Allergies | Ask Dr. Gott

Daily Column

September 1, 2008 By Dr. Gott

DEAR DR. GOTT:
Recently a reader said he had terrible itching caused by Centrum Silver and glucosamine/chondroitin. I also took both products and had itching.

Several years ago I learned I was allergic to shellfish. After some research I found that glucosamine/chondroitin was made with ground shrimp shells and that this was the cause of my itchy allergic reaction. As soon as the supplement was stopped, the itch stopped. I have never had a problem with the Centrum Silver.

DEAR READER:
Thank you for writing with your experience. This could be the reason some people have reactions to otherwise benign substances. It may not be the case for everyone but it will at least serve as a starting point.

Filed Under: Daily Column Tagged With: allergies, chondroitin, glucosamine

Daily Column

August 29, 2008 By Dr. Gott

DEAR DR. GOTT:
I faithfully read your column every day but haven’t seen my problem addressed before.

I am 78 years old. When I was 76 I developed a cough and mucus in my throat. I have never smoked so my doctor told me it was from allergies. I have never had allergies before. He prescribed Allegra-D to be taken twice a day on an empty stomach. I take them diligently but most times I find them still whole in the toilet after having a bowel movement. My husband cleans the septic tank every year asked me who was throwing away pills. I am too embarrassed to tell my doctor about it. Have you ever heard of this?

DEAR READER:
Cases where pills are taken and then passed while still intact, is usually because the normal process of ingestion, digestion and expulsion is sped up. [Read more...]

Filed Under: Daily Column Tagged With: allergies

Daily Column

July 5, 2008 By Dr. Gott

DEAR DR. GOTT:
My eye specialist recently told me that I need cataract surgery. My reaction was negative because I have ALWAYS been allergic to anything and everything in or around my eyes. I have never even been able to wear any kind of makeup. I can’t wear contact lenses because it was found I was allergic to the lenses themselves. I tried twice but not through this doctor.

DEAR READER:
A cataract is the clouding of the eye’s natural lens situated behind the iris and pupil. The condition is common in the elderly and affects about 70% of those over 75 years of age.

Allergies of the eye are no different than allergies affecting the lungs, nose and sinuses. In the case of cataract surgery, adverse reactions to anesthetic periocular (eye numbing) injections can cause hypersensitivity either from the compound itself or from the mechanical manipulation of the needle. [Read more...]

Filed Under: Daily Column Tagged With: allergies, An Informed Approach to Surgery, cataract surgery

Sunday Column

June 8, 2008 By Dr. Gott

DEAR DR. GOTT:
Thank you so much for you column. My mother and I live 1200 miles apart and both read it daily in our newspapers. We have learned so much from you — especially the bar of soap trick, what a lifesaver!

I’d like to ask your thoughts about recurrent, chronic hives. I’ve suffered from this problem for several months. I itch, I scratch, and then I get welts. They generally disappear in a half hour or so but pop up again somewhere else. It happens two-eight times a day, every day. Antihistamines help but do not totally get rid of the symptoms. I recently took a six-week trip from Florida to Nova Scotia, thinking all during the trip that the complete change of food and atmosphere would help the hives if they were from an allergic response. They kept on coming, daily, during the trip, just as they do at home.

My allergist has tested for me foods, chemicals and inhalants. I am allergic to some trees and grasses but when I have the hives I do not have respiratory symptoms. My dermatologist drew an X on my back with his fingernail, but no hives resulted. The welts do not appear if there’s no itch first. A blood test only revealed that I have a rather high eosinophil count (19% in the last test).

I’ve spent hundreds of dollars on tests and doctors, with no conclusive results. Based on reading I’ve done, I think this is idiopathic and I may just have to learn to live with it but I don’t recall ever seeing chronic hives discussed in your column. Any thoughts or ideas you have would be helpful, not only to me but to many others as well.

DEAR READER:
Chronic, recurring hives can be very difficult to treat. The problem is often compounded by the fact that almost half of all cases are idiopathic, meaning they have no known cause.

Your elevated eosinophil count is telling. These specialized white blood cells are usually only active during certain allergic diseases, infections (primarily parasitic), and in the presence of certain medications. Allergic disease can include asthma, eczema, hay fever, and autoimmune disorders. Medications include amphetamines, certain psyllium laxatives, certain antibiotics, interferon and tranquilizers.

Most chronic hives occur daily (as yours do) but last for several hours. Hives also tend to itch only after developing. Because yours do not appear until after itching and scratching, your dermatologist correctly performed a pressure test. This test using a blunt point and in individuals with delayed pressure urticaria (hives), the area drawn on will develop welts. This may occur within minutes but may take several hours before they are obvious. Again, however, you are atypical with welts only appears after scratching. I am tempted to say that you have a strange combination of delayed pressure urticaria and eczema (an area of dry skin that itches then rashes after scratching); however, I am not a dermatologist.

I urge you to seek out second opinions from a dermatologist and allergist. They may be able to provide new insight and order new testing. Because your symptoms are chronic, recurring and clearly affecting your quality of life, I recommend you visit the dermatology and/or allergy clinics of a teaching hospital. I note that you live in Florida. You are in luck because there is a specialty resource known as The Mayo Clinic located in Jacksonville, FL. You may also wish to check out some of the universities near you to see if any offer clinics at area hospitals where medical students and professors see the general public. This is a great option because you will be getting excellent care and aiding in a student’s education.

In the meantime, I recommend you take antihistamines as a preventive to reduce your symptoms.

To give you 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 number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Filed Under: Daily Column Tagged With: allergies, hives, itchin skin

Daily Column

May 23, 2008 By Dr. Gott

DEAR DR. GOTT:
I suffer from headaches associated with allergies and have tried numerous medications without much success. With spring here, the grass growing and flowers blooming, I’m really in a bind to find something I feel safe taking. Do you have any suggestions?

DEAR READER:
Allergies and headaches can be difficult to deal with and seem to affect us all at some point in our lives. Worse still, they seem to occur only at important occasions or other inappropriate times. You don’t indicate what you have taken for relief, so hopefully I can point you in the right direction.

I recommend a visit to your local pharmacy to see what is available over-the-counter. There are several allergy products offered by various companies which help many individuals. You may wish to try Claritin, a prescription medication now approved for over-the-counter sale. The newest allergy prescription turned OTC is Zyrtec. If you stop the allergies you should be able to prevent the headaches.

If you prefer homeopathic choices, I recommend Sinol which is the first headache nasal spray registered with the FDA. It is purported to relieve headache pain and also comes in an allergy relief spray. It supposedly reduces, prevents and/or stops sinus pain, as well as congestion and inflammation. It is non-addictive and free of harsh side effects.

If you need some guidance, speak with the pharmacist who may be able to provide more information about the types of medication that will best control your symptoms and provide prompt relief. If you still are confused or have questions, make an appointment with your primary care physician for his or her recommendations.

To give you related information, I am sending you copies of my Health Reports “Allergies” and “Headaches“. Other readers who would like copies should send a self-addressed, stamped, number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Filed Under: Daily Column Tagged With: allergies, Claritin, Headaches, Sinol, Zyrtec

Daily Column

May 15, 2008 By Dr. Gott

DEAR DR. GOTT:
I am allergic to both penicillin and sulfa. My concern is about sulfa. My hands and finger swell up when I take sulfa medications. This concerns me because I have heard that I shouldn’t drink wine because it also contains sulfa and will cause a similar reaction. I like to drink an occasional glass of wine, usually white but sometimes red. Should I refrain from this so I don’t have an allergic reaction?

DEAR READER:
You have, in essence, already answered your own question. If you have continued to drink wine without a reaction, you are fine. But the issue goes deeper.

It is a strong urban myth that those allergic to SULFA drugs are also allergic to the SULFITES in wine. This is not always the case. Rarely a person will be allergic to both but it is highly unlikely.

Sulfa is a compound of sulfur. Sulfur is essential to the body’s amino acids (the building blocks of DNA). To the best of my knowledge, no one is allergic to sulfur, per se. Rather it is the proteins and compounds it can create within the body. Therefore it is possible to be allergic to sulfa but not sulfites or other sulfur containing compounds.

According to www.WebMD.com, it is estimated that one out of 100 people has a sensitivity to sulfites but in most cases it is so minor that it doesn’t adversely affect health. The same sulfites in wine can also be found it other fermented alcohol beverages, dried fruits, processed or cooked foods and more.

Anyone who is worried about possible allergies should see an allergist who can review their personal and medical history as well as order testing to determine what substances cause reactions.

Filed Under: Daily Column Tagged With: allergies, sulfa

Daily Column

April 28, 2008 By Dr. Gott

DEAR DR. GOTT:
My in-laws insist that beef sold in most supermarkets is dyed red and they soak their meat to remove the dye. Is this true?

My oldest daughter has hives often and we have traced their occurrence to red food dye. Occasionally she will have an ongoing case of hives, which we cannot trace. We think it must be stress related, but now I wonder if it might be caused by meat consumption. Aren’t meat packaging companies required to list dye on package labels if they add it?

DEAR READER:
Red meat starts out red but the longer it sits on store shelves, the more it turns brown. This is not a sign that the meat is bad, but most consumers will by-pass it for redder meat. Therefore, in 2004, the FDA gave several large meat packers permission to inject carbon monoxide into the meat package. This makes the meat stay red, often even after the product has spoiled. While the amounts used probably will not cause a health problem, it does lend itself to other difficulties. Most consumers are unaware of this “additive”. It is not listed on the label because it does not get injected directly into the meat. It also increases the chances (should your supermarket be less than honest) of purchasing outdated, spoiled or near use-by-date meat.

I do not know if US meats contain red dye. I do know that some meat companies are under scrutiny in the UK for adding food dyes that may cause cancer.

If you are truly concerned about food dyes in your meat products, you may wish to purchase them from a butcher shop. This way you get incredibly fresh product without the fear of additives from major meat packers. Another option is simply to stop eating red meat. Chicken, turkey, and fish contain the same protein, have less fat and can be used in place of beef or pork in most dishes.

I suggest that you take your daughter to an allergist to be tested. Perhaps she is allergic to more than red food dyes. In this way, you can find out the cause of her hives, provide treatment and improve the quality of her life. If the hives are truly stress related, perhaps counseling to learn ways to deal with stress is in order.

Filed Under: Daily Column Tagged With: allergies

Daily Column

March 29, 2008 By Dr. Gott

DEAR DR. GOTT:
I read your column everyday and hope you can help.

My 50-year-old daughter has developed an allergy that causes a very itchy rash over her entire body. Tests have not determined the cause. She has been on prednisone and is now being weaned off. She has extreme pain over her entire body, especially her feet and is having trouble walking. She has been told that this is a side effect of going off the medication but that other tests cannot be carried out until her body is clear of the steroid.

Is there anything that can relieve the symptoms of withdrawal? Her job requires her to be on her feet most of the day and she is having a hard time functioning efficiently at work.

DEAR READER:
Severe itching can be caused by an allergy, but it can also reflect kidney disease or hidden cancer. Therefore, I suggest that your daughter have further testing performed once the effects of the prednisone have disappeared. To the best of my knowledge, prednisone withdrawal symptoms only occur if the drug is stopped abruptly or is tapered off too quickly. If her doctor is removing the medication too quickly, it could explain her pain. I suggest she speak to him or her and voice her concerns.

As an aside, the pain is a result of cortisol withdrawal. The body makes cortisol naturally until medication, such as prednisone or other corticosteroids, are introduced. Because the body makes only minimal amounts, the adrenal glands (which produce cortisol) shut down in the presence of the medication. It takes time for the body to resume its normal functioning . It can one week to several months to wean down properly from corticosteroid therapy.

Rarely, some individuals will not return to normal function, especially if the dosage and frequency are high and long. If this occurs, medication to replace the missing cortisol must be taken to avoid symptoms. If it is not, serious illness and death occur.

I suggest your daughter have blood work to test the function of her kidneys, a potassium level and certain cancer markers (available for breast cancer). A high potassium level (often caused by kidney disease) may be the culprit. If this is the case, I suggest she be examined by a nephrologist (kidney specialist). If her cancer markers come back abnormal she should be examined by her gynecologist or an oncologist. On the other hand, if everything appears normal, she should continue with the allergist.

If your daughter is having severe pain and side effects, she must be weaned down more slowly. If her physician is unwilling to do so, she should find a new one. Good luck and let me know how this turns out.

Filed Under: Daily Column Tagged With: allergies, cancer, cortisol, kidney disease, Prednisone

Daily Column

March 23, 2008 By Dr. Gott

DEAR DR. GOTT:
I am a 50-year-old female with allergies. I use sublingual drops to treat them.

About twice a year I get a sinus infection. My doctor prescribes a five day Z-Pac (azithromycin) because I am allergic to penicillin and it is the only antibiotic I can tolerate. However, most times I need two courses to clear the infection.

I try to avoid allergens the best I can, take numerous vitamins and herbs to help boost my immune system and try to keep my sinuses clear with Mucinex, plain saline spray and occasional Sudafed.

I was recently examined by an ear-nose-and-throat specialist. He diagnosed me with a deviated septum and enlarged turbinates. My septum is so deviated that my breathing is reduced to 15% on the right side. He advised surgery to straighten the septum and to also reduce the size of the turbinates (which I understand to be one of the nasal bones).

I have talked with some people who have had the surgery. Most say their breathing has improved but they still get sinus infections although they are now less severe and have shorter durations.

Since I have had this condition all my life, I am wondering if I should just leave well enough alone but also worry that if it worsens that the surgery will be more difficult at a later age.

My question is: would your advise me to have the surgery?

DEAR READER:
A deviated septum is a common cause of sinus infections because the involved tissues may block the sinuses from draining properly. In my experience, this problem can be successfully treated by septal surgery. I advise you to have it done.

To give you related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery”. 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.

Filed Under: Daily Column Tagged With: allergies, deviated septum, infection, Mucinex, septal surgery, sinus infection, Sudafed, Z-Pac

Switch medications to ease allergies

February 23, 2008 By Dr. Gott

DEAR DR. GOTT: I have been told that I am allergic to blood pressure pills. From the beginning I was advised to take an allergy pill with the medication. It makes my lips swell, causes me to have blisters in and a burning sensation around my mouth. I am desperate to get some kind of solution to my problem.

DEAR READER: There are many types of blood pressure medications. I doubt you are allergic to them all. You need to be switched to a medication to which you are not allergic.

That being said, I am appalled that your primary care physician did not immediately stop the medication and switch you to something else. Simply taking an allergy pill with the blood pressure pill is not enough as you well know, since you continue to have reactions.
[Read more...]

Filed Under: Daily Column Tagged With: allergies, high blood pressure, Hypertension

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