Environmental Medicine and Allergy

 

Environmental Medicine is devoted to the careful examination of those environmental factors that can disturb our health and behavior, and that are often neglected or ignored by conventional physicians. Allergy has been traditionally associated with the treatment of dermatitis, rhinitis, and hay fever. However, today we recognize the fact that adverse reactions to foods, inhalant allergens, and chemicals may be directly related to many systemic problems. Headache, chronic fatigue, asthma, heart palpitations, irritable bowel, and arthritis are among the many complaints that can be successfully managed through a more thorough understanding of allergy.

 

Using an integrative, holistic approach, we investigate the cause of illness by understanding how the individual interfaces with his or her environment. A detailed investigation of history, diet, and lifestyle along with state-of-the-art diagnostic methods allows us to achieve a better understanding of the underlying causes of sensitivities. We have carefully selected several methods of testing and treatment that we use because they are more effective in achieving optimal results. We can determine which methods fit best for a given individual and their unique circumstances.

 

What is allergy?

Recent statistics show that over 50 million people (about 25% of the U.S. population) suffer from some form of allergy. Allergy symptoms are responsible for more visits to the doctor’s office than any other single disease in this country. An allergy can be defined as an abnormal physical reaction to substances called allergens, or antigens, that are harmless to most people. Pollen, house dust mites, mold spores, animal danders, foods, drugs, dyes, cosmetics, perfumes, and stinging insects are common sources of allergens. These allergens can enter the body in different ways: pollens, house dust, and mold spores are inhaled; food allergens are swallowed; poison ivy and cosmetics produce symptoms in allergic people by touch: certain drugs and insect venoms enter the body by injection.

 

The immune system produces antibodies as a defense against infection and other diseases. In allergic people, excessive antibodies are produced and these antibodies react with the allergens, releasing inflammatory chemicals, such as histamine, and cause allergic symptoms. These reactions may be immediate, as in an acute hypersensitivity reaction, or delayed. Foods and molds can typically cause delayed reactions, even 48 to 72 hours after the exposure. Other types of reactions, such as cytotoxic reactions, lectin interactions, and intolerances, also cause similar symptoms but are not immune system mediated and therefore not classically an “allergy”.

 

What are the Symptoms of Allergy?

 

Allergic symptoms may take a variety of forms and affect many organs and tissues of the body. Some of these symptoms include:

HEAD:           Headaches, excessive drowsiness after eating, hyperactivity, panic attacks, depression, learning disabilities.

 

NASAL:         Runny nose, stuffy nose, post nasal drip, sneezing, recurrent sinusitis.

 

SKIN:              Hives, rashes, eczema, psoriasis dermatitis, pallor, itching, scaling.

 

EYES:             Redness, itching, swelling, tearing, blurred vision.

 

RESPIRATORY:       Asthma, wheezing, tightness in the chest, cough, recurrent bronchial infections.

 

DIGESTIVE TRACT:            Stomachache, bloating after meals, irritable bowel syndrome, constipation, diarrhea, gas, gastritis, acid reflux, indigestion, colitis, binge eating, addictive eating.

 

GENERAL:    Chronic fatigue, joint pain, muscle aches and pains, fibromyalgia, arthritis, chronic urinary tract symptoms, chronic vaginitis.

 

Is Allergy Inherited?

The tendency to develop allergies may run in families. Studies have shown if one parent has allergies, the child has approximately a 50% chance of also having allergies. If both parents are allergic, the chances may be as high as 80%.   Other factors that increase the likelihood of developing allergies include frequent antibiotic use, chronic candidiasis (yeast infections), certain vitamin or mineral deficiencies, and exposures to environmental toxins. Since the environment is becoming increasingly polluted, more and more people are developing allergies.

 

Will Children Grow Out of Allergies?

Sometimes the symptoms of allergy seem to disappear by themselves but research has shown that infants and children who suffer from allergies tend to develop more severe problems later in life, if left untreated. Hay fever or asthma in a child may lead to other physical abnormalities or emotional problems (such as learning disabilities). Therefore, early detection and control of allergies can reduce the possibility of complications in adulthood.

 

 

 

My allergy symptoms are mild; why should I get tested and treated?

Even though symptoms are mild and self-limited, allergic reactions put a strain on the immune system, drain energy, and contribute to chronic illness. Many allergy symptoms are subtle or hidden. In the pursuit of optimal wellness, it is beneficial to reduce these stressors and allow the body the freedom to heal.

 

How are Allergies Determined?

Appropriate treatment and control of allergy problems requires careful identification of specific allergens. The first step in diagnosis is taking a detailed history, which can provide essential evidence to confirm the presence of allergy, and, in some cases, identify the offending substances. We utilize several different methods of allergy testing at the Center for the Healing Arts that have distinct advantages over scratch/patch testing or blood testing, neither of which is very sensitive or effective.

 

Electro-dermal screening:             The Listen System is a computer based electro-dermal screening instrument that painlessly measures changes in skin conductance, utilizing acupuncture points. First developed in Europe about 50 years ago, this instrument now utilizes state-of-the-art technology. This non-invasive system does not present any serious risk of allergic reaction often associated with traditional scratch testing.   It is therefore the method of choice for children (especially small children), severely allergic individuals, or those with chemical sensitivity. It is particularly effective for assessing and treating food reactions, since a large number of foods can be quickly and painlessly screened, and neutralizing doses identified.

 

The Listen System is a non-invasive class III “Investigational Medical Device”. It has been approved by an institutional review board as a safe instrument to use on any patient. It is not a diagnostic instrument but may be used, in addition to conventional medical procedures, to help establish a better understanding of the patient’s problems.

Intradermal Testing:          In this method, a small amount of allergen is place under the skin with a small needle. After ten minutes, the site is examined to see if the size of the wheal has increased indicating a positive allergic reaction. By testing each allergen individually, instead of simultaneously with many other allergens as in scratch testing, the sensitivity of the testing is increased. Frequently, symptoms caused by the allergen can also be identified; this is called provocation of symptoms. This is especially important in the case of hidden or delayed reactions, when the wheal can be seen 24-48 hours later.

Provocation/Neutralization:          This method is also called serial endpoint titration. It utilizes intradermal testing while using increasingly dilute solutions of the allergen until the first negative skin reaction is achieved. This is called the neutralizing dose, as it will shut off or neutralize the reaction.

 

Allergy Test Panels Available:

Foods:           Includes 150 common foods and 30 food phenolic compounds. Specific additional foods can be tested upon request at no additional charge.

            Inhalants:      Mold spores, household dust and dust mites, animal danders (cat, dog, etc.).

Pollens:          Trees, weeds, grasses, usually cause seasonal allergies or hay fever.

Chemicals:    Household chemicals (chlorine, formaldehyde, tobacco smoke, perfume, etc.)

Industrial chemicals (plastics, petroleum, resins, etc.)

Biologics:      Hormones, neurotransmitters, and other substances.

 

How are Allergies Treated?

An allergy treatment program may include several phases for control of symptoms. Once the offending substances have been identified, it is necessary to implement a program of avoidance of these substances as much as possible, combined with a program of specific therapeutic management. We utilize several methods of immuno-therapy:

 

Optimal Dose Neutralization:       This method of neutralization is self-administered, according to physician recommendations. It is generally not accompanied by serious risk of allergic reactions associated with conventional allergy treatment, as the safety of this dose in the individual has already been established during testing. Optimal dose neutralization may afford relatively rapid relief of symptoms and stabilization of the immune system. Effective management, however, may require careful periodic assessment. It may be administered at home by injection or sublingual.

Sublingual: In this mode of administration, drops of the neutralizing dose are given under the tongue, usually daily, so injections are not required.

Injection:       In some individuals, this mode of administration is more effective, particularly for inhalant allergies. Injections are usually self-administered twice a week.

 

Low-dose Buildup Desensitization:        This method of treatment, pioneered by Marshall Mandel, MD, requires injections on a weekly basis. We begin in the office (to monitor adverse reactions) with extremely dilute solutions and gradually increasing the strength of the solution, until control of allergy symptoms is achieved. Once the treatment dose is achieved, the shots may be administered at home, every 1 to 4 weeks, as recommended. Although this is the most time-intensive treatment method, often requiring 3 to 6 months to reach treatment dose, it is also extremely effective for inhalant allergy symptoms, particularly in patients who have failed other treatment modalities, as the allergen extracts are prepared for maximum effectiveness.

 

 

AARSV:        This injection technique addresses all allergic reactions simultaneously. It uses the immune system to shut down allergic reactions. It is especially useful for patients with severe allergic reactions, reactions to multiple substances, those whose symptoms are not completely controlled by other methods, or who cannot tolerate treatment with desensitization or immunotherapy.   Treatment consists of weekly injections in the office for 10 weeks. For optimal effect, patients should expose themselves to their allergens 3 to 4 hours before each appointment.

 

Integrated Treatment Plan:           A successful outcome can be enhanced for all allergy sufferers by minimizing exposure to environmental stressors at home and at the workplace:

• Individualizing testing and treatment.
• Identification of possible sources of exposure.
• Education about environmental controls, including mattress barrier covers, less toxic cleaners, paints, air and water purifiers, etc.
• Proper nutritional and herbal support.
• Instruction and counseling about elimination of offending foods and rotation diets.
• Support and encouragement throughout the entire treatment process.

 

GUIDELINES FOR SCHEDULING ALLERGY TESTING APPOINTMENTS

 

Scheduling: If traveling a distance for your appointment with the doctor and will need testing, you may wish to arrange to schedule testing on the same day. Intravenous treatments must be done after allergy testing, if done on the same day. Please speak to our staff to coordinate these appointments to make the most of your time with us. The Center has no day care facilities for infants and children who are not patients. Please bring along another adult who will be able to monitor the child.

 

Electro-dermal Screening: Requires 60 minutes for the first panel, an additional 30 minutes for an additional panel. If you wish to have any supplements or medications tested, please bring these with you the day of your appointment.

Intra-dermal Testing: Testing for a single antigen at a time allows us the control and safety to identify the antigen’s reactions but is time consuming. Patients may schedule whole days or half‑days for testing. Please allow adequate time to accomplish the desired testing. The days you want to come for testing can be scheduled at your convenience and can be spaced out as needed. Please wear a short sleeve shirt that allows testing on the upper arms.

 

Do Not Wear Perfume or Any Scented Products to our office.

 

Preparations: Many medications, especially antihistamines, may alter test results and should be avoided prior to testing, if at all possible. Nutritional supplements do not interfere with testing. A few of the common medications that interfere with testing include:

‑Over the counter allergy drugs, such as Benadryl, etc: avoid for 48 hours

‑Zyrtec, Allegra: avoid for 1 week

‑Clarinex/Claritin: avoid for 4 weeks, if possible

 

The following medications should not be stopped abruptly without a doctor’s supervision:

‑Tricyclic antidepressants:            avoid for 4 weeks before testing

-Calcium channel blockers: avoid for l week before testing

-Corticosteroids: high dose blocks the whealing response and ideally should be tapered before testing to physiologic levels. (Hydrocortisone up to 30 mg/Prednisone up to 7.5 mg is okay.)

 

Please check with your physician if you have any questions about medications you are taking.