Eliminate the Root Cause!!

Antihistamines & Steroids Alone Fail!!

By 
Dr. Vyakarnam Nageshwar
Pulmonologist, Allergist & Immunologist
Chief Allergy Specialist – Aswini Allergy Centre
President – The World Allergy Foundation
www.aswiniallergycentre.com

Allergies and Autoimmunity: A Growing Concern

Allergic disorders and autoimmune conditions have become some of the most common reasons for medical consultations worldwide.

From children with recurrent skin rashes to adults with sinusitis, asthma, or unexplained digestive problems, millions depend on quick fixes like antihistamines or steroids. While these drugs give short-term relief, they do not correct the root cause. Long-term dependence can even worsen disease progression.

Why Antihistamines and Steroids Fall Short

For decades, antihistamines have been the first line of defense against allergic symptoms—blocking histamine to reduce itching, swelling, and sneezing. Steroids, whether oral, injectable, or topical, suppress inflammation temporarily.

But both share one limitation: their effect is short-lived. An antihistamine may last a few hours, a steroid a few days—neither alters the faulty immune response. Over time, patients notice weaker results, requiring stronger doses and more frequent prescriptions. Eventually, treatment fails.

Dangers of Symptom-Only Treatment

Relying only on these drugs without addressing the root cause can push patients into chronic illness.

Prolonged use may drive progression from allergies to autoimmune diseases, where the immune system attacks the body. Examples include:

Allergic asthma worsening into chronic hypersensitivity.

Urticaria persisting as autoimmune dermatitis or psoriasis.

Gastrointestinal allergies evolving into irritable bowel syndromes with immune involvement.

“When children grow up on quick-relief medicines without proper evaluation, we miss early warning signs. By adulthood, immune dysfunction is far deeper and harder to reverse,” warns Dr. Vyakarnam.

Post-COVID Spike in Allergic and Autoimmune Disorders

The COVID-19 pandemic and subsequent vaccinations introduced new complexity. Across practices worldwide, allergy specialists report a four- to five-fold rise in allergic and autoimmune presentations since 2020.

Patients now present with swelling of the lips, eyes, or face; recurrent headaches; gastrointestinal upsets; or unexplained skin rashes. Many do not respond to standard antihistamines or steroids.

Experts link these to mast cell activation syndrome (excess histamine), hypercytokinemia (overactive inflammatory signals), and gut dysbiosis (imbalance of gut bacteria).

“These are not simple allergies anymore,” notes Dr. Vyakarnam. “They reflect systemic immune activation that overlaps with metabolism, neurology, and gut health—demanding deeper diagnostics and personalized care.”

Investigating the Root Cause

Breaking the cycle requires structured evaluation:

Detailed history – patient and family background.

Allergen testing – Modified Allergen Skin Prick Test to identify or rule out triggers.

Other factors – genetics/epigenetics, gut health, environmental exposures, post-viral or vaccine-induced immune changes.

Whether allergy, autoimmunity, or even cancer, the root issue is underlying inflammation—and this is where clinicians must focus.

Rising Emergency Cases

Another alarming trend is the increase in angioedema and anaphylaxis—life-threatening reactions with airway swelling, breathlessness, and sudden collapse.

“We see patients entering emergency rooms believing their allergy was under control—until suddenly it wasn’t. This is the price of ignoring underlying disease mechanisms,” stresses Dr. Vyakarnam.

Moving Toward Holistic Care

All antihistamines, whether cetirizine, hydroxyzine, or chlorpheniramine, act the same way—by blocking symptoms. They should not be the long-term answer to complex immune disorders.

Root Cause Therapy Should Involve:

1. Identifying triggers through history, lab tests, and allergy screening—to stay away from allergens.

2. Correcting underlying imbalance—whether metabolic, allergic, autoimmune, or gut-related.

3. Allergen-specific sublingual immunotherapy—a scientifically proven approach offering excellent relief.

Encouraging Outcomes

At Aswini Allergy Centre, Hyderabad, more than 12,000 patients have received allergen-specific sublingual immunotherapy. Approximately 60% responded very well, showing significant improvement in their conditions.

“Allergies are early warning signals,” concludes Dr. Vyakarnam. “If we only silence them with antihistamines and steroids, we mute the alarm but fail to stop the fire. The earlier we treat the root cause, the fewer complications arise.”