Rx for readers: Spring fever!

The answer to all your pollen and Spring allergy troubles from your reliable Israeli doctor.

Yellowpollen_58 (photo credit: Keith Myers/MCT)
(photo credit: Keith Myers/MCT)
The yellow pollen in the air that comes from flowering trees and grasses is so terrible for many of us now. My eyes are red, and my nose is running. How does this work? What can one possibly do? – V.T., Karmiel
Prof. Arnon Goldberg, director of the allergy and immunology clinic at Meir Medical Center in Kfar Saba, answers:
The factors that are responsible for these reactions are called allergens, and they include all the variety of components of the environment to which we are exposed.
Aside from the seasonal things like the pollen you mention, there are also animal hair, dust mites, feathers, foods, medications, insect bites and metals with which the skin is in contact that have allergens that can affect some of us.
The allergy process involves the release of active chemical substances located in a group of cells in the skin and under the mucous membranes in the body. Contact between the allergenic cells, which are mediated by unique antibodies called IgE, will cause the cells to release active substances into their environment, and these substances arouse the allergic symptoms.
The symptoms include itching, redness, skin rashes, swelling, edema, dizziness, diarrhea and weakness. The specific nature and severity of the symptoms are set in accordance with the exposure and the amount of sensitivity of the person. For example, allergens from food will cause more stomachaches and diarrhea compared to allergens that come from the air, such as the yellow pollen, which manifest as sneezing, red eyes, respiratory difficulties and a runny nose. In rare cases, when a person is very allergic, exposure can cause an extreme reaction and even be life-threatening.
Skin tests are needed to diagnose the cause of the allergy. A tiny amount of different allergens is put into a small scratch on the skin to test for reactions. Within 15 minutes, swelling and redness appear at the site if the body is allergic to it. Blood tests can reach similar conclusions, but this method is slower, more expensive and less reliable.
Many people complain about “hay fever” in the spring, even though hay is not involved. Their quality of life seriously declines, and they suffer – even though there is no danger to life in these cases.
Not everything that flowers causes an allergic reaction. For example, citrus trees or flowers that are pollinated by bees and other insects do not cause such symptoms, which come from pollen carried by the wind.
People with a previous tendency toward allergic symptoms are at risk for hay fever in the spring. This is true also for people who have had asthma, atopic dermatitis (“asthma of the skin”) or food allergies in the past. These are clear risk factors. Genetics has an important influence; when one first-degree blood relation has the symptoms, it is more likely that other blood relatives will as well.
Treatment includes three options: reducing exposure to allergens, taking medications and getting shots to reduce reactions.
Exposure reduction means avoiding walking around in open areas and instead staying in closed places during the danger season.
But there is no way to avoid exposure entirely. Medication includes antihistamines in the form of pills, eye drops, nasal sprays and lung inhalers – depending on the type of symptoms. These medications can significantly minimize the suffering during the season, but they will not prevent the symptoms next spring.
The only way to avoid this is getting shots, in which a minute amount of pollen is injected under the skin, but not into the muscle as with ordinary vaccines given to prevent disease.
But the process is relatively long. One must get the shots once a week for three months, and then it is given for three to five years. The success rate is about 80 percent.
Recently there have been growing reports on the possibility of getting allergy vaccinations not by shots, but by drops put under the tongue. This is, of course, much more convenient, does not hurt and does not require going to the allergy clinic. It can be done at home. In Europe, this practice is growing, but the US Food and Drug Administration has not yet given its approval for the drops. The method has not yet been approved by our Health Ministry, either, but it is likely that in the next few years, the drops will come to us, too.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.