Upper Airway Resistance Syndrome

By: Frances Meredith, M.D.

“Sleep is the best meditation”    – Dalai Lama
We all know sleep is precious. The world is a wonderful place when we awaken after a night of good sleep. Lack of sleep not only leaves us with lack of energy for our day, but also puts us at risk for many health issues from flares of autoimmunity to Alzheimer’s disease.
 
Could you have this “silent” sleep problem unrecognized by many doctors?
All of us are familiar with obstructive sleep apnea. A less known condition often referred to as sleep apnea’s “silent sister”, also can cause the same daytime fatigue and can contribute to many health issues as well. This condition is known as Upper Airway Resistance Syndrome or UARS and can be due to a naturally narrowed airway (often in someone thin or ideal body weight), a tongue falling back into the airway, or loose throat tissue. This causes “micro awakenings” occurring throughout the night, often without snoring or the sufferer even realizing it. This causes fatigue, increased stress responses often with sensitivity to emotional triggers, light, sound, and/or weather changes. It can also cause low testosterone, tension headaches, anxiety and depression.
 
Many doctors have yet to hear about UARS. The first step is to suspect it with daytime fatigue or any of the symptoms listed above, and bring it up with a provider familiar with the condition. Testing can then be ordered, such as a home sleep apnea test and a peek in your mouth and airway as an initial evaluation. An in-lab study is more sensitive, however a home study can often pick it up and is certainly much easier especially during COVID times. Treatment can then be designed including a dental appliance or CPAP which has gotten so much more user friendly in the last several years.
 
If ongoing daytime fatigue is an issue for you call 919-999-0831 to schedule an initial visit or bring it up with your provider at CTW. Optimizing sleep is just one of the many factors that a Functional Medicine provider will investigate that supports optimal energy and brain function, but without it, life just doesn’t look as sweet.
 
Your Partner in Health!
 Frances Meredith, MD

Ten Tips To get A Better Night’s Sleep

By: Sara Yadlowsky, FMHC

Most of us know how important it is to get a good night’s sleep.  Seven to nine hours of quality restorative sleep is ideal.  But this type of sleep sometimes eludes us.  Here are ten tips to help with more and better sleep.

  • Preparing for the next day can alleviate some of the stress that keeps us up at night.  You can get a jumpstart on the next day by packing your lunch, picking out an outfit, bathing at night instead of the morning and jotting down a to-do list.
  • Shut down your devices at least 2 hours before bed.  If you must be on your phone or computer try wearing blue blocker glasses that keep the blue light out of your eyes.  This blue light that is emitted from our electronics suppresses the release of melatonin which is the hormone that makes us sleepy.
  • Try a supplement to help you get to sleep faster and stay asleep longer.  Some examples:  magnesium, melatonin, L-Theanine, passionflower, valerian and CBD oil. Start with the minimum dose and work up as some people are more sensitive to these supplements than others.  Certain calming essential oils such as lavender, chamomile and eucalyptus are also very beneficial to quality sleep.
  • Create a bedtime routine.  Try to do roughly the same thing every night before bed to help signal to your body that it’s time to sleep.  Relaxing ideas are meditation, a hot shower or bath, light stretches, journaling and reading a good book that’s not too thought provoking. 
  • Get some exercise during the day.  Any type of movement helps you sleep better at night.  Exercising outside is particularly helpful due to sunlight exposure. Be careful not to exercise too close to bedtime as this can raise your cortisol levels and make it harder to fall asleep. 
  • Try some 4-7-8 breathing after you get into bed and turn off the light.   Place the tip of your tongue on the back of your front teeth, breathe in through your nose to a count of 4, hold your breath for a count of 7 and exhale slowly through your mouth to a count of 8. Repeat this 4 times.  This breathwork is fantastic for calming your nervous system.
  • As much as possible go to sleep and wake up at the same time each day.  This will help train your biological clock.  Our bodies crave a consistent schedule when it comes to sleep.
  • Finish all eating 3 hours prior to going to sleep.  This allows digestion to occur while you are still awake and prevents insomnia and heartburn. 
  • In the winter try sleeping with a hot water bottle instead of an electric blanket.  It will keep you warm and help you to fall asleep more quickly.
  • Make the last thing you do before falling asleep a list of 5 “wins” for the day.  Five things that happened that felt good or five accomplishments.  When you make this the last thing you focus on you sleep more soundly and wake up in a better frame of mind.

Tips To Slow Down

By: Clarissa Kussin, FMHC, RYT 500, ND

It has never been easier to connect with someone on the other side of the world, yet it’s so easy to feel disconnected from the people closest to us.  We have more tools than ever to simplify tasks and accomplish more things quickly, yet our to-do lists have never been longer. Life is short, and time flies, especially in today’s fast-paced world.  

These exercises are meant to help you slow down, enjoy life, and focus on the most important parts of your day.  Take the time to prioritize daily objectives.
 By focusing on the most important tasks to get done, we eliminate the hustle and stress of trying to accomplish everything at once. 


Cut personal Internet use by half.
Technology has become a major element in most of our lives. Social networking, email, and web-surfing can occasionally cause our minds to lose focus and wander through hundreds of topics, thoughts and ideas.
Try to use half your designated Internet time to explore new hobbies, exercise, or meditate.

 Enjoy nature.
When time permits – take a five to ten minute break to step outside and breathe in some fresh air. Disconnect from the rest of the world and concentrate on the beauty of nature.

Eat slower.
A lot of us tend to speed through meals – missing the chance to appreciate different textures and flavors. Start to chew foods slower and distinguish new tastes, aromas, and consistencies. 
 
Connect and make time for yourself.

Acknowledge and consciously thank yourself for taking care of YOU.  When did you last spend valuable time with yourself? Take a night to find a new book, watch a favorite movie, try yoga, meditate, or cook a new recipe.

Give yourself more time.
Some of us like to stick to a tight schedule and plan all our daily events. Next time you’re jotting down new tasks in your planner, try to factor in a few extra minutes when estimating how long things will take. This will help you not rush through daily tasks.

Take the scenic route.
Next time you’re driving a somewhat long distance – try taking the scenic route. Driving through open fields, mountains, or viewing a city skyline can be very relaxing.

Sit for a moment with your eyes closed when you start your computer. Even just a few moments of meditation can set the tone for the rest of your day. Try to empty your mind and take deep breaths before jumping into your day’s tasks.

Remember your goals and aspirations.
Each morning when you wake up, take a few moments to think about your life goals and aspirations. Try to recall the milestones you’ve already made in your life, and your drive to achieve new ones. Try doing this for about five minutes before getting out of bed to start your day.

Take the time and share this with someone you love that may need some support in slowing down…

A Guide To Grilling Food


 Grilling or barbecuing meat at high temperatures leads to the production of heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs), compounds known as “mutagens” which damage DNA and may increase risk for developing cancer. HCAs are formed when amino acids and sugars present in meat react under high temperatures. Additionally, liquid fat drips into the flame of a barbeque and creates smoke filled with PAHs, coating the surface of the meat. While the best solution is to use other cooking methods when possible, there are several simple ways to balance the effects of grilling your favorite foods.

Choose meat wisely
Emphasize leaner cuts of meat. Less fat drippings means less smoke and less exposure to PAHs. Further, removing the skin from poultry before cooking will reduce HCA formation.

Marinate
Not only does marinating meat impart more flavor, it can also be protective against carcinogenic compounds. Acid-containing marinades (e.g., those containing vinegar or lemon/lime juice) are best to reduce formation of HCAs. It is also important to note that traditional barbeque sauces, which tend to have a high sugar content, can increase formation of HCAs. If using these sauces, they should be added to foods after they have been cooked.

Add herbs and spices
Herbs and spices have been shown to reduce formation of HCAs when meats are grilled. Mint, onion, turmeric, garlic, rosemary, ginger, thyme, and red chili pepper are all great choices. These herbs can be used in marinades, mixed into ground meats, or used as a dry rub.

Avoid over-cooking or charring
The amount of time your meat contacts the grill makes a difference. Try quicker -cooking proteins like fish or shrimp, or cut your meats into smaller pieces to reduce cooking time (meat and vegetable kebabs are a great solution). Rotate meat frequently to allow the center to fully cook without overheating the surface. Blackened or charred areas of meat can be removed to reduce exposure to HCAs and PAHs.

Try grilling other food groups
Fruits and vegetables have been shown to inhibit activity of HCAs and reduce DNA damage caused by these compounds. Fortunately, antioxidant rich produce can also be delicious when grilled. Try zucchini, bell peppers, sweet potatoes, apples, peaches, pineapple, or even watermelon for a unique addition to your meal.
 
Your Partner in Health!
Clarissa Kussin, FMHC, RYT 500, ND


 

 

Tips for Picky Eaters

By: Caroline Wilson, M.Ed., FMHC       

Do you have a picky eater?

Picky eating often begins early in life for our kids and is often one of the top concerns reported in our practice.  It’s not about perfection, it’s about creating a love of food and how it fuels our mental and physical health. 

Healthy eating habits start at home. With a few changes and persistence, we help patients go from eating chicken nuggets and white pasta meals to filling their plates with more colorful fruits and vegetables.

Here are a few of my favorite tips for picky eaters:

#1 Lead by example.  If you want your children to add more colorful and healthy foods to their plate, then you must eat them too.  Help them understand why it’s important to eat healthy.  “Because we want to feel good and have energy.”

#2 Make food FUN and Accessible.  We eat with our eyes so access and presentation are key.  For example, put healthy food at eye level in the refrigerator or create a vegetable tray and set it out on the counter.  Cut food into fun shapes or arrange the snacks in a mini muffin tin for something different. 

#3 Timed Snacking. Endless snacking does not allow time for kids to get hungry and eat what is prepared for meals.  One idea to help guide snack choices is to set out the veggie/fruit tray at designated snack times and “close” the kitchen soon after.  If you prefer them to choose their snacks, a great rule is to pick something from the fridge before the pantry. 

These are just a few tips to help you get started with creating more colorful plates that your kids will want to eat.  Our pediatric team has experience and more ideas to handle the pickiest eaters.  Every child is different and learns to eat new foods and make healthy changes at a different pace.  With a little persistence, patience, and fun, positive changes can happen.  

Contact our office for an appointment to get started with our Pediatric Team

919-999-8031

COVID-19 Vaccination Prep: Supporting Resiliency

By: Blair Cuneo, PA-C

Start 2 weeks before and continue for 1 week after vaccination:

1. Clean water: 8–10 glasses a day or ½ body weight in ounces

2. CTW Complete Vitamin C: 1 cap (500mg) two times a day

3. CTW Daily Multivitamin 2 caps two times a day OR MitoCore: 2 caps two times a day

4. Daily Probiotic

5. Vitamin D3 4000IU daily

6. Zinc Glycinate 15mg daily

In the days leading up to your vaccination, fuel your immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Rest when you need to rest.

If able, consider receiving the vaccination the day before you have time off work to have a day to rest.

Day of and day after vaccination:

CTW Vitamin C: 2 caps twice a day

After your vaccination, think muscle, immune and lymphatic system support:

Engage your deltoid! This is the shoulder muscle which received the vaccine. Movement and engagement of the muscle will reduce the tenderness and soreness which can start setting in a few hours later. Example exercises include arm circles, shoulder presses or modified push ups.

Go on a walk! Perform some light cardio and exercise after your vaccination to provide a healthy stimulus for your immune system for optimal response and reduce side effects.

Stimulate your lymphatic system! After the vaccine, you can begin gentle skin brushing of the vaccinated arm. When able, incorporate whole body lymph support with options like whole body dry skin brushing, gentle rebounding, or deep breathing. 

If you have questions about COVID 19 vaccinations, please contact your provider!

HOW TO PROPERLY PREPARE NUTS & SEEDS IN 3 SIMPLE STEPS

Make sure you are soaking RAW Nuts and Seeds.

All you need to do is mimic nature’s germination system and give those nuts & seeds a good soak to deactivate the phytic acid, giotrogens and enzyme inhibitors.

You can make sure those natural components get properly minimized or eliminated by following these 3 simple steps:

1. Add your nuts/seeds to a glass jar or bowl and mix warm water & sea salt (make sure there’s enough water to cover the nuts completely). Soak them for the time required.

2. When done soaking, drain out the soak water and thoroughly rinse the nuts.

3. You can do one of two things: refrigerate the soaked nuts and consume within 24 hours OR dry in a dehydrator (or in oven set on the lowest temperature). Store in an airtight container.

Important note: The soak water should always be discarded and never used as water in a recipe or given to your animals.

Required Soaking Times for Nuts and Seeds

Pumpkin seeds-Pepitas

4 cups of raw, hulled pumpkin seeds
2 tablespoons sea salt
1 teaspoon cayenne pepper (optional)
filtered water

Soaking Time: At least 7 hours, or overnight
Dehydrating time: 12-24 hours, until dry and crisp

Pecans or Walnuts

4 cups of nuts
2 teaspoons sea salt
filtered water

Soaking time: 7 or more hours (can do overnight)
Dehydrating time: 12-24 hours, until completely dry and crisp.

Pecans can be stored in an airtight container, but walnuts are more susceptible to become rancid so should always be stored in the refrigerator.

Peanuts (skinless), Pine nuts, or Hazelnuts (skinless)

4 cups of raw nuts
1 tablespoon sea salt
filtered water

Soaking time: at least 7 hours or overnight
Dehydrating time:12-24 hours, until completely dry and crisp

Store in an airtight container

Almonds

4 cups almonds, preferably skinless- SF notes “Skinless almonds will still sprout, indicating that the process of removing their skins has not destroyed the enzymes [they] are easier to digest and more satisfactory in many recipes. However, you may also use almonds with the skins on. “
1 tablespoon sea salt
filtered water

Soaking time: At least 7 hours, or overnight
Dehydrating Time:12 -24 hours, until completely dry and crisp

* You can also use almond slivers

Cashews

4 cups of “raw” cashews
1 tablespoon sea salt
filtered water

“Some care must be taken in preparing cashews. They will become slimy and develop a disagreeable taste if allowed to soak too long or dry out too slowly, perhaps because they come to us not truly raw but having already undergone two separate heatings. You may dry them in a 200 to 250 degree oven-the enzymes have already been destroyed during processing. “

Soaking time: 6 hours, no longer
Dehydrate at 200 degrees F: 12-24 hours
Store in an airtight container

Macadamia nuts

4 cups of raw macadamia nuts
1 tablespoon sea salt
filtered water

Soaking time: At least 7 hours or overnight
Dehydrating time: 12-24 hours, until dry and crisp.

KNOW YOUR NUTS AND SEEDS

Did you know that raw nuts and seeds have defense mechanisms made up of enzyme inhibitors, toxic substances (tannic acid & goitrogens) and phytic acid?

Yep, these natural components are there for their protection. Nature doesn’t want the seed to germinate prematurely or predators to consume them to the point where they become extinct. Those natural components can be removed naturally only when there is enough moisture to sustain a new plant after the nut or seed germinates.

WHAT’S THE BIG DEAL ABOUT PHYTIC ACID, GOITROGENS & ENZYME INHIBITORS?

The biggest defense mechanism in nuts & seeds is the phytic acid. Every nut and seed has different levels of phytic acid with almonds, brazil nuts and sesame seeds having the highest percentage.  When something that contains phytic acid is eaten, the acid binds itself to minerals like iron, magnesium, zinc, calcium, manganese and chromium in the gut, which prevents the digestive system’s ability to break the nut or seed or grain down properly (that’s why, often, when you eat nuts or seeds… you see undigested bits in your stool the very next day).

If you struggle with anemia, low zinc levels, osteoporosis and other illness related to low mineral absorption… you should not be eating un-soaked nuts, especially walnuts, almonds & peanuts.

Even though phytic acid is the big, bad guy in nuts and seeds… goitrogens & enzyme inhibitors should not be overlooked either.

Goitrogens is are known to suppress the function of the thyroid gland by interfering with iodine uptake, which can cause a goiter (enlargement of the thyroid), slow down the thyroid, hypothyroidism and other autoimmune thread disorders. Soaking helps reduces goitrogens and actually increases the necessary minerals needed for a healthy thyroid.

Enzyme inhibitors neutralizes vital enzymes that your body naturally produces and can lead to many illnesses that results of an unhealthy, enzyme-depleted gut. Signs that your body is lacking enzymes are bloating, constipation, diarrhea, heartburn, irritable bowels and gas. A lack of just one enzyme in the body can lead to many problems and you will only live as long as your body has enzymes… which is why it is important to neutralize the enzyme inhibitors to keep them from decreasing your body of its natural enzymes. Soaking increases the natural enzymes within the nuts & seeds, helps provide greater absorption of the its’ nutrients and increases digestibility.

Basically, when you eat raw nuts or seeds or grains that have not be properly prepared… those “healthy” morsels are actually robbing you of vital minerals, vitamins and enzymes needed to sustain a healthy body.

Top 5 Heart Healthy Fats

1. Butter

It is a very common fat that everybody has (or should have from now on) in their fridge. As opposed to industrial trans fat, which increases the the risk of heart disease, the trans-rumenic acid called conjugated linoleic acid (CLA) is thought to decrease the risk for cardiovescular disease. CLA along with other natural trans fats as well as vitamin K2 are abundantly found in grass-fed meat and dairy products, which is why butter is a great source to maintain cardiovescular health and to prevent heart attacks.

2. Coconut Oil

Coconut oil currently has gained in popularity for all kinds of health remedies and benefits. The hype is justified and it definitely belongs in the kitchen and on this list! First of all, coconut oil is one of the best oils to cook with as it is with more than 90% almost entirely saturated. Its chemical structure stands out to other fats and oils in our diet, which has a significant effect on the body and the heart. Coconut oil is composed of a special type of saturated fat called medium chain triglyceride (MCT). This structure makes the oil special because the vast majority of fats and oils we consume are composed of long-chain fatty acids (LCFA). In fact, both the saturated and unsaturated fat found in meat, eggs, milk, and plants consist of LCFA.

That means that most of the western world gets way too much of these fats and not enough of the MCFA’s that are found in coconut oil.

Why does that matter? Because of its shorter chemical composition, MCFA’s are absorbed with ease without requiring pancreatic enzymes to break them down. This means less work for the pancreas and the fatty acids can go directly to the liver from where they go into the mitochondrias and are immediately utilized for energy. The best part is that coconut oil makes our heart happy by protecting it from heart disease as well as lowering the risk of atherosclerosis.

3. Duck Fat

Just like butter, duck fat is packed with the favorable CLA’s and natural trans fat that were found, in animal studies, to prevent fatty streaks and plaque formation in the arteries of rodents by changing macrophage lipid metabolism.

Another statistic, however, shows that the same effect seems to apply for humans as well. According to the World Health Organization’s Multinational Monitoring of Trends and Determinants, in the United States, of every 100,000 middle-aged men, 315 die of heart attacks each year. However, in the Gascony region, where duck liver is a steady part of the diet, this rate is only 80 per 100,000. A great statistic for the consumption of duck fat and the relation to a healthier heart!

4. Leaf Lard

This fat is a highly popular fat in the kitchen of every celebrity cook. For good reason! Lard is a very stable fat which makes it an excellent choice for frying. Morover, it has a higher smoking point than other fats therefore it is excellent for cooking in general. It is gained from the visceral fat deposit that surrounds the kidney and loin and because of its little pork flavor, leaf lard is considered the highest grade of lard.

Nutritionally speaking, lard is composed of more than twice the monosaturated fat and nearly one-fourth the saturated fat than butter. In addition to that, it is also low in omega-6 fatty acids, known to promote inflammation, which is good news for a healthy heart.

5. Ghee

Ghee, a great fat for cooking, taste, and cardiovescular health. It is made from butter, however, the milk solids and impurities are removed, which makes it consumer friendly for everybody, including people who are lactose or casein intolerant.

Just like coconut oil, it is composed of medium chain fatty acids (MCFA), which are directly absorbed to the liver and burned as energy. Besides of being a fabulous energy source, it contributes to a healthy heart as it protects the arteries from hardening. A study from 2010 found that people in India, where ghee is originated from and thus has the highest population of consumers, had fewer cases of heart disease than our western world.

Golden Milk: Ancient Remedy

By: Clarissa A. Kussin, N.D., FMHC

Turmeric may not be the first thing you think about putting in tea, but with the right mixture of spices, it is a delicious soothing remedy. This tuber is a well-known remedy for its benefits including digestion, immune function, the liver and even possible protection from some types of cancer.

What is Golden Milk?

Turmeric Tea or Golden Milk is a great way to get the benefits of Turmeric daily. It’s great to drink this before bed because it aids relaxation and helps boost the immune system while sleeping.

The University of Maryland Medical Center reports that it is safe to cook with Turmeric while pregnant and nursing but that turmeric supplements should not be taken without a doctor’s advice. Since this tea contains Turmeric, consult with a doctor or midwife before consuming this if you are pregnant, nursing or have a medical condition.

Turmeric Tea/ Golden Milk Recipe

Ingredients:

2 cups of milk of choice (almond, pecan, coconut and dairy all work in this recipe)

1 teaspoon Turmeric or Turmeric Spice Mix

1/2 teaspoon Cinnamon

1 teaspoon raw honey or maple syrup or to taste (optional)

Pinch of black pepper (increases absorption)

  • Tiny piece of fresh, peeled ginger root or 1/4 tsp ginger powder
  • Pinch of cayenne pepper (optional)

Instructions:

First, blend all ingredients in a high speed blender until smooth.

Then, Pour into a small sauce pan and heat for 3-5 minutes over medium heat until hot but not boiling.

How to Make a Dry Turmeric Tea Mix:

If you’d rather not mix up the spices each time, you can easily make a mixture of the spices and just add to warmed milk when ready.

Mix up:

1/2 cup turmeric powder

1/4 cup cinnamon powder

1 ½ teaspoons ground black pepper

1-2 Tablespoons ground ginger

1/2 teaspoon of cayenne (optional)

Then, just add 2 teaspoons of this mix to 2 cups of milk of choice for a faster recipe.

 

Or, Make Turmeric Paste

Golden Paste:
1/2 cup organic turmeric powder
1/2 cup clean water (no fluoride)
1 1/2 teaspoon black pepper
5 Tablespoons virgin coconut oil


In a stainless steel pot cook together: Water, turmeric and black pepper until it forms a thick paste, stir and cook for 7 to 10 minutes. Remove from heat and add virgin coconut oil, using a whisk to fully mix in the coconut oil. Finally, transfer to a glass jar with a lid and store in the refrigerator.

Golden Milk:
1 tsp. Golden Paste
2 cups Almond Milk or Coconut Milk
1/8 teaspoon Vanilla (Optional)
Molasses to taste.
Pinch cinnamon (Optional)
In a stainless steel pot-gently heat, but do not boil, milk with 1 teaspoon paste. Use whisk
Add molasses and vanilla and cinnamon to taste.

Notes:

This may stain blenders and counter tops. The color isn’t harmful and will eventually fade. Recipe can be halved or doubled if needed.

Curcumin:

This bright yellow spice contains Curcumin (up to 3% by weight), which has been well studied for its benefits. It is believed to halt an enzyme that may be responsible for turning environmental toxins into carcinogens in the body. Turmeric is a folk remedy for helping protect the body from the affects of smoking or chewing tobacco.

Curcumin may also improve digestion of fats and sugars and help alleviate inflammation in the digestive system. It is an age-old skin remedy and is even used in the mouth to help alleviate gum problems.

Of course, Turmeric can be added to foods and is a great base for many spice blends, but those who want to consume it as a remedy often turn to turmeric tea.

Allergy Clinic Details

New Allergy Clinic
By: Susan Denny, MD

Here in North Carolina, allergy season is just around the corner.  For those of us with pollen, grass or tree allergies, symptoms typically begin in February and can last until November.  Many of us, however, may have indoor allergies to dust, mold or pet dander and suffer from stuffy nose, sneezing, itchy/watery eyes, wheezing or headaches year-round. 
 
We are now offering a simple allergy treatment for both indoor and outdoor allergies.  Sublingual immunotherapy, or allergy drops, is a safe, convenient way to treat the cause of your allergies and help you build long-term tolerance to the things that once made you miserable. 

  • The patient tailored drops work similar to allergy shots, but are delivered through a liquid drop under the tongue at home or wherever you are.
  • This method makes it easier to stay with your treatment and requires fewer office visits than with other methods.
  • Although most allergy sufferers can benefit from allergy drops, they’re especially ideal for those who can’t tolerate or don’t respond to allergy shots, as well as those who are unable to commit to allergy shot therapy.
  • Allergy drop therapy typically lasts 3 to 5 years, similar to allergy shots, however, the total cost of treatment is typically less expensive than the weekly copays required for allergy shots. 

 
INITIAL ADULT AND PEDIATRIC PATIENT ALLERGY DROPS VISIT: $240
Please allow 45 minutes for your initial visit which will include consultation with your physician or physician assistant, physical exam and discussion of allergy testing.  Skin prick testing will be performed at this visit and results and interpretation will be discussed.  Prescription will be provided for allergy drops and we will review how to administer these at home. 
 
FOLLOW UP ALLERGY DROPS VISIT: $85
Please allow 15 minutes for your follow up allergy visits.  This will include review of your allergy symptoms and immunotherapy plan of treatment as well as new 3 month prescription for allergy drops.  Follow up visits are recommended every 3 months for the first year and then every 6 to 12 months for the subsequent 2 to 4 years, depending on your response to treatment.
 
FOLLOW UP ALLERGY SKIN PRICK TESTING: $125
We recommend follow up skin prick testing for environmental allergies every 12 months to assess progress of immunotherapy and adjust your prescription allergy drops as needed.
 
If you are interested in more information, please call us at 919-999-0831.