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Spring Allergies Are Wreaking Their Annual Havoc

Experts offer advice on how to survive the pollen onslaught

SATURDAY, May 8, 2004 (HealthDayNews) -- If April showers bring May flowers, what do May flowers bring? Why, allergies, of course.

That's not precisely true. Many flowers don't release the kind of pollen that irritates sensitive constitutions. But their appearance in the spring marks the presence of other, more aggravating pollens that do spark allergies, those from trees, grasses and other plants.

"I'm always telling my patients they should move to the North Pole, but the job market's not very good there," said Dr. Kathleen Sheerin, an allergist at the Atlanta Allergy and Asthma Clinic, which serves one of the nation's most notorious seasonal allergy regions.

Fittingly, May is National Asthma and Allergy Awareness Month; it has been since Ronald Reagan proclaimed it so in 1984.

An estimated 40 million to 50 million Americans suffer from allergies, according to the American Academy of Allergy Asthma & Immunology (AAAAI). Nearly 36 million of them have seasonal allergic rhinitis, otherwise known as hay fever, a constellation of misery that includes sneezing, stuffiness, runny nose, and itchy eyes, ears, throat and nose.

These symptoms stem from a massive immune system response to the perceived threat of allergens -- regardless of the type, the reaction is essentially the same -- that enter the body. At the core of the reaction is a molecule called immunoglobulin E, or IgE. Allergens bind to IgE proteins, which in turn present themselves to other immune system cells that set off a cascade of inflammation.

Springtime can also mean trouble for people with asthma. The chronic allergic condition, in which the airways become inflamed and stifle breathing, now affects more than 20 million Americans, including more than 5 million children.

Asthma kills nearly 5,000 people a year, according to the AAAAI. Asthma attacks lead to 1.8 million emergency room visits and 14 million missed days of school annually, the group says.

Susceptibility to asthma is now thought to be largely inherited from one's parents. Once you are vulnerable to the airway disorder, you can suffer breathing attacks when confronted with triggers that provoke inflammation in the lungs.

Well-known triggers of asthma include respiratory infections, breathing cold air and cigarette smoke, and even vigorous laughing or sobbing. Allergens such as pet dander, dust mites, cockroaches, pollen and mold also can worsen the symptoms of asthma, according to the National Institutes of Health.

Some evidence suggests that women who take estrogen replacement therapy during menopause may be more likely to develop asthma as they age. However, the extent of the connection isn't fully understood.

Aspirin and other painkillers are also known to exacerbate asthma in about 10 percent of people with the condition. Dr. Carlos Camargo Jr., an asthma expert at Harvard Medical School, said some recent evidence suggests that acetaminophen, the active ingredient in Tylenol, may both cause and trigger asthma attacks in rare cases.

So how can you avoid the woes of allergies? Avoiding triggers is, of course, the best way to minimize symptoms, but that's not always practical.

Short of that, there are a few things allergy suffers can do to minimize the agony during peak seasons. Don't play outdoor sports like golf if you're allergic to pollen, Sheerin said. Wash your hair before getting into bed. Keep your pets clean.

Over-the-counter allergy treatments, called antihistamines, work well for many patients, Sheerin said. But they're not perfect. Older non-prescription allergy pills contain diphenhydramine (Benadryl), which makes people sleepy. "They prefer the symptoms of allergy over the side effects of the medicine," she said.

Claritin, a newer drug that's now available without a doctor's order, does not cause drowsiness, so many people find it a more appealing option, she said.

If over-the-counter remedies don't help and allergies persist season after season, it's time to talk with a doctor, Sheerin said. Patients should first discuss their condition with their primary-care physician, who can then call in an allergist if necessary.

"I'm always surprised at the number of people coming to see me because they have hay fever or allergies and they have asthma, too, but never bothered to mention it because no one asked them," Sheerin said. "It's always good to first involve your primary-care physician," who can catch conditions that might have gone undetected.

More information

For more on allergies and asthma, check with the American Academy of Allergy Asthma & Immunology. The Allergy and Asthma Foundation of America has a map of the nation's allergy capitals.

SOURCES: Kathleen Sheerin, M.D., Atlanta Allergy and Asthma Clinic; Carlos Camargo Jr., M.D., Dr.PH, associate professor, medicine, Harvard Medical School, Boston
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