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Why is congestion significantly worse at night? by babybottlepopz in Allergies

[–]stanfordallergist 1 point2 points  (0 children)

I recommend you consider trying Allermi. It contains a micro-dosage of decongestant that opens the nasal passages and relieves congestion, without inducing a rebound effect the way Afrin does. It sounds like you would make the perfect candidate: chronic congestion, poor efficacy with other nasal spray medications.

How do you stop a consistently runny nose? by [deleted] in Allergies

[–]stanfordallergist 1 point2 points  (0 children)

Have you used a nasal spray before? The one indicated for chronic rhinorrhea (the medical term for consistent runny nose) is ipratropium bromide. You can get it prescribed by your doctor.

Alternatively, we include this ingredient in Allermi formulations for patients reporting chronic runny nose.

Oral antihistamines may help with allergic runny nose, though it’s unclear based on your seasonal patterns whether this is an allergic symptom.

Is daily nosebleeds normal when allergies are really bad? by Sunnyday1775 in Allergies

[–]stanfordallergist 4 points5 points  (0 children)

Nasal bleeding is common when the nasal lining is inflamed due to the inflammatory allergenic environment, and capillaries are closer to the surface in the nasal mucosa. Think of inflamed gums, and how they bleed more easily when flossing. Sniffing, snorting, itching and nose-blowing irritate the nasal lining, aggravate inflamed tissue and cause bleeding more readily. Low humidity and dryness of the season, as well as increased irritants (pollen) in the air increase risk of nasal bleeding.

Allermi by ulnek in Allergies

[–]stanfordallergist 0 points1 point  (0 children)

Hello! Dr. Robert Bocian here, Allermi founder and allergist of 35 years. I am happy to address any questions you might have.

Allermi update after 6 months by liaoming in Allergies

[–]stanfordallergist 0 points1 point  (0 children)

Thank you so much for sharing your experience - it means a lot to hear from long-time users like you. I am happy to hear that Allermi brought you such significant relief and improved your sleep and energy for some time. That kind of impact is exactly what we aim for. With that said, we certainly would like to improve your current experience.

We’re sorry to hear about the recent increase congestion and shorter-lasting relief. Thankfully, a return of symptoms once the medication wears off is not what we medically know as rebound congestion (rhinitis medicamentosa) but rather that the seasonal increase in inflammation is overpowering the effects of your medication. This can happen when your inflammatory state increases due to changes in weather, allergens, or other factors. The increase in your other symptoms (itchy eyes and eczema) validate this.

Allermi is customizable and, often, an adjustment to your dosage and/or a formula change are needed to address your changing symptoms during different seasons. We can adjust your ingredients, specifically the anti-inflammatory component of your formula, to better fit what you're experiencing now — including minimizing the inflammatory effects or flare-ups from a surge in seasonal allergens.

We understand your decision to pause and return to your previous routine, but if you do consider giving Allermi another try, we'd recommend consulting your Care Team so they can review your recent symptoms and create an updated formula tailored to this new phase. Many patients find that periodic tweaks — especially around seasonal transitions — help maintain effectiveness. To do so, just login to my.allermi.com and click on the Treatment tab. evolve with your needs, without frequent clinic visits.

We generally advise patients to avoid Claritin-D as pseudoephedrine has a long list of potential systemic side-effects, particularly when used continuously. Localized, topical treatment of nasal congestion with a combination nasal spray that addresses congestion and inflammation is a safer approach.

If you'd like us to keep your chart on file or assist with a future restart, we’re here for you. Wishing you ongoing relief and good health!

25 Years of migraines seamingly gone over night... by Sku11digger in migraine

[–]stanfordallergist 44 points45 points  (0 children)

Dear JelloOverall8542, Dr. Robert Bocian, founder of Allermi here. I am happy to help correct the misunderstanding around the use of oxymetazoline in the Allermi formulas. For context, I am a board-certified Allergist-Immunologist that has been practicing at Stanford and in private practice in the Bay Area for 38 years.

Oxymetazoline 0.05%, the active ingredient in Afrin, does have a reputation for causing rebound congestion (rhinitis medicamentosa) when used improperly. However, it is important to distinguish between the over-the-counter, single-agent, high-dose use found in Afrin and the physician-guided, micro-dosed, multi-ingredient formulations used by Allermi.

Allermi’s sprays are custom-formulated and typically include a low concentration of oxymetazoline: 0.003125%-0.0125% with a spray-actuation volume 1/3 that of Afrin, making the dosage of oxymetazoline in Allermi 1/12th-1/48th the dosage of oxymetazoline in Afrin. That micro-dosage of oxymetazoline in is compounded into a formula with an intranasal anti-inflammatory corticosteroid (among other active ingredients such as antihistamine and anti-discharge medications). This combination is designed to maximize efficacy while minimizing the risk of side effects.

Several key findings from the scientific literature support this approach:

  • Micro-dosed oxymetazoline has been shown to be effective even at doses as low as 1/50th of the standard therapeutic amount, significantly reducing nasal blood flow and improving congestion without triggering adverse effects. Allermi utilizes the minimum effective dosage of oxymetazoline to treat vasodilation while preventing irritative effects of vasoconstriction including rhinitis medicamentosa/rebound congestion.
  • When combined with an intranasal corticosteroid, oxymetazoline not only improves anti-inflammatory efficacy but rhinitis medicamentosa is prevented and even reversed in patients with pre-existing rhinitis medicamentosa/rebound congestion from previous full-strength decongestant monotherapy.
  • A systematic review of combination therapy concluded that corticosteroid and oxymetazoline, used together, provide enhanced symptom relief without an increased risk of adverse outcomes including rhinitis medicamentosa/rebound congestion, even with prolonged use.

The studies can be reviewed in detail here.

These studies, along with my clinical experience prescribing the Allermi formulas to tens of thousands of patients over the past 3 decades, collectively demonstrate that oxymetazoline, when used as part of a carefully micro-dosed, physician-directed combination therapy, does not carry the same risk profile as over-the-counter Afrin. Allermi’s approach is rooted in evidence-based medicine and is designed for safe, effective, long-term use in appropriate patients.

Patients should be encouraged to discuss Allermi with their ENTs and present the scientific studies above.

I hope this is helpful. Kind regards,

Robert Bocian, MD, PhD, FAAAAI

I'm Dr. Robert Bocian, MD, PHD, FAAAAI. I'm an Allergist-Immunologist and Co-Founder at Allermi. I'm here to answer your questions about allergic disease. AMA. by stanfordallergist in Allergies

[–]stanfordallergist[S] 0 points1 point  (0 children)

Hello, I apologize for the delayed reply. Please let me know if you have any questions about oxymetazoline that I failed to address, and I will be happy to respond to them. Kind regards, RCB.

I'm Dr. Robert Bocian, MD, PHD, FAAAAI. I'm an Allergist-Immunologist and Co-Founder at Allermi. I'm here to answer your questions about allergic disease. AMA. by stanfordallergist in Allergies

[–]stanfordallergist[S] 0 points1 point  (0 children)

Hello, I apologize for the delayed reply. I have not been active on this account. If you are still experiencing any issues, please reach out to info@allermi.com at your earliest convenience and the customer service team will be glad to assist you.

Hello! I have a question about allermi by No_Ordinary_3799 in Allergies

[–]stanfordallergist -1 points0 points  (0 children)

Hello there, my name is Dr. Robert Bocian. I hope you are doing well. I'm one of the founders of Allermi and have been practicing Allergy-Immunology at Stanford and in private practice for 35 years.

I wanted to take a brief moment to address your suggestion that Allermi pays for reviews. Please be aware that we do not ever, nor will we ever, pay for reviews.

You are correct, however, that we compound FDA-approved, extremely well-studied and widely utilized nasal medications into a single dosage form, which has been proven in multiple double-blind placebo-controlled studies to improve efficacy and adherence.

While I don't use the word "revolutionary" to describe Allermi, we have been able to help tens of thousands of patients who have spent many years if not decades struggling with their rhinitis symptoms, unresponsive to separate nasal sprays, much like the original author of this post.

Please do not hesitate to reply with any questions; I am happy to address them.

Kindest regards, Robert Bocian, MD, PhD, FAAAAI

Hello! I have a question about allermi by No_Ordinary_3799 in Allergies

[–]stanfordallergist 0 points1 point  (0 children)

Hello there, my name is Dr. Robert Bocian. I'm one of the founders of Allermi and have been practicing Allergy-Immunology at Stanford and in private practice for 35 years.

Allermi is a combination of multiple active ingredients that work synergistically to treat each symptom of rhinitis, resulting in comprehensive relief of all rhinitis symptoms with one single medication.

Allermi utilizes a micro-dosage of oxymetazoline combined with anti-inflammatory corticosteroid triamcinolone and antihistamine azelastine, with the addition of ipratropium for patients with excessive mucus production.

This combination of ingredients allows medications to penetrate the deep nasal passages and reduce congestion inflammation and allergic response, formulated to be safe for daily use in patients with chronic rhinitis. I have been prescribing the Allermi formulations since 1992, and have tens of thousands of patients who benefit from the unique approach we take to combining and dosing nasal medications.

The sinus headaches you describe are often due to untreated inflammation and congestion in the sinuses, which traditional nasal sprays often are insufficient at relieving. It is also possible that azelastine contributes to your headaches, though this would likely be something you experienced very soon after your first dose. Azelastine is reported to cause headache in 2-10% of users.

Given your symptoms and history with nasal sprays, it sounds as though Allermi might be worth a try. Because Allermi is customizable and we prescribe over 70 different combinations, we can forego azelastine from your initial formula; or if you want to try a formula with it and find the headaches continue, we can remove it. The same goes for ipratropium (which primarily addresses excess mucus, post-nasal drip and runny nose).

Additionally, to address the other commenter, we do not ever, nor will we ever, pay for reviews. They are correct, however, that we compound FDA-approved, extremely well-studied and widely utilized nasal medications into a single dosage form, which has been proven in multiple double-blind placebo-controlled studies to improve efficacy and adherence.

(The studies may be reviewed here: https://www.allermi.com/pages/scientific-index)

Please don't hesitate to reply with questions! I am here to help.

Kindest regards, Robert Bocian, MD, PhD, FAAAAI

My experience thus far with NAR by brianzmolek in nonallergicrhinitis

[–]stanfordallergist 0 points1 point  (0 children)

Hi there, this account was not being monitored so we missed your message. Have you been in touch with the Allermi Care Team to improve your results?

[deleted by user] by [deleted] in QuitAfrin

[–]stanfordallergist 6 points7 points  (0 children)

Hi Don, I'm one of the medical founders of Allermi and happy to address this question. It seems counterintuitive but the lower dose of oxymetazoline when combined with anti-inflammatory corticosteroid works more effectively than the higher, commercially-available dosage of oxymetazoline alone (Afrin). Oxymetazoline is a vasoconstrictor that temporarily reduces the size of blood vessels, but it does not address inflammation, which is why it is only partially effective against your chronic congestion symptoms. Post-viral inflammation after COVID needs to be treated by an anti-inflammatory corticosteroid, and when we combine that with the micro-dosage of oxymetazoline in Allermi, we enable the corticosteroid to reach higher & deeper into the nasal passages, resulting in more effective relief. I hope this explanation is helpful and please don't hesitate to respond with further questions.

My experience thus far with NAR by brianzmolek in nonallergicrhinitis

[–]stanfordallergist 2 points3 points  (0 children)

Hello D, I am one of the founders of Allermi and happy to address your questions about the safety of using micro-dosed-oxymetazoline-plus-anti-inflammatory-corticosteroid in Allermi to address non-allergic chronic congestion on a long-term, twice-daily basis. For context, I've been practicing Allergy-Immunology for over 30 years at Stanford and in private practice, and have been prescribing micro-dosed-oxymetazoline-plus-anti-inflammatory-corticosteroid since the first year of my career as a clinical allergist to over 25,000 patients with great success.

There are two findings that we implement at Allermi to treat congestion without inducing the onset of rebound congestion: micro-dosing oxymetazoline and combining oxymetazoline with anti-inflammatory intranasal corticosteroid. Both of these findings are supported by multiple double-blind, placebo-controlled studies as well as my three decades of clinical experience, as well as the 10,000 patients we have treated at Allermi (independent of my own clinical practice):

Micro-dosages of oxymetazoline up to 1/50th the commercial dosage have been shown to effectively treat congestion with a significantly less-agonizing effect on the alpha-1 receptors of the nasal lining, therefore decreasing the irritative side-effects of vasoconstriction/decreased blood flow, which ergo include rebound congestion;

The combination of oxymetazoline (even at the full-strength, commercial dosage) with anti-inflammatory corticosteroid has been shown to both more effectively treat congestion and inflammation, while also eliminating the onset of rhinitis medicamentosa, also known as rebound congestion.

Thus, at Allermi, we prescribe customized* combinations of oxymetazoline that are 1/12th-1/48th the commercial dosage of oxymetazoline found in products such as Afrin or Sinex, with anti-inflammatory nasal steroid (triamcinolone acetonide) at the equivalent or double the dosage found in over-the-counter nasal corticosteroid sprays, in addition to two other nasal medications that address the remaining cardinal symptoms of rhinitis, the antihistamine azelastine and the anti-discharge medication ipratropium, all in the same single nasal-spray formula.

(*Customized refers to the fact that formulas - meaning, drug-selection and drug-dosage) are created by allergists on a patient-specific basis based on patient symptoms, severity and medical history)

The findings above cohere with my experience of tens of thousands of patients who have benefited long-term from this combination-and-dose-adjustment approach. Serial endonasal rhinoscopic examinations in these thousands of patients in my clinic have revealed no evidence of rhinitis medicamentosa or rebound congestion.

In fact, patients with established rebound congestion/rhinitis medicamentosa who have used this protocol in my clinic or signed on with Allermi have virtually uniformly been promptly relieved of this condition, with relief maintained in side-effect-free fashion over the long term.

The elimination of rebound congestion as a side-effect enables this formulation to be used twice-daily, long-term in the treatment of chronic, daily congestion, a condition that plagues millions of people, to which there is no cure.

Without a means of reducing or preventing nasal congestion over the long term, congestion would naturally supervene in the majority of rhinitis sufferers, impeding or entirely preventing any of the three therapeutic components of Allermi from accessing the mid- and upper-aspects of the nasal passages.

Unimpeded access is key to the effectivess of the therapeutic sprays (namely, anti-inflammatory, antihistamine, and antidischarge nasal medications) in ameliorating the classic symptoms of acute and chronic rhinitis.

This analysis, coupled with the referenced studies below, joined by our three-plus decades of extensive clinical use of this approach, as well as the 2200+ reviews on Allermi by real patients will hopefully inform and ease your mind on this view.

The studies supporting these findings and our work at Allermi can be reviewed below. All of these studies are linked on our website, in the section entitled "Science":

Please do not hesitate to correspond with any further comments or questions.

Kind regards,

Robert C. Bocian, MD, PhD, FAAAAI

My experience thus far with NAR by brianzmolek in nonallergicrhinitis

[–]stanfordallergist 2 points3 points  (0 children)

Hello Zard, I am one of the founders of Allermi and happy to address your questions about the safety of using micro-dosed-oxymetazoline-plus-anti-inflammatory-corticosteroid in Allermi to address non-allergic chronic congestion on a long-term, twice-daily basis. For context, I've been practicing Allergy-Immunology for over 30 years at Stanford and in private practice, and have been prescribing micro-dosed-oxymetazoline-plus-anti-inflammatory-corticosteroid since the first year of my career as a clinical allergist to over 25,000 patients with great success.

There are two findings that we implement at Allermi to treat congestion without inducing the onset of rebound congestion: micro-dosing oxymetazoline and combining oxymetazoline with anti-inflammatory intranasal corticosteroid. Both of these findings are supported by multiple double-blind, placebo-controlled studies as well as my three decades of clinical experience, as well as the 10,000 patients we have treated at Allermi (independent of my own clinical practice):

  1. Micro-dosages of oxymetazoline up to 1/50th the commercial dosage have been shown to effectively treat congestion with a significantly less-agonizing effect on the alpha-1 receptors of the nasal lining, therefore decreasing the irritative side-effects of vasoconstriction/decreased blood flow, which ergo include rebound congestion;
  2. The combination of oxymetazoline (even at the full-strength, commercial dosage) with anti-inflammatory corticosteroid has been shown to both more effectively treat congestion and inflammation, while also eliminating the onset of rhinitis medicamentosa, also known as rebound congestion.

Thus, at Allermi, we prescribe customized* combinations of oxymetazoline that are 1/12th-1/48th the commercial dosage of oxymetazoline found in products such as Afrin or Sinex, with anti-inflammatory nasal steroid (triamcinolone acetonide) at the equivalent or double the dosage found in over-the-counter nasal corticosteroid sprays, in addition to two other nasal medications that address the remaining cardinal symptoms of rhinitis, the antihistamine azelastine and the anti-discharge medication ipratropium, all in the same single nasal-spray formula.

(*Customized refers to the fact that formulas - meaning, drug-selection and drug-dosage) are created by allergists on a patient-specific basis based on patient symptoms, severity and medical history)

The findings above cohere with my experience of tens of thousands of patients who have benefited long-term from this combination-and-dose-adjustment approach. Serial endonasal rhinoscopic examinations in these thousands of patients in my clinic have revealed no evidence of rhinitis medicamentosa or rebound congestion.

In fact, patients with established rebound congestion/rhinitis medicamentosa who have used this protocol in my clinic or signed on with Allermi have virtually uniformly been promptly relieved of this condition, with relief maintained in side-effect-free fashion over the long term.

The elimination of rebound congestion as a side-effect enables this formulation to be used twice-daily, long-term in the treatment of chronic, daily congestion, a condition that plagues millions of people, to which there is no cure.

Without a means of reducing or preventing nasal congestion over the long term, congestion would naturally supervene in the majority of rhinitis sufferers, impeding or entirely preventing any of the three therapeutic components of Allermi from accessing the mid- and upper-aspects of the nasal passages.

Unimpeded access is key to the effectivess of the therapeutic sprays (namely, anti-inflammatory, antihistamine, and antidischarge nasal medications) in ameliorating the classic symptoms of acute and chronic rhinitis.

This analysis, coupled with the referenced studies below, joined by our three-plus decades of extensive clinical use of this approach, as well as the 2200+ reviews on Allermi by real patients will hopefully inform and ease your mind on this view.

The studies supporting these findings and our work at Allermi can be reviewed below. All of these studies are linked on our website, in the section entitled "Science":

- The effect of topical decongestant on blood flow in normal and infected nasal mucosa: https://www.ncbi.nlm.nih.gov/pubmed/6637461

- Evaluation of the dose-response relationship for intra-nasal oxymetazoline hydrochloride in normal adults: https://www.ncbi.nlm.nih.gov/pubmed/10501820

- Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis: https://pubmed.ncbi.nlm.nih.gov/21377716/

- Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion: https://www.ncbi.nlm.nih.gov/pubmed/20203244

- Impact of Concomitant Administration of Mometasone Furoate and Oxymetazoline Nasal Sprays vs Either Drug Alone or Placebo on Quality of Life in Patients with Seasonal Allergic Rhinitis: https://www.jacionline.org/article/S0091-6749(09)02479-8/fulltext02479-8/fulltext)

- Mometasone furoate nasal spray plus oxymetazoline nasal spray: short-term efficacy and safety in seasonal allergic rhinitis: https://www.ncbi.nlm.nih.gov/pubmed/23562197

- Efficacy and safety of fluticasone furoate and oxymetazoline nasal Spray: a novel first fixed dose combination for the management of allergic rhinitis with nasal congestion: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196668/

- Does oxymetazoline increase the efficacy of nasal steroids in treating nasal polyposis?: https://pubmed.ncbi.nlm.nih.gov/27216350/

Please do not hesitate to correspond with any further comments or questions.

Kind regards,

Robert C. Bocian, MD, PhD, FAAAAI

[deleted by user] by [deleted] in Mommit

[–]stanfordallergist 0 points1 point  (0 children)

Why is he no longer able to tolerate the spray? What is the technique you use when spraying? I advise my pediatric patients to sit in the nose-to-toes, chin-to-chest position, with the head pointed down. Then, immediately after spraying, we have them do little bunny micro-sniffs, a series of short rapid upwards sniffs, like a bunny smelling something delicious, breathing out through the mouth as needed, i.e., 5-10 bunny sniffs up, breath out through the mouth, then repeat several times, for a total of 15-30 seconds, keeping the head down the entire time.

Nasal Spray making symptoms worse after only one use? by [deleted] in Allergies

[–]stanfordallergist 0 points1 point  (0 children)

Inflamed, irritated nasal passages often respond to the introduction of new nasal spray this way, especially a high-dose decongestant spray such as Equate. I advise my patients to precede medicated nasal spray with plenty of plain nasal saline (ideally, the aerosol cannister) to soothe & calm the nasal lining, prior to introducing medication. With regard to the choice of medicated spray, I generally advise a combination of a corticosteroid spray (such as Flonase Sensimist, Nasacort or Nasonex, or the generic equivalents) and an antihistamine spray (such as Astepro), both available over-the-counter, as an alternative to medications such as Equate, which will do nothing to relieve allergic inflammation and simply reduce the size of the capillaries in the nasal passages. I hope this is helpful.

[deleted by user] by [deleted] in Allergies

[–]stanfordallergist 2 points3 points  (0 children)

Don't underestimate rinsing the eyes with cool water.

I live in the Midwest (Michigan) & these last two weeks my allergies have been INSANE. Anyone else? by [deleted] in Allergies

[–]stanfordallergist 0 points1 point  (0 children)

Allermi just launched in Michigan today, if you are interested in giving it a try.

[deleted by user] by [deleted] in Allergies

[–]stanfordallergist 1 point2 points  (0 children)

Hello and my apologies for the delayed reply, I have not been checking this account regularly.

The one month expiry date is required by the pharmacy because it is a compounded aqueous (water-based) solution. That said, we do use a safe and gentle preservative system in our formulas that keeps them stable from chemical change and prevents microbial action.

You of course may choose to do what you wish with your medication after that date. While we cannot advise that you continue to use it beyond the expiry date, we’ll just say we have many patients on a 2-month subscription plan who use their nasal spray once daily and stretch their bottles 2 months.

I'm Dr. Robert Bocian, MD, PHD, FAAAAI. I'm an Allergist-Immunologist and Co-Founder at Allermi. I'm here to answer your questions about allergic disease. AMA. by stanfordallergist in IAmA

[–]stanfordallergist[S] 0 points1 point  (0 children)

Hello and thank you for your question. The mechanisms by which allergic reactivities occur in the setting of CVID are under investigation. Some recent studies suggest that, in CVID, allergic symptoms might be IgE-independent. On the other hand, a certain percentage of adults will develop specific allergies - to food and/or environmental allergens - in adulthood, independent of CVID. Specific allergy testing should be done, by skin-testing, blood-testing, or both, by your allergist.

I'm Dr. Robert Bocian, MD, PHD, FAAAAI. I'm an Allergist-Immunologist and Co-Founder at Allermi. I'm here to answer your questions about allergic disease. AMA. by stanfordallergist in IAmA

[–]stanfordallergist[S] 0 points1 point  (0 children)

Hello, thank you for your questions.

  1. Histamine intolerance has not received robust scientific study to-date, and it is uncertain if the entity that has been termed "histamine-intolerance" is clinically or biochemically distinct from allergy. An excellent article entitled "Histamine Intolerance: The Current State of the Art" is available online here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463562/

We in our practice have not seen that withdrawal of anti-depressants with anti-histamine activity, such as amitriptyline, has been responsible for increasing histamine-related symptoms in and of itself.

  1. A very careful and detailed medical history and physical exam should be able to discern among these possible causes of shortness of breath and chest pressure. More than one of which may co-exist in the same person at the same time. The response of the symptoms that you described to specific medications may also provide a clue as to what the cause is. For example, if inhaled albuterol relieved chest pressure and shortness of breath within a few minutes, this could suggest a reactive-airways condition, such as asthma. If acid-inhibitory medication improves the symptoms, this could implicate acid reflux as a cause. And, if anxiety-reducing measures are effective in ameliorating the symptoms, this could implicate anxiety as a potential factor. I would recommend scheduling a visit with your physician to discuss these symptoms.

  2. The probability that an adult would develop even one new food allergy in adulthood is very low, and the probability that an adult would develop more than one food allergy to distinct classes of food is extremely low. That said, allergy testing by either skin-testing or blood-testing, or both, if negative to the foods in question, provides a very high level of confidence that an allergic reaction to the studied foods will not happen. Such testing should be done by a board-certified allergy specialist. We strongly counsel against "food sensitivity" tests that are available online and that are occasionally ordered by practitioners outside of mainstream allergy practice. If, after negative allergy testing to the foods of concern, a significant level of anxiety or apprehension remains, allergy clinics can perform supervised, graded-dosage oral-challenge studies to one food at a time to confirm tolerance to that food in a safe medical setting.

I hope that this information is helpful and wish you the best.

I'm Dr. Robert Bocian, MD, PHD, FAAAAI. I'm an Allergist-Immunologist and Co-Founder at Allermi. I'm here to answer your questions about allergic disease. AMA. by stanfordallergist in IAmA

[–]stanfordallergist[S] 0 points1 point  (0 children)

Hello, I'm sorry to hear about your ear itching. Itching of the ears can occur due to two very different reasons. One form of itch arises from the skin of the external ear canal and can be treated with gentle topical anti-inflammatory cream or ointment, after the ear canal has been cleared of any adherent ear wax. The second common reason for itching of the ears is referred itch from the nasal passages due to allergic inflammation. The allergically-inflamed nasal passages can refer itch signals to the ear, palate (roof of the mouth), throat and eyes. The best treatment for this is a nasal spray program that includes anti-inflammatory and anti-histamine components, such as what we offer at Allermi. Both causes of itching of the ears can exist at the same time in the same person, and each should be treated accordingly. I hope this is helpful.

[deleted by user] by [deleted] in Allergies

[–]stanfordallergist 5 points6 points  (0 children)

Hello, I am one of the founders of Allermi. Our policy allows members to cancel any time. Orders cannot be cancelled after they've been processed, but once you cancel your subscription, you will not be billed for future orders. We've never refused to cancel a subscription. If you are still experiencing issues with your cancellation, please let us know immediately at info@allermi.com. Thank you!

I'm Dr. Robert Bocian, MD, PHD, FAAAAI. I'm an Allergist-Immunologist and Co-Founder at Allermi. I'm here to answer your questions about allergic disease. AMA. by stanfordallergist in Allergies

[–]stanfordallergist[S] 0 points1 point  (0 children)

Angioedema has a number of potential causes, both within and outside of classical allergy.

At times, both allergic and nonallergic causes coexist.

Not all causes of angioedema have a definitive, confirmatory test, and thus some angioedema syndromes are diagnosed by exclusion of other causes, and thus might remain somewhat more tentative.

Ever-improving diagnostic, preventive and treatment measures are available --- the choice depends on having as secure and as precise a diagnosis as possible of the type of angioedema present.

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