Allergies: Nothing to Sneeze At

Like other allergy symptoms, hay fever's leaky eyes, runny nose, sneezing and burning palate mean your immune system is overreacting to an otherwise harmless substance you've inhaled, swallowed or touched.

"The immune system is our defense mechanism," says allergy specialist S. Michael Phillips, M.D., a University of Pennsylvania professor of medicine and neurology. "It has been ordered to destroy substances foreign to our bodies."

But the chemical weapons your immune system unleashes on these "allergens" have powerful inflammatory properties. The result? Those runny noses and eyes, or a variety of other symptoms from hives to itchy skin.

Roughly one person in four has some kind of allergy. The most common is "allergic rhinitis," which includes seasonal hay fever and year-round allergies to dust, pollen, animal dander, mold and some foods.

Learning your triggers

Q: How can I pinpoint the cause of my allergies?

A: You may already know what exposures trigger your allergies -- things like the spring pollen season, dust or certain pets. But if you are unsure, skin or blood tests can help identify the allergens that plague you. Once you know what you are allergic to, you can take steps to avoid your allergen(s) and tailor your medical treatment to prevent and control symptoms.

Q: How can I minimize my exposure to allergens?

A: Components of dust such as animal dander, molds and dust mites can cause allergic reactions, says the American Academy of Allergy, Asthma and Immunology (AAAAI). Keep your home clean and uncluttered. Replace carpeting with cleanable hard surfaces such as hardwood or tile. Avoid smoke and other irritants. Use air conditioners to keep pollen outside and, if you live in a humid climate, dehumidifiers to curb moisture and limit dust mites and mold. If a pet triggers your allergy, you may have to find your pet a new home. At the very least, keep your pet out of the bedroom and outside the house, if possible.

Q: What medication should I take for hay fever?

A: Antihistamines are the medications most commonly taken for hay fever. As the name implies, they block histamines, the substances your body releases that cause hay fever and animal allergies. Older antihistamines are more likely than newer prescription medications to cause drowsiness. One of the less-sedating medications, loratadine, is available without a prescription.

"Because the active ingredient works without entering the brain, they alleviate your symptoms without making you as sleepy," says Texas allergist Susan Rudd Wynn, M.D.

Newer time-released antihistamines can last up to 24 hours. The advantage of the older antihistamines, however, is that they work faster and are cheaper than the newer ones.

Newer nasal sprays

Q: What about nasal sprays?

A: Newer prescription-only sprays are safer than many over-the-counter decongestant sprays that can be habit-forming if used improperly. "Synthetic cortisone sprays have been designed to relieve swelling in the nose," says Dr. Wynn. Newer antihistamine sprays work like their oral counterparts -- to reduce symptoms locally without causing drowsiness.

Q: Do allergy shots help?

A:  Allergy shots cause the immune system to react by producing varieties of antibodies and cells that do not cause dangerous symptoms, instead of producing antibodies and chemicals that result in allergy symptoms. On rare occasions, allergy shots also can be used to prevent certain medication allergies. Allergy shots are not used to treat food allergies, because the shots themselves are too likely to cause anaphylaxis. But oral (swallowed) immunotherapy using extraordinarily diluted samples of allergy triggers is currently being tested as a possible new treatment for food allergy.

Q:  Why do I have allergies if my spouse doesn't?

A: Blame genetics. "If one of your parents is allergic, there is a 25 to 30 percent chance you will be," Dr. Phillips says. "If both are allergic, the likelihood increases to 75 percent."

Q: If I move to another part of the country, will I leave my allergies behind?

A: "You may escape the allergens your body is already familiar with," says Dr. Miles, "but, after a little while, you'll develop new allergies," probably within three years.

Age is a factor

Q: So I'm stuck with allergies for my whole life?

A: Age works in your favor. Allergies peak from ages 35 to 45, then level off. As the immune system starts wearing out in our 60s, we have fewer reactions to allergens. After age 75, it's unusual to suffer allergies.

Q: Can I keep my kids from inheriting allergies?

A: No, but you can affect their development and severity. "Breast-feeding for up to nine months is highly recommended," says Dr. Miles. To prevent food allergies, delay exposure to potentially allergenic foods. Solid foods should be delayed until 6 months of age, the AAAAI says. Then introduce very bland foods, one food type at a time. Some research indicates that keeping a pet, particularly a dog, in the first year of life may actually reduce the incidence of allergy and asthma.

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