Allergy is defined as an exaggerated immune response to a typically harmless substance in environment. These disorders are caused by an inappropriately vigorous innate and/or adaptive response to an antigen which possess little or no threat.
The word allergy was coined by 2 pediatricians, an Austrian, Clemens Peter Freiherr von Pirquet and a Hungarian, Bela Schick from Greek words allos meaning other and ergon meaning reaction. In 1871 Charles Blackely a homoeopath discovered the association of pollen and allergies.
20-30% of total population in India suffers from at least one allergic disease, of this 15% of the patients tend to develop bronchial asthma. Urban children have a higher prevalence of allergies than rural, with a male preponderance. About 4.5 % adolescents are allergic to food items leading to asthma, rhinitis or both.
Over the last 25-30 years, the incidence of allergic rhinitis, asthma, food allergy, food allergy or sensitivity, and atopic dermatitis has sharply escalated. There is increased burden of allergic diseases in lower- and middle-income groups. There has been a rising prevalence of food allergies over the past few years especially in developed countries. About 1 In 13 children worldwide are affected by food allergies in the developed world. In our clinic at Home of Homeo 30 % of all cases are of allergic rhinitis.
The possible causes for it are
a) Obesity
b) Vitamin D deficiency
c) Change in human microbiome due to urbanization, early antibiotic intervention and change in diet.
d) Increase in allergens due to pollution.
Role of immune system in allergies/ Mechanism of allergies:
The type of hypersensitivity in allergies is of immediate type where the response occurs within seconds to minutes and is mediated largely by humoral antibodies of IgE type or regain type. These antibodies sensitize the basophils/ mast cells release substances called as anaphylactic mediators such as histamine, serotonin, vasoactive intestinal peptide, chemotactic factors, leukotrienes and eosinophils. These are responsible for increase in vascular permeability, smooth muscle contraction, increased gastric secretion, increased nasal and lacrimal secretions leading to symptoms of allergies such as sneezing, nasal discharge, wheals and hives.
Some of the common allergens are house dust, dust mites, pollen, spores, mould spores and animal dander, food items like peanuts, nuts, perfumes, cosmetics, insect bites and stings.
How to differentiate between a common cold and allergic rhinitis?
A common cold usually has a slow onset and no clearly identified allergen association as opposed to allergic diseases where in you can identify the triggering allergen. Allergic rhinits usually has a sudden onset and is associated with more sneezing and thin watery nasal discharge whereas the secretions in a common cold which has infectious origin is usually thick starting from white, yellow and can turn green. Common cold is usually associated with systemic complaints like body ache and fever.
How to differentiate between food allergy and food intolerance?
Most of the times the symptoms which develop after consumption of certain food items are due to food intolerance. A true food allergy develops along with systemic symptoms such as swollen lips, difficulty breathing, wheezing and a falling blood pressure along with the gastrointestinal symptoms. Food allergies can be life threatening if not treated immediately. Symptoms of food intolerance are usually less severe and limited to GI system such as vomiting and diarrhea.
Are allergies genetic or environmental?
Allergic diseases are influenced by genetic predisposition and environmental exposure. Allergic diseases are complex diseases resulting from the effect of multiple genetic and interacting environmental factors on their pathophysiology. Allergic disease is likely to result from effects of environmental stimuli in genetically susceptible individuals. If there is no close relative with allergies then chances are 12 %, but even if one parent has any allergic disease the incidence rises to 30 to 50% and if both parents are allergic the incidence rises to 80%.
When to see a doctor?
Allergies where there is difficulty breathing, swollen lips and face, angioedema are a case of medical emergency and require immediate hospital admission and treatment. The symptoms here are systemic. In case of local allergies such as hay fever, urticaria, allergic conjunctivitis homoeopathic medicines can be beneficial.
Homoeopathic management of allergies.
Homoeopathic constitutional treatment can be given after detailed case taking for treatment of allergies. The medicines vary depending upon the site of affection, presenting symptoms. Medicines such as Sabadilla, Sinapis Nigra, Natrum Mur and Arsenicum Album are beneficial in treatment of allergic rhinitis and allergic bronchitis. In case of allergies on the skin that is urticaria and hives as presenting symptom then Apis Mel, Dulcamara, Urtica Urens are of great aid. At Home of Homeo homoeopathic medicines are prescribed not only to control the acute flare of allergies but also to reduce the sensitivity to the said allergen by acting on the immune system. By help of this treatment a reliance on medicines to control the allergies is reduced and the patient can lead a medicine free life.
Testing/Investigations
Allergies can be tested using a skin prick test or a blood test. The skin prick test in performed on the forearm with suspected allergens, if you have an allergy then redness will develop site of contact with allergen. The skin prick tests have faster results than blood tests but chances of false positive is present. Also, multiple pricks to the skin are involved and not suggested if you have a skin condition such as eczaema, psoriasis etc. Blood tests on the other hand involve a single prick blood collection, the results require more than 48 hours to come. Blood tests are more advisable in cases where there is a possibility of severe allergic reaction to the skin test.
There are two types of blood tests done for testing allergies. The RAST test done to identify the allergen and Absolute Eosinophil count and total serum IgE test done for quantitation.
Prevention and tips:
- Maintain a diary where in you write down your daily diet especially on days you have an allergy flare. This will help you identify the triggering allergen.
- In case of severity of allergic response talk to your doctor and get information regarding usage of autoinjectors.
- Make sure you inform you doctor and HCP regarding your allergies before-hand.
- Follow a histamine free diet.
List of foods to avoid or consume in less quantity/ histamine free foods:
• Fish like Tuna and mackerel.
• Chicken, eggs and egg-based mayonnaise
• Spinach.
• Fermented foods like idli, dosa.
• Soya bean, red pepper paste.
• Yoghurt/ curd.
• Tomatoes and tomato ketchup.
• Instant foods.
• All nuts including peanuts and walnuts.
• Chocolates.
• Oily and fried food, processed food, foods with monosodium glutamate.
References:
- HarshMohan textbook of Pathology.
- Kuby Immunology by Barbara Osborne and Janis Kuby.
- 70 years of Clinical Homoeopathy by Dr Kopikkar.
- Journal of Allergies and Clinical Immunology- genetics of allergic disease by John Holloway and Ian Yang
- Living with allergies by Dr Dhiraj Nanda