Allergies nothing to sneeze at
June 9, 2015
If you can't leave home without an ample supply of tissues to care for that constantly runny nose, it may be time to find out if you have environmental allergies.
Not every sneeze or watery eye is caused by allergic reaction. But farmers and ranchers are exposed to so many potential allergens every day it's wise to consider how to manage persistent allergy symptoms that can range from annoying to debilitating.
Dr. Chris Cleveland, Sanford Health Allergy/Immunology physician at Fargo, ND, says environmental allergies tend to be worst in fall during harvest season. However, a wide variety of spring pollens also spawn a multitude of symptoms.
"Everyone's allergen response is different," Cleveland says. "Environmental allergies are seldom life threatening, but allergic reactions might be managed with inexpensive over-the-counter medicines such as Zyrtec and Claritin. Nasal sprays like Flonase and NasaCort are also available without prescription. If you try those treatments and they don't seem to be effective, it may be time to consult a physician."
Many allergy triggers, such as Timothy grass, are common to a wide number of people. However, doctors will use scratch tests to assess specific allergies for patients since no two patients have the same kind of reaction to allergens.
"In a scratch test, we use a white plastic toothpick to apply a panel of about 46 different allergens on a patient's back," Cleveland says. "If the patient reacts to the allergen, red welts appear where the allergen was applied. Reactions are analyzed and a treatment plan is developed."
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Environmental allergies are seldom life threatening, however if symptoms cause difficult breathing, chest tightness, whistling sounds with breathing or swelling of face, eyelids or lips, a trip to the emergency room may be in order.
"If you start to look like a cartoon character because of an allergic reaction, it's time to go to the ER," Clevleand says.
In cases where allergic reactions are severe, patients may opt to go through a series of weekly desensitizing allergy shots. Since the treatment requires weekly doctor visits and can take as much as 8 years to complete, most people don't complete desensitization.
While precautions can be taken to minimize allergen exposure to some degree, avoiding common allergens such as mold is virtually impossible.
"Pollens and molds can travel for hundreds of miles," Cleveland says. "The only way to completely escape them would be to live in a biohazard suit. If you're exposed to an allergen that causes particularly severe reactions, you can wear a mask to reduce allegen inhalation. That's especially true during harvest for those working with harvested and augered grains."
Some allergens are just 0.5 microns (0.000197 inches) in size, 200 times smaller than a human strand of hair. When allergens enter the body, natural antibodies can overreact to them, producing huge numbers of antibodies to repel them. The physical reaction to the immune reaction is itching eyes, a running nose, sneezing and coughing.
The microscopic dust that can trigger an allergy response is found in every crack of crevice of the average home. In just a single gram of house dust, some 100,000 mold spores can be found.
In layman's terms, describing what happens in an allergic reaction gets a bit complicated. Immunoglobulin E (IgE) is a type of antibody naturally present in minute amounts in the human body. IgE plays a major role in allergic diseases. IgE binds to allergens, triggering release of mast cell substances that can cause inflammation. When that happens, a cascade of allergic reaction can begin.
"IgE was used in caveman times to fight infection," Cleveland says. "Some people are genetically predisposed to have a higher amount of IgE, which can make allergic reactions even worse."
Allergic reactions can begin at any age. Cleveland frequently sees people who return to an area where they grew up and experience allergic reactions to environmental elements. Actively avoiding things that stimulate allergic reactions helps, but allergies can either dissipate with time or grow worse.
In addition to over-the-counter and prescription drugs, allergy sufferers may find relief with some emerging natural remedies. According to WebMD's R. Morgan Griffin, natural supplements have been shown to have some effect in blocking allergy related chemical reactions in the body.
Some common supplements tested and recommended include Butterburr, Quercetin, and Stinging Nettle. As of yet, there are no definitive studies regarding the effectiveness of the supplements. Caution is advised in self-treatment with any natural supplement.
Treatments such as nasal washes and steam inhalation have long been recommended to help reduce allergic responses. HEPA air filters may help reduce inhalation of common household allergens. Specific acupuncture treatments may also be effective.
"One of the misconceptions people may have about allergies is that dusty environments, smoke or heavy odors could stimulate an allergic response," Cleveland says. "However, in those cases the dust and odors are likely just irritating nasal passages. You can't be allergic to things that aren't made of protein, so dust or smoke may cause sensations of nasal irritation but they're not allergens."
Improved medical technology and research are helping doctors more readily identify allergic responses. Health care advances are also making treatment more readily available.
"Every year we talk about having the worst allergy season ever, but in fact that statement is true," Cleveland says. "We're identifying more allergens all the time and as our global temperatures climb, pollen counts from trees, weeds and grasses are increasing, too. Over-the-counter treatment is inexpensive and can be a simple and effective way to treat allergy symptoms. If that doesn't work it's time to see an allergist."