Allergies affect more than 50 million people in the United States. This
time of year, thoughts often turn to seasonal or environmental allergies
caused by substances like pollen, mold, dust and animal hair or dander.
Pollen allergies—often called hay fever or allergic rhinitis—affect
about 8 percent of Americans over age 18; sinusitis, often caused by environmental
allergies, affects 11 percent of U.S. adults.
An allergy occurs when the immune system mistakenly thinks a normally harmless
substance is damaging to the body. “Think of it as an inappropriate
response … something that revs up your immune system,” explains
Torrance Memorial Physician Network primary care physician Joshua Tarpley,
MD. “Certain seasons produce particular triggers that may cause
your immune system to flare.”
The seasonal part may not be as simple as you think. “We describe
the allergies as seasonal, and that’s because there are certain
times of the year when the antigens become more active, more stirred up,”
he says. “Although in Los Angeles we don’t have as much difference
in the seasons as other parts of the country, we do see subtle changes,
such as dry, cold air and wind during the winter months, which often causes
an influx of patients dealing with symptoms they may not experience during
other times of the year.”
Ages and Stages: How Allergies Change
You might be one of those lucky people who doesn’t suffer allergies,
but that can change at any time in your life. “We tend to think
of being born with them, or developing them as a young child,” says
Dr. Tarpley, “But they can show up at any point in our lives. You
also can grow out of an allergy. I’ve seen people who lose their
allergy to cats, for instance, because their immune system no longer perceives
that antigen as foreign.”
While it’s not possible to predict who will develop an allergy and
when, there are people who tend to be at risk. “Allergies can be
seen more frequently in some families,” Dr. Tarpley says, “and
children who have the atopic triad—eczema, allergies and asthma—are
more likely to have, or to develop, allergies during their lives.”
And why does that happen? “That’s the million-dollar question,”
he says. “If we only knew the answer! It’s an area of constant
research. We see that something makes your immune response hyperactive,
and often those who have any portion of that atopic triad are more prone.
There also are times in life, such as during pregnancy, when one’s
physiology changes and can have an impact on the immune system and its
response.”
Avoidance: Allergy Shots and Medicine
Doctors say that’s the combo to coping with and treating any allergies:
avoidance, allergy shots/drops and medication.
Avoidance can be tricky, according to Dr. Tarpley. “Keep your indoor
environment—your office and especially your home—as free as
possible of anything that could be an allergen—dust, mites, mold
and dander—thereby optimizing the indoor environment,” he
advises. “That in turn can help protect you from any reaction to
what’s going on outside.”
Your doctor might recommend allergy shots or drops, which work with your
body to fight off the allergen. But they take time to work, sometimes
as many as 12 to 18 months, and require an allergy specialist, so you
need to find a treatment plan as well.
Recommendations for treatment do vary based on a patient’s age. “For
people over 65, I avoid the routine use of sedating medications like Benadryl
and the prolonged use of decongestants,” Dr. Tarpley says. “The
use of certain medications might be contraindicated in later life due
to conditions such as high blood pressure and glaucoma, for example, and
older people are often taking other medications with which there could
be an interaction. So you should always, always work with your doctor
to decide what’s best for you.”
Sometimes the best treatments are the simplest. “I love neti pots,”
Dr. Tarpley adds. “Whenever I get a runny nose or postnasal drip,
I use it to rinse out my nostrils, followed by a dose of Flonase nasal
spray and a non-drowsy antihistamine.”
But, he cautions, “You have to keep open communication with your
primary care physician. Treatment needs to be individualized. Your neighbor
who is the same age as you might need to be treated in an entirely different
way.”
Joshua Tarpley, MD, is a primary care physician with the Torrance Memorial
Physician Network. He practices at 855 Manhattan Beach Boulevard in Manhattan
Beach and can be reached at 310-939-7847.