Allergies LIVING WITH
FREE WITH COMPLIMENTS FROM YOUR PHARMACIST OR HEALTH PROFESSIONAL
& EXERCISE EATING YOUR WAY TO A HEALTHY IMMUNE SYSTEM
GIVEAWAYS FIVE GREAT competitions – see inside
eczema tips + eye allergies + nutrition advice
Allergies can be an issue all year round Insect Bites
1 in 3 New Zealanders suffer from allergies. Luckily Arrowcare offer a full range of allergy medicines to help you combat your allergy triggers. If you have itchy eyes or skin, sneezing or runny nose, allergies could be the culprit â€“ talk to your pharmacist about which Arrowcare product is right for you.
Recommendations should be consistent with the datasheet, label or pack insert of each medicine, which should be consulted. Arrowcare Zetop, Fexofast and Lorafix: always read the label and use as directed. People with kidney problems, and pregnant or breast-feeding women should seek medical advice before taking these medications. If symptoms persist see your Doctor or health professional. TAPS CH4464. *IMS, 2014. Total tablets including those on prescription.
Actavis New Zealand Ltd.
0800 800 097 fax: 0800 800 662 email@example.com Auckland, New Zealand
LIVING WITH ALLERGIES PUBLISHER Published by Hawkhurst Media Services Ltd PO Box 25679, St Heliers, Auckland 1740 Director: Kerry McKenzie 09 528 7103 or 0275 969 979 ADVERTISING Advertising Sales: Debbie Bishop 021 340 360 firstname.lastname@example.org BUY A MAGAZINE Visit our website www.livingwithallergies.co.nz 09 528 7103 email@example.com G www.facebook.com/ livingwithallergiesmagazine PRODUCTION Editor: Sara Carbery firstname.lastname@example.org Design: Rose Miller at Kraftwork email@example.com Proofreader: Stella Clark PRINTER McCollams Print
LIVING WITH ALLERGIES AUTUMN 2016
ALLERGY AWARE 2 News and Views
4 Gluten free and healthy
9 What kind of conjunctivitis?
HEALTHY HOMES 11 Banishing mould
14 Keeping fit
NATURAL HEALTH 16 Sick of being sick?
Disclaimer: Every effort is made to ensure accuracy but Living with Allergies accepts no liability for errors of fact or opinion. Information in this publication is not intended to replace advice by your health professional. If in doubt check with your allergy specialist, GP, nurse, dietitian or other health care professional.
Editorial and advertising material does not necessarily reflect the views of the Editor or publisher. Advertising in Living with Allergies does not constitute endorsement of any product. Living with Allergies is an independent publication and is in no way affiliated with or endorsed by the charity Allergy New Zealand. ÂŠ All rights reserved. No article in whole or part should be reprinted without permission of the Editor.
19 Tips for successful treatment
FOOD & RECIPES
25 Gluten free birthday treats
32 Useful snippets
Look out for 5 great reader competitions throughout the magazine. See inside for how to enter or go to www.livingwithallergies.co.nz
allergy aware DITCH SECOND HAND SMOKE Children with asthma who are exposed to second hand smoke at home are twice as likely to be hospitalised, according to an article in the Annals of Allergy, Asthma and Immunology, which reviewed 25 studies investigating smoking exposure at home. Children are perhaps more likely to be negatively affected by cigarette exposure than adults due to the immaturity of their lungs and immune systems, the article concluded. As well as that, toxins such as second hand smoke reduce lung growth rates, even though details of how this occurs aren’t entirely known.
Food Journal Apps If you’re looking for a food allergy journal app but don’t know which one to choose, check out Scratch Me Not’s recommendations at http://blog.scratchmenot.com/thebest-food-allergy-journal-apps/
An Evolutionary Basis for Allergy?
Using computational techniques, a new study out of the London School of Hygiene & Tropical Medicine supports the theory that allergies have an evolutionary basis. It is thought that the part of our immune system that has evolved to provide immunity against infection by parasitic worms can become hyper-responsive if there isn’t any parasitic infection to combat. The result? It mistakenly targets allergenic proteins in food or the environment instead.
GIVEAWAY GO Derma Protect has been designed specifically to help protect and soothe dry, sensitive or itchy skin. Safe to take during pregnancy and when breastfeeding. We have 10 bottles (RRP: $29.90) to give away. To be in to win, enter online at www.livingwithallergies.co.nz or email firstname.lastname@example.org with GO DERMA in the subject line. Entries close 30 June 2016. 2 LIVING WITH ALLERGIES Autumn 2016
Natural Remedies Safest for Colds Don’t be surprised if your pharmacist recommends a natural remedy for your child this winter. Pharmacy Today reports that pharmacies are recommending natural remedies for young children suffering colds, flus and chesty coughs, after Medsafe increased age restrictions on popular treatments last year. Children under six can no longer be given bromhexine, a medicine used to break up excessive or thick phlegm associated with a chesty cough, and the pain reliever codeine is now restricted to those aged 12 and over. Why? There is not enough evidence for the use of bromhexine for productive coughs, and there have been reports of rare but life-threatening adverse effects,
Medsafe said in its release. In relation to codeine (which is metabolised to morphine in the body), Medsafe said there is limited evidence supporting its use to treat acute coughs in either adults or children, and they have concerns about the risk of toxicity. Medsafe recommends that children with coughs and colds should be allowed to rest, be made comfortable and be given plenty of fluids. Honey drinks can help to soothe a cough in children over the age of one. (Babies younger than 12 months shouldn’t be given honey because it can sometimes contain a bacterium that causes serious illness – infant botulism – in babies under one.) Also, don’t give lozenges to young children – they’re a choking hazard.
We have one set of the new look 400ml Alpha Keri hydration range, including moisture boost body lotion, supple skin shower and body oil, and skin hydrating body wash to give away. Alpha Keri’s lanolinhydro moisture delivery technology applies a unique 3-way action to transform moisture sapped skin, protecting, hydrating and restoring. Lanolin is safe and ideal for even the most sensitive or skin condition prone skin. Available from leading pharmacies and selected supermarkets. RRP $50 Find out more at www.alphakeri.com.au Enter online at www.livingwithallergies.co.nz or email email@example.com with ALPHA KERI in the subject line. Entries close 30 June 2016.
Natural, non-invasive, drug-free allergy treatment addressing problems such as: *Hayfever *Sinus *Food intolerances Safe for all ages. Full naturopathic services also available. Call 09 361 3295 or 021 882071 35 Jervois Rd, Herne Bay, Auckland theallergyclinic.co.nz
LIVING WITH ALLERGIES Autumn 2016 3
GLUTEN FREE AND HEALTHY Gluten free, and worried you might be missing out on vital nutrients? Nutrition Consultant Sarah Elliott has advice on optimising your diet.
Q: Does following a gluten free diet leave us vulnerable to nutritional deficiencies? Yes it does. I liken it to becoming vegetarian. You can’t just take meat out of your diet without knowing what to replace the missing nutrients with. Those following a gluten free diet need to know which foods they need to be including in their diet. Q: What nutrients are people following a gluten free diet most at risk of being deficient in? Fibre would be top of the list as wholegrain bread, cereal and crackers are common and easy sources of fibre. Unfortunately many gluten free products are made from low fibre alternatives such as potato starch, maize starch and white rice flour. Iron is another important nutrient to be aware of as approximately 40% of our iron comes from wholegrains. Wholegrains also provide B vitamins such as thiamine (vitamin B1) and folate.
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Q: Fibre, iron and B vitamins – why do we need them? You may have heard of the gut microbiome, the good bacteria which live in our digestive tracts. Fibre is a valuable food source for these bacteria and helps to keep them (and therefore us!) healthy. Fibre also helps lower cholesterol and keeps us regular. Iron is essential because it binds to oxygen and transports it throughout the body. (In New Zealand, approximately 20% of women are iron deficient.) B vitamins perform a wide range of functions such as helping the body utilise fats and protein. B vitamins are needed for healthy skin, hair, eyes, and liver, and they also help the nervous system function properly. Q: If we’re following a gluten free diet, how do we ensure we’re getting all the nutrients we need? Learn to replace glutencontaining grains with good alternatives such as quinoa or buckwheat. Choose wholegrain options where possible, such as brown rice
Learn to replace gluten-containing grains with good alternatives such as quinoa or buckwheat.
and grainy gluten free bread. If you don’t have to follow a strict lifelong gluten free diet (such as with coeliac disease), then experiment to find your personal tolerance level. Also learn to love legumes and lentils as they are full of fibre, B vitamins and iron. Q: Anything special parents need to be aware of? This advice is for everyone, but it’s especially important for children. Go and see a registered dietitian to get a proper diagnosis if you suspect gluten is an issue for your child. Professionals can support you with individualised advice that will
meet the growing needs of your child. If you don’t feel removing gluten has made any improvement, then look at reintroducing gluten back into your child’s diet. If your child’s symptoms are gut related, it is more likely to be a FODMAP intolerance (see www.foodsavvy. co.nz/fodmap.aspx). Q: You were diagnosed with Crohn’s disease 20 years ago – do you have any tips from your personal experience you’d like to share? Experiment with different grains to find ones you enjoy. I personally dislike millet but enjoy quinoa
mixed into salads or soups. Even my kids will eat it! Play around with home baking. You can use brown rice flour, mashed banana, nut flours and ground flaxseed to boost the fibre and nutrients. Keep some in the freezer as quick on-the-go snacks. Sarah Elliott is a Nutrition Consultant & Registered Dietitian with FoodSavvy, specialising in the dietary management of digestive issues such as irritable bowel syndrome and inflammatory bowel disease. Having previously worked as the Immunology Dietitian at Wellington Regional Hospital, she is also skilled in the management of food allergies and intolerances. See www. foodsavvy.co.nz for more info. LIVING WITH ALLERGIES Autumn 2016 5
Conjunctivitis – an easy way to stop the spread Applying eye treatments up to five times a day can be tricky. So getting a treatment which can be used less often helps keep on top of conjunctivitis, which is highly contagious. Over-the-counter conjunctivitis treatments need to be applied up to five times a day. Applying eye drops can be fiddly at any age so the fewer times a day you need to do it, the better. Fortunately one uniquely formulated product, available on prescription from your doctor, only needs to be used twice a day. It’s called Fucithalmic® and now it’s fully funded.
6 LIVING WITH ALLERGIES Autumn 2016
Designed for both adults and children, its ease of use will be a welcome relief for both parents and little ones.
CONVENIENT FOR ALL THE FAMILY Its convenience means Fucithalmic® fits better around family commitments, such as work, school, preschool and daycare. For busy parents, being able to apply eye drops in the morning and evening only means it’s easier to follow through with treatment.
CONJUNCTIVITIS – A COMMON PROBLEM You may know conjunctivitis as ‘pink eye’ or ‘red eye’. Common symptoms include redness, itching, swelling of the eyelids and a discharge that may cause the lids and lashes to be matted together in the mornings. There can be a scratchy feeling, pain with bright light, or tearing. Conjunctivitis affects approximately 12% of New Zealand’s population and peaks from winter through to springtime. The three most common ways you can get it are through an allergic reaction, from bacteria, or from a virus.
FEATURES AND BENEFITS •E asier than multiple-application products • Opaque drop turns into clear gel, for clear vision after use • Effective and well-tolerated •U sed by New Zealanders for over 13 years •N ow fully funded (ie. you will not pay for the medicine – only doctor’s and pharmacy fees apply).
Ea sy to catch M ost ba cte ria th at ca us e conjun ctivit is are sprea d th rou gh direct ha nd-to -e ye conta ct fro m conta mi nated ha nd s. Th e dis ea se ca n be ca ug ht just by tou ch ing som ething th at wa s ha ndled by an infect ed pe rso n. For thi s rea son, pe op le wh o are dia gn osed wit h conjun ctivit is, pa rticula rly ch ild should sta y ho me until treat ren, me nt ha s sta rted, to avoid infect ing oth ers.
USE TWICE A DAY, NOT FIVE TIMES
Ask your doctor if FUCITHALMIC® is right for you.
Now fully funded conjunctivitis treatment.
Fucithalmic® (Fusidic Acid 1% ) is a Prescription Medicine for the treatment of bacterial infections of the eye like conjunctivitis. Medicines have risks and benefits. Do not use if you wear contact lenses. Do not drive or operate machinery if vision is blurred after application. Possible side effects: mild stinging and burning in the eye, tearing & blurring of the eyes. Use only as directed. If symptoms persist see your doctor. For further details refer to Consumer Medicine Information on www.medsafe.govt.nz, Seqirus (NZ) Ltd, Auckland. Fucithalmic® is a registered trademark of Amdipharm Limited. TAPS NA6382 FUCI-018-10/15
LIVING WITH ALLERGIES Autumn 2016 7
TELL-TALE SIGNS Itchy eyes and wondering whether your conjunctivitis is due to an allergy or an infection? Dr Malcolm McKellar separates out the symptoms and offers some advice.
ONJUNCTIVITIS is the medical term for inflammation of the conjunctiva, a thin layer of transparent tissue that covers the white of the eye and lines the inside of the eyelids. The most common types of conjunctivitis are infectious conjunctivitis and allergic conjunctivitis. But how do you tell the difference? If your conjunctivitis is recurrent or chronic; develops during the day; you have itchy, watery eyes and other allergies, such as asthma, hayfever or eczema; and your lymph nodes are normal, chances are you have allergic conjunctivitis. If, on the other hand, your conjunctivitis is oneoff and accompanies another infection, for example a cold or flu; is worse in the morning, and you have gritty, sticky eyes and swollen lymph nodes, you very likely have infectious conjunctivitis. LIVING WITH ALLERGIES Autumn 2016 9
eye allergies Allergic Conjunctivitis – But Which Type? There are three common types of allergic conjunctivitis – acute allergic conjunctivitis, chronic allergic conjunctivitis and giant papillary conjunctivitis. 1. Acute allergic conjunctivitis This quite spectacular reaction typically occurs in children playing in long grass or with pets. The eyes are very itchy and watery, and eyelid swelling is common. Most cases resolve spontaneously within a few hours, and the best treatment is cool compresses (see sidebar). 2. Chronic allergic conjunctivitis There are three types of chronic conjunctivitis: Hayfever conjunctivitis is the most common type. The main symptoms are itchiness and watering, which begin abruptly after exposure and resolve soon after the allergen is removed. Symptoms may be seasonal or occur year round. The eyelids may swell and darken, an appearance known as ‘allergic shiners’. Most sufferers are only too familiar with what causes their conjunctivitis. Common triggers include grass and tree pollens (seasonal allergic conjunctivitis) and animals, house dusts and mould (perennial
allergic conjunctivitis). Drug induced conjunctivitis: Every eyedrop and ointment can cause an allergic response, from a reaction either to the drug itself or to the preservative solution used to keep the bottle sterile. The reaction may occur within a few days of use or after many months of treatment. Patients typically complain of non-specific irritation and low-grade itch. Vernal keratoconjunctivitis is a severe allergic conjunctivitis that usually occurs in patients with other allergies. In adults the disease is called atopic conjunctivitis. Symptoms typically begin in spring and are often severe. The eyes are extremely itchy, watery, ‘burning’ and very sensitive to light. In severe cases vision is reduced. 3. Giant papillary conjunctivitis This much less common disease affects contact lens wearers and patients with artificial eyes. Large, cobblestone-like papillae (rounded protuberances) form on the inner surface of the upper eyelid. Treatment No matter what type of allergic conjunctivitis you’re suffering from, treatment will involve one or more of the following: simple home remedies (see sidebar),
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over-the-counter medicines, prescription medicines, specialist-only medicines and, perhaps most importantly, avoiding known causes. Simple measures of avoidance include: • Changing play areas • Hand washing after work or play • Staying indoors when pollen or dust levels are high • Closing windows • Delegating lawn mowing • Removing plants you’re allergic to • Air-conditioning/filtering • Wearing goggles and wrap-round sunglasses • Wet-dusting • Putting dust covers on pillows and mattresses • Exposing furniture to sunlight to kill dust mites • Removing carpet • Selling or giving away pets • Moving house (a not-quiteso-simple measure!) Try This At Home
Cool compresses can provide excellent relief, particularly in children with acute allergic conjunctivitis. The simplest way to do this is to keep a wet facecloth in a plastic bag in the fridge. Instant relief! Also try washing the eyes with artificial tears or a solution such as Optrex.
With thanks to Dr Malcolm McKellar, an optometrist and ophthalmologist based in Christchurch. www.drmalcolmmckellar.co.nz.
OUT, DAMNED MOULD!
As we head into winter, it’s time to think about minimising – or ideally banishing – mould from our homes. Nelson Lebo, Eco Design Advisor with Palmerston North City Council, tells us how.
damp, cool, still air. Therefore preventing mould in your home involves three main strategies. 1. Eliminating or minimising sources of moisture 2. Insulating and heating your home 3. Preventing air from getting trapped The main sources of moisture in New Zealand homes are cooking, showering, airing washing indoors, using unflued gas heaters, and – for homes with raised timber floors – rising damp. So what can you do to minimise mould?
Fan-tastic: Properly installing extractor fans in your kitchen and bathroom can remove most of the moisture generated by cooking and showering. Unfortunately, many bathroom extractor fans aren’t up to the task. If you have a below-par fan, try installing a 10-minute delay timer on the fan and/or installing a Steam Stopper or Shower Dome. Out with gas: Avoid using un-flued gas heaters; any heater is better than an unflued gas heater (particularly LPG portable gas heaters).
Banish the (clothes) horse: Avoid drying clothes inside and instead find an alternative that works for your family. Do you have a covered outdoor area you could use? A vented dryer? Could you hang clothes in your garage or shed with the windows open? Or how about going to the local laundry and using a dryer there? On the rise: Rising damp can be a major source of moisture for houses built on piles. Addressing this issue effectively will involve installing heavy-duty polythene on the ground beneath your home and, where appropriate, improving drainage around the perimeter.
LIVING WITH ALLERGIES Autumn 2016 11
Insulate: In terms of heating, the best way to heat your home is to thoroughly insulate it. After that, the World Health Organisation recommends heating living spaces to a minimum of 18 degrees and bedrooms to 16 degrees. The most cost effective heaters are wood burners, flued mains gas heaters, pellet stoves and heat pumps.
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12 LIVING WITH ALLERGIES Autumn 2016
Move … air: Mould often appears in bedrooms at the south end of a home in two main areas: behind furniture against external walls and in closets. In both cases the reasons are the same: the cold, damp air gets trapped there. During winter months, pulling furniture away from external walls (at least a hand-width away) and leaving closet doors ajar will help encourage air movement and discourage mould from growing.
Extraction: Use an extractor fan and pot lids while cooking. The best range hoods are larger than the cooking area, are vented outside, and have quiet motors. Green isn’t always good: Limit indoor pot plants and cover fish tanks. Gutted: Check gutters and downpipes for signs of leaks. Wipe it: Wipe condensation from windows as soon as you see it. Call for back up: Run a dehumidifier if and when needed. Flush: Finally, flush your home with fresh air for 10 to 20 minutes, once or twice a day. Simply open doors and windows at opposite ends of the house to ensure crossventilation. During winter months the best time to do this is around mid-day when outdoor temperatures are highest.
RECIPE FOR REMOVING MOULD If mould finds its way into your home, spray the surface with a mixture of 70% white vinegar and 30% water, leave for 15-60 minutes, and then scrub. Be sure to rinse off the vinegar afterwards with a sponge. This is extremely important as mould will grow back on the vinegar residue if itâ€™s not rinsed properly.
For more information, check out the factsheets (under Resources) at www.ecodesignadvisor.org.nz.
LIVING WITH ALLERGIES Autumn 2016 13
Managing Exercise Induced Asthma Exercise can be a trigger for some people with asthma… but that’s not an excuse to sit on the couch! Physiotherapist Brigitte Eastwood shares her tips for managing exercise induced asthma.
XERCISE IS VITAL for
our total body health and wellbeing. Having exercise induced asthma just means you need to find a form of exercise that doesn’t affect you as much. Be prepared and monitor the way you breathe while exercising. First up, some things to remember: • Your fitness level will play a part in how breathless you are while exercising. • To improve your fitness it is important to actually get a bit breathless. A good rule of thumb is the ‘walk and talk test.’ When exercising you should be moderately short of breath but still able to speak. • Do you really have exercise induced asthma? Exercise induced hyperventilation (or disordered breathing) can mimic exercise induced asthma and also cause shortness of breath, chest tightness and feelings of air hunger. In a study
of 52 school children in Canada, who had been told they had exercise induced asthma, 40.4% were found to have a form of disordered breathing and 23.1% were merely unfit. Only 15.4% had exercise induced asthma based on diagnostic criteria. Because of the prevalence of asthma in New Zealand, and the similarity of symptoms, it is easy to see how exercise induced asthma is often the first diagnosis people think of. What can you do if you have exercise induced asthma? Firstly make sure you get your asthma under control. • Talk to your GP and get an asthma action plan • Use your inhalers regularly and correctly. If you use a “puffer” inhaler make sure you use a spacer. • Take the asthma control test at www. asthmacontrol.co.nz
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You can also: • Consider when and where you exercise. Check the weather – if there is a cold, dry wind, use a scarf or bandana over your mouth to warm up the air. This trick can also be used if you are exercising around dust or fumes. Exercise inside if you find cold wind, pollen or fumes to be big triggers. This could mean joining a gym, finding an exercise group to join or walking around your local mall. • Warm up before exercising. • Consider the type of exercise that you do. Some people prefer exercise which stops and starts for rests such as tennis or team sports; others prefer exercise where they can pace themselves, like running, walking, tramping or swimming. • Be prepared – have your inhaler with you. This can help take the worry out of exercise.
Be prepared – have your inhaler with you. This can help take the worry out of exercise. • Think about the way you are breathing – it is important to start out breathing through your nose as much as possible and keep your breathing pattern calm. For more help with this contact your local respiratory physiotherapist (www. physiotherapy.org.nz is a great place to look) or ask your doctor to refer you to your local district health board respiratory physiotherapy department.
What to do if you get asthma symptoms during exercise 1. Firstly, don’t panic. 2. Take your reliever medication calmly. 3. Stop, sit down and lean forward, supporting your arms on your legs. If you are unable to sit down then place your hands above your knees and lean forward while standing. 4. Focus on breathing out, slowing and controlling your breathing until your reliever works.
Formerly a Senior Physiotherapist in the cardiorespiratory team at Counties Manukau Health in Auckland, Brigitte Eastwood now works as Senior Physiotherapist – Special Interest Paediatrics, at Bay of Plenty District Health Board.
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With the change from summer to autumn, it’s useful to start supporting your immune system, particularly if you’re living with ongoing allergies, says Naturopath Rebekah Paddy.
f you’re living with allergies, identified or not, you’ll very likely have a compromised immune system. This is simply because having allergies puts pressure on your general immunity as it stays in a more inflammatory or reactive state. Supporting the immune system to help reduce allergic tendency and severity of response is well accepted as part of the allergy treatment protocol; it will also help to strengthen immunity to ward off the risk of recurrent virus and infection such as the common cold. As the seasons change, there are a number of well researched and effective natural supplements you can add to your daily regime to help achieve good health and immunity throughout the long winter months.
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Probiotics: See Living with Allergies Summer 2015 to read how probiotics can support immunity and reduce allergic tendency. Taken daily in the appropriate strains this is a great way to increase important microbes in the gut. Slippery Elm Powder: This is one of my favourite pre-biotics. A pre-biotic helps to ‘set the scene’ by creating the perfect environment and ‘feeding’ our good gut flora which are at the very heart of a healthy immune system. Slippery Elm has the added benefit of healing the gut mucosa lining, which has often been compromised due to the inflammatory response, especially when food allergies have been present. This can lead to a condition called leaky gut syndrome which can increase the likelihood of ongoing allergic response and compromised immunity. Slippery elm powder can be added to any food – or put it in a smoothie. Just make sure you increase your fluid intake. Omega 3s: It is well known that Omega 3’s increase immunity and reduce inflammation associated with allergies. They are a first choice supplement especially for atopic conditions such as eczema and hives.
Vitamin D: Humans get this vitamin from sunshine. In New Zealand we have almost epidemic levels of Vitamin D deficiency – in summer we need to be covered from our harsh sun and in winter we see little sun. Low vitamin D levels are associated not only with recurrent illness, but increased allergy risk and the “winter blues”. Sometimes Vitamin D needs to be prescribed by a GP if levels are too low. For maintenance, I suggest cod liver oil (there are good tasting supplements these days!). This has high levels of natural vitamin D and A as well as Omega 3, so is a good all-round option. Other foods high in Vitamin D include saltwater fish, eggs, dairy and green leafy vegetables. Zinc: Deficiency in this mineral is associated with recurrent infection, slow wound healing, increased colds, fatigue, and growth retardation. Zinc needs to be part of a daily supplementation regime in winter if you have lowered immunity. Foods that can help maintain good levels of zinc are eggs, seaweed, mushrooms and lamb. Zinc can displace other needed minerals such as iron, so zinc supplements should be taken separately, at night.
Vitamin C: This is a wellknown immune booster. I suggest taking a supplement in an easily absorbable form once a day and increasing frequency throughout the day if you’re getting sick or when you’re ill. For appropriate dosing and peace of mind that you are taking good quality supplements, speak to your pharmacist, naturopath or local health shop. Finally, a few things to be conscious of if you or your kids keep getting sick or take a long time to shake illnesses off: • Check for further allergies or intolerances that may be compromising your immunity. • Get your iron tested. If this is low, your immunity will be low too. • When you’re sick, honour your appetite and only eat when you need to. Drink plenty of fluids, preferably warm, such as herbal teas and honey and lemon drinks, and get lots of rest. This will allow your body to heal and let you get back into the fast lane more quickly. Rebekah Paddy is a Naturopath, Medical Herbalist and Director at Mother-Well Holistic Health in Auckland www.mother-well.co.nz.
LIVING WITH ALLERGIES Autumn 2016 17
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ATTENTION TO DETAIL
Successful treatment of childhood eczema often comes down to the details, says immunologist and allergy specialist Dr Andrew Baker.
R BAKER encourages parents to seek out
expert advice on how to effectively use moisturisers and steroid creams. “Often, the benefits are in the details of how these are used,” he says. “Regular, more preventative use of these creams, when guided by an expert, is often best, rather than reactionary use just when the eczema is bad.”
See Dr Baker’s Top 5 Tips for Parents on the next page.
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DR BAKER’S TOP 5 TIPS FOR PARENTS 1
Consult with an expert who can supervise treatment with regular follow-ups.
Successful treatment is often in the details. For example, do you wait until your child’s eczema gets bad before you start treatment or do you start early? Do you put cream just on the spots or over the whole area? How much steroid cream should you put on? The Australasian Society of Clinical Immunology and Allergy website (www.allergy.org. au) has a good page on ‘Eczema’ which includes information on ‘fingertip units’ (or FTUs), which can help guide treatment.
Discuss any worries you might have about using steroid based creams with your doctor or specialist. These creams vary a lot, and while some are strong, others such as 1% hydrocortisone, are actually very weak and almost certainly do not cause skin thinning. (They can be used on the face as well.) All of these treatments are approached on a case by case basis though, so regular follow-ups with your GP or a specialist are necessary. Avoid all soaps and other cleansers. Stick to a simple soap substitute such as Sorbolene 10% glycerine. Have a plan in place: When a flare of eczema improves, a plan for preventative treatment should be put in place to stop recurrent flares. This might be as simple as avoiding all soaps and using moisturiser twice a day, but another more preventative approach sometimes used is the application of steroid cream twice weekly, also known as ‘steroid cream weekends’. This can be a good option for children with moderate recurrent eczema and some studies have shown less steroid cream is needed in total because exacerbations are prevented. Once again, this needs to be decided on a case by case basis, so talk to your child’s GP or specialist.
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DR BAKER ANSWERS THREE COMMON QUESTIONS ABOUT ECZEMA: Should I stop certain foods for eczema? There is a lot of misinformation about this. Advice to avoid large numbers of foods can be very harmful both nutritionally, psychologically and socially, both for adults and children. Almost all eczema in adults is not food related. In only a very small proportion of eczema cases in children should foods be avoided just because of eczema. In most cases, it is better managed by other means. Also, new evidence shows that avoiding some foods in early infancy may actually increase the chances of the child developing more severe allergy to those foods. The evidence for this is particularly clear for peanuts.
As a result, the Australasian Society for Clinical Immunology and Allergy (ASCIA) recommends introducing all typical allergenic foods to a child’s diet at age 4-6 months. Do bleach baths work? In one study, patients were randomised to normal baths, and the others to a bath with half a cup of Janola in it. This makes the bath basically about the same chlorine concentration as a swimming pool. Those having the bleach baths twice weekly for 15 minutes each time had a 30–40% improvement in their eczema. Bleach baths work by killing a bacteria on your skin called Staph Aureus, which drives eczema in some patients.
What about dustmite desensitisation? In those patients with a positive dustmite skin test, or IgE RAST blood test to dustmite, a study has shown that eczema improves on average by about a third if they have dustmite desensitisation. For people with only mild eczema, this may not be worth it, but for those with more severe eczema, this may be valuable. Correct use of moisturisers and steroid creams always comes first and 9/10 times it is better advice on the specifics of HOW these are used that will do the job. Dr Andrew Baker is an Immunologist and Allergy Specialist at Waitemata Allergy Clinic on Auckland’s North Shore. See www. allergyspecialistdoctor.co.nz.
Need relief from dry, itchy skin? Comvita has a full range of Medihoney® products for natural relief from dry, itchy skin. The formulations are certified natural, fragrance free, soap free and dermatologically tested. Enriched with medical grade honey, oat extract and nourishing plant butters, these products help to replenish dry skin for a healthier you. We have one full set of Comvita’s certified natural Medihoney® Range to give away, including the Soap Free Wash, Moisturising Lotion, Derma Cream, Skintensive™ Cream and Antibacterial Wound Gel™ (total RRP $96.75). Comvita.co.nz/medihoney Enter online at www.livingwithallergies.co.nz or email email@example.com with MEDIHONEY in the subject line. Entries close 30 June 2016. 22 LIVING WITH ALLERGIES Autumn 2016
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food and recipes
STRESS-FREE GLUTEN FREE
Sally Holland shares recipes that gluten free kids – and their friends – will love.
ATERING for gluten
free children can be challenging, particularly when it comes to filling lunchboxes and special events like birthday parties, says Sally Holland, Tauranga author of the newly released Goodbye Gluten cookbook. “Especially when you think that the school lunchbox staple is sandwiches, and common kids’
✓Gluten Free ✓Chemical free ✓No added water
party foods include cheerio sausages, flavoured chippies and fairy bread, all of which are likely to contain gluten.” It is this conundrum that prompted Sally to include a dedicated children’s section in her book, which was launched in December. “I think it’s very important that we teach our children how to cook, and even more so when they have special dietary needs,” says Sally.
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“Many of my recipes are simple and straightforward, so that children can try them for themselves.” If you are hosting a birthday party and you have a gluten free child on the guest list, it’s easier for everyone concerned to make the whole party gluten free, she advises. “There are many party foods that are gluten free anyway, so don’t forget about them. Popcorn, some marshmallows, meringues, jellies, ice creams and even smoothies are all good. “You can also make nachos with gluten free corn chips or homemade potato wedges
with child-friendly dips.” When it comes to school lunchboxes (a chore even for parents of non-gluten free kids!), Sally says the challenge is to fill it with foods that will travel well and not fall to pieces. “There are some good commercially made gluten free breads on the market now that are very springy and suitable for sandwiches. Keep them in the freezer and semithaw in the microwave in the morning and the sandwiches will be great by lunchtime. “Gluten free wraps are another good option.”
Find out more about Sally Holland and Goodbye Gluten at www.goodbyegluten.co.nz CHECK OUT RECIPES FROM SALLY’S BOOK ON PAGES 27 & 28
Bob’s Red Mill Natural Foods is a miller of stone-ground whole grains and a leader in organic and gluten free foods. With more than 40 gluten free products, there’s no shortage of choice for breakfast, morning tea or lunch.
26 LIVING WITH ALLERGIES Autumn 2016
Check out wheat free oats, nutritious gluten free cereals, baking and bread mixes at your local organic store, or visit www.organix.co.nz
THE BIRTHDAY CAKE is the ‘pièce de résistance’ of the party. I have used a vanilla cake which is perfect with either a chocolate or cream cheese icing. The chocolate numbers were made using a silicon mould from a kitchenware shop. Simply melt some chocolate and fill the mould, level off, and place in the refrigerator. When hard, gently peel away from the mould. White chocolate looks good on chocolate icing and dark chocolate is best on the lighter coloured icing.
BIRTHDAY CAKE Serves 10
This simple and delicious vanilla cake, paired with chocolate or orange cream cheese icing, is perfect for your next birthday party, or any special occasion. The recipes for gluten free flour mix and the icing can be found on page 28. 125 g butter 1 cup sugar 3 large eggs 2 tsp vanilla extract ½ cup sour cream 1½ cups gluten free flour mix (see page 28) 2 tsp baking powder, gluten free 1 tsp baking soda pinch of salt 1 x quantity chocolate icing (see p 28) or 1 x quantity orange cream cheese icing (see p 28) gluten free cake decorations as desired
Preheat oven to 170° C. Line the base of a 23 cm round cake tin with baking paper. Beat the butter and sugar until pale. Add the eggs, one at a time, beating well after each addition. Add the vanilla extract and the sour cream. Beat to combine. Fold in the sifted flour mix, baking powder, baking soda and salt. Pour into the prepared tin and level the top. Bake for 35–40 minutes until a skewer comes out clean. After 10 minutes, turn out on to a wire rack to cool. Ice with chocolate icing or orange cream cheese icing and decorate as desired. LIVING WITH ALLERGIES Autumn 2016 27
YUMMY STICKY CHICKEN STICKS These are a great savoury item for a birthday party. Makes 24
3 tbsp tomato paste Âź cup tomato sauce, gluten free 2 tbsp white wine vinegar 1 tbsp tamari, gluten free 100 ml maple syrup 8 skinless, boneless chicken thighs Mix the tomato paste, tomato sauce, white wine vinegar, tamari and maple syrup together in a bowl. Cut each chicken thigh into nine pieces and add to the marinade. Cover and refrigerate for several hours. Soak 24 bamboo satay sticks in cold water. This prevents them burning during cooking. When ready to serve, thread three pieces of chicken on each skewer. Either barbecue or grill, turning once or twice during cooking, until the chicken is done. This will take about 20 minutes. While cooking the chicken, place the leftover marinade in a small saucepan and bring to the boil. Simmer for five minutes. Drizzle over the cooked chicken sticks. CHOCOLATE ICING 50 g butter, melted 1 cup icing sugar, gluten free 3 tbsp cocoa Place all ingredients in a bowl. Beat in enough hot water to make a smooth creamy icing. ORANGE CREAM CHEESE ICING 125 g cream cheese, softened 50 g butter, softened Finely grated rind of 1 orange 2Â˝ cups icing sugar, gluten free Beat the cream cheese and butter together until creamy. Add orange rind and icing sugar and beat until smooth.
28 LIVING WITH ALLERGIES Autumn 2016
GLUTEN FREE FLOUR MIX Makes 4 cups
This is easy to mix up and is best stored in an airtight container in the pantry. I have used white rice flour and cornflour from maize not wheat. Xanthan gum is made from corn sugar and is used as a gluten substitute to give elasticity in gluten free baking. Tapioca flour is also known as arrowroot. 2 cups rice flour 1 cup tapioca flour 1 cup cornflour 2 tbsp xanthan gum Sift all ingredients into a large mixing bowl. Using a wire whisk, slowly stir until well blended. Transfer to an airtight container.
ADVICE, BENEFITS & CHOICES
Dexem Repair helps eczema in 3 ways:
Dermalab – natural care for winter skin
Soothes: Moisturises and conditions the skin to help relieve itching and aid healing. Restores: Skin friendly pH provides an optimal environment for skin healing and normalisation of skin health. Protects: Containing the natural bacteria blocker 2QR, Dexem Repair helps prevent bacterial infection on and around the eczema site. Always read the label and follow the instructions. Do not use if you are sensitive to one or more of the ingredients. For external use only. If symptoms persist, please see a healthcare professional. Distributed by Air Flow Products Limited, Wellington. 0800 247 356 www.air-flow.co.nz. TAPS CH4745 RRP from $14.99. Dexem Repair – cream and scalp – are only available from Pharmacies. For more information visit dexem.co.nz
Winter means less humidity in the air which can lead to dry, cracked skin and eczema flare ups. Keep skin soft and healthy with DermaLab, packed with skin-loving natural ingredients such as oats, honey, almond oil, shea butter, calendula and chamomile. Natural goodness made right here in New Zealand. • Skin Friendly pH • Fragrance Free • Colour Free • Paraben Free • Lanolin Free • SLS Free • PEG Free www.dermalab.co.nz
Dexem – more than just relief from eczema
Dairy free yoghurt … no bull!
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NoMoo proudly produce their new range of Dairy Free Yoghurts in their modern dedicated facility in rural Nelson. Containing the goodness of non-GMO whole bean soy milk, coconut cream, real fruit and live probiotic cultures, they don’t contain preservatives, artificial flavouring or colouring. NoMoo don’t make products containing cow’s milk, nuts, eggs or gluten either, so you can be sure their yoghurt is free of these common allergens too. Available at selected supermarkets and retailers or email: email@example.com
Rug Doctor’s DIY equipment covers it all. From whole floor cleans, to spills, mattress cleaning, stairs and upholstery (chairs, couches and vehicles). Cleaning your carpet regularly not only maximises the life of your carpet, it is also very important for the health of your family, eliminating fleas, cockroach eggs and dust mites, giving you a clean and healthy home. To find out more, visit www.rugdoctor.co.nz or call 0800 800 245
Clear Eyes™ -A relief for itchy eyes
Clear Eyes™ -A is a triple action formula that relieves itching associated with exposure to airborne allergens, removes, redness and moisturises irritated eyes. Always read the label use only as directed. If symptoms persist consult your healthcare professional. TAPSCH4095 Available in pharmacies www.cleareyes.co.nz
30 LIVING WITH ALLERGIES Autumn 2016
From top-to-toe and everywhere in between, Rhino Repair is the ultimate multi-tasking repair cream, packed with soothing and healing, natural ingredients. Recommended by doctors and dermatologists, Rhino Repair quickly absorbs into the skin to relieve everything from irritated skin around the eye area, flaky and dry skin, cracked heels through to nappy rash, itchy bites and sunburn. Request a free sample on 0800 OASISNZ and quote Living with Allergies.
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USEFUL SNIPPETS We’ve enjoyed putting together this issue of Living with Allergies and have learnt some interesting things along the way. Here are some of them …
That itchy, watery eyes are associated with allergic conjunctivitis; whereas gritty, sticky eyes are a symptom of infectious conjunctivitis. PAGE 9
That about 40% of the iron in our diet comes from wholegrains. PAGE 4
That the Australasian Society of Clinical Immunology and Allergy website, www.allergy.org.au, has an informative page on ‘Eczema’ which includes information on ‘fingertip units’ (or FTUs), which can help guide treatment. PAGE 20
That pulling furniture away from external walls and leaving wardrobe doors ajar will help encourage air movement and discourage mould from growing in bedrooms during the winter months. (And that this is particularly important in bedrooms on the south side of the house.) PAGE 11
That to improve your fitness it’s important to get a bit breathless. A good rule of thumb is the ‘walk and talk test’. When exercising you should be moderately short of breath but still able to speak. PAGE 14 That as well as being a pre-biotic that helps maintain gut flora, slippery elm has the added benefit of healing the gut mucosa lining which often becomes compromised in people with allergies. PAGE 17
That the pain reliever codeine is metabolised to morphine in the body. PAGE 3 32 LIVING WITH ALLERGIES Autumn 2016
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Treat your allergic rhinitis not just your symptoms A grass pollen immunotherapy tablet - a real solution for your allergic rhinitis1,2 • One tablet per day • For adults and children 5yrs & over • Take seasonally - before & during pollen season • Proven effective after the first season3,4
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100 IR & 300 IR or 300 IR sublingual tablets Oralair is an unfunded prescription medicine. Always use strictly as directed. Ask your doctor if Oralair is right for you. Oralair has risk and benefits. If symptoms continue or you have side effects, see your healthcare professional. Normal doctors fees will apply For futher information on Oralair contact your doctor or healthcare professional or view the Consumer Medicine Information (CMI) go to www.medsafe.govt.nz/consumers/cmi/cmiform.asp Stallergenes Australia Pty Ltd Suite 2408 4 Daydream Street Warriewood NSW 2102 Distributed in New Zealand by EBOS Group Ltd 108 Wrights Rd Addington Christchurch Ph: +64 (0) 9 4153 267 Fax: 0800 262 262 Stallergenes & Oralair are registered trademarks of Stallergenes SA STG12115 TAPSPP5855 REFERENCES: 1. AUST R 167565 - ORALAIR Initiation Treatment & AUST R 167566 - ORALAIR Continuation treatment. 2. Approved Oralair product information. 3. (VO34.04 study): Didier A. optimal dose, efficacy and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007;120:1338-45. 4. (VO52.06 study): Whan U.et al. Efficacy and safety of 5-grass pollen sublingual immunotherapy tablets in paediatric allergic rhinoconjuntivitis.J Allergy Cin Immunol 2009;123:160-6.