CLASS-SPECIFIC SIDE EFFECTS OF ANTIHISTAMINESClass I: The Ethylenediamines Sleepiness and gastrointestinal (loss of appetite, cramping) side effects are common with the use of this class of antihistamines.
Class II: The EthanolaminesSleepiness is a common side effect of this group. Drying of the mouth and nose, difficulty urinating, gastrointestinal cramping, and loss of appetite also occur.
Class III: The AlkylaminesThese drugs are not as apt to cause sleepiness or drowsiness as most of the other classes of antihistamines. Nervousness (restlessness, irritability, excitement) is a more common side effect of this class of drugs.
Class IV: The PiperazinesHydroxyzine by far is the most commonly used member of this class and has a marked tendency to cause sleepiness and drowsiness. Hydroxyzine has strong anti-itch properties, however.
Class V: The PiperidinesIn general, these have a very low incidence of side effects because they do not tend to enter the brain as readily as some of the other antihistamines. Also, there is a lower incidence of dry mouth and nose, urinary difficulty, gastrointestinal symptoms, sleepiness, and nervousness with the use of this class. Cyproheptadine and astemizole are unique to the class in their ability to cause an increased appetite.
Class VI: The PhenothiazinesThis class of antihistamines is known for its ability to dry secretions and cause drowsiness or sleepiness.
Class VII: The ButyrophenonesThis class is noted for its lack of sedation, due to its inability to enter the brain. Its most common side effect is headache, which occurs in a small percentage of users.
Class VIII: The OthersThis is a catch-all class that has no common characteristics. All antihistamines that do not fit into any of the other classes are grouped here.*41/322/5*

When wheezing and difficulty in breathing are episodic, bronchial asthma is the cause. Bronchial asthma may be brought about by:

a. Allergy

b. Irritation of the mucosa of the lungs ñ Aspirin

d. Prolonged exercise

e. A combination of factors

To diagnose the cause of bronchial asthma, a doctor needs chest X-rays, a laboratory workup, and a diary which should delineate the weather conditions each day (temperature, humidity, cloudiness, sunshine, smog, rainfall), the symptoms of the illness each day (shortness of breath, wheezing, coughing), the general daily activity, the medications used during the day, any unusual events that have happened each day (exams, a party, etc.), and a list of all the foods eaten by the child that day.

Symptoms can be mild, moderate, or severe. Shortness of breath is mild if the child can carry on his normal routine even though his breathing may be difficult; moderate if the child is able to breathe while lying down but is unable to do any physical work; and severe if he can breathe only while in the sitting position. Wheezing is mild if it can be heard by placing the ear of a stethoscope over the chest; it is moderate if it can be heard from a distance of three feet; and it is severe if it can be heard from another room. The cough is mild if it is easy and productive; moderate if it is difficult and sporadic; severe if it is continuous.

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Someone eating an average diet and drinking unfiltered tap water is likely to ingest at least a hundred different synthetic chemicals every day. Exposure to airborne chemicals will vary more widely, depending on where people live, what work they do, how well-ventilated their homes are, and what sort of household products they use. A smoker in the house will increase the variety and quantity of air pollutants considerably. In all, we are probably exposed to at least two hundred different synthetic chemicals every day – and some people will encounter many more.

WHAT CAUSES CHEMICAL SENSITIVITY?

Why are some people apparently made ill by everyday synthetic chemicals? There are two types of explanation on offer, which can be summed up as ‘allergic explanations’ and ‘deficiency explanations’. The first type of theory proposes that these people make an inappropriate immune response (allergic response) to certain synthetic chemicals, in the same way that a hay-fever sufferer reacts adversely to pollen. The second type of explanation suggests that these people have some sort of defect that makes them less able to cope with environmental chemicals. It is usually assumed that this

is a deficiency in the enzymes that detoxify foreign chemicals. We will look at the evidence – such as it is – for each of these explanations.

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During a fast, drinking plenty of water is essential. The body can live off its fat reserves for several days, but it needs water daily. Distilled water is best during a fast, since a few people are sensitive to ingredients in tap water.

Still, going without food is stressful, and most physicians who use fasting as a diagnostic tool do not recommend that people try it on their own, especially if they have diabetes, hypoglycemia, are underweight or suffer any chronic illness. Ideally, a person on an allergy fast should be away from the home, school or work environment to avoid allergens which may be reinforcing (or confusing) any reactions to food. In some cases, that calls for hospital-controlled fasting.

Because of both the inconvenience and stress on the body, allergy doctors feel that fasting is best reserved for highly allergic people.

As an alternative to a total fast, some doctors will allow an individual just one food at each meal during the test period (three to five days). That’s monotonous, but less gruelling.

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‘Every patient with nasal polyps should have a complete allergy study,’ says Meyer B. Marks, chief of pediatric allergy at the University of Miami School of Medicine (Annals of Allergy).

You can have large nasal polyps and not know it. You can’t always see them yourself, even with a mirror. But you may have some clues. If your nose is continually congested and your sense of taste or smell isn’t as sharp as usual, ask your doctor to check your nose for polyps.

If polyps grow so large that you can’t breathe through your nose, your doctor will probably want to remove them surgically. But once you’ve had nasal polyps, they tend to grow back. To prevent that – or to prevent small polyps from getting larger -it’s important that you keep your allergies under control. Using an air filter in your bedroom can clear up congestion and other breathing difficulties in just half an hour or so – and give you eight full hours of total relief. Vitamin Ñ acts as a natural antihistamine clearing a clogged nose and sinuses. Regular exercise keeps nasal mucus flowing, so it can’t back up and aggravate polyp-forming tissues.

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One cardiovascular surgeon has found that some heart irregularities may be triggered by overexposure to chemicals to which a person is highly allergic. Dr William J. Rea, a clinical associate professor at University of Texas Southwestern Medical School, describes twelve people who had no artery-clogging plaque (the main symptom of heart disease), but who suffered arrhythmias or chest pains (or both) when exposed to one or more chemicals commonly found in the home or workplace – natural gas, cigarette smoke, chlorine, perfume, floor cleaners, formaldehyde and pesticides. When placed in a setting free of all traces of chemical fumes, all heart symptoms cleared in ten out of the twelve individuals (Annals of Allergy).

One particularly frightening type of arrhythmia is a heart spasm. It feels as though you’re being hit in the chest with a two-by-four. In fact, some medical researchers now believe that spasms trigger some heart attacks, irrespective of any buildup of plaque in the coronary arteries. Dr Rea’s research indicates that, in some individuals, heart spasms may be a response to allergens by the muscles around the heart’s blood vessels. We spoke with a nurse in Dallas, a patient of Dr Rea’s who experienced heart spasms as a direct result of exposure to inhalant allergens. Her story is a dramatic example of the effectiveness of his approach.

‘One day I had some very sharp chest pains,’ she told us. ‘I got very lightheaded and dizzy. The doctor I work for sent me right over to the hospital, where tests showed I had a “malfunction of the heart of unknown cause”, as the doctors put it. They gave me some nitroglycerin.

‘Some months later, I was driving home from work when my heart raced and then seemed to stop. I passed out. When I came to, I had real sharp chest pains. I put two nitroglycerins under my tongue and drove home. My husband took me to the hospital and I was admitted to the coronary care unit.

‘The EKG showed some changes, which they diagnosed as a heart attack. Then they did an arteriogram [a series of X-rays of the heart], which showed spasms in the heart’s main blood vessel.

‘However, they overlooked the fact that I was allergic to the iodine in the arteriogram dye, even though the information was on my chart. I guess the doctor who ordered the arteriogram didn’t believe in allergy to medications. Anyway, he recommended heart surgery.’

But the nurse suspected that the iodine had something to do with the spasms during the arteriogram. At that point, Dr Rea was called in. ‘The first thing Dr Rea said was, “Before we talk about surgery, let’s talk about your allergies,’” she told us.

Tests showed that besides allergy to iodine, she was also allergic to pollen and other inhalants and to nine foods, as well as being highly sensitive to chemicals. As a nurse, she used various antiseptics and disinfectants in her daily work. No one had ever considered that fumes from the scrubbing solutions had anything to do with her heart spasms.

After a long and laborious process, Dr Rea formulated immunization injections for her allergies to pollen and other inhalants, and her reactions to chemicals such as scents and fragrances.

Dr Rea comments, ‘When I first saw this woman, I thought she was having one continuous heart attack. But we’ve finally pulled her out of it. She’s having fewer spasms, and she’s much better now.’

In addition to receiving her injections, the woman has learned certain techniques to avoid the odours and fumes which give her trouble. In supermarkets, for instance, she bypasses the aisles with scented candles, laundry soaps and household cleaners – or she holds her breath as she quickly passes through those sections. She also carries a pocket-size negative ion generator with her, and is very careful to avoid foods to which she is allergic.

Although this case is highly unusual, Dr Rea feels that it fits in well with current medical understanding of the role of spasms in heart disease. He believes that in certain cases, coronary artery spasms are the blood vessel’s reaction to not only foods and chemicals, but to anything in the environment to which the individual is highly sensitive. He also thinks that reducing exposure to allergens in such people – especially massive exposure to chemicals in the home, work-place or shopping areas -takes a huge burden off the heart and fosters rapid recovery.

‘Susceptibilities gradually subside and the patient is able to return to functioning in the outside world,’ says Dr Rea. ‘However, a home oasis must always be preserved’ (Annals of Allergy).

(A ‘home oasis’ is a separate room that has been cleared of all possible sources of chemicals and other allergic offenders, sometimes with the help of an air filter.)

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Are canker sores really so impromptu? Or do they have a predictable, controllable cause?

A doctor in Dublin, Ireland, thinks that, for allergic people, canker sores tend to be a result of food allergy. Dr C.W.M. Wilson noticed that of a group of sixty-one people with hay fever, over half had a long record of canker sores. In one out of five of those people, specific foods were clearly to blame. (The most common offenders were milk, eggs, cabbage, turnips, parsnips, pork, wheat germ, tea and coffee.)

Dr Wilson feels that in allergic people, the tissues in the mouth serve as a barometer of allergic stimulation. The burning and tangy sensations that precede a canker sore signal that they’ve eaten a food to which they are allergic.

These sensations probably correspond to similar sensations in the skin associated with allergic eczema,’ says Dr Wilson. Incidentally, half of the canker sore sufferers also had gas, diarrhoea and other abdominal discomforts, plus fatigue – common symptoms of food allergy (Annals of Allergy).

Other doctors tell of a particularly stubborn case of painful, depressing canker sores that responded to food allergy treatment. Ever since birth, a thirteen-year-old girl had never been free of canker sores for more than three weeks at a time. She’d been given almost every drug in the book, to no avail. During an elimination diet to identify food allergies, she reacted to potato, coffee and chocolate. (Potatoes rarely cause allergy, but the girl had been eating raw potatoes daily all her life, thus potentiating an allergic reaction.)

‘After withdrawal of these foods, the canker sores healed and she has been completely free of ulcers for four months,’ report Drs Ronald Finn and H. Newman Cohen, of the Royal Southern Hospital in the Department of Medicine, at the University of Liverpool {Lancet ).

The foods blamed for canker sores in these two studies are by no means the only possible offenders.

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As it turns out, there is no scientific evidence of any kind demonstrating the ability of bee pollen to relieve allergies. Even if it works as well as some individuals claim, though, the risks clearly outweigh the potential benefit. Raw bee pollen may contain impurities such as insect hair, insect parts, mites, bacteria, fungi and pesticides – all potentially allergenic. And the pollen itself is a common asthma and hay fever trigger. Researchers at the Mayo Clinic and the Medical College of Wisconsin, in fact, report that three people developed severe allergic reactions after taking a single tablespoon or less of bee pollen.

So while bee pollen is a wonderful food for bees, it’s not so wonderful for people with allergies – especially those with any kind of pollen allergy.

Modern folklore also says that people with asthma or hay fever will suffer less during the pollen season if they eat local honey containing the pollen to which they are allergic. By taking one teaspoon to one tablespoon of local \ honey a day, some people swear that they get through the season with little or no symptoms. Presumably, the pollen immunizes them. However, there has been no medical research to back up those claims.

As far as hay fever goes, you’re much better off seeking relief from the safe, documented nutritional means.

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