I saw somewhere in the course material that asthma can be associated with HPA-D. Having suffered from asthma for many years, I’d be interested in a summary of the pathogenesis, if you don’t mind, especially related to allergic-type asthma. I took a saliva test a year or so ago, which showed low free cortisol, but I put a lot of that down to an accidental low-carb diet combined with CrossFit. Having addressed these things, I feel generally better, but the asthma still comes and goes, so I’d love to take it further. I plan to do a DUTCH test when I can afford it, and I’ve addressed gut issues. Any go-to supplements would be very welcome.

Chris Kresser:  So, you probably know this term neuroimmunoendocrinology. It’s quite a mouthful, but it’s a term that a lot of researchers and clinicians are now using to describe the intricate and inexorable connections between the neurological system, the immune system, and the endocrine system. Asthma is obviously an immunological condition that affects the respiratory system, but it also involves the nervous system, which we know that stress is probably one of the biggest triggers for asthma. I mean, everyone has different triggers. This sounds like it’s allergic type, but stress—I’ve never met an asthmatic person who says that stress doesn’t make it worse. So, I’m not sure of the particular mechanisms, but if you understand the connection between the neurological system, which the HPA axis is obviously a big part of, and the immune system, it makes sense.

A couple other things to look into for asthma would be functional orthodontics or dental orthodontics. Many people—I think I’ve talked a little bit about this before, the work of Dr. Jennings. This goes back to Weston Price when he observed that traditional peoples had a very wide dental arch, and their bite was tip to tip, so the end of their top teeth in the front touched the tops of their bottom teeth when they closed their mouth, but in the developed world, you see very narrow dental arches, and you see overbite. It’s very common. When the lower jaw is recessed, it not only affects the airway and causes things such as sleep apnea, but it affects the nerves in the head, and, of course, all the nerves in the head innervate, many of them, the rest of the body, and they can cause profound changes in the neuroendocrine immune system. So that’s something to look into.

Certainly, with any kind of allergies, you’re looking for anything that would trigger immune dysregulation, so you’re looking at all of the gut stuff that we’ve talked about. You’re looking, when we get into the blood chemistry, at nutrient deficiencies or excesses. You want to consider things such as mold, biotoxins, and heavy metals, food intolerances certainly. There is a lot to consider with asthma. It is such a general symptom, but it really comes down to immune dysregulation, so that’s where you want to put your focus.