Are Your Allergies Bad This Year? Here's Why
KPBS Midday Edition / May 2, 2019
Doctors say once the hot, windy weather kicks up, we should experience a major allergy season in San Diego.
Speaker 1: 00:00 This is KPBS mid day edition. I'm mark Sauer. I'm Maureen Cavenaugh. We may not be fans of the Gray Chili's spring we're having so far, but one thing is doing is to tamp down allergens. Doctor say once hot, windy weather kicks up, we should experience a major allergy season in San Diego are heavy winter rains have led to super blooms and that's already affecting some allergy sufferers. Joining me is Dr. Taylor Doherty, he's associate professor of medicine at Uc San Diego health and an allergist immunologist with a specialty in treating asthma. And Dr Doti, welcome to the program. Thank you very much for having me. What are you seeing in your practice so far this season?
Speaker 2: 00:41 So this season we're seeing a lot of allergic disease, whether it involves the eyes or the nose. And this can be symptoms of stuffy or nasal congestion as well as itching, uh, puffy, swollen eyelids, sneezing, coughing. And one of the challenging aspects can be that some of these symptoms, especially the sneezing in cough, can overlap with some of the viral illnesses that are also still lingering around during viral cold and flu season. So I also see as Maddix that certainly during certain times of the year when their allergens are elevated, they also have more wheezing, coughing, shortness of breath.
Speaker 1: 01:21 What are you anticipating for the rest of this season for seasonal allergies? I think
Speaker 2: 01:26 that you alluded to some of it by mentioning that we have had some damp conditions over the past few months intermittently and that does several things. One of the things that it does is it allows of course the the vegetation leading to these blooms and we have potentially more intense pollen seasons and we also have with damp conditions, mold exposure that leads to respiratory symptoms in those patients that are allergic as well as some patients where it just causes some more irritant respiratory effects.
Speaker 1: 02:00 Can you briefly tell us why pollen and other substances cause allergies in our respiratory systems?
Speaker 2: 02:07 In terms of the actual response, what you have is a certain type of immune activation by things in the environment that you really shouldn't have activation too. So there's a molecule called the ige, which is a type of antibody that can be developed against uh, an allergen sake, a certain protein and cat or dust mite or pollens that wanted, interacts with the allergen in the nose or the lung. Ends up releasing lots of products through mass cells, which are a type of allergy should sell that contains histamine and many other mediators that lead to some of the symptoms that I mentioned.
Speaker 1: 02:48 Our children more susceptible to seasonal allergies than adults?
Speaker 2: 02:52 Yes, they are. In terms of prevalence, the exact mechanisms are unknown but definitely in adolescent ages as well as in the 20s. It is not uncommon to grow out of allergies. However, um, I see mostly adults and there's certainly a large persistence of allergies. In fact, about a third of the u s population has at least hay fever type symptoms and sensitization, um, which can actually be in half the population population if you test for the sensitization to allergens. So yes, it's more common in children, however, certainly still very common in adults as well. Why do older people develop allergies to pollen after they've never had them before their whole lives? That sort of Dogma that the teaching is that you develop these early on and then they persist or not. And that's just simply not true. I mean, we're seeing adults that develop food allergy with similar mechanisms that I mentioned.
Speaker 2: 03:50 Um, in terms of the ige molecule and, and certainly also seeing adults with the amount of moving between different cities, different climates, as well as the, uh, potential contribution of climate change over the last decade or two that could increase pollen counts as well as duration upon seasons as well as affect the allergenicity of this, of the pollens. Well, we all know the common symptoms of allergies, runny nose, sneezing, congestion. Are there other symptoms of seasonal allergies that suffers? Can Experience? Absolutely. And in some of these are secondary effects. One of the aspects that's underappreciated is the fact that many patients with allergic rhinitis, um, can also develop secondary bacterial sinus infections or even chronic sinus disease. So the sinuses are these air spaces within the skull and if those get impacted with bacterial infection, um, and there are unable to drain properly due to allergies, then the, you can absolutely be predisposed to more sinus infections.
Speaker 2: 04:54 The other issue that's underappreciated is the fact that patients with allergic rhinitis or the nasal hayfever type allergies are unable to sleep as well. And this has been studied extensively and we all know that the lack of sleep can affect many aspects of uh, the human body's functioning. And certainly one aspect would be just fatigue, severe fatigue throughout, you know, trying to wake up in the morning and you're already taking anti-histamines which can worsen fatigue in many cases. But the allergies themselves have led to a poor sleep cycle. Yeah. How effective are those over the counter allergy pills that are so heavily advertise this time of year? Yeah, absolutely. We see, we see commercials all the time for them and many are, if not most are over the counter now. Which, um, you know, it's something important to point out that we have pills like anti-histamines and then we also have nasal sprays, which include the nasal corticosteroids or nasal steroids sprays.
Speaker 2: 05:58 And given the fact that many of these used to be prescriptions, I think it's important to talk about the fact that the nasal steroids are used best when use daily, chronically at least for a month to see if they help. And it's not clear from the advertising or when you buy them at the store that you get those type of instructions unless you're carefully reading the labels. So, you know, those are more preventative, chronic use, whereas the anti-histamines a wheelie are an as needed. Now, some people need them every day, so they take them every day. And as many people know, there's many different varieties of these anti-histamine pills. Some could make some, uh, patient, sleepy and others, they barely notice them at all. Other than getting some relief. Doctor, what lifestyle advice do you have for your patients who are suffering from allergies? Should they stay indoors with the AC on?
Speaker 2: 06:52 It depends on the allergen exposure. So if in the, you know, for instance I'm in San Diego and we have a lot of house dust mite allergic individuals and because you know, we do have pollen but not to the extent that some of the other places in the country do, we might have patients that really tend to have perennial or year round allergies to dust mite and that in that case, staying indoors perhaps in their an environment may not be always the best thing to do. However, for the pollen allergic patients then, you know, absolutely it's a reasonable to try to avoid times during the day when there's high pollen counts to keep the windows closed, to make sure that the filters are changed and appropriately placed. With regards to uh, air conditioning and Hepa filters for those who are dust mite allergic, we also recommend in casement covers that are zipped that go over the mattress, the box spring as well as the Pello and have their linens washed in hot water once a week. So that will be completely different advice than what you would give somebody who's just Paul and allergic. I've been speaking with allergist immunologist, Dr. Taylor Doherty, associate professor of medicine at Uc San Diego health. Doctor Dougherty. Thank you. Thank you.
Speaker 3: 08:10 Okay.