Family Allergy Asthma & Sinus Care is located in Charlotte, NC, (Pineville), Enjoy our Educational Blog:

5/7/2018: May is Allergy & Asthma Awareness Month, Were you aware that...

Allergies

  • 10 – 30% of adults in the U.S. have allergic rhinitis
  • More than 25% of households are affected by allergies
  • A single Ragweed plant can release 1 million pollen grains in just one day
  • In children, if left untreated, nasal allergies can lead to facial growth issues and orthodontic problems
  • If both your parents have allergies, your risk of developing allergies is greater than 50%
  • 90% of all fatal food allergic reactions are from peanuts and nuts— Don’t take this allergy lightly!
  • Allergy shots (immunotherapy injections) are the only “disease-modifying” treatment for environmental allergies; the effect can be long lasting, even after the injections are discontinued.
  • Honey bees sting once (barbed stinger), while yellow jackets, wasps and hornets can sting multiple times (no barb on stinger)….. yikes!
  • Penicillin allergy resolves spontaneously in 75% of patients after 15 years of avoidance—- good news!
  • IgG testing for allergies is inappropriate and wastes your time and money

Asthma

  • The most effective treatment for persistent asthma is inhaled corticosteroids, i.e.  Qvar, Asmanex, Pulmicort...
  • Patients only take their corticosteroid inhalers 44 – 72% of the time.
  • Mold allergy is a risk factor for severe, life-threatening and fatal asthma— Good info to have!
  • During pregnancy, a mother’s asthma may get better (⅓), worse (⅓) or not change in severity (⅓)
  • You don’t have to have an “attack” to have asthma; symptoms can be subtle and variable.
  • Some people with asthma only cough and do not have wheezing, shortness of breath or chest tightness.
  • Only 10% of children and adults have correct inhaler technique (doctors are not much better!)
  • Most children who develop asthma have symptoms before 3 years old.
  • Study finds 65%-75% of asthmatic adults have an allergy.

Feel free to use these facts in trivia games or water cooler conversations.  Awareness precedes enlightenment!

Spring is in the air; which means March Madness for allergy sufferers!

March through May is peak tree pollen season.  A single plant can release up to a billion grains of pollen per season.  While most of the pollen grains fall within a few feet, some may blow in the wind for many miles.  For those persons allergic to pollen, only a few hundred pollen grains are needed to cause itchy, watery eyes, nasal stuffiness, sneezing, runny nose and fatigue.  These symptoms can decrease your quality of life: interfere with sleep and daily activities, become less productive at work, less effective learning at school and lead to sinus infections.

It is difficult to avoid exposure to pollens, but here are some tips to minimize exposure:

  • Keep windows closed to prevent pollens from drifting into your home.
  • Minimize early morning activity when pollen is usually emitted between 5-10 a.m.
  • Keep your car windows closed when traveling.
  • Stay indoors when the pollen count is reported to be high, and on windy days when pollen may be present in higher amounts in the air.
  • Wear sunglasses to prevent pollen entering the eyes.
  • Avoid freshly cut grass and mowing the lawn.
  • Shower and wash your hair before bed to prevent tracking pollen into your room.
  • Avoiding drying clothes outside on peak pollen days.
  • If you have pollen-food allergy syndrome, avoid fresh fruits and vegetables with cross reactive proteins.
When avoidance measures are not enough, various medications can relieve the symptoms.  For those persons with moderate to severe symptoms, allergy shots can improve symptoms, potentially prevent developing new allergies and possibly prevent the development of asthma and prevent asthma exacerbations.  Allergy shots can reduce symptoms in up to 85% of patients with seasonal allergies.  Find relief now and schedule an appointment for your evaluation and individualized treatment plan.

Decoding Food Allergies: Break the Code

Do you want to know how severe your milk, egg or peanut allergy can be?  These tests can help!

Allergies to egg, peanut and cow’s milk are among the most common food allergies affecting children. These reactions can range from serious, life threatening reactions (such as anaphylaxis) to milder reactions such as hives.  But, how do you know if the reaction will be mild or severe?

While testing for egg, peanut and milk allergies have been available for many years, there have been limitations.  Allergy skin testing has been very useful but only offers insight into how likely a reaction will be.  A large skin test reaction suggests a reaction is “highly likely,” but is unable to predict how severe a reaction will be.  A negative reaction is helpful in predicting that a food allergy is not present.  Advances in food protein science have made it possible for allergists to now help predict the severity of food allergies to milk, egg and peanut.  A blood test where serum IgE (the allergic antibody) is measured to certain specific proteins in milk, egg, and peanut is now available.  This is called “component testing”.  Having these answers may alleviate the fear many patients and their families face every day.

Egg
The two major egg proteins individuals with egg allergy may be allergic to are ovalbumin and ovomucoid.

  • If a person is allergic to ovalbumin, serious reactions may occur if undercooked egg is ingested but most will tolerate egg in baked goods.  Furthermore, the likelihood of resolution of egg allergy is high.
  • In contrast, if a person is sensitized to the ovomucoid protein, he/she is at risk for a severe reaction and unlikely to develop tolerance over time.  Strict egg avoidance is necessary if allergy to ovomucoid is identified while a food challenge in the allergist’s office may be helpful if ovomucoid testing is negative.

Milk
There are 2 major classes of milk proteins that can be used in differentiating severity of milk allergy.

  • Casein protein in cow’s milk is responsible for severe allergic reactions and less likely to be “outgrown.”
  • In contrast, whey proteins (alpha-lactalbumin and beta-lactoglobulin) tend to be associated with less severe reactions and the milk protein allergy typically resolves over time.  A milk challenge in the allergist’s office using baked goods containing milk can be a useful tool to assess tolerance.

Peanut
The proteins in peanuts, Arachis hypogaea, are identified as Ara h and divided into Ara h 1,2, 3, 8 and 9.

  • Those individuals allergic to Ara h 1, 2, 3 are more likely to have severe allergic reactions (anaphylaxis) and need to strictly avoid all contact with peanuts and carry self-injectable epinephrine (EpiPen®).
  • However, if the allergy is to Ara h 8, the risk is moderate and if sensitized to Ara h 9, the risk is low for anaphylaxis.

Why perform food component testing?

  • Testing for the specific protein components of milk, egg or peanut, can help predict the severity of an allergic reaction which can impact the recommendations by allergists when advising patients about safety, lifestyle, and long term risk.  While allergy skin testing is still valuable, the availability of component testing via the Pharmacia ImmunoCAP® test by ThermoFisher Scientific offers additional information on which to make important medical decisions and even long term predictions.

At Family Allergy Asthma & Sinus Care, we help patients understand their food allergy and get to the answer— 1 component at at time!  These pearls of information were brought to you by Jared Bozeman, Senior Medical Student at The Medical College of Wisconsin.

New Treatments for Asthma: Change Your Lifestyle

While the diagnosis of asthma has not changed significantly, the treatment has (and should).  Asthma affects 25 million people (including 7 million children) in the U.S.  The incidence of asthma has increased in the last few decades, and while the exact reason for this is unclear, evidence suggests a link between nutrition/diet, weight, air pollution and allergies.  The treatment for asthma is not just taking medications!

Think of the new asthma treatments as “lifestyle” changes.

Diet:

  • Antioxidants: While no diet will eliminate or cure asthma, evidence suggests those who embrace diets high in Vitamin C and E, beta-carotene, flavonoids, magnesium, selenium, and omega-3 fatty acids have lower rates of asthma.  Foods high in carotenoids include carrots, watermelon, mango and tomatoes.  Children who grew up eating a “Mediterranean Diet” high in nuts and fruits (grapes, tomatoes, apples) had less asthma symptoms.  Studies show a low Vitamin D level has been linked to asthma attacks and low lung function.  Vitamin D supplements may improve asthma control.  A high fat meal (over 48 grams) can lead to more lung inflammation and less recovery of low lung function with albuterol.
  • Obesity is associated with severe asthma (requiring ER visits) and decreased lung function. Inhaled steroid medications don’t work as well in patients with body mass index (BMI) over 25.  How much weight do you need to lose to help improve asthma?  Only 5 to 10%, and aim for a BMI less than 25.
  • Acid reflux is associated with asthma symptoms.  Heartburn is more likely if a person eats too much, too fast, or too late at night.

Exercise:  Although exercise can sometimes be a trigger of asthma, this is no excuse to be a couch potato.  Exercise has been shown to improve quality of life in persons with asthma with more symptom-free days, better oxygen consumption, and less inflammation.  How much exercise is enough?  At least 30 minutes three times a week, with a goal of 150 minutes per week (30 minutes minutes a day, 5 times a week).  Exercise can also be helpful with weight control.

Stress control:  Individuals with asthma who have anxiety and depression are at increased risk of asthma attacks.  A disorder called vocal cord dysfunction triggered by anxiety can complicate asthma but not respond to asthma medications.  Interventions may include counseling, breathing relaxation techniques, and sometimes anti-anxiety medications.

Allergen control: Up to 90% of children with asthma may have allergies and these allergies can trigger asthma.  In adults, about 70% of patients with asthma have allergies.  By treating your allergies, the asthma can improve.

Air pollution.  Air pollutants that include small particles can trigger asthma.  Sources include cigarette smoking, wood smoke (campfires, wildfires, poorly ventilated indoor stoves), diesel exhaust, soot and ash.  Strong chemicals and fumes are also triggers.

Vaccines:  viruses such as influenza, RSV, and the common cold virus called Rhinovirus can trigger asthma.  The flu vaccine is recommended for all individuals over 6 months old, but especially for those with asthma according to the CDC.

Medications:  They are still important!

  • Quick relief:  albuterol is still the most common inhaler in use today to help relieve symptoms of asthma and prevent exercise-induced asthma when used 15 minutes before exercise.  Whether it is by a nebulizer or inhaler, keep it on hand.  The newer devices have dose counters and are easier to use.
  • Daily controller:  this group includes the inhaled corticosteroids deemed the most effective treatment for asthma.  When combined with long-acting bronchodilators, the combination is even better for those with moderate to severe asthma.  The newest combination medications are taken only once a day.  Medications like Singular® block an inflammatory pathway without being a steroid medication and are taken as a pill once a day.  Spiriva, an inhaled medication long known to be used for COPD (chronic lung disease from smoking), was recently approved for treating asthma.
  • Biologicals:  The injectable medication Xolair® has been available since 2003 and blocks the allergic antibody IgE.  Mepolizumab marketed as Nucala® and approved in 2015 is monthly injection that works by blocking the protein interleukin-5 to prevent buildups of white blood cells called eosinophils in the lungs that can trigger asthma.

Individuals with asthma have choices.  While there is no cure for asthma, the available treatment options and lifestyle changes can help control asthma so individuals can lead healthy, productive lives.  By controlling asthma, it will not control you!

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These educational information does not take the place of your physician's advice.


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