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Ask An Allergist: Dr. Frank

Ask An Allergist - Frequently Asked Questions, Answered by a Board Certified Allergist - Dr. Frank

Ask an Allergist - Dr. Frank

As we not only continue to create and offer some of the best allergy relief products available, we are constantly looking for ways to better connect you with the information you need. In our latest effort, we have been collecting some of the FAQs we receive through our site and passing them to our allergist partners for expert answers and advice. You can also find the most recent set of questions and answers posted on our blog as well. You can submit questions for our Ask an Allergist column via any of our FAQ sections on product pages, call them in, send them via our live chat, email blog@achooallergy.com, use carrier pigeon or send them to us via donkey and cart. We'll select some of the most relevant and intriguing to pass along to our experts and post the answers.

Ask an Allergist - Your Allergy, Asthma, and MCS Questions


Dr. Frank's Bio

Dr. Frank Lichtenberger is a graduate of Ohio State College of Medicine and completed an advanced fellowship in Allergy and Clinical Immunology at the National Institutes of Health. He is an expert in allergic asthma, multiple chemical sensitivity syndrome, chronic sinus headaches, food allergy, and allergic skin conditions. He is a member of the AAAAI Mast Cell Disorders Committee. He currently practices in Iredell County, North Carolina.

He is dedicated to teaching his patients about how the body interacts with the environment, and is ready to answer your questions on allergy today!

Ask an Allergist - Is It a Allergy or Cold?How can I tell if it's a cold or allergies?

Determining the difference between a cold or allergies is actually quite difficult, even for some seasoned professionals. Allergies and colds are very similar in terms of symptoms and presentation. Both colds and allergies can cause inflammation of the upper and lower respiratory tract, irritated eyes, cough, and fatigue. Colds are infections caused by viruses, and multiple people that share a common residence, classroom, or workplace can be affected at one time. This is similar to allergies, as many people in the same family, classroom or workplace can be allergic to the same things in the environment. Finally, antihistamines which are medicines used to treat allergies, are the most common ingredient in cold medicine because they are very good at reducing nasal inflammation.

So, how do we tell the difference? Colds tend to cause more "systemic inflammation," which include things like joint and muscle aches, nausea and stomach upset. Allergies tend to cause more itching, and thin watery secretions from the nose and eyes.
- Dr. Frank

Asthma and Allergies Linked?How are allergies and asthma related?

Asthma, eczema, and allergies (food and seasonal) can all be part of a condition called "Atopy." Atopy refers to a decision our immune system makes on how it is going to behave (fight off bacteria, viruses, cancer, or allergies.) Anyone can be allergic to something, but people that are allergic to lots of things have "Atopy." The same basic processes that cause people to get stuffy noses can cause lungs to develop asthma or skin to become itchy and scaly. We know that children with food allergies, and/or eczema are much more likely to develop asthma later in life.
- Dr. Frank

Food Allergies and Environmental Allergies Related?Can environmental and food allergies be related?

Absolutely. We know that people that have food allergies tend to also have environmental allergies. We don't actually know how the two are connected, but we know that there is a lot of "Cross Reactivity" between pollen and fruits and vegetables. Imagine that the Allergic System recognized allergic things based on a 4 letter code, and if it senses these "codes" in the environment it triggers an allergy. Now imagine that the alphabet only has 20 letters instead of 26, and animal, plant, fungal, and viral particles all had their codes written with these letters, but in very different languages from one another. The plant language, using only 20 different letters with MILLIONS of plants, has some redundancies. For example: some pollen from the Birch family had the code "BRCH," which was similar to the apple fruit's code "BCRH." Because they are very similar, the Allergic System will trigger the birch reaction when it senses the apple's code. This is what we call "oral allergy syndrome" where people think they are allergic to fruits or vegetables when in reality their Allergic System is just over reacting a little bit. Other similarities exist between dust mites and shellfish, and ragweed and melons.
- Dr. Frank

Desensitization to Deal with Dairy Allergies?What an allergist could do to help me other than confirm what I already know? Specifically, is there any way to desensitize my body's responses to dairy so that I can enjoy products like cheese and ice cream again.

Cow's milk allergy is one of the more difficult allergies to deal with. Seeing a board-certified Allergist, they would be able to help define what level of reactivity you have to these food products, and if you may have allergic sensitivity to other foods. In addition, there are many different ways the immune system can react to food protein that produces a rash, and an allergist could help determine whether it is an IgE mediated process or not. Also, an allergist could help define the exact molecule in milk protein that you are reacting to, i.e. alpha-lactalbumin, etc. which could point towards cross-sensitivity to beef, chicken, etc.

We know have several methods of food desensitization, but only for IgE reactions. Cow's milk is one of the foods for which there are established protocols. Not every allergist does food desensitization as it is a very new technique. Some allergists do desensitizations to hen's egg and peanut as well.
- Dr. Frank

Is There Anything More Than Avoidance When it Comes to Fragrance and Smoke?Inhalants, such as, perfume, smoke, and chemicals, cause my asthma to get much worse. Are there any treatments that work? Simple avoidance makes me feel like a captive.

There are quite a few people out there that suffer from those types of triggers called "oxidants" and "volatile organic compounds" (VOCs). Oxidants are released when things burn, or by electrical equipment - or when stuff burns, and VOCs are petroleum based molecules which can directly or indirectly activate your body's nerves or allergy receptors. Many people with asthma can identify these things are triggers, and it usually means that their asthma is not well controlled and they have a lot of active inflammation in the lungs. the key to reducing the asthma triggers is to get the active inflammation under control as best you can.

Many products on this website can help you clean the air in your home, I would recommend a system that reduces VOCs as well as the standard smoke and dust.
- Dr. Frank

Am I Allergic to My Cockatoo?My nose runs when I am in the parrot room. Is there a test to see if I am allergic to my Umbrella Cockatoo?

True bird-feather allergy is quite rare, and most allergists do not have that in their testing equipment. We commonly see people who think they are allergic to feather pillows, and 75% of the time it is actually just dust mite matter that has built up in the pillow. People with true feather allergy tend to be reactive to a cross-reactive allergen (gal d 5) which is chicken serum albumin and report symptoms with ingestion of egg yolk and chicken meat. Even in exotic bird fanciers, the majority of fanciers that report symptoms are actually allergic to feather mites, Diplaegidia columbae, a cousin of the common dust mite.

The cockatoo is of the order Psittaciformes (Parrots) and there is a blood test called a Parrot Feather specific IgE, which can determine if you are allergic to it or not. However if you already know you develop symptoms when you walk into the room, you should think about wearing an N95 mask to protect your nose, mouth, and lungs. Depending on the diet, some bird droppings will release ammonia as a by-product of nitrogen metabolism, and this can be seriously irritating to the nose and throat.
- Dr. Frank

Latex Allergies?  Natural Rubber Allergies?Balloons make it difficult for me to breathe. If natural rubber is latex, and I have latex sensitivities are latex-free products safe for me to use?

Latex allergy is one of the most severe allergies that can affect people. Some people have allergies to only the latex gloves that used to be very common in medical practices. Unfortunately there are a few people with severe latex allergies that can react to hardened, or cured/ammoniated latex. People with this severe of an allergy have a difficult time with all forms of latex, even the thick processed gloves used for cleaning. If balloons make it difficult for you to breathe, I highly recommend formal evaluation from a local Allergy or Pulmonary specialist to determine if you have brochospasm. I cannot provide more specific recommendations, given the complexity of the issue.
- Dr. Frank

Sneezing and Morning Congestion - Allergies?  Smoking?  Something Else?I'm a smoker and while I have a little morning time congestion that quickly goes away, I often go through early morning bouts of rapid-fire sneezing. Could this be allergies?

First thing, and above all else, you must quit smoking.

Paroxysms of sneezing (the rapid-fire sneezing you are describing) tend to come from a short circuit in the nerves that go to the nose/pharynx. When there is inflammation (yes, it could be from allergies) these nerves are highly excited and can go into a repeat fire process that can last up to several hours. I have seen some people that have even developed neck pain from these. So, to answer your question, many things can cause nasal inflammation, allergies, viruses, particulates......smoke....., and finding out what is causing your inflammation will help you stop sneezing.
- Dr. Frank

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