Now is the time to double down on managing allergies while cold season is in swing, allergists say

Published on Monday, January 1, 2024

By: Danny Barrett Jr., dlbarrett@umc.edu

Allergies stem from an overreaction inside the body that more than 50 million Americans deal with on a year-round basis, through sunshine or rain.

But a new year brings resolutions often dealing with health care, so allergists are offering up suggestions to those looking to manage their allergies better in 2024.

“It’s not always easy to get allergies and asthma under control,” said Dr. Gailen Marshall, the R. Faser Triplett Sr. MD Chair in Allergy and Immunology at UMMC and president of the American College of Allergy, Asthma and Immunology (ACAAI), in the organization’s tip sheet for the new year for allergy sufferers.

The organization suggested five aspects of managing allergic conditions that people might consider as resolutions this year. Marshall offers added insight to each as it relates to the best prevention methods.

• Update your prescriptions and visit a specialist: Allergists can craft a plan to combat allergies and asthma with the most updated treatments and procedures. ACAAI advises to make sure all prescribed medicines are working as they should and visit an allergist when it might become obvious it’s not working.

• As for popular over-the-counter non-sedating oral antihistamines, Marshall said they work better to prevent symptoms than they do to treat them if they already persist.

  “Come Feb. 1 or so, when we start to see pine pollen on hoods of cars in the morning and their nose starts to bother them, it’s good to have started those treatments the week before,” Marshall said, adding Claritin, Zyrtec and Allegra all have different active ingredients and can work differently from one person to the next. “People will swear by one or more of them, or take two or three tablets if they find taking one doesn’t work very well. But, switching them up can be an option if one of them isn’t working.”
  
  

• Protect against respiratory viruses: People with asthma and allergies are considered high-risk for worse symptoms from seasonal flu, COVID-19 and respiratory syncytial virus (RSV) than those without known allergies. ACAAI recommends staying up-to-date on shots for all three.
  
  “It’s not that you’re necessarily more at risk to get the virus. It’s that if you indeed get those viruses, you’re going to be sicker,” he said. “It will affect your lungs and if you already have a rhinitis, then you’ll get a new rhinitis on top of it. The end of the cold and flu season usually overlaps nicely with the start of the spring allergy season, so it’s good for those with asthma and allergies to stay out of the line of fire for viruses.”
  
  

• Practice positive mental health habits: Marshall has studied the effect of daily stress on the immune system for much of the past 30 years. “The clear evidence is that people with high levels of anxiety, depression, stress perceptions have increased instance of allergic diseases,” he said. “It has brought about a new aspect of treatment guidelines, which is the idea of managing stress and anxiety.”
  
  As with managing prescriptions, paying attention to mental health is becoming more of a regular conversation between providers and patients.
  
  “We now teach providers to look more carefully for this in their patients. They in turn teach patients to look more carefully for it in themselves. The aim is to make patients feel more comfortable in telling their providers, ‘I need help in managing my anxiety or my depression.’ This should extend this to all patients, not just those referred to mental health professionals.”
  
  The relationship between chronic allergic disease and mental health is already a factor in patient loads at UMMC’s Allergy, Asthma and Immunology clinic.
  
  

  

  “I now implement depression and anxiety screenings for my chronic hives patients due to their high prevalence,” said Dr. Charles Grogan, assistant professor of medicine and pediatrics and medical director of the UMMC Adult Allergy Service. “Some patients who have struggled even with maximum medical therapy have seen great improvement after addressing their stress and anxiety.”
  
  

• It’s never too early (or late) for spring cleaning: Those who manage multiple allergies and/or asthma should use vacuum cleaners and other homeware devices equipped with HEPA (high efficiency particulate air) filtration system. The Environmental Protection Agency says these filters must be able to capture at least 99.97 percent of dust, pollen, mold, bacteria and other airborne particles. Regardless of equipment, there can be an “aerosol effect” with dust for up to two hours after vacuuming before it settles, Marshall said.
  
  Specialized sensitivities, such as with pet hair, demand special attention year-round, Marshall said.
  
  “If you’re sensitive to animal dander, then just keep the animal outside if it’s practical,” he said. “At least, keep the animal out of your bedroom. It’s the room where you sleep and often spend the most time. So, make your bedroom your respiratory sanctuary so it’s dusted regularly and the sheets changed regularly. And ideally, there’s hardwood floors with rugs and no carpet in there.”
  
  Hot water isn’t typically an ideal setting for washing clothes and bed sheets in general – but it’s different for chronic allergy sufferers. It’s especially the case if dust mites prove to be the cause of allergic rhinitis and asthma this time of year.
  
  “Simple cleaning techniques like regularly washing bed linens in hot water weekly and encasing your mattress, box springs and pillows with zippered, dust proof covers can greatly help your symptoms if you have a dust mite sensitivity,” Grogan said. “And they love humidity, so try to keep the home’s humidity level below 40 percent, if possible. We also have under-the-tongue immunotherapy and allergy shots for more definitive therapy.”
  
  

• Don’t have to work up a sweat to exercise: The ACAAI notes allergists might urge patients to use a pre-exercise asthma medicine, such as an inhaled bronchodilator, before exercising. However, Marshall emphasizes low-impact exercises using furniture as props, for example, are effective for more severe cases of asthma that often prevent activities like running and jogging.
  
  “You can find examples online on chair exercises, for example,” he said. “Those involve taking a straight-back chair and moving your legs and arms get a good exercise in. If you get short of breath, you can just stop.
  
  “A thing to remember is that our body de-conditions when we stop exercising. And the muscles that de-condition include the ones that control our lung function. There is clear clinical value to moving around and doing deep breathing exercises as a result. But having said that, be sure to talk to your health care provider and get their instruction and blessing when you start any specific exercise program.
  
  “There’s no respiratory disease I’m aware of, either allergic and non-allergic, that dictates you can’t do exercise whatsoever. Yes, it may be limited, but it’s another reason to have that conversation with your health care provider.”
• To see a specialist at UMMC’s Allergy, Asthma and Immunology clinic, call (888)815-2005.