Does Having Allergies Mean That You Have A Decreased Immunity?

iStock.com/PeopleImages
iStock.com/PeopleImages

Tirumalai Kamala:

No, allergy isn't a sign of decreased immunity. It is a specific type of immune dysregulation. Autoimmunity, inflammatory disorders such as IBS and IBD, and even cancer are examples of other types of immune dysregulation.

Quality and target of immune responses and not their strength is the core issue in allergy. Let's see how.

—Allergens—substances known to induce allergy—are common. Some such as house dust mite and pollen are even ubiquitous.
—Everyone is exposed to allergens yet only a relative handful are clinically diagnosed with allergy.
—Thus allergens don't inherently trigger allergy. They can but only in those predisposed to allergy, not in everyone.
—Each allergic person makes pathological immune responses to not all but to only one or a few structurally related allergens while the non-allergic don't.
—Those diagnosed with allergy aren't necessarily more susceptible to other diseases.

If the immune response of each allergic person is selectively distorted when responding to specific allergens, what makes someone allergic? Obviously a mix of genetic and environmental factors.

[The] thing is allergy prevalence has spiked in recent decades, especially in developed countries, [which is] too short a time period for purely genetic mutation-based changes to be the sole cause, since that would take multiple generations to have such a population-wide effect. That tilts the balance towards environmental change, but what specifically?

Starting in the 1960s, epidemiologists began reporting a link between infections and allergy—[the] more infections in childhood, [the] less the allergy risk [this is called hygiene hypothesis]. Back then, microbiota weren't even a consideration but now we have learned better, so the hygiene hypothesis has expanded to include them.

Essentially, the idea is that the current Western style of living that rapidly developed over the 20th century fundamentally and dramatically reduced lifetime, and, crucially, early life exposure to environmental microorganisms, many of which would have normally become part of an individual's gut microbiota after they were born.

How could gut microbiota composition changes lead to selective allergies in specific individuals? Genetic predisposition should be taken as a given. However, natural history suggests that such predisposition transitioned to a full fledged clinical condition much more rarely in times past.

Let's briefly consider how that equation might have fundamentally changed in recent times. Consider indoor sanitation, piped chlorinated water, C-sections, milk formula, ultra-processed foods, lack of regular contact with farm animals (as a surrogate for nature) and profligate, ubiquitous, even excessive use of antimicrobial products such as antibiotics, to name just a few important factors.

Though some of these were beneficial in their own way, epidemiological data now suggests that such innovations in living conditions also disrupted the intimate association with the natural world that had been the norm for human societies since time immemorial. In the process such dramatic changes appear to have profoundly reduced human gut microbiota diversity among many, mostly in developed countries.

Unbeknownst to us, an epidemic of absence*, as Moises Velasquez-Manoff evocatively puts it, has thus been invisibly taking place across many human societies over the 20th century in lock-step with specific changes in living standards.

Such sudden and profound reduction in gut microbiota diversity thus emerges as the trigger that flips the normally hidden predisposition in some into clinically overt allergy. Actual mechanics of the process remain the subject of active research.

We (my colleague and I) propose a novel predictive mechanism for how disruption of regulatory T cell** function serves as the decisive and non-negotiable link between loss of specific microbiota and inflammatory disorders such as allergies. Time (and supporting data) will tell if we are right.

* An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases Reprint, Moises Velasquez-Manoff

** a small indispensable subset of CD4+ T cells.

This post originally appeared on Quora. Click here to view.

12 Creative Ways to Spend Your FSA Money Before the Deadline

stockfour/iStock via Getty Images
stockfour/iStock via Getty Images

If you have a Flexible Spending Account (FSA), chances are, time is running out for you to use that cash. Depending on your employer’s rules, if you don’t spend your FSA money by the end of the grace period, you potentially lose some of it. Lost cash is never a good thing.

For those unfamiliar, an FSA is an employer-sponsored spending account. You deposit pre-tax dollars into the account, and you can spend that money on a number of health care expenses. It’s kind of like a Health Savings Account (HSA), but with a few big differences—namely, your HSA funds roll over from year to year, so there’s no deadline to spend it all. With an FSA, though, most of your funds expire at the end of the year. Bummer.

The good news is: The law allows employers to roll $500 over into the new year and also offer a grace period of up to two and a half months to use that cash (March 15). Depending on your employer, you might not even have that long, though. The deadline is fast approaching for many account holders, so if you have to use your FSA money soon, here are a handful of creative ways to spend it.

1. Buy some new shades.

Head to the optometrist, get an eye prescription, then use your FSA funds to buy some new specs or shades. Contact lenses and solution are also covered.

You can also buy reading glasses with your FSA money, and you don’t even need a prescription.

2. Try acupuncture.

Scientists are divided on the efficacy of acupuncture, but some studies show it’s useful for treating chronic pain, arthritis, and even depression. If you’ve been curious about the treatment, now's a good time to try it: Your FSA money will cover acupuncture sessions in some cases. You can even buy an acupressure mat without a prescription.

If you’d rather go to a chiropractor, your FSA funds cover those visits, too.

3. Stock up on staples.

If you’re running low on standard over-the-counter meds, good news: Most of them are FSA-eligible. This includes headache medicine, pain relievers, antacids, heartburn meds, and anything else your heart (or other parts of your body) desires.

There’s one big caveat, though: Most of these require a prescription in order to be eligible, so you may have to make an appointment with your doctor first. The FSA store tells you which over-the-counter items require a prescription.

4. Treat your feet.

Give your feet a break with a pair of massaging gel shoe inserts. They’re FSA-eligible, along with a few other foot care products, including arch braces, toe cushions, and callus trimmers.

In some cases, foot massagers or circulators may be covered, too. For example, here’s one that’s available via the FSA store, no prescription necessary.

5. Get clear skin.

Yep—acne treatments, toner, and other skin care products are all eligible for FSA spending. Again, most of these require a prescription for reimbursement, but don’t let that deter you. Your doctor is familiar with the rules and you shouldn’t have trouble getting a prescription. And, as WageWorks points out, your prescription also lasts for a year. Check the rules of your FSA plan to see if you need a separate prescription for each item, or if you can include multiple products or drug categories on a single prescription.

While we’re on the topic of faces, lip balm is another great way to spend your FSA funds—and you don’t need a prescription for that. There’s also no prescription necessary for this vibrating face massager.

6. Fill your medicine cabinet.

If your medicine cabinet is getting bare, or you don’t have one to begin with, stock it with a handful of FSA-eligible items. Here are some items that don’t require a prescription:

You can also stock up on first aid kits. You don’t need a prescription to buy those, and many of them come with pain relievers and other medicine.

7. Make sure you’re covered in the bedroom.

Condoms are FSA-eligible, and so are pregnancy tests, monitors, and fertility kits. Female contraceptives are also covered when you have a prescription.

8. Prepare for your upcoming vacation.

If you have a vacation planned this year, use your FSA money to stock up on trip essentials. For example:

9. Get a better night’s sleep.

If you have trouble sleeping, sleep aids are eligible, though you’ll need a prescription. If you want to try a sleep mask, many of them are eligible without a prescription. For example, there’s this relaxing sleep mask and this thermal eye mask.

For those nights you’re sleeping off a cold or flu, a vaporizer can make a big difference, and those are eligible, too (no prescription required). Bed warmers like this one are often covered, too.

Your FSA funds likely cover more than you realize, so if you have to use them up by the deadline, get creative. This list should help you get started, and many drugstores will tell you which items are FSA-eligible when you shop online.

10. Go to the dentist.

While basics like toothpaste and cosmetic procedures like whitening treatments aren’t FSA eligible, most of the expenses you incur at your dentist’s office are. That includes co-pays and deductibles as well as fees for cleanings, x-rays, fillings, and even the cost of braces. There are also some products you can buy over-the-counter without ever visiting the dentist. Some mouthguards that prevent you from grinding your teeth at night are eligible, as are cleaning solutions for retainers and dentures.

11. Try some new gadgets.

If you still have some extra cash to burn, it’s a great time to try some expensive high-tech devices that you’ve been curious about but might not otherwise want to splurge on. The list includes light therapy treatments for acne, vibrating nausea relief bands, electrical stimulation devices for chronic pain, cloud-connected stethoscopes, and smart thermometers.

12. Head to Amazon.

There are plenty of FSA-eligible items available on Amazon, including items for foot health, cold and allergy medication, eye care, and first-aid kits. Find out more details on how to spend your FSA money on Amazon here.

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What Is a Scuttlebutt, and Why Do We Like to Hear It?

Photo by Courtney Nuss on Unsplash

Casual conversation is home to a variety of prompts. You might ask someone how they’re doing, what’s new, or if they’ve done anything interesting recently. Sometimes, you can ask them what the scuttlebutt is. “What’s the scuttlebutt?” you’d say, for example, and then they’d reply with the solicited scuttlebutt.

We can easily infer that scuttlebutt is a slang term for information or maybe even gossip. But what exactly is scuttlebutt, and why did it become associated with idle water cooler talk?

According to Merriam-Webster, a scuttlebutt referred to a cask on sailing ships in the 1800s that contained drinking water for those on board. It was later used as the name of the drinking fountain found on a ship or in a Naval installation. The cask was known as a butt, while scuttle was taken from the French word escoutilles and means hatch or hole. A scuttlebutt was therefore a hatch in the cask.

Because sailors usually received orders from shouting supervisors, talking amongst themselves was discouraged. Since sailors could congregate around the fountain, it became a place to finally catch up and exchange gossip, making scuttlebutt synonymous with casual conversation. The scuttlebutt was really the only place to do it.

Nautical technology made the scuttlebutt obsolete, but the term endured, becoming a catch-all word for unfounded rumors.

The next time someone asks you what the scuttlebutt is, now you can tell them.

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