Are You Driving Everyone Crazy at Work?

Constant sneezing and throat-clearing, both symptoms of allergies, can irritate co-workers. There is a solution that will make everyone happy — immunotherapy.

Is there someone in your office who always sneezes, coughs and/or continuously clears their throat? That person may be suffering from allergy symptoms that include post-nasal drip. Co-workers offer a “bless you” once or twice, but the well wishes gradually taper off as thoroughly annoyed office mates secretly wish that person would get their allergies under control and put everyone out of their misery. It’s certainly not your fault but if you’ve been noticing dirty looks, you might be that person.

Similarly, is there a student at your child’s school who just looks miserable — suffering daily with watery eyes, runny nose, lack of energy and fleeting attention? The teacher and fellow students undoubtedly feel bad for that child — at least at first. But when symptoms continue day after day, sympathy turns to frustration and friends find excuses to slink away. That child’s grades are likely to suffer as a result of inattention and/or missed days. For this great, smart kid who isn’t achieving their deserved social or intellectual status, top notch performance seems an impossible dream. Is that your child?

Whether it’s you, your child, or someone who shares your air, there IS a solution that can clear symptoms and restore good relations — immunotherapy. Here are three need-to-know points about it … First, it can resolve reactions to multiple allergens like ragweed, mold and cat dander. Second, it lasts for years. Third, it’s entirely natural — it’s not medication. Immunotherapy exposes your immune system to very small quantities of the allergens, effectively teaching it “see, they’re really not so bad.” Since your system stops trying to fight off these harmless particles, your symptoms subside greatly or disappear altogether.

Allergy drops and shots are both forms of immunotherapy and they’re both effective. One of the major benefits of drops is you can take them at home — or on the road — so there’s no need to miss work or school for weekly doctor appointments, which are required with shots. (Missing work or school may be another strain on relationships with co-workers, friends and teachers.) Drops are affordable and are ideal for everyone from children to seniors. The upside of shots is that, currently, more insurance companies pay for them (co-pay and deductible may apply.)  In the long run, both shots and drops will likely be less expensive than medications — and will almost certainly be more effective.

If you or your child are the ones getting on everyone’s nerves, through no fault of your own, it’s time to put your allergies behind you and patch up those strained relationships. Talk to your doctor about immunotherapy. If it’s someone else, don’t bludgeon them to death — point them to https://www.allervision.com/allergies.

Make “Get Rid of My Allergies” Your New Year’s Resolution

Don’t let pollen keep you from enjoying the great outdoors. You can overcome your tree, grass and weed allergies with immunotherapy.

Some people resolve to diet. Others commit to exercise more. Whatever you promised yourself for this year, we suggest the additional new year’s resolution (it’s not too late to make one!) of improving your health and wellness by overcoming your allergies. It’s possible, and we’ll tell you how below. But first, in case you need a little extra motivation, here are a few activities that you should be able to enjoy, but which often provoke allergy symptoms: strolling in the park; playing soccer; watching a little league game; exploring a forest; hugging your dog; rolling in the grass; visiting friends; petting a cat; walking outside in spring; cleaning your home; sleeping; breathing.

When we say “get rid of allergies” we’re not talking about covering up your symptoms with medications or temporary treatments. We’re talking about using immunotherapy to teach your immune system not to react to the harmless allergens that it mistakes for enemies. When you do this with allergy drops or shots, your body stops creating allergy symptoms each time it encounters the allergens; in other words, you become healthier!

The first step is visiting your healthcare provider for a pain-free allergy skin test to determine what allergen(s) causes your symptoms. If your doctor doesn’t offer the skin tests, click here to find one who does. Then talk to your provider about whether immunotherapy is right for you. If you are a good candidate for the treatment, your doctor will recommend either drops or shots. Within two months of starting immunotherapy, you may leave your allergies in the dust – not just for this year, but for many years to come! And next year, your resolution can be based on using your good health to reach new goals!

The What, Where and When of Allergies

The AllerVision Allergy Map will show you the biggest allergen offenders in your area and when they cause the most damage. Click here to see it.

Maybe you’ve had an allergy test and you have a list of allergens that cause your symptoms. (If not, click here and AllerVision can help you find a provider who will give you the answers you deserve!) But unless you’re a botanist, you probably don’t know what most of those allergens looks like. And even if you do, you may not know when you need to watch out for them. Don’t worry, we have you covered! …

Click on the caption under the image at right to visit the AllerVision allergy map. Once there, click on your region of the country to see the trees, weeds and grasses that cause the worst allergy problems in your area. (AllerVision-affiliated providers test you for sensitivity to those pollens when you visit them for an allergy evaluation.) If you hover over the names of the plants, you’ll see pictures and the season(s) in which each allergen does the most damage. Take the seasons listed with a grain of salt, though — global climate change is, well, changing the environment. Many doctors and allergy specialists blame those shifts for the huge increases in pollen — and, consequently, allergy symptoms — produced each year.

That said, if you’re experiencing allergy symptoms or generally not feeling well right about now, there’s a good chance you can blame pollen from grasses including Rye, Bermuda and Red Top, among many others. As summer fades to fall, weeds become the more primary villain, with Ragweed topping the list as public enemy number one. Pollen tends to take a rest in early winter, but come late winter and early spring, Ash, Alder Cypress and other trees begin spewing pollen like there’s no tomorrow — and allergy patients suffer mightily.

Unfortunately, indoor allergens never go away. Dust, pet dander, cockroaches and mold can cause allergy misery all year long. The allergy symptoms they trigger tend to stand out in the winter because people spend so much time indoors but even in mid-summer any one of them can be the cause of your discomfort.

Given that outdoor allergies are cyclical, you may be able to stuff yourself with medication until your worst season is over — but next year you’ll experience the same problem. Or, you can turn to immunotherapy, which teaches your body to ignore allergens so the disease goes into remission for years. Immunotherapy lets you enjoy many, many seasons without symptoms. To learn more, click here so you can stop worrying about allergies wherever you are, whatever the season.

Does Your Child Have Allergies?… Are You Sure?

Allergies can cause a wide variety of symptoms, many of which you might not expect.

Viruses, bacteria, allergens — there’s any number of small organisms that can make children feel bad. Often the hardest part of treatment is determining the true cause of your child’s illness. For instance, is the latest ear infections the result of a “bug” going around day care or is grass pollen triggering an allergy?

Compounding the situation, allergies manifest themselves in many different ways. Of course, everyone knows that allergies can cause sniffles, watery eyes and sneezing. But here’s a list of other common, though often undiagnosed allergy symptoms in kids:

• Asthma
• Frequent ear infections
• Sinus headaches
• Nasal polyps
• Conjunctivitis (eye irritation)
• Skin rashes and eczema
• Mental problems such as confusion, slow thinking, depression and forgetfulness
• Respiratory effects including endless colds, chronic cough, recurrent bronchitis
• ADHD (Attention Deficit / Hyperactive Disorder)

That’s right,  allergies can even trigger ADHD. So, what do you do? The first step is a full allergy evaluation by a qualified medical provider. An allergy test alone — even a skin test, the gold standard — is not enough; it can show that your child is sensitive to an allergen but not determine if that is causing symptoms. Your provider should conduct a full health history. The results, in conjunction with your answers to when and where your child exhibits symptoms, can help determine if his or her maladies are allergies or something else.

One key to remember is that if your child’s ailments come and go regularly, or if they stay around constantly, there’s a good chance allergies are to blame. If they’re “one and done,” it may be just the cold going around. When in doubt, ask your provider for a full allergy evaluation. To find an AllerVision-affiliated doctor who is qualified to do this, click here.

Do You Have Allergies? Here’s a Quick Test

Allergies cause a wide range of maladies. Have you had an allergy test?

This time of year, allergies can cause all kinds of problems. More than 25% of Americans suffer from allergies to environmental factors from pollen to dust to mold to pet dander. Allergies are to blame for all kinds of symptoms including headaches, sinus infections, rashes, chronic cough, wheezing, eye problems and MANY more.

So how do you know if you have allergies? Discovery starts with this simple score sheet. For each item below, answer 0 for no symptoms to 5 for severe symptoms. If you score a 2 or higher on any question, we recommend you visit your healthcare provider and ask about an allergy evaluation, including a quick, painless skin test. (If your doctor doesn’t offer the skin test, click here. If you’re a doctor and want to offer the test for your patients, click here.) The test will tell you within just 15 minutes if you have allergies, and will reveal the triggers that cause your symptoms.

Nasal Discharge or sneezing         0 1 2 3 4 5

Watery or itchy eyes         0 1 2 3 4 5

Frequent sinus or ear infection         0 1 2 3 4 5

Frequent colds or sore throats         0 1 2 3 4 5

Wheezing or asthma         0 1 2 3 4 5

Cough         0 1 2 3 4 5

Poor memory or concentration         0 1 2 3 4 5

Hyperactivity         0 1 2 3 4 5

Itching, hives, eczema or skin irritations         0 1 2 3 4 5

Abdominal gas or cramping         0 1 2 3 4 5

Arthritis or muscle aching         0 1 2 3 4 5

Headache         0 1 2 3 4 5

The good news is that if you have allergies, there is an excellent treatment option — immunotherapy — because it doesn’t just cover up symptoms, it teaches your body to ignore the allergy triggers so the symptoms stop occurring. And immunotherapy in the form of allergy drops is appropriate for allergy sufferers of all ages, from children to seniors. So contact your provider or allervision.com today.

Top 7 Reasons Nearly Every Doctor Should Test for Allergies

The allergy skin test is painless, quick and accurate.

Family practitioners, internists, pediatricians, dermatologists, ENTs, neurologists, pulmonologists, ophthalmologists and nearly all other types of physicians and health care providers come in contact with patients who suffer from allergies virtually every day. That’s because allergies cause symptoms in every organ system. In fact, they cause many more symptoms than the average person realizes, including rashes (dermatitis), sinus infections, migraine headaches, dizziness, conjunctivitis, respiratory problems, fatigue, muscle and joint pain, and the list goes on. So here are our top seven reasons your healthcare provider should offer allergy testing — and treatment — in his or her office.

1) Since nearly every type of doctor comes in contact with patients suffering from allergies, it’s important that they are trained and have the tools to properly diagnose those patients’ allergies, suggest appropriate treatment, and know when to refer to an allergy specialist.

2) Allergies affect A LOT of people. The World Allergy Organization estimates that “30-40% of the world’s population is now affected by one or more allergic conditions.” And those numbers are growing; allergies have reached epidemic status.

3) There aren’t enough allergists to go around. Allergists make up a very small percentage of doctors. Even if there were enough, people often don’t know that their illness/ailment/discomfort is caused by allergies. Their primary care doctors should be able to make that diagnosis and offer first line definitive treatment as they do with most other chronic conditions (like hypertension and diabetes).

4) It’s impossible to be sure exactly what’s causing the allergic symptoms without a proper test. Pollens ride on the wind and cause discomfort for people up to hundreds of miles away from their source. Pet hair gets stuck in furniture and carpeting, causing allergic reactions even if the animal has been away for months. Dust mites float through the air and hide in bedsheets. Cockroaches leave hidden “presents” that trigger allergies. Which of these items cause your symptoms? The only way to find out is to test. AllerVision provides doctors with a program that allows them to test for reactions to a wide range of regional allergens and a variety of foods.

5) The allergy skin test is painless, easy to administer in the doctor’s office, and produces results in just 15 minutes. This convenient test, which is the diagnostic gold standard, helps doctors quickly determine the problem and the select the right course of treatment immediately.

6) Allergies can lead to asthma attacks. Asthma is a serious chronic airway disease that causes coughing, wheezing, and difficulty breathing. It often interferes with quality of life, preventing sufferers from participating in sports and outdoor activities. Severe asthma attacks in a patient without adequate disease control can be fatal.

7) Allergies can cause anaphylaxis, an extreme, life-threatening reaction. Anaphylaxis is usually associated with insect stings and food allergies but other allergens can cause it as well. Simply put, knowing what you’re allergic to can save your life.

Healthcare providers who don’t offer allergy testing should consider taking the time to learn and add the service to their practice. For more information, click here.

If you think that you may suffer from allergies, get an allergy test and evaluation. (Hint: if you’re feeling bad and don’t know why, it could be allergies.) AllerVision can help you find a local doctor who performs the test, or we can contact your provider to help him or her launch an allergy testing and treatment program. Click here to learn more.

Groundhog Day is Excellent Time to Start Allergy Immunotherapy

Whether Groundhog Day reveals that spring is here or not, there’s not a moment to lose in preparing to fight spring allergies.

By the time you read this, Punxsutawney Phil will be out of the hole and we’ll know what’s in store for the next six weeks. Whether he saw his shadow and scampered back to take cover for more Winter or stayed above ground to enjoy the start of Spring, there is no time like NOW to start sublingual immunotherapy! If spring starts in six weeks, you have time to build up your immunity to pollens that get in the way of enjoying beautiful spring days. If it starts today, you’ll still feel better before the season hits full stride. How and why Phil makes his prediction is one of the mysteries of the universe but how and why immunotherapy treats allergies so effectively is no mystery at all…

If you have allergies, your immune system misinterprets something that’s normal in the environment as an enemy. As a result of this misunderstanding, it builds up a defense network to respond every time it sees that element (also called an antigen or allergen). That internal process is called sensitization, and the most common culprits are pollens from grasses, trees and weeds; pet dander; molds; and insect/inhalants like cockroach and dust mites. The next time your body sees that antigen, let’s use olive tree pollen as an example, it calls in the defense force for protection. All of the mucous, swelling and tearing you experience is your immune system doing a superb job of building a wall to keep the olive pollen out of your body. Scientifically speaking, your body is releasing histamine. Unfortunately, it’s not only unnecessary, since olive pollen isn’t actually an enemy, it’s extremely unpleasant! Fortunately there are solutions.

One solution is to use medications — typically antihistamines — that block your body’s misguided immune response. They create a constant battle within your body, wherein the allergen stimulates a response and tries to release histamine and the drug basically performs a block and tackle on your natural response. The result is that you usually feel better than the allergy but you often experience side effects. There are several other drugs that help with the symptoms but, in general, there is always at least a little downside to taking medication.

Luckily, there’s an alternative. We can teach the immune system that allergens aren’t enemies – this is the purpose of immunotherapy. It’s accomplished by gently and carefully introducing small amounts of the antigens to which your body is sensitized. Your immune system gets re-familiarized with these little particles. Little by little, we build up the levels of the antigen until your immune system is so used to it that it tolerates the normal amounts of environmental exposure. It takes a few months to get to that highest concentration – AllerVision calls it the maintenance level – which is why Punxsutawney Phil’s prediction is important to you.

Once you reach the maintenance dose, your tolerance will be greatly improved and your symptoms will hopefully disappear. Studies tell us that the body needs about four years of the constant exposure provided by immunotherapy for the so-called-enemy to be consistently ignored.

Immunotherapy can be delivered in shots – usually administered weekly in the doctor’s office – or sublingual (under the tongue) drops – at home on a daily basis. Many AllerVision providers offer both options, though most prefer the drops because they have very little risk for severe allergic reaction and they are so much more convenient for patients.

Whether Phil says yay or nay to an early Spring, get to your provider as soon as possible for an allergy test so he/she can find your allergic triggers and order an immunotherapy set designed specifically for you. There is plenty of stuff out there that your immune system SHOULD fight; take away the distraction of battling the normal environment and your system can focus all of its resources on keeping you healthy! (Click here to find a doctor who offers allergy testing and immunotherapy if your doctor does not.)

Happy Groundhog Day!

Acute vs. Chronic Urticaria: What You Need to Know

Urticaria can be both painful and unsightly.

Urticaria can be a debilitating condition. Patients suffer with a sometimes diffuse rash along with pruritus that can drive a person crazy. Dermatology offices are often the first referral destination for urticarial patients, but the complex issues surrounding these patients extend beneath the skin. The latest research brings insight to the underlying cause of urticarial lesions.

Getting to the bottom of acute urticaria usually involves basic medical detective work. A good history will usually lead you to the diagnosis. The most common culprits are foods (especially in children), medications and even infections. The patient usually identifies the source with a recounting of occurrences over the several hours or even days prior to the onset of the hives.

Among medications, common triggers include antibiotics like Penicillins, Cephalosporins and Sulfa-based drugs as well as over-the-counter NSAIDS or antipyretics like Advil, Alleve and aspirin. With that in mind, I check carefully in the patient’s history for meds first. Patients sometimes don’t realize that a simple antibiotic or OTC medication can cause a reaction so it’s important to ask specific questions. An infection can trigger an urticarial outbreak in highly allergic patients since they have an excess of histamine and infection facilitates the release of that histamine from skin mast cells. The treatment for acute urticaria is often simple: antihistamines for a week and avoidance of the allergic trigger.

Chronic urticaria is another story. These patients have hives that never seem to go away no matter which combination of antihistamines you throw at them. For many years, doctors tended to blame stress and psychological problems for the condition but the latest research points to an autoimmune disorder as the culprit. The mechanism of disease appears to be based in the production of autoantibody to the patient’s own IgE molecules. Just this year, the FDA approved the use of Xolair — the monoclonal antibody injection that was previously approved only for allergic asthma — for chronic urticaria. The new indication for Xolair is an exciting breakthrough for chronic urticaria as long-time sufferers may be symptom-free with just a few injections… and the results last for months!

In summary, urticaria has been a vexing condition that requires some patience on the part of both the sufferer and the physician. With good diagnostic evaluation along with advances in treatment options, the future may be looking much brighter.

Dr. Dean Mitchell

The Important Difference Between Clinical Allergy and Allergy Sensitization

A doctor’s review of patients’ medical history is as important as skin test results in diagnosing clinical allergies.

I’m sure you have patients come into your office and say: “I was once tested by an allergist and told I was allergic to everything green!” I’m  always dismayed when I hear that patients were given results in this manner. Almost no one is allergic to “everything green.” Patients may be sensitized to multiple allergens but most likely they’re not allergic to them all. Making the distinction between clinical allergy and allergy sensitization requires the doctor to study each patient’s health history in conjunction with allergy test results.

Let’s demonstrate with a food allergy example… A patient visited my office and told me that he attended a party and ate a piece of cake. Within 15 minutes, he developed hives (urticarial) all over his body. He wasn’t sure what was in the cake but was worried about what he should avoid in the future. I tested him and the results showed a positive for tree nuts — walnuts, cashews and pistachios. The skin tests also showed positive for milk and eggs, but he told me that he eats eggs and drinks milk all the time without a problem. We found out that the cake contained walnuts, so I diagnosed him with walnut and tree nut allergy. I explained that his positive allergy tests to egg and milk demonstrated that he has allergic sensitization to the raw pure proteins in those foods, but, with no clinical complaints, he can still continue to eat them.

Here is another example of a potentially confusing situation that you may encounter using the AllerVision skin testing panels: you test a patient and find she is allergic to several tree pollens, grass pollens and ragweed pollen. The patient’s history says she only has symptoms in the spring — from March until June. She has no symptoms in the fall. My assessment would be that she has clinical allergy to the spring pollens, trees and grasses, and allergic sensitization to ragweed. This distinction becomes important not just in educating the patient, but in determining the patient’s course of immunotherapy. In this case, you might decide to treat the patient for the trees and grasses but leave the weeds out of the equation.

The allergy world is buzzing with research on diagnostic techniques to delineate clinical allergies more clearly. One company is working on a blood test that involves Resolve Component Testing. That measures a protein called Ara h2 — highly specific for peanut allergy. Preliminary studies indicate 95% accuracy. In the meantime, don’t forget the importance of clinical history in conducting the “detective work” required to distinguish clinical allergy from allergy sensitization. And remember that, as always, the AllerVision clinical team is available to work with you and discuss your cases any time you have questions.

Dr. Dean Mitchell

The Late Summer Breezes Send Ragweed Pollen Flying

Ragweed spreads widespread misery in late Summer.

We’re approaching summer’s finish line and we all want to soak up as much sun and fun as possible before the weather turns chilly. Unfortunately, in addition to marking the end of summer, August hails the beginning of the ragweed pollen season. Ragweed allergy, classically known as Hay Fever, is recognized by allergy suffers far and wide as the “summer cold” that lasts through Labor Day — and sometimes beyond.

I have vivid memories of my father suffering from Hay Fever. I was 10 years old and hopeful that my dad would play catch with me when he got home from work. But one look at his red nose and watery eyes and I knew I’d have to wait for another day… or another season. My father would head straight to his bedroom where he would turn on the air-conditioner and close the door. When my dad stayed outside for an extended period, he had to “pop” Spantial, an ornate combination of sedating antihistamine and decongestant. That helped the symptoms but he struggled to stay awake with the old-fashioned antihistamine, and fought agitation from the decongestant. We’ve come a long way since my childhood in the 70s.

Today, state-of the-art symptom control treatment is available to provide relief for ragweed allergy sufferers but a well-planned approach to treatment is necessary. That means starting a program several weeks before ragweed season peaks. For appropriate candidates, I recommend Nasalcrom spray twice daily starting in early August. This allows time to build up the necessary protection. Nasalcrom is composed of cromolyn sodium, a mast cell inhibitor, and it is extremely safe with virtually no side effects. However, early prophylactic use is the key to success since it takes several weeks to reach effective levels. This is in contrast to steroid nasal sprays which work immediately but, if used for long periods, can have adverse effects.

The new exciting breakthrough in treating Hay Fever is sublingual immunotherapy. The FDA has recently approved Ragwitek, the  pharmaceutical-grade sublingual tablet to treat ragweed allergy. The medical studies have shown the efficacy of this product and validated the benefit of sublingual immunotherapy. My concern is that this product is only available as a high dose tablet without the build-up recommended for desensitizing patients to allergens. 50% of patients had adverse reactions to Ragwitek — such as sublingual irritation from the tablet, itchy throat, sneezing and nasal congestion. Also, Ragwitek is approved only for adults 18 years and older. Since the tablet treats only ragweed allergy, it’s usefulness does not extend to patients with allergy to other weeds or to allergens in the other antigen categories.

Based on my clinical experience, I believe that a better option is the use of sublingual immunotherapy drops, also known as allergy drops. These liquid drops are made from the same allergen extracts used for injections. They can be used to treat multiple allergens at the same time, so they are not limited to ragweed, they are easy to use at home, and they actually taste good. The AllerVision program promotes the safe buildup of allergen doses to achieve tolerance to the allergen for safe, successful treatment. The AllerVision program uses FDA-approved allergens in an off-label method, which is a common practice in medicine.

I’m sure many of your patients have their final summer vacation days planned. Make sure that your ragweed sensitive patients are protected so they can create summer memories that DON’T revolve around allergic disease!

Dr. Dean Mitchell