Archive for February, 2014

Lactose Intolerance And Your Health

Recently, a young female patient came to me described to me what she said was a food allergy. She said “whenever I eat certain foods, I get cramps, diarrhea and nausea.” I asked her what was the food she was reacting to and she answered me, ” cheese, yogurt and milk.”

She said “I never had this happen to me before.”

I told her that she was lactose intolerant and explained to her that most cases first develop in people aged 20 to 40. Rarely, do they happen in babies or even young children. And that it affects both sexes equally.

It also appears that certain racial and ethnic groups are affected more than others, including 80% of African-Americans, Jews, Mexicans, Native Americans, as well as 90% of Asians.

An interesting article by the Cleveland Clinic website described lactose intolerance as “the inability to digest lactose, the sugar primarily found in milk and dairy products. It is caused by a shortage of lactase in the body, an enzyme produced by the small intestine that is needed to digest lactose.”

Symptoms include but are not limited to: abdominal bloating, abdominal cramps, diarrhea, gas (flatulence) and nausea.

The New York Times Health Guide says that “other intestinal problems, such as irritable bowel syndrome, may cause the same symptoms as lactose intolerance. Tests to help diagnose lactose intolerance include: lactose-hydrogen breath test, lactose tolerance test, and stool pH.”

Treatment for lactose intolerance varies from cutting down or removing dairy products from your diet, to adding lactase enzymes in the form of capsules or chewable tablets to your diet. Since not consuming milk may cause a Vitamin D deficiency, you need 1,000-1,500 mg of calcium each day depending on your medical profile.

You should contact a medical professional if you or your child’s symptoms of lactose intolerance get worse or do not improve with the above-mentioned treatment or develop new symptoms. Also if you have an infant younger than 2 or 3 years old who exhibits symptoms and if your child is growing slowly and not gaining weight.

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My Cat And My Allergies And Asthma

A number of my patients own pets, specifically cats. And they, or their children may be allergic to Mr. Whiskers but are loathe to give them away. So there are a few things to consider with living with a pet.

According to study conducted by the National Institutes of Health (NIH), “more than half of asthma cases in the US are linked to allergies, with sensitivity to cats responsible for 29% of allergy-related asthmas.”

“The findings would seem to indicate that exposure to cats increases asthma risk, but other studies have suggested exposure early in life may actually protect children from developing cat allergies in the first place,” says WebMD.

In a related article, Darryl C. Zeldin, National Institute of Environmental Health Sciences (NIEHS) says “we are not telling people to get rid of their cats. What we can say from this study is that people with documented cat allergies have an increased risk for developing asthma.”

When families want to have both children and pets, Todd Green, an assistant professor of pediatrics at the Children’s Hospital of Pittsburgh points out in NBC, that “it might make sense to get the cat or dog first when planning a family because a recent study found that kids who grew up in a home with both a cat and a dog were less likely to develop an allergy.”

And in another interesting article I read, by Allergy and Asthma Network Mothers of Asthmatics, even if you get rid of your cat, don’t think the allergy will suddenly disappear. “The allergen load typically takes as long as four to six months to reach that of non-cat homes. It has been shown that cat allergen may persist in mattresses for years after a cat has been removed from the home, so new bedding is recommended.”

So if you decide to keep Mr. Whiskers, I suggest you do the following. Get rid of wall-to-wall carpeting. Hardwood floors are easier to clean. Use a vacuum with a HEPA filter, because normal vacuums spread more cat dander in the air than they pick up. Keep the animal outside for as much time as possible or keep it out of sleeping areas of your house.

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Home Environment Linked To Asthma Cases

Last week I spoke about the hygiene hypothesis that is linked to rising peanut, food and other allergies in Western countries, particularly in the US. The hygiene hypothesis says that due to our sterile environment, we have less “dirty” microbes to fight allergies and asthma. But concerning asthma, that is only a partial explanation.

I read an interesting article in the New York Times which quotes Dr. Harold S. Nelson, a doctor at the specialty hospital National Jewish Health in Denver. He cited the reasons for higher asthma rates are due to “lower levels of Vitamin D, exposure to spray cleaning compounds, and a wider use of acetaminophen in place of aspirin have contributed to the asthma epidemic.”

The problem, he continues in saying is that with household cleaners, “the spray mist can be inhaled and irritate the lungs, increasing risk for asthma. The biggest culprits appear to be glass cleaners and air fresheners. A major European study of cleaning product use found that people faced double the risk of adult asthma. And Australian researchers have also found a link with household cleaning sprays and asthma in children.”

Also, concerning low vitamin D levels, the Journal of Allergy and Clinical Immunology stated in 2007 that researchers from Brigham and Women’s Hospital in Boston showed “a link between low D levels in mothers and childhood asthma “Coupled with inadequate intake from foods and supplements, this then leads to vitamin D deficiency, particularly in pregnant women, resulting in more asthma and allergy in their offspring,” states the journal.

In an another study of 200,000 6 and 7 year olds, the use of acetaminophen in the first year of life with associated with a 46 percent increase in prevalence of asthma symptoms.”

Dr. Nelson concludes to limit asthma risk, people should do the following. Use liquid cleaners or pump sprays that don’t generate a fine mist. Eliminate use of spray air fresheners. Pregnant women and mothers should talk to their physicians about taking vitamin D supplements and also discuss pain relievers with their pediatrician.”


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Rise Seen In Peanut Allergies Affecting Children

One of the allergies that is on the rise among my patients–especially ones that are children– is allergy to peanuts.

The New York Times suggested as much in an article dated February 2, 2014 stating that “peanut allergy among children in the United States has risen more than threefold, to 1.4 percent in 2010 from 0.4 in 1997, according to a study by food allergists at Mount Sinai Hospital in New York City.”

So you may ask, well with all that modern medicine has to offer, why is this and other allergies on the increase?

Well, there a few factors to consider, none is conclusive but taken together we may get a more complete picture. They are, as reported by an article from the UCLA Food and Drug Allergy Care Center:

The Hygiene Hypothesis. This theory states “that excessive cleanliness interrupts the normal development of the immune system, and this change leads to an increase in allergies.”

Delayed Introduction Of Foods. The Center also says that delaying the introduction of some foods like peanuts “may be associated with high rates of food allergy.” This is still a contentious issue among researchers and in the UK, a study to answer the delay in the introduction of peanuts to young children — known as the LEAP study– will answer that question this year.

Form Of Food We Eat. UCLA also reports that “different forms of the same food appear to be more likely to provoke an allergic response, specifically roasting peanuts rather than boiling them makes them much more likely to cause an allergic response.”

Increased Awareness & Reporting. The article finally states that “heightened awareness among doctors, parents, teachers and the general public about the symptoms and potential consequences of food allergies may contribute to the reason we are meeting more people with food allergy.”

I tell my patients that immunotherapy is an effective way to treat peanut allergies. This treatment, like shots given for pollen allergies starts “with exposure under the tongue to a minute amount of the allergic peanut substance, followed by increasing amounts under a doctor’s supervision,” says the New York Times. And in a study published last week in the British journal Lancet, it was found that after six months of oral immunotherapy up to 91 percent of children aged 7 to 16 could safely ingest five peanuts a day.”

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