Welcome to the, your mom on drugs podcast.
You've got me, Josh Klaus, the son and the mom, Jennifer Seltzer.
Hi everybody.
Yeah.
Uh, this is a podcast basically about drugs.
Um, usually the kind that you take over the counter, um, or the ones prescribed
to you by your medical professional, um, or by your local pharmacist.
And, uh, we just thought it would be a really good idea just to talk about, you
know, when you put something into your body, like what's actually going on.
And one of the best times to put that thing into your body.
Um, and so we just wanted my mom is a doctor of pharmacy and she always gave
me a great pharmaceutical advice.
And so I always thought it'd be a really great idea, uh, to share
her knowledge, uh, with the world.
And so here we are sharing the knowledge, uh, with the world, and we
hope that you find it useful.
Um, and today we're going to be talking about allergies, which is a huge topic.
It's very broad.
We're going to be talking about a couple of specific, um, allergic conditions.
Um, but we're going to give a broad overview first.
And so I'm going to turn it over, uh, to my dear mother, who's going to kind
of give an overview of allergies.
So mom, if you had to describe allergies to someone on the street, someone like
me, how would you describe allergies?
I think just generally a person needs to realize that an allergy is a particular
person or their body's response to something that's normally considered harmless.
So, and we don't necessarily know initially to expect that we're going
to have an allergic reaction to something.
I mean, it's an exaggerated immune response to something that's kind of benign.
Um, and it's an, actually, I thought this was really interesting as I did my research.
It's really the immune response.
It's our body's response to that and what we call an antigen or the allergen, but
it's not the actual allergen that's harmful to the person.
Oh, okay.
So, so I know a lot of people complain of things like pet dander or in here in Texas,
we have Cedar fever, which is something that people really complain about.
Um, so it's not the actual thing that you're breathing in or touching
that's causing the problem.
It's something else.
It's right.
It's your body's response to it.
Okay.
I wish I thought that was really interesting because if you have known anyone
that's had an allergy to something and you talk to several people, their
symptoms can be varied, you know.
Based on the way that their body is responding to that particular antigen or allergen.
Gotcha.
And a couple of episodes before we've talked about things like the common cold,
and we've talked about conjunctivitis AKA pink guy, and these are things
caused by things like bacteria and viruses, which normally when someone is
infected with a virus or a bacteria, it usually affects the same type of, I
would say most people in a similar way, like for someone to get a common cold.
She's going to affect people in a similar way, but not everyone who
breathes in pet dander is going to get a severe allergic reaction.
Absolutely right.
It's going to be dependent on a couple of things in your own body that are
going to be responsible for this reaction.
Yes, that is true.
So, um, what are some of the things that are going on inside of your body?
Um, I, I, I remember reading too, I think that there are a couple of
different types of, of allergic reactions.
I remember there's one that's associated with this, um, this chemical called IgE.
Um, and that stands for immunoglobulin, which is, uh, essentially it's an
immune mediator, um, it is globulin kind of, if you can picture something
almost like a globe and immunosending for, uh, you know, the immune system.
And then there are many different types of these, and this happens to be type E.
Um, you've also got IgG running around IgA.
There's IgA.
Um, IgM.
I don't know how they name these things, but they got their names.
And, um, so IgG IgE is associated with allergic reactions.
And there's also other types of IgE.
And those are things like, um, topical, uh, dermatitis.
So like things like poison ivy, like you actually don't get a lot of
IgE released in those reactions.
So I think today we're going to probably focus on things happening with IgE,
the stuff that happens inside of your body rather than on the top of your skin.
Um, so mom, you want to fill in any more information?
I'm going to, I'm going to try to like briefly cut out the
things that are happening inside of your body.
So I'm going to, I'm going to try to, I'm going to try to, I'm going to
try to like briefly cover, you know, all the different types of allergic
reactions that can happen, but we're really going to focus more on what we
label, um, immediate hypersensitivity reactions or allergic reactions and
delayed hypersensitivity reactions.
Yeah.
So something can happen right away or it can happen a few days later,
hours to a few days later.
Yeah.
So let me just kind of dive in a little bit as far as kind of how an allergy
can happen.
Um, when, when your body comes into contact with what we call the allergen
or we call it the antigen as well too.
So it's going to be the thing that comes into your body that maybe
your body has not seen before it can sensitize or prime your immune system
because it's your immune system that is going to give you the response if
you're going to have an allergic reaction.
So then if you get exposed to that same allergen or antigen again, that's
when you're going to see the allergic reaction.
Um, so sometimes it may happen in seconds, minutes to hours, where other
times it could take hours to days to see that reaction.
Um, the one that when we see that immediate reaction, as Josh was
talking about is usually the one that has IgE, um, that we see those levels raised.
They can be your anaphylactic reactions too.
Um, you know, where you, you know, they can sometimes be life threatening
and we'll get into that in just a minute.
Um, and, um, so what happens is that IgE will bind to things in your immune
system called mast cells and basophils.
And they will release what we call mediators such as things like histamine.
Everybody's heard of histamine or antihistamines.
And so when you get a bunch of histamine released, then you can
start having some symptoms.
Yeah.
And some of those symptoms as people who maybe have experienced an allergic
reaction before is that you can get some vasodilation, which means more blood
rushing to an area, which means it kind of means like swelling.
So you might feel some uncomfortable pressure.
Or you might get some bronchoconstriction, which makes it a little bit harder to
breathe.
Um, also some mucus production being increased as well.
Right.
Runny nose and, um, redness, you know, and stuff.
And I know y'all worth, we're throwing a lot of information out there and we just
want to let you know that, you know, this is to our best understanding and to any
scientists best understanding, this is not a definitive answer.
Um, you know, basically the immune system is very complicated.
Imagine when let's imagine you're ordering something on Amazon and you
click, I want to buy this toothbrush and you click buying the toothbrush and all
of a sudden the toothbrush appears.
Do you think the only two steps involved for you clicking that button and then
toothbrush appearing?
Absolutely not.
There's tons of stuff happening behind the scenes that you're probably
unaware of the person driving to work, the person going to pick up the
toothbrush from the bin, the person putting that toothbrush in the bin.
The person putting that toothbrush in the truck, et cetera.
You know what I mean?
So anytime you have a stimulus, AKA the, the allergen and the response, which is
feeling the allergic reaction, there might be one, two, or hundreds of steps
that happen in between.
And sometimes understanding those steps is really important to understand what
type of therapy you might need, whether it's pharmaceutical, whether it's life
style change, whether it's even something in your house, such as like a better
filter to filter out more antigens.
Because mom, I was going to say like, you know, I've been hanging around
pets all my life and I've never gotten a pet allergy.
So it seems to be that certain people, maybe with elevated IgE levels, just
due to genetics or sometimes even bad luck, like sometimes this cascade can
just be triggered and they can get allergic reactions, correct?
Right.
That's right.
So there's something really interesting.
Sorry to, I'm then I'm going to let my mom continue on.
There's something out there called the hygiene hypothesis, which is, um, as
countries, especially in the West places like Britain, Denmark, the US, et cetera,
as we've gotten cleaner and richer, we've basically removed ourselves from the
outside world that we've cohabited with for, you know, tens of thousands of years.
And things like parasites and different bacteria that normally live in our
body don't live in our body anymore.
So our immune system isn't used to fighting something off.
And so in absence of that, instead of twiddling its thumbs, it's thinking,
well, what can I attack?
And it basically attacks things like peanuts or the, or it's something like
pet dander, things that are normally harmless in an environment, but in such
a clean, pristine environment, your immune system is not going to be
able to do anything to protect you.
And so you're going to have to be able to do something to protect yourself.
And so, and I think that's a really good example of how our immune system
isn't smart enough to say, oh, that's foreign or that's good.
It is literally just ready and prime to go.
So there's actually current literature out there that actually exposing kids
or young, you know, young people to a various array of, of substances that are
into your adulthood.
So I just wanted to put that out there.
The hygiene hypothesis is a really interesting one.
The idea that we've just become a little too clean, but there's
trade-offs for everything.
Cause we also don't have to deal with river blindness or dengue fever, for example.
So I would much rather trade dengue fever for maybe some hay fever, if that's the
case, but I also don't have to deal with hay fever.
So maybe I'm speaking in a turn.
Sorry for anybody out there who's dealing with hay fever.
So enough with me talking.
So mom, would you continue on?
You were talking about mass cells and histamine and being released in your body.
Right.
And that was really part of what we call the immediate or sometimes the
anaphylactic allergic reaction.
There's also a delayed allergic or hypersensitivity reaction.
And that is really T cell mediated.
We have T cells inside of our immune system as well.
And they are going to activate what we call interleukins, which are really
powerful mediators of an allergic response.
And so again, we had the IgE with an immediate allergic reaction.
We've got T cells and a delayed reaction and it just takes them a little
bit longer to get activated.
That's why it can be hours to days before you see an allergic reaction with
a T cell mediated allergic reaction.
Yeah.
Just to give you an idea, T cells are actually cells.
And so they're much larger than IgE, which is just a protein.
So sometimes it just takes a longer time for that T cell to move to where
it needs to go, just due to physics and size.
Yes.
And so just let me give you two other, just for completeness, let me give you
two other types of hypersensitivity or allergic reactions, but we're not
going to spend a lot of time on these.
One is called cytotoxic hypersensitivity.
And this occurs when the antibody directed at those antigens or allergens
of the cell membrane, they act activate our compliment system.
And so this is going to cause a, it's called what a, a membrane attack
complex, or it's kind of like cytotoxicity where the cells are kind of
attacking, you know, the body and stuff.
So, um, and they'll literally attack their own tissue.
Right.
And so, I mean, you can see this in some drug, um, allergic reactions,
and you can also see it too in some, uh, if there's some things happen, um, when
you get certain infections, like, um, you could get hemolytic anemia and that,
that you can get hemolytic anemia.
And, um, and that would be due to this cytotoxic hypersensitivity.
We're not going to spend a lot of time on that though.
Yes.
And you said there was one more.
One more is called immune complex hypersensitivity.
And this is when that antigen antibody complex causes an
inflammatory response in tissues.
So the difference between that cytotoxic, um, hypersensitivity reaction and this
immune complex cytotoxic, um, uh, hypersensitivity reaction is that with the first one,
the, the allergen is bound to a part of the cellular membrane.
Um, but in the type three, I mean, I'm sorry, but within the immune complex
hypersensitivity reaction, the, the allergens are freely circulating.
So they can go, you know, in different places and that particular type of allergic
reaction is, um, is going to be commonly seen in maybe more complicated things
that we see like serum sickness or, um, um, just other more serious things and stuff.
So just for completeness, I wanted to mention those as well.
That's good.
Okay.
So we have immediate allergic reactions, which deals with IgG.
Yeah.
IgE.
Thank you.
Then we have long-term or basically delayed allergic, which deals with your T cells.
Yes.
And then we have, um, we have the cytotoxic, which deals with, uh, it's
an internal problem, which causes cells to essentially attack other cells or your
tissues.
So for example, they might attack lung tissue, for an example, cause they get
confused and they might attack the lung tissue and cause damage there.
Yeah.
Or you have the, um, the, the immunocomplex, which is the, the idea.
So it's not local.
It basically spreads through serum AKA blood and in lymph and other fluids.
Yes.
And causes some sort of an inflammatory, you know, reaction things like histamines.
And so they'll be get carried around the whole body because they're
going to be in the bloodstream.
Okay.
But I'm thinking the ones that we, as you know, our cells would deal with most
commonly, we're are going to be those immediate hypersensitivity reactions or
those delayed hypersensitivity reactions.
So, and again, the things, somebody might be thinking, well, what all causes
allergic reactions?
And there's a list and this won't be an uncommon, I mean, this'll be a familiar
list to most people.
So pollen, big, big one mold, animal dander, dust or dust mites, which people are
certainly aware of latex, anybody that's had a latex allergy, that's definitely
part of an allergic reaction.
That's been a kind of a newer allergic reaction, I'd say though, it's probably
now 25 or 30 years old, but it's definitely a newer one.
Medications, insect stings and bites, foods, different foods such as shellfish,
eggs, milk, tree nuts, peanuts and wheat.
Those are the common ones.
Chemical irritants can also cause an allergic reaction and things like poison
ivy, poison oak and poison sumac.
So those are, that's the, the pretty much the common list of allergic, allergens
that cause allergic reaction.
Those are the low hanging fruit.
They might affect most people.
Right.
There's a stat out there, the 25% of people experience some type of allergic
reaction and that's 25%.
I believe that's either America or that's of the world, but if you use America
as a sample population, then, you know, it's 25% of almost 8 billion people.
So that's about 2 billion people, which is pretty amazing.
There you go.
So let's, let's, let's talk about an example, because I think a lot of people,
maybe either have these allergies or they don't.
I think a common one is hay fever.
And so I think you're going to be talking about that, right?
I let, yes.
Let me, there's just a few other little details.
I just wanted to throw in here.
First of all is when we talk about those immediate hypersensitivity or allergic
reactions, the things that can commonly cause those immediate type reactions are
things like pollen, different foods, bee venom, and medications.
So those are common for that allergic.
They're common for people with allergies.
And medications, so those are common for that allergic.
And that's going to come, that's going to come into play in just a minute.
As I talk about symptoms.
And by immediate, we mean within minutes, minutes to hours, minutes to hours.
Whereas those delayed hypersensitivity reactions may be more commonly caused by
bacteria, fungi, chemicals, or plants.
Okay.
So you think, you think, well, how do I know if I'm having an allergic reaction?
So the common symptoms that you see are going to be sneezing, a runny nose, maybe
obstruction of your nasal passages, itchy, watery eyes.
You can have eyelids swelling.
You could have itching, just all body, all over, all over body itching.
Interestingly too, you could have stomach pain or diarrhea to go along with an
allergic reaction as well.
And so those are typically manageable on your own, but the things, the ones that
you want to be worried about are the ones that get more serious.
So anytime that you have been exposed to some sort of an allergen and you have
anything like difficulty breathing or your lips or your tongue starts swelling,
or you have hives all over, or you start having pale, cool, or you have a
pale, cool, damp skin, or you've got a fast or pounding heartbeat, you have
significant nausea and vomiting, or you feel drowsy or confused or you faint,
you're going to probably want to get some help.
Sometimes it's a 911 call, especially if somebody's having difficulty breathing.
So you need to be aware of that, you know, and sometimes people need to wear
medical alert bracelets that tell, you know, anybody else that you've got an
allergic reaction, a severe allergic reaction to something.
Okay.
Um, yeah, that's tough to say because if you don't know you're allergic to
something, you're going to find out in that moment, which is crummy.
Yeah.
But there are some ways to diagnose allergies, you know, especially when
they're not that severe, but you can, um, certainly by symptoms, you can tell
whether or not you're allergic to something.
If, if you had never been fine and all of a sudden you do something and you
have some of these symptoms, you can feel pretty certain that maybe that was
the cause of it.
You can also, um, see an allergist and do things like the skin prick test where
they will, they will, um, give you small little, you know, substances.
Usually I think they do it on your back and see whether or not your body reacts
to them to help you figure out whether you are allergic to cats, you know, or
you are allergic to, uh, uh, pollen from cedar, you know, and that, that kind of
thing.
Um, you can also do, if it's foods that you're having issues with, you can either
do a food elimination diet, or you can do a food challenge test as well too.
Yeah.
What's a food elimination diet?
I think it's going to be when, um, you, if you've noticed something that you feel
like might be causing something, you take it out of your diet and see whether or
not your symptoms get better.
Um, that can be kind of touch and go and kind of hit or miss and stuff.
So, um, I think that you can also involve those in some of those, um, skin prick
test type things as well too, like peanuts, you know, or something like that,
you know, cause you, I would, if you have a severe reaction to peanuts, you
wouldn't want to necessarily do a food challenge test with it, you know, and
stuff.
So,
but I know what you mean.
Like if you think that you might have a, uh, a wheat sensitivity as opposed to
celiac disease, it's easier to cut wheat out of your diet, see how you feel from
maybe a couple of weeks, um, or, you know, sugar or milk, milk as another one as
well, dairy type things.
And so, yes, absolutely.
And a lot, a lot of times, you know, it's, it's, you know, there's so many things
that could potentially be inside of you.
That's a, that, that could be causing you malady, uh, which is why keeping,
you know, don't rely too much on your intuition.
Like your intuition should inform you how you feel, like I feel bad or I feel good.
Obviously you feel things, but then, you know, go through the, keep proper
documentation, find a good template of a food elimination diet so that you can be
pretty rigorous about it because it's easy to draw conclusions, um, without
being rigorous.
So for example, um, you could eliminate, let's say you're feeling bad after eating
a piece of bread, but you failed to include that you also drank a glass of
wine with that piece of bread.
So if you continue to eat, just cut out bread, if you don't often drink wine,
then you might come to the conclusion that it was the bread that was causing
you to feel that way.
But then upon drinking wine again, maybe you only drink it with bread.
You'll then conclude, Oh, it must be the bread.
But really it was the red wine.
So really keep in mind that you have, you might have certain biases
towards certain foods.
Um, I know, uh, bread out there is, is a common culprit for, for being, uh, fairly
demonized and who wants to demonize red wine, uh, cause it's quite delicious.
But if you're really wanting to figure out what's going on with you, you also
have to be aware of your biases and also biases that have been thrown at you.
Um, but my popular media, and I'm not saying that you might not have a gluten
sensitivity or, um, but if you really want to know what's going on with your
body, um, you have to highlight even the foods that aren't highlighted by a lot
of publications, um, you know, there's, there's a lot of things out there that
could potentially be a potential allergen.
Um, we also talked about the food challenge, which I assume, I assume is
similar, um, a type of way of figuring out, you know, what foods are, are good
for you and which aren't the problem is with a lot of these is that they're,
they're difficult to do because food is so delicious and we eat so much of
different types of food at a meal.
So in order to really do this fairly scientifically, you would basically
need to eat one food.
You, one way I've heard about doing this is that you eliminate all foods from your
diet, you almost go on a fast for a couple of days and then you reintroduce
foods one at a time, um, into your diet, either days or week at a time.
And then once you get to the one that causes you discomfort, then you kind of
have a semblance of an idea is like, Oh, okay, it's this one that, that
caused me the problem, but that's really hard to do.
It's really hard to just eat kale and then do kale and broccoli and new kale
and Brussels sprouts, et cetera.
But on the whole, um, one thing to really keep in mind is like, if you are going
to eat food, um, other than things that can cause like anaphylactic shock, like
peanuts and things like that, um, tend to eat foods that aren't processed, um,
try to eat a lot more colors, you know, Brussels sprouts and sweet potatoes on
your plate.
And if you are going to get meat, you know, make sure it's sustainably
sourced, um, because a lot of those, a lot of these, um, you know, you're
going to get a lot of those, a lot of these additives, um, even, even though
they might be safe for the whole of the population, they could be causing a harm
for you and they might be that trigger.
So diminishing the number of ingredients might also diminish the probability of
having some of these allergic reactions.
Let me add just a couple of other little points about food challenge tests.
It does seem to, as I've done a little bit of additional research that they're
actually done in a controlled environment, like, like maybe an allergist's office.
Because I think if you did have a severe reaction, then there is medical personnel
readily available to help you, but you will determine to see whether or not
you've got something going on with that particular food, um, under a
controlled environment.
Um, it may be that you eat small amounts and then you have gradually increasing
amounts to see what kind of a reaction you have.
Um,
yeah, I know that's been done with infants who have a note because be having
peanut allergy is, is fairly genetic.
And sometimes you get tested for it as an infant and by dosing small amounts of
the peanut protein that causes the allergic reaction, you can actually
diminish the response.
Um, it's almost kind of like an inoculation, you know, to this type of antigen
or this allergen.
And so if you have kids out there and you're worried about them getting
allergies later in life, I would strongly do some research into the hygiene
hypothesis and let your kids play outside and get dirty.
And, um, because it really does wonder for their immune system and training
it and how to moderate itself because if it doesn't moderate itself, it can
kind of go crazy.
Um, so if you want to kind of delay some of these allergic responses down the
road, I would highly recommend you let your kids roll in the mud a bit within
reason.
Um, I think too, also just an additional fact about the food challenge.
It seems that food challenge tests are done when you've looked at other types
of tests, maybe like skin allergy tests and, um, maybe a medical history and
things seem to be inconclusive.
So it's going to be kind of a down the line type of a test as well too.
Okay.
That's great.
Okay.
So we've talked about some of the ways that you can prevent allergies.
We've talked about how allergies can form.
Now let's imagine I'm having an allergic reaction.
I'm going through it.
I've got, you know, puffy eyes.
I've got shortness of breath, et cetera.
What can I do to alleviate, uh, my pain?
Um, so, so there's a couple of things that are, are there's a couple, a couple
of, um, I guess, or there's a, I guess, treatment options for people with allergies.
First thing, uh, it kind of seems like a, you know, of course is that if you are
aware of something that causes you to have an allergic reaction, you might try
avoiding that thing, like if cats are the thing that caused you to be absolutely
miserable, that you can't breathe, your eyes are itching and your nose is runny
all the time, you may not be able to own a cat, you know, that kind of thing.
Um, so you're going to try to avoid something that might get a hairless cat.
Yes.
You could get a hairless cat or let's, let's talk about dust or dust mites in
your house, you know, which is in everyone's home, no matter how clean you are.
I mean, so there might be some certain types of filters that you could put in
your ventilation system, um, in order to filter out the dust and dust mites and
stuff so that you might see an improvement in your, um, in your, um, uh,
allergic symptoms, if that happens to be the thing that's causing you problems.
Um, if you, uh, you know, for, for dust and stuff as well, too, keeping your house
clean, you know, making sure that you don't have carpets in your house,
you keeping your, no carpet in the home because dust, dust, dust mites like to
live in the carpet.
So, you know, hardwood floors or tile, you know, something that, a linoleum,
you know, something that's not carpet would be good for that circumstance.
Um, sometimes you also want to, um, encase your mattress and box springs and
pillows in what they call mite impermeable materials.
And also then wash your bedding every week.
Um, again, this is talking about somebody who might be more sensitive to dust
mites and others and stuff.
Um, you know, you can also be allergic to cockroaches.
Um, so you want to keep your house clean and you want to keep your food tightly
sealed and stored properly and then treat infested areas for, if you have
problems with cockroaches.
I know one time I lived in a, in a city that rained a whole lot more than where
I live now.
And so cockroaches were definitely a problem, regardless of how clean I kept
my home.
So again, it's just, it's not always implying that you are not a good
housekeeper and stuff.
It's just, sometimes it's environmental problems and stuff.
Yeah.
Is it something that the cockroach is excrete that you're allergic to?
I believe it is.
Okay.
That's really interesting.
Yes.
Um, so I mean, those, those, um, what you've seen in this store, I've talked
to, I talked about putting filters into your, you know, ventilation system.
They're called HEPA filters.
HEPA stands for high efficiency particulate air or HEPA filter.
Um, and so they're going to help try to remove pollen and mold spores and cat
allergens from your household air, but they can't remove the fecal materials
from house dust mites.
That's what you're allergic from, from dust mites.
And it, it's just too small to be filtered and that's why they don't work for,
for dust mites.
And that's why you recommend washing your bedding.
Right.
Or sometimes you may have to encase it and stuff.
Yes.
And mites are very small.
I don't think you'll be able to see them with the naked eye.
Right.
Correct.
Right.
Uh, sometimes those filters are pretty expensive and so that can be costly and
stuff and so, and they may not be effective for all patients.
Also too, you can, your vacuum cleaner can also have a HEPA filter on it as well too.
So it just depends on what you need that you can try some of those things.
Um, if you need some medication therapy, then the categories that you're going to
see used most commonly are going to be antihistamines, decongestants.
You might see some intranasal corticosteroids used.
Um, there is a drug called Iprotropium that is an anticholinergic, so it can dry,
it can cause your, your nasal passages to constrict.
So you don't have as much of a runny nose if you really suffer with that.
Um, sometimes, uh, if you, uh, like for little kiddos that are too young to
receive some of these prescription therapies, if you use, um, salt water,
normal saline, saline, uh, intranasal solutions or washes that can sometimes
help wash things out.
Like a neti pot.
Right.
Um, and sometimes people might even need oral corticosteroids as well too.
That's not as common.
So the other thing too, that you'll see, um, in, um, for certain circumstances
is going to be, um, what we call allergen immunotherapy.
So you can either take, there are some oral therapies or you've got, it's
when you see, hear about people getting allergy shots.
So they're going to give you some of that thing that's subject to
that substance that you're allergic to and small amounts so that you can,
your body can build up a reaction to it so that when you get exposed to the real
thing, you'll have a much less of a response to it as well.
You'll see that a lot when you get the, when you, um, if it's, uh, you know, uh,
uh, pollen, you know, grass, that type of thing and stuff.
So, yeah, that's, that's really well said.
I actually think that advice not only goes towards getting tested for allergies.
It's just good life advice in general.
I think this is straying off topic a little bit, but the idea that things
should always be perfect all the time and that you should never suffer
from anything, um, is a misnomer.
I think sometimes learning how to suffer is, uh, is a great way to live through
life feeling also laughing through suffering is, is quite good.
I remember there was a, um, there was a politician who used to, uh, he was
a Navy seal and, um, Afghanistan and he, unfortunately got hit with an IUD and
then knocked his eye out.
Um, and, uh, and when his friend, you know, his rest of his crew came in and he
basically said, oh, it's a good thing they left me the other one, you know, as
this immediately after getting hit with a, an IUD, um, so this idea that there's
going to be this time where things are going to function perfectly and you're
going to get your house clean enough and your body is going to feel like it did
when you were, you know, 10, if you're listening and you're older than 10 is
not good, but it's definitely working towards getting to a place where you feel
like that you're making incremental incremental process, uh, progress.
There's no, there's no, um, Oh, what's the word I'm thinking of the cure all.
What's the word?
Yeah.
There's no panacea out there that does not exist.
It's all trade-offs.
So if you have an allergic reaction to something, essentially you are then
working to just reduce symptoms and, um, some things are better than others.
Um, there's actually, I remember listening to this other podcast I listened
to called radio lab about this man who, uh, went to, uh, Cameroon and he walked
around in the latrines.
If you don't know what a latrine is, uh, don't look up images, but it's essentially
where people go to the restroom collectively.
And it's no, there's no plumbing.
It's just a pit that everyone goes to.
And he walked through that pit barefoot.
Um, the purpose was to get infected with this, um, certain parasite called a hook
worm and a hook worm usually goes into your body and actually attached to your
small intestine, um, it actually can cause some pretty, um, I don't know about
painful, but it can cause some severe, um, digestional problems, but in the proper
dose, what it did for him at least is that he had severe hay fever and he's from
England and the hay fever was quite bad.
And, um, we also call that allergic rhinitis.
And when he went back to England after infecting himself, his allergic rhinitis
had gone away because, but based on what I said earlier about the hygiene
hypothesis, his immune system had bigger problems to worry about, which was the
hook worms and the allergens that they were secreting in his small intestine.
And it didn't have time to worry about, um, the allergens coming
from the pollen from the plants.
So there's some wisdom there.
This is this idea.
Can we coexist with parasites or can we maybe extract the chemical from the
parasite and find a way to dampen our immune system?
I think it'll be, it's going to be really interesting to figure out because I
think a lot of people suffer from allergies, especially in richer countries.
And it would be really nice way to diminish some of their suffering.
So I just wanted to bring that in the idea that we're all just kind of figuring
out the best solution here.
Um, and don't think that things are just going to automatically just be a hundred
percent better.
We're all just progressing towards some standard that we can live with.
I think you can still have our rich life.
If you'd suffer, suffer from an allergy though, because we've got a lot of
options to help people to feel better.
Um, just one extra caveat about immune therapy or immunotherapy.
Um, it can take several months to, and if you're taking either these immune
therapy tablets, pills, or you're getting an allergy shots, sometimes can take a
couple of months before you start seeing results.
So don't think immediate, you know, for that either and stuff.
So, yeah, we live in a world of instant gratification.
Uh, biology works much slower, so give it some time.
Um, and so just a couple of takeaways that I just wanted to just leave you
with as far as treatments for allergies, um, and, and the symptoms that happen,
you know, from them, uh, a lot of, I know a lot of these, as far as things like
decongestants, nanohistamines, we're talking about things like, you know, itchy
watery eyes and runny nose, those types of things rather than more serious allergic
reactions, but, you know, uh, so a decongestant is going to be the type of
medication that is most prompt is going to be most commonly used to manage those
types of symptoms.
Um, and, um, you, you know, again, are going to, um, um, if you're going to use
a decongestant though, if you have some underlying diseases, like, um, if you
have high blood pressure, um, or, um, glaucoma, um, even diabetes, sometimes
the medications that are used to treat that can be harmful to those diseases.
So it's definitely something to talk with your healthcare provider about first.
I would not, um, just go ahead and take it because you could end up with some
other issues if you don't, um, talk with them about, you know, how to take those
and stuff with those conditions.
Um, if you, um, have some other diseases that show up along with your allergy
symptoms, let's say your ears start hurting or, um, you start feeling running
a fever, um, you know, then, um, or your, um, you feel, you know, your use to have
an awful cough chest pain in your, in your, as you cough and stuff that could,
that those are all some, all indicators that maybe something more serious is
going on.
And again, you'd need to see a healthcare provider for those well too.
That's good advice.
Yeah.
I remember y'all with side effects, you're, you're putting a chem, especially
when you take medication or anything for that matter, even food, that it's going
all over your body and wherever there is a receptor that will take that thing
that you put into your body, it will fit in there like a lock and key.
And it will basically start the mechanism that it was designed to do.
And so when these drugs are designed, you, you're, you're trying to target an
area to alleviate suffering, AKA let's use the decongestant.
You want to reduce congestion, but upon doing the clinical trials, they also
found out that there were other side effects.
So they have to disclose these side effects and it wasn't purposeful that
these drug companies, you know, pick these side effects.
They just happen to happen inside of the body.
And so you tell them to the patients and say, just as a risk, be like, Hey, we
know you're suffering from deep, from congestion.
Just want to let you know, if you have high blood pressure, it might not be
worth the risk to take it because the side effects from this might be worse
than the congestion.
So that's why it's really good to know where you are at personally.
So that when you take drugs, you kind of can do your own risk reward.
Calculation, because sometimes it might not be worth it.
So even though being congested, isn't fun, it's also not fun to deal with, you
know, blood pressure problems that might come as a side effect.
Or you might be a patient that would then benefit from an intranasal corticosteroid
rather than taking a decongestant because there's other options that can be used
as well to manage that symptom.
That's well said.
One other thing that I just, I neglected to say to you, if you, if you are
identified as having a pretty significant allergic reaction to, let's say peanuts
or some other type of an allergen, sometimes you will be prescribed what
they call an emergency kit.
And usually it has epinephrine in it, which is something that will help to
counter the allergen response as far as causing the significant vasodilation
because epinephrine is going to cause things to constrict up and stuff.
And so, um, make sure that you have that available and make sure that you
check the expiration date on it.
Yeah.
And we should mention epinephrine is a hormone that naturally occurs in your
body.
So it is very readily used and biodegraded in your body.
So it's essentially there, just like my mom said, to counter the effects.
So this is a, this is not a foreign, uh, pharmaceutical that was created.
It was something that was extracted from the human body and then concentrated.
And let me also add an extra point to that as well, too.
If, if you have a situation where you do need to use the epinephrine, then you
need to contact your healthcare professional either, I mean, healthcare
professional as well to let them know, you know, that you had to give it or
that you gave it to your child or you're on your way to the emergency room or
you need to call 911, you know, as well, too.
If you're, if you're seeing really like somebody's having really difficulty
breathing, um, have a really crazy heart rate or whatever and need some help as
well too.
So when you walk out, you know, you'll have your keys, wallet, phone, and your
EpiPen, which is one thing to add to your repertoire.
Right.
Absolutely.
So, well, fantastic.
I was, I was just do a little overview.
So we've got, um, allergies, which are caused by allergens getting into your
body.
And normally they would do nothing.
But every now and then they're going to cause a little haywire, whether that's,
you know, essentially causing your immune system to kick into gear and, um, cause
some of the effects that the immune system would normally do when fighting an
infection from a bacteria and virus, which is causing vasodilation, which
causes swelling or even releasing histamines, which do the similar thing,
bruh, bronchoconstriction, which causes your tightening of your chest and also
increasing mucus production.
Which can cause you to feel quite stuffy.
Um, and also sometimes even swelling in your eyes or even in your ears or, and
sometimes it even worse cases, like mom said, you can develop hives all
throughout your body or sometimes the, you know, your throat can close up so
much that you might even suffocate.
Um, and that's, and we call that anaphylactic shock.
Um, when the, when the allergy is really bad.
So, uh, in order to avoid this, like my mom said, you want to avoid the
allergen altogether if you know it.
Um, and that can be done by, like you said, it has to do with pets, don't
have pets or try to limit your exposure to them.
And if you have to be exposed to them, um, it might be good to have a filter
in your house that can filter out some of this dander and also maybe potentially
find a way to, um, expose yourself slowly to this dander.
So maybe you can build up an immune tolerance.
Uh, there's no guarantees there.
Um, it definitely helps if you're younger, um, because your immune system
is more adaptable.
Uh, but if you're older, it might be good to try to build up some tolerance there.
So, but when you have the allergic reaction, when you're actually suffering
through something, it's good to, um, take things like decongestants, antihistamines,
and sometimes even things like Tylenol, uh, because some of the swelling can be
caused by prostaglandins, which if you want to take, uh, Tylenol, it can reduce,
um, the prevalence of those prostaglandins and reduce some of the pain, um, that is
happening inside of your body.
Um, Professor Seltzer, did I gather everything that you said, or do you
have anything to add?
Yeah, I'm not sure that let me just double check.
I mean, you could take something like ibuprofen to reduce prostaglandins, but I
think Tylenol has a different mechanism.
You're right.
It's not really for pain.
Tylenol is just blocks the, the nerve.
Right. And ibuprofen is, is the prostaglandin.
Thank you.
I appreciate the correction.
Yes.
See, it's good to be wrong because then you find out what's right.
So, um, and also to just add another, and one extra little caveat is that, you
know, there are, there are now two kinds of classes of antihistamines.
Those first generation antihistamines cause a lot more sedation, but we have
the newer non-sedating antihistamines things that you're really familiar with,
things like Allegra.
Or Claritin.
Um, and, uh, if you need to function during the day, I would suggest a
non-sedating antihistamine and save those sedating antihistamines if you
need to use them in the evening time.
That's good to know.
And do you suggest any decongestions that, that you prefer that you like?
Um, I think that all of the, I mean, I, you know, probably, you know,
Afrin or the Afrin generics are, are just fine.
You know, any of those in that.
Area are just going to be fine.
And you would look on the back of the box and look for Afrin if you're looking for
a decongestion.
Well, I think that the, uh, the generic name for Afrin is oxymetazoline.
I think, let me just double check that.
Hold on.
Yes.
Ox, oxymetazoline is, uh, I'm sorry.
Oxymetazoline is the generic name for Afrin.
Okay.
So if I see oxymetazoline, right.
Then that's a, that's a generic name.
That's a decongestion.
That is a decongestion.
Yes.
And stuff.
So it's, you, it's over the counter, you know, in, in the grocery stores and
pharmacies and stuff.
So, okay.
Is that different than mucinex?
Yes.
Mucinex is totally different.
Mucinex is for cough.
It has a, an expectorant in it.
And if it, if the dextromethorphan is in it, then it's got a cough suppressant.
It's totally for cough.
Gotcha.
Okay.
That's great.
Um, well, y'all, this has been a lot and there's a lot to learn about allergies
and, um, how your immune system, um, interacts.
It's not very straightforward.
Um, so we hope that you don't mind us not giving very straightforward answers.
The mechanism can be so different.
Like we said, there's four different mechanisms for, um, you know, allergic
responses, uh, but to treat the conditions, um, is, is fairly consistent.
Um, so we hope that some of this information is super helpful to y'all.
Um, and we hope that you get some relief, especially when you're going
through an allergy season or an allergy episode.
Um, so until next time, um, my name is Josh Klaus.
And I'm Jennifer Seltzer.
And thanks for listening to another episode of Your Mom on Drugs.