WHAT ARE ALLERGIES AND WHY DO I FEEL SO MISERABLE?
I am a Native Texan, born in Fort Worth. Like so many Texans I am proud of our state. We have a lot to brag about, but unfortunately many months of the year, we are NUMBER ONE at being the worst place to live for allergies. Because I spend so much of my professional life treating allergic conditions I thought I could help shed some light on this very very common medical problem.
Most of us know that our bodies have a powerful immune system to keep us well. While there are too many areas of the immune system to describe, a large part involves types of white blood cells that make antibodies. Antibodies are proteins that are created specifically against a germ or other infecting microorganism to neutralize it. To make antibodies your body has to have an exposure either through a naturally occurring infection or through immunization such as a flu or tetanus shot. Once a person has made an antibody he or she is protected from getting the disease when exposed.
Sounds great, right? Well, unfortunately things don’t always work as expected. This wonderful immune system sometimes starts attacking microscopic things around us that normally do not cause infection, such as tree pollen. Why this shift happens is still being studied by medical researchers. But the process is similar to what I described. A person who is prone to allergies by their family genetics gets exposed one spring or fall to pollen and the next year, the antibodies that have been made are ready to attack. But instead of killing or neutralizing something bad like flu virus, the result is severe inflammation in many parts of us.
Once the allergic antibodies contact the surface of that pollen (or dust mite, mold, cat dander, etc.) a waterfall of inflammation is let loose. Local blood vessels dilate causing red eyes and a stuffy nose, fluid comes into the area causing tissue swelling and watery drainage, and then stored body chemicals such as histamine are released which cause itching, burning and more swelling.
Allergies can effect almost every part of the body, but cause most of the misery in our noses, eyes, skin and lungs. You are all familiar with the symptoms of itching, sneezing, nose either stuffy or running like a faucet, coughing and sometimes wheezing. And while most allergic reactions are not life threatening, allergy in the lungs, commonly known as asthma, is fatal to hundreds of people yearly. That is one reason I don’t like the phrase, “It’s only allergy “.
So what can be done? Since living in a sterile bubble isn’t practical, I will talk about therapies.
We all have heard of the usual treatments for allergies. As a matter of fact, we are bombarded with ads on TV for allergy “cures”. The medications most commonly suggested are antihistamines. These drugs include old standards such as Benadryl, which usually makes the user too sleepy to function well during the day. More modern antihistamines such as Allegra or Claritin don’t have that sedative effect. As a rule antihistamines block one part of the allergic reaction after the whole thing has started, but don’t prevent it to begin with.
Nasal steroid sprays such as Flonase work in a manner to reduce the number of allergy white blood cells in the nasal tissues. This decreases in many people the severity of allergy symptoms such as stuffiness. Steroids can also be given orally as pills (a dose pack) or as a shot in your doctors’ office. However, just like antihistamines, steroids do not prevent allergic reactions from occurring, just make them more tolerated.
Many other medical therapies, both by prescription or over the counter can be tried, and I often recommend them. The list of possibilities is too long for me to include in this article, but certainly washing or flushing out your nose with some type of salt-water rinse or spray helps quite a lot.
The only way that I have found to truly prevent allergies from occurring is to prevent the entire biologic reaction. And in my experience the best way to do that is through allergy testing followed by immunization therapy, what most people know as allergy shots.
Before I go further I would like to say a little about my background. Not only am I a Board Certified ENT specialist, but in 1989 I completed extra training and examination to achieve Fellowship status by The American Academy of Otolaryngic Allergy. Other Allergist physicians are either Internists or Pediatricians who have also done extra training in Allergy as well, but do not also perform nasal or sinus surgery.
In my office we are able to test a person to determine if indeed allergies are the source of the problem, and then of course find out what he or she is allergic to. Then a planned program of desensitization starts. Before the year 2000, for my patients that meant once a week shots given in my office. However for 17 years now I have given my patients the option of oral therapy, given at home as daily drops under the tongue. Multiple studies have shown this to be as effective as traditional shots.
In my opinion this is the most natural form of therapy. It shifts your immune system to slow down making the white blood cells that cause allergies, and actually produce more infection fighting white cells.
The field of allergy treatment is continually advancing, with new forms of testing and therapy on the horizon. I will be happy to see sufferers of all ages and see what can be done.