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Allergic Rhinitis (Nasal Allergies, Hay Fever)

Allergic rhinitis, commonly known as hay fever, is the most common allergic disorder affecting approximately 20% to 25% of the population. The most frequent symptoms are nasal congestion, itchy runny nose, itchy runny eyes, and fits of sneezing. Other frequently accompanying symptoms are headache around the eye area, drainage in the throat, fatigue, and lack of energy. There can also be intense itching of the throat and deep in the ears. The term hay fever is really a misnomer in that it is rarely due to hay, and there is no fever associated with it even though patients feel feverish as the result of the effects of histamine on the blood vessels causing them to dilate and feel warm.

Allergic respiratory symptoms are a result of histamine release along with other chemicals that are either preformed or formed in allergy cells as a result of an antigen antibody interaction.

The job of the allergist is to determine whether the above symptoms are due to allergies or not. Allergic rhinitis is typically classified as seasonal (intermittent) or perennial (persistent), or both. Frequent triggers of true hay fever symptoms include the pollens from grass, tree, and weeds, house dust mite, mold spores, and animal dander. If the above described symptoms are triggered by cleaning one’s home, playing with pets, mowing the grass, etc., then there is high likelihood that symptoms are due to allergies. If your doctor cannot make a correlation of your symptoms with the above triggers, then you need to start thinking outside the allergy box.

The correct diagnostic term for nasal symptoms not due to allergies is non-allergic or vasomotor rhinitis. We don’t understand the mechanism of this condition totally. As the name applies, it is not on an allergic basis, that is to say an antigen antibody interaction. Triggers of non-allergic rhinitis include irritants such as tobacco smoke, chemical odors, cold air, strong perfumes, etc.

Other conditions to consider in people with symptoms of a stuffy nose are hypothyroidism (low thyroid), nasal polyps, tumors (cancer), foreign bodies, infection, and deviated nasal septum. There is also another condition that goes by the acronym N.A.R.E.S. which stands for nonallergic rhinitis with eosinophilia. This means that a person can have all of the symptoms of allergies but are skin test negative, and yet paradoxically have an abundance of allergy cells called eosinophils in their nasal mucus. This condition responds nicely to intranasal steroid sprays.

The nose is the center of the universe to an allergist. If a person does not describe classic nasal symptoms, and for instance only complains that ears or eyes bother them, then the likelihood of symptoms being due to allergies is lessened.

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OKC ranked 6th most challenging city in the U.S. for pollen allergies

The Asthma and Allergy Foundation of America (AAFA) released its annual Allergy Capitals™ report for 2022 on March 2. The report identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the continental United States. Cities are ranked based on spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists/immunologists. Oklahoma City was ranked sixth most challenging city and Tulsa ranked 21st.

For the second year in a row, Scranton, Pennsylvania, takes the top spot based on its high spring and fall pollen scores and lower-than-average number of allergy/immunology specialists per patient. The top 20 Allergy Capitals™ for 2022 are: 1. Scranton, PA 2. Wichita, KS 3. McAllen, TX 4. Richmond, VA 5. San Antonio, TX 6. Oklahoma City, OK 7. Hartford, CT 8. Buffalo, NY 9. New Haven, CT 10. Albany, NY.

AAFA began identifying annual Allergy Capitals™ in 2003. Since that first report, seasonal allergies have worsened. Climate change has caused the growing seasons to get longer and warmer, leading to higher pollen counts in both spring and fall. The warmer temperatures also get trapped in urban areas, which impacts air pollution. Urban areas are also often designed to have wind-pollinating trees instead of fruiting (or insect-pollinating) trees.

“Climate change is a public health emergency. More than 24 million people in the U.S. have seasonal allergic rhinitis which is most often caused by pollen allergies,” says Kenneth Mendez, CEO and president of AAFA. “If we don’t slow down the warming temperatures, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Allergies can also trigger asthma episodes or attacks. Around 60-80 percent of the 25 million people in the U.S. with asthma have allergic asthma.

“We see spikes in emergency room visits that coincide with spikes in pollen seasons,” said Mendez. “Around 3,600 people per year die from asthma, so it is important to address and manage asthma and allergy triggers where you live.”

Black, Hispanic, and Indigenous populations bear the disproportionate burden of air pollution, asthma, allergies, and climate change. This is the result of long history of housing policies in the U.S. that discriminate against these groups. These policies have pushed people of color to live in undesirable neighborhoods with greater environmental and social risks. As a result of systemic racism in U.S. policies, governance, and culture, racial and ethnic minority populations are more vulnerable to the health impacts of climate change.

“AAFA’s Allergy Capitals™ report helps raise awareness of the impact of pollen and climate change on individual and community health,” says Melanie Carver, chief mission officer of AAFA. “While there are steps individuals can take to manage their allergies, we need communities to improve their city planning and take action on health disparities impacting higher risk populations.”

For people who are impacted by pollen allergies, there are options available to prevent or treat allergy symptoms.

A board-certified allergist can diagnose allergies, and determine the specific triggers that cause them, through simple tests. The allergists at Oklahoma Allergy & Asthma Clinic (OAAC) evaluate and manage patients of all ages.  The main clinic is on the Oklahoma Health Center campus.  For patient convenience, satellite offices are in Edmond, Norman, Midwest City and Yukon.

The post OKC ranked 6th most challenging city in the U.S. for pollen allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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