For Asthma and Allergy Awareness Month, Dr. Steven Lamm, a medical expert on The View, and practicing internist and Clinical Assistant Professor of Medicine at New York University School of Medicine, talked to HealthCentral about the ABCs of allergies, including avoidance, natural remedies and the future of treatment. Watch our Skype interview for even more allergy expertise from Dr. Lamm.
HC: What are some of the common allergens this time of year?
Dr. Lamm: We always think of allergens in terms of indoor and outdoor allergens, and outdoor allergens during the spring, summer and fall are primarily trees, grasses and weeds. Those would be the primary reasons that most people are suffering during those spring, summer and fall seasons.
HC: Have you noticed that this allergy season has been worse/earlier this year?
Dr. Lamm: I think that with the warmer winter there has been an earlier season. There are people who would generally wait until May to start to suffer, who started suffering at the end of March or beginning of April. So it appears as though it’s going to be a more extended, prolonged season. And depending on the climactic situation in each state, will determine how badly you’re going to suffer. If you have a lot of rain, then you have sun and wind that blows all these pollens around you’re going to start to have some more reactivity. So, the answer is yes, there has been, it’s earlier and it appears to be a bit more severe.
HC: Can you give us some tips on how to avoid allergy triggers?
Dr. Lamm: For some, their threshold is so low…any minimal exposure in the air is going to be a problem for them, but for some it really only affects them when the counts are high. So, it just makes sense that you would wear a hat, for example, or wear sunglasses, or try to minimize your exposure to these pollens during those days that you really have a really high count.
During some of these high pollen days you’re better off being indoors or being in a car with the windows rolled up, the air conditioning on. When you get home you want to take off your clothing and take a shower.
What natural or traditional treatments do you recommend?
Dr. Lamm: There are some nasal sprays that I think can be very helpful. There are pharmaceutical ones, but I have become increasingly impressed with some of the natural nasal sprays, especially the ones that come from the Dead Sea salt. And, what they basically do is just irrigate the nasal passages, washing some of the pollens away, and the Dead Sea salts just happen to also have some anti-inflammatory activity. Allergy is a form of inflammation, so if you can reduce the inflammatory reaction of the nasal passages you’re better off.
I certainly think we should start out with local care, local nasal irrigation, local nasal sprays. Not of the type that we call basic constrictors, I don’t like those because there is a rebound associated with them.
HC: Any other natural remedies?
Dr. Lamm: We’ve recently written a book that’s out called No Guts No Glory, in which we talk about the central role of the gut in wellness, and how the gut, although primarily involved with digestive physiologic processes, really involve a lot of other processes like the immune system. And sometimes what happens as a result of the way we eat and the toxins we absorb, we induce what we call a leaky gut, which permit toxins and allergens to enter the bloodstream. It’s very possible that if we change how we eat, believe it or not, with fruits and vegetables and fiber, and we actually feed the gut what it needs, it’ll function better and be less likely to leak toxins, which ultimately will increase the reactivity of the body and having allergic reaction.
So, that’s a natural way that you may not think of, like, ‘How is it possible that if I eat fruits and vegetables and fiber that somehow my allergies are going to be better?’ Well, it’s very possible that it will cause less inflammation, which is an important newer concept.
HC: When should somebody go see their doctor for allergies?
Dr. Lamm: I think allergies can be more than a nuisance, especially if it produces or contributes to sinusitis, because the sinuses are not draining, so if you’re having fever or pain in your sinuses, certainly I would see a doctor. If you’re feeling short of breath and you’re wheezing, I would see the doctor. I think that it’s really about the severity of the symptoms. I do think that with reference to allergies, it’s a general rule of thumb that you want to initiate an intervention early rather than late.
HC: What causes allergies, and how do you feel about the hygiene hypothesis?
Dr. Lamm: The question is whether or not because we’ve changed the environment, the cleanliness concept, that we’ve taken a lot of the dirt out of the environment, our body is now reacting to more mundane substances - and that’s a possibility. I personally think it is some change in the reactivity as a result of foods and toxins, and how we’re eating and our lifestyle. We also have very cluttered lifestyles. I mean look at your own desk right now, look at your bedroom and see how much clutter is present, how much dust accumulates.
HC: Are there any new allergy treatments coming down the pipeline that you’re excited about?
Dr. Lamm: I think that as we increase our knowledge of the immune reaction there is no question that there are going to be new, what we call, biologics, that will damper that immune reaction, not to the degree that it puts a person at risk for overwhelming infection or cancer or things like that. But there is no question that we’re going to be moving away from the current state of medicine, which is to use some steroids and some Singulair and some antihistamine, to more potent biologics that are more targeted.
The other thing is we have to ask ourselves is what’s going on in the environment that so many of us who previously never had allergies as children all of a sudden seem to have them as young adults or adults? We used to never think that someone would develop asthma at age 50 or age 60, even - they didn’t have it when they were 12 years old. But now we’re seeing a new onset of allergic symptoms. So I’m certain that there are environmental factors or multiple factors that are contributing.
Published On: May 21, 2012