Thursday, April 27, 2017

Preventing and Treating Allergies

Flowering trees are one of the biggest allergy culprits in the Mid-Atlantic
Here in the Mid-Atlantic region of the U.S., everything seemed to start blooming at the same time this year, creating an allergy season even worse than usual. We were on vacation in Virginia the week that everything blossomed down there and returned home just in time for our own blooming season, so I had two really bad weeks of allergies in a row. My son, here in college, texted me on our vacation to say his allergies were horrible, so bad that his skin itched all over and he occasionally broke out in hives (spring trees are one of his biggest culprits).

Although allergies are a problem for much of the population, they are even more prevalent in those of us with ME/CFS. The particular type of immune dysfunction that characterizes our disease - a Th2 dominance - makes our immune systems over-react to allergens, making us even more prone to allergies or perhaps even developing them for the first time in our lives after getting ME/CFS. For me, sudden-onset allergies were a precursor to ME/CFS, one of many signs that my immune system was going haywire. I never had any kind of allergies until I was 30 years old, and now I struggle with them year-round.

One way this tendency toward allergy shows itself in ME/CFS is our likelihood of developing food intolerances and allergies. My older son and I used to drink LOTS of milk every day and never had a problem, but we both became dairy intolerant after developing ME/CFS. In fact, a recent study showed that 30% of ME/CFS patients are dairy intolerant, so if you have undiagnosed gastro-intestinal problems, definitely try giving up dairy (and remember to check your medications for lactose).

The other primary way this immune dysfunction shows up in allergies is a response to environmental elements. This can be seasonal - as in the case of my son's spring allergies when the trees blossom - or year-round, as are my own allergies to dust mites and molds. Lucky me - I also have occasional allergy flare-ups when things bloom, like I did this spring.

Allergies aren't just a minor annoyance. Even in healthy people, like my younger son, a bad allergy flare-up can make him feel sick and exhausted. And when you add allergies in on top of ME/CFS (or fibromyalgia or Lyme), allergies can be the straw that breaks the camel's back, worsening all of your "normal" symptoms. It's an additional load on our already-overloaded immune systems. So, what can you do about it?

Prevent Allergies By Normalizing the Immune System
This post explains all about the immune dysfunction in ME/CFS, which is at the heart of our disease. Treating immune system dysfunction can therefore get at the root of ME/CFS and help to improve all of its symptoms. My son and I have found this to be very true, and much of our improvement over the past 10 years has been from treatments aimed at normalizing the immune system. One of those treatments is low-dose naltrexone, which helped us in many ways and is aimed at correcting (to some extent) those immune system abnormalities.

The other main treatment we use to normalize our immune systems is inosine, sold as a supplement in the U.S. (and quite cheap). That blog post linked in the previous sentence has all the details of our use of inosine, what it does, and dosing (which is a bit complicated). As I explained in a post last week on Virally-Induced Crashes, inosine has greatly reduced those kinds of crashes for both my son and I. We used to spend most of the winter relapsed from being exposed to one virus or another, and now that is a rare occurrence.

Much to my delight, though, I noticed another benefit of inosine: my allergies got much, much better. I used to have bad allergy flare-ups several times a year, where my eyes would water constantly, making them so sore and inflammed I couldn't wear my contact lenses, plus the typical runny nose and congestion, which for me also leads to sinus headaches. Now, on inosine, these flare-ups are a rare occurrence. When it happened on our vacation this month, I believe it was because I was taking a break from inosine (again dosing is complicated, and you need to take a break every once in a while). Once I got back on inosine after my two-week break, the allergies cleared up quickly. Note to self: don't take my inosine break in the spring!

Treating Allergies
So, taking inosine has greatly reduced my allergies so that I rarely have a bad flare-up now. My younger son does, though (he's the one who's recovered from ME/CFS), and I still have occasional allergy symptoms. When they hit, there are all the usual over-the-counter remedies that you can find at the drugstore.

Your first step should be to take an antihistamine. Allergies are caused by inflammatory compounds called histamines that your immune system reacts to; antihistamines block these compounds. Most of the prescription antihistamines are now available over-the-counter in the drugstore, so you can take your pick. Claritin, Allegra, and Zyrtec are the three most popular ones, listed in order of strength. We have found Zyrtec to be most effective for us. I take it every night since my allergies are year-round, and my son takes it when his allergies flare-up. Note that the white Zyrtec pills (and very often, any pills that are white - read the labels under Inactive Ingredients) use lactose as a filler, so be sure to get the gel-caps if you are dairy intolerant.

Our doctor explained that there are 2 histamine pathways in the body, and most of these antihistamines only block one of those. Good old Benadryl (diphenhydramine HCl) blocks both pathways, which is why it is so effective...but alas, it knocks most of us out. My husband and son use it at night when their allergies get bad. (Note that I am using brand names here, but most of these drugstore products are now available in cheaper generic versions).

And, of course, you can treat allergy symptoms with decongestants, nose sprays, eye drops, and other remedies aimed at easing symptoms. We usually add a steroidal nose spray to our Zyrtec when things get bad - my son has a prescription one, but again, many of the ones that used to require a prescription are now available over-the-counter. Finally, we take Mucinex anytime any of us is congested - for allergies or other reasons. Mucinex thins mucus secretions which helps to prevent them from becoming infected. Back to the immune dysfunction in ME/CFS - since we are extra-prone to getting bacterial infections, like sinus infections and bronchitis, we take extra-strength Mucinex round-the-clock when any congestion is present.

In addition to the usual remedies in the drugstore, our dietician suggested an herbal supplement called Quercetin, which is known to have an anti-inflammatory effect and block histamine release. She was right - I found it to be fairly effective in my arsenal when allergies flare-up. At those times, I take 2 capsules 3 times a day, between meals. The rest of the year, I keep it in the cupboard.

What About Allergy Shots?
A lot of people have asked me whether they should try allergy shots. That's a decision for you and your doctor to make, but it's not a recommended approach for most people with ME/CFS. Vaccines, including allergy shots, are designed to stimulate your immune system. In the case of allergy shots, the strategy is to start with tiny amounts of what you are allergic to and gradually increase until you become less sensitive to it. The problem is that our immune systems are already WAY over-active against allergens, so further stimulating them is not usually a good idea. It is quite likely to result in a crash or relapse after every shot and perhaps even a permanent or long-term worsening of your condition. In fact, I am pretty sure that allergy shots were what triggered my ME/CFS to start or at least were a primary contributor. I got ME/CFS shortly after starting allergy shots, and I believe - in hindsight - that those helped to overload my immune system to the point where it just "broke." So, talk to your doctor (preferably one who understands the immune dysfunction in ME/CFS), but allergy shots are probably not a good idea for most ME/CFS patients.

So, those are our approaches: first, do what you can to normalize your immune system to reduce your allergic response, then treat allergies with over-the-counter and herbal remedies, as needed. As I mentioned above, the inosine has made the biggest difference for me...and I will not make the mistake again of going off it in the middle of the worst of allergy season!

Have you found anything that helps your allergies?

Note: This post contains affiliate links. Purchases from these links provide a small commission to me, to help offset the time I spend writing for this blog, at no extra cost to you. Note that this is an excellent price on Mucinex at Amazon - I usually get ours at the drugstore but ordered it as soon as I saw how cheap it was here!


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