Allergies and Allergic Reactions

July, 2006

Definition of the Problem
Allergies are one of the greatest causes of illness and disability in the United States. As many as 50 million Americans have allergies of some kind;. the most common allergy is probably hay fever (“allergic rhinitis”), which affects about 36 million people (AAAAI, 2006).

There are many other types of common allergies, including sensitivity to pets, food, and insect bites, and also various allergies that can cause rashes or scaly skin. Add to these the uncommon or atypical allergies that many people seem to experience, and it’s no wonder that they are so common. Nearly everyone seems to be allergic to something.

Having allergies can also make you more prone to other problems (including asthma, recurring ear infections, and sinus problems), or they can often make these problems worse (Settipan, 1999).

Typical allergy symptoms include itching, sneezing, runny nose, and cough, fatigue, and insomnia. The symptoms are not only physical, for allergies can even slow down your thinking.

Any of these symptoms can significantly affect the quality of one’s life, and they also can impose significant financial burdens on employers, their customers, insurers, and the economy from lost work due to increased sick leave time (Klein, Ziering et al, 1985; Settipan, 1999).

Scope and Cost of the Problem
Each year, lost productivity due to allergic rhinitis alone costs the American economy s lose 3 million workdays because of allergies at an estimated cost to the economy of $250639 million annually (Smart, 2004). Allergies in children result in a loss of about 2 million school days each year.

Hay fever alone Allergies results in about 15.216 million physician visits per year (NIH Fastats). The cost of medical tests, medications, and allergy shots for allergies costs about $2 billion ($2,000,000,000) a year.

When you add economic costs to medical costs, the numbers are even larger. For example, the total estimated cost to the economy for allergic rhinitis alone was $2.7 billion in 1995, exclusive of the additional costs for associated medical problems such as sinusitis and asthma (Dykewica and Fineman, 1998).

Medical Treatment
Standard medical treatment for allergies includes antihistamines, decongestants, steroids, cromolyn (for respiratory tract allergies), skin ointments, eye drops, nasal sprays, and a variety of new medicines called LTRA’s.

Unfortunately, none of these medications can cure allergies, and many of them can produce significant side effects or complications. Some, such as antihistamines, may cause drowsiness. Others, such as decongestants, can raise blood pressure and heart rate, and others, such as steroids, can cause many other problems.

Desensitization injections (“allergy shots”) may be helpful for some people, but they are expensive and require frequent clinic visits (Ivker, 1995).6

Complementary Treatment Including Imagery and Self-Hypnosis
The causes of allergies are thought to include heredity factors, past and present environmental exposure, and stress (Ivker, 1995).6 Anxiety is also strongly linked with many kinds of allergies, especially rhinitis and dermatitis (Addolorato, Ancona et al, 1999; Czubalski and Zawisza, 1976; Michel, 1994; Weir and Stephens, 1976).7-10

Anti-anxiety programs using relaxation and guided imagery have been used with great success in allergic dermatitis (Klein, Ziering et al, 1985; Shertzer and Lookingbill, 1987; Stewart and Thomas, 1995).11-13 These methods have not been studied as much in allergic rhinitis (AR). This may be because results are harder to measure in AR than they are in dermatitis.

When one researcher taught self-hypnosis to a group of patients with a variety of allergies, 76% said they felt better, and 86% reduced their medication usage. They continued to show improvement when they were examined for follow-up two years later (Madrid, Rostel et al, 1995).14 Patients taught self-hypnosis showed significant improvements in their hay fever symptoms (Langewitz, Izakovic et al, 2005).

A review of hypnosis in allergic subjects illustrated how relaxation, imagination, and concentration can change the immune system’s response to an allergen (Wyler-Harper, Bircher et al 1994).

Since allergies are usually mediated by the immune system, anything that affects the immune system can affect allergies, as well. Research in psychoneuroimmunology has demonstrated that psychological interventions, including relaxation and guided imagery, tend to “calm down” the immune system (Kiecolt-Glaser, Malarkey et al, 1993; Pennebaker, Kiecolt-Glaser, 1988; Zachariae, Kristensen et al, 199015-17, and a calmer immune system appears to be beneficial for many allergic reactions.

Thorough cleaning and effective ventilation to reduce allergens, avoiding allergy triggers, regular relaxation, exercise and healthier eating (Ivker, 1995)6 can also help to reduce or eliminate some types of allergies.

Research available to date supports the conclusion that guided imagery can people help cope with allergies, and reduce allergy symptoms, office visits, and medication usage in many cases.

Addolorato G, Ancona C, Capristo E, Graziosetto R, Di Rienzo L, Maurizi M, Gasbarrini G. State and trait anxiety in women affected by allergic and vasomotor rhinitis. J Psychosom Res. 1999 46(3):283-9.

American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/patients/resources/fastfacts/allergies.stm www.aaaai.org/media/newsroom/am2003/allergystatistics.stm. Accessed May, 2003. Accessed July, 2006.

Czubalski K, Zawisza E. The role of psychic factors in patients with allergic rhinitis. Acta Otolaryngol. 1976 81(5-6):484-8.

Dykewicz MS, Fineman S. Executive Summary of Joint Task Force Practice Parameters on Diagnosis and Management of Rhinitis. The Joint Council of Allergy, Asthma, and Immunology. 1998.

Ivker R. Sinus Survival (3rd Edition). (1995) New York: Jeremy Tarcher p. 65-68.

Kiecolt-Glaser JK, Malarkey WB, Chee M, Newton T, Cacioppo JT, May HY, Glaser R. Negative behavior during marital conflict and immunological down-regulation. Psychosomatic Medicine. 1993 55: 395-409.

Klein GL, Ziering RW, Girsh LS, Miller MF. The allergic irritability syndrome: four case reports and a position statement from the Neuroallergy Committee of the American College of Allergy. Ann Allergy. 1985 Jul;55(1):22-4.

Langewitz W, Izakovic J, Wyler J, Schindler C, Kiss A, Bircher AJ. Effect of self-hypnosis on hay fever symptoms - a randomised controlled intervention study. Psychother Psychosom. 2005;74(3):165-72.

Madrid A, Rostel G, Pennington D, Murphy D. Subjective assessment of allergy relief following group hypnosis and self-hypnosis: a preliminary study. Am J Clin Hypn. 1995 Oct;38(2):80-6.

Michel FB. Psychology of the allergic patient. Allergy. 1994 49(18 Suppl):28-30.

National Center for Health Statistics. Fastats. National Institutes of Health
Accessed July, 2006. http://www.cdc.gov/nchs/fastats/allergies.htm.

Pennebaker JW, Kiecolt-Glaser JK, Glaser R. Disclosure of traumas and immune function. J of Consulting Clinical Psychiatry. 1988 56:239.

Settipane RA. Complications of allergic rhinitis. Allergy Asthma Proc, 1999 20(4):209-13.

Shertzer CL, Lookingbill DP. Effects of relaxation therapy and hypnotizability in chronic urticaria. Arch Dermatol, 1987 123(7):913-6.

Smart BA. The Costs of Asthma and Allergy. Allergy & Asthma Advocate: Fall 2004. http://www.aaaai.org/patients/advocate/2004/fall/costs.stm. Accessed July, 2006.

Stewart AC, Thomas SE. Hypnotherapy as a treatment for atopic dermatitis in adults and children. Br J Dermatol, 1995 132(5):778-83.

Weir NF, Stephens SD. Personality measures in E.N.T. outpatients. J Laryngol Otol. 1976 90(6):553-60.

Wyler-Harper J, Bircher AJ, Langewitz W, Kiss A. Hypnosis and the allergic response. Schweizerische Medizinische Wochenschrift. Supplementum. 1994, 62:67-76.

Zachariae R, Kristensen JS, Hokland P, Ellegaard J, Metze E, Hokland M. Effect of psychological intervention in the form of relaxation and guided imagery on cellular immune function in normal healthy subjects. An overview. Psychother Psychosom, 1990 54(1):32-9.