Expert advice about allergies from Dr. Randy Young, chairman of the Division of Pulmonary and Critical Care Medicine at Einstein Medical Center Philadelphia
Expert advice from Dr. Randy Young, chairman of the Division of Pulmonary and Critical Care Medicine at Einstein Medical Center Philadelphia
Determining what you are allergic to is the first step.
“A lot of people think that they have seasonal allergies but they are actually allergic to things like dust mites, mold and cockroaches that have nothing to do with trees or pollen,” Young says.
Food and drugs also cause allergies. Research from the Asthma and Allergy Foundation of America shows that they are the cause of approximately 6 percent of allergy sufferers. Of all food allergies, 90 percent are caused by milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish. The most common drug allergy is to penicillin.
“If you are taking medication for seasonal allergies and not getting relief, talk to a doctor about getting tested to find the real culprit,” Young advises.
What are treatment options for seasonal allergies?
“The best thing one can do is avoid whatever one is allergic to,” Young advises. “Go online or watch the TV news to get the pollen count for the day. If it is very high, limit your time outdoors. Close the windows and put on the air conditioning. If you do go outside, change your clothes when you come inside.
“As for medications, start with an over-the-counter, non-drowsy antihistamine,” he says. “If that doesn’t provide relief, advance to a steroid nasal spray. If that doesn’t help, talk to a doctor about allergy shots.”
Immunotherapy drops are another option, Young says. Once ill regarded, the drops — which are placed under the tongue in a series of treatments — are gaining respect for their efficacy.
What’s the difference between asthma and allergies?
“Allergic disease, by definition, is an abnormal bodily reaction to an outside stimulant,” explains Young. “It can happen in any part of the body: skin, nose, eyes. There is a strong link between allergies in the upper airways and reactions in the eyes and on the skin. Allergies in the lower airways often manifest as asthma. Not all asthmas are allergies, but many are.”
Asthma medication not working? You might not have asthma.
“Some conditions masquerade as asthma,” Young says. “For example, acid reflux can cause a condition that looks similar to asthma. We’re still not completely sure what the link is, but it seems that acid receptors in the esophagus trigger allergic-type reactions. Drops of acid get into the back of the throat, then get breathed into airways and create inflammation that mimics asthma.”
Another example: malfunctioning voice boxes or vocal cords.
“Those conditions create problems in the upper airway, simulating asthma,” Young explains. “If you have been diagnosed with asthma but are not finding relief from medication, ask an asthma specialist to consider other causes for the problem so that you can get the right treatments.”
What is the hygiene hypothesis? Is there truth to it?
According to the Centers for Disease Control, the number of people diagnosed with asthma increased by 4.3 million from 2001 to 2009. Why is asthma such a fast-growing health problem? One explanation is the hygiene hypothesis.
“It is still a hypothesis and not yet proven, although there is a lot of research in that direction,” Young explains. “The theory is that our environments are now so hygienic — so absent of bacteria and germs — that our immune systems wreak havoc on our bodies because they have nothing else to do. That creates an autoimmune response, which is what happens when the body acts against itself, as with asthma.
“Another hypothesis is that as we are using so many antibiotics in the treatment of viral illnesses that we are altering the level of bacteria that we need in our bodies and that is changing our immune systems’ ability to respond to things like asthma,” Young says. “What we need to figure out is how to undo the damage that we’ve done to our immune systems.”