Armed Against Allergies

Sufferers do battle against symptoms with drugs, shots, even acupuncture

April 06, 2009|By Meredith Cohn | Meredith Cohn,

Spring means the same two things every year for Brian Nehus: The grass grows, and his nose runs.

The 27-year-old from Kingsville finally had enough and ended up at the Asthma Sinus Allergy Program at Greater Baltimore Medical Center. He learned after a battery of skin tests that he is indeed allergic to his lawn, as well as weeds and cats.

"I need to cut the grass," said Nehus, as he studied his arm, which was full of red blotches, the result of the tests. "I have about an acre of land. It takes me four hours to mow."

Many people can't completely avoid the things that make them sneeze, wheeze and itch, but those who treat the problem say there is help for Nehus and the estimated 35 million Americans who suffer from allergies to one or more kinds of pollen and mold.

The troubles begin in early spring, when trees begin to pollinate to fertilize other plants. Grass pollen follows in early summer, and weed pollen comes in late summer and fall. The tiny grains are inhaled and greeted in the body as foreign invaders. Chemicals called histamines, normally released in the body to battle viruses or bacteria, are let loose against the allergens. Symptoms of the process include nasal inflammation, sneezing and other watery reactions.

The American Academy of Allergy, Asthma and Immunology says such allergies lead to more than 12 million doctor visits annually and are one of the main reasons for missed days of work and school.

Dr. Alvin Sanico at the GBMC allergy center said the first step to getting relief is identifying that allergies are the problem, and he and his staff were conducting a stream of tests one recent day. Testing takes 20 minutes and normally involves 42 tiny pricks that place a small amount of allergen from trees, weeds, animals and pests into the skin on the arms. Those spots that develop a significant red bump mean an allergy. Extra tests can be added for less common pets and foods.

There generally are three strategies for treatment, Sanico said. The first is avoidance of allergens, which means such things as keeping cats or dogs out of the bedroom, using dust mite covers on pillows and using air conditioning instead of opening windows.

The second is medication. That includes over-the-counter antihistamines to stop the reaction to allergens, decongestants to clear up stuffiness, daily steroid sprays that control inflammation and inhalers for asthma.

The third strategy is immunotherapy, or shots, to build immunity.

"The treatments depend on the frequency and severity of the condition," Sanico said.

Mild and intermittent allergy symptoms can be treated with avoidance and medications. More severe or year-round conditions can be treated with nasal steroid sprays. Shots are recommended for people who want long-term relief from their severe reactions such as asthma, have multiple year-round allergies or live with a pet that causes symptoms. (It's the pet's saliva or even urine that can cause allergic reactions, Sanico said, so don't buy a "hypoallergenic" animal or shave the animal for a cure.)

Charles Trunk Jr., a 31-year-old from Baldwin, has been getting shots for about a year and a half for his allergies to pollen, grass and dust mites. A lifelong sufferer, he was tired of taking Benadryl, an antihistamine given to him by his pharmacist parents. And after twice-a-week shots for months and now once every two weeks, he's looking forward to less severe symptoms.

"I have a house with a yard and like to be out there," he said. "So, I come here at lunchtime. I think it's helping. We'll see how April and May go."

Drugs are commonly the first stop for many people, so the American Pharmacists Association recently surveyed members to identify their most recommended over-the-counter medications.

Allergy medicines were among the most asked about by pharmacy shoppers, and the antihistamine Claritin, closely followed by Zyrtec, were among the top drugs recommended. These new generation drugs typically do not make the takers as sleepy as older drugs such as Benadryl. Among decongestants, the most recommended was Sudafed.

Other options with fewer side effects than drugs are acupuncture and Chinese herbal medicine, said Jeff Gould, a specialist in both at the Johns Hopkins Integrative Medicine & Digestive Center.

He prescribes an herbal combination that works like shots and builds immunity to allergens while patients are well. During the season, he offers another combination to treat symptoms. He does not recommend patients mix their own herbs, because some can have dangerous interactions with common pharmaceuticals, such as blood thinners.

"Allergies are hyperactive reactions to allergens," he said. "Instead of treating symptoms, we like to treat the imbalance in your body that causes the hyperactive response. If we treat you when you don't have symptoms, next year you're better."

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