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Hello Hay Fever: Understanding Allergies

Seasonal hay fever, or allergic rhinitis, is extremely common in the U.S., affecting approximately 10-15% of the population. “That is somewhere around 30-40 million people,” says Matthew S. Bowdish, MD, FAAAAI, FACAAI, allergist and immunologist at The Allergy Center at Sacramento ENT.
Allergic rhinitis is inflammation in the nose when an immune system overreacts to allergens in the air, explains Binita Mandal, MD, allergist and immunologist at Dignity Health Mercy Medical Group. Yet, seasonal hay fever is just one type of allergy affecting us. “There are several types of allergies, including environmental, drug, stinging insect (bees, venoms), foods, and chemicals causing dermatologic reactions. The most common of these is seasonal allergies; in the Sacramento area, tree and grass pollen season can stretch from February through June or longer.”
What are the allergic agents around you? Jennifer Niemeyer, DAOM, LAc, of The Root Wellness, says, “People [are allergic to a] variety of things, including grasses, dust, mold, flower pollen, and tree pollen.” According to Ali Amirzadeh, MD, allergist and immunologist at Dignity Health Mercy Medical Group, common symptoms of a seasonal allergy attack include a runny and stuffy nose, sneezing, itchy and red eyes, and breathing problems such as wheezing, shortness of breath, and chest tightness, while skin symptoms can include hives and swelling.
Jamie Brinkley, ND, at Revolutions Naturopathic, further explains why the body responds with these reactions. “Our immune system interacts with the environment on a daily basis assessing if something is ‘self’ or ‘other’ and ‘threat’ or ‘not a threat,’” she says. “We get allergies when that system has decided this particle is harmful and an inflammatory response is warranted.”
As allergy season is officially upon us, sufferers can do their part to help remedy their symptoms. Dr. Bowdish recommends checking local pollen counts for your specific area. “Just Google the term ‘pollen count’ with your city name, and you should be able to get a general idea of what pollens are most active at that time,” he says. “Some allergy practices will also hand count pollens throughout the season, which can be the most accurate pollen counts since they’ll be individualized for your area rather than based upon weather patterns.”
Troy Scribner, MD, an allergy specialist in the Department of Allergy & Immunology at Kaiser Permanente Roseville, says the primary treatments for allergies tend to be medication that can be obtained easily, including oral antihistamines, such as diphenhydramine, cetirizine, fexofenadine, and loratadine. “For individuals who have moderate to severe symptoms or persistent symptoms, the use of a steroid nasal spray tends to be the most effective treatment,” he says. “Steroid nasal sprays help to prevent the inflammation that leads to allergy symptoms and work best when used consistently. Both the steroid nasal sprays and the antihistamines can be used together for better results.”
Dr. Brinkley suggests eating a low-histamine diet during the worst of your allergy season, which “includes a diet rich in fresh meat and freshly caught fish; non-citrus fruits; eggs; gluten-free grains, such as quinoa and rice; dairy substitutes, such as coconut milk and almond milk; fresh vegetables (except tomatoes, avocados, spinach, and eggplant); and cooking oils, such as olive oil,” she says. “There are many herbs and supplements that can be helpful during allergy season, too. My current favorite is freeze-dried stinging nettle leaf.” She also suggests allergy sufferers use a HEPA air filter in their bedroom when they sleep; shower at night so that outdoor pollen is removed before it can deposit into your bed; and use a daily sinus rinses or neti pot with saline to help remove allergens from nasal passages and keep sinuses clear.
Another way to treat allergies is with allergen-specific immunotherapy (SIT), Dr. Bowdish says. “Immunotherapy changes the body’s immune system by toning down the allergic response over time and better controlling the overactive inflammatory pathways,” he says. “Immunotherapy can be given either via a subcutaneous injection or with sublingual tablets or drops. The limitation with immunotherapy is that it takes several months before the treatment protocol kicks in.”
If you require multiple treatments to get relief, there may be additional treatment options, including some that are more long-term. “Talk to your doctor to discuss a plan that will work best for you,” Dr. Scribner says.

by  Kourtney Jason