Summary: A true codeine allergy is actually rare.  Most patients have what could be called a intolerance to codeine – meaning they get an upset stomach.  If you have a true allergy to codeine than your chance for having allergy to other pain killers rises.  The actual rate at which your risk will increase isn’t easy to determine.

Dear Curtis: In the past my doctor prescribed Tylenol #3.  It made me sick including hives, nausea and it closed up my nose and throat.  Now, my doctor has prescribed Lortab and I’m wondering if I’m going to run into the same problems?

My Answer: I get patient’s all the time who claim a codeine allergy but who really don’t have a true allergy.  Right off the bat, it sounds like you have a true allergy to codeine.  In other words, the hives and ‘closing up’ of the nose and throat are hallmark signs.  That’s opposed to a codeine intolerance which basically means that you don’t tolerate codeine well and it upsets your stomach.  If codeine truly causes an allergy like this it’s classified as an anaphylactoid reaction and can be very serious.

I’m assuming that your doctor knows well what happened last time when you took codeine.  That’s very important because if he or she doesn’t know it may very well change the fact that he prescribed Lortab.

As you may already know Lortab is the brand name for a combination of hydrocodone and acetaminophen.  Tyelonol #3 is the brand name for codeine with acetaminophen.  If you are truly allergic to codeine it’s important for you and your doctor to know that codeine is closely related to hydrocodone.  In fact, codeine is the starting point, chemically, for a number of different pain killers on the market – hydrocodone being one of them.  So, consider hydrocodone and codeine ‘cousins’ if you will.  In practical terms, this raises the chance of what is called cross-reactivity.  Meaning you can be allergic to a drug that closely resembles another drug.  In this case hydrocodone and codeine.

I can’t give you numbers or what your absolute risk is – but a risk exists and I would caution you and your doctor to tread lightly.  At the very least it might be wise to try your first dose in the doctor’s office and wait for at least 1/2 hour just to see how you react.

Q: Curtis, I have seasonal allergies and have taken both Zyrtec and Claritin in the past with decent results but they tend to make me drowsy.  Are there any ways to treat my allergies with natural substances that don’t have these type of side effects?

A: I feel sorry for people who suffer from seasonal allergies as they look absolutely miserable to me when they are going on.

As you mentioned, you’ve tried prescription/over the counter medications that do work to an extent but come with unwanted side effects.  This is very common as I find a lot of people view these types of medictions as necessary evils.

There are a lot of supplements, herbal preps and so forth that claim to help with allergies of the type you suffer from, which I’ll get to in a second.  But, let me start with a completely natural product that I’ve seen work first hand in seasonal allergy sufferers.

Local Raw Honey

Allergies are complicated.  There is a whole host of compounds that come into play that are too complicated for our conversation.  But, what you need to know is that constant exposure to ‘allergens’ – say, for example, ragweed – can cause your body to respond to the ragweed as an invader and set of an allergy cascade that gives you the runny nose, itchy, water eyes and coughing.

It often takes time for these allergies to develop.

The premise behind local honey is that you can give honey that contains small amounts of pollen and take a little bit each day in small, minute doses is often like taken allergy shots – just a lot cheaper and more manageable.  Why would this work when it’s the exposure to the allergens that causes the problems in the first place?  It’s due to the amount of the allergens.  When ragweed is pollinating there is large amounts of it and you are being exposed to it.  But, with raw honey (and allergy shots) the amount is much smaller and tends to act as an immune booster.

The trick is to make sure that the honey is local so it contains the actual allergen that is causing the problem.  And, obviously, this will only work for plant-based allergies and have no effect on animal allergies.

How much to take varies but the person I am thinking of took a spoonful a day.  It’s often advised to start taking the honey months before the pollination season starts to prepare your body ahead of time.  This person now actually takes the honey year round because he had such good results with it.  In fact, he claims to not have anymore allergy symptoms (unless he stops the honey).

Again, I realize this is ‘anecdotal’ but ask around and search online and you’ll find other, encouraging stories like this.

Sidenote: I talked to an respected allergist from Arizona who was in his late 60’s at the time who said that the amount of allergies he’s seeing in kids has skyrocketed over the last 15 years or so.  His hypothesis was that nowadays kids grow up in a bubble because parents are afraid to let them play outside, get dirty and get exposed to a lot of different things.  He said when he had started his practice allergies were not nearly as prevalent.  A little food for though if you are a parent.

Supplements and Herbal Preparations

Butterbur

In one study butterbur proved to be as effective as antihistamine drugs in controlling hay fever.  The dose was one tablet four times daily.  So the dosing is more inconvenient but without the drowsiness side effects.  It also proved to be beneficial for grass allergies in a similar study.

Saline Water Spray

I used this a lot to prevent sinus infections if I start getting a cold.  It flushes pollen out of the nose and helps thin out mucous.  Also cheap with no side effects.  Simply hold the saline bottle in one nostril, squeeze and let the solution flow out of the other nostril into the sink.

Goldenseal

Has astringent (drying) properties and antibacterial.

Other helpful natural treatments

• Vitamin C
• Grape Seed Extract

Other Methods That You May Not Think About

You may want to try cooking with more spicy foods as that can thin mucous secretions and clear nasal passages (onion or horseradish anyone?).

Consider food intolerance’s

The point of this is to lessen the burden on your immune system by not having to deal with assaults from different allergens.  Also, from some of the research that’s coming out food allergies and environmental allergies may be more related that we previously thought.

Accupuncture

There is mounting evidence to suggest that acupuncture can lessen (not eliminate) symptoms in the majority of patients.  Even in as little as two sessions.

Tread Lightly

In conclusion, there is evidence for the natural allergy treatments above.  But keep in mind even natural products can cause side effects and they can interact with prescription drugs so make sure to talk to your doctor and don’t self treat.  But, even your doctor might agree that these options may well be worth a shot.