Allergy Load   When we use the term “allergy load”, we are referring to the total amount of allergy within each individual. This “load” is determined by several factors such as environment, season, diet, etc. When someone has too much allergen present, they will have an increase in symptoms. The goal is to lower that load so symptoms will be controlled. To further illustrate this point, imagine a bucket. When exposures to allergens occur, the bucket begins to fill. If too much exposure occurs, the bucket overflows causing symptoms. In addition, stress, fatigue, poor nutrition, illness and other factors will add to the overflow. If all offending allergens were removed from the environment, the symptoms would disappear. Since this is impossible, the next approach would be to remove as much of the allergens as possible. Information on procedures and products that will assist with this environment control is available.

Treatment   Allergy injections or drops under the tongue (immunotherapy) will be initiated. This will cause the body to “block” the reactions that take place within and thus reduce the amount of symptoms that occur. Each week these injections are increased to achieve a “maintenance” dose. It is important that a regular schedule for injections be established. In addition, environmental factors will be discussed and recommended control measures given.   To best accomplish the goal of allergic management, these steps should be followed: Adhere to regular injection schedule.  Implement recommended environmental control measures. Get plenty of rest. Eat a balanced diet and follow dietary recommendations. Control stress. Follow directions given by physician and allergy staff. Allergy management is a partnership between the physician and the patient. Should you have any questions or concerns, please discuss them with the allergy staff or your physician.

Danders and Epidermals   Up to two thirds of the households in the United States own or have owned some type of pet. Dogs and cats are the most popular of all these pets, but recent years have given rise to the popularity of other animals such as rodents, birds and reptiles.   Individuals who are allergic to epidermals may experience symptoms of clear nasal drainage, sneezing, itching of the throat, burning of the eyes, asthma, shortness of breath, dermatitis, or coughing when exposed to the offending allergen. Many believe that the animal hair, or dander, causes the greatest degree of offense; however, recent studies show that there is clinical evidence that allergenic components are found also in the saliva and urine of some animals. Cat dander and saliva seem to cause the most allergic manifestations. Dog dander and saliva are also quite allergenic as well as rodent urine.   The primary source of exposure is in the home. Individuals working in research labs also have a greater risk of daily exposure. Those considering a move will benefit by inquiring as to whether former residents have kept pets. Steam cleaning the carpet may be helpful in reducing the amount of dander, but generally does not eliminate all.   Since the offender is most often a family pet, there is generally great reluctance to remove this offender from the home. Products, such as Allerpet, inhibit the release of dander, thus limiting the exposure levels. The allergic patient may find relief in using products such as this and bathing the animal more frequently. It is also important to keep the pet out of the allergic individual’s bedroom and never allow the pet to sleep with the patient or on the bed. If these efforts are ineffective, it is then advisable to remove that pet from the home environment for at least 1-2 months. If symptoms are lessened, permanent removal may be necessary for the benefit of the patient.

Pollens During the early months of spring, the trees and grasses begin their pollination. Tiny particles are released into the air and cause the first symptoms of hay fever. In the late fall, the dreaded ragweeds and weed pollens cause many allergy sufferers to have their greatest increase in symptoms. Some pollens are visible while others are not. The most common allergenic pollens are those that are airborne, such as tree, grass, weed, and ragweed. Most flowers are pollinated by insects and are generally not intensive to the allergic individual although any pollen has the potential to cause symptoms upon exposure. The most common symptoms of a pollen allergy are: itchy, swollen, red or watery eyes; clear, watery nasal mucus; or sneezing and nasal itching. These symptoms appear most often during outdoor activities and decrease when inside.   People who suffer from pollen allergies find the greatest relief in an air-conditioned area. Pollen allergic individuals should avoid sleeping in a room with opened windows. The pollen count is the highest during the hours of 7 a.m. and 10 a.m., so special attention should be given to any outdoor activity during this time. If outdoor activity is unavoidable, a filtering mask should be worn. Allergic patients who are having symptom increase, due to outdoor exposure, will benefit from showering and changing into fresh clothing.   During pollen season, it is advisable to follow a diet that eliminates the concomitant foods from the diet. A concomitant food reacts with the allergen causing greater symptoms. During pollen season some foods that should be avoided are: grains, melons, bananas, milk. The doctor may recommend that you avoid other foods also. Your diet should consist of fresh fruits and vegetables and fresh meats, increasing your intake of vitamin C enriched foods will help to bolster your immune system.

COMMON POLLEN SOURCES:   TREES: (early spring) maple, oak, birch, mountain cedar, walnut, pine, hickory, elm, ash. GRASSES: (spring-summer) bermuda, june (Kentucky bluegrass), fescue, rye, orchard, timothy, johnson, red top, sweet vernal. RAGWEED: (Sept-first frost) common (short), western, giant, false. WEEDS: (late summer-fall) english plantain, lambs quarters, dock, mugwort, russian thistle, marsh elder. NOTE: This is a list of the more common allergens and is by no means comprehensive to your region.

Molds and Fungi   Everywhere you go, you are surrounded by fungi or molds. As you walk through the woods, you will see them on trees or decaying leaves. In your kitchen, you encounter them as the yeast in the slice of bread you will eat. When you are sick, the doctor may give you penicillin, which is also made from fungus. A handful of soil contains thousands of fungi. Some of these fungi make the soil fertile, while others kill plants. Some fungi can be eaten, while others cause food spoilage. Other fungus can make you sick, and still others are used to make vitamins and medications.   Fungus or mold reproduces by releasing millions of spores into the air. These spores, once released, can have a dramatic effect on the allergic individual. The symptoms of a mold allergy are usually nasal congestion, cloudy nasal drainage, headache, chronic sinusitis, chronic fatigue, wet cough, chronic colitis media, or dermatitis, although other symptoms may arise.   People who are mold allergic can have symptoms during any season of the year. Many of the allergenic molds are found inside of our homes, especially in the dampness of the basement, in barns, the attic, or anywhere boxes, books, old newspapers, and clothes are stored. Some molds are contained in the foods that are eaten such as cheese, smoked meats, yeast products, alcohol, fruits and vegetables. Nature relies on molds to keep the soil fertile and feed the vegetation. During the fall months, wet leaves are a source of mold exposure. In heavily wooded areas, there is a considerable amount of mold in dead vegetation and stagnant water. The allergic patient must keep their environment as free from mold as possible. To control environmental mold/fungus: Discard old newspapers, magazines, books, furniture, leather and cloth. Moisture-proof basement or crawl space and keep dry with dehumidifier. Remove plants, dried flowers, aquariums, terrariums. Vent clothes dryer to the outside. Discard old pillows, especially feather pillows. Cover pillows, mattress and box springs with a vinyl encasement. Use air conditioning whenever possible. Clean air vents and filters at least monthly. Replace old furnace filters with a permanent allergen-removing filter. Choose upper level bedrooms and apartments if possible. Wear an allergy mask when working in moldy or musty areas. Use a mold-removing product to clean areas of mold growth. Keep the diet free of mold/fungus containing foods. Discourage allergic children from playing in heavily wooded areas and in or near stagnant water. Relative humidity of no more than 65% will limit mold growth. Refrigerate to prevent food spoilage and retard mold growth. The allergic individual should also avoid a diet that consists of mold containing foods. The following foods should be avoided: Cheeses of all kinds. All alcoholic beverages. Mushrooms. Vinegar or vinegar-containing foods. Breads, pastries or any products containing yeast. Pickled or smoked meats, fish or other products. Sour cream, buttermilk or yogurt. Delied fruits and vegetables. Unwashed fruits and vegetables. Dish that is more than 24 hours old or leftover meat. Products containing citric acid (citric acid is usually made from aspergillus mold).    Alternaria Parasite on plants and plant materials. The spores are easily airborne. Aspergillus Common soil fungus, also found in damp hay, grain, sausage and fruits. Cephalosporium Common soil inhabitant and has been isolated from dust in textile plants. Helminthosporium found in cereal grain plants such as corn wheat, oats and rye. Hormodendrum found in decomposed plants, leather, rubber, cloth, paper and wood products, released into the atmosphere in great numbers after rain and damp weather. Penicillium normally inhabits the soil but grows readily on fruits, bread, cheese and other foods. Mutant strains are use to produce the antibiotic penicillium. Parasite found on green plants such as peas, beans, cotton, tomatoes, corn sweet potatoes and rice; also found on decaying plants. Stemphyllium Grows rapidly on damp paper; canvas, cotton fabric as well as decaying plant material. Normally inhabits soil; frequently found around barns and barnyards where it grows on animal waste. Epicoccum Normally a soil organism which can often be found on decaying vegetative material, plant leaves and uncooked fruit.

House Dust and Mite   House dust and dust mite are actually separate allergens. House dust allergens may contain mite, dirt particles, human and animal danders and mold. Mite allergen consists of a specific mite. Guanine, found in mite excrement, is the most allergenic component of dust and therefore doctors choose to test for both dust mix and mite or for specific mite, molds or danders.   There are millions of tiny house dust mites living within your home. It does not matter how clean your home is, the dust mite will continue to reproduce at an astounding rate. The most common of all mites are Dermatophagoides pteronyssinus and Dermatophagoides farinae. These microscopic, creatures are present in vast quantities and thrive by feeding primarily on the dander produced by humans and animals. The substance guanine, found in the excrement of these mites, is one of the most offending of all allergens.   Mites make their home wherever there is a sufficient amount of epithelium for them to feed on and where environmental factors are favorable. The pillow, mattress, box spring, carpet, and upholstered furniture are the most likely places found to be infested by mites. Normal cleaning or steam cleaning is of little help in eliminating these tiny creatures. Your physician may recommend one of these products for you.   Individuals who are allergic to mite and house dust will often wake with nasal stuffiness and/or sneezing; have burning of the nasal passages; clear or cloudy nasal discharge; burning of the eyes; chronic sinusitis and have more prevalent symptoms when the heat is first turned on and during the winter months.   WHAT YOU SHOULD KNOW ABOUT HOUSE DUST MITES   House dust mites are natural inhabitants of our surrounding environment. The presence of house dust mites does not indicate a lack of cleanliness. House dust mites do not pose a problem for most people, but they certainly do for people who are allergic to them. House dust mites avoid contact with humans and do not transfer any diseases. They are not visible to the naked eye. They live in house dust and feed on its various particles, especially on the flakes from human or animal skin contained in the dust. The average human loses up to 1.5 grams of skin particles per day. This amount is sufficient for the nourishment of house dust miles and even tides them over during periods in which the rooms are not entered. In addition, they also consume material of other origin, such as pieces of fiber, feathers, etc.   The development and propagation of house dust mites is dependent upon the relative humidity and temperature. They thrive at temperatures between 200 and 30°C (68° and 8°F) and a relative humidity of 65-80%. This moderate, moist climate is prevalent in many parts of the United States from May to October. This is also the period in which house dust mites mature and breed. Relative humidity over 90% and below 33% is harmful to them. For this reason, house dust mites are rarely found in high mountain areas (that is, higher than 3,600 feet above sea level) because the relative humidity is too tow.   Temperature differences within one room or between various rooms create additional moisture. This sometimes keeps rooms damp for long periods of time, which in turn lets the house dust mites survive and even breed.   Relative humidity is more important than temperature for house dust mites living, growing and propagating conditions.   House dust mites are often found in mattresses, upholstery, rugs, carpets, quilts, pillows and almost all textile items (including children’s textile toys). Sleeping areas of house pets are also favorite spots.   Avoidance Cover the mattress, pillow, and box spring with a suitable encasing. Change the sheets and cloth pillow cases at least 2-3 times weekly. Avoid placing heavy drapes, stuffed animals, or any other dust catcher in the bedroom of an allergic individual. Clean and dust room frequently. Use vent covers for additional filtration. Consult with your physician or technician regarding products that will eliminate the dust mite. Use a facemask while cleaning, vacuuming or making beds. Use of an allergy vacuum will reduce the redistribution of allergen. HOUSE DUST MITE ALLERGY CAUSED BY MITE EXCREMENTS   House dust mite allergy is rarely caused by the house dust mites themselves, but rather by their excrements (feces). What makes matters worse, the excrement and the allergens contained therein are present all year long — as opposed to pollen allergens which induce allergic reactions only during periods of pollen. Constant exposure to house dust mite allergens can lead to chronic (long-term) illness.   Due to the dry air during the heating periods, the finely grained excrement breaks down to an extremely fine powder. This powder slicks to the surrounding materials, such as the fiber structure in carpets and upholstery and may become airborne. This happens when the carpet or rug is walked upon, when sitting down or rising from upholstery, and when shaking out blankets and airing out rooms.   The house dust mite problem can be solved only by first destroying the house dust mites. The excrement can gradually be removed from the textiles by repeated cleaning procedures.

Suggestions For Dry or Reactive Skin   If you have skin that is itchy, dry, or very reactive to irritants, consider the following suggestions: Do not take long, hot showers. Use a moderate water temperature when washing your hands or taking a shower. Evaluate the soaps and detergents you use. Strongly perfumed and drying soaps may make your condition worse. Mild soaps, like Cetaphil, are the best to use. Cetaphil lotion is also a very mild lotion. Use a light oil at the end of your shower or bath (Neutrogena is a good one). Apply this oil to your body before you dry off. When you dry off, use a gentle drying motion. Also, do not completely dry with your towel. Remember, to moisturize your skin with lotion.

Vitamins and Supplements   We advise you to take a daily multi-vitamin. It is very important that you get enough Vitamin C, Vitamin E, and Vitamin A. Check your multi-vitamin to see the amounts of these three vitamins. If the total in your daily vitamin is not as much as the amounts listed below, you may need to take a vitamin C, E, and/or A supplement. Vitamin C is a water-soluble vitamin, which means your body excretes excess amounts of it. Vitamin E and A are fat-soluble vitamins that your body stores. Therefore, you need to pay attention to the amounts you consume of these vitamins and take the recommended doses. The following recommended doses are for adults (over the age of eighteen).   Vitamin C: Vitamin C is cleared out of your body every four to five hours. Therefore, to give your body a sufficient amount of it, you need to take it more than once a day. We suggest that you take 1000 mg at least twice a day. If you feel like your immune system is down, take 500 — 1000 mg three to four times a day. The recommended dose of Vitamin C is a controversial issue. If you would like more information, we have articles available at the clinic.   Vitamin E: Your daily intake of Vitamin E should be 400 — 800 IU (International Units) taken once a day, in the morning.   Vitamin A: Vitamin A is also taken once a day, with a meal. The recommended dose is 2500 — 5000 IU every day.