Ask Dr. Gott » allergic reaction

Medication caused potentially deadly reaction

Dr. Gott — Sat, 08 May 2010 05:01:34 +0000

DEAR DR. GOTT: I am writing about something I have never seen addressed in your column before.

My daughter, who lives alone, took the first pill of a new prescription while at work. She went into anaphylactic shock. He co-workers immediately called an ambulance, and she got to the hospital with only minutes to spare. If she had waited and taken the pill at home, there would have been no one to help her. Please caution your readers to not take any new medication when they are alone just in case they have an allergic reaction.

DEAR READER: Allergies to medications are fairly common, but to be severe enough to cause anaphylactic shock is rare.

Also known as anaphylaxis, this type of allergic reaction is severe and potentially life-threatening, typically occurring within minutes of exposure to the offending substance. In some instances, a reaction can occur within seconds or can take as long as 30 minutes. Unless treated immediately with epinephrine, the sufferer can become unconsciousness or die.

Everyone, particularly those people with known allergies, is at risk of anaphylaxis, but certain medications, foods, food additives and insect stings are the most common triggers. In some instances, exercise, eating certain foods prior to the activity, or exercising in a vast variety of weather conditions can cause a reaction. Those who have had anaphylaxis in the past are at increased risk.

Symptoms include a weak, rapid pulse; dizziness or fainting; nausea; vomiting; diarrhea; skin reactions such as hives; itching or flushing; swelling of the tongue or throat; and constriction of the airways, leading to wheezing and difficulty breathing.

Treatment is by injection of epinephrine, which reduces the body’s response to the allergen. Then oxygen, IV antihistamines and cortisone, steroid pills and/or beta agonists may be used to reduce throat constriction, ease or improve breathing and more. People with a history of anaphylaxis are often prescribed single-dose Epi-Pens by their primary-care physician or allergist for self-injection at the first sign of a reaction, decreasing the risk of worsening symptoms.

Depending on the allergen, immunotherapy with allergy shots may be beneficial. This treatment involves receiving multiple injections of slowly increasing “doses” of the allergen. In this way, the body may develop immunity to the substance and stop overreacting. This is not appropriate for everyone. Even in those who choose to undergo this treatment, taking steps to prevent a reaction — and being prepared should one happen — is still vital.

Your advice about starting a new medication only when others are around in case of an emergency is very good. Had your daughter been alone when she developed the reaction, she probably would not have fared as well as she did. The good news is that this type of reaction is rare, and most people do not need to be overly concerned. But, as always, it is better to play it safe, because there is no way of knowing what could happen. Thank you for writing and sharing this important issue.

To provide related information, I am sending you a copy of my Health Report “Allergies.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 4409-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Spongiotic dermatitis a type of allergic reaction

Dr. Gott — Tue, 23 Feb 2010 05:01:04 +0000

DEAR DR. GOTT: Thank you for all your interesting questions and answers. I have questions about a condition I have never heard of — “spongiotic dermatitis eosinophils consistent with allergic contact dermatitis.” What is it? And what can be done for it?

DEAR READER: Spongiotic dermatitis (SD) is primarily an allergic reaction that causes swelling rather than a rash. It can sometimes be associated with the formation of microvesicles, which are small fluid-filled sacs. Eosinophils are a component of the blood, often found in elevated numbers when an allergic reaction is present, and can generally be used to determine how severe the reaction is.

There are two types of SD. The first is acute SD, which implies that the allergic reaction is occurring at that point in time. The second is chronic SD, which is present for an extended period. This type can also lead to permanent thickening of the outermost layer of the epidermis.

The condition is an allergic reaction most likely due to a skin irritant. Plants, animals, chemicals and much more can cause allergic contact dermatitis. An individual with this diagnosis would probably benefit from the care of a dermatologist or allergist.

Allergies, nosebleeds and honey?

Dr. Gott — Thu, 11 Feb 2010 05:01:20 +0000

DEAR DR. GOTT: I suffered from nosebleeds for years. I underwent cauterization nine times. I then found out I was allergic to cats and that my nosebleeds were how my body was reacting. I was told that nosebleeds are a rare sign of an allergic reaction.
Allergy pills helped, but I then heard that eating local honey could help. I haven’t had to take any allergy medication for several years now.
DEAR READER: Nosebleeds are most commonly due to dry air, so most often the advice from physicians is to keep the nasal passages moist by using saline sprays and using humidifiers. When these measures fail to provide relief, it is then time to look at other causes.
Allergies are a known cause of nosebleeds, but most people don’t link the two. Other causes can include colds or sinus infections, repeatedly blowing or picking the nose and, very rarely, nasal polyps or cancer.
As for your use of local honey as a treatment for your allergies, I want to caution others about this remedy. First, to the best of my knowledge, there is no scientific evidence either confirming or denying the effectiveness of this treatment. All indications are anecdotal and, as such, most of what people hear is positive because few people like to discuss bad experiences.
Second, since no studies have been done, there is no reason justifying how this therapy might work. The most popular theory is that it works as a type of immunotherapy. In this particular case, it most likely resembles desensitization injections. These shots work to build up the body’s immunity by injecting the offending allergens directly in very minute quantities, slowly increasing the amount of allergen with each subsequent shot. The process typically takes up to three months to determine effectiveness. After initial treatment, injections are often continued on a once-monthly basis for several years or even for a lifetime.
However, like the shots, honey can elicit an allergic reaction, because it contains many of the same pollens, fungi, etc., that are present in the environment in which bees live. So, while there is no hard proof that honey therapy for allergies works, there are plenty of people who swear by the treatment.
My advice to anyone interested in considering this therapy is to do so only under strict physician supervision, particularly if the allergies are severe. In this way, treatment can be monitored, and any adverse reactions can be handled appropriately to prevent potentially life-threatening consequences.
As an aside, honey is known to be beneficial in speeding the healing process of burns and lacerations and is just as effective in soothing coughs in children and adults as are cough syrups. Some of my readers have even used it successfully to treat eczema and minor skin irritations. Remember that children younger than a year old should never be given honey because it is a known source of bacterial spores that produce Clostridium botulinum bacteria. These bacteria produce a toxin that can cause a form of food poisoning known as infant botulism. It is prudent to give honey only to children over the age of 2 to allow their systems more time to develop.
To provide related information, I am sending you copies of my Health Reports “Allergies,” “Dr. Gott’s Compelling Home Remedies” and “More Compelling Home Remedies.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order per request to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Niacin causes severe itching

Dr. Gott — Sun, 02 Mar 2008 05:00:09 +0000

DEAR DR. GOTT: I read your column often and notice that you mention taking niacin for many things. I started taking one tablet of 250 mg time released niacin to see if it would help lower my blood pressure and my cholesterol levels. After taking it for about 30 days, I was feeling great. However, one day I began having little pricks throughout my body. Thinking something was terribly wrong with me, I looked on the internet and discovered some diseases with that symptom. I was just about to make an appointment with my doctor when I looked for information on niacin and discovered that one of the side effects is itching. I discontinued it and my prickly sensations stopped very quickly.

Does this mean I will not ever be able to take niacin again? Are there other forms that might work better? I had renewed energy and really felt great while taking it.

DEAR READER: Niacin (vitamin B3) has many beneficial properties. It is used to treat dizziness, headaches, circulatory problems, ringing in the ears, Raynaud’s syndrome, and depression. In addition, it may increase energy, stimulate circulation, maintain normal blood pressure, raise HDL (good) cholesterol levels, and lower LDL (bad) cholesterol levels. Other uses are for acne, age-related macular degeneration, arthritis, combating hardening of the arteries, migraines, psoriasis, the prevention of cataracts, and more. It’s no wonder you felt good and had renewed energy while taking this supplement.

The prickly sensation that you experienced is a common side effect. Others include flushing of the face, neck and ears, palpitations, liver irritation, and abnormal heart rhythms. Flushing and a prickling can occur when the daily dosage is 50 mg or higher. While the feelings are often annoying, they are essentially harmless. To combat flushing, an aspirin or non-steroidal anti-inflammatory (NSAID) can be taken for the first week or two with any form of niacin, or an antihistamine can be taken about 15 minutes prior to usage. This supplement should always be taken with food to prevent stomach upset. The U.S. Department of Agriculture does not strictly regulate herbs and other supplements. Therefore, different forms or brands of niacin might be more appropriate for you.

A low dose of flush free niacin can be used as a start for your hypertension and feeling of well-being. Unfortunately, perhaps because of the inclusion of the ingredient inositol hexanicotinate, the flush free form appears to block any cholesterol benefits that might otherwise be realized. Follow the recommended dosage to maintain your nervous and digestive systems, skin health and to support cell growth.

Extended release niacin may cause less flushing but can have a higher risk of stomach upset or liver irritation. Clotting problems, headache and decreased thyroid function have also been reported by some users. If the ultimate goal is for better cholesterol readings, this is the preferred form.

Of note is the use of niacin for certain conditions associated with Type II diabetes. Its use has been controversial because of the possibility of worsening glycemic control. Therefore, patients with diabetes should check with their physician or pharmacist before taking niacin (or any other supplement).

Niacin deficiency is known as pellagra. It affects all body cells, especially those of the skin, nervous system and GI tract where there is rapid turnover. Symptoms include indigestion, skin irregularities, weakness, fatigue, halitosis, anorexia and they can progress to include canker sores, nausea, vomiting and diarrhea.

Foods rich in niacin include lamb, poultry, tuna, eggs, peanut butter, avocados, peanuts, figs, and wheat germ. The consumption of these foods will work toward lowering total cholesterol levels naturally, can relieve the pain of arthritis, and may rival prescription drugs or over-the-counter supplements. Remember, the benefits of this vitamin (and many others as well) can be lost through vigorous food processing, when taking sleeping pills, or with alcohol consumption.

Vegetarians, vegans or individuals who drink alcohol in excess should consider taking a niacin supplement, as diets that lack protein are probably niacin deficient, and alcohol inhibits absorption of the vitamin.

To be on the safe side, check with your primary care physician before making the decision to resume your niacin. A simple blood test is all that is necessary to determine the possibility of B3 deficiency. When it comes to your health, it’s always better to have an outside professional opinion.

To give you related information, I am sending you a copy of my Health Report “Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.