Stop & Read: #1 Lesson for Preventing Allergies

bee-sting-allergies

During one of the first lectures I ever attended in allergy fellowship training was from esteemed Professor Vincent Beltrani, from the Columbia College of Physicians and Surgeons, a double-boarded allergist and dermatologist (one of a handful in the entire country.) In a room full of young allergists, Dr. Beltrani roared in his Brooklyn accent:

“Just remember to tell your patients that they are never allergic to anything the first time they are exposed to it…whether a food, pollen in the air or an insect sting. It is only from repetitive exposure that an allergy can develop.”

insect-bite-allergies

These wise words have stuck in my mind when diagnosing patients with various types of allergies: skin rashes, respiratory problems and especially food or drug reactions. In today’s Science section of The New York Times , the article on Allergies in the Time of Research , clearly demonstrates this principle. The article describes how a researcher working on cicadas–the insects that make that loud buzzing noise in the summer–had mold on their skin. The researcher working with them developed mold allergy from repeated exposure. The researchers hand itched when handling the bugs and had sneezing and shortness of breath.

I frequently hear stories in my practice how patients develop an allergic reaction to something they never had a problem with previously.

Examples:

“I had a strawberries with fruit and now I’m itching all over with a rash, but I’ve had strawberries a million times…”

Or,

“I grew up with dogs and then I went off to college and now when I visit my parents home I experience shortness of breath around my dog, how can that be?”

And finally, regarding medications:

“I frequently get sinus infections and I usually am prescribed Amoxicillin because it works, but this time I got hives all over my body.”

Rotation is Key

rotation

All of these examples are illustrations of the principle that reoccurring exposure can cause an allergy in an allergic (also called atopic) person. My advice to anyone with an allergic history or who has a family history (genetic) is Rotation, Rotation…and, you guessed it…Rotation.

The number one lesson in helping to prevent and reduce the incidence of especially food and medication allergies is rotating these when possible. I frequently advise patients with food allergies to not only avoid the foods they are obviously allergic to, but to rotate the foods they enjoy. Why? I commonly see that patients feel “safe” eating certain foods and out of habit will eat the same foods day after day. This is a problem when someone has allergic tendencies because they can build new allergy antibodies (IgE) to the food they assumed they wouldn’t become allergic to. Once a new food allergy develops, it can’t be reversed.

The same idea holds for medications. If you are prone to sinus infections or bladder infections where chronic use of antibiotics is needed, please discuss with your doctor about rotating your medication so that you don’t develop an allergy to the antibiotic or resistance of the bacteria being treated.

One last interesting finding:

If an allergen to a food or medication is avoided for many years, there is the possibility that the allergy can disappear as well. Please never ignore the signs of an allergic reaction to a food or medicine and think it is a minor nuisance. A mild allergic reaction can easily become a full-blown allergic reaction the next time.

Enjoy the rest of your summer–and use plenty of sunscreen–Doctor’s orders.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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