ASTHMA IN CHILDREN: THE INHALED ALLERGENS – ANIMALS AS ALLERGENSSome animals and insects are known to act as allergens and cause asthma.Animals. Henry Hyde Salter has given the first accurate description of the attacks of asthma caused by an exposure to a cat. In his book on asthma published around the middle of the nineteenth century, he wrote:’This singular phenomenon is, I imagine, almost peculiar to myself. The cause of this asthma is the proximity of a common domestic cat; the symptoms are very similar to those of hay fever, and, as in the case of hay fever, are occasioned by some sudden influence inappreciable by the senses. I cannot recollect at what time I first became subject to the cat asthma, but I believe the susceptibility has existedfrom the earliest period of even a pet dog can cause life. I believe there are even some asthma symptoms even if I were sitting by the fire and the cat sleeping on the hearthrug; but the effect is much greater when the cat is at the distance of about one or two feet or closer; it is further increased by the rising of the fur and moving and rubbing about; but most of all when it is in the lap, just under the face…. The asthmatic spasm is immediate and violent and accompanied with sneezing, burning and watery condition of the eyes and nose and excessive itching of the skin…., I believe that if the cause were suffered to continue, all or most of the other symptoms of hay fever would ensue, only with a more excessive and conspicuous asthma. After the removal of the cause, and if the paroxysm is not very severe, the cure is effected in five or ten minutes, leaving, as in all other cases of asthmatic spasm, a tendency to mucus at the top of the wind pipe, which being repeatedly removed in the ordinary way the last symptom disappears, and the lungs and throat resume their normal condition’.*30\260\8*

The Nose Drip of the Allergic Child

Mucus originating in the nose or sinuses is eliminated by filaments (cilia) which are attached to their mucosa. These filaments push the mucus toward the esophagus with a beating movement. However, when the mucus becomes thick and abundant, it is too heavy for the filaments to push back. It remains in place and forms beads that drop on the lungs causing an irritative cough.

The conditions that cause the mucus to be thick and abundant are allergies, low-grade infections, irritants such as tobacco smoke, excessive dryness in the air of the house, overuse of nose drops, emotional disturbances (which affect the sympathetic nervous system and cause an increase in nasal secretions), mechanical obstructions to the drainage of the sinuses (because of a deviated septum or enlarged adenoids), and endocrine deficiencies (such as hypothyroidism, which causes dry, thick mucus formation).

A nose drip is to be “managed” by treating the underlying allergies and by softening the mucus through the use of drops of a saturated solution of potassium iodide (so-called KI) given by mouth. The child should also sleep on high pillows to drain the mucus of the sinus mechanically. A cold air vaporizer should be installed in the bedroom during winter.

The Eye and the Ear in Nose Allergy

The eye becomes involved in allergy of the respiratory tract because the tear ducts drain into the nose. It follows that an inflammation of the nose spreads easily to the eye.

Vernal conjunctivitis is one form of eye allergy frequently seen in summer among male children in warm climates. Its symptoms are a fear of light, tearing, and a burning sensation in the eye. Its diagnosis is possible because of its seasonal occurrence and because of the cobblestone aspect of the conjunctiva. Treatment consists of corticosteroid drops in the eye (one drop of one percent hydrocortisone solution three to four times daily for one or two weeks). If this is not sufficient, corticosteroids have to be given by mouth.

A tube that connects the middle ear to the pharynx may become clogged by an allergic inflammation. This could cause a hearing loss by preventing the drainage of mucus from the middle ear to the pharynx. The treatment consists of ventilation of the middle ear with decongestants and antihistamines; eradication of the infection with antibiotics; suction of the fluid from the middle ear; removal of enlarged tonsils or adenoids; control of the allergies through diet, environmental control, desensitization, and corticosteroids; and respiratory vaccines to prevent recurrent infections.

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Most of the synthetic chemicals that we come into contact with – including pesticides, petrol, plastics and most solvents – are made from oil or coal. These are known as organic chemicals – which probably sounds like a contradiction in terms to anyone who buys ‘organic’ vegetables! The word organic is being used in two different ways – but with the same etymological root. It means ‘of living things’.

The chemicals that make up living things are all based on chains of carbon atoms, with hydrogen atoms attached to them all along the chain – such molecules are known as hydrocarbons. Until 1828 it was thought that only living things could make such molecules – hence the name ‘organic’. Chemists now know how to make most organic molecules in the laboratory, but the name has stuck.

In the case of ‘organic’ farming, the name was originally used to show that crops were grown using fertilizers derived from living things – manure or compost – rather, than inorganic fertilizers such as nitrates, which are made by chemical processes. As pesticides became more widely used by most farmers, ‘organic’ farming took on a broader meaning – the crops were not sprayed with synthetic pesticides either. So an ‘organically’ grown carrot is one that has not been sprayed with synthetic pesticides – despite the fact that these are ‘organic’ chemicals.

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Spermicides

Allergy to vaginal spermicides (sperm-killing creams, foams or jellies) isn’t common, but it happens nevertheless. The four most sensitizing chemicals in these products are phenyl-mercuric acetate, oxyquinoline sulphate, quinine hydrochloride and hexylresorcinol.

If a woman’s chosen spermicide is making her itch or giving her other discomfort, she should look for an alternative with different ingredients. Before using a brand or type of spermicide for the first time, she can do a patch test on her arm to determine her tolerance.

As with condoms, what’s good for the goose may be bad for the gander: a woman’s partner is also apt to react to contact with vaginal spermicides, even if she doesn’t.

Feminine hygiene sprays

Aside from the fact that these sprays do little or nothing for vaginal hygiene, they may irritate and produce a burning sensation if squirted too close to the skin or vulva. Applied from a proper distance, the freon propellant presumably evaporates before it reaches its destination. Even then, the perfumes can cause trouble. And a woman’s partner may develop a rash or burning sensation on his penis or scrotum if they have sex together soon after the spray is applied. So why bother with sprays at all?

Copper I.U.D.s

Copper-containing intrauterine birth control devices sometimes induce stubborn allergic reactions in women who use them. The classic symptoms are a recurrent rash on and around the vulva, lower abdomen and inner thighs. Less frequently, it may spread to the chest and lower back. Ointments, antihistamines and cortisone treatments provide only temporary relief. The only real cure is to have the I.U.D. removed and choose an alternative birth control method.

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To root out the cause of the migraine, Dr Hanington recommends you note everything you’ve eaten in the twenty-four hours prior to each attack. Or you can start by simply eliminating the most common migraine triggers.

‘Without going to any extremes, every migraine sufferer should be aware of the foods which might possibly be involved. It is simple to have a trial period of, say, six weeks and exclude chocolate, cheese and alcohol, which are the most common precipitants, from the diet.

‘Excluding citrus fruits and coffee may also be rewarding,’ continues Dr Hanington. She adds that dietary trials are of particular value to people who suffer frequent, severe attacks but who have no inkling that the cause could be their daily cheese sandwich, chocolate bar or other customary food (Journal of Human Nutrition).

Surprisingly enough, going without food can trigger migraine. In the survey of 1,883 migraine sufferers mentioned earlier, fasting for longer than five hours during the day or longer than thirteen hours overnight triggered migraine 67 per cent of the time. Presumably, that’s caused by the dip in blood sugar that some people experience when they go without food.

Dr Donald J. Dalessio, of the Scripps Clinic and Research Foundation in La Jolla, California, offers the following guidelines for migraine sufferers.

1. No alcohol, particularly red wines and champagne.

2. No aged or strong cheese, particularly Cheddar cheese.

3. Avoid chicken livers, pickled herring, canned figs, broad beans and chocolate.

4. Use monosodium glutamate sparingly (if at all, we might add).

5. Avoid cured meats such as hot dogs, bacon, ham and salami (which all contain sodium nitrite).

In addition, Dr Dalessio warns against skipping meals or over-consumption of carbohydrates (sugar, fruit, pasta, desserts) at any single sitting, to control blood-sugar-related headache.

You may find it helpful to know that food-induced migraine tends to be dose related: some people can get away with a nibble or two of cheese, but not an entire cheese sandwich. Or they can eat one piece of chocolate, but not a handful. Or they can drink a glass of orange juice – if they skip their coffee or tea.

Coffee and tea, particularly in large amounts, seem to be especially bad for migraine sufferers. Researchers at the Royal Southern Hospital in Liverpool tell of a twenty-six-year-old man with a long history of migraine that did not respond to drugs. Neurological tests were normal. Yet the pain grew so severe and frequent that he had to quit his job. Further quizzing revealed that the man drank more than twenty cups of coffee a day. He was advised to give it up.

‘His headaches and other symptoms promptly [disappeared],’ say the researchers. ‘He has remained symptomless for six months, and he has been able to set up business again’ (Lancet).

While you may not be downing twenty cups of coffee a day, a cup or two in the morning, combined with cola drinks later on and an occasional headache tablet (many of which contain caffeine), could add up to enough caffeine to trigger a migraine.

If you can’t attribute your pain to any particular food or beverage, you could be allergic to car exhaust, household cleaning fumes, tobacco smoke, perfume, paint, dust or mould.

In addition to allergy, it also appears that migraine is more likely to strike if you are under stress, having a menstrual period or taking birth control pills. Obviously a woman can’t do anything about her menstrual cycle, but controlling other factors will help to ward off stubborn cases of migraine.

Non-migraine headaches may also be allergy related, in which case the approach we’ve described should work just as well. When a group of thirty headache patients at the Charing Cross Hospital in London were placed on a food-allergy-elimination diet, their total number of migraine attacks dropped from 187 a month to zero – and the number of regular headaches dropped from 284 to 14.

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Vitamin C, however, acts as a natural antihistamine, counteracting the tide of histamine that causes your rose to swell, ache and run. According to doctors we spoke to, the average dose of vitamin Ñ needed to break a bout of hay fever is about five grams a day – ranging from four to eight grams (individual doses), depending on the individual.

Bioflavonoids – compounds found in the white pulp of oranges, grapefruits and other fruits and vegetables – boost vitamin C’s ability to relieve hay fever symptoms. Studies show that citrus bioflavonoids seem to favorably alter the way our bodies use vitamin C, concentrating the nutrient in certain tissues and making it more absorbable (American Journal of Clinical Nutrition). Bioflavonoid tablets – up to six grams a day – are the most convenient way to get the amounts needed to break a reaction.

For those days – or nights – when your nose is so stuffy that you feel like it’s been embalmed with rubber cement, there are several ways to get your head unstuck. One of them is pantothenic acid, à Â vitamin. Sandra Stewart, former assistant director of the Out-Patient Department of Children’s Hospital in Columbus, Ohio, decided to try it when she found she couldn’t tolerate antihistamines.

‘I took a 100 milligram tablet at night,’ she says. ‘And I found my nasal stuffiness would clear in less than fifteen minutes. I could breathe again. And I [no longer woke up] at four or five in the morning with a cough and mucus secretions. So pantothenic acid appears to have an antimucus-secreting effect on me personally.’ And, she adds, many of her patients report that it helps to relieve their nasal congestion, too (Annals of Allergy).

Hot broth also speeds up the flow of mucus, especially if the broth contains fiery foods or herbs such as onion, garlic, cayenne pepper or horseradish.

The vapors of eucalyptus leaves (available in many health food stores) also help to clear the head quickly. Place a few leaves in a large pot of boiling water for five minutes. Turn off the heat. With a towel draped over your head, breathe in the vapors. (Be careful not to get too close to the steam – you could scald your face.)

Exercise, too, promotes free breathing. Many hay fever sufferers find that running, walking, bicycling or other vigorous exercise relieves their stuffiness. Evening jaunts are best if you exercise outdoors – the pollen levels are lowest then. Pollen counts also tend to be lower after it rains and near lakes, ponds or other large bodies of water. Indoors, fifteen or twenty minutes of rope skipping or dancercise may do the trick.

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The fundamental problem of diabetes is a disruption in the way the body uses carbohydrates – the starches and sugars in the food we eat that turn into blood sugar, or glucose. Too little insulin – the hormone that regulates glucose – is secreted. As a result, glucose piles up in the bloodstream, never reaching the muscles and other cells that require it.

Hypoglycemia, on the other hand, is marked by periods of low blood sugar. The most common symptom is fatigue – a ‘burned out’ feeling – especially in the morning or late afternoon. Headaches, particularly the migraine type, are also common. This type of hypoglycemia is medically known as ‘functional’ or ‘reactive’, to distinguish it from the type of hypoglycemia that results from a disease.

To test for either diabetes or hypoglycemia, doctors usually give a glucose-tolerance test. After you drink a flavored solution of sugar and water, the lab technician takes periodic samples of your blood over a period of six hours to measure your glucose levels. If glucose soars too high or plummets too low, you presumably have a blood-sugar problem that calls for adjustment of your carbohydrate intake.

Treatments for functional hypoglycemia and diabetes are essentially the same: a diet which evenly distributes moderate amounts of carbohydrates over six meals. And the diet emphasizes high-protein foods – chicken, turkey, eggs, milk, cheese and so forth. Sugar, alcohol, coffee, tea and cola beverages are forbidden because they raise blood sugar levels by over-stimulating the release of insulin.

A small group of doctors feel that this diet may be ineffective, and that food allergy plays an unrecognized role in blood-sugar problems.

‘The typical assumption is that diabetes is a disease of carbohydrate metabolism, but we believe that it is a result of carbohydrate metabolism being interfered with,’ says Dr Thomas L. Stone, of Rolling Meadows, Illinois. ‘And allergy is just one of many things that can disturb carbohydrate metabolism. Yet the so-called diabetic diet contains the very foods that can raise blood glucose if you’re allergic to them – milk, eggs, chicken.

‘Our approach to diabetes is somewhat different. I measure people’s blood glucose after individual food tests. They avoid a food for four or five days, then eat it and I measure blood glucose thirty minutes to an hour later. In some people, blood sugar reaches as much as 375 (considered very high). When the foods that raise glucose are removed from the diet, the need for insulin goes down. We have yet to see someone who fails to improve with this approach.

‘As for hypoglycemia, there is a lot of confusion because most doctors rely on the conventional glucose-tolerance test to diagnose it,’ continues Dr Stone. ‘The glucose-tolerance test evaluates your blood sugar’s reaction to one food only – corn sugar – when in fact many foods can cause or aggravate blood-sugar problems. But reactions from those other foods won’t show up on the glucose-tolerance test. Not only is the test faulty; so is the diet. Many of the patients with hypoglycemia would get dramatically better within three months on a standard high-protein diet, but their symptoms would tend to return, even if they conscientiously stuck to the diet. So I felt a different approach was needed.

‘As with diabetes, I measured glucose levels after individual food tests,’ says Dr Stone. ‘As a result, each person has a unique set of foods he or she can and cannot eat to control their blood sugar. No one leaves here on the same diet.

‘I don’t want to imply that blood-sugar problems are simple. They’re not. The body is very complicated,’ says Dr Stone. ‘Blood sugar is only one aspect of a total problem, and allergy is just one thing that can disturb carbohydrate metabolism. But I’ve treated thousands of people with this approach. Even people who are quite sick get better in a couple of weeks.’

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It would be nice if all the nutritional needs created by allergies could be met by diet alone. A few calculations, however, quickly show that you would have to eat over a dozen oranges to acquire enough vitamin Ñ needed to break an allergic reaction. And you’d have to eat about seven cups of Brussels sprouts to get enough vitamin Ñ to shield you against an asthma spell. And you’d need to consume over 16 fl oz/450 ml of grapefruit sections to get the amount of bioflavonoids recommended to relieve hay fever. Obviously, supplements are a convenient alternative.

“I believe in supplementation,’ says clinical nutritionist Dart. ‘We use it widely to treat people with allergies.’

Brewer’s yeast, wheat and soya are often the basis for nutritional supplements, especially in natural products. Synthetic vitamins, on – the other hand, often contain dyes and flavorings to make the pills more appealing or easier to identify. But whether you choose natural or synthetic isn’t a matter of personal preference – it depends on what you’re allergic to.

“Many people with allergies automatically lean towards natural vitamin products without sugar or coloring,’ says Iris R. Bell. ‘But one of the paradoxes of allergies is that some people may actually do better with synthetic vitamins.’

Lyn Dart explained that paradox a bit further. The brewer’s yeast, wheat and soya that are added to natural vitamins are great for a non-allergic person. But if you’re allergic to any of those ingredients, they are a problem.’

‘Wheat and yeast are major sources of  vitamins,’ reiterated Dr Bell. ‘But many people sensitive to those foods do better with synthetic  vitamins or  vitamins based on non-allergenic foods such as rice.

‘Because many people are allergic to corn,’ continued Dr Bell, ‘some vitamin companies are eliminating cornstarch, a common filler.’ Vitamin Ñ made from sago palm, for instance, is now available.

Powdered products, in fact, are generally better tolerated than tablets, according to Lyn Dart. Tablets have more inactive ingredients – such as binders and coatings – multiplying potential allergens. ‘We give many people their supplements in powdered form,’ she told us.

As for dyes, Dr Bell remarked that some companies now sell clear, uncolored gelatine capsules for people who need to omit dyes from their diet.

‘Still, some people can’t tolerate even the clear gelatine capsules – they may be made from beef, pork or other allergenic food,’ says Dr Bell. ‘They can usually tolerate their contents, though, so they should empty the capsule, take the contents and discard the capsule itself.’

People who are allergic to wheat must be wary of vitamin E from wheat germ oil, and they may have to use synthetic forms of vitamin E. Similarly, people who are allergic to fish may react unfavorably to vitamins A or D from fish oil. And people who are allergic to soya beans may not be able to tolerate lecithin.

Before you buy any supplements, you should automatically check labels for wheat, soya, yeast, corn or any other ingredient to which you are allergic.

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