Allergies

Allergies

Easing the Sneezing

Mother Nature really painted a masterpiece today. Crisp blue skies, fragrant blooming flowers, a gentle spring breeze--perfect for a stroll through your favorite patch of woods.

For all of ten minutes, that is. Then the pollen police take over, stuffing up your nose, making you sneeze uncontrollably and turning your leisurely walk into a mad sprint for a box of tissues. You quickly go from spry spring chicken to grumpy old hen, ready to crawl back indoors, close up the windows and hibernate with a packet of sinus tablets.

Seasonal allergies like this affect an estimated 45 to 50 million Americans, or one in every five, according to the National Institutes of Health. But pollen isn't your only allergy enemy. Dozens and dozens of things can trigger reactions, from dust mites, mold and pet dander to shrimp and peanuts. Even a pair of latex gloves can cause trouble.

And allergies aren't always something to just sneeze at, either. In cases of asthma and severe allergic reactions, they can prove deadly.

"Fortunately, there's a lot you can do to improve things," says Harold S. Nelson, M.D., senior staff physician at the National Jewish Center for Immunology and Respiratory Medicine in Denver and a member of the National Asthma Education Expert Panel of the National Heart, Lung and Blood Institute. "Although they seem terrible when you have them, allergies really don't have to dominate your life."

A Case of Mistaken Identity

When it comes to fighting disease, your immune system is usually pretty sharp. It can quickly identify harmful foreign substances such as germs and viruses and whip them with lethal efficiency.

But sometimes your body gets a little confused. For reasons nobody quite understands, your immune system can mis-identify harmless substances such as mold, pollen and food by-products and attack them. Mast cells, part of your immune system, attach to these substances, which are known as allergens. The mast cells then release powerful chemicals called allergic mediators, including histamine, to combat the allergens.

The result, Dr. Nelson says, is a classic case of allergy symptoms: a stuffed-up nose, sneezing and watery eyes. In some cases, you can end up with a rash, hives, stomach cramps, nausea or vomiting, too. And 5 to 12 hours later, when other parts of the immune system join the battle, a second wave of similar symptoms can strike.

Heredity plays a big role in many allergies. You can inherit the ability to produce an antibody called immunoglobulin E, or IgE, says allergist David Tinkelman, M.D., clinical professor of pediatrics in the Department of Allergy and Immunology at the Medical College of Georgia in Augusta. If a person doesn't inherit IgE, he says, she is less likely to develop any allergies.

Food allergies are rarer than you may think. Only 0.1 to 5 percent of the population suffers from them, Dr. Nelson says--and most people outgrow them by age three. Still, some adults are highly allergic to nuts, seafood, milk, eggs or other foods. And in some cases, the reactions worsen over time.

Women rarely develop new allergies after age 30, Dr. Nelson says, unless you are exposed to some new allergen such as a pet or a pollen. The good news is that allergies tend to subside at about age 55, says Edward O'Connell, M.D., professor of pediatrics, allergy and immunology at Mayo Medical School in Rochester, Minnesota. That's because your immune system begins to decline, making it less likely to attack an invading mold spore or another allergen.

More Than a Little Trouble

Allergies are usually just an annoyance. Over-the-counter or prescription medication may ease the symptoms when taken properly, Dr. Nelson says. But some allergies can be much more serious.

In the case of bee stings and other unfortunate insect encounters, about 1 percent of the population can develop a dangerous allergic reaction called anaphylaxis, according to Susan Rudd Wynn, M.D., an allergist with Fort Worth Allergy and Asthma Associates in Texas.

Shortly after a bee sting, you may notice symptoms such as itchy palms, tightness in your chest, hoarseness or even a feeling of impending doom. "If so, get yourself to an emergency room fast," Dr. Wynn says. "Anaphylaxis is not something to mess around with." In fact, she says, as many as 50 people a year die of the reaction--many because their throats swell shut and they suffocate. In rare cases, food allergies can cause anaphylaxis as well, Dr. Wynn says.

There's no test to predict anaphylaxis. But doctors can give adrenaline self-injection kits to people known to have severe allergic reactions. "That can buy you some valuable time, so you can get to the hospital for further treatment," Dr. Wynn says.

There's also some evidence that women with allergies may be at higher risk of developing certain cancers, including breast cancer. A six-year study of more than 34,000 Seventh-Day Adventists in California showed that women with three or more allergies may be 1.25 times more likely to develop breast cancer. The good news is that the study found a slight decrease in ovarian cancer risk for women with allergies.

Researchers don't understand the possible link between allergies and cancer. In fact, Dr. Nelson says other studies have shown that the chances of developing some types of cancer actually seem to decrease in people with allergies. "That whole area is really up for grabs," he says.

Sniffle Stoppers

The best advice for beating allergies? Avoid whatever makes you sneeze or break out. An allergist can perform simple blood or skin tests to pinpoint your allergies. "Once you know what causes your problems, you can try to stay away from it," Dr. Wynn says. Here are some tips on keeping your allergies at bay.

Know your medicines. Two types of over-the-counter medication attack allergy symptoms. Antihistamines relieve sneezing, itching and a runny nose. And decongestants help unclog a stuffed-up nose. Some medicines combine both; read the label to find out what you need.

"The big drawback of antihistamines is that they can make you drowsy," says Edward Philpot, M.D., assistant clinical professor of medicine in the Department of Rheumatology, Allergy and Immunology at the University of California, Davis, School of Medicine. "If all you have is a stuffy nose, just take a decongestant." Or if you need an antihistamine, try one of the newer prescription antihistamines such as terfenadine (Seldane), which don't make you drowsy. If you're unhappy with the effectiveness of one antihistamine, try different brands until you find one that works.

Strike first. If you know the pollen count is high, or if you're going to visit Aunt Jane and her hairy cat, take your medication before symptoms arrive. "It's much more effective that way," Dr. Philpot says. "It gives the antihistamine a jump on your allergies." Make sure you take the medicine at least 30 minutes to an hour before you're exposed to allergens.

Avoid alcohol. Alcohol can worsen symptoms such as congestion, Dr. Wynn says, and mixing alcohol with antihistamines can cause serious health problems. Read the label on allergy medication before drinking anything.

Be doggone careful. Dander from dogs and cats is a major household allergen. If you're allergic to dander, the simplest way to ease the problem is to send Fido or Fifi packing. But that's hard to do emotionally--and it may be unnecessary. Dr. Nelson says taking these steps might correct the problem and still let Rover stay over:

* Keep pets out of your bedroom.

* Confine them to parts of the house that don't have carpeting.

* Bathe pets weekly to wash the dander away.

Wipe out dust. The biggest enemy in your house is also the smallest. The dust mite is a microscopic organism--but under magnification, it looks like the Beast That Ate Coney Island. Breathing these little buggers can cause all sorts of allergy symptoms. To help reduce the problem, the experts suggest these steps:

* Cover your pillow cases and mattress in plastic covers. Wash sheets, mattress pads and blankets every week in water that is at least 130°F.

* Clean house regularly. Vacuum at least once a week, and keep clutter to a minimum--it collects dust.

* Choose hardwood or vinyl floors over carpet whenever possible. A study at the University of Virginia at Charlottesville found that carpeting attracts and keeps allergens at 100 times the rate of bare polished floors. Use washable area rugs instead, especially in the bathroom.

Starve your food allergy. The only way you're going to avoid a food allergy is to avoid the food that's causing it. If you're not exactly sure which food causes problems, Dr. Nelson says a doctor can perform tests to check your sensitivity. You can also keep a food diary, noting what you eat each day and keeping track of when you have an allergic reaction. That should help you narrow down the source of the allergy.

Lay off the latex. A study of more than 1,000 U.S. Army dentists found that between 9 and 14 percent of people may be allergic to the latex found in gloves. Other studies found similar allergies to rubber products ranging from boots to condoms.

The bottom line? If one brand gives you a rash, try another. Since manufacturers use different additives in their products, Dr. Nelson says it may help to sample brands until you find one that doesn't bother you.

Sleep in. Pollen counts usually peak in the early morning, between 5:00 a.m. and 8:00 a.m. If you can stay inside until mid-morning, Dr. Philpot says you'll be better off. And no matter how nice it feels outside, don't sleep with the windows open on high-pollen days. "You'll guarantee yourself a miserable wake-up call," he says.

Halt the humidity. Keep your house or apartment dry to cut back on allergens. That means running the air conditioner, which dries the air as it cools it, or using a dehumidifier. A humidifier or vaporizer is a bad idea. "Dust mites just love the extra moisture from a humidifier," Dr. Wynn says. "And so does mold. If you have allergies, just forget the humidifier altogether."

Uproot your problem. The American Lung Association says the following plants can cause big-time allergies: oak and walnut trees, juniper, cypress, privet shrubs and all types of Bermuda grass. If you're looking for sneezeless replacements for your yard, try these: mulberry, fir, pear and silk trees; hibiscus, yucca and pyracantha shrubs; and dichondra, Irish moss and bunchgrass lawns.

You can obtain a complete list by writing to the American Lung Association of California, 424 Pendleton Way, Oakland, CA 94621. Enclose a self-addressed, stamped envelope.

Give it a shot. If your allergies resist every trick, you may need allergy shots, Dr. Philpot says. Doctors can inject you with small quantities of what you're allergic to, helping your body build immunity to the allergen. This is usually a last resort, since you may need from six months to a year of weekly shots plus another shot each month for up to five years.

"It takes a commitment," Dr. Philpot says. "But it's the only thing that helps some allergy sufferers." Dr. Philpot recommends that you steer clear of corticosteroid injections, which he says can suppress your immune system and linger in your body. "They're like using a bazooka to rid your house of termites," he says. "You'll get rid of the termites, but you'll damage the house pretty badly, too."