~Allergies, Part 2 - Therapeutic Options

  • Essential Fatty Acids
  • Coenzyme Q10 (CoQ10)
  • Vitamin E
  • Flavonoids
  • Alpha-Lipoic Acid
  • N-Acetyl-Cysteine
  • Magnesium
  • Zinc
  • Ginkgo Biloba And Beta-Glucan
  • Cordyceps Sinensis
  • DHEA
Essential Fatty Acids. Adequate supplements of essential fatty acids with omega-6 and omega-3 types should be taken because these have an anti-inflammatory effect when taken together. A pro-inflammatory effect of common unhealthy dietary fats is the overproduction of arachidonic acid. This pro-inflammatory effect is blocked by the omega-3 fatty acids. The omega-3 essential fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are found in the oil from fatty fish. The minimum dose of EPA/DHA is 1400 mg daily. Precursors of EPA/DHA are found in flax and perilla seed oils. Minimum dose is 6000 mg daily. A potent anti-inflammatory fatty acid is GLA (gamma-linolenic acid) which can be obtained from evening primrose, black currant seed, or borage oils. A suggested dose would be 900-1500 mg daily of GLA from these oils. Borage oil provides the highest concentration, thereby requiring fewer capsules to be taken. All supplements, if possible, should be kept in the refrigerator or freezer and should be taken at the beginning of a meal to reduce heartburn and after-taste.

The average American diet contains ten times more dangerous omega-6 fatty acids compared to omega-3 fatty acids. This alters the cell membrane phospholipids and increases the likelihood of inflammatory responses in atopic (allergic) diseases. A study by Kankaanpaa et al. (1999) concluded that careful manipulation of polyunsaturated fatty acids (PUFAs) may play a key role in the successful management of inflammation occurring in atopic (allergic) diseases.

Note: Beneficial fatty acids are found in the oils in fish, corn, walnut, sunflower seeds, soy beans, cotton seed, safflower, and most other edible oils except those of olive and peanut which are predominantly monounsaturated (a single unsaturated bond per molecule). It is the polyunsaturated omega-3 and omega-6 fatty acids that are essential because the body cannot manufacture them, but which are required in multiple vital body processes, including synthesis of beneficial prostaglandins.

A deficiency or imbalance in these essential fatty acids has profound adverse effect on health, yet this is a common problem in America today. An ointment containing the essential omega-3 fatty acids, DHA and EPA, produced satisfactory results in 64 patients with refractory dermatitis (Watanabe et al. 1999), and a study of 135 children with allergic diseases showed that a supplement containing omega-3 essential fatty acids resulted in healthier cell membranes. Clinical evaluation substantiated that improved membrane integrity lessens the numbers of allergic assaults (Gorelova et al. 1999).

A study listed the diets of 3-month-old infants and their mothers to assess the effect of fatty acids in the diet. Infants with allergies had less GLA in their serum phospholipids than healthy infants. It was also noted that even though the mothers had similar fatty acids in their diets, the allergic mothers had less GLA in their breast milk. The authors concluded: "high dietary proportions of N-6 PUFA (arachidonic acid and its precursors common in the American diet) with reduced portions of regulatory PUFA such as gamma-linolenic acid (essential omega-6) and N-3 PUFA (ALA, EPA, DHA) may be a risk factor for the development of atopic disease" (Kankaanpaa et al. 2001).

This would suggest that women with allergies who are breast-feeding should take GLA (essential omega-6 in borage oil, evening primrose oil, etc.), and the essential omega-3 fatty acids EPA and DHA (or their precursor, alpha linolenic acid found in flax or perilla oil) as supplements.

Coenzyme Q10 (CoQ10). CoQ10 is an essential factor in the tiny energy producers, the mitochondria, present in all cells. Mitochondria produce the vital chemical ATP (adenosine triphosphate) which is the energy source for all living processes. CoQ10 is also a potent antioxidant and, along with vitamin E, functions as an antioxidant in hard to reach cell parts, such as the mitochondrial membrane. Dangerously low CoQ10 levels were originally noted in gravely ill cardiac patients; however, CoQ10 can also become seriously depleted in many forms of degenerative disease and a study showed that 14 out of 36 patients with diverse allergic conditions had CoQ10 levels equal to a group of gravely ill cardiac patients (Ye et al. 1988). In general, CoQ10 levels decline significantly with age. CoQ10 is best taken as an oil-based supplement with tocotrienols in a dose of 30-300 mg daily.

Vitamin E. Vitamin E is a fat-soluble vitamin that acts as a free radical scavenger of lipids or fat, protecting cell membranes and preventing damage to membrane-associated enzymes. Leukotrienes (LT) are lipid membrane-derived compounds generated by the metabolism of arachidonic acid by the enzyme lipoxygenase found in leukocytes and other cells. In a manner somewhat analogous to histamine, leuko-trienes have a number of undesirable allergic and inflammatory effects, including smooth muscle contraction; vaso-constriction; vasodilatation and increased blood vessel permeability; simulation of mucus secretion; and increased airway hyporeactivity.

Centanni et al. (2001) considered the role vitamin E plays in treating asthma and allergies by modifying the leukotriene pathway with vitamin E. Vitamin E in a concentration-dependent manner inhibited the receptor-mediated activation of neutrophils which, in an asthmatic, results in the synthesis of leukotrienes. The study indicated that vitamin E may suppress leukotriene pathways, making it potentially useful in the treatment of asthma/allergic patients. Four types of vitamin E occur in nature as well as an additional four types of its close relatives, the tocotrienols, which are particularly effective free radical fighters at the cell membrane level. Since each of these agents seems to have unique functions, a supplement containing a mixture of these naturally occurring compounds called Gamma E Tocopherol/Tocotrienols is available.

Recommendations for vitamin E are usually 400-800 units daily. This can easily be achieved through the use of the basic Life Extension Mix plus one "gamma E" supplement. A study by Hijazi et al. (2000) indicated lower levels of antioxidants such as vitamin E increased the risk of allergies by threefold. Allergic reactions can be mitigated and sometimes eliminated by maintaining high levels of antioxidants. The research of Dr. Linus Pauling, two-time Nobel Prize winner, has highlighted vitamin C as an essential water-soluble nutrient that acts as a free radical scavenger, enhances collagen synthesis, and boosts immune function. In particular, vitamin C is a natural antihistamine and may be taken at doses up to 12,000 mg or more daily, provided the dose is kept below the diarrhea level.

Flavonoids. Certain flavonoids, particularly rutin and quercetin, have anti-allergy effects (Fanning et al. 1983) and team up well with vitamin C, as do the oligomeric proanthocyanidins (OPC) found in grape seed extract. Proanthocyanidins (grapeseed extract) may be taken (100 mg) one to three times a day. Bucca et al. (1990) found that compared to a placebo, 2 grams of vitamin C improved pulmonary function 1 hour after taking. Featon et al. (2000) found a sevenfold increase in bronchial hyperreactivity among those with the lowest intake of vitamin C. The most effective form of quercetin is a patented water-soluble version that is available from only a few supplement companies in the United States.

Alpha-Lipoic Acid. Alpha-lipoic acid (LA) has been called the universal antioxidant because of its broad-spectrum effects in the body. LA not only works independently as an antioxidant, but it also works synergistically with other antioxidants such as vitamins C and E, glutathione, and CoQ10, helping to recycle their biologic actions in the body. In Germany, LA is an approved treatment for neuropathies and liver disease. LA should be taken at doses of 250 mg 2 times a day along with the B vitamin biotin. Individuals with elevated blood sugars should start LA treatment gradually because an initial dose that is too high could bring elevated blood sugars down too abruptly and produce transient hypoglycemic symptoms.

N-Acetyl-Cysteine. Glutathione (GSH) is a naturally occurring tripeptide that protects every cell from toxic free radicals. It contains the three amino acids glycine, glutamic acid, and cysteine. N-acetyl-cysteine (NAC) is an acetylated ester of the amino acid, cysteine. NAC has a powerful effect on raising glutathione levels in the body. In fact, it has been found more potent than giving glutathione itself. For many years, NAC has been used in the treatment of bronchitis and other lung conditions as an expectorant or mucous thinner as well as for its anti-inflammatory effects. NAC is also the treatment of choice to reduce the toxicity of acetaminophen, particularly when toxic doses are present. NAC has been shown to enhance T-cell function. NAC should be taken in a dose of 600 mg once daily. NAC should be accompanied by vitamin C, 1000 mg or more per 600 mg of NAC, to maintain its effectiveness.

As noted, L-glutathione may be taken as a supplement, however, NAC as a precursor to glutathione may naturally raise glutathione to optimal levels more readily than glutathione itself taken orally. Intravenous glutathione has been used by Dr. Perlmutter in the treatment of neurological conditions, raising the possibility that similar therapy may be of value in certain severe allergic/immunological conditions, such as severe asthma (Perlmutter 2000). Studies have indicated a causal role for oxidative stress in asthma and in contact dermatitis. Glutathione, NAC, and other antioxidants are recommended to counter oxidation (Willis et al. 2001).

IgE antibodies are involved in hay fever, asthma, anaphylactic shock, and atopic skin disease (e.g., eczema). Interleukin 4 (IL-4) is a factor in the production of IgE antibodies. A study by Bengtsson et al. 2001 showed supplementation with NAC and glutathione lowered levels of IL-4 and enhanced T-cell proliferation. Nitric oxide (NO) in expired air is a good indicator of the severity of respiratory diseases such as asthma, emphysema, and cystic fibrosis (Corradi et al. 2001). Glutathione binds with NO to create nitrosothiols (RS-NOS). This binding can help reduce the inflammatory effects of NO. Future studies should give a better picture of how effective this may be.

Magnesium. Magnesium is a mineral utilized by every cell of the body and participates in energy metabolism and protein synthesis. The body vigilantly protects blood magnesium levels, in part because at least 350 enzymatic processes depend upon magnesium status for activation. An intake of magnesium supplements from 500-1000 mg daily is particularly helpful in many conditions such as bronchial asthma, as well as cardiac arrhythmias, hypertension, migraine headaches, and others. The dose should be kept below the diarrhea level. Magnesium should be accompanied by 900-1000 mg daily of elemental calcium in a tablet or capsule that completely dissolves. Some individuals may require higher levels of calcium, up to 1500 mg daily. Calcium has a constipating effect which tends to offset the diarrheal effect of magnesium. Calcium and magnesium supplements should not be taken at the exact same time as the essential fatty acids because they tend to mutually interfere with absorption.

Stress plays a major role in allergic reactions. Magnesium plays an important role in managing all forms of stress, whether the stress is physical, emotional, or the result of injury/trauma (Seelig 1994). As magnesium levels decline, the incidence of allergies and asthma increases (Hijazi et al. 2000). As noted earlier, magnesium is required for many necessary functions, making it easy to understand the need for magnesium supplements.

Zinc. Zinc plays an important role in proper functioning of the immune system. A safe daily dose is 30 mg daily for an adult. It is recommended that the total daily intake be kept below 60 mg.

Ginkgo Biloba And Beta-Glucan. Ginkgo biloba comes from a tree considered the last existing member of a group of ancient trees called Ginkgoaceae still found in China. Extracts from the leaves of ginkgo are used to stimulate circulation and improve brain function. Beta-glucan (carboxy-methyl-beta-1,3-glucan) is isolated from the medicinal hiratake mushroom and other sources, particularly other oriental mushrooms. Beta-glucan is a non-digestible long-chain carbohydrate derived from the cell walls of these plants. Taken orally, beta-glucan is a potent immune stimulant with a beneficial effect on multiple areas of immune function. It has no known toxicity. As a topical agent, it has been found to help relieve skin conditions, including dermatitis and eczema. Ginkgo biloba in combination with beta-glucan has helped to alleviate contact dermatitis (Castelli et al. 1998). An ingredient from ginkgo has been shown to have a positive effect on asthma (Mahmoud et al. 2000) and significantly reduces airway hyporeactivity. In another study, the authors concluded that ginkgo was an effective drug for relieving airway inflammation (Li et al. 1997).

Cordyceps Sinensis. The Chinese medicinal fungus Cordyceps sinensis is said to have once been reserved for use only by the Emperor. It has long been used in Chinese medicine for the treatment of respiratory problems as well as heart, liver, and kidney dysfunction and as a longevity-promoting agent (Zhu et al. 1998). C. sinensis has been used for the treatment of allergic rhinitis and asthma. This was due to both its action as a smooth muscle relaxant (bronchodilator) and also from its action in reducing airway reactivity and inflammation. Extracts from the stinging nettle leaf and the herb angelica have also been reported to have anti-allergy properties. Stinging nettle leaf extracts are particularly useful when combined with quercetin (preferably water-soluble quercetin) and vitamin C, and have been found to be useful in patients who are intolerant to antihistamines or fail to respond to them.

DHEA. DHEA is a steroid hormone produced by the adrenal glands. It is used by the body in a variety of functions and acts as a precursor for male and female hormones. DHEA is the most abundant steroid in the bloodstream and is present in highest levels in brain tissue. DHEA can modulate autoimmune reactions and has been used in treating conditions such as lupus erythematosis. Levels of DHEA are found to be progressively lower in people as they age and supplementation has been shown to reverse some of the effects of aging on the immune system (Weksler 1993). DHEA is contraindicated in men and women with certain hormone related cancers. Refer to the DHEA Replacement Therapy protocol for dosing and safety precautions before using DHEA. Before using any nutritional supplement, hormone supplement, prescription medication, or over-the-counter drug, all women who are either pregnant or who may become pregnant should check with their personal physician, preferably their obstetrician.

Continued . . .

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