Allergy Answers - avoiding and treating allergy triggers

Keep those sneezes and sniffles under control

FOR MOST OF HER 28 YEARS, Janay Johnson of Gaithersburg, Maryland, fought a losing battle against severe nasal allergies. As a child, she took allergy shots and downed more of Grandma's shredded horseradish than she cares to remember. As an adult, she took frequent sack days despite use of steroids, antibiotics, an antihistamine and a decongestant. "Allergies can make you feel like you always have a bad case of the flu," says Janay. "People think you're making excuses when you miss work or can't leave the house. It wears on you physically and emotionally."

But as this spring's allergy season gets under way, Janay can breathe easily because she's learned to cope with her symptoms. At home, she's removed dust-collecting clutter and rugs, changed her heating-cooling unit's air filter and tossed out strong-smelling perfumes, potpourri and scented candles. Before going outside, she takes a prescription antihistamine and packs nasal spray. She's also reduced her intake of mucous-producing dairy products and increased her consumption of immunity-boosting fruits and vegetables.

Janay is among the one in five adults and children in the United States who suffer from some type of allergic disorder, including hay fever or allergic rhinitis. African-Americans may be more susceptible to this problem for two reasons. First, we tend to live in urban communities where pollution is worse and where dust mites, cockroaches and rodents in homes add to the list of allergy triggers. The second factor is our genes. Research has found that Blacks naturally have a higher level of IgE, an antibody involved in allergic reactions. But despite our susceptibility, you can keep your allergies in check with the help of new allergy-treatment recommendations and more effective medications.

Know the Causes and Symptoms

Allergic rhinitis, the most common allergic disease, develops when the immune system overreacts to an otherwise harmless substance such as pollen or mold. "If you have the genetic tendency and come in contact with an allergen, your immune system may respond by making IgE. Further exposure may lead to the production of histamines, leukotrienes and other substances that cause an allergic reaction," says Floyd Malveaux, M.D., Ph.D., allergy expert and dean of the College of Medicine at Howard University.

The resulting symptoms are often confused with those of a cold or the flu. "Allergies are often trivialized," says Gary Rachelefsky, M.D., a clinical professor at UCLA and cochair of the American Academy of Asthma, Allergies and Immunology (AAAAI) Task Force on Allergic Disorders. "So patients aren't treated properly, or they try to treat themselves with over-the-counter medications." To clarify the proper diagnosis and treatment of allergies, the AAAAI recently gathered experts from 21 health and medical organizations to set national guidelines. This first-time effort resulted in a report that provides guidance to physicians, calls for more research and notes the link between allergies and other conditions such as asthma.

Allergy symptoms often include more than sneezes: * itchy nose, palate and throat; * runny nose and postnasal drip; * coughing; * head and nasal congestion; * itchy, watery eyes; * altered sense of taste or smell; and * recurrent sinus or ear infections.

One way patients and providers can diagnose allergies better is through testing, says Malveaux. During testing, an allergist injects various allergens beneath the skin and cheeks for an allergic response like swelling or redness. "Accurate testing is crucial," Malveaux explains. "If a person has a genetic predisposition, her allergies may begin to manifest in the lower respiratory track as asthma symptoms. And asthma has many more serious health implications if not treated properly."

Prevent the Triggers

Experts agree that your first line of defense is minimizing exposure to allergens. So plan to make these changes in your environment: * Wash your bedding in hot water at least once a week. * Keep pets clean and out of your bedroom at night or give them away. * Keep windows shut and use the air conditioner at home and in your car. * Use high-efficiency particulate air (HEPA) filters to help eliminate fine air particles in your home. * Wash your hair frequently to rid it of pollen, * Wear a dust mask when mowing the lawn, raking leaves or gardening.

You should also check the news for pollen, mold and ragweed counts each day and, if possible, stay inside between 5:00 and 10:00 A.M., when the pollen count is highest.

Use the Latest Medications

To relieve allergy symptoms, Rachelefsky suggests nonsedating prescription antihistamines and nasal sprays instead of over-the-counter medications that can cause drowsiness, memory lapses and inattentiveness. Ask your doctor about the leading antihistamines--Allegra, Claritin, Zyrtec, Hismanal. To clear congestion, you may want to add a nasal spray such as Beconase, Flonase, Nasacort, Rhinocort, Nasarel or Nasalcrom to your allergy regimen. Both antihistamines and sprays work best if taken prior to exposure; they may take days, or even weeks, to start working.

Originally approved by the Food and Drug Administration for the treatment of asthma, a class of drugs known as leukotriene inhibitors may also offer relief. Taken in pill form, leukotriene inhibitors prevent mucus production and airway inflammation. As a last resort, talk with your doctor about immunotherapy (allergy shots). While shots don't cure allergies, they relieve symptoms in 60 to 70 percent of people with pollen allergies, and may be especially useful for those with asthma and hay-fever. However, this treatment requires frequent visits to the doctor's office for three to five years, with results not becoming evident for several months or longer. With all these options, you and your health-care provider should be able to find the one treatment or combination of treatments that works for you.

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RELATED ARTICLE: The Alternative Route

If you prefer not to take medication, alternative therapies can also work. To treat allergies, Andrea D. Sullivan, a naturopathic physician based in Washington, D.C. first evaluates each patient's likes, dislikes, fears, and stare of mind as well as physical symptoms. She then recommends that patients avoid dairy foods and alcohol, which contribute to congestion. She also urges them to drink plenty of water to flush toxins out of the body and to take 2,000 to 4,000 mg of vitamin C a day in divided doses to bolster the immune system. Herbs, such as goldenseal and echinacea, and supplements, including ligusticum, quercitin and bromelain can also help. Dosages vary, so consult a licensed naturopath or herbalist before taking these products.

Paula M. White is a writer living in Los Angeles.

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