Jul
3
Leukotriene Modifier Montelukast (Singulair)
We used to think Singulair was a very cool drug. It is an oral prescription medicine that blocks the effects of those inflammatory chemicals called leukotrienes. So, it only made sense to us that a drug like Singulair would relieve symptoms. This medication is widely prescribed to ease the breathing problems associated with asthma.
Research suggests, however, that Singulair is only modestly effective for alleviating itching, sneezing, congestion, and runny nose. It is roughly comparable to antihistamines such as loratadine (Claritin). One study reported that Singu-
***** Corticosteroid Nasal Sprays
Most allergy experts believe that these steroid sprays are the most effective treatments available and should be the first-line therapy. They are not likely to cause drowsiness or sedation and should be safe for people who must drive or operate machinery.
Side effects: Nasal irritation, stinging, burning, and bleeding. Other adverse reactions may include sore throat (and, rarely, yeast infections), headache, nausea, and cough. Rare adverse reactions may include perforation of the septum, nasal ulcers, reduced growth. rate in children, glaucoma, cataracts, and asthma symptoms.
Downside: These drugs are pricey and may alter the senses of taste and smell.
Cost: Approximately $85 to $95 for brand•name nasal sprays. Generic flunisolide is $35 to $40 per bottle.
lair, which costs more than $3 per pill, was no more effective than the oral decongestant pseudoephedrine (Sudafed) for relieving typical allergy symptoms. 56 Generic pseudoephedrine is far less expensive than Singulair. It is harder to purchase these days because pharmacists can only dispense it from behind the counter. You don’t need a prescription, but you will have to sign for it. Too many people used pseudoephedrine to make the illegal drug methamphetamine, so states and the federal government cracked down on easy access.
The research demonstrating that pseudoephedrine is quite effective in relieving allergy symptoms has forced us to reevaluate this old and inexpensive vasoconstrictor. It works by shrinking blood vessels in the nose. Perhaps that’s why so many drug companies now add this OTC ingredient to their antihistamines. Whenever you see a D appended to the name of an allergy medicine, you can pretty much assume that there is a decongestant on board, and frequently it is pseudoephedrine. It is found in Allegra-D, Claritin-D, Clarinex-D, Zyrtec-D, and other similar formulations.
O.I would like to point out a side effect of allergy medications that contain pseudoephedrine for nasal decongestion. Taking Claritin-D left me completely unable to fall asleep. I was literally up all night with a racing heartbeat.
I have had insomnia problems before, so I did not immediately associate this with the medication and continued to take it for 5 days. I was so sleep deprived that I couldn’t work.
I finally read the warning about nervousness, dizziness, or sleeplessness. I called my doctor, who said I should switch to Claritin (non-D). On this drug I sleep like a baby.
I found that some OTC allergy medicines I had taken for years also contain pseudoephedrine. I suspect this contributed to my earlier insomnia problems.
I urge anyone with insomnia to check all medications for pseudoephedrine. It does not affect everyone, but some of us just can’t handle even a small amount.
A. Millions of people struggle with insomnia and many don’t realize that the medicines they take may be contributing to their problem.
Decongestants aren’t the only culprits. Antihistamines, antidepressants, asthma medicines, blood pressure pills, and pain relievers are some of the drugs that can cause insomnia.
As popular as pseudoephedrine may be, there are some side effects to be alert for. Many people complain of insomnia, anxiety, agitation, headache, nausea, dizziness, and tremor. The most serious adverse reactions are elevated blood pressure and irregular heart rhythms. Men with prostate enlargement must avoid this decongestant because it can make urination much more difficult.
Jul
3
Allergy: Corticosteroid Nasal Sprays
July 3, 2009 | Leave a Comment
Corticosteroid Nasal Sprays
The big revolution in allergy treatment involves the use of steroid nasal sprays. Allergists have known for decades that cortisone-like drugs (prednisone, for example) can dampen the reactions of an overactive immune system and calm allergy symptoms amazingly well. The trouble is that relief comes at a stiff price. So many side effects are associated with oral corticosteroids that few physicians would ever consider prescribing such medications for nasal allergy symptoms except as a last resort. Even then, cautious doctors prescribe medications like prednisone for the shortest period of time necessary. Adverse reactions can include irritability, insomnia, anxiety, high blood pressure, potassium depletion, headache, nausea, and dizziness.
Not surprisingly, people wanted the benefits of steroids without the risks. That’s where nasal sprays come in. There are about a half- dozen different intranasal corticosteroids available by prescription. Most experts would say that these formulations are the most effective allergy treatment available. Although it may take a week for the benefits to reach peak effect, these sprays should relieve allergy symptoms such as itching, sneezing, and congestion quite well. They are pricey, however. A small bottle can run $85 to $95. At the time of this writing, generic flunisolide costs around $40. We cannot say whether one spray is better or safer than another.
The general consensus is that there are few, if any, systemic
GENERIC
BRAND NAME
Beclomethasone
Beconase AQ
Budesonide
Rhinocort Aqua
Flunisolide
Nasarel
Fluticasone
Flonase
Mometasone
Nasonex
Nasacort AQ
Triamcinolone
INTRANASAL
CORTICOSTEROIDS
side effects associated with topical steroids. In other words, the experts do not believe people absorb enough of the drugs into the system to cause much, if any, concern.55 One study did report growth suppression in children, but other research has not confirmed this complication. There have been rare reports of nasal perforation (creating a hole between the nostrils) and increased pressure within the eyes. More common are local reactions such as irritation and burning in the nose, sore throat, nasal dryness, nosebleed, and headache.
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3
Allergy Medications: Antihistamines
July 3, 2009 | Leave a Comment
Antihistamines
Antihistamines have been the mainstay of allergy treatment for decades. The so-called first-generation drugs like diphenhydramine (Benadryl), brompheniramine (Dimetane, Dimetapp), and chlorpheniramine (Chlor-Trimeton) are linked to drowsiness and cognitive impairment 47 Second-generation antihistamines such as cetirizine (Zyrtec), desloratadine (Clarinex), fexofenadine (Allegra), and loratadine (Claritin) have been promoted as nonsedating. Because they were supposed to be so much safer and better tolerated than the old-fashioned drugs, many came with a very steep price tag ($2 to $3 per pill). But there is growing concern that when given in doses that are adequate to relieve allergy symptoms, even these newer compounds may cause some sedation in some patients and produce mild impairment.48 Researchers now believe that “a clear and consistent distinction between sedating and nonsedating antihistamines does not exist.”‘
What this means is that the allergy victim is truly caught on the horns of a dilemma. Suffering with allergies makes you spacey, sleepy, and irritable and can impair your ability to function. Antihistamines can also cause sedation and impair performance. If such drugs only partially control symptoms (a fairly common situation), then you may end up with the worst
Claritin used to be the most widely prescribed antihistamine on the market. When it lost patent protection, the company took it OTC. Compared to many of the older nonprescription antihistamines, loratadine is probably less likely to cause drowsiness at recommended doses. We have seen no data to suggest that it is less effective than pricier prescription antihistamines.
Side effects: Headache, sleepiness, dry mouth, fatigue, jitteriness, and stomach upset. Liver problems may be a rare adverse reaction.
Downside: More expensive than old-fashioned antihistamines. Insurance companies may deny you affordable access to drugs like Allegra now that loratadine is available OTC. Loratadine may cause sedation and impair driving in susceptible people. Do not assume you are safe behind the wheel.
Cost: Approximately $5 to $10 for a month’s supply when purchased generically in bulk. The brand-name Claritin can cost two to four times that much.
situation of all—sedation from the medicine and from the allergic condition.”
In such a confusing situation, we would normally suggest that the allergy sufferer experiment with a variety of antihistamines to try and determine which one works best and is least troublesome in terms of side effects. The difficulty is that people are notoriously bad at assessing their level of impairment. There is a warning on the label of Benadryl and many other OTC allergy medicines reminding users that “marked drowsiness may occur” and urging them to “be careful when driving a motor vehicle or operating machinery.” Such cautions are as meaningless as telling a drunk to be careful behind the wheel. In fact, researchers have reported that diphenhydramine”had a greater impact on driving than alcohol did: ,51 These scientists discovered that “drowsiness ratings were not a good predictor of impairment, suggesting that drivers cannot use drowsiness to indicate when they should not drive.”
By the way, did you know that you could be arrested for driving while impaired after taking an OTC allergy pill? If your driving skills are not up to par, an officer can give you a ticket even though you have no alcohol in your system.
So, dear reader, we have no easy answers. We would like to say, if you have allergies, do not drive, especially if you are taking antihistamines. That would be the only prudent thing. We know that some people will disobey such a suggestion, however. Some experts believe that fexofenadine (Allegra) may be one of the least sedating and safer antihistamines to take if you must drive. 52,51 Others point out that even this non-sedating antihistamine may pose problems at higher doses. 54 If driving or operating machinery is essential or if you must make important decisions, we encourage you to look for other options besides oral antihistamines.
There is now a prescription antihistamine nasal spray called azelastine (Astelin). It is fairly fast acting but has the disadvantage of requiring twice-daily nasal spritzing. Some data suggest it may be as effective as oral antihistamines. Side effects may include a bitter taste in the mouth (20 percent of patients), headache, drowsiness (11 percent of patients), nasal burning or inflammation, sore throat, dry mouth, sneezing, fatigue, and dizziness. A 1 -ounce bottle can cost $75 to $85. Not exactly a perfect solution to the problem, eh?
Jul
3
Allergy Medications - Nasalcrom (Cromolyn)
July 3, 2009 | Leave a Comment
Allergy Medications Nasalcrom (Cromolyn)
Speaking of stabilizing mast cells, another way to do this is with a nasal spray. Cromolyn (NasalCrom) was first introduced as a prescription product in 1983. NasalCrom went over the counter in 1997. Cromolyn, the active ingredient in Nasalcrom.
This nonprescription nasal spray. is often ignored by doctors; but it is a valuable tool in the fight against nasal allergies. By stabilizing mast cells in the nose, NasalCrom makes it harder for histamine and other inflammatory chemicals to be released and do their dirty work.
Side effects: Cromolyn is very safe and does not cause drowsiness or rebound nasal congestion the way OTC nasal decongestants can. Some people may experience temporary sneezing, nasal burning, or a bad taste in their mouth.
Downside: You must use NasalCrom at least four times a day to really benefit. Some experts believe it is much less effective than intranasal corticosteroids.
Cost: Approximately $17 to $20 for a 1- to 2-month supply finally derived from an herb, the fruit of bishop’s weed (Ammi visnaga), which was traditionally used to treat asthma.
The compound cromolyn stabilizes highly sensitive mast cells in the lining of the nose and lungs so they can better resist the onslaught of pollen. It won’t cause drowsiness or cognitive impairment and, if used regularly, it is quite effective. Unlike decongestant nose sprays, there is no need to fear developing dependency.
cromolyn is available in eyedrops (Crolom) for itchy, red eyes due to allergies. There is also an aerosol inhaler (Intal) for treating asthma. Both products require a prescription, whereas NasalCrom does not require your physician’s assistance.
Q. I’m going to visit my daughter in a few weeks and she has two cats that have the run of the house. When I’m there, I suffer runny nose, watery eyes, and sneezing from the cat hairs that are all over the house and furniture.
Can you recommend something over-the-counter for me to take during the visit?
A. NasalCrom is a nasal spray that can be quite effective if taken preventively. You will need to start spritzing several days before arriving so you can stabilize the cells in your nose and protect them against cat allergens.
If you also took the oral antihistamine Claritin (loratadine), you might be able to minimize the sneezing and allergic reactions.
Jul
3
Allergy: Quercetin and Bromelain
July 3, 2009 | Leave a Comment
Quercetin and Bromelain
Two other natural products that may be worth consideration against allergies are quercetin and bromelain. Quercetin is an antioxidant flavonoid that is found in many fruits, vegetables, and herbs. The anti-inflammatory effect of quercetin helps stabilize mast cells. These are the cells in your eyes, nose, and lungs (and other places in your body) that are highly sensitive to allergens.
Think of mast cells as floating mines. When they come into contact with allergens like ragweed pollen or dust mite poop, a switch gets thrown on these cellular “mines” and all hell breaks loose. Mast cells start releasing histamine and other chemicals called kinins (pronounced KYE-nins), which then turn on a cascade of other nasty things like leukotrienes and prostaglandins. The end result is sneezing, itching, inflammation, and congestion.
Quercetin, especially when combined with bromelain (an enzyme derived from pineapple), seems to stabilize mast cells and make them less likely to trigger the release of such chemicals.44 45,46
We think such an approach may be more logical than trying to block the effect of histamine with antihistamines.
Think of it this way. If your mast cells are like a barn holding in a bunch of wild horses (histamine molecules), then what would be more efficient—reinforcing the door and walls of the barn to keep those wild histamines inside or trying to protect all the grass in your pasture from having those histamine “horses” nibbling away at it? Antihistamines are like a chemical barrier that tries to protect your grass once the horses are out of the barn. But they are not 100 percent efficient, and some histamine will always find a target and wreak havoc. Keeping the barn closed tightly (or the mast cells stabilized) seems to us to be a more effective approach.
Jul
3
Allergy: Butterbur (Petasites hybridus)
July 3, 2009 | Leave a Comment
Butterbur (Petasites hybridus)
Another interesting allergy treatment involves the herb butter-bur. This botanical medicine has been used to treat symptoms of migraine headaches, asthma, and allergy. It has anti-inflammatory activity and blocks the formation of compounds called leukotrienes (pronounced lew-co-TRY-eens). These rascals cause all sorts of mischief in the nose, including itching, sneezing, swelling, and congestion. In some respects, leukotrienes may be even more of a problem than histamine. Leukotrienes contribute to the inflammatory cascade that underlies both allergy and asthma. The prescription asthma and allergy drug Singulair (montelukast) also works by inhibiting leukotriene formation.
Swiss researchers compared butterbur with the antihistamine cetirizine (Zyrtec) in a randomized, double-blind study. They found that both products were equally effective at controlling symptoms, but butterbur was significantly less sedating than Zyrtec. 43
Q. I have suffered from chronic sinusitis, which in turn led to bronchitis and frequently into pneumonia. My physician put me on Allegra and then switched me to Clarinex.
I continued to have sinusitis and pneumonia annually for 5 years, so my doctor sent me to an allergist. He diagnosed several allergies and added a prescription for Nasacort to the Clarinex.
Two years ago, having suffered through another bout of sinusitis and pneumonia, I saw an integrative alternative medicine physician. He took me off Clarinex and prescribed butterbur, stinging nettles, and quercitin instead. I’ve taken this combination for 2 years and it has reduced the frequency of the sinusitis.
I read that I should take butterbur only 6 weeks a year. Now I am concerned about the danger of liver damage.
A. Pharmacologist David Kroll, PhD, offered this clarification on butterbur. “I wanted to follow up on a
reader who wrote to your newspaper column regarding the potential liver toxicity of butterbur (Petasites hybridus), an herb that’s become popular due to positive efficacy trials in migraine prevention and allergic rhinitis. While the herb is potentially toxic to the liver, it shouldn’t be a problem with high-quality products like Petadolex. I do-fear that some less honorable companies may latch onto this herb and not take such care with the high-tech extraction process that is necessary to reduce the risk. That might lead to some major liver injury cases.”
There is one fly in the ointment, however. Concerns have been raised about potential liver toxicity associated with compounds in butterbur. If the herbal preparation is not manufactured under very stringent quality-control conditions, there could be problems. As a result, we suggest that people use butterbur only temporarily (say, for 6 weeks during hay fever season) and that they monitor their liver enzyme activity with medical supervision. One product that should be safe is Petadolex. The German manufacturer is Weber and Weber, and it is available in the United States.
Jul
3
Nondrug Allergies Treatment
July 3, 2009 | Leave a Comment
Nondrug Approaches for Allergies
Even if you created a perfect living environment by eliminating carpets and rugs, minimizing stuffed furniture, banning your pets to the outdoors, and filtering your air, you could never truly eliminate allergens from your personal space. And every time you go outside, you are vulnerable to whatever is in the air. So, what can you do to minimize your reaction to pollen and all the other nasties flowing through your nose every time you breathe?
Nose Cleaning with Neti
Americans have a hard time imagining that you can clean your internal environment. But the Ayurvedic tradition of India encourages nasal washing with what’s known as a neti pot. This porcelain container looks a little like Aladdin’s lamp. It allows saltwater to be poured into one nostril and exit out the other. This washing process is supposed to clear the nasal passages of dust, pollen, and other allergens.
You can find neti pots at some health-food stores or by calling the Himalayan Institute at 800-822-4547. Visit their Web site at www.netipot.org to get an idea of what we are talking about. A ceramic pot costs $18 to $20.
For years I was troubled with allergies. But I have discovered the following natural approach. I use a ned pot to wash my sinuses with salt water Sinus and ear infections are now a thing of the distant past. Many people are grossed out at even the suggestion of pouring something into their noses, but the sensation is really very pleasant if done properly (with lukewarm filtered water and mild saline solution).
I also vacuum my bedding daily to get rid of dust mites.
Vitamin C
We are the first to acknowledge that vitamin C studies are squishy. There just have not been large, well-conducted clinical trials to test the effectiveness of ascorbic acid (vitamin Q against allergic disorders. The allergists will rightfully say that without decent data they cannot recommend this vitamin.
Nevertheless, some research suggests that this nutrient might help reduce allergy symptoms through a kind of antihistamine action.”,” There is also the possibility that vitamin C modulates immune-system reactivity and has anti-inflammatory effects.37 The benefits, if they exist, appear fairly short-lived. That’s why the general recommendation is to take 500 milligrams of ascorbic acid three or four times a day. 38
Stinging Nettle (Urtica dioica)
The very name of this herb is enough to scare many folks away. If you were to come into contact with stinging nettle, which grows widely throughout Europe and North America, you would have even more misgivings. Touching the tiny hairs on this plant can cause an impressive rash that can itch and sting for up to 12 hours.
It is ironic that these hairs contain a witches’ brew of ir-*** Stinging Nettle (Urtica dioica)
This herb is well known in Europe, where it is used primarily to relieve allergy symptoms and improve urinary flow in cases of benign prostate enlargement. The dose that has been used for treating nasal symptoms is 300 milligrams of freeze-dried Urtica dioica per day.
Side effects: This herb is usually well tolerated. Mild digestive upset has been reported, especially if it is taken on an empty stomach. Some people may experience an allergic. rash and should discontinue use immediately if this occurs. Downside: Large, well-controlled trials are lacking. Better research is needed before we can give this herb a ringing endorsement.
Cast: Approximately $5 to $10 for a month’s supply
ritating chemicals, including histamine and formic acid (also found in ant stings), yet the herb may be helpful in controlling allergy symptoms. When the leaves and other parts of the aboveground plant are extracted and swallowed, they may offer some fascinating pharmacological benefitS.39′
In Europe, where Urtica dioica is quite popular, physicians have been prescribing it to treat allergies for a long time. One double-blind trial noted that 58 percent of the study participants had good relief of SyMptoMS.41 Almost half of the patients said that stinging nettle was just as effective, if not more so, than their standard allergy medicine. Why something that contains histamine might actually help to relieve allergic symptoms is somewhat mysterious. Investigators suspect that it may help to modulate the immune response. 41
O. 1 feel like I am caught between a rock and a hard place. My allergies are awful, but most antihistamines and decongestants warn that they’re not to be used by men like me. I have an enlarged prostate, so Benadryl and Sudafed are off limits. Is there anything natural that would help my allergies and not aggravate my prostate problem?
A. Most over-the-counter (OTC) allergy medicines contain either an antihistamine or a decongestant that can make urination more difficult for a man with an enlarged prostate. An herbal remedy that might substitute is stinging nettle (Urtica dioica).
According to European research, extracts of this herb can do double duty to relieve allergy symptoms and help improve urine flow in men with benign prostate enlargement. Side effects are uncommon.
Now that the value of saw palmetto has been called into question for treating benign prostate enlargement (BPH) ‘42 some men may want to consider stinging nettle instead. Urtica dioica has been used to treat BPH in Europe for decades. There are good reasons why this herb might be effective. For one thing, stinging nettle root affects sex hormone–binding globulin and its ability to interact with hormones like testosterone. Another key player in prostate problems, epidermal growth factor, is inhibited by 53 percent by stinging nettle lectins. In addition, this herbal extract has anti-inflammatory activity that interferes with an enzyme (Na/K-ATPase) that is necessary for prostate cell growth.
Most important, human studies have shown that nettle root extract improves urine flow and decreases the amount of urine left in the bladder after voiding. Many men with an enlarged prostate report that the herb reduces the number of times they have to get up at night to go to the bathroom.
I read a letter in your column about a man with allergies. Because of an enlarged prostate, he couldn’t take the usual over-the-counter antihistamines.
You suggested the herb “stinging nettle’ as a substitute that might relieve allergy symptoms and improve the flow of urine. My husband looked these stinging nettles up and began taking them. He has improved 100 percent in both his allergy condition and his prostate symptom of frequent urination. In addition, his PSA number has come down!
The urologist said, “Yes, I’ve heard of it and it helps some but not others.” We are so glad you mentioned this herbal medicine, and we have shared the information with others.
Jul
3
Allergy: Vacuum Cleaners
July 3, 2009 | Leave a Comment
Vacuum Cleaners
You can reduce dust and pollen with good air filtration, but you can never eliminate it. A decent vacuum cleaner can go a long way toward reducing the dirt and dust that can cause allergies. But many machines suck up dust and allergens at **** Miele Solaris Electra Plus
Choosing a vacuum cleaner is a highly personal: decision. We like this Miele machine because it comes with a HEPA filter, is highly rated by Consumer Reports, and has served us suc- cessfully for years. You may find the Sears canister vacuum just as effective at a substantially lower cost.
Downside: A little on the pricey side. Filter needs to be changed regularly.
Cost: Approximately $800
one end and spew them out with the exhaust at the other end. These vacuum cleaners may actually cause more problems for the allergy sufferer.
According to Consumer Reports, vacuum cleaner models “with a HEPA filter have been very effective at reducing emissions. However, some models that don’t have HEPA filters have performed just as well in our tests, and such vacuums may cost less than HEPA models.”34
The Sears Kenmore nmore canister models generally scored high in the Consumer Reports testing. The Progressive 25512 model, at $300, was a Consumer Reports “Best Buy.” Miele vacuums come with HEPA filters and range from $500 to $800. We have been very pleased with ours. The Bosch Premium, at around $800, and the Aerus Lux Guardian, at roughly $1,200, also come with HEPA filters and score well.
Jul
3
Allergy: Air Filters and Dehumidification
July 3, 2009 | Leave a Comment
Air Filters and Dehumidification
It is impossible to eliminate all the airborne allergens that trigger symptoms, but you can reduce the amount of dust floating around your rooms. Forget the old-fashioned fiberglass filters that only capture large particles. That is like trying to catch mosquitoes with a fishnet. We are not big fans of ozone-type air “purifiers” either. The fine folks at Consumer Reports warn that many small room-size ionizing air cleaners (or “electrostatic precipitators”) can generate ozone.25 As far as we’re concerned, ozone is the last thing someone with allergies or asthma needs, since it can be irritating and decrease lung function.
Our first choice in air-cleaning technology is the HEPA
**** Aprilaire Whole-House Air Cleaner
This high-efficiency particulate air (HEPA)-type filter is highly efficient, uses no electricity, lasts 1 to 2 years, and captures most pollen, mold spores, and large dust particles. The box that holds the filter needs to be installed next to your furnace by a heating, ventilating, and air-conditioning (HVAC) professional.
An alternative to the HEPA-type air filter is the Aprilaire Model 5000 Electronic Air Cleaner. Consumer Reports consistently gives this system its highest score.26
Downside: The Aprilaire HEPA-type filter needs to be changed every year or two. Initial installation requires a professional. The electronic alternative is pricey.
Cost: Initial installation of the HEPA filter box is done by your HVAC expert. Should cost less than $200. A packet of two filters is $50 to $60. The Aprilaire Model 5000 Electronic Air Cleaner is roughly $600. Installation can run an additional $200.
(high-efficiency particulate air) filter. These devices are made of densely packed fibers that look like thick paper. The filters are pleated or folded and look like a mini-accordion. That way they maximize the air’s contact with the filter. Industrial-strength HEPA filters are used in computer clean rooms, pharmaceutical manufacturing plants, and hospitals, where it is essential to trap very small dust particles.
To install a whole-house HEPA filter you will need professional help. Ask a heating and air-conditioning (HVAC) expert whether they can retrofit such a system for your home. We think the Aprilaire Media Air Cleaner (formerly Space-Gard) is the place to start (800-334-6011 or on the Web at www. aprilaire.com). This HEPA-type filter achieves 99 percent efficiency for particles bigger than five microns and 95 percent efficiency for the smallest one-micron-sized particles. (Pollen and mold spores usually range from 10 to 100 microns.) The longer you use the filter, the more efficient it becomes, at least to a point. It should be changed every one to two years.
If you cannot afford either a HEPA filter or an electronic air cleaner, consider the less efficient, do-it-yourself 4-inch American Air Filter for around $40 or the 1-inch 3M Filtrete for about $25. These should fit into your existing air return system in place of the old-fashioned filter you may be using.
We find it astonishing that there hasn’t been more clinical research on home air filtration. Pharmaceutical companies have spent hundreds of millions, if not billions, of dollars testing drugs to relieve symptoms. Only a pittance has been devoted to air quality in the home and its relationship to symptom relief.
One review of the available research concluded that “Among patients with allergies and asthma, use of air filters is associated with fewer symptoms. A small study showed that a HEPA air cleaner could reduce the amount of cat allergen levels in the house, but it did not demonstrate improvement in nasal symptom scores.28 Another tiny study showed that a HEPA filter could reduce dog allergens in the air. 29
A pilot study in two daycare centers demonstrated that when a HEPA filter was combined with a dehumidification system, airborne fungal spores were substantially diminished .30 Most people do not realize how serious dampness and humidity are for the home environment. Wherever there is moisture, mold has a marvelous opportunity to multiply. Mold spores can be highly allergenic.
The solution is to get rid of the source of the moisture and keep dampness under control by dehumidifying. The drier your home castle, the less likely it is that there will be mold, mildew, and dust mites. These latter nasty little critters live in mattresses, bedding, carpets, and furniture. Mite poop is also highly allergenic and is responsible for many people’s discomfort. Dry air makes it harder for mites to flourish.
By the way, we used to encourage folks with allergies or asthma to encase their mattresses and pillows with allergen-impermeable bed covers. The goal was to separate the allergy sufferer from the mite poop. Sadly, well-conducted clinical trials have established conclusively that this effort is ineffective.
Jul
3
Allergy: Your Home Environment
July 3, 2009 | Leave a Comment
Your Home Environment
People are now exposed to a chemical soup at home and in the workplace. Buildings are tightly sealed for energy efficiency and may trap chemical gases and dust from a variety of sources. Cleaning agents left on floors and other surfaces dry and can eventually circulate on dust particles throughout the house or workplace and be inhaled with each breath. Fire retardants and other chemicals used in fabrics and foams in furniture, mattresses, and electrical insulation can be irritating to the airway. Mold can flourish wherever there is humidity—in basements, crawl spaces, bathrooms, air conditioners, and automobile air ducts.
It is crazy to treat the symptoms of allergies if you don’t examine your environment and try to eliminate what’s causing the problem in the first place. If you lived in a house with faulty wiring that kept blowing fuses or tripping the circuit breakers every day, it would be foolish to ignore the underlying problem. Continually throwing the circuit breaker to the on position or replacing fuses might leave you vulnerable to a fire. In the old days, people sometimes stuck a penny in the fuse box to bypass the warning system completely. No doubt some homes burned down as a result.
We know of one family that moved into a charming old house. Within a few months, the dad starting sniffling and sneezing. Then he developed asthma for the first time in his life. Not long after, both children also became congested and had periodic bouts of asthma. They were all treated with various medications to relieve their symptoms. It wasn’t until they moved that their symptoms eventually went away and their need for allergy and asthma drugs disappeared.
No dermatologist in his right mind would keep prescribing prednisone to someone who showed up with a poison ivy outbreak every other week. At some point the dermatologist would tell this patient to stay away from poison ivy to avoid the itchy, red rash in the first place. We wish allergists and lung experts would do more than prescribe antihistamines, bronchodilators, and corticosteroids for their patients. If they actually visited their patients’ homes or workplaces they might discover the cause of the symptoms.
Of course, that is not going to happen. Instead, you will have to become your own Sherlock Holmes, sniffing out the culprits if you can. In some cases it might even be worthwhile to employ a certified environmental engineer to look for sources of allergens in a house or apartment. Watch out for charlatans, though. There are lots of quacks out there who would love nothing more than to sell you a pricey home inspection and cleanup. Make sure that whoever analyzes your living space isn’t selling a service or recommending an organization they have a financial relationship with.