Spring Allergies

Does the approach of spring make you flinch in self-defense? True, the days grow longer and warmer, the breezes blow gently, and more birds gather around the feeder. But what about those blooming trees and grasses? If your eyes tear and redden, if your nose drips or grows stuffy, if you sneeze and feel drowsy in the daytime yet lie awake gasping at night, you may have seasonal allergic rhinitis, often called “hay fever.” Caused by dust, mold, pollen and other airborne culprits, it is the most prevalent type of allergy, though hay fever is just one of many reactions to foods and environmental factors that plague people who have sensitive systems.

An allergic reaction happens when a person’s immune system aggressively fights irritants that might cause no problem at all for other people. Three-quarters of Americans have no allergies whatsoever. Pity the rest of us: One allergy can prime the pump of sensitivity, causing reactions to other environmental aggravations. About 40 percent of asthma is caused by allergies, according to Dr. Pamela Georgeson, an allergist at the Kenwood Allergy and Asthma Center in metropolitan Detroit.

Potential irritants include foods, dust and mold, medications, latex, animal dander, insect stings and bites and the debris—all right, let’s just say it, the fecal matter—from dust mites and cockroaches. Many foods can set off an immune response in the right person, but most food allergies are from one of eight causes: cow's milk, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish (shrimp, crab and lobster cause most of the shellfish trouble).

Allergens—the provocateurs that cause allergies—are perceived by the immune system as dangerous. The symptoms and the attendant misery, from swelling or itching, from congestion or stomach pain, are the body’s noble but misguided effort to fend off the “danger” by sending out a flood of chemicals, including histamine, which creates the swelling. Your own constitution, along with the severity and length of your exposure, decides if you’ll react and how intense the experience will be.

Symptoms

Three of the body’s systems—the skin, the digestive system, and the respiratory system—take the brunt of the punishment. They are the battleground, in effect, where the pain and suffering from allergies plays out.

Despite the notorious misery they cause, allergy symptoms are easily misread. Allergists say that new patients often come in complaining not of red, itchy eyes and postnasal drip but of feeling cranky and sluggish. People with undiagnosed allergies are likely to say they are sick of being sick and tired. If you have three or more sinus infections per year, there’s a 50 percent chance you’ve got allergies, possibly caused by dust mites, and yet most allergic people blame their symptoms on the flu or a cold.

Yet, for a few unlucky people there’s no mistaking the allergic response. People with severe allergies to the slightest trace of peanuts, for example, or to bee stings or shellfish must be on alert constantly. Exposure to the allergen can provoke anaphylaxis, a total-body response including hives, swelling, plummeting blood pressure and sometimes loss of consciousness, shock and even death. In such cases, get emergency treatment, with injectable epinephrine or antihistamines immediately.

The difficulty of pinning an allergy down is compounded by a several things:

• allergies can change;
• allergies can be masked by other irritants and once your body is in a state of allergic inflammation, other non-allergen pollutants, like perfume, chemicals or smoke, can further aggravate the symptoms;
• and, although allergic tendencies are inherited, no two people—even twins—are allergic in exactly the same way. Why? Because the expression of an allergy needs both the genetic predisposition and an environment of repeated exposures.

Treatment allergists are doctors who specialize in allergies. Their arsenal includes three main tools: avoidance, medication and immunotherapy (shots)—in that order, says Allergist Georgeson.

The first line of defense for sensitive people is to stay away from any and all allergens, she says. Rhinitis, or hay fever, responds best to a prescription topical nasal steroid. (Unlike over-the-counter decongestant sprays that create dependency when used more than three days in a row, these sprays aren’t addictive.)

Allergy immunotherapy really works, but it’s a huge commitment requiring weekly shots for the first six months, then shots every two or three weeks for about four years. Half the people who start the treatment drop out, estimates Dr. Stephen J. McGeady, a pediatric allergist at Thomas Jefferson University in Philadelphia. The results are worth it: Many people completely recover; another large percentage is symptom-free for five to 15 years; and a smaller group may relapse within a couple of years and need more treatment.

Stick to your guns if you want immunotherapy to work. As McGeady warns, “When I start somebody on the shots, I really want them to understand that this is no picnic. I want them to be in it for the long haul.”

Additional Links

The Food Allergy and Anaphylaxis Network’s site has information on common food allergies and tips for managing them.

One of the best Web resources on allergies is the American Academy of Allergy, Asthma and Immunology’s area for consumers, with brochures, tips, a medication guide and the ability to search by condition.

The AAAAI’s National Allergy Bureau has updated pollen counts and will e-mail pollen alerts.