organ in their body, as well as developing their hormone, neurological and immune systems, and replacing critical fats with poisonous fats will create havoc now and down the road. Packaged foods are easy, they hold a strange novelty for kids, but an apple or other fruit with nut butter is just as easy and portable. Let’s do our kids a favor and give them real food. Let’s do it for ourselves too. Real food (produce, protein, nuts, seeds, and whole grains) is the best choice all around.

Source: FDA

Source: NEJM Journal Watch

By Kristin J. Kelley

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Food manufacturers must remove partially hydrogenated oils — the major source of artificial trans fats in processed foods — from their products within 3 years, the FDA has announced.

The agency finalized its determination, first proposed in 2013, that partially hydrogenated oils are not “generally recognized as safe” for human consumption. This action — in part a response to citizen petitions and based on data linking trans-fat consumption to health risks — will reduce coronary heart disease and prevent thousands of fatal myocardial infarctions per year, the FDA predicts.

After June 18, 2018, companies must petition the agency for approval to add partially hydrogenated oils to their products.

– See more at:

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A low carbohydrate diet for weight loss

Effects of low-carbohydrate and low-fat diets: a randomized trial.

Eating low carbohydrate for weight loss is not new information. This study shows us that a low carbohydrate diet is more effective than a low fat diet for weight loss, and does not increase cardiovascular risk factors.

Low fat diets have been promoted for many years for weight loss and cardiovascular health, and often lead in the increased consumption of processed, nutrient deficient foods such as breads and pastas. Don’t be afraid to eat fat!

DO: Make sure that the fat you do eat is of good quality. Diversify intake to include pasture raised eggs, nuts, seeds, nut and seed butters, olive oil, coconut oil, butter, ghee, fatty fish, cheese if you can, and meats if you are not vegetarian.  Importantly, know where your animal products come from.

AVOID: Avoid processed vegetable oils such as sunflower, safflower, vegetable oil, soy oil, and corn oil. Avoid animal products from factory farms, where quality is lacking in comparison to smaller farming operations and animal products contain a higher omega-6 to omega-3 fat ratio.

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Food & Exercise references


Here is a workout that you can always fit into your schedule wherever you are:

The Scientific 7 Minute Workout


Food and Recipes

I tend to reference sites with recipes that include a wide variety of vegetables, are simple to prepare, and from which recipes suitable for many diets can be found.


Websites and Blogs

Nourished Kitchen

Elena’s Pantry

Food Babe

The Nourishing Gourmet

George Bryant’s Civilized Caveman Paleo Recipes

The Kitchn

Smitten Kitchen

Nom Nom Paleo

Eat Drink Paleo

Gluten free recipes from Dr. Perlmutter’s site for brain, nutrition, and gluten information, and links to articles on gluten free foodsgluten containing foods and food products, and gluten-associated cross-reactive foods


Eating plans with recipe and meal planning references

Whole 30 Diet

Whole 30 recipe & shopping guides

Alejandro Junger Clean recipes  More Clean recipes

GAPS intro diet gaps-introduction-diet Gaps Intro Diet Simple Overview GAPS Food List Adapted GAPS INTRO DIET

Comprenensive eliminaton diet EliminationDiet-ASPreferred

Dr. Mark Hyman Ultra Simple Diet Guide

Chris Kresser on Irritable Bowel Syndrome, food intolerance, and FODMAPS a resource for finding ingredients in packaged and fast foods, and what to eat and avoid for specific food allergies


Allergen free recipe websites and references

Some sites on this list comes from Healthwire “The 16 Best Food Allergy Blogs of 2014”

The Nut Free Mom

Lexie’s kitchen

The Allergic Kid

Cybele Pascal and an additional page on substitutions

Learning to Eat Allergy Free

Food Allergy Research & Education (FARE) This blog is full of allergy resources and information

Jeanette’s Healthy Living

Food Allergy Mama

Food Allergy Queen


Other Resources

Chris Kresser informative eBooks on various health topics