Seasonal Allergy

Pollen, pollen everywhere! It's like Christmas, except instead of snow, it's yellow pollen, and instead of receiving gifts, all you get is sneezing, congestion, a runny nose, allergic rhinitis or sinusitis. Though pollen levels are traditionally very high during the springtime, nature sometimes tries to do its part to help mitigate the mucousy misery that it spreads. Nature's idea of helping with pollen? Rain.

While wet, warm conditions are very conducive for the production of pollen, it tends to be drier days that see some of the highest pollen counts. This is because dry, low humidity days are better "pollen travel days". When not encumbered by moisture, pollens are freer to float about in the air and coat, well, everything. Ever notice the air feels "heavier" or "thicker" when it's humid out? There is some merit to this as humidity does make microparticles, like pollen, heavier and more likely to precipitate out of the air rather than continue floating along, tickling the noses of people across a very wide area.

Often rains spell relief for many folks since the humidity levels rises and grounds pollen faster than one of those new Boeing Dreamliners with a faulty battery (too soon?). Rain not only inhibits the spread of pollen, it also washes it away. Areas of the country, like Atlanta, that experience high levels of pine pollen often get that yellow, powdery coat over everything. While these larger, visible particles can sometimes be less responsible for allergic reactions than their smaller cousins, this pollen nonetheless is a good indicator to all that allergy season is in full swing.

So whether you're a farmer in many parts of our drought stricken country or just a seasonal allergy sufferer, spring rains bring welcome relief. Check out a few of the pictures I shot recently. No, it's not a chemical spill. That's pollen!

You can't always wait on the rains to give you a break during week long stretches of high pollen counts, but you can help to reduce the pollen you breathe by wearing an allergy mask, rinsing your sinuses and using OTC allergy medications when symptoms flare up. Or, there is always a rain dance.

Author: K. Gilmore

With Spring finally here, the many months of keeping up with my yard begins. From pressure washing away red clay and pollen to mowing and trimming, lawn care is one of those outdoor tasks that can really aggravate those with allergies or asthma. Pollen levels are up but so is the grass, so aside from hiring someone to take care of your lawn (or napalming it), what can you do about allergies? There is one simple item that can help regardless of the season - a mask.

Since I'm not allergic to pollen, I personally don't wear a mask for this reason, though during the dry summers, I do wear one to eliminate dust. Masks remain one of the most effective ways to block tree, weed and grass pollen without having to change your regular lawncare routine. N95 masks are the most common type available. Inexpensive paper masks like this are an easy way to block reaction causing allergens. Most N95 masks are disposable, so after a use or two, you simple replace it.

The N95 rating is a NIOSH classification that means any mask with this rating traps 95% of particles 0.3 microns or larger. While this certainly isn't HEPA, it works well in many situations. With this type of filtration, it will block most of your pollens as well as dust and other particulate in the air. If you try one of these masks but find that the filtration isn't quite doing the job, you can step up to a P100 or N100 rated mask/respirator instead.

NIOSH 100 rated masks meet HEPA standards, trapping 99.97% of particles 0.3 microns or larger. This type of filter represents the gold standard when it comes to particle filtration in masks. Some of these masks are disposable while others have replaceable filters, but both types will provide the extra protection against allergens for those who need it.

Aside from keeping up with your lawn, masks also work well for simple gardening. We all like the look of a well put together flower bed or the taste of a fresh tomato from a plant in the backyard (I know I do!) but planting this time of year presents the same problems as cutting the grass for the first time. With gardening, you often don't stir up pollen like you do when mowing, but this can often involve digging around in decaying or moldy vegetation or leaves. Again, an N95 mask can often be your best bet, but if allergies aren't as severe you may be able to go with something like a Silk or Vogmask. The filtration level on these is a bit lower than N95 but both can help to reduce exposure to particles that can cause allergies or asthma to flare. Plus, these types of masks are a little easier on the eyes, fold up to fit neatly in your pocket, and are generally a bit more comfortable.

Regardless of whether your mowing, gardening or simply cleaning up after your dog, masks an easy and convenient way to block particles while helping to keep you enjoying the outdoors longer.

Author: Kevin G.

Well, it's time for Atlanta's annual rite of passage - spring pollen, and particularly pine pollen.  While there are certainly more tree pollens than just pine floating around in the air, pine pollen is what gives this city it's lovely yellow hue this time of year.  For those affected by allergies or have allergy-induced asthma, the next several weeks can be miserable without taking some steps to control exposure.

We generally recommend you first start at home.  What's floating around outside cannot be helped, but what's floating around inside your house can.  This time of year it's important to remember that a few simple steps can help keep many of those allergens outside, where they belong.

• Take your shoes off.  It seems pretty self-explanatory, but you can track a lot of pollen into the house.  This is also true for pets.  While your cat or dog probably doesn't wear shoes, using a pet wipe or simply damp rag to quickly wipe them down when they come in can help keep them from tracking throughout the house.
• Change the filter.  This can apply to a couple things.  Your HVAC filter is likely due for a change.  After spending much of the winter indoors, these filters can work overtime trying to keep your indoor air clean.  Start with a fresh filter every two to three months.  If you are using a HEPA air purifier, keep tabs on when your filter change is due.  Often they'll have timer based indicators, but keep this running properly can help reduce the pollen that you're bringing in the house.
• Don't skimp on the spring cleaning!  Regular vacuuming, washing, and dusting are more important during high pollen times than at any other point in the year.  By letting allergens build you can easily quickly increase your "allergen load" past the tipping point and be overwhelmed with symptoms.
• Keep the windows closed.  In places with high levels of pine pollen opening the windows can be about the equivalent of coating everything in your home with baby powder, except it will be yellow and likely cause a lot more sneezing.  If you do want to keep the windows open without the mess and allergens, try using a window filter.  They're not a efficient as a HEPA filter, but they do a good job in removing larger particles and much of the pollen in the air.  Besides, if they were HEPA rated, no air at all would pass through.

While these tips can help to keep pollen out of your home, we don't want people to be shut-ins.  So when you're out and about, plan certain tasks around specific times of the day.  Late morning and midday are often your worst times for peak pollen.  There are also a variety of resources that will give you a daily pollen count.  So if something could be pushed off from a particularly high pollen day, you can do a bit of short term planning.  If you are going to be out and about, whether for fun, work or exercise, OTC medication can help prevent and treat many of the symptoms, and a high quality allergy mask can block most of the allergens in the air.  Using a nasal irrigation device can help rinse away reaction causing pollen and other allergens that collect in the nose and sinuses.

None of these things cost much money.  More than anything, it is simply spending a little extra time or stepping up the frequency of things that you are already going.  Spring is here, so buckle up!  We have about three weeks of this lovely yellow powder ahead of us!

Author: Kevin G.

With Easter and Passover now behind us, the spring allergy season is set to begin making millions across the U.S. miserable. And while there is no shortage of weather forecasters and others singing "doom and gloom" for this allergy season, I am somewhat more optimistic about it. Why would I be optimistic about this spring allergy season you ask? There are a few reasons why I think the "doom and gloom" crowd are missing the mark.

Don't get me wrong here. Spring allergy season is going to really stink for tens of millions of people. It has, and likely always will, but think back to last year around this time. Do you remember the stories about the upper third of the country being buried under snow? Nope. Instead what we had was record setting high temperatures.

Remember this? A little digging around shows that temperatures in the upper Midwest ranged as widely as almost 70 degrees warmer on days last year versus the same days this year. Speaking strictly in terms of averages, much of the country is still above temperature averages for 2013 (1.9 degrees according to NOAA), but 2013 went even further (3.6 degrees). All that warmer weather last year meant spring, sprung early.

More than simply the temperature, the entire jet stream pattern is different. If you check out images from NOAA for March of this year and last year, you can see a big dip in the west that helped pull warmer air and temperatures up and disperse them throughout the country. This year the pattern more closely resembles the norm, and with it has come more normal winter temperatures and a more than healthy amount of snow to much of the country.

In February of 2012, people in different parts of the country began their annual trek to the allergist, and for most, this was a month sooner than they were used to. It was little wonder though. At the end of last March, we here in Atlanta saw the old pollen count record shattered by 55% (9369 vs. 6013). We didn't see anything even remotely close to that last week.

Again, I'm not saying spring allergy season took a vacation this year. Sneezing and coughing are likely to be the common sounds you hear for the next couple of months, and now is the time to start preparing for another round of springtime sniffles. However, I don't work for a company that has to make a news story out of everything as mundane as an inch of rain. So, time will tell but, I'm not buying that 2013 will be the worst allergy season ever. To quote Dana Carvey (impersonating G.H. Bush), "Wouldn't be prudent. Not gonna do it."

For good information on comparing historical trends, from year to year, visit The National Climatic Data Center, a division of NOAA (National Oceanic and Atmospheric Administration).

Author: Kevin Gilmore

When it comes to allergies, rarely are they isolated or singular. Often there are groupings, like allergen punches in bunches, that can affect the body. Peanut allergy sufferers are often allergic to other types of tree nuts, or those allergic to ragweed pollen are also likely affected by dust mites. But more than being multi-allergenic, cross reactivity is also an issue for many allergy sufferers. Cross-reactivity is the body's immune system mistaking a similar protein or chemical as one it typically has a reaction to, and most people see this reaction with food.

So what are some common cross reactive allergens? Birch is one of the biggest culprits. A protein found in apple peels is very closely related to one found in birch, and this means the body can sometimes confuse the two. You may be diagnosed with an allergy to birch, but then, while eating a raw apple, you might experience tingling, swelling or itching around the mouth and lips. This type of symptom is most common for people with cross reactions to foods. Another example of this is with grass pollens and seemingly unrelated foods like kiwis, tomatoes, or peanuts. Sometimes referred to as "latex-fruit syndrome," a third common cross-reaction stems from a latex allergy and a sensitivity to certain fruits like bananas and kiwi.

Unfortunately, the problem with this can be felt year round. So while your spring allergy season may play hell on your birch pollen allergy, a reaction to eating fresh apples is likely to appear regardless of the season.

Challenges in identifying and categorizing these reactions can be difficult and cause false positive test results. Common allergen tests, like the skin prick test, can reveal a sensitivity to a particular allergen, potentially a cross reactive food, but then lead to a diagnosis of a full blown allergy to this food. Cross-reactivity does not mean that someone will have a reaction to ALL types of food that share a particular, similar protein. Because of this, eliminating an entire class of foods from the diet because of cross reactivity can sometimes be a bit unwarranted, though not uncommon.

One interesting away around this can be by cooking foods. While the cross reactions can be common when it comes to fresh food, cooked food often alters the proteins enough that the body no longer misidentifies them. This is not always the case (particularly with a cross-reaction to nuts), but this does explain why someone with a birch pollen allergy can feel a tingling in the lips and mouth when eating a fresh apple but experience no symptom at all when eating apple cobbler or drinking apple cider.

Without a doubt, cross reactivity complicates our understanding of allergies and the allergic response. Yet, solving the problem of allergies can't be solved until more is known, and cross reactivity is just another part of puzzle. If you think you may be cross-reactive, talk to your doctor or allergist. While the knowledge in this area is still rapidly expanding, he may be able to help further pinpoint the actual cause of the issue.

Author: K. Gilmore

We're not quite two weeks in to February, and while much of the Northeast and Midwest is literally digging out from under a few feet of snow, in other parts of the country, there have already been a couple days of high pollen counts. In Atlanta, the Easter lilies have been in bloom for almost a week, and much like last year, spring pollen season is likely coming early for many allergy sufferers.

Last year, the sneezing started earlier due to a warmer winter, and for much of the country this is again the case. Now, if you're sitting under three feet of snow right now in Boston, this doesn't really apply, but the spring allergy season there typically trails the start in the southeast, south and west.

Spring allergy season is an annual event marked by plenty of sneezing, congestion and in some places, a putrid green-yellow dust covering everything. In more recent years, milder winter temperatures and heavier rainfall has led trees, grasses and other plants all beginning to bloom earlier in the year, effectively prolonging the season. The same is likely going to be true for this year.

Most people are familiar with seasonal allergies and the symptoms they bring, including, sneezing, congestion, watery eyes, sinus pressure, swelling, and a sore throat. Avoiding the pollen of spring is difficult for many but by making a few slight changes to your everyday routine, you can can reduce much of your exposure.

• Check the pollen count - Most local forecasts give you a pollen count and the types of pollen that are prevalent on any given day. You can also find this information relatively quickly online or through many of the weather apps available for your mobile.
• Take your shoes off - Kicking your shoes off at the door can keep you from tracking pollen in and all through your home.
• Keep the windows closed - Open windows let in a fresh, spring breeze, but they also allow unwanted guests like windwalking pollens. Window filters can remove much of the pollen in the air and still allow some air to pass through.
• Replace your furnace filter - After a winter of being shut in more than usual and using the furnace, your HVAC or furnace filter is likely long overdue for a change. Most filters use simple particle filtration but some have electrostatic properties that boost filtering ability. Electrostatic filters generally only last about three months before they are full of particulate, so regular replacement is a must.
• Irrigate - I'm not talking about your lawn. Instead, nasal irrigation is a quick and easy way to wash away allergens that can accumulate in airways and throat. Removing them with a saline rinse not only moisturizes but also reduces reactions by flushing the allergen out of your system.

These are just a few ways you can prepare and cope with spring allergies. While you cannot eliminate pollen, you can take these simple steps to reduce their impact (and your misery) during this time of year.

Author: Kevin Gilmore

The popular allergy relief drug, Clarinex, will soon be available in a generic form. The active ingredient in Clarinex, desloratadine, has received FDA approval and is now offered in 5mg doses under the Mylan Pharmaceuticals label.

Desloratadine is an antihistimine prescribed to allergy sufferers to relief runny nose, red, itchy and tearing eyes as well as other hay fever and allergic rhinitis symptoms. Currently, desloratadine is only available as Clarinex, but with the introduction of this new generic, allergy sufferers will soon have a less expensive alternative to turn to when seeking allergy relief medication.

Clarinex, available as a tablet and oral solution, has been prescribed to millions of allergy sufferers worldwide, with sales reaching nearly $200,000,000 last year.

Though this entry isn't as provocative as the title might lead some to believe, for those of us with dogs, you may notice your dog licking and biting their paws from time to time. There are a few reasons why they do this, and as a recent piece posted at NorthJersey.com suggests, it may be due to allergies.

I notice my dog, Cotton, licks his paws from time to time, but then I've also noticed that he's very particular about his feet. Specifically, he doesn't care much for you touching them or getting them wet. I really don't pay that much attention to my own, but since he is much shorter and has four of them, I assume that he likely takes many more steps throughout the course of the day. Thus, I reason he's "on his feet" more than I(not to mention barefoot). Regardless, what can cause your dog to lick his/her paws can sometimes be allergies.

There are three main types of allergies that can be the culprit, flea, food and environmental. Flea allergies seem fairly obvious. When your dog comes in contact with fleas or flea saliva, they will dig and itch at the point of contact. Vets will always recommend sometime of monthly flea control, and while I've never been a fan of applying topical insecticides or pesticides directly to Cotton's skin, I do use the pet shampoo by Ecology Works, and that keeps him flea-free throughout the year. So whether you go with a shampoo or medication, keeps tick and flea repellents in mind.

The next two causes may be somewhat less obvious. Of the two, environmental allergies are a bit easier to spot since this culprit will likely be seasonal in nature - noticeable during the warmer months with the licking and biting tapering off during the winter. Since most dogs are 99% hair factories, the paws are places where allergens can most directly affect exposed skin. I can imagine that if I never wore shoes, from time to time, my feet would likely come in contact with a few unsavory things that would make me want to scratch them too!

The last culprit is food allergies. This may be the case if your dog is licking and biting his paws all year round. While the ingredient list is most dog foods is as long as a monthly grocery list, it can be difficult to pin down what's causing it, but in working with your vet, you can try a few different types of protein bases to begin eliminating what ingredients may be causing the reaction. As the article suggests, you may try a dog food with a protein base of venison or rabbit. Test a few different types and see if you begin to notice a difference. In more severe cases your vet can run your dog through a variety of allergy tests to help you narrow down the list of culprits.

In the case of seasonal allergies your vet can prescribe antihistamines and you can also try avoidance. Though, the latter can be difficult if your dog typically spends a fair amount of time outdoors.

I'm not sure if Cotton has allergies. I tend to think he is a bit like a feline since he usually starts the licking and cleaning right after bath time or if he has had the unfortunate luck of going outside when it was raining. I had never given thought to an allergic reaction being the cause for this, but if nothing else, it gives me something to keep an eye on and directly discuss with the vet on his next visit.

Author: Kevin Gilmore

On May 1st, the FDA approved a new seasonal allergy nasal spray, Dymista, for use in the U.S. Manufactured by Swedish pharmaceutical company Meda, Dymista is for children over the age of 12 and adults. It will be available by prescription only. As a treatment for seasonal allergic rhinitis, this new hay fever drug is a "combination drug", meaning it combines both azelastine hydrochloride and fluticasone propionate.

Azelastine hydrochloride is an antihistamine currently being used to treat rhinitis and seasonal conjuctivitis and is the active ingredient in Asteplin and Astepro, both products in the Meda line of allergy products. Fluticasone propionate is an anti-inflammatory found in Flonase.

Dymista is expected to roll out in the U.S. in the latter part of 2012. It claims better efficacy than drugs that contain either of the active ingredients alone. In clinical trials, there were no instances of nasal ulceration or septal perforation (reported side effects of some nasal corticosteroids). In three double blind trials conducted by the FDA, Dymista was shown to be an effective treatment for seasonal allergic rhinitis. Click here for a full transcript of the FDA clinical trial results for Dymista.

Meda, Sweden's largest publicly traded pharma company, is based in Solna, and sells products in 120 countries. As one of the 50 largest pharmaceutical companies worldwide, Meda's sales exceed $1.6 billion annually.

Follow these links for more information on seasonal allergies or to see non-pharmaceutical allergy control products.

Author: Kevin Gilmore

As we settle in to the last official day of winter (who knew, right?), temperatures across the south have been hovering around record highs - Think 80-85 degrees. Like the high temperatures, pollen counts are also setting records, and for many allergy and asthma sufferers, all of these records mean miserable weeks ahead.

This morning, the Atlanta Allergy and Asthma Clinic recored a pollen count of 8164. This leaves the old record, set in 1999, in the dust - figuratively in that the old record was 6013, and literally, like the greenish/yellow cloud of pollen that is currently blanketing the city.*

From sore throats and sneezing to pain in the ears and congestion, allergy symptoms can truly make a person miserable. To combat some of the record setting pollen and allergy symptoms, there are a variety of things you can do to reduce exposure.

First, limit your time outdoors while the pollen is the heaviest. If you must spend significant time outdoors, consider wearing at least an inexpensive dust mask if not a true allergy mask. Second, keep up with the cleaning and vacuuming. Each time your, a family member or pet comes back in, pollen is hitching a ride into your home, so it's important to keep these allergens from spreading throughout the house.

For pets, pet wipes are handy to have in that you can quickly wipe your pet's coat and paws as they enter the house. They are a great way to prevent the pollen paw prints all over your floors. Family members and guests should be encouraged to take their shoes off at the door.

Opening the windows is something many people enjoy, particularly during temperate spring months. This can mean letting in a lot of pollen during peak months, but to combat this, try a window filter. While they do not eliminate all particles, they allows some fresh air in while trapping most of the pollen in the outdoor air.

Lastly, irrigate. Proper use of a neti pot or nasal irrigator can not only clear away pollen and allergens trapped in your sinuses, but they can also rinse away congestion. And nasal irrigation is not just to relieve symptoms in your nose and sinuses. Nasal irrigation can also sometimes help relieve pain in the ears that is caused by sinus pressure.

With warm, dry weather driving pollen counts up, St. Patrick's Day isn't the only reason you'll see green. Just remember a few simple steps, and don't let seasonal allergies get you down.





*The old pollen count record not only fell, but was crushed by over 30%. To put this into perspective.... For someone to beat Joey Chesnut's record (68) at the Nathan's hot dog eating contest by the same margin, they'd have to consume 93 hot dogs!