Allergies And Asthma

Allergies are the 6th most common chronic disease in the US and there is a tremendous amount that can be done to give patients relief from these chronic issues.

In America, 50 million people report allergic symptoms and 12 million people have asthma. Asthma and allergic reactions are responsible for 30,000 million ER visits per year and these numbers have doubled in the last 5 years. Atopy is now at epidemic proportions of 1:3. Pollution and industrialization, excessive hygiene, frequent antibiotics, an increase in C-sections and (in some genetically prone cases) vaccination have been major drivers of this change (1). That to which we are exposed early on, has the ability to help activate the immune system, and can either lead to education and tolerance, or confusion and autoimmunity.

Allergies can involve the skin, the gastrointestinal tract, the cardiovascular system or the respiratory tract. Symptoms can certainly manifest as the typical hay fever, eczema and asthma, but they can also manifest as arthritis, memory and cognition difficulties, behavioral problems, fatigue, dark circles under the eyes, dizziness, abdominal pain, bloating, vomiting, diarrhea, muscle wasting, migraines, and acne. Complications include: ear, sinus, and respiratory infections, asthma, snoring, poor sleep quality, sleep apnea, chronic fatigue and under performance at school, work and athletics.

Allergies tend to have a genetic component and are seen generationally. Several genes are highly associated with Atopy. For instance, SNPs in GSTM1, GSTP1, IL-10, IL-13, IL-4, HLA DRB1 and DGB1, as well as many others, have shown high association with atopy. And while these genes cannot be changed, it may be helpful to know your genetic status because their expression can be modified by environment.

Allergy to wheat, in the form of Celiac disease, can manifest as headaches, fatigue, joint pain, abdominal pain and bloating, chronic diarrhea, acid reflux, skin rashes, nervous system injury, and ataxia. Consequences of Celiac include: anemia, osteoporosis, damage to dental enamel, failure to thrive, delayed puberty, ADHD, poor coordination and learning disabilities. In a 2003 study, on SPECT scan, people who had Celiac disease, showed decreased perfusion to their brains after ingestion of wheat (2). A 2008 study from Holland a showed 50% improvement of ADHD symptoms, in 73% of children with ADHD, when they were placed on an elimination diet (3). So we certainly know that food allergies and sensitivities can affect the brain. We now also know that Gluten has the ability to provoke Zonulin, which is a protein that increases intestinal permeability (4). Some people are more sensitive than others. When the tight junctions of the intestine are “leaky” or damaged, proteins and molecules that normally would not enter the blood stream can pass through and this can lead to additional/new food sensitivities.

Food Allergies can be acute and severe (IgE mediated) and can start within minutes or up to 6 hours. Delayed “sensitivities”, which are generally IgG mediated, can take days to begin. Ninety percent of all food allergies include the following foods: Milk, Eggs, Peanuts, Wheat, Soy, Fish, Shellfish and Tree nuts. Sixty percent of food reactions are cross reactions with environmental inhalant allergens (fruit and vegetable pollen). Ask your allergist or Medical Provider about Pollen/Food syndrome or cross reaction relationships. If an allergy or sensitivity is expected, your doctor may order blood, or skin testing, or he/she may order an elimination diet. Elimination diets are the gold standard for food allergies and sensitivities. They remove all offenders, and allow the gut and the immune system to rest. After time, food can be reintroduced one at a time, watching for reactivity. It is more common for a person to be allergic to 1-2 foods, than 10-20. If a person test positive to many foods, it is more likely a problem of intestinal permeability, or dysbiosis and these issues can be ameliorated.

Twenty six million Americans have asthma, and they often also have allergies. These environmental or food allergies are often triggers for their asthmatic attacks. Common allergens and asthmatic triggers include dust mites, animal dander, molds, pollen and cockroach droppings. Smoke, air pollution, strong odors or fumes can be triggers, and of course so can foods, and many food additives. Sulfites, MSG, Aspartame, food dyes, and preservatives such as, BHA, BHT, parabens and benzoates may cause asthma, anaphylaxis or skin reactions. Other Asthmatic triggers can be cold air, exercise or upper respiratory infections.

Drugs are common allergens as well. Penicillin and Aspirin are the most common cause of anaphylaxis. And if a person has this type of allergy, it is important that family members are aware and the offending medicines are they are strictly avoided. When a person has had a severe reaction to food, medicine or insect stings, they should always carry an Epinephrine Auto injector Pen, an inhaler (if history of wheezing) and oral Benadryl.

When you are looking to relieve allergy symptoms, it is best to look at the total body burden and try to reduce whatever element you can. Removing triggering foods can be immensely helpful. In the home, a HEPA filter, frequent dusting, installation of wood floors and use of natural, non-toxic cleaners can make a big difference. Low to moderate humidity can prevent mold, which is a common allergen. The use of semi-permeable pillow and mattress covers and washing linens every 1-2 weeks in 130F water, along with no carpet, and mopping the floor once a week can reduce dust mite exposure by 100-1000 fold within 1 month.

There are many pharmaceutical OTC allergy and asthma medicines, and these may be necessary and lifesaving. For severe allergies and asthma, rescue medications should be available at all times. It may be helpful to know that there are some natural agents that can help as well. Vitamin C is actually a natural antihistamine, and Quercetin is a natural mast cell stabilizer, a leukotriene and it acts as a prostaglandin inhibitor. Fish oil is a natural anti-inflammatory agent. Magnesium is a calming mineral and a smooth muscle relaxer, which can help relax the airway some (they use high doses of Magnesium Sulfate in premature labor to relax the uterus; smaller doses can helpful with the airway). Zinc is a helpful mineral for the immune system (and those with zinc deficiency are at higher risk for asthma). Quality probiotics have also been shown to reduce atopy, asthma, and inflammatory intestinal issues.

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Functional Psychiatry and Medicine

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