Allergic Rhinitis
Allergic rhinitis, sometimes called hay fever, is one of the most common health issues in the developed countries. As much as 20% of the population is affected by some form of nasal allergy. Many of the symptoms are similar to having a cold. But unlike a cold, which is caused by a virus or bacteria, allergic rhinitis is caused by airborne allergens such as pollen, mold spores, pet dander, and dust mite droppings. These allergens produce the same symptoms as having a cold such as runny nose, sneezing, and tearing eyes. Being allergic to something in the air will have an effect on your nose, eyes, throat, and airway passages. Airborne allergens are such a problem because they are everywhere and difficult to avoid. They are floating around in your home and outside in your yard. They can settle on your carpet, bed, and furniture. Airborne allergens tend to exist in high concentrations. One ragweed plant, for example, can produce a billion grains of pollen in just one season. Inside your home, the dust mite allergen can be in the millions in your bed. The high concentration of the allergen along with it being all around us is what makes allergic rhinitis so common. Unfortunately, to make matters worse, it is very common to be allergic to more than one type of airborne allergen. Symptoms may occur on a seasonal basis or they may come and go all year long.
Types of Hay FeverMany different types of allergens produce nasal allergy symptoms. The type of allergen and where it is found often can have an impact on when allergy symptoms occur. An allergist will make a distinction between seasonal symptoms and symptoms occurring all year long.
Seasonal Allergic RhinitisSeasonal allergic rhinitis is usually thought of as outdoor allergens. The two main kinds of outdoor allergens are pollen and mold. These are considered the most common forms of hay fever. The quantity of allergens in the air is going to peak at different times of the year, depending on which allergen it is. The season for hay fever starts in the spring and will last until the first hard frost.
Perennial Allergic RhinitisYear-round hay fever is usually thought of as indoor allergens. The two main kinds of indoor allergens are house dust and mold. Most people are usually allergic to more than one type of these allergens. If allergic to only one kind, being allergic to dust mites is the most common type of perennial allergic rhinitis.
Dust Mite Debris: It is not the dust mite themselves that cause dust mite allergy symptoms. Dust mites settle out of the air quickly. The culprit is the many droppings that they produce each day, their shed skin, and their decaying bodies that become airborne and inhaled by people. Usually if people are allergic to dust mites, their symptoms are worse at night.
Cockroach Debris: Cockroaches are a nasty pest that puts out a strong allergen. The allergen consist of dead body parts, eggs, cast skin, and fecal waste matter. Cockroaches live in colonies so where you see one, there are more that you don’t see. Both the cockroaches and their allergen are hard to get rid of once they are present in a building.
Pet Protein: Pet allergy is caused by the dander (skin flakes), the saliva, and the urine of pets. Contrary to popular belief, the hair/fur on the pet is not the allergen that triggers allergy symptoms, although it does collect and retain a large amount of the allergen. Pet allergens are very sticky and can cling to anything including walls, drapery, and bedding. Their small particle size keeps them airborne for a long period of time.
Mold Spores: Mold spores inside our home grow all year long and mold allergy will have no defined season. Moisture that mold needs for growth can come from high humidity, condensation, and water leaks. Many household activities such as cooking and taking showers can put more than enough moisture into the air. Unlike many plants, mold does not need sunlight for growth. It can thrive in moist, poorly ventilated, and dark areas.
Hay Fever AllergyOur immune system has the remarkable ability to distinguish between substances that belong to our body and substances that are foreign. If something is foreign and harmful to our body such as viruses and bacteria, the immune system produces antibodies to combat them. The immune system can simply dispose of the antigens that are identified to be harmless to the body. In the case of allergic rhinitis, allergens such as dust mite droppings, pet dander, pollen and mold spores are harmless substances and most immune systems easily dispose of them. The allergic immune system responds differently because it erroneously identifies these as harmful. The allergic immune system fails to distinguish between harmful and harmless antigens. The allergic reaction is an inappropriate response to a harmless substance. The immune system over-reacts to something that poses no threat to the body. The body launches an attack against it unnecessarily. The allergic response begins by the detection of the allergen. Believing that the allergen is harmful, the body produces IgE antibodies that are very specific for that particular allergen. One type of IgE antibody is produced to fight pet dander while another type of IgE antibody is made to detect ragweed pollen. The body is said to be sensitized when such a large amount of IgE antibodies is produced. The antibodies are waiting and looking for the next exposure. This large amount of IgE antibodies produced is one major difference between those who have allergies and those who do not. The antibodies wait for the allergen by attaching themselves onto mast cells. Mast cells are found in the tissue of ports of entry into the body such as the nose, eyes, and lungs. The mast cells have a special receptor for holding onto the IgE antibody. From this stage in the process, the attack begins at the next exposure to the specific allergen for which the IgE antibody was made for. The exposure causes the antibody to distort the mast cells which results in breaking them open. Mast cells are filled with granules consisting of many different kinds of inflammatory chemicals. Histamine is the most well known of these. Breaking open of the mast cells is called degranulation. The chemical granules inside the mast cells is what the body uses to defend itself. It is these chemicals, and not the allergen itself, that cause all the symptoms associated with allergies. The chemical granules released into the surrounding tissue will cause inflammation to prevent more allergens from entering into the body. Furthermore, histamine will cause fluid to appear, mucus production, sneezing, and watery eyes to expel what allergens have already entered into the body. When the exposure to the allergen stops, the body will stop releasing inflammatory chemical into the tissue. This makes the case (in my opinion) for avoidance to be the cornerstone for any allergy treatment. Avoidance and using environmental controls prevents the release and attack from the inflammatory chemicals. Drugs and medication do not always prevent the release of the inflammatory chemicals from the mast cells. The allergic reaction is still happening with the mast cells still trying to launch an attack. Anti-histamine medication will block the receptors for the histamine that has been released and prevent the symptoms from occurring. Not having the immune system from launching the attack in the first place should always be the first choice for treating allergies and is considered the most natural approach.
SymptomsIt is the inflammatory chemicals released from the mast cells (tissue cells) and basophil cells (blood cells) that produce the allergic symptoms. The symptoms are designed to expel the foreign invader and to prevent more allergens from entering into the body. The most common symptoms from airborne allergens are going to be associated with the ports of entry into the body and respiratory passage ways. The symptoms can be mild or severe, depending on our sensitivity to the allergen. The most common symptoms include:
The symptoms mentioned above are just the most common symptoms involving the eyes, nose and mouth from an airborne allergen. Most commonly, they resemble the condition of having a cold. Without knowing exactly what you are allergic to, sometimes it can be difficult determining if it is a cold, or is it an allergy.
Complications of Allergic RhinitisAllergic rhinitis describes the condition of irritation, inflammation, and excess mucus production in the nose. The word rhinitis comes from the root word rhino, which means nose. Thus, rhinitis means “inflammation of the nose and nasal passages”. Rhinitis accurately describes the irritation of the nasal lining and the swelling of the nasal passages. Having a cold does not seem to be a serious health issue. Likewise, having allergies is not regarded as having a serious health condition. Many people simply put up with the allergic condition and learn to live with it.
Failure to treat allergic rhinitis by ignoring and living with our allergic symptoms can and do lead to other complications such as:
Indoor Air QualityPoor air quality in our homes makes having allergic rhinitis worse. Irritants are not allergens, but can contribute in making symptoms worse. Having allergic rhinitis makes you more sensitive to irritants. Irritants and poor indoor air quality is becoming more and more of a common problem. The EPA estimates indoor air pollution to be 2-5 times worse inside our homes. People with allergic rhinitis can be more sensitive to strong odors such as: paint stripper, mineral spirits, moth repellents, air fresheners, household cleaners, wood preservatives, drain and oven cleaners, and bleach to name only a few. Indoor air pollution can come from man-made sources, natural sources, and pollutants from combustion. Examples of made-made sources are lead, asbestos and formaldehyde. Examples of natural sources are radon and biological pollutants. Examples of pollutants from burning are carbon monoxide, smoke, and sulfur dioxide. The major concern is with volatile organic chemicals known as VOC’s. These are man-made chemicals. They can evaporate into the air and be in our air as a gas or a vapor. Our bodies don’t have an adequate mechanism from stopping such small particles from getting into our lungs. Often the health issues from poor indoor air quality doesn’t show up until years later in life.
Determining What You Are Allergic ToIf you suspect that you might have allergic rhinitis, you should consult with your physician. It is important in managing your health to know what you are allergic to. Knowing exactly what your allergies are will result in a better plan of action for treating them. Allergies have a genetic and environmental component so your physician may ask a lot of questions. They may look for clues in your lifestyle and look for patterns of when your symptoms become worse. For example, if symptoms tend to get worse when you go to bed and wake up, dust mite allergies may be suspected. Your family medical history will be looked at and more often than not, a physical exam will be required. The most common way of discovering what exactly you are allergic to is by an allergist performing a skin test. It is the easiest and least expensive way. The idea is put a sample of the suspected allergen on your skin to see if there is a reaction. Diluted extracts from various allergens are used for testing. They can be injected under the patients’ skin or the extracts can be scratched into the skin by using a special needle. If the test site appears red and produces a bump, the test is positive. The size of the wheal (the bump) can give an indication as to the degree of sensitivity one has to the allergen. Interpreting the results of testing for allergic rhinitis is not always as simple as it might seem. Always have an allergist with experience in interpreting the results performing the test. If a skin test is not possible, a blood test can be given which will measure the amount of IgE antibodies in the blood.
TreatmentThe goal in the treatment of allergic rhinitis is to be able to live a normal life with the minimum amount of interruptions from allergy symptoms. Whatever way produces this kind of results for you is the best treatment plan for you. Treatment for allergic rhinitis boils down to a few choices:
DrugsAirborne allergens can be very difficult to avoid. They are constantly around us. Sometimes it can be impossible to avoid household dust or pollen. For some, adding drugs to the treatment plan may be the only way to find some relief. When drugs become an option for treating allergic rhinitis, always consult with your physician. This is good advice even if you are only considering over-the-counter medication. Never try to diagnose yourself and self-medicate. All drugs have the potential for side effects. Problems arise when you mix allergy drugs with medication that you may be already taking. Problems can develop when drugs are over-used or not used as instructed. Always consult with your physician so these pitfalls can be avoided. Patients with high blood pressure, for example, should not take decongestants because decongestants can raise blood pressure. Your doctor can prescribe the best medication for your situation.
There are many different kinds of drugs to treat nasal allergies. Some of the more common types are: There are many more choices for your physician to choose from and these medications come in different forms in which you can take them. Drugs are certainly an option for the treatment of allergies. They definitely have their place. Many people have much success with this type of treatment. But this treatment is one in which it addresses the problem and not the cause.
ImmunotherapyAllergy shots are another option for treating allergic rhinitis. Sometimes avoidance strategies and medication does not provide enough relief. For some people, immunotherapy is their only hope for reducing symptoms and improving their quality of life. Immunotherapy is a process of being injected with a small amount of the known allergen that is causing the allergy symptoms. The goal is to reduce the sensitivity to that particular allergen over time. Build up stage: Small amounts of the purified allergen extract are injected once or twice a week. Slowly, the dose strength is increased to help develop tolerance. The build up stage can last between 6-12 months. Maintenance stage: When the maximum amount of the dose is achieved, the injections are given less often. The allergy shots are given once or twice a month. The maintenance stage can last between 3-5 years. Immunotherapy can be very effective in the treatment of allergic rhinitis. The treatment plan is a process and does not produce results immediately. It can take several months for allergy shots to start showing results. Just because allergy shots are being taken does not mean that we stop taking allergens out of our environment. There are also risks involved with taking allergy shots. After all, you are being given an allergen that you know your body is allergic to and will produce an allergic reaction. Most commonly, symptoms only develop at the injection site. On rare occasions, a severe reaction may occur. For this reason, immunotherapy should only be performed in a medical facility and there is a waiting period prior to being released to go home.
AvoidanceWhich ever method is chosen for treating allergic rhinitis, avoidance should always be included in the over-all plan. Avoidance strategies is:
The key to this strategy is simply to just start allergy-proofing your home. Don’t try to do too much at one time. Start small and build on your progress. My family discovered that some things worked and some things did not work. Find out what works for you and build on it. Many people never start and suffer unnecessarily. More often than not, the best place to start is in our bedroom. We all need at least one room that we can find relief from an airborne allergen. The bedroom is the best choice because it has an impact on the quality of our sleep. Good sleep is more important to our health than what society gives it credit for. After starting in the bedroom, then you can build on your progress by focusing on cleaning, humidity levels, and temperature. There are various types of allergic rhinitis. To learn more about avoidance, go to the specific page that addresses your type of hay fever.
Remember,
To learn more, read the Allergic Rhinitis article from the American Academy of Allergy Asthma & Immunology.
Go to HOME PAGE from allergic rhinitis.
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Trees begin the hay fever season in the spring for 
Grass is next on the list for producing pollen. They begin their pollination in late spring. Their pollen is light enough for the wind to carry it for great distances. Walking on the grass, mowing the lawn, and raking the yard will help propel the pollen into the air. Grass can produce a massive amount of pollen. Common grasses that cause grass allergy symptoms are: Redtop grass, Bermuda grass, Johnson grass, Kentucky bluegrass, Timothy grass, and Orchard grass.
Weeds are last on the list for producing pollen. Late summer through fall is when they produce pollen. Perhaps they are the most prolific producers of pollen. Being allergic to ragweed might just be the most well known form of weed allergy, with the peak being mid-September. A single 
Mold outdoors affects allergy suffers from late summer into fall. The cooler temperatures provide plenty of dampness and there is plenty of dying organic matter for the fungi to feed on. Outdoors, mold begins to grow in the spring and does not stop until a hard frost. Fungi need moisture for growth so the weather conditions and climate can have a greater impact on mold growth than the calendar cycle.
