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MANAGING YOUR ALLERGIES

If you suffer from allergies, you are not alone. Seasonal and year-round allergies afflict between 10-30% of the world’s population and are the 6th most common chronic illness for adults in the U.S.

People with allergies are not demanding patients - they suffer in silence because they are not aware of treatment options that address the cause of the disease. In reality, it takes relatively minimal effort over time to live a life free of symptoms.

Allergies Are More Than Just A Nuisance

An allergic response happens when the body adversely reacts when exposed to ordinarily harmless substances. The immune system releases chemicals to fight the intruder, causing symptoms of allergic rhinitis and leading to chronic inflammation.

Allergic reactions are more than a runny nose, sneezing and itchy eyes. It’s a chronic inflammatory disease that will get worse with age if not treated. Allergies take up the capacity of the immune system. Exposure to additional stressors like illness, hormone imbalance, thyroid disorders, stress, and more is likely to overwhelm the immune system for people with allergies.

There are three phases of the body’s development of allergies:

1. 

Sensitization

Sensitization is the earliest phase of developing an allergy in which the body first recognizes an allergen as a threat. There is no allergic reaction when exposed to an allergen for the first time, but the body registers the allergen, memorizes its structure, and produces immunoglobulin (IgE) antibodies in defense. IgE then attaches to mast cells, a type of white blood cell or leukocyte found in airways, skin, and intestines that regulate the immune system. After that sensitization process happens, the body produces IgE whenever it is exposed to the allergen in the future.

2. 

Early Phase

Anytime the body is re-exposed to the allergen, the IgE antibodies in the body recognize it. Then, mast cells are activated, causing the release of histamine and other inflammatory mediators, which produce symptoms. Blood vessels dilate, mucus is secreted, and Early Phase symptoms like sneezing, runny nose, itchy eyes, and coughing begin within an hour of exposure to the allergen.

3. 

Late Phase

The Late Phase allergic response happens when the activated mast cells attract other inflammatory cells. Basophils, neutrophils, and lymphocytes work similarly to mast cells and release irritating, toxic chemicals that can damage the body’s tissues. Patients will notice nasal congestion most often during the Late Phase reaction, which begins 2-6 hours after exposure to the allergen and usually ends after 1-2 days.

How Do I Know If I Have Allergies?

Patients may not know they have allergies because symptoms aren’t always apparent, but they are still burdening the immune system. In many cases, the body doesn’t produce symptoms until after the immune system is overloaded by exposure to allergens, on top of other environmental stressors. Then, the total allergen load or threshold is passed, and a patient may feel symptoms.

Because symptoms are different for everyone, before a patient can effectively manage allergies, they need to be aware of which allergens they are sensitive to and the sensitivity levels.

Intradermal skin tests are the most accurate form of allergy testing. They can determine even slight sensitivity to allergens, which is impossible with only a blood test. With that information, you can better manage your allergies.

Minimize Exposure

Prevention is a helpful tool for improving quality of life with allergies. The following strategies can help you avoid allergens when possible:

Air purifiers

An air purifier can work wonders removing allergens from the air in a patient’s home if they are allergic to smoke, pollen, or animal dander. However, it's impossible to contain all airborne allergens.

Weatherstripping

Weatherstripping is another beneficial method to protect against airborne outdoor allergens such as pollen and certain molds. Naturally, it will not prevent exposure to indoor allergens like pet dander, dust mites, and mold.

Keeping a diary

People with multiple allergies, especially seasonal allergies, may benefit from keeping a diary. It’s easy to get lost trying to keep up with various irritants. A log of symptoms and places of exposure can help you develop a healthy routine.

Over-the-Counter Medication

Many people living with allergies use over-the-counter (OTC) medications to treat symptoms:

  • Antihistamines work by suppressing the immune system and blocking the release of histamines, some of the chemicals that produce the allergic reaction. However, these medications can also stress the defense mechanism of the immune system, as well as lead to weight gain, high blood pressure, and more. Antihistamines relieve sneezing, runny nose, and itchy eyes during the Early Phase of the reaction but are not really effective for Late Phase symptoms.
  • Anti-inflammatories, like corticosteroids, work to reduce inflammation and swelling and relieve congestion, itching, and some respiratory symptoms. Due to their effects on the adrenal glands, cortisol levels, and other functions, regular and prolonged use of anti-inflammatories can lead to a number of health issues. These include osteoporosis, high blood pressure, and mood changes.
  • Decongestants reduce the swelling of blood vessels inside the nose, treating symptoms like stuffy nose, runny nose, and overall congestion that happen during the Late Phase. Using decongestants for long-term symptom relief can have adverse effects such as increased blood pressure and even worsened congestion.

Most over-the-counter medications come in three forms:

  • Nasal sprays, including topical steroid sprays and saline sprays, reduce swelling and congestion in the nasal cavity.
  • Pills can treat multiple symptoms at one time.
  • Eye drops relieve itchy, red, watery eyes.

It is important to note that using OTC medications does not provide the same level of instruction and care as working with a professional. Many patients may turn to the wrong medication because they’ve seen it advertised, though they need a different level of care.

Additionally, because OTC products are available for anyone, they are weaker than prescription-strength versions and may not be strong enough to treat severe symptoms.

While over-the-counter allergy medications may ease symptoms, they do not address the underlying issue. Instead, they just put a bandaid over the symptoms that also may cause negative effects. There are better options for management that deal with allergies at the source, removing the burden on the immune system.

Desensitization and Immunotherapy: A Long-Term Solution

Immunotherapy is the best long-term form of control. It doesn't just aim to ease the symptoms and prevent them from happening; it alters the immune system's response towards various allergens.

The treatment is similar to vaccines, where a doctor inserts a small amount of the bacteria or the virus into the body so that the immune system can form antibodies against it. However, with immunotherapy, the result of exposing the body to allergens is that it becomes desensitized. After desensitization, the body does not react when exposed to that allergen.

Immunotherapy can now be administered in two forms, shots or drops.

Allergy shots

Allergy shots, or subcutaneous immunotherapy (SCIT), consists of weekly injections given over a few years. A patient visits the allergist’s office to receive the shots, then waits in the office to monitor possible complications from the dose of allergen. The injections contain a purified extract of the allergen, creating a "small" allergic reaction every time a shot is given. By the end of the treatment, the body no longer reacts to the allergen. Shots cannot be administered for some patients, in which case drops are used instead.

Allergy drops

Sublingual immunotherapy (SLIT), or allergy drops, works the same way as shots, but it is far more convenient and less shocking to the immune system. Drops, like allergy shots, are personalized based on the patient’s allergy tests and medical history. With that information, an allergist develops the customized drop mix to contain the right dose of a particular allergen - enough to near sensitivity without passing the threshold. Like shots, a precise dose is delivered to build up the body’s tolerance, but drops can be taken from the comfort of home. Usually administered three times daily, drops are placed under the tongue, the area of the body with the most tolerance-building dendritic cells, or cells designed for protective immune responses. Every 3-6 months throughout the treatment, patients receive periodic allergy Intradermal Tests to adjust the strength of the allergens according to their threshold. There are three phases to the treatment:

  • Initial oral tolerance (0 - 3 months), in which the patient may begin to feel results.
  • Symptom relief (3 months - 3 years), during which the body builds tolerance.
  • Long-term tolerance (3 years - 5 years), the so-called maintenance mode, is a treatment period when the body develops permanent immunity.

Because allergy drops are administered on a more regular basis, they offer a superior continued exposure to the ideal dose of the allergen. After completing all three phases, the body is desensitized for total relief.

Living Free of Allergy Symptoms

Managing your allergies is possible with the right strategies and treatment approach. You can lead a normal, healthy life, without the constant threat of frustrating symptoms, by using proper allergy management.

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