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Tackling allergy remedies and immunotherapy

Going nuts thinking about food allergies? Shedding tears about pollen? Remedies are far, wide, and complicated as shellfish.

A food allergy reaction sends someone to the emergency room every 3 minutes. Millions more can experience this anaphylactic shock from medication, insect venom, and even latex. We can thankfully treat these reactions with the lifesaving EpiPen, now available with free auto-injectors for schools. Spin-off epinephrine products include a new talking-training kit by Auvi-Q and stylish leg and thigh holsters with bling varieties for girls. Yet these reactive solutions cannot reduce the chance of exposure and physical response.

Identifying our allergens is the first step toward avoidance and treatment. Some of us know by experience, while others have discovered allergens through IgE antibody testing and diagnosis by physician (see partial list below). Blood and skin prick tests often help determine sensitivity, though ingredients are limited and may not accurately mimic the triggers in our environment. Generally, test results can help us modify our lifestyle and reduce exposure to major allergens like dust, mold, and foods. Many people choose to treat symptoms with antihistamines, but other options are worth considering for long-term relief.

Rescue medication and remedies

Over-the-counter or prescription drugs that inhibit histamine are only temporary relief for allergy overload. These drugs typically work by shutting down your body’s histamine-based immune response – not eliminating the allergen or antibody production. Side effects can be equally frustrating, including increased appetite, dizziness, fatigue, and dry mouth/nose. Even more alarming, antihistamines affect both hormone levels and appetite and are now linked to obesity. Chronic allergy sufferers may want to pursue other treatments to prevent long-term inflammation and weight gain.

Avoiding or reducing food allergens is tricky in schools and restaurants, but tackling environmental exposure to airborne allergens is even more difficult when it comes to pervasive dust, mold, pollen, and pet dander. HEPA air cleaners can help remove allergens from the air, and exciting new UV light treatments are reducing the potency of allergens in air and food. A simple nasal rinse with kits like NeilMed Sinus Rinse can also purge the offending particles from sinus passages and provide instant relief. For others, long-term allergy immunotherapy can reprogram the body to tolerate food and environmental allergens.

Desensitization by injection therapy

For the last several decades, allergy immunotherapy has involved allergy shots to prevent anaphylaxis or debilitating symptoms. Subcutaneous injection therapy (SCIT) involves weekly visits to the doctor to receive injections of one or more minute doses of allergen in order to achieve desensitization. This method is considered at least as effective as drugs to alleviate symptoms, with the promise of long-lasting protection in many cases. Yet the idea of visiting the doctor for regular shots for years is a depressing and expensive antidote.

Over the shot, under the tongue

A promising new therapy has emerged that’s much easier to swallow. Sublingual immunotherapy (SLIT) involves taking tiny dilutions (billionths of a gram) of an allergen such as peanut powder under the tongue, slightly increasing doses daily over many months or years until tolerance is achieved. Most importantly, it offers a simple, convenient, low-cost alternative to combat the millions of cases of nut allergy and thousands of hospital visits each year. This therapy should always be conducted with professional allergy clinics that are thoroughly experienced with SLIT and the condition of the patient.

SLIT is already widely used in Europe, South America, Asia, and Australia but rarely mentioned by most US doctors. A clinical study published in The Journal of Environmental and Public Health compared SCIT and SLIT and clearly supported use of SLIT for asthmatic and young patients.

Growing pains

SLIT is slowed by numerous roadblocks including the daunting commitment to months of disciplined treatment. Research for SLIT here is also fiscally challenged, as allergy fuels a multi-billion dollar drug industry. The FDA has not yet approved SLIT, though similar FDA-approved extracts are used in allergy therapy by injection. Supporting evidence is limited to studies conducted outside of the United States using non-FDA approved extracts – a classic catch-22. Consequently, insurance companies have not approved SLIT treatment. Some of these pros and cons are detailed in a recent overview of sublingual and oral immunotherapy by Dr. Peter Creticos.

The controversy is further clouded by striking disagreements in the medical community. Earlier this year, the highly-respected Journal of the American Medical Association published a review describing the benefits of SLIT for asthma and allergic rhinitis while simultaneously publishing an editorial scrutinizing the limitations of research. Incidentally, the author of the editorial was paid over $13K in 2012 by pharma giant Merck according to the database Dollars for Docs.

Doctors treating with SLIT

Internet-searching for a local doctor that specializes in allergy, asthma, and immunology will turn up allergists that likely treat only with SCIT. These doctors may argue that SCIT has proven itself worthwhile. While SLIT research has not agreed on optimal doses and duration, we are forging ahead. Some ambitious allergy clinics actively support SLIT, so check them out and proceed carefully:

Please note that this is only a partial list created by Internet searching each state + “sublingual immunotherapy” and scanning their Web sites for SLIT services. The linked doctors and clinics have not contributed to this list in any way. This list does not make any claims or guarantees about their service, experience with SLIT, or appropriateness of allergy treatment for any condition, and it does not substitute for the advice, diagnosis, or referral by a qualified health provider. If you have difficulty finding a practitioner using SLIT, inquire with local naturopathic or integrative medical doctors in your area. Be informed and ask questions when consulting with health professionals!

Alabama

Hoover

 

Alaska

Allergy & Asthma Associates

Alaska Family Wellness Center

 

Arizona

Family Allergy Clinic – in and out of state program

Fountain Hills

Phoenix

Scottsdale

Scottsdale

Sundance Medical Associates

 

California

Bay Area

Bay Area – East Bay

Bay Area – SF

Central Coast

Los Angeles – Brentwood

Los Angeles – Long Beach

Los Angeles – Marina Del Rey

Los Angeles – Torrance

Orange County – Orange

Orange County – Santa Ana

Sacramento

San Diego – North

San Diego – Solana Beach

 

Colorado

Colorado Springs

Denver

Denver

Grand Junction

 

Connecticut

New England Food Allergy Treatment Center

Southport

Trumbull

 

Delaware

ENT & Allergy of Delaware

 

Florida

Lake Mary

Orlando

Orlando, Kissimmee

Sarasota

 

Georgia

Atlanta

Atlanta and community

Atlanta and community

Athens, Winder

Blairsville

Marietta, Atlanta, and community

 

Idaho

Boise, Fruitland, Nampa

Eagle

 

Illinois

Aurora and community

Chicago

Chicago

Joliet, New Lenox, Morris

Northern Illinois

 

Indiana

Carmel

Carmel

Central Indiana

 

Iowa

Iowa locations

 

Kentucky

Ft. Thomas, Florence, Edgewood

Louisville and Southern Indiana

Northern Kentucky

Winchester

 

Maryland

Baltimore

Baltimore – Johns Hopkins

Lutherville

 

Massachusetts

Boston Medical Center

Winchester, Woburn

 

Michigan

West Bloomfield

West Bloomfield and Livonia

Grand Rapids

 

Minnesota

Baxter

Oakdale

 

Missouri

Columbia

ENT and Allergy Center of Missouri

St. Louis

 

Nevada

Henderson

Reno

 

New Jersey

Redbank

 

New Mexico

Santa Fe and Los Alamos

 

New York

Manhattan

NYC – Upper East Side

NYC and Rockville Centre

Rochester

 

North Carolina

Raleigh

Western North Carolina

 

North Dakota

Fargo, Grand Forks, Carrington

 

Ohio

Cincinnati

Columbus

Concord, Willoughby, Madison

 

Oklahoma

Midwest City

 

Oregon

Bend, Redmond

Portland

Portland

 

Rhode Island

Multiple locations

 

Tennessee

Brentwood

Eastern Tennessee

Franklin, Columbia

Middle Tennessee

Nashville

 

Texas

Dallas

Dallas, Frisco

Garland-Plano

Houston Sinus & Allergy

Houston, Pasadena, Pearland

Houston

Houston

Irving

Plano

San Antonio

Tyler

 

Utah

Pleasant Grove, Provo

Murray, Layton

 

Virginia

Alexandria

Ashburn

Chantilly

Charlottesville

Roanoke

Warrenton

 

Washington

Issaquah

Seattle

Shoreline

 

Wisconsin

Waukesha

Onalaska

 

Wyoming

Casper

Sheridan

 

Doctors using AlleForge allergy drops across the US

 

SLIT and homeopathy – sibling rivalries?

“The symptoms of patients undergoing homeopathic treatment [for allergic conjunctivitis, allergic rhinits, bronchial asthma, and neurodermatitis] were shown to improve substantially and conventional medication dosage could be substantially reduced.” – The Central European Journal of Medicine, 2011

Doctors may scoff at the mention of homeopathy, but SLIT has much in common with this 200-year old medical system. An overly simplified definition of homeopathy is “like cures like.” In both SLIT and homeopathy, symptom-triggering substances are highly diluted and consumed orally or under the tongue for a range of conditions. In homeopathy, extreme dilutions of Rhus tox (poison ivy) might be used to alleviate pain from sprains and stiff joints, and less than a molecule of Arsenicum (arsenic trioxide) might be used for asthma and breathless anxiety. Homeopathy can sometimes require weeks or months to improve chronic cases, not unlike SCIT and SLIT. In classic homeopathy, only one substance is used at a time to treat patients based on a complete set of physical and psychological symptoms, and similarly we have experienced reduced efficacy in some combination vaccines. Not surprising, some over-the-counter homeopathic remedies have emerged to help some of us relieve symptoms.

Do-it-yourself allergy drops

BioAllers homeopathic allergy drops, sprays, and tablets provide a low-cost, low-risk solution with many rave reviews. Check out BioAllers Mold, Yeast and Dust drops, BioAllers Pollen Hayfever drops, BioAllers Tree Pollen drops, BioAllers Dairy Allergy drops, BioAllers Pet Allergy tablets, BioAllers Grass Pollen drops, and BioAllers Indoor Allergy. These products feature extreme dilutions of substances with additional homeopathic ingredients that gently and immediately eliminate symptoms for known allergies. These products are not the individualized, singular remedies touted in classical homeopathy, but cover most popular environmental allergens with no side effects. These products are not representative of homeopathic treatments by a professional, and would likely work best in conjunction with allergy testing and professional naturopathic/homeopathic consultation.

Tinkering with our future immune health

The variety of allergy treatment options give us multi-level options from quick-fix, histamine-blocking drugs to long-term immune reprogramming. We know that rescue remedies don’t change our underlying sensitivities and can reduce our total histamine – a vital chemical for brain and immune function. Allergen-specific immunotherapy can provide us with long-term tolerance but we don’t yet know how this tampering might affect other areas of our health. Before jumping in, let’s peek into the dark.

Remember that immediate allergies (i.e. peanut, shellfish, pollen, pet) are associated with elevated immunoglobulin E (IgE) antibodies to specific substances. Interestingly, as we reduce IgE antibody levels with immunotherapy, levels of IgG (IgG4) antibodiesIL-10 and TGF-β tend to rise. Researchers suspect that this same shift in antibody activity can reduce the therapeutic effect of some medication. Given these insights to the immune response, we have to wonder how repeated exposure to unsuspected allergens might negatively impact our overall health. Perhaps the keyword here is “repeated,” as diversity of exposure to both fungus and bacteria in early life has been associated with reduced allergy.

While research has not indicated that IgG4 antibodies actually cause harm, extremely elevated IgG4 antibodies are associated with a range of lesion-forming diseases such as autoimmune pancreatitis, swollen lymph nodes, Riedel’s thyroid disease, interstitial nephritis (a type of kidney disorder), IgG4-hepatopathy (a type of liver disorder), some cases of interstitial cystitis (bladder inflammation), and various other organ-related conditions. More recently, scientists discovered that elevated IgG4 antibodies associated with tumor growth and reduced survival in cases of melanoma.

In reviewing existing medical literature, it appears we have neither explored nor uncovered any long-term disease risk associated with allergy immunotherapy or consumption of homeopathic dilutions. Yet we must recognize that extended immunotherapy treatment dramatically alters the immune system. If we plan to reprogram ourselves, we need a way to measure “how much” and “how long” our immunotherapy should be used to address our individual imbalances. In the meantime, allergy immunotherapy has potential to reduce inflammation, lower risk of anaphylaxis, and improve quality of life.

How can we stop allergy from happening?

Allergy symptoms are indicator lights for our immune system, and the rise of allergy incidence around the globe is alarming. Theories that explain the increasing risk are slowly forming. Scientists are now associating allergy with reduced exposure to UVBautumn season of birthearly life exposure to substances through vulnerable skinincreased exposure to pollution, maternal and child use of antibiotics, and exposure to the antimicrobial ingredients triclosan and parabens in consumer products. Diverse bacteria in the gut and skin play an important role in regulating our immune system, and our Western diet and culture have promoted microbe-poor environments that promote allergic disease.

The widespread vitamin D deficiency is no less complicated, especially in conjunction with UV-allergy links. New studies reveal allergy risk with high maternal vitamin D levels at birth and higher intake of vitamin D3 during infancy. We must be cautious in assuming the early life benefits of vitamin D, as one study associated allergy with childhood consumption of cod liver oil (high in vitamin D) and childhood sun exposure during the winter. Genetics may explain some of this impact, with 86% of white Europeans carrying the gene for vitamin D deficiency that links with allergy.

Environment can modify genes to influence allergic disease – particularly in early life development – and we have certainly seen and contributed to rapid changes in our environment in the last 200 years. As we relieve our immune system through allergy remedies or immunotherapy, we must not forget to explore the catalysts hiding in our own shadows.

 

2 comments to Tackling allergy remedies and immunotherapy

  • Hello Tammy,
    You might try to contact one of the Canadian manufacturers of sublingual immunotherapy – Western Allergy – they might be able to connect you with doctors in your area that use their products.

  • Tammy Solleveld

    Hi there
    im living in Winnipeg, Canada
    and I was wondering if u have the name of any Canadian drs who perform this service so far im having no luck

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