Oh, the sneezing and sniffling and runny noses and itchy eyes that are all around us this time of year. And it’s not just your imagination – Knoxville ranks as the fifth worst city in the country for allergy sufferers. That comes as no surprise to the legions of residents who this spring are dealing with all that sneezing and sniffling. Add on the headaches, fatigue, cough, and popping in the ears, and you have a real damper on your enjoyment of spring and summer. Further complications to allergy can include asthma flare-ups, sinus infections, ear infections, and sleep disturbance to name just a few.
Estimates vary, but up to about 20% of the population suffer from allergy, and about 20% of allergy sufferers also have asthma. That doesn’t even include a category called non-allergic rhinitis (rhinitis is the medical term for an inflamed runny nose). These folks have all the symptoms of allergy, but upon testing, come up negative. There are seven different types of non-allergic rhinitis and each is treated a bit differently from true allergy. We won’t delve further into all that, but it is one reason why treatment of allergy symptoms isn’t a one size fits all proposition.
Diagnosis of allergy often involves simply recognizing the symptoms and doing a trial of an over-the-counter antihistamine such as Claritin, Allegra, Zyrtec or one of their generic equivalents. If that does the job, it’s sometimes not a bad way to go. If not, it’s probably time to check in with your physician. Treatment options will include:
- Environmental control measures and allergen avoidance: These include keeping exposure to allergens such as pollen, dust mites, and mold to a minimum
- Medication management: Patients are often successfully treated with oral antihistamines, decongestants (if high blood pressure is not a problem), Singulair, or nasal steroids, antihistamines, or anticholinergics to name only some of the available options.
- Immunotherapy (allergy shots): This treatment may be considered more strongly with moderate or severe disease or poor response to other treatment options.
Specific allergens can be identified by skin testing or blood testing, with skin testing generally being deemed the most precise. So, who should have allergy testing? Allergy testing can have several benefits. First of all, it can identify those who have non-allergic rhinitis. These folks will generally not respond to traditional antihistamines and need other approaches. Secondly, allergy testing may identify certain allergens to which the person can reduce their exposure. For example dust mites, mold, animal dander or cockroach are indoor allergens which can be reduced by a variety of methods.
Finally, for those who are not getting good relief despite meds, immunotherapy may be a good option. Its success rate is generally over 80%, although it usually takes a few months to see improvement. The entire process may take a couple years to establish and maintain the benefits. But for those who habitually sneeze and sniffle their way through the day in misery, often grabbing meds on a daily basis, it can be well worth while.
So if the sights and smells of this beautiful East Tennessee spring and summer are being blurred by watery eyes and masked by a runny nose, check in with your doctor and see what can be done!
Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville. Contact him at 982-0835