House CallFeb/Mar 2011 Issue

Pediatric Allergies Q & A - Herbal Therapy, Coughing and Asthma, School Safety

<br>©Nicole Hill/Rubber Ball/maxximages.com


©Nicole Hill/Rubber Ball/maxximages.com

Herbal Therapy

I’ve heard that certain Chinese herbs can cure a food allergy. Could this be true?

Dr. Jain Chinese herbal remedies have long been touted as an effective treatment for a variety of problems, including food allergies. Recently, researchers sought to discover whether there’s any truth to these claims and they used an herbal formula on food-allergic mice—with promising results.

This work in mice led to a newly published study that used an herbal formula to treat humans with food allergies. Results revealed that the formula of nine herbs, called Food Allergy Herbal Formula-2, or FAHF-2, was safe and relatively well tolerated when used for one week. The study was too short to demonstrate any significant improvement in the patients’ food allergies as measured by skin tests or blood tests. However, it did show some effect in lowering other markers of inflammation, which are typically elevated in patients with allergies.

Ultimately, if FAHF-2 is shown to be effective, it will be used primarily to make the risk of accidental ingestions less dangerous, not as a cure for food allergies. Additional studies are needed to determine whether FAHF-2—or any other herbal formula—is a safe and effective treatment for patients with food allergies. The doses and list of ingredients in FAHF-2 are readily available to healthcare professionals and most Chinese herbalists can prescribe the formula at doses similar to those used in the study. However, I would urge extreme caution to patients who decide to take this supplement in hopes of curing or reducing their sensitivity to foods, as it has not been studied in this way.

Allergic to Love

I’m having an allergic reaction every time my husband and I make love. Is it possible to be allergic to sex?

Dr. Jain Unfortunately, the answer is yes. There are numerous reports in medical literature of people who have allergic reactions from sexual intercourse, including oral sex. Symptoms of an allergic reaction can include itching, hives, difficulty breathing, local or widespread swelling, low blood pressure (sometimes with accompanying dizziness) and vomiting. In some cases, these reactions can be severe, even life-threatening. Some women and men can actually be allergic to a protein found in seminal fluid. This allergy seems to be more common in people who are also allergic to a particular allergen found in dog dander. (Not everyone allergic to dogs is allergic to this protein.) We don’t know how common these types of reactions are, as they’re likely under-reported.

Many people are embarrassed to discuss these issues with their doctor.

Sometimes your partner can unwittingly expose you to an allergen during sexual activity or other intimate contact. If you’re allergic to a food your partner has eaten or an antibiotic your partner is taking, sexual contact may expose you to that substance and cause a reaction.

If you have had an allergic reaction during or after intercourse or other types of sexual activity, you should not feel ashamed or embarrassed. It is important to seek out an allergist to identify the cause and help prevent further reactions. For patients who are allergic to seminal fluid, there is hope. A treatment does exist that seems to be safe and effective in reducing or even eliminating the allergy. Consult your doctor for more information.

Coughing and Asthma

I’ve had a cough that’s been bothering me for the last couple of months. Could this be asthma?

Dr. Jain Asthma is just one of many causes of cough. Other common causes include viral infection, sinus infection, nasal allergies, acid reflux and medication side effects. Less commonly, chronic cough can also be prompted by serious medical conditions like lung disease or cancer.

In many cases, the pattern of symptoms can help distinguish whether the cough is asthma or something else. People with asthma will usually cough more after activity and at night. They’re also likely to experience other symptoms, such as shortness of breath or wheezing.

You should consult your doctor, who can conduct tests to identify whether or not asthma is the culprit. Lung function tests, called spirometry, can sometimes offer a clue to help diagnose asthma although, in many instances, results come back normal or they are difficult to interpret. A newer test, called exhaled nitric oxide (eNO), detects whether or not the type of inflammation commonly seen in asthma is present in your airways. This test, which can predict whether or not a patient will respond to certain asthma medicines, can often also help rule out asthma. If not asthma, your doctor can perform additional tests to identify the reason for your cough.

Safe at School

I see that the president of the American College of Allergy, Asthma and Immunology states that peanut-free zones in public schools aren’t necessary. My son has anaphylaxis to peanuts and I’m happy school officials didn’t hear this guy’s message. What’s your thinking on this?

Dr. Leo Few topics conjure up more controversy than whether or not a child’s school or daycare center should be peanut or nut free. Varying opinions from legal, educational and medical experts, like this one from ACAAI president Dr. Sami Bahna, add to the debate.

Let’s start with what everyone agrees on. The incidence of life-threatening food allergies in children is increasing. At some point, these families will be confronted with safety issues outside the home, whether that’s childcare, school or airplanes. Since children lack the maturity to advocate for themselves, it’s the responsibility of adults to act in the child’s best interest to ensure safety. The controversy centers on how best to accomplish this.

Some families feel that accommodations like food-free zones and peanut-free schools are the answer while others consider personal avoidance the solution, i.e., removing the food-allergic child from the risky situation. The tension is between families who request food accommodations and those who contend that food allergies should not compromise community freedom or violate personal rights. As expected, this difference prompts anxiety and strong opinions on both sides.

Given my professional experience as an allergist and my personal experience as a parent (my daughter is peanut allergic), I’m often asked to mediate public discussions on this issue and I’ve witnessed dramatic conflicts. I urge both sides to consider the best interest of the overall community and hope that by building safe environments for all children, we can find middle ground.

I usually point out that no school can ever be considered completely allergen free. School administration doesn’t police the “nut-free” zone during non-school hours and lapses do happen. Also, schools cannot infringe on the personal rights of an individual (teacher or student) to eat offending foods outside of school hours; since residue can persist on hands and mucous membranes, there are inherent risks. Finally, although many people would agree that peanuts and tree nuts generally pose the greatest risk of reaction, many children have severe allergies to other common foods, such as milk, egg and soy. These allergens are no less important than peanut and tree nuts. If accommodations are to be made, other food allergens should be considered. This leads to a slippery slope with no clear answers.

The bottom line is that each community should work together constructively to find the balance that’s best for its children. By encouraging tolerance, sensitivity to differences and kindness to others, adults can model important, life-enhancing values and teach valuable lessons.

Appropriate diagnosis and time spent under the guidance of a physician with expertise in food allergies is the underlying foundation for all parties to avoid unnecessary anxiety and conflict.

Neal Jain, MD, is an allergist and immunologist with San Tan Allergy and Asthma in Phoenix, Arizona.
Harvey L. Leo, MD, is a pediatric allergist with Allergy and Immunology Associates of Ann Arbor and an assistant research scientist with the Center for Managing Chronic Disease at the University of Michigan.

Do you have a question for the doctor? Send it to editor@LivingWithout.com
Food allergies affect more than 12 million Americans, including 6 percent of children under the age of three. Allergic reactions can range from mild to anaphylaxis, a serious condition that can cause hives, swelling, nausea, closing of breathing passages and even death. There is no cure, just the strict avoidance of the offending foods. Ninety percent of all food allergies are caused by eight foods: wheat, milk, peanut, tree nuts, egg, soy, fish and shellfish.

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