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HOUSE CALL WITH DR. SANJAY GUPTA

Springtime Allergies: Causes and Treatments

Aired April 16, 2005 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


HOUSE CALL begins right now.
SANJAY GUPTA, HOST: Good morning. Welcome to HOUSE CALL. I'm Dr. Sanjay Gupta.

Well, spring has arrived, and the longer, sunnier days have people rushing to get outside and to enjoy that weather.

But as Christy Feig (ph) reports, you're going to have to contend with pollen. That poses a big problem to millions of Americans who suffer from spring allergies.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Spring is in the air. But for thousands of allergy sufferers like Kristen Stone, the warm weather of spring doesn't bring relief. It brings misery.

KRISTEN STONE, ALLERGY SUFFERER: My head would just explode. It would just be a lot of pressure behind my eyes.

FEIG: Kristen suffers from allergies year round. As a teenager, she got allergy shots. Now, she takes medication. She says she can't function without it.

STONE: It's a haze, like a fog, like you're just walking through life in a fog. That's when it's mild. When it's severe, it's almost -- I would feel like getting a migraine.

FEIG: Experts believe 36 million Americans suffer from seasonal allergies. Often called hay fever, spring allergies are triggered by allergens, usually tree and grass pollen. And the symptoms range from sneezing and congestion to a runny nose and itchiness. For many, it's debilitating. Allergist Dr. Paul Ehrlich says they are problems that should not be taken lightly.

DR. PAUL EHRLICH, ALLERGIST: People with allergies just aren't focused. They feel they don't sleep well at night. They get up in the morning, they drag through the day.

FEIG: And some confuse the symptoms with a cold. But there are real risk when allergies go unchecked.

EHRLICH: (UNINTELLIGIBLE) can become infected, and you can wind up with sinusitis or pneumonia.

FEIG: Because of the severity of her own allergies, Kristen made sure her three daughters were tested. Her 5-year-old, Emily, has been diagnosed too, and like her mother, now takes medication.

In Washington, I'm Christy Feig.

(END VIDEOTAPE)

GUPTA: All right, thanks, Christy.

You heard some of the symptoms there in Christy's piece. But what gets confusing to many people is that these symptoms sound and feel a lot like a cold. So how do you know the difference? Well, colds generally last a week, while allergies can last an entire season or longer.

Also, a cold is often accompanied by a fever or sore throat. Not so with allergies, which can leave you feeling congested, with itchy eyes and sneezing.

Here to help us answer all of your questions this morning about battling your spring allergies is Dr. Linda Guydon. She's a board- certified immunologist and allergy specialist here in Atlanta.

Welcome back to the show.

DR. LINDA GUYDON, ALLERGY ASTHMA SPECIALIST: Thank you, (UNINTELLIGIBLE)...

GUPTA: Appreciate your time, yes.

GUYDON: Thank you for inviting me.

GUPTA: Lots of people are thinking about allergies this time of year. What's new out there in terms of fighting these allergies?

GUYDON: Well, we have a battery of medications that are very useful. It spans from the common antihistamine to intranasal steroids. Actually, in the last year or so, we've had another agent added on, a leukotriene antagonist, which has gained the approval for treatment of allergies.

GUPTA: Are these all prescription medications?

GUYDON: These are. There are some over-the-counter antihistamines, of course.

GUPTA: OK, yes, and we're going to talk more about those as well.

If you think you may have allergies, there are some simple ways to figure out what your triggers might be, which is important. That's something that Karen in Alabama is trying to figure out.

Let's jump right in. She writes, "My doctor suggested I take an allergy test to determine the cause of my constant head congestion, watery eyes, and sneezing. What does the test involve?" she asks.

GUPTA: Doctor, can you sort of talk us through this? A lot of people have heard about allergy tests. But what typically happens when they come into your office?

GUYDON: Allergy testing is really the method by which we identify the allergens that our patients are allergic to, because often patients have symptoms, and it may turn out they're not allergic.

The process entails pricking the skin with a series of allergens that are relevant to your environment. And it includes year-round allergens and seasonal -- dust mites, cats, dogs, cockroach allergens, mold allergens, tree, grass, and weed pollen. These allergens are actually applied to the back via a device that pricks the skin. If people...

GUPTA: Is it painful?

GUYDON: It's actually not painful. We often say it feels like a kitty cat walking on your back. So there's a prick sensation. And then, those reactions that you have on prick testing really are the allergens that you're the most sensitive to.

It's generally a twofold process. The next step is to perform what's called intradermal testing, where we actually inject a tiny amount of the allergen under the skin and elicit a wheal-and-flare response, which basically means a reddening that indicates that you are allergic to those allergens.

GUPTA: And how do you -- everyone that comes into your office, do they end up getting this testing?

GUYDON: It depends. If your symptoms are seasonal, two weeks out of the year, it's not necessary that you have skin testing. However, if your seasons are just -- if your symptoms, excuse me, are generally two seasons of the year, say spring and fall, or they are year round, and they're debilitating, or you're miserable, or you simply want to know, then skin testing is performed.

And you're actually able to see and feel the reactions at the time of the testing.

GUPTA: That's very interesting. Oftentimes, adults are surprised, as you know, when they start feeling allergies coming on for the first time. How unusual is it for someone who's middle-aged, for example, to develop allergies later in life?

GUYDON: It's actually not that unusual. Your allergic symptoms can manifest themselves at any time in your life. I think historically we have equated allergies and children. It's true that it often starts in childhood, peaks in adolescence and young adulthood, and then wanes. But in the times in which we live, we see more and more adults who initially manifest their allergies in their 20s, 30s, 40s, 50 years of age range.

GUPTA: And in case anybody at home thinks allergists are immune to getting allergies themselves, you yourself get shots.

GUYDON: I absolutely do. I am a long-time allergy sufferer. And immunotherapy for me is the best choice, because I was a perennial sufferer, and also suffered with sinus infections. And it's been a tremendous help.

GUPTA: We are going to talk more about preventing allergies when we come up.

Also, could your allergy medicine be making you sick? That answer is coming up when HOUSE CALL returns.

ANNOUNCER: Allergies slowing you down? Find out which treatments are right for you.

Plus, our own top 20, those foods you need to be eating for good health.

That's all coming up on HOUSE CALL.

But first, today's quiz. What household pet is being genetically engineered to be allergy-proof? That answer coming up.

(COMMERCIAL BREAK)

ANNOUNCER: Before the break, we asked, What household pet is being genetically engineered to be allergy-proof?

Cat lovers, rejoice. The company Alerca says its fancy felines will be on the market in 2007 for about $3,500.

GUPTA: Thirty-five hundred dollars for an allergy-free cat.

Listen, if you're a cat lover who also happens to be allergic, looks like you've got a few years to wait still. But maybe, maybe something to think about.

If you're suffering from seasonal allergies, though, there are steps you can take right now to cut down on your sniffling.

First, start on the spring cleaning. And I know you don't want to hear that, but it's important. Dust and mold can build up during winter months and rev up your allergies.

Don't open the windows on high-pollen days. That goes for the house and for your car. And if you don't have to go out on those bad pollen days, don't, especially between the hours of 10:00 a.m. and 4:00 p.m. That's when the pollen counts are often at their highest.

Dr. Linda Guydon is here, and she knows all about how to avoid triggering allergies. She's an allergy specialist here in the very allergy-prone Atlanta.

(UNINTELLIGIBLE), I want to say something about Atlanta, because, you know, we're obviously here this morning. The normal pollen counts that I hear are about a -- high pollen count's about 120 to 135. Atlanta, 5,200. Are there some areas of the country that are just more allergy-prone than others? GUYDON: Yes, indeed. Warmer climates tend to be, and you are right. The counts above 130 are considered extremely high. So once you reach 5,000, it's overwhelming, even for those who are actually not allergic. In the South, we tend to have a fair amount of tree pollen. In California, they tend to have problems with grass pollen.

GUPTA: That's interesting, and, you know, but it just boggles my mind, 130 is considered high, and then we're 5200 here. Everybody's been sniffling and sneezing around here lately.

GUYDON: Absolutely.

GUPTA: Yes, all right. And they're coming to see you, so they're giving you business.

GUYDON: Indeed.

GUPTA: OK, to some more questions now.

Harry in Georgia, he has a question, a great question. "There are so many allergy drugs on the market. How do I know which one would be best for a particular type of allergy?"

And doctor, this is a really common question. Let's assume that he's talking about over-the-counter medications. How do you decide?

GUYDON: As far as over-the-counter medications, one of the most important things is sedation. You have to bear that in mind. And many of the agents that are over the counter are sedating. Fortunately, there is one over-the-counter agent that was prescription, that is nonsedating.

And so I would recommend, if that's the only option, certainly to use the nonsedating over-the-counter antihistamine.

GUPTA: You're talking about Claritin.

GUYDON: Yes.

GUPTA: Claritin was a prescription medicine, now over the counter, and you recommend it.

GUYDON: I would recommend it. It's a very good agent. Certainly not every antihistamine works for each individual equally. And if it is not effective, I think that's really important to remember, to see your physician. Because there are a number of different medications available.

Important in the treatment of allergic rhinitis is to remember that the first step is really to use an anti-inflammatory agent. They are not over the counter.

GUPTA: That's a good point, good advice we're getting here.

Let's keep going with the e-mail questions. This is from Todd, who wants to know, "Do allergy shots work better than medications? Can prolonged use of allergy and/or sinus medications have a negative impact on the body?"

Let's get to the first part first, shots versus medication. I think I might already know your answer, because you take shots.

GUYDON: Absolutely. There are three methods of treating allergies. Avoid them as you can. Medications, medications control symptoms. Allergy shots control the immune system. By doing so, you have a much better chance of becoming medication-free, and also diminishing the complications as a result of having allergies. And those would be sinus infections, eczema, and asthma, which is quite important.

GUPTA: It's hard to get in to the doctor every so often to get your shots. How often do you have to go get your shots?

GUYDON: There is a process. Initially, because you are, in fact, being injected with what you are allergic to, requires a very steady visit to the office, generally once or twice a week. And that requires several weeks until you reach what is called the maintenance. Realizing you are being injected with small and increasing amounts of what you are allergic to, for safety reasons, and also in order to obtain what's called a critical amount, in order to effect a good response.

GUPTA: OK. Let's keep going on this theme here. Allergies and asthma, for example, can be a dangerous combination. And their link is what is concerning Jamie in North Carolina. He writes this, "Can asthma be triggered by certain allergies?"

And now, you know, we hear a lot about asthma and allergy separately. What is the link here?

GUYDON: Well, it's an important link, because being allergic can manifest as having asthma. It's one of the complications. So if you recognize that you are allergic, and you are an asthmatic, you have a much greater chance of controlling your asthma. That is a very important link, because if you do not consider the allergic component in the management of asthma, then you are not completely treating that patient's asthma as well as you could.

GUPTA: We're talking to Dr. Linda Guydon. Lots of good information here.

More HOUSE CALL coming up after the break. Don't go anywhere.

FEIG: Is your yard making you sick? Coming up, the do's and don't's of allergy-proof gardening.

First, check out this week's medical headlines in The Pulse.

An FDA advisory committee has recommended lifting the 13-year ban on silicone gel breast implants. The panel approved implants made by the company Mentor under several conditions, including a five-year review by the FDA and educational programs for doctors and patients. Earlier, the panel denied a competitor's bid for implant approval. The FDA has the final decision on whether these implants should be allowed.

And the World Health Organization is urging more than 4,000 laboratories around the world to destroy vials of the deadly flu strain that was responsible for the 1957 Asian flu pandemic. The flu samples were sent to the labs as part of a routine testing program. The director of the CDC says public health authorities are doing everything possible to destroy the vials of the dangerous virus.

Christy Feig, (UNINTELLIGIBLE).

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

The source of your sneezing may be right outside your front door. The trees, flowers, shrubs, and grass you planted could help determine how bad your allergy season will be.

The good news is, you can take steps to allergy-proof your yard by keeping your grass short, experts say about two inches. And fertilize that yard to crowd out the weeds, because they're some of the worst allergy triggers. Plus, timing is crucial. Do your yard work after you've had a soaking rain. Why? Because pollen is usually highest on dry and windy days.

Lastly, make sure to take a shower after all that yard work to rinse off any lingering pollen.

Helping us get allergy-free this season is Dr. Linda Guydon. She's an allergy and asthma specialist here in Atlanta.

Lots of questions coming in on this topic, doctor, people worrying about the allergies in their yards and those sorts of triggers. We've talked about some of the techniques already but let's get to a couple more e-mails here.

Lee Ann in California wants to know, "Are there any preventive measures I can take to combat either natural allergies or unnatural ones, specifically pesticides and other chemicals used in homes and yards?"

Before, you talked a little bit about this, doctor. But what sort of advice do have you for Lee Ann?

GUYDON: It's very difficult to control the (UNINTELLIGIBLE) allergens. The problem is this. These are airborne allergens. Even if the allergen is not at your home, in your yard, they are spread as far as 200 miles. So it's very, very difficult to be able to control the outdoors.

GUPTA: What is it about Atlanta, specifically, since we're here in this pollen count of 5,200?

GUYDON: Atlanta is a warm city. We have lots of beautiful trees, but unfortunately they pollinate. And as they do, coupled with the pollution, it become as very dynamic duo. GUPTA: If there's somebody watching at home who says, I want to live in the place in the country that's going to give me the least trouble with allergies?

GUYDON: I always tell patients the beach is a wonderful place to be. The trade winds come in and dilute the pollution and the pollen. And you generally feel better.

GUPTA: Note from Dr. Guydon, move to the beach.

GUYDON: Absolutely.

GUPTA: Not bad.

Let's get some more e-mails in here. We got one from Holly in Texas, who's writing, "My husband always has allergy attacks in the evening. What contributes to allergy problems in certain parts of the day?"

What do you say about that, doctor?

GUYDON: Well, it's interesting. Our bodies make hormones that help protect us. And as the day goes on, your body makes less cortisol, less epinephrine. You've also had exposure throughout the day. And that propagates something in immunology we call the late -- call the late phase reaction. So you've had some exposure. Your body's had a time to respond throughout the day. And your symptoms increase as the day moves on.

Also, if you're not taking any medications, your symptoms mount as you've had continuous daily exposure.

GUPTA: I'll buy that, it sounds like a pretty good explanation.

Let's keep going on theme here, though. One of the main complaints of allergy sufferers are itchy eyes. And we got a lot of e-mails from people searching for relief.

This one comes from Don in Kansas. "My biggest allergy problem is my itchy eyes. Is there an eyedrop medicine that will help soothe them? What about an eyewash?"

Is -- first of all, is that one of the biggest symptoms that people complain of?

GUYDON: Typically, in the spring, with the tree pollen and the grass pollen, patients often do complain of itchy eyes. And we forget about the eyes, but it's the most obvious place.

Washing the eyes by using simple liquid tears is helpful. Antihistamine drops that are very well tolerated also are available, and those are prescription.

GUPTA: What about people who wear contact lenses?

GUYDON: People that wear contacts have a rough time during the spring. And often they have to wear their glasses, because of the small particle-size pollen. It interferes with the ability of the eyes to tear. Or your eyes tear, and you become very irritated, and it can predispose you to infections in the eye.

GUPTA: Dr. Linda Guydon is here talking to us about allergies. Lots of good advice here.

Could taking the right vitamins be the answer for your allergy problems? Stay tuned for that answer.

ANNOUNCER: Coming up on HOUSE CALL, Web sites you need to know about for tips on beating your spring allergies.

And...

(BEGIN VIDEO CLIP)

LIZ WIESS, "HEALTH" MAGAZINE: Everybody is looking for a simple way to stay healthy.

(END VIDEO CLIP)

ANNOUNCER: We'll show you the new power foods, after the break.

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

HOLLY FIRFER, CNN MEDICAL CORRESPONDENT (voice-over): We know fruits and vegetables are rich in antioxidants, natural plant chemicals that help our body fight off things like cancer, heart disease, Alzheimer's, and Parkinson's disease.

Researchers at the USDA looked at more than 100 different kinds of foods and found antioxidants in some places they really didn't expect. It turns out beans pack a powerful antioxidant punch.

WIESS: And they've found that red beans ranked number one, followed by wild blueberries, red kidney beans, pinto beans, and cultivated blueberries. So these foods were the top five foods for antioxidant power or activity.

FIRFER: Other foods that ranked high for antioxidant activity included blackberries, raspberries, strawberries, plums, apples, like Granny Smith, red delicious, and Gala, nuts like pecans and walnuts. Artichokes and black beans also made the top 20 list.

Researchers say you can enjoy the benefits of these foods raw or cooked.

WEISS: So we eat these foods, then, throughout the week, and get creative with your recipes, and change the way you eat just a little bit to incorporate them into your diet.

FIRFER: Holly Firfer, CNN.

(END VIDEOTAPE)

GUPTA: All right, thanks, Holly.

Dozens of alternative allergy treatments, from restricted diets to herbs and vitamins, claim to relieve the sneezing and itchy eyes of allergies. The question is this, do any of them work?

Now, we're talking with certified immunologist and allergy specialist Dr. Linda Guydon. Lots of e-mails coming in this particular topic regarding alternative treatments. People want to try something else.

Hillary from South Carolina asks, "I've been told that if you incorporate local honey and bee pollen into your diet, it will reduce your allergies significantly."

What do you say, doctor?

GUYDON: I think that's a very good question. Conceptually, it would make sense. I do not recommend bee pollen in my patients, simply because I feel it's important to have scientifically controlled, rigorous clinical studies that look at efficacy, and also mechanism. So I honestly cannot recommend it.

But I think that is a very exciting area, and one that immunologists are looking at.

GUPTA: And a lot of people are looking at it as well. Allergy suffers, for example, a recent survey found 60 percent of allergy sufferers would consider alternative treatments to help with symptoms.

That brings us to another question from Margie in New Jersey. She writes, "Is it true that you can control allergy symptoms with certain vitamins?"

What do you say, doctor?

GUYDON: Vitamins are certainly important in general health maintenance. For the management of allergic diseases, their role is not so major. There was a study that looked at vitamin C for controlling asthma, preventing exacerbations. Didn't quite pan out as well as one would like.

I think it's important to remember the basic concept in managing allergies is control of inflammation. And so your therapy has to be geared towards doing that.

GUPTA: OK, lots of good advice today, an important topic.

For more allergy tip information, check out mayoclinic.com. Click on their Allergy Center and quiz yourself on common myths about allergies.

And before you go outside, search to aaaai.org. That's the American Academy of Allergy, Asthma, and Immunology, where you can find today's pollen count. Unfortunately, we're out of time. I want to thank Dr. Linda Guydon.

GUYDON: Thank you so much.

GUPTA: Thank you. Returning to the show again, really good advice today.

GUYDON: My pleasure.

GUPTA: Also, make sure to watch HOUSE CALL every weekend. You get to ask the experts your health questions.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com


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