Allergies: ‘Tis the Season

If you are one of the approximately 36 million Americans who suffer from seasonal allergies, there is some hope. As you probably already know, however, it is not always easy to ease the discomfort.

Allergic Rhinitis, as it is known medically, is the allergic inflammation of the nasal airways. When pollen, dust or animal dander is inhaled by someone who is sensitive to that particular allergen, it causes symptoms similar to colds and/or flu.

When it is caused by the pollen of any plant, it is technically known as pollinosis. When it is caused by grass or tree pollens, it is known as hay fever, which is the name commonly attributed to most allergies in the past. This name resulted from the (incorrect) theory that the symptoms were caused by new hay in the haying season. It has also been called hay asthma.

If you are one who suffers from allergies, clearly you are not alone. Allergies are very common, with estimates at up to one in three persons having symptoms at any given time. It is also estimated that at least one in four people will have at least one reaction at some point in their lives. In Western countries, between 10-25% of people are affected annually by allergies.

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In 1819, the physician John Bostock first identified hay fever, believing it was a disease. In 1859, Charles Blackley correctly identified pollen as the causal agent . In 1906, Clemens von Pirquet correctly theorized that hay fever was a hypersensitivity, and modern research and treatment is based on this premise.

The symptoms then are still the same symptoms that are identified today:

  • excess nasal secretion
  • itching
  • sneezing
  • nasal congestion and obstruction—“stuffy nose”
  • swelling of eyes
  • middle ear discharge

*The “nasal salute” is the action of the allergy sufferer rubbing his/her nose upward with the palm of their hand. This may result in a crease running across the nose, and can actually lead to permanent physical deformity if repeated enough.

*There is no true fever with hay fever; rather, it may cause an increased fluctuation of core body temperature due to inflammation.

*Some allergy sufferers also report a cross-reaction to certain foods such as potatoes or apples. Protein similarities between the allergens and these foods are responsible for this reaction.

*While hay fever is most prevalent during the spring, it can cause symptoms throughout the year.

*The most common plants responsible for hay fever include:

  • pine, birch, cedar, willow, poplar and olive trees
  • rye and timothy grass
  • ragweed, plaintain, nettle/parietaria and mugwart weeds.

DIAGNOSIS

While it may seem easy to self-diagnose allergies, the only way to define the exact allergens are to complete medical allergy testing, ideally under the care of an allergist. Skin testing is the most common method of testing, which involves exposing a patch of skin to particular allergens to determine the possible allergic reactions.

A less common method is to drop a small amount of the allergen onto the lower eyelid of the patient to determine sensitivity, but should never be performed by the patient, since it can cause harm if not conducted properly. If the doctor determines the patient is not able to undergo skin testing, there may be alternate blood tests that can diagnose the allergy.

TREATMENT

The goal of treatment is to reduce the symptoms caused by allergic inflammation in order to provide relief to the patient, but first, reducing your exposure to allergens is a recommended step:

  • Stay indoors on dry windy days. The best time to go outdoors is after a rain, which essentially rinses the air clean. However, long-term moisture with repeated rains may increase the pollen counts. This may also increase outdoor mold. If the area has experienced heavy rain or flooding, the allergy symptoms may be exacerbated.
  • Delegate any activities that may expose you to allergens such as lawn mowing, weeding and gardening.
  • Remove clothing after coming indoors, showering may also help.
  • Don’t hang laundry outside—pollen can attach to fabrics.
  • Wear a dust mask if you must go outside for chores.

When pollen counts are high, extra measures may be necessary:

  • Check pollen forecasts via internet, TV or radio. When they are predicted to be high, start taking any allergy medications you normally take before symptoms start.
  • Close doors and windows at night or any time when pollen counts are high.
  • Pollen counts are highest in the early morning; avoid outdoor activities during that time if possible.

While the air outdoors cannot be controlled, the air in your home can be somewhat controlled:

  • Use the air conditioner in your home—and car.
  • Use high-efficiency filters if you have forced air heating or air conditioning.
  • Use a dehumidifier to keep indoor air dry.
  • Use a portable HEPA (high efficiency particulate air) filter in your bedroom.
  • Clean floors with a vacuum with a HEPA filter.

While these measures can help prevent or minimize allergy symptoms, it is often necessary to take medications to alleviate discomfort. Oral antihistamines such as Allegra and Claritin are available over the counter, while Zyrtec and Clarinex are by prescription only. Prescription eye drops can help itchy eyes, and prescription steroidal nasal spray can alleviate symptoms as well. Nasal irrigation with a saline water solution has helped some allergy sufferers as well. Your physician should be consulted regarding any allergy remedy that is not prescribed by him/her prior to using it.

A long-term solution for some people is to take allergy shots, also known as immunotherapy. Tiny amounts of the allergen are introduced into the body over time, provoking a controlled response. This method is intended to actually change a person’s immune system, by desensitizing them to the allergen slowly over a long period of time. This long-term method generally is employed over a 3-5 year period.

A new therapy currently in its developmental stages is known as “sublingual” allergy therapy, whereby a small amount of the allergen is placed under the tongue, which employs the same theory of slow desensitization as do the allergy shots. This mode of delivery is thought to be more convenient than a series of shots.

Any allergy sufferer is well-advised to consider the “oral allergy syndrome”, whereby certain foods may provoke symptoms in those with ragweed allergies. The most common foods that cause such sensitivity include: bananas, cucumbers, melons, zucchini, sunflower seeds and chamomile tea.

Pollen in the air obviously causes great physical stress, as well as mental and emotional stress. Just as it is important to keep other stressors to a minimum, try to remember to not let this get the best of you—just breathe.

Bless You.