Sneezy, Dopey, Sleepy, Grumpy (Doc)

Well into my teenage years, every summer I’d get so throttled by allergies that I became consolidated into 4/7ths of Snow White’s dwarves. Some years later, after my allergies had temporarily eased up, I would add a fifth: Doc.

My younger self as Dopey and Sleepy were, of course, a response to the side effects of the antihistamines I dutifully swallowed every morning. Some adults don’t remember their childhoods because of repressed psychic trauma, others because they were watching too much TV. Me, I walked around in a drug-induced haze taking pills that rarely affected my allergies. I remember playing center field one hot afternoon, sneezing constantly and letting balls fly overhead, much to the fury of my teammates.

Right now in April we’re entering allergy season. As I write this on April 8, I see not a  single leaf on any tree and yet the tree pollen count is soaring. Patients are calling for refills on their medications and asking about alternatives to allergy drugs.

As summer progresses, tree pollen will be replaced by grasses and weeds will follow. If you sneeze year-round, it’s more likely to be the cat, the trillion dust mites with whom you share your condo, or that black mold at the bottom of your shower curtain.

We planetary citizens are more allergic than ever. In fact we’re three to five times more allergic now than we were 30 years ago. No one has a sure-fire explanation for this, but global warming and exposure to excessive pollution are currently being blamed, the two throwing our immune systems into confusion.

Allergies appear in three common ways: skin rashes (hives, eczema), the miserable combination of allergic rhinitis and conjunctivitis better known as hay fever, and, finally, asthma. Allergic tendencies are very genetic—every August my mom and I headed to Wisconsin’s north woods to escape our ragweed allergies. Many Chicagoans move to the southwest, foolishly bringing bags of lawn seed to recreate their Midwest back yards, only to wonder why their summer allergies return.

What happens when you have an allergic reaction?

With an allergic response, your immune system has been primed to see an enemy where none exists. Ragweed pollen, dust mites, and so forth are harmless substances, but if you’re a genetically allergy-prone person, when you were a baby your immune system overreacted to one or more of these, shouting “This is an enemy!”

It then created a specific defense molecule–an antibody–called IgE (immunoglobulin E) against it. These molecules course through your bloodstream acting as security guard, so that whenever you come in contact with the pollen or dust mites again the antibodies go berserk, triggering a reaction called an inflammatory allergic response. Part of this response involves specialized cells in your eyes, nose, throat, and lungs releasing the chemical histamine.

If you could tell your immune system to stop wasting its time, that dust mites and pollen are harmless, it might grunt, “Hey, lady, just doin’ our job.” The histamine your own body is producing makes you cough, sneeze, and wheeze. Your eyes water. And you attempt to counter this whole pointless allergic reaction by taking antihistamines, sprays of anti-inflammatory steroids, and other medications.

For years, specialists in allergy medicine used skin scratch tests to try to diagnose what triggered our allergies, treating those specific triggers by injecting tiny amounts into us, hoping to confuse our immune systems enough to stop the process.

As a former patient myself, I never had much faith in allergy shots. After a couple of years of nothing happening except the tedium of weekly visits to a doctor’s office, my parents decided to spend their money on my crooked teeth instead. Childhood allergies generally disappear on their own during the teen years (although allergists are happy to take credit for it themselves) and resurface again in adulthood. Skin testing is notoriously inconsistent. You can go to three allergists and sometimes get three different sets of results.

A blood test for allergies

You can now uncover what’s triggering your allergies with an extremely accurate blood test that measures your IgE levels to numerous common villains (including several pollens, mold, dog/cat dander, dust mites, and cockroaches) in a single test panel, with the pollen selection aligned to where you live. Once you know what you’re allergic to, you can take some steps, like cleaning, closing windows during key months, moving to Sedona, or stopping the cat from sleeping on your face.

The advantage of blood testing is consistency. Skin scratch test results vary by injection technique, whether or not you’ve previously taken an antihistamine, and even according to the person interpreting the test.

If you’re a WholeHealth Chicago patient with allergy symptoms (including not only hay fever and asthma, but also chronic sinusitis, sore throat, cough, wheezing, and so forth) getting tested is simple. Just call the office and schedule a blood draw. No fasting or change in medication is needed. Because IGE testing (either by scratch or blood testing) is part of the accepted diagnosis and treatment of allergies, virtually every health insurance company covers. 

Beyond allergy shots, antihistamines, and steroids, there are several alternative ways to deal with seasonal allergies. Next time I’ll discuss nutritional, herbal, Chinese and homeopathic approaches.

Before I close, let me reassure you regarding allergies that there’s no need to resort to a Mr. T-style approach.

Be well,

David Edelberg, MD