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Allergy And Asthma

7 Ways Drops for Allergies Shine Again: Asthma

April 29, 2013 by James Bogash

This is not the first time I’ve written about the wonders of drops for allergies for different conditions. But drops for asthma…this is new…

A large chunk of the population deals with the discomfort and limitations of allergies and asthma here in the US.  This allergy season seems to have hit patients particularly hard.  Worse, rarely do I see that commonly used medications like Advair, Allegra and Zyrtec do more than make life a little easier.  Resolution or complete control is not the norm.

While the medications to treat allergies and asthma may be slightly different, I have always lumped them together because the immune system imbalance is the same (Th2 dominance, in case you’re curious).  This also means that the early-life risk factors are similar, such as:

  • Antibiotic use
  • C-section birth
  • Formula feeding instead of breastfeeding
  • Immunizations

When asked what organ plays a critical role in allergies and asthma, few would answer that it is the gut that drives these types of problems.

Why the gut?  Because 2/3 of the immune system is centered around the gut; so designed because the vast majority of foreign material that you are exposed to comes from the stuff you shove in your mouth.

So what if the stuff you were putting into your mouth was very carefully crafted to trick the immune system around your gut into behaving the way it is supposed to?  Sounds pretty cool, right? That is the goal of sublingual immunotherapy, otherwise known as drops for allergies.

This approach to allergies here in the United States, however, lags far behind Europe.  Here in the states, these drops are off-label use because the FDA has not approved its use.  But certainly not for lack of research, as we can see from this particular review.

Researchers looked at the data on drops for allergies and asthma across 63 studies with over 5100 participants total.  What did they find?

  1. Strong evidence supports that sublingual immunotherapy improves asthma symptoms, with 8/13 studies showing 40% improvement.
  2. Moderate evidence supports that drops for allergies decrease rhinitis or rhinoconjunctivitis symptoms, with 9/36 studies showing greater than 40% improvement.
  3. Medication use for asthma and allergies decreased by more than 40% in 16/41 studies.
  4. Moderate evidence found the drops improve conjunctivitis symptoms (13 studies).
  5. Evidence found that drops improved the combined symptom and medication scores (20 studies).
  6. Evidence found that disease-specific quality of life was improved (8 studies).
  7. Local reactions were frequent, but severe allergic reactions were not reported.

Overall, I would have to say that the FDA is WAY behind Europe on this one. Sadly, many allergists dismiss drops for allergies as not having any research to support its use.  You have to be avoiding an awful lot of medical literature to not notice 63 studies IN YOUR FIELD that deal with this approach.

Maybe it’s time to find a new allergist (luckily for those of you in our clinic’s area, we offer drops for allergies).

Filed Under: Allergies, Asthma Tagged With: Allergen Immunotherapy, Allergy, Allergy And Asthma, Allergy Asthma, asthma, Asthma And Allergy, immunotherapy, Improve Asthma, Strengthen your immune system, Sublingual immunotherapy

Pregnant and Have Allergies? You’re Going to Need This

December 10, 2012 by James Bogash

Pregnancy is rough enough as it is. Worsening allergies in pregnancy just makes it worse. Can you  do something to spare your unborn child the same fate?

Turns out that the answer may be yes, and the fix may be pretty simple.  But first, let’s go over some other factors during pregnancy that we already know contribute to problems in the as-yet unborn child.  The fist that pops to mind is the seemingly innoculous Tylenol.  Yes, I know that your OB told you to stay away from ibuprofen during pregnancy because of the potential side effects.  As an alternative, many are still recommending Tylenol / acetaminophen as a safe alternative.  It’s not.  In an older blog post, we discussed the links between paracematol (Tylenol) use during pregnancy and allergies and asthma in the child.

This actually makes sense because it is well accepted that Tylenol use is linked to development of allergies in an adult.

Other pregnancy factors that play a role in the child’s health include:

  1. Artificial sweeteners and sugar sweetened beverages have been linked to preterm birth. (Tweet this)
  2. Antidepressant use in 3rd trimester increases risk of infantile convulsions by 490%. (Tweet this)
  3. Eating polycyclic aromatic hydrocarbons (PAH) (from grilling meat) in pregnancy is linked to ADHD and anxiety.
  4. Heavy exposure to a commonly used pesticide has been linked to brain damage in the infant.

There are others, but you get the idea.  The choices you make during pregnancy play a huge role in the future health of your child.  Some of the above may be a little more challenging, so I’ll give you an easy and inexpensive tool.

Vitamin D.

Yup.  How’s that for simple?  We already know that low vitamin D levels are linked to the development of obesity in children and wheeze in children.

This particular study looks at vitamin D levels in cord blood and what effect they had on development of eczema in the infant’s first year.  In particular:

  • Mom’s vitamin D levels were related to supplement use and sunlight (based on the season during testing) and NOT dietary intake (don’t rely on your milk to help you here)
  • When vitamin D cord blood was below 75 nmol/L (30 ng/ml) the risk of developing eczema was 266% higher. (Tweet this)

The bottom line is that vitamin D supplementation during pregnancy seems like a pretty good idea along with the use of probiotics to maintain a healthy bacterial flora in the mom.  Stick with nursing instead of formula and add in some probiotics occasionally during the first few months and the risk of eczema should be almost zilch.

Given the increasing evidence, should ob/gyn’s be recommending vitamin D to all their pregnant patients?

Filed Under: Asthma, Healthy Pregnancy Tagged With: Allergy And Asthma, Eczema, pregnancy, Pregnancy And Allergies, Tylenol Use During Pregnancy, Vitamin D

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