Why are seasonal allergies getting worse. How does climate change impact pollen levels. What can allergy sufferers do to find relief. How do allergies develop in the body. Are masks effective against pollen. When does allergy season typically start.

The Rising Tide of Seasonal Allergies

Seasonal allergies, also known as allergic rhinitis, affect nearly 60 million Americans annually. In recent years, the Northeast has experienced particularly severe allergy seasons, largely attributed to climate change. Dr. Fred Little, a clinical associate professor at Boston University’s Chobanian & Avedisian School of Medicine and director of the Boston Medical Center allergy-immunology fellowship, sheds light on this growing concern.

Record-high pollen counts have led to earlier and prolonged allergy seasons, causing increased discomfort for those affected. This trend is not isolated to a single region but is becoming increasingly common across temperate climates in the United States.

Understanding Allergies: The Body’s Misguided Defense

Allergies are essentially an abnormal immune response to typically harmless substances in our environment. Unlike genetic conditions such as cystic fibrosis or sickle cell anemia, allergies result from a combination of hereditary factors and environmental exposure.

When the body encounters allergens like pollen or cat dander, it mistakenly identifies these harmless proteins as threats. This triggers an immune response, activating specific cells that release substances causing nasal congestion, sneezing, and excessive mucus production. In some cases, this reaction can lead to more severe symptoms like wheezing and asthma.

The Development of Allergies

Can allergies develop later in life? Indeed, allergic responses can emerge in adulthood as well as childhood. Dr. Little notes that patients at Boston Medical Center who grew up in different ecological environments often develop allergies after living in the Northeast for a few years. This occurs as their immune system becomes primed to react to the local allergens, potentially resulting in hay fever or asthmatic symptoms.

Climate Change: A Major Factor in Worsening Allergies

Climate change plays a significant role in the increasing severity of seasonal allergies. Here are some key factors:

• Longer pollen seasons due to warmer temperatures
• Earlier onset of grass pollen production
• Increased pollen generation from warm, wet springs
• Higher pollen levels during dry periods

Warmer temperatures extending for longer periods lead to increased pollen production. Additionally, drought and dryness exacerbate the problem, as rain typically helps reduce airborne pollen levels.

The Pine Pollen Misconception

Interestingly, the yellow pine pollen often visible on cars and in storm drains is not as allergenic as pollen from deciduous trees like birch, maple, and oak. This misconception can lead people to overestimate pollen levels based on visual cues alone.

The Impact of Changing Behaviors on Allergy Symptoms

Recent changes in human behavior have also contributed to the perceived increase in allergy severity. The reduced use of masks compared to previous allergy seasons has led to greater exposure to allergens both outdoors and indoors. Masks provide a barrier against airborne allergens, offering some protection for allergy sufferers.

Identifying Allergy Symptoms

Recognizing the symptoms of seasonal allergies is crucial for proper management. Common signs include:

1. Itchy, watery eyes
2. Sneezing
3. Nasal congestion
4. Runny nose
5. Itchy throat or ears
6. Coughing
7. Fatigue

These symptoms can significantly impact quality of life, affecting sleep, productivity, and overall well-being. It’s important to differentiate these symptoms from those of a common cold or other respiratory infections.

Effective Strategies for Allergy Management

Managing seasonal allergies effectively requires a multi-faceted approach. Here are some strategies that can help alleviate symptoms:

1. Medication Options

Over-the-counter antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) can provide relief from itching, sneezing, and runny nose. Nasal corticosteroid sprays such as fluticasone (Flonase) or mometasone (Nasonex) are effective in reducing inflammation and congestion.

2. Environmental Control

Reducing exposure to allergens is key. Keep windows closed during high pollen days, use air purifiers with HEPA filters, and shower after spending time outdoors to remove pollen from skin and hair.

3. Immunotherapy

For severe or persistent allergies, allergen immunotherapy (allergy shots or sublingual tablets) can help desensitize the immune system to specific allergens over time.

4. Natural Remedies

Some people find relief with natural remedies like saline nasal rinses, local honey, or herbal supplements. However, it’s important to consult with a healthcare provider before trying any new treatments.

The Role of Technology in Allergy Management

Advancements in technology have provided new tools for allergy sufferers. Mobile apps can now track pollen counts and provide personalized forecasts, allowing individuals to plan their activities and medication use more effectively.

Wearable devices that monitor air quality and allergen levels are also becoming more common, offering real-time data to help users make informed decisions about their exposure to potential triggers.

The Importance of Professional Guidance

While self-management strategies can be effective for many allergy sufferers, seeking professional medical advice is crucial, especially for those with severe or persistent symptoms. Allergists can perform tests to identify specific allergens, recommend appropriate treatments, and monitor the effectiveness of interventions over time.

Additionally, they can help differentiate between allergies and other conditions that may present with similar symptoms, ensuring that patients receive the most appropriate care for their specific situation.

Future Outlook: Adapting to Changing Allergy Patterns

As climate change continues to influence pollen production and distribution patterns, it’s likely that allergy seasons will become increasingly unpredictable and potentially more severe. This evolving landscape necessitates ongoing research and adaptation of management strategies.

Scientists are exploring new approaches to allergy treatment, including the development of more targeted immunotherapies and novel medications that can provide longer-lasting relief with fewer side effects. Additionally, efforts to mitigate climate change may have indirect benefits for allergy sufferers by helping to stabilize pollen production patterns.

The Role of Urban Planning

Urban planning and landscaping choices can play a significant role in managing allergen levels in cities and towns. Selecting low-allergenic plant species for public spaces and encouraging diverse ecosystems can help reduce the concentration of highly allergenic pollen in urban areas.

Empowering Individuals: Knowledge and Preparation

Education plays a crucial role in empowering individuals to manage their allergies effectively. Understanding the specific triggers, recognizing early symptoms, and knowing how to access and use various treatment options can significantly improve quality of life for allergy sufferers.

Preparing for allergy season in advance, such as starting medications before symptoms typically begin and making necessary lifestyle adjustments, can help minimize the impact of seasonal allergies.

The Importance of Tracking Symptoms

Keeping a detailed record of allergy symptoms, their severity, and potential triggers can be invaluable. This information can help healthcare providers tailor treatment plans and allow individuals to identify patterns in their allergic responses over time.

Allergies and Overall Health

While often viewed as a mere annoyance, seasonal allergies can have broader implications for overall health. Chronic allergies can lead to sleep disturbances, decreased cognitive function, and increased susceptibility to respiratory infections. Moreover, untreated allergies can exacerbate conditions like asthma, potentially leading to more serious health complications.

Understanding the connection between allergies and other aspects of health underscores the importance of proper management and treatment. By addressing allergies effectively, individuals can improve not only their immediate symptoms but also their long-term health and well-being.

The Mind-Body Connection

The relationship between allergies and mental health is an area of growing interest. Chronic allergies can contribute to stress, anxiety, and even depression in some individuals. Conversely, stress and emotional state can influence the severity of allergy symptoms, creating a potential feedback loop.

Holistic approaches to allergy management that consider both physical and mental well-being may offer more comprehensive relief for some sufferers. Techniques such as mindfulness meditation, stress reduction strategies, and cognitive behavioral therapy have shown promise in helping individuals cope with the psychological impacts of chronic allergies.

The Global Impact of Changing Allergy Patterns

The changing landscape of seasonal allergies is not limited to the United States or even North America. Countries around the world are reporting shifts in allergy patterns, often linked to local climate changes and urbanization. This global trend highlights the need for international collaboration in allergy research and management strategies.

As populations become more mobile and climate patterns continue to shift, individuals may find themselves exposed to new allergens as they travel or relocate. This emphasizes the importance of flexibility and adaptability in allergy management approaches.

Economic Implications

The economic impact of seasonal allergies is substantial, encompassing direct healthcare costs, lost productivity, and reduced quality of life. As allergy seasons become longer and more severe, these economic effects may intensify, potentially leading to broader societal impacts.

Investing in allergy research, prevention strategies, and accessible treatments could yield significant economic benefits by reducing the overall burden of allergies on individuals and healthcare systems.

Innovations in Allergy Prevention and Treatment

Ongoing research continues to yield promising innovations in allergy prevention and treatment. Some areas of focus include:

• Gene therapy approaches to modify the immune response to allergens
• Development of hypoallergenic plant varieties through genetic engineering
• Advanced air filtration systems for both indoor and outdoor environments
• Personalized medicine approaches based on individual genetic and environmental factors
• Novel delivery methods for immunotherapy, such as oral tablets or patches

These advancements offer hope for more effective, targeted, and convenient allergy management in the future. However, it’s important to note that many of these innovations are still in the research or early implementation stages and may not be widely available for some time.

The Role of Community and Policy in Allergy Management

Effective management of seasonal allergies extends beyond individual actions to encompass community-wide efforts and policy decisions. Local governments and community organizations can play a significant role in mitigating allergy impacts through various initiatives:

Public Education Campaigns

Raising awareness about allergy triggers, prevention strategies, and available treatments can empower communities to take proactive steps in managing allergies. This can include informational campaigns, workshops, and school-based education programs.

Pollen Monitoring and Reporting

Establishing comprehensive pollen monitoring networks and ensuring easy public access to this data can help individuals make informed decisions about outdoor activities and medication use. Many cities already provide daily pollen forecasts, but expanding and improving these systems could offer more accurate and localized information.

Green Space Management

Urban planning policies that prioritize the use of low-allergen plants in public spaces can significantly reduce allergen levels in cities. This approach, sometimes referred to as “allergy-friendly landscaping,” involves selecting plant species that produce less pollen or are less likely to trigger allergic reactions.

Air Quality Initiatives

Efforts to improve overall air quality, such as reducing vehicle emissions and industrial pollutants, can have indirect benefits for allergy sufferers. Pollutants can exacerbate allergy symptoms and increase sensitivity to allergens, so cleaner air can lead to reduced allergy impacts.

Healthcare Access and Coverage

Policies that ensure access to affordable allergy treatments, including both medications and specialist care, are crucial for comprehensive allergy management. This may involve advocating for insurance coverage of allergy treatments or supporting community health initiatives focused on allergy care.

Adapting to a Changing Allergy Landscape

As the allergy landscape continues to evolve, adaptation will be key for individuals, healthcare providers, and communities. This may involve:

• Regularly updating allergy management strategies based on new research and changing environmental conditions
• Developing more flexible healthcare approaches that can quickly respond to shifting allergy patterns
• Encouraging interdisciplinary collaboration between allergists, climatologists, urban planners, and policymakers to address the complex factors influencing allergy trends
• Promoting resilience and adaptability in individuals through education and support

By taking a proactive and comprehensive approach to seasonal allergies, we can work towards minimizing their impact and improving quality of life for millions of affected individuals.

Conclusion: A Path Forward in Allergy Management

As we navigate the changing landscape of seasonal allergies, it’s clear that a multifaceted approach is necessary. From individual management strategies to community-wide initiatives and ongoing scientific research, addressing the challenges posed by worsening allergy seasons requires collaboration and innovation.

By staying informed about the latest developments in allergy research and treatment, individuals can take proactive steps to manage their symptoms effectively. At the same time, broader efforts to mitigate climate change and improve air quality may help slow the trend of worsening allergy seasons.

Ultimately, the goal is to empower allergy sufferers with the knowledge and tools they need to lead healthy, active lives, regardless of the season. With continued focus on this issue from medical professionals, researchers, policymakers, and communities, we can work towards a future where seasonal allergies are less of a burden for millions of people worldwide.

No, You’re Not Imagining It: Seasonal Allergies Are Getting Worse | BU Today

One reason for the spike in seasonal allergies in recent years? Drier springs and summers mean less rain to tamp down airborne pollen. Photo by Freestocks/Unsplash

Seasonal Allergies

School of Medicine’s Fred Little on reasons for the spikes and what you can do about it

April 27, 2023

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It’s that time of year again—you’re sitting outdoors enjoying the sunshine, when all of a sudden, you start to feel…itchy. Within an hour, that itch has turned into a full-blown sneeze attack complete with watery eyes and congestion, and now you’re running to the nearest pharmacy to buy some Zyrtec.

Seasonal allergies—or an allergic reaction to the tree and grass pollens that float around in the spring and summer, known as allergic rhinitis—affect nearly 60 million people in the United States every year. In recent years, they’ve become particularly bad in the Northeast, which can largely be attributed to climate change, says longtime allergist Fred Little, a Boston University Chobanian & Avedisian School of Medicine clinical associate professor of medicine and the director of the Boston Medical Center allergy-immunology fellowship. And this year, record-high pollen counts have caused seasonal allergies to start even earlier than usual—which means prolonged symptoms for allergy-sufferers.

We spoke with Little about how allergies work and what you can do to cut down on the sneezing, itching, and watery eyes.

Q&A

with Fred Little

BU Today: So, what are allergies, exactly?

Little: Allergies are an abnormal immune response to normally harmless substances that are in the environment. Allergies aren’t like other diseases, such as cystic fibrosis or sickle cell anemia, where there’s a very strong hereditary [component]. Allergies are a mix of heredity and environment. 

What’s basically involved [for nonfood allergies] is that one becomes exposed to allergens in the environments that are part of normal day-to-day living. These harmless proteins—like cat dander and pollen—are seen by the immune system as a threat, which leads to an immune response where certain immune cells are activated and release substances that cause congestion in the nose. That can also lead to sneezing from histamine release in other cells and excessive mucus production in the conducting airways. And there are other cells which release mediators that cause narrowing of the airways beyond what excess mucus does, which is what leads to the symptoms of wheeze and asthma for people that have allergic asthma. 

Allergic responses can develop in adulthood as well as in childhood. We often see patients at Boston Medical Center who grew up in a different ecological environment from the Northeast and may not have had problems with allergies when they were younger. But two or three years after arriving here, their immune system gets primed to start developing that maladaptive response. Over time, that can lead to symptoms of hay fever—the technical term is allergic rhinitis—like sinus inflammation or asthmatic symptoms. So, that’s a general background of how people can be susceptible to developing sensitization to allergens.

BU Today: Why have seasonal allergies been so bad lately?

Little: There are several things that contribute to allergy symptoms being worse in recent years. For one, I think people are wearing masks a lot less compared to previous allergy seasons. Masks obviously provide a little bit of protection from being exposed to allergens outdoors and indoors. 

Last year, the grass pollen counts also started to climb a little earlier in the season than usual. People who are allergic to grass pollen started having symptoms earlier than before. That’s related to climate change, as well as things that contribute to more pollen generation in general (like a warm, wet spring that helps plants grow). I’m not a climate scientist so I can’t get into the nitty-gritty science, but certainly, over the last 20 years, there have been longer pollen seasons throughout the temperate climates of the United States. Warmth is definitely a factor; if it’s warmer—and warmer longer and earlier on—before and during allergy season, that particular area is going to have more pollen production. Drought and dryness is also a factor: dryness during allergy season increases pollen levels just because rain cuts down on airborne pollen.  

One interesting tidbit: pine pollen—the yellow pollen you see on cars and in storm drains—is not actually as allergenic as pollen that comes from deciduous, or leafy, trees, like birch, maple, and oak. People may have a perception that the pollen levels are terrible because they see yellow stuff all over the place, but that doesn’t necessarily correlate with the pollen that is the most allergenic.

BU Today: What can people do to decrease their pollen exposure?

Little: Unlike somebody with a food allergy, who can control their exposure to that food, it’s very hard to control exposure to pollens, as they’re so pervasive. Even indoors: as we come in and out of our houses, we wear the clothes we were wearing outdoors and bring pollens into the house. There are some things that can be done to minimize pollen levels in the house. For one, if you have the resources, keep windows closed during the night and day and use air conditioners to keep the air cool. 

For people with really bad allergies to pollens, they might want to change out of their outside clothes when they come inside and wash them [as soon as possible]. That can be helpful for people who have severe allergies (or live with someone who does) and want to keep the house as pollen-free as possible. But no house or apartment is airtight, so it can be hard to keep the outdoor environment from coming indoors.

BU Today: What about allergy medications? Are there any tips or tricks to remember?

Little: From a medical standpoint, there are medications that people can get used to. A good example is topical decongestants like Afrin [nasal spray]. The active ingredient in those is oxymetazoline, a decongestant that causes blood vessels to constrict [in the nasal passages]. You know, you have a really bad cold and you do a few squirts and you can breathe better. But, those shouldn’t be used for more than three days at a time. After that, there can be a rebound effect where the nasal tissues themselves become accustomed to the spray and almost dependent on it. You can actually end up worse off than you were at the beginning. 

Instead, a mainstay treatment [for congestion] is nasal steroid sprays like Flonase or Rhinocort, which are available both over the counter and by prescription. They can, however, take two or three weeks to kick in and have the maximal effect. If someone uses a spray for a week without noticing a difference in symptoms, it’s not because it’s not working anymore. It’s because nasal steroids take a longer time to modify the abnormal immune response.

An interesting tidbit for allergy sufferers in New England is that our tree pollen season starts before our local trees are even producing pollen. It’s because of all the leafy trees up and down the Eastern Seaboard that pollinate earlier than ours do and send pollen up the jet stream. I’ll often have patients start their nasal sprays in mid-March to prime the pump, so to speak, for immune protection against tree pollen.

Then there are things like antihistamines, which work in a day or two after taking them. There are many patients with mild hay fever symptoms who do fine with just taking Zyrtec or fexofenadine or loratadine once or twice a day. Others with more severe symptoms, particularly nasal congestion, won’t be helped much by antihistamines alone and will need something like a nasal steroid to help control that.

BU Today: One last question: How can you tell the difference between allergies and COVID-19?

Little: The truth is, it can be very difficult to differentiate allergy symptoms from mild COVID symptoms during allergy season. The main differentiators are that people with allergies should not have a fever, and certainly not the high fever that you can get with COVID, nor experience the fatigue that’s associated with COVID. We do have to remember that people who have allergic asthma can also develop respiratory symptoms during their allergy season, which can make it a little bit harder to differentiate. But people with asthma are usually familiar with their asthma symptoms and should be able to tell them apart from COVID-19 pneumonia symptoms.

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High pollen count: Why are my allergies so bad right now?

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Pollen has exploded to eye-watering levels this spring in some parts of the country after warm weather pushed plants out of their winter slumber much earlier than normal.

In Atlanta, the pollen count sky rocketed to “extremely high” in early March and stayed high through much of April, according to the Atlanta Allergy and Asthma physicians practice. Farther north in Washington, DC, allergy sufferers have been dreading the lime-green film of pollen covering that covers windshields and porches and piles up on streets and sidewalks.

But these aren’t isolated trends. As the planet warms, researchers say allergy season is starting earlier and lasting longer. And a study from the journal Nature published last year found that pollen count is projected to increase by 200% by the end of the century if planet-warming pollution continues to rise.

Climate Central, a nonprofit focused on climate news and research, recently analyzed how warmer temperatures have affected allergy season in 203 US cities since 1970.

It found that on average, the growing season – the period between the last freeze in spring to the first freeze of fall – is lasting 16 days longer in the Southeast, 15 days longer in the Northeast and 14 days longer in the South.

In the West, growing season is 27 days longer on average, Climate Central reported. Reno, Nevada, for example, has seen a shocking increase of 99 days.

And a longer growing season means a longer allergy season.

Growing season in the US has lengthened by 15 days on average, according to a Climate Central analysis.

Climate Central

“Because of climate change, we’re now seeing an earlier and longer growing season for plants, which of course make pollen, which is the enemy of many Americans that suffer from pollen allergies – and mold allergies as well,” Lauren Casey, a meteorologist with Climate Central, told CNN. “Pollen can also trigger an asthma attack, which of course is much more serious for people that suffer from asthma.”

When plants reproduce, typically during the spring, many release tiny pollen grains that are carried by wind. The pollen grains are small enough to be inhaled, and some people’s immune systems react very poorly to the miniscule particles.

More than 24 million people in the US have pollen-induced respiratory allergies like hay fever, according to the Centers for Disease Control and Prevention. The center’s data shows that more than one in four adults suffered from seasonal allergies in 2021.

Growing season has lengthened by 34 days in Atlanta, according to a Climate Central analysis.

Climate Central

Growing season has lengthened by 20 days in Washington, DC, according to a Climate Central analysis.

Climate Central

A longer and earlier start to pollen season could trigger a public health emergency, researchers say. As temperatures get warmer in the South and drought plagues the Southwest, pollen from plants like ragweed or poaceae – a plant that typically grows in grasslands or salt-marshes – is projected to be higher across those regions than in the North.

Wind-driven pollen, which plays an important role in plant fertilization, is closely tied to temperature and precipitation changes. So, as spring seasons get warmer earlier due to climate change, plants could pollinate much earlier and for a longer period of time than they currently do.

Plant pollen isn’t the only trigger of seasonal allergies. Mold, a type of fungi that reproduces with tiny airborne spores, can also be allergenic for some people and can exacerbate seasonal allergies, according to the report.

While outdoor mold is not as well-studied as pollen, according to the report, one thing is clear: Warmer and wetter weather – conditions that many locations are seeing more of amid the climate crisis – is favorable for mold development.

Adobe Stock

Allergy season will start much earlier than normal and be far more intense because of climate crisis, study suggests

“With climate change, we’re seeing increases in warming in all seasons, but particularly the fastest warming season for most locations across the US is the winter season,” Casey said. “So now we’re dealing with mold at a time of year that we typically wouldn’t.”

Casey also pointed out that the climate crisis is making extreme precipitation more likely, which provides that crucial dampness for mold to grow. The report highlights the link between allergens and thunderstorms, which researchers say spread pollen and mold spores through the air more efficiently.

“The problem with pollen grains is that when they get wet, they rupture, and they break into tinier bits called sub-pollen particles,” Casey said. “Those tinier bits are more easily dispersed by the wind when they dry out, and they have an easier time getting into your nasal passages.”

Oak trees are pumping out pollen in the Southeast, contributing to extremely high levels early in the season.

Andrei Zhigaltsov/iStockphoto/Getty Images

Dr. Mitchell Grayson, chair of the Asthma and Allergy Foundation of America’s Medical Scientific Council and chief of the division of allergy and immunology at Nationwide Children’s Hospital, said he has seen pollen allergies arrive earlier than usual.

“In general, we may be seeing people a little earlier in the spring with symptoms – so mid-February from what might have been early March in the past – but there is significant year-to-year variability in this,” he told CNN. “I haven’t seen worse symptoms, but I’m in a hospital that provides specialist care, and we do see people with all ranges of severity.”

CNN Weather

After a record warm February, winter cold is returning

The treatment of allergies won’t change even as the season gets longer, Grayson said. But it’s important to be aware of what you’re allergic to and know where these triggers are in the environment.

Experts recommend:

• Staying indoors, especially early in the morning or late in the afternoon, when most plants release pollen.
• Wear masks outdoors when possible to mitigate the effects, Amiji said.
• Keeping windows closed in your home and car to minimize your exposure to pollen particles.
• Changing air filters more frequently for your A/C and heating systems in your home and car, according to the manufacturer’s instructions.
• Preparing early by stocking up on anti-allergy medications. If you use a steroid nasal spray, Grayson said it’s important to start using it one to two weeks before your allergy season and to continue through the full season.

Casey, the meteorologist, also noted that allergy season could be a financial burden on low-income families, especially those whose members have asthma, due to the “billions of dollars spent a year on the medical costs of asthma and allergies. ”

She said awareness is key, especially as the world pumps more carbon pollution into the atmosphere, which could worsen allergy seasons.

“You know your own body and are aware of what a typical year is going to look like for you, especially if you’re an allergy sufferer,” she said. “But that whole paradigm is changing with this increase in the growing season, so having awareness that you may be suffering now and going forward in times of the year when you typically wouldn’t, so be prepared for that in your daily life.”

Correction: A photo previously included in this article incorrectly identified a plant as ragweed. The image has been removed.

How to prevent allergies? What to do if you are allergic to cats, but you really love these fluffy buns and suffer incredibly? Answers to questions from Meduza readers about allergies

Francesco De Tommaso / Unsplash

At the end of April, we invited Meduza readers to ask us what they would like to know about allergies. We received more than two thousand questions, chose the most interesting ones and answered them (and clarified some other points related to allergies).

How to prevent allergies?

Short. Unknown.

Doctors only speculate why an allergy might develop – that is, an inadequate aggressive immune response to some foreign substance that does not pose a threat (usually protein, but in rare cases it can also be something inorganic – for example, nickel. ) There are several risk factors, but in most cases a person cannot influence whether he will have an allergy or not.

What’s more, research shows that a complex combination of factors usually leads to allergies. For example, allergic rhinitis often occurs in people with a genetic predisposition to allergies, born during the flowering season of the main allergenic plants, while being born first in the family and receiving antibiotics early. Food allergies are also more likely to develop in a person with a genetic predisposition.

Medical communities do not list stress, old grudges, unsatisfactory relationships with relatives as risk factors for developing allergies, despite the statements of individual doctors and psychologists. However, as noted by Olga Zhogoleva, an allergist-immunologist, founder of Everyday Clinic (St. Petersburg), the symptoms of bronchial asthma and atopic dermatitis can worsen against the background of psycho-emotional stress. The risk factors and causes of allergies also do not include chronic infection, adrenal dysfunction or parasites.

Will a dog in the house help protect the child from allergies or, on the contrary, will it harm?

Short. Leave the dog alone, there are other ways to reduce the risks.

People who had contact with a dog as a child are statistically less likely to develop allergic diseases. There is a hypothesis that the animal adds bacterial diversity to the child’s body. However, doctors do not yet give recommendations to future parents to give away cats, dogs and hamsters or, conversely, to buy: firstly, data on the influence of pets on the development of allergic diseases cannot be called very reliable; secondly, it is impossible to have animals solely for the prevention of allergies in children.

Here are some things parents can do to help reduce their child’s risk of developing allergies:

• Do not smoke during pregnancy and after the birth of a child with it – this increases the risk of developing asthma, and tertiary smoking can also have a similar negative effect.
• Breastfeed only for the first 3-4 months.
• Moisturize baby’s skin. “Dry skin in the first year of life is one of the risk factors for the development of atopic dermatitis,” says Olga Zhogoleva. – In atopic dermatitis, the skin is one of the routes for the formation of allergies. When an allergen gets on dry, permeable skin, a person may become allergic to these proteins due to the malfunction of the immune system. That’s why skin care is so important.”
• Fight dust mites: maintain a relative humidity of 35-50% at home, wash bedding in hot water weekly, use mattresses and pillows with special covers that protect against dust mites, get rid of carpets, vacuum regularly – a vacuum cleaner should have a good filter.

While pregnant or breastfeeding, there is no reason to eliminate popular allergens from your diet. As well as during the start of complementary foods.

By the age of 30, I had no allergies. Am I lucky?

Short. Not fact.

Allergies can appear at any age, although for most people it does start in childhood. It happens that in adults it occurs during pregnancy or after a viral infection, but the mechanism of this phenomenon is unclear.

In the modern world, allergic diseases have become so widespread that it is easier for people to explain the incomprehensible reaction of their body with allergies. In fact, symptoms similar to an allergic reaction may indicate other diseases or disorders. Here are just a few examples:

• Food intolerance is an unpleasant reaction of the body to food, not associated with the functioning of the immune system, but with difficulties in digesting certain foods. Intolerance is more common in adults than food allergies.
• Other diseases of the gastrointestinal tract. For example, gastroesophageal reflux disease (heartburn), or irritable bowel syndrome – then the body can really react badly to certain foods.
• Mental disorders. “People often confuse panic attacks with allergy symptoms: it’s hard to breathe, there is a lump in the throat, heart palpitations – and the person thinks he has inhaled the allergen,” says Olga Zhogoleva. “Or, it happens that a person feels that he has an intolerance to all foods, medicines in general – such symptoms can go well on antidepressants.”
• Symptoms of an infectious disease or side effects of a drug. Most people with a previously diagnosed allergy to penicillin do not actually have it. Misdiagnosis is made because, for example, the drug caused adverse reactions that just look like an allergy. It happens that a doctor treats a viral infection with antibiotics, and then a rash occurs due to the disease, which would have appeared anyway, but it is mistaken for an allergy to the medicine;
• Skin diseases caused by exposure to ultraviolet radiation. They are commonly referred to as “sun allergies”, although such a reaction is rarely allergic. When it is really an allergy, the allergen is not ultraviolet light, but a substance that has been applied to the skin – for example, as part of a sunscreen (but it happens that the reaction is associated with a medicine taken orally). The sun’s rays only provoke an inadequate response to contact with the substance.

How is atopic dermatitis different from allergies?

Short. Symptoms.

Atopic dermatitis is a chronic inflammation of the skin that is itchy and cracked. People with atopic dermatitis often have allergies, and in this case, after eating the allergen, other symptoms appear: for example, itchy mouth, runny nose, abdominal pain. But it happens that with atopic dermatitis there is no allergy, although the test results show sensitization to certain allergens. An allergy is a condition in which there is both sensitization and characteristic symptoms. Sensitization in itself is not an allergy and may never lead to one.

Atopic dermatitis can also be confused with allergic contact dermatitis, which, as the name implies, occurs when the skin comes into contact with an allergen: a person puts on a ring or latex gloves, and within hours or days an itchy rash appears on this site. In order to distinguish one disease from another, a competent doctor will do the best.

How do you tell an allergy from a cold?

Short. With ARVI, everything hurts, with allergies, everything itches.

Although SARS can be confused with allergic rhinitis, sometimes the difference is still noticeable. With ARVI, there is usually a sore throat and muscles, cough, fever, symptoms develop gradually, disappear after a few days. Allergic rhinitis causes itchy eyes.

If there is a suspicion that it is an allergy, then some tests will give an accurate answer. Total IgE, which is often checked in such cases, cannot be called a reliable method: with allergies, this indicator is not increased, and vice versa. Therefore, competent doctors more often use other methods that allow them to determine which allergen leads to the development of symptoms:

• skin tests (prick test) – these are usually used first because they are cheaper and more accurate when it comes to allergies to what enters the body through the nose;
• specific antibody (IgE) blood test – this is usually used if skin tests are not available or if the results are unclear (determining the level of immunoglobulin class G (IgG) does not indicate whether a person has an allergy or intolerance).

All of these methods can be applied from any age, but allergic rhinitis is rare before the age of two, because it takes several encounters with the allergen and time for the reaction to develop.

In any case, the tests should be ordered by the doctor after a long conversation in order to determine the most likely allergen. Taking tests for a large number of allergens at once is expensive and unjustified. This can identify sensitization to an allergen that does not actually cause any symptoms.

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How do you deal with allergies yourself?

Short. None. Contact your doctor.

Without a doctor, there is a risk of wasting time and money. First of all, you need to make sure that the diagnosis is correct and clarify what exactly the allergy is. This will make it easier to avoid contact with the allergen by tracking pollen levels using online services when it comes to allergic rhinitis. On the worst days for you (dry, windy, with a high level of allergen in the air), it is better to close the windows and not leave the house. If this is not possible, then doctors recommend putting on glasses with tight-fitting frames, and after returning home, take off your clothes without going into the bedroom and go to the shower. Theoretically, nasal filters and ointment around the nose can be useful, and there are even small studies with positive results about filters. As for face masks, the recommendations of medical societies do not even consider them as a possible protection option.

If a doctor diagnoses a food allergy, then some product will have to be excluded from the diet. “If you continue to eat these foods, the severity of symptoms is likely to increase,” explains Olga Zhogoleva. “Moreover, this is a lottery: today there may be hives, and tomorrow anaphylaxis.” If you have to give up a whole group of foods, consult a nutritionist – you may need to somehow adjust the diet so that it remains complete.

The doctor is also needed in order to select the treatment in accordance with the symptoms (including during pregnancy and breastfeeding). Do not think that there is one best antihistamine that everyone can take in the morning and not remember about allergies all day. “For pollen allergy, we start basic therapy, regardless of whether there are symptoms, at least two weeks before the start of flowering,” says Olga Zhogoleva. – We select a treatment that can then be used independently from year to year. But if therapy ceases to help, then it is better to consult a doctor to correct it.” Tablets (and even more so first-generation antihistamines) are not always used: for example, in some cases, steroid nasal sprays or other topical preparations can be used.

In Russia, anti-allergic immunoglobulin is sometimes offered for the treatment of allergies, which is not mentioned in American and European recommendations. Homeopathic remedies, blood filtration, fasting, acupuncture, shilajit, Chinese medicine have also not proven effective in treating allergies.

What can I do to prevent allergies from becoming asthma?

Short. To be treated.

Allergy can indeed develop into bronchial asthma, and, unfortunately, doctors do not have universal advice on how to avoid this, but there is allergen-specific immunotherapy (ASIT) and sublingual immunotherapy (SLIT). This treatment has been reported to prevent the development of asthma in people with allergic rhinitis. The essence of the treatment is that a person is gradually injected with an increasing amount of the allergen using subcutaneous injections (ASIT) or tablets under the tongue (SLIT), and the body gets used to it. For 3-5 years of such treatment, many people have symptoms of an allergic disease disappear. Both methods have pros and cons, and the decision of which one to choose should be made with the doctor.

Immunotherapy can be used for allergic reactions to certain tree and grass pollens, cat and dog dander, dust mites, cockroaches, certain molds and stinging insects. Unfortunately, there are no drugs for food and other types of allergies that have shown their effectiveness. “In Russia, foreign weed allergens are also not registered – there are only domestic ones, and there are no sublingual forms,” says Olga Zhogoleva. — Animal allergens are not registered. There are also no allergens from stinging insects, so in our country you can undergo ASIT with this allergen only at the Institute of Immunology in Moscow.”

According to Dr. Zhogoleva, in Russia (as of spring 2019) there are interruptions in the supply of French-made drugs for injectable therapy, but everything should change by the end of the year or the beginning of the next. Sublingual forms and Russian-made preparations for injection therapy are now available. “With Russian allergens, the problem is standardization: different bottles with the same allergen may contain different amounts of the main molecules,” says Olga Zhogoleva. “That is, you can start therapy with a Russian allergen and, when you change the series of vials, get a different concentration and side effects. ”

How to recover from an allergy to cats (“ because you really love these fluffy buns and suffer incredibly ”)?

Short. Leave Russia, try symptomatic treatment or accept.

Immunotherapy would be a good option in this situation, but there are no drugs registered in Russia to treat cat allergies. Although, according to Olga Zhogoleva, they are promised to be registered in the foreseeable future. So far, such therapy is available only abroad, including in some European countries and the United States.

People for whom this option is not suitable may try symptomatic treatment. But not always. “If a person has asthma, while maintaining contact with a cat, there is a high risk that the symptoms will increase,” says Olga Zhogoleva. “And if you consider that asthma is a life-threatening disease, then you will have to consider giving the cat away.” In milder cases, when the symptoms are minimal, Dr. Zhogoleva suggests that her patients who do not want to part with the animal try drug therapy. The drugs will need to be taken continuously. “But I always make it clear: if the symptoms progress, you still have to think about parting with the animal, because asthma always looms with symptoms of respiratory allergies,” explains Olga Zhogoleva.

If you are leaving a pet, it is also a good idea to do your best to minimize contact with the allergen. To do this, as advised by the British National Health Service, it is better to let the animal only into certain rooms (preferably without carpets), not let them into the bedroom, bathe once a week, wash the bed regularly, ventilate the room and use an air purifier.

A hypoallergenic animal will not save in such a situation: they simply do not exist. However, some people notice that they have an allergic reaction to some cats, but not to others. This is due to the fact that in cats, as Olga Zhogoleva says, the secretion of the main allergen (out of eight) is interconnected with sex hormones, so it is less in cats and neutered cats. Such nuances can affect the symptoms. 20% of people, according to Dr. Zhogoleva, can also adapt and develop tolerance to allergens, which, in fact, happens with ASIT. However, doctors cannot predict who exactly this will happen to.

What should I do if I have an acute allergic reaction before the medical staff arrives?

Short. Carry adrenaline with you, teach your friends about cardiopulmonary resuscitation.

People who have already had a severe anaphylactic reaction should carry an adrenaline auto-injector with them at all times. Adrenaline, unlike antihistamines, quickly relieves symptoms, which can be critical. However, only one such drug was registered in Russia – in 2017. It is not on sale, there is no information about it on the company’s website, they also cannot say by phone whether it is planned to be delivered. Therefore, now patients have two options:

1. Go abroad, visit a doctor there, get a prescription for such a drug and buy it.
2. Ask your doctor for a prescription for regular epinephrine ampoules and an explanation of how to use it. Carrying this kind of “anti-shock kit” (an ampoule and a syringe or, in some cases, a syringe with pre-filled adrenaline) is suggested in Russian clinical guidelines. However, as Olga Zhogoleva notes, the instructions for adrenaline say that it must be stored in the refrigerator. “The good news is that there are studies that show adrenaline is stable at room temperature,” says Dr. Zhogoleva. “Accordingly, you can actually take it with you without an ice pack.”

If there is no adrenaline with you, you need to call an ambulance. Prior to her arrival, the people around should be ready to start cardiopulmonary resuscitation on their own if the person stops breathing.

Daria Sargsyan

The diagnosis of food allergy (food allergy)

The diagnosis of “food allergy” is heard in the practice of a dietitian as often as possible – probably most often. I will give here the basic information about this phenomenon and tell you what to do if such a diagnosis has sounded in the life of your dog or cat.

Allergy – reaction of the immune system to substances that are safe for the body as dangerous, an excessively strong response to a meeting with a molecule that normally does not cause any reaction. Food allergy is an increased sensitivity of the immune system to substances coming from food or feed additives.

An allergen is the same substance that caused an excessive immune response. For food allergies, these can be either the main nutrients, usually of a protein nature (chicken, beef or lamb, for example), or additives used in feed. When processing protein ingredients together with carbohydrates (in an extruder in the production of dry food, for example), they can form complexes with each other. And with long-term feeding of dry food to a dog prone to allergies, these complexes become allergens for it. This explains why some dogs are allergic to dry food, but if you cook the same foods in their natural form (say, chicken-rice), they do not become allergic to food.

Feed intolerance – the inability of the body to absorb certain substances from the feed, not related to the immune system. This happens, for example, with a lack or absence of the necessary enzymes that break down such substances. For example, in dogs and cats, the lactase enzyme, which breaks down milk sugar, is not enough to digest cow’s milk. Therefore, when certain small amounts are exceeded, they develop diarrhea. There are also a number of foods that are toxic to dogs and cats. These include, for example, chocolate, or rather, the theobromine contained in it. Plants of the onion family are also poorly tolerated by dogs and cats, and in certain doses can cause serious poisoning.

What is an allergy?

What are the features of this phenomenon, what are the forms, and what to look for if you suspect an allergy, including an allergy to food.

Allergies develop individually , each animal has its own history of feeding, so the allergen in each case is different. The strength of the response of the immune system depends on many interrelated processes and can also be different. Nature can create the prerequisites for the emergence of allergies, i.e. predisposition to this disease is inherited, but not the disease itself. It is now a very common misconception that all dogs of a certain breed cannot tolerate the same protein – for example, chicken. Or the breed has a gluten sensitivity, so all these dogs should avoid food with corn. Overlaps are possible because dogs in each population are fed the most common food in the area. But each case requires an individual approach, so each case should be carefully analyzed by a veterinarian.

Allergy – disease acquired , not born with it. A puppy or kitten may be genetically predisposed to allergies, and it is not at all necessary that he will have an allergy. Much depends on the conditions of feeding and maintenance. The immune system in puppies and kittens is formed during growth, and it goes a long way as they get older before giving rise to a hypersensitivity reaction. This means that in small puppies and kittens (even up to six months of age), a real food allergy is extremely rare. Most often, the cause of their symptoms is other diseases or feeding errors.

Allergy – a disease cumulative , this means that for some time the allergen and the components of the immune system meet, and only as a result of this “acquaintance” does the body react.

That is why common food allergens are those food components that are most often found in local food. If chicken has been most common in feed for a long time, it falls into the list of common allergens. After the boom in “hypoallergenic” lamb in feeds, lamb has also become a common item on this list.

There are two forms of manifestation of food allergy – intestinal and skin . In the cutaneous form, itching is almost always observed, which can be supplemented by various violations of the integrity of the integument. In the intestinal form, diarrhea and flatulence are observed.

Food Allergy Diagnosis

Before suspecting a food allergy in your pet, your doctor will offer you a differential diagnosis depending on the symptoms observed. This is an important step, because in the vast majority of cases, the cause will be found in something else. These can be parasitic and infectious diseases, various skin (intestinal) diseases, as well as non-food allergies, such as flea bites. Unbalanced feeding can also cause problems with similar symptoms.

There are various methods for diagnosing food allergies in pets, but the elimination diet method is by far the most reliable. The veterinarian will prescribe a diet after a thorough analysis of the history of feeding and talk about the rules for its application. The more detailed the previous feeding experience is described, the more accurate the recommendations will be – it is important not to miss anything here, including treats, feed additives, vitamins and other preparations.

Each change of food is capable of causing an improvement due to the renewal of the microflora and the activation of metabolic processes. This explains the improvement that is often seen with food changes. A veterinary nutritionist will analyze the situation individually and conclude whether it was a food allergy.

Allergic animals often require several food changes during their lifetime as they Allergies may also develop over time to the new food. But, fortunately, in dogs and cats, the immune memory is relatively short, so when a problematic product is excluded for a long time, it is often “forgotten” and perceived normally.

If you have a real food allergy, you will need a lot of patience to deal with it. But do not despair – for each case there is a solution. To solve this problem, contact a veterinarian-nutritionist.

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