Allergic to Allergy Medicine!
Sometimes the treatment is worse than the condition itself! That's what happens when people with allergies are allergic to the medication they take to relieve their symptoms, and sometimes the reaction can be life threatening. But now, treatments for people with sensitive systems are available.
Sandy DenBraber is allergic to her favorite things, working in her garden, or playing Frisbee with her dog, Katie. Turns out, Sandy is also allergic to allergy medicine.
DenBraber told Ivanhoe, "Every time I took an antihistamine, the problem got worse, and so, at that time, my throat would start swelling and I'd start turning purple."
After several hospitalizations, Sandy finally found relief. Alfred Johnson, D.O., Internal Medicine Specialist of Johnson Medical Associates in Dallas, Texas specializes in chemical sensitivity and environmental exposure. In addition to seasonal allergies, Sandy is also hypersensitive to smells and chemicals, including the ingredients found in allergy medicines.
"She was reacting to incipients in the medicine, either the dyes, or some of the additives" Dr. Johnson told Ivanhoe.
Dr. Johnson pinpoints people's sensitivity through extensive skin testing and uses allergy shots containing no preservatives or dyes. He recommends that people with allergies avoid the allergen and boost their resistance with allergy shots.
Sandy, a retired registered nurse, makes charcoal filtered masks for severe allergy patients. But with her allergies under control, she'd much rather be outside playing with Katie.
Experts say there are no cures for allergies just prevention to control the symptoms. The most common allergy triggers are: tree, grass and weed pollen; mold spores; and cat, dog and rodent dander.
Contributors to this news report include: Cyndy McGrath, Supervising Producer; Don Wall, Field Producer; Cortni Spearman, Assistant Producer; Mikon Haaksman, Videographer and Jamison Koczan, Editor.
BACKGROUND: Asthma and allergies strike one out of every five Americans. An estimated 50 million Americans suffer from all types of allergies. An allergy is an overreaction of the human immune system to a foreign protein, substance or allergen. These foreign substances can be eaten, inhaled into the lungs, injected or touched. There are several different types of allergies that one can have. These include indoor/outdoor allergies, food and drug, latex, insect, skin and eye allergies. Some symptoms of allergies include coughing, sneezing, itchy eyes, runny nose and a scratchy throat. In some severe cases allergic reactions can also result in rashes, hives, a lowered blood pressure, difficulty breathing, asthma attacks, and even death.
TREATMENT: Allergy is the fifth leading chronic disease in the U.S. among all ages and is the third most common chronic disease among children under 18 years old. There is no cure for allergies but they can be managed with proper prevention and treatment. Many medications and antihistamines are known to help subdue the symptoms of allergies but they do not get rid of allergies all together. Now there are also different forms of shots to help treat severe allergies. If you suspect you or your child has an allergy it's important to see a board certified allergist for confirmation.
ALLERGIC TO ALLERGY MEDICATION: In some cases, those who suffer from severe allergies are even allergic to allergy medicine. Sandra DenBraber is allergic to many items including her dog, molds, herbicides and pesticides. She is even allergic to antihistamine medications which are a key ingredient in many allergy medications such as Benadryl. She says, "I have had severe allergic reactions to antihistamine medications. Benadryl caused large welts the size of grapefruit and that was when I first noticed reactions to allergy medications." Sandra is also allergic to diesel exhaust, perfumes, and other chemicals. She says she has only been able to find relief through preservative-free antigens, supplements, careful diet control using organic food, and a nontoxic living environment.
(Source: Sandra DenBraber)
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Alfred Johnson, D.O., Osteopathic Physician of Johnson Medical Associates and Hyperbaric Centers of Texas, talks about his findings on the alternatives to allergy medicines and what can cause allergies.
Interview conducted by Ivanhoe Broadcast News in December 2014.
Would you say it's a fact that allergy treatments don't always work?
Dr. Johnson: Yes, that is in fact true. The population at large, about 40-percent, has allergies. Part of that group may react to preservatives, chemicals, or odors in an environment. You hear all the time that people react to perfumes or scented products and so you see laundry detergents and other products now that are scent-free. This is because people have allergies or adverse reactions to these products. It can cause headaches, watery eyes, itchy eyes, runny nose or skin rashes.
Can you define what we're talking about when we ask, what is an allergy?
Dr. Johnson: There are different types of allergies. The traditional allergy is an IGE allergy, which is an allergy to environmental factors such as pollens, dust, molds and dander. Those are environmental factors that are IGE mediated, which means you get exposed and then you get an immediate response.
What does IGE mean?
Dr. Johnson: IGE is Immuno Globulin E. It's a genetic component of your immune system that produces antibodies that recognize things you are sensitive to and causes adverse reactions.
Why are people allergic to so many different things?
Dr. Johnson: Some are genetic. If you have a mother and a father that are allergic, then it's most likely their children will be allergic. If only one of them is, then it may be 25 to 30-percent possible that their children will be allergic. Then, there's the predisposition genetic component. If you get exposed enough to a certain item, say you live in a moldy house for a long period of time; you develop an allergen even though you may not have high IGE, which is that predetermining factor.
Some people are allergic to foods?
Dr. Johnson: Exactly. If you eat too much of one food too frequently and you have a virus infection at the same time, that inhibits your gut intestinal track protective mechanism and you may develop a sensitivity to that food.
Why are we allergic to dogs and cats?
Dr. Johnson: Well, you could get overexposed to them. You're exposed to their dander all the time. Most people that are sensitive to dogs and cats have a predisposition for that. Their family members are allergic to it so that's a fairly set genetic pattern.
Here in Texas, we are exposed to a lot of things in our growing seasons, right?
Dr. Johnson: Yes, and we have long growing seasons. Up north, you may have snow cover for three or four months out of the year which gives your body a rest. Here, you do not get that. When the wind blows, mold is constantly stirred up so it's a major factor. In the fall, we have ragweed and ragweed comes from the south and from the north. We get a double exposure type situation all the time. We get mountain cedar in the wintertime and then in the spring, we have the trees and the grasses. So, yes, we have a pretty constant bombardment on our bodies and if you happen to be one of those people that are highly sensitive or have the high IGE, you can develop an allergy if you don't already have it.
Can you explain how Sandy was affected?
Dr. Johnson: She had trouble when she took the antihistamine, Benadryl. It caused shortness of breath, wheezing and on occasion she was hospitalized. They gave her Benadryl and it made her worse. Finally, in testing, we found out that Benadryl was the culprit that was flaring her up and making her whole allergy situation worse.
Can you talk about, through your testing, how you found antihistamines may cause these problems?
Dr. Johnson: In Sandy's case, it's a particular antihistamine and in other people we've had adverse reactions to different antihistamines. Sometimes, it may be a true allergic response and other times it classifies as an idiosyncratic reaction. This means it just happened for that one person. Their body doesn't tolerate it for some reason whether it's how they metabolize it, or how it affects their nervous system in an abnormal way. It keeps them awake when it should make them sleepy.
Sandy actually mentioned that some medications she was taking were actually making her depressed. Can this be true?
Dr. Johnson: Yes. It's a side effect of a medicine and in some people it's worse than others. That's not really an allergic reaction where it releases histamine or those inflammatory mediators where you get bronchospasm and asthma and shortness of breath as I described earlier.
Antihistamines can react differently in some people than others, right?
Dr. Johnson: Yes, and that's very individual and fairly rare, but it does happen with antihistamines as well as all other kinds of medicines. In that particular individual, it's very important to recognize that and to let their doctors know if they do have allergic reactions to medicines. Whether it is an antihistamine, an antibiotic or heart medicine, it's important to get a medical alert bracelet, have it in your billfold, make it known to a caretaker that that's what is happening and what your experience is with that drug.
What should a person do if they have allergies to medications or adverse reactions, which in emergency room situations, they may not know?
Dr. Johnson: First of all, if a person has an allergy to a medication, always have them get a medical alert bracelet so that doctors, nurses or paramedics can look for that. You can wear one around your neck or even your arm. If they have adverse reactions to drugs and not a true anaphylactic reaction, I have them put that on a medical alert bracelet which says see letter in purse or see letter in billfold. The letter describes what happens when they take that medicine. If they're in a situation where they can't tell someone, the medical personnel can read that and say, yes, they do not tolerate this medicine well and causes this type of side effect; we need to use this type of medicine. It helps with the care and helps with the information so that the person can get optimal care and doesn't by happenstance have an adverse reaction that may make their condition worse at the time they're being treated.
The basic premise of this is that allergy medicine could make you sick. Are we talking about a lot of people?
Dr. Johnson: It's a significant enough amount that it's really worth talking about. People may have reactions and they don't know it, so it's important that the information is out there. They make Benadryl in a dye-free product now because they found that children had adverse reactions to dyes. There's been more awareness about incipient medications that may cause problems and not necessarily the medication. When we test a medication we actually have to test the pure form of it. A person may react different to an oral form versus an I-V form because of how it's prepared.
What types of things might be in your medication that you think could cause an allergic reaction?
Dr. Johnson: Oral medicines either come in capsules or tablets. Capsules may be made out of gelatin, but there are veggie capsules too. A gelatin is a protein from an animal, so it could be pork or beef. If you're sensitive to one of those food items, then you can react to that product. Also, in the capsules are fillers called inert ingredients, but they may be corn or dairy product or some other substance that somebody can react to. There are dyes in different products that can cause reactions. You need to read the fine print as to what the ingredients are. They're dying some pills now with ferric oxide which is a mineral not a chemical dye. There are oral medicines, intermuscular medicines and I-V medicines. Those medications are typically more pure and have less additive ingredients. They do have preservatives, so some people react to the preservatives in those types of medications.
To what degree do you take a different approach in diagnosing allergic reactions? Is it because you are looking for it?
Dr. Johnson: Exactly. I see a lot of people with food allergies, chemical intolerance, dermatological problems that are related to contact dermatitis and people with industrial exposures to different industrial products. All of these things relate to what is in a medication. When we see this, we can actually skin test or challenge that individual to the items which are in these products to find out whether they have an adverse or allergic reaction to it.
Why do you go to that level?
Dr. Johnson: My philosophy is to really look and see what's going on with the individual and not just take a quick history and say try this. If there's an acute situation, then you have to try something else, but if not we need to make sure that what they're taking is safe for them. Skin testing can be done or oral challenge under supervision can be done but it takes time. It's well worth it for that individual to find out exactly what is going on.
It seems like the research over the past 20 years has validated the whole concept of environmental exposures and things that are in our environment that have an adverse effect on us that we just assumed were safe.
Dr. Johnson: Exactly. Dr. Haley, here in Dallas, found that the Gulf War vets that were affected actually had an enzyme deficiency that breaks down those chemicals that were in the Gulf that soldiers were exposed to. We see now with genetic testing that a group of genetic defects can add up together to cause problems. We can actually define that this person will have a problem with it. Whether it's gluten sensitivity or other ways in how they handle chemicals or drugs. They can predict who is going to have trouble with medications. There are all kinds of new data out there to support what people have been telling us for years and what we find with adverse reactions or allergies.
What are some alternatives for people who have allergies?
Dr. Johnson: The alternative is that there are all kinds of different medicines for allergies that aren't related. If you're dependent on medicine for your allergy, then there are different types of antihistamines that work in different ways. There are anti-inflammatories that help calm down the allergic factors and there are steroids which help calm down the inflammation and allergic factors.
And, lifestyle is a factor too, right?
Dr. Johnson: Exactly. It's just like if you lose ten pounds, it will definitely help your blood sugar and blood pressure and your overall health. But, trying to get people to lose ten pounds is really difficult. They just want a pill to fix it. If they're having adverse reactions and intolerances, then you have to define all that, explain it to the individual and get them on a program that works for them. We try to use allergy immunotherapy or allergy shots to build up blocking antibodies. That helps calm down the reactions over a period of time. My preference is to define what the problem is, avoid it and build up a tolerance to it, and then use medications after that.
What if someone is allergic to dogs, but they want to have a dog?
Dr. Johnson: You can get them on dog allergy shots for dog dander. You can keep the dog out of the bedroom, filter your air in the house and don't have carpet. You can also get a HEPA vacuum.
You can't really determine by yourself what you're allergic to?
Dr. Johnson: You can in some instances, but many times there's so many things that we're exposed to on a daily basis that it's hard. If you think it's a food in your diet, then just eat one food at a time. If you think it's your medicine causing a problem, then separate out your medicines and don't take them all at once. Generally, a reaction will occur within thirty minutes to an hour or even sooner.
What would be your best guidance to people who may develop allergies and they don't know what to do?
Dr. Johnson: It's best if you have a medical condition or an intermittent problem to see a doctor and try to sort out what is going on. You can explore yourself by keeping a daily diary of what you eat, what you do, where you go and what you drink. Many times that will sort out the whole problem. I had one patient years ago that came in with severe migraine headaches. I asked her when it started and she said in the morning. I asked her "What do you do in the morning? Well I get up and I have a Dr. Pepper." I said "Let's just stop your Dr. Pepper and see what happens to your headaches." Sure enough, they all went away. She had seen umpteen doctors trying to figure out what her headache was and it took just some specific questions to sort it out.
For the person who sees 10 doctors and still can't find the answer, the answer does exist, right?
Dr. Johnson: The answers do exist and a lot of time the patients can figure it out, but they just don't know what to do about it. I have people come in all the time saying I have this problem, I've been to all these doctors and here's what I believe it is. It's just a matter of listening to the patient, helping them sort out exactly what it is and then deciding what to do about it. Sometimes it's as easy as avoidance. Artificial sweeteners are one of the things that people react to fairly frequently and get headaches from. They get indigestion from it and then esophageal reflux. You just have to look at the cause and effect, take the history and see what they're doing on a repeated basis and what type of environment they're in.
Do we know why some people are more sensitive than others?
Dr. Johnson: It's genetic most of the time. Or, they had an unfortunate event in their life that caused their immune system to be altered and more sensitive or suppressed for some reason.
How much satisfaction do you get when you get a patient like Sandy who's been through that whole history, all those doctors, all those tests, and then you finally help her?
Dr. Johnson: It's very satisfying. It makes you feel like you're doing something worthwhile as a physician to really see a person thriving and doing a lot better. It's nice when you can help sort out what's causing problems and what's not causing problems and help them have a better quality of life.
A person should invest the time to seek some help because relief is possible, right?
Dr. Johnson: Oh yes, relief is possible. If you're having allergies, it makes sense to really address it and understand what's happening because we never know when that next exposure is going to cause an acute asthma attack, acute hives, or an acute life threatening situation. It's a good idea to have a good handle on it to know how to reduce your risk in daily living.
With the allergy shots are you getting an antihistamine?
Dr. Johnson: No. With an allergy shot, you get a small amount of that actual substance you're allergic to. It produces blocking antibodies which then creates resistance. Many people remember grandmother saying, eat local honey and your allergies will go down. Well, that's true because the honey has the pollen in it and you get a little bit on a consistent basis which boosts your resistance.
The report that started this was presented this year at the annual meeting of the American Academy of Asthma and Allergy. Is that an affirmation of the mainstream medical community that all this stuff is a new acceptance by that group?
Dr. Johnson: Well, it's a better understanding of what is going on. We're having more and more research done on a daily basis than ever has been done before. We have new methods to look at the whole process. So, yes, it's a much better understanding. Medicine is typically pretty slow in accepting new things and it takes a while. It's just like H-pylori was discovered 10 years before it was really accepted as the cause of ulcers. It's a bacteria that's hard to culture, hard to define, and then was slow in being accepted by the medical community. It took eight to 10 years before it was really accepted.
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