HCA Midwest Physicians August 09, 2016

Seasonal allergies appear in the spring and fall, making a lot of people miserable. These allergies are a reaction to tiny pollen grains and mold spores that are spread through the air, and then breathed in through the nose and mouth. Allergies occur when the immune system, which defends the body against foreign invaders such as bacteria, responds to a false alarm. When a person with allergies breathes in airborne allergens, their immune system treats a normally harmless substance such as pollen as a threat and attacks it, producing symptoms of an allergic reaction.

Symptoms

Symptoms that occur shortly after you come into contact with the substance you are allergic to include:

Symptoms that may develop later include:

  • Stuffy nose (nasal congestion)
  • Coughing
  • Clogged ears and decreased sense of smell
  • Sore throat
  • Dark circles under the eyes
  • Puffiness under the eyes
  • Fatigue and irritability
  • Headache
  • Gastrointestinal symptoms  

What Causes Allergies

It’s possible to develop seasonal allergies at any age, but they usually do not appear until age three or older. “Allergies are very common, but most people with allergies are unaware of what their triggers are,” says allergist-immunologist Bruce Pfuetze, MD of College Park Family Care. “Allergies can change over the lifetime of a person and depend on many factors, primarily what allergens they are exposed to. Allergies are definitely inherited and can run in the family.”

Plants that can cause allergies are trees, grasses and weeds. Their pollen is carried by the wind.

The amount of pollen in the air can affect whether allergy symptoms develop. Plants such as sagebrush, curly dock, lamb’s quarters, pigweed, sheep sorrel and the most common culprit, ragweed, are prolific producers of pollen allergens. Ragweed season runs from August to November, but pollen levels usually peak by mid-September in many areas in the country. Pollen counts are highest in the morning, and on dry, hot, windy days when there is the highest percentage of pollen in the air. Cool, rainy days can provide relief from allergies because pollen can’t travel through the air as much in those conditions.

Unfortunately, most people never see an allergist during their lifetime and they suffer year after year.

When to see a doctor

You can’t control what’s in the air around you, but it’s possible to control how your body responds to it. Call for an appointment with your healthcare provider if:

  • You have severe allergy symptoms
  • Your symptoms do not respond to over-the-counter treatment
  • Treatment that once helped you no longer works

Diagnosis and tests

“Unfortunately, most people never see an allergist during their lifetime and they suffer year after year,” observes Dr. Pfuetze. “Primary care physicians can frequently take care of many allergies and allergy related problems. Allergists can see patients on a one-time, new-patient visit and help many without further testing. However, when needed, we can do a comprehensive allergy evaluation including pulmonary tests, sinus X-rays, blood studies and skin testing. With this information we work as a team with our patients to identify their allergy triggers, and come up with the best practices and solutions to control their symptoms and put them on a safe and effective treatment program.”

If needed, there are several tests used to pinpoint allergies:

  • Allergy skin tests—Allergy skin testing is considered the most sensitive testing method and provides rapid results. The most common test is the "prick test," which involves pricking the skin with the extract of a specific allergen, then observing the skin's reaction.
  • Serum-specific IgE antibody testing— These tests, known as IgE RAST tests, can measure the levels of allergy-related substances. If your doctor determines you cannot have skin testing, special blood tests may help with the diagnosis.
  • An absolute eosinophil count (CBC) test may also help diagnose allergies. It measures the number of white blood cells, which become more active when you have an allergic condition.

Lifestyle-based allergy prevention

There are a number of other steps you can take to lessen your allergic reactions, either by themselves or in conjunction with medicines.  Here are just a few:

  • Stay indoors between 5:00 and 10:00 in the morning when allergen levels are at their highest.
  • Keep windows in your home and car closed to lower exposure to pollen. During pollen season, you should stay indoors where it is air-conditioned, if possible.
  • Don't use window or attic fans, they just blow pollen around the room.
  • Use a dryer inside, not a line outside, to dry clothes. It will help keep pollen from getting onto your clothes and being brought into the house.

Medications

For allergy sufferers, the best treatment is to avoid the offending allergens altogether. This may be possible if the allergen is a specific food, like peanuts, which can be cut out of the diet, but not when the very air we breathe is loaded with allergens, such as ragweed pollen. Fortunately, there are many options. “We have a number of over-the-counter medicines that can be very helpful when used appropriately and under the direction of an allergist,” says Dr. Pfuetze. “Prescription medications are also very effective. There are a number of products, including specialized allergy injections that take advantage of new knowledge in immunology and body chemistry. Through injections, we can control 90 percent of most patients with significant inhalant allergies. After two and a half to three years of injections, patients have decreased their allergy symptoms by 50-75 percent. These benefits can last for many years after injections have been discontinued.”

Some of the common treatments for allergies include:

  • Antihistamines — These medications counter the effects of histamine, the substance that makes eyes water and noses itch and causes sneezing during allergic reactions. Sleepiness was a problem with the oldest antihistamines, but the newest drugs do not cause such a problem.
  • Nasal steroids — These anti-inflammatory sprays help decrease inflammation, swelling and mucus production. They work well alone and, for some people, in combination with antihistamines; in recommended doses, they are relatively free of side effects.
  • Cromolyn sodium — A nasal spray, cromolyn sodium can help stop allergy symptoms, perhaps by blocking release of histamine and other symptom-producing chemicals. It has few side effects.
  • Decongestants — Available in capsule and spray form, decongestants may reduce swelling and sinus discomfort. Intended for short-term use, they are usually used in combination with antihistamines. Long-term usage of spray decongestants can actually make symptoms worse, while decongestant pills do not have this problem.
  • Immunotherapy — Immunotherapy (allergy shots) might provide relief for patients who don't find relief with antihistamines or nasal steroids. Allergy shots alter the body's immune response to allergens, thereby helping to prevent allergic reactions.
  • Complementary medicine — For those who want to avoid or limit medications for their allergies, many complementary health approaches are available, such as acupuncture or the use of a neti pot. Rinsing the sinuses with a neti pot or with other devices, such as bottles, sprays, pumps or nebulizers, may be a useful addition to conventional allergy treatments.

Allergy complications

For most people, hay fever is a seasonal problem — something to endure for a few weeks once or twice a year. But for others, such allergies can lead to more serious complications, including sinusitis and asthma.

Sinusitis is one of the most commonly reported chronic diseases. It’s caused by inflammation or infection of the four pairs of cavities behind the nose. Congestion in them can lead to pressure and pain over the eyes, around the nose or in the cheeks just above the teeth. Chronic sinusitis is associated with persistent inflammation and is often difficult to treat. Extended bouts of allergic reactions can increase the likelihood of chronic sinusitis.

Asthma is a lung disease that narrows or blocks the airways. This causes wheezing, shortness of breath, coughing, and other breathing difficulties. Asthma attacks can be triggered by allergens. Almost 80 percent of people with asthma have allergies. Some people are diagnosed with allergic asthma because the problem is set off by an immune response to one or more specific allergens, like mold. Increased pollen and mold levels have also been associated with worsening levels of asthma in the U.S.

Allergy season doesn’t have to impact your activities or put your health at risk. If your allergy symptoms won’t quit, start with a visit to your doctor. Let them help you determine what treatment is best for you, so that you can stop sneezing and get back to enjoying the outdoors again.