Don't Suffer From Allergies!

Roughly 50 million Americans are affected by allergies, their number is climbing, and their symptoms are worsening. The problem is on the rise, but effective, doctor recommended, treatments are available.
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You may have heard the bad news about allergies: roughly 50 million Americans are affected, their number is climbing, and their symptoms are worsening. Plus, the harsh winter we experienced is making this allergy season an especially tough one. But the most important news is good: If you’re a prisoner of the sneeze, runny nose, congestion and itchy eyes caused by seasonal allergies, there are effective treatments that can set you free.

“It’s a myth that you simply need to suffer,” says Theodore Falk, M.D., an attending allergist and director of allergy programs at Holy Name Medical Center in Teaneck. “appropriate medical treatment by an allergy specialist can dramatically improve your quality of life.” The first step is to make sure your symptoms are caused by allergies rather than a cold—the chart on the side of the page can help. If allergies are indeed the culprit, a specialist in allergy and immunology can pinpoint the substances you’re allergic to.


 

+Is it a Cold or an Allergy?

Symptoms of these conditions can be similar—both, for example, commonly cause runny or stuffy nose, usually produce sneezing and sometimes also bring weakness or fatigue. But other symptoms differ—itching, for example, “is the hallmark of allergy,” says Holy Name Medical Center allergist Theodore Falk, M.D., while allergies do not cause fever. Check the chart below. If your symptoms last more than a week or so, an allergic reaction may well be the cause. That should trigger a visit to the doctor for testing.


Symptom Cold Airborne Allergy
Ichy Eyes Never or Rare Common
Sore Throat Common Sometimes
Fever Rare Never
Duration 3 – 14 Days Weeks

The most common triggers, or allergens, are plant substances such as pollen and mold spores. In 40 to 50 million Americans, they can trigger allergic rhinitis, also called hay fever—a persistent state of nasal inflammation that causes these unpleasant allergic symptoms. Other common allergens are animal dander, insects and dust particles.

While we associate pollen allergies primarily with springtime, the danger can persist into the summer, says Marjorie Slankard, M.D., director of allergy and immunology at The Valley Hospital in Ridgewood. Mold spores are also present throughout the warm months, she adds—“especially if you happen to be in a damp environment, in a beach house, for example.” And ragweed, which people think of as a fall pollen, actually appears as early as August 1.

To treat your allergies, look for a doctor certified by the American Board of Allergy and Immunology. He or she will take a thorough history, conduct a physical exam and do allergy testing to identify your allergens. “The gold standard is skin testing,” says Stuart From, M.D., chief of allergy at Engle- wood Hospital and Medical Center in Englewood. “Blood testing is available for those who are afraid of needles, but skin testing is more accurate.”

Steer clear of a practitioner who proposes “shotgun” testing of as many as 200 substances at once, Dr. From warns. “That’s not good medicine.” Better, he says, is “directed allergy testing,” in which the history taken beforehand guides the selection of substances that are the most likely culprits, and the doctor zeroes in on those. “For allergic rhinitis, for example, we initially do just 12 tests.”


 

Once a doctor has identified your allergies, he or she can develop an individual plan for treating them. It may include over-the-counter medications for symptom relief (Allegra and Zyrtec can be effective, says Dr. From) and/or a steroid nasal spray such as Nasacort, which recently became available over the counter. But nasal decongestants such as Afrin, Dristan or Neosynephrine are not the answer to allergic rhinitis, he says. “There’s a place for them in combating congestion, but they should be used only under the care of an allergist and accompanied by a topi- cal nasal steroid spray,” says the doctor, adding that if these products are overused, they can make things worse by promoting dependency.

For many patients, the best remedy is immunotherapy in the form of allergy shots. In this treatment, small amounts of the allergens themselves are regularly introduced under the skin in a saline solution over time to desensitize your body. Your allergist injects an extract of the specific offending allergens—usually grass, weed or tree pollen, dust mites, molds or animal dander—in gradually increasing quantities, starting weekly and progressing to monthly. Some patients begin seeing a noticeable improvement after the first few months, but the treatment should be given six months to a year to determine if it’s making a difference, and a full course of five years is recommended.

Allergy immunotherapy must be administered in the doctor’s office, and patients must wait at least 30 minutes after each injection to be checked for any reactions. Most health insurance plans cover the therapy, usually with a modest co-pay per visit. And the symptomatic relief it provides can be dramatic.

“I had terrible allergy symptoms as a teenager, and when I started allergy shots they literally changed my life,” says Dr. From. “That’s one of the reasons I became an allergist—I found out what an allergist can do for someone.”

Finally, immunotherapy for certain allergens is now available in “sublingual” form—that is, in a dissoluble tablet placed under the tongue. As Dr. Slankard notes, this April, the Food and Drug Administration approved three new products of this kind: Oralair and Grastek for certain grass pollens and Ragwitek for ragweed. But, as with shots, a patient must take his or her first tablet in the doctor’s office under supervision so that the doctor can check for possible reactions.

“This could be the beginning of a treatment revolution,” says Dr. Falk. But he cautions that so far, the tablets treat only one allergen at a time. “Probably 95 percent of the people who now receive allergy shots are ‘multisensitive’—they’re allergic to more than one substance,” he explains. “So it could be several years before under-the-tongue treatments become a wide- ranging substitute for shots.” Check with your allergist to see if these new medicines can be an option for you.

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