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.
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.
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
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. 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 (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. 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. Another tiny study showed that a HEPA filter could reduce dog allergens in the air.
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 . 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.
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.
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.
Jul
3
Allergy: Diagnosis and FAQs
July 3, 2009 | Leave a Comment
ALLERGIES
• Install an Aprilaire HEPA-type air filter
• Use a high-quality vacuum cleaner (Miele)
• Rinse your nasal passages with saltwater
• Try vitamin C
• Experiment with the herbs stinging nettle and butterbur
• Try Nasal Crom (cromolyn) spray to prevent allergy symptoms
• Look for loratadine, an over-the-counter antihistamine
• Ask your doctor about a steroid nasal spray
• Consider pseudoephedrine for symptomatic relief
Breathing is basic. Most of the time we take it for granted. But if your nose is congested and your sinuses are stopped up, you are miserable. For one thing, your head feels as if it’s full of cotton. Studies have found that people suffering from allergies frequently experience sleep difficulties, fatigue, poor concentration, drowsiness, irritability, delayed reaction times, memory problems, and cognitive impairment. When you are in the middle of an allergy attack it is hard to drive safely even if you are not sneezing. Making decisions or operating other kinds of machinery can also be problematic.
Paradoxically, although antihistamines are the mainstay of allergy treatment, they can also cause drowsiness, delayed reaction times, sedation, and cognitive impairment. Even the so-called second-generation nonsedating antihistamines that are so heavily advertised to consumers may not be as benign as drug companies would have you believe. When given in doses that are adequate to relieve symptoms, some of these nonsedating antihistamines may also make people drowsy and impair performance.
Research has shown that driving skills are affected with both the older and the newer antihistamines. A massive study conducted for the National Highway Traffic Safety Administration discovered that driving while drowsy—no matter what the cause—increased the risk of a crash or near crash by four to six times.
Physicians often think of allergies as more of a nuisance than a life-threatening condition. But we now realize that impairment poses huge risks if people are driving. And allergy symptoms don’t just occur in the spring and fall, when pollen is in the air. Nowadays many folks are congested all year long. At last count, 50 million people are sensitive to things like dust mites, cat dander, cockroaches, mold spores, and pollens from oak, elm, and maple trees as well as ragweed and rye, blue,and Bermuda grasses.24 Symptoms include nasal stuffiness, runny nose, itching, sneezing, and coughing. Chronic sinusitis, which may develop as a consequence of allergies, affects more than 30 million people. And asthma, which can be life threatening, often has an allergic and inflammatory component.
What is so scary about these statistics is that they keep going up. No one knows why, but it appears that more people are suffering than ever before.
Allegra online is sold in a generic form which is 100% the same as a brand one. Buy Allegra without a prescription online and save up to 80% off this drug price.
Conclusions
Allergies don’t get the respect they deserve. When you complain about your congestion, most friends and family members will barely sympathize. But allergies can slow you down and make you dangerous behind the wheel. Finding the right treatment to ease your symptoms without causing worse problems is a challenge. Combining several options, including environmental control, may be the most effective solution for solving this common problem.
• Use a HEPA-type air filter and a dehumidifier to remove allergens from the air you breathe and make the environment inhospitable for the three Ms of allergy—mold, mildew, and mites.
• Get a high-quality vacuum cleaner that won’t spew dust and dirt back into the air. Miele models rank high on our list.
• Wash your nasal passages with saline. A neti pot will help.
• Consider an herbal approach such as stinging nettle (Urtica dioica) or butterbur (Petasites hybridus). Men with prostate enlargement may find nettles especially helpful since some OTC allergy medicines may make this condition worse.
• The natural products quercetin and bromelain may help stabilize mast cells and prevent histamine release.
• Cromolyn (NasalCrom) is an OTC remedy that also stabilizes mast cells. It should be used preventively before exposure to allergens occurs. Cromolyn does not cause drowsiness.
• Oral antihistamines can control symptoms, but they may also make you dangerous on the highways. Even nonsedating products may interfere with driving ability. Generic loratadine (Claritin) is now available without a prescription.
• Among prescription allergy medicines, steroid nasal sprays offer the most effective symptom relief with a minimum of side effects. The cost is significant, since they are available only by prescription. One generic variety (flunisolide) is less expensive than brand-name products like Flonase and Rhinocort AQ.
• Pseudoephedrine can be surprisingly effective at controlling allergy symptoms. Beware of side effects such as insomnia, nervousness, high blood pressure, and irregular heart rhythms.