Drs. Oz & Roizen: Sneezing and Wheezing

Allergies are caused by a mix of factors, including environment (dust mites, animal dander), lifestyle (where you live dictates toxin levels) and genetics. According to the Asthma and Allergy Foundation, if both your parents have allergies, you have a 75 percent chance of having them; if one parent has allergies (or if one side of the family has allergies), you have about a 50 percent chance of developing them. Reactions to allergies range from pesky to life-threatening.

Allergic asthma is more likely to occur if you have allergies such as hay fever or a family history of allergies, or both. Asthma impairsthe windpipe branches, or bronchial tubes, that move air to and from the lungs. The American Academy of Allergy estimates some 10 million Americans have allergic asthma, and 10 million more suffer from other forms of the disease.


Allergy Types and Symptoms

Allergies are exaggerated immune-system reactions to various substances that don’t prompt any symptoms in most people. They attack through the skin (contact allergies) as well as from foods or from the air. Allergic reactions include:

Skin rashes (typically from chemicals)

Runny and stuffy nose (dust, pollen, etc.)

Itchy eyes (dust, pollen, certain substances in cosmetics, etc.)

Digestive upset (food allergies)

Coughing, shortness of breath, wheezing or respiratory distress (any type of allergen can cause respiratory symptoms)

Here’s a typical scenario for the onset of an allergic reaction: An allergen enters your body, and yourhyper-vigilant immune system detects the invader. Your immune cells pull out Uzis rather than BB guns to fight this minor pest. The inflammatory overreaction goes beyond the invasion site, triggering symptoms such as hives, itchy eyes or a runny nose.

An allergy that launches an asthma attack can result in much more serious effects. Muscles constrict around the airways, narrowing them in what’s called a bronchospasm. In addition, the airways’ lining swells (inflames) and produces thick mucus. Breathing becomes labored, so you experience wheezing—the faint kazoo-like sound of trying to force air through the small opening. If breathing becomes very difficult, a shot of epinephrine (adrenaline) from an EpiPen can open airways until you receive emergency treatment from medical professionals.

Anaphylactic shock, or anaphylaxis, is a life-threatening reaction to an allergen. Seconds or minutes after you’re exposed to an allergen, such as a bee sting or a peanut (rarely an inhaled allergen), your airways narrow and your blood pressure drops. Symptoms include a rapid but weak pulse, nausea and a rash. As with severe asthma, a shot of epinephrine can be a life-saving intervention until medical professionals administer emergency care.

Prevention and Treatment

Avoidance is the first line of defense against many allergies. Naturally you should forgo foods and skincare products you know will provoke an allergic reaction. Avoidance tactics for dust and dander allergies might include eliminating rugs, banning pets from your bedroom or giving up your pets entirely.

Another tactic is the use of over-the-counter antihistamines. Drugs such as Claritin (loratadine is its generic name), Allegra (fexophenadine) or Zyrtec (cetirizine) keep your body from releasing histamines, the substances that trigger a whole cascade of allergic events. These antihistamines may be all you need to keep hay fever and other mild allergic reactions at bay. They can control many mild allergies and also can be used to treat hives brought on by an allergy.

Inhaled prescription medications also are part of the arsenal against allergies. Your doctor may prescribe bronchodilators that, once inhaled, relax the muscles in airways so more air can pass. Another common prescription is an inhaled steroid such as Nasonex (mometasone) or Beconase (beclomethasone), which will prevent your symptoms and head off inflammation.

Your doctor may recommend immunotherapy injections to help more severe allergies that can’t be avoided altogether or relieved in other ways. Administered regularly over a period of a few years, these injections contain purified allergen extracts that desensitize your immune system to troublesome substances such as foods, pollens and pet dander.

Heading Off Allergies at the Pass

It’s generally best to block the cause of the allergy or treat it early in the reaction phase. Without a proactive approach, you’re treating only symptoms (such as itching and sneezing), and the immune reaction to the protein will continue—as will inflammation.

Many people don’t understand the importance of avoiding chronic inflammation. More than a third of Americans have allergies, but most of them don’t have their symptoms or the associated inflammation under control.

While the worst a rash will do is crimp your enjoyment of a 1980s disco-theme party, inflammation has potentially devastating long-term consequences. It can damage lungs, leading to chronic bronchitis or emphysema. Another type of collateral damage from inflammation is a plaque rupture in your arteries, which can cause a heart attack.

So even though you feel well, you must take medications in the proper dosage and on the proper schedule to avoid inflammation. Do your body a favor and use your medication exactly as your doctor recommends. You’ll enjoy a longer, higher-quality life despite having allergies or asthma.



The Fix Is Not In

A runny nose is a common allergic reaction. To deal with it, many people go for a quick fix with an over-the-counter nasal decongestant such as Afrin. Oxymetazolone, the active ingredient, temporarily constricts the blood flow to your nose.

If you use a nasal spray containing this chemical for more than three days, the nasal drip comes back stronger than before. Because of this rebound effect, we recommend you use other medications that stop the problem before it starts.


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