1. A BETTER PILL
If you’re among the many who need an antihistamine to survive tree pollen season, it’s time to branch out. The diphenhydramine and chlorpheniramine pills that mom used to give you do help fight the drippy, weepy symptoms, but who needs the daily drowsies? One Canadian allergist describes seeing patients feeling sleepy up to four days after stopping these pills.

To the rescue: there are second-generation antihistamines on pharmacy shelves that are far less sedating. These include the brands Allegra, Clarinex, Claritin, Zyrtec, plus generic versions. In Canada, the brands include Aerius, Claritin, Reactine and Allegra.

Here’s a hot tip: try finding more than one brand that works for you. New York City allergist Dr. Paul Ehrlich, author of Asthma Allergies Children: A Parent’s Guide, recommends switching between drugs if, after several weeks, you find your body stops responding as well to one of the pills.

2. CLEANSE YOUR GARDEN
Your worst hay fever foe could be planted right outside your window, warns horticulturalist and author Tom Ogren. Take stock of your plants: if one has fruit or berries, it’s not male and won’t release pollen (female plants don’t produce pollen). If you can’t identify a plant on your own, take a clipping to a nursery for help identifying its gender.

“If you’ve got a highly allergenic plant, particularly if it’s in proximity to your doors, you should replace it with the exact opposite,” Ogren says. “You will have just made a wonderful change in your yard.”

Some examples of allergy-friendly flowering plants are: peonies, hydrangea, roses, foxglove, fuchsia and poppies. Click to see more allergy-friendly plants.

3. TAKE THE STING OUT
Have you got a stinging insect allergy? Then it’s high time you reclaimed spring and summer. Any reaction to the sting of a honeybee, yellow jacket, hornet or other insect that turned into more than itching and swelling at the sting spot suggests you’re at risk for a serious reaction.

“Almost all the time, patients who had a slight reaction the first time then had a more severe reaction the second, and they’re going to have a real problem if they get stung a third time,” Ehrlich says. “Each sting is worse than the previous one.”

That is, unless, you get allergy shots. The American Academy of Allergy, Asthma & Immunology recommends that those who have had a systemic reaction to an insect sting, and who test positive to that venom, get immunotherapy. Doing so reduces the risk of a full-body reaction phenomenally – to less than 5 per cent. Dr. Paul Keith, a Canadian allergist, says an immunized person should be able to receive up to 50 stings at once before the body is overpowered by toxins.

Next: The Robot That Mows

On April 3, Dr. Mehmet Oz hosted a segment on his TV show called “How to Survive the Allergy Epidemic”. In keeping with many news reports released this spring, Dr. Oz declared: “This year, you’re going to feel even more miserable than ever before.”

New York allergist and Allergic Living contributor Dr. Clifford Bassett was invited to help explain to viewers why this may be. He said that climate change factors, such as warm seasons starting earlier and ending later, are to blame. He also noted that tree pollen and grass pollen seasons can overlap resulting in a “pollen bomb” that can cause misery for allergy sufferers.

Dr. Oz did an excellent job explaining how certain weather patterns can cause what allergy specialists and botanists now call ‘the priming effect’ – where pollen levels rise, fall and rise again in late winter and early spring. When it’s unseasonably warm, plants begin producing pollen early. When the temperature drops again, they stop, and then begin again once the warmer weather returns. In pollen-sensitive individuals, this can cause worsened allergy symptoms that are tougher to control because their immune system has been ‘primed’ for pollen allergens.

The topic of conversation then moved to treatment. Most medications for spring allergies work by blocking histamine receptors, so the histamine in one’s body has nowhere to bind to and cause symptoms. These treatments are effective for most people, but they treat the symptoms but not the underlying allergic disease. Upon each re-exposure, the symptoms will have to be blocked again.

This is why doctors often recommend immunotherapy, or allergy shots, in which a small amount of the allergen (i.e. pollen) is injected into a sensitized individual on multiple occasions over a long period of time. The goal is to allow the patient to build tolerance to the allergen and eventually no longer be sensitized to it.

The trouble with this traditional type of immunotherapy, which Dr. Bassett noted has been available for almost 100 years, is just that – the trouble: injections are required several times before each allergy season for several years, resulting in many, many hours in the allergist’s office.

Fortunately, Dr. Bassett informed Dr. Oz’s audience that sublingual immunotherapy (SLIT), which is a type of immunotherapy that uses under-the-tongue tablets or drops instead of needles, is gaining ground. It is far less invasive: once an allergist determines the proper dosage, a patient can actually conduct this immunotherapy by themselves, at home.

While not yet approved by the FDA, several clinical trials have demonstrated that this type of treatment can be effective, and it has been available in Europe for years. One brand, Oralair, was recently approved for prescription use in Canada.

See the full episode of The Dr. Oz Show here

See also:
Peanut Drops Hold Treatment Promise
Milk OIT Not Lasting
Dr. Oz on Nut Proteins in Olive Oils

Jackson, Mississippi has been declared the worst U.S. city to live in for those with spring allergies, according to the Asthma and Allergy Foundation of America (AAFA). Jackson wrested the number one spot from Knoxville, Tennessee, which had held the dubious title three years running. Knoxville didn’t improve that much: it came in second this year.

In AAFA’s annual Spring Allergy Capitals list (released April 2) – the 100 largest U.S. cities are ranked according to how problematic they are for spring allergy sufferers. Three factors are taken into account: pollen scores, number of allergy medications used per patient, and number of allergy specialists per patient.

This year, Jackson was declared the “winner” due to higher than average pollen counts and medicine usage, despite the fact that the state capital was determined to have a greater number of allergists per patient than average. Here is a list of the top 10 spring allergy capitals for 2013:

1. Jackson, MS
2. Knoxville, TN
3. Chattanooga, TN
4. McAllen, TX
5. Louisville, KY
6. Wichita, KS
7. Dayton, OH
8. Memphis, TN
9. Oklahoma City, OK
10. Baton Rouge, LA

While most of the top cities were located in the south, where pollen season has already begun in earnest, some northern cities were present as well, such as Buffalo, New York, which ranked 15^th overall. Another northern city, Springfield, Massachusetts, rose an astonishing 74 spots to number 18, indicating this year’s spring will be much more challenging in this city for allergy sufferers than previous years.

Some other finds: the city with the overall highest pollen count was Wichita, Kansas. Virginia Beach had the lowest number of allergists per patient, while winner Jackson had the most medicine used per patient.

This report coincides with numerous news reports that say this year’s allergy season will be “the worst yet,” and which cite the increase in pollen concentration because of climate change factors.

The “worst yet” claim is becoming an annual spring ritual in itself in news reporting. Those contending with hay fever should be aware that these claims tend to be based on anecdotal evidence of doctors seeing more allergy patients, and the fact that scientists have been accumulating data on longer pollinating seasons. They are not based on actual pollen counts.

As well, allergy triggers aren’t equally distributed across the country: high pollen counts in Mississippi don’t necessarily equate to a bad allergy season in Washington.

Still, it is possible that this year will be the “worst allergy season yet”– at least until next year.

See the AAFA’s full list

One of the tablets, known as Oralair, recently became available by prescription in Canada, but not the United States. This pill has proven effective in international studies, and is now approved by Health Canada.

Another tablet, known as Grazax in Europe, has been submitted to the FDA in the United States for final approval. Unfortunately, the tablet (which will have a different brand name in the U.S.) most likely won’t become available until next year’s grass season at the earliest.

When it comes to grass allergy, taking antihistamines does the job for some people. But allergists have traditionally steered those with more severe symptoms and asthma toward immunotherapy, also known as allergy shots. The tablets are a new form of this therapy – called sublingual immunotherapy, or SLIT, because the dose is taken under the tongue.

Although it’s recommended to begin taking these tablets four months before allergy season begins, they have been known to show significant improvement after being taken for as little as one month. This is far less invasive and time-consuming than traditional immunotherapy: instead of visiting an allergist several times to get your shots, you can simply place a tablet under your tongue and allow it to dissolve.

Sublingual immunotherapy is actually not so new.  For years now, researchers have been studying it, not just for grass allergy but potentially for food allergy as well. It works with the same principle as traditional allergy shots: introduce tiny amounts of the specific allergen into the patient’s system (in this case, via drops), with the goal of building toward tolerance.

See also:

Allergic Living’s Full Report on SLIT for Grass Allergy
Milk OIT Not Lasting

Allergy Foundation Releases Annual “Fall Allergy Capitals” Rankings, Louisville is #1

WASHINGTON, Sept. 27, 2012 – Fall is a time to enjoy beautiful colors and autumn weather outdoors. But for 40 million Americans with seasonal allergies, this time of year brings an unwelcome harvest: trillions of pollen particles traveling through the air right into your eyes, nose and mouth. Allergic rhinitis – also called nasal allergies, seasonal allergies or hay fever – is among the most common chronic diseases for children and adults, affecting more than 12 percent of the U.S. population.

The primary fall allergy trigger – ragweed pollen – causes itchy runny nose, nasal congestion, repeated sneezing, watery eyes, inflamed sinuses and, in severe cases, difficulty breathing. It can be more problematic if you also have asthma.

The Asthma and Allergy Foundation of America (AAFA) recently announced its 2012 Fall Allergy Capitals™ ranking, and Louisville, Kentucky, tops the list as “the most challenging place to live with fall allergies.” The annual report names 100 U.S. cities based on an analysis of three factors including pollen, allergy medications usage and the number of allergy specialists per patient. See the full list at www.AllergyCapitals.com.

 The Top 10 Fall Allergy Capitals

“Everyone seems to be feeling allergies these days and fall is the most common allergy season after spring,” says Dr. Beth Corn, a Board Certified Allergist in New York City and a member of the American College of Allergy, Asthma and Immunology (ACAAI). “No matter if it’s men, women or children, in the city, suburbs or the country, allergies don’t discriminate,” says Corn.

However, AAFA is quick to remind that no matter what city you live in allergies can be a problem all year long, indoors as well as outdoors. According to Brian Oliver, a spokesperson for AAFA, “With a little bit of planning and some good cleaning habits, you can keep your home as allergy-friendly as possible.” AAFA offers these tips no matter where you live:

1. Keep windows and doors closed to prevent pollen from blowing into the house.
2. Control dust mites on the bed. Look for a Certified asthma & allergy friendly mattress, like the Breathe mattress from Spring Air, and wash sheets weekly in hot water (130 degrees F) to kill mites and their eggs.
3. Use a quality vacuum that has a high-efficiency filter weekly to keep indoor allergens to a minimum.
4. Change the air filter in your furnace regularly. Filters can trap lots of dust and allergens, so replace them every 30-90 days. Look for Certified asthma & allergy friendly filters, like Lysol brand air filters.
5. Reduce the presence of mold by decreasing moisture around the house, keeping humidity below 50% and clearing the yard of damp firewood and leaves.

About AAFA

AAFA is the leading patient organization for people with asthma and allergies in the U.S. The asthma & allergy friendly™ Certification Program is a joint project of AAFA and Allergy Standards Limited (ASL), an international research and testing organization. Learn more at www.aafa.org/certified.

]]> http://allergicliving.com/index.php/2012/10/09/aafas-fall-allergy-capitals-louisville-is-no-1/feed/ 0 http://allergicliving.com/index.php/2012/05/02/all-stuffed-up-from-pollen-allergies/ http://allergicliving.com/index.php/2012/05/02/all-stuffed-up-from-pollen-allergies/#comments Wed, 02 May 2012 17:49:00 +0000 Lisa Ferlaino http://allergicliving.com/?p=13345 The pollen’s out and once again you’re congested and bleary-headed. Do you get a few allergy symptoms or the whole enchilada?

HEADACHE

Allergies cause fluid to build up in the sinuses, putting pressure on the nerves in the area. This can lead to a headache directly above the eyes. The pain is different for each person, and can come on suddenly or gradually.

SLEEPINESS

Fluid in the sinuses puts pressure on the brain, sometimes resulting in fatigue, says Dr. Paul Ehrlich, a pediatric allergist based in New York. Other  reasons for daytime fatigue? A lack of nighttime sleep, caused either by your congested nose which makes it difficult to breathe or a decongestant medication containing pseudoephedrine, which is a stimulant and can keep you awake. Some antihistamines have a sedative effect and can make you feel tired during the day. Finally, hay fever sufferers can become overtired from constantly fighting the body-wide reaction.

IRRITABILITY

Usually caused by that lack of sleep, irritability is an under-recognized but very real
symptom of hay fever, says Vancouver allergist Dr. Donald Stark. Another cause: times of high stress often coincide with the different allergy seasons – and the convergence of the two would make anyone grouchy. For example, students’ final exams in June are at the height of grass pollen season, and back to school in September coincides with the start of ragweed season.

Next page: Aggravated eyes, nose, ears and cheeks

Each tree species has a signature pollen that can be identified under a microscope. As a certified pollen counter who regularly collects pollen from stations in New Jersey and Philadelphia, Dvorin can identify about 30 different trees just from examining the pollen’s size, shape and surface “architecture” of distinctive pits and apertures.

In high pollen season, the number of tree-pollen grains in the air can reach up to 3,000 particles per cubic meter, according to some estimates – pretty scary, since experts say that people with tree-pollen allergies will become symptomatic when pollen counts are 200 particles per cubic meter.

Dr. Waserman: Daffodils are considered “allergy-friendly,” since plants with showy flowers are generally pollinated by insects rather than the wind. Daffodils produce less pollen, and symptoms such as allergic rhino-conjunctivitis and asthma aren’t commonly associated with them.

However – handling daffodils is another story. Among florists and flower pickers, allergic contact dermatitis, irritant contact dermatitis (from sap) and hives are quite common.

Your daughter may have had an allergic or irritant contact dermatitis reaction or urticaria (hives). I recommend that she not handle daffodils and related narcissus varieties.

While unusual with daffodils, the throat symptoms might be an acute reaction, or anxiety as you suggest. Your daughter needs to be assessed by an allergist. If her symptoms and testing indicate allergic rhinitis, the allergist likely will prescribe intranasal steroids to alleviate the allergy.

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Susan Waserman is an allergist and Professor of Medicine in the Division of Allergy and Clinical Immunology at McMaster University in Hamilton, Ont. She is also a past president of the Canadian Society of Allergy and Clinical Immunology.

DECORATING

1. Scented Candles
The thought of cinnamon or vanilla wafting through the house may appeal, but scented candles smell of big trouble for those with allergies or chemical sensitivities.

“People who have environmental allergies such as to pollen or pets develop very sensitive inflamed nasal tissue which is hyper-reactive,” explains Ottawa allergist Dr. Antony Ham Pong. “These tissues then react more strongly to scents, and act as if they are allergens and mimic an allergic reaction.”

Plus, consider whether soy-allergic guests will be visiting before you light up that soy wax candle. While most are made from hydrogenated oil, which won’t cause an inhalant reaction, your soy-allergic guest or her child may feel uncomfortable knowing that a soy product is wafting through the air.

Advice: Use unscented, beeswax candles or opt instead for trendy fairy light strings for table décor or wreaths.

2. Festive Spores
If you have environmental allergies, a pine or cedar dominating the living room can bring you to sneezes and tears (or worse). Allergists warn at this time of year about “Rudolph the Reindeer Syndrome,” literally a reaction to the Christmas tree.

“Allergic reactions can occur to any pollen from the pine cones, or to mold in the bark of the tree,” Dr. Ham Pong notes. He says the tree’s resin can also cause “either eczema from contact with the skin, or nasal symptoms due to the scent.”

Mold is the biggest issue – some studies suggest household mold counts can increase as much as 10 times with a cut tree in the home. But an artificial tree can also harbor mold if it was stored in a damp basement.

Advice: Reduce the allergen load of a fresh-cut tree with a good blow-out – either taking it home on the roof of your car or subjecting it to a leaf blower on your front lawn. This gets rid of pollen grains and some mold. If mold is an asthma trigger, the Asthma and Allergy Foundation of America additionally suggests wiping around the tree’s trunk with a solution of 1 part bleach to 20 parts of lukewarm water. Also, wear gloves when moving a tree or boughs to avoid contact with the sap.

Or: Opt instead for a nice faux tree. Just be sure to enclose it plastic post-season, and store it in a dry spot.

3. Up in Smoke
Watch out for a roaring wood fire when visiting. As Certified Asthma Educator Jo-Anne St. Vincent has explained in Allergic Living magazine, that can expose those with asthma or allergies to a variety of environmental triggers, including smoke and mold.

If visiting friends in a home with a trendy enclosed gas fireplace, that’s a safer bet. But even then don’t linger close by. Vincent says gas-burning fireplaces still emit nitrogen oxide, which can increase inflammation of the airways.

While manufactured fireplace logs used to be infamous for off-gassing toxic chemicals (since industrial waste was part of their composition), today these logs are much more environmentally friendly. There are still two problems though from an allergy/asthma perspective:

a) smoke, no matter how “green” still irritates sensitive airways.
b) Nut allergy concerns. Several brands make “crackling” fire logs, and they use walnut or other nut shells to achieve the sound while burning. It’s wise to avoid putting such proteins into the air around a nut-allergic individual.

Advice: Best of all is to ask close family to forego the fire in the living room, if that’s to be the main party room.

Next: Gift Giving, Food and Drink Tips

In most people, OAS is a relatively mild allergic response, and people who have it can eat the vegetables or fruits that cause inflammation and itchiness in their throat and mouths – as long as those foods are cooked.

The reason for this? OAS sufferers are only allergic to the “heat labile proteins” – the proteins in the fruit that get destroyed once exposed to heat.

This explains why the symptoms are confined to the mouth: “When you eat the fruit raw, it’s your own body’s heat that breaks down the protein, which is why the reaction doesn’t move beyond the mouth,” says Dr. Paul Keith, an associate professor of allergy and clinical immunology at McMaster University in Hamilton, Ontario.

So while a raw apple a day might keep the person with OAS away, she can eat a slice of apple pie without a problem. The same goes for vegetables. While celery or carrots and dip may make your lips puff up, a nice hearty vegetable soup will go down smoothly.

There are some tricks you can use to try to cheat nature – but they may not work for everyone. Dr. Bruce Mazer, director of the division of allergy and immunology at the Montreal Children’s Hospital and associate professor at McGill University in Montreal, suggests microwaving the fruit, like an apple, for a few seconds.

He also suggests sprinkling lemon juice on the raw fruit and letting it sit for a few minutes before eating. These tricks may help to break down those heat labile proteins while still allowing the fruit to be somewhat crisp. You can also simply try peeling the fruit first since most of the fruit’s proteins are in its peel. Of course, this would only help for fruits that have a peel and not for fruits like raspberries and strawberries.

Dr. Keith approaches management from a different angle. He suggests trying to better control the hay fever so that your body will no longer recognize the offending proteins, even in the related fruits and vegetables. This can be done by using saline nasal sprays to keep the nose clear, wearing glasses to protect the eyes, and keeping windows and doors closed to lessen exposure to pollens.