Dealing With Allergies
By Vijaya Polovaram, MD
According to the National Center for Health Statistics, more than 50 million Americans have nasal allergies. It’s a very common problem, affecting at least two out of every ten Americans. Our nose knows what we are exposed to and what season we are in.
Some individuals overreact to certain substances otherwise well tolerated by others. The allergy-causing substances are called allergens. The most common allergens are:
- Pollen
- Mold
- Animal dander
- Dust and dust mites
- Latex
- Medicines
- Insect stings
- Foods and metals |
Symptoms
When you come into contact with an allergen, or a trigger, your body produces higher levels of certain types of substances, histamine for example. Another substance is called leukotrienes (loo-koh-TRY-eens). These substances signal your body to respond to allergens with symptoms such as:
- Stuffy nose
- Runny nose
- Postnasal drip
(a drip in the back of the throat that may cause coughing)
- Sneezing
The medical term for these symptoms is allergic rhinitis, also known as hay fever or, simply, indoor and outdoor allergies. The allergens may cause different kinds of allergic reactions. The most common allergic conditions are hay fever, asthma, and skin allergies.
In one study, hay fever is estimated to be the 5th highest direct and indirect economic burden with only hypertension, heart disease, mental illness and arthritis ranked higher. Asthma also causes thousands of deaths and nearly 500,000 hospitalizations annually.
Allergic reactions of the skin can have many possible causes. Examples of irritants that can cause allergic reactions when they touch your skin are hair or skin-care products, nickel in jewelry and belt buckles, dyes in leather or fabric, and poison ivy or poison oak. Eczema is a skin condition that causes itching, dryness, fine scales or flaking, and sometimes mild redness. The cause of eczema is usually not known. It is also possible to have an allergic reaction to sunlight or temperature extremes.
Common foods that may cause allergy symptoms are shellfish, eggs, milk, nuts, and peanuts. Allergies run in families, but not every family member may be allergic to the same thing.
Sometimes an allergic reaction may be severe. This is called anaphylaxis. This life-threatening emergency can affect breathing and circulation within several minutes. Symptoms of anaphylaxis are: fast pulse; trouble breathing that may include wheezing, nausea and vomiting; swelling of the lips, tongue, or throat; hives; pale, cool, damp skin; drowsiness; confusion or loss of consciousness; and insect stings. These severe allergic reactions may precipitate an acute asthma attack.
Diagnosing Allergies
1. A blood test (displaying both environmental and food allergens).
2. Skin test (also called a scratch test-exposing the skin to a very low dose allergen)
3. To identify a food allergy, your provider may suggest that you not eating certain foods for a while. Then you can carefully try eating these foods again, one by one, to see if your symptoms come back.
Preventative Measures
The goal of living with allergies is primarily to obtain a comfortable, daily routine. Take steps to limit your exposure to pollens and outdoor mold spores. If you're allergic to pollen, keep windows closed when pollen season's at its peak, change your clothing after being outdoors — and don't mow the lawn.
- Keep family pets out of certain rooms, like your bedroom, and bathe them if necessary.
- Remove carpets or rugs from your room (hard floor surfaces don't collect dust as much as carpets do).
- Don't hang heavy drapes, and get rid of other items that allow dust to accumulate.
- Clean frequently.
- If you're allergic to dust mites, use special covers to seal pillows and mattresses.
- If you're allergic to mold, avoid damp areas such as basements, and keep bathrooms and other mold-prone areas clean and dry.
- Turn on the air conditioner. Use air-conditioning at home and in your car on days when the pollen count is high.
- Turn off fans. Limit the use of window or attic fans that can draw pollen-rich air from the outside into your home.
- Shower or bathe before bedtime.
- Change your clothing after spending a lot of time outdoors. Dry your laundry in a dryer rather than hanging outside to dry.
According to the American Academy of Allergy, Asthma & Immunology (www.aaaai.org), pollen from trees, grasses, and weeds and outdoor mold spores (from fallen leaves, soil, and rotting wood) can trigger seasonal allergies. Try to plan outdoor activities at times of day when pollen counts are lower (pollen counts are often higher in the morning).
Treatment
Avoidance of the suspected allergen is the first-line therapy. Thereafter, other courses of action would include:
- Decongestants
- Antihistamines
- Steroid medicine
- Quick-acting, inhaled bronchodilators
to treat breathing problems
- Other types of inhaled medicines
to prevent breathing problems
 Allergy shots are a method of reducing the allergic symptoms on a long-term basis by altering the immune response. It is a safe and effective therapy for hay fever, allergic asthma, and stinging insect hypersensitivity. A mixture is prepared that contains the allergens identified in your allergy tests. The mixture is injected into your skin in tiny but increasing amounts over the course of many months. Over time, the shots make you less sensitive to the allergens. Usually after four to six months of allergy shots you will begin to have relief from your allergies. You will probably need to continue the shots for two to three years or longer.
If you have severe allergies, your provider may prescribe an emergency kit for you to carry with you at all times. Examples of brand names for these kits are EpiPen and Ana-Kit. These kits contain a ready-to-use syringe of epinephrine. These kits are not intended as the sole treatment of an allergic reaction. Rather, they “buy” time to get to treatment.
There is no known way to prevent allergies. However, some research has shown that breast-fed babies may be less likely to develop allergies and asthma. Also, if your family has a very strong history of allergies, you might try to avoid your family’s most common allergens. For example, you may need to stay away from cats. This might help stop you from developing severe symptoms.
Cigarette smoke can make hay fever and asthma symptoms worse. You can help your symptoms by not smoking or avoid being around smokers.
A Note About Food Allergies
Food allergy most often begins in the first two years of life. Over time, the majority of food allergies are lost, although allergies to certain foods are long-lasting. As examples, cow’s milk and egg allergies are generally outgrown, whereas most peanut and tree nut allergies are persistent.
A true food allergy can be confirmed in 5 to 10 percent of young children with a peak prevalence at about one year of age. Children who begin with a single food sensitivity have a high chance of developing additional food allergies, as well as allergic rhinitis and asthma. Egg allergy appears to affect between 1 and 2 percent of the population. Cow’s milk allergy affects approximately 2.5 percent of children during the first two years of life. Peanut and tree nut allergy affects about 0.5 to 0.8
percent of children and 0.5 to 1 percent of the general population.
Dr. Polavaram specializes in internal medicine and is the owner of Capital Primary Care with offices in Cary and Raleigh. |
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