What is an allergy?
An allergy is an abnormal sensitivity or exaggerated reaction of the immune system to a substance, which, in the majority of people causes no symptoms at all. The substance that triggers the allergy is known as an allergen. Examples of allergens include plant pollen, pet dander, insect venom, dust, mold, foods and drugs. The body’s immune system makes an antibody, which is also a protein, called IgE, in response to being exposed to an allergen. People with allergies, make IgE antibody that is specific for the allergen that they are allergic to, which then in turn can cause allergy symptoms. Common conditions associated with allergies are sneezing, itching, nasal congestion and drainage and are referred to as allergic rhinitis, or more commonly, hay fever. Eye itching and swelling are referred to as allergic conjunctivitis. Asthma, eczema and hives can also be conditions associated with allergies.
How do allergies develop?
Allergies have a strong genetic component. If you have allergies, others in your family are likely to have allergies as well. If one parent has allergies, a child has a 40% chance of having allergies. If both parents have allergies, there is a 7-8 in 10 chance that their offspring will have allergies. Even though children may be born with a predisposition to develop allergies, they do not always develop the same allergies as their parents.
Unlike eczema and food allergies, which may start at a young age, inhalant allergies usually require several pollen seasons to develop. The signs and symptoms of inhalant allergies are usually not apparent until 3 years of age or older. However allergies can develop at any age with symptoms occurring later in life.
Children with allergies are also more likely to develop asthma. It is estimated that 80% of children with asthma have evidence of allergies. Therefore, recognizing and treating allergies can have a significant impact on reducing asthma symptoms.
What should I expect when I see an allergist?
The allergist will conduct a patient history including an assessment of your symptoms, a relevant physical exam and a thorough environmental evaluation. In order to identify your specific allergies, the allergist will conduct a skin test/allergy test. Substances such as dust mites, pollens, mold and pet dander are considered common allergens. This skin test is effective to evaluate both inhalant allergens and food allergens.
What are the symptoms of allergies?
There are some symptoms that are commonly associated with allergies such as:
- Runny nose
- Post nasal drip
- Itchy / Watery eyes
Less common allergy symptoms include:
- Loss of taste and smell
- Low productivity/Poor concentration
- Sleep disturbances
Allergy symptoms can be more than bothersome or irritating. They can interfere with your day-to-day activities and sleep. Allergies can result in loss of productivity, missed work or school and an overall poor quality of life. Seeking the help of an allergist is the key to treating your allergies.
How do you test for allergies?
Allergy tests, combined with the knowledge of your allergy specialist to interpret them, can give precise information as to what you are or are not allergic to. Testing done by an allergist is safe and effective for adults and children of all ages.
The most reliable and common test for allergies is a skin test. This simple, in office procedure introduces a very small amount of a specific allergen or allergens selected by the allergist based on your medical history. The allergen is introduced through an indention or “prick” on the surface of the skin. The results are available within minutes allowing your allergist to develop a treatment plan immediately.
Blood tests called RAST (radioallergeosorbent test) may be performed when skin testing cannot due to medications or skin conditions. Results are not available immediately as it generally takes a week or more to obtain results of RAST testing. Which tests are better, skin or blood?
Allergy skin testing is the most accurate and preferred method of evaluating allergies. These tests are safe, minimally invasive, and easily interpreted. Blood assays or RAST may present the clinician with diagnostic challenges. Studies have shown variability between different labs so that results can be difficult to interpret. Blood tests also may have decreased sensitivity compared to skin testing. Depending on the individual patient, more than one type of test may be utilized for an accurate diagnosis.
What is involved in a skin test?
A skin test is a simple procedure that is best described as tiny pricks that are made on the surface of the skin on your back. The pricks are conducted with a small device, similar to a plastic toothpick. The device contains small amounts of common allergens. The skin is lightly punctured on the surface with a tiny amount of the allergen. If you are allergic to an allergen, a small mosquito bite-like bump will appear.
For those patients who do not react to this type of skin test, an intradermal process may be performed (similar to a TB test). The allergist can determine your specific allergy profile. Because everyone is unique in what their specific allergic triggers are, knowing what you are allergic to is essential for the effective treatment of allergies.
How are allergies treated?
Once the allergist knows the allergens that are causing your symptoms, an effective treatment plan can be recommended. These treatment plans may include:
- Avoidance of allergens [Download printable brochure on allergy avoidance.]
How can I avoid allergies?
Obviously, you aren’t expected to live your life in a bubble, but there are things that can be done to minimize your exposure to specific allergens. For example, if you are allergic to dust, you can dust-proof your bedroom by using allergy-proof mattress and pillow covers. If you are allergic to pollen and/or grass, it is beneficial to keep your windows closed and to shower immediately following outdoor activities. There are many ways to cut down on the allergens in your environment. Talk to your allergist about any information that they can provide on allergy avoidance. [Download printable brochure on allergy avoidance.]
Is there a cure for allergies?
Although there is no "cure", allergy immunotherapy (shots, drops, or tablets) can be a disease modifying treatment option that is a solution for many allergy sufferers. As you are exposed to small amounts of a particular allergen, you gradually decrease your sensitivity and build up your tolerance to the specific substances to which you are allergic. Immunotherapy gives allergy sufferers an alternative to a life of allergy medications. There are three types of immunotherapy currently available:
Allergy shots are a series of injections that help control your allergy symptoms. They are not a medication, but rather a vaccine that contains the natural allergens that are triggering your symptoms. Over time, and as the dosage is increased, the patient will gradually develop a stronger tolerance for his or her allergic triggers. Symptoms can be decreased, minimized or even eliminated. In the beginning, immunotherapy patients will typically have one or two injections per week for three months during buildup to maintenance dose. Injections are then spaced out and completed within a three to five year period. By this time, most patients are able to discontinue their allergy immunotherapy injections and maintain their tolerance.
Allergy drops (Sublingual immunotherapy or SLIT), is a desensitization treatment in which patients’ self-administer allergen drops under their tongue on a daily basis. Although not as effective as allergy shots, medical research done both in Europe and the United States has found that SLIT therapy is quite safe and effective at building a patient’s tolerance to allergic triggers and ultimately improving symptoms. SLIT may be an option for certain types of allergy patients, but SLIT is not yet approved by the FDA. Therefore at this time, insurance companies are not reimbursing for this form of immunotherapy.
Allergy Tablets are another form of oral immunotherapy and have recently been approved by the FDA for use in the United States. These fast-dissolving tablets are placed under the tongue and work to help the body build tolerance to allergens through consistent exposure. The tablets only contain one type of allergen and are indicated for peopel with allergies to grass or ragweed.
Speak with your board certified Atlanta Allergy & Asthma physician to determine the best treatment option for your allergic triggers.
What happens if my allergies go untreated?
Allergies can be the underlying cause of frequent sinus, ear and upper and lower respiratory tract infections. Untreated allergies can even exacerbate or cause asthma; The Academy of Allergy, Asthma and Immunology states “approximately 80 percent of all asthma in children and half of all asthma in adults is caused by allergies.”
Allergies are responsible for symptoms that may make it difficult for you to concentrate or they may cause sinus headaches––both of which can result in a loss of productivity. This loss of productivity can filter into your work, school and home life. Don’t let your allergies control you, take control of your allergies!