Spring Allergies

Allergies cause millions of people around the world to be miserable from suffering. The body organs that can be affected from airborne triggers include the nose, ears, sinuses, throat, lungs, and eyes. The signs and symptoms of allergies include any combination of nasal congestion, sneezing or itchy nose, clear runny nose, itchy or congested ears or sinuses or throat, coughing, wheezing, itchy, red, or watery eyes. About 20 to 25% of the United States population may suffer from what physicians would diagnose as allergic rhinitis (hay fever), allergic conjunctivitis, or asthma. Over 1 billion dollars annually are both spent on medications for relief and lost due to poor productivity, as in missed school or work, or poor concentration.

During the spring, these three diseases are usually caused by pollen from trees and grasses plus mold spores. In the southeastern United States, tree pollination typically begins during early March, peaks during the 2nd week of April, and continues for another month. Meanwhile the grass pollination season begins late April, typically peaks during mid-May, and then slowly declines through June. So not only do the seasons overlap, which is not common, but also the temperate weather leads to very high counts. These counts can be viewed daily at the only pollen counting station in the upper half of South Carolina https://pollen.aaaai.org/nab/index.cfm?p=allergenreport&stationid=154. Furthermore, about 90% of patients allergic to tree pollen are also allergic to grass pollen. Allergy patients are expose to a months long and high counts of pollen, which is why the allergy season is particularly intense.

Before beginning treatment for patients with allergies, a complete health assessment of their health should be done. This should include a detailed interview, asking about a faily history of allergies, counting the number of respiratory infections, such as for the ear, sinuses and lungs, and counting the number of flare ups of asthma, which may be treated with steroid medications.

The goals of an ideal treatment plan are: to prevent symptoms + complications, to minimize symptoms that do break through, and to be able to live as normal and productive life as possible.

The first step in optimally treating allergic diseases is to learn about the disease. Read up about the problem and learn about the options to reduce the suffering. Allergies do not simply have to tolerated until they go away. Confirm the diagnosis as best as possible.

The second step is to try to reduce exposure to the triggering pollen and mold. Here are some steps:

• Keep windows closed to keep pollen outside homes and cars. Use the air conditioner, which filters, cools and dries air.

• Stay indoors when pollen counts are highest, typically between 10 a.m. and 4 p.m.

• Check daily pollen counts.

• Change clothing after time spent outdoors and avoid drying laundry outside.

• Sleep well by taking a shower before bed to wash pollen from your hair and face, preventing it from ending up on your pillow.

The third step is to start taking the anti-allergy medications early and until the end of the pollen season, to prevent needless suffering from allergies and their complications, sinus infections and asthma exacerbations, Depending on the exact symptoms and degree, a single or combination of medications may be necessary to achieve the goals. The classes of medications available include nasal corticosteroid sprays, antihistamines, antileukotriene blocker (Singulair), decongestants, eyedrops, and inhalers for the chest. Many of these are available over-the-counter. Be sure to match the symptoms to the medications taken. If you have continue to have bothersome symptoms despite these medications, patients should consult their physician.

What are some home remedies that help prevent or reduce symptoms from spring allergies? First, saline sprayed into the eyes, nose and sinuses can wash off the surfaces and remove allergens. Next, for nasal and sinus congestion, menthol can be soothing for some people. Menthol comes in 2 forms: a gel,

like Vicks, to be put into the nose; and lozengers to be placed in the mouth. Finally, local honey has not been shown to be helpful, but harmful either, so this may be tried.

Fourth, allergy immuntherapy, also known as “allergy shots,” should be considered if patients: have severe symptoms and signs of allergies, while not getting relief from a combination of medications: find the cost of all of the medications necessary for relief is not affordable; do not want to take medications; or not be able to tolerate medications because of adverse effects; are worsening despite maximum medications tried, which includes developing complications such as recurrent sinus infections or asthma. How do allergy shots work? Normally, people have a high immunologic tolerance to allergens commonly found in the environment and not harmful to humans. People with allergies have lower than normal immunologic tolerances. Their immune system mistakenly interprets allergens as harmful substances and reacts to them by releasing a chemical called histamine. Allergen immunotherapy works by initially giving a small, sterile, and increasing dose of the same allergens that cause a reaction in that person. When a high dose can be safely given, this dose is given without unchange for a duration of three to five years. During this time, the patient’s level of immunologic tolerance is pulled up towards normal. Now, the patient can encounter the allergen without reacting, having symptoms, and so needing medications. Perennial immunotherapy is preferred because the level of immunologic tolerance is much more likely to be raised up towards normal and stay there. Allergy immunotherapy, is generally effective treatment in up to 90 percent of patients

In summary, if you have symptoms consistent with allergies, first do your best to confirm your diagnosis, then research your options, and begin treatment to avoid needless suffering.

This information was prepared by Neil Kao, M.D., a board certified allergist, as an educational service for patients and all health care professionals.