Cheryl Martin (Host): It's that time of year when millions of people deal with seasonal allergies. Symptoms include a runny nose, sneezing, and congestion. Here to tell us more about seasonal allergies, their triggers and how to treat them, is Dr. Lisa Roth, the Director of Allergy and Immunology at Jamaica Hospital Medical Center.

This is Jamaica Hospital Med Talk, the podcast from Jamaica Hospital Medical Center. I'm Cheryl Martin. Dr. Roth, so glad to have you on this episode.

Lisa Roth, MD: It's a pleasure to speak with you.

Host: First of all, what's an allergic reaction?

Lisa Roth, MD: An allergic reaction is our immune system's response to get rid of potential threat to our body. And it's important to understand how our immune system works. So let me first explain. Our immune system functions as defense. And it's an efficient system that has evolved over millions of years to recognize a possible threat or an enemy, and that may cause harm our body and to respond quickly to get rid of it, all for the purpose of keeping us healthy. And initially this response was designed to recognize infections and infectious pathogens such as viruses and bacteria and parasites, and it worked very, efficiently. And through evolution of time, there have been other environmental triggers that have a potential to cause harm to our body.

And the similar response called an allergic reaction, is the immune system response to recognize those potential triggers such as pollen and mold, and respond quickly to get rid of it, all to keep us healthy.

Host: Hmm. So what are seasonal allergies?

Lisa Roth, MD: Seasonal allergies. Well, we have three important seasons here in New York and those include spring, summer, and fall. And they are associated with the release of specific plant pollen. In the spring season, it's mostly tree pollen. In the summer season, it's a combination of grass and weed pollen, and in the fall season it's predominantly ragweed pollen. But mold is also important and it is present all year long, but does increase in times of high humidity, which is mostly during the summer season, and it's the pollen and mold that really are the causes of seasonal allergies.

Host: Hmm. You were talking about allergies in general, what causes an allergic reaction?

Lisa Roth, MD: There are many common triggers that can cause allergic reactions, and there are a lot that are found in the air that we breathe. Specifically, there are outdoor environmental triggers such as tree pollen and grass pollen, ragweed, and mold. But there are also indoor triggers that are common causes for allergic reactions. And those include dust mites and our furry friends, cats and dogs, as well as cockroach and rodents. There are also foods that we eat that can cause allergic reactions and even some medications.

Host: How common are allergies, Dr. Roth?

Lisa Roth, MD: Allergies are very common. In fact, statistics say that there are more than 50 million people in the United States that do have allergies. In fact, seasonal allergies affect 30% of our population. A fun fact is that there is a genetic component for the development of allergies. And if there was one parent who has allergies, it's 30 to 50% possibility of you developing allergies.

And if both parents have allergies, the higher risk, close to two thirds risk of developing allergies, and you can develop allergies at any age.

Host: So what are the symptoms of seasonal allergies?

Lisa Roth, MD: Allergy triggers really enter our body through mucus membranes and specifically, they are eyes, nose, and mouth. And at each of these locations we can see allergic symptoms such as sneezing, stuffy nose, runny nose, itchy, teary, red eyes, itchy throat, postnasal drip from mucus production, coughing, wheezing, and even itchy skin rashes.

Host: So, what are the differences between seasonal allergies and infections?

Lisa Roth, MD: It's a very important question. So there are some similarities, but very specific distinct differences between seasonal allergies and infection. Early infections, such as a respiratory infection, does resemble an allergy. And for an example, let's think about pollen in the air and virus in the air and how they are inhaled in the nose.

In the nose, there are immune cells that are in the lining of our nasal passages, and they're there specifically to recognize potential threats such as pollen and the viruses. And when they are recognized, there are chemicals that are released to get rid of them and that can cause a sneeze and a runny nose.

Both are very similar symptoms that are present in both seasonal allergies and infections. But there are some major differences between the two. And fever is one of them. Allergies do not cause fever, but infections do, and in fact, there are other, what we call constitutional symptoms such as body aches and really a painful sore throat that are present in infection but not in allergies. The durations of seasonal allergies and infect and infection are different as well. Symptoms of a viral infection usually resolve in seven to 10 days. But allergy symptoms can linger for weeks.

Host: What's the impact of climate change on seasonal allergies?

Lisa Roth, MD: A very insightful and important question. So, climate change is defined as long term shifts in temperature and weather patterns. And what we have observed here in New York is that we have warmer temperatures, and specifically we had a very mild winter. Spring season usually starts earlier, lasts longer, and has a higher detectable pollen count that had been previously detected years before. And a lot of these observations are due to the presence of carbon emissions in our environment. Carbon emissions contain carbon dioxides, which is actually a gas from burning of fossil fuels, such as oil, gas, and coal. And it's the increased levels of the carbon dioxide, which are part of what we call the greenhouse effect that traps sunlight, solar energy and causes global warming, the increased temperature. This also extends the growing season for plants to grow, and in addition, the increased carbon dioxide levels, our nutrition and carbon dioxide is used by plants through photosynthesis in their nutrition to grow. And as they grow, they increase and they increase the pollen release and they become almost super pollinators. We can have a pretty intense pollen season.

Host: So how can you diagnose the seasonal allergies?

Lisa Roth, MD: The first step is to schedule an appointment with your local allergist. And here in Jamaica Hospital Medical Center, we would be more than happy to accommodate that. Once you have scheduled the appointment, there will be an evaluation, including a history and physical exam, and a discussion of the concerns. And are special ways that we can identify causes for your allergies. And a blood test can measure specific antibodies, IgE, to a specific allergen such as trees and grass and ragweed pollen. But there are other different types of indoor and outdoor environmental allergies that can be tested as well. And the results of the blood tests can guide treatment options. And another option is the allergy skin test. And that's a wonderful way to immediately identify allergic triggers. And specifically, there are purified drops of the specific allergens that are placed on the forearm and scratched with a plastic device, which is actually not a needle. And after a few minutes, there can be a measurable local allergic response that resembles a mosquito bite, feeling itchy, a little redness, and a little swelling at the site. And once again, the results of the allergy skin test can help guide treatment options.

Host: And what are some of those treatment options, Doctor?

Lisa Roth, MD: The first really is to monitor the pollen counts. And there are free apps that can be downloaded on your smartphone entering your zip code where you live, and you can see an idea of the type of pollen in the area, as well as how high it is in a number value. If the number is 10 or above, it indicates a pretty high pollen count, and I have some pretty good tips to share that can help you live more comfortably, especially if the pollen count is pretty high.

And the first has to do with allergen avoidance. Close the windows during the season of causing a problem and that really provides a barrier from the outside pollen from coming inside. Taking a shower at night can physically remove the pollen that settles during the day. Consider having an air purifier at home and that will help clean the air you breathe. What is interesting is that the pollen count is highest in the morning and to schedule outdoor activities accordingly. But if you do have to go outside during the morning and the pollen count is high, consider using a mask and sunglasses because that will also help prevent you getting pollen into the body.

There are some very good non-prescription medications that target the inflammation of the allergic reaction, all to help you feel better. Such as nasal steroid sprays such as Flonase, Nasacort and Nasonex. Nasal antihistamine sprays, such as Astelin. Antihistamine pills such as Allegra, Claritin, Zyrtec and Xyzal and allergy eye drops, such as Zatidor and Pataday.

And if all of these suggestions are not effective, there are allergy shots, also known as allergy immunotherapy, and that is the most effective preventative treatment. And basically it's a process that helps change your immune system so that you become less allergic, less symptoms, less need for allergy medications, and really to help you have a better quality of life. Specifically a small amount of the allergens such as a tree pollen can be injected, as an allergy shot in the upper outer portion of the arm.

And the goal is to stimulate the immune system in a beneficial way to produce a protective antibody that in time will help you become less allergic, all to help personalize treatment plan, to provide comfort and a better quality of life, and to help you enjoy the outdoors.

Host: Dr. Lisa Roth, thank you so much for educating us about allergies, especially seasonal allergies, and how to get some relief. Thank you so much.

Lisa Roth, MD: It's my pleasure.

Host: To schedule an appointment with an allergist at Jamaica Hospital Medical Center, please call 718-206-7001. That's 718-206-7001. For more information about the services Jamaica Hospital offers, visit our website, Jamaicahospital.org/podcasts.

If you found this podcast helpful, please share it on your social channels and remember all content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast.

And thanks for listening to Jamaica Hospital Med Talk.