Compiled by WebMD Staff
moderator Welcome to our chat. Today we are discussing Allergies and Asthma with Dr. Russell Roby, M.D., J.D. Dr. Roby runs the excellent website www.onlineallergycenter.com, which is well worth checking out. Welcome, Dr. Roby!
speaker Thank you. Glad to be here.
moderator What was your reason for creating an allergies website?
speaker The web site is strictly informational. Patients should always consult there own doc but many common questions arise about technical things like how to use inhalers etc.
moderator We have some questions from the audience, so let’s get to those.
eelz What do you think is the most promising approach for treating allergies?
speaker Prevention is the greatest approach. Patients should diligently explore all the possible causes of the problems and try to avoid those at all costs.
redeyes How is allergies related to the immune system?
speaker The immune system is responsible for all of our defenses to virus, bacteria, and cancers. If we are allergic our immune system has become TOO sensitive and begins to attack things it shouldn’t attack like pollen mold, and foods and chemicals.
moderator What happens then?
speaker If we attack these non-enemies we have an inflammatory reaction which is like a small case of flu or cold. We swell in the soft tissue of the nose, sinuses and sometimes the lungs. This swelling is our bodies mistaken attempt to block what it interprets as an attack by virus or bacteria. When we swell we get the symptoms of allergy…sinusitis, ear infections, asthma etc next.
sdt6751 I had heard that allergy shots specifically for cat allergies were being developed. Do you know anything about this?
speaker It is possible but you can only desensitize to the specific animal involved and it seems silly to try to desensitize to an animal the person insists in remaining in contact with. It’s like taking anti-snake venom so one can continue to handle rattlesnakes.
moderator Here’s another question about shots.
hyacinth_59 Are shots only used for certain types of allergies?
speaker The most common denominator for all allergies is usually airborne allergens like mold and pollen. We have a long record of success at desensitize patients to these substances. If we get rid of or reduce this part of their allergies this will usually help a great deal at reducing their overall allergic load and thus prevent or minimize all their allergy symptoms. This is the cornerstone of all allergy treatment.
cali-may Can you explain what enzyme treatment is?
speaker Enzyme potentiated desensitization is a fairly new and fairly radical approach to desensitize. At this time only a few docs are performing it because of the great risk of a severe or anaphylactic reaction. Thus most docs I know of who attempt always do the treatment in an emergency room so they have support if the pt has a violent reaction.
moderator In what cases would you use this treatment? That is, when does a person have such a reaction?
speaker I wouldn’t use it because I am not trained in it’s use. I might recommend it if the pt had some urgent need to get the treatment prior to going to some dangerous area. Like an executive who simply had to go to the wheat fields of Kansas during his worst season and had to get some immediate desensitization for some reason I cannot imagine.
Jkitty Do allergy shots cure you of allergies?
speaker Nothing “cures” you of anything as far as I can tell. You always have the genetic predisposition to hypersensitivity. However, if you are made insensitive to your allergens and if the doc helps you understand how to stay symptom-free then you might remain free of hypersensitivity reactions so long as you prevented or avoided the beginning of a new increase of you allergic symptoms. If you are symptom-free then you are not “allergic” at that time. Keep yourself symptom free and you are not allergic. Not cured, but not allergic.
moderator Shots seem to be the topic of the day…
sdt6751 Follow up to the question about cat allergy shots: Why can you only desensitize to a specific animal? All cats carry the same allergen (fel-d), correct? So if you can identify the allergen, why can’t you make a shot for it?
speaker I can for that cat. But cats are ALL different even if of the same litter…different diets, development etc. We can do pollens and mold spores because they are hundreds of millions years old and each one is precisely the same as its neighbors. Every mammal is different. We can’t desensitize you to the beef you eat unless you eat the same cow we used to densisitize you with.
cali-may Can you develop allergies at any age?
speaker Allergy develops because you start to make less cortisol than you need to combat these “pseudo” immune reactions. When you run low on cortisol…the anti allergy hormone …you begin to get more and more allergic reactions. Lots of things make you low on cortisol…advancing age, especially ladies going through hormone changes. We see great increases in allergy when girls go through hormone changes, say at puberty and again in peri-menstrual years. Men when they get older make less cortisol.
moderator Last time you were here, you said that asthma is an allergy. Can you explain what you mean by this, and how allergies are defined in general?
speaker Allergy is the lay term that we use to describe the misfunction of the immune system. If the immune system functions correctly it attacks bacteria, viruses and toxins. When it attacks them it forms a heavy molecular wt antigen-antibody complex that migrates into soft tissue space and results in swelling. This is lymph node enlargement you see in your neck when you get a case of tonsillitis. If your immune system runs amuck and begins to treat mold or pollen like virus them you begin to swell in soft tissue. The nose and sinuses swell. If the swelling goes on long enough more soft tissue begins to swell. Some people swell in the soft tissue that lines the respiratory tree…they get asthma. Some people swell in the cortex of the brain…they feel loss of short-term memory and overwhelming fatigue. Where you swell determines what kind of symptoms you get. Stop the allergy, stop the swelling and you don’t have to worry!
nimbus Are allergies related to auto-immune conditions, like fibromyalgia?
speaker Auto-immune is simply a term that indicates the target of the immune system is US. If your immune system gets so hyped up that it is ready to attack anything that divides rapidly (the classic example is diabetes where the immune system mistakenly thinks the rapidly dividing cells of the pancreas need to be KILLED as it would a cancer). If you get this allergic then the immune system begins to attack YOU. That’s what “auto-immune” means. It’s just a severe form of allergy.
eelz Does wearing sunglasses really help for hayfever?
speaker I’ve never heard that one. However, when I look directly at the sun I often begin to sneeze (always five times). So maybe sunlight causes a nervous stimulation of the cells in the nose. If it does then this might result in swelling in the mucus membrane of the nose. I haven’t thought about it but I can see where one might have fewer nose reactions if the sunglasses prevented the sneezing.
sdt6751 Can you outgrow your allergies? Or can you become less sensitive the more you are exposed?
speaker I think that is wishful thinking. Small infants, especially boys, seem to improve when they go through hormone changes…about 13 to 15. Sometimes they are never allergic again. Girls seem to begin their allergy about puberty and they may have fewer allergies when their hormones change later in life, around menopause. Older people get allergic and tend to get increasingly allergic as they get older. That is people in their 60′s and 70′s.
abstrack Can you clarify how hormones are related to allergies?
speaker All of our reproductive hormones 9 estrogen, progesterone and testosterone) all almost identical as well as our anti-allergy hormone cortisol. They all have exactly the same ring structure and differ only in a single side-chain. If your balance of hormones gets out of whack (serious pms, menopausal changes, etc, stress) then nature diverts your limited assets trying to keep you fertile. Cortisol is one of pour least abundant and most readily depleted hormones. If you need estrogen then nature makes even less cortisol trying to keep you fertile. So you gain weight, have more allergies, less energy and handle stress less well. All the hormones are related. Cortisol is the key. That’s why your doctor likes to give you prednisone (synthetic cortisol) because it makes your allergies go away (only temporarily) and that ‘s why hormone balance is so important next
moderator We’ve got some real cat lovers here today…
Jkitty So if you test as being allergic to cats but your own cats cause you no symptoms then maybe you’re not allergic to your own cats?
moderator Do you think most people with allergies and asthma receive sufficient care?
speaker Maybe. I would have to get near death before my cat would be in any serious danger. But yes, you might easily tolerate your cat and yet have a tremendous reaction to so me other cat. It is the saliva they groom with that seems to be responsible for most reactions. So you might react to some other cat that lived in a different environment, ate different food etc..
moderator I think we have time for one last question. Do you think most people with allergies and asthma receive sufficient care?
speaker If you are wheezing, if your asthma isn’t under control…you are not getting correct care. The gases ALWAYS work…if they are used correctly. Check my site for the proper uses of the steroidal gases. Diet is ALWAYS part of the problem if an asthma pt is out of control. If if you stop eating entirely (I don’t recommend this ) for 24 hours you will almost certainly stop wheezing. Talk to your doctor.
moderator Dr. Roby, as always, you’ve been an interesting and informative guest. Thanks for chatting with us!
speaker thank you for having me.
moderator And thanks also to the audience for your great questions! Have a great night, all!
* This treatment is not approved by the FDA