Allergens Cause Inflammation: Are corticosteroids the long-term solution?

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A steroid – the cortico version not the infamous anabolic version – provides relief to an allergic reaction. The allergic reaction is caused by an allergen. The allergic reaction is an inflammation in or on the body. The inflammation can be expressed through skin, feces, ears or eyes. A corticosteroid suppresses the immune system to reduce the inflammation but does not actually cure the body’s inflammatory response to the allergen.

The explanation above describes a spectrum of mild to life-threatening reactions. In essence, an inflammation is the devastation caused by a war going on inside the body. It is definitely a complex chain reaction and too often corticosteroids are playing a devastating role instead of us working to protect our bodies.

(In all honesty, I dislike the use of the phrase “allergic reaction” since that narrowly describes a rare, hypersensitive life-threatening reaction. From here forward, I will use the preferred word “sensitivities” as the definition encompasses all reaction levels.)

Allergens Are Antagonizers

Allergens are the opposing side, offenders or stressors from the environment that attack the body. You name it – bee stings, pollen, weeds, trees, mold, wasp stings, cotton, wool, metals, dust, food – are all offenders.  

Sensitivities to Allergens – The Immune System

Allergens provoke reactions from the immune system, the infantry. The immune system (the sergeant) rallies the plasma cells (the privates) to produce antibodies. The immune system then uses the antibodies to identify and neutralize foreign objects that cause inflammation.  

The antibody, IgE, is called on to confront inhaled and contact allergens. Food sensitivities (aka food intolerances) are very common and the body asks the IgA and IgM antibodies to isolate the problem.  

For more information on antibodies, read my other two articles The ABC’s of Antibodies and Inhalant & Contact Sensitivities.

Adrenal Glands

Let’s say the immune system needs help battling the opposing team and inflammation sets in. The endocrine system, the general, then joins the fight. The hypothalamus and pituitary glands tell the adrenal glands to produce three hormones: epinephrine (adrenaline), norepinephrine, and cortisol (the stress hormone).

The adrenal glands then ride over the battle-fatigued immune system by producing and releasing these hormones to reduce inflammation.

In the best case scenario, the glands are immediately ready to release epinephrine and norepinephrine while they work on producing cortisol. The adrenaline keeps the body alive until the cortisol can provide long-term reinforcements. This is actually the fight or flight response you learned about in high school biology.  

Example: Level of Severity

A bee sting reaction is an excellent example of the inflammatory response. This inflammation is categorized into three different levels: mild, moderate and severe.

Mild but common reaction – Instant, sharp burning pain at the sting site; red welt at the sting area; small, white spot where the stinger punctured the skin; and, slight swelling around the sting area.

What this means: The immune system and adrenal glands have the situation under control. 

Moderate reaction
– Extreme redness; swelling at the site of the sting that gradually enlarges over the next day or two; possible mild bodily swelling; slight difficulty to breathe; and resolves over five to ten days.

What this means: The body has it under control but one may take an antihistamine to help out.

Severe but rare reaction
– Anaphylaxis requiring emergency care; difficulty breathing; swelling of throat and tongue; rapid and weak pulse; nausea; diarrhea; dizziness; fainting; loss of consciousness; hives; itching; or, flushed or pale skin.

What this means: The immune system is kaput compared to this particular offender and the adrenal glands fail to release enough epinephrine and norepinephrine to control the problem. One shot from an epi-pen (epinephrine) is used to keep the body alive until cortisol is produced or corticosteroids are administered to replace lack of cortisol production.  

Once you have been stung by a bee, your level of reaction may increase with each additional sting.

Level of Severity – Food Offenders

Similar to contact sensitivities, bad reactions to food and inhaled sensitivities can become more severe each time the immune system is assaulted by a repeat offender. Food can also cause skin inflammations and can produce weird bodily smells.  

While the debate rages on if Irritable Bowel Syndrome (IBS) is an inflammation, I do believe it is most of the time. Diarrhea, abdominal pain, cramps and constipation are all symptoms of IBS. My question is: if these are symptoms, what is causing the symptoms if not possibly an inflammation?

Where Corticosteroids Come In

If you visit the veterinarian or medical doctor for mild sensitivity symptoms, they might prescribe an antibiotic or direct you to an over-the-counter NSAID (nonsteroidal anti-inflammatory drug). If you are persistently visiting a health care provider for the same reactions or if the symptoms of the reactions are more moderate to severe, they will more than likely resort to corticosteroids as a treatment option. Unfortunately, this resort option is visited way too many times.

Again, remember, corticosteroids (hydrocortisone, prednisone, prednisolone, methylprednisolone, dexamethasone, and others) are synthetic steroidal hormones that replace or “fill in” for cortisol. This is why you have to step down the dosage gradually so the body will start to produce cortisol at normal levels again – hopefully. In the end, steroids are a temporary solution to a long-term problem. They do not cure.

Corticosteroids have short- and long-term side effects and the consequences are not good. They affect serum concentrations of thyroid hormones. Corticosteroid use runs the risk of manifesting side effects such as increased drinking and urination, increased appetite, lethargy, gastric and intestinal ulcers, muscular weakness or atrophy, increased risk of pancreatitis, liver damage, pot-bellied look and thin skin, generalized immune suppression, and failure of the adrenal glands to function properly. Corticosteroids may also induce diabetes.

Many of the side effects of corticosteroids mimic those of Cushing’s disease (hyperadrenocorticism) [a common disease seen in middle aged dogs, especially females, and caused by overproduction of adrenal gland steroid hormones]. When the symptoms are due to the use of cortisol-containing drugs, the condition is called iatrogenic [induced, as opposed to natural] Cushing’s disease

Anti-Inflammation Preventatives

Traditional Western medicinal practices do not provide a cure or a long-term solution to inflammation but rely on corticosteroids. So, if you are a diehard Western medicine fundamentalist, you can continue down this path and risk side effects. If we look to homeopathy, several natural options are available to strengthen the immune system and reduce the inflammatory response to food, inhaled and contact sensitivities. They are not “overnight” solutions but need to be given over time to cause positive effects.  

Eastern medicine also provides a good guideline regarding foods that produce inflammation. For instance, Chinese medicine states that chicken is pro-inflammatory (“hot”) and should be avoided but that turkey is a “cool” food. I do recommend that chicken is always avoided. However, an integrative approach is necessary because turkey can still cause pro-inflammatory responses in certain individuals.

This is where the emerging science of epigenetics comes in.  It studies the environmental factors that can switch genes on and off. The epigenome is a structural layer that surrounds DNA and the proteins to which they are attached. The epigenome initiates chemical reactions within cells that control gene expression, determining which genes are turned on or off and which proteins are produced. By changing a cell’s gene expression, the epigenome also changes the cell’s destiny, determining whether it will become a healthy cell or a diseased cell.

For instance, if a client approaches me about a dog’s diarrhea, I will suggest running a NutriScan panel which is based on epigenetics. The test results will take 7-10 days once the sample is received in the Hemolife Diagnostic Laboratory to reveal what is occurring within a dog’s body. However, Chinese medicine gives the intermediary and temporary solution by eliminating all chicken and switching to turkey. Once the test results are available, the pet caregiver can adapt the dog’s diet to be appropriate for his best health and longevity.

W. Jean Dodds, DVM
Hemopet / NutriScan
11561 Salinaz Avenue
Garden Grove, CA 92843


References

“Bee Stings.” Mayo Clinic. N.p., n.d. Web. 03 Jan. 2016. http://www.mayoclinic.org/diseases-conditions/bee-stings/basics/symptoms/con-20034120

Dodds, Jean, DVM, and Diana Laverdure, MS. Canine Nutrigenomics: The New Science of Feeding Your Dog for Optimum Health. Wenatchee: Dogwise, 2015. Print.

Dodds, W. Jean., DVM, and Diana Laverdure. The Canine Thyroid Epidemic: Answers You Need for Your Dog. Wenatchee, WA: Dogwise Pub., 2011. Print.

Kerr, Michael, and Kristeen Cherney. “Irritable Bowel Syndrome vs. Inflammatory Bowel Disease.” Healthline. N.p., 14 May 2015. Web. 03 Jan. 2016. http://www.healthline.com/health/crohns-disease/ibs-vs-ibd#Overview1

Sargis, Robert M., MD, PhD. “An Overview of the Adrenal Glands.” EndocrineWeb. N.p., n.d. Web. 03 Jan. 2016. http://www.endocrineweb.com/endocrinology/overview-adrenal-glands

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