In 2014, researchers released results from a study on a new skin patch called Viaskin, aimed at treating peanut allergies. Now, more results have been released. The idea behind the patch was that by exposing people to small amounts of the protein in peanuts that causes allergic reactions, the patch could train the immune system to get used to the protein and recognize it as innocuous. The hope was that this approach – known as epicutaneous immunotherapy - would reduce or eliminate peanut allergy by desensitizing people to peanuts.
The creators of the patch suggest that the patch should be worn for three years, but the initial study was conducted over the course of just one year. This new set of results come from an extension of the original trial and involved patients using a higher dose patch for two years.
The new study showed that for children between the ages of 6 and 11, 83.3% were able to tolerate ten times the amount of peanut after wearing the higher dose patch than they could at the start of the study. These results suggest that the combination of higher dose and longer use is more effective, as only 53.6% of these children showed this improvement in the original study.
In the more recent study, 171 patients were studied. Of the 171, 97 were children. Unfortunately, the patch did not have the same beneficial impact on teenagers and adults as it did in children. Dr. Hugh Sampson, the Director of the Jaffe Food Allergy Institute at Mount Sinai in New York, therefore commented that the younger we can start those with peanut allergies on the patch, the better.
Why does the patch work better in children than in adults? The answer to this question may have to do with the specific cells that the patch works on – called Langerhans cells. These cells exist around hair follicles, and as you age the hair follicles spread apart, separating these cells. It therefore harder to get the same amount of the medicine to as many cells in older people than in younger people. It is therefore possible that a higher dose patch could be more effective in teenagers and adults than the patch that was used in the current study.
The company the produces the patch, Salmun, is hoping to apply for approval from the United States Food and Drug Administration (FDA) later this year. However, one critical question remains regarding the use of the patch: would users ever be able to take off the patch and continue to reap the rewards over the long-term? The company is currently conducting research to address this question, as well as ones to address safety issues. While the vast majority of study participants experienced no adverse side effects from the patch, 2.3% of the patients dropped out of the study due to symptoms.
The positive impact the patch has shown on children demonstrates the promise for skin patches in addressing food allergies. Another patch, for milk allergy, is currently in a Phase 2 trial, and there is pre-clinical work underway for an egg allergy patch.
It has long been recognized that patients who suffer from asthma may struggle to use their inhalers properly. There are a number of mistakes that people can make when using inhalers. Research has shown that patients tend to make at least one of these mistakes 70% to 90% of the time. When these mistakes occur, the amount of the drug to reach the lungs is significantly reduced. Incorrect use can lead to only 7% of the recommended dose actually getting to the lungs.
A study was recently conducted to determine how frequently and why those with asthma incorrectly use their inhalers. The results helped to clarify the specific causes and implications for inhaler mistakes. To conduct their study, the scientists placed sensors on the inhalers of 23 patients, which allowed them to keep track of details about how the inhalers were used, including how they were shaken, activated, and breathed from. The patients included in the study were diagnosed with either asthma or chronic obstructive pulmonary disease (COPD).
Data from the inhalers with sensors showed that everyone made at least one error using their inhaler during the course of the study and that 74% of people made at least 3 mistakes. Some mistakes involve failing to follow instructions for inhaler use. Not shaking the inhaler, for instance, is one common problem that prevents the medicine from being sufficiently mixed. Another problem is that people often do not wait the suggested 15 to 30 seconds between inhaler puffs.
Other mistakes have more to do with the way patients breathe in the medicine from the inhaler. For instance, some people breathe in too quickly and miss some of the medicine. Others exhale too quickly rather than holding their breath once the inhaler medicine has hit the lungs. Coordinating the squirting of the inhaler with the breath also causes problems, as does the angle with which patients use the inhaler. Patients are advised to use an upright orientation when using inhalers, but people often lean their bodies or put the inhaler at an angle when deploying the medicine.
According to the recent study, the coordination is the most problematic mistake that occurs with inhalers because mis-coordinating by as little as half a second reduces the amount of medicine that reaches the lungs to 20% of the intended amount. Not breathing deeply enough was reported as the second most dangerous error that occurs during inhaler use.
The researchers noted that there are certain populations that are more likely to struggle with coordination and breathing deeply while using their inhalers. Specifically, elderly patients, children, and those with cognitive impairments have been shown to be less likely to successfully coordinate their breathing with the activation of the inhaler and less likely to breathe deeply enough to get optimal results.
These research findings point to the need for physicians and patients to work together to ensure that inhalers are being properly used. Rather than assume that patients are getting the recommended dose of their medicine, physicians need to be aware of the difficulties associated with the deployment of the medication and to focus some time on minimizing these challenges, particularly in populations that are prone to have trouble with the proper use of inhalers.
To mitigate the problems associated with improper use of inhalers, researchers have also suggested the use spacer devices, which are tubes that are attached to inhalers. These tubes can help deliver the medicine properly. With progress in both technology and physician-patient communication, the effective use of inhalers can likely improve.
Last year, Mylan the company that produces the EpiPen, received a lot of backlash for its increasing prices that reportedly preventing access for a number of people who require the medicine. The EpiPen is an injectable device that delivers epinephrine to those experiencing a severe allergic reaction. In the case of anaphylaxis, when the airways are closing, epinephrine is often life saving. Consumers and healthcare providers were therefore outraged when the price of EpiPens skyrocketed to $608.61 for a pack of 2 pens in 2016.
After the significant amount of negative press that Mylan received, and some changes in relevant policy, the EpiPen is now facing competition. Specifically, the major health insurance company, Cigna, decided to stop carrying the EpiPen in its brand-name form, and the major pharmacy, CVS, drastically reduced the price of a competing drug, the generic Adrenaclick auto-injector, thereby increasing its demand and lowering that of the EpiPen. The new price for generic Adrenaclick is $109.99 for 2 pens. In addition, a $100 coupon for CVS customers enables people to pay just $10 for this auto-injector, even if they are not insured.
In 2015, Mylan became the clear leader in the EpiPen market after a competing product, called Auvi-Q, which was produced by the French company Sanofi, was recalled due to problems with the device’s ability to deliver the correct amount of epinephrine. The vast majority of epinephrine prescriptions (over 95%) since then have been for EpiPens, but the start of 2017 has seen a sharp rise in the number of prescriptions for EpiPen competitors. An analysis performed on over 60,000 prescriptions for epinephrine auto-injectors made by more than 1400 medical providers in the United States showed that prescriptions for competitors to the EpiPen has more than quadrupled since the end of 2016. The EpiPen had 94.7% of the market share for auto-injectors in December 2016. By February of this year, that share had been reduced to 71.1%.
Auvi-Q has in recent weeks been reintroduced to the market by a drug maker called Kaleo. Unlike its competitors, Auvi-Q includes audio instructions that detail how to administer the epinephrine. Auvi-Q is also different from competitors in that it is being sold with a byzantine pricing structure. The pack of two auto-injectors is free for families who earn less than $100,000 a year. For others paying cash for the two-pack, the cost is $360. Insured patients pay $0 out of pocket, while health insurers are being charged $4500.
The fate of the EpiPen and its competitors is not clear. However, the good news is that access to life saving epinephrine auto-injectors is no longer a significant struggle. Given the swift reaction to the high prices for EpiPen and the efficiency with which solutions were provided, there is hope that these important medicines will always be accessible to those who need them.
Penicillin refers to a group of safe and inexpensive antibiotics that are frequently prescribed for an array of bacterial infections. Unfortunately, some people have demonstrated allergies to penicillin. These allergies occur when the immune system reacts to the penicillin. These reactions often lead to hives or rashes. In extreme cases, anaphylaxis can occur, which is life-threatening. Though a number of people believe they suffer from a penicillin allergy, there are recent suggestions that a number of these people do not in fact have this allergy.
Researchers from the University of Texas Southwestern Medical Center have said that 90% of those who believe they have a penicillin allergy are not actually allergic to these antibiotics. One reason for our misperception of the prevalence of penicillin allergy is that allergy status changes over time. As with many other types of allergies, people who once suffered from penicillin allergy can outgrow the allergy. What this means is that there are often many people avoiding these antibiotics at times in their life when the antibiotics would actually not cause them any problems.
Another reason that people mistakenly believe they are allergic to penicillin is because they are misdiagnosed or misinterpret the cause of the symptoms they endure after taking these antibiotics. Because antibiotics only help people with bacterial infections, those with viral infections will continue to experience their symptoms after taking penicillin or other antibiotics. Often when sick people do not respond to antibiotics, they believe that their persistent sickness is due to the medication.
Because there is a significant chance that patients who believe that they are allergic to penicillin are not actually allergic to the antibiotics, it is prudent for these patients to ask to be tested for this particular allergy. Tests for a penicillin allergy generally include a skin test. If the skin test is negative, people who are suspected to have a penicillin allergy are often then also given an oral test for the allergy. The oral test involves giving the patient a small amount of penicillin and monitoring them for any reaction.
The most important reason to confirm whether one suffers from penicillin allergy is that these antibiotics tend not to have the negative side effects of other antibiotics that are prescribed for those who cannot tolerate penicillin. The antibiotics that are prescribed to patients who believe they are allergic to penicillin are known as broad-spectrum antibiotics, and there is research that shows that these types of antibiotics can kill bacteria that are beneficial. For instance, these antibiotics can kill bacteria that promote a healthy gut and healthy skin. Broad-spectrum antibiotics are also thought to contribute to superbugs, or bacteria that do not respond to antibiotics. These superbugs can lead to infections that are life-threatening. MRSA, bacteria that are resistant to antibiotics, have been found to be more common among people who have reported penicillin allergies, which supports the idea that broad-spectrum antibiotics promote the growth of antibiotic-resistant bacteria.
Though it is important to avoid penicillin if one is in fact allergic to it, the advantages of treating bacterial infections with penicillin are significant. Those who believe that they are allergic to penicillin may therefore benefit from confirming their allergy status at different points in time.
There are a number of known risk factors for asthma. Pollution, dust, as well as certain chemicals increase the risk for developing asthma. Smoking, allergies, viral infections, and obesity are also linked with the chronic disease. Additionally, genetics are thought to play a role. Recently, research has also pointed to depression and anxiety as contributing factors for asthma. Insomnia is perhaps the newest risk factor to gain attention from the scientific community. Researchers in Norway have published findings supporting the correlation between insomnia and asthma in the European Respiratory Journal.
Though it has been recognized that there is a general correlation between insomnia and asthma, it has not been clear if those with asthma have difficulty falling asleep and staying asleep as a result of their asthma symptoms, or if on the other hand, issues with sleeping could somehow lead to the development of asthma. The recent study, however, showed that people with chronic insomnia are 3 times more likely to develop asthma over the subsequent 11 years than those without chronic insomnia. Further, the researchers found that people who reported having trouble falling asleep almost every night over the course of the previous month were 108% more likely to develop asthma. Even for those who reported having trouble falling asleep “often” had a 65% increased risk for developing asthma in the same time frame.
Difficulty falling asleep was not the only type of sleeping problem that the researchers found to be linked with asthma. Those who reported an inability to resume sleeping upon waking up too early also experienced this increased risk for developing asthma over the following 11 years. In addition, people who said that they experienced poor sleep quality more than one time each week had a 94% higher likelihood of developing asthma.
Though the recent research on the chances that those who experience different types of insomnia will develop asthma does not establish a clear causal link between insomnia and asthma, nor does it point to any particular mechanism by which lack of sleep may lead to the development of asthma, sleep is known to be critical for health. It is therefore important to work to develop good sleep habits. Preventing and treating insomnia may not eliminate the risk for developing asthma, but it could potentially reduce the risk.
A new analysis, published in the Journal of Allergy and Clinical Immunology, compiled data from 8 previous studies that investigated a total of 1.6 million patients and found that women who were prescribed heartburn drugs during pregnancy were more likely to have children who went to a doctor for symptoms associated with asthma. The study does not provide evidence for why the association may exist and does not suggest a causal relationship between the heartburn drugs and childhood asthma.
It is common to experience heartburn while pregnant, especially later on in pregnancy during the second and third trimesters. The condition occurs when acid from the stomach leaks into the esophagus. The reason it occurs more frequently during pregnancy is not completely understood, but it is generally thought that the growing womb may be the culprit because by pushing on the stomach, it could increase pressure and lead to acid leakage. It has also been suggested that the hormone changes that accompany pregnancy could contribute to the increased frequency of heartburn.
Several drugs for heartburn have been deemed safe during pregnancy because they have not been found to interfere with the development of the fetus. Drugs for heartburn tend to fall into two categories – H2 blockers and proton pump inhibitors. H2 blockers are also known as histamine H2-receptor antagonists and include Pepcid and Tagamet. These medicines work by blocking the histamine receptors in the stomach’s acid-producing cells. With these receptors blocked, the cells do not receive the signal to produce acid, and acid secretion is thereby minimized. Proton pump inhibitors, like Prilosec or Nexium, also reduce the amount of acid secreted by the stomach, but unlike H2 blockers, they achieve this result by shutting down the proton pumps in the stomach.
The recent analysis found that the children of those who were prescribed heartburn medications during pregnancy were 30% more likely to see a doctor for asthma concerns. What this means for the link between heartburn drugs and asthma is unclear. It is tempting to jump to the conclusion that pregnant women should not take heartburn medications because the medications increase risk to the fetus. However, it is important to keep in mind that this study does not establish a causal link. Previous research has shown that people who suffer from asthma often also suffer from heartburn, and it is possible that something other than medications causes both asthma in the child and heartburn in the mother. Until further research helps to clarify the reasons for the findings of the recent analysis, little can be concluded about heartburn medications in pregnant women other than that they do not seem to directly impact fetal development.
The few scientific studies that have investigated a potential link between cured meats (including sausage, salami, and ham) and asthma have not found any relationship. A new study published in the academic journal Thorax, however, claims to have identified a negative impact of cured meats on asthma symptoms. These results are consistent with some other research projects that have found that processed meats adversely affect the health of the lungs. Indeed, cured meats have been linked to a number of health problems, including heart disease, diabetes, and cancer.
The study analyzed adult asthma patients, based on their diet, their asthma symptoms, and their weight. Researchers first collected information on the patients between 2003 and 2007 and then followed-up to see how their asthma symptoms had changed between 2011 and 2013. The scientists found that each week, the average patient consumed 2.5 servings of cured meat. Researchers divvied the patients up into three groups for their analysis: low consumers (who ate one or fewer servings of cured meat per week), medium consumers (who ate one to four servings of cured meat each week), and high consumers (who ate more than four servings of cured meat each week).
During their follow-up, scientists found that more than half the patients (53%) had not experienced a change in their asthma symptoms. However, 20% of the patients had experienced worsening symptoms, whereas 27% had experienced improved symptoms. When analyzing the data from the perspective of cured meat consumption, the researchers found that of those patients with worsening asthma symptoms, 22% were high consumers. By contrast, only 20% of those with worsening symptoms were medium consumers - and an even smaller percentage (14%) were low consumers.
Body mass index (BMI) has been shown to be associated with asthma symptoms, with overweight individuals tending to have more severe asthma symptoms than others. It has therefore questioned whether the potential link between consuming cured meats and experiencing worsening asthma symptoms could simply be a reflection of higher BMI in these groups. However, upon closer inspection of their data, the researchers found that BMI only accounted for 14% of the worsening asthma symptoms in those eating cured meats. The study also controlled for other factors, including age, sex, education, exercise routine, and smoking habits, but because the study was observational, it is not clear if the apparent relationship between cured meats and asthma symptoms indicates that eating high levels of cured meat actually causes worsening asthma symptoms.
Scientists have pondered what might make cured meats worsen asthma symptoms if the relationship is actually causal. Most of their ideas point to ways in which cured meats may cause damage to the lung tissues over time. For instance, the high levels of nitrates that are present in cured meats can cause the oxidative stress that is strongly linked to tissue damage. Cured meat consumption is also associated with enhanced levels of C-reactive protein, which has a role in the immune system. Specifically, C-reactive protein can lead to inflammation, a well-known cause of tissue damage. Now that a link between cured meat consumption and worsening asthma symptoms has been demonstrated in one study, further research is likely to follow that will enhance our understanding of this potential link and any reasons it may exist.
It is often claimed that food allergies have been on the rise for years. According to the U.S. Centers for Disease Control and Prevention (CDC), 4 million children currently suffer from food allergies, the most common of which are to peanuts, tree nuts, eggs, milk, wheat, soy, fish, and crustacean shellfish. However, a new report published by the National Academies of Science demonstrates that there is a lot of confusion over the prevalence of food allergies, and experts are not sure if the frequency of food allergies is actually changing.
The report, which was put together by a team of 15 physicians who were appointed by the National Academies, helps to clarify why it is so difficult to know the actual incidence of food allergy. One major complication is that incidence is constantly changing, even within individuals. Many kids outgrow their allergies, while adults often acquire them. While allergies to eggs and milk are very commonly outgrown, about 20% of children will outgrow peanut allergies. At the same time, we often hear of adults suddenly becoming allergic to shellfish. Tracking the proportion of the population that endures food allergies becomes increasingly difficult when the allergy status of individual patients changes over time.
Another major challenge for understanding the prevalence of food allergies is related to difficulties with diagnosis. First, there is no perfect tool for diagnosing food allergies. Skin prick tests may be used to determine how likely a food allergy may be, though oral food challenge tests are generally used to confirm a diagnosis. With oral food challenge, the healthcare provider exposes the patient to small amounts of the potential allergen to see if the patient reacts. If the patient reacts, the test is stopped, and the patient is treated.
Another barrier for proper diagnosis is that patients often self diagnose and do not properly interpret their symptoms. The overlap in symptoms between allergies and other conditions, such as lactose intolerance, can make it difficult for patients, their families, and even their physicians to delineate the root cause. Gastrointestinal distress is the most common overlapping symptom, and many parents who notice that a food causes an upset stomach in their child assumes that the child has an allergy. Unfortunately, in these cases, kids will often end up unnecessarily avoiding foods. This type of behavior runs counter to recommendations based on the recent consensus that exposing young children to potential allergens earlier has a protective effect against developing allergies.
The main distinguishing feature between food allergies and lactose intolerance is that food allergies are life threatening, whereas lactose intolerance is not. Food allergies are also more likely to cause itchiness of the mouth, dizziness, and swelling of the lips and tongue, so those types of symptoms may indicate that a reaction is not simply due to lactose intolerance.
The report from the National Academies made a number of suggestions for increasing safety for those with food allergies. One idea was to have schools train personnel other than the school nurse in how to administer drugs like epinephrine that could be lifesaving when a student suffers a severe allergic reaction that may lead to anaphylaxis. They also made recommendations related to research, including
including enhancing research efforts to understand the actual prevalence of food allergies and what contributes to them.
Since the rise in peanut allergies, physicians and scientists have primarily focused on how to protect allergic patients from the problematic proteins that cause the dangerous allergic reactions. They have tried teaching patients, their families, and even their schools and other environments how to prevent exposure to peanuts. They have attempted to expand the accessibility of epinephrine, the drug that works to reverse anaphylaxis during life-threatening reactions. They have tried numerous approaches for preventing the development of food allergies and for treating them once they arise.
Through all the work focused on food allergies, and specifically, on peanut allergies, it has become clear that these allergies are not simple, and we do not have a complete understanding of why they occur. Some scientists believe that we see higher reported rates of peanut allergies because as information about allergies has become more widespread, parents have their children tested at an unprecedented rate. The result of such behavior on our understanding of peanut allergy incidence may be two-fold. First, we may identify a greater proportion of the population that has this allergy than we used to, and second, we may over-diagnose, labeling children as allergic when they do not suffer from a true allergy.
Another idea for why peanut allergies appear more prevalent is the hygiene hypothesis, which states that our immune systems now overreact to innocuous stimuli because we grow up in such sterile environments that the immune system does not have a chance to learn to recognize certain substances as harmless. Consistent with this hypothesis is the immunotherapy approach, which eposes allergic patients to small amounts of an allergen in an attempt to train the immune system to understand that the allergen is itself not life-threatening. Though this approach sometimes often to reduce allergies, it sometimes does not.
Now, instead of trying to change the behavior of allergic patients and those around them, scientists are considering changing the peanuts themselves. Back in 2008, U.S. scientists showed that ultraviolet light could produce shocks that reduced the potential of peanut extracts to induce allergic reactions. Similarly, Chinese scientists have shown that gamma rays can have the same effect. A recent Australian study also reduced the power of peanuts to cause allergic reactions by boiling raw peanuts for up to 12 hours in deionized waters. However, the boiled peanuts were reported as tasteless and shriveled.
Progress in genetic engineering has made it possible for molecular biologists to imagine producing peanuts that do not contain the problematic proteins in the first place. A group at the Institute of Plant Breeding at the University of Georgia has used tools from genetic engineering to produce nuts with significantly lower levels of the harmful proteins. Another group at the Alabama Agricultural and Mechanical University is trying to make a hypoallergenic peanut called Peanut4Life.
Perhaps at the forefront of this push to create peanuts that will not lead to allergic reactions is a food-technology start-up called Alrgn Bio, which is employing a peanut cleansing approach. These scientists are working with Alcalase, which is an enzyme that destroys the parts of peanut proteins that make them harmful while leaving the protein otherwise intact. The “Safer Peanuts,” as the company is calling them, which have been put through the cleansing process, apparently look much like other peanuts, except a bit darker, and also taste generally the same as other peanuts.
One of the biggest challenges that researchers face as they move toward safer peanuts are the risk that the “harmful” proteins are actually vital to the integrity of the peanuts and therefore destroying them also essentially destroys the peanut. Another challenge is that people react to different proteins found in peanuts, so eradicating all of those proteins in a way that will make all allergic patients comfortable being exposed to peanuts is a complex problem. Despite the obstacles, scientists are pushing forward with preclinical and clinical trials of their modified peanuts. There is good reason to think that we will have more news on the promise of this approach in 2017.
Since 2006, labels on foods that contain the major food allergens, which are peanuts, milk, eggs, fish, crustacean shellfish, wheat, soy, and tree nuts, must make it clear that these allergens are present. As a result of the Food Allergen Labeling and Consumer Protection Act (FALCPA), these products must be labeled in the ingredients list, or else, the label must say: “may contain” followed by the name of the specific allergen. In Canada, sesame, mustard, and mollusks must also be included. The specific type of allergen, such as shrimp, must also be listed.
When an allergen has not been deliberately added to the food, there is often still a chance that the allergen may be present due to cross-contamination during its manufacturing. Many companies therefore include precautionary content, such as “may contain” the allergen, “processed in a facility that also processes” the allergen, or “made on equipment with” the allergen. However, these advisory labels are voluntary and are not required by law. While individuals with food allergies, as well as their families, have been encouraged to read food labels in their entirety, a recent study demonstrated that there remains some confusion about what the information on these labels means, and this confusion tends to be caused by these precautionary statements.
The study, published in November in the Journal of Allergy and Clinical Immunology: In Practice, asked over 6,500 U.S and Canadian consumers, who either had food allergies or who were the caregivers of those with food allergies, about their food purchasing habits. Researchers found that because of a misinterpretation of the meaning of these precautionary labels, about 40% of respondents purchased products with these labels. About half of these respondents believed that the precautionary labels were required by law, when they are instead voluntary, and about 33% of them thought that the precautionary labels were indicative of the amount of the allergen present in the food, which, according to the lead researcher, Dr. Ruchi Gupta, is not true.
Because it is impossible to know whether a food with a precautionary label will contain an allergen or cause an allergic reaction, Gupta and others agreed that they generally recommend that patients avoid foods that have anything on the label suggesting that the allergen may be present, including the voluntary precautionary wording. In response to this study, James Baker, the CEO of Food Allergy Research & Education (FARE) has said that there needs to be more consistency and transparent on food labels. Gupta went further to say that more regulation is needed for food labels. Regardless of what the government decides to do about labeling foods, it is important that people will food allergies, and those who feed people with allergies understand that precautionary labels be taken seriously and that they suggest a true chance that the named allergen is present in the food.
With the dramatic increase of peanut allergy incidence in children in recent years, pediatricians had begun to recommend that parents avoid feeding their young babies peanuts until their immune systems matured. Taking care of new babies can be stressful enough without adding the possibility of a potentially life threatening allergic reaction to the mix. However, scientific research has helped doctors realize that it may actually be a bad idea to wait to feed babies peanuts because without peanut exposure, the immune system may be more likely to mistake peanuts for harmful substances. On the other hand, if babies consume peanuts, or the proteins contained in peanuts, from a young age, their immune systems may learn to recognize those elements as harmless and therefore not react upon subsequent exposure.
Scientists have confirmed this idea of the immune system learning to recognize peanuts as non-threatening with studies showing that babies who are exposed to high levels of peanut proteins before they are 9 months old are less likely to develop peanut allergies than those whose parents avoided giving them peanuts until later in life. These findings have helped shed light on why Israeli children, who are known to often be fed Bamba, a popular Israeli snack, have also been found to suffer from peanut allergies 10 times more frequently than Jewish children growing up in the United Kingdom.
With this new evidence for the appropriate age at which to give babies peanuts comes the question: when and how exactly should we be feeding our babies peanuts? Though we may now want to expose young babies to peanuts, there are challenges related to doing so, particularly because babies cannot safely eat whole peanuts because their combination of size and hardness presents a choking hazard. Even creamy peanut butter can be difficult for infants to eat before they are 10 months old. Nonetheless, peanut butter is one way many parents start exposing their babies to peanut proteins, with, for example, a thin layer of peanut butter on toast or on a cracker.
However, as sticky products can be hard for babies to chew and swallow, babies eating peanut butter should be closely monitored. Even easier than creamy peanut butter is powdered peanut butter, which can mixed into other things, such as yogurt, that babies are already eating and that are easier for them to eat than creamy peanut butter. Ground nuts can also be used as a substitute for part of the flour used when baking. However, for those who prefer to use creamy peanut butter, it can also be mixed into yogurt, cereal, and applesauce and should be safe for babies, as long as it is not too thick.
It is generally good practice to first introduce peanuts to your baby during the day so that there is time to monitor the baby for any reaction that may occur. An upset stomach, leading to diarrhea or vomiting can be a sign of allergy, as can a skin rash or hives, or an abnormal level or amount of fussiness. In addition, feeding your baby a small amount of peanut products at first and gradually increasing the amount is a good way to prevent a significant reaction. Research suggests that feeding infants more than 2 grams of peanut proteins each week, which amounts to about 7 whole peanuts per week, is associated with more than a 90% reduction in the chance of developing peanut allergies.
Though there are a number of benefits to introducing peanuts early in a baby’s life, the likelihood of a peanut allergy should be considered before starting babies on peanuts. Babies who have peanut allergies in the family, who suffer from eczema, or who have already been found to have food allergies are at a higher risk for peanut allergies. Parents of these babies should discuss the introduction of peanut products with their pediatricians. Luckily, physicians just met at the annual Americal College of Allergy, Asthma, and Immunology conference to determine federal guidelines about how and when to introduce peanuts to infants, and those guidelines will be officially developed with the National Institutes of Allergy and Infectious Diseases and released in early 2017. At that point, there will be more clear information and specific recommendations on how exactly to go about providing your infant with peanut proteins
Researchers at the University of South Carolina recently published a study in Allergy, Asthma, and Clinical Immunology, suggesting that exposing children to antibiotics very early in life may increase their risk for developing allergies. The researchers looked at over 7000 patients through Medicaid data from 2007 to 2009. Specifically, they compared 1504 kids that had food allergies with 5995 that did not and found that those that did suffer from food allergies were more likely to have taken antibiotics before their first birthday. The analysis showed that being prescribed with antibiotics in the first year made people 1.21 times more likely to eventually suffer from a food allergy.
The amount of antibiotic that kids are exposed to in the first year also seems to influence the risk for developing allergies. In other words, the more that children were exposed to antibiotics, the more their risk for allergies increased. For instance, those who were prescribed antibiotics three times were 1.31 times more likely to develop allergies than those who were not prescribed antibiotics during their first year, whereas those with four prescriptions were 1.43 times more likely to develop allergies. The risk of food allergy was 1.64 times more likely in those with five or more prescriptions than those without antibiotic prescriptions in the first year.
Another important factor that researchers found to impact allergy risk was the type of antibiotic. Drugs considered broad-spectrum therapies, such as cephalosporin and sulfonamide antibiotics, were more strongly associated with allergy development than drugs like penicillins and macrolides, whose spectrums are narrower. It therefore seems that a broader impact on microbes may compromise kids’ ability to avoid allergic disease. Previous research has indeed found that having normal flora in the gut is critical for normal immunity, and so it is not entirely surprising that antibiotics, which affect that flora, could prevent the immune system from learning to recognize harmless foods as harmless.
Currently, children in the United States are usually prescribed antibiotics on average 2.2 times between the ages of 3 months and 3 years, which represents a rise in infant and toddler exposure to antibiotics and may at least partially explain the increased incidence of food allergies that has been observed in children in recent years. Researchers say that this study adds to the reasons to minimize antibiotic prescriptions, particularly in children. While other lines of research focus on the potential for developing antibacterial resistance, this study highlights another important potential side effect of antibiotic use – namely, the potential for a higher risk of food allergy.
Further research on larger patient populations has been undertaken to help broaden our understanding of the link between antibiotics and allergy. Scientists in the Netherlands, at Utrecht University, presented findings weeks ago in London from over 650,000 patients with eczema or allergic rhinitis, also known as hay fever. The scientists showed that the risk of developing both diseases increased if children used antibiotics before they were 2 years old. Specifically, eczema risk increased between 15% and 41%, and hay fever risk increased between 14% and 56%.
Antibiotics are often used to treat viruses, even though they do not rid the body of viruses. This overprescribing tends to occur because it can be very difficult to differentiate between bacterial and viral infections. Nonetheless, as the evidence that antibiotics may cause unwanted side effects and risks, physicians are likely to become more cautious with respect to antibiotics and more conservative in their doling out prescriptions. However, they’ll have to balance the desire not to overprescribe with the critical role antibiotics can play in deadly infections like pneumonia or meningitis.
EpiPens could be purchased for less than $50 in the United States in 2007. The injection devices deliver epinephrine through the thigh to combat anaphylaxis, a severe, potentially fatal allergic reaction that closes the airways. For those with allergies or with kids with allergies, having an EpiPen on hand has been a recommended precaution that has helped to reduce anxiety associated with allergies and the potential for serious reactions.
In 2007, a pharmaceutical company called Mylan took over ownership of EpiPens. Since then, their price has been rising. By last May, each EpiPen would cost a pharmacy over $200, and this May, the price increased to over $300. Given that allergy patients requiring EpiPens are generally told to have two at all times in case an extra dose is needed for a severe reaction, patients and pharmacies tend to buy EpiPens in pairs, meaning that purchasing an EpiPen prescription now costs over $600. Further, EpiPens have relatively fast expirations, so even if they are not used, patients have to restock when the expiration date approaches, usually within a year of the original purchase.
Details of patients’ insurance plans vary, and so too does the actual price people pay for EpiPens. Luckily, many families have commercial insurance plans that include low deductibles and copayments, so they are not significantly affected by the increased price. Nonetheless, many people are now paying much steeper prices for the medication, either because they are uninsured or because their insurance plans have high deductibles, meaning patients pay more out of pocket for drugs. Mylan has provided $100 coupons for EpiPens, but many people do not feel that the $100 savings is sufficient for making the EpiPens affordable. Mylan’s initial response to the controversy largely involved raising concerns about high deductible health plans and their impact on consumers.
EpiPens are the go-to treatment option for anaphylaxis and the one medication that doctors recommend for those with severe allergies at risk for experiencing anaphylaxis. The price hike has therefore led to questions about whether the EpiPen represents a monopoly. Amy Klobuchar, a Senator from Minnesota has asked the Federal Trade Commission and the Senate Judiciary Committee to investigate whether Mylan is breaking anti-competition rules. Sanofi, another pharmaceutical company, was producing a similar product, Auvi-Q, but it was failing to deliver the right amount of epinephrine and so was recalled last year. With EpiPen as the only medication of its type on the market, many people feel that Mylan is engaging in price gouging.
The president of the Allergy and Asthma Network, Tonya Winders, has said that she is going to work with advocacy groups to try to make the EpiPen more widely covered by insurance as a way to deal with the price hikes and ensure that people have access to the medication if they need it, without it imposing a huge financial burden. Though changing the role of insurance providers and the specifics of health insurance plans is one way to help patients and their families deal with the increasing cost of EpiPens, those concerned that Mylan is running a monopoly wants to see changes on the side of the company and the FDA.
The House Oversight and Government Reform Committee held a Congressional hearing this month called “Reviewing the Rising Price of EpiPens,” and claimed that because Mylan does not provide generic forms of the drug, it should have been classifying the drug as a “single source” medication, which it has not done. The proper classification, they argue, would require Mylan to offer Medicaid a regular rebate, as well as an “inflation rebate” to offset the cost when the company raises the price of the EpiPen at a rate that is greater than the rate of inflation.
Mylan is now being forced to introduce a generic form of the EpiPen, which it plans to sell for half the price of the name brand. At the same time, FDA is being pressured to quicken its review of EpiPen competitors. Given the changes the company is making and the steps the federal government is taking to minimize the potential price effects of anti-competition, it is likely that people will soon be able to access EpiPens without having to worry about the medication being prohibitively expensive.
A study released in July in the journal JAMA Internal Medicine claimed that a group of asthma patients that researchers studied in Pennsylvania were more likely to have asthma attacks if they lived near fracking developments. The researchers looked at data from over 35,000 patients that attended a particular clinic in Pennsylvania from 2005 to 2012. Fracking, which is a method for collecting natural gas, is a politically contentious exercise that has been deemed dangerous on a number of counts. Many of these have been debunked, but the issue remains controversial.
In this particular study, run by a group at the Johns Hopkins Bloomberg School of Public Health, researchers found that asthma patients’ risk for experiencing an asthma attack increased four fold if their residence was in close proximity to where fracking took place. Further, the group looked to see if this association between asthma attacks and fracking depended on the seriousness of a patient’s disease. They therefore classified asthma into mild, moderate, and severe when analyzing their data.
Mild asthma was defined as that which only required medication. Moderate asthma, on the other hand, required a visit to the emergency room. Severe asthma was characterized as asthma that required actual hospitalization. The scientists found that fracking was correlated with increased risk for asthma attacks in all three categories of asthma.
The researchers also looked at the different phases of fracking to see if certain parts of the process may be more detrimental than others. They broke the process up into well development, which includes preparation, drilling, stimulation, and fracturing, and production. They found that all of the phases were associated with increased risk for asthma attacks.
Barbara Gottlieb, who is a program director for Physicians for Social Responsibility, a group that supports a ban on fracking, claims that living near fracking is similar to having an industrial facility in your yard. She also says that there are three different mechanisms by which fracking can lead to asthma attacks. First, she says that an ozone on the ground can be formed by the mixing of chemicals at fracking sites, which leads to asthma. Second, the natural gas, or methane, that can leak out at fracking cites can make asthma worse and at the same time speed up climate change, which may enhance the ozone on the ground. Finally, Gottlieb says that fracking sites usually have more industrial activity around them, which is accompanied by asthma-aggravating factors like transportation.
The study was only a descriptive study showing correlation, so there is no way to determine whether the fracking actually caused an increase in asthma attacks. It is certainly possible that some other factor could be attributed to the observation of increased proximity to fracking being associated with asthma attacks. The study did not explore whether the incidence of asthma attacks was any different before fracking began in this area. Further research that could clarify that issue would help us understand whether the fracking itself was likely to have contributed to asthma attacks. Such information is important for understanding if there is a true relationship between fracking and asthma. If it is determined that fracking does in fact cause or exacerbate asthma symptoms, then it will be important to figure out exactly how fracking impacts the respiratory and immune systems so that steps can be taken to reduce the risk to those living near fracking sites.
A new study has reported that children who suck their thumbs or bite their nails may be at a lower risk for developing allergies than those kids who keep their fingers out of their mouths. This finding is quite intuitive when you consider the hygiene hypothesis. According to the hypothesis, allergies have been occurring in higher frequency in recent decades because children are raised in cleaner environments than ever before. Because of their lack of exposure to germs, their immune systems do not learn to recognize innocuous environment material and therefore overreacts to it later in life, misinterpreting the material for something life threatening.
Those who support the hygiene hypothesis believe that other allergic diseases, such as asthma, eczema, and hay fever may all result from this increased environmental sterility early in life. However, this study did not find a relationship between thumb sucking or nail biting and these other allergic diseases. Nonetheless, other research has pointed to a role of allergens in staving off these allergic diseases. Specifically, research has shown that when parents suck babies’ pacifiers before putting them in their babies’ mouth, those babies develop asthma and eczema at a lower rate than those who do not do this “cleaning” practice. The idea behind this effect is that parents pass microbes from their adult mouths to their babies, thereby introducing substances to their systems that they would not otherwise experience at that age.
The specific results of this study were that kids who sucked their thumbs or bit their nails were less likely to test positive for certain allergies when they underwent skin prick tests. The study, which tracked 1000 people who were born in 1972 or 1973 over 3 decades, collected information on thumb sucking and nail biting habits when the children were 5, 7, 9, and 11 years of age. They conducted the skin prick allergy test when the kids were 13. Whereas 49% of kids who did not engage in either of the relevant habits tested positive in response to common allergens, only 38% of those who regularly put their fingers in their mouth tested positive. Of those who both sucked their thumbs and bit their nails, only 31% tested positive. The specific allergies that were tested included dog dander, cat dander, dust mites, and grass.
When these children grew up and were tested at age 32, the protective effect of thumb sucking and nail biting still appeared to be there. Though those who engaged in both habits did not experience allergies less frequently than those who engaged in just one, those who had sucked their thumb or bitten their nails were still less likely to test positive for allergies than those who had not done either. These effects held up even when researchers controlled for other variables such as gender, family history of allergies, owning a pet, parental smoking, and breastfeeding.
Though these findings fit nicely with the hygiene hypothesis, they do not prove that there is a causal relationship between thumb sucking or nail biting and allergies. Researchers therefore emphasize that it would be too hasty to start to recommend that children suck their thumbs or bite their nails as a way to protect against developing allergies. Instead, further research will help clarify the relationship between these habits and allergies specifically, and the potential role of early exposure to “germs” and other substances in allergy development.
It is perhaps not surprising that allergies and allergic diseases can have a negative impact on quality of life. Patients with these conditions can be chronically nagged with symptoms that in addition to causing discomfort, can also minimize productivity and prevent the ability to engage in certain activities. However, studies are starting to show that allergies may be specifically linked to depression.
The Utah Department of Health has just released the details of a study into a link between depression and the allergic condition, asthma. According to the Utah Asthma Program, more than one third of the adults with asthma living in Utah also have depression. Given that this rate of depression is higher than it is for the general population, researchers believe that there may be an association between asthma and depression.
Those with allergies are not only at increased risk for depression, but the severity of asthma predicts the likelihood of depression, adding support for the link between the conditions. The Utah study showed that people who suffered asthma symptoms on more days also had a higher rate of depression than those who suffered asthma symptoms on fewer days. The study reported that overall, 44% of adolescents who had had an asthma attack in the past year also said that they felt sad or depressed more times than not.
The Utah group speculates that asthma may cause depression because of the adverse effects it has on everyday life. For instance, those with asthma often report feeling out of control. Indeed, the Utah study showed that those with allergies who missed work or school were more likely to be depressed. Allergy patients also often suffer from anxiety related to whether they will endure an asthma attack. Asthma attacks themselves can also be highly anxiety provoking because they can make it very difficult to breathe.
Asthma is not the only allergic disease associated with depression. It is also seen in patients with eczema. Approximately 12% of children suffer from the allergic disease eczema. The disease often resolves by adolescence, but over 7% of adults still suffer from eczema, with around 1.6 million people suffering from a severe form of the disease. In this population, depression and other emotional and mental health disturbances frequently occur.
Whether allergic diseases actually cause depression is still not clear. The Utah groups study demonstrated an association between the two, and the researchers suggested reasons why allergic disease may cause depression. However, other researchers have suggested that depression can actually exacerbate allergic diseases. For instance, studies have shown that when a caregiver has depression, a child with asthma will often endure worsening symptoms.
Scientists at the University of Texas, Dallas and the University of Buffalo have been granted money from the National Institutes on Health to explore this link. They are specifically interested in whether treating a depressed caregiver could help a child’s asthma symptoms. The team will study 200 families recruited through the Women and Children’s Hospital of Buffalo and Dallas’ UT Southwestern Medical Center.
Researchers who are helping to illuminate the links between depression and allergic diseases advise that it may be best for doctors of those with allergic diseases to screen patients for depression. Because having allergies and depression can harm health more than having either condition alone, it is important for health care providers to reduce the likelihood that patients suffer from both types of disease. Given that pollen is peaking at this time of year, both patients and doctors should be aware that allergy symptoms may be exacerbated and that this may be a time when allergy sufferers are particularly vulnerable to depression.
More than 300 million people suffer from asthma. Though many people with the disease are able to control symptoms and disease progression, many others struggle to manage the disease. For some, the struggle is simply in figuring out the best drugs and doses to use. Others, though, seem unable to control their asthma with any of the drugs that are currently available on the market.
The London-based pharmaceutical company, AstraZeneca has developed a new drug for asthma that is showing promising clinical results for those who have been unable to control their asthma with other drugs. The company just released data on phase III studies on this respiratory drug candidate, named benralizumab. The newest studies aimed to evaluate whether the drug is effective in minimizing asthma in patients, and whether the drug is safe.
Benralizumab has been successful in reducing the frequency of asthma attacks in this population of severe asthma sufferers. Specifically, those who used the drug experienced fewer asthma attacks in the course of a year than did those who did not use the drug. Patients also tended to tolerate the drug well, with few or no adverse side effects. More details on safety outcomes will be released in coming months. However, there do not appear to be any red flags in terms of the drugs safety at this time.
To date, the clinical trials on benralizumab have included around 2500 people, ages 12 and up, who suffer from severe asthma and who have what is known as eosinophilic inflammation. The drug, which is an injection therapy, is intended for people who have not been able to control their asthma with conventional asthma medications, including inhalers and pills. Benralizumab is not the first injectable drug that has been developed for severe asthma. Other companies, including GlaxoSmithKline and Teva Pharmaceutical Industries produce drugs that are similar to benralizumab in a number of ways.
The impact of benralizumab has not been compared to that of the other injectable drugs yet. So far, AstraZeneca’s drug has only been tested against placebos and other types of asthma drugs that are not injected. However, whereas the injectable drugs created by GlaxoSmithKline and Teva Pharmaceutical Industries act on a protein that activates eosinophils, the cells that are believed to cause asthma, benralizumab acts directly on these cells. Given that benralizumab works via a more direct mechanism than other injectable drugs, it may turn out to be more effective. Another potential benefit of benralizumab is convenience and ease of use. Unlike other injectables, benralizumab comes in a prefilled syringe and thus does not require the additional preparation that many injectable drugs do.
About 1 in 10 asthma sufferers has severe asthma, totaling approximately 30 million people worldwide. The drug could therefore have a significant global impact on asthma. Additionally, AstraZeneca plans to test the drug in other phase III trials for use in patients with severe chronic obstructive pulmonary disease, potentially expanding the impact of the drug. AstraZeneca plans to submit the drug for regulatory approval in both the United States and European Union by the end of 2016.
Though it is not necessarily intuitive, there is a significant amount of research that shows that the time of year when you are born can impact a number of factors in your life, including your eventual height, whether you develop diseases, and how long you live. In recent years, there has been speculation that your birth season may predict your chances of developing allergic diseases such as asthma.
In 2010, following observations that children born in the fall or winter suffer from allergic symptoms like wheezing and eczema at higher rates than those born in spring or winter, scientists in Finland studied a group of almost 6000 children whose ages ranged from 3 to 9. Of the 6000 children, 1000 had been tested for food allergies by the age of 4. When the researchers dove deeper into the details of the allergies of these children, they found that birth season predicted a number of allergic factors. For instance, 11% of children whose 11th week of gestation was during April or May suffered from food allergies during their baby or toddler years. Far fewer children whose 11th week of gestation occurred at other times had food allergies at this young age.
Similarly, the researchers noticed that specific foods seemed to affect children differently depending on when children were born. For instance, some foods that affected only 5% of those born in June or July affected almost twice as many children (9.5%) born in October or November. The researchers believe that pollen may be the culprit for this pattern of findings, as pollen levels in the air would have peaked in April and May, during a critical time in these children’s fetal development when they are able to start producing antibodies. The scientists note that by 24 weeks of gestation, babies are able to produce antibodies to specific allergens. The study was published in the Journal of Epidemiology and Community Health.
Now, there is new research that confirms and expands upon these 2010 findings. A study conducted by researchers from the University of Southampton and just released in the medical journal Allergy provides new evidence that being born at a certain time of year increases your risk for suffering from allergies and helps clarify why this may be the case. The scientists found that people who were born in the autumn months were more likely to develop the allergic condition eczema. When they looked at the DNA of these people and compared it to the DNA of people born in other seasons, they found that the DNA of those born in the fall underwent specific epigenetic changes not see in those born in winter, spring, or summer.
Epigenetic changes are changes that occur to genetic material as a result of environmental factors. In the case of those born in autumn months, the epigenetic change was seen to be specifically a process called DNA methylation, which can change gene expression in a way that allows people to produce different types of proteins. For those born in the fall, who have these specific types of epigenetic changes, it may be the case that the altered gene expression they experience modifies the way their immune systems responds to allergens.
The researchers suggest that there may be certain factors that lead to the epigenetic changes seen in those born in autumn and that further research is needed to understand how such factors, which may include the food that is in season, the temperature, or specific sunlight levels, may make the season one is born in predictive of the development of certain conditions.
Asthma has been reported as the primary cause of chronic disease and disability in children. Because asthma can be life threatening, effective drugs and inhalers that are used to combat asthma symptoms can be critical to survival. However, some doctors are arguing that asthma is being over-diagnosed in children and that too many children are now using drugs whose effects should not be taken lightly.
Though the drugs used to treat asthma can save the life of someone enduring an asthma attack, they also have non-trivial side effects. The drugs can suppress growth and also suppress immune activity in the airways, which can increase the risk for respiratory infections. In addition, the drugs tend to be costly. According to some doctors, wheezing, which is a hallmark of asthma, is not always accurately identified. It is important that doctors recognize normal respiration in children if they are to distinguish asthma from other conditions or from healthy respiratory activity.
To remedy the situation, doctors are suggesting more stringent diagnosis protocols.
Rather than making a subjective judgment based on symptoms or a few clinical features, these doctors argue that an objective test must be employed before an asthma diagnosis is made. Airflow obstruction measurements and airway inflammation are two tests that these doctors believe are essential for an asthma diagnosis. Some argue that more invasive tests may be warranted if there is any doubt that a patient is suffering from asthma. For instance, blood tests and testing nitrogen oxide levels can help doctors be more confident of their asthma diagnosis.
In light of the problem of over-diagnosis of asthma, doctors and scientists are also pushing for more funding into asthma and allergy research, with the hopes that a more definitive asthma identification test will be created. Unlike some diseases, asthma does not represent one single condition but instead many, and it has different triggers and causes for different people and at different ages. Given its complexity, there has before been fear that asthma is under-diagnosed, which may be a contributing factor to over-diagnosis today.
Another issue with the overuse of asthma medications is that children often outgrow asthma. Many people continue taking their medications, assuming that they need them. However, rather than continue using unneeded drugs and subjecting themselves to side effects and potential complications, the status of patients’ asthma should be regularly monitored and updated. Further, close monitoring will allow doctors to see how patients respond to their medications. If asthma drugs do not seem to benefit a child, then the asthma diagnosis was likely incorrect. Unfortunately, when this is the case, physicians often increase the dose of the drug rather than reconsider the use of the rug. Even if a child does suffer from asthma, finding the right drug and drug dose can be time consuming. Thus, regardless of how confident a physician is in an asthma diagnosis, close monitoring and continual evaluation is warranted.
A new study analyzed this concern over misdiagnosis and found that half a million children that have been diagnosed with asthma do not in fact have the disease. In the study, researchers used a spirometer, which is a device that measures lung function, as well as other allergy tests to analyze the lung function of approximately 650 children, aged 6 to 17 years, that had been diagnosed with asthma. The scientists found that over half of these children did not actually have asthma. Further, only about 16% of these children had been tested with a spirometer prior to their diagnosis.
Respiratory doctors who published their views on over-diagnosis of asthma in children in the Archives of Disease in Childhood said that inhalers have “almost become a fashion accessory.” It is perhaps then not surprising that the Centers for Disease control (CDC) say that 1 in 12 people have asthma in the United States, which amounts to about 25 million people and that this number has grown since 2001. The estimated number of asthma sufferers in the US was only 20 million 15 years ago. However, now that fears of under-diagnosis of asthma have shifted, and awareness is growing as to the potential for over-diagnosis, changes in protocols and research focus should help ensure that appropriate asthma diagnoses are made and that children are provided with only the drugs that will best benefit them.
The significant rise in peanut allergies in recent years has puzzled physicians and scientists. In the past decade, peanut allergies have quadrupled in the United States. The scientific community has started to suspect that doctors’ recommendations to parents, regarding when to feed their children peanuts, could be partly to blame for the rise in peanut allergy incidence.
Doctors used to tell parents to avoid feeding their children foods that are often associated with allergies, such as peanuts, eggs, and fish, until their children were about three years old. The idea behind this protocol was that young immune systems may not yet be ready to deal with these potentially problematic foods. In 2008, however, these recommendations changed when the American Academy of Pediatrics decided that delaying the introduction of these foods may in fact increase the chances that allergies develop.
Last year, a long-term study known as LEAP showing that 5 year olds were 81% less likely to be allergic to peanuts if they ate peanuts products like peanut butter before they were 11 months old was published in the New England Journal of Medicine Last month, another study, known as LEAP-On, was published in the same prestigious medical journal that further supports the idea that exposing kids to peanuts early may actually be an effective way to prevent the development of peanut allergies. In addition, the study demonstrated other positive effects that peanuts may have on health.
As in the previous study, this recent research focused on children with a high risk for developing an allergy to peanuts. They found that kids who ate peanut products from infancy until they were 5 years old could avoid peanuts for a full year without affecting their risk of developing a peanut allergy. There were 550 study participants who were asked not to ingest peanut products for one year, from the age of 5 to the age of 6. Once they were 6, these children were tested for peanut allergies, and 21.5% of those who had always refrained from ingesting peanuts were found to be allergic to them, whereas only 2.4% of those who ate peanuts in their first 5 years of life were now allergic.
Enough exposure early on in life therefore seemed sufficient enough to allow children’s immune systems to recognize peanuts as innocuous in the long-term, even if peanut exposure was not consistent afterward. This new study builds on the previous finding that early peanut exposure reduces the risk of developing peanut allergy by showing that this protection can last even through a subsequent avoidance phase.
Several other problems often seen in children, including stomach bugs, eczema, lower respiratory tract infections, and near-sightedness were also found to be lower in the children who ingested peanut products from infancy to the age of 5. Given the latest findings on the relationship between peanut exposure and the likelihood of developing peanut allergies, as well as the correlation between peanut exposure and other health benefits, the American Academy of Pediatrics are working to develop updated guidelines. For now, pediatricians are told to suggest to parents that children be introduced to peanuts between the ages of 4 and 11 months if the children are at risk for developing peanut allergies.
Another recent study, known as EAT, looked at the ability of early exposure to other foods, such as egg, fish, milk, and wheat to desensitize children to allergies to these foods. Though the study clearly showed that early exposure to egg could reduce rates of the development of egg allergy, the findings for the other foods were less clear. Researchers plan to improve their study designs so that they can clarify the specific impacts of early exposures to problematic foods and determine any differences that may exist in the pattern of allergy development for different foods.
There are a number of reasons why babies may not be able to receive sufficient nutrition from breast milk. To combat the obstacle and ensure that babies are offered proper nutrition easily and early in life, formula was created. Given that breast milk is lacking in certain nutrients, formula provided an opportunity to provide babies with these added nutrients. Indeed, breastfed babies are generally required to take supplements such as vitamin D and iron. In addition, formula creators can formulate the product to address any number of health issues, aiming to provide as many health benefits as possible.
A “hypoallergenic” formula was created by Nestle, which the company claimed provided protection against autoimmune diseases and problematic health issues like asthma. Nestle was granted permission in 2011 by the US Food and Drug Administration (FDA) to market its formula as a product that reduces the risk of developing eczema. However, a new study, published in the British Medical Journal is raising doubts that the formula actually provides the health benefits its creators have been claiming.
Robert Boyle and other authors of the study reviewed information from approximately 19,000 participants in 37 different trials between the years of 1946 and 2015 and concluded that there was little evidence to suggest that formula, or the process that is undertaken to create formula confers any protection against allergy-related conditions or autoimmune disease. To make hypoallergenic formula, cow’s milk is heated to break down proteins in a process called hydrolysis.
Proponents of formula’s health benefits have argued that by breaking up proteins, and thereby making them smaller (into what are known as peptides), the proteins have less power to produce allergic reactions. They claim that with less exposure to allergenic peptides could prevent the sensitization that occurs when allergies develop, thereby reducing the risk of allergies and other autoimmune reactions. As a result of their claims, formula is recommended for infants at increased risk for allergies, asthma, eczema, allergic rhinitis, and even type 1 diabetes.
Immune conditions including allergies and asthma have increased in recent years, particularly among young people, which has increased the incidence of chronic disease. There is much evidence to suggest that dietary exposures during infancy may be associated with the development of some of these conditions. Though it is well established that a proper diet is essential for healthy development and the avoidance of chronic diseases, there is still much to learn in terms of what the ideal diet is for infants and children. The specific nutrients and their optimal doses are still debated by scientists and doctors.
Given the findings of the systematic review and meta analysis conducted by Boyle and his colleagues, some scientists are now urging the FDA to reconsider its recommendations regarding the use of formula and suggest that commercial interests may have interfered with the integrity of the scientific investigation of the health benefits of formula. They also point out that claims made about formula in marketing campaigns could undermine mothers’ motivation to breastfeed, which has been established as the healthiest option for feeding infants.
Scientists from the National Institutes of Health (NIH) have discovered a genetic mutation that causes for a very rare type of allergy - an allergy to vibration. The team of scientists, who were specifically housed at the National Institute of Allergy and Infectious Diseases (NIAID) and the National Human Genome Research Institute (NHGRI) published their findings in the New England Journal of Medicine on February 3rd.
Allergy to vibration, known as vibratory urticaria, causes sufferers to break out in itchy hives or skin rashes on areas of the body that endure vibration. Though the allergy tends to lead to only mild symptoms, for those with this particular allergy, everyday activities, such as exercising, riding in motor vehicles, hand clapping, and using towels can pose serious inconveniences. For some, the allergy to vibration can lead to symptoms unrelated to the skin, such as headaches, blurry vision, and fatigue.
To gain some insight into why and how the immune system reacts to vibration as it does in those with vibratory urticaria, the scientists looked at how key immune cells, called mast cells, reacted to vibration. They looked at these cells in a family with multiple generations of vibration allergy sufferers, as well as in other people who did not suffer from the allergy and were not related to anyone with the allergy.
Researchers found that people with vibratory urticaria had higher levels of substances called histamine and tryptase in their blood than those without the allergy. These substances are normally found in mast cells, so the rise of these substances in the blood indicated that mast cells released their contents in response to vibration. In those without vibratory urticaria, these rises in histamine and typtase were not observed in the blood. Vibrations therefore initiated a specific immune response in those allergic to vibrations and not in those without the allergy.
The researchers realized that the symptoms in the family they were studying resembled those of a family described in 1981 by scientists at Yale. To test for a genetic contributor to vibratory urticaria, researchers took DNA samples from both families and identified a mutation in a single gene, the ADGRE2 gene. The mutated form of the gene was present in all family members who were allergic to vibration and in none of those who were not. The mutation was also not found in a database of DNA of 1000 other individuals who did not have vibratory urticaria.
Researchers were therefore convinced that the genetic mutation of ADGRE2 contributes to allergic reactions to vibrations. Further studies have shown how the gene leads to allergy symptoms in response to vibrations. The ADGRE2 gene produces an ADGRE2 protein that is present on immune cells. The protein has two portions that are normally close together and relatively stable. In those with vibratory urticaria, the two subunits of the ADGRE2 protein are less stable and separate more easily in response to vibration. When these cells separate, it signals to the immune system that an immune response is needed. At that point, mast cells are activated, and they release their contents.
These findings by NIH researchers clarify details of immune system responses generally and allergic reactions specifically. Researchers hope to find out how the subunits of the ADGRE2 protein act once vibrations are over because that information could help them better understand the allergy to vibration and potentially treat it. They also plan to study more families with vibratory urticaria to develop a more comprehensive view of this intriguing allergy.
Vitamin D, also known as the sunshine vitamin, has long been linked to allergies. Studies have shown that children who live farther from the equator are more likely to develop allergies and suffer higher rates of hospital admissions due to allergic reactions. From November through February, it is thought that people in the north (at a latitude above 35°) cannot synthesize vitamin D because they are not sufficiently exposed to sun.
Children and adolescents with lower levels of vitamin D in their blood are more sensitive to allergens than those with higher vitamin D levels. In 2012, a study published in the Journal of Pediatrics demonstrated that infants with vitamin D deficiency are at higher risk for allergies and eczema than those with sufficient levels of the vitamin. Further, the severity of allergy in infants was shown to be linked to the severity of vitamin D deficiency.
Now, researchers at the Mount Sinai School of Medicine have discovered that one’s exposure to vitamin D may impact their likelihood of developing allergies even before they are born. The recent study, published in The Journal of Allergy and Clinical Immunology on February 11th, showed that women who eat foods that are rich in vitamin D during pregnancy are less likely to have children who will develop allergies. This finding is consistent with previous reports that maternal vitamin D levels are related to the likelihood that children will wheeze at the age of 3.
This new study examined 1,248 American women and their children from the first trimester until children were approximately 7 years old. Children with a reduced risk for developing allergies had mothers who had consumed higher amounts of vitamin D. Vitamin D can be found in dairy products including milk and eggs, as well as in other foods such as fish, mushrooms, and cereal. Women who consumed at least the amount of vitamin D that would be found in 8 ounces of milk per day were shown to confer the allergy benefits to their children. These children had a 20% reduced risk of hay fever in their school years.
Vitamin D likely reduces the chance of developing allergies because of its effect on the immune system, which has been demonstrated in a number of ways. Vitamin D has been shown to quickly rid the body of hives and other allergy symptoms. This vitamin is critical to the proper functioning of T-cells, which are a major part of the immune system.
The finding that vitamin D can protect a fetus from eventually developing allergies is a promising discovery in the allergy field. However, it should be noted that vitamin D supplements did not have the same effect as vitamin D found in foods. In other words, pregnant women had to eat foods containing vitamin D to confer the allergy benefit to their children. However, the research linking vitamin D supplements to allergies and asthma has produced a large mix of results.
Whereas some scientists have supported the idea that vitamin D supplements taken by pregnant women can reduce the risk that their children will develop allergies and asthma, others have shown that adults who took vitamin D supplements as infants were in fact more likely to develop allergies than those who did not take the supplements. One study showed that vitamin D supplements were effective in both preventing and treating seasonal allergies, but other studies found that vitamin D supplements had no effect on the likelihood of developing allergies. Scientists therefore believe that further research is needed before we can truly understand the impact of vitamin D supplements on allergies. It may be the case that higher doses of the supplements are needed to achieve the same effect as consumed vitamin D.
For now, it is likely that clinicians will recommend that pregnant women consume vitamin-D rich foods during pregnancy. Not only are the recent data on the protective effect of vitamin D against allergies promising, but vitamin D has a number of other health benefits and is therefore a critical component of our diets.
Scientific research has shown that having allergies makes it more likely that people will suffer certain anxiety disorders, such as generalized anxiety disorder (GAD) and panic attacks. According to a new study published in Pediatrics, children who suffer from allergies starting at a young age are at an increased risk for anxiety and depression. Specifically, seasonal allergies seem to be the culprit for this group of people with a higher likelihood for anxiety and depression, and the more allergies these people have, the higher their risk. For those allergic children who suffered anxiety or depression, the degree of anxiety or depression varied from very mild to disorders that required treatment. However, allergic rhinitis, which involves allergy symptoms that specifically affect the nose, was specifically linked to the highest scores of anxiety and depression.
This recent study, which followed almost 600 children between the ages of one and seven, examined allergy symptoms in children who had gotten skin tests at ages one, two, three, four, and seven and had the parents of these children complete behavioral assessments. The behavioral assessments included 160 questions aimed at identifying anxiety and depression in children. These questions related to children’s emotions and behaviors that may have demonstrated fear, nervousness, worry, or sadness. Based on the data, researchers concluded that that four year olds suffering from classic allergy symptoms, such as itchy eyes, sneezing, wheezing, and skin inflammation, are more likely to be depressed or anxious than seven year olds with the same symptoms.
Though the results of the study appear robust, controlling for several patient factors, including gender and race, they do not provide clarification on why the association between allergies and anxiety and depression exists. The researchers speculate that allergies could cause chemical changes in the brain in areas involved in mood, thereby leading to anxiety and depression. However, they also acknowledge that anxiety and depression in this group may simply be due to the impact allergies have on their lives. For instance, often feeling sick and having to get shots or take medications may be the culprit for increased anxiety and depression in these children.
Regardless of the specific reasons that young children with allergies are more likely to develop anxiety and depression than those without such allergies, researchers believe that when anxiety and depression do occur, it is linked to the children’s tendency to ‘internalize.’ Internalizing behavior involves directing feelings inward. People who internalize tend to inflict harm on themselves when they are frustrated or upset rather than externalizing, and taking their emotions out on others. Specific internalizing behaviors include substance abuse, overeating, and anorexia. Certain groups of youths are more likely to display internalizing behaviors. For instance, both bullies and those being bullied are more likely to internalize. Youths who are obese are also at a higher risk for internalizing behavior. Because internalizing tends to be more socially acceptable than externalizing, it can go unnoticed as a problem for long periods of time.
Given the important role of internalizing in anxiety and depression among those with allergies, some physicians now advise that children who suffer from allergies should be monitored for behavioral issues, as well as signs of anxiety and depression. More research on the reason that those with allergies suffer from anxiety and depression at a more frequent rate than those without allergies will help clarify what specific risk factors predispose children to these disorders. New information should also help parents ensure that their children get proper treatment for their allergies while minimizing the likelihood that they develop anxiety or depression.
Autism and autism spectrum disorder involve impairments in communication and social interaction and are thought to result from abnormal brain development. This type of abnormal brain development is most likely due to a combination of genetic and environmental factors. The rate of autism diagnosis has increased significantly since 1980, as has the diagnosis of asthma. Nonetheless, because autism is primarily thought to be a manifestation of abnormalities in the brain, its potential link to asthma is not intuitive.
However, research has shown that women who are diagnosed with asthma or allergies while in her second trimester of pregnancy is at an increased risk for having a child with autism. Further, a new study, published in the medical journal Pediatrics in January, found that mothers who take certain types of asthma medications while they are pregnant are slightly more likely to have children with autism than those not exposed to such medications. This effect was seen regardless of whether a woman was using drugs for asthma during her first, second, or third trimesters, or even during preconception.
The United Sates Centers for Disease Control and Prevention (CDC) estimates that autism currently affects approximately one out of every 68 children in this country. Not all asthma medications were found to be associated with autism in offspring. Even more important is that failing to manage asthma during pregnancy can be much more dangerous than the drugs used to manage the disease.
The drugs studied in this study were drugs called beta-agonists. Such drugs tend to influence the muscles around the airways, relaxing them so that breathing becomes easier. The beta-agonist asthma medications that are often used are: salmeterol, also known as Serevent, formoterol, also known as Foradil, and albuterol, which is often used as a rescue inhaler during an asthma attack. The former two drugs are more often used to prevent asthma attacks. Because the drugs are able to cross the placenta, they can biologically impact the growing fetus during its development.
Laboratory studies on these drugs show that they can affect the development of brain cells, or neurons. Nonetheless, scientists who have looked at national databases in Denmark found that only 4% of children diagnosed with autism had been exposed to beta-agonist drugs. This finding demonstrates that the vast majority of autism cases are caused by something other than beta-agonist drugs. Further, the study published in Pediatrics only shows that babies exposed to beta agonists have a slightly increased risk for autism but does not demonstrate a causal link between these drugs and the disorder.
There are a number of other drugs for asthma that are not beta-agonists, and doctors may recommend some of these medications to pregnant women as alternatives to beta-agonists. For quick relief of asthma symptoms, corticosteroids, which are anti-inflammatory drugs, and anticholinergics, which are bronchodilators, may be used. These drugs tend to get rid of coughing, wheezing, and chest tightness in the short-term. For long-term control of asthma, leukotriene modifiers can block chemicals that cause inflammation, whereas mast cell stabilizers can minimize the release of chemicals that lead to inflammation. Theophylline is a bronchodilator that specifically reduces nighttime symptoms of asthma. Finally, for those who do not respond to inhaled drugs, immunomodulator injections may be recommended. These injections tend to be used for patients whose asthma is related to allergies.
When asthma is not well controlled in pregnant women, outcomes for babies have been shown to be poor. Babies born to mothers with uncontrolled asthma are more likely to be born before they are full term and to be born at a low birth weight. These babies are also more likely to end up being admitted to the neonatal intensive care unit. The drugs that are used to control asthma help ensure that the mother and baby are getting sufficient oxygen, which is critical for their health. It therefore important that pregnant women who are taking asthma medications do not just stop taking their medications without speaking with their physicians.
Though the medical community has not acknowledged it as a legitimate allergy, people have begun to claim that they suffer from allergies to Wi-Fi. Over the years, a number of health risks associated with our smart devices have been revealed – including insomnia, neck pain, and brain changes. According to the World Health Organization (WHO), Electromagnetic Hypersensitivity Syndrome (EHS) is a disorder that involves a number of non-specific symptoms that affect those who are exposed to electromagnetic fields. The apparent existence of EHS may be confused with an allergy for Wi-Fi, and EHS has itself come under scrutiny as a legitimate disorder.
Because the symptoms said to be involved in EHS, including headaches, fatigue, dizziness, rashes, and heart palpitations, are so common and caused by a number of different factors, it is difficult to determine if EHS is a true condition. People claim to suffer the symptoms when exposed to a number of devices, including mobile phones, televisions, and Wi-Fi routers. WHO has attempted to determine what specific environmental triggers could lead to EHS and have considered things such as excessive noise, air pollution, and fluorescent lights emanating from screens. However, no causal association has been persuasively identified.
Recently, a woman in the UK blamed an allergy to Wi-Fi for her daughter’s suicide. She claimed that both she and her daughter had become ill because of the Wi-Fi in their house, suffering from bladder pain, headaches, and fatigue and had thus discontinued Wi-Fi at home. However, according to the woman, her daughter continued to suffer because of the use of Wi-Fi at her school. She claimed her daughter did not intend to commit suicide and blamed the school, and especially the principal, who refused to accommodate the “Wi-Fi allergy” by allowing the girl to participate in activities only in areas free of Wi-Fi, for her daughter’s untimely death. Nonetheless, the medical examiner investigating the girl’s case did not find any evidence to suggest that the suicide was a result of either a Wi-Fi allergy or EHS.
In a separate case in France, a woman was able to collect $900/month in disability benefits as a result of her apparent EHS, the first time the legal community appeared to legitimize the syndrome. The court case sparked controversy and concern among the medical community, who generally do not believe that EHS is appropriately viewed. Specifically, research has shown that the syndrome that is termed EHS does not seem to have any true connection to exposure to electromagnetic or radiofrequency signals. WHO has therefore suggested that EHS be renamed “idiopathic environmental intolerance with attribution to EMF.”
A psychiatrist at George Washington University in Washington D.C. says that EHS it not recognized as a real medical disorder and that those who apparently suffer from EHS are more likely to be suffering from a psychiatric condition. In this case, the patient would be said to be suffering from a somatization disorder. Of particular concern is that the likelihood of people believing they suffer a disease or disorder is much more likely when people first know of, or believe in the existence of that disorder. A study demonstrating this phenomenon exposed subjects to a fake Wi-Fi signal after showing half the subjects a BBC series that claimed that Wi-Fi signals were dangerous. Those who saw the series were significantly more likely to develop symptoms associated with EHS. The tendency for people to believe they are sick after being exposed to something they believe should sicken them has serious implications with respect to the growing concern about EHS and Wi-Fi allergies.
As a result, the medical community has appeared to become more vocal about their belief that people cannot really be allergic to Wi-Fi. As evidence for their position, they point out that the radiofrequency signals to which we are constantly exposed are quite weak and that there is no good evidence to show that they do true damage. Given the growing concern of health risks associated with the Internet and smart devices, as well as the known health risks posed by some devices and technologies associated with radiation, it is likely that research into any potential health threat that the Internet or relevant devices could pose will continue. Though allergies to Wi-Fi appear a far-fetched idea, it is not out of the question that the growing use of the Internet may pose new health risks in indirect ways.
Though sesame allergies affect less than 1% of the United States’ population, somewhere between 300,000 and 500,000 people in the U.S. are allergic to sesame. According to allergists, many more people are afflicted in the U.S. today than a decade or two ago. The most common symptom associated with sesame allergy is hives, with hives, stomach problems, and respiratory problems also occurring quite frequently.
The allergy appears to now be as serious and as frequent to other common allergies, like those to tree nuts. Tree nuts include walnuts, cashews, hazelnuts, almonds, pistachios, and Brazil nuts. Further, recent research has shown that those allergic to tree nuts are at a higher risk for also suffering from a sesame allergy than those who are not allergic to tree nuts. One study found that 70% of those who were allergic to sesame were allergic to tree nuts, and 65% were allergic to peanuts. A study on children conducted in Boston determined that kids with tree nuts allergies were three times more likely to be allergic to sesame seeds as well.
The growing prevalence of sesame allergies could be due to greater awareness of the allergen or due to more people actually experiencing it. With respect to the latter reason, one explanation that has been posed for the rise in the number of allergic reactions to sesame is the enhanced popularity of Middle Eastern foods. Whereas sesame seeds were once most commonly associated with bagels in the U.S., they are now found in a number of foods that can be purchased in grocery stores and that are served in restaurants. Hummus, falafel, and halvah for instance, are now popular foods in the U.S. and contains sesame.
A major concern with regard to the growing number of allergy cases related to sesame is that sesame is often not found on the label of foods that contain sesame. A number of cases have been reported where identifying the problematic food was quite difficult due to a lack of knowledge about the presence of sesame. Tahini, for instance, contains sesame that has been transformed into either a paste or a powder, and it is often not explicitly said to contain sesame. Similarly, many foods with sesame often account for that ingredient by including the term “spice” or “natural flavoring” on the label. Some foods more common to the U.S. historically that often serve as sources for sesame include: breads (especially hamburger buns and pizza crust), noodles, cookies, pretzels, crackers, oils, margarine, soups, ice cream, salad dressing, energy bars, and pastries.
Other countries, such as Canada, Australia, New Zealand, and several European nations are required to list sesame on their food labels. However, because the Food Allergen Labeling and Consumer Protection Act, passed by Congress in 2004 did not include sesame because it was not known to be a major contributor to allergic reactions. The foods included were instead: milk, eggs, peanuts, tree nuts, fish, shellfish, wheat, and soy. Because the idea of the Act was to cover 90% of all food allergies, many argue that our new knowledge regarding sesame allergies constitutes a need to add it to the list.
Though there have not been many deaths related to sesame allergy, there have been allergic reactions severe enough that they could have led to death if not treated properly and promptly. As a result, last year, the Center for Science in the Public Interest proposed that the Food and Drug Administration (FDA) require that foods containing sesame or have cross contact with sesame during the manufacturing process have “sesame” on the food’s label.
Another concern related to sesame allergy is that exposure to sesame is not limited to foods. Certain beauty products, such as moisturizing creams and lipsticks also contain sesame and so can lead to allergic reactions, especially in those who would understandably not suspect the presence of sesame in their cosmetics. It is therefore important to educate those at risk for sesame allergy on the various ways they may be exposed to sesame and ensure that those people are protected from severe allergic reactions with medications. For those at risk for anaphylaxis, carrying an EpiPen is generally advised.
Many people are allergic to insect stings, which can be associated with a number of insects including honeybees, sweatbees, bumblebees, paper wasps, white-faced hornets, yellow hornets, yellow jackets, harvester ants, fire ants, and jack jumper ants. Less often, allergies can also occur to proteins found in the saliva of other insects, including mosquitos, horseflies, and kissing bugs.
Stinging insect allergy can occur in response to insect venom and has the potential to be fatal if it causes anaphylaxis and disrupts the breathing process. This type of reaction occurs in approximately 0.4-0.8% of children and 3% of adults, leading to about 40 annual deaths in the United States. However, when it does not cause anaphylaxis, stinging insect allergy is not and manifests in non-respiratory ways.
There are three main ways that the relevant insect venom tends to affect those with stinging insect allergy. For systemic reactions that include anaphylaxis, other systems may also be impacted. These systems include the gastrointestinal tract, the respiratory system, the heart, and the brain. A second potential outcome is a systemic reaction that is isolated to the skin, impacting skin all over the body. Finally, the venom could cause a local reaction, leading to swelling that is focused around the area where stings occurred.
When systemic reactions occur, they usually happen fairly quickly after the sting and often involve highly noticeable symptoms such as anaphylaxis. On the other hand, local reactions may occur over a day or two, and it may take up to about 10 days for the associated swelling to go away.
There main ways to prevent allergic reactions to insect venom are to avoid insect stings and to undergo venom immunotherapy (VIT). The latter is an effective way to prevent anaphylactic reactions in certain patient populations that have demonstrated allergic reactions to insect venom. In this case, patients are usually screened with tests such as skin tests to assess their suitability for VIT, though screening tests are not generally a recommended preventative measure for insect venom allergies.
When VIT is employed, 95-98% of systemic reactions are successfully prevented, and the therapy may also minimize local reactions. Rarely, VIT itself causes allergic reactions and can cause anaphylaxis, so patients undergoing this preventative measure must be monitored for about half an hour following each session of therapy. This form of therapy is usually started at a low dose (0.1-1 mg weekly) and is increased incrementally (to about 100 mg). The highest VIT dose is thought to be equivalent to about 2 insect stings and would thus ideally protect against at least the relevant amount of venom. Therapy is usually used for 3 to 5 years but is generally extended in high risk patients who continue to have severe reactions or are frequently exposed to insects.
Because the best way to ensure that allergic reactions to insect venom do not occur is to avoid stings, there are a number of recommendations for how to do so. Removing nests from places where patients spend a lot of time, such as the home, is an important first step. Wearing closed shoes and clothing that covers the skin while outdoors can also be effective. Wearing muted colors and scents is a less intuitive means for preventing insect stings but can work because insects are attracted to bright colors and can track strong scents. Areas like bushes and attics should be approached with caution when attempting to avoid insect stings.
When stings do occur and are followed by an allergic reaction, the type of reaction dictates what type of treatment should be undergone. Local reactions can be treated with cold compresses and analgesics to help manage any pain occurring as a result of the sting, as well a antihistamines for itchiness. However, if anaphylaxis occurs, an epinephrine needs to be administered to reverse the dangerous respiratory symptoms.
Different treatment plans may be indicated for distinct patient populations suffering from insect sting allergy. Though it is often suggested that pregnant women adhere refrain from taking medications they took before pregnancy, both VIT and anaphylaxis interventions can continue in pregnant women. However, patients who take beta-blockers or angiotensin converting enzyme inhibitors may be more susceptible to anaphylaxis from VIT so are generally encouraged to undergo an alternative treatment plan. Children with skin reactions to insect venom are less likely than adults to eventually suffer severe reactions. The assessment of children and adults for suitability for VIT therefore differs.
There are a number of cells of the immune system that are involved in allergic reactions. Relatively recently, platelets were added to the list of known immune cells that contribute to the body’s response to allergens and to underlie aspects of asthma. Platelets are the smallest cells that travel within the blood and are shaped like plates when they are inactive. One microliter of blood usually contains somewhere between 150,000 and 450,000 platelets.
Platelets are traditionally viewed as functioning to stop blood flow, which they do by clumping together to form blood clots. Given this function, it is important that we have enough platelets so that we are not at risk for losing too much blood should we cut ourselves. However, too many platelets can cause cardiovascular issues. Given their role in thrombosis, or blood clotting, platelets are also often referred to as thrombocytes.
In the 1980s, seminal scientific research demonstrated that the role of platelets is not limited to blood clotting. The work showed how platelets can also kill some parasites. This other function of platelets was realized when scientists observed the presence of certain receptors, called IgE receptors, on the surface of platelets. IgE receptors are antibodies whose main function is to fight parasitic infections.
Also in the 1980s, other scientists observed that platelets appeared depleted in rabbits suffering airway constriction due to allergies. These observations were the initial findings that helped confirm that platelets have a broader role than their role in blood flow and clotting.. It is now clear that platelets play a direct role in allergic reactions. Specifically, they impact other cells of the immune system during inflammatory reactions to help recruit leukocytes into tissues. Not only do their coordinate inflammation responses, but they are also activated by other inflammatory mediators. When platelets are depleted, leukocytes are not as populous within tissues as when platelets are present in normal amounts.
Because of their specific role in inflammation, platelets are critical in inflammatory diseases other than allergies, such as asthma. Research in both animals and humans has demonstrated that platelets are also associated with the pathogenesis of aspirin-exacerbated respiratory disease (AERD), which is an inflammatory disease that involves not only asthma but also nasal polyposis and pathognomonic respiratory reactions when aspirin is ingested.
When asthma occurs, changes in platelet activity are often observed, including changes in the amount of platelet secretion, as well as the molecules that are expressed on the surface of platelets. Asthma and allergies are also associated with abnormalities of both the aggregation and adhesion of platelets to one another.
In this scenario, platelets have been referred to as “exhausted platelets” that may have been activated too often during allergic responses and are thus unable to respond appropriately when needed for clotting functions. Accordingly, people with allergic disease often have what is referred to as a mild hemostatic defect, where it takes them longer to stop bleeding when they are cut than those without allergies. On the flip side, this group of people may also experience cardiovascular benefits as a result of their reduced clotting. Some research has suggested that these people have less calcified arteries.
The specific activities of platelets within the immune system lead to the pathogenesis of asthma in a few different ways. First, platelets cause bronchoconstriction. They do this by releasing what is known as spasmogens, which included chemicals like serotonin. Second, they lead to the remodeling of the walls of the airway by signaling to a number of relevant cells to modify their activities. Third, they cause inflammation of the airway, which is often accompanied by the release of free radicals. Free radicals are physiologically destructive and often associated with poor health.
The blood-related effects that are seen in patients with allergy and asthma are likely a result of reduced platelet survival time, which can be reversed with glucocorticosteroid medications. However, given that platelet activity can both help and harm people, depending on the context in which the platelets are activated, as well as on the specific needs of the person, it is important not to aim to minimize or maximize platelet activity but instead to find a balance that optimizes outcomes. As more research helps clarify the specific role of platelets in allergies and asthma, new treatments options that involve platelet activity will likely be developed.
The incidence of allergies and asthma has been on the rise in recent years. Western countries have seen more of a rise than other countries. However, even in Asia and Africa, the allergies and asthma occur with higher frequency in urban areas than in rural ones.
The impact of industrialization on health is not a new concept. During the Industrial Revolution, people in the United States and Great Britain experienced a number of symptoms consistent with allergies, such as itchy and watery eyes, inflammation of the respiratory tract, and increases in the production of mucus. Public health experts often attribute enhanced allergy and asthma issues to reactions to the Industrial Revolution. Specifically, because decontamination, sterilization, and pasteurization measures were undertaken to reduce the incidence and spread of infection following the Industrial Revolution, people became less significantly exposed to diseases and bacteria. This reduction in exposure may carry with it the development of an overly sensitive immune system that is not well protected against allergies and asthma. Indeed, many countries today that do not have high health standards tend to have lower incidences of allergies than those with higher health standards.
In addition to our growing focus on cleanliness as we become more industrialized, we have also focused on efficiency, which may cause other issues related to asthma and allergy. For instance, we have created better means for insulating our homes to keep heat in, but these measures also increase the ability of dust and mold to stay and accumulate in our homes. These substances are common irritants to allergy and asthma sufferers.
Industrialization seems to promote allergies and asthma, but urbanization appears to do so as well. There is a significant amount of research showing that those dwelling in cities experience allergies and asthma more often than those who live in rural areas. Air pollution is widely blamed for the rise in these disorders in urban areas. Research aimed at supporting the hypothesis that industrialization increases allergies and asthma by causing air pollution has shown that animals exposed to air pollutants and allergens suffer synergistic effects that increase the impact of each irritant on the animals’ respiratory systems. In humans, air pollution caused by vehicles has been shown to aggravate asthma. Further, those living in highly populated cities may put even more emphasis on cleanliness, using sanitizers and anti-microbial products more often than those living in less heavily populated areas, who may worry less about the spread of germs.
Another problem for allergy sufferers in cities is the interaction that occurs between allergens and the air. Specifically, air pollution can react with irritants like pollen to produce compounds that are much more impactful on the human immune system. Other aspects of cities, such as their higher levels of carbon dioxide and generally higher temperatures can also increase the production of allergens like pollen and make them more likely to cause allergic reactions.
People often assume that cities are more protective against allergies than other areas because of their relative lack of trees and flowers. In response to this idea, the hygiene hypothesis was formulated, which suggests that growing up in rural areas can help build strong immune systems protect individuals against allergies later in life. Consistent with this hypothesis is the observation that children who grow up in cities do suffer from allergies more frequently than those who grow up in rural environments.
Though the increased exposure to microbes in rural areas is often viewed as a reason for better protection against allergy and asthma in these areas, researchers have also found asthma frequency to be high in inner city areas that have high levels of microbes. It has therefore been suggested that exposure to microbes may impact the likelihood of developing allergies but not asthma.
Given that the factors that are thought to contribute to rising allergy and asthma rates – namely, air pollution, global warming, and sanitation measures – are likely to continue or even increase, so too may the enhanced incidence of allergy and asthma. If we are going to slow the pace of allergy and asthma incidence, researchers will need to focus efforts on more clearly delineating what has caused the recent rise in these disorders and determining what can minimize the effect of those factors on allergies and asthma.
While many medical efforts have focused on increasing access and use of epinephrine, a powerful, often life-saving allergy medication, to ethnic, racial, and socioeconomic groups that have been shown to suffer from lack of access to this important drug, recent efforts have also emphasized the importance of research that clarifies differences in allergy incidence among different racial and ethnic groups. Indeed, it seems that those of different races and ethnicities may be prone to different allergies or allergy severities. Given the distinct genetic makeup of those of different such demographics, this insight is perhaps not that surprising. Racial differences in disorders related to allergy, such as asthma and atopic dermatitis, also make the idea that there are racial differences in allergy susceptibility quite intuitive.
Of particular concern is the rise of allergies that has occurred over recent years. Given that the specific change in allergy incidence has varied by race, it seems reasonable to assume that there are differences in racial vulnerabilities to allergens. One study found that the incidence of allergies increased about 1.0% in whites individuals between 1988 and 2011. The study found that during the same period, Hispanics suffered a 1.2% increase in allergy incidence, whereas non-Hispanic blacks suffered a 2.1% increase in allergy incidence.
So what are the differences in allergies among different ethnic and racial groups? Some data suggests that African American children are more prone to food allergies than those of other groups. Among black children, black boys appear particularly at risk for some of the most common food allergies, such as allergies to milk, soy, eggs, shellfish, and peanuts. A study conducted by the Centers for Disease Control (CDC) found that Hispanic children, on the other hand, are less likely to suffer from food allergies than children of other ethnicities.
It has also been shown that Chinese people are less likely to demonstrate allergies to peanuts than are Americans. However, the difference in incidence in allergies in these groups has been suggested to be due to different cooking techniques generally used by these distinct groups. Supporting this idea are the results of a United States government study that found that boiled or fried peanuts, which are often found in Chinese cuisine, are less likely to cause allergies than the roasted peanuts often found in the United States.
Though more research will be needed to clarify how race impacts allergen vulnerability, healthcare professionals emphasize the importance of knowing what you are ingesting to avoid allergic reactions. The differences in cuisine associated with different races, ethnicities, and cultures can pose a problem for allergy sufferers because it is not always transparent what ingredients are in certain dishes.
Asian food incorporates a significant amount of the most common food allergens such as shellfish, eggs, peanuts, and soy. Thai food is particularly peanut-heavy. One challenge for those with peanut allergies is the difference in cooking technique. For instance, fried egg rolls and spring rolls are often sealed with peanut butter, but a menu would not necessarily include the information that peanut butter is included in the dish. Those unfamiliar with Asian cuisine may therefore experience increased vulnerability to allergies when dining on Asian food.
Another common issue with Asian cuisine is cross-contamination. The woks that are traditionally used in Asian cooking are often not cleaned between different cooking sessions because the buildup of food over time can act as a seasoning that flavors the food. Thus, though someone who is allergic to shellfish may order a meat dish, their meat may be cooked in a wok that recently housed shrimp, thereby leading to an allergic reaction. Nonetheless, the soy sauce that is used in Asian cooking often does not affect those with soy allergies because the soy proteins have been broken down by the time the sauce is created.
French food contains a number of allergens, including nuts, seed oils, and dairy products. One thing that can be particularly dangerous for nut and seed allergy sufferers is that the French often hand-press oils from these ingredients, and these types of oils tend to have more of the nut protein in them than oils found in other cuisines. Thus, those who think they can tolerate certain oils may be surprised by their reaction to those oils when they are found in French food.
Italian food can cause problems for a number of different allergy sufferers. Those with wheat allergies often have a difficult time with Italian food because of the amount of bread and pasta incorporated in this type of cuisine. Italian food also includes a good amount of dairy. Sauces, such as pesto, also contain nuts.
Indian food is made up largely of spices that tend to be safe for most people with allergies. However, those allergic to dairy products and nuts should use caution when eating creamy curries, pre-prepared teas, or Indian desserts, such as kheer. Mexican food is similarly filled with spices and often safe. However, some sauces used in Mexican cooking contain nuts.
Though cultural aspects of different race’s food tendencies can raise allergy issues, it is becoming an increasingly popular idea that people of different races may in fact have different susceptibilities to certain allergens. Research focused on identifying these differences may help different demographics protect themselves against the allergies to which they are particularly vulnerable.
People who work with laboratory animals are susceptible to developing allergies to the specimens to which they are regularly subjected, a condition termed laboratory animal allergy, or LAA. Lung function and changes in the immune system have been identified in a number of such workers, and it is believed that between about 1 in 3 to 1 in 5 of those who regularly work with animals will develop these allergies within 2 years. However, females appear to be more vulnerable to developing these animal allergies than are males. People with higher levels of immunoglobulin E, an antibody involved in fighting off parasites, are also more likely to develop LAA. From an environmental standpoint, it seems that the more hours that workers tend to spend with laboratory animals, the more likely they are to develop allergies. The most common symptom is rhinitis, which involves inflammation of the nose, but asthma also often develops in these workers.
There are a number of animals that cause allergy problems in those working in laboratories. Some of the most often cited are rodents, cockroaches, and squirrel monkeys. Though people often associate fur and dander with allergies, people tend to react more to proteins in animals' urine. Major urinary proteins (Mups) are the culprit for many LAA cases and can lead to the development of asthma. One study found that over 65% of laboratory workers who had developed asthma while working in their laboratory displayed antibodies to Rat n 1, which, like Mup13, is a human allergen found in rodent urine .Because urine and its associated proteins are often embedded in animals' hair and fur, the presence or lingering of that hair or fur can cause allergic reactions.
Allergies and asthma tend to be especially problematic for workers whose work environment does not have effective mechanisms for controlling the presence of allergens. For instance, when laboratories are not engineered to eliminate allergens, do not involve administrative guidelines for manually doing so, or do not require that protective equipment is used or worn, the workers within those laboratories are more likely to develop allergies and asthma. Interestingly, rabbits appear to lead to the highest rates of allergy symptoms than any other laboratory animal. Rabbits do tend to spray their urine as a means for communication and also to shed more fur than other animals, which may account for their higher likelihood of leading to allergies.
LAA can pose a number of challenges for workers. It can make them less efficient at work and even jeopardize their professional career if they are eventually forced to abandon their area of research. The psychological impact can be significant, as workers worry not only about their health but also about the uncertainty regarding their career paths. Lifestyle can also be adversely affected, with many of those suffering from LAA experiencing chronic itching, watery eyes, cough, and shortness of breath. These symptoms can make not only work activities, but other personal activities, such as hobbies and exercise, difficult to participate in.
The most serious consequences associated with LAA are of course related to health. The onset of allergies and asthma can be both severe and sudden, making them quite dangerous. Workers can suffer anaphylactic shock, which is potentially fatal. Even if they avoid anaphylactic shock, the development of complications related to allergies, such as asthma, tend to worsen health outcomes over the lifespan.
The scientific community has not focused a lot of attention or resources on the issue of LAA to date, though there are a number of cases of famous scientists suffering from such allergies. Barbara McClintock, a Nobel Prize winning geneticist developed an allergy to corn flowers, whereas Orley Taylor, an ecology at the University of Kansas developed an allergy to sulfur butterflies over the course of a decade. However, given what is known about LAA, there are some things that can be done to minimize its occurrence or to reduce the suffering experienced by those who develop it. The most critical component of LAA is exposure to allergens. Thus, any strategy that reduces this exposure should also reduce allergic reactions and symptoms. As more hours spent with animals is known to increase the chances of developing LAA, reducing the number of hours that are physically spent with the laboratory animals each week can help reduce allergies and asthma. Institution-wide measures can also significantly help the problem of LAA. By implementing filtering systems that rid the laboratory air of allergens, for example, can greatly improve air quality and reduce the burden on laboratory workers' immune systems. Requiring that protective gear, such as face masks, gloves, or body suits, are worn can have a similar effect.
People often wonder if their loving pets are susceptible to the same allergies that they are. Though our pets are less likely to suffer from the same symptoms that we do when we experience allergies, they are in fact vulnerable to allergies. Allergies occur in pets for the same reason they occur in us – their immune systems recognize certain substances as harmful, even though they may not actually be threatening. Pets usually do not show symptoms of allergies until they are between one and three years old, and when it comes to dogs, females are more likely to display allergy symptoms than males. Certain dog breeds are also more susceptible to allergies than others. Breeds with flat faces, such as pugs, bulldogs, and Boston terriers are more likely to suffer from allergies than breeds with longer snouts. Retrievers and setters are also particularly vulnerable to allergies.
There are a number of signs that can help you confirm whether your pet suffers from allergies. However, it is important to keep in mind that animals’ allergy symptoms are often quite distinct from human allergy symptoms. Whereas we are likely to have itchy, watery eyes and runny noses, our pets are more likely to experience irritation of the skin when exposed to environmental allergens. Though they may sneeze while experiencing allergies, pets are not likely to sneeze or cough like we often do when our allergies act up but instead are likely to be found scratching or licking their ears, eyes, or skin when allergies attack. Skin near their tails is often irritated when animals suffer from allergies. You may also notice red or scabbed skin on pets suffering from allergies, which could result from chronic scratching.
In addition to allergies that tend to be seasonal, our pets, like us, may also be allergic to certain foods. Symptoms associated with food allergies are more likely to resemble our own symptoms to food allergies. Vomiting, diarrhea, and an inflamed throat are likely to occur in your pet if they have ingested a food to which they are allergic. This type of allergy may require more immediate medical attention than seasonal allergies.
Seasonally, our pets are often allergic to pollens, dust, mold, perfumes, cleaning products, rubber, and plastic – just like we are – but also often succumb to flea saliva. Prescription drugs and certain foods, such as beef, chicken, pork, wheat, soy, and corn can also cause allergic reactions when ingested at any time. Though the severity of symptoms associated with food allergies are not likely to go unnoticed for long, it is also important to recognize seasonal allergies in our pets because the scratching that tends to occur while our pets suffer from these allergies can lead to bleeding to infection. Animals can also suffer secondary infections, such as yeast or bacterial infections, which can lead to significant discomfort.
Veterinarians can do allergy tests to determine if your pet experiences allergies, and if so, to what your pet may be allergic. Intradermal skin tests, like those used in people, are a common way to identify pet allergies to environmental allergens. Food allergies are more laborious to diagnose, usually requiring a special 3-month protein diet. Animal doctors can also provide treatments for these allergies, including allergy shots, or immunotherapies, which act much like allergy treatments that people use. There are also specific dietary supplements that have been shown to help allergy symptoms. Other treatment options include antihistamines, antibiotics, and corticosteroids.
There are a number of preventative measures that can also be taken to reduce the chances that your pets suffer from allergies, or to minimize their discomfort when allergies do strike. Bathing your pets regularly can rid them of irritating allergens. Cleaning pets’ bedding and vacuuming regularly are other effective ways of eliminating allergens from your pets’ environments. Using unscented litter that is dust-free can help minimize allergies in cats. Preventative flea medications can protect pets from common flea allergies. Many veterinarians suggest topical or oral flea medications be taken regularly, or at least during seasons when fleas are likely to be a problem in your area. Removing the potential allergen is the most effective way to prevent allergies in animals, just as in people.
It is common for people to be allergic to pollen, and to know that pollen irritates them. What is less well recognized is that there are a number of types of pollen, which peak at different times in the year and cause distinct symptoms for allergy sufferers. Having a precise understanding of the causes of one’s allergies can significantly increase the ability to manage symptoms, so learning the differences among allergens from various plants can be extremely useful for allergy sufferers.
A first step for allergy sufferers is to be tested for allergies to try to pinpoint which particular allergens irritate them. Once those allergens are identified, people can learn about when and where those allergens are likely to strike and take the necessary precautions to avoid exposure to those allergens. Below is some information on when different pollen types are likely to impact you. Because even allergy tests cannot always determine your particular allergies, paying attention to when you find yourself suffering from allergies can help you figure out what your immune system may be reacting to.
If you notice your allergies toward the beginning of the calendar year, you may be suffering from alder pollen, hazel pollen, or yew pollen, all of which are being released at the year’s start and lasting into April.
If your allergies begin early in the year, but not in January, elm pollen or willow pollen could be to blame.
If you notice that your allergies do not start until March or later and tend to be “spring allergies,” one of the following pollen types could be causing your symptoms:
One or more of the following plant types may plague those who find that their symptoms are particularly bad during summer months.
If you notice that your nose is running all year long, you are likely allergic to something that is around longer than the pollens mentioned above. Pets, mites, mold, or dust could be the culprit. Mold allergies tend to be most noticeable in fall and spring, a big sign of mold allergies is that symptoms are worse indoors than outdoors. Similarly, dust allergies are worse indoors and tend to peak in the winter. Central heat can be a major contributor to dust allergies. One thing to be aware of is that your sniffling is likely not from a food allergy. Though about 30% of people believe they suffer from a food allergy, only about 3% of the population actually suffers from such allergies. Further, if an allergy occurs as a result of ingestion, symptoms are usually much different than those that occur with the allergens we have discussed here.
Though people often feel that their allergies get worse every year, it is not highly likely that seasonal allergies get worse over time. It is true, however, that the severity of allergies varies from year to year. Predicting how bad an allergy season will be is difficult because individual weather events can have a significant impact on allergens. The weather, for instance, largely contributes to how long and how strong an allergy season is. Hot, dry summers and harsh, cold winters often inhibit the growth of tree and flower buds in, which can reduce symptoms for those who suffer from hay fever, or allergies to grass. Further, just because an allergy season may start earlier does not mean it may end earlier. Weather can produce a longer allergy season.
Rain is an interesting contributor to seasonal allergies, as it can both exacerbate and improve allergy symptoms, depending on the context. Rain in the spring may get rid of pollen from trees, minimizing the effect of that pollen on allergy sufferers. Nonetheless, the longer-term impact of the rain could be improved conditions for grasses and weeds to grow in the summer, enhancing the pollen in the air throughout the summer months and wreaking havoc on the immune systems of those with relevant allergies. Pollen and ragweed, which are late summer allergens, are some of the most problematic allergy triggers. Thus, though spring rain may seem wonderful in April, the impact it has on those with allergies in the summer may outweigh the spring benefits. However, if winter was particularly harsh, the rain from spring may not be enough to ensure a lot of pollen in the air in the summer. Thus, the best weather for minimizing allergy symptoms may be a long, cold winter and a rainy spring.
Trees can also have both a negative or positive impact on allergies. Though they can act as natural filters that remove pollutants from the air, some studies have shown that higher exposure to tree pollen increases the chances of developing an allergy to the pollen. The spacing of trees can also improve allergy conditions. When trees are concentrated too heavily in certain areas, the amount of pollen in the air can reach levels that are going to adversely affect those with pollen allergies. It therefore may be that there is an ideal balance in tree density, and the type and distribution of trees, to minimize allergies in a given area.
Research that aids in our understanding of allergies can help us to improve allergy severity over time. For instance, research suggests that a great number of plant species is better for our health. Thus, by strategically breeding and planting plants, we can design environments that are more amenable to low levels of allergies. Certain plants, such as the dawn redwood, the hawthorn, and the tulip poplar, have lower allergy potentials than other plants. Further, insect pollinated plants do not bloom as long as wind=pollinated plants and so are also better for allergies. Insect plants’ pollen is also stickier, preventing it from traveling easily through the air.
Another issue for allergy sufferers is that in many places, there is a disproportionate amount of male trees. The problem with having more male trees is that the males are the ones that produce pollen. Female trees are better for allergies than are male trees not only because they do not produce pollen, but female trees also filter pollen from the air by trapping pollen particles. Thus, by increasing the proportion of female trees, we could reap the benefits of trees while minimizing the amount of pollen in the air.
Certain cities are capitalizing on research to try to reduce allergies. For instance, Albuquerque, Las Vegas, and Tucson do not allow extremely allergenic plants like mulberries and olive trees to be planted. Of course, because many of these trees are already present, it could take years for these trees to die and for people to reap the benefits of lower numbers of these allergy-inducing plants.
Though it may not be possible for general citizens to impact the specific types and distributions of trees in their local area, there are strategies individuals can take to minimize exposure to pollen and reduce the impact of allergies during years that are particularly conducive to allergy problems. For instance, implementing preventative measures, such as seeing a doctor and taking proper medications before allergy symptoms occur is a good way to shield yourself from allergies in tougher seasons or years. Keeping yourself and your belongings indoors and showering at night when pollen levels can help. Keeping only plants that are allergy friendly, such as bamboo palm, ficus, English ivy, and peace lilies is another good strategy to minimize allergy symptoms.
With the growing incidence of peanut allergies and the consequent deaths that are often reported on the news, many parents instinctively avoid feeding their children peanuts, assuming that the nuts may cause an adverse and scary reaction in their kids. Even doctors themselves have been known to urge parents to refrain from exposing their babies to peanuts. In 2000, the American Academy of Pediatrics specifically advised parents to avoid feeding their babies peanuts if they were at risk for allergies.
Groundbreaking research conducted over the past five years and finally published paints a new picture of how this intuitive reaction to the growing issue of peanut allergies may actually exacerbate the problem. A study published earlier this year in one of the most respected medical journals, the New England Journal of Medicine reported that exposing babies to peanut products reduces the risk of peanut allergy by 70-86% in those infants at high risk for developing the allergy. The researchers conducting the study, led by Dr. Gideon Lack, presented their findings at the American Academy of Allergy, Asthma, & Immunology (AAAI) conference in Houston in February.
For their study, the researchers tested the idea that regularly eating peanuts during the first year of life would protect against the development of peanut allergies by allowing the immune system to get used to peanuts. The idea for the study stemmed from observations that Jewish children in Israel develop peanut allergies 10 times less frequently than do those in England – and also start eating peanuts much earlier in life, usually before they are a year old. Other motivations for the study were the observations that early introduction of eggs and milk could reduce the development of allergies to these products, often also associated with food allergy. Because these observations were merely observations – and not controlled studies, the researchers wanted to design studies that would allow them to collect meaningful data on the effects of early exposure to allergens on the later development of relevant allergies.
The investigators tested their idea on over 600 infants, ranging from 4 months to 11 months in age. All of these infants were categorized as high risk due to egg allergy, eczema, or both. Approximately half of the children served as a control and were kept away from peanuts, whereas the other half were given snacks containing peanuts three or more times each week until they were five years old. When these children were tested for peanut allergies at the age of 5, only 3.2% of those who ate peanut snacks as babies had developed peanut allergies, compared to 17.2% of those in the group that did not ingest peanuts as babies.
The Food Allergy Research and Education (FARE), an institution dedicated to improving the quality of life and treatment options for those suffering from food allergies, funded this critical research study. Their CEO, James Baker, importantly pointed out at the meeting that the specific timing of initial peanut exposure can significantly impact the likelihood of developing a peanut allergy. FARE also emphasized that these results should not be interpreted to mean that older children and adults who are already diagnosed with peanut allergies should expose themselves to peanuts as a way to cure themselves of the allergy. Though techniques in this spirit are often used therapeutically, in strategies known as immunotherapies, these therapies should be administered and monitored by physicians. While some reports have noted that the World Health Organization (WHO) may be incorrect in recommending that people avoid peanuts if they are allergic, those with peanut allergies do still need to use significant precautions around peanuts. Indeed, the study excluded babies who already showed signs of peanut allergies and so does not offer data on how peanut exposure affects existing allergies.
Though the results of the study on the impact of early peanut exposure to the later development of peanut allergies is striking and highly promising in terms of our growing understanding of peanut allergies and how to protect against them, as with any influential scientific study, the results may open up more questions than they answer. First, will these protected children continue to be protected against peanut allergies later in life and into adulthood? Future research programs aim to track these children to answer that question.
More research will also need to be conducted to determine the optimal exposure dose and timing so that we can best leverage our ability to prevent peanut allergy development and potentially alter guidelines accordingly. For now, the results provide relevant physicians with new data and opportunities for helping their patients avoid the detriments of peanut allergies. With time, we may know enough about the development of peanut allergies to make general recommendations for all parents to follow.
Around 5.4 million people suffer from peanut allergies in the United States and Europe alone. Among those with peanut allergies are millions of children, who, along with their parents, have to deal with the anxiety that comes with these allergies on a daily basis. Peanuts are the biggest culprits for food allergies, with approximately 8% of American children being diagnosed with the allergy. As a society, we are impacted not only by the death that can result from severe allergies and anaphylactic reactions but also by the reduced quality of life associated with dealing with such allergies. The psychological impact of allergies on patients and their families can lead to severe anxiety and antisocial behavior.
The incidence of this specific allergy does not seem to be declining, or even remaining steady. Instead, one study shows that four times more children had peanut allergies by 2010 than in 1997. Another pair of studies, conducted in the Unites States and The United Kingdom, shows that in the past five years, peanut allergies have doubled in kids younger than five years of age.
Today, between 150 and 200 deaths occur each year in the United States as a result of peanut allergies, and around 125,000 emergency room visits result from allergic reactions related to peanuts. It is possible for children to outgrow their peanut allergies, but research suggests that this occurs only about 20% of the time. Though the number of individuals with peanut allergies may not be improving, medical interventions to improve outcomes associated with these allergies seem to be.
A pharmaceutical company based in France has developed a drug (Viaskin Peanut) that may offer a solution for the families impacted by the growing incidence of peanut allergies and improve the economic impact of these allergies on our healthcare system.
Viaskin Peanut, created by DBV Technologies, is delivered in the form of a patch and has been accepted into the United States Food and Drug Administration (FDA)’s expedited approval program. The program, also known as a fast-track program, has less stringent testing requirements for allowing drugs onto the market.
What this means for consumers is reduced waiting time before they can access the drug. Viaskin Peanut should begin Phase III trials this year and become available in the United States in early 2018. It has already been shown that some peanut allergy patients using the patch can eat about four peanuts without suffering allergic consequences.
DBV Technologies is not the only company attempting to create products that can help people who are allergic to peanuts. A United States company, Aimmune Therapeutics, which used to be called the Allergen Research Corporation, is developing a drug, AR101, which would be offered in pill form to desensitize patients to peanuts. Like DBV Technologies, Aimmune Therapeutics has also been accepted into the fast-track approval program by the FDA and plans to start Phase III trials before the end of 2015. Aimmune Therapeutics is also looking into creating interventions for other types of food allergies.
How do these new solutions addressing peanut allergies work? Unlike conventional treatment options, like antihistamines and EpiPens, which aim to reduce the effects of an immune reaction on the body, effectively minimizing the symptoms associated with severe allergic reactions, Viaskin Peanut and AR101 attempt to intervene much earlier along in the process of an allergic reaction. These drugs introduce small amounts of peanut products to the patient, with the goal of desensitizing the patient’s immune system to peanuts. In other words, rather than intervening in the immune reaction, these new drugs are designed to prevent the reaction from occurring in the first place. This strategy for dealing with allergies is known as immunotherapy and is growing in popularity.
The Centers for Disease Control and Prevention (CDC) continues to warn that there is no cure for food allergies. Though the drugs currently being tested and potentially commercialized may improve things for peanut allergy sufferers, they do not claim to cure patients of their allergies or to 100% prevent or stop immune reactions to peanuts. Thus, even if these drugs do soon hit shelves, doctors are likely to continue to recommend that those with peanut allergies take precautions for preventing exposure to these nuts, particularly high-dose exposures. Such exposure can occur, for instance, when prescription drugs containing peanut oil are ingested. Nonetheless, if these drugs are able to minimize the adverse impact of peanut allergies, they are likely to significantly improve millions of lives.
When we think of treating allergies, we often think of pills, inhalers, nasal drops, and EpiPens. However, preventing allergies can be one of the most effective ways to deal with them. Because there are no cures or vaccines currently available for allergies, prevention generally requires controlling one’s environment. For instance, those with food allergies are advised to avoid exposure to problematic foods. Those allergic to indoor and outdoor allergens, such as pollen and dust mites, can also reduce the impact of those allergens on their bodies by employing measures to decrease the levels of those allergens to which they are exposed.
For those with allergies, it has often been recommended that vacuum regularly can improve allergy symptoms by getting rid of allergy triggers like dust mites. Some people suggest keeping windows closed when outdoor allergens are at high levels, minimizing the use of window fans because they pull pollen from outdoors indoors, and to vacuum two or more times per week. Vacuuming is recommended because it is one effective way to keep floors clean, and though not always well recognized, dusty and dirty floors are often primary culprits for indoor allergies. Some people also recommend leaving shoes at the door, to minimize the dirt and dust that accumulates on floors in the first place. Nonetheless, whether shoes are worn indoors or not, dust will naturally occur, and it will need to be removed. Unlike vacuuming, sweeping actually stirs up dust and can therefore exacerbate allergies. Vacuuming is thus recommended as the best way to keep floors clean and allergen-free.
Though vacuuming is a great way to reduce indoor allergens, experts specify that vacuum cleaners will be most effective if they contain a high efficient particulate air (HEPA) filter because these filters are superior at pulling in dust particles. When vacuum cleaners with HEPA filters are used, filters need to be changed approximately every six months and should be changed outdoors so that the trapped dust particles are not released back into the indoor space.
Some recent research studies suggest that rather than improving allergy symptoms, vacuums can in fact make those symptoms worse. Careful inspection of the details of the research reveals that a key issue in whether vacuum cleaners help or exacerbate allergies is the vacuum mechanism – or how the vacuum cleaner works. Some vacuum cleaners, including those with HEPA filters, actually release tiny dust particles and bacteria into the air, which can cause allergies or infections.
A comprehensive study on air emissions of different vacuum cleaners was conducted in Australia, and its results were published in the journal Environmental Science & Technology. After inspecting 21 different vacuum cleaners, the researchers concluded that every single vacuum cleaner released allergens and bacteria into the air. However, there were differences in the extent to which the vacuums did so. Generally, newer and more expensive models polluted the indoor air less than did older and cheaper models. Additionally, though it is claimed that HEPA filters remove 99.9% of bacteria and allergens like pollen from the environment, cleaners with HEPA filters released only slightly less of these substances than did cleaners that lacked HEPA filters.
Despite these findings, experts conclude that vacuum cleaners are still a good way to remove allergens from the environment. Specifically, they claim that a vacuum cleaner would have be extremely old and dirty to do more harm than good in minimizing allergens and reducing allergy symptoms. As far as HEPA filters go, regardless of the precise amount of allergens they are able to remove, it is clear that they remove more of these allergens than are removed without the use of these filters, and it is thus recommended that people continue to employ these filters to get rid of environmental allergens.
When recommending ways to reduce exposure to allergens, there are other recommendations related to cleaning as well. For instance, living in homes with hard wood floors is recommended over homes with carpet. For those with rugs in the home, cleaning the rugs weekly to remove dust and dirt particles can significantly improve allergy symptoms in the home. In addition, using microfiber, rather than paper towels or other types of cloths, can more effectively rid surfaces of irritating dust particles. Because microfiber cloths have small microfibers, they are able to cling to dirt and dust particles in small areas or cracks, which is difficult to achieve with other types of cloths. An added benefit is that to achieve good results, microfiber cloths can be used on their own, or with water, rather than with chemicals that can themselves act as irritants or allergens.
When microfiber cloths are used, it is critical to dust past the end of surfaces, or else dust and dirt will accumulate at the edges of surfaces that are being cleaned. One common suggestion for microfiber cloths is to use them after showering to clean surfaces in the shower and bathroom. This practice reduces moisture and prevents the growth of mold and mildew, which are common allergy triggers. Leaving the door open or keeping the shower curtain partially open can also decrease moisture accumulation by allowing air to flow into the shower rather than trapping moisture inside.
For people allergic to environmental agents like pollen and dust mites, reducing the levels of these allergens to which they are exposed can be a highly effective way to manage allergies and allergy symptoms. Vacuum cleaners can minimize the amount of both indoor and outdoor allergens that are present inside, particularly if they incorporate HEPA filters, which are capable of removing these allergens at high rates.
Before puberty, boys tend to suffer from allergies and asthma more frequently than do girls. However, after puberty, these conditions are more common in women than in men. Women who suffer from acute asthma, which is related to allergies, are 60% more likely than men to require emergency intervention or hospitalization. Further, women suffer more frequent and more severe anaphylaxis, which is a potentially fatal severe allergic reaction that can inhibit a patient’s ability to breathe and lead to stroke. Researchers have wondered for years why the sex difference in tendency to experience anaphylaxis exists, and recent research points to a potential role of estrogen.
Estrogen refers to the main female sex hormones, which are critical in female reproduction and menstrual cycles. Estrogen promotes female characteristics, such as the growth of breasts, and also serves a number of critical physiological functions. Estrogen is used medically for a number of purposes, including birth control (it is contained in oral contraceptives), hormone replacement therapy, and the treatment of certain cancers, such as breast and prostate cancer.
Researchers at the National Institute of Allergy and Infectious Diseases (NIAID), which is one of the National Institutes of Health (NIH) published their relevant findings in The Journal of Allergy and Clinical Immunology. The researchers showed that when exposed to allergens, female mice endured longer and more severe anaphylaxis than did male mice. However, when estrogen levels were reduced in female mice, the sex differences disappeared.
To do this experiment, researchers ovariectomized the female mice, meaning they removed their ovaries. Because ovaries produce estrogen, this procedure minimizes the amount of estrogen circulating in female mice’s bodies. They then compared allergic reactions and anaphylaxis in male mice, regular female mice, and female mice lacking ovaries.
To induce anaphylaxis, the researchers used histamine, which is a natural component of the immune system that causes inflammation, combined with immunoglobulins, or antibodies that initiate allergic reactions when stimulated. Not only did the female mice that lacked ovaries display anaphylactic reactions that were more similar to their male counterparts than did non-ovariectomized female mice, but when researchers injected an estrogen hormone called estradiol into these ovariectomized mice, the mice also suffered more severe anaphylaxis. These results point to a clear role of estrogen in promoting more severe allergic reactions.
After recognizing that estrogen is a key player in allergic reactions and in their severity, researchers asked what it is about estrogen that allows it to exacerbate anaphylaxis. A set of experiments then led to the discovery that estrogen enhances the swelling and blood vessel dilation associated with anaphylaxis because it increases the activity of endothelial nitric oxide synthase (eNOS), which is an enzyme that causes these symptoms. When researchers blocked eNOS activity in female mice, they again observed the disappearance of sex differences in allergic reactions and anaphylaxis.
It is important to note that these studies were conducted in mice, and so it is not yet clear whether the findings apply to humans as well. Because neither physicians nor scientists can ethically induce anaphylaxis in human patients, nor can they remove ovaries in human patients for the sake of experimentation, studies parallel to those conducted in mice cannot be recapitulated in humans. However, additional experimentation is likely to help confirm whether these findings in mice do in fact extend to humans.
Though removing the ovaries of mice to understand the impact of estrogen on different physiological reactions is arguably reasonable for scientific research, it is highly unlikely that female patients with severe allergies would want to remove their ovaries or deplete their systems of estrogen. Thus, the finding that estrogen exacerbates allergic reactions helps us understand the difference in reactions in men and women but does not provide a practical treatment option.
It does, however, provide a useful lesson to females with severe allergies. Namely, it is especially important to avoid allergens and to carry an EpiPen when estrogen levels are high. Estrogen levels are high throughout puberty, just before menstruation, or when estrogen is being used for medical purposes. For example, women undergoing hormone replacement therapy following menopause may be at higher risk for anaphylactic reactions than those who do not undergo hormone replacement therapy. On the other hand, parents of young girls can rest assured that when their daughters are pre-pubescent, their estrogen levels are low, making them less susceptible to anaphylaxis than they may be later in life.
However, the finding that estrogen imparts its effect on allergies by specifically increasing the activity of a certain enzyme – i.e. eNOS – provides a more promising route to treatment. For instance, medications may be developed that specifically inhibit the activity of eNOS in those who suffer severe allergic reactions or anaphylaxis.
It is clear that adult women are more susceptible to severe allergic reactions and complications arising from asthma than are adult men. New research helps clarify the existence of sex differences by demonstrating the key role of estrogen in promoting more severe reactions. By increasing the activity of eNOS, estrogen indirectly enhances swelling and inflammation, which are dangerous characteristics of anaphylaxis. Understanding the critical role of both estrogen and eNOS can enable patients to employ more effective strategies to prevent severe allergic reactions and anaphylaxis and also open up doors to the development of more effective allergy treatment options. Specifically, medications that are able to block eNOS activity may be a particularly powerful way to help women with severe allergies experience fewer or less severe anaphylactic reactions.
We often associate weather with our allergy symptoms because certain seasons bring with them specific allergens that trigger our sneezing, runny noses, and wheezing. Often, the causes for our allergies are agents that thrive in certain weather conditions. For instance, mold grows in the winter, poison ivy is rampant in the summer, and pollen fills the air in the spring and fall. However, sometimes it is the weather itself that makes us suffer form allergies.
Specifically, changes in temperature and humidity can cause allergy symptoms like sneezing and congestion, which occur due to swelling that results from changes in the nose’s membranes. These types of symptoms are generally referred to as non-allergic rhinitis. Other weather specific conditions, however, are allergic reactions rather than non-allergic reactions. For instance, cold urticaria is an actual allergic reaction to cold weather.
Those who experience cold urticarial suffer from itching and swelling when they are exposed to cold air. People often get cold urticaria as a result of a viral infection, while others are born with the issue. Though symptoms are usually more annoying than dangerous, severe reactions can cause anaphylaxis and therefore be life threatening, so some patients with cold urticaria are advised to carry an EpiPen. Lucky patients will outgrow the condition and no longer suffer the associated symptoms.
Many allergy sufferers who do not have cold urticaria still feel as though they are allergic to the weather because of the weather’s impact on their allergies. Each season brings with it specific allergens, and transitions between seasons are often when people have the hardest time with their allergies. During winter, indoor, rather than outdoor, allergies are usually an issue. As winter turns to spring, grass and tree pollens becomes more abundant, and spores begin being released by outdoor molds. When summer rolls around, grass pollen is problematic, and mold spores peak in warm regions. Ragweed is a common culprit in the fall.
The nature of weather within seasons can affect how bad your allergies are. For example, wet winters enable trees to produce more pollen, which can exacerbate pollen allergies in the following months. Some proponents of theories of global warming claim that climate change is adversely affecting allergy and asthma levels. They point to the dangerous combination of ozone pollution and pollen as sources of increasing numbers of allergy and asthma sufferers.
This year, talk of a “pollen tsunami” has been popular, with the apparent rise in allergic reactions in the northeastern portions of North America. Experts say that rather than releasing pollen at different times, several tree species are releasing pollen simultaneously, leading to a huge level of pollen production that is causing allergies that are more severe than usual. Given the rise in pollen, those allergic to the substance have been recommended to keep their doors and windows closed to shield them from the allergen this year. Reducing the amount of time spent outside also helps reduce allergy symptoms, as does avoiding regions where pollen is particularly prevalent. After coming inside, removing and washing clothes is another good preventative measure during this high pollen time.
Those who suffer allergy symptoms at different times of year often have customized medication plans that include increasing certain medications during the times of year when they tend to experience allergies or when they are traveling to areas where they are likely to be exposed to the allergens that affect them. Antihistamines are often effective interventions to both prevent and manage the symptoms associated with allergies. Doctors also sometimes recommend using saline solution to clean the nose so as to rid air passages of allergens. In the winter, using dehumidifiers and allergen filters can help with indoor allergies, whereas avoiding problematic areas in the outdoors is often effective during spring, summer, and fall. However, specific medications are often useful for specific allergies, and those who suffer from severe allergies are often advised to carry an EpiPen in case of an emergency.
It was once thought that shielding babies from potential allergens would protect them from developing allergies. However, research has begun to show that those babies who are exposed to allergens and complex combinations of allergens early in life tend to be at lower risk for developing allergies than those who are kept in sterile environments. These findings are likely the result of the working of our immune systems. As allergies are our bodies’ way of responding to a substance that the body deems threatening, exposing the body to foreign agents earlier can potentially reduce the likelihood that the body will perceive those agents as threatening in the future and will instead recognize them as innocuous parts of the person’s environment.
Though varying levels of antigens throughout different months of the year is an unavoidable concept, being aware of when and why certain allergens will be more prevalent can allow you to minimize the impact of those allergies on your health and quality of life. Avoiding allergens and engaging in activities to effectively reduce the levels of those allergens in your environment and to minimize the effects of those allergens on your body can make certain seasons and seasonal transitions less stressful and more enjoyable.
Several allergy drugs are on the market. There are over-the-counter medications and prescription medications that minimize specific symptoms associated with allergic reactions. EpiPens are generally prescribed for those with severe allergies because they can reverse the life threatening anaphylactic reaction that can occur in patients with allergies. EpiPens contain epinephrine, which can stop the vasodilation that occurs during a severe allergic reaction, thereby saving the patient. Though the sequence of events that occurs during an allergic reaction is generally well understood by scientists and physicians, we have not developed an actual cure for allergies or asthma. Though there are a number of effective interventions that prevent or reduce the symptoms associated with allergies, treating the underlying cause for allergies has eluded scientists. Nonetheless, several promising lines of research provide hope that we can more effectively treat allergies in the future and possibly even cure them.
In recent years, immunotherapies have been touted as promising strategies for interventions in medications related to allergies. Immunotherapy leverages what we have learned about why allergies occur to try to prevent or minimize allergic reactions and the associated symptoms. Specifically, because allergic reactions are the immune system’s overreaction to an otherwise innocuous agent, immunotherapy aims to train the immune system to recognize that the substances the immune system is reacting to are not in fact harmful. Immunotherapy involves exposing a patient to small amounts of the allergen that causes an allergic reaction, so that the immune system has a chance to recognize that agent but at low doses that will not motivate the immune system to initiate an enormous reaction. With continuous and frequent exposure, the hope is that eventually the immune system will learn that the substance is not harmful and will therefore no longer react and cause the symptoms associated with allergies.
In the past, immunotherapy has taken often come in the form of shots, which requires that patients make frequent visits to the doctor’s office, usually weekly. Though this type of immunotherapy has proven effective, many people struggle to maintain the schedule of weekly doctor’s visits due to the inconvenience, while others do not like the invasive nature of shots. The Federal Drug Administration (FDA) has recently approved a new form of immunotherapy, which is a pill that dissolves in the mouth. The pill is approved for allergies to grasses and ragweed, and scientists are hopeful that they will soon have pills that can address all allergens. The next available pill will likely be one that combats allergies to dust mites.
Probiotics refer to microbes that promote the growth and survival of “good bacteria” and have been identified as a possible solution to allergies. Some researchers have suggested that a paucity of good bacteria in the stomach may enable the immune system to overreact to certain allergens in the environment. These scientists claim that living in extremely clean environments can reduce the amount of these important bacteria and actually make us more susceptible to allergies. A recent study conducted at Vanderbilt University demonstrated that those with allergies who took probiotics showed better health outcomes than did those who were given a placebo that involved no probiotics. Another study showed that kids with peanut allergies were able to overcome their peanut allergies with a treatment regimen that included probiotics. In this study, the probiotic treatment was done in conjunction with immunotherapy, so while the patients were subjected to probiotics, they were also exposed to increasing amounts of peanuts. It is therefore difficult to say whether the probiotics specifically impacted the immune system’s response to peanuts in this patient population. Another reason to question the impact of probiotics is that studies have also shown that administration of probiotics failed to improve symptoms associated with hay fever. Experts suggest that more research is required to understand the precise impact of bacteria and probiotics on the immune system and allergic reactions, but probiotics may offer a new intervention for dealing with allergies.
Ongoing scientific research that clarifies the mechanisms involved in allergic reactions will likely lead to more effective therapeutics and potentially allergy preventions. Some scientists have expressed hope that vaccines for certain allergies will one day be available, but the development of vaccines would depend on furthering our understanding of the complexity of allergic reactions, as well as the differences between different allergy types. In April of this year, researchers published an article in the academic journal Nature Communications that pointed to the role of a specific protein, Mbd2 in allergic reactions. Mbd2 appears to impact inflammation and to initiate epigenetic influences by affecting gene expression. This discovery may eventually shed light on new ways to treat allergies and asthma.
As allergies are on the rise, many clinicians and researchers believe that changing elements in our environment are increasing the prevalence of allergies. Thus, though our therapies and interventions for allergies may be improving over time, this progress is not necessarily reflected in the allergy status of human populations. With allergies on the rise, it is more critical than ever that we determine the specific causes and sequence of events that lead to allergic symptoms, particularly those that are life threatening so that we can develop ways to combat these reactions. Treatments like immunotherapies, which aim to minimize the reaction itself rather than to minimize symptoms associated with the response, will likely be those that are most likely to lead to full cures or preventions for allergies.
Anaphylaxis is an extremely severe allergic reaction, where the immune system releases histamine, basophils, mast cells, and other substances. The excessive reaction of the immune system to an allergen causes tightening of airways and difficulty breathing. Anaphylaxis can be fatal if not properly treated. Once it is clear that a patient is experiencing anaphylaxis, epinephrine is generally administered. People with extreme allergies often carry EpiPens, which facilitate a simple injection of epinephrine. EpiPens often save lives because there is a limited amount of time from the onset of anaphylaxis and death. For those who cannot get to the emergency room fast enough, an EpiPen makes all the difference.
While difficulty breathing and swallowing, as well as chest tightness are common and recognizable signs of anaphylaxis, there are several other symptoms that can indicate an anaphylactic reaction. These include: cough, diarrhea, anxiety, skin redness, slurred speech, swelling of the face, wheezing, unconsciousness, nausea, vomiting, hives, nasal congestion, and abdominal pain.
Some drugs can cause symptoms that are similar to those experienced during anaphylaxis. These drugs include aspirin, morphine, and x-ray dye. When people suffer anaphylactic-like symptoms in response to these drugs, they are not enduring an immune reaction like that which occurs in response to an allergen.
There are two main features of anaphylaxis: one is respiratory difficulty, which can occur as a result of asthma or laryngeal swelling, and the other is hypotension, which can present as loss of consciousness, collapse, or fainting. Anaphylaxis occurring without hypotension generally indicates the immediate use of epinephrine intramuscularly. However, epinephrine that occurs with hypotension is better treated with intravenously.
Anaphylaxis is usually diagnosed based on observation of clinical features consistent with the symptoms described above. However, there are also two biomarkers that can be tested for in the laboratory: histamine level and tryptase level. However, these tests cannot be performed rapidly and are not always available. Further, tests for histamine and typtase levels are not specific to anaphylaxis, as these levels can rise due to other conditions as well. Thus, it is most often the case that physicians and patients recognize the onset of anaphylaxis without biological tests.
Epinephrine, also known as adrenaline, helps reverse anaphylaxis by stimulating different adrenoreceptors. For instance, epinephrine stimulates a adrenoreceptors and thereby increases the resistance of peripheral vasculature. When the resistance of this vasculature increases, blood pressure improves and swelling reduces. When epinephrine stimulates b2 adrenoreceptors, bronchodilation occurs and swelling is further reduced.
Beta blockers reduce the effects of adrenaline and can therefore make anaphylaxis worse. They can also limit the ability of epinephrine to reverse an anaphylactic reaction. Other limitations in the treatment of anaphylaxis unfortunately derive from improper administration of epinephrine. Often epinephrine is not administered fast to enough to have maximal benefit, which can result from lack of availability of epinephrine (often due to never filling a prescription or not physically carrying an EpiPen) or lack of recognition of anaphylactic symptoms. Patients also frequently report being too scared to self-administer epinephrine with an EpiPen.
Knowing when and how to use the EpiPen for safe and precise delivery of epinephrine is critical during an anaphylactic reaction. There has been significant criticism of health care providers’ care of patients who are at risk for anaphylaxis. Of particular concern is that medical professionals tend not to properly train patients on how to use an EpiPen should they need one. Additionally, medical professionals and patients alike tend not to know the details of the dosing of epinephrine, which is also critical to the successful and safe reversal of anaphylaxis. Propoer training in this respect could significantly enhance the proper use of EpiPens, thereby saving more lives.
Though it can be critical to use epinephrine in response to anaphylaxis, doses that are too small or too large can themselves be life threatening. When epinephrine is administered intramuscularly, as it is with EpiPens, the proper dose for adults is 0.3 to 0.5 mL for a 1:1000 solution. Overdose is particularly risky when epinephrine is given intravenously. Those who are most vulnerable to the adverse overdose effects of epinephrine are the elderly and those with cardiovascular disease or hypertension. Nonetheless, the benefits of using epinephrine in the face of anaphylaxis appear to far outweigh the risks of not using it, even at higher risk patients.
Women suffer anaphylaxis more frequently than do men. People who suffer anaphylaxis from exposure to certain antigens are certainly at risk for future anaphylactic reactions, but the severity of their reactions is not predictive of the severity of future reactions. One reason for this is that the dose of allergen can impact the severity of reaction, and knowing the dose to which one was exposed can be difficult. In the long-term, however, the frequency and severity of anaphylactic episodes has been reported to decrease. Nevertheless, as anaphylaxis is a severe, potentially fatal condition that cannot always be reversed, it is important that patients acquire information on their allergies, understand their risks for developing anaphylaxis, and avoid allergens that could contribute to such a reaction.
For millions of people allergic to eggs, exposure to these agents can lead to severe and dangerous reactions. Children are much more likely than adults to suffer from egg allergies, and eggs are the second most common food that causes allergy in children, behind cow’s milk. In the United States, 1.5-3.2 percent of children are allergic to eggs, many of which are also allergic to milk. About half of those children diagnosed with egg allergy will outgrow the allergy by the age of 17. The American Academy of Allergy, Asthma, and Immunology has reported that of those children who do outgrow their egg allergy, approximately 45% outgrow it by the age of 5. The highest levels of antibodies against egg proteins were observed in these children around the age of 1.
Egg allergies occur when the immune system overreacts to substances contained in the white or the yolk of eggs. More often than not, egg allergies are a result of antibodies in the immune system that react to one of the proteins found in the egg white. These proteins are: ovomucoid, ovalbumin, ovotransferring, and lysosome. Of these proteins, ovomucoid is the one most likely to lead to an allergic reaction. Because egg whites cause the release of histamines, which are part of the immune system, non-allergic reactions can also occur in response to egg white exposure in what is referred to as egg white intolerance. In these cases, the immune reaction usually stays localized in the gastrointestinal tract. However, it can escalate to the point of anaphylaxis so, like egg allergies, must be taken seriously.
The egg yolk can also cause allergic reactions and tends to do so more often in adults than in children. The proteins in the egg yolk that can be problematic are: livetin, apovitillin, and phosvitin. For those who are allergic to a protein in egg whites can usually safely consume egg yolks, and those allergic to a protein in egg yolks can likely eat egg whites without difficulties. People with egg allergies can also usually tolerate egg substitutes.
Egg allergy diagnosis is usually made with skin prick testing or blood testing. Skin tests allow for the visual observation of inflammation in response to egg exposure, whereas blood tests can reveal the levels of relevant antibodies in the patient’s system in response to the food. There is no cure for egg allergies. Avoiding egg consumption is the most effective way to avoid allergic reactions, but accidental consumption does occur. If patients start feeling symptoms of anaphylaxis, such as a tightening throat, enlarged tongue, or difficulty breathing, epinephrine can be administered to reverse the dangerous reaction. It is therefore important that those with severe allergies to eggs carry an EpiPen.
Exposing young children to eggs can help protect them against an egg allergy. Specifically, giving infants cooked eggs around 4 to 6 months of age can potentially help safely introduce eggs and the associated proteins to the child’s immune system in a manner that will allow the immune system to subsequently recognize eggs and their proteins as innocuous.
A number of vaccines contain egg products and can cause reactions in those with egg allergies. In severe cases where patients cannot receive vaccines due to the egg products contained, physicians will likely recommend that all family members are vaccinated for the relevant condition to reduce the chances that the patient with suffer as a consequence of their lack of vaccination.
In addition to the dangerous results of egg exposure for those allergic to egg, other aversive reactions can also occur, such as urticaria and eczema, which are skin reactions that include rashes and hives and can itch and cause pain. A runny nose, sneezing, coughing, wheezing, and itchy, watery eyes can also result from egg allergy reactions.
These days, we hear a lot about kids developing allergies at a higher rate than in previous generations. Often, these allergies are quite serious. A common example is the peanut allergy that can be fatal if it leads to anaphylaxis, and the patient is not treated quickly enough. Given the growing number of allergies and associated anaphylaxis, many parents worry about how they can protect their children from these serious conditions.
First, it is never too early to test children for allergies. There is no minimum age for which testing is required. However, it is important to understand that allergies will not develop until people have been exposed to the allergens. In other words, children do not become allergic to pollen until they have been around pollen for a few springs. Similarly, they do not become allergic to peanuts until they have ingested peanut products. Testing too early may therefore lead parents to falsely believe that their children are protected from allergies, when they may simply not have had a chance to develop allergies yet. Indeed, many allergies do not present until adulthood, after significant exposure to an allergen has occurred over decades.
Testing your kids for allergies is therefore something you will want to do when true symptoms of allergy occur, even if they have tested negative in the past.
Another possibility to recognize is that “allergy-like” reactions can be indicative of other issues. For instance, rashes can occur for a number of reasons and do not necessarily signal an allergy to a product that was used in the area of the rash. At the same time, intolerance to certain substances can appear allergy-like while not posing the same risks as allergies. Glucose intolerant patients are not allergic to milk. Both food allergies and intolerance result in diarrhea and vomiting, but these symptoms are caused by different factors. Whereas allergies cause these symptoms because of an immune reaction, intolerance causes these symptoms because of deficiencies in enzymes that normally digest or absorb foods. Food allergies will often include key symptoms not conferred by intolerance that can help the child and parent identify the allergy. For example, swelling, hives, or difficulty breathing can occur with allergies but should not occur with intolerance.
There are a number of ways to test for allergies. Blood tests, skin tests, and diet tests are the most common. Blood tests are very quick, but because they involve a needle, kids often become upset at the prospect of this type of test. Similarly, intradermal skin tests involve injecting allergens into the skin with a needle.
Though in some circumstances, the allergist may determine that the blood test or intradermal skin test is most appropriate, percutaneous skin tests can provide highly accurate results and are less invasive. They are therefore often used for allergy diagnosis.
The percutaneous skin test exposes the top layer of skin to the allergens being tested. This exposure involves a quick scratch or prick that is minimally invasive. To prepare for this type of test, all antihistamines must be stopped a week before the test, so that the immune system goes back to its “natural” state, and its normal reaction to the allergens can be observed in testing. After the skin test is initiated, there is a waiting period of up to about 15 minutes, which gives the immune system time to react. At that point, the doctor can look at the skin and determine whether a reaction has occurred. Often, the doctor will test the reaction to a number of allergens at once, including a control, which is a substance that should cause no reaction in any patient.
Because the skin has been pricked or scratched, it may appear a bit redder or more inflamed than other parts of the body. The control therefore allows the doctor to see what “no reaction” should look like. The doctor can then compare the skin that received the control to the skin that received each allergen to determine which allergens the patient is allergic to, and also, to what extent the patient may be allergic to specific allergens. For instance, pollen may cause skin to become a bit more inflamed than the control, whereas mouse dander may result in highly inflamed skin. In this case, the doctor would know that the patient may be slightly allergic to pollen but that exposure to mice will cause much more severe symptoms for the patient.
Diet allergy tests, often called “elimination diets” test for allergies by individually removing certain foods from the diet and then monitoring allergy symptoms. These tests are often used when food allergies such as allergy to milk, nuts, eggs, wheat, or soy is suspected. If eliminating one of these foods also eliminates symptoms, the doctor may deem your child allergic to that food. However, a limitation of elimination diets is that they can also eliminate symptoms associated with other issues, such as a food intolerance and so may not necessarily pinpoint an allergy. Misdiagnosis of allergies, particularly of food allergies, is also on the rise lately and is of concern because the avoidance of certain food groups is implicated in malnutrition. It is generally agreed that unless there is a significant medical concern associated with ingestion of important food groups, these groups should not be avoided.
If your child tests positive for an allergy, the specific treatment will depend on a number of factors, including the specific allergen, the symptoms associated with the allergy, and how severe the allergy appears to be. Often, allergies can be managed with regular allergy shots or oral medications. If the allergy is serious enough, you and your child may need to learn to use an Epi Pen and to create a plan that enables your child to always have access to one. An Epi Pen is used in the case of anaphylaxis that occurs outside a medical facility. By pushing the Epi Pen into the skin of the patient (often in the thigh), the Epi Pen injects the chemical epinephrine into the blood stream, which constricts blood vessels and opens up the airways in the lungs. By its actions, epinephrine reverses typical symptoms of allergic reactions, including wheezing, low blood pressure, hives, itchy skin, and most importantly, breathing difficulties. Its impact on the latter is a lifesaver in many scenarios.
A growing number of latex allergies are being recognized and diagnosed. It is believed that about 3 million people in the United States are allergic to latex. Those allergic to latex react to a milky fluid found in latex that is produced by rubber trees. As with other allergies, the immune system perceives the allergen (i.e. the milky fluid found in latex) as harmful. Many latex allergies are mild and may simply cause some slight irritation to the skin, termed irritant dermatitis. However, the allergy can also be much more serious, leading to hives, asthma, rhino-conjunctivitis, and of particularly concern, anaphylaxis. Because anaphylaxis is potentially fatal, increasing our understanding of latex allergy and how it may lead to this serious condition is important. Further, it is critical that people recognize risk factors for latex allergy so that they can minimize the likelihood of developing this allergy and manage the allergy safely when it does occur.
Like many other allergies, the risk for developing a latex allergy increases with exposure to latex. Between 7 and 10% of workers who where latex gloves regularly become allergic to latex. For instance, one study determined that over 12% of all anesthesiologists suffer from latex allergy, and many studies have reported the relatively high numbers of nurses with latex allergy. Though latex free gloves tend to be more expensive than latex gloves, several hospital programs have been developed to implement latex-free only gloves for use within the hospital. Supporters of these initiatives argue that the liability and spending that is saved by preventing employees from developing bothersome and potentially dangerous allergies is worth the added financial cost. A Japanese analysis, for example, concluded that using latex-free gloves could actually end up saving 3.5 million yen each year.
The FDA, however, says that latex free labels are misleading because there is no test that can accurately and definitively assure that no latex is present in products. However, they also acknowledge that complete elimination of latex is probably not required to prevent allergic reactions to latex. Accordingly, programs that switch to “latex free” gloves have
indeed significantly reduced latex allergies among healthcare workers.
Those with a family history of allergy seem to be more likely to suffer from latex allergies. About 33% of all people who receive positive skin test results for latex allergy do not demonstrate any allergy symptoms. For those who do suffer from allergic symptoms when exposed to latex, using powder free latex gloves can reduce symptoms, particularly if those symptoms are respiratory because reducing powder minimizes the airborne exposure to latex.
Those allergic to fruits and vegetables may be more prone to latex allergies. Recently, some researchers have begun to focus on the potential cross-reactivity between latex allergies and food allergies. Indeed, a number of people who are allergic to latex turn out to also be allergic to specific foods Some of the most highly implicated foods for those allergic to latex are avocado, potato, and banana. Tomato, chestnut, bell peppers, papaya, and kiwi are also often problematic for those with allergies to latex. Some clinicians use the term “latex-fruit syndrome” because of the relatively high incidence of comorbid allergy to both latex and fruit. The reason this cross-reactivity occurs is that the protein in latex that leads to an allergic reaction is structurally similar to proteins found in many foods, particularly fruits and vegetables.
The elderly population also appears to be vulnerable to latex allergy, though whether this vulnerability is simply due to an increased likelihood that elderly individuals have been exposed to latex more than younger individuals is not clear. Another group that often suffers from latex allergies is children with spina bifida. Between one quarter and two thirds of children with spina bifida test positive for latex allergy. Many studies conducted in Northern America, Europe, and Asia find about half of those with spina bifida also suffer from latex allergy.
Much of the literature focuses on latex in gloves, which has been shown to significantly impact the healthcare community. However, latex has been identified in a number of products, ranging from balloons to yoga mats to eyelash glue. There have also been reports of vaccines and flu shots causing latex allergy reactions. Though many people misinterpreted these observations as indicating a problem with the medicine that was injected into patients, it is generally agreed that the most likely cause for these reactions is the latex found in syringes. Further support for this notion comes from the fact that the reactions tended to be local, causing irritation in the area of the skin where the injection was made. If, on the other hand, the medicine itself contained latex, a more widespread reaction would be expected with the injection of that medicine into a patient’s circulation.
Restaurants are another place where people report latex allergies. Because workers often wear latex gloves while handling food in restaurants, those who later consume that food can react to the latex that remains on the food. As a result, many restaurants have switched to vinyl gloves, though it has been reported that vinyl suffers its own dangers. In 1999, Rhode Island became the first restaurant to ban the use of latex gloves in restaurants. In the next few years, both Arizona and Oregon followed.
Latex allergies can be identified with both serum testing and skin prick testing. The American Latex Allergy Association says that the early symptoms of latex allergy include: hives, welts, a runny nose, swelling, headache, sneezing, itching, watery or reddening eyes, sore throat, chest tightness, wheezing, shortness of breath, or abdominal cramps.
There is not yet a universally adopted highly effective treatment for latex. The best option for preventing latex allergy is currently avoidance. However, other treatments have been shown to be useful in certain cases. For instance, last year, researchers successfully desensitized a nurse to latex using sublingual immunotherapy, which involves placing a small amount of latex under the tongue. This type of therapy works by getting the immune system used to the allergen in small doses so that it no longer reacts to the allergen as if it is a dangerous foreign invader.
Omega-3 fatty acids are a specific type of fatty acid that are essential for a number of human functions and that can be found in plants and oils and many of the things we eat. Fatty acids provide us with energy and are essential for a number of human functions.
Asthma is the leading cause for death among children, and recent research suggests that susceptibility to asthma can be reduced with methods as simple as changes in diet. Specifically, eating more omega-3 fatty acids may improve resistance to asthma. Several studies now demonstrate that dietary omega-3 fatty acids improve asthma symptoms in children. However, some studies fail to show this beneficial effect of omega-3 fatty acids on children’s health. Genetic factors may underlie the inconsistencies found in studies analyzing the impact of omega-3 fatty acid consumption on asthma. Future research will likely help clarify when and in whom omega-3 fatty acids will improve health outcomes.
Though omega-3 fatty acids are implicated in a number of inflammatory diseases, including asthma and allergy, their benefits appear to extend to other types of diseases as well, including depression, heart disease, Alzheimer’s disease, diabetes, arthritis, gum disease, and hearing loss. These fatty acids are in fact critical for health and have been shown to be particularly important for growth in children. They are important for the development of the brain’s cell membranes and for blood clotting.
The body does not make omega-3 fatty acids, so our need for these fatty acids must be met by ingesting them. They are found in many foods including several oils, green vegetables, and fatty fish. Specifically, kale, spinach, and other salad greens, as well as brussel sprouts and salmon are all known sources for omega-3 fatty acids.
Though we know that these types of foods can provide the benefits associated with omega-3 fatty acids, we do not have good techniques for quantifying these benefits or comparing benefits across food types. However, it does appear clear that ingesting omega-3 fatty acids in food is more beneficial than taking supplements of omega-3 fatty acids. Further, some studies find an associated between the reduction in our intake of fish oil and our increased incidence of asthma and allergy. This finding is perhaps intuitive given the studies that show that children who consume oily fish tend to be less at risk for developing asthma than those who do not consume oily fish.
An important thing to recognize in terms of the benefits of omega-3 fatty acids is that the effects of omega-6 fatty acids can counter them. Unfortunately, omega-6 fatty acids are also abundant in foods we consume, including corn and soybean. Scientists and physicians therefore suggest that it is important to maintain a ratio of omega-3 fatty acids to omega-6 fatty acids that favors more omega-3 fatty acids in your system.
Though many of the diseases that are affected by omega-3 fatty acid consumption are not categorized as inflammatory disease, the benefits imparted by omega-3 fatty acids may occur through the minimization of inflammation. For instance, it appears that for those who consume omega-3 fatty acids and enjoy benefits related to asthma and allergy, omega-3 fatty acids reduce immune responses associated with these disorders. Specifically, by reducing eosinophil activities, omega-3 fatty acids may help maintain lung function and prevent symptoms of asthma and allergy, including coughing, sneezing, and runny noses.
Not only can asthma and allergy be affect by the consumption of omega-3 fatty acids by patients themselves, but consumption by patients’ mothers may also have an influence. A study conducted in 2011 showed that if pregnant women took supplements of omega-3 polyunsaturated fatty acids, their children were less likely to develop asthma or to test positive on the egg skin prick test. However, once asthma or allergy have developed, it may take longer than 9 months of omega-3 fatty acid consumption to experience the health benefits. One study recently showed that 8-12 year olds who consumed omega-3 fatty acids over a 6 month period showed what should immune system changes that should theoretically reduce asthma and allergy symptoms, but they did not actually experience those clinical effects. Researchers therefore suggested that the severity of symptoms may not be reduced unless omega-3 fatty acids are consumed over a long period of time. It is also possible that there is a critical dose of omega-3 fatty acids, under which the clinical benefits are not realized.
Research suggests that omega-3 fatty acids may help combat natural immune responses that lead to problematic health outcomes, such as asthma and allergy. The specific way omega-3 fatty acids achieve this effect on the immune system is not well understood, and there is a great degree of variability in the effects of omega-3 fatty acids between individuals. It is important to consume adequate amounts of omega-3 fatty acids in your diet to support several bodily functions and so that potential health benefits will be afforded. If you eat a lot of omega-6 fatty acids, it is particularly important to ingest omega-3 fatty acids as well.
In the late 1970s, the first incidence of exercise-induced anaphylaxis was described. The patient had consumed shellfish and had a late onset reaction that was catalyzed by exercise. Since that day, over 1000 more cases of exercise-induced anaphylaxis have been reported. Research on these cases indicates that young adults are more likely than those of other age groups to suffer from exercise-induced anaphylaxis and that females are about twice as likely as males to experience this type of anaphylaxis. The cases also suggest that atopic disorders commonly associated with the immune system, such as asthma, eczema, or rhinitis, are often found in those who suffer from exercise-induced anaphylaxis and that jogging is the most common exercise type to lead to this aversive outcome.
The specific symptoms and sequel of events can differ from patient to patient, but there are often many similarities among exercise-induced anaphylaxis cases. Symptoms usually appear sometime between 5 and 50 minutes into exercise and often involve fatigue, a feeling of warmth throughout the body, and an accelerated heartbeat. Of course, these “symptoms” are often felt during exercise anyway so can easily be mistaken as normal reactions to a workout. Next, a reaction will often appear on the skin with what are known as urticarial lesions. These lesions tend to be raised from the skin, measure about 10-15 mm in diameter, be pink or red in color, and cause the patient to itch. Angiodema, which is swelling much like hives, is also likely to occur at this point, particular on the face, hands, and feet. Finally, widespread symptoms can occur, including gastrointestinal issues like nausea and vomiting, cardiovascular and pulmonary issues that can make it hard to breathe or cause chest pain, and neurological issues, which can lead to loss of consciousness. Even after intervention, when the specific reaction has resolved, headaches can persist for 1-3 days.
Why exercise-induced anaphylaxis occurs is not precisely known, but there are a number of factors that may contribute. Taking certain medications like aspirin can increase ones chances of exercise-induced anaphylaxis, as can exhaustion, menstruation, infections of the airway, insect bites, and exposure to allergens. Exposure to extreme temperatures has also led to exercise-induced anaphylaxis, particularly cold temperatures. As cold temperatures are also often problematic for those suffering from asthma, it is generally recommended that those at risk for these issues refrain from outdoor winter exercise.
For a subset of those patients who have endured exercise-induced anaphylaxis, the anaphylaxis depends critically on the ingestion of a certain food before exercise. Interestingly, the foods that can lead to this type of anaphylaxis are not necessarily the same foods normally associated with allergy, or for which the patients have an active allergy. Some foods that have led to exercise-induced anaphylaxis are: fruits and vegetables, including peaches, tomatoes, corn, and celery, dairy products, such as milk, eggs, and cheese, alcohol, shellfish, soy, garlic, rice, and wheat.
Another less common variable that has become associated with exercise-induced anaphylaxis is inheritance. Familial exercise-induced anaphylaxis was described when two siblings and their father all suffered these incidents.
How and why exercise-induced anaphylaxis occurs is not well understood. Exercise is known to have both pro-inflammatory and anti-inflammatory effects, which complicates the picture of how it leads to anaphylaxis, which occurs as an effect of an extreme or excessive inflammatory response. However, certain cells of the immune system, called mast cells, have been implicated in the condition. It has been suggested that the lowered pH that occurs with exercise allows for specific activity among mast cells that can lead to anaphylaxis.
Basophils are another type of immune system cell that may be involved in exercise-induced anaphylaxis. Physical exertion leads to hyperosmolarity in the blood, and it is thought that basophils may be particularly sensitive to this change, which leads to histamine release, an event that can lead to or exacerbate anaphylaxis.
A more complicated immune response involving macrophages and lymphocytes is also possible in exercise-induced anaphylaxis, and one hypothesis has been put forward for how these cells could contribute specifically to food-dependent exercise-induced anaphylaxis. According to this theory, macrophages and lymphocytes of the immune system are sensitive to food allergens and during exercise, are released into systemic circulation. Thus, during exercise, these cells can react with mast cells and basophils and drive anaphylaxis.
Aspirin may lead to exercise-induced anaphylaxis for a variety of reasons. It, along with alcohol, enhances the absorption of allergens from the gastrointestinal tract. However, aspirin also appears to have the capacity to activate mast cells and thus prime immune cells to become more sensitive to allergens and perhaps other stimuli. Studies have shown that giving a subject aspirin will enhance their reaction to skin prick tests. Additionally, some incidents of food-dependent exercise-induced anaphylaxis have also required the ingestion of aspirin for anaphylaxis to occur.
Luckily for those who suffer from exercise-induced anaphylaxis, people usually build a tolerance to exercise over time and do not continue to endure the highly stressful experience of anaphylaxis. However, being education about the risks and signs of exercise-induced anaphylaxis can help prevent such an incident, as can avoiding foods and other factors that could act as triggers for you.
Colds and allergies have a number of overlapping symptoms, including runny nose, congestion, and cough. Given that these symptoms can indicate different issues that require different interventions, confusing one condition for another can prolong symptoms and reduce quality of life for an extended period of time. Understanding the different etiologies and other distinguishing features of colds and allergies can help increase the likelihood that the symptoms are accurately assessed and that optimal steps are taken to rid the patient of those symptoms.
Viruses cause colds. Once viruses invade the body, the immune system recognizes and attacks them. The process of immune response causes the symptoms that are associated with a cold. Like colds, allergy symptoms arise because of actions of the immune system. However, unlike with colds, the immune system’s role in allergies represents over-activity of the immune system. Specifically, the immune system mistakes an innocuous foreign substance as a harmful invader. In response, the immune system causes the body to release certain chemicals that it would also release upon an infection with a cold. For instance, histamine is released in both allergies and colds, which causes swelling in the nose, as well as coughing, and sneezing.
Because allergies represent the nature of one’s immune system, rather than the nature of what is coming into the body, allergies are not contagious. On the other hand, colds are easily transmitted from one person to another when a person with a cold transfers infected material – through things like a sneeze, cough, or handshake. Though this does not happen with allergies, having family members with allergies can increase one’s likelihood of developing them.
Several overlapping symptoms of colds and allergies can make them difficult to distinguish. For example, a runny or stuffy nose is often associated with both colds and allergies, and each condition can lead to fatigue. Though fever is rare in both conditions, it does sometimes occur with colds but should never occur with allergies. A cough or a sore throat is more likely an indicator of a cold, though each can also occur with allergies. Better distinguishing characteristics are aches, which do not occur with allergies but can occur with a cold, and itchy, watery eyes, which often occur in allergies and rarely occur in colds.
In addition to the symptoms themselves, some other features of colds and allergies can be used to determine from which ailment one is suffering. The onset of symptoms can occur immediately in allergies once one is exposed to an allergen, whereas colds normally take a few days to occur after infection occurs. However, knowing when one was introduced to a virus can be difficult, so this difference in symptom onset is not always useful for identifying the cause of one’s symptoms. The time of year can provide a clue as to whether one is experiencing a cold or allergies, as colds are most frequent in the winter. Allergies can occur any time of year, but they are often specific to the time of year when specific allergens are in season.
One of the best indicators that one is suffering from allergies rather than a cold has to do with the duration of symptoms. Whereas cold symptoms last from a few days up to bout 2 weeks, allergies can last months and will likely persist as long as one is exposed to allergens. Thus, if symptoms exceed about 2 weeks, it is likely that those symptoms are associated with allergies rather than a cold. It is often at this point that patients realize that what they thought was a cold is actually a different type of immune reaction.
Prevention in both colds and allergies involves avoiding the agent that causes the illness. For a cold, this means staying away from infected people and keeping your hands clean. Allergies are harder to avoid if one does not know what causes their allergies, but some allergens are common and cause more allergies in our population than others. For instance, pollen, dust mites, mold, animal dander, and cockroaches are among the substances most frequently associated with allergies.
Unfortunately, there is no cure for either colds or allergies, but there are specific medications that can help manage the symptoms. For colds, rest and consuming fluids can improve symptoms and help the body recover from the invading virus, whereas such healthy practices do not help one recover from allergies as long as allergens are present. Colds can also be treated with non-steroidal anti-inflammatories, which help reduce the most common symptoms of colds. Pain relievers can also be used to reduce aches that may be experienced during a cold.
Allergies are often treated with antihistamines, which prevent the histamine that the body releases in response to allergens from causing congestion. Decongestants help minimize swelling in the nasal passage, which can also be accomplished with nasal steroids. A doctor may decide to employ immunotherapy, which often involves allergy shots, to reduce one’s allergies over time. By injecting small amounts of the allergen, the body can get desensitized over time so that the immune system no longer overreacts to the presence of that allergen, and the symptoms of allergies are avoided.
By focusing on the specific experience one has during the presence of symptoms that resemble both colds and allergies, one may be able to determine which illness is occurring. Quicker recognition of the illness allows for better management of the underlying symptoms and quicker overall recovery from those symptoms.
Almost 40% of the global population currently suffers from allergies, and the percentage is expected to increase to 50% soon. There is no cure for allergies that is currently approved by the FDA. Stanford University School of Medicine is launching a new research center aimed at developing innovative solutions for allergies. The center received a $24 million donation, which is among the largest private gifts ever dedicated to allergy research in the United States. Of the $24 million $4 million will go toward a matching program for new gifts to the center.
The gift comes from from Sean Parker, a Silicon Valley entrepreneur who suffers from severe allergies to a number of foods. Parker was the co-founder of Napster and has also served as president of Facebook. He was prompted by Facebook COO Sheryl Sandberg to make this specific donation. Sean has landed in the emergency room over a dozen times due to accidental ingestion of allergens, which include avocados, shellfish, and nuts. Because allergies can be genetically passed on to children, Parker worries for the safety of his two children and wants to help in the global challenge to prevent, or at least safely control, allergic reactions. Reported allergic reactions to food allergens double each decade. It is estimated that about 1 in 4 people suffering from food allergies will have a potentially fatal anaphylactic reaction at some point in their lives.
Parker considers his gift more of a form of venture capital funding than a traditional endowment, as the investment is much like that of an investment in a startup. Specifically, Parker views the center as an opportunity to assemble an idea team to conduct important research and develop effective clinical applications.
The new center for allergies will be inter-disciplinary, combining research initiatives with programs that ensure that care is compassionate and comprehensive. The center will also initiate clinical trials and organize community outreach. Several fields within Stanford’s medical school will also contribute to the center, including not only immunology, but also otolaryngology, pulmonology, pathology, genetics, gastroenterology, chemistry, and bioengineering.
Led by Kari Nadeau, MD, PhD, the center’s research will focus on both therapeutic interventions, as well as the uncovering of mechanisms by which allergies develop and the relevant causes for alterations within the immune system. Nadeau’s immunological research focusing on allergies – and in particular, the activity of regulatory T cells - is internationally recognized. She points to the need for a better understanding of how allergies emerge and evolve for the development of long-term therapies. Nadeau herself suffers from life-threatening allergies, which has inspired aspects of her career.
Nadeau developed the first combination therapy that involved multiple food allergies, demonstrating that it is safe to desensitize patients to multiple allergens at the same time. Using immunotherapy, Nadeau exposes patients to small doses of the substances to which they are allergic to help accustom their immune systems to these substances. Over time, as higher doses of these substances are introduced, the danger of natural exposure to these substances decreases, as the body no longer perceives these substances as harmful or dangerous. Nadeau has conducted these studies on how to build tolerance against multiple food allergies at once at Stanford’s Lucile Packard Children’s Hospital and Stanford Health Care. She was able to cure 680 of the 700 patients using methods from these clinical trials.
The experience of an eighth grade boy from Los Altos, CA in one of Nadeau’s clinical trial demonstrates the results of these studies. This youth had a severe peanut allergy and entered the study, hoping to become desensitized to peanuts. During a trial of oral immunotherapy, where he at small peanut doses, he became more able to tolerate nuts. He can now eat moderate doses of peanuts with no allergy symptoms. Future research should help determine if continued exposure is necessary for maintaining tolerance to allergens. For now, this patient eats about 8 peanuts a day, which helps ensure that he remains immune to peanuts. In the trial in which he was a part, Nadeau showed that this type of exposure to allergens could be particularly effective when used in combination with allergy an allergy drug, Xolair.
The hope for the future is that better therapies will be developed. The combination therapies that Nadeau has shown can be effective can take a long time to become effective and can be both dangerous and scary for both patients and their loved ones. For some patients, the exposure to small amounts of an allergen can cause reactions without enabling the patient to build a tolerance against the allergen. Understanding the pathology associated with allergies could lead to cures that become active more quickly, are safer, and are more feasible as long-term solutions for allergies. Nadeau has said that the goal of the new Center for Allergy Research is to find a cure for allergies within 10 years.
These days, we're hearing a lot about the benefits of a gluten-free diet. Gluten is a protein that makes dough elastic, and it's found in many of the staple food items we consume every day. While many people without sensitivity to the substance are opting for these diets, those with gluten allergies have a more urgent reason to cut this substance out of their daily routines.
Gluten sensitivity differs from many food allergies, as it can have chronic, malignant effects on the intestines, muscles, and joints. Over 250 symptoms have been observed in patients with an observed sensitivity. Patients most commonly complain of bloating, abdominal pain, constipation, and diarrhea. This condition has a genetic origin: there are several types of sensitivity, each traceable to the body's failure to handle these specific proteins properly.
It's important to distinguish gluten allergies from other similar conditions, such as celiac disease and wheat allergies. Celiac disease is, in fact, a specific kind of gluten sensitivity that is treated by cutting the protein from a patient's diet. However, the disease poses a host of risks to the immune system that an allergic condition does not. Wheat allergy is often confused with gluten intolerance, but it involves a reaction to a totally different set of substances.
How is gluten intolerance diagnosed? Well, the jury's still out on this. At present, researchers have not found any surefire biomarkers to indicate the disorder. Physicians will often ask patients to undergo a "gluten challenge," during which they are required to either regularly eat or cut out the substance for a specified time period. A diagnosis can then be made based on any symptoms patients experience. Those who seem prone to intolerance are advised to cut this protein from their diet, which means excluding foods that contain wheat, barley, rye, and cross-contaminated oats.
If you're experiencing some of the symptoms listed above, you should consider asking your doctor about getting tested for gluten allergies. The sooner you know, the sooner you'll be able to modify your habits for a healthier, happier lifestyle.
Thanksgiving is the time of year when cooks prepare magnificent feasts. Special dishes are often served that you just don't get the rest of the year. These yummy recipes are great, but you need to be careful if you have food allergies. The best way to enjoy a holiday meal is to identify allergies, make food substitutions, and communicate your needs to the cook.
Make a list of foods that you cannot eat. This will refresh your memory, and you can give the list to the cook if you will be sharing a meal at a friend or relative's home.
When you are doing the cooking, you can create side dishes that do not contain the ingredients that you can't eat. That is one of the simplest solutions, or you can make ingredient substitutions and still enjoy a nice meal.
Most people with food allergies can eat fresh slices of vegetables like carrots, celery, or cucumbers. If you are allergic to milk products, however, you need to check the ingredients in the homemade dips that often accompany these veggies or avoid them all together.
The Main Course
The best turkeys are those that are tender and juicy. However, if you have an allergy to wheat, you need to be careful when choosing the turkey. Turkeys that are exceptionally juicy are often injected with wheat that many people cannot tolerate. Check the label on the packaging to determine if it contains wheat. Another alternative is to buy gluten-free birds. Also keep in mind that gravy purchased from the store contains wheat. Making your own gravy is safer and probably tastier.
Many different cooks often prepare Holiday meals, so it may be hard to convey what you cannot eat ahead of time. If some dishes look questionable, just politely ask what the ingredients are. The cooks will certainly rather answer a few questions that have you suffer through an allergy attack.
Individuals with food allergies must take great care to be selective about what they eat during the holidays. Just because you have to be careful doesn't mean you can't have any fun. As long as you make sure to check the ingredients of each dish you try, you're sure to be able to taste your way through the season!
Dogs make wonderful pets and are found in many homes throughout the world. However, about 10 percent of the people in the United States are actually allergic to some dogs and experience itchy eyes, stuffy noses, wheezing, sneezing, and coughing when they are around them. Nevertheless, people with pet allergies still want the love and companionship provided by these animals. There are some ways to make this possible.
For starters, it's important to realize that you're not actually allergic to dogs – you're allergic to their dander. Dog hair is actually not the allergen, but it contains dog dander that people are often allergic to. Dander consists of old skin cells that are shed from a dog. Saliva and dog urine also contain dander. Choosing a dog that sheds less and produces less dander could make it possible for you to have this pet in your home. Read on for some of the best breeds for those with pet allergies.
Choosing a Breed
The Chinese Crested Hairless has just a little hair on the tail, feet and head. It is considered to be a popular breed for those people who have pet allergies because it has so little hair to carry dander.
The American Hairless Terrier was specifically bred to reduce allergy symptoms. People who react to many other types of breeds often do just fine with this terrier.
Miniature Poodles shed just a little hair and usually make good pets for anyone suffering from allergies.
The Bichon Frise has a double coat, which helps to lessen the amount of dander that is shed and reduce allergy symptoms for the pet owner.
These breeds are suggestions that seem to work well for those people with known pet allergies. However, it doesn't mean that all people can tolerate these breeds. You should spend a little time with the dog you are considering to see how you personally react. With the proper breed, pet ownership could be in the cards for even those with the worst allergies!
Traveling can create unique challenges for people with allergies. Hotels may have dust mites or even mold, and airplanes and trains seem to always contain an allergy trigger. Whether it's from spending time in new places or around new people, you're likely to be exposed to something that can irritate your allergy conditions. Try a few of the following tips on your next journey to make your allergies less of an issue.
Get medications refilled before your trip. In case of travel delays, it may be a good idea to carry an extra dose of medications. Medications should always be packed in a carry-on bag or purse for easy access. Never pack them in luggage that could be lost at the airport. It is also a good idea to keep all medications in original containers to get through airport security.
Additionally, people that have an allergy to food should put snacks in their carry-on so they can avoid disagreeable foods on airlines and trains.
Try to locate a hotel that offers allergy-friendly rooms. Some hotels are now totally smoke-free, which could be helpful. Avoid smoke-free rooms that are located one floor above the smokers' floor. The smoke can rise up to your floor and aggravate your allergies.
Many hotels advertise if they are pet friendly. Since animal dander can be tough to control or clean up, your allergies may act up if a dog or a cat has recently stayed in the room you are assigned. These hotels should be avoided when you have allergies to animal dander.
Pollution is generally at its lowest during the late evening and early morning hours. It is a good idea to use the recirculation setting when running your air conditioner in the car, so you do not pull in outside air. This minimizes your chances of being exposed to environmental elements that may trigger your allergies.
Although it is illegal on most domestic flights, some international flights may still permit smoking. If you have allergies, request a seat far from the smoking area.
Taking some of these things into consideration is a nice way to ensure that your travel will be as easy as possible. Never let your allergies get in the way of going on a trip and having an adventure again!
We are hearing talk of food allergies more often because there seems to be an increase in allergies found in children. What should you do if you think your child might have an allergy? Stay calm and consider these important points. Don't hesitate to contact a pediatric allergist if you see serious symptoms.
If you are familiar with some of the symptoms of food allergies, you may think about trying to diagnose your child but this is usually a mistake. Common symptoms can include stomach pain, hives, sneezing, coughing, itching or diarrhea. Diagnosing a food allergy is difficult because many of the symptoms could be pointing to another problem and not necessarily a food allergy.
Changing a Diet
Parents assume that changing the child's diet is the best course of action when in reality it is another pitfall. Health professionals don’t recommend changing a child's diet before you have seen a pediatric allergist. It is actually harder to get a proper diagnosis when foods are removed from a diet. Eliminating essential food groups from a child's diet can be unhealthy and they could become deficient in key nutrients needed for growth.
Keep a Log
Write down all the food your child eats for a couple of weeks and note any symptoms seen after eating. It is a good idea to note the time they ate in relation to the time a symptom may have appeared. A log with two weeks worth of documentation can help a specialist to rule out several foods and determine a better recommendation.
Since most parents do not have the training to properly determine what is wrong with their child, it is best to get professional help. Avoid practitioners who are not qualified to test for food allergies. If you see unusual symptoms, contact a pediatric allergist to get your child tested. Consult with a dietitian about food and nutrition if your allergist finds problems.
Parents and schools have come to realize the seriousness of treating severe allergic reactions quickly with allergy shots. Schools are taking the initiative to see that epinephrine auto-injectors are available and used to stop allergic reactions in children and staff.
Federal legislation for keeping epinephrine at schools was signed by President Obama in 2013. The Emergency Epinephrine Act provides strong incentives for states to legislate epinephrine and provide trained personnel to dispense the shots. All states except two already have legislation in place or having pending legislation ready to go. Rhode Island and New Hampshire have no legislation in place for stocking schools with epinephrine at this time.
Anaphylaxis is a dangerous allergic reaction, which can be life-threatening. Allergy shots containing epinephrine can stop allergic reactions in an instant. Most classrooms have an average of at least two children with known food allergies that may need immediate attention and require an injection of epinephrine.
Medications, foods, insect stings, latex and other triggers can cause anaphylaxis reactions. In most cases, 90 percent of food allergies are the result of eating soy, milk, tree nuts, shellfish, peanuts, fish or wheat. In some instances a child merely has to touch or inhale an allergen to have an allergic reaction.
Now that most states have epinephrine legislation in place, it will be up to the schools to keep epinephrine and find the money to make the purchases. In addition, the schools must provide training to teachers, nurses and administrative personnel for administering shots. Auto-injectors come loaded with medication that is dispensed with a small needle into the upper region of the thigh.
Parents who have children with known allergies are advised to have their children carry their own allergy shots. Young children can easily lose their epinephrine shots, so emergency epinephrine auto-injectors stored on the school's premise provides an excellent backup source.
Peanut allergies have frustrated researchers for a long time but they may have finally found a solution to the problem. Recently, researchers from the Oxford University found possibly conclusive evidence regarding the cause of peanut allergies. The results may surprise you.
People consume peanuts fried, boiled, raw or dry-roasted and they are found in a number of commercial products. Unfortunately, allergies to peanuts are quite common and symptoms can be severe. So, why do some people have food allergies to peanuts and some do not? Researchers now believe that the processing process is the key.
It has been known for a long time that Western countries have higher incidents of peanut allergies than people in East Asia. Genetic backgrounds may play a small part in whether people have allergies. However, researchers know that people in East Asia have a preference for fried, boiled or raw peanuts and Western people seem to prefer dry-roasted peanuts.
Researchers from the University of Pennsylvania and Oxford University conducted studies with mice to determine if the roasting process could possibly cause allergies. Mice received injections of dry-roasted nuts or raw nuts to see if they reacted differently.
Mice that received dry-roasted samples had strong immune system responses indicating a definite reaction to dry-roasted peanuts. The results of the study indicate that peanut roasting at high-temperatures to make dry-roasted nuts and peanut butter is more than likely causing allergies than raw peanuts.
In addition to studying peanut processing, researchers from the Cambridge University found that children exposed to small amounts of nuts over time might become desensitized to peanuts. These exciting breakthroughs could make a huge difference for people suffering from peanut allergies. The studies are still in the early stages of development, but researchers are making positive strides in determining the causes of peanut allergies.
For unknown reasons, allergies are on the rise in classrooms. One in 13 children is likely to develop allergies and need a pediatric allergist. As a parent, you need to know the symptoms of allergies and how to protect children from serious illness.
Symptoms from allergies can appear in just a few minutes or take several hours before they are noticed. Mild symptoms could include difficulty breathing, hives, itching or coughing. Dangerous symptoms may include wheezing, chest pain, trouble swallowing or losing consciousness.
Children are often diagnosed by a pediatric allergist as being allergic to eggs, wheat and milk products when they are young. Surprisingly, many children grow out of these allergies as they mature. However, in some cases, children that are allergic to shellfish, peanuts, tree nuts or fish deal with allergy symptoms for life.
When sending your child to school each fall, you may notice an increase in allergy like symptoms not associated with food. Schools have a unique environment filled with odors from new flooring, dust, animal dander, dust mites and chalk dust. A visit to school could reveal the source of allergy symptoms such as classroom pets or dirty chalk boards.
Teach Your Child About Food Allergies
Make sure your child knows exactly what foods they are allergic to, and you should explain why they should not eat them. Teach your child not to trade food with other kids. Make sure your child has access to epinephrine at school if required. Talk to them about the dangers of eating home-baked goods or foods with unknown ingredients. Teach your children to recognize allergy symptoms and where to go for help at school.
Working with the School
If your pediatric allergist has determined your child has an allergy, you need to advise the school of the situation. Talk to the nurse, cafeteria staff, administrators and teachers to explain the allergy and care needs. Provide an Emergency Care Plan with the school listing details and emergency contact information.
Breastfeeding has seen an increase in popularity in recent years, with advocates touting a number of benefits for both mother and baby. Two recent studies provide more information on the health-related benefits that many babies enjoy. Specifically, experts credit breast feeding with a lowered allergy risk and number of ear, throat, and sinus infections.
As a pediatric allergist, these findings are incredibly meaningful. Dealing with allergies as a young child and into adulthood can be a taxing responsibility, and knowing that perhaps we have some way of limiting the likelihood of that happening is reassuring for parents everywhere.
The first study presents data gathered from the medical office visits of an estimated 1,300 6-year-olds. The results showed that children who had been breastfed for nine or more months had significantly lower odds of getting an ear, throat, or sinus infection than children who had not. Doctors cited the fact that a mother’s milk provides immunologic protection that can have a lasting impact later in life.
A second study provided some remarkable information about the potential for a greatly reduced allergy risk in children who were breastfed for a period of at least four months after their birth. Researchers found that these children, who had been exclusively breastfed, were approximately 50 percent less likely to develop allergies than those who had been breastfed for a shorter period of time. They warn that these numbers did not apply evenly to high-risk children whose families have an established history of food allergies. Low-risk populations were much more prone to seeing a dramatic improvement.
Today, the American Academy of Pediatrics recommends that women breastfeed exclusively for six months, then use other foods to supplement the baby’s diet through at least the first birthday. With findings like these, which point to a much lower infection or allergy risk, it won’t be surprising to see more and more new moms pursuing the idea of breastfeeding for their little ones when it is possible.
For those who suffer from asthma, treatment is more than important–in the most serious of cases, receiving quality care can be a matter of life and death. Those with the most advanced and complicated cases depend on medication on a daily basis just to stay alive. And while a complex, customized mix of inhalers and pills can often grant relief, it may take more than that to fight this disease.
Researchers and industry experts continue to work to provide new and better solutions for patients. As new products become available, allergists are creating more and more individualized plans that give their patients a better quality of life. They take factors like age, symptoms, severity of the disease, and any potential medication side effects into consideration. Furthermore, an asthma treatment plan may be altered year to year, or even more than once per year, as new medications and other options become available.
Inhalers are often the first option that’s explored. Many combine a steroid with a bronchodilator. Pills known as leukotriene receptors reduce airway inflammation by blocking the chemical reaction that causes it. These pills use a different approach than inhalers in that they do not have steroids. Some patients use a combination of both treatments or of multiple inhalers to treat their symptoms.
Those with the most severe symptoms cannot get relief by using these prescription medications. For situations such as this, the newly FDA-approved procedure known as bronchial thermoplasty may be an ideal solution. The entire procedure is spread out over a series of 3 surgeries in which a catheter is inserted into the lungs. A powerful heat destroys the smooth muscle there that is often guilty of restricting airways. This smooth muscle not only restricts and blocks airways, but it can also constrict lungs further in response to an allergy trigger.
While bronchial thermoplasty is only recommended in the most severe of cases, it’s good to know that researchers continue to develop new solutions for those who seek asthma treatment.
If you suffer from seasonal allergies, you know just what a struggle it can be to overcome. If you’re looking for relief, you may be surprised to know just how many things are at work around you worsening your symptoms. Here are seven of the most unexpected factors that may be partially to blame for that runny nose or those itchy eyes:
Alcohol - The sulfites in red wine are particularly notorious for causing allergy problems, and other types of alcohol can also take their toll. Sulfites are naturally occurring compounds that appear in our favorite wines and beer.
Chlorine - When swimming or even sitting near a chlorinated pool, you are sure to inhale the fumes. Any allergist will tell you that indoor pools are especially problematic since the fumes are so concentrated.
Contact Lenses - Pollen is one of the greatest culprits when it comes to seasonal allergies. These small particles can become trapped in the eye, especially when using soft contact lenses. These are more likely to absorb irritants like smoke and pollen. It may be worth your while to consider using glasses when you’re experiencing major symptoms.
Perfume and Artificial Scents - Heavy scents are woven into the fabric of most households, including everything from the perfume you spritz, to the deodorant you use, to the candles you burn. You may be pleasantly surprised at how much better you begin to feel after cutting out unnecessary scents from your life. Look for unscented options or those with more mild scents.
Stress - Stress makes you more prone to sickness and other issues related to your physical well-being. This is just another reason to keep your stress levels in check–not only for better mental stability and increased happiness, but to keep those seasonal allergies under control!
Food allergies are a growing concern across the United States. Researchers at the Food Allergy Research and Education organization have gathered important information in recent years, publishing extensive information that individuals, including parents of young children who are affected, should know about. Here are eight facts and statistics about food allergies that you may find surprising:
Approximately 15 million adults and children are affected.
This includes about four percent of adults, or nine million adults, and 8 percent of children, which represents nearly six million kids.
Traces of peanut can be particularly difficult to remove from surfaces.
Antibacterial gels will not clean all peanut residue from the hands. Only running water and soap or the use of commercial-grade wipes will do the job. Dishwashing liquid will not remove it from household surfaces, but spray cleaners and sanitizing wipes will. This is a very important fact to know because those allergic to peanuts often face life-threatening reactions when exposed to it.
Eight items account for 90 percent of food-related allergic reactions.
Wheat, soy, tree nuts, peanuts, eggs, milk, fish, and shellfish are included in this list.
Dining outside the home leads to about half of all fatal cases.
Even trace amounts of key ingredients can lead to a life-threatening situation.
Some issues resolve themselves in childhood.
Kids who are allergic to milk, wheat, egg, and soy frequently outgrow it. On the other hand, those who have reactions to peanuts, fish, shellfish, and tree nuts may do so for their entire life.
The number of children affected has increased dramatically.
The Centers for Disease Control and Prevention (CDC) reports that between 1997 and 2011 food allergies in children increased 50%.
Food allergies cause more than one-quarter of a million ambulatory-care visits per year.
The CDC estimates that there are more than 300,000 such visits for children under the age of 18.
While there is no cure, there are ways to manage symptoms.
The best way to manage symptoms and reactions is to avoid triggers. In some cases, this includes inhalation of particles that carry the allergens. For example, steam from a kitchen where fish is being prepared could cause a reaction in someone with a sensitive fish allergy.
Many people who suffer from allergies appreciate the arrival of rain. A good rain shower can wash away the mold and pollen particles responsible for causing their watery eyes and itchy throats. But some people have quite the opposite reaction to a heavy downpour. In fact, thunderstorms can worsen some people's symptoms.
Although scientists are still researching and debating the results of thunderstorm allergies, initial analysis reveals some interesting and counterintuitive findings. Not only can thunderstorms increase allergy symptoms among people, some asthma symptoms can be prompted by thunderstorms. This rare health problem has been well documented, yet is not as predictable or understood as other allergic reactions. Some experts suggest that the reaction may be due to an updraft in pollen and mold particles as the beating rain hits the ground. This theory goes on to suggest that these particles are smashed into even smaller sizes which, when inhaled, stick easily to the walls of the lungs.
Instances of these thunderstorm-related symptoms have been tracked most heavily in Italy, Australia, and the United Kingdom, but even in these countries it is a rarity. In fact, only 35 articles touching the subject have reportedly been published. In the United States, one 2008 study from Atlanta shows a three percent increase in the number of emergency room visits related to these specific medical concerns following a thunderstorm.
Looking ahead, medical professionals question the future for those who suffer from thunderstorm-related allergies as it relates to global warming. Some scientists predict that thunderstorms will be more frequent with the rising temperatures, causing new concern over this unique medical issue. Urbanization trends also increase the likelihood of thunderstorms and may trigger new cases as well, meaning researchers may shift their focus to understanding this issue as a growing medical problem.
If you suffer from allergy symptoms, you're not alone. Millions of people across the U.S. have the same issue, whether it's in response to indoor or outdoor allergens, seasonally or year-round. You may take an over-the-counter antihistamine to address those itchy, watery eyes and seemingly constant sneezing, but day-to-day life just must go on whether your eyes dry up and go back to normal or not. One of those daily tasks we all take on is driving, whether it's to work, to appointments, to the gym, to school, etc., the list goes on.
New research sheds some light on just how dangerous driving around with major allergy symptoms is. In fact, that research suggests that these drivers compare to those who are under the influence of alcohol with a blood alcohol content of .03 percent. This stark fact shows just how serious it is to find allergy relief. Not only are your eyes, throat, or nose affected, but your memory and driving abilities are affected as well.
Researchers in this particular study focused on those who had documented issues with tree and grass pollen. Participants who were given nasal sprays or non-drowsy antihistamines were able to competently drive during a one-hour driving test that was administered. Those who had not received any treatment to combat allergy symptoms had driving skills comparable to someone with a .03 blood alcohol content.
Though it may seem shocking to some, this outcome makes sense to those in the medical field. The body reacts to allergens by releasing histamines, which can influence the brain. It only makes sense that this impact on the brain would lead to impaired driving skills, they say.
If you suffer from seasonal allergies, you may have turned to routine allergy shots to control your symptoms. Many of us have gone through the experience as a child and continue to do so now as adults. There's a new solution called rush immunotherapy that has gained national attention as a more convenient solution to the age-old problem of seasonal allergies. If you or your child relies on routine shots for symptom relief, you'll want to learn about this innovative option. Here are answers to some of the most frequently asked questions:
What is rush immunotherapy?
It is an anti-allergy plan that is given on a condensed timeline. For example, instead of a patient coming in for weekly injections for a period of many months, he or she may be able to receive the entire series in a period of just a day or two.
Is it safe?
Yes, this procedure has been tested and proven effective and safe for use among allergy sufferers.
What does a typical treatment plan look like?
One typical plan would be a series of 50 allergy shots being replaced by a series of four to six shots which are administered over the course of a single day. The same dosage would be administered, but in a much smaller number of injections and on a dramatically shorter timeline.
What happens during this type of all-in-one-day treatment?
In between the injections, you will be closely monitored to make sure you don't experience any adverse reactions.
Is this a permanent solution?
For many patients, rush immunotherapy is in fact a permanent solution. While additional treatments may be necessary for a period of several months, the one-day session often provides the relief needed almost instantly.
Allergies got you down? It's time to fight back. While you can't mitigate what's outside, you can control the inside of your home. Follow these seven tips to allergy-proof your house. Take back control of your life.
1) Change air filters as directed. People often forget this simple task, but it means a world of difference. An old, clogged filter builds up allergens over time, pumping them back into your home through your heating or cooling system. If changed regularly, a new, clean filter won't blow back allergens.
2) Ditch the drapes. Install blinds or shades instead. Blinds or shades don't trap allergens like cloth and cloth-like materials, and are easier to clean with household products.
3) Get rid of wall-to-wall carpet. Carpets accumulate pet dander, dust, pollen, and more, an allergy attack waiting to happen, all underneath your feet. When you step across the carpet you kick allergens into the air before they slowly settle back into the carpet and into a vicious cycle. Install easy-to-clean hardwood floors instead.
4) Clean your bathroom. Any allergy doctor will tell you there are more than 10,000 species of mold on the planet and they all love warm, moist places like your bathroom. Clean it regularly. Remove standing water. Ventilate it.
5) Pump allergens out, not in. Many built-in home-fanning systems like those in your bathroom or kitchen circulate indoor air. If there are particles that upset your allergies, install a true exhaust system that forces unwanted particles out of your home entirely.
6) Purchase a testing kit. Kits will indicate what allergens reside in your home so you can pinpoint the cause, like pet dander, and mitigate it.
7) Purchase a standing air filter. These machines improve your allergies by trapping airborne allergens and clean the air your breath.
If you have allergies, you've probably experienced most of the symptoms involved. While most people think sneezing is a common reaction, many people don't realize that it's our eyes that are also under attack when we sneeze. Itchy, red, swollen eyes are a common reaction to dust, pollen, and otherallergens that tend to crop up during the springtime. There are a number of treatments available, and allergy tests can help you pinpoint the specific problems causing the reaction.
Why are itchy, red eyes generally a symptom, and what causes the problem?
Just as any other reaction, itchy eyes are caused when the body reacts to things that are not harmful. Things like pet dander, mold, and pollen cause allergies. These substances release histamine and causes swelling. Your eyes' blood vessels can become inflamed, leaving them itchy, red, and teary.
You can treat your itchy eyes with histamine blockers to reduce puffiness and swelling. Pills and eye drops can also work to relieve itchiness and watery eyes. There are a variety of treatments available both over the counter and through a prescription from your doctor.
Trees, weeds, pet dander, dust, perfumes, and other chemicals are common causes for an allergic reaction. You should keep track of what causes your itchy eyes in order to better treat your allergies. If you are still having problems with itchiness and red eyes even after taking over the counter medications, consult your doctor about getting allergy shots.
There are other precautions you can take as well. Contact lenses may worsen symptoms, so try wearing eyeglasses instead. Wearing sunglasses can also actually help to reduce the chances of itchy, red eyes. Also make sure stay away from touching or rubbing your eyes. Doing so will make the problem worse.
Watery eyes. Itchiness. Trouble breathing. Some of us know much better than others that the effects of spring allergies can be very problematic during that certain time of the year. While others see beautiful sunny skies and flowers blooming, some of us are just waiting for the months to pass, so we can get back to normalcy. Did you know that some cities are much worse for these reactions than others? Take a look at some of the worse cities to live in for springtime allergic reactions.
With so much pollen in the air at springtime, people living in this southern city can find it difficult to walk outside without dealing with itchiness and water eyes. Spring allergies in Birmingham are very common.
Dallas is guilty of having one of the highest pollen counts in the United States. The cypress, elm, ash and cedar trees that heavily populate this city are to blame for the allergic reactions that Dallas residents have to deal with throughout March and April. The area is also low in doctors, so appropriate allergy treatment can be scarce.
Jackson is the largest city in the state of Mississippi, and its citizens understand how complicated it can be to live there when the allergy season is at its worse. Unlike some other cities Jackson is home to a high number of doctors who specialize in this area, so the future may be bright for people dealing with itchy, watery eyes.
Are you noticing a pattern here? The cities with the worst spring allergies are all located in the south of the U.S., and Louisville is at the top of the list for the worst cities to experience those troublesome allergic reactions during springtime with pollen counts getting high as early as February.
If you suffer from allergies, you are probably curious about what exactly causes your specific problems. Allergy testing can help you to get to the bottom of the cause of your symptoms. Whether you get red, itchy eyes when you go outside during springtime, or you can't pet a cat without become extremely itchy, these thorough examinations can help you discover what exactly is causing your issue. Depending on the nature of your reaction, a different examination may be more appropriate for your needs. There are two main types of examinations that can be conducted.
During this examination, different allergens will be placed on your skin. The doctor will take note of the reactions that you exhibit. There are a few types of skin allergy tests that can be conducted. The intradermal exam involves injecting an allergen into the skin. The prick test is conducted by putting a small allergen solution onto the skin. Needle pricks or scratches are made to allow small amount of the allergen to get into the skin. Skin patches can also be placed onto the skin for extended periods of time to reveal skin allergies.
This type of allergy testing leads to on-the-spot results where your skin may or may not react within a few minutes to the allergens you are exposed too.
Your blood can be analyzed for substances that may cause allergic reactions. Skin testing is the more common form of examination, but blood allergy tests are common for people who have an existing skin condition, or people who are unable to stop taking a certain medication. This test is a bit more comfortable for patients considering that the allergens are not being directly exposed to the skin, but this also means that results may take a while longer to return from your doctors lab.
The results of your examination can reveal what kind of treatment you that you may benefit you best. Consult your doctor today to learn more about which allergy tests will be right for you.
For people who suffer from allergies, the home can be an unexpected source of irritants. In almost every room in your home, there are allergens lurking that can make you miserable. Here are 4 tips for combatting them in your home:
1. Is there a fireplace in your house? If your fireplace is made of wood, it can be a source of displeasures. The wood you’re using may be growing mold. Be sure to check any wood before bringing it into your house.
2. Are any of your rooms carpeted? If you can replace your carpet with hardwood or tile floors, this would be a great way to reduce the amount of allergens in your home. Transitioning to hardwood floors will prevent any unwelcomed irritants from claiming a residence in your plush carpet.
3. Are your windows and doors in good shape? If replacing the carpet is not a possibility, you should make sure all windows and door entrances are in good shape and are sealed as tightly as possible. Allergens that make their way inside of your home will normally find someplace to settle.
4. Have you taken a good look at your bathroom, lately? Mold can be a huge problem on many different bathroom surfaces. It can grow on shower curtains and even be circulated through the air. To prevent this problem from spreading, you can use mold killing solutions, and an exhaust fan to help reduce the humidity in your bathroom.
Scientists have studied that those who suffer from allergies have bodies that produce a specific antibody in response to its exposure to substances that are harmless in most cases; these substances can include peanuts, pollen, cat and dog dander, and more. Scientists also discovered that symptoms tend to change as people age.
As many understand today, the explanation is relatively simple. When someone is very young, between birth and the age of 18, they tend to remain in the same environment and therefore, around the same substances. Parents or other adults probably serve them the same types of food and use the same laundry detergent and cleaning supplies for most of their life, so far.
When someone moves out of their family’s home, the substances around them will be different. In a college dorm, for instance, pets aren’t there, mattresses are covered in plastic, and tiles are on the floor rather than carpet. Removing potential allergens can help to lessen allergic reactions and symptoms in this stage.
Once the thirties begin, however, people tend to report an increase in their symptoms. This can be a result of many things. Having children in their home can be one of the reasons. Kids carry huge amounts of germs and allergens; they spread them to anyone who’s around.
Some reasons can be purely psychological. For instance, a person in their twenties is normally better at distracting themselves from symptoms by engaging in so many other pursuits. The logic here is simple - someone who is young and having fun won’t let allergies stop them. Someone in their thirties is more likely to notice and complain about their symptoms.
So what can someone in their thirties do to get rid of their resurgence of allergies? The perfect answer is being researched. However, you can choose to live such an exciting life that you don’t even notice, like twenty year olds, or you can simply continue taking your allergy medications.
Drastic climate changes have been known to affect the environment in a great way. Most simply notice hotter summers and colder winters, but many haven’t considered the effect extreme climate changes have on allergies.
For an allergy sufferer, there is an immense amount of evidence that shows how climate change can complicate their comfortable lifestyle. Many doctors this season have reported an increased number of patients who were sneezing or complaining about itchy eyes. This can be attributed to an increase of carbon dioxide (CO2) in the atmosphere. Higher levels of CO2 is always great for plants because it makes them grow quicker, producing more. For instance, it can help a rose bush grow more flowers. However, the increased growth in plants causes them to produce more pollen and other allergens. As a direct result, the increase of pollen in the air will lead to more people suffering from allergies and asthma.
So, what is being done to help alleviate the problem? Today, studies are being funded by the EPA to help analyze any long term effects of more pollen counts in the air. They are also studying to learn if other types of allergies, such as food or hay fever, will also be affected. Scientists and physicians are working on the problem from many different angles, to both alleviate patients’ symptoms and to mitigate climate change and its effects.
You may think the misery of the “polar vortex” winter is over, but sadly, it can still have an effect in months to come for allergy sufferers this allergy season. It seems as if the extreme cold temperatures should have killed everything, but that, unfortunately, is not the case.
Since we had extreme cold temperatures for much longer than our average winter months, it shortened the typical growing season for all of the spring plants that produce allergens. So now, the new spring temperatures, that we are all so excited for, have caused the pollen producing plants to come into bloom at once! This can compound problems for allergy sufferers. The growing season would usually take place over several weeks, but this spring and summer, it is taking place all at the exact same time.
Normally, we think of different allergens as having different seasons. This means that trees tend to cause problems during the spring and that grass tends to cause problems during the summer. However, when the weather gets warmer very quickly, it can cause some complications for allergy season.
So, what can you do to lessen your suffering this year? One thing is to keep your windows closed to prevent any pollen or other allergens from getting into your home. You should also shower before you get in bed to get any errant pollen off of you. A neti pot would also be very helpful. Hopefully, you can enjoy a safe allergy season!
We know you have choices when it comes to picking an allergist., and we think there are a lot of reasons to pick Premier Allergy. First, we have eight convenient locations in the Columbus metro region. This makes appointments for your whole family easier, whether you are coming from school, work, or home.
We can offer faster results with our rush immunotherapy solution. Instead of waiting weeks or months for full relief, you can ask your allergist to speed up the process. And typically, they can do it!
If you suspect a penicillin allergy, our allergists have a unique testing procedure that tests for all components of the drug allergy. Our testing is more comprehensive than the standard penicillin test. Don’t take chances with this potentially life-threatening allergy.
We use a special tool called a nasal endoscope to look inside of your nose and throat. Our endoscope is smaller than what is typically used, so we can see more potential issues than others can.
We know you’re busy and we want to be available when it’s convenient for you. Ask for an appointment as early as 7 a.m. or as late as 7 p.m. You can also come see us on a Saturday if you just can’t find free time during the week.
Have you been suffering from seasonal allergies for months or years, but were afraid to get tested for fear of needles or discomfort? What if we told you that we could give you a skin test without needles and get you results in just 20 minutes? Yes, you read that right. Our office provides allergy testing that requires no needles.
Our procedure uses small plastic devices containing a small amount of the allergen we test for. The allergy test can check for many different allergies including pet dander, local grasses and trees, molds, and pollen. Our allergist will place the plastic devices on the back and do a small scratch of the skin. The skin is then labeled so we know which allergen was tested in that spot. Then, you just have to hang out and wait about 20 minutes to see which allergens produce a welt. A welt is just a small bump similar to a mosquito bite. It may be itchy, but most patients do not experience pain from the procedure.
Allergy testing doesn’t have to be scary. Once you know what your body is allergic to, you can work with your allergist to come up with a treatment plan that addresses your specific allergies. In addition to skin testing, we offer other diagnostic procedures to test for asthma, lung diseases, food, and chemical allergies. Check out our procedures on our website: http://www.premierallergyohio.com/diagnostics-procedures/.
Food allergies are typically caused by eight common ingredients: milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. These foods can initiate annoying skin reactions or life-threatening breathing problems. Because of the danger posed to those who are allergic to these foods, companies are required to display allergy warnings on their ingredients list.
Milk is the most common allergy among American children. Typically, 80% outgrow the allergy by the time they are six years old. Those allergic to cow’s milk must also avoid butter, yogurt, sour cream, cottage cheese, cheese, and any other products made from cow’s milk.
Eggs are second in the list of most common food allergies. Once again, 80% of children often outgrow this allergy by six years of age. Many immunizations are grown in hen’s eggs, so you’ll want to be sure to double check with your doctor before your child is given any shots.
Peanuts are more likely to cause severe allergic reactions. Only 20% of children outgrow this allergy, while 80% will have to deal with it throughout life. In addition to the nut itself, you’ll need to avoid products that contain peanut oil.
Tree nuts also tend to bring lifelong food allergies. Only 9% of children outgrow the sensitivity. As with peanuts, tree nuts are very likely to cause life threatening reactions. It’s entirely possible to be allergic to one type of nut, or many different varieties.
An allergy to fish or shellfish tends to develop later in life. Once it’s discovered, this allergy is typically severe and lifelong. It’s especially important to inform restaurant staff of a fish or shellfish allergy as fish are often fried in the same oil as other foods. Soy and wheat allergies seem to be increasing in the United States. In addition to foods, soy and wheat products are used to make toys and other non-food items. As with foods, these ingredients should be listed on the products tag.
Ragweed sufferers may now be able to find relief in the form of a one-a-day pill. Ragweed allergy is commonly referred to as hay fever, or by the medical term seasonal allergic rhinitis. Sufferers often experience stuffy noses, itchy, watery eyes, and congestion, sometimes so severe that they seek relief from an allergist. Midwest residents are particularly susceptible to the condition, due to the amount of pollen the environment produces. However, until now, there was no medical remedy specifically targeted at this particular malady.
A team of physician-scientists at Johns Hopkins have released information about a new, one-a-day pill that could end the suffering related to ragweed allergies. This pill contains a concentrated dose of ragweed pollen protein, or Ambrosia artemisiifolia, and is placed under the tongue to dissolve. Their studies show that the dose, taken 12 weeks before the onset of the allergy season, effectively prevents all the symptoms of the ragweed allergy. Doctor approval has been widespread, with the U.S. Food and Drug Administration advisory committee ruling that the pill is safe and effective.
So when will this revolutionary new drug be available to the public? That may take some time, experts predict. The FDA hasn’t officially approved the new drug, and warns that the pill only affects the symptoms of ragweed, so people who are allergic to other plants as well may not get the relief they expect.
If you are currently suffering from pollen-related symptoms, consider visiting your local allergist. You can receive weekly or monthly shots that have proven to reduce allergy symptoms. People with severe allergies know how difficult living with this problem can be, and in some cases symptoms can actually hinder daily activities. Hopefully this new drug will ease the pain of millions of ragweed sufferers.
Immunotherapy is a medical term for the treatment of disease by inducing, enhancing, or suppressing an immune response. Not surprisingly, this type of therapy is often used for treating allergies. While other allergy treatments only target the symptoms of allergic reactions, immunotherapy is the only treatment available that actually reduces the body’s sensitivity to all allergens. Typically, a patient receives shots over the course of six months to a year, helping to suppress the unwanted effects of pollen and other allergy triggers. However, immunotherapy offers a chance to completely change the way your body responds to these triggers.
With rush immunotherapy, a patient will receive multiple shots throughout several hours to several days, achieving a maintenance dose in a very short period of time. After the initial period of treatment, a person is able to come into the allergist’s office typically only once a week for the next few weeks, and then even less often after that. People undergoing rush immunotherapy also achieve benefits from allergy shots rapidly, typically within a few weeks.
Some reasons to undergo this treatment include:
1. If you have a life-threatening allergy to a particular insect venom, and that insect season is about to start.
2. Shots are only available from an office that is far from your home, and you cannot make the needed number of visits.
3. You are about to travel.
Unfortunately, rush immunization is not effective for all patients, but has been proven to work in most. Those worried about adverse effects of this fast-paced immunization schedule should know the treatment is proven safe by the American College of Allergy, Asthma, and Immunology. In 2006, the college reported that the protocol for administering this type of treatment to patients with multiple allergies is highly safe and effective. If you are considering rush immunotherapy, speak to your allergist today to find out if it’s right for you.
If you suffer from seasonal allergies, you are not alone. Millions of Americans deal with the runny noses, itchy, watery eyes, and congestion due to an allergic response to pollen and other foreign bodies in the air. An allergic reaction is simply a negative response by your body’s immune system to an often harmless substance. Pollen, for instance, is in no way harmful to humans, yet millions of people each year are victims of its effects. But why do are so many people allergic to common substances such as these? An allergy doctor would say genetics are often to blame.
If a child has a parent with an allergy, they are 50% more likely to be allergic to that same substance. If both parents have allergies, this likelihood jumps to 70%. Not surprisingly, a study done to measure the likelihood of identical twins being allergic to the same substance (in this case peanuts) showed that 65% of the twins shared the allergy. Interestingly, though, the twins often manifested different reactions. For instance, one twin may develop a rash after contact, while the other twin could exhibit asthma-like symptoms.
Another study, done by the Mt. Sinai School of Medicine, showed that genetics account for 81.6% of the risk of peanut allergy. An additional study, done by British researchers, claimed that this particular allergy is inherited up to 87% of the time. Clearly, genetics factor heavily when it comes to allergies. However, this curse might turn out to be a blessing in disguise.
Because peanut allergy is so common, research is being done on the nut to see if its allergenic properties are also genetic. If so, genetic modification might be able to eliminate these factors to make a new and improved nut safe for everyone. Such advances in science speaks of only great things to come for allergy sufferers worldwide.
People who suffer from allergies understand the fear of becoming violently ill, or even facing a life-threatening situation due to minute traces of a particular substance. These substances are often otherwise harmless, or even prevalent food items. Peanuts, for example, are a particularly common food allergy trigger, afflicting millions of Americans both young and old. However, there may be a cure on the horizon.
A doctor-led research team at Addenbrooke’s Hospital in the U.K. conducted an experimental study recently that showed a small dose of the potentially lethal substance can actually save lives. Similar to a vaccine, the report posted in the Lancet medical journal stated 99 allergic children were administered a small dose of peanut powder. After a six month period of treatment, 84 to 91 percent of the children tested in the study could tolerate 800mg, or the equivalent of about five peanuts. This amount could be a potentially lethal dose to severely allergic patients, and could signal huge strides in the fight against food allergies.
Peanut allergies are particularly common in children, affecting between .5 and 1.4 percent of children in affluent countries. 400,000 school-aged children in the United States have this allergy, according to the American College of Allergy, Asthma, and Immunology. It is the most common life-threatening food allergy, and can place immense strain on families, as even a small amount of the protein can cause a dangerous reaction. Parents of children with this allergy are forced to remain hyper vigilant to prevent even trace amounts of the substance from contaminating their children’s food.
While this revolutionary treatment is not a cure, it may foreshadow an end of all such food allergies. For those who suffer from allergies, or parents who live in fear of a shared snack their kids might ingest at school, this hope is welcome news.
Hives are itchy, red bumps that are a common condition for those who suffer from allergies. Those bumps may be quite swollen and can vary in size from being under an inch to as large as a few inches in diameter. They can appear on just about any area of the skin and may last for just a few minutes, several hours, or even days in length. Triggers include all kinds of allergens, such as such as medicines, foods, exposure to certain elements, or even genetics. However, many people confuse different types of skin disorders with hives. It can be nearly impossible to self diagnose these skin disorders because they are all characterized by raised bumps on the skin or a red coloring.
Heat Rash Babies are most prone to heat rash, though it can occur in people of all ages. This issue arises when the sweat ducts are blocked in high temperatures. When the pores are clogged, small, red bumps appear on the skin. They are often swollen and very itchy, though their size is generally much smaller than an inch in diameter and they look something like a patch of small pimples. The rash usually clears up on its own within a few days. Hydrocortisone cream or calamine lotion can be applied to get relief from the itchiness.
Rosacea One chronic skin disorder that is limited to the facial area is rosacea. Red blotches may appear along the chin, nose, cheeks, forehead, or other areas of the face. It often looks like the redness spreads across the face and that you’re frequently blushing.
Contact Dermatitis This skin disorder is unique in that it appears only on the area of the skin that has direct contact with the allergen or other type of irritant. Hives, on the other hand, can appear all over the body even if it hasn’t been in direct contact. Contact dermatitis also feels itchy and looks like a red, bumpy rash.
As anyone who deals with life-threatening allergies knows, allergy education is a critical part of the school curriculum. Not only do children need to learn about this serious issue, including the ability to identify it, seek help, and even treat it, but so do the adults around them. Teachers, other school staff, and parents should take it upon themselves to learn what to do when confronted by or exposed to this life-threatening issue.
Anaphylaxis is a severe allergic reaction that affects the whole body. It can be triggered by many types of allergens, including insect stings or bites, food, and certain medications. Some of the most common food allergens for kids include shellfish, peanuts, milk, tree nuts, wheat, and soy. Latex is another common trigger for anaphylactic reactions.
In order to be prepared for an anaphylactic flareup, schools should have multiple automatic external defibrillators on site and staff members who are trained in how to use the equipment as well as CPR. By taking these two precautionary steps, along with providing allergy education to students and staff, they can be prepared for a case of anaphylaxis. Students with known allergies should always have their prescription epinephrine shot nearby.
The 2014 Food Allergy Awareness Week is May 11-17. Teachers and administrators are encouraged to include training about anaphylaxis throughout the week. Parents who would like to get involved are encouraged to do so. Get information online, partner with school administrators, and insist on a safe and educated environment where your child, and his or her peers in the classroom, will all be protected from a life-threatening allergic reaction.
Natural allergy remedies are a real source of relief for sufferers of all ages. Fortunately, since they don’t involve chemicals or drugs of any kind, most of them can be used on everyone from young children to senior citizens. If you’re looking for an allergy remedy that you can try yourself at home, consider this list.
1) Saline Nasal Pot Also known as a Neti pot, this handheld device is used to flush the nasal passages. First, you fill it with a saline solution that can be purchased pre-made or can simply be mixed at home with just boiled water and non-iodized salt. Tilt your head over a sink and pour it in through one side of the nose. The water will come out the other side, flushing out pollen, allergens, and other buildup.
2) Steam Inhalation For those who feel congested, inhaling steam can offer tremendous relief. Even holding a hot cup of tea and inhaling its steam often feels good and can clear out the nasal passages. For a more intense treatment, create a nasal steam bath. Start by boiling water on the stove. Once it is boiling, remove the pan and add a few essential oils, such as eucalyptus, rosemary, and tea tree. Place your head a safe distance above the pan, draping a towel over your head and the pan, trapping much of the steam inside. You can safely repeat this up to three times daily for a refreshing, cleansing effect.
3) HEPA Filter An air purifier that has a built-in HEPA filter is a great tool in capturing pet dander, dust, and pollen from the air. Central heating and cooling systems that feature built in HEPA filter performance offer even better results.
4) Showering Taking a shower after coming home after a day outside is considered to be an effective allergy remedy for many sufferers because it removes allergens from the skin. It also stops you from wearing outside clothes in the house for extended periods of time, which is important since allergens can spread throughout the home on that clothing. The steam from the shower can also clear up nasal passages and provide temporary relief.
Asthma sufferers are on the rise: recent statistics show that nearly 17 million people are affected by it in the United States, an increase of 2.5 million in the last 5 years. Because there is still no cure, sufferers of the disease are often in search of non-traditional or homeopathic remedies that may reduce or alleviate its symptoms.
There are two types of sufferers; allergic and non-allergic, allergic asthma sufferers are the more common type. This means an attack is most frequently brought on by a “trigger,” such as dust mites, pollen, or even a food allergen such as strawberries. However, with a non-allergic condition, an attack can be sparked by exercise, strong perfume, dry air, and even stressful situations. While inhalers and medications are available to reduce and manage attacks, the best way to prevent them is to eliminate as many triggers as possible from your life.
For example, dust and pet dander are common irritants to people with respiratory issues. Using an airtight mattress cover or switching to polyester pillowcases will help eliminate dust from becoming trapped in your bedding. Keeping your windows closed and using a vacuum or damp cloth to dust will also keep your home free from loose dirt and dust particles.
Certain foods may also help inflammation of the bronchial tubes, which is the cause of the suffocating feeling an asthma attack creates. Ginger, a common spice in cooking, has been shown to help relax the bronchial tubes, alleviating restriction in the airway. Researchers have found that the addition of ginger-based compounds in the diet will work in tandem with medical bronchodilators to enhance their effects.
Sufferers also should avoid eating processed foods, and foods with increased nitrates/sulfates, such as hot dogs, most deli meats, and cheeses. Choosing organic products, whole grains, and limiting refined sugars and carbohydrates can all help to reduce inflammatory reactions. Taking vitamin B-12 and omega-3 fatty acids has also been shown to help reduce inflammation in the body. Magnesium supplements may also provide a bronchodilating effect. Of course, asthma sufferers should always consult their physician before starting a supplemental regimen.
Many people associate allergies with the spring and summer months, when the pollen count is high and they’re spending a great deal of time outside. For pollen allergy sufferers, winter generally means a reprieve from the symptoms that plague them the rest of the year. However, many allergies actually get worse in winter because the allergens are located indoors. Common winter allergies include mold, dust mites, and animal dander.
All of the these allergens are located inside the home, meaning that spending increased time indoors can trigger or worsen allergy symptoms. Turning your heating system or furnace on can also make the symptoms worse, because your home’s heating system can send mold spores, pet dander, and dust particles into the air and distribute them throughout your home. Common symptoms associated with winter allergies include coughing, runny nose, watery or itchy eyes, sneezing, and dark circles under the eyes.
The above symptoms are often mistaken for those of a cold or flu, both of which are also prominent in the wintertime. If your symptoms persist for more than 10 days, it may be winter allergies, because colds generally don’t last that long. Another sign that you’re afflicted with winter allergies is if your symptoms are unaccompanied by aches or soreness, both of which are common indications of the flu.
To keep the symptoms of winter allergies at bay, you should wash all bedding and curtains regularly and have your home inspected for mold. Using a dehumidifier can also help.
Weather allergies are common from coast to coast, regardless of the exact climate or temperature around you. Whether it’s wet or dry, cold or hot, or anywhere in the middle, plenty of people find that they have an itchy nose, runny eyes, or show other allergy symptoms at one point or another.
If you suffer from weather allergies, don’t feel helpless. There are things you can do proactively to gain better control of the issue and get relief from the symptoms. Consider if any of these common issues describes your situation:
Rainy or humid conditions are notorious for prompting the growth of mold. Dust mites also love these conditions and thrive in high humidity. Mold grows both indoors and outdoors, and can be present in the home in hidden places like ducts or vents. If your allergy problems flare up during times like these, consider hiring a professional duct cleaning service to ensure no mold is present. Investing in a dehumidifier and air conditioning system may also lead to significant relief from your symptoms.
Dry, windy days create the perfect environment for pollen to circulate freely. If your eyes water up on windy and zero humidity days, that’s a surefire sign that pollen is to blame. Try shutting the windows and staying inside on a day like this and see if that helps at all. Additionally, using air conditioning cuts down on the presence of pollen in the home. On the opposite end of the spectrum, humid or rainy days keep pollen from moving around, so you may find those are your best days for being outside.
Cold and heat can also trigger reactions. The cold often causes people with allergic asthma to have excessive coughing, especially when exercising or being very active outside. Heightened ozone and smog on very high temperature days is another trigger as well.
By taking the time to understand the triggers of your weather allergies, you’ll learn how to better control them. Plan your outdoor activities accordingly, run a dehumidifier or air conditioner to lessen indoor allergens, and seek proactive treatment when you know an allergy-triggering change of season is near.
Anyone who has ever had an allergic reaction knows how uncomfortable and even dangerous it can be to come in contact with certain allergy triggers. Whether you react adversely to pollen, mold, pet dander, insect stings, dust mites, or certain foods and medications, there are measures you can take to avoid offending substances. The key is to know what to do before you encounter these harmful elements.
Unlike seasonal allergies caused by pollen in the atmosphere, dust mites are allergy triggers that one can encounter at almost any time of the year. Symptoms linked to exposure include eye irritation, sneezing, and nasal congestion. In order to avoid such reactions, a person may want to have antihistamines and nasal decongestants on hand. It is also possible to keep these microscopic insects at bay by putting dust mite covers over mattresses and keeping all areas of your home free of dust. Carpets, couches, and curtains are places where dust mites frequently flourish.
Unfortunately, many animal lovers find that their pets can serve as dangerous allergy triggers. Proteins in animal saliva and oil glands secreted by the skin can cause people to sneeze, break out in hives, or even suffer asthma attacks. Treatments for such reactions include the use of antihistamines, corticosteroids, and other anti-inflammatory drugs. Immunotherapy treatments can also be effective, particularly if symptoms persist. Keep pets groomed, off of furniture, and out of areas where dander can collect to avoid such symptoms.
Talk to an allergist if you are having trouble keeping reactions to a minimum. Together, you and a specialist can review your activities in order to determine when and where you are being exposed. Armed with this knowledge, you will be better equipped to avoid substances that spark allergic reactions.
Environmental allergies can occur at any time of the year, especially in warmer climates. Symptoms vary from person to person, but the most common things to expect include a runny nose, watery eyes, stuffy nose, and sneezing. So what causes outdoor allergies? Well, you might be surprised that they usually stem from just two things: pollen and mold.
The pollen that plants produce is transported in different ways. Brightly colored flowers depend on bees and other insects to transport the pollen so it can be fertilized. In general, these plants don’t cause issues for allergy sufferers. Other plants, however, produce a powder-like pollen that is spread by the wind. This type of pollen is likely to cause allergic reactions.
Mold is the second major culprit. It can be present nearly anywhere you can imagine, in both the outdoors and indoors. Mold is actually a collection of microscopic fungi that are related to mushrooms. Just like pollen, mold spores float around in the air and can sit on hard surfaces.
Both mold and pollen particles trigger your immune system. The symptoms you feel when you’re having an allergic reaction are actually a response to antibodies that your immune system has produced.
You can decrease the impact environmental allergies have on your life by tracking your symptoms and remembering when symptoms present themselves. One way you can do that is by keeping a simple allergy calendar, marking down the days when your symptoms are severe, moderate, mild, or not present. After a year, you’ll have a good base of data so you and your allergist can prepare for and combat symptoms before they appear in the future.
Some individuals suffer from a wheat sensitivity that is not related to celiac disease. New research suggests that this non-celiac wheat sensitivity may be an allergy. While it was formerly considered an innate immune system response, that opinion is slowly shifting.
So what exactly is non-celiac wheat sensitivity and what types of symptoms does it cause? Essentially, this term applies to individuals who cannot tolerate wheat in their diets, yet lack the intestinal damage and antibodies present in people who have celiac disease. Symptoms can include headaches, joint pain, and numbness in the legs, arms, or fingers. In other words, it affects many major organs, including the nervous system, gastrointestinal tract, and skin. Symptoms disappear completely when wheat is excluded from the diet, making it a treatable condition.
In order to consider whether or not non-celiac wheat sensitivity is an allergy, it’s important to understand the two major categories of food allergies. The first is known as IgE mediated allergies. These cause an almost immediate reaction. In other words, if you’re allergic to peanuts and you eat peanut butter, you could have trouble breathing or notice the appearance of hives within minutes. The second type of food allergies are labeled as non-IgE mediated. These affect the gastrointestinal tract and may not produce symptoms for an extended period of time. Celiac disease falls into this second category.
To learn more about this research, which was just published in The American Journal of Gastroenterology,
If you suffer from food allergies during the holidays, you’re not alone. The holiday season means lots of eating out, whether at restaurants, parties, or friends’ houses. For many people, all that eating out can cause a few issues. There’s no reason to limit your social schedule or suffer through allergic reactions though. With just a little planning and preparation, you can keep those reactions to a minimum and enjoy this wonderful time of year with family and friends. Follow these allergy tips so you can have joyful and allergy-free festivities:
First, don’t give in to temptation. Holiday parties are chock full of goodies that you’ll be tempted to try. If you know–or suspect–that a dish has something you’re allergic to in it, skip over it. There is always plenty of food available, so find another dish to try that won’t leave you suffering later on.
Next, don’t be afraid to ask what’s in a dish. Your host or hostess will no doubt understand that you’re trying to avoid an allergic reaction and should have no qualms with sharing details about the food. Be clear about what your allergies are so they can specifically think of any ingredients that may pose a problem.
Lastly, bring a dish you know you can eat. If the food you’re sensitive to is especially hard to avoid, it will be convenient to have at least one option that you’ll be able to enjoy. In the case of an office party or other big group event, ask a few of your closest friends or colleagues to bring dishes you know you’ll be able to eat as well.
Many people have false information about allergies. They may experience different symptoms and link them to allergies when in reality there is a different culprit to blame. Some of the common myths below have been passed down for many years, but experts know there is no truth to them.
Myth: I’m allergic to foods that make me feel unwell.
Many people who think they are allergic to a certain type of food actually experience a kind of food intolerance, sensitivity, or even food poisoning. The only way to get an accurate diagnosis is to visit an allergy specialist and undergo testing.
When someone is allergic to a specific food, the immune system deems that food as harmful and usually responds within a few minutes. Histamine is released to fight the harmful food and symptoms such as itching, hives, and wheezing appear. In the most serious cases, a trip to the emergency room is necessary.
Myth: I’m allergic to dog fur.
In reality, those who experience an allergic reaction around dogs or cats are not allergic to the animals’ fur. Instead, the allergens come from the animals’ saliva, perianal glands, and sebaceous glands. While there are breeds of both cats and dogs that are described as being hypoallergenic, the truth is that no animal is completely hypoallergenic.
Myth: I’m allergic to gluten and can’t eat wheat.
While gluten intolerance is somewhat common, being allergic to the protein of wheat is extremely rare. If you question a potential aversion to gluten, see an allergist near you for further discussion and analysis. Save yourself a lot of hassle and money by getting an accurate evaluation from an allergy specialist.
To learn more about this topic, check out this
Pregnancy can be an exciting and overwhelming time in a woman’s life. Women who are pregnant know to expect many changes to their body. During these changes, it is important to know how to manage existing conditions or diseases, such as asthma. Fortunately, there are some easy-to-implement changes that women can make at home that may help control asthma during pregnancy.
First, it’s important to recognize that asthma and allergies are often closely related. Because of this, it’s important to free the home of things that trigger allergic reactions. The most common triggers include things like pollen, mold, pet dander, or dust mites. Items that promote the growth or presence of these irritants should be taken care of appropriately. Pillows, mattresses, and box springs should be sealed up in dust mite-proof casings. Bedding should be washed weekly in 130-degree water. Mold growth can be limited by monitoring home humidity levels and addressing problem areas, such as damp basements or dirty air filters.
Additional environmental elements can also worsen allergy and asthma symptoms. Pregnant woman should not be exposed to dangerous air pollutants like tobacco smoke, smog, chemical fumes, and strong odors.
An important factor in managing asthma during pregnancy is maintaining an active and open line of communication with your doctors. This is the absolute best way to control the problem and ensure that you will have a healthy and safe pregnancy. Doctors sometimes alter medications depending on each individual situation, so it’s important for women to track their symptoms so that they can communicate them at regularly scheduled check-ups.
Most children consider Halloween one of their favorite holidays. They get to dress up in costumes, go trick-or-treating with all their friends, and of course the candy. However, if your child has a food allergy, Halloween can be tricky. Fortunately, if you follow a few simple tips, your child will be able to have a safe and fun Halloween without consuming any foods that may trigger an allergic reaction.
If you decide to take your child trick-or-treating, you should always carry your child’s emergency medicine. In the event that your child consumes unsafe candy, you will be able to act fast and administer the medicine right away. If you live in a place where you know most of your neighbors, you could meet with them in advance and give them safe treats to hand out to your child. This will eliminate the risk that they unknowingly give your child candy that triggers his or her food allergies.
Once you’ve returned home from trick-or-treating, you should take any candy your child has collected and carefully read the labels to make sure your child doesn’t have an allergy to any of the ingredients. It’s important for your child to be aware of their allergies as well.
For more food safety tips, here’s a great article for parents:
When allergies strike! Here are seven signs you are one of the millions who suffer from allergies. From coughing to sneezing to itchy eyes, we feel your pain!
1. You have your allergy doctor on speed dial.
2. You buy stock in Kleenex tissues because you might as well profit from your misery.
3. Your bedside table looks like it belongs in the ICU.
4. Your sneezing has gotten so out of control, your co-workers start giving you dirty looks.
5. People start calling you Rudolph.
6. You purchase a separate handbag to store your supply of cough drops.
7. Your eyes water so much, you earned the nickname “cry baby”.
How many of these tell-tale signs apply to you?
Penicillin and the family of antibiotics that fall under its umbrella are some of the most commonly prescribed options available in the United States. Many parents, however, may have had an adverse reaction to one of these medications themselves or may have witnessed it in their children, causing them to believe a serious allergy is present. Did you know an estimated 1 in 10 Americans claims to be allergic to Penicillin? Continuing research suggests that these numbers are not accurate, and that far fewer people suffer from a serious Penicillin allergy than is reported.
As a parent, especially, it’s important to consider that allergies can dimish over time. You may have witnessed your child having an adverse reaction to amoxicillin or another drug from this family, but will be relieved to know that they may outgrow it within a matter of a few years. Penicillin and related drugs are often the most affordable and effective antibiotics available for common medical issues and illnesses, so it’s good to know if your child is truly allergic.
Another cause for the overblown statistics around penicillin allergies include confusing the direct symptoms of the illness as side effects of the medicine. Older citizens may have been misdiagnosed many years ago when technology was less advanced and should consider getting retested to confirm any allergies. Other people who do technically have an allergy have one that is so mild that the benefits of using Penicillin far outweigh any mild allergic reactions they may experience.
The good news is that testing is simple. An allergist can perform a simple skin test to determine with certainty whether the person has a serious allergy or not. If you think you may be allergic to penicillin or any other medication, you should consider visiting an allergist near you. View our 8 convenient locations
With the school year just beginning, many moms are busy preparing their children to meet the challenges of the classroom. If your child suffers from allergies or asthma, you’re probably concerned about attendance throughout the school year as well as keeping him or her safe from attacks. It’s been estimated that about one out of every ten school-aged children has asthma, and more than 10 million school days are missed each year due to this condition. Rest assured however, there are precautions you can take to ensure he or she has the highest attendance possible, but this requires careful planning and communication with an allergy doctor.
One of the best places to start is to pinpoint the triggers for the asthma or allergy attacks. Armed with this knowledge, you can work on trying to avoid these substances. Also be sure to enforce regular communication with your child’s teacher and school personnel regarding his or her condition. All 50 states allow the self-administration of asthma inhalers, and most allow epinephrine injections if necessary. It is vital that your child and their teacher fully understand how to use her inhaler or injection pen.
Make the back to school season a success for your child. In order for you and your child to be prepared for how to handle his or her allergies, schedule an appointment with an allergist so you can have a plan of action for making this school year the best it can possibly be.
As many of us know, it can be very frustrating to experience a summer cold. From the first sign of a stuffy nose, many of us head straight to the local pharmacy to pick up some over-the-counter medication to manage our symptoms. It never occurs to us that what we could be experiencing is actually allergy symptoms.
In recent studies, researchers have found that many adults will experience allergic reactions to common triggers, such as grass pollens and mold spores, for the first time in the summer. The symptoms these allergies present are very much like those of the common cold, so it’s important to learn about the differences between the two. Before speaking with an allergy doctor, there are a few signs to help you identify exactly what’s going on.
If symptoms last for longer than two weeks or more, it is more likely that you are suffering from allergies.
While some colds might be associated with these symptoms, allergies always are. If you are experiencing itchy, watery eyes, persistent sneezing, and an itchy nose and throat, chances are that you have allergies and should speak with an allergy doctor.
If you have asthma and your symptoms are amplified or exacerbated by symptoms such as those listed above, you are likely suffering from allergies. It can be important to test for these allergies, as untreated symptoms could put you at risk for an asthmatic attack.
While there is no cure for seasonal allergies, there are many over-the-counter medications and prescription medications to alleviate the symptoms. Individuals with allergies can also work to avoid triggers and get treatment from an allergy doctor. Contact us today to learn more about summer season allergies.
Do you suffer from inherited allergies? Soon, an Ohio allergist will be able to help you identify your allergen risks using genetics. Thanks to collaboration between 23andMe, a personal genetics company, and the Avon Longitudinal Study of Parents and Children, our knowledge of genetic allergies is expanding.
The combined work of 23andMe and the Avon Longitudinal Study of Parents and Children yielded a
But what does this mean for allergy sufferers here in Ohio? In the near future, allergists may be able to use this information to help patients. When there are clearly defined genetic links to certain allergens, this research can help advance diagnosis and prevention. The findings can be especially helpful for infants and young children who have a parent or both parents who suffer from allergies. With advanced knowledge, one can plan ahead to avoid allergy triggers or properly treat them to avoid adverse reactions.
The new genetic connections can also lead to the development of new medications. To learn more about how current medicine is working to manage allergy symptoms, talk to your allergist today.
Allergy season is starting to get worse for many allergy sufferers due to changes in the climate. According to
But why are your allergies worse this year? The shift in the climate is also creating longer growing seasons, resulting in allergens remaining present for an extended period of time. Pollen from trees is showing up two weeks earlier in the spring, and ragweed pollen is sticking around for up to four weeks longer in the fall. With the steady increase, some scientists are projecting pollen counts to double by as early as 2040. According to USA Today, ragweed allergies saw an increase of 15% from 2005 to 2009, resulting in doctors across the country seeing more patients complaining of allergies.
Premier Allergy offers a variety of options to test for allergies from traditional allergy shots to needles free testing. We have eight convenient locations in the Columbus, Ohio area. Contact us today to set up an appointment or call our office at (614) 328-9927 for more information!
Are your allergies in full swing? You’re not alone! Dr. Shah talks with
Right now, we are in the middle of tree pollen season, and that will be closely followed by grass related allergies. Heavy bouts of rain can provide some relief by temporarily clearing out the air. Allergies are not just for the summer time though. Many people experience allergic reactions in the winter due to dust mites, pet dander and dust.
Dr. Shah does have some insight on how to combat your allergies. With mild symptoms, over the counter antihistamines can provide you with temporary relief. However, if your symptoms are becoming more regular, it’s time to consult with your doctor or look for an allergist.
Are you suffering from allergies? Contact one of our offices for more information or to schedule an appointment.
When your body is allergic to a foreign object such as dust, pollen, or a certain food substance, it produces a sneeze in an attempt to get rid of the irritant. A sneeze can project out of the body at up to 100 miles per hour and up to 5 feet away from the source. Certain allergens are more widespread during different times of year, which can cause you to sneeze more in the warmer months. Tree and grass pollen are most prevalent during the spring, while weed pollen is common in the summer and fall. But, allergens aren’t the only cause of sneezing. Exercising, plucking your eyebrows, and bright sunlight are all potential triggers. Interestingly enough, you have to be awake to produce a sneeze, as it is impossible to do so while sleeping.
The average person breathes in approximately 45 pounds of dust in their lifetime, which has led to allergies becoming the fifth leading chronic disease in the United States. Fifty million Americans (that’s 1-in-5 people) suffer from allergies, and nearly 55% of people test positive for one or more allergens. In fact, 30,000 emergency room visits per year are caused by food allergies. For those who test positive for an allergen, genetics are the culprit. If one parent has an allergy, there is a 1-in-3 chance that the child will have allergies as well. If both parents suffer from allergies, those odds increase to 7-in-10.
While there are a variety of sources in nature that can trigger allergies, you might be surprised to learn that the time you spend indoors can have an even greater effect. The average person spends 90% of their life indoors, and 33% of that time is spent in the bedroom, which is the room that contains the most allergens. Another common allergen is pet dander. Every home contains pet dander, despite the fact that only 33% of households have a cat and 39% of households have a dog. Whether you suffer from allergies indoors or outdoors, you are at an increased risk to miss time from work or school. Allergies are the number two reason why adults miss work, and $2.2 billion is lost annually due to loss in productivity caused by allergy symptoms that force people to miss work or school. When allergens are at their peak, sufferers can miss up to 32 hours per week.
There are three common ways to treat allergies. Avoiding mild irritants or food allergies can reduce the overall impact, but it is not considered a long-term strategy or cure. Using over-the-counter and prescription medications can provide short-term relief, but it is not a long-term solution as most medicines should not be taken for longer than 28 days. Weekly shots for 50 weeks a year can also reduce symptoms, but the most effective way to stay symptom-free for life is rush immunotherapy. Rush immunotherapy involves eight shots the first day and weekly shots for three months.
No matter which treatment option you choose, it is important to consult an allergist. Columbus residents can benefit from visiting a skilled professional, who can create a customized treatment plan to help manage their allergies.
Spring gets the reputation of being the most beautiful time of the year because of all the flowers in bloom, but for allergy suffers, this isn’t what they think of when they realize that spring has sprung. The same bee pollen that makes the flowers grow also makes your nose runny and stuffy. Allergy sufferers experience anything from headaches to coughing fits. And with the combination of a wet winter and alternating warm and cold spells, tree pollen has been bursting forth a bit early this year.
Before you start to dread the outdoors, realize that you can plan ahead by visiting an allergist who can provide treatment to prevent the onslaught of such unforgiving allergies. A physical examination can determine how much pollen affects you. You may be able to avoid the sniffles and runny eyes with just over-the-counter medication. If this is not the case, further testing could help. A scratch test can tell you whether you’re hypersensitive to the allergens that float about in the spring air. From here, a doctor can determine the extent of treatment needed. Other preventative measures could include immunotherapy shots that help bolster patients’ immune system and pollen tolerance level.
Just like with any medical condition, being fully informed is important, and you should find out all you can about how you can
Ohio allergist Dr. Patel appeared on Fox 28 news to discuss the upcoming allergy season. Experts predict this year to be the worst allergy season to date. There are a few reasons why you can expect your allergies to begin acting up:
Dr. Patel dives into what an allergy is and who can suffer from them. An allergy is when you experience a reaction to something you are sensitized to such as dander and pollen. Some people are born with allergies, and others develop them later on in life. If your parents suffer from allergies, you are more likely to experience allergies.
View the full video on YouTube. Dr. Patel covers allergy treatment options and tips to limit your allergic reactions.
The urge to spend time outdoors is never greater than in the early days of spring. The days start to get longer, the snow melts away, the sun comes out and gardens bloom. But when some of us pull off our winter boots and stop to smell the roses, we’re hit with the reality of our spring: runny noses, sneezing, coughing, and itchy, watery eyes.
What causes spring allergies?
For most spring allergy sufferers, pollen is the culprit. But to suffer the effects, you don’t have to stick your nose in a flower and breathe in. No, pollen makes its way through the air we all breathe, making it seem impossible to avoid– unless you barricade yourself inside with the windows closed. That’s because while it is certainly found in most flowers, it doesn’t end there. Pollen is also found in many types of trees, including pine, cedar, maple, ash, elm, willow, poplar and sycamore. It’s even found in grass and weeds, making it even more difficult to avoid.
What can you do?
While it may be tempting to sit inside and avoid the sunshine, it’s not necessary to go to such extremes. There are things you can do to make allergy season more pleasant and enjoy the fresh air.
Pick pollen-free flowers. If you want to have fresh flowers in your home (or garden), choose a variety with little or no pollen. This includes roses, tulips and daffodils, making them the perfect choice for allergy sufferers.
Use air conditioning. Instead of keeping windows open or using a fan, use an air conditioning system to get some relief from the heat, both in your home and in your car.
Avoid the clothesline. It’s not worth what you’ll save on your energy bill; pollen can easily collect on your clothes if you hang them out to dry. Instead, continue using the dryer or an indoor drying rack, just like you do in the colder months.
Check pollen counts. Get your vitamin D when the pollen counts are lowest. Usually pollen levels peak in the mornings, and they are especially high on breezy days.
Keep clean. Pollen tends to collect in hair, making it a good idea to wash it each time you come in from outdoors. You should also change your clothes each time you come inside, and wash your clothing and sheets regularly.
Get some help. If allergies are an ongoing problem, you can get some relief with one of many over the counter medications. Antihistamines work to target allergies specifically, and there are many different brands on the market. Decongestants and nasal sprays can also be helpful for those struggling with allergies, as they work to clear out nasal passages. If itchy eyes are a problem, eye drops will most likely provide some relief. Though all of these medications are available without a prescription, its a good idea to check with a physician before taking anything new. And, if these medications aren’t doing the trick, your doctor might be able to provide more allergy treatment options.
Cabot Rea: If you have allergies, the worst season could be on our doorstep.
Colleen Marshall: Central Ohio is a hotspot for seasonal allergies. In For Your Health tonight, Ellie Merritt is going to tell us what to expect. Ellie, I hear it’s going to be a bad one.
Ellie: Yes, allergy season comes on fast and furious and while it is chilly outside today, doctors are expecting seasonal allergies to be earlier this year. And you’re right, Colleen, much more intense. Blame the weather. Get ready for the sneezing.
Ekta Chabria: I was panicking, because when you get hives, especially when you get them on your face and things like that, it scares you.
Ellie (VO): Allergies…
Dr. Shah: Hi, how are you?
Ellie: Sent Ekta Chabria straight to the doctor.
Dr. Shah: Alright, how are your allergies going this spring?
Ellie: Bad allergies that she never had until her late twenties.
Ekta: My throat would be itchy, my eyes would be itchy, my nose would be running. I was just a mess every morning… I’m allergic to grass, pollen, ragweed, certain kind of trees, dustmite, cat and dog.
Ellie: A long list. And doctors say those seasonal allergies are coming on strong this spring. And you can blame the weather and our temperature roller coaster.
Dr. Shah: When you have real warm days, then cold days, then warm days, it kind of tricks or almost cues the plants that ok, the season’s starting again, and they can almost feel that the season’s starting over and over again, and then you get real intense bursts of pollen that are released. That can be really bad for the allergy sufferers.
Ellie: And not just intense—Dr. Shah thinks they will be early this year, too.
Dr. Shah: If your symptoms are only there for a couple days, or if you’re having mild symptoms, then those over-the-counter medicines, like antihistamine medicines, will work fine.
Ellie: But if you are one of those suffering every season…
Dr. Shah: are your symptoms worse in the morning when you wake up?
Ellie: Talk to your doctor about long-term medicine or allergy shots.
Ekta: Well, I’m glad I started immunotherapy when I did.
Ellie: And even if you have never had allergies before, they can come on at any age—so there’s your warning—especially if you move across country. Treatment usually starts with avoidance, stay inside on the peak days, then go for the over-the-counter allergy meds, and if that doesn’t work, it’s about the time to head to the doctor for a prescription. If it’s something you are seeing, Cabot and Colleen, every season, every year, that’s about the time to talk to a doc about it.
Runny noses and sniffles aren’t exactly rare this time of year; colds and the flu run rampant among adults and children alike. After the twentieth sneeze or so, chances are you’ll pop a sinus pill, load up on Kleenex, and plop yourself in front of the fire to watch another holiday-themed movie. Sometimes this works, but sometimes there’s something a bit more complicated going on that might require allergy testing. Ohio has an allergen-friendly climate, and often people go years without realizing they have seasonal allergies. If a cold and sinus medication hasn’t been doing the trick, and symptoms seem to drag on for days or weeks, you may be suffering from allergies.
The season for allergy testing
Many people believe that summer is the season for allergies, but that’s not necessarily true. While pollen is a common trigger, it’s certainly not the only one. Pet dander or dust might be more plentiful around your home in the cooler months, and the holiday season might bring out your allergies thanks to Christmas trees or scented candles and oils. December is also a common month to be tested for allergies because many people want to have it taken care of before their insurance deductible starts over. Allergy testing is covered by the large majority of insurance plans. If your plan carries a deductible, you probably know that you’ll have to start paying over again in the new year. If you’ve already covered it this calendar year, then you can take advantage and get tested for allergies before time runs out.
The testing process
The most common type of allergy testing Ohio residents will encounter is the skin prick test. During this procedure, the medical professional performing the test will place drops of solution containing potential allergens on the skin, each an inch or more apart. They will then use a needle to prick the skin under each drop. If you have an allergic response to any particular allergen, a hive will appear at that site within about 15 minutes. The skin prick test will identify the following:
If the skin prick test yields no results, yet there is still a strong suspicion that you have a specific allergy, an intradermal test may be done. During this test, the allergen is injected into the skin. While this test is more sensitive than the skin prick test, it is also more likely to give a false-positive result.
Triggers for asthma
While an allergy test alone won’t diagnose asthma, it could help you and your physician determine what your triggers are. For this reason, your physician might suggest a skin prick test to see if your asthma is triggered by dust or pollen, for example. If you suffer from both allergies and asthma, there is an excellent chance they have the same trigger.
Whether you know you’re suffering from allergies or you’ve been struggling to identify the source of your discomfort, come into Premier Allergy for allergy testing. Ohio residents statewide have found simple solutions to lifelong problems with the treatments of Dr. Summit Shah. Have you noticed your nose running a lot more this year? Perhaps you’re left wondering if it’s more than just a cold. A simple allergy test is the first step toward narrowing the possibilities so that you can begin treating the symptoms. Make the most of these colder months with a visit to Premier Allergy.
Just because the seasons change, that doesn’t mean your symptoms will.
Most of us enjoy summer’s perks; it’s the season of long nights, bikinis, and pints of beer on the patio. But summer is also the season of pollen, and for the unlucky among us that means sneezing, runny noses, and dry, itchy eyes. If that sounds like you, you might happily trade warm weather and sunshine for early evenings and chill winds, if it comes with the promise of symptom relief.
If you’re an allergy sufferer you might eagerly anticipate the transition between summer and fall. So when temperatures drop to the low thirties and your nose is still as red as Rudolph’s, you probably feel a bit cheated. Isn’t summer supposed to be allergy season? Shouldn’t it all be over when the ground turns white?
Well, not exactly. It’s true that pollen is a common trigger, but it’s not the only one. With winter comes a whole new slew of allergens to look out for.
Pets. When the temperature drops, your pet cat or dog might start spending a lot more time indoors– which means their dander builds up a lot more quickly. Make sure to bathe your pet once weekly, and clean and vacuum regularly.
Damp areas. Winter is damp and humid– conditions where mold thrives. Bathrooms and basements often breed mold, and damp shoes trudged through the house can give it an even greater opportunity to grow.
Dust. You always need to be concerned about dust, and cleaning regularly can help keep symptoms at bay. But the problem often increases as holidays approach; pulling out decorations for Thanksgiving or Christmas can mean pulling out layers and layers of dust.
Christmas trees. While the trees themselves don’t usually trigger allergies, the mold spores they produce do. Within days of bringing your tree home the mold will release into the air, wreaking havoc on allergy sufferers.
Firewood. Cold, damp wood for the fire is another breeding ground for mold.
Another curse on allergy sufferers: sinus infections. Those with nasal allergies are predisposed to this uncomfortable winter staple.
Healthy sinuses produce fluid, which is drained through the nasal passages. The problem occurs when these passages are blocked. The fluid has nowhere to go and builds up in the sinuses, causing them to become inflamed and infected. This can be caused by a bacterial infection or the common cold, or by allergies.
It’s important to determine whether you are suffering only from allergies, or if you have developed an infection. Pay attention to your symptoms; if they seem to be getting worse or your normal method of treatment isn’t helping, you may be suffering from an infection. Some things to look out for include the following:
It probably sounds like you have a lot to worry about; mold might make decorating the tree go from “merry” to “misery,” and reading by the fire is a lot less pleasurable when you’re blowing your nose more often than you’re turning the page. So what can you do to suppress your allergy symptoms, and keep sinus infections from developing?
If you have any questions consult a Columbus Allergist. Dr. Summit Shah and his experienced team are here to help you.
A link between eating, exercising and a severe allergic reaction?
Dr. Shah seems to have found just that throughout his observations and findings that he presented at the World Allergy Conference. Throughout studies of exercising without eating beforehand and eating without exercise – Dr. Shah found that patients seem to have no unique allergic reaction. Yet when patients combine eating a particular food or meal, then partaking in some form of exercise right after, an anaphylactic or severe reaction of some sort has taken place. Sparking a clue into the reason behind this happening could be the increase in blood flow and absorption in the stomach while exercising, thus bringing to life an allergic reaction.
Dr. Shah and one Premier Allergy patient, Donna DePalma, are captured in the video below taking an in-depth look at the severe allergic reactions she found herself experiencing within minutes of working out after eating specific foods.
Dr. Shah presented his findings on Food Allergies and Exercise at the recent XXII World Allergy Congress, where he spoke on the importance of waiting 60 minutes after eating before exercise.
In December, Dr. Summit Shah, allergist at Nationwide Children’s Hospital, was asked to present his findings on food allergies and Exercise at the XXII World Allergy Congress. In his presentation, the Ohio allergist cautioned individuals to be mindful of reactions with food allergies and exercise.
Being asked to speak at the Congress was a tremendous honor for Dr. Shah and his research team. “We are pleased that the World Allergy Organization appreciated the importance of our findings enough to invite us to speak,” stated Dr. Shah. “Like us, they believe that allergy patients and clinicians need to be aware of the various forms of food allergies.”
Dr. Shah, allergist at Dublin Methodist Hospital, discussed two patients who experienced anaphylactic reactions after eating foods they were not previously allergic to, and exercising shortly after the foodwas ingested. The first, a 23-year-old Asian male, had a reaction to cashews after exercising, despite having eaten them previously without any problems. The second, a 42-year-old male, had a similar reaction to shrimp. In both cases, the patients exercised less than 60 minutes after eating.
“What was interesting about these findings,” stated Dr. Shah, “was that the skin prick tests were inconclusive. In the first patient, he tested positive for a reaction to cashews, but the second patient tested negative. Based on this, we believe that anaphylactic reactions after food ingestion followed by exercise can be more common than with food ingestion alone.”
The study also suggests that patients can have an anaphylactic episode to a food that they are not actually allergic to if they exercise after eating it. “We believe that allergen absorption increases in a post-exercise state,” stated Dr. Shah. “For this reason, we recommend that people who have food dependent exercise-induced anaphylaxis only exercise on an empty stomach, waiting at least 60 minutes after eating to exercise. This time frame appears to limit the chances of a reaction.”
What is frightening about this particular situation is that the anaphylaxis may be unknown to the patient, because it does not present as a food allergy unless the food and exercise are mixed. Because the reactions are life threatening for many patients, Dr. Shah reminds clinicians that they should be aware of the possibility, and should consider this combination when taking patient histories.
Dr. Shah is passionate about educating people on food allergies. “Unlike other allergies, food allergies are usually life threatening,” he said. “My goal as an allergist is to teach people how to manage their allergies and find ways to avoid allergens altogether.”
A ground breaking research study by Dr. Summit Shah on accelerated allergy shots has been in the news! Dr. Shah’s study shows quicker results and no increased reaction rate using rush immunotherapy for treatment of allergies and asthma.
Pass the tissues. Allergy season has arrived early this Spring, bringing with it sneezing, wheezing, and itchy, watery eyes. But along with early allergies, Central Ohio is still dealing with a late flu season, and the symptoms often overlap. Dr. Shah chats about getting your Allergies under control before April arrives.
AllergistDr. Summit Shah lent his knowledge to the folks at Columbus Parent Magazine to help clear the waters surrounding food allergies–and the verdict isn’t in yet. Even if your child doesn’t have food allergies, most parents know which foods most often ignite allergic reactions: nuts, wheat, eggs and milk. But what do you do if you fear your child has a food allergy?
When September rolls around, it usually means back to school for the kiddos. Back to school also typically means allergy season, high ragweed concentrations, and a mix of allergens all creating a disruption for your little ones and their school routine. Last week, NBC4i stopped by our Dublin office to chat with Dr. Shah about the problems of back to school allergies and what can be done to help. Ellie Merritt interviewed allergist Dr. Summit Shah and gave an inside look at how a few young ladies deal with their allergies in a school setting.
The beauty of budding plants and bouquet of aromas are sources of satisfaction for many gardeners. For allergy sufferers, though, gardening can be as much a chore as pursuit of passion.
Pollen from trees, shrubs and grasses can cause an onslaught of allergy symptoms, including sneezing, itchy eyes, congestion and in some cases, an asthma attack.
But sensitive people can take a few simple steps to minimize their risk of exposure to bothersome allergens, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).
“Gardening outside during times of high pollen counts puts patients at risk for severe allergic symptoms,” said Dr. Summit Shah, allergist and President of Premier Allergy. “Avoidance measures, as well as the use of medications and allergy shots, can make the difference between having fun in the garden and being miserable.”
An allergist/immunologist can help determine what plant species are causing an allergic reaction and advise on the best times of day or season to work in the garden. For example, pollen levels are typically lower on rainy, cloudy and windless days. Immunotherapy (allergy shots), medications and other treatments can also help reduce symptoms.
People with allergies can also trim irritation by carefully choosing the plants they include in their landscaping or garden. Certain flowers, trees and grasses are naturally better suited for the gardens of allergic people. They are less likely to produce bothersome pollen and will still add color and variety to the garden.
The best way to determine which plants will trigger reactions is through skin testing at an allergist/immunologist’s office. An allergist/immunologist can help patients develop strategies to avoid troublesome plants and pollen and can prescribe medication to alleviate symptoms.
Whenever working around plants likely to cause an allergic reaction, avoid touching your eyes or face. You may also consider wearing a mask to reduce the amount of pollen spores that you breathe in. Wear gloves and long sleeves and pants to minimize skin contact with allergens. Leave gardening tools and clothing – such as gloves and shoes – outside to avoid bringing allergens indoors. Shower immediately after gardening or doing other yard work.
Contact an allergist/immunologist to identify specific causes of allergic reactions or to get information on treatment options and tips to reduce allergen exposure. An allergist/immunologist is the best qualified medical professional to manage the prevention, diagnosis and treatment of allergies and asthma.
As the number of people suffering from seasonal allergies rises, it’s been increasingly important to discover new ways to combat allergic reactions and symptoms. There are current medical practices and medications that can manage symptoms, but rarely does a treatment aim to eliminate the problem. A new way of treating patients with these health issues is through a new method called rush immunotherapy. This not only helps reduce the frequency of reactions or the severity of symptoms, but it has in many cases helped patients overcome allergies all together. Learn more about Premier Allergy’s rush immunotherapy allergy treatment.
The method replaces the more common practice of immunization shots over the course of a year. Throughout the year, patients have met with their allergist to build up an immunity to common seasonal allergies, such as ragweed. This helps them build immunity to the allergen when the seasons change. Over the course of several hours in a single day, patients will receive regular immunizations. The benefits of rush immunotherapy are much more profound and long lasting. In one day, patients will receive up to six shots, each shot including the equivalent of 20 single shots. The frequency planned is one shot per hour over 4 to 6 hours. Because an immunization is a small amount of that which you are allergic to, patients undergoing this treatment will remain in the medical offices for observations so as to monitor the effects of the immunizations. This also ensures that should an issue arise, you will have access to emergency care.
Using this method, patients will more effectively build up an immunity to particular allergens. Many of the patients that go through this treatment find that, over time, they are symptom free. This then eliminates the need for future treatment, providing a life long cure for treated seasonal allergies. To learn more about our approach to rush immunotherapy, we welcome you to explore your options by contacting Premier Allergy. This treatment is covered by insurance plans!
Each person’s symptoms are different, but everyone must pay attention to the early warning signs to recognize that an episode may be developing. These signs may include breathing changes or coughing, feeling tired, having less energy for exercise and having lower peak flow meter numbers. A peak flow meter is an easy-to-use plastic device that measures how well air moves out of your lungs.
Common signs and symptoms include:
Severe symptoms require immediate attention and can be a life-threatening emergency. Signs of severe symptoms include:
During an attack, the air passages become swollen and narrow and produces a thick mucous. At the same time, the muscles around the airways become tight. The tightening of the muscles, called bronchospasm, causes the airways to become even narrower.
At Premier Allergy in Columbus, Ohio, asthma can be treated and diagnosed. Asthma is a chronic inflammatory lung disease that can cause repeated episodes of coughing, wheezing and breathing difficulty. It can be triggered by allergens, infection, exercise, cold air and other factors. It is one of the most common chronic diseases of childhood, affecting more than six million children and 15 million adults.
Avoidance is the best treatment for any allergic disease. If you avoid the allergen, you’ll avoid the allergic reaction. Diagnosis and education are crucial steps in allergen avoidance. Educated allergy and asthma sufferers fare much better than those who do not understand their condition.
An allergist/immunologist is a pediatrician or internist who has undergone two to three years of special training in the diagnosis and treatment of allergic and immunologic diseases. To understand what you are allergic to, an allergist will:
An allergist can create a management plan with you for better control of your environment and your symptoms. Your plan may also include proper medication and, if necessary, allergen immunotherapy (allergy shots).
At our clinic in Columbus, Ohio, allergy shots will be administered to slowly reduce the severity and frequency of your allergies. Despite this, allergies cannot be totally cured. A combination of avoidance measures, our medication, and our therapies will improve the quality of your life. Call us today or submit through our one-click form to schedule an appointment!
In some cases, yes. Severe and untreated hay fever may lead to asthma, sinusitis and other serious conditions. Atopic dermatitis or eczema can spread to secondary skin infections if they are not treated properly, and untreated asthma can lead to chronic symptoms. Early detection and treatment of all allergic diseases is important.
Allergic reactions can develop at any age, no matter how old you are. Since repeated exposure to certain allergens can cause an allergic reaction, it makes sense to develop allergies when you’re older, as you’ve had more time to be in contact with dust, dander, mold and pollen.
It normally works the other way around – people can grow into allergies. There are cases in which one allergy replaces another, such as with childhood food allergies. Children normally suffer from food allergies more than adults. Once they grow up, they may get rid of food allergies but then be affected by seasonal or environmental allergies. About 85% of children outgrow food allergies to milk, soy, egg and wheat, but only 20% outgrow a peanut allergy. Up to half of young children outgrow their asthma, but many find that their symptoms return later in life. For most children, eczema improves during childhood.
There are two main theories. One blames our increasing immune system sensitivity to the many synthetic chemicals in today’s society. Another theory, known as the “hygiene hypothesis,” states that the human immune system is becoming more reactive to allergens because of modern hygiene and health care. Our immune system is designed to fight off viruses, bacteria, parasites and other microbes. However, with modern hygiene, sanitation, vaccines, antibiotics and health care, our immune system does not have many invaders to fight off, and so its attention and energy are re-directed to normally harmless foreign substances.
A specific allergy is not usually inherited, but your tendency to develop allergies is often passed down through families. If both parents have allergies, their child is likely to have allergies. However, your chance of developing allergies seems to be greater if your mother has allergies.
People with seasonal allergic rhinitis (hay fever) experience symptoms during the time of year when certain allergens are in the air outdoors. There are several allergy seasons: springtime, when plants bloom and tree pollen counts soar; summer, the season for grass and weed pollen allergies; and autumn, the time for ragweed and mold allergies. Perennial allergies, or year-round allergies, are typically caused by indoor allergies to dust mites, mold, cockroaches and pet dander.
About 50 million Americans, or 1 in 6 people, have environmental allergies, or allergic rhinitis. Allergic disorders are the sixth leading cause of chronic illness in the United States, according to the Allergy Report from the American Academy of Allergy, Asthma and Immunology.
An allergic person produces a specific type of antibody called immunoglobulin E, or IgE, in response to normally harmless substances such as certain foods or medicines, pollen, animal dander and mold. These IgE antibodies cause allergic reactions. If a person is exposed again to the allergen, the IgE antibodies stimulate what are called mast cells to release chemicals such as histamine to destroy the “foreign” substance.
The release of histamine causes typical allergy symptoms such as runny nose, itchy and watery eyes, sneezing, asthmatic reactions, hives, and a drop in blood pressure in severe cases. This is why antihistamines are the mainstay of treatment for allergies.
An allergy is a disorder of the immune system, an exaggerated response, occurring when a person is exposed to normally harmless environmental substances known as allergens.
The first step in treating a drug allergy is to stop the drug that is causing the reaction. Mild allergy symptoms such as hives and itching may be relieved with antihistamines. Topical corticosteroids may also be recommended. If asthma-like symptoms such as cough or wheezing are present, a bronchodilator such as albuterol may be prescribed by an allergist.
Serum sickness is a delayed type of drug allergy that occurs a week or more after exposure to a medication. The immune system misidentifies a protein in the drug as a potentially harmful substance, and it develops an immune response to fight it, causing inflammation and other symptoms.
Symptoms of serum sickness do not develop until seven to 21 days after the first exposure to the drug. However, people may develop symptoms in one to three days if they have previously taken the medication. Within one to two weeks of taking a medication, the following signs and symptoms may be present:
Drug rashes are the body’s reaction to certain medications. The type of rash that occurs depends on the type of drug that is causing it. Rashes can range from mild to severe.
Rarely, drug rashes may result in blisters. These blisters can be a sign of a more serious condition, so they require medical attention.
Fortunately, at long last, we now have the ability to test for penicillin and penicillin derivatives through a simple skin test. If the history and testing align, the diagnosis is confirmed in about 97% of cases. Diagnosis of other drug allergies is done mostly through a patient’s medical history. Allergists are specifically trained for this.
veryone reacts to medications differently. One person may develop a rash, while another person on the same drug may have no adverse reaction. All medications have the potential to cause side effects, but only about 5% to 10% of adverse reactions to drugs are allergic. Reactions to medications can range from mild to life threatening.
Most allergic reactions occur within one hour of taking the medication, and involve the following signs and symptoms:
Antibiotics are the most common cause of anaphylaxis, but more recently, chemotherapy drugs and monoclonal antibodies have also been shown to do so.
A drug allergy is an allergic reaction that occurs when the body’s immune system produces antibodies and activates disease-fighting cells in response to a specific drug. In the development of a drug allergy, the immune system is triggered by the first exposure to the medication. A future exposure causes an immune response, including the production of allergic antibodies and release of histamine. So, drug allergy reactions occur after a person has been previously exposed to the drug one or more times without any allergic reaction.
There is no cure for immunodeficiency disorders. The goal of treatment is to control infections and maintain the patient’s quality of life. Infections are treated with antibiotics, which are sometimes taken on a regular schedule for preventive treatment. Patients with low antibody levels may be given injections of immunoglobulins (antibodies) to increase antibody levels.
A patient will have a comprehensive assessment, including a medical history, a complete physical examination and laboratory tests performed by an allergist. The type of infection that a patient has experienced helps to determine the type of immunodeficiency disorder.
People with immunodeficiency disorders experience recurrent ear infections, sinusitis, bronchitis or pneumonia. It is common for children with immunodeficiencies to develop thrush (a fungal infection of the mouth) and other infections of the skin and mucous membranes in the eyes, mouth and genital area. Gastrointestinal infections may cause diarrhea, weight loss and failure to thrive.
Immunodeficiency refers to a group of diseases in which the immune system does not function normally. A normal immune system will attack what is seen as a foreign invader, like bacteria and viruses. When the immune system does not work properly, a person is more likely to suffer from frequent and longer-lasting infections, often from organisms that usually don’t make most people sick. Most cases of immunodeficiency are acquired (“secondary”), but some people are born with defects in the immune system (a “primary” immunodeficiency).
Your breathing will be easier after an Ohio allergist has performed skin prick testing and/or blood testing to identify possible airborne allergens that trigger your rhinitis. Once these allergens are identified, you should avoid them if possible. Such measures may include remaining indoors when the pollen count is high and on windy days, dust-proofing the home and keeping animals out of the bedroom.
Treatment options may include the use of:
Corticosteroid nasal sprays
Allergy shots, also known as allergen immunotherapy, may be recommended if avoidance and medications are not effective.
Allergic rhinitis can lead to recurrent or chronic sinusitis. The nasal obstruction and inflammation associated with allergic rhinitis interrupts the normal clearing of mucus from nasal passages, causing the sinus cavities to become clogged with mucus and making it difficult to breathe. Common symptoms include:
Thick yellowish/green nasal discharge
Loss of smell
Sinusitis may be considered acute (lasting less than 4 weeks), subacute (four to eight weeks), chronic (eight weeks or longer) or recurrent (three or more episodes of acute sinusitis per year).
When you’re looking to breathe easy in Columbus, you’ve got to know what you’re up against in the area. Not all rhinitis can be blamed on Mother Nature. Rhinitis can result from anything, from the common cold, to cigarette smoke, cleaning solutions or chlorine in swimming pools. Rhinitis symptoms may also be caused by structural blockage of the nasal passage, irritants, medications, temperature changes and other physical factors. These are often called vasomotor rhinitis or non-allergic rhinitis.
Seasonal, which occur mainly during pollen seasons. Particularly bad Ohio allergens include Canadian goldenrod and carnations. Blooming trees, grass, and weeds also release pollen. With blooms occurring earlier and more pollen in the air, it is increasingly hard for allergy-sufferers to breathe easy in Ohio.
Perennial, which occur year round. Common allergens are mold, animal dander and dust mites.
Environmental allergies are generally known as allergic rhinitis. This is an allergic reaction that occurs in the nose when allergens in the air trigger the release of histamine. Histamine makes it difficult to breathe, causing inflammation, nasal congestion, swelling of the nasal membranes, blockage and reduction of normal sinus drainage.
There is no cure for food allergies, although many children do outgrow them. Here are some precautions Ohio allergists suggest you take:
A person is usually diagnosed with a food allergy after having a reaction that requires medical attention. If it is not clear what food caused the reaction, skin prick testing and/or ImmunoCAP blood testing may be performed by an allergist to identify the food allergen. Elimination diets, which involve removing certain foods from the patient’s diet, may also be implemented.
Eight foods account for up to 90% of all food-allergic reactions. They include:
Food allergies are on the rise. There is much ongoing research to learn more about the causes. The following factors make food allergies more likely:
If you have a true food allergy, there is always a chance for anaphylaxis. Symptoms usually appear a few minutes to 1-2 hours after eating the food. The following are the most common symptoms of anaphylaxis, but each person may experience symptoms differently.
Food allergies develop when the immune system, for unknown reasons, fights against a particular food protein even though it is harmless. There are many people with food intolerances, which cause symptoms such as minor skin rashes or stomach upset. Food allergies, which trigger the immune system, are less common and more severe. True food allergy can cause anaphylaxis – a serious allergic reaction that is rapid in onset and may cause death.
There is no cure for eczema. The main goal of treatment is to remove any irritants and to decrease the amount of dryness and irritation of the skin.
Some specific treatments include:
Aggravating factors may include:
The location of eczema on the body changes with age. In infants and young children, the cheeks, neck, knees and elbows are typically affected. In older children and adults, the hands, feet and areas inside the elbows and knees may be affected.
Symptoms may also include:
Eczema, or atopic dermatitis, is a chronic allergic skin condition mainly affecting infants and children. It often begins within the first year of life, with 60% of cases occurring by age 1 and up to 90% of cases by age 5. It may last until adolescence or adulthood. If eczema is diagnosed in adulthood, it is generally a long-term or recurring condition. Fifty percent to 75% of patients with eczema may eventually develop hay fever and/or asthma.
The main feature of eczema is itchy, dry skin that scales and flakes. Often, there is a personal or family history of eczema, hay fever, hives, food allergies or asthma. When skin itchiness is not controlled, an “itch/scratch cycle” leads to continued rubbing and scratching and subsequent thickening of the skin called lichenification.
Avoidance of the allergen is the best treatment. If it is caused by a medication, strict avoidance is necessary.
Allergists may recommend antihistamines to decrease histamine release, which can lessen the symptoms of hives and/or angioedema. They may be prescribed on a regular schedule to prevent symptoms. Chronic hives may be treated with antihistamines or a combination of medications. For severe hives and angioedema, an injection of epinephrine may be needed.
A diagnosis is usually made based on a complete medical history and physical examination. There are no specific tests for hives or angioedema. Skin testing may be performed to identify allergens. Routine blood testing may be done to determine whether any other illnesses are causing hives and/or angioedema.
Hives and angioedema occur when histamine is released from special cells found along the skin’s blood vessels. In response to histamine, plasma leaks out from these blood vessels in the skin. Allergic reactions to things like foods, medicines, insect stings and sunlight exposure can cause histamine release. Sometimes it is impossible to determine exactly why hives have formed.
Angioedema is an allergic reaction similar to hives, but it causes swelling deeper in the layers of the skin. It commonly affects the hands, feet, genitals and face (lips and eyes). It generally lasts longer than hives (which can occur simultaneously) but the swelling usually goes away in 24 hours. In rare cases, angioedema may involve the throat and tongue, blocking the airway and causing breathing difficulty. This can become a life-threatening emergency.
Hives, also known as urticaria, is a condition in which swollen, red, itchy areas appear on the skin. It is usually due to an allergic reaction from eating certain foods or taking certain medications. Hives vary in size from less than an inch to a few inches. They may be on one area of the body or all over the body. They can last minutes to hours, or even several days before fading.
If the insect left its stinger in your skin, remove the stinger within 30 seconds to avoid receiving more venom. The stinger and its sac may be removed with a quick scrape of your fingernail.
To treat local reactions to insect stings:
The most effective way to prevent stings is to stay away from stinging insects. These insects are most likely to sting if their homes are disturbed. It is worthwhile to have nests around your home destroyed.
Here are a few tips for avoiding insect stings:
When most people are stung by an insect, the site of the sting develops redness, swelling and itching. However, when people are allergic to insect stings, their immune system overreacts to the venom by producing allergic antibodies called immunoglobulin E (IgE). This triggers the release of substances including histamine that then cause an allergic reaction.
For some people, especially adults, stings may be life threatening and can result in anaphylaxis. The symptoms of a severe allergic reaction may include itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea.
If you or your child has had a serious reaction to an insect sting in the past, then testing for an allergy to venom is necessary. Allergy testing is performed for five stinging insects: the white-faced hornet, yellow hornet, yellow jacket, honey bee and wasp.
Venom is the substance injected into the skin during an insect bite or sting.
Anaphylaxis is a medical emergency and immediate medical attention is necessary. The sooner the reaction is treated, the less severe it will become.
Those with a severe allergy may be prescribed epinephrine autoinjectors, which are shots of adrenaline that relieve breathing problems and improve heart rate and blood pressure. This medication should be carried at all times. Antihistamines such as diphenhydramine (Benadryl) may also be given for itching and hives. Oral steroids may be given to reduce further allergic inflammation.
Those with severe allergies should wear a medical alert bracelet or necklace that identifies the allergy in case of an anaphylactic reaction. Family, friends, employers, and school staff should be informed and educated about the allergy. This way, they will be able to recognize the problem and better assist if a reaction occurs.
The allergen triggering anaphylaxis can vary for each allergic person. However, some of the more common causes of anaphylaxis include:
Each person may experience symptoms of anaphylaxis differently. The most common symptoms include:
The most dangerous symptoms, which should prompt an urgent 9-1-1 call, include breathing difficulty, loss of consciousness and low blood pressure. All of these can be fatal.
Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. The reaction can occur a few seconds to as long as an hour after exposure to the allergen. It is a medical emergency, and in most cases it requires immediate treatment and then follow-up care by an allergist. Anaphylaxis is triggered when the immune system overreacts to a normally harmless substance such as food or medicines. The symptoms may be mild to severe and affect various body organ systems.
Theses tests are performed at a hospital or radiology center where X-rays or CT scans are taken of the chest or sinuses in order to diagnose various lung diseases. Following the scan, a report will be sent to us and we may request that you bring a copy of the X-ray or CT scan to your appointment in order to go over the results. If it is determined you suffer from a lung condition, we will help determine the best course of action for treatment, which might include avoidance, allergen immunotherapy, and medication.
This test is typically administered for those who are unable to undergo a skin test due to antihistamine use, skin diseases, chronic hives, or an immune system disorder. By taking a sample of blood, this test can determine environmental allergies and food allergies, as well as immune system deficiencies. It can also evaluate those with chronic hives. Test results are not immediate and typically take a few days to a couple weeks to become available.
By breathing into a mouthpiece that is attached to a spirometer, the physicians are able to determine the the amount of air in your lungs and your ability to move the air out of your lungs. It is designed to diagnose issues with asthma and monitor any treatment methods. The test is non-invasive and the results are immediate. Upon taking the test, you might be given a bronchodilator treatment that will relieve some of the effects of asthma.
Patch Testing checks for chemicals that cause a delayed reaction, such as contact dermatitis. This test is performed by placing a safe, chemical patch on the person’s back. In order to have the patch placed on, patients should properly clean the skin and be freshly showered. No rubbing alcohol should be used in the cleaning process, and the patch will not be able to be properly placed if the subject is still wet. It the tape peels off, the entire process will have to be repeated. This patch stays on the skin for two days before being removed to be examined. It is again examined three to four days later to make sure nothing new has developed. The test is considered positive if blisters, bumps, or swelling develops. When you are preparing to have this test done, you should avoid taking any systemic immunosuppressants or oral steroids up to one month before, and topical steroids should not be used on the area of the skin that the patch will be placed one week before having the test done. Any use of inhaled steroids, leukotriene receptor antagonists, or antihistamines are still allowed to be used.
Our skin testing procedure checks for insect, food, and airborne allergens through the measurement of your allergic antibodies levels to these allergens. To do this we use a small plastic device that applies tiny amounts of solutions to the skin with a prick or scratch that contain the various types of allergens. By checking for an area of raised skin, we’ll be able to determine if there is a positive reaction. However, even if there is an area of raised skin, it does not necessarily mean you are allergic to an allergen, as other factors play a role in the test. If an allergen does not show up on a prick test, we will repeat the test using a tiny needle in which we will inject a small amount of that allergen into the first layer of skin, which will form a small, mosquito-like bite bubble. This test typically yields results in 15-20 minutes, and the area tested could get itchy, but not for very long. Prior to having this test administered, you should avoid using antihistamines 5 to 7 days before coming in to get tested. This skin test is not usually performed on those who have suffered a life-threatening reaction, or to someone who has hives or severe eczema.
Each patient may express their rhinitis differently, but symptoms and signs include:
Struggling to breathe
Itchy nose, throat, eyes and ears
Clear drainage from the nose
Children with perennial allergic rhinitis may suffer frequent ear infections, snore, breathe through the mouth, be frequently fatigued and, thereby, perform poorly in school.