Richard G. Petty, MD

Self-hypnosis and Hay Fever

I first learned to do hypnosis in 1980, and I have always found it a useful adjunctive treatment for some people, though in recent years I have spent far more tie teaching people to use self-hypnosis.

The research data on hypnosis has also been growing, to the extent that nearly two years ago an article in the Mayo Clinic Proceedings, a fairly conservative journal, suggested that the time had come for an expanded role for hypnosis in general medicine as well as a study of different techniques that are in use.

Hypnosis and self-hypnosis may affect an illness directly, or it might reduce a trigger to the illness, say if anxiety triggers an asthma attack, we could use hypnotherapy to treat the anxiety. Hypnosis may improve a person’s subjective responses to the illness. It might also be useful to help counteract side effects in people who just have to be treated with conventional medications.

Many case reports of apparent cures with hypnosis have found their way into the popular press.  I have mentioned that over a period of five years I spent one to two days a week going through and checking most of these reports in all the languages that I can read. Sadly some of them turned out not to hold much water.

But now the quality of the research has improved enormously. I have been particularly impressed with some of the studies on allergy: it is very remrakable to think that we can make specific suggestions that produce demonstrable effects on the immune system. I particularly liked a study from Switzerland that was published in the journal Psychotherapy and Psychosomatics.

A team from Basel University taught 66 people with hay fever how to do self-hypnosis and found that it helped them to alleviate symptoms such as runny nose.

The volunteers also took their regular hay fever medicines, but the effect of hypnosis appeared to be additive so that they could reduce the doses that they needed to take.

The study took place over two years and included two hay fever seasons. During the first year, one group of the volunteers with hay fever were taught and asked to regularly practice hypnosis as well as take their usual allergy medicine. The training consisted of one two-hour session with an experienced trainer. The remaining volunteers had no other treatment apart from their normal allergy medication.

After a year, the researchers found the volunteers who had been using self-hypnosis had reported fewer symptoms related to hay-fever than their fellow volunteers.

During the second year, the researchers taught the remaining "untrained" volunteers how to use hypnosis. By the end of this year, these volunteers also reported improvement in their hay-fever symptoms.

Although the improvement in symptoms was not statistically significant the researchers also found that the volunteers had cut down on the amount of hay fever medication they used after learning self-hypnosis.

There is another interesting piece of research on this topic. You will probably have experienced a histamine reaction: the typical wheal, flare and swelling that can occur after, say, an insect bite. Researchers form Denmark used hypnosis to induce emotions of sadness, anger, and happiness, to see whether these emotions would have any effect on the skin’s response to histamine. Not only did mood have an effect on the skin reactions, but also people who were more susceptible to hypnosis were more reactive to histamine.

Hypnosis is being used with many clinical conditions, from asthma to migraine and irritable bowel syndrome. It is not a panacea, but it can be a very useful tool. And it tells us a lot about the power of the mind to influence virtually every system of the body.

The Red Tide

There is an important report about the impact of environmental change in this month’s issue of the journal Chest.

Red tide is a common name for a phenomenon known as an algal bloom,
a well known event in which marine algae accumulate rapidly in the
water column, or “bloom”. These algae, more correctly termed phytoplankton, are microscopic, single-celled, plant-like organisms that can form dense, visible patches near the water’s surface. We know that red tides have been occuring in the Gulf of Mexico for centuries, but they appear to be spreading and to be becoming more common and severe.

The main type of plankton is a species of dinoflagellate known as Karenia brevis, that is concentrated along shorelines and produce highly potent aerosolized toxins. The new research shows that Florida red tide toxins – called brevetoxins can impact respiratory function and increase respiratory symptoms in patients with asthma.

In otherwise healthy people inhaled aerosolized red tide toxins can lead to eye irritation, runny nose, postnasal drip, nonproductive cough, and wheezing. The symptoms usually subside after leaving beach areas. But things can be far more serious for people with asthma, who may experience respiratory problems and decreased lung function after just one hour of beach exposure to the toxins.

This was a fine piece of research funded by the National Institute of Environmental Health Sciences, and makes it clear that not only that asthma sufferers need to be aware of this potential source of trouble but that we all need to be alert to the possibility that human activities are increasing the red tide and with it, the risk of further health problems.

Vaccinating Against the Snivels?

I’m using a deliberately provocative title for a story that is quite serious, both medically and ethically.

We have today heard about two new developments. Researchers from the University of Rochester Medical Center announced that they are starting trials of a new vaccine aimed at eliminating childhood ear and sinus infections as well as many cases of bronchitis in adults. Second, and on the same day, the University of Rochester announced that it had won a $3.5 million grant from the National Institute of Deafness and Communication Disorders, one of the divisions of the National Institutes of Health, to develop the new vaccine. The team at Rochester helped to develop the vaccine marketed by Wyeth as Prevnar. It is used to protect infants and toddlers against some strains of bacteria that can cause pneumonia, meningitis and ear infections.

The vaccine will target Nontypeable Haemophilus influenzae or NTHi, which is the main remaining cause of ear and sinus infections and bronchitis, now that vaccines exist for various forms of streptococcal bacteria and Haemophilus influenzae B, the previous leading causes. NTHi is now the leading cause of ear and sinus infections, and of bronchitis in adults.

But why this news is so important for all of us, is that unlike virtually all other vaccines on the market, this one will not be aimed at saving lives, but at preventing what are usually nuisance illnesses. But please note my use of the word “usually.”

Dr. Michael Pichichero, a professor of microbiology, immunology, pediatrics, and medicine at the University of Rochester Medical Center who is leading the trial, was quoted as saying, “While ear infections are never fatal, they can cause serious damage in some children.” He went on to say that “83 percent of U.S. children experience one or more ear infections by age 3 and in some cases hearing loss becomes permanent.”

This is the point, and also why the National Institute of Deafness and Communication Disorders has chipped in. Most of these infections get better on their own, so an initial reaction might be to say, “why bother with this at all?” The trouble is that not only can they lead to long-term problems with hearing, I have seen more than one person develop a cerebral abscess as a result of a severe infection: the illness is not always innocuous.

Another problem is that infections of the sinuses and ears bring children to clinics and emergency rooms, and are the leading reason for antibiotic prescriptions. Even though many of the infections are viral, and viruses do not, of course, respond to antibiotics. Every expert agrees that antibiotics are overused in the United States, which wastes money and also helps the evolution of bacteria that ultimately resist all antibiotics.

What’s the downside of these announcements?

  1. We have already run into a great many problems with previous vaccinations. Some long-term and some subtle; so we desperately need long-term safety data.I know many natural healers who blame many of our health woes on vaccinations.
  2. I hope that the researchers have built into the contract a clause to allow them to report efficacy and safety data without having to clear everything with the study’s sponsor.
  3. We are facing major resource problems, not just in the provision of health care, but also in the funding for research. So should we be diverting resources into these kinds of problems while every 30 seconds another child dies of malaria?
  4. There has been a great deal of discussion about what is often called the “hygiene hypothesis:” the idea that the increasing rates of some allergic illnesses and asthma are a result of children having avoided minor infections early in life, that would have stimulated their immune systems. The hypothesis is not proven, but there is a great deal of circumstantial evidence.
  5. If successful, would the vaccine create a host of secondary problems ten or twenty years from now?

Attention Deficit Disorder, Allergies and Membranes

There has been a long-running debate about the relationship – if any – between allergies and attention deficit disorder (ADD).

As long ago as 1991 a paper seemed to indicate that there were higher rates of hyperactivity in the parents of children with allergies as well as increased rates of allergies in children with ADD. Recently a study from New York seemed to show higher rates of allergic rhinitis in children with ADD. The problem with all this is that we are looking at two common problems and trying to sort out a genuine connection can be tricky.

I started thinking about this problem again, after a recent report that some children had symptoms of hyperactivity, inattention, attention-deficit/hyperactivity disorder, and excessive daytime sleepiness as a result of sleep-disordered breathing. But what was remarkable was the number who improved after they had their tonsils taken out. The tonsils are one of the first lines of defense in the immune system, which is why they so often become enlarged with infections, or for that matter in any kind of immunological reaction. Now I’m not much of one to take out tonsils unless there’s a really good reason, but it is certainly an important observation for anyone who has a child with behavioral or cognitive difficulties: he or she may not be sleeping properly.

I have seen quite a number of people who had physical and psychological problems, including headaches, depression and attentional problems, who turned out to have either allergies or environmental sensitivities, and when those were addressed, the symptoms resolved. I have also seen some people who followed the notoriously difficult Feingold diet with some success, even though the research doesn’t seem to be very supportive of elimination diets. And I’ve seen just as many people who got no relief at all from elimination diets.

I have just done a detailed literature review on the topics of allergy and attention, and I don’t think that we have enough evidence to suggest that everybody with attention deficit needs to see an allergist. But what this highlights is that not all people with attentional problems or hyperactivity have ADD. They may have attentional problems because of sleep disturbance, depression, anxiety, obsessive compulsive disorder and a range of other problems.

There is some exciting research indicating that one of the problems in many cases of ADD is a disturbance in the normal functioning of cell membranes. If that is correct, it may be that there are disturbances in the membranes of both neurons in the brain and membranes of cells in the immune system. That link is not entirely proven. But it has received further credence by the finding that some children and adults with ADD seem to show improvements of both attention and immune function when they take omega-3 fatty acids. I have recently been hearing some encouraging reports from people who have used the Omega-3 Formula made by Omegabrite (And no, I have no link with the company!)

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