When allergies spike, so do migraines

This article claims that those who suffer from both allergies and migraine headaches have more severe headaches when allergies are bad.

People with migraine who also battle allergies and hay fever (rhinitis) endure a more severe form of headaches than their peers who struggle with migraine, but aren't affected by the seasonal or year-round sniffles, according to researchers from the University of Cincinnati (UC), Montefiore Medical Center and the Albert Einstein College of Medicine of Yeshiva University and Vedanta Research.

About 12 percent of the U.S. population experiences migraine, which is three times more common in women than men. Allergies and hay fever -- also known as allergic rhinitis -- are quite common as well, affecting anywhere from a quarter to half of the U.S. population. They produce symptoms such as a stuffy and runny nose, post nasal drip and itching of the nose.

The results were published in the Nov. 25, 2013, online edition of the journal Cephalalgia. The study is one of the first tying the relationship of rhinitis -- irritation and inflammation of the nasal mucus membrane caused by allergic and non-allergic triggers -- to the frequency of migraine headaches, says Vincent Martin, MD, professor of medicine in UC's division of general internal medicine, co-director of the Headache and Facial Pain Program at UC and lead author of the study.

"We are not sure whether the rhinitis causes the increased frequency of headaches or whether the migraine attacks themselves produce symptoms of rhinitis in these patients," Martin says. "What we can say is if you have these symptoms, you are more likely to have more frequent and disabling headaches."

Martin and Jonathan Bernstein, MD, professor of medicine and director of clinical research in the division of immunology, allergy and rheumatology at UC, teamed with Richard Lipton, MD, and Dawn Buse, PhD, both of Montefiore and Einstein; and Kristina Fanning, PhD; Daniel Serrano, PhD; and Michael Reed, PhD, all from Vedanta Research, to conduct the study.

The researchers analyzed data from the American Migraine Prevalence and Prevention (AMPP) Study. A 2008 questionnaire was filled out by nearly 6,000 AMPP Study respondents from across the country who have experienced migraine. To define rhinitis, participants were asked the question, "Do you suffer from nasal allergies, seasonal allergies or hayfever?"

Rhinitis occurred in two out of three people with migraine in this study. Bernstein adds, "The fact that rhinitis occurred in more than half of these individuals emphasizes that these disorders are intimately linked."

Based on the results, researchers found the odds of experiencing more frequent headaches for individuals with rhinitis and migraine was 33 percent greater than those battling migraines without rhinitis.

The study also categorized participants with rhinitis in subsets -- allergic, mixed and non-allergic rhinitis -- based upon their response to questions regarding specific allergic and non-allergic rhinitis triggers. They were considered to have "allergic rhinitis" if they "only" reported having nasal symptoms with exposure to allergic triggers such as cats, dogs, molds or tree pollens. They were called "mixed rhinitis" if they "not only" had nasal symptoms with allergic triggers, but also had them with non-allergic triggers such as cigarette smoke, weather changes, perfumes and gasoline. They had "non-allergic rhinitis" if they "only" reported having symptoms when exposed to non-allergic triggers.

Those with mixed rhinitis -- experiencing both allergic and non-allergic triggers -- fared worse than others. They were 45 percent more likely to experience more frequent headaches and 60 percent more likely to endure headaches more disabling than those without rhinitis.

These findings could have implications for treatment, says Richard Lipton, MD, co-director of the Montefiore Headache Center, professor of neurology at Einstein and principal investigator of the study.

"The nose has largely been ignored as an important site involved in the initiation and exacerbation of migraine headache," Lipton explains. "If rhinitis exacerbates migraine, as these results suggest, treating rhinitis may provide an important approach to relieving headache in people with both disorders."

This builds on past research conducted by UC researchers regarding the link between allergic rhinitis and migraine, explains Martin. They found in a past study that migraine patients with allergic rhinitis receiving allergy shots had 52 percent fewer migraine attacks than those not receiving allergy shots.

"This and other research indicate that allergies and hayfever may not just represent innocent bystanders in the migraine patient," Martin states. "Clearly more research needs to be done to define their precise role."

Read more here

Study: Children with ADHD more likely to have asthma or allergies

A study claims that children, specifically boys, with ADHD are more likely to have allergies or asthma.

Boys diagnosed with attention-deficit/hyperactivity disorder are more likely also to have asthma, allergies and skin infections than youngsters without ADHD, a new study finds, suggesting a possible link between these conditions.

Of those in the study, boys newly diagnosed with ADHD were 40 percent more likely to have asthma, 50 percent more likely to have needed a prescription for allergy medicine and 50 percent more likely to have had a bacterial skin infection than other boys.

"Our study provides additional evidence to support the hypothesis that atopic disorders, such as asthma and food allergies increase the risk of developing ADHD," the authors wrote, adding that further research is necessary to determine just how these conditions might be connected.

Their results were published in the August issue of the Annals of Allergy, Asthma & Immunology.

ADHD, a chronic mental health condition involving difficulty paying attention, hyperactivity and impulsivity, affects as many as 9 percent of American children, according to background information in the study conducted by Eelko Hak, of the University of Groningen, and colleagues in the Netherlands and Boston.

The increase in the prevalence of ADHD has been paralleled by an increase in allergic (also called atopic) diseases, such as asthma and allergies, the researchers reported. They also noted that environmental risk factors, such as foods that cause an allergic reaction, may trigger symptoms of both ADHD and allergic asthma.

To get a better idea of whether or not there actually is an association between these conditions, the researchers used data from a large U.K. study. Within that database, the researchers found nearly 900 boys who were first diagnosed with ADHD and prescribed medication for the condition between 1996 and 2006. All of the boys were between 4 and 14 years old when first diagnosed.

The researchers compared the children with ADHD to about 3,500 children without the condition.

After adjusting the data to account for age, and for low birth weight or premature birth, they found significant relationships between the diagnosis of ADHD and a history of asthma, impetigo or a prescription for antihistamines (allergy medicines).

They also found weaker associations between ADHD and cow's milk intolerance, and prescriptions for oral or topical corticosteroids, antibacterial or antifungal drugs.

The authors theorize that the links they found may be food-allergy related. However, this study didn't attempt to prove cause and effect, so the exact reason behind the association remains unknown.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York, said the connection between ADHD and allergic diseases has been seen in other studies.

"The association seems to be real. The chicken-and-the-egg question remains unanswered. The challenge is in teasing out why they're linked," he said.

For her part, Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Hospital and Medical Center in Detroit, said, "This is an interesting, but very early study. They're definitely not showing cause and effect."

Appleyard pointed out that impetigo and milk intolerance aren't typically considered allergic diseases. Impetigo is a bacterial infection of the skin. And, a milk intolerance isn't the same as an allergy to milk.

"They looked at food allergies, too, and they didn't find an association. They also didn't find an association with atopic dermatitis [eczema], and impetigo is not necessarily correlated with an allergic reaction," she said.

The bottom line, she said, is that parents don't need to have any additional fears from this study. She added that parents of children with asthma or allergies shouldn't start worrying that their children will develop ADHD -- and parents definitely shouldn't make any changes to medications because of this study.

"All of these conditions seem to have increased. Let's pursue this link further, but there's no need for any changes right now," Appleyard said.

Read more here