Chat transcript: CNN's Rhonda Rowland discusses allergy treatments

May 19, 1999
Web posted at: 2:59 p.m. EDT (1859 GMT)

(CNN) -- The following is an edited transcript of a chat session with CNN Medical Correspondent Rhonda Rowland on allergies and treatments held on Tuesday, April 20, 1999. She was joined in the chat by Sherri Caldwell, a distributor for an online nutrition store.

Rhonda Rowland: When researching a story on seasonal allergies, we discovered a growing number of patients are turning to alternative therapies. The allergists we spoke with confirmed more of their patients are seeking alternatives because they want to avoid side effects such as drowsiness, or they want a natural alternative to medications. Most people seeking alternatives tend to be highly educated.

Chat Moderator: What were the most popular alternative remedies?

Rhonda Rowland: We were told most patients seeking alternatives are looking for quercetin, an herbal remedy derived from the bark of the white oak tree, and nettles, an herbal derived from leaves. In the course of our reporting we found some patients are trying grape seed extract. Apparently, grape seed extract works like a natural antihistamine.

Chat Participant: I've been waking up every morning to an inch of yellow pollen all over my car and yard. Can this harm me?

Rhonda Rowland: The pollen on your car actually looks worse than it actually is. That yellow pollen comes from trees. Only about 10 percent of people with allergies are allergic to trees. A much greater percentage of people are allergic to grasses, for instance, but you don't see that pollen

Chat Participant: If I use natural remedies like nettle, etc., are there any contradictions to other vitamins I am taking?

Rhonda Rowland: I can't answer that question. We didn't research those types of contra-indications.

Chat Moderator: What is the benefit to using, say, grape seed over a conventional antihistamine drug?

Rhonda Rowland: The benefit of using grape seed over conventional antihistamine is not clear because no scientific studies have been done comparing the two. You can feel assured scientific studies have been done of the allergy remedies you can buy over the counter or by prescription. There's limited scientific data on herbals such as grape seed. The touted benefits are mostly anecdotal for now.

Chat Participant: If you are allergic to natural substances like pollen, isn't it dangerous to take natural substances like nettle?

Rhonda Rowland: Interesting question. Actually scientists at the University of California at Davis are doing a study with grasses to see if they work almost like a vaccine. You'd take the substance you're allergic to in order to build immunity. A pilot study indicated this technique might work. A larger study is under way, and results should be available within a year.

Chat Participant: I'm curious about options for people who have difficulty using medications like Nasonex and Vancenase.

Rhonda Rowland: I'm not familiar with the two drugs you mention ... but an allergist would be able to suggest alternative medications.

Rhonda Rowland: Hi, Sherri. Sherri is the person we profiled in our story who has had a good experience with using an alternative therapy. Her family has been using grape seed extract and getting symptom relief.

Chat Participant: Sherri, have you experienced any adverse side effects?

Sherri: With grape seed extract -- no. It is a natural substance, so it is safe and nontoxic (well, Rhonda would probably prefer me to say, "There is no evidence of.É") While there have been many studies on grape seed extract and similar natural antioxidants, the hard, scientific rigorous testing is still under way.

Chat Participant: How are allergy tests are conducted these days? I remember being pricked by a few hundred needles some years ago to test my reactions.

Rhonda Rowland: Allergy tests are still done the same way. An allergist will inject various substances to see if you develop an allergic reaction. People allergic to many substances are often turning to allergy shots for treatment. The therapy takes a number of weeks to complete but can ultimately provide relief for up to five years.

Chat Participant: Why shots? Could the same therapy be done with pills?

Rhonda Rowland: Allergy shots are reserved for people who can't get enough relief from the pills. Pills can help with symptoms but don't go after the source of the problem. The shots help you build up immunity to the allergens.

Chat Participant: Thanks for the pointer in the right direction. I have mold and other allergies, polyps, and sinus problems, so I'm really in a spot.

Rhonda Rowland: An allergist can figure out your allergens and treatments as well as treatment for sinus problems. But sometimes you'll be referred on to an ENT (ear, nose and throat specialist) to check out the polyps.

Chat Participant: I've seen the ENT guy. He removed them, but they are coming back. And from what you're saying, shots are probably my only option.

Rhonda Rowland: I would certainly ask if the shots would help with the polyps. The allergist would be the best source for that question.

Chat Participant: Aren't there different allergies for the different seasons? Do these alternative remedies you reported on only aid in springtime allergies, or other allergies like dust, mold etc.?

Rhonda Rowland: That's a good question. It's my understanding that people are turning to alternatives for various allergies. For instance, in the fall, molds are more prevalent. There is some information in books on herbals and from other sources about which herbs help for various problems.

Chat Participant: What percentage of the general population suffers from allergies? Is the problem of allergies the same worldwide, or are there differences from country to country, region to region?

Rhonda Rowland: People can suffer from allergies worldwide, but they will vary according to the natural plant life. Once you move to a new part of the country or world, you can develop new allergies. That's why some people who have never suffered from allergies can develop them at, say, age 30. You have to be exposed for at least a year, and the following year you may develop symptoms. But you have to be predisposed to developing allergies in the first place. For example, I developed allergies at age 25 when I moved from Wisconsin to Atlanta

Chat Participant: Of the over-the-counter allergy medications, is there one that is more recommended over the others that relieves the most symptoms and with less side effects?

Rhonda Rowland: There are some newer over-the-counter remedies that claim to have fewer side effects like drowsiness. But you figure out which works for you by trial and error. One medication may work great for you ... but your friend or husband doesn't get good relief. That's why there are all those choices out there.

Chat Participant: What is the best place to live if you are an allergy sufferer?

Rhonda Rowland: The northern parts of the United States are probably best for allergy sufferers because spring, summer, fall are shorter seasons.

Chat Participant: I heard that the Southwest, where it is dry, is the best place to live to escape allergy problems.

Rhonda Rowland: The Southwest has different vegetation compared to the South. The Southwest has been suggested as a good environment for people with asthma, and asthmatics are often susceptible to allergies.

Chat Participant: What is worse, allergy problems in highly vegetated areas, or lung problems in highly contaminated cities like Los Angeles or Mexico City, where vegetation doesn't grow?

Rhonda Rowland: It will depend on the individual. Some people are highly allergic, so a Southern climate will be tough on that person. People who suffer from asthma or other lung problems are going to have trouble in highly polluted areas or where the ozone level can get high.

Chat Participant: Do the alternative medicines cause similar side effects as the over-the-counter drugs, such as drowsiness?

Rhonda Rowland: A big reason people turn to alternative remedies is because they don't tend to cause drowsiness, and side effects are limited. But people can make the mistake that because alternatives are natural they're totally safe. The naturopath we talked to about grape seed, for instance, said some people could get an upset stomach, headaches or a little skin irritation.

Chat Participant: Are alternative remedies any cheaper than prescription allergy drugs like Allegra?

Rhonda Rowland: Good question about cost. The naturopath sells some of his grape seed extract products for $25 to $40 a bottle. That's not inexpensive.

Sherri: About the cost -- I probably do pay more for nutritional supplements than OTC vitamins and symptomatic relief formulas bottle for bottle. Quality is more expensive, as in anything, but I think we make up for it in better health, minimal medical expenses (doctors or prescriptions), and productivity (not missing school or work due to illness).

Chat Participant: My grandmother used to plaster my chest with Vicks Vapo Rub for ANY kind of sickness -- but especially allergies, to help with breathing. Does this actually work, or is it an old wivesÕ tale?

Rhonda Rowland: I think that was an "old wivesÕ tale," but it certainly couldn't have hurt you, and the nice human touch your grandmother offered probably made you feel better. That's one of the benefits of alternative remedies -- there's often a lot of human touch, which has been shown to be beneficial for a variety of problems.

Chat Participant: How can I find out what alternative remedies I should use for which allergies (pollen, dust, etc.)?

Rhonda Rowland: There are a number of books about herbal remedies. Also, people in health food stores often know a lot. [There is] also information on the Web.

Chat Participant: Are more doctors in allergy medicine actually recommending natural alternatives, or do they still lean toward other medications?

Rhonda Rowland: What we found, which I think is encouraging, is conventional doctors are becoming more open-minded to alternatives. They generally feel, if they don't hurt you, then why not try? Also, Dr. Renata Engler, an allergist we interviewed, said she's trying to educate other allergists about alternative therapies. A recent issue of the medical journal "Asthma" has a 40-page review on alternative therapies for allergy relief. The authors compiled all they could find in the scientific literature.

Chat Participant: Why does there seem to be so many more problems with allergies these days?

Rhonda Rowland: That's a great question. It could be that more people are recognizing they have allergies. Often people have thought they had a cold or sinus problem. So they're not just putting up with the seasonal allergy symptoms, they're trying to get relief.

Chat Participant: None of my doctors have offered any alternative to prescription medication.

Rhonda Rowland: You probably have to bring it up with your doctor. The doctors don't have a lot of knowledge in this area. What is happening is patients are coming to doctors with lists of herbs, etc., and asking questions. Doctors would prefer to know what their patients are using so they can try to work with them and watch for any interactions with other drugs the patient may be taking. Also, if a patient has a health problem, like asthma, it's important for the doctor to know about alternative therapies that the patient may be taking, because it's possible they could mask a potential problem.

Chat Participant: Where should I look for information to present to my doctor?

Sherri: Rhonda, I can suggest an excellent reference that is available at any library or bookstore: "Prescription For Nutritional Healing" by James F. Balch, M.D., & Phyllis A. Balch, C.N.C.

Chat Participant: Can you tell us anything about what long-lasting effects result from untreated allergy problems?

Rhonda Rowland: I think the main problem is being miserable. But if a person has, say, asthma, the allergies could make symptoms worse, and not getting appropriate treatment could lead to lung damage.

Chat Participant: Can allergies cause asthma?

Rhonda Rowland: Allergies can make asthma symptoms worse.

Chat Participant: Tell us what alternative remedies or combos thereof your experts recommended?

Rhonda Rowland: Sherri, whom we interviewed as a consumer, uses grape seed extract. The naturopath we interviewed found anecdotally that 60 percent of his patients got symptom relief when using grape seed extract. The naturopath said when vitamin C, quercetin and green tea extract were added, 90 percent of his patients got better.

Chat Participant: Grape seed does little for me -- supplements, like traditional medicines, are hit-or-miss.

Rhonda Rowland: It may be difficult to figure out which alternative therapies may help because large-scale, scientific studies are lacking. Doctors would like to have that information to help their patients. On the whole, herbals have not been rigorously studied. But the studies are starting ... for example, a number of good studies have shown grape seed extract can reduce heart disease risk.

Chat Participant: Herbal rookies should stick to the known supplement brands, even if they are pricier, because these brands undergo independent assays frequently. Twinlife, Schiff, Country Life, Now, Solgar, Enzymatic Therapy (who meets all German laws), etc.

Chat Participant: Aren't some of these herbs just as dangerous as other remedies when their use is not carefully monitored?

Rhonda Rowland: That is a very important question. Because herbals are not considered drugs, they are not regulated. Therefore, consumers cannot be sure the labels are accurate or the dosages within a product brand or across different brands are the same. Some herbal products have been recalled because of bad side effects. Therefore, it's recommended if you try these products you try to go for a large manufacturer. Because these regulations are lacking, Dr. Engler told us she tells patients they are experimenting on themselves when they use these products.

Sherri: We should differentiate between "herbals" and vitamins and supplements. Grape seed extract is not a herbal -- the active ingredient is a natural antioxidant, much like Vitamin C and Vitamin E. Some research indicates these natural substances (bioflavonoids) may even be more powerful than Vitamin C and Vitamin E in their antioxidant ability -- and also work with them to improve their functioning.

Chat Participant: What is quercetin?

Sherri: Quercetin is a bioflavonoid (like grape seed extract) that is obtained from citrus fruits, buckwheat and other foods (From Dr. Andrew Weil's "Self Healing").

Chat Participant: How should a person decide whether to go with alternative remedies or traditional drugs? Do doctors give advice on alternatives?

Rhonda Rowland: It's really been the patient's personal choice. Doctors would prefer patients stick with the over-the-counter and prescription drugs because they have more information on dosage, side effects, etc.

Chat Participant: Many doctors have no training in alternative medicine. Try to find a traditional doctor who also has studied complementary medicine. Easier said than done -- there is only one in my area, and he is booked out for 6 months for new patients!

Rhonda Rowland: Good point. It's tough to find good practitioners with a lot of knowledge. From our research it seems naturopathic physicians, who are considered alternative medicine practitioners, have a good amount of training. Also, Dr. Andrew Weil does offer a course on alternative medicine at the University of Arizona. So, more traditionally trained doctors in the future should have more knowledge about alternatives.

Chat Participant: I use a naturopathic doctor, and she's been helpful. She had to go to a four-year college after her undergraduate degree for her ND degree. There are a couple of four-year schools that are excellent in ND training in this country.

Chat Participant: Can a person overdose on these natural methods? I've heard people say when they feel badly that they double up on it because it is natural and they feel it can do no harm.

Chat Participant: People can and do OD on natural medicine. Before self-medicating, people should talk to their doctor, read up, and consult a holistic practitioner. Natural medicine is very powerful -- in both good and bad ways.

Rhonda Rowland: Doctors are concerned that some people may think a little more of a good thing may be better, but too-high doses of some vitamins, for instance, can cause toxicity. And doctors are concerned some patients may be taking a number of different herbals, etc., at one time and taking too much.

Chat Participant: One thing I was told -- try one remedy at a time, not too many at once

Sherri: One thing that made the decision for me and my family to prefer natural alternatives is the statistics on recent deaths caused by prescription drugs (in the hundreds of thousands) vs. vitamin supplements (very few). I wish I had that statistic -- I believe it was from the AMA.

Editor's note: Adverse reactions to prescription and over-the-counter medicines kill more than 100,000 Americans and seriously injure an additional 2.1 million each year, researchers say. Such reactions -- which do not include prescribing errors or drug abuse -- rank at least sixth among causes of death in the United States, behind heart disease, cancer, lung disease, strokes and accidents, according to a report published in December 1998 in the Journal of the American Medical Association.

Chat Participant: Can you do this on your own, with just books and the Internet to guide you? Or do you really need an alternative medicine doctor?

Rhonda Rowland: You should at least tell your regular doctor that you are trying alternative remedies. The bottom line from the experts we interviewed: More people are turning to alternatives for allergy relief as they are for other ailments. Currently, there is a limited amount of good, scientific information on what works, the side effects, dosage, etc. But in general, herbals, vitamins, etc., are thought to be safe. That being said, doctors want to be informed about what their patients are using so they can watch for any problems.

Chat Moderator: Thanks for joining us today, Rhonda, to discuss your recent report on allergy season.

Sherri: It is my opinion that we need to visit doctors less and listen and learn to our own bodies more. We work with our traditional doctor and pediatricians and would never neglect care in a medical emergency, but we are taking a much more proactive role in our own health.