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Allergy response can be a wide range of symptoms: sneezing, congestion, rhinitis (runny nose), post-nasal drainage, watery/itchy eyes, itchy/sore throat, hives, headache, fatigue/malaise, coughing, wheezing, shortness of breath, atopic dermatitis (eczema), digestive issues, and more. For some people, allergies can occur seasonally, or for some unlucky sufferers, constant year-long allergies. Some people's allergies can seemingly appear to occur out of nowhere at a later stage in life or can persist since childhood. It is a major inconvenience when dealing with allergy symptoms. Allergic reactions can range from minor problems to life-threatening. Allergies are the sixth leading cause of chronic illness in the US with an annual cost in excess of $18 billion. More than 50 million Americans suffer from allergies each year. 30% of adults in the US and 40% of children in the US have allergies.1 Worldwide, the rise in prevalence of allergic diseases has continued in the industrialized world for more than 50 years.2 There is an increased use of alternative medicine by allergy sufferers due to assumption of fewer side effects, avoiding the use of drugs, and unsatisfactory results with conventional medicine.3,4 This article will discuss using a personalized treatment approach while addressing the patient as a whole.
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Looking for Underlying Causes
With allergies, there are numerous underlying causes to why a person develops symptoms. One can start with the most common approach through looking for environmental triggers like dust, pollen, dander, and foods.
Taking a step further is to look at food sensitivities or food intolerance. These are delayed hypersensitivities that can also present a burden on the patient and lead to the above symptoms.5 Other underlying causes for allergies can be found within the gut. Elevated histamine is present in gastrointestinal conditions such as IBS and SIBO, which can exacerbate allergy response.6,7 Also, exposure to parasites like giardia may lead to allergies, increases in food intolerance, and IBS symptoms.8,9
Other issues, such as mycotoxin exposure, can lead to allergy/asthma symptoms. Mold and mycotoxin exposure affect the immune system deeply and can be related to more complex illnesses beyond allergies.10-12 Evaluating mold exposure may require a thorough workup and specialized treatments, but it is helpful to keep this as a possible consideration when dealing with chronic allergies.
Air pollution can exacerbate allergy/asthma symptoms.13-16 Data suggests that living in an e-waste-exposed area may lead to increased levels of heavy metals and accelerated prevalence of respiratory symptoms and asthma.17
Taking a comprehensive environmental exposure intake is helpful, looking for previous and current exposures to potential allergens.
Treating the Whole Body
Before starting on specific symptom relief treatments, I try to address the whole body as a complete system. This process seems to give allergy sufferers great relief, as well as address any other concomitant symptoms. There still may be more specific individual components to address as the reasons for allergies are individualized.
I usually start my patients off with the bucket analogy when trying to address the total body burden. Keep in mind this is an overly simplistic view of the biochemistry and mechanisms but helps to paint the picture. The bucket analogy goes like this:
Imagine your body is like a bucket. Everything that we are exposed to gets into the bucket: food, water, air, pollution, toxins, emotions, infections, etc. As all these exposures enter your body and start to fill up the bucket, your organs of detox and elimination have to go to work to break them down and process them. Your liver/gallbadder is responsible for the bulk of the initial processing and metabolism of all of those exposures and the broken-down exposures go to your bloodstream, then to your organs of elimination: lymph, lungs, skin, colon, and kidneys.
Somewhere along the line, if your liver is overburdened or not efficient, then those exposures can overfill the bucket and spill over the brim, leading to an increase in allergy-related symptoms or other symptoms. Alternatively, if the liver/gallbladder is functioning satisfactorily, but the organs of elimination are compromised, then the bucket will still overfill or not drain properly leading to the same symptoms. If the system as a whole works well, then the bucket can eliminate these exposures, which helps keep the bucket from filling up too quickly. If the bucket never fills over the edge, you can tolerate these exposures with little to no symptoms.
First step is helping the patients limit the outside things coming into this bucket, such as exposures of irritating foods, drinks, chemicals, emotions, and known allergens if possible. We start with avoidance. We educate patients about possible contaminant exposures through air pollution, food, and drinking water, such as chemicals in the tap water, contaminants in plastic water bottles, glyphosate, or other herbicides in produce. Glyphosate has been linked to issues of celiac sprue and gluten intolerance.18 We encourage patients to drink adequate amounts of filtered water. Exposure of chemicals through the skin is also another issue that is addressed. A good resource to look into popular skincare products and their possible contaminants is www.ewg.org/skindeep/. We talk about the possible effects of emotions such as stress and trauma and other repressed feelings that could lead to chemical hormones in the body that also have to be dealt with too. Unresolved emotions can have larger implications for overall health that go beyond the scope of allergies.19
Secondly, we work on the diet. We recommend an allergy elimination diet, which limits the most common reactive foods: wheat, dairy, soy, corn, sugar, and eggs. In addition, we limit the intake of processed foods and beverages and encourage to source organic foods if possible. We recommend whole foods with a variety of vegetables, good quality fats and protein. A good source for learning about organic fruits and vegetables is www.ewg.org/foodnews/.
The third step we address is the patient's micronutrient status. There are various nutrients that are important for supporting the basic liver detox pathways. I generally try to start with a medical food or broad-spectrum multivitamin that contains nutrients that support these detox pathways. I look for products that have methylated B vitamins, supportive amino acids, and herbs that can encourage healthy liver function. In addition, we may add vitamin C (3,000-5,000 mg), magnesium (400-1,000 mg), fish oils (1-3 g).20
Fourth, we focus on the other organs of detox and elimination.
For healthy gallbladder function, we may suggest gallbladder-supporting nutrients that include lipotropic agents, ox bile, taurine, beet extracts, or botanical choleretics.21 Micronutrients from our second step also support this process.
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