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Sneezing and Wheezing: Springtime Allergy Chat

April 17, 2019 12:00 PM with Dr. Jamee Tantoco

Spring is in the air, as well as pollen, mold and other allergens.  Join Jamee Castillo Tantoco, MD, Allergy, Immunology & Asthma as she responds to questions about your allergies. She will be discussing the causes of seasonal allergy and asthma symptoms, prevention tips and ways to best manage your symptoms.

Woman Sneezing

Lauren (Moderator) - 10:24 AM:
Get your questions in now, we will be starting the chat in about an hour and a half. Ask early to make sure your questions are in the queue.

Jamee Tantoco (NorthShore) - 12:00 PM:
Hello everyone! I am Dr. Tantoco, one of the Allergy / Immunology Physicians at NorthShore. Welcome to our chat. I'm ready to take your questions.

  Olivia (Skokie) - 12:01 PM:
I have year-round allergies. The doctor called it Allergic Rhinitis and prescribed Flonase and OTC Zyrtec daily. Are there any natural remedies or other treatment options available so that I can stop taking meds every day?
Jamee Tantoco
Thank you for your question! One natural remedy that can be very helpful is the use of a nasal saline rinse to clear the nose of mucus and any allergens. Alternative remedies have not been well-studied, but some include using probiotics, and acupuncture. What may be helpful to you is to find out what exactly you are allergic to so that you have ways to avoid the allergens and know during which seasons you may need medications. Allergy immunotherapy or allergy shots are available for patients who would like to reduce the use of medications and have a long-term improvement in their symptoms.

  Ray (Glenview, IL) - 12:08 PM:
Hello. My 7-year-old daughter has seasonal allergies which are kicking in. She is having a hard time taking swimming lessons due to nose stuffiness. She sneezes a lot, and can't hold her breath underwater for too long as a result of stuffiness. Swimming lessons are after school. What can I do to resolve this?
Jamee Tantoco
The first line of medications for controlling nasal congestion or stuffiness are nasal sprays, such as Flonase, Nasonex, Nasacort, Rhinocort, etc. These medications control nasal stuffiness the best, but it does take consistent use for a couple of weeks to have the maximum benefit. I would recommend starting one of the nasal sprays - 1 spray in each nostril daily - during the allergy season. For quick relief, the tablets such as Claritin, Allegra, or Zyrtec, can be used as needed - about 30 minutes before swim class - to reduce sneezing.

  Stephen Gliva (Evanston, IL) - 12:13 PM:
Do meds like Claritin lose potency over time?
Jamee Tantoco
Many patients do notice that certain medications seem to be less effective with time, but this is usually an indication that the allergic symptoms are worsening. Claritin tends to be less potent than the other oral antihistamines, such as Allegra, Zyrtec, and Xyzal. I will often suggest that patients try these antihistamines if they feel Claritin is not as effective. Some patients do alternate among the different antihistamines, and that is perfectly fine to do, especially if they find that one is no longer as effective than it was previously.

  Jon (Wilmette, IL) - 12:19 PM:
Will a dirty home cause someone to be more allergy-prone? Like, if their home is dusty or their vents are dusty?
Jamee Tantoco
Not necessarily. Dust is a natural irritant for many people and exposure does not make someone more allergic or less allergic. The known risk factors for developing an allergy are genetics/family history. If your parents or other members of the family have allergies, there is a high likelihood you may have allergies also. With regards to a dirty environment, the hygiene hypothesis is a hot topic in allergy research. There is evidence that exposure to microbes (bacteria, viruses) in early life can be protective against developing allergies. What we do know is that this exposure is crucial during early infancy when our immune system is developing, but it is still under investigation and too early to give treatment recommendations on how to prevent allergies.

  Celeste (Niles) - 12:28 PM:
Can people grow into or out of allergies? I never used to have problems but now in my 30s I seem to have a really bad month at the start of spring that resolves in a month or so.
Jamee Tantoco
Most patients will develop early signs of Allergic Rhinitis - nasal congestion/stuffiness, runny nose, sneezing, itchy eyes - in childhood and adolescence, but you can definitely see it come on in adulthood. Some patients will also notice their allergy symptoms seem to improve as they get older. So it can come and go. It really can be different for each individual. Springtime allergies are a sign of possible tree pollen allergy. Using a nasal steroid spray and/or antihistamine tablet can be helpful from March until June.

  Jonelle C. (Elgin, IL) - 12:33 PM:
My fiancé continues to eat avocados and bananas, even though he’s slightly allergic. It irritates his stomach, but he still eats it. Should he continue to eat these foods and try to desensitize himself? Is it a good idea to do so?
Jamee Tantoco
Food allergy can be severe and life-threatening, and the proper treatment would be the avoidance of the food and an epinephrine autoinjector in the event of accidental ingestion with severe symptoms. I would recommend formal testing to the avocado and banana to find out if it is an allergy. There is a different type of condition called oral allergy syndrome or food-pollen association, where patients who are allergic to pollens can have oral symptoms - mouth itching, tingling, or swelling - after eating certain fresh fruits, raw vegetables, or nuts. A list of common cross-reactivity patterns between pollens and food can be helpful. In these patients, often cooking the food will help degrade the protein and therefore minimize symptoms. We can help determine if it is a food allergy or oral allergy syndrome by performing skin testing.

  Daniella (Gnome, AK) - 12:41 PM:
Is blowing your nose bad for you? Like, if you do it every day and sometimes you see blood?
Jamee Tantoco
The body has many ways of getting rid of foreign pathogens, such as viruses, bacteria, and allergens, and needing to blowing your nose of the mucus that traps these pathogens is a good thing to do. If you see a small amount of blood and can stop the nose bleed readily, this is a sign of nasal irritation and dryness. There are many nasal lubricants that are available over the counter. Applying a small amount into the nose can help lubricate the nose, prevent irritation and dryness from excessive nose blowing, and therefore stop the bleeding.

  Ray (Glenview, IL) - 12:46 PM:
Do you advise/recommend allergy shots for pediatric patients? Or are they a last resort sort of thing?
Jamee Tantoco
Allergy shots are safe and can be given to children. In fact, there is evidence that immunotherapy (allergy shots) in children can prevent the development of more allergies and allergic conditions, such as asthma. There is no age limit for allergy shots. When to start allergy shots is individualized to each patient. Allergy shots are recommended for patients who do not have good control of symptoms with medications, cannot tolerate medications due to many side effects, or wish to be off medications. Allergy immunotherapy has been shown to reduce symptoms, reduce medications use, and improve quality of life.

  Alicia (Park City, Utah) - 12:52 PM:
What are the long term effects on your health if you constantly have a stuffed up nose or other allergy symptoms?
Jamee Tantoco
We know that patients with uncontrolled Allergic Rhinitis tend to have more severe upper respiratory illnesses, such as the common cold, sinus infections. In patients with asthma, uncontrolled allergies can also flare their asthma symptoms - cough, wheeze, shortness of breath. On a day to day basis, uncontrolled allergies can cause fatigue and an inability to concentrate. This can have a huge impact on the quality of life and at work or school. Getting control of the symptoms with medications or allergy immunotherapy can make a dramatic improvement and prevent these complications.

  Cindy (Skokie) - 12:56 PM:
I'm allergic to my dog, but I won't give him up. What can I do?
Jamee Tantoco
In this case, the best thing you can do is to create a dog-free room in your house. I usually recommend that the bedroom, be pet-free. HEPA filters can also be helpful and cleaning the house regularly. Taking allergy medications may also be necessary. Lastly, while not an indication for allergy shots, some patients do get benefit from their pet allergies with immunotherapy.

Lauren (Moderator) - 1:00 PM:
That's all the time we have for today. Thank you, Dr. Tantoco for your time today, and for all of your expertise.

Jamee Tantoco (NorthShore) - 1:01 PM:
Thank you to everyone for submitting questions and participating! Have a good day!
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