Understanding Allergies And How To Deal With Them By: Dr. Douglas K. Schreiber MD, FACAAI http://www.AllergistHoustonTX.com http://www.KatyAllergyAndAsthma.com http://www.CopperfieldAllergyAndAsthma.com Like Us On Facebook and Share This Book With Your Friends http://www.facebook.com/DrDouglasSchreiber 1 Table of Contents Introduction .................................................................................................................. 3 What is an allergy? ..................................................................................................... 4 Recognizing some more common allergens ....................................................... 6 How do allergic reactions manifest themselves? .............................................. 9 Why do some people develop allergies while others do not? ..................... 11 Hereditary factors ................................................................................................. 11 Environmental factors.......................................................................................... 12 Other possible causes of allergies ................................................................... 14 The conclusion ....................................................................................................... 15 So, what’s next? ........................................................................................................ 17 Diagnosing your condition.................................................................................. 17 Treating allergies................................................................................................... 19 Conclusion ................................................................................................................... 21 2 Introduction Thank you for requesting this free guide to understanding allergies and how to deal with them. Given that suffering an allergy is an increasingly common complaint nowadays, almost everyone is familiar with the general concept of what an allergy is. Indeed, being allergic to something or other is so commonplace that it is not even impolite to talk about it around the dinner table! Nevertheless, there are many misunderstandings and false beliefs about allergies. Consequently, my primary objective in this report is to dispel many of the more common myths and mysteries surrounding allergies, what they are and what they are not. Most importantly of all, I am also going to highlight exactly what you should do if you believe that you might be suffering from some form of allergy or allergic reaction. I understand that this is vital information that you need and that you need it as quickly as possible. So, let’s get going! 3 What is an allergy? According to the widely respected Dorland’s Medical Dictionary for Healthcare Consumers, an allergy can be defined as “a state of abnormal hypersensitivity acquired through exposure to a substance called an allergen; re-exposure reveals a heightened capacity to react”. In simple terms, allergies are caused by the reaction of your immune system to a substance or situation which should not cause any problems under normal circumstances. If you had no allergy, there would be no reaction to this particular substance but because it has become an allergic trigger for some reason, your immune system releases chemicals that cause the allergic episode. The normally harmless substances that cause allergic reactions in those who are susceptible to them are known as allergens. These allergens cause a reaction because an allergic person suffers hypersensitivity, more specifically what is known as a Type I reaction or an immediate hypersensitive reaction. What this means is that in the presence of an allergen to which you react badly, your body is allowing the allergen to react with a form of protein known as immunoglobulin, namely IgE or immunoglobulin E. This causes the excessive activation of certain white blood cells that under normal circumstances defend your body against infection and attack. In the case of an allergic reaction however, the overproduction of protective white blood cells results in the production of histamines and leukotrienes resulting in an inflammatory response, often an excessive one. Some authorities now suggest that the explanation linking IgE to all forms of allergy may be an oversimplified one as it appears increasingly apparent that many areas or aspects of your immune system might be involved in any allergy that you have. For example, MedicineNet.com reports that current research indicates that other cells is the immune system known as T and B cells appear to play a role in the development of allergies. Leaving aside the intricacies of medical science however, the main point to understand is that an allergy is an indication of an abnormal reaction in certain parts of your immune system to a trigger that for most people is entirely harmless. 4 In effect, when you suffer an allergic reaction, your immune system is sending out a false alarm signal which triggers an equally false reaction to the imaginary invader. Hence you have a situation where one person has an immune system that sees a particular allergen as a would-be invader whereas the person stood next to them has an immune system that does not. The final thing to reiterate is that an allergy is a condition that your body ‘learns’ or acquires. In other words, the very first time you are exposed to any particular allergen, your immune system is not going to react to it. However, as a result of this initial exposure, your body might learn to react badly to that particular substance in the future. 5 Recognizing some more common allergens As our knowledge of exactly what causes allergies is never likely to be 100% complete and because every individual is different, the causes of allergic reactions vary from person to person. Nevertheless, there are some allergens that are widely recognized as presenting the greatest threats. To begin with, there are airborne allergic threats such as pollen, airborne chemicals and dust. As these substances are in the air, symptoms tend to arise in areas of the body which are in contact with it like your eyes, nose and lungs. When you are outside, it is difficult to avoid ingesting airborne pollution from the surrounding traffic and industry in the town and cities, whereas in more rural areas, pollen and other plant produced allergens will be very difficult to avoid. However, even when you are indoors, you are not safe from airborne allergens. In fact, the complete opposite may very well be true. Most houses and apartments are a rich breeding ground for the almost unfettered development and growth of a multitude of allergens. As many live in an artificially maintained environment that is heated in the winter and cooled in the summer, the conditions are ideal for house mites, bed bugs and the like to thrive. Many of these unseen bugs live on dust and other less attractive sounding food sources such as dead skin flakes. Hence, you have a ‘double whammy’ in most domestic residences. On the one hand, you have the mites and bugs themselves – and many people are allergic to their secretions – while dead skin and other household detritus causes allergic problems for some people as well. Then you have the preponderance of household pets like cats and dogs, with many people being allergic to the fur and skin particles they naturally shed. Study results published in 2008 suggest that in excess of 50% of domestic American residences have at least six known allergens in the home. You might therefore think that you are safe indoors but if you do, you’d better think again! Next, there are millions of people all over the world who suffer allergic reactions to particular foodstuffs. As an example, allergic sensitivity to peanuts is extremely common. 6 Allergic reactions to peanuts can be extremely severe in some cases but fortunately, this tends to be a condition that is more prevalent in children and one that many childhood sufferers grow out off. In addition to peanuts, there are many who are allergic to ‘real’ nuts like pistachios, pecans, almonds and walnuts, with some people unfortunately allergic to several of them. Milk and the by-products of milk such as cheese are also a common cause of allergic reactions, with milk from cows, goat and even sheep equally at fault. And as beef contains a trace of the same proteins that cause allergic reactions when milk is consumed, a small percentage of children are allergic to beef as well. Next, there are oily seeds such as poppy and sunflower seeds that contain proteins that might cause allergic reactions in some. Eggs are also a known cause of allergies, particularly in children. This form of allergy is believed to be caused by proteins in the egg yoke and is one that is normally grown out of by age five or six. Insects are also a major source of allergic medical problems, with wasp and bee stings known to cause systematic allergic responses. Skin contact with allergens is also a problem for many. To begin with, some patients suffer skin problems as a result of contact with latex, possibly as a result of the allergenic proteins in the compound. Although some sources suggest that less than 1% of individuals who come into contact with latex will suffer an allergic reaction, others put the incidence of allergic problems among those who are exposed to latex contact as high as 10%. Suffering an allergic reaction to contact the latex can be particularly troublesome as medical professionals use latex protection while treating patients, during medical or dental surgery as an example. In the case of exposure under these circumstances, it is not unknown for patients to suffer an allergic reaction. Furthermore, it was reported in the Annals of Allergy in 1993 that some latex-induced allergy sufferers may be more susceptible to allergies to certain foods including bananas, chestnuts, kiwi and avocado as well. Another cause of allergic skin reactions is contact with certain plants such as poison ivy, poison sumac or either Eastern or Western poison oak. In this case, the cause of the problem is Urushiol oil which is an extremely potent irritant. 7 Sensitivity to this incredibly strong irritant is one of the most common allergies in the country to the extent that it is covered by workers compensation in some states including California. 8 How do allergic reactions manifest themselves? As suggested in the previous chapter, there are many different substances that cause allergic reactions in different people. In the same way that the causes of allergic responses will vary, so will the degree of the response as well. Beginning with airborne allergens, there cannot be many people who do not know someone who suffers allergic rhinitis, a condition more commonly known as hay fever. Fortunately for most sufferers, hay fever tends to be a seasonal condition which is not too serious in the majority of cases. However, other conditions that are caused or exacerbated by airborne pollutants such as asthma can be considerably more serious, with symptoms such as bronchoconstriction (a narrowing of the airways), a buildup of mucus in the lungs and shortness of breath causing serious discomfort or perhaps even worse. If you know anyone who suffers from asthma, you will be aware that the symptoms of the condition can be extremely severe and very distressing for the patient and for those around them. In the most extreme examples, there is also a risk of anaphylactic shock, a widespread and traumatic systematic allergic reaction, the symptoms of which can include dizziness, struggling for breath, a swollen tongue, shortness of breath, blue skin (caused by a lack of oxygen), low blood pressure, heart failure and ultimately possibly even death. Given the potentially lethal nature of this condition, emergency medical treatment must always be sought when any allergic reaction appears to be severe. As with all medical matters, it is better to be safe than sorry and the possibility of anaphylactic shock is one that you should never ignore. As you are also aware, there are many foodstuffs that can cause allergic reactions. When they do so, the most common symptoms of an allergic response to a foodborne allergen would include digestive problems such as bloating, diarrhea and vomiting as well as cutaneous symptoms such as itchy rashes and/or hives. Insect stings (as well as certain drugs and antibiotics) cause symptomatic allergic reactions, internal symptoms that might cripple your respiratory system, digestive and circulatory systems. 9 These effects are together known as anaphylaxis which can manifest itself as a cutaneous reaction, breathing difficulties, edema and possible death from anaphylactic shock. Once again, the same proviso applies as in the previous example – and I’ll remind you because this can never be stated often enough ☺ – emergency medical treatment is absolutely essential if you have even the slightest suspicion that shock is setting in. You should also be aware that anaphylaxis is a condition which does not always manifest itself in a consistent manner. For instance, the onset of anaphylaxis can be immediate and sudden whereas in other cases, the appearance of the condition might be significantly delayed. Furthermore, the condition can appear to be ‘cured’ only for it to return with a vengeance. As they might say in an old spy movie, anaphylaxis can be a very ‘tricky customer’ so it is essential that the condition is monitored and treated. Substances or materials that come into contact with your skin such as latex, chemicals and plants like poison ivy often cause itches and rashes which can result in eczema, dermatitis and other recognized skin conditions. In the case or of an allergic reaction to latex or chemicals, itching can lead to ulceration and broken skin which may allow infections in. Common reactions to contact with poison ivy or (even worse) poison sumac include redness, itching, blisters and pustules. 10 Why do some people develop allergies while others do not? There is no is one single definitive answer to this question as there are many factors that are believed to play a part in dictating whether you react badly to a particular allergen or not. Hereditary factors The first factor in to take into account is your family history as there is plenty of evidence to suggest that hereditary factors play a part in deciding how predisposed you are to suffering an allergy. If you have a family history of allergies, the chances of you being allergic to something are generally higher. Most allergies first appear in childhood and studies indicate that even at an early age, there are differences between children who have allergy sufferers in the family and those who don’t. For instance, this report suggests that while identical twins carry a 70% likelihood of suffering the same allergies, only 40% of non-identical twins are subject to the same level of probability. Furthermore, a study conducted in Belgium in the late 1990s suggests that there is significant evidence that parents who suffer allergies are far more likely to have children who also suffer than those who don’t. In addition, the children who have parents who suffer allergies are likely to suffer more severely than those who don’t. The same study concluded that it is likely that the predisposition to allergies is inherited due to some form of immune system malfunction but it also appears that the specific allergen to which children will react is not predetermined. Research has scientifically established what most parents already know which is that childhood is the time when allergies are most likely to develop. This is in line with other studies that indicate that IgE levels are highest in the early years with a marked decline between the ages of ten and thirty. As examples, research suggest that the peak hay fever years usually occur in childhood and early adolescence while asthma is most common in the under tens. Interestingly, in these early years, there is a difference between the prevalence of certain allergic conditions between boys and girls but these differences gradually dissipate with the passing years. 11 For instance, boys are more likely to suffer allergic conditions as children or youngsters but with asthma in particular, the highest prevalence is among young adult females. Environmental factors All of the available statistics indicate that the incidence of allergies and the percentage of the population who suffer them has dramatically increased over the past few generations. As a consequence, many have suggested that the changes in the dayto-day environment in which we live wrought by development and progress is at least partially responsible for the increase. In many ways, the statistics about the prevalence of allergies are terrifying. For example, according to the American Academy of Allergy Asthma and Immunology website, a nationwide study established that 54.6% of all Americans tested positive to at least one known allergen. Furthermore, the same site reports that between 40 and 50 million American citizens are affected by some form of allergic disease or condition while over 50% of homes in this country show traces of at least six detectable allergens. Another website report effectively concurs with the AAAAI findings but puts them in even more stark terms by suggesting that ‘the allergy epidemic effects one in four Americans’. The same site also suggests that allergies lie at number six in the league table of conditions that cause chronic diseases in the USA and that 15 million people visit their doctor or allergist as a result of suspected hay fever every year. As an example of the way that our modern urban lifestyle may be contributing to allergic problems, it is believed that chemicals in diesel fumes damage the outer membranes of pollen. Consequently, when damaged pollen is inhaled, the proteins in the pollen are immediately much closer to the delicate membranes of your nose, mouth and lungs than they would be otherwise. Furthermore, as the pollen may still have traces of the chemicals attached, your immune system reacts by attacking the pollen, causing hay fever. The cost of dealing with allergies and other associated conditions (e.g. asthma) costs the medical services in excess of $20 billion every year in America alone, and these problems (or the size of them) are not limited to the USA. 12 As an example, the Energy Medicine website suggests that the level of allergy problems suffered in the UK is not all that different to those that we are suffering here. From these brief snapshots of two societies, there is strong evidence that in the developed, industrialized West, the prevalence of allergies is on the increase. At the same time however, there has been no such explosion in the occurrence of allergies in less developed societies, those countries where ‘progress’ has not been so rapid or travelled so far. Similarly, the evidence suggests that in developed countries like America, the incidence of allergies is higher in urban areas than it is in more rural communities, although the divide between the two is gradually becoming less marked. Thus, the conclusion that there appears to be a connection between our ‘Western’ style of life and the explosion in the prevalence of allergies becomes inescapable. Of course, the real question is, if there is a connection between our lifestyle and the explosion in the incidence of allergies, what is the connection? This sadly is a question that science and research is still trying to find a firm answer to. There are however many clues and theories, some of which seem to have some validity at least from a common sense point of view. To begin with, we have already established that the average modern western home is a perfect incubator for all sorts of allergens that would have found it far harder to survive in days gone by when we couldn’t maintain the same indoor climate all year round. But there is another angle to this theory as well. While many allergists believe that the presence of household mites and other bugs is a major cause of the modern allergy plague, others believe something akin to the opposite. According to this theory, IgE and other antibodies exist to fight off both infections and parasites. With our clean water and pasteurized, sterilized or processed foods, there are less parasites to fight off than there have ever been before. Hence, we have an idle immune system that is forced to work harder than ever to find a ‘real’ enemy to repel. As a result, your immune system ‘invents’ invaders to fight off and so you have an allergic reaction to an invader that doesn’t really exist. 13 Incidentally, there are still others who see allergies as being caused by excessively active parasites. You can therefore see that there is little consensus about what the environmental factors are that drive allergies. The same is true of the idea that dirt plays some part in causing allergies. There are two sides to the argument and the only thing that the two agree on is that dirt somehow plays a part in the presence or absence of allergies. On the one hand, there are those that believe (perhaps not unreasonably) that living in industrialized, heavily populated societies creates more dirt which in turn means that there are more allergens surrounding us. Hence, there is more chance of being allergic simply because there is more dirt around us according to this theory. On the opposite side of the fence are those who believe that allergies occur because of our modern obsession with cleanliness. This theory holds that a certain element of dirt is a good thing in the youngest days when a child is first developing an immune system as it teaches their immune system to react appropriately. The suggestion of the so-called ‘hygiene hypothesis’ is that because our bodies have evolved to expect to fight against certain levels of infections and other invaders (such as common childhood ailments), the fact that these are kept at bay means that the immune system looks for something else to fight against. Similarly, there are some medical practitioners that believe that childhood vaccinations are not necessarily a 100% good thing. Of course, vaccinating your children is normally a good idea but the problem is that because we vaccinate children against what were once common childhood ailments, this theory suggests that we might be weakening our children’s immune systems at one and the same time. In a supreme irony, the fact that we are too clean makes us more prone to allergies because there are no invaders to fight against. In the same way, vaccinations that protect children against common illnesses and diseases also make them more susceptible to allergies. Other possible causes of allergies If your immune system has been somehow weakened by illness or disease, your ability to fight against allergies is significantly weakened as well. Another factor that is often present in those who suffer allergies is stress. Stress naturally weakens your immune system and as already 14 established, a weakened immune system makes you far more prone to medical problems including allergies. Studies also indicate that bottle-fed babies are more likely to suffer allergies later in life than those who are breastfed. It is also suggested that babies who are weaned suddenly or too early are also more susceptible to allergies. In fact, diet throughout your life may play a part in dictating whether you suffer allergies or not. It’s a simple truth of modern Western living that while our diet is often high in calories, it is far less so in terms of essential nutrients and goodness. It’s no secret that fast and junk foods are not good for you and yet the pace of modern life dictates that fast food is an essential for many rather than a choice. At the same time, the soil in which our food is grown is depleted of the minerals and other nutrients that we once took for granted. It is therefore a sad fact that the food you eat and the beverages you drink are simply not helping your system to build up the immunity that it needs to fight off allergies and other medical ailments. It is even suggested that electromagnetic pollution may play a part in causing allergies as some researchers and scientists suggests that the parallel growth in energy radiation of this form and allergies over the past few years is no coincidence. For example, many people who seem to be sensitive to the electromagnetic field generated by computers are also prone to allergies. In these cases, treating the patient to suppress their sensitivity to electromagnetic forces often gets rid of their allergy-like symptoms as well, so the two are unlikely to be entirely continental. And of course, with billions of mobile phones and other similar devices in use everywhere, we are literally walking around bathed in an unseen but unremitting electromagnetic ‘soup’ each and every day. You may not be aware of it, but it’s there every minute, surrounding you right now, even as you read these words. The conclusion As I have just illustrated, there are many possible reasons why you are allergic to some particular substance or substances. And from my own experience, I know that there is no one identifiable reason why particular individuals are allergic, sensitive or intolerant of some substances. 15 The bottom line is, there are a huge number of possible contributory factors that could cause allergies and it is not uncommon for sufferers to display several of the factors highlighted in this chapter. Of course, without analyzing every single aspect of a patient’s background, it is impossible to isolate exactly what it is that has caused them to be allergic, and no doubt this will apply to you as much as it does to any other sufferer. Nevertheless, now you have a clearer idea of some of the factors that may cause allergies, it might help you to identify some of the elements that might be at least partially responsible for your condition. 16 So, what’s next? Diagnosing your condition If you believe that you or a close family member is suffering an allergic problem – whether it is hay fever, asthma, a skin condition like eczema or hives or whatever it might be – the first thing that you need to do is see an allergist or doctor to have the condition professionally examined and diagnosed. As an essential part of the diagnostic process, the first thing that your allergist or doctor will do is ask you to present a detailed medical history to enable him or her to form an idea of what it might be that is causing problems. It therefore follows that the more thoroughly you can present your medical history, the more accurately your allergist will be able to formulate a clearer idea of what it might be that is causing you difficulties. From your medical history, it is likely that your allergist will be able to identify what causes your allergic problems with a reasonable degree of accuracy. After this, it will therefore be necessary to test whether the suspected allergen that is causing problems for you is indeed the guilty party. This may be done in one of several different ways depending upon the suspected cause of your allergic reactions. For example, if a particular food seems to be the root cause of your difficulties, your allergist may ask you to eliminate these foods from your diet for a period of time before reintroducing them. In this case, removing the suspected foods from your diet should mean that your allergy dissipates while reintroducing them should restart it. In these circumstances, it is however extremely important that this test is only carried out under careful medical supervision. In a worst-case scenario, a severe allergic reaction could lead to serious repercussions and therefore medical supervision is absolutely essential. If the suspected allergen is not a particular food and assuming that you are not suffering some skin condition that makes it impractical, your allergist may attempt to diagnose your condition with a skin test. There are three forms of skin test that your medical practitioner might use in these circumstances: • The prick or scratch test. In this situation, your medical attendant will place a drop of the suspected allergen on your skin before 17 making a tiny pinprick hole directly beneath it. If the suspected allergen is indeed the cause of your allergy, this should result in skin swelling and/or hives, thereby proving that the suspected allergen is indeed the cause of your difficulties. • The intradermal test is one where a tiny drop of the suspected allergen is injected just below the skin of your upper arm. Once again, this should cause swelling or hives within 15 minutes or so. • A patch test might be used in a situation where a particular substance is suspected of causing contact dermatitis. In this scenario, the allergen is placed on the skin which is then covered by a patch for a period of 48 hours. After this, the skin should be red and/or peeling if the allergen under suspicion is indeed the cause of your dermatitis. As a general rule, one of the three methods of skin testing is the preferred method of diagnosing an allergy, primarily because it is quick and very simple. However, in a situation where skin testing is not practical – if for example you are suffering eczema or some other skin condition – your allergist or Doctor might use a RAST blood test to determine the cause of your problems. This is an allergen specific blood test that must be carried out under close medical supervision because depending on the specific allergen that is suspected, your reaction to the test must be carefully monitored. As suggested, conditions such as eczema or dermatitis can compromise the effectiveness of the RAST test. Similarly, some medications such as antidepressants or histamines can also negate the validity of the test results. In any situation where your allergist or doctor suspects that the RAST may not be effective or that your reaction to the test may not be favorable, he or she may suggest an allergen specific IgE antibody test as this is a test that is performed on a blood sample. As suggested previously, children are more prone to developing allergies than adults but they often grow out of them. The external allergen specific IgE test you may also be used to assess whether a child has grown out of a specific allergic condition although the test is general in nature and not 100% conclusive because a child who has outgrown an allergy may be IgE positive for many years afterwards. 18 Treating allergies In terms of treating allergies, there are three approaches that your allergist might adopt or suggest. To begin with, he or she may discuss with you how you can avoid the specific allergen that is causing you problems. Depending upon what particular allergen is causing your condition, the recommended remedial steps might include some the following: • Wearing a dust or pollen mask when outside during the summer or when cleaning indoors. • For people with food allergies, it is essential that you always remember to read the label on any food cans or packaging materials. • You might need to stay inside in the morning (which is when the pollen count is usually highest) or on windy days if you suffer hay fever. • For the same reason, keeping the windows and doors closed during the summer months would be beneficial in the case of hay fever. • Get rid of indoor plants that might cause mildew and other forms of fungus. • Don’t keep dogs, cats or birds in the house. • Change feather pillows and woolen clothes or blankets for those that are made out of artificial materials. • Keep the air conditioning switched on in your car and home during ‘high risk’ periods such as during the summer and when cleaning. • Wash all of your bedding at least once a week in hot water (and least 130°F). • Use a tannic acid solution to neutralize the allergens in mite droppings. • Use humidifiers and air filters to keep the quality of air in your home as high as possible. • In the most extreme circumstances, you may need to remove carpets and upholstered furniture from your home. If avoiding contact with the specific allergens that appear to cause your problems is not sufficient or effective, your allergist may recommend some form of medication to deal with your allergy problems. 19 The most appropriate form of medication will naturally be predicated on the allergen that your allergist has identified as being the cause of your problems but could include: • Decongestants rendered either as a spray or orally. These unblock your nasal passages making it easier to breathe, with well-known over-the-counter brands including Vicks Sinex nasal spray being safe and effective. • A steroid-based nasal spray such as fluticonase (Flonase) which is designed to reduce the inflammatory response. • Antihistamines are drugs that hinder the production of histamines which are responsible for causing allergic reactions. Short-acting antihistamines are available over-the-counter and are often effective in the short term. They can however cause drowsiness and there is some evidence that they hinder learning in children as well. These would include Benadryl and Tavist. Longer acting antihistamines do not however exhibit these adverse qualities but they are only available by prescription. Medicines in this category would include Zyrtec and Allegra. In a situation where neither of these two remedies is effective, your allergist may turn to allergy immunotherapy or allergy shots. In this case, you will receive a shot containing the allergen to which you are allergic one to five times a week to begin with, starting with a very weak solution of whatever it is that is causing you problems. The strength of the injected solution will gradually be increased so that your body will slowly build up resistance to the substance which was previously causing a problem. After you arrive at a full strength dose, you will then be placed on a maintenance dosage, where a shot once every few months is all you need to maintain your immunity to the allergen that previously caused allergic reactions. If your problem is asthma, the main form of treatments that you would receive will be anti-inflammatory drugs or bronchodilators. As the names probably suggest, anti-inflammatories prevent inflammation whereas bronchodilators widen your air passages. If on the other hand the problem is related to your skin – eczema or dermatitis as examples – your allergist may recommend cold compresses to reduce the inflammation and/or topical corticosteroids, creams or ointments that you apply to the area of damaged skin. 20 Conclusion As you have seen in this report, allergies are on the increase throughout the industrialized West but at this moment, we do not know exactly why. Nevertheless, the fact is that if you suffer an allergy or even if you suspect that you might, it is absolutely essential that you seek professional medical attention as soon as possible. As suggested earlier, a ‘worst case scenario’ allergic reaction could be very serious indeed and this is not a risk that you should willingly or knowingly take. As I have also pointed out, for most patients, diagnosing the root cause of an allergic problem is not difficult, complex or expensive. On the contrary, for the majority of patients that I see, a skin test combined with analyzing a full medical history is all that is needed to diagnose the root cause of their allergy problem. There is no reason to delay if you suspect that you might be suffering an allergy and you have already seen, delaying a professional diagnosis could even lead to life-threatening consequences. So, if you think that you might be allergic to something, talk to us now we’re always here to help. 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