By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

TREE POLLEN ALLERGY TREATMENT: AVOIDANCE, MEDICATION OR SHOTS

Question: Spring is coming and I hate this time of year. I have spring allergies, and they seem to be getting worse the older I get. I sound like I have a cold all of the time. What can I do for them? Is there anything new going on?

Answer: People with allergies often only have symptoms in a certain season, like in your case. Others, however, are more unfortunate and suffer from allergies year-round. Regardless of the time of year, common symptoms are runny nose, itchy eyes and wheezing.

Though some individuals have all of these allergy symptoms, others just have one -- most commonly the runny nose. This is called allergic rhinitis. It is the most widespread, chronic disease in the United States, affecting over 35 million people. While allergy problems usually start in childhood, they can begin at any age, and most people never “outgrow” their allergy.

Let me explain a bit about what happens in your body when you have an allergy. Foreign substances to which you have a reaction are called allergens. These allergens are usually things such as pollen, mold or animal dander. When one of these allergens enters your body, your immune system reacts.

First, your immune system acts as though it’s being invaded by a germ or other harmful substance, so it produces antibodies that circulate in the blood. These antibodies attach themselves to special mast cells located throughout your body -- but in greater numbers in the nose, throat, lungs and gastrointestinal tract. The mast cells then release various chemicals -- most notably histamine. It’s the histamine that causes the runny nose, itchy eyes, wheezing and other symptoms.

Since your allergies only bother you in the spring, you are most likely allergic to tree pollens. But to determine exactly which tree or flower pollen allergens you react to, you would need to have allergy testing done. The skin tests for allergies are accurate, inexpensive and rapid. They are performed by a physician in the office.

Once you know what you are allergic to, you can try to avoid contact with the allergen. If it is tree pollen, however, your job will be pretty difficult unless you stay in an air conditioned environment all the time. Unfortunately, most people cannot do that.

If you cannot avoid the allergen, prescription and over-the-counter medications may help prevent and relieve your symptoms. Many physicians use nasal steroid sprays to help control allergies. If used prior to allergy symptoms, some patients find they prevent many, if not all, nasal and eye symptoms. Many people also take a long acting antihistamine, either the over-the-counter variety or a prescription brand. You should discuss which one is best for you with your doctor.

Some people get relief from allergy shots. This treatment -- called immunotherapy -- involves receiving regular injections of the substance that you're allergic to. These are usually given weekly. Some people get the shots year round, others get them only during the part of the year when their allergy symptoms are present. The shots seem to work best for those who are allergic to grass, ragweed, trees, and dust. A new type of immunotherapy is being developed that replaces the shots with drops that are placed under the tongue in a physician’s office. This won’t be widely available for a couple more years.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.