Allergies Archive

Sinus problems are common, especially those caused by allergies, which affect some 40% of American adults. They often manifest as stuffiness, congestion, or a reduced sense of smell. Sinus problems most commonly fall into three categories: acute viral infections, allergy triggered inflammation, and chronic sinus infections.

Here's how to prepare for spring and summer pollen allergies.

Ah, spring is in the air. But unfortunately, so are billions of pollen particles that make millions of stuffed-up Americans suffer through weeks and months of sneezing, coughing, and wheezing. Even if spring and summer allergies never bothered you before, it's possible for symptoms to suddenly appear now in your 60s or 70s.

"Your immune system changes over time. Although most allergies begin early in life, it's possible to develop seasonal allergies at any age," says Dr. Mariana Castells, an allergist and immunologist in the department of Allergy, Rheumatology, and Immunology at Harvard-affiliated Brigham and Women's Hospital.

For decades, people with an allergy to dust mites took over-the-counter medications for relief, and if those were not effective they could choose to receive a course of immunotherapy shots that lasted years. A newer form of treatment is available in pill form and is taken at home.

Ask the doctors

Q. Is it true that I should skip my annual flu shot if I'm allergic to eggs? If not, is it too late in the season to get one?

A. In the past, people with egg allergies were advised not to get the flu vaccine, but that advice no longer holds true. Most flu vaccines contain small amounts of egg proteins, which are introduced during the vaccine-manufacturing process. However, the CDC now advises that even people with egg allergies should receive the flu vaccine, because the risk of a severe allergic reaction is so small — only an estimated 1.31 vaccinations in every million.

Some types of cheese, including Swiss and Gouda, are a good source of probiotics, but eat cheese in moderation.

Even if you're isolating to avoid COVID-19, it's still important to be proactive when it comes to allergies.

This is normally the time of year to think about taking medications to ward off spring allergies. Starting treatment about a month before the season (which begins in February in some parts of the country) gives the drug time to achieve its full effect and prevent symptoms.

But the pandemic may have you questioning that approach: is an early regimen necessary if you're isolating and you're not going outside very often? The answer is yes. "Even a short walk around the neighborhood, sitting on a patio, or simply opening the windows for fresh air could expose you to allergens," says Dr. Anna Wolfson, an allergist and immunologist at Harvard-affiliated Massachusetts General Hospital.

The potential causes may be hard to pin down. Here are some of the most common ones — and what to do about them.

Sometimes it's easy to know why a particular part of your body is itchy. Maybe you have a bug bite, allergies, or a visible skin condition such as eczema. It's harder to know the cause when there's nothing obvious behind all-over, generalized itching. "It's the most common skin complaint in people over age 65," says Dr. Kenneth Arndt, a dermatologist and former medical editor of the Harvard Special Health Report Skin Care and Repair.

Potential causes

Generalized itching has many potential triggers. One is aging. "The skin barrier doesn't work as well as it used to, and things that may not have irritated you before may now be absorbed in the skin and cause itching," Dr. Arndt explains. "The skin also develops a somewhat impaired immune response, a reduction in fat and blood flow, and altered sensory perception, making it more prone to itching."

In the journals

Many commonly used drugs have anticholinergic effects, meaning the drugs block the action of acetylcholine. Nerve cells release acetylcholine to transmit impulses to other nerves in the brain and throughout the body. Previous research has shown a link between these drugs and dementia. Now a study has found a similar link with mild cognitive impairment (MCI), especially if you take larger doses. The findings were published online Sept. 2, 2020, by Neurology.

Some medications are designed purposefully to block acetylcholine, such as those used for urinary incontinence. But more often the anticholinergic action is a side effect of drugs taken to treat conditions like allergies, colds, and depression.

On call

Q. What would cause my tongue to suddenly swell? Could this be a possible side effect of medication, or something else?

A. There are many reasons for a swollen tongue. Indeed, a reaction to a medication is one of the more common causes. For example, a well-known side effect of ACE inhibitors (a class of drugs used to control blood pressure) is a condition called angioneurotic edema. Swelling of the face, lips, and tongue can happen quickly in people who take an ACE inhibitor. The reaction may occur soon after it's first taken or at any time thereafter. Sometimes people get this reaction even though they have used the drug for several years. ACE inhibitors are more likely to cause angioneurotic edema in African Americans.