Jeffrey Millstein, MD, a primary care physician at Penn Internal Medicine Woodbury Heights, explains what “allergies” are and how you can win the battle against them this season.
It is that wonderful time of year again. The leaves are changing and the air is crisp, but unfortunately for some, the sniffling and sneezing of allergies has blurred the idyllic picture.
What are allergies?
Allergies – also known as “hay fever” or seasonal allergic rhinitis – is the fifth most common chronic condition in the United States. Pennsylvania and New Jersey have three allergy “seasons” the spring (when trees pollinate), the summer (when grasses release their pollen) and the fall (ragweed season).
An allergy occurs when your immune system overreacts and mistakes an ordinary substance, such as pollen, as a harmful invader. Inflammatory cells swarm to the area of contact (nose, sinuses, skin and eyes) and release antibodies, histamine and other destructive chemicals in an attempt to combat the “invader”, resulting in an allergic reaction.
How do I know if I have allergies?
Because common symptoms include runny nose, sneezing along with itchy and watery eyes. It can be difficult to distinguish allergies from an upper respiratory infection. There are, however, some clues to help determine what you are suffering from. Allergies can cause fatigue and misery from congestion to irritation of the respiratory tract, but will usually not make one feel truly “ill.” A fever, green or yellow mucous, deep cough or shortness of breath are indicative of infection and should prompt a call or visit to your primary care provider.
Allergies typically begin in childhood or adolescence, but they can develop at any time thereafter. While specific allergies are not directly inherited, your risk of developing allergies is increased if family members are affected.
Are there ways to fight allergies?
Here are some tips to help you get through the sneezing season more comfortably.
Avoid the thing you’re allergic to. Monitor pollen counts in your area and avoid outdoor activity when the count is especially high. The National Allergy Bureau or local weather stations provide accurate, accessible pollen count information. Keeping windows closed, and showering after coming indoors may also help prevent symptoms.
Try over-the-counter medications. Antihistamines are the most common of these remedies. Newer types, like certrizine, fexofenadine and loratadine are effective and are much less sedating than ones of the past. Nasal steroids, mast cell inhibitors and montelukast are other prescription options for refractory symptoms. A number of eye drops are available as well, specifically to treat itchy and watery eyes. Talk to your primary care provider to discuss what options would be best for you.
Natural remedies have shown efficacy for treating allergies. A few natural or homeopathic remedies have been shown to be effective, though some are outside the FDA’s purview: the European herb butterbur has shown some efficacy in clinical studies, similar to antihistamines and migraine relief medicine; salt water nasal spray can help wash out pollen from the nose and sinuses and, some cases, acupuncture can be helpful.
When symptoms do not respond to these interventions, as expected, and symptoms are severe or persistent, it may be time to see an allergist. They can perform skin and serologic testing for specific allergens and offer immunotherapy (allergy shots) when appropriate. Immunotherapy is based on the concept that the immune system can be desensitized to substances that trigger allergies. Injections can potentially lead to a lasting solution to allergy symptoms.
Allergies can be very annoying and sometimes disabling, but many effective options for prevention and treatment are available.
Establishing or maintaining a good rapport with your primary care provider or allergist will most likely lead to a satisfactory solution to this common problem.