Sniffling, sneezing might be fall allergies
With its colorful leaves, football games and cooler temperatures, fall is a favorite time of year for many people — unless they suffer from allergies. The severity of symptoms varies widely among people, but the sneezes, wheezes, sniffles, headaches and fatigue nearly incapacitate some sufferers.
The fall allergy season actually begins in August, but it is in full force now. From the volume of traffic we are seeing in our practice, this is an especially bad year for fall allergies.
The primary culprit is ragweed. The release of its airborne pollen into the noses of certain people triggers an abnormal immune response expressed in allergic reactions. Ragweed grows just about everywhere around here — in fields, vacant lots and on roadsides.
More than 50 million Americans suffer from allergies, the sixth leading cause of chronic disease in the United States. Ragweed allergies affect 10 to 20 percent of the U.S. population, according to the Asthma and Allergy Foundation of America. The threat persists until cold weather kills the weed.
Other culprits this time of year are mold spores and dust mites that can easily become airborne, just like plant pollen. We begin to see fall allergy symptoms just prior to the start of school, and students who contract viruses at school often feel worse than usual if they also have allergies.
Allergies can trigger or worsen asthma attacks. People with asthma are at higher risk for allergies, and vice versa. According to the American Academy of Allergy, Asthma and Immunology, about half of the 20 million Americans with asthma also have allergic asthma — the type triggered by an allergen.
Our first step in treatment is to determine the source of the allergy. This often can be accomplished through a physical examination and careful review of the symptoms and when they appear. Many allergies often are easy to identify because the outbreaks follow specific patterns of exposure.
Otherwise, we might try a skin test that exposes the patient to a tiny sample of the allergen to see if there is a reaction. In rare cases, when a skin test is not appropriate, a blood test can reveal the source of a reaction by measuring the antibodies to a specific allergen.
Because allergies cannot be cured, the most effective treatment is to avoid exposure to the offending allergen, but this is not always practical. Still, we advise patients with fall allergies to stay indoors on days or hours (usually between 10 a.m. and 3 p.m.) when the pollen count is at its peak. The American Academy of Allergy, Asthma and Immunology web ite, aaaai.org, and several other websites keep track of pollen counts in our area.
After they have been outdoors, we advise patients to shower, change clothes and rinse their nasal passages with a salt-water solution (several saline rinse kits are available commercially). We also recommend that patients regularly change their furnace filters. (Students with food allergies should be watchful of school cafeteria choices).
Otherwise, the focus of our treatment is symptom management. Corticosteroids, usually administered through a nasal spray, decrease inflammation that causes several symptoms. Antihistamines block the release of the substance histamine, created by the immune response, producing the allergic reactions. Decongestants break up mucus and relieve nasal congestion.
Steroids are available by prescription, while antihistamines and decongestants can be purchased over the counter. It’s always a good idea to consult your physician before trying any medication. All have side effects and some may be more effective than others or contraindicated due to conditions such as high blood pressure. And don’t forget to follow the dosing instructions, especially for nasal sprays. When used for more than three consecutive days, they can actually worsen symptoms.
In some cases, we may recommend allergy shots that build tolerance by exposing patients to gradually increasing doses of an allergen.
Scott Reineck, DO, is a family medicine physician at Delaware Primary Care and an active member of the Grady Memorial Hospital medical staff.