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Seasonal Allergies: Triggers & Treatment Options

Dr. Petra Razdan discusses the difference between seasonal allergies and allergies caused by foods or products. She shares how to tell if it's an allergy or cold, treatment options available, and if there's a way to prevent them.
Seasonal Allergies: Triggers & Treatment Options
Featured Speaker:
Petra Razdan, MD, Allergy, Asthma & Immunology Associates
Dr. Petra Jonsson Razdan is an allergist-immunologist with Allergy, Asthma & Immunology Associates. 

Learn more about Dr. Petra Jonsson Razdan
Transcription:

Melanie Cole (Host): If you’re someone that suffers from seasonal allergies, you know that at certain times of the year, wow it can be hard to breathe and all the running, and sniffling, and eyes watering can be really such a pain and something that you have to deal with every year, but do you really have to, and how do you know that it’s seasonal allergies and not a cold? My guest is Dr. Petra Razdan. She’s an allergist/immunologist with Allergy, Asthma, and Immunology Associates. Dr. Razdan, I’m so glad you could join us today. Tell us a little bit about seasonal allergies and how they are different from allergies to food or products, and how do you know if it’s an allergy or a cold?

Dr. Petra Razdan (Guest): Well you know seasonal allergies means that you will have seasonal symptoms like rhinitis symptoms like runny nose, itchy eyes, congestion, and sneezing after breathing in usually a harmless substance, which is called an allergen. That can be a pollen, it can be a mold substance, pet dander and such things, and you will then have an activation of your immune system and release of histamines and other chemical mediators that then make you have this long term runny nose and congestion and itchy eyes, etc. So when you have a cold usually it only lasts about 10 days, but seasonal allergies are usually spot on when tree pollen comes out and in the fall when you have your ragweed and the other guys like mold coming into play during harvest season.

Host: Great answer, so we know how to tell if it’s an allergy versus a cold. Are people that have allergies at an increased risk for asthma or vice versa, if someone has asthma, are they now at an increased risk for allergies?

Dr. Razdan: You know that is a very important topic that I discuss with my patients on a daily basis. Having an atopic diseases, meaning an allergic disease like asthma or allergies or food allergies or eczema, predisposes you to have increased amount of allergies. You have that genetic predisposition, and then upon certain environmental exposures, you will then have an increased risk of developing that. So I will always assess a patient that comes in with asthmatic symptoms for seasonal allergies, that they are very commonly a known trigger for their airway symptoms.

Host: Are there other risk factors that you’d like to discuss, Dr. Razdan, that would kind of alert someone or children if we start to notice? Who’s at risk?

Dr. Razdan: The way that our allergic diseases present themselves, usually during early childhood the child will present with eczema, and usually around age 5 or 6 they’ll start developing hay fever symptoms or rhinitis symptoms. So a child that has eczema is a child that I will watch very closely in my clinic and I will advise allergy testing to confirm or rule out certain allergens around age 5 to 6, and anyone with asthma, I would say or a young child with a strong genetic component of allergic disease is also someone that I will try to test as soon as possible.

Host: What are we looking to as the most common causes of seasonal allergies? Not everybody lives where there’s fall or spring, so where do seasonal allergies seem to show up the most and what are some of the most common reasons for them?

Dr. Razdan: You know seasonal allergies, as I mentioned, is caused by any substance that’s called usually a pollen. A pollen is a small substance that is released by various plants and molds, etc that can be carried in the area to various distances, and different parts of the states and the world have different types of allergens. Here in the Midwest, we have a lot of weeds, it’s the plains, we have tons of grass. If you look at New England, there’s a lot of tree pollen there. Looking down South, you’ll have tons of mold. So for the seasonal aspect you’ll have to look at the geographic location, what plants are growing there, what potential allergens could be there, and if you’re looking to perineal allergens that would be indoor things like droppings from cockroaches and dust mites, and pet dander, etc, so it’s a lot of history that goes behind trying to diagnose somebody with hay fever.

Host: How do we know then about those pollen levels? Is there a way to find out? How do you identify the triggers so hopefully you can do something before it hits you?

Dr. Razdan: So I would say if you have significant symptoms, I would advise you to go see a board certified allergist and first of all have an in depth history and then also confirmatory testing to see when and where you need to be more cautious. You can have skin testing done. Sometimes people that come in to see us have also done some blood tests that are done by mostly primary care providers to see what they’re allergic to, and based on that we’re able to cater a very goal directed therapy for the patient and if desired, start them on allergy shots for long term care.

Host: Let’s talk about some of that long term care and allergy shots, speak about treatment options if you would Dr. Razdan, we see over the counter products, we hear about allergy shots, what are some treatment options as first line of defense and where do you move from there?

Dr. Razdan: So I would say if you start developing symptoms suggestive of allergies, I would go for a non sedating antihistamine of your choice. They all work in the same way and you don’t develop tolerance to them. I would also try some sort of intranasal steroid. They’re now available over the counter so that makes it easy to grab and go at the store, and you can also add some eye drops. A lot of patients that have no symptoms will have kind of an ocular reflex and have a lot of eye symptoms at the same time, and if you are having break through of your symptoms despite this therapy, and particularly if you have asthma, my recommendation if you have significant allergies is either to go to sublingual tablets that are available to certain allergens, but if you’re allergic to multiple allergens, I would suggest allergy injections that are given over time. They’re the only diseases modifying therapy we currently have for allergies and you’ll have longevity after you stop your allergy shots as well, meaning you will have relief after you’re off the shots as well.

Host: Wow, it’s an amazing field that you’re in Dr. Razdan. So many people suffer from these. As far as things we can do at home, how does our home and lifestyle effect those allergies and what are some things – do you like neti pots or nasal lavage, do our air filters and pillowcases, do these things have an effect on us?

Dr. Razdan: So I would say if you have bad seasonal allergies and spring is almost upon us, and if that’s a bad season for you, I would recommend to not open your windows and such things and don’t dry your clothes outside on the rack and if you suffer from bad indoor allergens, I would make sure that you don’t run a humidifier in your bedroom because that can promote growth of house dust mites. Definitely cover your mattress and pillows, and for your children, I would remove all stuffed animals from their bedding, or keep one and wash it on a weekly basis, and also if you have any problems with mold, that’s kind of tricky, that’s usually an outdoor thing, but it definitely – keep your doors closed and windows closed during those harvest time when there’s a lot of those substances in the air, and I am definitely a promoter of sinus lavage. I do recommend my patients using distilled water in those for safety reasons, but yes a lot of patients will go for just neti pot if they don’t desire to use an intranasal steroid.

Host: Which is not easy to get kids to use a neti pot if you’ve ever tried to wrangle one down and get them to use that, but what about simple things like washing your hair? If you’re someone who likes to garden, but you do have these kinds of allergies, changing our clothes or washing our hair, do these things even help or is that a myth?

Dr. Razdan: I would say if you’re out mowing your lawn and you have terrible grass allergies or you’re out in the field, you’re a farmer, you have terrible allergies, I would say when you come home and you change your clothes and shower that will help you. If you can throw in a lavage there, that would be great for your sinuses, that would remove the allergens that can sit in your sinus passages and just present those rhinitis symptoms from starting.

Host: What great information and can help so many people. Dr. Razdan, wrap it up for us. Give us your best advice on seasonal allergies, triggers, identifying those, and things that we can do so that we’re not so miserable all the time.

Dr. Razdan: I would be glad to. I would say, don’t suffer. Go and have yourself checked out. Come and see us and get a goal directed therapy for you. There’s not one sized fits all. We always try to make the best for the patient and improve the quality of life, in particularly if your child is suffering in the fall when they’re playing football or baseball, don’t let that – don’t continue that. Just come and see us, and we will be able to help you with those symptoms.

Host: Thank you so much for being on with us today and really it is such great information and thank you for sharing your expertise and explaining the treatment options available as well. If you would like more information about allergies, or want to schedule an appointment with an allergist, please visit allergyasthmaimm.com, that’s allergyasthmaimm.com. This is Bryan Health Podcast. I’m Melanie Cole.