An Allergy Impasse?

I have severe allergies and have tried just about everything (mainstream and alternative), and nothing works. My allergist has recommended oral steroids, which I don’t want to take. He also suggested allergy shots. Are they worthwhile? I’ve tried quercetin, stinging nettle and NasalCrom, all of which no longer help me.

– March 15, 2007

Allergies are due to “misplaced immunity,” a defensive reaction against something that really is not a threat to health. Allergic responses are also learned responses that can be unlearned. The goal of treatment should be to convince the immune system that it can coexist peacefully with the substances that currently irritate it.

I haven’t found allergy shots to be worth the trouble, cost and risk they entail. The percentage of patients who experience satisfactory relief is disappointingly low. (I do recommend the shots for desensitization to life-threatening allergic responses – to bee venom, for example.) I also discourage use of oral steroids. They are too toxic to be used long term to manage minor ailments (however annoying those ailments may be).

Instead, you could try two dietary approaches to help relieve your allergy symptoms. The first is the elimination of dairy products. Milk protein, or casein, increases mucus production in most people and acts as an immune system irritant when allergies are present. Even if skin tests don’t show a true allergy to milk, removing it from the diet often leads to improvement in such allergic conditions as asthma and eczema. (Don’t just switch to nonfat milk products, which have the same amount of milk protein as full fat varieties. Nondairy cheese substitutes made from soybeans and almonds may still contain casein. Read product labels carefully to be sure that they do not contain casein.) However, you can substitute sheep and goat’s milk for cow’s milk. Both have a different protein composition and don’t cause the sinus, allergy, and immune-system problems associated with cow’s milk.

My second dietary recommendation is to cut down on the amount of protein you consume. I believe that high protein diets irritate the immune system in some people, aggravating allergies and autoimmune diseases. Because proteins are the components that make an organism unique, the immune system reads them to decide whether materials in the body are “self” or foreign. When the immune system is overactive, as it is in allergy, flooding the body with animal and plant protein may confuse it further and make resolution of these conditions less likely. I have found that low protein diets can be helpful to people with chronic allergies and other immune system problems.

I also suggest trying mind-body techniques such as hypnosis, which can lessen or completely prevent allergic reactions and facilitate the immune system’s unlearning of its pointless habits (in the case of allergy, an inappropriate response to pollen, dust, mold or animal hair or other substances that cannot really hurt us). If stress impacts your allergy symptoms, take steps to reduce it. I’ve seen long-standing, severe allergies disappear when people switched jobs, left a relationship or otherwise eliminated a source of stress.

You don’t specify what type of allergy you have. If you’re sensitive to dust, animal dander, pollen or mold, try to dust-proof your house by removing rugs, Venetian blinds, and other dust-catchers. You also could consider buying a HEPA (high-efficiency particulate air) filter, which removes particles in the air by forcing it through screens containing microscopic pores. These devices work well and aren’t too expensive. Get one for each of the main rooms in your house, or move one unit from room to room regularly. Avoid air-filtering equipment that generates ozone (HEPA filters don’t).

And if you haven’t tried it, experiment with the herbal remedy butterbur (petasites hybridus), in products like Petadolex. Many people report success with it for allergies.

Andrew Weil, M.D.

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