My allergies are killing me

Preventing Allergic Reactions and Controlling Allergies

An allergy management plan is key to preventing allergic reactions. It is also necessary to control your allergies. Work with your doctor to create your allergy management plan.

Controlling your allergies and preventing allergic reactions depends on your type of allergy. Here are some ways to manage your allergies:

  • Avoid your allergens. This is very important but not always easy. Some allergens are easier to avoid than others. When you can’t avoid an allergen, try to reduce your contact with it.
    Learn more about how to manage your specific allergies:
  • Take your medicines as prescribed. They can be helpful for managing your symptoms. Take them while also avoiding allergens.
  • If you are at risk for anaphylaxis, keep your epinephrine auto-injectors with you at all times. Epinephrine is the only treatment for a severe allergic reaction. It is only available through a prescription from your doctor. Each prescription comes with two auto-injectors in a set.
  • Keep a diary. Track what you do, what you eat, when symptoms occur and what seems to help. This may help you and your doctor find what causes or worsens your symptoms.
  • Wear a medical alert bracelet (or necklace). If you have ever had a severe allergic reaction, please wear a medical alert bracelet. This bracelet lets others know that you have a serious allergy. It can be critical if you have a reaction and you are unable to communicate.
  • Know what to do during an allergic reaction. Have a written anaphylaxis emergency action plan. It tells you and others what to do in case you have allergic symptoms or a severe allergic reaction. Always ask your doctor if you have any questions.
    It is crucial to recognize that you are having an allergic reaction and to respond quickly and properly. If the reaction is progressing and getting severe, call 911 (activate the Emergency Medical Services) immediately. Do not try to take yourself or a family member or friend to the hospital. You might have to stop and render aid on the way. It is always best to stay where you are and have an ambulance transport you.

Medical Review October 2015.

That was bad advice.

A few years ago, research began to suggest that there was no particular benefit to waiting to give those foods. Children seemed to develop food allergies whether their parents waited or not. And then a year ago, a really remarkable study showed that giving babies peanut products earlier in life made it less likely that they would develop a peanut allergy.

Basically, we had it backwards.

A new study just released in The New England Journal of Medicine confirms last year’s study. The study involved more than 1,000 exclusively breastfed 3-month-old babies who were divided up into two groups. The parents of one group were told to give the babies only breast milk for six months, as has traditionally been recommended by the American Academy of Pediatrics. The parents of the other group were told to give the babies six foods that often cause allergic reactions: peanut products, eggs, wheat, cow’s milk, sesame, and whitefish. Less than half of these parents were able to pull that off (little babies aren’t always excited about eating these foods), but among those that did — or at least tried — fewer children ended up with peanut or egg allergy when tested between ages 1 and 3 years.

The researchers didn’t find decreases in allergies to the other foods, but — this is important — they didn’t find increases, either. Giving those foods was safe.

Another study released with this one showed that if you stop giving peanut products to children who were given them as babies, the children don’t get allergic reactions when they start eating peanuts again. Truly, it does seem like those early foods can make a lifelong difference.

Now, there’s lots more we need to study and understand — like how much babies need to eat to prevent allergy (in this study, it was only about 2g per week of peanut or egg white, which is not very much), or for which foods this works. But given that food allergies affect approximately 15 million Americans, including one in 13 children, it is exciting news.

There are a couple of important safety caveats:

  • Parents should not give these foods to their babies if there are any known or suspected food allergies. It’s not always possible to know if your baby has an allergy, but if he or she has eczema or blood in the stool, or has had vomiting, rashes, or fussiness after eating anything, you should absolutely talk to your doctor before starting any solid foods. You should also get your doctor’s advice if either parent or a sibling has food allergies.
  • Don’t ever give babies or toddlers actual peanuts — or anything else they might choke on. The researchers in these studies used a snack meant for babies that is made with peanuts. You can put some smooth (not chunky!) peanut butter on your finger and give it to your baby, or mix it (or a sauce made with it) into other foods, or bake it into a soft bread. Eggs are easy to mix or bake into things, and small soft pieces of cooked eggs are fine for babies. There are lots of safe ways to introduce these foods without giving anything hard or in large pieces. Talk to your doctor if you’re not sure how to do it.

I feel bad about the bad advice all of us gave for years — if only we had known! But now we do know. It’s time to spread the word — and the peanut butter.

Allergies

Allergic diseases and symptoms occur because of an active immune system that reacts to things that are usually harmless, such as pollens, pet dander or foods. For that reason, it can be puzzling that people with immune deficiencies would have allergies. In fact, taken as a whole, people with immune deficiencies probably have a far greater disease burden of allergy than the general population, although perhaps not in the same patterns. It is generally true that people with immunodeficiencies do not have problems with allergies as often as those who are immunocompetent. However, specific changes to the immune system in some immune deficiency diseases may increase the risk of the developing allergies.

Definition of Primary Immunodeficiency Diseases and Allergies

Allergies manifest in a number of very specific ways, including nasal and eye symptoms, allergic asthma, eczema, hives and anaphylaxis. It is common for a person to have more than one allergic disease. The immune system in people with allergies reacts in a specific way to allergens. Allergens are those things that trigger allergic symptoms. Common allergens include materials and particles in the air and environment such as dust mites, molds, pet dander, tree pollen, grasses and weeds, foods, drugs and stinging insect venoms.

Generally, an allergic reaction occurs when a person develops “allergic” antibodies, called IgE, which are specific for an allergen. The IgE antibodies bind tightly to allergic cells, called mast cells or basophils, in the skin, airways, gastrointestinal tract and around blood vessels. The allergic cells get activated when the bound IgE recognizes an allergen, and these cells then release histamine, a chemical that can cause hives, runny nose, sneezing and itching. Depending upon where in the body the reaction between the IgE and the allergen happens, different symptoms can occur.

Hay Fever

Hay fever, or allergic rhinitis, causes itchy, stuffy, and runny noses and sneezing when the affected person breathes in certain allergens. Watery, red and itchy eyes (allergic conjunctivitis) can also occur. The timing and severity of symptoms depends upon exposure to the allergens to which the person reacts; for example, symptoms are prominent in the spring for patients with tree pollen allergy but occur in the fall for patients with ragweed allergy. When the stuffiness gets very bad, it can lead to rhinosinusitis where fluid and pressure accumulates in the sinuses, leading to discomfort and risk of infection. This is particularly a problem in people with immune deficiencies, as it can be difficult to determine whether sinus problems are due to infection, allergy or, as is often the case, a combination of the two.

Managing hay fever can include:

  • Avoidance of allergens when possible, such as dust mites, mold or pet dander.
  • Oral ‘non-sedating’ antihistamines, such as Zyrtec (cetirazine), Allergra (fexafenidine) or Claritin (loratidine); Benadryl (diphenhydramine) or Atarax (hydroxyzine) are anti-histamines that are sometimes used, but these usually cause drowsiness, so should be used with caution.
  • Nasal steroids for more severe symptoms, particularly with nasal congestion.
  • Allergy shots (immunotherapy).
Allergic Asthma

Allergic asthma is a chronic allergic condition of the lungs. In people with allergic asthma, breathing difficulties such as wheezing, chest tightness and coughing can be triggered after inhaling something to which they are allergic, like tree pollen or mold. Changes in temperature, smoke, strong smells and other non-allergens can trigger symptoms as well. Asthma is usually diagnosed based on symptoms and by using pulmonary function tests where a computer measures airway function. Asthma is a chronic disorder that requires ongoing management. Treatment of asthma includes therapy, such as albuterol, to dilate constricted airways for immediate relief of symptoms. For many patients, depending on the severity and frequency of symptoms, daily inhaled steroids and other medications are also used to prevent symptoms and control the disease.

Of special relevance to people with known or suspected immune deficiencies, asthma attacks, especially those, which occur when the affected person has a fever, can often be confused with pneumonia. It is important to differentiate between an asthma attack and pneumonia as the treatment for the two problems is very different.

Food Allergies

Food allergies result from the development of specific immune responses to foods. Symptoms of food allergy usually occur within minutes to a few hours of eating a food to which a person is allergic. Symptoms of food allergy can include hives (which look like mosquito bites), flushing and itching of the skin, vomiting, diarrhea or abdominal cramping. In severe cases, difficulty breathing, a feeling of throat closure. Significant decrease in blood pressure and unconsciousness can occur. Food allergies are treated by carefully avoiding the offending foods. In cases of an anaphylactic reaction, an injection of epinephrine is used.

Food Intolerances

Food intolerances do not involve the immune system, and they are not usually life threatening. An example of food intolerance is lactose intolerance in which the lack of an enzyme to break down milk sugars results in abdominal cramping and diarrhea, when dairy products are consumed. Celiac disease, in which affected people experience gastrointestinal symptoms after eating gluten-containing products, like wheat, is an immune disease directed at wheat and not a “true” food allergy.

Eczema

Eczema, or atopic dermatitis, is chronic skin inflammation that is sometimes made worse by exposure to foods or environmental allergens, particularly in children. The main problem with eczema is usually a breakdown of the skin barrier and activation of the immune system in the skin, leading to inflammation with severe itchiness. The skin barrier functions to keep water in the skin and to keep other things (such as bacteria and allergens) out. Loss of this barrier leads to skin dryness and increased risk of infection. Interactions between genetic susceptibility and environmental exposures early in life are likely to play a major role in the development of eczema. Several immune deficiencies are associated with the development of eczema, including Wiskott-Aldrich Syndrome, the autosomal dominant hyper-IgE syndrome and IPEX, but the underlying genetic causes are quite different.

Treating eczema requires ensuring that the skin barrier stays intact by frequently bathing to soak the skin, applying emollients to lock in moisture and lock out unwanted exposures, and adding topical steroids or other drugs that can calm down the immune response (inflammation) in the skin. In some patients with primary immunodeficiency, skin bacteria can worsen the symptoms, and so oral and topical antibiotics are often used. In addition, many patients also respond well to bleach baths (or swimming in chlorinated pools) as another way of killing the bad skin bacteria.

Drug Allergies and Intolerances

Drug allergies and intolerances are more common in people with immune deficiencies largely because they are exposed to more drugs. In general, the more types of drugs and exposures to drugs people have had, the greater the chances to develop drug allergies or intolerances. Having reactions to drugs does not necessarily mean that the person is an “allergic” person, but of course, much care must be taken to avoid serious reactions.

As with food allergies, many reactions to drugs are not true “allergies” caused by IgE; however, these reactions still can be severe and must be taken very seriously. A thorough evaluation of previous reactions is critical to ensuring that the use of potentially dangerous medications is avoided, while not restricting medications unnecessarily. In some patients with allergic reactions to drugs, particularly antibiotics, allergists can temporarily “desensitize” patients so that they can receive these medications in life-threatening situations.

Diagnosis of Primary Immunodeficiency Diseases and Allergies

Diagnosing allergies can be tricky, especially in the context of an immune deficiency. The most common tests used are skin prick testing and a blood test for IgE specific for allergens (sometimes referred to as a RAST test, Cap RAST or ImmunoCap). Skin prick testing involves taking a drop of allergen and poking the surface of the skin. Positive reactions lead to what looks like a hive. Blood tests can be sent to see if the person has IgE that reacts to specific allergens. The validity of the results varies depending on which allergen is being tested (food allergens tend to be the most accurate). However, especially in settings when the IgE is high, and when people have immune deficiencies, it is sometimes difficult to interpret these results. Allergy testing in patients with primary immunodeficiency should never be interpreted without the help of someone who regularly cares for patients with primary immunodeficiency diseases and allergies.

Some primary immunodeficiencies are more commonly associated with allergic issues. These include Hyper-IgE syndromes (HIES) and IPEX.

Omenn’s Syndrome is caused by the same genetic mutations that lead to Severe Combined Immune Deficiency (SCID). However, for reasons we do not fully understand, a few T- and B-cells “leak out” as it were and lead to swelling of the lymph nodes, spleen and liver, and lead to a head to toe rash that looks like terrible eczema. Patients have very high IgE levels and many eosinophils. However, they do not really have allergies to specific foods or anything else because the T-and B-cells they make are unable make a specific response.

Hyper IgE Syndromes (HIES) are a series of immune deficiencies, which are characterized by extraordinarily high levels of IgE. These patients are prone to serious infections. The most wellknown and best-characterized HIES are the autosomal dominant hyper-IgE syndrome (AD-HIES), which is due to STAT3 mutations, and autosomal recessive HIES cause by DOCK8 deficiency. Not everyone with a high level of IgE has a HIES. Many people with bad eczema or allergies can have high IgE (thousands to tens of thousands), and no other symptoms at all. People with AD-HIES have a specific set of symptoms that includes Staph abscesses, pneumonias, fungal infections of the skin, easily broken bones, very flexible joints and retained childhood teeth. People with DOCK8 deficiency not only have bacterial infections but also have severe viral infections, especially of the skin, very bad eczema, allergies to foods and an increased risk of a number of cancers. (See chapter titled “Hyper IgE Syndrome.”)

IPEX is a syndrome of immunodeficiency, endocrine, gastrointestinal and skin disease, which has an X-linked pattern of inheritance. Boys with IPEX have severe eczema, high levels of IgE and allergies.

Excerpted from the IDF Patient & Family Handbook for Primary Immunodeficiency Diseases FIFTH EDITION Copyright 2013 by Immune Deficiency Foundation, USA. This page contains general medical information which cannot be applied safely to any individual case. Medical knowledge and practice can change rapidly. Therefore, this page should not be used as a substitute for professional medical advice.

8 Tips for Surviving a Horrible Allergy Season

Seasonal Allergies on the Rise

Aside from this season’s unique weather conditions, the incidence and severity of allergies (which are an overreaction of the immune system to harmless substances, like pollen or mold) seems to be increasing for other reasons too. According to the National Institute of Allergy and Infectious Diseases, the prevalence of allergic rhinitis has increased substantially over the past 15 years; now 10 to 16 percent of U.S. adults are estimated to have allergies, which cost the healthcare system $18 billion annually.

There are no definitive answers as to why allergy rates are increasing. One theory is that climate change has gradually been making allergy season last longer, according to a recent study from the U.S. Department of Agriculture. “Rising carbon dioxide levels allow things like ragweed, fungal spores, and poison ivy to thrive,” says Lewis Ziska, study author and a plant physiologist with the USDA’s crop system and global change laboratory.

Coping With Allergy Misery

So what can you do if allergies are hitting you harder than ever, or for the first time? Here, the best ways to survive the season:

  1. Determine if it’s really allergies. The sudden swing from cool to warm weather can make it hard to tell an allergic reaction from a cold or virus, particularly if you don’t usually get seasonal allergies. Neil L. Kao, MD, director of research at the Allergic Disease & Asthma Center in Greenville, S.C., says to suspect allergies if your congestion lasts for more than two weeks; if your eyes, nose, and the top of your mouth itch; if your mucus is thin and clear; or if your symptoms seem to get worse after you’re exposed to triggers, such as spending a day at the park or running outside. The absence of fever and aches is another clue it’s probably allergies and not a cold or other virus.
  2. Head to your drugstore for symptom relief. Your go-to meds may not work as well this year if your symptoms are worse, so you may need to experiment with other kinds, or use multiple drugs, to get relief. Over-the-counter decongestants will help relieve a stuffy nose; antihistamines can tackle sniffles and itching. If you take the indicated dosage and it doesn’t work, it may be that your individual metabolism is a mismatch for that particular medication. “Try switching to other brands and types until you find the right fit and combination,” says Dr. Kao. If you’re really suffering, see an allergist who can prescribe medications that are longer-acting and non-sedating. And if your allergies are severe, consider getting immunotherapy shots for long-term relief.
  3. Give salt water a go. Not a fan of the way many allergy meds make you feel tired and foggy? Try a saline nasal rinse (either with a neti pot or a spray), which helps clear allergens like pollen from your nasal membranes, minimizing symptoms. Gargling with salt water can soothe a sore or scratchy throat. Do this once or twice a day throughout allergy season to ease congestion.
  4. Kick off your shoes and work clothes as soon as you get home. Don’t drag allergens throughout your home, where they’ll continue to cause your symptoms to act up. Remove your shoes outside the door and throw your clothes in the hamper and change into something else. Shower at night to wash off any lingering pollen from your body and hair before you get into bed. Have a dog or outdoor cat? Wipe their paws and fur when they enter your home too, since pollen can cling to them.
  5. Take your workout indoors. Check pollen counts in the morning and try to stay indoors when they’re high. This may mean trading your daily neighborhood stroll for a treadmill at the gym or an exercise DVD in your living room. Pollen tends to be highest in the mid- to late-afternoon, so try to run errands first thing in the morning or after work instead of during your lunch break.
  6. Get window savvy. If you’re allergic to pollen, keep your windows closed and run an air conditioner. On the other hand, if you’re allergic to indoor allergies like mold and dust, throw the windows open and let in the fresh air, which can help clear allergens from your home.
  7. Wear a mask for outdoor chores. When you’re tending your garden or yard, a surgical mask can help minimize your exposure to pollen particles. Look for ones marked N95, which means they meet the standards of the National Institute of Occupational Safety and Health by filtering out 95 percent of particles.
  8. Take allergy symptoms seriously. You may brush off your nasal congestion or lingering headache as “just allergies,” but the truth is that allergy symptoms can take a big toll on your well-being. If you feel totally lousy, give in to your body: Rest, go to bed early, take a sick day. Overdoing it and running around when you feel awful will only make you feel worse.

Learn more in the Everyday Health Allergy Center.

How to Stop Seasonal Allergies the Natural Way

Mike Henry

By Hallie Levine Sklar
From Health magazine

Its like a scene from a low-budget horror flick: the trees are blooming, the grass is growing … and runny-nosed zombies are invading the planet! Seasonal allergies are here, but if youre one of the sniffly multitudes, you may have noticed that the “allergy season” can span most of the year (and that symptoms may flare right before your period).

Heres your best defense—from least to most invasive, medically speaking. Try the first few and you may not need to hit the pharmacy at all.

The triggers: Seasonal Tree Pollens, Grasses, and Weeds

Your symptoms surfaced as early as February, when trees started blooming. Right now, its grasses that are making you miserable (they will through late summer). Weeds will keep you wheezing through fall.

Related links:

  • How to Stop Allergies at Home
  • Your Secret Allergy Triggers Revealed
  • 15 Hypoallergenic Dogs and Cats

Police pollen. Click on the The National Allergy Bureaus Web site (Aaaai.org/nab) for a daily ranking of allergens, including seasonal tree pollens, grasses, weeds, and outdoor molds. Stay indoors when levels are high or very high for those that youre sensitive to.

Wear a mask. If you must finish that gardening before the in-laws show up, don a not-so-chic but très useful N95 filter mask ($24.95 for 20), which keeps pollen out of your nose and mouth.

Wash your hair at night. Rinse the pollen out, especially if youre a gel or mousse fan. These products can trap pollen.

Soak up the calm. In one study, seasonal allergy (hay fever) sufferers had a more extreme reaction the day after performing a stressful task, such as giving a speech. “Stress raises levels of the hormone cortisol,” says Clifford Bassett, MD, an allergist at New York University Medical Center, and that often leads to an amped-up allergic response. A few minutes of meditation or a soak in the tub should help.

Keep your nose clean. “Your nose is like a car windshield—pollen sticks to it,” says Neil Kao, MD, an allergist at the Allergic Disease and Asthma Center in Greenville, South Carolina. Try a saline sinus rinse, found at any drugstore. If that doesnt do it, buy the nonprescription herbal nasal spray NasalCrom (cromolyn sodium), which helps prevent allergic reactions in your nose.

Take an antihistamine. There have never been more over-the-counter antihistamine options. You may be able to find relief with 10 milligrams of cetirizine (Zyrtec) once a day. If those dont work, ask your doctor for a prescription antihistamine such as fexofanadine (Allegra, but also available as a generic) or levocetirizine dihydrochloride (Xyzal).

Try the sprays. If nasal washes and antihistamines dont work for you, up the ante with a prescription steroid spray like Flonase, but you can skip decongestants; Dr. Kao says they dont work for allergies and may worsen your congestion after several days of use.

Next page: The trigger: Dust Mites

The trigger: Dust Mites

Cool (and dry) it. Dust mites thrive in homes that are warmer than 70 degrees and have a humidity above 50 percent. Keeping your home temp in the mid to low 60s and the humidity between 40 and 45 percent should send them packing. Buy a home hygrometer to measure humidity levels for about $30 on Amazon.com.

Use barriers. You can find mattress and pillow encasements at stores like Target, as well as online retailers like AllergyBuyersClub.com; costs range from $50 to $150 for bedding made from organic cotton.

Boil your bedding. Not literally, but you should wash your sheets and pillowcases weekly in water thats at least 140 degrees; a study in the Annals of Allergy, Asthma and Immunology found that this temperature wiped out all dust mites.

Outsource housekeeping. This wont take much arm-twisting, will it? Vacuuming and sweeping stir up dust mites and their droppings, which can take more than two hours to settle. If you cant hire someone else, invest in a vacuum cleaner with a high-efficiency particulate air (HEPA) filter, like the Eureka Boss SmartVac ($169.99)—and wear a trusty filter mask.

Try acupuncture. At least one study and lots of anecdotal evidence suggest it can help. “Ive seen amazing results in my allergic patients,” says Roberta Lee, MD, vice chair of the Department of Integrative Medicine at the Beth Israel Medical Center in New York City. She thinks acupuncture may decrease stress hormones, which can reduce inflammation. A session usually costs $100 to $150; ask your insurance company if some or all of that is covered.

Next page: The trigger: Indoor Mold

The trigger: Indoor Mold

Mold thrives in warmer, more humid weather. Dont assume its not there just because you cant see it: mold can hide under carpets, in walls, or anywhere. To beat it:

Bleach it. A 5 percent bleach solution and a rag or sponge can zap small mold problems. If youve got a very large moldy area (more than 10 square feet), consider hiring a mold-cleanup crew (find one at the Indoor Air Quality Association Web site, Iaqa.org). And if mold triggers your symptoms, toss indoor plants—mold blooms in potting soil.

Dry up rooms. Put an exhaust fan in bathrooms and laundry rooms, and a dehumidifier in unfinished basements.

Get HEPA. Filters, that is. Ideally, you want a central air-conditioning system with a HEPA filter attached. If you dont have central air, try free-standing air cleaners in key rooms such as the bedroom. Change the filters at least every three months and have your heating and air-conditioning units inspected (and cleaned, if necessary) every six.

The trigger: Pet Dander

If youre set off by pets, you may be allergic to proteins found in the animals saliva, dander (dead skin flakes), and urine. And all furry pets carry these proteins; studies suggest hypoallergenic cats and dogs can cause just as many symptoms as the regular kind. Here are better steps you can take if you cant bear to part with Rover or Frisky:

Ban him from the bedroom. Just keeping pets out (or better yet, away from your upstairs entirely) can help relieve your symptoms.

Cut the rug. Consider replacing wall-to-wall carpeting with hardwood floors, tile, or linoleum, which wont trap dander.

Get him groomed. Ask your non-allergic partner or child to comb him every day, preferably outside, with a comb dipped in distilled water, which traps dander. And a weekly bath (more often will dry his skin, making the dander problem worse) is a must.

Get shot. Immunotherapy has about an 85 percent effectiveness rate in decreasing allergic symptoms, including those triggered by animal proteins. You get one to two weekly shots to expose you to very small doses of the allergen, and the dose is gradually increased over about six months. Youll need maintenance shots about once a month for three to five years.

Is it an allergy … or something else?

Do you have a runny, stuffy nose that just wont quit? If dust-proofing your house and taking antihistamines dont make you feel better, you may have a condition called chronic nonallergic rhinitis, a swelling of your nasal lining and passages that leaves you congested and drippy.

“Unlike your usual allergies, you dont have an itchy nose, eyes, or throat, and you dont respond to allergy medications,” explains Clifford Bassett, MD, an allergist at New York University. Try eliminating irritants like strong odors (like perfume or household cleaners). Saline nasal sprays and rinses often bring relief, but if they dont work, ask your doctor for a steroid nasal spray.

Top Tips to Fight Seasonal Allergies

Updated: May 9, 2019

According to the American Academy of Allergy, Asthma and Immunology, roughly 7.8% of adults in the U.S. have hay fever. If you suffer from seasonal allergies, you know just how miserable the constant sneezing, coughing and itching can be. While we can’t stop the trees from dropping pollen, we can drop some knowledge on how to deal with seasonal allergies and prevent some of the worst symptoms.

Reduce your exposure

The best thing you can do for your seasonal allergies is reduce your exposure to allergy triggers. Common allergy culprits include tree and grass pollen and mold. Here are a few ways to avoid triggering your symptoms when it comes to those annoying allergens:

  • Stay inside on dry, windy days when pollen is more likely to be traveling through the air. Likewise, pollen counts tend to be lower after a good rain.
  • During peak allergy season, avoid tasks that kick up pollen like yardwork and gardening. Focus on other chores while someone with a more resistant immune system mows the lawn or weeds those flowerbeds.
  • If you can’t or don’t want to avoid yardwork, you can purchase and wear a pollen mask to keep you from inhaling irritants.
  • Take a shower after you’ve spent time outside to rinse allergens out of your hair and off your body. Change out of your outdoor clothes and wash them immediately to avoid spreading pollen throughout the house.

Track pollen counts

Some days are worse than others when it comes to allergies. Check the news or a trusted weather app for pollen forecasts and pollen levels so you can plan activities around times that are better for your allergies.

  • When pollen counts are high, close windows and doors at night to avoid breathing in irritants while you sleep.
  • If you take allergy medication, start taking it before the pollen counts are forecasted to climb so you can prevent your symptoms from starting in the first place.
  • Turn on the AC when pollen counts are high and change out your filters
  • Vacuum daily when pollen counts are higher. Allergy experts recommend using a vacuum with a HEPA filter.

Seek treatment

Luckily, for allergy sufferers, there are many remedies available to ease allergy symptoms.

  • Oral antihistamines. Antihistamines help relieve common symptoms like watery eyes, sneezing and itching—and they’re available over-the-counter. Oral antihistamines can also make you drowsy, so keep that in mind when taking these medications.
  • If your allergy symptoms are more along the lines of nasal stuffiness and congestion, a decongestant might be the right option. Decongestants are available in both oral and nasal form, but note that nasal decongestants are not recommended for long-term daily use.
  • Nasal rinse. Rinsing your nasal passageways with a saline solution is a great way to reduce nasal symptoms like congestion and a runny nose. Look for a nasal rinse bottle at your pharmacy and only use distilled, sterile water.
  • If your allergy symptoms are severe or too bothersome for over-the-counter treatment, talk to your health care provider about treatments like allergy shots (allergen immunotherapy). Allergy shots involve regular injections of small amounts of your allergy triggers. Over time, these injections reduce and can even eliminate your immune system’s reaction to allergens.

You don’t have to suffer with a stuffy nose all summer—take control of your allergies and say sayonara to seasonal symptoms.

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Ask Dirk: My allergies are killing me! How can I reduce allergens in my home?

If you suffer from allergies, you might view spring with mixed emotions. Yes, it will be warmer and sunnier. But those conditions cause plants to grow and bloom, and pollen from those plants can be a problem for allergy sufferers.

What are we dealing with?

Northern Nevada is a beautiful place to live, but it is rich in allergens. Airborne pollens from rabbit brush, sagebrush, ragweed, and dozens of other plants can cause discomfort like sneezing, wheezing, coughing, itchy eyes, stuffed-up noses for allergy sufferers. In addition, you, your family, your pets, and visitors all bring allergens with them when they enter your home.

How can I avoid allergens?

While there’s not much you can do about allergens when you are outdoors, you can take steps to minimize them in your home.

Infiltration is a significant contributor to poor indoor air quality. Open doors and windows, pet doors, poor sealing of the building envelope, and leaks around registers are prime offenders. But remember, not all allergens come from outdoors. Pet dander, dust mites, mold, and other sources of allergens may already be inside your home.

A properly maintained HVAC system can help in removing these allergy-aggravating substances from the air. The addition of free-standing air cleaners may work even better, especially if your HVAC system isn’t designed to provide extra-clean air.

What can I do?

Remember, the HVAC system only filters when it is moving air. If you are not running central air conditioning in the summer, you may be able to set the fan to “on” if the system allows. This could increase your electric bill as well as accelerated wear on the blower motor.

You’ll want to choose a filter that collects more of the microscopic spores and other pollutants that may aggravate your allergies without stressing the system. Restricted airflow caused by filters that are designed to improve air quality can make the blower motor work even harder, so make sure you select the correct filters and change them regularly. Your service technician can help you choose the best filter for your system.

How will I know what filter to choose?

Filters are rated by the Minimum Efficiency Reporting Value (MERV rating), and range from a value of 1 to 20 . Flat panel filters, installed by most furnace manufacturers, have a 1 to 4 MERV rating. Medium efficiency filters with a MERV rating of 5 to 13 are the most common types used in home HVAC systems. High efficiency with a rating of 14 to 16 MERV, are considerably more expensive, and should only be used in systems designed for them.

No matter what filter you choose, remember to replace it as directed on the packaging. Some homes require filters to be changed monthly at a minimum. If the filter is very dirty when you change it, replace it sooner next time.

What else can help?

Your ducts may also contribute to the problem. Duct leakage can occur over time, allowing dirty air from the attic or the crawlspace to enter the system. Increased pressure in these spaces can also cause that dirty air to leak in around the registers. If you suspect this is happening, have the system inspected by a professional, who will seal any leaks found.

The bottom line

Your first line of defense in reducing allergens in your home, next to a free-standing air cleaner, is regular filter changes with a good quality filter. It’s also a good idea to have your HVAC system inspected on an annual

basis to prevent any problems before they occur.

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Have a question for Dirk? Send it to [email protected] and he’ll try to answer it in an upcoming column.

Last Updated 5.2.18

Spring and summer are a joy, unless you’re one of millions who suffer with seasonal allergies. Then it can be a really miserable couple of seasons of sniffling, scratchy throat, coughing, itchy eyes – or the alternative – taking medications that make you sleepy, or that you just don’t want to take because you prefer to be au natural.

I suffered from horrible seasonal allergies well into my mid-teens, so I am no stranger to the symptoms. My summers were spent retreating to an air-conditioned room with an antihistamine on those high pollen count days just to be able to breathe easily (you know what I’m talking about…). I loved being outdoors as much as possible so it made me miserable on every level.

It’s even worse if your allergies trigger your asthma – which is the case for many adults and increasing numbers of children. Evidence shows seasonal allergy rates are rising throughout the world, and especially in urban areas. But here’s what I’ve learned: with the right approach, you can kick your seasonal allergies to the curb for good

Over the years, I’ve established a 3-step plan that I’ve recommended to countless patients, and to great result. Read on to learn how you can get started healing your gut, plus head right over here to learn which natural remedies I recommend for fast relief from seasonal allergy symptoms that you can incorporate starting today.

My own allergy story: how healing my diet healed my seasonal allergies

Like I shared earlier, I’m no stranger to the yearly discomfort of seasonal allergies. But one year, everything changed for me. I became a vegetarian (no, you do not have to become a vegetarian to get rid of your allergies!), cleaned up my diet of all sugar, soda, preservatives, additives, dyes and other non-food junk, and drastically decreased my dairy intake (yes, if you want your allergies to go away forever, you will have to do this – sorry).

I went as organic as I could afford to. I did this for political, not health, reasons. I was part of the early movement to “take back our food” and be free of dependence on Big Agra — It took a lot of effort to find local coops and small farms from which to get my foods (No, Virginia, there were no cells phones or Whole Foods back then) – but I felt good about my choices. The unexpected bonus was that health issues, which I just assumed were a normal part of life for me, simply vanished – including my allergies.

That spring and summer came and went without a tickle, sniffle, cough, or medication. Then the next. And the next. At some point I realized what had happened… I had become allergy free. I didn’t even use herbs or supplements at the time because I wasn’t intentionally trying to get rid of them.

Raising seasonal allergy-free kids

Even more interestingly, by the time I had kids – in spite of rampant colds, allergies, and asthma on both sides of our families – they weren’t getting sick, needing antibiotics, or having any allergy or asthma symptoms. An original organic foodie, I breastfed each child for a well over a year (or three), introducing healthy, organic, homemade foods slowly into their diets around 10 months to a year of age. They never had juice or sugar, and dairy was at a minimum – occasionally just some organic, live culture yogurt. I was amazed.

I knew I was onto something.

What really causes seasonal allergies?

The dry itchy eyes and sore throat that come with seasonal allergies are often blamed on high pollen counts. But all of the symptoms associated with seasonal allergies are signs of inflammation: redness, swelling, and itching, for example. In other words, to get rid of allergies, you have to get rid of inflammation and hyper-reactivity. The place to start is in your gut.

If you’ve got allergy symptoms right now, there is help before you dig in deeper to the next steps. Feel free to jump to the end of this piece and start with But I’ve Got Allergies NOW and work your way backwards. Everyone in this for the long haul, read on…

The Gut and Allergy Connection

While the connection between your gut and seasonal allergy symptoms might not be instantly obvious, healing your gut is the first step to waving your seasonal allergies goodbye. Let’s take a closer look.

One of the major jobs of your digestive system is to provide an interface between the external world (foods, allergens, bacteria, etc.) and your bloodstream. It does this in the stomach by using natural digestive acids to break down potentially allergenic proteins and in the intestines via a layer of barrier cells that prevents these proteins from getting into your blood stream. You also have a whole host of special bacteria in your gut, as well as immune cells, whose job it is to break down and get rid of proteins and other molecules that can cause you to get sensitized to them, leading to gut – and systemic – inflammation.

What causes your gut to become inflamed?

Many lifestyle habits and food choices can weaken your gut lining over time, making you more prone to inflammation and allergies. Here are a few examples:

  • Acid reflux medication, such as proton-pump inhibitors. When you are taking medications for reflux (like a PPI such as Prilosec) this takes out the first line of defense – your stomach acid.
  • Food sensitivities. When your gut barrier gets weakened from chronic exposure to foods that irritate your gut, you’re more likely to experience inflammation.
  • Antiobitics. When the good gut bacteria get out of balance from antibiotics, you can develop a leaky gut.

Foreign proteins get into your system and place your body on red alert to react to many harmless triggers in your environment, such as tree pollen.

So the first step to quieting down your body’s over reactivity is to heal your gut. This will reduce both seasonal allergies and common food sensitivities (bonus!).

Heal your gut with the 4R program

Just as a caveat, I am not talking about getting rid of severe IgE allergies such as peanuts, bees, medications, or other allergens which can cause you to have an immediate, severe, or anaphylactic reaction. Those tend to be permanent. I am talking about common seasonal allergies such as pollens, dander, and common foods that trigger IgG reactions – the ones that make you miserable but aren’t going to kill you! So please don’t try this treatment and go eat nuts if you’re severely allergic! But if you have the other kind of allergies, over weeks and months, you might be pleasantly surprised to find that old triggers just don’t bother you anymore!

To simplify the process of healing the gut, I teach my patients the 4R program. It takes about 4-6 weeks and it looks like this.

Let me break this down for you:

Remove: This step is all about removing the food triggers in your diet that might be responsible more inflammation in your gut.

Try an Elimination Diet. An elimination diet is 2 weeks of eating a simple diet from which you have removed the most common food triggers including gluten, sugar, dairy, eggs, soy, coffee, soda, and artificial ingredients – as well as anything you typically crave (i.e., sugar, carbs, salty snacks). Ideally, you would also stop many of your medications, especially reflux medications, NSAIDS, and antibiotics – but talk with your doctor first! If you have reflux, DGL licorice is a great alternative to PPIs and H2blockers. It safely heals the stomach without the potentially serious adverse effects of the above medications.

The elimination diet takes little bit of planning and coordination, especially with kiddos, but it is simple and makes a huge difference. I’ve got a blog on how to do one.

If you have constipation, you’ll want to deal with this now. Get plenty of fiber in your diet and drink ample water, too. Supplements such as flax seed, psyllium, and magnesium citrate are safe for most people to take daily. For kids, slippery elm, which tastes like maple syrup, may be used, 1-2 tsp daily in oatmeal or a smoothie. The goal is 1 healthy BM every day.

Replace: You’re ready for the second step once you’ve been on the elimination diet for about 2 weeks. This step is all about enzymes, which support digestion and the breakdown of food. Start taking a good quality digestive enzyme product (you can give these to kids over 4, too). This is safe for pregnant and breastfeeding women, too.

Reinoculate: After another week, add in a good quality probiotic. This step enables you to reinoculate your gut with beneficial bacteria and enhance digestion. Also safe for pregnant and breastfeeding women, and for kids.

Repair: Once you’ve removed food triggers from your diet, replaced important digestive enzymes, and reinoculated your gut with beneficial bacteria, it’s time to repair your gut lining. The following supplements can now be taken for about a month (up to 6 months) to help to heal the intestinal lining:

  • Turmeric, aloe vera, marshmallow root, and DGL licorice (aloe and licorice are not for internal use during pregnancy; these are fine for children) are some of the most effective herbs for healing the gut lining. They are best taken in capsule or extract form, though turmeric can also be added to foods. DGL licorice is available as chewable lozenges and thus may be the simplest one to give to kids.
  • Zinc: 5-10 mg/day for children 4-7 years, 10-20 mg/day for children to age 12, 25-40 mg/day for older children and adults
  • An antioxidant supplement containing vitamins A and carotenoids, C, E, and selenium. These are often found in a multivitamin. Pregnant women should get these from their prenatal vitamin only.
  • Fish oil: I prefer Nordic Natural Pro-DHA Jr. for kids, and any good quality fish oil for adults. For kids you can put the oil into smoothies. Fish oil is important for general health in pregnancy and breastfeeding, too.
  • L-Glutamine Powder: 5-10 gm of powder twice daily for one month. (Much less for kids but talk with your child’s doctor before using and don’t supplement in pregnancy).

Voila! You’ve completed the 4R program for gut healing. But don’t stop there. Even after you complete all of this, you’ll want to keep your diet as healthy as possible – indefinitely. You can reintroduce some of the typical allergens you’ve removed, but do it one by one, each a few days apart, noting any symptoms that might arise when you resume eating them. If you have any allergy symptoms, that food might not be optimal to include in your diet. You can also continue on the gut healing supplements for 3-6 months, and then see how you do with a challenge of that food. As for sugar, baked goods, additives, and junk food – you’re going to want to leave those out pretty much forever. They’re not good for you – or anyone.

But I’ve Got Allergies NOW

I know … 4 weeks+ is a long time to get your gut repair on when you’ve got symptoms now. Never fear! There’s help! to learn which of my favorite herbal medicine and nutritional supplements for allergies work wonders for more immediate relief. Many of my patients who switch to them do not have to use OTC or prescription allergy meds anymore. If you don’t do the 4R program, symptoms may come back, so you’ll need to keep treating with these natural supplements.

If you choose to do the 4R program, you may find that like me, changing your diet not only frees you from being dependent on a food industry that is not in our best health interest, but it also frees you from seasonal allergies – 4Ever.

Let me know in the comments below how “allergy-free” goes for you!

To your health!

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