The Seasonal Pest

Just as the kids head back to school, it’s time for ragweed, says S. Scott Nicholas, MD, a physician at Eisenstadt Allergy & Asthma Specialists in Minneapolis. Ragweed rears its ugly head in mid-August and persists through September. An especially hot summer can also increase the local mold count, triggering symptoms in people with even mild mold allergies.
Symptom Check
When the body’s immune system kicks into gear to fight an invading allergen—even if the substance seems harmless, like grass or tree pollen—an allergy is born. The immune system fights by trying to flush out the offender and producing histamines that overreact, causing inflammation and irritation. The body uses histamines to oust the allergen, causing:

• Sneezing
• Nasal congestion
• Watery, runny nose
• Itching in nose, throat, or on skin
• Fatigue

In some cases, allergies can lead to a more serious problem, allergy-induced asthma. Allergies may affect the airways in the lungs, causing inflammation in that organ that can result in obstructed or irritated airways, and increased mucous production that hampers breathing. During some attacks, less air circulates through the lungs. Over time, this can lead to the development of asthma.

Testing, Testing
A skin or blood test can help determine the exact cause of an allergic reaction, according to Wyatt. “Back in the old days, we’d take a needle and prick the skin, but these days we’ve found a scratch test is just as effective,” he says. Plastic tines are dipped into a substance and then pressed against the skin, usually on a person’s back. Typically, up to twenty-two substances are tested, Wyatt says, including six types of trees, dust mites, feathers, and pets.

After a short wait, the physician and patient check the skin to see the allergy reactions taking place. Sometimes, Wyatt says, the effects can be dramatic, resembling mosquito bite welts, which can help determine the severity of an allergy.

Another method is a blood test, which looks for immunoglobulin E (IgE), a protein associated with allergic reactions. The IgE antibody kicks in when exposed to a certain allergy, and the test screens for the amount of IgE in the blood.

For allergy-induced asthma, doctors can perform a series of breathing capacity tests to discover the extent of the problem.

Treatment Options
Doctors tailor allergy treatments to individuals, since there is no one-size-fits-all approach, including:

• Oral antihistamines
• Nasal sprays (Pharmaceutical companies offer a range of products and often update their offerings. For example, GlaxoSmithKline has developed a new allergy treatment, Veramyst, which it created to treat a range of symptoms with just one nasal spray.)
• Allergy shots (when other treatments aren’t effective)

Nicholas advises patients to start taking medication up to ten days before their seasonal allergies begin. For example, someone with a ragweed allergy would begin treatment in early August, rather than waiting for the season to grow into full bloom.

“Allergies seem to be increasing—we’re not sure why,” Wyatt says. “But the good news is that strategies and medications are working better, so people can go out and enjoy the sunshine.”

This article has been adapted from the original, which was published in the May 2008 issue of Mpls.St.Paul Magazine.