Transcription:
Living With Allergies

Melanie Cole (Host): Up to 50 million people in the United States have allergies. Allergies are caused by the body's overzealous reaction to normally harmless substances, and they can be triggered by pollen, animal dander, mold, dust, insect droppings, certain foods or insect stings. They seem to be everywhere, these triggers. My guest today is, Dr. Jane Unzeitig, she's an allergist and a member of the medical staff at Doctors Hospital of Laredo. Welcome to the show, Dr. Jane. So, when we're talking about allergies there are so many different types and so many things, so let's start with the premise of somebody who's got wheezing and coughing and stuffy nose and eyes, and how do you decide what they're allergic to? How do you figure out what it is?

Dr. Jane Unzeitig (Guest): So, Melanie that's a typical patient, I think I just saw that patient here a minute ago. And you really hit the nail on the head because allergies tend to involve certain target organs, and those are the target organs that have the allergy cells, the Mast cell. So, the target organs, the lining of the eyes, nasal passages, sinus passages, bronchial tree and skin, so any of those organs can be involved. And you also made a very good point in that, asthma affects about 35 to 40 percent of people with nose allergies.

So, when people have nose allergy which is the most common manifestation, we're always on the lookout for, when are they going to have symptoms, such as coughing, night cough, restriction of exercise activity. And so, the really the history in the allergy patients is crucial. We want to know, not just what brought him into us today, but what else is going on in their lives. Have they had a reduction in their ability to exercise? Have they gained a lot of weight? And weight gain is a huge problem in just about every medical field, and I think all the physicians that you talk about, that talk about chronic diseases find that overweight lifestyle changes are huge factors for them.

And the same thing happens with allergy, it can reduce your ability to breathe well, reduce your ability to exercise, but allergies per say can be real variable, depending on what area of the country, and also, the age of the patient, the occupation of the patient and their household. So, again taking a real thorough history is the first start, and the important start in getting to the educational process.

Melanie: So, Dr. Jane, if somebody experiences these symptoms a lot of people try it first before they would go see an allergist to even get things sorted out. They try some over-the-counter, and some at home because they think to themselves, “Oh, I can manage this or I can take care of this.” So, there's so many things over the counter. What do you recommend to people about when they should get into their doctor, and get these triggers identified, so that they don't have to just keep reusing these things that are over-the-counter?

Dr. Unzeitig: So, it's excellent point. I think that we do have some fantastic medicines. In fact, most of the things that had been prescription only have stood the test of time. There are safe products, they’re effective products, and there over the counter. So anti-histamines is first and foremost, I think for most people, and there's all different brand names, and most of them have also gone generic.

We like the so called second generation anti-histamine because they tend to be less sedating. They don't cause as much drowsiness. They're safe pretty much for all ages, and they work pretty well, over the counter also is nasal saline. We love saline, that pretty much, we call it free meaning, free of side effect, low cost, no limitation the on the frequency of use, and it can be quite helpful in rinsing, flushing out irritants, dust and pollens that we breathe in. So, we like nasal saline, we like nasal steroids, nasal steroid is probably the most effective of the medications that are available, other than allergy shots for controlling and preventing allergies. So, some people will use the nasal steroid pre-seasonally, and this is where their allergist or their physician can really come in handy in diagnosing what allergies they have. And if we can predict a difficult time period for an individual, then we can counsel them, what to do ahead of time, so that the medication works better. Both use the nasal steroids worked much better taken in advance of a known allergic reaction, and even anti-histamine work much better, if you take it, for example, before you mow the grass rather than waiting until you get allergy symptoms, and then you take the medicine. So, those are the main categories, I think you mentioned decongestants, decongestants are quite effective. But, here's also another situation where consulting your physician would be helpful because decongestants may interfere with blood pressure, they may raise blood pressure, they may interfere with the cycle. And so, we want to be sure that the individual is a candidate for taking a nasal decongestant, and also, perhaps not to take it all the time. They can be quite habit forming.

Melanie: What role do you feel that our auto immune system and stress even and, even certain things, like, people say we're over sanitizing, and that and that our gut flora, and these things because we are kind of wearing that down, that now we’re more susceptible to certain things such as allergies, when maybe we wouldn't have been so susceptible to those before. Do you think that plays a role?

Dr. Unzeitig: So, this is a concept of the microbiome, the microbiome is all of the organisms that live in your G.I. tract, and, it is said, various resources quote that between 40 percent and 90 percent of all of the genetic information in the human body is not human origin. It's actually from the microbiome, so we now know that that robust microbiome, which has all the microorganisms in the GI tract, have a very robust relationship with the immune system. And so, by being too clean and being too healthy, perhaps we don't have as good, a microbiome, we have less, we have a weaker microbiome. Those microorganisms are susceptible to answer by audit, we don't get as many microorganisms when we drink clean water, when we have clean houses. We don't live with our very animals, and so, perhaps we have altered immune responses because of that.

So, it is not an FDA approved approach, but we tend to recommend addition of probiotics, especially in those individuals who perhaps need to take antibiotics on a regular basis, perhaps they have chronic infections whether their respiratory, urinary, GI. There are individuals who pretty much require frequent antibiotics. What we want to make sure that they have a healthy microbiome, and so, perhaps addition of probiotics can be helpful, even though that's not yet FDA approved, mandated there's no dosage that’s know, but they're all good on the over-the counter basis. So that's an easy thing to do to help out our microbiomes.

Melanie: And what about some other things that we hear about, and things that we can do in the home, Dr. Jane, like air filters and nasal Lavage, it's not easy to get a kid to do one of those, but it certainly is like giving your giving your nose a shower. So, what do you think things…

Dr. Unzeitig: Perfect. I think that's a great analogy. Yeah, so we talk about all the things that you inhale all day long, and the court knows how to do a constant job in filtering humidification warming the air. And so, sometimes if there's a lot of stuff in the environment and you do a Lavage, you can help rake that…all of that out. The other common area where Lavage can be helpful is in people who have recurring sinus infections. So, it's the first sign that they'll start doing nasal lavage. Sometimes that might lessen their eventual need for an antibiotic, and that's our goal is to try and back off on frequent use of antibiotics.

So, there are several products over the counter. The famous Neti pot, the Neal mad scientist rinse kit, there's a lot of rinse kits, that really are not difficult to do. They're inexpensive. And so, we do tend to recommend them. Now, sometimes, not every individual can do it. So, if they experience discomfort in the ear, something like that, then they may not be able to. So, it’s good to get a nice checkup first with your physician to try it out, make sure that you're a good candidate for that. And that's one of those treatments that is a good home remedy, and no medicine involved. So, we like nasal Lavage, in terms of what to do in the household, common sense is probably the biggest thing here, and that is, yes, our furry pet best to be outdoors if you're allergic to them, you have a carpet, best to get rid of it if you can afford that. If you can afford a room air purifier for the bedroom that's a great idea. No smokers in the home. And then also keep those windows shut. So, it’s better to have air conditioning going with changing and cleaning air filters, rather than having a lot of that so-called fresh air come in because the fresh air may be bringing a lot of pollen with it. So, I would say more common sense in the household. And then also recognizing the importance of getting rid of things that may be triggering your allergies or your asthma, maybe even those stuffed animals for the kids.

Melanie: Well, those are all good points, Dr. Jane, and certainly even, as you mentioned, before the tap water and our dish towels, it can kind of be everywhere, but wrap it up for us. In summary, if you would, what you would like people to know about managing and living with those allergies, and what you tell them as an allergist that they can do to help manage those symptoms or possibly reduce their allergies

Dr. Unzeitig: So, allergies, I think, will be a constant with us. I don't think there's anything that will happen in our environment that’s going to take it away. And so, each individual really needs to look to, what is it that bothers them the most, and how can they get the best feeling every day, look forward to going to work or going to school every day. That's the key there, reduce those co-morbidity, such as Asthma, sinusitis, skin infection, and get some help, get some advice because sometimes if what you're doing is not cutting, is not controlling it, and it seems that your allergies are controlling you. There's plenty of help out there. So, I think starting with your physician, your pediatrician, your family doc, getting a referral to an allergist. It’s a simple thing, they’re not working. There's going to be plenty of ways to help. So, it's a matter of making that first call.

Melanie: It certainly is, and thank you so much for being with us. It's really great information. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to, IChooseDoctorsHospital.com, that's, IChooseDoctorsHospital.com. Physicians are independent practitioners, who are not employees or agents of Doctors Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital of Laredo is directly or indirectly owned by a partnership that includes physician owners, including certain members of the hospital medical staff. This is Melanie Cole, thanks so much for listening.