Environmental allergies

Environmental Allergies 101

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More than 50 million Americans experience all types of allergies every year, and that number is on the rise regardless of age, sex or race.

What are allergies?

Allergies are the immune system’s abnormal response to generally harmless substances such as pollen, foods, and animal dander. And allergens is the term used for the substances that cause these reactions.

Your body can develop allergic antibodies (IgE) over time to different substances. Subsequent exposure can lead to the activation of various parts of your immune system and the release of a chemical called histamine, which is a major cause of allergic symptoms.

The clinical manifestations of allergies may include:
- Asthma
- Rhinitis (sneezing, itchiness, and a blocked or runny nose)
- Conjunctivitis (eyes are red, itchy, and sore)
- Anaphylaxis
- Eczema
- Urticaria (hives)
- Angioedema (swelling)


How do allergies impact your quality of life?

More than 50 million Americans suffer from allergies each year. They are physically, socially, professionally, and mentally taxing. Further, allergies are a burden to society. Symptoms impair sleep and derail productivity at school and work. Both the direct costs (i.e., medical expenses) and the indirect costs (i.e. reduced efficiency) are significantly high. There is even an American study showing allergic rhinitis to be the costliest disease of all, from an employer’s perspective.¹

Allergen avoidance and over-the-counter medications can be effective in improving symptoms but not for everyone.² Only allergy immunotherapy has the potential to modify the underlying cause of the disease and offer a truly better quality of life.


Are allergies becoming more common?

At the beginning of the 20th century, allergies were less common. Today, respiratory allergies (i.e., dust mites, pet dander, mold, and pollen) represent a significant and expanding health problem in both developed and developing countries, so much so that it is the most common chronic disease among adolescents and young adults.³

“More than 50 million Americans suffer from allergies each year."


How do allergies present?

Exposure through the eyes would lead to conjunctivitis, which includes itchy, watery, and/or red eyes, and allergic shiners, which are ​​dark circles under the eyes caused by congestion of the veins in allergic patients.

Inhalation through the nose causes rhinitis, which includes sneezing, congestion, itchy/runny nose, and postnasal drip.

Inhalation to the airways, including the lungs, results in asthma symptoms, including wheezing, coughing, and shortness of breath.

Most patients have symptoms from multiple organs simultaneously and the expression of their allergies can change over time.

Allergies can be intermittent/seasonal or could be persistent (year-round) and can range from very mild to severe disease. Over time, allergies can often worsen leading to a further decline in quality of life.


How are allergies diagnosed?

Doctors typically use three types of tests to diagnose allergies. The tests alone cannot give a diagnosis; your medical history, personal history, and lifestyle also play a role in getting a clear understanding of the allergy.

1. Blood Tests (Specific IgE)
The lab measures the number of antibodies in the blood that are specific to the allergen in question.

2. Skin Prick Test (SPT) - also known as percutaneous or scratch test
The doctor or nurse will prick the skin on your back or forearms with a small amount of an allergen and observe for a local reaction at that site.

3. Intradermal Skin Test
The doctor or nurse injects a tiny amount of allergen into one of the outer layers of skin to observe the body’s reaction which generally manifests as a small hive at the testing site.

If you’re wondering what your allergies are, we’ve made it easy to find out. Our Nectar At-Home Allergy Test can be taken at home. This is followed by an at-home consultation with one of our providers to talk through your results and find out if you are eligible for the Nectar Allergy Prescription Drops.


How are allergens treated?

Generally, allergies are controlled, not treated, through a mixture of allergen avoidance and pharmacotherapy.


Allergen avoidance
Avoiding an allergen could include remaining indoors when pollination is high, making use of dust mite covers for your pillows and mattresses, cleaning often, and using a mask when doing so. While it does reduce and sometimes prevent symptoms, it is not always possible, particularly for respiratory allergies. Worse still, many patients don’t receive an allergen-specific diagnosis.⁴ Find out what you’re allergic to with our At-Home Allergy Test.


Pharmacotherapy
Pharmacotherapy is effective in reducing symptoms, but it does not address the underlying cause of the allergy, it does not prevent the disease from progressing, and it must be utilized so long as symptoms are present, which can mean for life.⁵

Interestingly, 57% of patients describe symptom control as being poor/insufficient even though their pharmacotherapy treatment is prescribed by a physician.⁶ And 69% of patients feel restricted in their daily life.⁷


Allergen Immunotherapy
Based on the above statistics, pharmacotherapy alone is insufficient to control symptoms in all patients and allergy avoidance is unrealistic for many patients. Only allergen immunotherapy can modify the disease for the better and offer a future without allergies.



Citations:

¹ Charles E. Lamb, Paul H. Ratner, Clarion E. Johnson, Ambarish J. Ambegaonkar, Ashish V. Joshi, David Day, Najah Sampson & Benjamin Eng (2006) Economic impact of workplace productivity losses due to allergic rhinitis compared with select medical conditions in the United States from an employer perspective, Current Medical Research and Opinion, 22:6, 1203-1210, DOI: 10.1185/030079906X112552

² J. Bousquet, et al., Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen), Allergy, 63 (Suppl. 86) (2008), pp. 8-160

³ J. Ring, et al., Davos declaration: allergy as a global problem, Allergy, 67 (2012), pp. 141-143, Erratum: 67, 712

⁴ T. Chivato, et al., Allergy, living and learning: diagnosis and treatment of allergic respiratory diseases in Europe, J. Investig. Allergol. Clin. Immunol., 22 (2012), pp. 168-179

⁵ A.W. Burks, et al., Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report, J. Allergy Clin. Immunol., 131 (2013), pp. 1288-1296

⁶ P. White, et al., Symptom control in patients with hay fever in UK general practice: how well are we doing and is there a need for allergen immunotherapy?, Clin. Exp. Allergy, 28 (1998), pp. 266-270

⁷ T. Chivato, et al., Allergy, living and learning: diagnosis and treatment of allergic respiratory diseases in Europe, J. Investig. Allergol. Clin. Immunol., 22 (2012), pp. 168-179