Cure Your Allergies

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It’s allergy season again (does allergy season ever end in Hampton Roads?) If you suffer from allergies, you may be miserable with itchy watery eyes, runny nose, sneezing, sore throat, cough, sinus headaches, earaches, dizziness, and fatigue. You may also get frequent colds, ear infections, and sinus infections. If you have asthma, allergies can cause frequent flares and even trips to the emergency room. Allergies can make eczema worse and cause other allergic rashes, like hives. If you have food allergies, they may worsen during allergy season.

You may have considered allergy shots or even tried them.  Allergy shots are a form of immunotherapy: giving yourself tiny doses of the things that you’re allergic to on a regular basis for several years until your allergies resolve. Allergy shots are extremely expensive, around $10,000 per year. Allergy shots are inconvenient because you have to visit your doctor once or twice a week to get a shot. Allergy shots have a low success rate, probably because it’s so challenging to keep hundreds of doctor’s appointments and get hundreds of shots.

There is another form of immunotherapy which is much more effective, convenient and affordable: sublingual immunotherapy. These are drops which you place under your tongue several times per day. It’s pain-free and easy and does not require any trips to the doctor. 70% of those who complete sublingual immunotherapy cure their seasonal allergies, pet allergies and even mild food allergies. My patients can obtain allergy testing and treatment for less than $800 per year! There’s no need to continue suffering. Contact me today to get started.

Should I Get a Flu Shot?

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I know that many people do not get an annual flu shot.  Some people hate to get it because they feel sick afterwards.  Others are just frustrated that even after getting a flu shot, they still get the flu.  Let me share some information about the flu shot and why I get one every year myself and make sure that my husband and children get one as well.

The flu shot contains proteins from several strains of the influenza virus.  Since the vaccine does not contain the virus itself, you cannot get the flu from the flu shot.  You may experience some flu-like symptoms after getting the flu shot, which is a sign that your immune system is making antibodies against the flu.

Every year, an educated guess is made about which strains will be the most common, and the flu shot will be more or less effective depending on the strains chosen.  If you develop antibodies against a particular strain of influenza and encounter that strain, you will not get sick.  If you encounter a different strain of influenza, you may still have partial immunity based on the antibodies that you do have. Although you may get the flu, you will experience milder symptoms and will not be at risk of severe complications and death.  If a COVID-19 vaccine is made available, it will have the same issues as the influenza vaccine due to multiple strains of SARS-CoV-2.

So, I get the flu shot for myself and my family to protect against hospitalization and death.  I also hope, as a bonus, that we won’t get the flu at all.  Last year, my entire family got the flu despite the flu shot, but our illnesses were brief and mild.  I had fully recovered within two days.

Last flu season was a terrible one with an estimated 56 million cases of influenza in the US with 740,000 hospitalized and 62,000 deaths.  In January 2020, there were so many patients hospitalized with influenza in Hampton Roads, that none of the hospitals had available beds.  I fear that next flu season will be even worse due to high numbers of both influenza and COVID-19 patients requiring hospitalization.

Preventing Severe Complications of COVID19

The virus which causes COVID19 can produce severe inflammation called a cytokine storm, which can then set off a chain reaction which results in thrombosis (tiny blood clots), which can damage all of the organs in the body.  This process is known as DIC (disseminated intravascular coagulation).  As we age, we become more prone to thrombosis, which is why heart attacks and strokes are more common among the elderly.  Men are more prone to thrombosis than women.  Certain medical conditions put you at higher risk of thrombosis, including high blood pressure, high cholesterol, and diabetes.  Smoking and eating processed foods increases the risk of thrombosis as well.

These are the reasons why COVID19 poses a higher risk for the elderly, for men, and for those with certain chronic medical conditions.  If you have one of these conditions, the best thing you can do is to keep that condition under good control by taking your medication, eating healthy foods, exercising, avoiding smoking, and getting plenty of sleep and water.

For these same reasons, medications which lower your risk of heart attack and stroke seem to prevent COVID19 complications, such as statins like lipitor, ACE-inhibitors like lisinopril, and anti-coagulants such as aspirin and Plavix.  N-acetyl cysteine and Vitamin C also help to decrease inflammation within blood vessels and prevent thrombosis.  On the other hand, medications which increase your risk of heart attack and stroke, such as ibuprofen and other NSAIDs, also increase your risk of COVID19 complications.  If you have cold or flu symptoms, you should avoid taking NSAIDs for fever and body aches and stick to Tylenol.

Antihistamines like Claritin decrease inflammation, and Claritin seems to help with COVID19 prevention.  Vitamin D helps to suppress inflammation as well.  In fact, Vitamin D and antihistamines decrease inflammation by the same molecular pathway as chloroquine.  Zinc prevents viruses from replicating, so it is helpful in preventing COVID19.  One of my colleagues works at one of the leading infectious disease centers in the US, and they are recommending the following regimen to all of their medical students and residents: Claritin 10 mg once daily and a multivitamin three times daily, in order to get adequate Zinc, Vitamin C and Vitamin D.  Although I do not typically recommend daily multivitamins, during this pandemic, I am taking and recommending this regimen.  Although the benefits have not been proven, the potential benefits outweigh the minimal risk of taking these supplements.

Treating COVID19 with Hydroxychloroquine and Azithromycin

I have received many questions about azithromycin and hydroxychloroquine.  These medications have been on the news, and some politicians and reporters are touting them as miracle cures.  At this time, these medications are being used experimentally for treating COVID19, mostly on hospitalized patients with severe disease.  The studies which have been done are small with mixed results.  Hydroxychloroquine and chloroquine are currently being investigated in randomized controlled trials, but at this time, we cannot say with any certainty whether these treatments work.

Azithromycin, chloroquine, and hydroxychloroquine all have anti-inflammatory properties.  Azithromycin is an antibiotic, which means that it is used to treat bacterial infections and has no effect on viruses, including corona viruses.  However, azithromycin is given to patients with certain inflammatory lung conditions to clear up the inflammation.  Hydroxychloroquine and chloroquine are used for treating and preventing malaria, a parasite which attacks red blood cells.  Hydroxychloroquine is also used in treating autoimmune inflammatory conditions such as rheumatoid arthritis and lupus.  Hydroxychloroquine may actually help to prevent the COVID19 virus from entering our cells.

The majority of patients with COVID19 have mild cold symptoms and do not require any special treatment, but certain high-risk individuals develop severe inflammation which affects lung function, sometimes requiring a ventilator.  Azithromycin and hydroxychloroquine have been used together to treat severe cases of COVID19.  Both medications can cause very serious side effects, including a fatal heart arrhythmia.  This particular risk increases when the two medications are taken together; however, hospitalized patients have continuous heart monitoring.  A local hospital was previously treating all COVID19 patients with both azithromycin and hydroxychloroquine and is now only using hydroxychloroquine.  It is unclear whether this change was made due to the complications of taking these medications together or because azithromycin was shown to be ineffective.

At this point, I feel that the risks of taking these medications for prevention or for treating mild cases of COVID19 outweigh any benefits.