Living With Allergies | Dr. Stephen Sinatra's Heart MD Institute

Respiratory System

Living With Allergies
Understanding How to Stay a Nose Ahead in the Game

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Allergy season is here again! Having been sneezing and constantly blowing your nose, you thought you might have caught a cold. The persistence of your symptoms and hindsight, though, both clued you to the inevitability that bed rest and fluids just aren’t going to do the trick. The problem only seems exacerbated when you’re propped up in bed under plushy pillows with your cats or dogs innocently snuggled up with you. You realize there’s a bigger issue at work here and that Mother Nature and the comforts of home might be rubbing you the wrong way.

Allergic rhinitis is characterized by symptoms like sneezing, excess mucous production, runny nose, watery eyes, and itchy eyes, nose and throat. Caused by airborne allergens such as pollen, dust mites, pet dander, and mold spores, these upper respiratory symptoms affect approximately 35 million Americans. Such allergens will provoke symptoms of asthma for another 11 million Americans: coughing, wheezing, and shortness of breath due to narrowed and inflamed airways.

Allergic rhinitis may be seasonal or perennial. With seasonal rhinitis, the allergy affects you when the particular allergen at issue is “in season,” or blooming. You know you have perennial rhinitis, on the other hand, when your symptoms occur year round and are due to pet dander and saliva, dust, and mold.

If you’ve suddenly developed allergies for the first time, it can be challenging to distinguish whether your symptoms are due to allergies or the common cold. As a general rule of thumb, allergy symptoms persist longer, for more than a week, at least. You might develop allergies because one or both of your parents did, although allergies to particular types of pollen, for example, do not “run in the family.” You may have been exposed to certain allergens when your immune system was weakened, possibly during a virus or pregnancy.

What are Allergies?

Allergies are symptoms of your immune system overreacting to a substance or substances that do not normally pose a threat to the body. Your body mistakes these substances, called “allergens,” for something more alarming, like invading germs, harmful bacteria or viruses. In the case of allergic rhinitis, when you breathe in an airborne allergen, your immune system responds by producing large amounts of antibodies called immunoglobulin E (IgE). Your body will generate a type of IgE that is specific to the particular allergen affecting you.

When an allergen you breathe in reaches the lining of your nose, it encounters the IgE specific to it. IgE then signals your body to release histamine, which initiates an inflammatory response in respiratory tissues. Histamine can cause the irritation, itching, sneezing, and excess mucous production that characterize allergic “flare-up.” Cells in the nose may then contract, causing congestion and swelling of nasal passages. As you continually breathe in the allergen which continues to bloom around you or simply circulates in the air of your home, your immune system continues to attack it, causing chronic allergy symptoms.

Reducing Severity of Allergic Reactions

So, aside from stocking up on tissue, how do you deal with allergies, especially when there are no known “cures”? Knowing which allergens affect you and how to avoid unnecessary exposure to them can make life a lot more bearable when “the season hits,” or when perennial allergies plague you at home. Various treatments may also help lessen symptoms or allergic reactions.

I. Determine the Cause of Your Allergy / Avoiding Allergens

A medical professional can help you determine whether a particular allergen affects you by looking at family history and patient medical records, and performing a skin test. S/he can scratch your skin and make an injection to see how your body reacts. By identifying the types of any IgE antibodies present, your physician can identify allergens which cause common respiratory allergies, as well as penicillin, food, and insect stings. Alternately, s/he may perform a blood test for IgE antibodies, or radioallergosorbent (RAST) test.

Before subjecting yourself to needles, you may want to try to figure out which allergens may be the culprits behind your symptoms, and take steps to reduce your exposure to them. Common allergies include:

• Pollen allergy, or “hay fever,” is one of the most common chronic diseases in the U.S. A fine powder released by trees, grasses, and weeds during flowering season, pollen is the initiator of reproductive processes in plants. It is carried, often over great distances, by the wind as well as by insects like bees. Different plants bloom during different seasons. Recognizing when you are most affected can help you determine which plants are the culprits behind your symptoms. For example, if your allergies are acting up in late summer or fall, chances are, you are allergic to ragweed.

As a rule of thumb, trees bloom in the spring, grasses in the summer, and weeds in the fall. There’s truth to the phrase, “spreading like weeds”: weeds are the most prolific producers of pollen, and are widely responsible for allergic rhinitis. While the primary offender is ragweed, sorrel, mugwort, nettle, redroot pigweed, lamb’s quarters, & tumbleweed may also trigger allergies. Trees that commonly provoke allergic reactions include birch, oak, ash, hickory, alder, elm, box elder, hazel, mountain cedar, willow, or hornbeam. As far as grasses are concerned, pollens from Timothy, rye, Kentucky blue, orchard, Bermuda, redtop, sweet vernal, and Johnson grasses all are common allergens.

Internet technology has made identification of possible problem-pollens a much easier task these days. By typing in your zip code at www.pollen.com, you can access information about the relative pollen count in your area as well as which plants are in bloom. Pollen count is a measure of the concentration of pollen in the air (grains of pollen per square meter of air collected over 24 hours).

When you are allergic to any type of pollen, you may feel powerless against Nature. If allergy season has seasoned you over the years, you might plan to vacation during the time the allergen tends to peak. Although moving to a region where the allergen affecting you doesn’t grow may also seem an attractive, if not necessary, option, most authorities don’t recommend doing so; not only can wind can carry pollen over vast distances, but you may develop allergies to new vegetation once you are repeatedly exposed to it. A better solution (coupled with one or more treatments listed below) is to know when pollen count is high in your area and stay indoors with the windows closed as much as possible. If you have to work outside, wear a face mask that will help prevent allergens from entering your respiratory tract.

• Mold allergy. Allergic rhinitis may also be caused by the inhalation of mold spores, the seeds or reproductive pieces of fungi. Molds generally grow, and produce millions of spores, in various places with moisture and oxygen. Areas to watch for mold in your home include damp basements, closets and bathrooms (especially the shower), places where you keep fresh food, refrigerator trays, garbage cans, humidifiers, air conditioners, upholstered furniture, and mattresses.

Reducing your exposure to mold is not only important to avoid symptoms of allergic rhinitis, but infections too. When aspergillus mold gets into in the lungs, for example, it can cause severe inflammatory asthma in people with compromised immune systems. A health professional can diagnose respiratory illness due to mold through skin tests, blood tests, x-rays, or examining sputum (the stuff you cough up) for fungi, and will generally treat it with corticosteroid drugs.

Some molds produce toxic substances, called mycotoxins, which may cause more dangerous health effects like lung diseases and liver cancer. Stachybotrys chartarum is a greenish-black mold with a reputation for toxicity. However, the Centers for Disease Control and Prevention (CDC) does not recommend treating it any differently than all other molds with respect to potential health risks and removal.

You may recognize mold as growths or discolorings on walls and ceilings; they may also emit a musty, earthy or foul odor. To remove mold on hard surfaces, scrub it away with detergent and water, then dry the area completely. Bleach diluted in water (no more than one cup to a gallon) effectively kills mold, however it can produce toxic fumes if mixed with other cleaners. Instead, you might want to try using a spray bottle with a solution of water and a few drops of tea tree oil (a natural antibacterial and antifungal) to clean moldy surfaces. It’s advisable to wear a face mask, gloves, and goggles when cleaning mold to avoid inhaling or otherwise making contact with the spores.

Prevent mold growth in your home by controlling the amount of moisture available for mold spores to grow. Keep indoor humidity low: below 50 percent. In the bathroom, keep mold to a minimum by opening the windows or running the bathroom fan when showering. Clean bathroom surfaces with water and tea tree oil before mold has a chance to form and fix water leaks.

• Dust mites. Ever see particles floating in a ray of sunlight? These are dust mites, microscopic organisms that live in the dust in your home or workplace, which can produce symptoms of allergic rhinitis and may also cause asthma. Dust mites are a common allergen and may live in bedding, upholstered furniture, and carpets. They thrive in the summer (or in any warm, humid house, regardless of season) and die in the winter. It is not the dust mites themselves, but proteins secreted in their waste products, that provoke allergic reactions.

House dust generally consists of a mix of various substances such as fabric fibers, lint, stuffing materials, feathers, animal dander, food particles, bacteria, fungus and mold spores. It may also include bits of allergenic plants and insects (cockroach saliva and feces contain proteins that cause allergic symptoms).

There are several actions you can take to reduce dust and dust mites, and make your home or workplace a more pleasant environment. It’s better to have hardwood, tile or linoleum floors which you can cover with washable throw rugs, than wall-to-wall or shag carpeting. Vacuum carpets often with a machine that has a HEPA (high efficiency particulate air) filter. Machine-wash your floor rugs in water that is at least 130 degrees Fahrenheit, the temperature necessary to kill dust mites. Frequently dust blinds and furniture with a wet cloth, and don’t let your fans accumulate too much dust before you clean them.

Other strategies include avoidance of stuffed animals, down-filled pillows and blankets, closets full of clothing, heating vents with forced hot air, and cats and dogs. If giving up these things seems to difficult, pick and choose your poisons. Also, avoid cockroaches by keeping food in airtight containers, immediately cleaning up liquid and food spills, and using roach traps (always try traps before subjecting yourself and your family to pesticides in the home).

• Household pets are an extremely common source of allergens. It’s not just their dander that may be making you sneeze, but the proteins in their saliva. Even if they are not licking you, when they lick themselves clean, as cats frequently do, the allergens can get into bedding, furniture and carpets.

If you can’t live without furry companions, as is the case for many people (or perhaps their spouses), you can reduce your exposure to pet allergens by bathing your cat or dog weekly and brushing it’s fur often. It may help you to wear a face mask when doing this. If bathing a cat seems impossible, try wiping its fur with a wet cloth. Keep cats out of bedrooms. Try limiting the amount of carpeted and upholstered surfaces the pet(s) can lie on, and use (and frequently wash) machine-washable covers on your furniture. Use vacuum cleaners and air filters with HEPA filters.

It may take up to 2 years to develop an allergy to a household animal, and up to 6 months after contact with the animal ends for the allergy to cease. If you are severely allergic to pets, be sure to check with the landlord or previous owner when moving into a new place to find out whether any pets were recently living there.

• Chemical sensitivity. Chemical irritants can also cause allergy-like symptoms in people, even though the reaction does not involve IgE and histamine. Some people may be more sensitive to natural or synthetic chemicals in their environment than others. Common substances of concern include paints, carpeting, plastics, perfumes, and cigarette smoke.

An allergic-type reaction to chemicals indicates that they have toxic effects on the body. Avoid unnecessary exposure to chemicals by using natural cleaning products that you purchase or make yourself. As with pets, wearing a mask while cleaning may help as well.

When buying cleaning products, be sure to read labels to make sure they are truly free of harmful chemicals; many product labels read, “green” or “natural,” yet still contain toxins. You can also make your own cleaning products using common household ingredients. Baking soda is a great scrubbing agent when mixed with unscented powdered or liquid soap, white vinegar mixed with water is good for cleaning glass, counters and floors. Adding tea tree oil and/or lemon juice adds an antimicrobial punch.

• Food allergies. Allergic reactions to food or food intolerances can exacerbate symptoms of allergic rhinitis. While some food allergies can result in severe, even fatal, reactions, others cause milder reactions that may be mistaken for a stomach bug, irritable bowel syndrome, mild hives or skin rash. Food allergies, especially if they are lurking under the radar, can increase your “allergic load,” or the amount of offensive substances you can be exposed to before allergy symptoms occur. If your “allergy bucket” is 80 percent full of food allergies, the bucket can easily overflow when seasonal allergens are present.

Many pollen, dust, and pet allergies may clear up simply by determining a food allergy and removing that food from your diet. Determining a food allergy or intolerance can be difficult, through, as the antibodies involved (IgG, not IgE) can cause delayed symptoms, often appearing a day or two later. A health practitioner can administer a blood test and look for IgG antibodies to screen for delayed reactions to particular foods. This is the most time-effective test.

The most cost effective means of detecting a food allergy is do an elimination diet challenge. Refrain from consuming the top five allergic foods (wheat, dairy, corn, soy, eggs) for 3 weeks, then slowly introduce each, one by one, back into your diet. You may also want to try avoiding sulfites in food and alcohol. The offending food will make itself known when re-introduced into your diet.

II. Allergy Treatment: Alternative and Conventional Solutions

Get an air cleaning device. Using an air filtration device can help remove allergenic particles like pollens, molds, animal dander, dust and smoke from your indoor air. You can add one to your heating and cooling system, or get portable ones for individual rooms. The key is to find one with a flow that changes the air in the room 5-6 times per hour and that does not emit ozone, a lung irritant that can trigger allergic symptoms. HEPA (high efficiency particulate air) filters are good, and don’t release ozone.

Sometimes avoidance of allergens isn't enough. Various alternative and conventional treatments may also be of help to diminish or eliminate allergy symptoms. Any combination of the following treatments may also be helpful to diminish or eliminate allergy symptoms.

Alternative Treatments:

• Use a Neti Pot (nasal lavage) to wash away dust, dirt, pollen, and smoke that gets trapped in the nasal passages. While pouring a warm salt water solution into one nostril until it drains out the other, then expelling out excess mucous through your nose may take some getting used to, using a Neti Pot is one of the most efficient ways of clearing nasal airways daily and reducing chronic exposure to allergens.

• Herbs and Nutrients: Eyebright, an herb that acts as an inflammation modulator can be taken in supplement form or made into a liquid solution. Boil the eyebright leaves and flowers and water, let the water cool, then strain the solution through cloth to use as an eye wash or nasal lavage. Another helpful herb is nettles, the leafy part of which is an inflammatory modulator. Frequently drink tea made from nettle leaves, or take a tincture made from nettle leaves under the tongue. Quercetin is a bioflavonoid nutrient with powerful anti-inflammatory properties. Found in red and yellow onions, cabbage, broccoli, and apples, quercetin may also be taken in supplement form. To boot, this nutrient has powerful antioxidant properties as well.

• Acupuncture may also be helpful in reducing symptoms of allergic rhinitis.

Conventional Treatments:

• Anti-histamines are over-the-counter drugs which act to prevent or assuage allergy symptoms by preventing the attachment of histamines to your cells. As antihistamines can cause side effects such as drowsiness, and lack of alertness and concentration, you may want to seek a non-sedating product. People with heart disease, high blood pressure, or breathing problems like asthma should avoid taking anti-histamines.

• Steroids / other medications can be used in combination with antihistamines, but only for a few days at a time. Topical nasal steroids are safe at recommended doses, and chromolyn sodium, a nasal spray may also help. Decongestants can also help bring symptom relief by suppressing excess mucous production. Eye drops with olopatadine hydrochloride, which inhibits the release of histamine, may also help relieve itchy eyes.

• Immunotherapy (allergy shots) work like a temporary vaccine. Designed to decrease the immune system response, immunotherapy exposes you to small amounts of allergens which stimulate your immune system to build up antibodies. The small dose helps your body avoid “over-reactive” immune system activity later on. However, immunotherapy must be continued over the long term to remain effective.

While natural treatments are generally preferred, integrative healing combines the best of conventional and alternative therapies. That being said, if your allergy symptoms are making you miserable or you're having difficulty breathing, try employing antihistamine medications or other conventional remedies for a short time to give your immune system a rest, then continue on with natural solutions. With allergies, a multi-strategy approach is often the best bet for breathing easy again.

Additional Resources and References:

“Airborne Allergens: Something in the Air,” The U.S. Dept. of Health and Human Services National Institutes of Health National Institute of Allergy and Infectious Diseases.

“Indoor Air Pollutants and Toxic Materials.” Chapter 5 of the Healthy Housing Reference Manual, available at the Centers for Disease Control and Prevention.

“Guide to Air Cleaners in the Home.” The United States Environmental Protection Agency (EPA), May 2008.

“A Brief Guide to Mold, Moisture and Your Home,” EPA.

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The health of the body begins to deteriorate when its physical, emotional, and mental processes fail to work in harmony. Establishing health and balance within a person requires a multidisciplinary approach which may include elements of proper breathing, exercise, release of painful emotions and past traumas, energy enhancement, nutritional healing, reopening of the heart to love, and the development of a spiritual connection.

-Heartbreak and Heart Disease