Allergies Suck! How to Handle Allergy Season

How to arm yourself against the hidden hazards of indoor and outdoor allergens -- and the surprising ways they can make you sick.
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Allergies Explained

Alana Nicol of Cumberland, Maryland, used to take long hot showers in the middle of the night, hoping that the steam would ease the pain of her throbbing sinuses. Her back-to-back sinus infections had been making her sick and miserable all winter long. Despite popping loads of over-the-counter pain meds, she'd missed several days at work. Antibiotics didn't help, either. After trying stronger and stronger drugs, she actually started having heart palpitations, a reaction to the medications, and wound up in the hospital. At that point her physician suggested that she see an allergist.

An allergist? "It never occurred to me that I had allergies, because I had them when I was a child and the symptoms weren't the same," she says. "I used to have the sneezing, the runny nose, the itchy eyes, but as an adult I just had sinus infections." Still, her tests came back positive. She was seriously allergic to tree pollen, grass, and cats. Nicol immediately started taking allergy shots to build up her resistance and has had only one mild sinus infection since then.

As Nicol discovered, allergy symptoms can be more subtle, and serious, than most people realize. And they are often the culprits behind respiratory ailments like sinusitis and asthma. Researchers are finding that they also contribute to seemingly unrelated conditions like sleep apnea, migraines, and acid reflux -- even depression. On a more basic level, allergies can make you feel crabby, tired, and not in the mood for sex. Yet many allergy sufferers are never diagnosed, and most aren't getting treated.

Why the neglect? While the symptoms of allergies are aggravating and can even be dangerous, they're not the kind of life-threatening problems that often push people to see a doctor, says UCLA allergy expert Gary Rachelefsky, MD, a member of the LHJ Medical Advisory Board. Many people put up with postnasal drip or stuffiness, self-treat with over-the-counter decongestants, or mistake allergy symptoms for a spring cold or infection.

When people do go to the doctor about their symptoms, they often leave with a prescription for an antibiotic, antihistamine, or inhaler but without a diagnosis. "Doctors aren't being medical detectives," says allergist Dean Mitchell, MD, author of Allergy and Asthma Solution. Or they're just not well educated about allergies, adds Dr. Rachelefsky. Chasing your symptoms with antihistamines and decongestants may not be enough to make you feel better -- in fact, they can make you worse. If you have any of the following conditions, the message is simple: Consider the possibility of allergies.

Chronic Congestion

Are you constantly stuffed-up and congested or sniffling with a runny nose? So are about 60 million other Americans. It's called chronic rhinitis, and allergies are at least partly to blame in as many as two-thirds of these snifflers, experts say. Most people who have allergic rhinitis don't have it under control, says Linda Cox, MD, past chair of the American Academy of Allergy, Asthma & Immunology diagnostics committee.

Congestion can lead to other issues like sinusitis, sleep problems, and facial pain. So ask your doctor to check you for allergies -- to outdoor allergens and indoor ones like mold, dust mites, and pet dander. It's important that he know whether your congestion is due to allergies before he prescribes medication. For example, oral antihistamines are helpful for allergic rhinitis, but nasal antihistamines may be better for non-allergic rhinitis.

Sinus Inflammation and Migraines

About 55 percent of people who have chronic sinusitis -- inflammation of the sinuses that causes throbbing pain in the face or head -- also have a history of allergic rhinitis, says one study. Yet doctors often recommend that patients with recurring sinus infections get CT scans to look for sinus malformations and even recommend sinus surgery without testing for allergies. The CDC estimates that Americans undergo more than 200,000 sinus surgeries every year. Sinuses, the air pockets around the bones of the face and forehead, are lined with mucous membranes, which can become inflamed when the nose is exposed to allergens. The swelling can prevent sinuses from draining, making them a breeding ground for infections, says Mark S. Dykewicz, MD, director of allergy and immunology at the Wake Forest University School of Medicine. Before you go under the knife (or get a CT scan), ask your doctor to screen you for allergies.

One study also found that people with allergies were 14 times more likely to have migraines. "When the lining of the nose becomes inflamed from allergies, it may activate the trigeminal nerve, which provides sensation to the face and can trigger migraines," says Brian Grosberg, MD, director of the Inpatient Headache Program at Montefiore Medical Center in New York City.

Continued on page 2:  Allergies Explained, cont'd.


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