Allergy and Immunology Treatments

Featuring: Ranjeet Minocha, Sam Weiss
Doctors Ranjeet Minocha and Sam Weiss explain what allergies are, how you can be tested for them and what type of treatments are best.

Profile:

Ranjeet Minocha, MD, is Board Certified in Allergy and Immunology. After graduating from the prestigious Physician-Scientist Program at Rensselaer Polytechnic Institute (BS) & Albany Medical College (MD), Dr. Minocha completed his residency in Internal Medicine at the University of Chicago, Northshore. 

Learn more about Ranjeet Minocha, MD 

Dr. Sam Weiss, MD is a Allergy & Immunology Specialist. Dr. Weiss has more experience with Upper Respiratory Conditions and Environmental Allergies than other specialists in his area.  He graduated from Creighton University School Of Medicine medical school in 1980. 

Learn more about Sam Weiss, MD

Transcription:

Bill Klaproth (Host):  So, what are allergies? Why do some people have allergies and others don't and what type of allergy therapies or treatments are there? Well let's talk about allergy and immunology treatments with Dr. Sam Weiss, and Dr. Ranjeet Minocha, Board Certified in Allergy and Immunology at Eisenhower Health, Healthcare As It should Be. Dr. Weiss, we're going to start with you. First off, what are allergies and why do some people have allergies and others don't?

Sam Weiss, MD (Guest):  Allergies overall are an overreaction to something in your environment.  we think that the immune system years and years ago, in early humans, was probably related to this point of contributing to allergies is probably related to fighting infections such as parasitic infections and over the years, we've had less and less need for that part of the immune system and may be that it's now turning towards overreacting to something in our environment. So, that can be of many things whether it's pollen or whether it's foods. It's just an overreaction, a product of humankind and how we are evolving.

Host:  And since we're all different then, we are all individuals, that would make sense to then why some react, and some don't. and Dr. Minocha, what symptoms then might prompt someone to see an allergist?

Ranjeet Minocha, MD (Guest):  Believe it or not, allergies can be quite debilitating for a lot of people and can involve more than just the occasional runny nose or itchy eyes. So, if you are an individual that really suffers from more severe symptoms and simple over the counter medications aren't really doing the trick; that's a really great reason to see an allergist. Sometimes if you are just curious to find out what you're allergic to, are you really allergic to that cat or dog of yours at home, we can give you those specific answers and then we can also provide you with better solutions and treatment options. So, there's really a number of things that we can do to really help.

Host:  So, let's talk about those things. How do you ten test for allergies?

Dr. Minocha:  Yeah, our most common method is where we physically place an allergen drop on your skin to see if you react to that particular substance. While you can also obtain blood tests, we know that our skin tests are a little bit better and correlate to your symptoms more than the blood tests. Those are highly specialized tests typically performed in an allergist's office.

Host:  Got it. So, then once it's determined that the person has allergies, what types of allergy therapies or treatments are there?

Dr. Minocha:  Well certainly we can optimize a person's medical regimen with various prescription and over the counter allergy pills and nasal sprays however, really our allergy shots are a unique treatment in our field. I think it's one of the only fields where we can give you the very thing that you are reacting to and sort of desensitize your body and that's what the idea behind an allergy shot is.

Host:  So, then I hear this term immunotherapy. Dr. Minocha, what is accelerated immunotherapy?

Dr. Minocha:  Yeah, so immunotherapy is synonymous with allergy shots and while they are remarkably effective as I allude to earlier; it can be quite cumbersome for the patient. Sometimes we could desensitize your body, we ask a patient to come in almost once a week for almost a whole year and a lot of you out there may be thinking that's quite a time commitment and it certainly is. With our accelerated forms of allergy shots or immunotherapy we are able to condense that nearly one year of coming in to the office to six to eight weeks. So, that's quite a dramatic improvement in terms of your time commitment. Not only that, we get you feeling better so much quicker. I really think it's a game changer for folks suffering with allergies.

Host:  When you can crunch the time down to six to eight weeks versus a year; that is a huge benefit and we know how immunotherapy really can help people. And Dr. Weiss, let me ask you this. So, what is the difference then between allergies that we've been talking about and asthma? How common is asthma?

Dr. Weiss:  You can think of allergies and asthma being this process of the respiratory tract, basically goes from your nose all the way into your lungs. So, in some ways, there are some similarities but there's also some differences. You can have allergies and asthma together, but you can also have asthma and have no underlying allergies at all. So, we are not 100% sure about the genetics that contribute to that, but it is very common for - for example genetically about one out of four people will have allergies in the United States if one of their parents has allergies. And if two parents do that's well over 50%. As far as the incidence of asthma, one in thirteen people in the United States have asthma. That's about 8% of the children, the population of children and 7.7% from what I looked up in adults. So, these are very common illnesses that have a very significant socioeconomic burden for the population of the United States.

Host:  So, then let's talk about bees then Dr. Weiss, a common venom allergy is to bee stings. What can someone do if they are allergic to bees and when is an EpiPen important to carry?

Dr. Weiss:  Sure. The incidence of bee stings which is - goes along with wasps, hornets, yellow jackets and particularly in southern California, fire ants are also a problem. There's between 60 and 100 deaths per year still with these types of insects which we call Hymenoptera. Most common thing to do is to try to avoid these types of insects obviously. There are certain things you can do such as realizing that they are attracted to shimmering water, if you are in a pool. They are attracted to bright colors. The best colors to wear are tan and white as far as not attracting these types of bugs. Getting away from odors and smells like in backyard barbecues. So, some basic things can minimize exposure and attracting them to you but there are so many people in the United States that have potential problems including deaths from these types of stings. As Dr. Minocha was discussing before, for immunotherapy, for pollen allergies and animal allergies we can do the same thing for these types of insect allergies and they are overall extremely beneficial and effective.

Host:  And then Dr. Minocha, how common are drug allergies? When does that come into play?

Dr. Minocha:  Drug allergies are quite a bit common. We believe it affects 10% of the population worldwide and up to 20% of hospitalized patients and really, they come into play especially anytime you open up a patient's medical chart, you'll almost always see any medication allergies listed in there. And often what we find is that patients are not allergic to these medications or drugs and are avoiding these things unnecessarily. I think one of the important services that we can provide as allergists is testing for some of these medications and I think one of the most important services we provide is specifically for penicillin antibiotics which represents the most common class drug allergy in the united States. And through our testing process, we are successfully able to tell patients that they are no longer allergic to penicillin or really whatever medication that is in question and be able to open up a whole new window for them and we think it's improves public health drastically as well. And combats the antibiotic resistance [00:08:08]

Host:  Yeah that's really an important fact. That's good to hear. So, if we could quickly, let's talk about food allergies. So, Dr. Minocha, what are the most common types of food allergies and do children generally outgrow food allergies?

Dr. Minocha:  That's a complicated question. Most common food allergen currently is to peanuts. When we're talking about food allergies, we generally group them into sort of kids and adults. But worldwide and in the United States, peanut is the most common. And in children, that's followed by milk. Shellfish tends to be more common in adults though. In terms of outgrowing food allergies, it is entirely dependent on what foods we're talking about. Peanut for example there's about a 30% chance that one will outgrow it. So, you can imagine that the odds are not great. But there are new therapies not only on the horizon but that have just been approved to help people with food allergies that they are not outgrowing. Akin to the immunotherapy for environmental and venom allergies we now have solutions for those with food allergies. I think that's probably one of the more exciting things in our field right now.

Host:  Well it affects so many people so, it's interesting to hear that there are new and exciting ways to combat this. So, that is really important. And then as we wrap up, Dr. Weiss and thank you both for your time. If we could just touch on eczema and dermatitis. Are those allergies and what's the difference?

Dr. Weiss:  Eczema is another word is atopic dermatitis. It's one of the more common skin conditions that you find in young children. And it's the what we call the atopic march oftentimes. What do I mean by that? Frequently, you'll see eczema present in young children and then as the years go by, it will proceed to development of food allergies, the development of allergic rhinitis and development of asthma. Managing atopic dermatitis in young children is an early predictor that we're going to see other types of the atopic march as they grow older. As Dr. Minocha was talking about, the new and exciting management of medications, the same thing holds true for eczema both in children and adults, monoclonal antibodies have come available which are basically smart bullets. They are particular proteins that have been developed against one specific type of protein that researchers have shown contributes to the inflammation of the skin. One particular medication particularly is Dupixent. It's a remarkable success story as far as one of these new smart bullet types of medications that has dramatically improved the lives of patients with eczema.

Host:  Well, again that is really good news to hear and thank you both. This has really been a broad discussion about allergies, and I know it can be really complicated underneath that umbrella so, thanks for clearing some of this up for us and explaining this to us. Dr. Weiss and Dr. Minocha, thank you both for your time. We appreciate it.

Dr. Weiss:  Thank you.

Dr. Minocha:  Thank you.

Host:  That's Dr. Sam Weiss and Dr. Ranjeet Minocha and to learn more, please visit www.eisenhowerhealth.org/allergyrelief. And if you found this podcast helpful, please share it on your social channels. And be sure to check the entire podcast library for topics of interest to you. This is Living Well with Eisenhower Health. I'm Bill Klaproth. Thanks for listening. Eisenhower Health, Healthcare As It Should Be.
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