Sunday, 3 November 2013

Allergies - Hay Fever (Allergic Rhinitis)

Allergy is the over reaction of immune system to harmless substances after entering our body affecting 1 in every 3 people.

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Allergy is defined as the type I reactions or Immediate Hypersensitivity as a result of
over production of Immunoglobulin E (IgE), a class of allergic antibody by the immune system against harmless substance that lead to mediated release of histamine and other mediators from mast cells and basophils, resulting in allergic reaction, including sneezing, nasal congestion and eyes irritation

Types of Allergy
E. Hay Fever
Hay fever, also known as allergic rhinitis, is defined as condition of inflammation of nasal airway, effecting mostly in the nose and eyes as a result of the over reaction of immune system in production of production of the antibody immunoglobulin E (IgE) to an allergen, a harmless substance such as pollen, dust, etc. It is one of most common allergies in US.

E. 1. How to determine the severity of the allergic effects

Depending to the allergy stimulating effect, some researchers suggested to scale the severity from 1 to 4 and followed by degeneration scale, but from -1 to -4
E.1.1. The severity scale from +1 to +4
+1. The first level of stimulation
If there is no symptoms at all or If the patient is alert and function morally after allergic is eaten
+2. The second level of stimulation
The patient have become irritable, hyperactive, tense, thirsty, etc. after a suspected allergic foods is eaten
+3. The third level of stimulation
The patient have become hypomanic, aggressive, apprehensive, etc.
+4. The fourth level of stimulation
The patient have become mania, agitation, over excitement, etc.

E.1.2. Degeneration scale from -1 to -4
-1. If a patient is experience symptoms of reaction of runny nose, hive, diarrhea, etc.
-2. If a patient is experience symptoms of reaction of tiredness, fatigue, swelling etc.
-3. If a patient is experience symptoms of reaction of depression, mental disturbance, confusion, mood change, etc.
-4. If a patient is experience symptoms of reaction of sever depression, paranoia, etc.

E. 2. Symptoms
Symptoms are the result of airway inflammation of which can affects the daily activity including quality of life, productivity, and other chronic conditions, including asthma.
In the study of " Nasal endoscopy in children with suspected allergic rhinitis." by Ameli F, Brocchetti F, Tosca MA, Signori A, Ciprandi G. (Source from ENT Unit, Villa Montallegro Private Clinic, Genoa.), posted in PubMed, researchers found that in 176 children (99 males; mean age, 7.5 years) studied. Clinical visit, nasal endoscopy, and skin prick test were performed in all patients. Nasal endoscopic signs were pale turbinates, middle turbinate contact, and inferior turbinate contact. The AR diagnosis was made when nasal symptom history was concordant with sensitization. AR was diagnosed in 141 children. Inferior and middle turbinate contact were reliable predictive factors for AR (odds ratio 5.38 and 3.42, respectively), whereas pale turbinates did not predict it and researchers suggested that that nasal endoscopy may reveal signs predictive for AR diagnosis in children.
1. Nasal congestion, a clear
2. Runny nose,
3. Sneezing, nose and
4. Eye itching
5. Excess tear production
6. Asthma
7. Etc.

E.3. Diagnosis
If you are experience Allergic Rhinitis, it is possible to find what types of allergen have trigger that. After recording the family history and a complete physical exam. you doctor may order
1. Skin test
a. Intradermal test
It is one of most common test but time consuming( some patient may return for more 20 time for the injection) in diagnosis of allergy and depending to the symptoms, by injecting small amounts of diluted allergens into the top layers of the skin to see how the immune system react to them.
b. Skin prick testing
Similar to the Intradermal test, but the diagnosis involves in applying a drop of allergen into to punctures made on the skin.

2. Blood test ((RadioAllergoSorbent Test)
This is the test for evaluating of the levels of IgE-mediated reaction to a particular allergen. If you RAST score is higher than the predictive value, 95% chance you will have an allergic reaction. Unfortunately, non-IgE mediated allergies cannot be detected by this method.

3. Challenge Tests
Because of the risk of anaphylaxis, most doctors will avoid the test unless it is absolutely necessary and the test is performed only in the hospital. In this test, suspected allergen package into capsule taken by patient and signs or symptoms of an allergic reaction are observed.

4. Etc.

E.4. Prevention
There is no way to prevent hay fever. But one can always enhance the immune system by eating healthy and living a healthy lifestyle. For more information of healthy foods, visit 100+ Healthy Foods Classification

E.5. Treatments
E.5.1. Conventional medicine
According to the "Treatment of allergic rhinitis." American Family Physician - Volume 81, Issue 12 (June 2010), posted in MD preview, the writer wrote that allergic rhinitis is a common chronic respiratory illness that affects quality of life, productivity, and other comorbid conditions, including asthma. Treatment should be based on the patient's age and severity of symptoms. Patients should be advised to avoid known allergens and be educated about their condition. Intranasal corticosteroids are the most effective treatment and should be first-line therapy for mild to moderate disease. Moderate to severe disease not responsive to intranasal corticosteroids should be treated with second-line therapies, including antihistamines, decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies (e.g., nasal irrigation). With the exception of cetirizine, second-generation antihistamines are less likely to cause sedation and impair performance. Immunotherapy should be considered in patients with a less than adequate response to usual treatments. Evidence does not support the use of mite-proof impermeable covers, air filtration systems, or delayed exposure to solid foods in infancy.
1. There is no specific treatment for Hay fever, but depending to the symptoms. Medication includes bronchodilators, anti-allergics, antihistamines, NSAIDs, etc.
2. Allergic shot
Allergy shot, also known as immunotherapy, contains extracts from the most common substance which people are allergic to, including pollen, insects, pets, etc., by providing long-term relief from certain symptoms. In some people, after series of allergic shot, the disease is cured

E.5.2. Nutritional supplements
1. Antioxidants
Since Allergies are caused by immune over reaction of certain harmless substance, enhancing immue system is one of the best way to prevent and treat them as some researchers suggested that allergies may be caused by weakened immune system over aggression. Vitamin A, E, C are antioxidants and free radical scavengers, they protect the immune system from free radicals attack and help to reduce levels of histamine in the blood. For more information of antioxidants and health effects

2. Vitamin D
According to the article " Vitamin D deficiency may be a factor in development of allergies posted in Washing Post, Monday, March, 7, 2011, " Allergies and Vitamin D, Youths low in 'sunshine vitamin' may be more prone to allergies",the author wrote that analyzed data on 6,590 people, roughly half of them 21 years of age and younger and half older. The group was deemed representative of the U.S. population. Vitamin D levels were determined by blood tests, as was sensitivity to 17 common allergens. Among the youths, food and environmental allergies were greater in those with lower levels of Vitamin D. Young people deficient in Vitamin D were about twice as likely as those with higher levels of the nutrient to have peanut or ragweed allergies and nearly five times as likely to be allergic to oak.

3. B-complex
in a study of "Vitamin B-6 deficiency impairs interleukin 2 production and lymphocyte proliferation in elderly adults." by Meydani SN, Ribaya-Mercado JD, Russell RM, Sahyoun N, Morrow FD, Gershoff SN., USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111. posted in US National Library of Medicine National Institutes of Health, researchers found that Vitamin B-6 deficiency impairs in vitro indices of cell-mediated immunity in healthy elderly adults. This impairment is reversible by vitamin B-6 repletion.

4. N-accetyl-cysteine (NAC)
It is an antioxidant and an amino acid precursor to glutathione which helps to strengthen immune system against cold, flu and allergy and enhances the respiratory system functioning.

5. Minerals
a. Zinc
It corrects the digestive system cause of allergy as a result of deficient production of stomach acid.
b. Calcium
It beside is considered as essential mineral for healthy bone, calcium is also important to reduce the risk of allergy. According to the study of "Calcium-deficiency rickets in a four-year-old boy with milk allergy." by Davidovits M, Levy Y, Avramovitz T, Eisenstein B.(Nephrology Unit, Children's Medical Center, Petah Tiqva, Israel) posted in US National Library of Medicine National Institutes of Health, researchers found that These findings were thought to be the result of dietary calcium deficiency caused by the prolonged elimination from his diet of cow milk and milk products because of allergy. Adequate intake of calcium resulted in rapid improvement.

c. Potassium
It enhance the adrenal gland function, thus reducing the symptoms of allergy cause of fatigue, weakness, tiredness
d. Magnesium
It is vital to relieve the allergy symptom of asthma and respiratory problems
e. Etc.

6. Etc.

E.5.3. Herbs
1. Panax Ginseng
In a study of "Effects of Red Ginseng extract on allergic reactions to food in Balb/c mice." by

Sumiyoshi M, Sakanaka M, Kimura Y. (Division of Functional Histology, Department of Functional Biomedicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime 791-0295, Japan.) posted in US National Library of Medicine National Institutes of Health, researchers suggested that It may also protect against sensitization to antigens as an immunomodulator by increasing intestinal IgA secretion without affecting antigen-specific IgE levels. In conclusion, Red Ginseng roots may be a natural preventative of food allergies.

2. Garlic
It is best known for treating cold and flu and enhances immune system against alll types of foreign invasion. According to the study of "Immunomodulatory Effects of Aged Garlic Extract"

Eikai Kyo, Naoto Uda, Shigeo Kasuga and Yoichi Itakur, Posted in the "Journal of Nutrition" in March 2001, researchers strongly suggest that AGE (Aged Garlic Extract) could be a promising candidate as an immune modifier, which maintains the homeostasis of immune functions; further studies are warranted to determine when it is most beneficial.

3. Turmeric
Turmeric paste has been used in traditional herbal medicine as an antimicrobial and anti-inflammatory agent, it also helps to treat allergy. According to an article "Vitamin D and turmeric for allergies" by Joe Graedon and Teresa Graedon posted in Washington Post, May 11-2009, the authors wrote that In animal studies, turmeric prevents the release of histamine from mast cells (Molecular Nutrition and Food Research, September 2008). If it works similarly in humans, this would prevent allergy symptoms from developing.

4. Butterbur
Has been used over thousand of years in herbal medicine in treating symptoms of allergy, including to treat coughs,, asthma, stress, muscle relaxant, etc..According to the article of "Allergy" posted in The University of Michigan health System, the article indicated Two double-blind studies have compared butterbur extract to standard antihistamine drugs in people with hay fever. The first compared it with the drug cetirizine (Zyrtec) and found the drug and butterbur extract relieved symptoms equally well. However, cetirizine caused significantly more adverse effects, including a high rate of drowsiness.4 The second study compared butterbur extract with fexofenadine (Allegra) and placebo. Butterbur extract was as effective as fexofenadine at relieving symptoms, and both were significantly better than placebo.

5. Ginkgo
Ginkgo leaves contain ginkgolides, which inhibit platelet-activating factor cause of asthma and allergies. according to the study of "Ginkgolides Antagonizing Some Effects of Platelet-activating Factor in Vitro" vy Dong JC, Li M, Shi ZY (Huashan Hospital, Shanghai Medical University) posted in, researchers found that exposure of guinea pigs' bronchus to PAF in vitro resulted in a loss of beta-adrenergic receptors and responses to isoproterenol, and this effect of PAF was prevented by prior incubation of the guinea pigs' bronchus with ginkgolides (P < 0.05). The results showed ginkgolides were a potent PAF antagonist.

6. Etc.

E.5.4. Traditional Chinese medicine
In a study of "Complementary and alternative medicine in pediatric allergic disorders." by Li XM. (Source from Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA., posted in PubMed, researcher indicated that in the last 2-3 years, there have been more controlled studies of TCM for allergic asthma and allergic rhinitis. Several publications including ours indicate that some TCM herbal formulas are well tolerated and produce some level of efficacy. Some herbal formulas also showed beneficial immunomodualtory effects. Several preclinical studies demonstrated that the food allergy herbal formula-2 was effective in protecting against peanut anaphylaxis in animal models. Two TCM products have entered clinical trials in the United States for treating asthma and food allergy, respectively. Both of these trials include children. In Summary, researcher concluded that Recent studies indicate that TCM therapy including herbal medicines and acupuncture for allergic disorders in children is well tolerated. There are also promising clinical and objective improvements. More controlled clinical studies are encouraged.
1. Xin Yi Hua is a lily-shaped flower with a hairy bud and Xin-yi-san (Magnolia Flower Powder)
a. It is a type of traditional Chinese medicine used to treat allergy and dramatically reduces the symptoms of sneezing, anosmia, nasal congestion and profuse rhinorrhea (runny nose) caused by allergies triggered by dust mites, pets and fungi.
According to the study of "Traditional Chinese medicine, Xin-yi-san, reduces nasal symptoms of patients with perennial allergic rhinitis by its diverse immunomodulatory effects" by
Sien-Hung Yang, Chia-Li Yu, Ying-Lin Chen, Sheng-Lin Chiao, Mei-Ling Chen f. Posted in International Immunopharmacology 10 (2010) 951–958, researchers found that this proposal is based on the fact that different combinations of Chinese herbs involve different mechanisms. It appears that the immunosuppressive and anti-inflammatory effects derived from the mixed formula of Chinese herbs are broader than XYS. Nevertheless,we found that XYS alone sufficiently exerts immunomodulatory effects on patients with AR.
In conclusion, this study provides evidence to support that XYS, when used singly, is beneficial in nasal allergic inflammation through enhancing IL-10 and IL-8 production.
b. Ingredient
Main use: Expels wind-cold, unblocks nasal passages, congestion, loss of smell, sinus headache.

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