What to do about Allergies

By Harvard Health Publications
Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Dear Reader,

I wish I had a dollar for every time I've heard someone say, "Oh, it's just an allergy." After a couple of decades as an allergist who sees patients every day, I can assure you that allergies can be a debilitating health problem and cause lasting damage. With that said, it's important to know that better, safer treatments are now available for the millions of people with allergies and allergic asthma. The numbers are staggering: allergic diseases affect 20% of the U.S. population. More than 20 million Americans have asthma, and more than 70% of people with asthma also have allergies. Allergic rhinitis, the type of allergy that makes your nose run, accounts for nearly 17 million visits to the doctor each year.

Let me share with you what I share with my patients on a daily basis. An allergy is what happens when the body's defense mechanism, the immune system, gets its messages scrambled. Normally, the immune system fends off dangerous invaders such as bacteria and viruses. But an allergic response occurs when the immune system tries to defend the body against something that isn't ordinarily dangerous, such as pollen. In that sense, the immune system's response is abnormal.

We've learned a lot about how the immune system works during an allergic reaction. One major breakthrough is that we now know that there is much more to it than the release of histamine, one of the substances involved in an allergic reaction. Inflammation also plays a major role, along with a sizable cast of chemical players. Furthermore, the inflammation that occurs in an allergic attack doesn't merely make you feel miserable by narrowing your airways; it can also cause actual tissue damage. Left untreated, this damage can become irreversible.

At the same time, medical research has made available a wealth of effective and safe medications. We now have drugs that can treat inflammation over the long term. And this brings me to my reason for optimism: chronic allergy sufferers can safely take medications as long as they need them to control their symptoms, improve their quality of life, and prevent lasting damage.

This report includes much of the information I provide to my patients — namely, ways to get allergic symptoms under control and live life more fully.

Kind regards,

John Costa, M.D.
Medical Editor

What to do about allergies

In springtime, when trees burst with leaves, flowers open, and pollen takes flight, are you distracted by sneezing, sniffling, and itchy eyes? In summer, do you shut out the breeze and hide indoors? Year-round, do you wage a constant battle against the effects of dust mites or pet dander? If so, you are familiar with the symptoms of an allergy attack. But whether you're afflicted with seasonal allergies or endure symptoms all year, you are not alone. The American Academy of Allergy, Asthma and Immunology (AAAAI) estimates that 40 million to 50 million Americans suffer from allergic diseases.

Allergy misery has a high sticker price. The National Institute of Allergy and Infectious Diseases (NIAID) estimates that the annual direct health care cost of chronic allergic conditions is $14 billion. Then there are indirect costs, which include lost work days, missed school time, and curtailed leisure activities. And the situation is getting worse: in Western industrialized countries and heavily urbanized areas of other countries, cases of allergic reaction — the body's overly sensitive immune response to a harmless substance — are on the rise. Furthermore, scientists believe that the ramifications of climate change for allergic disease (see "Allergies and climate change") are likely to be significant.

Allergies can range from irritating inconveniences to chronic debilitating conditions. They can even be life-threatening, as in the case of allergic shock (anaphylaxis). Because of their potential severity and increasing prevalence, allergic reactions have been the focus of rigorous research. This work has resulted in a greater understanding of the complex nature of allergic reactions, which in turn has led to more effective treatment options. While allergies still can't be cured or prevented, doctors are learning more about how to manage symptoms successfully. This means that, with treatment, you'll not only feel better but also be less likely to suffer the permanent tissue damage that uncontrolled allergies can cause over time.

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