Which allergy medication do you reach for first? | TulsaAllergyNews

Are you unsure which allergy medication to take when your symptoms start acting up? Read this article for a breakdown of the three most common types of treatments.

When it comes to allergies, there are a variety of medicines and treatments available to help manage them. However, with the broad range of choices available, choosing which medicine or treatment to take first can be difficult for patients and even doctors. Right now, we’re fortunate enough to have access to options such as antihistamines, decongestants and corticosteroids–but how do we make sure that our choice is continuing us down the right path? In this blog post we will explore these different medications and examine which one should come first when considering treating your allergies.

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#allergy, #allergy-shots-2, #american-college-of-allergy-asthma-immunology, #medications, #sneezing

I Can’t Get My Allergist to Diagnose Allergy!

If you’re an allergy patient or doctor managing allergies, you will likely come across situations where there is a discrepancy between the suspected allergens and skin test results. While this can be frustrating for both patients and doctors alike, it is important to understand why such discrepancies can occur, in order to make sure your patient receives the best possible care and treatment. In this blog post, we’ll discuss some of the potential reasons as to why negative skin testing results might not match a patient’s diagnosis or symptoms. We’ll also look at how to interpret these test results more accurately when they don’t reflect expected outcomes.

From Reddit–>This is a real patient comment and a real patient concern: My allergist told me to use Dymista nasal spray until allergy testing. However, I googled it and found out that Dymista should be stopped 5 days before allergy testing. In my allergy test, dust mites came back negative but I don’t believe it. I have obvious symptoms of dust mite allergy and I want to get allergy shots as soon as possible, before my allergies get worse and start ruining my life.

Should I find another allergist for allergy testing and allergy shots? Because my allergist made the mistake of prescribing me Dymista before my allergy test so I got false negatives on my skin and blood tests.

Credit to Reddit to find out what people really think and can join together to make changes in their daily lives. Anyone doubt that after GameStop and AMC? I have some concerns, however, with using Reddit as your source of medical information. Let’s take the issue of using Dymista prior to skin testing. Dymista indeed has antihistamines (azelastine) as well as topical corticosteroids and it recommended to stop this spray 3-5 days before skin testing. Topical antihistamines do not have the potency of ORAL antihistamines, and often the topical sprays with antihistamine do not interfere with the testing. How do you know for sure if Dymista has interfered with testing results? One of the quality controls I always use is a histamine control and saline control when testing for allergy. The positive histamine control should always be positive and the saline negative, guaranteeing accurate testing.

“I have been to so many allergist and my skin tests are all negative.  I cannot believe this is true.  Why has not anyone found a way to fix this?  Patients will even have a seasonal pattern to other allergy symptoms.”

You can feel the frustration of negative allergy testing, when clinical symptoms of allergy are so present. I myself have to explain why testing is negative when patients sneeze and cough during the pollen seasons of Spring & Fall. Here’s some insight into negative allergy testing with VERY positive clinical symptoms of allergy.

  • I wish our memories were 100%–it would be obvious if we messed up and took antihistamines or nasal sprays too close to testing and caused false negative allergy results. As mentioned previously, I can generally tell when skin testing is “suppressed” by comparing a positive histamine with negative saline prick testing. They should be wildly different.
  • There is a condition called local allergic rhinitis that occurs when all skin testing and blood testing for allergy is negative, but the body still responds right in the nose.  My problem is getting treatment for local allergic rhinitis in a convenient cost-effective manner.  Of course it is neither cost effective nor pleasant to have your allergist blow dust mite in your nose and record nasal congestion on a scale of 1-10– how would you like to do that?
  • You may not have IgE-mediated allergy as the cause of your symptoms. Believe it or not, not everybody has allergy in the sense of hypersensitivity that responds to allergy shots. Sometimes the culprit is an irritant such as dust, fumes, cigarette smoke, aerosols, all of which will cause “allergy” symptoms, but no positive skin tests.
  • Another strategy I will use for negative skin testing is to confirm results with blood tests. This is direct measurement of IgE and fortunately, is not suppressed by any medication you take, including antihistamines.

So here’s the conundrum–>Allergy symptoms, but no positive tests? ENTER Local Allergic Rhinitis. Simply put, LAR is allergy that’s limited to the nose, and not in the skin or blood, making skin testing/blood testing very unfruitful for diagnosis.

In order to perform testing to measure local allergic rhinitis, the clinician must by the equipment to perform nasal challenges and develop protocols that are only suited for research hospitals. (at least for now) Medical literature has been published regarding diagnosis and treatment of LAR, but not in the United States which always means an additional hurdle is the FDA.

  • I’ll summarize some published articles on LAR for those of you who want to know more.
  • Allergy symptoms are very common, up to 30% of the general population. No wonder everyone thinks they have allergy.
  • In Europe, allergists are using AIT (allergy immunotherapy) for treatment of LAR and it works! Knowing that dust mite accounts for 60% of local allergic rhinitis, it’s a very reasonable strategy to use dust mites and pollens in allergy extracts for LAR.
  • BTW, the article below is written by the guru or AIT, Dr. “Hal” Nelson; if nothing else, read the article to catch up on the latest in allergy shots.
  • And now for the “meat” of LAR–published by Dr. Campo who is the leading author for LAR diagnosis and treatment. Now you’ll understand why only 30% of rhinitis patients have IgE-mediated allergy. Fortunately, treatment is still available for LAR.
  • The second article in this block is also a review of LAR. It is interesting that despite adequate research on local allergic rhinitis, treatment and diagnosis of this condition hasn’t caught on here in the States. Perhaps the more we talk about it, the better treatment will evolve.

 If you are having allergy symptoms, but tests come back negative, it is still possible that you have Local Allergic Rhinitis. Now during the winter months, you are not going to have the typical sneezing postnasal drainage and coughing that you get during the spring or fall–but that does not mean you do not have allergy to dust mite. Treatment is available and can help improve your quality of life. If you find yourself experiencing symptoms of allergy but cannot get your allergist to diagnose allergic rhinitis, you may be dealing with local allergic rhinitis. Call us today @ 918-495-2636 and get your allergies controlled.

#allergy, #american-college-of-allergy-asthma-immunology, #local-allergic-rhinitis

Allergens can change depending on the Food you Eat

https://news.yahoo.com/study-finds-mennonite-moms-breast-161448515.html

Do you have allergies? Are there certain triggers that can make your allergy symptoms worse? One of the things to consider when it comes to managing your allergies is what you’re eating. From dairy products, to legumes and nuts, and even some vegetables – all these foods can cause allergic reactions in many people. Every person will react differently so it’s important to keep track of how specific items affect you. In this blog post, we’ll explore how different types of food can trigger or reduce allergic reactions in individuals with allergies.

It turns out one way to protect babies from developing bad allergies in life is to give them breast milk from Mennonite mothers who grew up on farms. Yes, that’s for real: a new (peer reviewed!) study published in Frontiers in Immunology found that breast milk from Mennonite moms has a greater abundance in the type of antibodies and other immune systems components that protect babies from common allergies.

“Our findings indicate that that breast milk from old order Mennonite mothers contains higher levels of beneficial antibodies, microbes and metabolites that help to ‘program’ the developing gut microbiota and immune system of their babies,” study coauthor Antti Seppo from the University of Rochester said in a statement. “These may protect infants against developing allergic diseases.”

What prompted the study? Allergy rates in Western societies have exploded in the early 20th century. One theory explaining this phenomenon argues that lately people have adopted cleaner and more sedentary lives that leave them less exposed to the outside world, which means the immune system is unable to prime itself to co-exist with a lot of foreign substances. A lot of immunity during infancy is passed down from mother to child via breast milk—so over several generations, that breast milk would contain fewer antibodies that tell the body certain airborne dust and certain foods are actually safe.

Mennonite mothers, on the other hand, live very traditional one-family farming lives with little modern technology. They are constantly exposed to pollen and animal dander, unpasteurized milk and other dairy products, and livestock. The research team compared the breast milk of 52 Mennonite women living in Western New York to 29 urban and suburban women living around the city of Rochester. Not only did Mennonite breast milk contain more allergy-associated antibodies, but it also contained a greater diversity of milk microbes that bolster the developing gut microbiota of babies.

The main takeaway here is that it might be good to get outside and touch some grass, at least for your future children’s sake. It is not suggesting you go out and find some Mennonite breast milk.

Seppo AE, Bu K, Jumabaeva M, Thakar J, Choudhury RA, Yonemitsu C, Bode L, Martina CA, Allen M, Tamburini S, Piras E, Wallach DS, Looney RJ, Clemente JC, Järvinen KM. Infant gut microbiome is enriched with Bifidobacterium longum ssp. infantis in Old Order Mennonites with traditional farming lifestyle. Allergy. 2021 Nov;76(11):3489-3503. doi: 10.1111/all.14877. Epub 2021 May 14. PMID: 33905556.

The prevalence of allergic diseases and asthma is increasing rapidly worldwide, with environmental and lifestyle behaviors implicated as a reason. Epidemiological studies have shown that children who grow up on farms are at lower risk of developing childhood atopic disease, indicating the presence of a protective “farm effect”. The Old Order Mennonite (OOM) community in Upstate New York have traditional, agrarian lifestyles, a low rate of atopic disease, and long periods of exclusive breastfeeding. Human milk proteins are heavily glycosylated, although there is a paucity of studies investigating the milk glycoproteome. In this study, we have used quantitative glycoproteomics to compare the N-glycoprotein profiles of 54 milk samples from Rochester urban/suburban and OOM mothers, two populations with different lifestyles, exposures, and risk of atopic disease. We also compared N-glycoprotein profiles according to the presence or absence of atopic disease in the mothers and, separately, the children. We identified 79 N-glycopeptides from 15 different proteins and found that proteins including immunoglobulin A1, polymeric immunoglobulin receptor, and lactotransferrin displayed significant glycan heterogeneity. We found that the abundances of 38 glycopeptides differed significantly between Rochester and OOM mothers and also identified four glycopeptides with significantly different abundances between all comparisons. These four glycopeptides may be associated with the development of atopic disease. The findings of this study suggest that the differential glycosylation of milk proteins could be linked to atopic disease.

Holm M, Saraswat M, Joenväärä S, Seppo A, Looney RJ, Tohmola T, Renkonen J, Renkonen R, Järvinen KM. Quantitative glycoproteomics of human milk and association with atopic disease. PLoS One. 2022 May 13;17(5):e0267967. doi: 10.1371/journal.pone.0267967. PMID: 35559953; PMCID: PMC9106177.

Background: Growing up on traditional, single-family farms is associated with protection against asthma in school age, but the mechanisms against early manifestations of atopic disease are largely unknown. We sought determine the gut microbiome and metabolome composition in rural Old Order Mennonite (OOM) infants at low risk and Rochester, NY urban/suburban infants at high risk for atopic diseases.

Methods: In a cohort of 65 OOM and 39 Rochester mother-infant pairs, 101 infant stool and 61 human milk samples were assessed by 16S rRNA gene sequencing for microbiome composition and qPCR to quantify Bifidobacterium spp. and B. longum ssp. infantis (B. infantis), a consumer of human milk oligosaccharides (HMOs). Fatty acids (FAs) were analyzed in 34 stool and human 24 milk samples. Diagnoses and symptoms of atopic diseases by 3 years of age were assessed by telephone.

Results: At a median age of 2 months, stool was enriched with Bifidobacteriaceae, Clostridiaceae, and Aerococcaceae in the OOM compared with Rochester infants. B. infantis was more abundant (p < .001) and prevalent, detected in 70% of OOM compared with 21% of Rochester infants (p < .001). Stool colonized with B. infantis had higher levels of lactate and several medium- to long/odd-chain FAs. In contrast, paired human milk was enriched with a distinct set of FAs including butyrate. Atopic diseases were reported in 6.5% of OOM and 35% of Rochester children (p < .001).

Conclusion: A high rate of B. infantis colonization, similar to that seen in developing countries, is found in the OOM at low risk for atopic diseases.

Seppo AE, Choudhury R, Pizzarello C, Palli R, Fridy S, Rajani PS, Stern J, Martina C, Yonemitsu C, Bode L, Bu K, Tamburini S, Piras E, Wallach DS, Allen M, Looney RJ, Clemente JC, Thakar J, Järvinen KM. Traditional Farming Lifestyle in Old Older Mennonites Modulates Human Milk Composition. Front Immunol. 2021 Oct 11;12:741513. doi: 10.3389/fimmu.2021.741513. PMID: 34707611; PMCID: PMC8545059.

Background: In addition to farming exposures in childhood, maternal farming exposures provide strong protection against allergic disease in their children; however, the effect of farming lifestyle on human milk (HM) composition is unknown.

Objective: This study aims to characterize the maternal immune effects of Old Order Mennonite (OOM) traditional farming lifestyle when compared with Rochester (ROC) families at higher risk for asthma and allergic diseases using HM as a proxy.

Methods: HM samples collected at median 2 months of lactation from 52 OOM and 29 ROC mothers were assayed for IgA1 and IgA2 antibodies, cytokines, endotoxin, HM oligosaccharides (HMOs), and targeted fatty acid (FA) metabolites. Development of early childhood atopic diseases in children by 3 years of age was assessed. In addition to group comparisons, systems level network analysis was performed to identify communities of multiple HM factors in ROC and OOM lifestyle.

Results: HM contains IgA1 and IgA2 antibodies broadly recognizing food, inhalant, and bacterial antigens. OOM HM has significantly higher levels of IgA to peanut, ovalbumin, dust mites, and Streptococcus equii as well TGF-β2, and IFN-λ3. A strong correlation occurred between maternal antibiotic use and levels of several HMOs. Path-based analysis of HMOs shows lower activity in the path involving lactoneohexaose (LNH) in the OOM as well as higher levels of lacto-N-neotetraose (LNnT) and two long-chain FAs C-18OH (stearic acid) and C-23OH (tricosanoic acid) compared with Rochester HM. OOM and Rochester milk formed five different clusters, e.g., butyrate production was associated with Prevotellaceae, Veillonellaceae, and Micrococcaceae cluster. Development of atopic disease in early childhood was more common in Rochester and associated with lower levels of total IgA, IgA2 to dust mite, as well as of TSLP.

Conclusion: Traditional, agrarian lifestyle, and antibiotic use are strong regulators of maternally derived immune and metabolic factors, which may have downstream implications for postnatal developmental programming of infant’s gut microbiome and immune system.

The food we eat can change the way our body reacts to form allergies. Our western culture is almost too clean, and this leads to changes in our microbiome that favors the development of allergies. There is research demonstrating that subcultures within the United States have very different breast feeding habits during infancy that actually decrease the incidence of allergy in that population. You can remember that probiotics are a good way to prevent allergies and please pay attention to your food–you are what you eat!

#allergy, #food

PEG Allergy and COVID-19

Are you an allergy patient? Are you worried about the effects of COVID-19 on your condition? You’re not alone. With the current pandemic that doesn’t seem to be going away, many people are facing unprecedented circumstances, and one area that is particularly vulnerable includes PEG allergies. But don’t panic – understanding what PEG allergy is, how it relates to COVID-19 and some tips to help manage your symptoms can make life easier during these challenging times. Read on for all the essential information you need to know about managing a PEG allergy in this time of crisis.

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#allergy, #anaphylaxis, #covid-19-vaccination, #peg

This Can’t Be Right

So what is going on with persistent allergy symptoms when the pollens are NOT very high? This patient is using the term “allergies” to describe “symptoms” of allergy that may not be IgE-mediated allergy at all. Doesn’t mention skin testing, but this testing can be completely negative in this scenario. How frustrating!

Positive skin tests look like this….


In fact, often I am tested for allergy and had no reactions even though I sneeze my head off during the fall season?
You cannot assume that pollens are the only cause of persistent rhinitis. Various conditions are called infectious rhinitis, vasomotor rhinitis, that have nothing to do with allergy but still because lots of nasal drainage and congestion.
In fact we are now entering into the time of year (late fall and winter) when many symptoms of sneezing, coughing, asthma are thought to be due to allergy but are really due to infection or cold air. Your body does not tell you when triggers change, but that is actually what is happening.
This writer from Reddit also complained of more symptoms that would suggest asthma during the fall pollen season, but yet low allergy counts.
Again, allergies are not the only cause of asthma even though the highest time of admissions for asthma occurred during the third week of September. Certainly, not all these patients have allergy. We have been inundated with COVID-19, and this virus shares many similarities with the common cold–do not be surprised if sneezing congestion, nasal drainage during the winter makes you think of Covid-19, but is actually rhinovirus induced asthma.

Look at the examples of sinus infection below. Slide a is the only normal CT scan as all of the others have some evidence of sinusitis. Any sinus infection is bound to cause problems with PND, congestion, and even sneezing–allergy can be involved, but many patients with chronic sinusitis have no allergy on skin testing. Asthma during the winter is often exacerbated by sinus infections just like the ones shown below.

What to do with this conundrum?

  1. Take your regular medications as prescribed by your doctor–do not stop using your inhaled corticosteroids just because the seasons change.
  2. It may even be beneficial to increase your dose of inhaled corticosteroids to 2 puffs 4 times a day when you are ill
  3. Always use a spacer device for your asthma
  4. Be open to “nonallergic” trigger for your nasal congestion sneezing, coughing. It is not unusual for patients to have both allergy and sinus infection for instance.
  5. Treating sinus infections may require oral corticosteroids and antibiotics for up to 1 month at a time. 10 days just won’t do it with chronic sinusitis
  6. Take your regular medications as prescribed by your doctor–do not stop using your inhaled corticosteroids just because the seasons change.
  7. It may even be beneficial to increase your dose of inhaled corticosteroids to 2 puffs 4 times a day when you are ill
  8. Always use a spacer device for your asthma
  9. Be open to “nonallergic” trigger for your nasal congestion sneezing, coughing. It is not unusual for patients to have both allergy and sinus infection for instance.
  10. Treating sinus infections may require oral corticosteroids and antibiotics for up to 1 month at a time. 10 days just won’t do it with chronic sinusitis

#allergies, #allergy, #respiratory-disorders

More Reason to Consider Allergy Shots if your hayfever isn’t controlled by medications.

Click here for Christmas Greeting from Dr. Wiens! https://youtu.be/i020Y_gEunU

Huge Growth of Allergy Shots Market by 2028 with Top Key Players – ALK Abello, Stallergenes Greer, Allergy Therapeutics

I have been telling patients for years that allergy immunotherapy (#allergy shots) are very helpful for controlling the sniffles, sneezing and coughing that patients experience particularly during the fall and spring. This is a very interesting market research report on allergy shots that analyzes marked growth of allergy immunotherapy, uses cost structures and various other statistical tools to make their predictions. If AIT does not work, my reasoning is why would the market increase over the next 5 years? I have referenced the research report if you are interested in pursuing a more detailed analysis. Just so you know, our clinic uses Greer extracts and they are one of the top companies in the report.
I’ll provide some specific answers from a clinical standpoint to questions that this research report discusses. They are found at the bottom of the blog. Thanks to data analytics, many industries are now converting a “gut instinct” into mathematical equations–I do not know if this is really good, but “just the facts”

A2Z Market Research announces the release of Allergy Shots Market research report. The market is predictable to grow at a healthy pace in the coming years. Allergy Shots Market 2021 research report presents analysis of market size, share, and growth, trends, cost structure, statistical and comprehensive data of the global market.

The top companies in this report include:

ALK Abello, Stallergenes Greer, Allergy Therapeutics, Aimmune Therapeutics, Anergis, Arrayit Corporation, Biomay AG, HAL Allergy Group, DBV Technologies.

Get Sample Report with Latest Industry Trends Analysis: https://www.a2zmarketresearch.com/sample-request/568899

As analytics have become an inherent part of every business activity and role, form a central role in the decision-making process of companies these days is mentioned in this report. In the next few years, the demand for the market is expected to substantially rise globally, enabling healthy growth of the Allergy Shots Market is also detailed in the report. This report highlights the manufacturing cost structure includes the cost of the materials, labor cost, depreciation cost, and the cost of manufacturing procedures. Price analysis and analysis of equipment suppliers are also done by the analysts in the report.

This research report represents a 360-degree overview of the competitive landscape of the Allergy Shots Market. Furthermore, it offers massive data relating to recent trends, technological advancements, tools, and methodologies. The research report analyzes the Allergy Shots Market in a detailed and concise manner for better insights into the businesses.

The report, with the assistance of nitty-gritty business profiles, project practicality analysis, SWOT examination, and a few different insights about the key organizations working in the Allergy Shots Market, exhibits a point-by-point scientific record of the market’s competitive scenario. The report likewise displays a review of the effect of recent developments in the market on market’s future development prospects.

Global Allergy Shots Market Segmentation:

Market Segmentation: By Type

Allergic Rhinitis
Allergic Asthma
Food Allergy
Atopic Dermatitis
Others

Market Segmentation: By Application

Allergic Rhinitis
Allergic Asthma
Food Allergy
Atopic Dermatitis
Others

Geographic analysis:

The global Allergy Shots market has been spread across North America, Europe, Asia-Pacific, the Middle East and Africa, and the rest of the world.

Get Exclusive Discount on this Premium Report: https://www.a2zmarketresearch.com/discount/568899

COVID-19 Impact Analysis

The pandemic of COVID-19 has emerged in lockdown across regions, line limitations, and breakdown of transportation organizations. Furthermore, the financial vulnerability Allergy Shots Market is a lot higher than past flare-ups like the extreme intense respiratory condition (SARS), avian influenza, pig influenza, bird influenza, and Ebola, inferable from the rising number of contaminated individuals and the vulnerability about the finish of the crisis. With the rapid rising cases, the worldwide Allergy Shots refreshments market is getting influenced from multiple points of view.

The accessibility of the labor force is by all accounts disturbing the inventory network of the worldwide Allergy Shots market as the lockdown and the spread of the infection are pushing individuals to remain inside. The presentation of the Allergy Shots makers and the transportation of the products are associated. If the assembling movement is stopped, transportation and, likewise, the store network additionally stops. The stacking and dumping of the items, i.e., crude materials and results (fixings), which require a ton of labor, is likewise vigorously affected because of the pandemic. From the assembling plant entryway to the stockroom or from the distribution center to the end clients, i.e., application ventures, the whole Allergy Shots inventory network is seriously compromised because of the episode.

The research provides answers to the following key questions:

  • What is the projected market size of the Allergy Shots market by 2027? **As you probably guessed, it’s going up. One of the favorable features of AIT is the frequency of injections–once you complete the build-up phase, allergy shots are given once monthly and it’s hard to beat this “convenience factor”.
  • What will be the normal portion of the overall industry for impending years?
  • What is the significant development driving components and restrictions of the worldwide Allergy Shots market across different geographics? **This is more FYI than anything. I was very surprised that world-wide use of allergy shots is predicted to increase. In previous years, the use of allergy shots around the world had been decreasing–why? AIT involves some risk (albeit small) of anaphylaxis and even death from allergy immunotherapy. In recent years, we’ve been able to reduce this risk by better selection of patients for AIT, more standardized allergen extracts, and more appropriate clinical setting (minimize home shots) for giving shots in order to treat any anaphylaxis quickly with appropriate back-up (urgent care and ER in this case). It’s working as there have been zero deaths from AIT in the United States for the past number of years–wahoo, that’s progress!
  • Who are the key sellers expected to lead the market for the appraisal time frame 2021 to 2027? ** We’ll find out in 5 years. Obviously, this is a very profitable market for companies making allergy extracts. Twenty years ago a gallon of pure dust mite extracts sold for $10,000–I wonder what inflation has done to that cost today?
  • What are the moving and arising advances expected to influence the advancement of the worldwide Allergy Shots market? **Currently, we inject the entire allergen (say ragweed) under your skin to induce tolerance. Researchers have been looking for years at the possibility of injecting only the important parts of the allergen that retains immunogenicity, but reduces the risk of anaphylaxis. This “Holy Grail” is not far off.
  • What are the development techniques received by the significant market sellers to remain ahead on the lookout?

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Contact Us:

Roger Smith

1887 WHITNEY MESA DR HENDERSON, NV 89014

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#allergy-immunotherapy, #allergy-shots-2

Fishing for allergy

Who doesn’t like to fish during this time of the year? Doesn’t matter if it’s catfish on the local pond, or trout at Roaring River, there’s nothing like feeling the tug on your line before you set the hook. And I have relatives that are experts at catching any type of fish you want. Fish allergy can be divided into 2 groups: the white fish and shellfish. You are usually not allergic to both groups and testing for sensitivity can be very helpful to avoid anaphylaxis and give you the tools to avoid the wrong kind of fish. Shellfish allergy to shrimp, crab, and lobster isn’t the focus of this writing, so we’ll discuss only allergy to “white fish” today. At times, I enjoy searching the medical literature for other allergist’s opinions on food allergy and this is no exception. What is most important for the white fish allergy, is can you outgrow this condition?

The data of whether someone can outgrow fish allergy is scarce. Fish allergy is one of the most common causes of food allergy, especially in children and young adults, with rates from 0.1 to 0.5%. The major fish allergen identified is beta-parvalbumin, it is resistant to heat and digestion. Many patients with an allergic reaction to one fish will also react upon ingestion of other fish. Sharks and rays mainly contain alpha-parvalbumin which has been shown to be less allergic.

Journal of Allergy and Clinical Immunology: In Practice.

Previous studies have shown that 15% of children can outgrow fish allergy within a period of 2-5 years, whereas telephone studies have shown it to be 3.5% in the United States.

A recent study called “Natural History of IgE-Mediated Fish Allergy in Children” published in The Journal of Allergy and Clinical Immmunology: In Practice, aimed to describe the natural history of fish allergy.

Children in the study ranged from 4 to 18 years who were previously diagnosed with fish allergy. The results showed:

  • 22% of children tolerated all fish tested, the average timeframe was 8 years after their first reaction.
  • Complete tolerance to fish increased with age, from 3.4% in preschool children to over 45% in adolescents.
  • Most children were able to tolerate swordfish (94%) and tuna (95%).
  • The best predictor of fish allergy was the IgE test to cod greater than 4.87 kUA/L.

The study has shown that fish allergy in children starts early, mostly during the first 2 years of life and a considerable proportion of children will outgrow fish allergy.  Particularly those with less sever reactions and a lower level of sensitization (skin prick and IgE testing). Those who continue being allergic may still tolerate several fish species, such as tuna and swordfish. This probably is a reflection of their parvalbumin content and/or composition.

Tolerance to at least 1 fish can be important for allergic children because fish has beneficial effects on health owing to the high omega-3 content and it is associated with a lower risk of coronary heart disease.

  • So what’s the take away from fish allergy, so you can fantasize what the “big fish” is doing underwater before you set the hook?
  • Most children will outgrow fish allergy and this applies particularly to swordfish and tuna. A definite must is to have testing performed to determine the level of IgE (or skin testing) to white fish that will prevent an allergic reaction that can spoil your next great fishing trip.
  • Tolerating fish to include at least one species can have clinical benefit due to omega-3 content to reduce heart disease and stroke.

#allergy, #fish-allergy, #food-allergy

Four reasons I still practice Allergy in the Information Age

Ever notice how everyone has #allergies these days?  I kid you not, almost everyday, a patient will tell me that #Tulsa (where I practice) has more allergies than any other place in the country.  The irony of it all, is so did patients in Kansas, and patients say the same thing in Virginia and Texas.  You get my point–we all love to be known as the Allergy Capital of the World! Maybe it’s because allergies make us feel so miserable, and we love to hear stories about how to deal with the nemesis.  Or maybe we want some “inside information” to share with our friends & family who also suffer from allergy. Whatever the reason for our obsession with allergy, you can’t argue with the fact that good allergy advise is not only helpful for better quality of life, but it’s crucial in making sure that allergy sufferers avoid heeding the WRONG advice for treating #hay fever. This is the passion I experienced in order to complete a fellowship training in allergy– I wanted to be able to interact with patients about their #allergic symptoms on their journey to good health. But wait, why practice a specialty that has so much incorrect information on-line and no doubt, “everyone’s an expert in allergy” when you could be doing real medicine to treat someone’s heart attack? Here are four reasons I still practice allergy for your consideration: Continue reading

#aller, #allergic-rhinitis, #allergy, #allergy-blogs, #allergy-shots-2, #asthma

It’s allergy season and what can I do?

The following YouTube video describes a process called “Rush Immunotherapy” conducted in Ohio.  It’s now a more common way to deliver #allergy shots and reduces the total number of shots required to achieve clinical relief from your #allergies.  Some caveats about #RUSH Immunotherapy need to be included and your bullet list is below the video.

I would make the following corrections to this video:

1.  Unfortunately, you can’t answer all questions about immunotherapy (allergy shots) in a 3 minute news clip.

Continue reading

#allergen-immunotherapy, #allergy, #american-academy-of-allergy-asthma-and-immunology, #american-college-of-allergy-asthma-immunology, #oklahoma, #tulsa-oklahoma

Why See an Allergist?

Believe it or not the pollen season is just around the corner–6 weeks to be exact.

#allergy, #american-college-of-allergy-asthma-immunology, #childhood, #kids, #tulsa-oklahoma