Archive for June, 2011

Have you heard about the New Test for Asthma?

Comments Off on Have you heard about the New Test for Asthma? Written on June 27th, 2011 by
Categories: Allergy Advice, Asthma, Asthma Articles
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Exhaled nitric oxide (eNO) is a new test you may he asked to complete in your clinician’s office if you have symptoms of asthma. This test is receiving wide spread attention from pulmonary and allergy specialists because it offers an easy and noninvasive means to directly monitor airway inflammation. Why is it important to be aware of the level of inflammation in your airways? It is well known that asthma is a disease of chronic inflammation, which causes airway constriction, excessive mucous production, and bronchospasm. Generally speaking, the higher the level of inflammation, the greater are one’s asthma symptoms. One of the causes of this inflammation is the presence of white blood cells called eosinophils in the lungs. The eosinophils are believed to release inflammatory mediators that contribute to inflammation and the resultant symptoms of asthma.

exhaled nitric oxide asthma testNitric oxide is a gas that is produced naturally in the airways and is detectable in the exhaled breath. Research has discovered that eNO levels significantly increase when airway inflammation is present. It is now possible to measure this gas in order to aid in the diagnosis and management of asthma as well as other lung diseases. Levels will be high in untreated or poorly managed asthma and will lower when asthma therapy is initiated and asthma is controlled. Therefore, the results of the test can help to determine how well inhaled anti-inflammatory medications (such as steroid inhalers) are working and can provide further guidance regarding when to increase or decrease medication dosages. This will be helpful in determining patients minimal effective dose of medicine.

Additionally, this valuable tool will be useful in distinguishing asthma from other diseases not associated with nitric oxide elevation such as vocal cord dysfunction, gastroesophageal reflux disease, pulmonary embolism, and acute respiratory illness. This test will assist the clinician in determining the severity of asthma as well as offering insight into patients’ compliance in use of medications. While asthma symptoms may he intermittent, the inflammation of asthma is persistent. Exhaled nitric oxide testing can serve as a marker providing objective evidence of ongoing disease activity even in the absence of symptoms.

Another great benefit of eNO testing is its usefulness with young children who are not always able to understand and follow directions with other methods of pulmonary function testing. The test requires no preparation, is very easy to complete (taking only a few minutes), and is non-threatening for both children and adults. Patients are provided a sterile mouthpiece
that is connected to the eNO device. They will be asked to breathe in slowly followed by a slow, steady exhalation. A computer screen will assist in prompting patients regarding when to take a deep breath and when to exhale. That’s all there is to it!

A patient’s personal history continues to he the most reliable tool in diagnosing and evaluating asthma; however the addition of exhaled nitric oxide testing can augment disease management when used in combination with other conventional diagnostic options (such as pulmonary function testing). Being able to evaluate the level of airway inflammation in asthma
can now more accurately assess treatment responses and ultimately improve quality of life. Allergy, Asthma and Immunology is pleased to have the capability of measuring exhaled nitric oxide in our offices. As health care providers, we are excited when new methods of managing asthma and IMPROVING YOUR HEALTH are available.

Please check our website at or call the office at 480-614-8011 for more information.


Vitamin D and Allergies and Asthma

Comments Off on Vitamin D and Allergies and Asthma Written on June 8th, 2011 by
Categories: Allergy Advice
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Vitamin D seems to be all the rage these days. You can hear about it around the water cooler at work, in your physician’s office, and store shelves seem to be brimming with vitamin D supplements. Currently, there are several studies that suggest vitamin D may play a role in allergies and asthma, but definitive results are pending.

Research has revealed vitamin D’s role with calcium, and how it affects our bones and parathyroid glands. Vitamin D is important for the absorption of calcium by the intestinal tract. It prevents problems with our bones, such as osteomalacia in adults and Ricket’s disease in young children. This supplement also prevents abnormal function of the parathyroid glands. Finally, we know that vitamin D plays a role in our immune system; however, the specific role is still unclear.

Augusto A. Litonjua M.D. has proposed vitamin D may also protect patients from getting asthma and allergies. Dr, Litonjua’s proposal has inspired others to further research the correlation between vitamin D and allergies and asthma. One such study headed by John Brehm M.D. was CAMP, Childhood Asthma Management Program. CAMP studied over a thousand children with asthma from diverse backgrounds and various locations within the United States. Dr, Brehm reviewed vitamin D levels in the children’s blood. His research revealed that patients with low levels of vitamin D have more severe asthma and more frequent emergency room visits than those with higher levels of vitamin D in their blood. Other studies are finding vitamin D receptors in cells that are associated with the immune system. This is important because asthma and allergies are caused by an overactive immune system.

In summary vitamin D is important for calcium absorption, bone strength and parathyroid gland function. The medical community is interested in learning more about vitamin D’s possible correlation with allergies and asthma. Vitamin D can be naturally produced when our skin is exposed to sunlight. It may also be obtained through our diet. Currently, the recommended daily dose is 400 I.U.’s of vitamin D. Vitamin D can be found in foods high in fat, such as fish, egg yolks. and liver. People can increase their daily dose by eating foods fortified with vitamin D, such as milk and cheese. If you have questions regarding the role of vitamin D and your health, please ask your health care provider.