Allergies: Answers to Some Common Questions

Allergies, often referred to as “hay fever” or allergic rhinitis, occur when the human body is exposed to an external substance (also known as an allergen) and the immune system sees this allergen as a foreign invader. The body perceives that the allergen could cause harm and therefore releases various chemicals into the bloodstream. These chemicals are actually intended by the body to help protect itself, but instead they cause the pesky symptoms of allergies. Humans can develop an allergy to many things, including food, medication and environmental allergens. We will focus on the latter in this column, answering some of the most common questions about environmental allergens.

What contributes to the symptoms of allergies?

There are multiple substances the body makes to deal with allergens but one of the most prominent ones is histamine. Histamine contributes heavily to the itchy eyes, nose and throat that many people experience with allergies. This is where the class of medication called antihistamines gets its name.

What are some common allergens?

The most common outdoor allergens include springtime pollens from flowers and trees, summertime grasses, fall weeds, and mold and fungus, which are also found indoors. Other indoor allergens include dust/dust mites and our four-legged furry friends—cats and dogs.

How many people in the United States suffer from allergies?

Recent estimates put this number at approximately 40 to 50 million individuals.

Can you inherit allergies from your parents?

No. However, you can inherit a tendency to develop allergies. In fact, if one parent has allergies, the child has about a 50 percent chance of developing allergies as well. If both parents suffer from allergies, then the child’s risk jumps to about 65 percent.

At what age can you develop allergies?

This is a topic of considerable debate in the pediatric world, but it is widely accepted that allergies can begin as young as the toddler years, usually starting with indoor allergens, followed by the outdoor culprits. As for adults, allergies to different substances can develop at any time in one’s life.

What are the symptoms and signs of allergies?

The list is long and variable. Many people, particularly children, experience runny nose with sneezing, itchy and watery eyes, itchy and scratchy throat, and dry cough. Others have stuffy nose and congestion. In most cases the discharge from the nose is clear and thin, but folks with chronic (and more severe) symptoms can have thick secretions from the nose. Children with allergies often perform the “allergic salute”— pushing the tip of the nose upward with their hand to help stop the itching. Furthermore, children and adults can have swollen eyelids and “allergic shiners,” which are dark circles under the eyes from the collection of the chemicals the body releases in response to allergens.

“I have had a runny nose and cough for five days. Do I have a cold or allergies?”

This is when your doctor has to do some investigative work because the symptoms of both conditions often overlap, particularly in a young child. First, if a person’s symptoms recur during certain times of the year (e.g. springtime), it is likely he or she is suffering from environmental allergies. Second, duration of the symptoms helps shed light on the situation. Most colds or upper respiratory infections last one to two weeks. On the other hand, people with allergies have symptoms typically lasting weeks to even months. Third, allergies are never associated with low-grade fever or muscle aches. If any of these are present, a cold (or, less commonly, a bacterial sinus infection) likely exists.

What treatments are available for allergies?

Over-the-counter (OTC) antihistamines such as Benadryl, Alavert, Claritin and Zyrtec offer much relief. These are best for individuals with mild or seasonal allergy symptoms. Saline nasal sprays and oral decongestants such as Sudafed are also effective at relieving congestion. However, it is best to avoid medicated OTC nasal sprays such as Afrin, as these can actually worsen your nasal congestion with prolonged use. For those with more severe allergies or persistent symptoms, it is best to see your doctor. In these cases a nasal steroid spray and/or other types of prescription medications may be given.

What are allergy shots?

Also known as immunotherapy, these are designed for the worst of allergy sufferers. These shots teach the body to respond differently to allergens so that these substances are not viewed as foreign invaders. Your family physician or pediatrician will refer you to an allergist who will make the decision as to whether allergy shots are right for you.

How do I know for sure if I have allergies?

Your clinical history is obviously the most important piece of information your doctor will need in order to make the diagnosis. If necessary, your doctor or an allergist can perform a blood test to see if you have a predisposition to allergies. Or, a skin test may be performed by an allergy specialist.

What can you do to help prevent allergies?

For those who suffer from outdoor allergies, it is best to stay inside during times when pollen counts are highest (early to mid-morning). Keep an eye on the newspaper or Internet sites that provide allergen information on a daily basis. Additionally, keep windows closed and run an air conditioner instead of fans during the warm spring and summer months. For indoor allergens, such as dust, consider purchasing dust-mite covers. These plastic, allergen-proof coverings encase pillows and bedding, keeping the dust out and your allergies at bay.

To prevent mold and dust build-up, choose hardwood floors over carpet and blinds instead of curtains. Change your HVAC filters regularly. You might even want to purchase an air purifier as well. Last but not least, if you are a dog or cat lover but have allergies, you may want to think twice about bringing your favorite pet home. Talk with your family physician or allergist first about your options. n

Dr. Jonathan Siuta is a board certified physician practicing with Wilmington Health Associates at the North Brunswick location. Dr. Siuta holds boards certifications in Internal Medicine and General Pediatrics. He completed his medical training at the State University of New York at Buffalo and his internship and residency at the Brody School of Medicine at East Carolina University.

Want to learn more about allergies?  Visit the following websites: www.aaaai.org, www.aap.org, or www.aafp.org and perform a search using the keyword “allergies.”