LOW DOSE ALLERGY TREATMENT (LDA)

Low Dose Allergy Treatment is a form of enzyme potentiated desensitization (EPD).
This is a very low dose or homeopathic allergy treatment method.

What LDA is and how it works:

“EPD” or “Enzyme Potentiated Desensitization” was developed from a chance observation by Dr. Frantisek Popper, an Ear, Nose, and Throat Physician working in London in 1959. He found that “Hyaluronidase” injected into the nasal mucosa of patients with nasal polyps sometimes relieved sneezing. Then Dr. Len M. McEwen of London in 1967 showed that the enzyme “beta glucuronidase” derived from hyaluronidase had desensitizing activity. Beta glucuronidase mixed with a tiny dose of allergen or antigen could desensitize humans and animals.

Low Dose Allergy treatment or Enzyme Potentiated Immunotherapy produces tolerance to allergens at the cellular level.

The precise “ultra low doses of allergens” required for enzyme potentiated desensitization with the enzyme beta glucuronidase have led some authorities to consider LDA to be compatible with Homeopathic principles.

Beta glucuronidase is now recognized as a natural biological response modifier and under normal circumstances is likely to be a significant physiological up regulator of the lymphocyte immune system.

All present evidence is that LDA restores/ reinforces the natural active cellular immune tolerance to specific environmental antigens (allergens), which has broken down in allergic disease.

The Safety of Low Dose Allergy Immunotherapy: LDA uses a natural pathway of immune modulation at a strength less than that which occurs in nature. The treatment would be expected to be exceptionally safe. In a United States study, repeated ear infections in children responded to LDA better than any other condition. Many double-blinded studies have proven the effectiveness and safety of the LDA (EPD) treatment. LDA is discussed as “EPD” or Enzyme Potentiated Desensitization in current medical textbooks including the medical textbook “Food Allergy and Intolerance” by Dr. Jonathon Brostoff et al.

LDA allergy treatment in hundreds of patients over the last 20 years. The enzyme beta glucuronidase and the ultra low dose antigens required for treatment were first produced in England by McEwen Laboratories and they became FDA approved for use in this country under an investigational protocol that Dr. Robbins participated in for over ten years. When it became unavailable from England, we were able to obtain it from College Pharmacy under the direction of Dr. W.A. Shrader in the U.S. Dr. Albert Robbins is one of the original investigational members of the American EPD Society and took the original courses given by Dr. Len McEwen in London, England as well as those currently sponsored by the American Academy of Environmental Medicine…(AAEM.com)

Simple inhalant allergy treatment with Low Dose Allergy Immunotherapy:

Pollen, dusts, molds, and animal danders can be treated with a minimum of preparation.

Other Non-atopic (usually non IgE mediated) allergic conditions require more preparation:

Asthma, migraine, irritable bowel syndrome and crohn’s, urticaria, allergic arthritis, genitourinary allergy, neurologic allergy, food allergy, and chemical sensitivity all may require more sophisticated evaluation for treatment.

Precautions required for best results: To promote the maximum beneficial effect of LDA, these are the important recommendations:

Improve environmental controls beginning two weeks prior to the LDA injection. Avoidance of cats, dogs, and clean up of a dusty or moldy house. And it is important to stop using all fragrances and fabric softeners.
Improve nutrition and diet beginning two weeks before the LDA injection. A low yeast diet and/or a rare foods diet may be recommended and prescribed.
Eliminate any hidden infections prior to injection
Eliminate any hidden yeast infections (using gut preparation) prior to LDA injection. Elimination from the gut of hidden yeast infection with Diflucan or Nystatin/Amphotericin is the minimum precaution especially in treatment of food allergy.
In most patients it will be wise to prepare for LDA with Fluconazole or Itraconazole. A yeast free diet alone is not adequate to eliminate vaginal Candidiasis.
Bismuth eliminates yeast and Heliobacter from the gut and should be used in the gut preparation.
Use the special nutrient protocol that enhances the effect of LDA after the injection
Zantac used prior to the LDA injection may potentiate the benefit of the injection in food allergic individuals
You are not to take an injection of LDA if:

you are in the first five days of a cold
you are pregnant
you have just been immunized
you have had dental work within 7 days
you take pain killers or aspirin within 3 days
you are on singulair, cod liver oil, evening primrose oil, or vitamin C…..ulcer drugs like zantac or tagamet…(*although tagamet and zantac may enhance the effect of EPD if taken prior to the injection…
you are on asthma inhalers
you are on diet pills
you have cold sores
After the LDA injection you must:

Avoid Aspirin, anti-inflammatories, and Acetaminophen for 3 weeks.
Avoid alcohol for 10 days.
Avoid immunizations and dental treatment for two weeks.
The Basic LDA Diet (unnecessary with only inhalant allergy injection):
consists of avoiding the foods you usually eat… for three days-the day before, the day of, and the day after the EPD injection…

These foods are allowed-sweet potato…….yam…..cassava…..sago….lamb……fish not usually eaten….….cooked cabbage….celery…lettuce….rhubarb

When to take LDA Injections:

They are given every three months: April 15-May 15; July15-August 15; October 15th to November 15; and January 15-February 15

For pollen allergies the best time for an inhalant injection is prior to ragweed season

Insurance coverage and acceptance in the medical community: LDA is currently not covered by American health insurance carriers.

MULTIPLE CHEMICAL SENSITIVITIES UPDATE

In August, 2006 I attended a “Case Definition Workshop” for Multiple Chemical Sensitivities in San Francisco hosted by the Chemical Injury Information Network (CIIN.org)
The purpose of this important international conference was to bring together experts from many different scientific disciplines worldwide to share their insights and understanding of the diagnostic and treatment recommendations for sufferers of Multiple Chemical Sensitivities, and also to establish a case definition for MCS that would be accepted by the medical community.

The goals of this important conference were met and we accomplished much. We are still awaiting the final draft of the recommendations.

Physicians typically diagnose MCS by taking a health history, performing a physical examination and investigating whether symptoms come and go in response to chemical and other environmental exposures. To determine if an individual’s symptoms are the result of chemical exposures in the work, school, or home environment, an environmental/occupational exposure questionnaire is utilized to determine if symptoms increase or decrease in different indoor and outdoor environments.Generally, physicians who practice Occupational/Environmental Medicine are in the best position to diagnose and treat individuals with MCS.

The Multiple Chemical Sensitivity Syndrome raises many questions for the medical and scientific community. And it alerts us to the need to explore and become more aware of the tremendous role and impact that environmental chemicals have on human health in the 21st century.

The MCS case definition workshop in San Francisco in August, 2006 was attended by scientists and physicians from the U.S., Canada, Great Britain, Italy, Spain, Japan, and Australia. Allergists and Immunologists, Neurologists and Psychologists, Molecular Biologists,Social Scientists, Occupational and Environmental Physicians, Toxicologists, Attorneys and many chemically sensitive and chemically injured patients attended.

I have updated my viewpoint on MCS because it is has become a serious but poorly recognized silent epidemic. Both the Yale Occupational Medicine Clinic in New Haven,Connecticut and the Mount Sinai Occupational Medicine Clinic in New York City increasingly diagnose and recognize this serious environmental illness. Over 20 states have proclamations signed by their Governors making May,2007 MCS Awareness Month throughout the U.S.A.

It is my opinion that with the serious threat of chemical, biological and nuclear warfare, proper recognition and better understanding of chemically induced illnesses and chemical sensitivity disorders should be of the highest national priority.

I personally believe that we are currently in the midst of an epidemic of chemical induced MASKED illnesses. We are seeing more and more chronic illnesses that are either caused or aggravated by modern environmental chemical exposures. Many chronic illnesses respond to an environmental medical approach with an understanding of MCS as part of that masked illness. We may be at the cusp of a paradigm shift in the recognition of “modern Environmental illnesses.” Yet most physicians are failing to recognize and diagnose MCS (and its significance) for various controversial reasons.

The medical and scientific community may be under significant pressure to minimize recognition of MCS and its impact due to political and economic pressures from the chemical industry and insurance companies. This serious major medical controversy places the Occupational/ Environmental physician and the suffering environmentally ill patient in quite a difficult position.The physician is placed on the defensive when forced to justify his diagnosis of MCS and treatment recommendations to the medical community. The patient must defend him/herself against accusations that he/she is suffering from an “imaginary’ nonexistant illness. This controversy must be resolved, since various medical societies have issued “evidence based position statements” that advise physicians to negate the recognition and treatment of MCS at this time.

Based on my clinical experience, I suspect that large numbers of adults and children in our population are chemically sensitized and completely unaware of the seriousness of this problem and its implications. Without proper diagnosis of MCS, many chemically sensitized patients are treated with symptom relieving medications that may make them worse. Failure to make the proper diagnosis leads to improper treatment and progression of the disease.

In the modern world increased exposures to a wide variety of chemical agents have found their way into our air, food, personal care products, indoor and outdoor environments and our water supplies. The widespread use of many thousands of modern chemical agents carries the health risk of making a certain segment of our population more susceptible to chemical sensitization and the potential adverse health effects of becoming “sensitized” . The scientific community has the ethical responsibility to inform the population about what we know and what we don’t know and to appropriately warn our population.

There were three major areas of agreement at the 2006 “MCS Case Definition Workshop” in San Francisco:

    1. Physicians require a “Case Definition” for proper recognition of Multiple Chemical Sensitivities.

 

    1. Once the illness is diagnosed and recognized by the physician, the patient must be taught how to avoid incriminating environmental exposures and how to “UNMASK” the illness.

 

  1. More research is necessary to determine the various causes and treatments for those with MCS.

It is extremely important for physicians to diagnose the MCS problem in its earliest stages in order to prevent the progression of illness and the development of serious impairment and disability. If allowed to progress unknowingly, Multiple Chemical Sensitivities can devastate an individual’s quality of life.

The major classes of exposures that appear to initiate the MCS phenomenon include exposures to pesticides, working in sick buildings, living in toxic communities, occupying mold or moisture contaminated homes, working in the chemical industry, being exposed to formaldehyde products, new furniture products, new building materials and exposures to latex.

Multiple drug exposures and multiple drug allergy or medication intolerance may also initiate the phenomenon of MCS.Smokers may also be at high risk.

Psychosocial stress, heavy metal poisoning and hidden infections may also play a role in initiating MCS. Genetic, immunologic, and nutritional factors may play a role in making one more susceptible to developing MCS (Zenz, Occupational Medicine).

There appears to be a “Spectrum of Chemical Sensitivity Disorders” according to Ashford and Miller who authored the book recommended by the AMA: “Chemical Exposures, Low Levels and High Stakes.” This is comparable to the spectrum of infectious diseases; they are all similar, but each case of MCS may require a different individualized treatment.

The mechanisms of injury in MCS may involve the brain and nervous system with neuronal damage. Evidence is accumulating according to Martin Pall, PhD, that the nitric acid-peroxynitrite biochemical cycle is affected. Neuronal or brain inflammation may be a major factor in symptom production.

Neurogenic inflammation appears to be the fundamental problem in both upper and lower respiratory hyperreactivity associated with MCS according to William Meggs, M.D. author of “The Inflammation Cure.”
Asthma patients may be chemically sensitive.

Immunologic hyperreactivity may play a role in many cases of MCS.
It is currently recognized that allergic reactions are not confined to type I-IgE mediated reactions. All four types of Gel-Coombs allergic reactions are capable of triggering hypersensitivity reactions throughout the body explaining multisystem symptoms. Formaldehyde sensitivity occurs by way of hapten formation. The human body is very complex. The immune system plays a major role in many diseases of dysregulation including autoimmune diseases and autonomic nervous system dysfunction.

Damage to the body’s biological defense systems from toxic or allergenic chemical exposures can occur at the cellular level damaging cell receptor sites on cell membranes; genetic damage may also occur. Pesticide exposures are capable of damaging enzyme systems responsible for muscular, neurological, and behavioral controls. Once the body’s defense systems are damaged, minimal environmental exposures once previously tolerated may result in major symptoms.

A new protocol for an antioxidant nutritional treatment of chemically injured MCS victims has been developed by Martin Pall, PhD. AllergyResearchGroup.com has developed these nutrients for the chemically sensitized.

“The Inflammation Cure” by William Meggs, M.D. is an important book for all those who suspect they may have MCS. This book explains what is currently known and is very important for educational and treatment purposes.

There are many treatments that environmental physicians (members of the American Academy of Environmental Medicine) utilize to treat those with MCS.

People with MCS report that avoiding exposures to environments, chemicals, foods and drugs that trigger exposures is an important first step.

The following are a list of “some” available treatments for various aspects of MCS that I have utilized with some success in some patients:

  1. Optimal Dose Allergy (neutralization) Immunotherapy or Maximal Tolerated Intradermal Dose (MTID)-treating all hidden allergies
  2. Low Dose Allergy Treatment-or enzyme potentiated desensitization
  3. Individualized Nutritional prescriptions-based on nutrient testing
  4. Various Antihistamines including imipramine, doxepin, and astelin
  5. Heparin drops and intravenous
  6. Histamine drops and injections
  7. Leukotriene inhibitors-Singulair
  8. Neurontin-an antiseizure medication
  9. Antidepressants like prozac and lexapro
  10. Clonazepam wafers for reactions
  11. Trisalts and alka seltzer gold
  12. Glutathione injections
  13. Intravenous Nutritional Support including vitamin C and magnesium
  14. Vitamin B injections
  15. Individualized Exercise prescriptions
  16. Environmental controls for the home, office and personal care products
  17. Chemical free(no pesticides or artificial sweeteneres or sulfites) foods and water
  18. Antifungal therapy where indicated-treating hidden mold allergy and fungal infection
  19. Correcting any hormonal and thyroid imbalances
  20. Eliminating any hidden infection
  21. Evaluating and treating for toxic poisoning or injury
  22. Osteopathic Manipulation
  23. Appropriate comprehensive evaluation to rule out other serious illnesses like cancer, autoimmune diseases, diabetes, heart disease, mental illness,genetic diseases, Gilbert’s disease
  24. Gamma Globulin
  25. Lifestyle Education and counseling

For further information visit Allergycenter.com

By Albert F. Robbins, D.O., MSPH, FAAEM

Food Allergy Made Simple

THERE ARE TWO BASIC TYPES OF FOOD ALLERGY. Some forms of “food intolerance” are not considered food allergy, even though symptoms may be similar. True “food allergy“ is immune mediated.

  1. Immediate reactivity or “IgE” mediated food allergy…This is a “fixed” food allergy and is usually inherited meaning genetically determined…These foods may need to be completely removed from the diet or avoided if symptoms are serious…This is referred to as “Type 1 IgE mediated food allergy”…In some cases allergy immunotherapy can help
  2. Delayed reactivity or hidden food allergy is IgG mediated. This is a cumulative type of allergy. The body develops antibodies against foods eaten frequently. Many chronic illnesses triggered by food allergy are associated with delayed or cumulative food allergy.

Sometimes a food allergy is a concomitant allergy. A concomitant food allergy may be related to a pollen or mold allergy. This is a masked or hidden food allergy. For example, in ragweed or hayfever season certain foods should be avoided if you are allergic to ragweed…like milk, melons or bananas.

AXIOMS OF ENVIRONMENTAL MEDICINE related to Food allergy:

  1. Food allergy reactions can cause symptoms in any area of the body:

Food allergy can cause headaches, asthma, sneezing, skin rashes, stomach aches, bedwetting, fatigue, irritability, brain fog and other neurological symptoms, cold sores, esophageal reflux, irritable bowel syndrome, itching, hives, muscle and joint pain, fluid in the ears, sinus swelling, hoarseness, vaginal irritation, and even heart palpitations. Food allergens can also cause or aggravate neurologic tic disorders and Attention Deficit Disorder as well as Allergic Tension Fatigue Syndrome

If you are symptomatic and suffering from recurrent symptoms suggestive of hidden food allergy, it is important to identify major allergens through allergy testing.

Examples: Pork allergy can trigger allergic arthritis. Citrus allergy can trigger genitourinary allergy and increased susceptibility to frequent urinary tract infections. Yeast and mold allergy can trigger skin rashes, asthma, stomach bloating and gastritis and even susceptibility to yeast infections in women and Allergic Vulvovaginitis. Egg allergy can trigger headaches and migraine. Milk allergy can trigger recurrent ear infections, sneezing, leg aches and stomachaches. Tomato and wheat allergy can trigger inflammatory bowel disease or Crohn’s Disease.

It is important to note that the scientific medical literature supports the viewpoint that food allergy is often an overlooked cause or aggravating factor in many chronic illnesses. Many physicians do not look for food allergy as a cause of chronic illness; therefore, food allergy is overlooked. When food allergy is discovered and properly treated, it can sometimes prevent the need for symptom relieving medication.

  1. Susceptibility to infection may be a symptom of chronic food allergy due to an immune system overload phenomenon…. or the allergic load threshold effect.
  2. Food Allergy and food intolerance are not the same but may present with the same symptoms. The controversy in medicine surrounding food allergy and food intolerance has not been resolved. This controversy is related to the medical controversy surrounding chemical allergy and chemical sensitivity. Food intolerance may be related to chemical sensitivity.Many physicians refuse to treat food allergy because its role in causing or aggravating chronic disease is not perfectly clear, and it is emphasized in medical training unless you are a trained allergist.
  3. Milk allergy and lactose intolerance are not the same. One may have either or both conditions.
  4. Wheat allergy and gluten intolerance are not the same but may present with similar symptoms.
  5. Food allergy and chemical sensitivity may be interrelated due to the chemical composition of foods. Also many foods have added chemical additives or are sprayed with herbicides or pesticides.Sometimes allergy treatment for foods with allergy immunotherapy will also decrease chemical sensitivity symptoms.Eating organically grown foods may decrease food intolerance reactions.
  6. You can become allergic to your favorite foods.Cumulative food allergy is a masked food allergy/addiction. If you crave a food like peanut butter, you might eat it almost every day. Peanut butter then would become a suspect hidden food allergen triggering your bodily symptoms. When you stop eating peanut butter your body might actually go into a withdrawal phase, similar to withdrawal in drug addiction, and you could feel worse initially. You might even get a “buzz” or a stimulated effect from the addicted food. Fatigue, edema, weakness, and symptoms of hypoglycemia from the stimulatory and withdrawal symptoms of allergic addiction to foods can affect your autonomic nervous system leaving you feeling drained and feel out of balance. Food allergy can affect your other airborne allergies making them worse.You can become “maladapted” to the foods you crave and are addicted to. Then you feel sick and seek medical attention. Any craved food can be an addictive hidden allergic food.
  7. There are pro-inflammatory foods and anti-inflammatory foods. An allergic food can trigger inflammation. Inflammation is what causes symptoms in the body. Inflammatory mediators being released in the body from the allergic process cause the fatigue one feels from an allergic reaction.A vegetarian diet appears to be the least inflammatory diet and is also an alkaline diet. However, this does not always help everyone. Individualized allergy rotation diets work best once you find out which foods is your safe and which foods are your allergic ones.
    See “The Inflammation Cure” by William Meggs, M.D. for further information on an anti-inflammatory diet.
  8. Leaky gut syndrome symptoms are symptoms of inflammation causing vague digestive disturbances. Food allergy may be a major factor causing leaky gut syndrome. Other factors include a hidden gut infection from bacteria (H. Pylori), parasites (sometimes pinworms), or even a gut yeast/Candida infection that can disrupt the normal balance of intestinal flora. Stool studies may be helpful in making the diagnosis. Treatment of the hidden infection sometimes decreases allergic symptoms.

TESTS FOR FOOD ALLERGIES:

  1. The Elimination Diet Test for food allergies: If you completely remove a food from the diet for 5-7 days, symptoms will disappear if that food is the only one causing symptoms.Following an allergy elimination diet may help to determine if a food is causing symptoms. Some physicians use therare foods diet as a test. This rare foods diet advises using only foods that the person rarely or never eats. This diet would include things like lamb, sweet potato, cabbage, or a rarely eaten type of fish and plain distilled water and nothing else for 5-7 days. If symptoms are eliminated on this diet then one can add one food family back into the diet every 3 days to determine which foods you are allergic to.
  2. Blood test for food allergies: There are several medical laboratories that offer blood tests for the identification of food allergies that measure IgE and IgG antibodies against foods. These tests are not always that accurate and sometimes show false positives and false negatives. These blood tests are sometimes considered controversial in the medical community and therefore most health care insurance will not pay for these tests. However, they may be very valuable in identifying major food offenders…. and are very useful especially in children when we find it sometimes very difficult to skin test.
  3. Skin tests for food allergies: The best and most reliable skin tests for food allergies are “Intradermal Skin Tests” based on the book, Relief At Last, by Joseph Miller, M.D.; and also, recommended in the book, Is This Your Child, by Doris Rapp, M.D. Jonathan Brostoff, M.D, also explains this type of Maximal Tolerated Intradermal Testing and Treatment in the allergy textbook, Food Allergy and Intolerance.

TREATMENTS FOR FOOD ALLERGIES:

  1. Treatment for Food Allergies: Some people will benefit from immunotherapy for food allergies. This type of treatment, Maximum Tolerated Intradermal Dose, is based on Serial Dilution Endpoint Titration Allergy Testing recommended by the American Academy of Environmental Medicine and the American Academy of Otolaryngic Allergy. Treatment is for both adults and children using weekly injections for the foods they cannot avoid. We can treat also with sublingual drops. Maximum benefit usually occurs within weeks of beginning treatment.
  2. Enzyme Potentiated Low Dose Allergy Injection: This is a “homeopathic” type of very low dose allergy treatment that was developed in England by Dr. McEwen and it is available for selective patients unresponsive to other therapies. It involves getting one injection every 2-3 months for two to three years to decrease allergies. It is used to treat chemical sensitivity, widespread food allergies, and airborne allergies. In England and Italy this type of treatment is called Enzyme Potentiated Desensitization or EPD and utilizes the enzyme- beta glucuronidase. In the U.S. this type of treatment is called Low Dose Allergy treatment or LDA.
  3. Food Allergy Diet Rotation: Food allergic individuals may benefit from rotating foods. This means understandingfood families (we have a list for you to review). Just remember that any food you are allergic to should not be eaten more than once every three or four day. Repetitious eating is not recommended. This may be difficult but food rotation is very helpful in decreasing symptoms. For more information on diet rotation for food allergy see Rotation Bon Appetite, by Carolyn Gorman, available through the American Environmental Health Foundation in Dallas.

Allergy immunotherapy treatment is recommended even while rotating foods.

By: Albert F. Robbins, D.O., MSPH, FAAEM
AllergyCenter.com *

What Medical Services & Conditions Do Allergy Doctors or Centers Provide & Treat

MEDICAL SERVICES

  • Allergy Testing and Treatment: M.I.T.D. and Neutralizing Dose.
  • Environmental/occupational medical evaluations for acute and chronic illnesses.
  • Environmental intolerance/multiple chemical sensitivity evaluation and treatment.
  • Environmental and nutritional approaches (non-drug) to chronic conditions.
  • Toxicologic/chemical injury evaluation and treatment.
  • Preventive medical approaches to chronic illness.
  • Intravenous nutritional therapies.
  • Osteopathic Manipulative Services.

Other Special Services Include:

  • Independent Medical Examinations (IME’s) in environmental and occupational exposure injuries.
  • Expert Testimony for occupational and environmental exposure cases, specifically relating to cases involving chemical toxicity, indoor air pollution, sick building syndrome, and chemical sensitivity.
  • Indoor air quality environmental/occupational building and home investigations and recommendations.

MEDICAL CONDITIONS

Allergic Rhinitis

Allergy affecting the nose is the most common form of allergic disease affecting about a third of the population. When severe and annoying it requires proper treatment. Pollens, dusts, molds, animal danders, foods and fragranced chemical cosmetics are common causes. Some individuals require Allergy Immunotherapy (allergy shots) to cure the condition. Seasonal problems may benefit from medication and environmental controls. There are very safe medications currently available including intranasal steroids, nonsedating antihistamines, and Singulair. For year round chronic sufferers it is always important to determine if there is a chronic hidden infection. Nasal cultures are recommended for bacteria and fungus.

Asthma

This condition usually presents with symptoms of wheezing, cough shortness of breath. It is sometimes triggered by exercise. Cough variant asthma may present with just a chronic cough. Spirometry or breathing tests are advised for proper diagnosis. This is a simple test done in the office. Dust mite is the most common cause of allergic asthma. It is aninflammatory condition involving obstruction of the airways and usually responds well to an Environmental approach to treatment. Many asthmatics are very allergic and environmentally hypersensitive. It is important to determine what your allergic triggers are in order to treat it.. RAST Blood testing for allergy evaluation is recommended. All asthma patients should avoid fragranced products and fabric softeners. All patients with asthma should read the book “The Inflammation Cure” by Dr.William Meggs. Newer medications for asthma include antiinflammatories, bronchodilators and antihistamines.

Eczema and skin rashes

This atopic (allergic) rash can be caused by any contact allergen, food or inhaled allergen. In children foods may be a major factor. Hidden fungal allergy or bacterial infection may contribute to symptoms. RAST Allergy blood testing is recommended to determine what one is allergic to.Newer nonsedating antihistamines and environmental controls are usually helpful. Allergy immunotherapy may help dramatically. Enzyme potentiated desensitization has beeen very helpful in selected cases.

Urticaria or Hives

Hidden infection and parasitic infection should be evaluated for. Many drugs can trigger hives including antibiotics. Molds are common cause of hives. Foods, house pets, chemical gases, insects bites, laundry detergents and fabric softeners can cause hives. Allergy evaluation is recommended for chronic hives. Treatment involves treatment for any hidden infection (sometimes fungal or parasitic), environmental restrictions, elimination diets, and antihistamines. Sometimes immunotherapy including Low Dose Allergy treatment is beneficial.

Angioedema

This is a more generalized swelling of the body and the throat can close up. The whole body can swell. This can be lifethreatening. It is important to determine the cause. Drugs are common causes of both angioedema and urticaria.

Allergy of the Nervous System

Allergy may be a major factor in all types of recurrent headaches and migraines. Behavioral problems including hyperactivity, irritability and restlessness, fatigue, weakness, achiness, cognitive dysfunction, coarse tremor, and tics may all be manifestations of allergy. It is even possible for seizures to be a manifestation of an allergic reaction. Chemical, food and mold allergens are common causes of neurolgical allergy symptoms. A trial of avoidance of certain foods and chemical exposures sometimes gives dramatic relief of symptoms. I usually advise removal of all smelly chemicals from the home including fabric softeners, perfumed products, air fresheners, and smelly chemical cleaning agents. Cat allergy can also trigger migraines and neurological allergy symptoms.

Gastrointestinal Allergy or Irritable Bowel Syndrome

This is an area of neglect in modern medicine. Food allergy is a common cause of gastrointestinal symptoms as well as vague symptoms of fatigue and irritability. Cow’s milk is the most common cause of topical gastrointestinal allergy. Cold sores inside the mouth as well as reflux symptoms, heartburn, gas, bloating , bad breath, diarrhea, rectal itching and constipation can all be caused by hidden food allergy. Skin testing for foods commonly eaten is recommended. Usually foods commonly eaten and craved are suspected allergens.

Eye Allergy

This can be caused by pollens, foods molds, dust chemicals and animals. Contact lenses can be a cause.Medications are helpful but it is important to determine the cause to eliminate the problem. Itching of the corners of the eye are usually due to pollens, animal danders and dust. Itching of the whole eye is usually caused by foods. Eyelid irritation is usually caused skin care products, eyeliners , scented cosmetics and hair care products.

Mold Allergy

Mold sensitive patients usually have multisystem symptoms including nervous system hyperirritability, cognitive dysfunction, fatigue, and headaches. Moisture contaminated buildings and high mold allergen exposure can cause increased intolerance to perfumes and related chemical products (see article on Candidiasis and Allergy). Severely mold allergic individuals should have their homes evaluated for hidden mold exposure problems. Environmental controls are recommended. Mold sensitive patients should minimize the use of mold related foods. Molds not only produce allergens but also produce toxins and release chemical smells that have the ability to sensitize. More information on molds can be obtained through our office. Ask for our free handout entitled “Health Effects of Molds”

Pollen Allergy

Most pollens are seasonal pollinating once or twice per year. People claiming to get frequent colds in the fall (ragweed) or in the spring or summer (grass and trees)may have pollen allergy. Maleleuca pollen is common in South Florida. A simple blood test or skin test can determine if you are pollen sensitive. Allergy desensitization is very effective and safe utilizing our low dose treatment method. Certain foods are related to certain pollen allergies and in pollen season one should avoid those foods.. Ask for our free handout entitled “Concomitant Food Allergy.”

Allergic Fatigue

Most people are completely unaware that fatigue is a cardinal symptom of chronic allergy. Along with itching, day/night and seasonal variations and susceptibility to respiratory infections, fatigue is one of the most common allergic symptoms that is rapidly alleviated by proper allergy treatment which usually includes avoidance of incriminated allergic foods, and desensitization to inhalent allergens.

Genitourinary Allergy

Some doctors have referred to this as “bladder asthma”.Foods are the most common causes of genitourinary allergy. In the case of enuresis , the most common offender is milk followed closely by artificial colors. In recurrent cystitis and vulvovaginitis citrus fruits, black pepper, tomato, chocolate and cola are common offenders. Inhalent allergens may play a role in the very allergic child.

Allergic Arthritis

A significant percentage of arthritics suffer from atopic palindromic arthritis. Their joint pains are precipitated by food allergy reactions. Pork has a predilection for involvement of the joints. Pork has frequently been overlooked as a major cause of allergic arthritic pain. Joint pains are a late manifestation of of a food allergy reaction and may occur two to five days after eating a food. Other foods causing arthritis include beef, chicken, turkey , milk, wheat and corn.

Allergic Headache

Both inhalent and food allergies are often overlooked during the search for headache cause. Food allergy is the more common cause. Neck pains, achy legs, fatigue, insomnia, irritability, and pallor all increase the suspicion of food allergy. The most common foods causing migraine include milk, chocolate, peanut, pork, egg, coffee, and chicken. Cheese, chocolate, MSG, soy sauce, beers and wines are vasodilating foods and may cause headache. Molds and chemical fumes and smells can cause headache. Cat allergy can trigger headache.

Allergic Vulvovaginitis

Women who develop recurrent vaginal yeast infections and irritation of the genitourinary tract may have an allergic problem that can be treated with Candida immunotherapy, avoidance of perfumed products and a low yeast/mold diet. Education is the key to further progression of the disease. For further information ask for free handout entitled “AllergicVulvovaginitis”

Tourette Syndrome

This tic disorder may respond dramatically to an environmental approach which includes an allergy evaluation and treatment, environmental controls, stress reduction, a low allergy nutritional plan, elimination of any hidden infection. For further information go to Latitudes.org and read the book Tics And Tourettes by Sheila Rogers in which Doctor Robbins environmental approach is discussed.

Formaldehyde,phenol and Glycerine sensitivity

Treatment is available either through Optimal Dose Allergy immunotherapy or Low Dose Allergy Treatment . Ask for our free information booklets. Also AllergyResearchGroup.com has developed nutrient protocols for the chemically sensitive by Dr. Martin Pall

Cat and dog allergy

Sublingual allergy drops or optimal dose immunotherapy can be prepared to help you tolerate a dog or cat in the house. The ideal recommendation is to remove the animal from the home if you are allergic.

Viral or Herpes Desensitization

Utilizing very low doses of the influenza viral vaccine this treatment developed by Allergist Joseph Miller, M.D. can help to eliminate both type 1 and type 2 herpes infections and cold sores. It can also help the symptoms of Epstein Barr virus and Chronic Fatigue Syndrome.

Dust Allergy

Dust sensitive individuals should create an allergy free bedroom. Free information on how to do this can be obtained through this office. Carpet removal from bedrooms is recommended and encasing mattresses and box springs. Eliminate any dust collectors in the bedroom and clean all air conditioning vents and filters regularly.

NSBRI or Nonspecific Building Related Illness (Sick Building Syndrome)

There are many causes including poor ventilation and airflow, moisture contamination and roof leaks, poor air conditioning and air duct system maintainance, inadequate fresh air, improper remediation and chemical air pollutants. Individuals who become ill in sick buildings should avoid those buildings until they are determined not to be a health hazard.

Sinusitis

Most individuals with frequent sinus problems have hidden allergies and should be properly evaluated. Hidden infectioncaused by bacteria and fungi are also common and require treatment. Many have fungal sinusitis. Cultures of the sinuses can be done for an accurate diagnosis. Allergies are the most common causes of recurrent sinusitis.

Optimal Dose Immunotherapy

This approach to allergy desensitization allows us to treat your allergies safely and effectively and gives us the option of teaching you how to take your injections at home. For further information ask for the “Goldilocks Allergy Treatment” article.Also for children we offer sublingual allergy drops instead of injections!

Preventive Medicine

We all need to practice preventive health strategies daily. A daily health plan is necessary to prevent the progression of any disease process. Doctor Robbins is board certified in Preventive Medicine and has expertise in Health Education and can advise you in developing a healthy lifestyle action plan. Yearly checkups are recommended.

 

Post Nasal Drip, Septal Deformities, and Natural Treatment for Allergy Sufferers

Most of us never notice the one to two quarts of mucus, produced daily by glands in the nose and throat, necessary to moisten and clean the nasal membranes, humidify the air, clear foreign matter that is inhaled and fight infection.  This is because the majority of it is swallowed unconsciously within the course of the day.  Sometimes however, a clogged, or dripping sensation from the back of the throat referred to as, “post-nasal drip” occurs causing mild irritation and discomfort.

What Causes Post-Nasal Drip? —Treatment Options

Abnormal Secretions—Excessively thick mucus secretions, or increasingly thin secretions can contribute to post-nasal drip.  Thick secretions may result from dryness due to overheated buildings in the winter, sinus infections, or nasal allergies.  These can be from foods such as dairy products.  Sometimes thin secretions can become thick and turn green or yellow because of bacterial infection in the sinus area.

Thin mucus secretions may contribute to post nasal drip as well. These can be due to certain spicy foods, pregnancy, cold temperatures, hormonal changes, allergies, or bright lights.  Some medications, such as oral contraception, or blood pressure medication may cause increased secretions in the sinus passages as well.

Swallowing—Sometimes muscles in the throat, mouth and esophagus fail to interact properly causing secretions to overflow into the larynx and breathing passages.  This can cause hoarseness, coughing, and throat clearing.

The following factors may contribute to difficulty swallowing:

  • Age—Muscles often lose coordination as we get older and lose strength.  This can make it difficult for secretions to easily pass into the stomach.
  • Sleep—Secretions gather since swallowing occurs less frequently.  Coughing and throat clearing is often necessary when waking.
  • Stress—Spasms may occur when throat muscles tighten making it feel like a lump in the throat.  Throat clearing can actually irritate soft tissue at this point, as it often produces little or no mucus.
  • Swelling or growths—These, (when obstructing the food pathways) can prevent the smooth passage of mucus secretions.
  • GERD (gastroesophageal reflux disease)— Causes the contents of the stomach to back up, spilling acid into the throat or esophagus. 

Effects on the Throat

  • Sore, irritated throat
  • Swollen tonsils, throat tissue
  • General discomfort, (lump-like feeling) in throat

Treatment for Post-Nasal Drip-Allergy Remedies

A physician must conduct a detailed ear, nose, and throat examination.  If necessary, x-rays, endoscopic procedures and laboratory tests may be conducted.

Treatment Options Based on Causes

Bacterial Infection—Antibiotics for short-term sinusitis.  Surgery for chronic conditions to open blocked passages.

Remedies for Allergies—Prevention and avoidance of known allergen.  Relief through antihistamines, decongestants, steroids, and allergy shots, (these may be sedating or non-sedating and come in the form of pills, liquids, sprays, or injectables.)

GERD—Elevating the head of the bed, eliminating caffeine and alcohol from the diet, and avoiding food or drink, two to three hours before bedtime.  Certain over-the-counter and prescription medications are available to help treat GERD as well.

General Measures—Drink more water, avoid caffeine and diuretics.  There are some mucus thinning agents available.  Using a nasal douche or neti pot may help drain the sinus passages as well.

http://bit.ly/1x1Hcyq

The Neti Pot—Home Remedies for Allergies 

Although the practice of “saline irrigation” for allergy relief and the sinuses has been around for many years, there has been a resurgence of interest in the convention with the introduction of the “neti pot”, a teapot like container used to flush a saltwater solution through the nose and sinus cavities.  By leaning over the sink and pouring the saline solution into one nostril, the neti pot helps rinse away mucus and other irritants in the sinus cavity and nasal passages. 

Finding homeopathic remedies and “natural allergy medicine” solutions is important for many people, especially during times of high pollen such as during the spring and fall seasons.   

Historic Use of the Neti Pot

Many people with sinus allergies develop a chronic condition known as, “rhinosinusitis”.  This involves inflammation and sometimes infection of the sinus passages and cavities.  Many centuries ago Ayurvedic Indian medicinal practices utilized saltwater to flush the nasal cavities of ancient peoples to remove foreign debris, pollen, and excess mucus.  Practitioners of homeopathic allergy relief would irrigate the nasal cavities up to four times per day by delivering saltwater into one nostril and allowing it to readily drain out of the other.

Natural Allergy Relief-How it Helps

  • Reduces nasal congestion
  • Reduces headaches caused by sinus congestion
  • May decrease dependence on antibiotics that fight sinus infection
  • May decrease dependence on corticosteroid sprays used for nasal inflammation due to allergies
  • Considered safe and well tolerated

Safety Concerns

  • Should not be used for infants.
  • Physician should be consulted regarding regular use.
  • In certain cases, may actually create conditions for sinus infections.
  • May remove critical lining of mucus membranes necessary in sinus passages with overuse.
  • Sterile water must be used due to a parasitic amoeba, known as, “naegleria fowleri”, that has been linked to several deaths in neti pot users.

Natural Cure for Allergies—How the Neti Pot Works

A neti pot is a vessel that resembles a smaller version of Aladdin’s lamp.  When warm sterile saltwater is placed in the pot, the user tilts their head to one side and places the spout in the nostril that is elevated.  They then allow this to drain through the nasal cavities and through the other nostril.  Nasal irrigation should never be attempted using non-sterile water or seawater due to issues with contamination.   

Kosher salt is safe for use and prevents the discomfort of a burning sensation associated with a non-isotonic solution.

http://mayocl.in/1G343Cd

The Deviated Septum—Symptoms, Causes, and Treatment

A deviated septum can wreak havoc in the lives of both allergy and non-allergy sufferers, depending on the significance of the blockage created by the condition.

When the thin wall (nasal septum) between the nostrils is displaced to one side, this causes one nasal passage to be smaller than the other.  This can be significant, blocking one side of the nose and reducing the flow of air to the lungs.  Crusting or bleeding may occur as well, due to the effect of dry air flowing through the nose.  Obstruction of the nasal passages can happen also because of swollen tissues in the lining in the nose.

Symptoms

Many people live their entire lives without ever realizing they have septal deformities.  Some structural abnormalities do however cause troubling symptoms.

These may include:

Obstruction of the nostrils:  This may cause difficulty breathing, especially when allergies, a cold, or upper respiratory infection is present, which can already cause swelling or narrowing of nasal passages.

Nosebleeds:  The drying of the nasal septum may increase the risk for nosebleeds.

Facial pain:  One-sided facial pain may be caused by a deviated septum.

Noisy breathing while sleeping:  Infants and young children may breath loudly if intranasal tissues are swollen or if they have a deviated septum.

Over awareness of the nasal cycle:  Becoming overly aware of the cycle of obstruction from one nostril to the other may indicate a deviated septum.

Preference for sleeping on a particular side:  A strong preference for sleeping on one side, as opposed to another may indicate that breathing is impaired due to a narrow nasal passage.

Causes of a Deviated Septum

A birth condition caused during fetal development

Injury:  Injury during childbirth may cause a deviated septum in infants.  Accidents may occur in children and adults that cause trauma to the nasal structure.

Aging:  The normal aging process can exacerbate an already existing condition with the septum.

Acute Rhinosinosinusitus:  This can make a deviated septum worse because of swollen nasal tissues that will further narrow nasal passages and cause obstruction.

Treatment

Treatment of nasal obstruction may include medications to reduce the swelling, or adhesive strips that may help open the nasal passages. To completely correct a deviated septum however, surgery is necessary.

http://mayocl.in/1dX4xxO

Allergies and the Histamine Connection

HOW IT ALL WORKS

Certain substances cause our body’s immune system to overreact and produce histamine as a response to proteins found in foods, insect venom, or airborne allergens.  Normally these agents are inhaled or absorbed through the skin.  The body’s immune system creates antibodies to attack the foreign substance by releasing chemical histamines in the body.

WHAT CAN HAPPEN

When too much histamine is released into the body, several allergy symptoms may occur.  These include skin irritations, such as rashes, hives or eczema.  The eyes are also affected and may become watery, inflamed, irritated or scratchy.  Nasal passages can become swollen, and airways congested with runny nose and sneezing.  Too much histamine in the airways may bring about allergy-induced asthma as well.  This can lead to shortness of breath, coughing and wheezing.

http://bit.ly/1Ke1NKH

The Antihistamine Solution

Antihistamines are used to treat allergy symptoms and come in pill form, liquids, tablets, and capsules.

Antihistamines treat:

Skin rashes and hives

Runny nose, sneezing, congestion, or itching

Nasal passage swelling

Runny, itchy eyes

Treatment for an Allergic Reaction

The body releases chemicals known as, “histamines” as a response to contact with allergens such as pet dander, pollen, ragweed or dust mites, for example.  This causes the swelling, itching or stuffiness that accompany an allergic reaction.  Antihistamines work to either reduce the level of histamine released in the body, or block it altogether to lessen allergy symptoms.

Allergy treatments may include medications such as steroids, allergy shots, or antihistamines.

These may be either prescribed by a physician or purchased OTC (over-the-counter).

Antihistamines: These are used to treat allergy symptoms and generally fall into two categories, sedating and non-sedating.  Older antihistamines fall into the first category.  These medications relieve allergy symptoms, but cause drowsiness, and several other side effects such as dry mouth.  Non-sedating antihistamines, often considered a newer class of medications do not cause as much drowsiness.

All antihistamines work to lessen or prevent the amount of histamine that causes an allergic reaction in the body such as, swelling, itching, tearing, and breathing issues and secretions.

Antihistamines come in pill form as creams, nasal sprays, lotions, nose drops, and eye drops.

Other allergy drugs may include:

Corticosteroids: These work to reduce inflammation and include creams, ointments, nasal sprays, and tablets.

Mast cell stabilizers: These must be taken regularly to prevent allergic reactions.  Some inhalers such as (Cromolyn Sodium) may be used for the prevention of asthma.   

Leukotriene inhibitors: These drugs target specific leukotriene receptors in the body to reduce allergic symptoms.

Nasal anticholinergics: These medications work to reduce nasal discharge only.

Decongestants: These drugs constrict blood vessels in the nose, which help limit the secretions that come from the inner lining.  They are available in nasal sprays, liquids, and pills.

Immunomodulators: These help to relieve skin allergies and are topical.

Auto injectable epinephrine: This drug application is used to treat anaphylaxis, a severe allergic response to food, insect venom, or other substances.

http://1.usa.gov/1dhkCy7

UrticariaThe Management and Treatment of Hives

Hives, also known as, “urticaria” will affect about 20 percent of people in their lifetime.  Several different substances, causing an allergic reaction that creates itchy patches of skin that become swollen red welts, trigger this skin condition.  Certain activities may exacerbate hives such as, stress, alcohol, or exercise.

Symptoms

The symptoms of hives are itchy, raised, red or skin-colored bumps.  “Blanching” also occurs when the center of a red hive is pressed and it turns white. 

Triggers

Common triggers include:

  • Food Allergies (Food allergy rash)—Peanuts, eggs, nuts, shellfish
  • Medications—Antibiotics, Ibuprofen, aspirin
  • Insect venom—Bee sting allergy
  • Physical stimuli—Sun, heat, cold
  • Latex allergy
  • Blood transfusions
  • Infections—viral or bacterial
  • Pet dander
  • Plants—pollen, certain plants such as poison ivy, poison oak

Allergist Prescribed/OTC Medication

Treatment for hives includes both low-sedating and non-sedating antihistamines available by prescription or over-the-counter.  These may be taken along with anti-itch creams or salves, or cold compresses to reduce the swelling from hives.  Severe urticaria may require a temporary steroid such as Prednisone, a corticosteroid medication, or an immune modulator to reduce more severe symptoms.  In cases where the tongue or lips swell, or breathing is affected, a physician may prescribe an Epinephrine injector to be kept on hand in case of anaphylaxis, a potentially fatal severe allergic response.

It is important to identify, avoid, and eliminate triggers if possible including:

  • A food allergy or foods that may cause an allergic response
  • Scratching or rubbing
  • Harsh soaps
  • Pressure from tight-fitting clothing
  • Temperature, including cold air or water
  • Excessive sun exposure
  • Specific medications

Chronic Hives—Not Forever

Chronic hives may occur if urticarial symptoms exist for more than six weeks.  If no known cause can be found for the condition, it is said to be, “idiopathic”, or “unknown”.  Many of these cases can be linked to immune disorders, however.  Chronic hives may also be associated with other medical conditions, such as cancer, thyroid disease, or other hormonal disorders.  In general, even chronic hives disappear over time, however.

Anaphylactic ShockA Life-threatening Condition

This potentially fatal condition occurs as a severe allergic response toward a particular substance.  When this happens, the body can quickly shut down.   Breathing becomes labored, and blood pressure drops rapidly.  Thinking becomes unclear as the brain becomes starved for oxygen.  Cell-fluids in the throat can cause it to swell shut and death can occur within three to four minutes of exposure to a specific allergen. 

Anaphylaxis is a severe reaction to a food allergy such as peanuts or seafood.  It can also occur in persons allergic to bee stings or other insect venom. This is a life-threatening condition that needs emergency medical treatment to prevent anaphylactic shock.  It is important to note that the body may not react to initial exposure, but may produce a large amount of histamine upon subsequent episodes of exposure to specific allergens.

General symptoms of anaphylaxis may develop within seconds or minutes and include:

  • Pain in the abdomen
  • Abnormal breathing sounds
  • Anxiety
  • Tightness in the chest
  • Cough
  • Diarrhea
  • Breathing difficulties
  • Swallowing difficulties
  • Light-headedness, dizziness
  • Hives, itching
  • Nasal congestion
  • Nausea, vomiting
  • Heart palpitations
  • Skin redness
  • Slurred speech
  • Swelling in the eyes, face, or tongue
  • Unconsciousness
  • Wheezing

Emergency Medical Care

At this time, an injection of the hormone, epinephrine, (which is naturally produced in the adrenal glands) is the only treatment for anaphylactic shock.  This works to open the airways by constricting the blood vessels in the body.  Unfortunately however, the effects of an injection only last about 10-20 minutes and the drug must be administered before, or at the onset of symptoms.  It is critical to get help immediately upon exposure to a known allergic substance that could lead to anaphylaxis.

http://1.usa.gov/U2D9ot

Allergies or Sinus Infection? —Similar Symptoms

According to the Centers for Disease Control, the recent number of adults diagnosed with sinusitis in the United States is about 28.5 million.  That’s roughly, 12.1% of the adult population, and at least some of these cases can be attributed to allergies alone.

http://1.usa.gov/1ff32MQ

Bacterial Causes of Sinus Infection

Seasonal allergies affect many of us in different ways, especially in the area of the sinuses and the sinus passages.  Pollen from trees, plants, and grasses often causes stuffy noses, runny eyes and achy heads.  Sometimes, however this can lead to a more serious condition known as, “sinusitis”, or swelling and inflammation of the sinuses, (the air cavities surrounding the nasal passages). This may prevent normal drainage of the mucus the body creates to protect the lungs from foreign invaders such as dust and debris.

As mucus collects in the nasal passages bacteria begins to grow.  This may cause infection of the surrounding tissue that can spread through the sinus cavities.

While allergy symptoms may appear similar to that of a sinus infection, a physician must diagnose this through a physical examination, an x-ray of the sinuses, or a specific test for bacteria of nasal discharge.

http://bit.ly/1ekqZ5k

Sinusitis and Sinus Infection—Acute and Chronic

Symptoms of sinus infection may range from discharge that is thick and yellow, or green in color that runs from the nose, or down the back of the throat.  The nasal passages will generally also be obstructed, causing congestion.  There may be swelling in the face, around the nose, cheeks, eyes, or forehead, and it may be more difficult to taste or smell.

There are two types of sinusitis, which include, acute sinusitis, and chronic sinusitis.  (Sinusitis can be caused by infection or allergy irritation). 

Acute sinusitis:  This is the temporary inflammation of the sinuses where mucous membranes in the nose, sinuses, or throat become inflamed due to allergies.  The swelling caused by allergies blocks mucus from draining, causing pressure to build in the sinus area.

Chronic sinusitis:  If symptoms persist for more than 12 weeks, or if persons experience more than three sinus infections in one year, then sinusitis is considered chronic.  Over 50 percent of people with moderate to severe asthma have chronic sinusitis.

Sinus Infection Treatment—Getting Allergy Relief

A sinus infection may be treated in a variety of ways depending upon the severity of the infection. 

Unblocking the Nasal Passages:

This is the initial first step that is needed to treat a sinus infection.  Without proper drainage, the bacterial infection will remain in the nasal cavity causing further inflammation and damage to the tissues.  A physician may flush sinus passages or advise the patient to inhale steam, or sleep with a vaporizer to loosen phlegm. 

Options in Allergy Medicine

Nasal steroids:

Sprays containing steroids can be used to decrease inflammation of the nasal lining. 

Antibiotics:

Physicians prescribe a course of antibiotics to fight infection in the sinus cavities.

Oral steroids:

These may be prescribed for chronic sinusitis, but are powerful with significant side effects.  Generally they are only prescribed when other medications have failed. 

Nasal steroids: 

Sprays are helpful for many people to decrease inflammation, but can often lead to damage of the nasal lining.

Surgery: 

Some patients with chronic sinusitis that have not responded to antibiotics or other medications may be candidates for functional endoscopic sinus surgery (FESS), or a “balloon sinuplasty” to help clear sinus pathways and allow for normal drainage of mucous.

http://bit.ly/1TqtX8a

Can Allergies Cause Headaches?The Truth About Whether Sinus Allergies Can Lead To a Sinus Headache

Sometimes allergies or hay fever can lead to sinus pressure and headaches in the front of the head or around the eyes.  A physician must diagnose true sinus headaches since they may also be confused with migraine pain because of their location.  Sinus pressure caused by blocked or inflamed sinus passages may press on the nerves surrounding the ocular area and head causing severe headaches for some allergy sufferers. 

If an infection occurs due to bacteria from mucus build up, the sinus passages will remain swollen and inflamed causing pressure and possible headache pain to persist. 

Allergy Headache—The Sinus Pressure and Pain Connection

It is important to note that many people who “self diagnose” their headache as a sinus headache really suffer from migraine pain.  (Research finds there is a link between migraines and allergies). 

There are four pairs of paranasal sinuses contained in the skull that help the voice resonate and make the skull lighter.  Within this area, severe headache pain may occur in connection with allergies, sinusitis and sinus infection.  Physicians use specific criteria to diagnose true sinusitis (rhinosinusitis) headaches.

These include:

  • A headache must be present in the front of the head with additional pain in the ears, face, or teeth.  There must also be clinical evidence of either acute or chronic rhinosinusitis.  (A nasal endoscopy, CT, or MRI could provide this, as well as some type of nasal or sinus culture performed by a physician).
  • A headache must be present at the same time as rhinosinusitis symptoms.
  • Within a period of seven days of successful treatment, (or reduced symptoms) of acute or chronic rhinosinusitus, the headache and/or facial pain disappears.

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Allergies—Our Overactive Immune System

Over 50 million Americans suffer from chronic allergies each year. Caused by an overreaction of the body’s own immune system, symptoms may range from sneezing, coughing or mild skin irritation to more serious conditions such as allergy induced asthma or life threatening anaphylytic shock. While the Centers for Disease Control report that allergies are the 6th leading cause of chronic illness in the nation, and that over $18 billion is spent annually for treatment, some persons may be at higher risk than others for allergy related illnesses.

Persons at risk include:

Infants who have already developed cow’s milk allergies
Small children who have asthma or food allergies
Anyone who has developed an allergic reaction to an insect bite or bee sting
Any person with a preexisting allergic condition
Anyone with close family members with allergies including hay fever, skin allergies, food allergies, or allergies to insect stings

So, what are allergies and why do we get them?

Normally, the body’s own immune system produces antibodies to protect itself from substances that cause illness or infection. In the case of allergies however, the body mistakenly identifies allergens as harmful agents, triggering the immune system to release chemicals such as, histamine that produces allergy symptoms. These can irritate and inflame the skin, clog sinuses and airways, and negatively affect the digestive system.

Allergies may be relatively minor, causing only minimal discomfort, but can also escalate to a serious condition known as, “anaphylaxis”, requiring emergency medical treatment.

While the majority of allergies cannot be cured, most can be treated to relieve symptoms.

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Food Allergies and Seasonal Allergies—Among the Most Common

Many people suffer allergic reactions to certain foods, and plant and tree pollens during specific times of the year.

Food Allergens: peanuts, tree nuts, wheat, soy, fish, shellfish, eggs, milk

*Peanut Allergy—An allergy to peanuts can be especially serious since it can cause anaphylaxis.

Airborne Allergens: pollen, animal dander, dust mites, mold

Insect Stings: bee stings, wasp stings, hornet stings, yellow jacket stings, and fire ant stings

Materials Allergies: Latex is a common substance that may promote an immune system response. Proteins found in latex rubber, used in gloves, condoms and other products cause contact skin allergies for some people.

Drug Allergies: These can affect the skin or other tissue or organs
of the body. This includes Penicillin or Penicillin derivatives.

Allergic Reactions—Signs and Symptoms

These vary depending on the substance and the area of the body affected. This includes the digestive system, nasal passages and skin.

Seasonal allergy symptoms/airborne allergies: sneezing, runny nose, stuffy nose, red, swollen eyes, watery eyes, itching on the roof of the mouth

Food allergy symptoms/food allergies: swelling of the lips, tongue, throat, face, mouth, hives, anaphylaxis

Insect sting allergies: swelling at the sting site,
hives or itching covering the body, wheezing, coughing, chest tightness, shortness of breath, anaphylaxis

Drug allergies: hives, itchy skin, skin rash, swelling in the face, wheezing, anaphylaxis

Atopic dermatitis—a skin allergy also known as “eczema” that may cause skin to become red, peel or flake

Medical conditions associated with allergies include asthma, conjunctivitis, eczema, dermatitis and sinusitis, hives and hay fever.

http://mayocl.in/1ynjG5r

Anaphylaxis—Life Threatening Consequences

Anaphylaxis is a life threatening condition caused by a severe allergic response requiring emergency medical assistance. Some foods and insect stings can cause anaphylaxis, causing the body to go into anaphylactic shock.

Signs of anaphylaxis include:

Tingling/Palms/Hands/Feet/Lips
Tight chest
Seizures
Cardiac arrhythmia
Shock
Face Flushing
Loss of consciousness
Loss of blood pressure
Shortness of breath/ragged breathing
Skin rash
Lightheadedness/dizziness
Weak/rapid, pulse
Upset stomach/nausea/vomiting

Risks and Concerns

An allergy may increase your risk of:
Anaphylaxis
Asthma
Atopic dermatitis (eczema)
Sinusitis
Infections of the ears or lungs
Fungal complications of your sinuses or your lungs
Bronchopulmonary aspergillosis, (a hypersensitivity response to the fungus Aspergillus if you’re allergic to mold)

Can Allergies Be Prevented?

Once the body develops an allergic reaction to a certain substance there is generally no way to prevent that allergen from reacting with the body again. Eliminating a particular substance from a person’s environment or controlling the amount of exposure a person has to an allergen is the general protocol surrounding treatment for allergies. This can be done by avoiding particular foods that trigger allergic responses, installing air filtration systems that filter out pet dander, dust mites, pollen, and dust particles, and taking medication to minimize the symptoms and effects of allergies.

http://1.usa.gov/1FG8c9Z
Multiple Allergy Treatments—Many Forms

Allergies may be treated by prescription medications, or over the counter products. These are available in the form of pills, liquids, nasal sprays, inhalers, eye drops, skin creams and injections.

Antihistamines—Antihistamines block histamine, a symptom-causing chemical released by your immune system during an allergic reaction.

Pills and liquids—Oral antihistamine to ease symptoms

Nasal sprays— Relieves sneezing, runny nose, sinus congestion, postnasal drip

Eye drops—Antihistamine for itchy, red, swollen eyes

Decongestants— Offers immediate relief from sinus and nasal congestion.

Pills and liquids—Oral decongestants

Nasal sprays and drops—For short applications

Corticosteroids—Corticosteroids relieve symptoms by suppressing allergy-related inflammation. Most of these medications require a prescription.

Nasal sprays—Prevention and relief of stuffiness

Inhalers—Daily use for asthma prevention

Skin creams—For relief of itching, scaling, redness, swelling, or irritation

Immunotherapy—Gradual increased exposure to allergens to build tolerance

Allergy Shots as Treatment

Regularly scheduled allergy injections can also be taken to either prevent the symptoms of an allergy from occurring or to lessen the severity of the symptoms.

Emergency epinephrine shots—self administered shots to treat anaphylaxis

http://mayocl.in/1AWyln1

Food Allergies in Children

There are, without question, few conditions that cause more widespread parental concern and confusion than food allergies. Because of the potential for severe consequences, such as swelling of the lips or throat, breathing problems or, in the extreme case, sudden death, parents justifiably are concerned for their children’s safety. This concern extends beyond the home, to school, birthday parties, summer camp, and other activities. In addition to classical food allergy, children are frequently labeled food allergic primarily because of intestinal symptoms such as colic, vomiting and diarrhea. Other groups of children may be placed on avoidance diets because of frequent colds, eczema, hives and other rashes, and asthma. Thus, a myriad of symptoms or diseases are ascribed to “food allergy”.

Even physicians have difficulty organizing the possibilities and explaining to parents some of the subtleties of food allergies and related conditions, and those that may mimic these problems. The problem may be aided by agreeing on a definition, which is not always an easy task for the medical establishment. However, for the purposes of this discussion, a food allergy will be defined as a group of symptoms associated with a food that can potentially cause harm to more than one organ or body system at a time. An example is the patient who has vomiting, and develops hives and difficulty breathing after eating peanuts. This association is made stronger if the patient has a positive skin test to the food in question, confirming the presence of a specific IgE, the unique antibody responsible for a particular allergy. This is different from the problem of intolerance, where the problem lies in the inability to digest a particular food, such as milk and other dairy products (lactose intolerance), because of an enzyme deficiency. The distinction between skin test-positive food allergies and other food related problems is important because food allergies can potentially lead to very severe symptoms or even fatalities.

What are the main symptoms of food allergy? The first warning sign often begins in the mouth and throat. Lip tingling, mouth and throat itching, and lip swelling may occur within seconds of contact with the offending food. A person may also experience nausea or may actually vomit and/or have diarrhea. A feeling of flushing or itchiness may ensue. Within ~ minutes to 2 hours, sensitive persons may develop hives on their skin and often swelling of the face and throat. In most severe reactions, breathing problems, that resemble asthma, as well as dizziness, weakness and fainting (true loss of consciousness) may develop rapidly and be fatal if not treated quickly (anaphylactic shock).

Not all children with food allergies experience all the symptoms. Most commonly, the symptoms do not involve more than localized itching in the mouth and an episode of hives. Commonly, young infants will have their eczema flare when they eat certain foods. This happens within 30 minutes to 2 hours after eating. Itchiness will develop and, over the next six to eight hours, the child’ s eczema may flare badly. This type of reaction, although seldom leading to anaphylaxis, is uncomfortable for the child.

Another group of patients, who suffer from hay fever, may get lip and tongue tingling and a feeling of swelling in the mouth when they eat fresh fruits and vegetables. They have ns real prsblems with the cooked variety. These patients rarely develop a severe total body reaction. Again, it may not be life-threatening to eat the food, but the symptoms are nevertheless bothersome. Sometimes, children with unexplained hives, poor growth or asthma suffer from a food allergy.

What are the main foods implicated in allergic reactions? In our pediatric population, there are seven “offenders” that account for over 90% of food allergies. They are milk, eggs, fish, wheat, soy, peanut* and tree nuts. This list is likely influenced by the prevalence of these foods in our diets. In countries where peanuts are not eaten, peanut is not a major cause of allergy. Rice allergy, which in North America is rare, is more common in Asian countries. This observation and other scientific evidence suggests that avoidance of these allergens in the early months of life may decrease the risk offood allergy in later life. Many food allergies are life long; however, some of the most common allergies seen in infancy, such as milk, egg, soy and wheat allergies, disappear in almost 70% of children by the age of 5 years. If a less common food is suspected as a cause of symploms, the parent should discuss this with the child’s doctor to arrange appropriate testing and treatment.

What arc the best tests for food allergies? A good history taken by a physician who has experience with these problems is the most important aspect of the assessment of an allergic child. Many concerns about food allergies can be dispelled by paying attention to certain important facets of the history. What are the areas of the body affected? Do the symptoms recur every time a food is eaten? How long after eating the food does the problem occur? These and other questions help discern if there is a real food allergy, an intolerance caused by enzyme deficiency or no real problem at all. After a good history, it is often important to confirm the allergy with skin tests. Allergy skin testing is a very sensitive indicator of whether or not the food is significant in producing the reaction that has occurred. A positive history and skin test is a good indicator that the problem is, indeed, allergic. Negative skin tests suggest that perhaps a different food is the cause of the problem or that the symptoms are not caused by allergy. Skin tests may be performed with the fresh food itself, or with commercially-available allergy testing products. For some children, especially if they have severe eczema or are very young, a blood test for allergy, known as a RAST test, may be performed. Be wary of blood tests that are touted as a way to screen many foods at once or that promise to explain symptoms other than those classic for food allergies. These tests are often very costly and do not generally measure the antibodies related to development of allergies. Muscle strength testing after eating or touching a food or food tests using drops of food placed under the child’s tongue have not been scientifically substantiated as reliable indicators of food allergy.

Food challenges are occasionally suggested by the physician if skin tests are negative or if there is still a question about the diagnosis. These should only be done by physicians with experience in food allergy. They are safe, since these tests generally start with extremely small amounts of the food substance in question, with increasing doses being given if the patient tolerates the previous amount taken. If someone can eat a significant amount of a specific food with no symptoms developing within two hours, they are likely not allergic to the substance in question. Food challenges can be very useful in complicated cases of food allergy.

How are food allergies treated? The most important facet of the treatment is the elimination and avoidance of the substance from the child’ s diet. This may be a hardship in some cases, such as in egg, milk or wheat allergy. This approach entails reading labels carefully and knowing the commercial synonyms for products listed on labels; for example, milk can be listed as whey, casein or lactoserum. This is a critical part of food allergy treatment since, in very sensitive patients, contact with even small amounts of a food can lead to severe symptoms or even death.

There are also medications that are given to treat symptoms in case of accidental food ingestion. Antihistamines such as diphenhydramine (Benadryl) should be given if any contact with a food allergen is suspected, especially if there are symptoms such as hives, or skin and/or throat itchiness. In case of a more severe allergy, adrenaline (Epi-pen, Ana-kit) injected rapidly under the patient’ s skin can be life saving. Your physician should explain how and when to use adrenaline if your child requires this medication.

It is unfortunate that our bodies do not always appreciate some of the finer foods in life. However, it is more unfortunate that several people die each year from food allergies. If you suspect food allergy, discuss this matter with a physician. The testing and counseling of your child may be crucial to his/her overall well being in the future.

* The peanut is a legume, like peas, rather than a nut.

Multiple Chemical Sensitivity

“ABSTRACT.  Consensus criteria for the definition of multiple chemical sensitivity (MCS) were first identified in a 1989 multidisciplinary survey of 89 clinicians and researchers with extensive experience in, but widely differing views of, MCS.  A decade later, their top 5 consensus criteria (i.e., defining MCS as[1] a chronic condition [2] with symptoms that recur reproducibly [3] in response to low levels of exposure [4] to multiple unrelated chemicals and [5] improve or resolve when incitants are removed) are still unrefuted in published literature.)  Along with a 6th criterion that we now propose adding (i.e., requiring that symptoms occur in multiple organ systems), these criteria are all commonly encompassed by research definitions of MCS.  Nonetheless, their standardized use in clinical settings is still lacking, long overdue, and greatly needed–especially in light of government studies in the United State, United Kingdom, and Canada that revealed 2-4 times as many cases of chemical sensitivity among Gulf War veterans than undeployed controls.  In addition, state health department surveys of civilians in New Mexico and California showed that 2-6%, respectively already had been diagnosed with MCS and that 16% of the civilians reported an “unusual sensitivity” to common everyday chemicals.  Given this high prevalence, as well as the 1994 consensus of the American Lung Association, American Medical Association, U.S. Environmental Protection Agency, and the U.S. Consumer Product Safety Commission that “complaints [of MCS] should not be dismissed as psychogenic, and a thorough workup is essential,” we recommend that MCS be formally diagnosed–in addition to any other disorders that may be present–in all cases in which the 6 aforementioned consensus criteria are met and no single other organic disorder (e.g., mastocytosis) can account for all the signs and symptoms associated with chemical exposure.  The millions of civilians and tens of thousands of Gulf War veterans who suffer form chemical sensitivity should not be kept waiting any longer for a standardized diagnosis while medical research continues to investigate the etiology of their signs and symptoms.”

 

*”archives of Environmental Health”, May/June 1999 [Vol. 54 (No. 3)]