Allergy FAQ

One of the marvels of the human body is that it can defend itself against harmful invaders such as viruses or bacteria. In some people, the body reacts to harmless substances such as dust, mold or pollen by producing an antibody called immunoglobulin E (IgE). When patients with one of the allergic diseases (such as rhinitis or asthma) are exposed to these substances, the immune system then rallies its defenses, launching a host of complex chemical weapons to attack and destroy the supposed enemy. In the process, some unpleasant and, in extreme cases, life-threatening symptoms may be experienced.

Hundreds or even thousands of ordinary substances can trigger allergic reactions. These are called “allergens.” Amongst the most common are plant pollens, molds, household dust (dust mites), animal dander, industrial chemicals, foods, medicines and insect stings. An allergic reaction may occur anywhere in the body, but usually appears on the skin, in the eyes, lining of the stomach, nose, sinuses, throat, and lungs. These are places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed or come in contact with the skin.

The most common causes of fatal allergic reactions include severe reactions to foods such as shellfish, peanuts and cod, or to stinging insects such as yellow jackets and imported fire ants.

Allergies can affect anyone, regardless of age, gender, race or socioeconomic status. While it’s true that allergies are more common in children, they can occur for the first time at any age or, in some cases, recur after many years of remission. Although the exact genetic factors are not yet understood, the tendency to allergies, as well as to allergic disease, is linked to heredity.

The most common diseases caused by allergy mechanisms are those of hay fever (allergic rhinitis), asthma, eczema (allergic dermatitis), contact dermatitis, food allergy and urticaria (hives). The term, “allergy”, really has different names depending upon where in your body the reaction is occurring. If an allergic reaction occurs in your nose, eyes, and sinuses physicians will call it allergic rhinitis. If the allergic explosion is occurring in the lungs, we call it asthma. All of these allergic diseases are inflammatory in nature. That is to say, there is inflammation characteristic of allergy immune mechanisms occurring in those parts of your body when we give the condition the above scientific names.

The best first step in the diagnosis of allergies is a thorough health history and physical examination. If you have allergy symptoms that occur in association with exposure to certain things, that is highly significant. Allergy diagnostic tests, such as skin tests or blood tests, provide similar information and merely confirm what your health history tells the doctor. If your doctor were to rely exclusively on the results of skin or blood tests (without history and physical examination), you could be diagnosed as having an allergic problem that you don’t necessarily have. Skin tests, in most situations, are preferable because (1) the results are available immediately, (2) they are less expensive and (3) they are more sensitive to subtle allergies. A blood test is appropriate in certain situations, particularly when you (1) cannot suspend antihistamine therapy which can inhibit skin tests, (2) have widespread skin disease making skin testing difficult, (3) are so sensitive to the allergen that the test might be risky or (4) cannot be skin tested for some other reason.

Allergy shots are an effective and safe treatment for people who suffer from a variety of allergic diseases, including allergic rhinitis (hay fever), asthma and insect stings. The treatment – also known as immunotherapy or allergy immunization – works by introducing small amounts of purified substances to which the person is allergic, in gradually increasing amounts. The allergy shots improve the patient’s natural resistance to the allergens and minimize or eliminate the need for medications.

Like all medical treatments, allergy shots (immunotherapy) can have side effects. Your doctor will discuss this with you in detail. Under no circumstances should you consider allergy shots without at least an attempt at avoidance of the troublesome allergen. For instance, cat allergy shots are no substitute for cat avoidance. Some allergens, though, such as grass pollen, are almost unavoidable. Why is it that frequent exposure to an allergen can increase sensitivity and cause an allergic reaction, yet repeated exposure to an allergen in allergy shots helps build up immunity? Regularly scheduled, repeated exposure to small amounts of an allergen can lead to immunity, whereas infrequent and erratic exposure does not confer immunity but increases the likelihood of producing allergen sensitization. Irregular exposure to allergens can lead to the production of antibodies (called IgE-mediated antibodies). The presence of these antibodies, when exposed to an allergen, can lead to an allergic reaction. In allergy shots or immunotherapy, the allergen exposure is closely regulated and given on a scheduled basis. Small amounts of allergens are given over a period of time to build up to maintenance doses. This leads to the production of blocking antibodies (called IgG antibodies) and a decrease in the level of allergic or IgE-mediated antibodies.

While reactions to an allergy shot are normal,  a severe reaction (anaphylaxis) is rare, but may happen. Your doctor and the medical staff are trained and experienced in diagnosing the onset of anaphylactic reaction and in providing treatment regimens to alleviate the reaction before it becomes life-threatening.   You don’t want to experience an anaphylactic reaction while away from a medical facility; hence the need to wait 30 minutes after you are given an allergy shot.

Asthma is a chronic, inflammatory lung disease characterized by recurrent breathing problems. People with asthma have acute episodes when the air passages in their lungs get narrower, and breathing becomes more difficult. The problem is an oversensitivity of the lungs and airways, which overreact to certain “triggers” and become inflamed and clogged.

The cause of the lung abnormality that is asthma is not yet known. Through research, scientists have established that the disease is a special type of inflammation of the airway that leads to contraction of airway muscle, mucus production and swelling in the airways. The airways become overly responsive to environmental changes. The result is wheezing and coughing.

There is no cure for asthma, but asthma can be controlled with proper treatment. People with asthma can use medicine prescribed by their physician to prevent or relieve their symptoms, and they can learn ways to manage episodes. They also can learn to identify and avoid the things that trigger an episode. By educating themselves about medications and other asthma management strategies, most people with asthma can gain control of the disease and live an active life.

Asthma can be difficult to diagnose because it can resemble other respiratory problems such as emphysema, bronchitis and lower respiratory infections. For that reason, asthma is underdiagnosed – that is, many people with the disease do not know they have it and therefore are never treated. In some cases, sometimes the only symptom is a chronic cough, especially at night, or coughing and/or wheezing may occur only with exercise. Some people mistakenly think they are having recurrent bronchitis since respiratory infections usually settle in the chest in a person predisposed to asthma. To diagnose asthma and distinguish it from other lung disorders, physicians rely on a combination of medical history, a thorough physical examination, and certain laboratory tests. These tests include spirometry (using an instrument that measures the air taken in and out of the lungs), peak flow monitoring (another measure of lung function), chest X-rays, and sometimes blood and allergy tests.

An asthma episode feels somewhat like taking deep breaths of very cold air on a winter day. Breathing becomes harder and may hurt, and there may be coughing. Breathing may make a wheezing or whistling sound. These problems occur because the airways of the lungs are getting narrower. The muscles that surround the airways tighten, the inner lining of the airways swells and pushes inward, and the membranes that line the airways secrete extra mucus, which can form plugs that further block the air passages. The rush of air through the narrowed airways produces the wheezing sounds that are typical of asthma.

No! If you would like to have a consultation, simply contact us and we will schedule a convenient appointment time for you. Please note, however, that insurance policies may vary and a referral may be necessary for insurance to cover some forms of treatment. If you have questions on what is covered, you should contact your insurance company directly.