Great Smokies Medical Center of Asheville

Archive for the ‘Allergy: Inhalant’ Category

Q/A: Pollen Allergy by Dr. Wilson

Sunday, September 11th, 2005

Q. Help! The pollen is so bad this year. What can I do for the allergy symptoms?

A. I find different remedies work for different people. Some respond very well to the use of Neti Pot to deliver passive (not forceful) saline irrigations that remove pollen from the nasal passages.

Avoidance of pollens is an effective and necessary strategy. Pollen levels are highest from 5 to 11 a.m., so plan outdoor activities accordingly. Keep the fresh air intake in your car closed while driving, and keep your home’s windows closed and air conditioning on to lower pollen exposure. Keep your bedroom especially free of allergens, as you spend a third of your life there. Regular vacuuming, and dusting, and continuous HEPA air filtration helps by reducing levels of not only pollen, but also danders, dust, mites and molds.

A number of natural remediescan be very helpful to decrease symptoms of pollen allergy. Quercitin (available in nasal spray or capsules) and Stinging Nettlestop the release of histamine from mast cells, much like antihistamines, but without the side effects. Stinging Nettle and Quercitin are both available in a blend of herbs called D-Hist.

I find a homeopathic preparation, Allergiplex, to be very helpful for pollen allergy. Vitamin C and Flavonoids are basic and important treatments for seasonal allergy symptoms. Less commonly, but no less important, Thymus or CoQ10 is just the ticket for some. Similason eye drops #2 can soothe the most irritated allergic eyes.

Strictly limit sugar intake. Cross reactions between foods and pollens can occur. For example, raw carrots and apples may result in symptoms when birch pollen is present. Avoid known cross reactive foods during pollen season.

QuikMed Allergy Facts

Monday, August 22nd, 2005

* An estimated 40-50 million Americans are estimated to suffer from allergies.

* About 15% of the population will need to seek medical help for the treatment of their allergies.

* Outdoor mold counts are at their highest in the cooler darker hours prior to sunset.

* The moderately high annual rainfall of Western North Carolina fosters both indoor and outdoor
environmental mold growth.

* The most allergenic part of dust mites is their feces.

* Remember Legionnaire’s Disease that resulted from bacterial contamination of the hotel’s ventilation system? Home air conditioners can also be contaminated from standing or splashed condensed water in air conditioning systems. Have your air conditioner coils and pans serviced twice a year to prevent growth of bacteria or mold harming your family’s health.

* High Efficiency Particulate Accumulator (HEPA) air filters are among the most efficient at filtering pollen, mold, dust, dust mites, and danders. In fact, their porous filter material becomes more efficient with use. In an average home they require filter replacement every 12-18 months. Some HEPA air filters have an additional carbon pre-filter to capture some volatile chemicals.

* High humidity in a house fosters both mold growth and dust mite population increases. Low humidity in a house can result in dry skin and mucus membranes which could in turn result in sinusitis or bronchitis. The ideal humidity level for a home is 35-50% relative humidity.

* Most people spend about a third of their life in their bedroom, so one can greatly decrease their allergy exposure by making your bedroom a respite from an otherwise allergic world. Allow no pets in bedroom. Hardwood or tile flooring is preferred to carpeting. Use mite barrier cloth pillow and mattress covers, minimize frills and dust collectors in drapes and accessories. Wash bedding weekly in hot water and dry in clothes dryer. Keep windows closed in high pollen seasons, and use a HEPA filter to help assure high air quality.

* Up to one tenth of the weight of an old bed pillow can be dust mite feces. Bed pillows also contain moisture from breathing that accumulates and can foster mold growth. An allergic person is well advised to buy a new hypoallergenic pillow every 12-18 months, and cover it with a barrier cloth pillow case. Dry your pillow in a hot clothes dryer with a pair of tennis shoes every couple of months to deter mold growth.

* If you are sensitive to poison ivy, oak, or sumac, there is an increased chance that you will react to the following foods through cross-reactivity: pork and black pepper.

* Poison ivy and oak are in the same botanical family as cashew nuts.

* If you are especially dust sensitive, there is an increased chance that you will react through cross-reactivity to: seafood and nuts.

* Alternaria and Hormodendrum (Cladosporium) are the most commonly encountered indoor and outdoor molds.

* Clean up any wet or moist furnishings or construction materials within 24-48 hours to prevent potentially serious mold contamination.

* Stachybotrys chartarum is a particularly harmful greenish black mold that grows on water damaged drywall and other materials with a high cellulose content, including wood. Stachybotrys exposure can result in immune system damage.

QuikMed Hay Fever Facts

Monday, August 22nd, 2005

* Hay fever consists of a group of allergic symptoms that are caused by pollen. It is also called Seasonal Allergic Rhinitis, to differentiate it from year-round or Perennial Allergic Rhinitis, caused from dust, dust mites, molds, and animal danders.

* Outdoor pollen counts are at their highest level of the day between 5 am and 10 am. If you are allergic to pollen, limit your outdoor time during these peak hours.

* All trees pollinate in the late winter or spring. Grasses and some plants pollinate in late spring and early summer. Most weeds pollinate in the summer and fall.

* Click on www.pollen.com for a local pollen count.

* Pollen counts approach zero in an air-conditioned indoor space assuming the doors and windows are shut.

* Simply removing your shoes at the entry of your home when coming from the outside will reduce the number of allergens in your home environment.

* Showering and washing one’s hair before going to bed especially during pollen season can help reduce pollen allergy symptoms.

* The biological diversity of plant life in Western North Carolina results in both large quantities of pollen and many different species of pollen.

* If you are trying to determine if you have hay fever or a simple cold, often the presence of itchy, irritated and watery eyes and facial itching are a clue that pollens are more likely causing your symptoms.

* There is no geographical cure for hay fever. Although relocation may result in an initial decrease of allergy symptoms, the second season of exposure to the new location may well be the sensitizing one. Allergy is primarily an internal problem, not external.

* Pollen has been found in the ocean 400 miles from shore. Pollen will find you.

* A single ragweed plant can generate a million grains of pollen per day.

* If you are especially allergic to ragweed, there is an increased chance that you will react to the following foods through cross-reactivity: chamomile, melons, squash, egg, milk, mint, bananas, and lettuce.

* If you are especially allergic to grass pollen, there is an increased chance through cross-reactivity that you will be allergic to: legumes, including beans, peas, cottonseed, soybean, and its byproducts, and cooking fats.

* If you are especially allergic to birch pollen, there is an increased chance that you will react to the following foods through cross-sensitivity: raw apples, carrots, and celery.

* A micron is .0000394 inch or .0001 cm. Pollen is a relative giant at approximately 30 microns in diameter, molds come in at 3 microns in diameter, and cat dander is the small kid on the block at 2 microns in diameter in size. It may take months to rid cat dander from a home even after the cats are removed because it is so easily airborne.

* If you are in the midst of hay fever season, decreasing the intake of your known allergic foods and limiting one’s chemical exposure will decrease the total load on your immune system and likely increase your tolerance of pollen. Take extra care to keep your home environment clean during your worse pollen symptoms.

* Many people report they are allergic to pine pollen because it is so abundant and obvious as it falls on cars and other objects. However, pine pollen is less allergenic than other tree pollens due to its relatively heavy weight . . . it is between 40 and 85 microns in diameter. That’s why it ends up on your car and not in your nose.

* When driving during peak pollen season, keep your car clean, keep car windows closed, use the air-conditioning, and re-circulate the air in your car to shut off all incoming air.

Mold Allergy: Facts and Treatment

Monday, August 22nd, 2005

By Connie Wilson, RN

If you are allergic to molds, you will need to familiarize yourself with molds-how to identify them, how to eliminate or reduce them in your environment, and the treatment of mold allergy.

Mold is a living plant and a member of the Fungi family. Mold spores are not visible to the naked eye, so by the time mold is visible on an object, literally millions of spores are present. Mold spores are very light and easily airborne, averaging 3 microns in diameter (.0001182 inch). Mold is part of what we call house dust, the ever present little specks that swirl in sunbeams in houses. “Mold showers” occur outside on breezy days when weather conditions, in particular high humidity, favor mold growth. Mold has both an urban and rural presence, and an indoor and outdoor presence.

Unlike pollens, molds are present year-round. Consequently, molds can be the culprit causing year-round symptoms. Molds, however, do have a peak season outdoors – from the time of early spring rains to the first hard frost. The mold population is significantly reduced after snow has been on the ground for five days of longer. Indoors, mold can be a very significant factor in allergic illness on a year-round basis, with basements and crawl spaces being the single greatest source of indoor mold. A particularly virulent blackish-green mold, stachybotrys, grows well on dry wall with its high cellulose content, and exposure to it has been linked to severe immune system dysfunction.

Over-humidification, poor ventilation, and increasingly energy efficient housing that has decreased a home’s supply of fresh air all contribute to an environment that encourages mold growth in homes on a year-round basis. That, combined with the fact that we now spend 90% of our time indoors, (and 70% of that time is spent at home) greatly magnifies the health hazards of poor indoor air quality. A 1994 Harvard University School of Public Health study of 10,000 US and Canadian homes found half of those homes had conditions of water damage and mold that was associated with a 50 to 100% increase in respiratory symptoms. Anyone with a genetic predisposition to allergic illness can become allergic if exposed for long enough to high enough mold levels.

Allergists have long tested and treated patients for reactions that environmental molds have on the mucus membranes of the eyes, ears, nose, throat, sinuses, and bronchial tubes. A Mayo Clinic study reported in Newsweek in December of 2000, that a study of 210 patients with chronic sinus infections found that most had allergic fungal sinusitis. The prevailing medical opinion was that mold accounted for 6 to 7 percent of all chronic sinusitis. This study found that 93 percent of sinus infections were caused by molds.

We now know that in addition to the direct effects of exposure to environmental molds, toxins emitted by molds called mycotoxins, originating both from our external environment and our internal environment of the digestive tract, can be responsible for general symptoms such as fatigue, spaciness, depression, and immune system dysfunction.

Treatment of Mold Allergy

Source Reduction

* The first tactic in mold allergy treatment is to reduce your exposure. All other treatments may be of little value unless you discover and eliminate or reduce the sources of mold in your home, car, and workplace. For some people, elimination of the sources of mold is adequate treatment by itself.
* Rid your home of unwanted and unused items-old shoes, clothes, magazines, and odds and ends stored in your basement and elsewhere. They can harbor mold.
* Exhaust your clothes dryer to the outside of your home and make sure the connections are solid and not leaking moisture into your home.
* Exhaust the bathroom and kitchen range to the outside of your home. Use cooking techniques that reduce the amount of moisture put into the air of your home. Cover your cooking pots with lids. Use your exhaust fans when cooking, showering, or bathing.
* Use dehumidifiers in your basement and in other damp areas in the summer, in particular. They can be the answer for mild moisture problems that support mold growth. Buy the best unit you can afford, preferably with an option of connecting a hose to the water reservoir to drain to a floor drain, to allow the dehumidifier to run regardless of whether or not you remember to empty the tank. The water tank itself can be a source of mold contamination. Clean it monthly.
* Thoroughly dry bath towels after use. Dry clothes thoroughly after laundering. Line drying clothes in sunny weather with lower humidity is recommended to lower mold growth, but not on days with higher humidity. Never put slightly damp clothes in dark drawers or closets. Use ? cup of borax in the wash cycle per load of laundry to deter mold growth.
* Old bed pillows can be a source of mold from subtle moisture accumulation that occurs through use every night. Get a new pillow every 12-18 months and dry your pillow in a clothes dryer at hot temperature setting once a month with a pair of tennis shoes. Pay special attention to the environment of your bedroom, as most people spend about a third of their life in their bedroom. Keep your bedroom free of allergens and chemicals (art and craft supplies, etc.) and houseplants which can harbor mold. Keep closet doors open as much as possible if they do not have their own ductwork for air-conditioning. Air-conditioning makes a home comfortable in part because of the reduction of humidity that makes indoor air more comfortable. Air-conditioning deters mold growth. If you do not have air-conditioning, use fans, as moving air also deters mold growth to some extent.
* Use a face mask if you have unavoidable contact with high mold concentrations-such as barns, compost heaps, or while eliminating mold sources in your home.
* Place pebbles on the top of your potted plants’ soil. This will not get rid of the mold that is always present on the soil, but it will decrease the number of spores that become airborne as air currents in your home set the spores into flight. Houseplants are like good friends – hard to part with. But the molds that can thrive on their soil may stand between you and better health. If you fail to improve despite other efforts, consider housing your plants with a friend for a while and see if you feel better. Cacti require dryer soil which produces less mold.
* Raking leaves results in a high level of mold exposure. Wear a mask while raking or have a less sensitive person rake leaves if you are mold sensitive.
* If you have forced air-heating system with ductwork, consider having your ductwork cleaned. Check out the Environmental Protection Agency’s (EPA) website for useful discussion on air duct cleaning and how to choose a contractor. http://www.epa.gov/iaq/pubs/airduct.html Do not have any chemical biocides or sealants put in your home’s ductwork, as they themselves are sources of indoor air pollution and pose health hazards.

* Don’t over-humidify your house. Moisture condensation on your windows in the winter is a sign of excess humidity. A guideline for indoor relative humidity if 35-50% to strike a healthy balance between too moist and too dry.
* Sprinkling powdered borax in your home in moldy areas is an effective mold deterrent. Or use one ounce of Zephiran chloride (available at most pharmacies) per gallon of distilled water and use that solution as an agent to kill mold. Mold growth will recur unless you take steps to eliminate the conditions that cause its growth in the first place. Poor air circulation, darkness, and moisture all support mold growth. One part chlorine bleach mixed with10 parts water also kills mold, but chlorine exposure also has harmful effects on human health, particularly the lungs.
* If you notice a musty odor in your home, or if others do, and you are unable to determine its source, consider moisture in the insulation of the walls and attic as a possible source of this odor. Improper construction techniques can cause extensive moisture problems that support phenomenal mold growth that can ruin the health of an entire family. Concrete block or cinder block, if not properly sealed, can constantly wick moisture from the surrounding environment. Straw bale homes in the humid environment of North Carolina are certain mold reservoirs. You may need to hire an environmental consultant for severe mold contamination in indoor environments.

Air Filtration

* Depending on the type of furnace filter you have, replace your filter every one to six months.
* Mechanical filters are available that offer many patients relief from airborne (inhalant) allergy symptoms, including those caused by molds. We recommend a HEPA filter for individual rooms that are occupied most frequently as most efficient in filtering airborne allergens, preferably when combined with a carbon block to capture volatile gases that can emit from molds. Whole house systems are also available. In addition ultraviolet light can kill mold whether from the sun or an air filtration unit. Electrostatic precipitators are helpful if you have ductwork and a main plenum with forced air heating and cooling, but they do need frequent cleaning that can be easily overlooked to maintain their efficiency.

Mold Allergy Desensitization

* Due to the fact that some level of mold exposure is unavoidable, employing methods of source reduction and air filtration are often necessary. At Great Smokies Medical Center, we utilize Sensitivity Reduction Technique (SRT) to restore balance in the body to foster desensitization to allergenic substances.

Cross-reactivity

If you are allergic to environmental molds, it is likely that you are also reactive to other members of the same Fungi family that can occur in our food supply. Do not assume that you are, but be aware of where molds are in foods, and watch for any possible intolerance. Click for Dietary Sources of Molds and Yeasts.

Members of the Fungi family can also cause persistent rashes on the skin and mucus membranes, resulting in ailments including thrush, vaginitis, diaper rash, ringworm, and an overgrowth of the fungi Candida albicans, a normal inhabitant of the intestines in small populations. Refer to the information on candidiasis for further information. If you are having immune system dysfunction related to candidiasis or any of the aforementioned diseases involving fungal infections of the skin, sublingual desensitization to Candida, trichodermaphyton, and epidermaphyton can be very helpful in addressing these fungal problems.

Pharmacological and Nutritional Treatment of Mold Allergy

* Antifungal drugs can be used to treat acute and chronic fungal infections. While sometimes providing symptomatic relief, they are more effective when combined with strategies that support the immune system including desensitization, environmental controls, and immune system building specific nutrient supplementation. Simply prescribing antifungal drugs without other supportive treatments is unlikely to have the desired benefits.
* A Neti Pot is available from the Medical Center to use for sinus irrigation with a weak saline solution for treating chronic sinusitis.
* We also utilize superficial injection therapy over acupuncture points related to the sinuses to address autonomic nervous system contributing factors that can perpetuate inflammation and swelling.
* A variety of immune system building strategies are used and individualized for each patient’s specific health situation.
* We aim to minimize the use of antihistamines that can ultimately have a drying effect that sets one up for infections through a loss of integrity of the mucus membranes of the respiratory tract and sinuses. In addition, drug therapies most often address symptoms but rarely treat underlying causes.
* Dietary decrease of sugar is essential, as sugar intake fosters increased populations of fungi. Yeast thrives on sugar.
* We use a variety of herbal, glandular, and nutritional therapies which are given for the immune system support they provide. Most patients develop a protocol which works for them and can be safely initiated at home at the first sign of allergic symptoms.

Alternative Treatment for Hay Fever

Monday, August 22nd, 2005

by Dr. John L. Wilson, Jr.

An estimated 40 to 50 million Americans suffer from seasonal allergy to pollen, commonly referred to as hay fever. Tree pollens predominate in the spring, grass pollens in the late spring, continuing through late summer and fall, when weed pollens predominate. Watery, itchy, red eyes; runny nose; itchy throat and persistent sneezing afflict sufferers during pollen seasons. Asthma, sinusitis, and bronchitis may also result. Mental dullness and fatigue are commonly reported by allergy sufferers, resulting in routine work responsibilities and even thinking becoming difficult. You can count on pollen from the diverse trees and weeds of Western North Carolina finding you in a crowd if you suffer from hay fever – pollen has been found in the air over the ocean 400 miles from land.

Conventional medical approaches to hay fever consist of drugs including antihistamines, decongestants, and steroids to suppress symptoms. Since giving individuals tiny doses of the same pollens they’re allergic to can result in desensitization, individuals who fail to respond to drug treatment may have prick and scratch skin testing, and resulting treatment with allergy shots, typically beginning with two shots per week, reducing to one shot per month over time.

Allergy symptoms result when mast cells, specialized cells in mucous membranes, release histamine on exposure to an allergen in a sensitized person, contributing significantly to the symptoms of allergy. Natural substances known to stabilize mast cells include the bioflavonoid Quercetin and the herb Stinging Nettle. Homoeopathics, including Allium cepa (red onion) and various over-the-counter homeopathic combination remedies can be very helpful in treating hay fever, as can pycnogenol, a powerful antioxidant found in the skins of grape seeds as well as the inner bark of the Maritime Pine tree.

Environmental control is important for a person with hay fever and includes limiting outdoor exposure especially between 5:00 and 10:00 a.m. when pollen counts are at their highest, keeping windows in your home closed during pollen season, and closing windows and fresh air intake when in your vehicle. Since pollen counts approach zero in air-conditioned buildings, air conditioned home or workplace can be helpful, though some will experience worsening of nasal symptoms on exposure to cold air. Since most people spend a third of their life in their bedroom, making a bedroom an oasis from allergens with high efficiency particulate accumulator (HEPA) air filtration and careful attention to house cleaning can be very helpful. Minimizing exposure to allergens, decreasing stress, eating simply and well (no sugar), identifying and avoiding food allergens, and getting adequate sleep also help a body cope with the effects of allergies.

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