Oral Allergy Syndrome: Why does my mouth itch when I eat certain fruits, nuts and vegetables?

Summer is the season when New Yorkers tend to eat more fruits. Certain fruits, vegetables and nuts can cause oral itching and other symptoms in people with various pollen allergies, particularly tree pollen. The symptoms, which may also include nasal, eye and even gastrointestinal symptoms, usually occur within minutes of eating the food. Rarely, the food exposure can result in anaphylaxis, a more generalized life-threatening reaction marked by low blood pressure, hives and wheezing. Read more

Exercise-Induced Bronchospasm: Cause and Treatment

In the summer, we are outdoors—and hopefully exercising—more often. About 10% of people who exercise will get exercise-induced bronchospasm (EIB). Symptoms may include wheezing, excessive shortness of breath, chest tightness, or just coughing beginning 5 to 10 minutes after exercise. EIB occurs most frequently in persons with asthma, particularly those whose asthma is not well controlled. Various studies show that up to 90% of people with asthma have EIB. But it can also occur in isolation—in a person without asthma. Read more

Tree Pollens: Why May Is Allergy and Asthma Awareness Month

Pollens — the microscopic plant particles that cause seasonal allergies in many people — come from three general types of plants: trees, grasses and weeds. In general, trees pollinate in the late winter/early spring; grasses often overlap the trees at the end of their season and extend late into the summer; and ragweed, the most important of allergenic weeds, starts pollenating in mid-August through September. Read more

Indoor Allergies: Should I Bathe My Cat?

This is the second in a series on indoor allergies—of which cats are common culprits. For people allergic to cats, the major allergen (substance that causes an allergic reaction) is found in the cat’s saliva, urine and dander (dried flakes of skin).

How can I reduce cat allergen in my house?

The most effective way is to rid the house of the cat. This is not acceptable to most people, and after pet removal, the allergen will remain in the house for 6 months or more.  The second choice might be to keep the cat outside, which is not possible in certain climates. And, if the outdoor cat is played with, the sticky allergen makes its way into the house anyway.

What about bathing my cat?

Studies have shown that washing a cat can reduce the amount of allergen on it (the allergen is mostly in cat saliva, and is transferred to the fur by licking). Based on scientific studies, twice weekly washing would be required—and a lot of rinsing, too—so this is not very feasible, nor favored by cats. Perhaps a Cleopatra-style bath (milk bath) would be acceptable to the cat!

What are some other options to reduce cat allergen?

• Removing reservoirs for the allergen, such as carpets, sofas and other upholstered furniture

• Using vacuum cleaners with effective filtration systems

• Installing HEPA-type air filters in rooms, particularly the bedroom

• Increasing ventilation in the house

Is there anything else I can do?

I like to recommend making the bedroom (where we spend most of our indoor time) a “cat-free zone.” After the room is closed off to the cat, it should be cleaned thoroughly, including damp mopping the sticky allergen off the walls, and cleaning window treatments and bedding. After this cleaning, the cat cannot reenter the room (ever), otherwise the allergen level will increase. This means the door to the room needs to remain closed at all times. But, cats are sneaky, so this is not so readily accomplished.

Stay tuned for more information on indoor allergies.

To find an allergist who is right for you, please call the Physician Referral Service at 1 (866) 804-1007 Monday through Friday, 9 am to 5 pm.

‘Tis the Season to Be Sneezin’ and Wheezin’: Dust Mite Allergy

Nasal allergy symptoms (rhinitis) and asthma caused by allergens that are inhaled usually have seasonal patterns. While symptoms from various pollens occur in the spring, summer or late summer/fall, nasal allergy symptoms in fall and winter are due mainly to indoor inhalants and also usually seasonal. But in the case of indoor allergens, this seasonal pattern is the result of spending more time indoors in these months, with the windows closed and heat on, leading to both increased exposure times and increased levels of indoor allergens.

Dust mites—microscopic insect critters that live in our bedding—are the most important culprit among the indoor allergens causing allergic disease. Our pillows and mattresses are loaded with them. When you buy a new mattress that weighs, say, 100 pounds, it will weigh 102 pounds within a couple of years. That extra 2 pounds are from the accumulation of living and dead dust mites and their droppings. Fortunately, dust mites do not bite, though in addition to their role in causing nasal allergy and asthma, they probably also contribute to flares of eczema in certain patients.

Why Dust Mites Love Us

The diet of a mite consists mainly of human skin scales, of which we shed a lot in the course of a day. This is why they love our bedding.

The life cycle of dust mites is related to humidity. They love the humid days of summer and proliferate wildly. Then, when the heat goes on indoors in autumn, the humidity falls and they die off, leaving additional particulate matter to breath in.

If you want to read some of the scientific research on dust mites, Google the name “Thomas Platts-Mills,” who is a world expert on mites and gives very entertaining lectures on the subject.

Diagnosis

There is no way to know if one is allergic to dust mites without being tested. If you tested positive to “house dust” years ago (a test most allergists don’t do anymore), you should be tested again. Since house dust is a mixture of dust mites, animal dander, insect material and other dusts, allergy to any of these components would have resulted in a positive house dust test. Today, we test for the individual components of house dust.

Treatment

1. The treatment for dust mite allergy is, first and foremost, avoidance.

Bedding ­– Various companies market breathable covers that seal the bedding. Mite covers have even been shown to reduce the risk of developing asthma for children born into families with a history of allergic disease.

Humidity – The use of humidifiers in most houses in winter is not recommended, as it encourages mite growth. Optimal humidity in the home of someone with respiratory illness is in the 30% to 40% range; most homes are within that range or higher in winter. If you are not sure, you can measure it with a hygrometer.

2. The second line of treatment is medication for the symptoms of rhinitis, asthma or eczema. These include various combinations of prescription and over-the-counter medications, including pills, nasal sprays, eye drops and, in the case of eczema, creams and ointments. Antihistamines (ocular and oral) are the only medications for rhinitis that are available over the counter without a prescription. Any over-the-counter medications for asthma should be avoided, particularly Primatene, which is not very safe.

3. For patients who do not respond sufficiently to the above measures, or those wishing to reduce their use of medications, immunotherapy (allergy injections) might be in order.

I hope your holiday season is happy, and that you can avoid the sneezin’ and wheezin’!

To find an allergist who is right for you, please call the Physician Referral Service at 1 (866) 804-1007 Monday through Friday, 9 am to 5 pm.

Asthma in the Fall and Winter

I guess Santa doesn’t have asthma, since in all likelihood he would have missed some Christmases given the rates of exacerbation for asthma during the fall and winter. Santa would especially be vulnerable during this worse time of year for most asthmatics since he rides around on a sleigh in frigid arctic air and climbs down a smoke-filled chimney. He also laughs a lot (ho-ho-ho). When we laugh (or cry) we breathe in and out rapidly, and our lung airways cool off and cooling of the airways causes asthma. That being said, let’s discuss what the average asthma patient can do to prevent exacerbating their asthma during the fall and winter. Read more

Severe Food Allergy

The ancient Roman poet and philosopher Lucretius observed, “What is food to one is to another bitter poison.” In those times, a violent food allergy was a mysterious and alarming condition. Imagine a healthy guest at a Roman banquet suddenly choking and gasping, then collapsing and dying. It’s easy to understand why many innocent survivors were suspected of poisoning the poor victims.

Read more