Laurie Menk Otto, ND, MPH

Naturopathic Medicine | Portland, Oregon

Portland Allergy Naturopath Dr. Laurie Menk Otto

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Comprehensive allergy treatment and the “allergic load” – what does it mean?

Allergy treatment in my practice often extends beyond direct treatment of the allergy alone. Whether or not a person has allergy is determined by genetics, as well as environment and other factors about the person. The “allergic load” is a helpful concept to understand how I view comprehensive treatment of allergy and asthma, and how I get better results with patients who haven’t had relief in the past.

The most powerful direct tool I have for treating allergy is immunotherapy, which changes the way the immune system reacts in response to allergen exposures and relieve symptoms over time, directly addressing the genetic predisposition towards allergy. I also go deeper to address other factors that may trigger symptoms. The allergic load refers to the non-genetic factors that may lead to and influence overall inflammation in the body, and therefore increase expression of allergy and allergic symptoms. Addressing and understanding allergic load as a concept helps to minimize the influence of irritating factors that have the potential to make allergy symptoms worse.

Some patients come to see me having had allergy treatment in the past, usually through allergy shots, or medications to reduce symptoms, and they tell me that those therapies “helped a little bit,” or “ I think that helped mostly,” but their symptoms weren’t completely relieved. Why are treatments sometimes only partially effective? Why are symptoms worse some days than others, and sometimes inconsistent?

The answer is that there were likely some factors causing inflammation in the body that were not addressed as part of treatment – factors that weren’t addressed using allergy therapy alone, and only temporarily calmed by using medications for symptom control. This is where you gain the most benefit from working with me. We’ll go deeper, and here is what is different:

  • Trigger management. Irritating triggers such as dust, pet dander and hair, mold and pollens are removed or managed, and personal care measures to reduce exposures are addressed. Reducing trigger exposure by cleaning, air filtration, and avoidance is specifically important.
  • Other environmental factors are addressed. Irritant triggers like smoke, perfumes and other chemicals in the home or work environment are addressed when possible.
  • Individual health factors are addressed. Things like hormones and other chronic illnesses or low level infections can worsen allergy symptoms, although they have nothing to do with allergy technically, but aggravate inflammation and symptoms, are addressed or minimized as much as possible.
  • The role of diet. Diet is a very important intervention not only for allergy but also for overall health and longevity. Getting the right nutrients through diet, and reducing foods that are irritating to the system has the effect of reducing inflammation, improves nutritional status, and reducing allergy symptoms. Diet changes always include increasing vegetable consumption to increase intake of chemicals called flavinoids, which help manage inflammation and allergy expression.
  • Digestion and biome. Digestion, absorption of foods, and the intestinal biome influence allergy and inflammation. Elimination of food intolerances, where relevant, are important to decrease inflammatory load and support the biome in such a way that allergy and inflammation are minimized.
  • Chronic stressors such as stress, and sleep have a significant impact on allergy. High stress and poor sleep drive inflammation and tax all body systems, negatively influencing repair and immune balance.

What would it feel like to live with minimal allergy symptoms next year? With some work and investigation, along with carefully chosen therapies, it is possible.


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