Say Goodbye to Hay Fever, Hello to Winter Allergies

Although allergies to pets, mold and dust last all year, they may be more pronounced in the winter when people spend more time indoors.

Depending on where you live, hay fever season might be coming to a close in a few weeks. That’s the good news, and it isn’t coming a moment too soon for the millions of people who suffer from weed pollen allergies. The bad news: with the approach of cold, wet weather, you’ll likely be spending more time indoors where a new set of allergens will step into the spotlight.

Mold, pet dander and dust mites can cause problems year round but when you’re cooped up with them, their effect becomes more pronounced. That head cold or “sinusitis” that just seems to hang around all winter … maybe it’s not a cold after all — it could be an allergic reactions to one of these common triggers. And those recurring ear infections your child gets — they, too, could be caused by allergies.

On the positive side, there are simple ways to fight at least two of these allergens. You can combat mold by keeping your kitchen and bathrooms dry. Be especially diligent about drying showers, where mold likes to grow in corners, and tile countertops where grout can soak up moisture.

Similarly, you can keep dust at bay by cleaning regularly and washing your bedsheets and pillow cases in HOT water weekly. Specialized covers over your mattress and pillows can help control dust mite migration. Dust mites also live in carpets, so vacuum constantly. In addition, dust clings to drapes, stuffed animals and other soft fabrics so make sure you wash them frequently in hot water if you plan to keep them around.

Pet dander can be harder to control if you have a pet, or visit homes with pets. Vacuuming helps if you do it often, but pet hair also sticks onto furniture, clothing and more. And if you let your pet lick you, you’re getting a full dose of allergen right to the face. But who wants to turn away their lovable friend when it’s showing affection? If you can’t keep up the rigid cleaning regiment, and/or don’t want to snub your pet, your best bet might be immunotherapy (allergy drops or shots).

Immunotherapy teaches your body to ignore allergens so allergy symptoms don’t develop in the first place. And both allergy shots, and allergy drops can help you overcome multiple allergies at once — for instance, pet dander, tree pollen and ragweed pollen — so you can resolve all of your allergy triggers with one form of treatment and enjoy the entire year allergy-free. To learn more about immunotherapy, click here.

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Which Allergy Treatment is Best for You?

There are a lot of options for treating your allergies but only immunotherapy can keep your symptoms from returning.

Fall is hay fever season so there is a good chance you are experiencing some allergy symptoms. After all, over a quarter of Americans suffer from significant allergies. And for many, the symptoms begin in adulthood. So the question is, what should you do about them? To a large degree, that depends on their severity and your tolerance for discomfort.

Officially, the first course of action is avoidance, which means keeping away from your allergy triggers. In theory that makes sense but it’s often undesirable and all but impossible. For instance, say you’re allergic to the family pet. Are you going to get rid of it even though everyone in the family — including you — loves it? Now consider tree, weed and grass pollen. Even if you move far away from the source of the pollen that’s bothering you, a good stiff breeze will send it flying right to you — tree pollens travel hundreds of miles. 

When symptoms start, a majority of people turn to the next courses of action: over-the-counter medications and natural remedies, including nasal irrigation products. Sometimes these measures work very well at relieving symptoms short term. The key here is “short term.” What these products do is overcome your current reaction to allergens. That’s great if you get occasional and/or mild symptoms. There are two “howevers,” though.

The first is the side effect “price tag.” Medications often cause side effects, like drowsiness, that can significant reduce your productivity. And they may not work right away, if at all; doctors now recommend you start taking medications weeks before your symptoms normally start for maximum effectiveness. Even if you do that, the only potential benefit is symptom relief. So you are supposed to take meds in anticipation of symptoms you don’t have yet just to get temporary relief from this year’s onslaught.

The second “however” is even bigger. Let’s say, best case scenario, the medication or natural remedy overcomes your symptoms today. Excellent. But tomorrow when you encounter your allergy trigger — be it pollen, pet dander, mold, etc. — the symptoms start up all over again. You’ll be taking the medication, or using the remedy, for the rest of your life. That’s a lifelong commitment to meds.

There is another option: immunotherapy. This natural treatment exposes your immune system to small amounts of the pollen — or other allergens that your body thinks are enemies — until your immune system learns to accept those allergens as normal. When the body stops trying to fight them off, your allergy symptoms decline and often disappear. In other words, immunotherapy actually makes you better. Every day on immunotherapy is a step towards an allergy-free life.

Immunotherapy doesn’t work overnight. It typically takes a few weeks to two months for treatment to start working. For best long term results, you should continue treatment for three to five years. There are three types of immunotherapy: allergy drops, allergy shots and tablets.

Allergy drops have been popular throughout the world for over 60 years. In the comfort of your home, you simply place a few drops of serum (which is composed of the allergens that trigger your symptoms) under your tongue every day. The drops are convenient, easy, safe, nearly side-effect-free and suitable for allergy sufferers of all ages. The best drops formulations are ones that are designed specifically for you. You start with a low dose and ramp up to a higher dose when your body is ready.

Allergy Shots have been used successfully in the U.S. for decades. Healthcare providers administer the shots to you in their offices on a regular basis, often weekly or bi-weekly. Health insurance policies usually cover many of the out-of-pocket costs associated with allergy shots. Both shots and drops can be formulated to address multiple allergies at once. So, for instance, if you’re allergic to cat dander and tree pollen, you can be treated for both at the same time. Like drops, shots start at a low dose and ramp up.

Tablets are a new form of immunotherapy. Each one is made to combat a single allergen. Unfortunately, most people are allergic to more than one thing. But the companies that makes these tablets have targeted the most severe allergens, like ragweed and grass pollen. Tablets start at full dose, so you get a large amount of allergen under your tongue from day one, ready or not.

So which sounds right for you? If you’re symptoms are mild and very sporadic, and over the counter medications do a good job of hiding them for you without too many side effects, you may choose to go that route. But if they’re more severe, you’re tired of the recurring battle with symptoms, you have side effects with the drugs, or you just don’t want to take medication for the rest of your life, immunotherapy might be your best bet. Either way, you should ask your doctor for an allergy evaluation. You should always be armed with information and a definite diagnosis of allergies before taking even the stuff you can buy over the counter.  Once you have answers about the cause, you and your doctor can discuss the right treatment.

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Allergies Took His Breath Away, Drops Gave it Back

Allergy drops have made a huge, positive difference in the life of nine-year old Faris,  from Tulsa, OK.

Since shortly after he was born nine years ago, Faris from Tulsa, Oklahoma has been allergic to tree pollen. So allergic, he often found it difficult to breathe. And with Tulsa’s temperate climate, his allergy symptoms — which trigger asthma attacks, as well — typically persist year round. But one year ago, he started taking allergy drops and, in the words of his ecstatic mother, Michelle, “the drops literally changed his life! He can breathe now!”

Not only can he breathe, Faris recently returned from sleepover summer camp, in the woods, which he enjoyed without symptoms. In addition, he’s signed up to play soccer this fall for the first time, a feat which would have been impossible before. Previously, Faris used nasal sprays and took twice the ADULT dosage of Claritin daily. In addition, he also regularly used QNasal, Singulair, Qvar and an emergency inhaler. He has now stopped Claritin entirely and no longer requires daily nasal spray, though he does maintain his asthma medication as a precaution.

Faris heard about the drops on a visit to his doctor’s office, KIDS Pediatric & Adolescent Care, an AllerVision-affiliated provider in Tulsa. Sammi Byrne, a nurse there, told Faris and Michelle about the drops and Faris was eager to try. “He could not be a happier customer,” said Michelle, beaming.

“We are ecstatic with Faris’ response to the allergy drops,”Sammi expressed. “It is a unique opportunity for our office to be able to provide testing in a familiar environment and offer a less invasive form of treatment to our patients,” 

Now that he is happily and carefully taking allergy drops, both Michelle and Faris are excited about all the normal activities he can finally take part in, starting with breathing.

Allergy Perils Await Your Child This Fall – What to Watch Out For and What to Do

Back-to-school season can expose your child to a wide variety of allergens.

It’s almost September — time for school, football, cross-country, marching band and soccer. There are lots of allergy traps for your child out there. Read on to find out what to look for — and what to do about it.

At school, three immediate threats come to mind. Number one is dust. Most classrooms sit empty over the summer, giving dust plenty of time to settle on tables, books, window frames, etc. Dust mites find a way of hiding inside of window coverings and light fixtures and lurking deep in hidden corners. When teachers return to those rooms to prepare for a new crop of students, dust may be among the last things they consider — if they have time to think about it at all. Once activity returns to the classroom, that dust gets stirred up and fills the air, wreaking havoc for allergy sufferers.

The second potential problem is food allergies. Depending on the severity of your child’s allergies, simply sitting next to someone eating a peanut butter sandwich could be cause for serious alarm. And peanuts aren’t the only risky allergen out there; for some food-allergic kids, a trip to the cafeteria could be like walking through a mine field. While it may be simple to avoid a specific allergen that appears on a plate in its whole form, that same trigger could be an unsuspected ingredient in another dish. Or a trace amount in the kitchen from a previous day’s meal could wind up in the food by accident. The safest course to avoid problems for allergic children is to pack their lunch at home with known ingredients.

And last but certainly not least, there’s good old pollen. It can affect your child at school both on and off the sports field. Grass and weeds are the serious troublemakers in late summer and fall. Football players, runners, marching band members, and soccer players will spend a lot of time rolling around on — and kicking up — grass and weeds. Their parents, you, will likely find yourself at parks and fields for hours where mown grass will take to the air with the slightest breeze. Even the kids who plays sports themselves are surrounded by the allergens floating in the air and drifting off their classmates’ clothing. Aside from the sniffling and wheezing that affects athletic and musical performance, allergy symptoms have a significant effect on attention and concentration in school, and, consequently, on grades. Unfortunately, while antihistamine use may curb the symptoms, side effects from the meds also tend to negatively impact performance.

So what to do about it all? The first step is to take showers and/or change clothes after spending a lot of time outdoors. For the here and now, it may be necessary to take allergy medications to get a handle on immediate symptoms. But equally important, prepare for the next phase of allergen invasion (for instance, winter mold and spring trees) and get way ahead of the curve for next fall by teaching your children’s bodies to stop overreacting to environmental allergens. Immunotherapy is the only fix, and it is all natural with no medication. It trains your child’s body to ignore the allergens that trigger their symptoms so the allergies go into remission for many, many back-to-school seasons.

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Anaphylaxis, The True Allergic Emergency – What You Need to Know

Anaphylaxis, which comes from the Greek term “reverse protection,” is the most

There are many possible signs of anaphylaxis…

dangerous type of allergic reaction. It is described as a type 1 Hypersensitivity reaction that involves release of IgE triggered, most often, by a food, medication or insect sting. Anaphylaxis is a frightening reaction where a patient, who moments before appeared fine and healthy, almost within seconds can be wheezing, hypotensive, and covered with hives.

The foods most commonly associated with anaphylaxis in children are peanuts and tree nuts; in their adult counterparts it’s usually shellfish. The confusing part for patients and clinicians is that a food allergy can develop after eating a particular food on many occasions. However, once that threshold has been crossed, even a minute amount of that food can cause an explosive reaction. If a food is the suspected cause of anaphylaxis, but the specific food unclear, it’s wise to evaluate the patient through several steps.

Initially, I would recommend a panel of food allergy blood tests. ImmunoCap is a common one used by most labs to evaluate IgE reactions to specific foods. The results range from zero to six, with a score of at least two indicating a positive reaction. If there is a positive reaction to peanut, the allergy should be further explored by ordering a UKnow Peanut test which analyzes the proteins Ara h1,2&3, as well as Ara h8. My article in Consultant for Pediatricians, “Pinpointing the Proteins in Peanut Allergy,” explains why these proteins are important to predict the severity of peanut allergy. If, for some reason, the blood test is negative, I would recommend referral to an allergist for skin testing and/or oral challenge in case there is a hidden allergen that requires more extensive testing.

Any medication can cause an anaphylactic reaction however the common culprits are antibiotics and non-steroidal anti-inflammatory drugs. Many antibiotics are mold-based, which may be part of the reason for their allergenicity. In the past, beta-lactam antibiotics such as penicillin and related cephalosporins were the most likely offenders but today we also see anaphylaxis to the widely used category of quinolone antibiotics. To complicate matters, it is not unusual for a patient to have multiple antibiotic sensitivities; there is a genetic component to this reaction. While Pre Pen can be used to diagnose penicillin allergy (talk to your AllerVision representative for more information), there is no such test for most antibiotics, and a drug challenge may be required for conclusive diagnosis.

Non-steroidal medications, such as Advil, Motrin and Alleve, work by blocking the cyclo-oxygenase pathway and trigger release of leukotrienes which are potent mediators of anaphylaxis. In my experience, patients allergic to NSAIDS are usually unaware of the source of reaction until they suffer several episodes of anaphylaxis. Be on high alert for NSAID hypersensitivity when evaluating a patient for anaphylaxis or urticaria. Unfortunately, a drug challenge is the only conclusive test NSAID hypersensitivity.

The clinical diagnosis of anaphylaxis can be complicated. The World Allergy Organization recently came out with new criteria. Essentially, it includes exposure to a possible or known allergen and the finding of two or more clinical signs: urticarial, bronchospasm, gastrointestinal distress and cardiovascular collapse. In case of cardiovascular collapse, no additional signs are needed — call 911 and immediately transport the patient to the hospital.

While anaphylaxis is fairly rare with allergy injections, and exceedingly rare with allergy skin testing, it is important that you and your staff be prepared just in case. When a patient is in your office, the question of whether or not to treat a potential reaction is simplified, and doesn’t include an extensive review of the clinical findings nor consideration about number of signs. If you place an allergenic substance on the patient’s skin, or inject them with a substance you know they are allergic to, and they have a reaction anywhere other than the local site of exposure, TREAT THEM! Common signs to look out for are itching of hands and feet, or clearing of throat that wasn’t happening when the patient came in to the office. If you apply antigen to one area of the body, and the patient has symptoms somewhere else, you have to assume that the reaction has gone systemic and you should treat accordingly.

The initial treatment of anaphylaxis is unambiguous: epinephrine intramuscularly into the lateral thigh. Don’t play around with Benedryl! Don’t give a cortisone shot! Anaphylaxis progresses immediately, and neither antihistamine nor steroid drugs act on the spot to reverse the severe pathophysiological reaction. Deaths resulting from anaphylaxis happen when epinephrine is not administered in under 3o minutes from the onset of symptoms. If you are giving allergy injections in your office, you MUST have the patient wait 20 minutes in the office to make sure they don’t have an immediate allergic reaction. If they develop ANY sign or symptom within that time, administer epinephrine. The EpiPen is convenient for an office because it contains the 0.3 ml of epinephrine with the needle size for an intramuscular injection. It also comes as the EpiPen Jr. for children or infants less than 66 lbs. Once epinephrine has been given, the patient must be monitored for several hours to make sure there isn’t a biphasic reaction; this usually takes place in a hospital.

Anaphylaxis can be the most frightening of clinical reactions. The good news is with quick recognition and prompt treatment with epinephrine, you can be a real hero!

– Dr. Dean Mitchell