Dr. Anders Nerman, N.D. Naturopathic Doctor in Israel
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Eczema on the Rise in Israel: Can Naturopathic Medicine Help?

5/22/2014

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A week does not go by when someone does not bring his or her child into my Jerusalem based office for treatment of Eczema (also termed Atopic Dermatitis). This skin condition is located primarily on the face, back of the knees, wrists, hands, or feet. It is almost always itchy. It is often red and inflamed and can become infected. It may be hard to believe but sometimes its is so severe people seek emergency medical treatment in hospitals. I have had a few patients who were hospitalized at Hadassah for this condition.  

Eczema is on the rise in all first world countries.  The prevalence of eczema has doubled or tripled in industrialized countries during the past three decades.
 In Israel, atopic eczema was found to be increasing [from 5.9% (1997) to 8.7% (2003). No one knows precisely what causes eczema or why it is becoming more prevalent in western societies. While first world countries decreased steadily in the number of cases of infectious disease, there has been a yearly increase in cases of allergic (atopic) diseases.  

Research has shown eczema to have a clear genetic component, as a child with parents having either eczema, asthma or hay fever will be far more likely to develop eczema or one of these other atopic/allergic conditions.

I am writing this article to give my perspective on what alternative medicine has to offer children and adults with eczema. Although what causes eczema is not known, much research has been done looking at alternative treatments and their effectiveness. Some of these studies shed light on what is going on in the body with people who have eczema. My hope in this article is to expose you to some real evidenced based treatment options and give some new insights about the disease.

Western Treatment Options:

Before we begin with alternative medicine, lets consider the options our western medical doctors offer.  In truth, treatment options are limited, with some having unwanted side effects. The two main options are emollient therapy - moisturizers – and topical steroid creams, which suppress the skin's immune response. Topical steroids are a common first line of defence and may be necessary to deal with the severe symptoms of eczema. However, Naturopathic Medicine strives to treat the cause of the disease, not only the symptoms. 

The Triggers:

Anxiety and stress, arid climates, irritants, allergens and infections are all known triggers of eczema. Food allergies and early food introduction are big culprits. 35-40% of children with eczema have food allergies. Eggs are the most common allergen along with milk, peanuts, soy, wheat, fish, shellfish, tree nuts and citrus fruits – all accounting for 90% of food allergies in eczematous children.

Does It Ever Go Away?

The good news is that approximately 50% of children will no longer be troubled by eczema by the age of 2 and 80% cent by the age of 5. The bad news is there is no cure for eczema except to reduce occurrences and control the disease.

Prevention

Babies are born to be breastfeed. Breast milk contains over 100 hundred substances not found in formula but are vital to normal development and function of your child’s immune system. Breast milk contains gamma-linoleic acid that is particularly important for babies with a family history of eczema. Recent trials have found that breast fed babies have reduced or delayed incidence of atopic diseases such as eczema, allergies and asthma and conclude that eczema tends to occur more in bottle-fed babies.

Things To Consider

Interestingly research has shown that children with poor hygiene are at a lower risk for developing eczema, as are children who drink unpasteurized milk.  These findings align with a theory called the ‘Hygiene Hypothesis’, which postulates that a lack of early childhood exposure to infectious agents, bacteria and parasites increases susceptibility to allergic diseases by suppressing the natural development of the immune system. Our overly clean environments in the industrialized world may be backfiring on us. This theory has yet to be conclusively shown to be the cause of eczema, but it is definately something to consider.

Naturopathic Understanding of Eczema:

It is believed in the alternative medical world that inherited eczema may be related to a disturbance how the body deals with essential fatty acids. It has been suggested that people with eczema have a problem with the enzyme called delta-6-desaturase, which is critical to the conversion of omega-6 fatty acids to various other important fatty acids. For people with a genetic disposition to this problem, over-consumption of refined processed foods and saturated fats can become a major trigger.  Also food allergy is believed to play a major role in eczema. Many studies have pointed specifically to cows milk and eggs as a major trigger. One study I saw showed 80% improvement in children after being off these foods for 4 weeks.

Naturopathic Treatments For Eczema:

Food Allergy: Addressing food allergies and using elimination diets and then food challenges to find the trigger foods is critically important for dealing with eczema. This however, should only be done with the supervision of a nutritionist, naturopathic or dietician. This is especially important in children, who need proper minerals and vitamins from foods to grow. For instance, when we take children off dairy and eggs without knowing what else to feed them we can compromise their development. As well, some children with very bad cases of eczema have been found to become even more allergic to a food when it is removed from the diet and then reintroduced, and there have been a few cases of severe life threatening allergic reactions. For this reason, this approach may not be safe in all cases. It is important then to find a qualified health practitioner to supervise and guide you through these dietary changes. 



Often people with Eczema come to see me after they find that the tests  with their allergist did find any IgE food allergy. In Jerusalem, I am one of the few practitioners that provides IgG Food intolerance testing. I have found time and again that this test is effective for finding the food that is triggering a patients eczema. 

Fatty Acids: As mentioned above, biochemical evaluations of patients with eczema have demonstrated abnormalities of fatty acid metabolism.  Supplementation with oils such as evening primrose oil, sunflower oil, flaxseed oil, borage oil, fish oil and hempseed oil has all shown to have very positive effects on reducing symptoms of eczema. Each has different amounts of the essential fatty acids so you may need to do some experimenting till you find the right one. I often use flaxseed oil with my patients and have seen good results.

Nickel Sensitivity: Contact with Nickel is a known cause of eczema. An allergist can test for this sensitivity.  What is less known is that even ingestion of foods high in nickel or nickel that has leached into food from stainless steel cookware can trigger eczema in people sensitive to nickel.

Environment: Improving your environment by removing dust mites from the home, washing linens weekly in hot water, avoiding carpeted bedrooms and adding a humidifier to combat dry air can all help reduce eczema symptoms and lower the incidence of relapses.

Herbal Medicine: There are many herbs that are used to support the immune system and reduce inflammation. These include Chamomile and Echinacea. Chickweed is an excellent cooling remedy for hot inflammatory skin conditions. Eczema associated with stress or anxiety can benefit from herbs that support the nervous system such as lemon balm, chamomile or vervain. Local herbal applications can be very soothing and can help resolve inflammation and infection. Licorice gel in a recent double blind trial was found to be beneficial & “Kamillosan” containing chamomile was found to be slightly superior to 0.5% hydrocortisone. Ask your local herbalist about these products to see whether they are right for your case of eczema.

Baths: Soaking in baths for 15-20 minutes daily helps to retain moisture. But it is important to dry off completely and immediately coat the skin with a naturally based emollient cream or ointment. Because eczema predisposes your child’s skin to weakness, it is less able to retain water and can cause shrinking and cracking of the skin. I often recommend an oatmeal bath because it really soothe the skin well when there is extreme itching.  Premade oatmeal bath packets are available for purchase. For weeping or infected eczema, naturopathic treatments are available and it is best to consult your doctor to ensure the infection can be well managed.

Eczema is on the rise and there is very little that western medicine can do to treat the cause. I hope that this article has shown that alternative medicine has much to offer in this regard, much of which has research behind it to show its effectiveness. It may well be time to consider the natural alternative!

Dr. Anders Nerman, ND.

Dr. Anders Nerman, N.D. is a Naturopathic Doctor with an Integrative Family Medical practice in Wolfson Medical Center in Jerusalem, Israel. For more visit www.drnerman.com or call 972-54-427-8667.

Information is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or adopting any treatment for a health problem.




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Overcoming Seasonal Allergies: A Natural Approach to Dealing with Hay Fever

3/4/2014

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Allergy season is upon us. For those who suffer from Hay fever or seasonal allergies (medically termed allergic rhinitis) this time of year can be extremely frustrating and debilitatiting. Itcthy or burning eyes, stuffed up or runny noses, with constant sneezing that returns on a yearly basis are the classic signs of hay fever. Allergies are becoming a modern era pandemic. Research shows that the incidence of allergies is on the rise in most developed countries. The number of sufferers from seasonal allergy has tripled in the last 20 years. Allergies are a long-term health problem; typically beginning between 8 and 12 years of age and lasting for decades if not for a lifetime.

What causes seasonal allergies?

Hay Fever/Seasonal allergies are caused when the body makes allergic antibodies (IgE) to a substance such that occurs at specific times of year such as tree pollen, grasses and weeds (these are known as allergens). Symptoms of allergy that continue all year long are called perennial allergic rhinitis and commonly relate to indoor allergens, such as house dust mites, pets and indoor moulds.

In people sensitive to these allergens, exposure causes the release of chemicals (such as histamine) from special cells (called Mast cells) in the nasal passages, eyes or airways. Chemicals such as histamine released from these mast cells then trigger inflammation and irritation to the lining of the eyes, nose and throat.

Hay fever or seasonal allergies is actually an immune disorder characterized by an inappropriate allergic response to pollen and these other allergenic substances mentioned above. Inflammation is normally a beneficial and essential event in the body. It is the immune system's response to tissue injury and infection, and ensures that the body recovers from damage and continues to function properly. However, this response is meant to be short lived but for people with seasonal allergies it can go on for months on end.

The Best Defense - Avoid the Triggers

The best way to combat an allergen assault is to avoid coming in contact with the allergens.  Symptoms can be often be prevented if you can directly control your environment and avoid the allergen “triggers.” Here are a few helpful tips on how to do this:

1) Close your windows and doors; use your air conditioning.

2) Pollen levels are highest in the morning, so schedule your outdoor activities for afternoons or evenings.

3) Change your clothes after you come in from outside.

4) Bathe before bed to keep pollen off pillows and sheets.

5) Wash your hands if you pet an animal that’s been outside.

What if I do not know what I am allergic to?

Allergy testing is not usually required in simple hay fever because the trigger substances can be easily identified from the history of when and where symptoms occur. However, in certain cases a doctor or allergist might use a skin prick test or blood test to find out exactly what you allergic to. This is especially important in certain desensitization treatments that allergists use. If you want to find out what you might be allergic to ask your doctor for a test or a referral to an allergist.

What can be done about Hayfever naturally?

Naturopathic medicine has many tools to help you with your Seasonal Allergies. The following are some of the natural treatments options available:

Supplementation Therapy: Various nutritional supplements have shown to greatly reduce seasonal allergies.  At my clinic in Jerusalem we use supplement protocols that have shown to be effective in reducing allergic symptoms. Our supplement therapy often includes a few supplements. I will speak hear of two notable superstars to be aware of:

Quercetin:

Quercetin an antioxidant derived from apples and onions and it has been shown to prevent the release of histamine, which is responsible for many allergic symptoms. It also decreases the number of cells in the blood that contribute to allergic responses. In animal models, Quercetin has been shown to inhibit elevated levels of IgE, the antibody responsible for allergic reactions, and to inhibit bronchial obstruction in a model of allergic asthma.

Vitamin D:

Another important supplement to be aware of for people with hayfever is vitamin D. If you suffer from Hay fever it is crucial to investigate your Vitamin D status. Researchers out of Korea found that adults with low levels of vitamin D are at greater risk of hay fever.  Ask you doctor for a vitamin D blood test and if low make sure to take Vitamin D.

Homeopathic Treatment:

Homeopathic medicine can be taken as a preventive medicine before allergy season to avoid the onset of allergies.  As well, they can be used when a person is already suffering from allergies.  Going to a trained homeopath for allergy treatment can often help reduce hay fever greatly.

Special Anti-Allergy Diet:

As a general rule adding Omega 3 oils to the diet can be very helpful in lessening seasonal allergy symptoms. Excellent omega-3 fatty acid sources include flaxseeds, cabbage, cauliflower, walnuts. brussels sprouts, French beans, broccoli, turnip, collard greens, and of course fish and their oils.

Refined sugars should be avoided as they are mucus forming.  As well, Dairy products are also mucus forming and they contain omega-6 fatty acids, which are believed to worsen allergy symptoms. Cutting out dairy altogether would probably significantly benefit your hay fever, but it is not recommended unless you are familiar with ways to get calcium outside of dairy and willing to do so. Calcium rich foods include nuts, vegetables and fish (such as collard greens, bok choy, spinach, almonds and Salmon to name a few) as the calcium in dairy foods is essential for building and maintaining strong bones and teeth. Children, pregnant and breastfeeding women, and people with the bone-thinning disease osteoporosis need substantial amounts of calcium and in our communities often dairy is the best option. If you do choose to avoid dairy you can also use almond milk and rice milk, which if fortified with calcium, can be used as a replacement. Unless you belong to one of the groups mentioned above, try to limit your consumption of animal milk products or cut them out altogether.

Desensitization therapies – Some allergists can identify your allergen and help you desensitize to it through various modern techniques. There are a few different kinds of desensitization therapies. Ask your allergist what test might be right for you.

Conclusion:

Hay fever is growing problem for people in westernized countries and the number of sufferers is getting worse each and every year. There are however many ways to deal with hay fever naturally. It is my sincerest hope that by heeding some of the advice given here in this article that this year and years to come will be ones free of the frustration of seasonal allergies for you or someone you know. Refuah Shelaima!

Dr. Anders Nerman, ND

Dr. Anders Nerman, N.D. is a Naturopathic Doctor with an Integrative Family Medical practice in Wolfson Medical Center in Jerusalem, Israel. For more visit www.drnerman.com or call 972-54-427-8667.

Information is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or adopting any treatment for a health problem.


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    Dr. Anders Nerman, N.D. is a Canadian-trained Naturopathic Physician living and practicing in Jerusalem, Israel.

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