Posted in allergies, Health, news, sex

Woman Suffers Severe Allergy After Exposed to Penicillin During Oral Sex

Doctors report in  BMJ Case Reports a rare episode of severe allergy (anaphylaxis) after a women performed oral sex.

The patient presented to a hospital in Spain in “moderate anaphylaxis.” Her boyfriend had been taking Ibuprofen and Augmentin (amoxicillin/clavulanic acid) for an ear infection with a dose 4 hours prior to engaging in oral sex. She within hours began vomiting, having difficulty breathing and full body hives.  Doctors deduced she had a penicillin allergy and was reacting to the amoxicillin that could have concentrated in her boyfriend’s semen.

Amoxicillin is in the same antibiotic class as penicillin.

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Although there have been cases of people reporting allergic reactions to the proteins in semen this was one of the first documented cases in which a drug taken orally by a person was transferred to a hypersensitive patient through oral sex.

Study authors write:

To our knowledge, this is the first case reported of a suspicion of amoxicillin-induced anaphylaxis in a woman after a sexual contact with a man who was taking the drug, we hypothesised an oral drug transfer through semen.
Studies about amoxicillin concentrations achieved in semen after a drug intake are scarce. There are few cases reported of hypersensitivity reactions induced by drugs transported in semen but we have found some concern in sensitive patients about the possibility of transference of allergens via sexual intercourse. As clinicians, we consider that it is important to be aware of the existence of this possibility both in the diagnosis and in the prevention of anaphylactic reactions.

10% of the population reports an allergy to penicillin, but the CDC estimates less than 1% are truly allergic.

What is anaphylaxis?

Anaphylaxis is a severe allergy that may be life threatening.

Symptoms include:

  • Difficulty breathing
  • Dizziness
  • Rapid heart rate
  • Hives
  • Rash
  • Low blood pressure
  • Feeling of throat tightening
  • Nausea
  • Vomiting
  • Abdominal Pain
  • Weakness
  • Chest Pain
  • and more…

It can lead to cardiac arrest, hence it’s a medical emergency and any suspicion of it should prompt a call to 911.

What are allergies?

Allergies are the result of the immune response to a foreign particulate that our body senses.  One could be allergic to pollen, dust, dander, food, insects, mold, metals, transfused blood, grafts, medicine and anything the body senses as a foreign intruder.  Even though these may be individually harmless, a hypersensitivity reaction occurs as a result of their intrusion into the body.  IgE antibodies find the allergen (intruder) and activate mast cells in the tissue and basophils in the blood.  When these cells get activated, they release substances to help protect the body, including histamines, leukotrienes, and cytokines. These help the body attempt to sneeze and cough the allergen out, wall off the antigen, signal more antibodies, or produce tears and nasal secretions to flush it out.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in allergies, Health, news, weather

Allergy Season May Start Early This Year

Multiple states are bracing for “early” allergy seasons.

We still have a month left of winter yet grass is sprouting, leaves are growing and flowers are blooming.  Add just having a wetter winter and warmer-than-normal temperatures to the mix and this is the perfect recipe for an early allergy season.

Allergy season usually begins with the start of Spring in March.  Yet many may start their symptoms as early as February if they are allergic to what’s blooming.

Tree pollens start first in January and then taper off in April.  Grass pollen starts to rise in February and March.   Finally weed pollens join the party by the Spring and extend through the Summer and Fall.

Here are your questions answered:

What are allergies?

Allergies are the result of the immune response to a foreign particulate that our body senses.  One could be allergic to pollen, dust, dander, food, insects, mold, metals, transfused blood, grafts, medicine and anything the body senses as a foreign intruder.  Even though these may be individually harmless, a hypersensitivity reaction occurs as a result of their intrusion into the body.  IgE antibodies find the allergen (intruder) and activate mast cells in the tissue and basophils in the blood.  When these cells get activated, they release substances to help protect the body, including histamines, leukotrienes, and cytokines. These help the body attempt to sneeze and cough the allergen out, wall off the antigen, signal more antibodies, or produce tears and nasal secretions to flush it out.

What are symptoms of seasonal allergies?

Symptoms of allergies could include any or a combination of the following:

  • Sneezing
  • Coughing
  • Wheezing
  • Runny nose
  • Eye watering
  • Red Eyes
  • Itchy eyes
  • Itchy skin
  • Rash
  • Itchy throat
  • Fatigue
  • Congestion….. to name a few.

How do they differ from a cold?

Colds may have very similar symptoms to allergies.  However they are different.

The common cold is caused by a virus.  When one gets infected by the virus they may feel malaise, fever, and achy.  This does not occur with allergies.

Moreover, nasal secretions from allergies are usually clear.  In a cold, the mucous could be thicker and with color.

The same holds true with sputum.  During an allergy the cough may have little to no mucous and if so, be light-colored.  Thick mucus could be a sign of an infection.

An allergic sore throat will seem more dry and scratchy.  A sore throat from a cold is more uncomfortable and less easy to soothe.

Allergies may persist or be cyclical.  Cold symptoms will usually subside after a few days and rarely persist longer than 10 days.

Can allergies lead to a cold?

Yes and no.  Allergies should not in and of themselves cause an infection. However they may make one more vulnerable for a virus or bacteria to take over.    Hence a bronchitis, sinus infection, or pneumonia could uncommonly follow an asthma attack.

Are seasonal allergies dangerous?

As stated previously, if one is susceptible to colds, an allergic attack could make them vulnerable. Moreover if one suffers from asthma, an allergy attack could incite an asthma attack.  Very rarely would we see a life threatening anaphylaxis to an allergen such as pollen.

Allergy season is here: What are the worst offenders?

 

How can we prevent and treat allergies?

Avoiding, or decreasing exposure to the allergen is key.   We suggest the following:

  1.  Be aware of your local weather and pollen counts.  If the weather begins to warm and regional vegetation is blooming, allergy season may be upon you sooner than you know.
  2. Avoid outside pollen from coming into your house.  Avoid the urge to open all the windows during Springtime as wind will bring the pollen in.
  3. Clean your air filters.  Replace air filters frequently and consider using HEPA Filters
  4. Wash off pollen from your hair and clothes before you sit on the couch or jump into bed.
  5. Close your car windows when you park.
  6. “Recirculate” the air in your car
  7. Discuss with your medical provider if you are a candidate for medications such as antihistamines, nasal corticosteroids or leukotriene antagonists.  
  8. If you suffer from respiratory illnesses or a chronic medical condition, discuss with your medical provider if you need to start your allergy medication before allergy season hits. Some of these medications may take a couple of weeks to reach therapeutic levels.

How can I find my local pollen counts?

Local tree, ragweed and grass pollen counts can be obtained here.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Could Your Hangover Actually be an Allergy to Alcohol?

Drinking too much can make one feel pretty sick the next day.  But a small population will claim their “hangover” to be a little too exaggerated for the small amount of alcohol they actually consumed.

Holly Shaw, Nurse Advisor at Allergy UK, reports to Cosmopolitan that some may actually have an “allergy” to alcohol.

Not all hangovers are equal. Some complain of headache, some nausea, some feel achy.  According to Shaw, those with an allergy to alcohol, “may also be accompanied by a red rash, swelling to the eyes, lips, face, breathing difficulties, stomach upset, feeling dizzy or faint due to low blood pressure.”

She also cites sulphites and their effects on those with asthma or sensitive lungs.  “The amount of sulphites contained in alcohol will vary between products, but sulphur dioxide is one of the fourteen major food allergens that are required by law to be included on labels.” So some may have an exacerbation of their asthma or lung disease when they drink.

Does alcohol contain allergens?

Sure, it can.  If one is allergic to grapes, yeast, rye, hops, wheat, barley, etc., they may  have a reaction when they drink alcohol.

WebMD lists the following potential allergens in alcoholic beverages:

  • Barley
  • Egg protein (usually in wine)
  • Gluten
  • Grapes
  • Histamines
  • Hops
  • Rye
  • Seafood proteins
  • Sodium metabisulphite
  • Sulphites
  • Wheat
  • Yeast

What is alcohol intolerance?

Alcohol intolerance is not an allergy.  It occurs in those who lack the enzymes needed to break down alcohol.  Alcohol dehydrogenase (ADH), for example, converts alcohol to acetaldehyde, and this becomes converted to acetic acid by an enzyme, acetaldehyde dehydrogenase (ALDH).  Some populations, including East Asians, may lack ALDH, becoming flushed when drinking alcohol as they have difficulty converting acetaldehyde, the latter building up, causing hangover-type symptoms.

 

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So what is a hangover?

It’s a constellation of symptoms that occur post-partying…..and include headache, muscle ache, nausea, anxiety, moodiness, wanting to avoid light and loud sounds, eye redness, thirst and dizziness, though some hangovers may have many more symptoms.

They could be caused by a variety of factors:

  • Dehydration – alcohol isn’t the best choice to replace lost fluids during a night of dancing, plus it causes increase in urination
  • Low blood sugar – caused by lack of good nutrition over the last 12 hours and enhanced by drinking alcohol
  • Poor sleep – let me guess, you didn’t get a good nice, cuddly, deep sleep for 9 hours once you came home
  • Irritated stomach lining – alcohol tends to do that and ticks off the pancreas as well
  • Acetaldehyde – a chemical converted from alcohol that has been postulated to make you feel nauseous and achy, either during its breakdown in the liver or after its metabolism
    • acetald
  • Cytokine production and release – seen in inflammatory states and can make you achy

Other theories suggesting lactic acid build up, withdrawal from drinking the night before, and congeners that are compounds that vary in alcohol types (red wine vs vodka).

 

How you can you treat a hangover?

The following  are the most popular ways to treat hangover.

 

Water

Hydrate people, hydrate.  Alcohol is a diuretic, which means it makes you urinate more and lose valuable fluid and salts. Water is the easiest, most tolerable, cheapest way to hydrate. Take it slow so you don’t vomit.  And not scotch and water.  Just water….

 

Eat something

An empty stomach is an irritable one.  While most sources say eat a “greasy breakfast”, I would recommend balanced breakfast with protein. Give the stomach acid something to chew on but make it easily digestible.  Remember the alcohol irritated your gut so you need to go easy on it. Baby steps, but healthy baby steps.

 

Exercise

Take a short, brisk walk.  The adrenaline gets the blood pumping and can help with the headache.  The cool air outside will feel good when you inhale and some endorphins will release. This may help with your headache.

 

Drink some Sprite/Sports Drinks

Chinese researchers back in 2013 found Sprite to be the best hangover cure and even though we don’t have many other studies to back it up, the sweet and bubbly it provides makes your head and tummy feel better.

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Sport’s Drinks add the salts you lost from alcohol’s diuretic features. Though many of us don’t like the taste, those who do find it a nice way to hydrate.

What is “hair of the dog”?

Originally it was a treatment to ward off rabies.  One would, after being bit by a dog, put a piece of dog hair on the wound.  A treating fire-with-fire strategy. It later was used for hangovers.  Treating a hangover with a chaser of alcohol was supposed to elevate moods and lessen the withdrawal.  To date there is not enough scientific support to recommend hair of the dog.

 

For next time, how do you avoid the dreaded hangover?

Want to avoid a hangover?  Here’s how:

Firstly, try to avoid getting drunk.  Set your limits and stick to it.

Secondly, drink plenty of water throughout the night and once you get home.

Finally, don’t drink on an empty stomach to “speed up the buzz”. Your empty gut will absorb alcohol quicker so eat a good nutritious meal prior to partying.

Avoid popping antiinflammatories or Tylenol once you get home because your stomach and liver are already irritated from the alcohol and this may make matters worse.  But if any of the above “cures” don’t help, you may need to use these as a last resort.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio, KDWN…..

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada