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Integrative approach for Pediatric Allergies

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73% of class rooms contain 4 or more allergens. 85% of class rooms have irritants ... Women with allergies and hormone imbalance 600 IU a day. Men need 400 IU per day ... – PowerPoint PPT presentation

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Title: Integrative approach for Pediatric Allergies


1
Integrative approach for Pediatric Allergies
  • Richaritha Gundlapalli MD, FAAP

2
Disclaimer
  • No financial intention or association to any
    companies.
  • Not intended to use for prevention, treatment or
    cure any disease.

3
Objectives
  • Discuss Conventional Approach for allergies
  • To learn about holistic approach for management
    of allergic rhinitis
  • Ayurveda
  • Naturopathy
  • Chinese medicine
  • Aromatherapy
  • Chiropractice

4
Allergy
  • The word allergy derives from the Greek words
    allos meaning "other" and ergon meaning
    "reaction" or "reactivity".
  • An allergy is a immune malfunction whereby a
    person's body is hyposensitized to react
    immunologically to typically nonimmunogenic
    substances.

5
Epidemiology
  • Marked increase in prevalence of AR in urban
    setting and small rise in rural areas.
  • 20-40 of children suffer from AR.
  • Recent study showed
  • 73 of class rooms contain 4 or more allergens
  • 85 of class rooms have irritants

6
Allergies on rise..
  • ? Small genetic mutation
  • Allergen Exposure Hypothesis
  • Diverse and exotic foods with artificial flavors,
    preservatives, additives
  • Spend more time indoors - contact with dust,
    synthetic materials, chemicals, indoor pets.
  • Technical development - air conditioning, central
    heating, wall to wall carpeting, sealed windows,
    increase use of formaldehyde, plastics.
  • Electro magnetic pollution
  • Hygiene Hypothesis
  • Inadequate exposure to genuinely harmful agents
    leads to immune dysfunction.
  • Increase use of antibiotics, vaccinations,
    obsession with germs, sanitizers.
  • Ig E in the absence of harmful agents, attacks
    harmless environmental substances.

7
Allergies on rise
  • Severe virus infection damage immune system
  • Stress, Stress, Stress..
  • Diet
  • Too early weaning
  • Abundant in calories and low in nutrients
  • Depleted soil

8
Allergic rhinitis
  • Allergic rhinitis inflammation of the lining
    of the nose, characterized by one or more of the
    following symptoms
  • Nasal congestion
  • Rhinorrhea
  • Itching
  • Conjunctival irritation
  • Sneezing
  • Tiredness

9
Complications
  • Chronic sinusitis
  • Nasal polyps
  • Otitis media, ET dysfunction
  • Adenotonsillar hypertrophy, mouth breathing
  • Co-exist with asthma
  • Obstructive sleep apnea, day time fatigue
  • Learning difficulty

10
External aggravators
  • Seasonal allergies (Intermittent) 20
  • Weed (late summer)
  • Grass (early summer)
  • Tree pollens (spring)
  • Fungal spores (after rain)
  • Perennial allergies (persistent) 40
  • Animal dander, cockroaches, dust mites, molds.

11
Internal Aggravators
  • Allergic Personality - nervous, with neurotic and
    hypochondriacal tendencies.
  • Chronically stressed and hyper-alert state
    demands high alpha-sympathetic activity (nor
    epinephrine). Chronic histamine elevation.
  • Adrenal exhaustion blunted cortisol production
    in response to normal daily stressors, or,
    functionally low cortisol activity with normal to
    high serum or salivary cortisol.
    (Buske-Kirschbaum A. Psychosom Med. Sep-Oct
    200365(5)806- 810).

12
Environmental triggers
  • Indoors (school)
  • Chalk powder
  • Insufficient air flow
  • Magic markers
  • Paints
  • Dust mites, molds
  • Glue
  • Cleaning agents

13
Medical Management
  • Avoidance
  • Antihistamines
  • Glucocorticoids
  • Leukotriene modifying agents
  • Chromones
  • Immunotherapy.

14
Ayurvedic perspective
  • Allergy is explained in Ayurvedic literature as
    the concept of asatmya.
  • Aushadha anna viharanam upayogam sukhavaham sahi
    satmyam. Satmya is when persons doshas accept and
    adjust to medicines, dietary, and environmental
    changes.
  • Satmya means tolerance.
  • Asatmya (intolerance) is when one or more
    doshas do not accept these things and they react
    often as an allergy.
  • The root cause is imbalanced agni.

15
Vata Type
  • Gas, bloating, distension, discomfort.
  • Breathlessness, sneezing.
  • Headache, insomnia, tinnitus.
  • Due to Vishama agni (irregular digestion).
  • Season Winter, Fall
  • Emotionally -Repressed fear, anxiety, insecurity.

16
Chikitsa (treatment)
  • Two categories
  • Shamana Palliative therapy for acute phase of
    allergies
  • Shodana Detoxification program to remove doshic
    causes of allergies. Panchakarma is only done
    once the acute symptoms are under control.

17
Management
  • Herbal formula
  • Ashwagandha (Withania somnifera) - 2 parts
  • Bala (Sida cordifolia) - 1 part
  • Vidari Kanda (Ipomoea digitata) - 1 part
  • Yastimadhu (Glycyrrhiza glabra) - 1 part
  • Haritaki (Terminalia chebula) - 1 part
  • 1/4 tsp TID with warm water before meals.

18
For Wheezing..
  • For Wheezing
  • 1/4 tsp ginger (Zingiber officinale)
  • 1/4 tsp Yastimadhu (Glyceriza glabra)
  • 1/4 tsp Pippali (Piper longum)
  • A pinch of salt
  • 1 cup hot water
  • Panchakarma Basti (Enema)
  • Dashamoola decoction

19
Management
  • Vata Herbal Tea
  • Ashwagandha 20gm
  • Vidhari 20gm
  • Tagar 20gm
  • Trikatu 10gm
  • Triphala 30gm
  • Make tea with 10gm of the mixture
  • Vata Massage oil Mahanarayana Tailam

20
Pitta type
  • Stomach ache, diarrhea, nausea, vomiting
  • Hives, rashes, urticaria, eczema, psoriasis.
  • Due to Teekshna agni (sharp digestion)
  • Season Summer season.
  • Allergic - peanuts, strawberries, citrus fruits,
    eggs, hot spicy foods, hard cheeses.
  • Environmental chemical sensitivity.
  • Emotionally Anger , hate, irritability, envy

21
Management
  • Herbal formula
  • Shatavari 500mg
  • Guduchi or Gulwel Satva 300mg
  • Kama dudha 200mg
  • Take ½ tsp with warm water or cilantro juice
    after meals.

22
Management
  • Blood cleansing
  • Manjishta (Rubia cordifolia) - 3 parts
  • Nimba (Azadirachta indica) - 1 part
  • Turmeric (Curcuma longa) - 2 part
  • Amalaki (Phyllanthus emblica) - 2 parts
  • Guduchi (Tinospora cordifolia) - 1 part
  • Beneficial for Allergic skin problems

23
Management
  • Blood purification
  • Burdock tea - three times daily
  • Dermatological problems
  • Apply liberally Neem oil externally on the skin.
  • Rose water for cooling effect on the skin
  • Cilantro pulp
  • Mix equal parts of sandal wood and turmeric with
    water and apply on the affected area.

24
Management
  • Panchakarma
  • Raktamokshana
  • (Blood letting / blood donation) Donate 1/2 pint
    or 100 cc blood to blood bank.
  • Virechana (Purgation therapy)
  • 2 Tbs Castor oil or Flax seed oil or Olive oil
  • 1/4 teaspoon dry ginger powder
  • 1 cup hot milk / soy milk / rice milk
  • Bed time for 3 consecutive days

25
Management
  • Pitta Herbal Tea
  • Dhania 5gm
  • Saunf 5gm
  • Jeera safed 5gm
  • Dalchini 5gm
  • Guduchi 10gm
  • Punarnava 20gm
  • Brahmi 10gm
  • Make tea with 10gm of mixture

26
Kapha Type
  • Hay fever, cold, congestion, cough, sinus
    infection, or asthma.
  • Due to Mandagni (Slow digestion).
  • Season spring season.
  • Sensitive to milk and dairy products, wheat, red
    meat and other kapha aggravating foods.
  • Emotionally - lethargy, depression, repressed
    greed, possessiveness, attachment.

27
Kapha type
  • Herbal formula
  • Sitopaladi 500mg
  • Mahasudarshan 300mg
  • Licorice 300mg
  • Pippali 200mg
  • ½ tsp with warm water after meals.

28
Management
  • Herbal formula
  • Sitopaladi - 4 parts
  • Tulasi (Ocimum sanctum) - 2 parts
  • Yastimadhu (Glycyrrhiza glabra) - 2 parts
  • Kantakari (Solanum xanthocarpum) - 1part
  • Vasa (Adhothoda vasica) - 1 parts
  • Bibhitaki (Terminalia belerica) - 1part
  • 1/2 tsp three times daily with honey before meals

29
Management
  • Panchakarma Vamana (Vomiting therapy)
  • Licorice tea with rock salt, drink full stomach
  • Rub or irritate the back of the tongue to induce
    vomiting reflux
  • Kapha herbal Tea
  • Mulati 20gm
  • Shatawari 10gm
  • Trikatu 10gm
  • Tulasi 40gm
  • Gokshru 10gm
  • Triphala 10gm
  • Use 10gm for making tea

30
Tri-dosha Allergies
  • Triphala - Combination of three fruits
  • Haritaki - Balances Vata
  • Amalaki - Balances Pitta
  • Bibhitaki - Balances Kapha
  • Natural antioxidant, removes free radicals, help
    to maintain doshic balances by detoxifying cells
    and increasing longevity.

31
Rejuvenation
  • Rejuvenation program (Rasayana) Art of
    rebuilding and revitalizing tissues through
    proper lifestyle, diet, herbs, yoga and
    meditation.
  • Allergy is natures demand for physical, mental
    and emotional cleansing through radical change.
  • Haritaki - vata type allergies
  • Amlaki - pitta type allergies
  • Vibhitaki - kapha type allergies
  • Combination of all three is triphala.

32
Dietary Regimen
  • Vata allergy - Vata pacifying foods
  • Eat warm, lubricating foods.
  • Pitta allergy - Pitta pacifying foods
  • Eat cooling foods.
  • Kapha allergy - Kapha pacifying foods
  • Warm, spicy foods.

33
Viruddha Ahara
  • Milk - Yogurt, fish, sour fruits
  • Meat, Poultry -Diary products
  • Corn - dates, raisins, bananas
  • Nightshades - yogurt, milk, melon, cucumber
  • Fruits, Melons - Starches, Grains
  • eg banana milk shakes, fruit smoothies etc.

34
Breathing Exercises
  • Sukha Pranayama (Alternate nostril breathing) -
    hay fever, wheezing, sneezing, Immune system.
  • Bhastrika Pranayama - Congestion
  • Ujjayi Pranayama - Improve immunity

35
Yoga
  • Yoga Postures
  • Surya Namaskar (Sun salutations) - Kapha, Vata
  • Chandra Namaskar (Moon salutations) - Pitta
  • Stress Management
  • Meditation mindfulness, mantra, guided
    meditation.

36
Naturopathy - treatment
  • Body Detoxification
  • Most allergies - due to impaired digestive system
  • Bentonite clay 1 tsp in 10 oz water.
  • Hydrotherapy colonics and enemas
  • Fasting Watermelon lemon fast is great
    detoxifier.
  • Detoxifying home, school
  • Air filters, plants

37
Naturopathy
  • Diet Best menu for preventing allergies -
    Rotation diet
  • Lifestyle changes Avoid commercial products with
    artificial ingredients.
  • Soaps without artificial scents, colors,
    petroleum products.
  • Shaving cream made from natural soap
  • Moisturizer sesame oil (Vit E)
  • Room deodorizer lemon juicevinegar

38
Naturopathy- cont
  • Avoid pesticides. Boric acid get rid of ants,
    roaches.
  • Glass cleaner 3Tbs vinegar 1 quart water
  • Baking powder for scouring powder
  • All purpose cleaner Borax with water
  • Fabric softener 1 cup vinegar to final rinse
    cycle
  • Avoid dry cleaning if possible

39
Supplements
  • Vitamin C 3000mg in divided doses.
  • Reduce histamine levels
  • Detoxifies, strengthens immune system, reduce
    inflammation
  • Best with 100-200mg bioflavonoid quercetin and
    100-200mg of pycnogenol.
  • Vitamin E Strengthens endocrine, immunity.
  • Women with allergies and hormone imbalance 600 IU
    a day.
  • Men need 400 IU per day
  • Vit E works well with 100mcg of selenium

40
Supplements
  • Probiotics
  • Supporting immune function. Modulating T-cell
    activity
  • Generate B vitamins
  • Quercetin 500mg BID
  • Inhibit histamine release and reduce nasal
    congestion
  • Reduce IL, acts as antioxidant and cell membrane
    stabilizer.
  • Best food sources - capers, fennel, bee pollen,
    cocoa powder
  • Bee propolis and pollen
  • Modulate mast cell degranulation, histamine
    activity. Anti-inflammatory
  • Use local honey.

41
Supplements
  • B Complex
  • Enhance immunity. B5, B6, B12
  • B5 is building block of cortisone
  • Minerals
  • Zinc good for food allergies
  • Calcium citrate
  • EFA and GLA
  • EFA stabilize mast cells
  • Flax seed oil. GLA - primrose oil, black currant
    seed
  • Fish oil 20mg/kg/day for children. Adults
    1-2g/d
  • Digestive enzymes anti inflammatory.

42
Herbs
  • Garlic
  • Builds immunity and natural antiseptic
  • Astragalus
  • Immune stimulant. Increase number and activity of
    immune cells
  • Echinacea
  • Boosts immunity and fast recovery. Should be used
    for short intervals.
  • Ginseng
  • Builds stamina and endurance by boosting
    immunity.

43
Avoid
  • STRESS physical, psychological
  • Stimulants caffeine, cigarettes
  • No White poisons- white flour, white sugar, salt
  • Avoid low ph foods.
  • Avoid chemicals in soaps, detergents, lotions..
  • Avoid processed foods, stale foods.

44
Aromatherapy
  • Stress - Lowers immunity and decrease mast cell
    stabilization.
  • Medical grade Essential oils of Lavender, Roman
    chamomile, Neroli, Petitgrain reduce NE release
    and central anxiolytic via GABA. (Perry N. CNS
    Drugs. 200620(4)257- 280).
  • A 3-5 concentration of lavender and chamomile
    taken BID reduce nervous tension.
  • Frankincense, peppermint hydrosol - relieve
    congestion
  • Diluted lavender or frankincense essential oils
    for anti-inflammatory and skin regenerative
    properties

45
Chiropractic
  • Increase NK cell production, Ig, lymphocyte,
    neutrophils. Rectifies Autonomic imbalance.
  • Specifically assess C6 to T3 and T7 to T12 (for
    adrenals) as well as L4 and L5.
  • Applied kinesiology muscle testing

46
Chinese
  • Allergies are regarded mostly as being caused by
    either
  • Spleen Qi deficiency, which tend to manifest as
    liquid/runny allergic response. (Kapha type)
  • Yin deficiency which tend to manifest with
    redness, itching and dryness. (Pitta type)
  • Bu Zhong Yi qi Tang classical prescription for
    allergic rhinitis.

47
Acupuncture/Acupressure
  • Wind-cold effecting the lung (Vata)
  • Sneezing, runny nose, slight headache
  • Protocol Expel wind-cold, restore descending and
    dispersing LU Qi.
  • Treatment points
  • UB 12 Main point for wind disorders
  • UB 13 LU back shu
  • GB 20 Expel wind (Karnamoola marma point)
  • GV 23- Expel wind from nose
  • LU 7 Restore descending dispersing function
    of LU Qi

48
Acupuncture/Acupressure
  • Root deficiencies of Spleen, LU, KD, GV
  • Tonify Spleen SP 6
  • Tonify Kidney KD 3, UB 23
  • Tonify Lung UB 13, GV 12
  • Strengthen governing vessel GV4, CV 4, GV 14

49
(No Transcript)
50
  • Namaste
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