Other Allergies

Other Allergy Triggers

Some people have allergic reactions to other sources, including:

Airborne Pollutants

• Aerosols
• Chemicals
• Exhaust particles
• Tobacco smoke
• Wood smoke

Animal Dander

• Cats
• Dogs

Biological Agents

• Insects
• Insect stings
• Rodents

Drugs

• Aspirin
• Benadryl, EpiPen or steroids
• Flu vaccine
• Iodine dye
• Penicillin

Fragrances

• Air fresheners
• Perfumes

Pollen and Plants

• Christmas trees
• Garden plants
• Ragweed pollen

Some factors can make allergies feel worse, including:

• Cold air
• Humidity
• Wind

Car Allergy

Rule #1 in allergy is avoid what you're allergic to. That includes the automobile. Here are a few tips:

• Most every car has carpeting. We walk around outdoors, often in the rain, mud, and pollen, then put our dirty shoes on the floor. When carpet gets wet, mold spores can grow easily. Vacuum and dry the carpeting well, then place down water-proof, grooved, plastic floor mats.
• We sit in the seat for extended periods of time, sweating and shedding old skin. That's a perfect recipe for growth of dust mites. Vacuum the upholstery regularly as well.
• Never allow smoking in your car as the irritants penetrate the carpet, upholstery, and the liner above your head.
• When the weather is beautiful in Houston, there will be lots of pollen in the air. Allergy sufferers should keep the windows up, with the fan set on recirculate.
• Look under the seats for last year's French fries; don't ever give mold a chance to grow.
• Many newer cars have air filters. When doing maintenance, remember to replace these regularly. Old filters impair fresh air from coming in. Old filters that get moist can produce musty odors.
• Air fresheners that hang from the mirror are designed to mask odors, not to remove the source of the odor. Most of them contain chemicals that can irritate your lungs and nose.
• Make sure the weather stripping is intact and that all doors shut properly. You may not notice a slow leak until the mold spores become very apparent.
• When driving your cat or dog to the vet's office, place them in an animal carrier. This is not only safer for them, but reduces the amount of pet dander that ends up in the car.
• You may love that new car smell, but it's actually caused by the off-gassing of volatile organic compounds (VOC's). A brand new car usually needs about 6 months for levels of VOC's to come down to levels present in an older car.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Cat Allergy

Most people allergic to cats don't keep a cat in their home. The best treatment for any allergy is avoidance, but many cat lovers do what they can to keep the cat in the house. It is always best to remove a cat from an allergic individual's home. Having said that, most patients I counsel want to reserve cat relocation as the last option. I'm okay with that, as long as the cat is not sending you to the emergency room with brittle asthma.

Assuming Fluffy will not be evicted, here's what may help:

1. Keep the cat out of your bedroom at all times, even when you're not home.
2. Remove carpeting from your bedroom floor. Removing carpet from your home completely is even better.
3. Put a HEPA filter in your bedroom and run it 24/7. I usually don't recommend fancy filters because most allergens are heavier than air. Cat allergen is tiny and remains airborne. Thus, it can be captured by a good filter.
4. Mild or moderate cat allergy responds very well to allergy shots. When administered correctly, allergy shots actually induce tolerance in the allergic patients so that future encounters with cats produce milder symptoms.
5. After playtime with your cat, wash your hands well and change shirts afterwards. Be careful not to touch your eyes.

Often, we are able to bridge the gap between a cat lover and their cat allergy. When all else fails, removing a cherished member of the family, your cat, from your home can be difficult.

One company I no longer recommend is Allerca Lifestyle Pets which claims to have bred non-allergic cats. The internet is full of stories from people who paid up to $10,000 and never received their cat or a refund. In 2006, Time Magazine called the new cats one of the best inventions of the year, but it was too good to be true. The U.S. Better Business Bureau has 14 documented complaints and gives Allerca an "F" rating, the worst grade allowable. Google the words "allerca" and "scam" and you'll find some interesting reading.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Christmas Tree Allergy - Nothing to Sneeze At

The Christmas tree you buy each year is at the end of its long journey. Having grown up in Oregon, it is harvested and placed on a flat bed truck for its cross country journey. Once every few stops, the trees are watered down to keep them moist and fresh. Just make sure that the beautiful Tannenbaum you invite into your living room doesn't make your allergies worse! Although an artificial tree is best (if you rinse off the attic dust!), here are some tips if you decide to go with a real tree:

That continual watering promotes mold growth. Make sure to spray your tree with a garden hose before bringing it inside. This also helps rinse the pollen off the tree. Although pine trees aren't a major source of tree pollen, they can trigger hay fever if you get a big dose of the powder right in your face. Rinsing the tree off, plus using your allergy medicines before you enjoy trimming the tree, may prevent your Christmas-time allergy. Speaking of trimming the tree, your ornaments may have spent the off-season in the attic with dust mites and mold. Carefully clean them off in a well-ventilated area. After Christmas, pack the ornaments carefully in sealed plastic bags to make next year's job a bit easier.

Keep the living room well-ventilated. The aromatic resins that impart the pine scent can act as non-allergic irritants. Our Texas Aggie buddies suggest the Leyland Cypress tree since, as a true hybrid, it cannot produce pollen. Fewer resins on the Leyland Cypress mean fewer odors.

Along with cheerful holiday gatherings come colds and flu. How does your doctor keep from getting all those bugs? We wash our hands with hot soapy water or Purell about 753 times a day. Careful hand washing can prevent transmission of respiratory viruses.

Stay well and Happy Holidays from The Allergy Clinic, your allergy and asthma specialists!

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Diesel Engines

With gasoline over $3.00 per gallon, automobile manufacturers are trying to figure out how to let Americans have their cake, and eat it too. We want luxury, safety, and of course, fuel efficiency. Honda, Ford, Lexus, GM and Toyota have hybrid engines that run on both gasoline and electricity. Mercedes, BMW and Volkswagen, on the other hand, increase fuel economy using diesel engines. Most trucks are available with diesel engines.

Diesel exhaust particles (DEPs) are terrible for people with allergies and asthma; they even raise the allergic antibody (IgE) levels in people who do not even have allergies. According to the Environmental Protection Agency (EPA), diesel exhaust particles may be the component of air pollution most responsible for the huge increase in allergies throughout the western world. The exhaust that these soot-filled tailpipes release into your lungs make the immune system produce chemicals, called cytokines, which worsen allergic inflammation. In all fairness, the new Mercedes, VW and BMW diesels have much cleaner as emission-control technologies than they did several years back. However, the cover article from the Febuary, 2005 Journal of Allergy & Clinical Immunology shows diesel fumes driving production of IgE, the allergic antibody. And diesel pick-up trucks still use the older, dirtier diesel engines.

Granted, diesels produce fewer greenhouse gases and are more fuel efficient than their gasoline counterparts. But if you have allergies or asthma, consider a gasoline hybrid before a diesel.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Hypoallergenic Dog. Myth or Fact? (Both.)

You may have read that certain dogs, including the Portuguese water dog adopted by President Obama's family, are less likely to worsen allergies. According to the July 2011 American Journal of Rhinology and Allergy, this is a myth. Poodles, schnauzers, and Portuguese water dogs have the same amount of dog allergen (Can f 1) as other dogs not promoted as hypoallergenic: "There is really no statistical difference in 'hypoallergenic' dogs and others as far as allergen levels in the home. The allergen comes out of a dog's saliva and their pelt..." Interestingly, though, the researchers don't comment on the fact that some breeds' longer or thicker fur may trap pollen better, making them better at bringing outdoor pollen and mold inside. Most people with dog allergy are also allergic to other airborne allergens. Dogs who shed less leave less dander all over the home. A smaller dog has less body surface area to produce Can f 1. Lastly, certain dogs of the same breed produce less allergen. If your neighbor's Bichon makes you sneeze but yours doesn't, that's believable.

The new findings don't mean people with allergies can't have dogs. This is America! We want to have our cake and eat it too. And then have more. Seriously, while our first advice is to remove the pet from the home, there are steps that can be taken to help reduce exposure:

• Bathe the dog twice weekly to remove dander from its coat.
• Keep the dog out of the bedroom at all times, even when the allergic patient is not in that room.
• Run a HEPA filter 24/7/365 to remove dander in the air.
• Consider immunotherapy to treat the underlying animal allergy. Immunotherapy, delivered as allergy shots or drops, can be remarkably effective in decreasing or eliminating the actual cause of the symptoms (whether it's dog, grass, mold, weeds or trees).

Allergy shots didn't work? Not all allergists test and treat with acetone precipitated dog. AP dog is 47 times more potent than the old dog allergen.

We understand that pets are an important part of many households. We have successfully helped thousands of patients become much less allergic, decreasing their symptoms and medication needs, and increasing Spike's job security.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Gardening and Allergies

A couple of years ago, National Public Radio aired a review of a book called, Safe Sex in the Garden: And Other Propositions for an Allergy-Free World. What a title! The premise of the book is that how you garden, and what you plant, can have a big impact on how your allergies bother you. Gardening is a wonderful activity, but what you plant might make you sneeze, wheeze or itch. The author, Thomas Ogren, has been hired to advise on pollen-free landscapes at schools, businesses, even the Virginia headquarters of the American Lung Association.

Basically, avoid male plants because they make pollen. Female plants do not make pollen. By choosing plants with colorful flowers, you do yourself a huge favor. These plants rely on insects to pollinate them, not the wind. So they are less likely to bother your allergies. (If you are allergic to the insects, like honeybees, however, then disregard what I just said!)

It's a good idea to use your antihistamine pill or nose spray before you start your outdoor activities. Even though Claritin, Allegra and Zyrtec treat allergy symptoms, they work even better at preventing allergic reactions. I also advise my horticulturally-inclined patients to wear gloves, goggles and respiratory masks to reduce exposure to pollen and other irritants while enjoying this hobby. When done working outdoors, it's a great idea to shower and wash your hair to remove excess dust and pollen. Also, place your clothes in a covered hamper until you get a chance to wash them.

Pick up a copy of Tom Ogren's book or visit Allergy-Free Gardening for more tips. He has great chapters on plants that cause skin rashes, and a great discussion on poisonous plants. At $14.95, it's probably less expensive than your co-pay to go see the doctor!

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Is Fresh Air Making You Sick?

The number of people suffering with allergy symptoms is at an all-time high. Sales of air fresheners are at an all-time high. These two facts may be related.

Stan Fineman, MD, president of the American College of Allergy, Asthma & Immunology, presented the following information at our annual meeting in November, 2011: 80 percent of Americans buy some type of air freshener each year. No one wants their house to smell like cat litter or cigarette smoke; however, the ingredients of those products can include formaldehyde, benzene, other volatile organic compounds (VOC's), phosphates, and ammonia. This includes sprays and diffusers (wicks). Plug-in deodorizers have over twenty different volatile organic compounds.

Okay, but aren't "organic" and "green" products safe? Literally, "organic" means it contains carbon. Therefore, my cat's solid waste contributions to his litter box are "organic". Organic, "natural" or "unscented" does not equal safe; many of these products contain phthalates. Phthalates, which are industrial chemicals used to make plastics flexible, are thought to cause many endocrine/hormone problems. (SC Johnson is voluntarily phasing out phthalates in its plug-in deodorizers by 2012).

Especially beware of the word, "unscented". Unscented products can still contain an irritating fragrance. It will also contain a masking fragrance to hide that odor. Instead of unscented, look for "fragrance free".

What about my scented candles, you ask. 63 percent of scented candles produce soot. Candles often also contain VOC's, lead, and other non-allergic irritants. A study done at the University of South Florida concluded, "the toxicity characteristics of candle emissions match those of diesel emissions", and "their size, < 1 micro-meter, allows penetration into lungs". A 2009 study from the Journal of Environmental Health reported that 20 percent of all people reported health problems from air fresheners, and 30 percent of all people report problems when exposed to certain perfumes, colognes and other scented products. Okay, but what about my potpourri? (You don't even want to know about potpourri).

Current health claims about aromatherapy may (or may not) be true about emotional well being. I love the way my house smells when we are baking chocolate chip cookies. However, if you think air fresheners are irritating your lungs, nose and throat, you're probably right. Here are some recommendations for keeping your home smelling clean: Don't let anyone smoke inside, empty the garbage outside regularly, put baking soda at the bottom of your garbage can, grind up some lemon in the garbage disposal, and open windows to let in fresh air (assuming pollen/mold is not too high outside).

I'm still trying to teach my cats how to clean their own litter box.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

New Math

2 + 2 + 2 = 200

We had our winter. It even snowed Christmas Eve! Followed by a quick return to Houston Summer Redux, with 75 or 80 degrees. Through it all, our patients showed up at The Allergy Clinic needing relief. The quick changes from cold to hot, and high humidity to low humidity worsened sinus symptoms in all people, not just those with allergies.

I was reminded of the explanation that Dr. Andy Grant used to give University clinic patients back when Dr. Malick and I were post-doc allergy fellows at U.T.M.B. Galveston. Dr. Grant would say that when you' re allergic to more than one thing, it's more than just adding up the sensitivities. Regarding allergy testing, he would tell patients, "Your 2+ sensitivity to molds, plus your 2+ sensitivity to ragweed, plus your 2+ sensitivity to dust mites add up to 200!" That's because of the priming effect. Remember priming a ground water pump at a farm? Getting it to pump water by cranking it a few times? Then, the water flows just fine. Well, the mold, which was high all summer, primed many of us into moderate misery – it only took a little bit of ragweed to send your allergy symptoms into the stratosphere.

Then the non-allergic weather changes played havoc with our heads and noses. Talk about adding insult to injury. What to do? As always, put out the fire with a continual coating of low dose nasal corticosteroids if recommended by your physician. Add on antihistamines to help immediate symptoms, and do your best to stay away from what you're allergic to.

When necessary, get to the doctor's office sooner rather than later so you're still being treated for allergies instead of for a sinus infection or for bronchitis. Lastly, prevention beats treatment in the long run. Prevention of symptoms usually means the prescription nose sprays. Prevention of the allergy itself is accomplished with allergy shots.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Ragweed Pollen

After a long Houston summer, we're all ready for cool evenings. But when nighttime temperatures drop below 70 degrees, and humidity drops below 70%, ragweed starts to grow. Ragweed is the main source of allergic misery for those who suffer in September and October. Ragweed will continue to make pollen until early November unless we get an early freeze.

Interestingly, several foods cross-react with ragweed. If you are allergic to ragweed, you may experience itching or tingling of the lips or tongue when you eat cantaloupe, watermelon or bananas while ragweed pollen counts are high. Interestingly, by cooking the related food, heat will alter the structure of the antigen, usually making it non-allergenic. Drinking chamomile tea may cause a similar reaction.

Ragweed puts out more pollen in the mornings than in the evenings, so if you're allergic to it, save outside activities for late afternoon or after a heavy rain, when pollen levels are lower.

We've been waiting all summer to roll down the windows in our car, but if you're allergic to ragweed, this is asking for trouble. Take advantage of the filtering system in your car's HVAC system to keep symptoms in check. If you have an indoor dog that goes outside to play for a while, consider giving him/her a bath; dog fur has a static charge which acts as a transport mechanism to bring in all sorts of pollen.

Ragweed is named for the raggedy shape of its leaves. It's not a very pretty plant; still, what it lacks in beauty, it makes up for in potency. One ragweed plant can put out over one billion grains of pollen! Its scientific name, Ambrosia, was the delicious food eaten by the mythical Greek gods to make them live forever.

Remember, if you're on one of those preventative steroid nose sprays (e.g., Nasonex, Rhinocort, or Nasacort), start it soon so it will be working when ragweed pollen hits its peak.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.