I have developed severe allergies to ragweed and some trees in my home state of Maryland. I also suffered from some problems when I lived in Green Valley, Arizona. I've actually begun to have asthmatic symptoms because of the severity of my body's reaction. Are there any areas (or particular states) in America that have fewer allergens, at least for me?

— Brenda, Maryland

Unfortunately, the immune system is incredibly adaptive, and once a person has environmental allergies, they will usually find something to be allergic to no matter where they live. Sometimes, when a person with pollen allergy moves from one part of the country to an area with very different trees and plants, they will have fewer symptoms for a year or two, and then their problems will be just as severe as before. A possible explanation for this short respite is that it takes the body a while to produce enough of the allergic antibody molecules (IgE) to the plants in the new environment. Many allergy sufferers moved to the West in the past, thinking that there would be less pollen in a desert setting. However, plants are everywhere, and other things (especially mold) are problematic in the West.

My advice would be to consider allergen immunotherapy (allergy shots) to try to change your body's sensitivity to pollens. It is very hard to avoid pollen, and being outdoors is a basic pleasure in life. In order to receive this treatment, you should seek out a board-certified allergist and undergo skin testing to identify all of the allergens you are sensitive to. Then, you could get injections for three to five years. This treatment essentially vaccinates you against the allergens in question. It is time consuming, but effective. It also allows people to reduce the amount of medication they need to control symptoms, and most insurance policies cover the therapy. Also, if the allergist is careful to include a representative species from each of the major pollen groups in your immunotherapy solutions, then you can be vaccinated to a wide range of trees and weeds, hopefully giving you the freedom to live anywhere comfortably.

Immunotherapy is not usually given to people with moderate to severe asthma because such individuals are at higher risk for whole body reactions during the process. However, if your asthma is relatively mild, immunotherapy can be safely given, and the symptoms should get better as a result.