By Dr. Philip Pasternak
An estimated 35 million Americans suffer from seasonal allergic rhinitis, more commonly known as hay fever. The biggest spring allergy trigger is pollen. These are tiny grains released into the air by trees, grasses and weeds for the purpose of fertilizing other plants. When pollen grains get into the nose and eyes of someone who is allergic, they send the immune system into overdrive. The immune system, mistakenly seeing the pollen as foreign invaders, releases antibodies which bind to the allergens and leads to the release of inflammatory molecules including histamine and leukotrienes. These chemicals trigger the runny nose, sneezing, itchy watery eyes, and scratchy throat, which typify hay fever. Allergy suffers will often feel stuffed up, congested and headachy. They can be moody and irritable.
Allergic rhinitis related to pollen occurs most commonly in the spring and late summer, the times of year when allergenic plants produce most of their pollen. There is a very predictable pattern to the pollen release: in the first few week of spring, trees like elm, maple and birch release their pollen, followed by the ash, sycamore and oak; later in the spring and early summer, grass pollens spread into the air, often starting in early May and lasting through mid-July. Various weeds can begin to pollinate in spring (such as sage) or summer (such as plantain). However, the dominant weeds (for example, ragweed) often produce their allergens in the late summer to fall, a process that may continue until the first frost.
Pollen can travel for miles, spreading a path of misery for allergy sufferers along the way. The higher the pollen count, the greater the misery. As a general rule, sunny, windy days correlate with higher pollen counts as compared to damp, rainy days where the pollen counts drop because the allergens are washed away.
In addition to seasonal allergic rhinitis, many individuals may also suffer from perennial allergic rhinitis, which are indoor allergies. These include allergies to dust mites, cat and dog dander. Molds are both indoor and outdoor allergens. Mold spores tend to rise in damp, humid weather and they are prominent in the fall with decaying leaves.
The treatment of allergies involves a three-pronged approach. Prevention measures should be instituted. This is easier for indoor allergies such as dusting and vacuuming frequently for dust mite control as well as eliminating carpets and pets from the bedroom.
Pollen and outdoor mold spores cannot be avoided. Limit your time outdoors when pollen counts are high. Exercise where and when pollens are least likely to affect you. Don’t exercise in parks where pollen-bearing trees and grass are prevalent. The best days for exercise are those that are overcast and free of winds. Keep the windows in your home shut to prevent pollen and mold spores from drifting in. If you have been outdoors, shower and wash your hair before going to sleep. Pollen gets trapped in your hair and on your skin when you are outdoors.
Medications play an important role in the control of allergy symptoms. These include antihistamines, decongestants, nasal sprays and allergy eye drops. Even though you can buy many of these allergy drugs without a prescription, it’s a good idea to talk to your doctor first to make sure these medications are right and safe for you.
If medications are not sufficient to restore health, the allergic symptoms may be controlled or eliminated with immunotherapy, better known as allergy shots. Allergy shots have been used since 1911. This time-tested therapy decreases a person’s sensitivity by introducing increasingly larger doses of the substances to which that person is allergic. The treatment is a method for increasing the allergic person’s natural resistance to the things that are triggering the allergic
reactions.
There are several exciting therapies in the pipeline, but you don’t have to wait for the future. Get tested. Get treated. Get better.
Dr. Philip Pasternak, M.D., is a board certified allergist and assistant professor at the Department of Allergy and Immunology at Robert Wood Johnson University Hospital, New Brunswick. Dr. Pasternak has private practices in East Brunswick and Lakewood. He can be reached at 732-254-4000.