Asthma Turn-Arounds With Oral Immunotherapy
I wake up every day and I think, 'I'm breathing! It's a good day.' - Eve Ensler
If you live with allergic asthma, you can relate to that quote in a way that others cannot even grasp. 15 million Americans share your dilemma.
When you worry about having enough breath to blow out your birthday candles, and you carry your life-saving inhaler everywhere you go… then breathing is a gift you cherish every second of the day.
What is allergic asthma?
Asthma is a narrowing of the airways, caused by both excessive contractions of the smooth muscles around the airways, as well as excess mucous inside the airways. When these two factors combine, our airways, or bronchi, get too tight for air to flow thru properly. Symptoms include wheezing, coughing, and of course shortness of breath.
Surprisingly, it is actually harder to breathe out, or exhale, than it is to breathe in, or inhale, because the airways collapse even more on the exhale, thus causing air trapping in the lungs.
While a number of factors can worsen asthma, such as emotional upset, exercise, and cold air, the most common cause of the asthmatic inflammation is allergies. Primary allergic triggers, known as allergens, include foods as well as environmental inhalants, such as pollens, dust, mold, and animal dander. Specifically, we react to the proteins in these.
Exposure to these allergens confuses our immune systems, which attack the allergens as it they are an infection. Our white blood cells rush to the scene of the imagined battle (namely our sinuses and lungs), then begin to release histamine and other chemicals… inflaming our tissues.
Inflammation soon generates mucous, which we cough up, causing spasms in the airway muscles and then, voila, an asthma attack.
How do I know what I’m reacting to?
Conventional allergists test for allergies, both foods and inhalants, by skin tests. The skin tests are good for finding most of the inhalant allergies. However, skin tests often miss important food allergies, as our allergic reactions to foods are often delayed in their response, so may not show up on the skin tests. Therefore, we recommend testing for food allergies with blood antibody tests instead.
How are allergies treated?
There are some medicines that can treat the surface symptoms:
Antihistamines – to block the histamine effect at the tissue receptors.
Beta-agonist inhalers (such as albuterol) - to relax the smooth muscles and open the airways.
Steroids – to decrease the inflammation.
However, each of these has undesirable side effects. The antihistamines often cause drowsiness, blurred vision, and dry mouth. The beta agonists cause fast heart rates, sleeplessness, and a ‘wired’ feeling. Steroids can cause weight gain, obesity, diabetes, stretch marks, and osteoporosis when overused.
When choosing medications for asthma management, one of the better ones these days is Montelukast (e.g. Singulair), which is a leukotriene-inhibitor and breaks the inflammatory cycle with fewer adverse reactions, although some are still possible.
Is there something better?
The most sophisticated treatment response is to teach our bodies to stop attacking allergens; their only real danger to us is our own excessive reaction to them.
Desensitization is the process of exposing our immune systems to small doses, continuously over a period of several years, to the very protein allergens that we are reacting against. This induces a ‘tolerance’ or ‘desensitization’ to these proteins. It is much like introducing a new friend to your family’s guard dog: “Down boy; this is a friend.” Allergists do this by injecting tiny amounts of serum, containing the allergens, into our muscles once or twice weekly. This retrains our immune systems to stop attacking stuff that is otherwise quite harmless to us.
Enter, sublingual immunotherapy
The drawbacks to injections for allergy treatment include the cost, the inconvenience of traveling to the office each week for the shot, getting needle-pricked repeatedly, and the risk of an excessive immune response to the shot itself, which can cause anaphylaxis (breathing may stop altogether).
Instead of putting the allergen serum into an injectable shot, it also works quite well to put it into a dropper bottle, and then squirt the serum under our tongues. Although this must be done two or three times a day for several years still, it is far less costly, more convenient, and safer than the shots. Better yet, it provides about the same level of effectiveness.
With oral drop desensitization, you do your own therapy in the comfort of your home, and there have never been serious anaphylactic reactions reported.
Conclusion
While a variety of medications can lessen the symptoms of allergic asthma, the most fundamental approach is to treat the underlying problem, which is our excessive immune reaction to foods and/or inhalants. Desensitization is a proven method for addressing the root of the issue and resolving it profoundly.
The first step is to identify the proper allergens that we are reacting against. Then, the next step is to induce tolerance thru the process of desensitization. Oral drop therapy (sublingual immunotherapy) has advantages over injections, as the drops are less expensive, more convenient, and far safer.
Once you begin to feel the benefits of desensitization to your allergens, you will indeed breathe a sigh of relief.