With early spring, so come allergies

Stephanie Dickrell
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Akeelah Welsh, 12, St. Joseph, gets her allergy shot from Lindsey Paggen, licensed practical nurse, Thursday, March 10, at the CentraCare Health Plaza.

Warm March temperatures mean allergy season has started already for many of the 50 million allergy sufferers in the U.S.

Tree pollen, which kicks off allergy season, is at a moderate concentration already, according to the American Academy of Allergy, Asthma and Immunology.

"That's the price we pay for a pretty nice winter this year," says Sarah Groen, a clinical pharmacist with HealthPartners.

Warmer temperatures late in the year have extended the allergy season into November and December, after a hard frost kills outdoor mold.

And so, the itchy, watery eyes, runny nose and sneezing commences.

How do I get it? 

Allergies are very heredity. If neither parent is allergic, the chance of developing allergies is about 15 percent. With one parent with allergies, the risk increases to 30 percent. If both of your parents have allergies, your risk is more than 60 percent.

Children inherit the tendency to have allergies, not the specific allergies themselves.

Scientists know there are environmental factors that affect the development of allergies as well. You need the tendency to develop allergies and exposure to allergens to develop symptoms. And the more intense and repetitive the exposure, the earlier in life, the more likely allergies will develop.

It also is possible to outgrow allergies and to develop allergies at any time in your life. They come and go.

For instance, with allergy shots, some patients never have problems again, while some develop problems later.

"It's probably just the way our immune system is affected by allergens. We're all a little bit different," says Dr. Mary Keating, a CentraCare Health physician who has training in pediatrics and allergy treatment.

Is it a cold or allergies?

What happens when? 

It happens in cycles as various plants release pollen, Keating said. Trees are usually first in the spring, followed by grass in late spring and early summer. Outdoor mold starts in late winter and early spring as the snow melts. Weeds are heavy August through September, and outdoor mold is pretty bad September through November.

What can you do? 

"Most people understand allergies are not something they can take a pill and poof, everything gets better," Keating says. "They're usually very willing to do things in the environment."

Many prefer making environmental changes instead of taking medications. But even if you change your environment, you may still need to use medication.

Modifying your environment is one good way to reduce allergy symptoms.

When outdoor allergens are high, close windows and run the air conditioner instead of opening the windows.

Take a shower at night before bed to wash allergens from your skin or hair.

If you know what you're allergic to, keep an eye on allergy reports. They can warn you when allergens are likely to be high, so you can start to take your medication ahead of time.

Nasal irrigation is another way to go. Brands like the Neti Pot  can moisturize your tissue and flush out any fluid that's built up. There are virtually no side effects, Groen said.

Gavin Welsh, 10, St. Joseph, gets his allergy shot from Lindsey Paggen, licensed practical nurse, Thursday, March 10, at the CentraCare Health Plaza.

Most times if people have discomfort, they made the solution too strong and should reduce the salt concentration. Some brands have pre-made packets that are easy to use.

What about medications? 

There are many more options available over the counter, with brands like Allegra, Zyrtec and Claritin and their generic versions available without a prescription. In the past few years, nasal steroids like the brands Flonase, Rhinocort and Nasacort have become available over the counter.

Nasal steroids slowly decrease the inflammation that occurs in the nose.

In general, Keating doesn't recommend decongestant nasal sprays, like the brand Aprin. You can get rebound stuffiness if you use them for a long period of time, she said. It's OK for a day or two, but she recommends the nasal steroids.

First generation antihistamines like Benedryl and Chlor-Trimeton are still available but tend to cause more side effects such as drowsiness, dry mouth and eyes, and constipation.

The new antihistamines are also safe for people with high blood pressure, while the older ones may not be. If you have those conditions, check with your doctor or pharmacist.

Decongestants also have risks for people with high blood pressure, heart disease and glaucoma.

The downside? 

Nasal sprays can take three to seven days to be effective. They can also cause nasal irritation and bloody nose.

If you have glaucoma, check with your ophthalmologist, as nasal steroids can affect eye pressure.

Other options? 

For some, allergy shots may be a good idea. Over a long period of time, they change the way your immune system reacts to allergens, reducing symptoms.

The idea is the same as living with a pet you're mildly allergic to. Your symptoms will probably decrease over time as your immune system adjusts.

"It changes our immune system, so our body does not recognize the allergen as a foreign substance," Keating said.

Because doctors are injecting a substance you're allergic to, they have to do so very slowly.

Shots usually continue for four or five years. In the beginning, doctors start with a shot once or twice a week, until they get to a maintenance dose. Then shots happen once a month.

"It's a commitment. But it generally helps people quite significantly," Keating said.

It's sometimes difficult to do with a child. Needles aren't too popular, and the frequency may be difficult with a child's school and activity schedule.

Kids typically start shots around age 5.

How do you know? 

Dr. Mary Keating listens to the lungs of Akeelah Welsh, 12, St. Joseph,  before she get her allergy shot Thursday, March 10,  at the CentraCare Health Plaza.

Your symptoms are a good clue. For some, watching what time of year your symptoms are the worst can narrow down what you're allergic to.

There are also skin tests. To get allergy shots, you'll have to know exactly what causes your symptoms.

It's a fairly easy procedure, Keating says. She'll prick the skin and introduce the allergen onto the skin. If you're allergic, your skin will get red and itchy.

It takes about 16 minutes, and children usually tolerate it nicely, she said.

"It's nice to know what you're allergic to so you can start ahead of time and avoid if you can," she said.

Common misconceptions? 

Some people don't realize the antihistamines don't cover nasal stuffiness. That's where the nasal steroid comes in.

Also, give the nasal spray at least two weeks before you decide it doesn't work. It takes a while to get to full strength.

What about asthma? 

Allergies can trigger asthma but not everybody with allergy symptoms has respiratory symptoms. For instance, in the fall most emergency room visits for asthma are triggered by allergies. It's also fairly common that outdoor mold can be bad for asthma patients.

And kids? 

Children who have allergies can develop asthma. So the sooner a child's allergies can be controlled, the better they do. By treating them or getting allergy shots, that could keep them from developing asthma.


For more information ...

For pollen count updates in Minnesota, visit the American Academy of Allergy, Asthma and Immunology website

For details on risk factors and treatments, visit the U.S. Library of Medicine's MedlinePlus

Fore much more information, visit WebMD

By the numbers ...

  • Roughly 7.8 percent of people 18 and over in the U.S. have hay fever.
  • Worldwide, the rise in prevalence of allergic diseases has continued in the industrialized world for more than 50 years.
  • Worldwide, sensitization rates to one or more common allergens among school children are currently approaching 40 percent-50 percent.
  • In 2012, 10.6 percent or 7.8 million children reported respiratory allergies in the past 12 months.
  • Worldwide, sensitization to foreign proteins in the environment is present in up to 40 percent of the population.
  • Worldwide, hay fever affects between 10 percent and 30 percent of the population.

Source: American Academy of Allergy, Asthma and Immunology, Centers for Disease Control and Prevention.

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