Allergy and Asthma ‘Q and A’ with Dr. Siri at COUNTRY Financial

Q: …

Dr. Siri: So, her question is about food triggers and migraine headaches. Things such as MSG, Chinese restaurants, chocolate, in particular, white chocolate, and other foods. She tries to eat whole foods for the most part, but can’t avoid chocolate for the rest of her life because, I agree, that’s just torture. You can’t avoid chocolate for the rest of your life… So, your question is really about migraine headaches, and almost all of us have had migraines once in our lives. They’re characterized as pressure typically behind one’s eye; there’s a lot of pressure that can lead to nausea… where light can trigger it, things like that. But, all of us have probably had it at least once in our lives. So people who have [chronic] migraines are people who have them a lot, and there can be a lot of triggers. Of course, allergies play a part in that (food allergy, environmental allergy, etc.)… So, an allergy to us means that it [could] kill you. What you have is a food intolerance that actually triggers your migraines, and it’s not uncommon. It’s well-defined in medical literature. [So, you could have an MSG intolerance]; there’s even something called Chinese Restaurant Syndrome… [and it’s simply referring to a response in the immune system to the additives in this particular type of food.] And MSG is the extra flavoring [in Chinese food]… it’s umami that gives it that rich, flavoring, that some people may be sensitive to. But, it could also be all the other things that are used: soy sauce, which has a high salt content. For you, it could be the salt, it could be the smokiness, it could be all the other chemicals, which we don’t define as true food allergies, we call [them] food intolerances. But, they can certainly be a problem for you. If you’re having uncontrolled issues with your sinuses, too, those could be easy triggers. So, when you say, “Oh, the barometric pressure! I’m at a ball game; I know when the storm’s coming. I can feel it, and then, also, it triggers my migraines.” It’s known that sinus pressure and sinus headaches can trigger migraines, too. And so when you are not feeling well, just like an allergic person who has uncontrolled allergies and [is] not feeling well, your body is primed and hyped. And so you may go somewhere, and, normally, you wouldn’t have any problems. But [when] you’re in that state, that allergic state or that inflamed state that may trigger your migraines, you may be more sensitive to it. So, it’s not uncommon for people who have uncontrolled allergies to walk in a room that’s freshly painted and then all of a sudden have a headache, an attack, those kinds of things. But if your allergies were controlled, you were on medications, doing sinus rinses, whatever, they may walk in the same room and not have it. So it’s hard for [those prone to migraines] sometimes to know because sometimes it seems like a little and sometimes it seems like a lot when [they’re] exposed to it. And that’s the same with allergy, too. So, the answer is yes, we have seen that, but that’s a food intolerance, not necessarily a food allergy.

Q: …

Dr. Siri: The question is do we need a referral to see us or can we make an appointment right away? That depends on your insurance. If you have, what we call, an HMO, that typically means you have to go through your primary care doctor to get a referral… If you have something called a PPO… then typically you can make an appointment yourself… We do not require a referral.

Q: Is there any truth to the myth that eating locally sourced honey will help you develop a resistance to allergies?

Dr. Siri: That’s a really good question. The question is: Is the honey you’re eating raw? So, her question is: Does eating locally sourced honey help with your allergies? Well, honey has been pasteurized… Bees are really important to our environment to cross-pollinate, particularly with flowers. So, if you’re a person that’s sensitive to flowers, then yes, it could help because when they cross-pollinate and things like that, they get some of the pollen in the honey. If you are allergic to things like trees, trees are actually pollinated without insects. They are pollinated by wind, and so [are] things like ragweed and grass… So, it’s unlikely for there to be substantial amounts of those pollens in honey, in raw honey, that will help. But, honey has other good properties, besides being high in sugar-content because it’s delicious. In addition to that, honey also has a lot of antimicrobial properties that can be helpful in other ways. It doesn’t help with things like grass pollen allergy, tree pollen allergy, mold allergy, cat and dust mite allergy… But, for people who are allergic to flowers, maybe.

Q: …

Dr. Siri: Wow; that’s a loaded question. You should come over to my house and have dinner; we could talk for hours. So, his question is that there have been a lot of advancements from the medical community to treat allergies, but what is society, doctors, the environment, the President of the United States, doing for our country and the world to help with allergies. That’s a tough one. I think that on a personal level you [can] eat as clean as possible and… eat as best as you can; you [can] go back to the basics, like regular toothpaste… But, we live in a modern society. Most of us aren’t going to want to give up apartments and our carpets and our homes, things like that… There’s a lot of research in this regard, as far as what we call primary preventions – that means preventing the problem in the first place… The issue is unfortunately with longer lives, you know we’re all living to the age of 70-75 on average these days, longer lives, vaccinations, developments in medical science, longer/healthier lives, unfortunately comes with some side effects. So, I agree; our immune systems are all jacked up, but how can you control what’s in your water? That’s a big question. How do you control what’s in your food and where it comes from? That’s a big question. I’m just an allergist, so I can’t give all the answers, but it is a great question.

Q: A year ago our son had his tonsils removed, and he hasn’t had strep since then. But, he has developed more allergies that we’ve been able to control mostly with Benadryl and things like that. But, how much is too much of that stuff before we should have him tested or see what the real deal is…

Dr. Siri: So, her question is that her son got a tonsillectomy and had a miraculous recovery… But, since then he’s developed a lot of allergies, and they treat him with a lot of Benadryl. And, they’re worried about the side effects and any long term problems. Benadryl has been around for 50+ years, so largely we’ve thought of it as safe. But, recent literature has shown that it’s been associated, especially in the older age group, with… Alzheimer’s Disease… But, are all medications safe? Well, we’d like to think so. I think vitamins are safe, but too many vitamins will kill you, too. So, we should be judicious about the use of any medication in anybody of any age group, and you should use as little as you can. This is where getting tested, knowing what your triggers are, maybe knowing if your child is only allergic to tree pollen and how symptoms will only appear during certain times of the year… Then you don’t have to give them Benadryl during the other times of the year because sometimes those are infection, [not allergies]. So, information is helpful.

Q: Can you outgrow asthma?

Dr. Siri: …Yes! So, the majority of children, 80-90% of them, have allergic asthma. The ones who don’t probably are born with… something wrong with their lungs. So, if you outgrow your allergies, you will outgrow your asthma. But, some people who have uncontrolled asthma, [they need treatment] so we can maximize the lung function that they have. And so, it’s important to recognize asthma [and] treat it because it’s a much more serious problem than a runny nose. So, if the child outgrows the allergy, they can [outgrow asthma]. But, we can have long-term changes from inflammation that can affect the lungs that maybe a person can’t outgrow.

Q: How long before you would say someone could outgrow asthma? My son is ten; he hasn’t had an asthma attack in three years, but we still have the nebulizer and everything on hand just in case. But, how long do you think… before we would say he outgrew it?

Dr. Siri: …That period in puberty is a magical time – 10, 11, 12 – it’s a magical time… So, [in that time], they can either get worse or they can get better. Sometimes, if they’re really close, and they’re not having severe problems, parents wonder if they should start [allergy] shots [at nine], but no… The worst time is really from closely after birth to basically young childhood, which we consider under ten. And then the second period that’s awful is actually at the age of thirty… [Consult your doctor or allergist if you suspect you’ve outgrown your asthma.]