Sneezing Your Way Through Allergy Season

By: Dr. Rob Danoff

You're Sneezy, Dopey, Grumpy and Sleepy. No, you're not auditioning to be one of the Seven Dwarfs - you're probably suffering with the common seasonal respiratory allergy known as hay fever.

Sure, many of you just grin and sneeze through it, but for most, the pollen, dust and mold may cause significant respiratory and physical distress. In fact, it's estimated that 35 million Americans suffer with seasonal upper respiratory symptoms as a result of allergies to airborne pollen, mold and dust mites.

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What Causes an Allergy?

Any way you put it, allergies can be downright annoying, life altering and, in some cases, life threatening. The reaction depends upon the individual. In its simplest terms, an allergy is the body's hypersensitivity to certain substances (known as allergens) in our environment. When exposed to these allergens, our immune systems treat them like invaders and release antibodies known as immunoglobulin E (IgE for short) to fight the perceived enemy. However, this production of IgE triggers our immune cells to release chemicals (one of which is histamine), which can cause certain reactions in our bodies.

As many of you are aware, histamine can cause hives, sneezing, watery eyes and itching. In fact, the more we're exposed to the allergen, the worse the reaction can become. One of our main defenses against this chemical response is the antihistamine, which tries to counteract the effects of histamine.

Is It a Cold or an Allergy?

Both can cause a runny nose. However, a cold tends to run a seven to 10-day course, while an allergy can go on for weeks or even months. Another important difference: A cold may cause a fever, while an allergy does not.

According to the National Institute of Allergy and Infectious Diseases, the most common symptoms of allergies to airborne substances such as pollen include:

  • Sneezing, often accompanied by a runny or clogged nose
  • Coughing and postnasal drip
  • Itching eyes, nose and throat
  • Conjunctivitis (an inflammation of the membrane that lines the eyelids, causing red-rimmed lids, as well as crusting)
  • Allergic shiners (dark circles under the eyes caused by increased blood flow near the sinuses). Additionally, a child may get the "allergic salute," where the constant upward rubbing of the nose causes a crease mark on the nose.
  • It is important to know that some people with allergies develop asthma, which may cause coughing, wheezing and shortness of breath.

Allergy Triggers

The Spring Allergy Triggers: Pollens and Molds

Each spring, summer and fall, tiny particles are released from trees, weeds and grasses. These particles, known as pollen, can hitch rides on air currents and travel 400 miles. Some plants are so good at giving off pollen that a single ragweed plant can generate more than 1 million grains of pollen a day. What's more, each plant has its own pollinating period.

Because of these variables, it makes sense to be aware of the pollen count, which measures how much pollen is in the air during a 24-hour period in a specific area at a certain time. The pollen count tends to be highest in the morning on warm, dry and breezy days, and lowest on wet, cool and chilly days. The pollen season tends to end with the first frost.

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Unfortunately, because mold can withstand frost, folks who are allergic to mold can suffer with symptoms from spring through late fall. Molds are members of the fungus family and can be found wherever there is moisture and oxygen. The seeds from the fungus family are called spores, which can give rise to new mold growth and more spores. When inhaled, these spores can cause an allergic runny nose and may even reach the lungs. Outdoor mold spores are abundant in soil, rotting wood and leaves. Even though there are many different types of molds, only a few can cause allergies.

The Dust-Mite Dilemma

Dust mites are microscopic organisms that live in the dust found in homes, workplaces and even your mother-in-law's clean and sparkling dining room. House dust is made up of many substances, including fibers from fabrics (especially those nice curtains), cotton lint, feathers, dander from pets, bacteria, mold and fungus spores, bits of plants and insects, and even particles from the food you ate last Tuesday.

Mites tend to live in bedding, upholstered furniture and carpets. They love the summer and die in the winter, except of course in a warm and humid house, where they continue to be unwanted and nonpaying guests. Their waste products, which are proteins, are responsible for provoking allergic reactions.

OK. Don't panic. There's help. I'm going to tell you how to get tested for allergies, how to lessen your chance of a reaction, and how to avoid becoming Sneezy, Dopey and Sleepy (I don't know if we can help old Grumpy, but we'll try).

Testing & Treatment Options for Allergies

What to Do About Allergies

If you suspect you have an allergy, please don't self-medicate. Instead, see your physician. Your doctor will most likely ask detailed questions to try and identify whether a seasonal allergen is making you miserable.

The diagnostic approach will depend on the individual. If the problem is minor and seems to occur in a pattern, your physician may prescribe a medication to relieve symptoms and suggest ways to avoid the suspected allergen, or allergy testing (skin and blood tests) may be in order.

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Skin testing helps your physician determine if there is an allergy to a specific substance (allergen). Extracts of diluted substances commonly found in the affected person's area (pollens, molds, etc.) are injected into his or her arm or back. If there's a positive reaction, a small, reddened and raised area (called a wheal) occurs. The most common blood test is called a RAST test, which tests to see if the person has antibodies (called IgE) to certain allergens.

Allergy Treatment Options

There are three basic approaches to allergies: avoidance, medications or shots. Even though there is no cure for allergies, one or more of these strategies should help provide some degree of relief from your symptoms.

Avoidance tactics may be very difficult (relocating or giving up your pet), and may only be temporarily effective. However, here are some tactics that might work.

Medication is often prescribed when avoidance measures don't work. Choices include antihistamines, decongestants (often used with antihistamines), nasal sprays, eye drops and inhalers. The type of drug(s) you receive depends upon your symptoms. As a side note, please do not use over-the-counter decongestant nose drops for more than a few days unless directed by your physician. These medications can have a rebound effect, which causes more nasal swelling and worsening symptoms.

Immunotherapy (allergy shots) can reduce symptoms for a longer period of time than other treatment options. As many of you know, this treatment involves a series of allergy shots that reduce the IgE antibodies in the blood, which trigger your body's reaction, and instead produces a protective antibody known as IgG. Many patients with allergic rhinitis experience symptom relief within 12 months. Some patients have experienced excellent long-term results after stopping the shots, while others have had to restart and continue the immunotherapy series.

For more information on allergies, please contact the American Academy of Allergy, Asthma and Immunology at 1-800-822-ASMA begin_of_the_skype_highlighting            1-800-822-ASMA      end_of_the_skype_highlighting.

Copyright 2003, Dr. Rob Danoff

Robert Danoff, D.O., M.S., is a family physician. He is program director of Family Practice Residency Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He also is a medical correspondent for The Comcast Network, CN8, contributing writer to the New York Times and writes a weekly medical column for the Bucks Courier Times, Bucks County Pa.