Carbon Dioxide Helps with Nasal Allergies

MSNBC reported recently that a shot of carbon dioxide gas into the nose can help with allergies based on preliminary findings funded by Capnia, a company that makes the product.

Upside:
Symptoms of nasal allergies improved within 30 minutes.
No liquid is involved... just carbon dioxide gas.

Downside:
Lasts only 4 hours
80% has nasal discomfort after use
25% became teary eyed
14-20% developed headaches

My take?
I'll pass on this drug... There are already good drugs with minimal side effects that lasts up to 24 hours already on the market .

Read the story here.

Of note, some readers may point out that there is an older study that had better results. With two one-minute carbon dioxide treatments into the nose resulted in symptom relief within 10 minutes and lasted for 24 hours. Even with these results, I'll still pass... not sure how many people will go with 2 one-minute treatments when a 1 second swallow with an allergy pill or nasal spray use works just as good.

Reference:
Nasal carbon dioxide for the symptomatic treatment of perennial allergic rhinitis. Annals of Allergy, Asthma & Immunology - 19 August 2011 (10.1016/j.anai.2011.07.014)

Intranasal noninhaled carbon dioxide for the symptomatic relief treatment of seasonal allergic rhinitis. J Allergy Clin Immunol. Volume 121, Issue 1, Pages 105-109 (January 2008).

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Kids Exposed to Fido or Fluffy in the First Year of Life Decreases Risk of Becoming Allergic to Them

There have been a number of studies in the past investigating whether it is healthy for a baby to be around pets and whether such exposure increases or decreases risk of becoming allergic to them later in life.

In a recent study (published online June 2011), the researchers found that among males, those with an indoor dog during the first year of life had half the risk of becoming allergic to dogs at age 18 compared with those who did not have an indoor dog in the first year of life regardless whether born by C-section or vaginally. Also, teens with an indoor cat in the first year of life also had a decreased risk of becoming allergic to cats. Neither cumulative exposure nor exposure at any other particular age was associated with either outcome. So it appears that the FIRST year of life is key to whether a child develops pet allergies or not.

Although in this study, cat and dog ownership appears to be beneficial in kids, prior studies have suggested that for at least cats, it increases risk of overall allergies in children by 13 times! Dog exposure, however, reduces overall allergy by 4 times.

Reference:
Lifetime dog and cat exposure and dog- and cat-specific sensitization at age 18 years. Clinical & Experimental Allergy Volume 41, Issue 7, pages 979–986, July 2011

Genetic and environmental risk factors for childhood eczema development and allergic sensitization in the CCAAPS cohort. J Invest Dermatol. 2010 Feb;130(2):430-7. Epub 2009 Sep 17

Opposing Effects of Cat and Dog Ownership and Allergic Sensitization on Eczema in an Atopic Birth Cohort. J Pediatr. 2011 Feb;158(2):265-71.e1-5.

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Anti-Histamine Eye Drops

Allergies often cause eye symptoms of itching, swelling, redness, and tearing.

If other allergy symptoms are also present involving the nose and skin, it is best to try an oral anti-histamine as a first step.

This one oral drug may be able to resolve all these symptoms. As I am fond of telling patients, oral medications affect the whole body as the medication goes to the stomach after swallow, gets digested, and spreads to the big toe just as much as the skin, nose, and eyes.

However, if symptoms are limited to just the eye, it is best to use topical medications like eye drops rather than an oral medication which goes everywhere (where it is not needed).

There are in essence two anti-histamine eye drops available over-the-counter.

The first is the combination of naphazoline and pheniramine found in NaphCon-A and Visine-A (formerly called Ocuhist). Naphazoline is a decongestant that helps eliminate the red eyes whereas pheniramine is an anti-histamine to help eliminate itching. It can be used up to 4X per day for relief.

The other contains the active ingredient ketotifen and has 3 modes of action: anti-histamine, mast cell stabilizer, and eosinophil inhibition. All three actions in essence help resolve current as well as future allergy eye symptoms. It's also why it can be used only twice a day opposed to 4X per day required with naphazoline/pheniramine.

There are three main brands of ketotifen that basically are the same thing:

- Zaditor

- Alaway

- Zyrtec Eye Drops

- Claritin Eye Drops

The "zyrtec" and "claritin" eye drops names are quite misleading in that the eye drops do NOT contain the same ingredient as that found in the oral medication by the same name.

Personally, I prefer ketotifen over naphazoline/pheniramine due to longer-lasting relief per use, 2X per day dosing, and less risk (glaucoma and hypertension specifically). Ketotifen can be used from the age of 3 years (age 6 years for the other).

Of course, if these eye drops don't work, there are prescription antihistamine eye drops that work quite well including pataday/patanol (olopatadine), bepreve (bepotastine),  and lastacaft (alcaftadine). Of course, most insurance companies require trial of OTC eye drops first before they will authorize these prescriptions.

On a final note, there is one steroid nasal spray called Veramyst that has an FDA indication for eye allergies though I suspect all steroid nasal sprays can help similarly. As such, if a patient has only ocular and nasal allergy symptoms, it may be worth trying a steroid nasal spray, though I'm not sure how often this is practiced in reality.

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Patients with Iodine or Seafood Allergy CAN Receive Contrast During CT Scans

It is a prevalent belief out in the medical (and lay public) community that patients with iodine or seafood allergy can not receive contrast when undergoing certain radiological tests like CT or MRI scans. The concern is that contrast contains minute amounts of free iodide and as such, IV administration of this material puts the patient at risk of a life-threatening anaphylactic reaction.

Contrast is often given in these tests as it traces out bloodflow enabling the physician to see organ and mass architecture much more clearly allowing for improved accuracy in seeing anything abnormal.

Well... rest assured that patients with iodine and seafood allergy CAN receive contrast without any significant increased risk of an allergic reaction as compared to other allergies.

In a large study encompassing 112,003 patients, only 5% had a reaction. The relative risk of a reaction in patients with seafood allergy was 3.0 compared with 2.9 for those with allergy to eggs, milk, or chocolate; 2.6 for those with allergy to fruit and strawberries; and 2.2 for those with asthma [7]. In other words, a seafood allergy increases the risk of a contrast reaction by about the same factor as does any other allergy. At least 85% of patients with seafood allergy receiving IV contrast material will not have an adverse reaction.

Reference:
Formation of potential antigens from radiographic contrast media. Acta Radiol 1987; 28:473-77
Immunologic basis for adverse reactions to radiographic contrast media. Acta Radial 1990; 31:605-612
Contrast media reactions: experimental evidence against the allergy theory. Br J Radiol 1984;57: 469-173
Adverse reactions to intravascularly administered contrast media. AJR 1975;24: 145-152

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New and Only Over-The-Counter Anti-Histamine Nasal Spray

Up until now, there has been three anti-histamine nasal sprays in the United States market available only by prescription... Astelin, Astepro, and Patanase.

However, in May 2011, Meda Pharma announced a new anti-histamine nasal spray Rhinolast Allergy that is available over-the-counter.

The active ingredient is azelastine, the same one as found in the prescription nasal spray Astelin and Astepro.

Azelastine has a triple mode of action: anti-histamine effect, m,ast-cell stabilizing effect, and anti-inflammatory effect. Azelastine has a rapid onset of action of 15 minutes.

It can be used from the age of 5 years.

This nasal spray can be used in combination with other over-the-counter anti-histamines medications taken orally like zyrtec, claritin, allegra, and benadryl.

Read more about this new nasal spray here.

Read more about allergy medications in general here.

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Generic Singulair Expected in August 2012

Why August 2012? That's when the patent for singulair, an allergy and asthma medication, goes off-patent. Generic versions of singulair should be expected soon after the patent expires.

For those who don't know... generic versions of medications are much cheaper than brand name medications, but contain the same active ingredient. Here's a list of a few brand name medications relevant in the ENT world with generic names in parentheses.

Flonase (fluticasone)
Prilosec (omeprazole)
Prevacid (lansoprazole)
Claritin (loratidine)
Zyrtec (cetirizine)
Benadryl (diphenhydramine)

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Nasal Hair Protective Against Asthma in Patients with Allergies?

Researchers in Turkey found that there is an association between nasal hair density and risk of asthma developing in patients with seasonal rhinitis patients. No joke... They published their findings in the International Archives of Allergy and Immunology in March 2011.

The rate of asthma found in patients with little or no nasal hair was 44.7% whereas only 16.7% of patients with a dense forest of nasal hair had asthma.

They hypothesize that increased nasal hair improves allergen filtration thereby preventing the allergens from irritating the airway. The assumption here being that allergen irritation of the airway can potentially cause asthma.

IF this is true (and that's a big if)... patients with allergies should be encouraged to grow nice thick nasal hair to prevent future asthma!

Read the research abstract here!

Reference:
Does Nasal Hair (Vibrissae) Density Affect the Risk of Developing Asthma in Patients with Seasonal Rhinitis? Int Arch Allergy Immunol. 2011 Mar 30;156(1):75-80

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Hypoallergenic Cats and Dogs

CBS news published a story on hypoallergenic pets on their website here.

The story did report that pricey pets that claim to be easy on allergy sufferers are probably more hype than true, but than did go on to list dogs and cats that are purportedly hypoallergenic.

The claim for hypoallergenicity is based on hair/fur/dander length or quantity... mainly the shorter or smaller the amount, the less allergenic. However, there are other reasons why hypoallergenic pets are NOT hypoallergenic. These include a pet's saliva and skin which contain the same protein that trigger allergic reactions.

Also, many dog allergy sufferers also have weed, tree, and grass allergies. If your hypoallergenic dog likes to roll in the grass and weed, they are getting that all over them and bringing it into the house and to you. So even if you are not allergic to the dog, you probably are allergic to what's on the dog.

Read the CBS story here.

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Possible Novel Cure for Cat Allergy?

A research team in Canada has developed a possible cure for patients suffering from cat allergy using a novel type of allergy shot called peptide immunotherapy.

To understand the significance of this development, one needs to understand how traditional allergy shots are made. Currently, allergy companies purify a protein called Fel d1 from cats and make a vial out of it. This purification process is like removing the corn kernels from a cornstalk to put into a can to sell at the supermarket.

Peptide immunotherapy as described in this new research is like making the "essence" of the corn kernel in the lab. For this cat vaccine, the key molecule created is a 7 amino acid long peptide sequence.

The benefits of this novel treatment is the lack of side-effects when the shots are administered (meaning, no waiting around after the shot)... and only four to eight shots per year are required (rather than the weekly injections with current allergy shots).

The optimal dose to use is currently being determined in phase three clinical trials.

Reference:
Development and preliminary clinical evaluation of a peptide immunotherapy vaccine for cat allergy. J Allergy Clin Immunol. 2011 Jan;127(1):89-97, 97.e1-14.

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Home Allergy Shots

DISCLAIMER: This post is not meant to condone or promote allergy shots to be given at home. It is meant to promote discussion and make patients aware of the issues involved.

Allergy shots, unlike medications like claritin and flonase, offer patients with significant allergies a way to potentially be cured of their misery without the need for daily medication use. However, there is a small, but substantial risk for anaphylaxis and even death with allergy shot administration. After all, a patient is being injected with the very substances that cause their allergies. As such, many allergists will allow allergy shots to be administered ONLY within a medical setting. Also, the American Academy of Allergy Asthma and Immunology (AAAAI) specifically forbids allergy shots to be administered at home.

Furthermore, the allergen extracts used to make the allergy vial serum used for allergy shots carry a black box warning on the medication package insert:

"This product is intended for use only by physicians who are experienced in the administration of high dose allergy injection therapy, or for use under the guidance of an allergist. Allergenic extracts may potentially elicit a severe life-threatening systemic reaction, rarely resulting in death. Therefore, emergency measures and personnel trained in their use must be available immediately in the event of such a reaction. Patients should be instructed to recognize adverse reaction symptoms, be observed in the office for at least 30 minutes after skin testing or treatment, and be cautioned to contact the physician's office if symptoms occur. Standardized glycerinated extracts may be more potent than regular extracts and therefore are not directly interchangeable with non-standardized extracts, or other manufacturers' products. Patients with cardiovascular diseases and/or pulmonary diseases such as symptomatic unstable, steroid dependent asthma, and/or those who are receiving cardiovascular drugs such as beta blockers, may be at higher risk for severe adverse reactions. These patients may also be more refractory to the normal allergy treatment regimen. Patients should be treated only if the benefit of treatment outweighs the risks. Patients on beta blockers may be more reactive to allergens given for testing or treatment and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions. This product should never be injected intravenously."

The downside of allergy shots is that they are given 1-2X per week not just for a month or two, but for YEARS. If shots are given only within a medical facility, the patient must commit a significant amount of time, travel, and gas in order to complete a shot series. There is also the time missed from work. In essence, the patient must approach allergy shots like a part-time job.

Given all this... what are the actual risks of anaphylaxis and death from allergy shots?

VERY small...

In one Mayo Clinic study on 79,593 immunotherapy injections over a 10-year period showed the incidence of adverse reactions to be less than two-tenths of 1 percent (0.137 percent). Most of the reactions were mild and responded to immediate medical treatment. There were no fatalities.

More than 1 million injections were given without a fatality to 8,706 patients in allergy clinics at Roosevelt Hospital, New York City, between 1935 and 1955.

Worldwide, there were only 35 deaths reported from allergy shots between 1985 - 1993. It has been estimated that during that period there were 52.3 million immunotherapy procedures, making the incidence of fatality less than one per million (0.6692 per million). Data recently compiled by the Allergen Products Manufacturers Association (APMA) estimated the incidence of fatalities to be about three per 190 million annual injections, or approximately one per 63 million injections.

Now compare this to other medical interventions. Approximately 1 in 5000 exposures to a IV dose of penicillin or cephalosporin antibiotic causes anaphylaxis of which more than 100 deaths per year are reported in the United States. Fatal reactions to penicillin have ranged from 0.4 fatalities per million injections to 1 fatality per 7.5 million injections.

One to 2% of people receiving IV contrast (for a CT scan) experience some sort of systemic reaction. The majority of these reactions are minor, but fatalities have occurred in about 1 in 13,000 to 1 in 75,000 procedures in the 1980s (a more recent study has shown a decrease of 1 fatality in 169,000 procedures).

So... the main question now is should home allergy shots ever be allowed?

There are two ways of answering this question.

The first way is to consider any fatality due to an allergy shot (no matter how extremely rare) to be unacceptable, especially when considering the disease being treated -- allergies -- to be a quality of life issue rather than a life/death issue (heart transplant surgery). There is also that black box warning mentioned above.

The other way to view the answer is to consider things in perspective. There are MANY quality of life activities that people perform that has a risk of severe bodily harm if not death. Swimming results in 1,150 deaths per year in the United States alone. There are about 43,000 fatalities per year from car accidents.

Also, if one takes the stringent view that any fatality due to an allergy shot to be unacceptable, than patients should be monitored in a medical facility for not just 30 minutes or less, but 24 hours as late reactions can still occur the following day after an allergy shot! Indeed, in England, patients are required to wait under observation for anaphylaxis as long as ONE HOUR after each and every injection!!! In fact, the one hour observation was an improvement over the TWO hours that was imposed initially. Read more about this here.

So why draw the line at 20 minutes (or more) as recommended by the AAAAI in the United States? It's because the vast majority of severe reactions occur within the first 30 minutes. Beyond 30 minutes, severe reactions become less common (but NOT zero). Well, severe reactions are not very common to begin with... and if allergy shots must be given in a medical facility due to this concern... than should it not follow logically that no matter how rare the possibility, that patients MUST be observed for 24 hours no matter how small the risk of anaphylaxis than?

Why state that allergy shots must be given in a medical facility due to small, but possible risk of severe reaction on the one hand, and than state that there is a small, but acceptable risk of severe reaction after 20+ minutes of observation in a medical facility?

It is just through this thought process that some physicians who provide allergy shots allow home injections. At this time, it is estimated that about 15% of allergists allow home injections (based on a blinded survey of allergists).

IF home allergy shots are allowed (and this is by no means a recommendation or a statement condoning home allergy shots, but just saying in a hypothetical sense), it should be done only in carefully selected patients:

- Are on maintenance regimen (allergy shots are not being increased)
- No significant reactions during buildup and maintenance
- Proper training in administration (just like diabetics are trained to give themselves their shots)
- Epi-pen available and understanding in how to use
- In-office allergy shot with post-injection monitoring for a period of time with every new vial
- Only in adults
- CONSENT signed by patient informing of the risks as well as black box warning



References
Systemic reactions to immunotherapy at the Mayo Clinic. J Allergy Clin Immunol 1997; 99:S66.

The risk of inducing constitutional reactions in allergic patients. J Allergy 1957; 28:251-261.

Deaths associated with allergenic extracts. FDA Medical Bulletin 24, May 1994.

Allergenic extracts used in immunotherapy fatalities. J Allergy Clin Immunol 1997; 99:S67.

Nature and extent of penicillin side-reactions with particular references to fatalities from anaphylactic shock. Bull WHO 1968; 38:159.

Mortality during excretory urography: Mayo Clinic Experience. AJR 1982; 139:919-922.

Reactions to ionic and nonionic contrast media: A report from the Japanese Committee on the Safety of Contrast Media. Radiology 1990; 175:621-628.

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Xyzal and Clarinex Generics Now Available

Xyzal and Clarinex are both anti-histamines used to treat allergies. Both medications are now available as generics by prescription since December 2010. The active ingredient for both xyzal and clarinex are the active stereoisomer of the over-the-counter zyrtec and claritin respectively.

In other words, zyrtec and claritin available over-the-counter contain the same active ingredient found in xyzal and clarinex, but in an "un-purified" state. Still confused? Read this article which probably contains more information than you ever wanted on this subject.

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Bottles / Vials for Allergy Drops (Under Tongue) Immunotherapy

We have received a number of requests of where one can obtain allergy vials for use in SLIT (sub-lingual immunotherapy) whereby a drop is placed under the tongue to try and achieve allergy cure. This mode of treatment is an alternative to the more traditional allergy shots.

Our office provides both modes of immunotherapy.

Regarding the allergy vials themselves, you can obtain them from Edge Pharmaceuticals. They offer a number of different vial types as shown in the picture. They range in sizes from 15cc to 20cc and provide 40ul to 200ul drops with each dispensation.

Contact Info:

7264 NW 63rd Terrace

Parkland, FL 33067

Phone: 877-580-3343

Fax: 877-581-3343

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Migraine Headaches Associated with Allergies & Response to Allergy Shots

A recent study published this month in the journal Headache reported an association of migraine headaches with allergy severity and response to allergy shots... but only in those less than 45 years of age.

The study suggested that lower "degrees of atopy" (or allergy) were associated with less frequent and disabling migraine headaches in younger subjects while higher degrees were associated with more frequent migraines. The administration of allergy shots was associated with a decreased prevalence, frequency, and disability of migraine headache in younger subjects.

The age cut-off used to described "younger" subjects depending on the measure described was either 40 years or 45 years.

Read the abstract here.

Of course, one must consider the possibility that perhaps what these patients are suffering from is not migraine headaches, but allergy triggered sinus headaches.

Our office provides allergy testing, allergy shots, and allergy drops. We also offer botox injections in the treatment of migraine headaches.

Reference:
Allergy and immunotherapy: are they related to migraine headache? Headache. 2011 Jan;51(1):8-20. doi: 10.1111/j.1526-4610.2010.01792.x. Epub 2010 Nov 4.

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Tongue Piercing Infections

It seems that tongue piercing is slowly becoming more popular than ever... and correspondingly, there seems to be even more tongue infections than ever before due to the piercing.

If tongue piercing MUST happen, it is recommended that you avoid studs made of metal which increases the risk of infection, at least according to a recent study in the Journal of Adolescent Health.

The study demonstrated that studs made of steel might promote the development of a bacterial biofilm leading to increased risk of infection whereas those made of polytetrafluoroethylene or polypropylene are inert to such bacterial colonization.

I should also add that metal studs may cause an allergic reaction leading to painful tongue swelling/itching, especially in those with metal allergies. This is similar to the skin reactions that some people experience with cheap metal jewelry.


Reference:
Tongue piercing: the impact of material on microbiological findings. J Adol Health online, 2011

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Chronic Hives Due to Vitamin D Deficiency

It seems that there is more and more research being published indicating that vitamin D deficiency leads to allergy exacerbation (and by supplementation, the severity can be reduced). Particularly problematic given so many people are vitamin D deficient as a possible byproduct of working indoors for so many of us (including physicians).

The most recent research out of Nebraska suggests that chronic urticaria in adults may be due to reduced vitamin D levels. In the small study, researchers compared 25 patients with chronic hives to 25 patients with nasal allergies. Researchers found patients with hives had significantly reduced levels of vitamin D, with nearly half of them considered to be vitamin D deficient.


References:
Reduced vitamin D levels in adult subjects with chronic urticaria. J Allergy Clin Immunol. 2010 Aug;126(2):413; author reply 413-4.

Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab. 2007 Jun;92(6):2130-5. Epub 2007 Apr 10.

Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010 Jul;126(1):52-8.e5. Epub 2010 Jun 9.

Vitamin D in atopic dermatitis, asthma and allergic diseases. Immunol Allergy Clin North Am. 2010 Aug;30(3):397-409.

Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010 Jul;126(1):52-8.e5. Epub 2010 Jun 9.

Vitamin D in atopic dermatitis, asthma and allergic diseases. Immunol Allergy Clin North Am. 2010 Aug;30(3):397-409.

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Santa Claus, A Sick Patient Needing Medical Care

ENT Journal published in December 2003, a humorous paper on Santa Claus as a patient with numerous medical problems. Given it is Christmas Eve, it is probably worth revisiting the article which lists among his many medical problems:

• Allergies to woodwork (sawdust and varnish) and materials used in preparing teddy bears, dolls, and other gilts.
• Asthma exacerbated by reindeer exposure as well as the hay and straw in the stable which makes his nose run
• His symptoms get worse when he leaves the North Pole where there is no pollen to regions of the Earth where vegetation and pollen are plentiful, especially in the Southern Hemisphere where it is summer.
• Going down chimney's irritates the eyes and his nose resulting in sneezing fits. Probably carcinogenic as well.
• Santa is considerably overweight, and his cheeks appear quite ruddy suggesting high blood pressure.
• Probably has type 2 diabetes exacerbated by milk and cookies left for him in millions of homes.
• He smokes a pipe putting him at increased risk of oral, throat, and lung cancer

Merry Christmas!

Suggest you leave for Santa a glass of water and a low-calorie, low-salt granola bar instead of milk and cookies tonight!

Read the full article here.

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Different Types of Immunotherapy for Allergy Cure

Most people are already familiar with allergy shots and even sublingual (under the tongue) allergy drops as treatment to try and achieve cure (or tolerance) to the things they are allergic to.

However, there are other forms of immunotherapy that may one day provide just as good if not better allergy cure rates. These include (most currently under research):

- Intra-Lymphatic Injections (ILIT): Rather than weekly shots in the arm, one research paper reported only 3 injections into a groin lymph node over 2 months provided equivalent results to allergy shots in the arm after 3 years!

- Allergy Tablets: Potentially in the next year or 2, tablets may become available to treat certain allergies. Grazax by Merck which treats grass allergy is the first which is currently undergoing FDA approval.

- Epicutaneous immunotherapy (EPIT) involves lightly scraping a patient’s skin and then applying a patch that delivers the allergens through the bloodstream.

- Intra-Nasal Spray: Declared effective and safe by WHO.

- Bronchial Inhalers: Marginal effectiveness and risky.

At this time, our office only provides allergy shots and allergy drops.

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Can A Person Have Allergies Even if Allergy Testing Comes Back Negative?

YES!!! But how can that be?!! Well, here is the simplified answer. When allergy testing is performed whether by skin prick or blood testing (RAST), one is testing to certain specific proteins known to cause allergic reactions in majority but not all patients (these are called major allergen).

Patients need to remember that for a given allergy like CAT (or tree, mold, dust, etc)... there are millions of proteins (minor allergen) that have the potential to cause an allergic reaction in people. Allergy testing to cat ONLY tests for ONE of these proteins called Fel d1 as well as a few other minor allergens. As such, if a patient is CAT allergic, but not to the Fel d1 protein, then the allergy testing will come back normal!

Given this information, that's why skin testing is a bit more "accurate" when it comes to determining whether a patient has allergies or not as there are more "proteins" for a given allergen like CAT being tested than the blood test like RAST which STRICTLY tests for a single protein.

Of course, it is possible that a patient may TRULY not have any allergies. So, how can a person tell? Look at the total IgE serum levels. If it is high, than you most likely have allergies even if everything comes back negative.

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Strange But True Allergies People Suffer From (Sex, Kissing, Water, etc)

As shown on CBS news here, these things can cause an allergic reaction in the rare unfortunate individual:

1) Water can cause hives in some people (aquagenic urticaria)
2) Sunlight
3) Kissing (a person has recently eaten a food substance that the person being kissed is allergic too)
4) Sex (some women are allergic to seminal fluid)
5) Hops and barley can cause an allergic reaction
6) Low temperatures
7) Cell phones (due to Nickle content)
8) Pressure (too tight a belt, necktie, bra, etc)
9) Chocolate
10) Exercise (cholinergic urticaria)
11) Vibration (dental drill, lawn-mower, jackhammer, etc)
12) Allergy medications (or more precisely, the additives found within allergy medications)

See your local allergist if you suspect you have this!

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Hotels Offering Hypoallergenic Rooms

Recently, a few hotel chains including Hyatt, Wyndham, and NYLO have introduced hypoallergenic rooms for those suffering from asthma, allergies, or just want a room with a clean breathing environment.

At least for Hyatt, the rooms are called "Respire" and as per their website:

"Respire by Hyatt rooms undergo an additional six-step process to reduce airborne particles and minimize the presence of potential irritants. This process includes installation of a state-of-the-art air purification system and treatment of all fabrics and surfaces in the guestroom. All Respire by Hyatt rooms are installed and maintained on an ongoing basis by PURE Solutions NA.

The Respire by Hyatt – Hypo-Allergenic Rooms purification process includes:

• Application of PURE Shield and PURE Clean to minimize presence of allergens on carpet, upholstery and other surfaces in the room.
• One-time shock treatment to minimize irritants.
• Complete disinfection of Air Handling Unit and Installation of removable tea tree oil cartridge to maintain these conditions.
• Installation of hypo-allergenic mattress & pillow encasings.
• Installation of a powerful air purifier by Healthway, listed as a Class II Medical device by the F.D.A.
• Recertification every six months."

These rooms (regardless of the hotel) are implemented by New York–based company Pure Solutions.

Read more about what exactly is done to these rooms here.

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