What Is Hyperinsulinism?

Simply put, hyperinsulinism is the condition that results from too much
insulin being produced by your body. It's easy to see how this might happen when
you realize that there's a relationship between the kinds of foods you eat and
the amount of insulin in your bloodstream.

Foods rich in carbohydrates-especially sugar, honey, milk and fruit, which
contain simple sugars, and refined carbohydrates such as flour, white rice and
potato starch-are readily absorbed through the stomach, so they speedily convert
to glucose. When these foods are eaten in excess, they require a lot of insulin
for transport.

Foods made of protein and fat, on the other hand, require little or no
insulin. (Protein in excess converts to glucose in the liver and requires some
insulin to transport it to the cells; fat requires essentially none.) And what
happens when there is too much insulin?

As an overweight person becomes heavier, insulin's effectiveness may decline.
The cells become desensitized to the action of insulin so it can no longer
effectively transport glucose to them. This is known in medical circles as
insulin resistance, which quickly leads to hyperinsulinism.

Numerous studies have shown that insulin resistance is more prevalent among
the obese, although even some individuals who appear slim and healthy may
actually be insulin resistant. What appears to happen is that the insulin
receptors on the surfaces of the body's cells are blocked, which in turn
prevents glucose from reaching the cells for energy use.

That's one reason overweight individuals may be tired much of the time. When
insulin is ineffective in taking glucose into the cells, the liver converts more
and more glucose to stored fat. Your body is, in fact, becoming a fat-producing
machine instead of an efficient energy-producing machine.

Your body's hormonal system is now in desperate straits. At this point,
insulin is being secreted more and more frequently to deal with high blood-sugar
levels, and it is doing its job less and less effectively. Which makes you crave
sweets and carbs, which compounds the problem in a vicious cycle.

In time, even the insulin receptors that convert glucose to fat start getting
worn out, forecasting diabetes.

Here are some further reasons why high insulin levels can lead to big
problems:

  • Insulin increases salt and water retention, a recipe for high blood
    pressure.
  • Insulin is directly involved in creating atherosclerotic plaques, which,
    if not controlled, can lead to heart disease.
  • High insulin levels have been shown to correlate with high levels of
    triglycerides and low levels of "good" HDL cholesterol.
  • High insulin levels correlate with increased risk of breast cancer and
    polycystic ovarian syndrome. (Conversely, the lower the levels of insulin,
    the better the survival rates for breast cancer.)

Obesity increases insulin resistance. This means that you can sharply reduce
your risk of blood-sugar disorders-and by extension, heart disease and other
ailments-by simply keeping your weight down and controlling carbohydrate intake.
Even if you have a hereditary predisposition to diabetes, you may be able to
stall or completely avoid its onset.

Understanding the Importance of Insulin

Almost everyone knows that insulin is given to people with a certain kind of
diabetes, to help control their blood sugar levels when their own supplies
become depleted or insufficient. Insulin is one of the most powerful and
efficient substances that the body uses to control the use, distribution and
storage of energy.

At its most basic, insulin is the control hormone for glucose, a basic form
of sugar. So listen up. Your body is an energy machine, never resting, always
metabolically active-and it powers its operations mainly through the use of
glucose in the blood, which is why glucose is interchangeably called blood
sugar.

The body must maintain a certain level of glucose in the blood at all times.
So when there is no carbohydrate food source to make glucose, the liver will
actually convert protein to glucose.

Remarkably, even on a prolonged, total fast, a healthy body can maintain its
glucose level within a rather narrow normal range. As a general rule, of course,
the body obtains its principal supply of fuel from food.

What Happens to a Meal

You sit down at the table and consume a three-course dinner. Somewhere
between chewing and excreting, your body absorbs certain substances from your
food, mostly across the surface of your small intestine.

From the carbohydrate you eat, your body will absorb sugars, all of which
are, or quickly and easily become, glucose. From fat, it absorbs glycerol and
fatty acids, and from protein, it absorbs amino acids, the building blocks of
all cells.

Obviously, if you eat a lot of carbohydrate, you'll end up with a lot of
glucose in your blood. Sounds good, doesn't it? All that energy coursing through
your system. Eat sugar, starches and fruits and you're going to get those
blood-sugar levels up fast, aren't you?

If you love candy bars, perhaps you're saying, "That's great-the more I eat,
the more energy I'll have." Alas, a bad mistake. You see, the human body evolved
and primitive humans thrived as hunter-gatherers who subsisted primarily on
meat, fish, vegetables, fruit, whole grains and seeds and nuts. Candy bars were
few and far between.

The human body is used to dealing with unrefined foods as they occur in
Nature. Consequently, your body's capacity to deal with an excess of processed
foods is pretty poor, which is why our twenty-first-century way of eating so
often gets us into trouble. If you don't understand this yet, let's look at what
insulin and the other energy-controlling hormones do when you eat.

As Your Blood Sugar Rises

Consuming carbohydrates impacts your blood-sugar levels. The amount of
carbs-and the type-will determine how your blood sugar responds. For example, a
food full of refined sugar and white flour, such as a jelly doughnut, will raise
blood sugar much more dramatically than does a salad.

To be useful to your body, blood sugar has to be transported to your cells.
Think of insulin as the barge that transports glucose from your blood to your
cells. Once it reaches the cells, three things can happen to that glucose: It
can be mobilized for immediate energy; it can be converted into glycogen for
later use as a source of energy; or it can be stored as fat.

Let's delve in a little deeper. Insulin is manufactured in a part of your
pancreas called the Islets of Langerhans. As the sugar level in your blood goes
up, the pancreas releases insulin to move the sugar out of the blood. It then
transports the blood sugar to your body's cells for their energy needs.

But as we previously mentioned, when these needs are met the liver converts
excess glucose into glycogen, which is stored in the liver and muscles, where it
is readily available for energy use.

Once all the glycogen storage areas are filled, the body has to do something
with excess glucose. And here is the big revelation: The liver converts the
remaining glucose to fat, which becomes the "storage tanks" of fat on your
belly, thighs, buttocks and elsewhere. That's why insulin is called "the
fat-producing hormone."

Since fat is much more efficient-and has more capacity to store energy-than
glucose, we can store a lot more fat in our bodies than glucose. That, my
friends, results in obesity. And by the way, the main chemical constituent of
all this fat (the fat you're reading this book to get rid of) is triglyceride,
the very same triglyceride that, in your blood, can be a risk factor for heart
disease and stroke. Insulin is a pretty efficient worker.

If it were not, your cells could not get enough glucose, their basic fuel,
and blood-glucose levels would rise while the cells searched for other
fuels-first for protein in your muscles and organs, and then for fat in your fat
stores.

That's why people with poorly controlled, insulin-deficient diabetes can lose
weight when no insulin is present. And that's why a person on a low-calorie diet
may lose lean body mass. (This shouldn't happen on Atkins, where sufficient
calories and protein are consumed to meet the body's energy needs.)

On the other hand, excessive carbohydrate intake results in high amounts of
blood sugar and may, in turn, overstimulate insulin production. When this
happens, it causes a drop in blood sugar, robbing the body of energy for the
cells.

The result of the process is destabilized blood-sugar levels, quite possibly
causing fatigue, brain fog, shakiness and headaches. The body attempts to adjust
by liberating counter-regulatory hormones-such as adrenaline-to raise the
glucose level, but another stiff dose of insulin can overpower the effect of
those hormones.

Fortunately for most of us, this glucose balancing act takes place
automatically and our blood sugar stays in a fairly narrow, normal range.

But for some, the bodily insult of massive insulin release to deal with
massive blood-glucose levels has been going on for years, causing the
glucose-regulating mechanism in the body to break down, initiating unstable
blood sugar and eventually diabetes.

Dogs May Protect Kids From Allergies

Infants who live in a house with multiple dogs may be less likely to develop allergies later in life, according to a new study.

Researchers found that infants who live in a home with two or more dogs and a high level of certain types of a bacterial substance were a third less likely to develop wheezing in the first year of life than those who didn't live with dogs.

Wheezing in infants is associated with a higher risk of developing allergies and asthma later in life.

In the study, researchers looked at the effects of pet ownership on wheezing in more than 500 infants at high risk of developing allergies because at least one parent had them.

The results, published in the Journal of Allergy and Clinical Immunology, showed that wheezing was not independently associated with either dog or cat ownership, or a high level of indoor endotoxins.

Endotoxins are natural compounds produced by bacteria. Some believe exposure to these compounds may stimulate the immune system.

However, infants living in a household with two or more dogs and a high level of indoor endotoxins (measured from house dust) were a third less likely to develop wheezing than infants living without dogs.

"Our bodies are programmed to produce allergic responses early in life," says David Bernstein, MD, professor of immunology at the University of Cincinnati, in a news release. "But there are environmental factors like bacterial endotoxins that may modify the immune system and block development of allergies early in life.

"We do not yet understand how and why exposure to high levels of bacterial endotoxins and multiple dogs in the home exert a protective effect in these high-risk infants from wheezing early in life," says Bernstein.

Hot Water Removes Allergens Best

May 21, 2007 -- Hotter is better when it comes to killing dust mites and other allergens in your laundry.

A new study shows washing laundry in hot water (140 degrees Fahrenheit) kills 100% of dust mites. But turn the dial down just 36 degrees to a warm, 104 degree Fahrenheit wash and only 6.5% of dust mites are killed in the laundry. Hotter water was also better at removing dog dander and pollen.

But if your delicate laundry can’t take the heat, researchers also suggest another way to reduce dust mites and allergens in the laundry: wash at a lower temperature (between 86-104 degrees Fahrenheit) and then rinse the laundry twice with cold water for at least three minutes each.

In the study, presented at the American Thoracic Society’s 103rd International Conference in San Francisco, researchers compared the effectiveness of washing cotton sheets with regular laundry detergent at various temperatures in removing dust mites, dog dander, and pollen allergens.

The results showed that washing laundry at hotter temperatures was significantly more effective than warm water at killing dust mites as well as other allergens. For example:

  • Washing laundry in warm, 86- to 104-degree Fahrenheit water killed only about 6% of dust mites.
  • Hot water washing (at 140 degrees Fahrenheit) killed 100% of dust mites.
  • Washing in hot water also removed nearly 90% of dog dander compared with about 60% removed in warm water washing.
  • Hot water washing removed nearly 97% of pollen in the laundry compared with 69% at 86 degrees Fahrenheit and 95% at 104 degrees Fahrenheit.
  • The study also showed that steam cleaning of the sheets was equally effective as hot water (140 degrees Fahrenheit) washing at killing dust mites and removing dog dander and pollen.

In addition, researcher Jung-Won Park, MD, PhD, of Yonsei University in Seoul, South Korea, and colleagues found rinsing laundry twice in cold water was also effective at removing all traces of dog dander in laundry washed at any temperatures.

Herbal Remedy Soothes Seasonal Allergies

Jan. 18, 2002 -- A European study suggests that an obscure herbal supplement may be as powerful as the most effective antihistamine for treating the symptoms of hay fever, but an expert warns that it is way too soon to head to the health food store for it.

Researchers in Switzerland report that seasonal allergy patients treated with an extract of the botanical butterbur reported symptom relief similar to patients treated with the antihistamine cetirizine, known by the brand name Zyrtec. Butterbur -- also known as butter dock, bog rhubarb, and exwort -- grows in Europe, northern Africa, and southwestern Asia.

The 125 patients participating in the study were treated with either butterbur or cetirizine for two weeks and then were evaluated though questionnaires. Patients reported similar symptom relief with both treatments, and there were equal numbers of adverse reactions in both groups. Those treated with the antihistamine did report more drowsiness, however.

"Butterbur was well tolerated and did not have the sedative effects associated with antihistamines," the authors wrote in the Jan. 19 issue of the British Medical Journal. "We believe butterbur should be considered for treating seasonal allergic rhinitis, particularly in cases where the sedative effects of antihistamines need to be avoided."

But a California rheumatologist who has spent years searching for effective alternative therapies to treat allergies and asthma is not impressed by the study. M. Eric Gershwin, MD, of the University of California at Davis, says it does little to convince him that butterbur extract is either effective or safe for treating hay fever. Gershwin is a founder of The Center for Complementary and Alternative Medicine Research in Asthma, Allergy, and Immunology at UC Davis.

"Butterbur has been around forever, and it has been used for everything from treating migraines to urinary symptoms to asthma," Gershwin tells WebMD. "And a few years ago, there was a study suggesting that it inhibits testosterone. But the fact is, very little is known about its constituents and interactions with other drugs."

Gershwin says the European study was poorly designed and failed to answer basic questions needed to prove the efficacy and safety of butterbur extract. The European researchers acknowledge that more studies need to be done.

"There is a tendency to think that if something is natural, it is safe," Gershwin says. "But hemlock is natural. Socrates drank hemlock and died. Just because something is natural doesn't mean it is good for you."

So far, Gershwin says, studies evaluating alternative approaches to the treatment of allergies and asthma have proven disappointing. He adds that the best strategies for dealing with seasonal allergies are still avoiding environmental triggers and taking antihistamines.

"All kinds of things have been tried for hay fever, but nothing looks very promising," he says.

Relieve Allergies the Natural Way

If spring and fall send your seasonal allergies into a spin, many experts say look to Mother Nature for relief that can be as comforting and easy as a day at the beach.

Whether it's the long-awaited change of winter into spring, or the quiet fading of summer into fall, for many folks the changing of the seasons means more than just vacation plans and a new wardrobe -- it signals the start of seasonal allergies.

Sneezing, wheezing, runny nose, and itchy, watery, red eyes -- these are just some of the symptoms that more than 35 million Americans face each year as the pollen from trees, grass, flowers, and plants makes it way into the air.

For many, relief is just a drugstore counter away -- with a wide array of traditional medications available to help. However, for an increasing number of allergy sufferers the road to relief is best paved by Mother Nature, with a variety of all-natural treatments that studies show can help -- often without many of the troubling side effects ascribed to traditional care.

"Using nature-based products can be a very useful way to handle mild allergies and a useful adjunct for more significant allergies, and there are many types of treatments you can safely try," says Mary Hardy, MD, director of integrative medicine at Cedars Sinai Medical Center in Los Angeles.

Among those generating the loudest buzz right now is the European herb butterbur (Petasites hybridus), which, says Hardy, "has had some very impressive clinical trial results."

In one study, published recently in the British Medical Journal, a group of Swiss researchers showed how just one tablet of butterbur four times daily was as effective as a popular antihistamine drug in controlling symptoms of hay fever -- without the traditional symptom of drowsiness that sometimes occurs. In a second study, presented at the 60th annual meeting of the American Academy of Allergy, Asthma, and Immunology (AAAAI), a group of British researchers put their stamp of approval on butterbur's effectiveness in quelling symptoms of grass allergy.

Other herbal supplements proving helpful, says Hardy, include freeze-dried nettles and a tonic made from the herb goldenseal, which she recommends adding to still one more natural treatment -- a saline (salt water) nasal spray.

"The saline works to wash out pollen and reduce or thin mucous -- the goldenseal has astringent and local antibacterial properties which can aid in this process," Hardy tells WebMD.

In addition to herbs, many naturopathic doctors also believe certain nutrients can be helpful in quieting seasonal symptoms. Among the most popular are grape seed extract and a flavonoid compound known as quercetin. Although both occur naturally in many foods -- and are especially abundant in red wine -- when used in supplement form they can be extremely helpful in reducing allergy symptoms, particularly in conjunction with vitamin C, says James Dillard, MD.

"There is even some evidence that quercetin may control the release of histamine and other chemicals that help initiate the allergic response," says Dillard, clinical advisor to Columbia University's Rosenthal Center for Complementary and Alternative Medicine, and assistant clinical professor at Columbia University College of Physicians and Surgeons.

Turning the focus from the medicine chest to the kitchen cabinet, you might want to try cooking up some allergy relief in the form of hot, spicy foods. The reason: Experts say the spicier the dish, the more likely it is to thin mucous secretions, which in turn can clear nasal passages. Among the most frequently recommended spices for this purpose include cayenne pepper, hot ginger, and fenugreek, as well as the traditional onion and garlic.

Interestingly, what you don't eat may be even more important than what you do eat. The reason, according to Hardy, is that food intolerance may be far more intimately entwined with seasonal allergies than we realize.

"You have to really look at your diet and cut out any foods that seem to provoke even a mild sensitivity, such as occasional hives or even stomach upset, " says Hardy. In doing so, she says, you can literally lighten the burden on your immune system, which in turn may help reduce the impact of seasonal allergic reactions.

According to New York University allergist Clifford Bassett, MD, if you suffer from ragweed or other weed pollen allergies, "you should avoid eating melon, banana, cucumber, sunflower seeds, chamomile, and any herbal supplements containing echinacea, all of which can make symptoms much worse," he says.

Seasonal Allergies From the Inside Out

If your seasonal allergies are causing you to spend more time indoors than out, you may be tempted to try an air filtration system, which many say can remove irritating dust and pollens from your personal space, and in the process improve seasonal allergies. But according to a recent report from the Agency for Health Care Research and Quality, while these sometimes-costly units may clear the air, once an allergy is in progress they don't appear to have much impact on symptoms.

What may work somewhat better, however, is donning a paper dust filter when outdoors in high pollen conditions.

In addition to whatever natural treatments you try on your own, you may also find significant relief visiting a practitioner of the ancient Chinese medical practice known as acupuncture. Based on the idea that stimulating points outside the body can change or initiate reactions inside, in this case treatment is thought to affect the immune system, where allergic reactions begin.

In a small but significant study of 26 hay fever patients published in the American Journal of Chinese Medicine, acupuncture reduced symptoms in all 26 -- without side effects. A second study of some 72 people totally eliminated symptoms in more than half, with just two treatments.

"Acupuncture can be particularly useful if you are suffering from multiple allergies, since it works to quiet the areas of the immune system that are overstimulated by exposure to multiple irritating factors," Dillard tells WebMD.

Though many nontraditional treatments can be extremely helpful, allergist Marianne Frieri, MD, cautions that natural doesn't always mean better -- or safer. She points out that it's possible to overdose on even the most seemingly mild preparations, and it's important to remember that almost anything in nature's pharmacy could cause a toxic reaction if you use too much.

More important, she says, is never to mix alternative treatments with traditional drugs without your doctor's approval.

"If, for example, you are taking the allergy drug Allegra -- an antihistamine -- at the same time you decide to try a natural substance with antihistaminic properties, you can end up with far too much antihistaminic activity -- which can result in some significant problems," says Frieri, chairwoman of the department of allergy and immunology at Nassau University Medical Center in East Meadow, N.Y.

In addition, both Hardy and Frieri caution that if allergies are moderate to severe, you should not self-treat -- even with seemingly benign natural products -- without checking with your allergist first. When you are ready to try some alternative care, Hardy says one key to success is starting treatment before allergy symptoms kick in. The ideal time to begin, she says, is "three weeks before allergy season is scheduled to start."

Is Conventional Testing Important?

Conventional testing of allergies remains an important part of any workup in a patient. Most of my patients have already been tested before they come to see me. I just review the testing to ensure that they have been tested correctly. Allergy testing can confirm a reaction to clinically suspected allergens.

If you do undergo allergy testing—and I highly recommend that you do—here are the main points to keep in mind:

  • Percutaneous testing should be done first.
  • Intradermal testing should be done on anyone over thirty or on anyone who tested negative to the percutaneous test, especially if the allergen is highly suspicious.
  • Percutaneous and intradermal testing must be performed and interpreted by an experienced practitioner.
  • In vitro antibody testing (RAST) gives little useful information, so I recommend that you not have it done.
  • If something tests positive, then do everything you can to avoid it—even if it means drastic changes in your life.

Despite their importance in helping to diagnose your problem, these conventional tests usually show positive for the same things in most patients: molds, dust, grasses, pollens, and cats. I would say that most patients have had these tests and have been found to be positive to at least one of those five things. That information never did them any good.

While it is true that most of us are allergic to these things, there is something missing in the diagnostic process. I have seen too many patients who eliminate these things from their environment, and still suffer.

Diagnosing Your Allergies

Since allergies play such a significant role in lost productivity, increased healthcare costs, and simply making your life miserable, it is important to determine which allergens are responsible for specific diseases, so the proper medical decisions can be made.

 Allergy testing has serious limitations, and the diagnosis of an allergy to a specific allergen cannot be made on the basis of testing alone. Your history is just as critical to the diagnosis. The basic conventional forms of allergy testing include percutaneous testing, intradermal testing, in vitro antibody testing, and delayed hypersensitivity testing.

Percutaneous Testing

This is the skin prick testing most of us are familiar with. The basic mechanism behind skin testing is the interaction of the injected allergen with specific IgE antibodies on the surface of your skin mast cells.

This injection will trigger the release of histamine and the formation of a wheal and flare at the site. A wheal is the swelling you see; a flare is the redness. This reaction usually will occur within fifteen minutes after the allergen is introduced. This test remains the primary diagnostic procedure to determine the cause of allergies in this country.

Most practitioners perform this test on the back of the forearm, the upper arm, or the upper back. The upper back is by far the most sensitive but is not used as often. Certain guidelines should be followed to ensure that the test is done properly. For example, each allergen must be a certain distance apart, never done near the wrist or the elbow, and skin testing should never be performed on sites of active skin flare-ups such as dermatitis or hives.

Your doctor should use both positive and negative controls. A negative control tests the diluent that the allergen is in, to make sure you are not allergic to that rather than to the allergen. A positive control is usually histamine itself, to ensure that your body’s immune system is giving an adequate response.

The prick test can be performed in patients as young as one month of age, although this is quite rarely done. Allergen skin reactions start to decline in adults after one’s twenties, due to decreased skin reactivity to histamine and lower IgE levels. Therefore, if you are older than this when this test is done, you may get many false negative results.

This test is also limited because it measures only a clinically immediate IgE hypersensitivity. If you do not have an IgE-mediated allergy, the test will be negative, and your doctor will tell you that you are not allergic to a certain substance.

The test is also dependent on the person performing the test. Such factors as the exact amount of allergen used, the depth and force of the needle, the duration of force, the angle of application, and the stability of the allergen extracts are all variables that can cloud interpretation of the test.

Use of antihistamines should be stopped twenty-four to seventytwo hours prior to taking these tests; use of tricyclic antidepressants and benzodiazepines (Valium and similar substances) need to be stopped for seven to fourteen days beforehand; use of systemic corticosteroids and topical steroids should be stopped up to three weeks prior to any testing.

It is believed that nonsteroidal medications such as ibuprofen do not interfere, but I always advise my patients to stop use of these as well. You do not want anything to interfere with the accuracy of your test results. It is better to get a proper test result than one that does not give you the correct information.

Intradermal Testing

This is used when skin prick testing is not deemed sensitive enough to detect the cause of an allergic reaction. This is usually what happens when a patient tests negative on a prick test but has a strong clinical history of symptoms triggered by exposure to a specific allergen. This should also be used in patients for whom skin prick testing is not valid, as in anyone over thirty.

However, skin prick testing usually is done first, to avoid a systemic allergic reaction, which may be quite serious. Intradermal testing is performed through injection of an allergen extract that is diluted a hundred to a thousand times of what would be given in a skin prick test.

It is injected into the back of the forearm or on the upper arm. Swelling occurs immediately; changes in the size of the swelling and the redness are measured after twenty minutes.

This test also has limitations because small positive reactions may actually not be reactions, and positive and negative controls must be used so the test is interpreted properly. Despite their many drawbacks, percutaneous testing and interdermal testing are the most widely used conventional allergy tests.

In Vitro Antibody Testing

The first test of this kind was the RAST (radioallergosorbent test). It is a simple blood test that measures the amount of IgE that binds to a specific allergen versus the amount of IgE that doesn’t. This test can be used in patients for whom skin testing cannot be performed, such as those who cannot stop taking their medications, those with severe skin conditions, and those who have near-fatal reactions to certain offending substances.

The main disadvantage of this type of test is that there is no uniform method for reporting results, making separate tests not comparable to each other and difficult to use in clinical practice with any certainty. I hardly ever recommend this test because of its lack of useful information.

Delayed Hypersensitivity Testing

Whereas skin prick tests measure IgE immediate hypersensitivity responses, delayed hypersensitivity testing uses patches to measure type 4 delayed hypersensitivity. A clinical example of this involves contact dermatitis.

The antigens that cause this type of reaction are found in cosmetics, jewelry, household cleansers, and similar products, as opposed to pollens and foods. This test is performed by applying various materials to an absorbent pad, which is then placed on your skin, usually your back.

The site is then checked at forty-eight and at seventy-two hours after application. A positive response is characterized by redness and swelling. Most of us have taken a test like this such as for tuberculosis—a PPD.

Food Allergy

There are many foods that can cause true allergies. These can be lifethreatening and are quite common. A food allergy occurs through an IgE-mediated response similar to what I have previously described.

The most common symptoms of a food allergy are vomiting; stomach pain; asthma attack; breathing difficulties; headaches; joint swelling and pain; hives; itchiness; diarrhea; and, in the worst cases, anaphylaxis. Some minor food allergy symptoms can be a tingling sensation in the mouth or a swelling of the tongue.

Some people are so allergic to certain foods that they will get a reaction if the food is simply in the room, or if their skin comes into contact with the food. Sometimes patients may even have reactions to food residue on restaurant tables and chairs.

Ninety percent of all food allergies are to milk, peanuts, soy, eggs, nuts such as cashews, almonds, or walnuts (peanuts are actually legumes), shellfish, fish, or wheat. Peanuts, fish, shellfish, and nuts usually cause the most severe reactions.

Peanut allergies are increasingly common, and this is especially important in school-age children because peanuts are in so many foods. It is not just the peanut itself that can cause the allergy but also peanut oil, peanut sauce, and anything that contains peanuts.

Peanut oil is so commonly used that it may be one of the ingredients in your food, so check labels. Peanut allergies are usually so severe that if a pot had peanut oil in it prior to your use, a reaction may occur. Peanut allergies are very common, and the reactions tend to be the most severe. Peanuts are responsible for 63 percent of all food-allergyrelated deaths.

For this type of severe food allergy, I recommend three things:

1. Prepare for an emergency. Should a situation arise where the allergy occurs, you and/or your child should know immediately what to do. In the case of a young child, let the school or sitter know exactly what to do and send written instructions with the child so there is no confusion.

2. Very careful shopping. Read food labels very carefully. Know what is in everything that you buy or that your child is buying at school or in a store. If you don’t know what is in a particular item and the school or store can’t tell you, do not buy it. Always carry a snack for yourself or your child in case there is nothing else available. This especially holds true for airline travel. Never get caught unprepared.

3. Carry an Epi-pen. This is a disposable cartridge that carries the drug epinephrine. Learn how to use it, and teach anyone, including your child, in its proper use. This is something you get a prescription for from your doctor.

Allergic Rhinitis or Hay Fever

Although the name may be a misnomer since this rarely produces a fever and hay has nothing to do with it, hay fever affects millions of people. Most people are allergic to pollens, and that is why the symptoms are seasonal.

The most common offenders are trees, grasses, and ragweed. The timing of the symptoms is variable due to where you live. Other common offenders are weeds, dust mites, and mold spores.

The symptoms of allergic rhinitis can make us very uncomfortable. Nasal congestion is usually the most troubling of the symptoms— it can affect our speech and give us a dry mouth. Other symptoms include a runny nose, and swelling and inflammation of the mucus membranes.

This inflammation causes sneezing, itchy eyes, itchy and scratchy throat, and loss of smell and taste, all of which can make life miserable for a hay fever sufferer. Most people also get a clear mucus drainage that leads them to blow their nose all day and to get a red nose from the irritation.

Allergic rhinitis symptoms also include the following characteristics:

  • intermittent symptoms that are either seasonal, food-related, environmental, or emotionally triggered
  • symptoms are relieved with antihistamines, food elimination, environmental elimination, or stress reduction techniques
  • symptoms are persistent or perennial
  • postnasal drip, sore throat, cough, hoarseness, wheezing or difficulty breathing, and/or skin rash
  • dark circles under the eyes
  • symptoms are usually preceded by a personal or family history of allergies, eczema, or asthma