Thursday, March 27, 2014

Food Allergy- the ugly, the bad, the good....

Peanut, egg, milk, seafood are common culprits of food allergy.  Severe and deadly reactions drive schools to be nut free and to have anaphylaxis plans in place.  But why the increase?  Why the severity?  Are there potential treatments or even a way of curing food allergy?

What's the ugly, the bad and the good for food allergy?

The Ugly
  • Food allergies affect about 8% of children and 5% of adults
  • These numbers have risen from by more than 50% since 1999
  • Peanut allergy increased from 0.4% to 1.4% over the same time period
  • Every 3 minutes someone has an allergic reaction to food sending them to the emergency room
  • Having food allergies doesn't potentially cause just a severe allergic reaction, but is associated with bullying, increased anxiety, and a lower quality of life.
The Bad
  • Eight foods account for 90 % of all reactions: milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. Even trace amounts of a food allergen can cause a reaction.
  • Risk factors for developing food allergies include:  male, race, family history of allergy, low vitamin D levels, and food preparation.  
  • Bottom line though is we don't know what causes food allergy.  There is probably a complex interaction between genetics and the environment leading causing the increase.
The Good
  • Can you out grow food allergy?  
    • Yes, luckily milk, egg, wheat and soy allergy generally resolve with age!  Unfortunately peanut and tree nut allergy persist.
  • Is there a potential treatment for food allergy?
    • Yes!
    • Research and trials are being done on slow oral desensitization for milk, egg, and peanut allergy.
    • Results are promising so stay tuned for updates.
Do you have food allergies and need help? Call the office so we can formalize an individual plan for you 212-679-3574 or schedule an appointment here.

Monday, March 10, 2014

Why Should you Feed Your Gut? The Importance of the Microbiome

What is a Microbiome?

  • Did you know that our guts (intestines) are filled with over 100 trillion bacteria?  Each part of our bodies has specific types of bacteria peacefully living.   These bacteria are called our microbiome
  • The microbiome helps teach our immune system what's safe not safe.  In doing so, they modulate our immune response.  
  • Our guts provide the microbiome a safe place to live.  It's definitely a mutually beneficial relationship.
Where Does the Micrbiome Come From?
  • We are colonized very early in life with a bacteria that will be with us through our entire life.
  • Typical species of bacteria living in our gut are:
    •  Bacterioides species is the most abundant species
    • Lactobacillus, Peptococcus, and E. Coli  along with others are also present.
  • Which bacteria are the most important to our digestion and absorption of nutrients?  
    • Bifdobacteria and Lactic acid bacteria.
Can you Alter Your Microbiome?
  • Yes...The food we eat and medications we take can alter our microbiome.  
  • Antibiotics can have a negative effect on the microbiome and change the balance of bacteria living within us. This can cause problems with our digestion- gas, bloating, constipation and diarrhea
  • Foods we eat can change the microbiome- think active cultures in yogurts and probiotics 
  • Foods that bacteria like to eat and support their growth are called prebiotics. Important prebiotics are foods containing inulin and  trans-galactooligosaccharide.
  • Foods rich in these substances are Acaica gums, beans, and artichoke roots.  
Why is an Allergist Interested in the Microbiome?  
  • The microbiome helps teach our immune system what's safe and not safe.
  • More and more evidence suggests that changes with the microbiome can lead to allergic disease like food allergies, eczema and even asthma.
  • Stay tuned, the microbiome is an exciting area of research in allergy and immunology.
Have questions or need help with another allergic issue.  Call the office for a consultation 212-679-3574 or schedule an appointment here.

Monday, February 17, 2014

What Should You Know About Over the Counter Nasal Steriods?

The next time you’re at the local pharmacy, you may be surprised to see your prescribed allergy nasal spray available over-the-counter. Many drug manufacturers are pushing for this move to make finding relief easier for some of the 50 million Americans with allergies. But this warrants caution for some. 

Before you use these over the counter medication, what should you know about over the counter nasal steroids? 

1) Is it safe? Not only can the new nasal allergy spray relieve congestion, sneezing and a runny nose, it also does not cause drowsiness and is non-habit forming.  Improper use of nasal sprays may cause nasal bleeding and in worse case scenario a hole in your nose.   Follow the package instructions and inform your allergist if bleeding and/or irritation occurs.

2) If I'm controlled with this nasal spray, why should I still see an Allergist?  
  • Allergies and asthma are serious diseases and self medicating may not be the best way of controlling your symptoms. 
  • Getting testing for allergies and instituting environmental controls are powerful ways to prevent allergies without using medication.  An allergist is the best person to advise you on this.  Many allergy sufferers that have year-round allergies to pets, dust and mold often find nasal sprays are not enough for symptom relief. Many allergists prescribe immunotherapy (also known as allergy shots), which not only provides symptom relief, but can modify and prevent disease progression.
  • Asthma is a disease commonly found in people with allergies in their nose.  An allergist can screen you for this. 
3) Can I stop antihistamines? If you find solely using the nasal allergy spray is helping to suppress your symptoms, you may not need to take an antihistamine. Each person is different and they will have to be the judge of how they feel only using one medication. However, if you’re not finding relief from one or both medications, you should speak with your allergist.

4) Is it safe to give my child?
The medication is approved for children two-years and older. But it may complicate some infections your child might have, so check with your allergist.

5) Can it be used year-round?
Yes, it is approved for year-round use.  As with any over the counter medication, you should speak with your doctor about long term use.

6) Will my insurance cover it?
It is unlikely your insurance provider will cover over-the-counter nasal allergy sprays, even if it was covered when it was prescribed.

7) Do I need to continue following up with my allergist?
Allergy sprays are a band aid approach to allergies and only control symptoms.  They do not a cure for allergy. Because allergies can change over time, it’s important to be under the care of an allergist for proper testing, diagnosis and treatment that may go beyond over-the-counter medications. Allergies can also cause symptoms such as chronic sinus infections, nasal congestion or difficulty breathing.

Need more help controlling your allergies?  Please call 212-679-3574 or click here to schedule an appointment online. 



Tuesday, February 11, 2014

How to Celebrate Valentine's Day with Allergies?

Valentine's day can be an especially difficult time for persons with allergic disease.  Most consider only food allergies as a problem, but uncontrolled asthma, latex allergy, allergic skin, or allergic sinusitis symptoms can impact your ability to feel romantic with your partner. 

What should you do if you suffer from allergies around Valentine's Day?  Here are some simple tips to keep you giving and receiving the love that abounds this time of the year.

Love someone with food allergies?
  • Make homemade treats for your sweetie so you'll be sure not to include ingredient. 
  • Too busy to bake?  Divvies is a wonderful company launched by a mom with children with food allergies.  The idea is to have snacks persons with food allergies can share with others. Premium Chocolatiers, Amandas Own and Vermont Nut Free are other options to order allergy free chocolates.
  • Making reservations for a date night out?  Notify the restaurant before you go of any allergies you or your loved one  have to prevent an accidental exposure.  Here's a list of allergy friendly restaurants in NYC.
  • Want to give a good night kiss?  Many food allergies are transferred in saliva.  If your dating someone with food allergies, it's smart to watch what you've eaten as well. 
Want to send flowers? 
  • Pollen from flowers is a common cause of allergic asthma. 
  • What are the best flowers to send those with allergies? Orchids, begonia, cactus, clematis, columbine, crocus, daffodil and geraniums are terrific options.
  • Use caution with flowers like lilies, chamomile, chrysanthemums, daisies, goldenrod and ordinary sunflowers are among the worst. They have strong pollens that can often cause a severe allergic reaction.
Ordering up a Massage?
  • Use caution with new creams and oils.  Many suffer from allergies in their skin and new contact exposures can trigger an out break.
  • Beware many organic products contain nut oils.  These can trigger a reaction.
Want to be Very Intimate?
  • Latex allergy with condoms can cause severe irritation during sex.  I've had patients with latex allergy who ended up in the emergency room after a night of passion because of latex allergy. 
  • If you're loved one is latex allergic make sure to use latex free condoms and other latex free products.
  • Visit Latex Allergy Resources for more specific advice.
Follow this simple advice to keep the focus on the love rather than the allergy this upcoming Valentine's Day.

Need more specific advice?  Contact me in my office at 212-679-3574 
or on line schedule appointment.

Thursday, February 6, 2014

Why Test For Allergy?

It's hard to believe that the spring is just around the corner with temperatures here in NYC still in the 20's and ice covering the sidewalks, but soon trees and flowers will be blooming.  And, with their blooms, will come spring time allergies. 

  • Did you know that 1 out of 3 people are allergic? 
    • Allergies often cause social embarrassment, missed days of school and/or work, and can leave you feeling like you have a cold that won't go away.
    • Don't suffer without knowing that allergies are the cause.
  • Avoid Being Treated with Antibiotics When it's Actually an Allergy. 
    • Allergies are often mistaken for a cold and/or sinus infection and treated with antibiotics.   Minimizing your exposure to antibiotics is important because of increasing rates of bacterial resistance.
    • Antibiotics won't help symptoms associated with allergies.  You need the right type of medication.  An allergist/immunologist will give you personalized guidance on avoidance measures.
  • Know Your Allergic Triggers- Get Tested
    • Most people in the U.S. are allergic to more than one allergen.
    • Knowing a full composite of what your allergic to, can aid in helping you to use avoidance measures rather than just medications.
    • Testing for allergies is a painless test that's done through skin prick testing.
  • Allergies Change Over Time
    • Many people ask me how they can develop allergies when they never suffered before.  Allergies can develop and change at any point in your life.  New sensitizations can pop up and if you're lucky resolve.
    • Being testing on an interval basis will help you keep up to date with what you are sensitized to so you can have a direct approach.
  • Not All Allergy Runs in Families
    • While many people with allergic disease will have a family history of disease, you may be the only one with symptoms.
    • While they may not understand, I do....
Don't be left out of enjoying spring because your nose is running, the end of winter is the perfect time to get checked for allergies and make sure you have medications to treat your symptoms.  Get tested before the ice melts and temperatures melt so you can enjoy spring to it's fullest.

Want help or more information on testing for allergies?  Contact the office at 212-6793574 , Gramercy Allergy & Asthma, 205 East 22nd Street, NY NY 10010 or visit our website

Thursday, January 30, 2014

What is Shellac Allergy?

Cosmetic allergy is a common complaint I hear in my practice.  Symptoms include swollen red eyes, irritated eyes, flaking of the eyelids, or redness/rash around the mouth.  Sometimes, individuals will be treated for eczema, when in fact they are allergic to their cosmetic. Once you identify what the chemical is that's causing the irritation, avoiding it leads to a cure.

A common cause of cosmetic allergy is shellac.  Shellac is a natural plastic resin secreted by a lac bug ( Laccifer lacca) onto the bark of trees that's been in common use for over 3000 years.  Shellac is FDA approved to be used in cosmetics, foods, and medications.

Where is shellac found?
  • In cosmetics like lip gloss, mascara, hair spray, eye liner and finger nail polish
  • Dentures
  • Furniture and painting glazes
  •  Shellac is found on the outside of fruits and vegetables to make them shiny (think apples, and peppers)
  • On the inside of ice cream cones where it acts as a moisture barrier.
  • Pharmaceutical companies use it to prevent breakdown in the stomach or in time released medications.
Can you be allergic to shellac?
  • Yes...
  • While shellac allergy is not common, it is a common cause of eye lid dermatitis because of it's presence in cosmetics.
  • If you ingest it in food and are allergic, it can cause abdominal pain, bloating, and irritation.
  • We don't know the incidence of shellac allergy. 
How can you be tested for shellac allergy?
  • Your doctor if they suspect shellac allergy will "patch test" you for common chemicals present in cosmetics and look to see which one causes a rash.
Want to read more about cosmetic allergy?

Need help with deciphering a cosmetic allergy?
Please call the office for an appointment and we'll be glad to help- 212-679-35754

Tuesday, January 28, 2014

What is Allergic Asthma?

What is Allergic Asthma?
  • Allergic asthma affects almost 60% of asthmatics
  • There is a history of cough, chest tightness, shortness of breath, or wheezing around an allergic trigger.
  • Allergic triggers can be pollens, cats/dogs, dust, or cockroaches, or molds.  This will present with asthma symptoms in season (spring, fall or summer) or with exposure to other triggers.
  • Often there is a family history of allergies
  • Often there is a personal history of an allergic nose, eczema or food allergies as a child.

What should you do if you suspect you have allergic asthma?
  • Get tested for allergies.  You doctor or allergist can do simple skin or blood testing to identify what your triggers are.
  • Ask your doctor to check a total immunoglobulin E.  This is an important marker of allergic asthma
Is there treatment for allergic asthma?
  • YES!  Your allergist will recommend avoidance measures, medications and based on your symptoms may recommend allergy treatment.

Want more information?  Please contact me at 212-679-3574 or