Spring brings with it beautiful blossoms, a chance to spend more time outside and pollen. Allergies cause problems all over the country, but it can seem like this region gets hit particularly hard. “East Texas may be particularly bothersome for allergic patients as the pollination may be more prolific than in other areas and the “seasons” may be prolonged,” explains Dr. Jonathan Buttram, allergist and immunologist at UT Health East Texas. “For instance, ragweed season in the Northeast may last three to four weeks, whereas in East Texas, it may last three months.” Since allergies will affect a large portion of this community, Dr. Buttram shares how allergies work and how to find relief.
What are allergies?
Allergies occur when your immune system reacts to a foreign substance, such as pollen or pet dander, that doesn't cause a reaction in most people. When you have allergies, your immune system makes antibodies that identify a particular allergen as harmful, even though it isn't. When you come into contact with the allergen, your immune system's reaction can inflame your skin, sinuses, airways or digestive system.
The severity of allergies varies from person to person and can range from minor irritation to anaphylaxis. Your reaction to allergens also may change season to season and with age. Reactions may change with levels of exposure. For instance, seasons with higher pollen counts may result in worse symptoms in those who are sensitized. In addition to variable exposures, allergic patients often develop new sensitization to pollens and other inhalants as they age, usually into the mid to late 20’s. Allergy symptoms may improve with advancing age, especially in the 60s and 70s.
How common are seasonal allergies?
Over the past 20 years, the frequency of allergy in the general population has increased, in some studies up to 10-12 percent. Frequency of allergy has been steadily rising in the industrialized world for the past 40 to 50 years. Overall, the diagnosis of allergy has become more common. There are several potential contributing factors, including increased exposure to pollens and prolonged allergy seasons, suspected sensitizing factors from air pollution and the “hygiene hypothesis.” The hygiene hypothesis refers to the observation that allergy is more common where early exposures to infections and bacterial toxins are lower. If not prompted early by infections, the immune system seems to skew toward allergic responses.
What can be done to lessen symptoms?
The first line of treatment is avoidance. This is often guided by skin testing but can be empirically pursued by limiting outdoor exposures, keeping doors and windows closed, wearing sunglasses when outdoors, washing pets regularly and bathing (including washing hair) after any prolonged outdoor exposures. A variety of over-the-counter medications may be helpful, but should be discussed with a physician to ensure appropriate use and expectations for improvement. The best treatment is immunotherapy, which may be delivered by injection (allergy shots) or sublingual tablets/drops which dissolve under the tongue. Immunotherapy should be conducted via an allergy/immunology specialist in the interest of appropriate dosing and safety considerations.
What should I watch out for?
Don’t assume you have allergies. Many non-allergic syndromes may mimic the symptoms of allergies. This is often the case when allergy treatments don’t seem to work. A detailed history and appropriate testing can help sort this out.
A common misconception in my practice regarding seasonal allergies is that “local honey” or “bee pollen” can be helpful in treatment of seasonal allergies. Such preparations contain “entomophilus pollens” (pollinated by insects, i.e. flowers) rather than “anemophilus polllens” (pollinated by wind). Seasonal allergy is mediated by wind-pollinated trees, grasses and weeds, and these are not routinely contained in honey or bee pollen preparations. For those anemophilus pollens that may be contained in these treatments, the doses are so small and inconsistent that they do not have any appreciable or lasting effect to result in significant improvement.
Who can help?
If allergy symptoms have been persistent and/or life-altering, a board certified allergist can help diagnose the problem, guide specific avoidance measures, prescribe the most appropriate therapies and make a big difference in your daily health. A board certified allergist has completed an initial three years of residency in pediatrics or internal medicine and an additional two to three years of specialty training in allergy, asthma and immunology. Thus, they are specifically and comprehensively trained in the diagnosis and treatment of allergic diseases.
Jonathan Buttram, MD, FACP, is an allergist and immunologist who practices at UT Health East Texas Physicians Lindale. “I strive daily to provide the most up-to-date, comprehensive and practical care for my patients in an environment of integrity.”
Dr. Buttram chose to focus on allergy and immunology because the field encompasses all of his favorite aspects of internal medicine. “All areas of allergy and immunology, with focus on immunodeficiency, are appealing. I particularly enjoy evaluation and treatment of nasal symptoms, difficult-to-control asthma, chronic cough, eczema and hives/swelling.”