HAYFEVER HELL: IS THERE ANY HELP?

 

Have you ever wondered “Is it just me or is the pollen season getting worse every year?”

 It’s not just you, the pollen season is getting worse year on year and there’s little to think the future will be any different. With climate change, different temperatures, and lower lying pollen; pollen counts have exploded and as a result, up to 25% of adults and 10-15% of children are suffering, with often very little understanding from those that don’t have the illness. These days GPs are being encouraged to send patients to the pharmacy to buy over the counter medications and this means that when they don’t work, you’re left thinking there are no options open to you. Many people are turning to an annual Kenalog injection out of sheer desperation. This is a cheap drug; no longer available on the NHS because of the serious risks it brings. Whilst you may feel a whole new person and are not likely to have problems initially (although some get mood disturbances and sleep disturbances), it has many serious long-term consequences. These include diabetes, cataracts, osteoporosis and serious infections. Due to these risks the British Society of Allergy and Clinical Immunology do not recommend it in the slightest for the treatment of aeroallergens (allergies brought about by things in the environment).

“So now what?” you might be thinking. “Do I just put up with the symptoms and suffer then?”

The answer from me? – a resounding “no”! No one should have to suffer with the severe symptoms of hayfever and seasonal allergies. Even mild symptoms are troublesome but for those that have constant, severe symptoms it will affect your sleep, your concentration, your mood, your life. Did you know that it has been shown that children don’t achieve their full potential at school in exams because of these allergies? Did you know that adults are less productive and miss more days of work?  Hayfever is no laughing matter and it is most certainly not a trivial illness. Even if you ‘only’ have grass pollen allergy that’s 3 months out of every year that you’re suffering. If we imagine the average age of developing hayfever to be around 9, and most of us living until at least 70 years; that’s 183 months of suffering – over 15years!!!  It is time we as a hayfever suffering population stand up and demand better access to treatment.

Many people who come to see me at Dorset Allergy  simply have not been using the correct medications or are using them incorrectly. Did you know, if you put the nasal spray up your nose and sniff hard, you will swallow the drug and it won’t work? Make sure you’re using a nasal spray correctly -see a handy document from the University of Southampton on how to use your sprays correctly How to use a nasal spray – patient information (uhs.nhs.uk)

For some though, regular use of a nasal spray and antihistamine will not be enough. In this case, we have immunotherapy. This is a form of desensitisation that exists. For grass and tree pollen, you can either have this as a series of injections or via a daily tablet. This is given to expose the body to small amounts of the pollen and in time you build up tolerance. The treatment is given for 3 years to ensure long term improvement, but within months, you should start to notice the benefit. We cannot start treatment during the pollen season as it will make things much worse. So get ready now, plan for the future and speak to your doctor or a private service about having immunotherapy. Don’t be the person who has Kenalog every year for 10 years and then develops irreversible consequences.

At Dorset Allergy I can confirm what allergies you have and ensure your treatment is maximised to reduce suffering right now. We can do allergy tests in the form of a skin prick test or blood test. Oral immunotherapy is available at Dorset Allergy for those with grass pollen from the age of 5years. We also offer immunotherapy to tree pollen and house dust mite and for those that might want to consider it, we can even perform immunotherapy for your cat and dog allergies.

If you want to learn more about how to manage your allergies and be fully equipped with as much information as possible, click here to find out about our Hayfever Help Course;

DON’T SUFFER WITH HAYFEVER, come, and see me at Dorset Allergy. Contact us now to arrange either a virtual or face-to-face consultation. I can help anyone, anywhere in the UK.

Dr Helen x

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Allergy Testing

Invariably, whenever anyone finds out my specialty is allergy, everyone says ‘ooh, I’d love to have allergy testing and find out what I’m allergic to’. Allergy is a fascinating subject and I completely understand everyone’s interest but allergy testing is only a small part of the assessment process used to determine what someone is allergic to. The most crucial part of an allergy assessment is finding out the history of the problem. This entails a detailed conversation about what the concerns are, what symptoms are described and what other health problems are present. There are key points that will emerge from an allergy focused medical history which will dictate whether or not allergy testing is beneficial. If someone tells me they can eat peanuts without any symptoms whatsoever then why would one need an allergy test? The answer would clearly be that they aren’t allergic to it and even if the test came back as positive, it would simply be a red herring. The biggest challenge we have with allergy testing is that they are not 100% accurate and patients (especially those with eczema) commonly have positive tests despite not having any allergic symptoms. This situation frequently leads to people having unnecessarily restrictive diets which is cumbersome, hard to achieve and can result in nutritional difficulties.

Who Needs an Allergy Test?

Allergy testing can only identify those with IgE Mediated allergy. People with IgE mediated food allergies can develop hives, swelling, abdominal pain, vomiting, diarrhoea, congestion, itchy eyes and anaphylaxis when they are exposed to the food they are allergic to. This commonly occurs within minutes of exposure to the food they are allergic to and reactions tend to resolve within an hour or so. People with allergies to dust, pollens, animals, moulds can develop rashes, swelling, runny nose/ sneezing/congestion, or itchy/swollen/ discharging eyes when they are exposed to their allergic trigger. They may also develop breathing problems. These allergies can be tested for. Other types of allergies exist – some of which can be tested for with specialist investigations like endoscopies and others cannot be tested for. A specialist is needed to explain what is right for you.

How do you do an Allergy Test?

There are only 3 validated methods of testing for IgE mediated allergy – a blood test to check for the IgE to a substance (be careful that someone is not testing the IgG), a skin prick test (quick and easy and gives results within 15minutes of being done) or a food challenge which is done in a hospital setting. For more information on all of these tests – see Allergy Testing – Dorset Allergy (allergydorset.co.uk)

My biggest warning to you is to make sure that you are having a validated allergy test. If you google ‘allergy testing’ you will find all sorts of people offering allergy tests which are inaccurate, useless tools. Sadly some of these tests are even offered by doctors. You may be offered hair analysis, an IgG blood test, electrodermal testing (vega testing) and many others. Please read this document for more information when you are making your choice – Choosing-wisely-ALTERNATIVE-TESTS.pdf (bsaci.org). Taking food out of yours or your child’s diet without clear reason causes anxiety, growth impairment and nutritional deficits. Be careful – please see an allergy specialist with clear qualifications and experience in allergy.

Allergies

Can Anybody Help Me?

Being an allergist, one of the things that I’m often struck by is how long people have struggled in life without any answers to their concerns. Many people who are concerned that they may be allergic to foods are simple told to ‘avoid it’ and they live their life never knowing if they are really allergic or how serious a reaction could be. Despite allergies and atopic conditions (eczema, asthma, hayfever, food allergies) affecting so many people in the UK, it is an area poorly understood by many medical professionals and sadly this means the advice given is highly variable and often inaccurate. I freely admit that when my son Ethan had an allergic reaction when he was 6 months old, I was completely clueless. Despite being a doctor at the time and in training to be a General Practitioner, I think the most training I had ever had on allergies was one day at university. This is unfortunately all too common a story despite campaigning from various allergy charities and the British Society of Allergy (BSACI). In order to improve my knowledge to benefit my son and patients I went back to university for a second time and completed the Masters in Allergy. From this point on, I’ve worked in the field of allergy and spent countless hours educating my colleagues in primary and secondary care.

Do I have an Allergy?

Studies have shown that around 25% of parents believe their child has a food allergy and whilst allergy is common – only around 3-6% of children will be affected and 1-2% of adults. This means there are a lot of people in the community with potentially unnecessary worries or other undiagnosed problems.

Whenever food allergy is being considered, it is vital that time is taken to listen and hear what the concerns are. Time should be spent finding out what foods are being avoided and why.

Food allergy is broadly divided into two types of allergy – IgE Mediated Allergy and Non IgE Mediated Allergy. IgE mediated allergy presents quickly after exposure to the food or substance you are allergic to – it can cause hives, swelling, vomiting, diarrhoea and anaphylaxis. It is often obvious and testing can confirm the diagnosis.

Non IgE mediated allergy is harder to diagnose and food diaries can be helpful to pin point the problem (an example can be found on the AllergyUk website Food and Symptoms Diary | Allergy UK | National Charity). This type of allergy cannot be tested for and careful questioning is needed to ensure it is not missed.

Living with allergies is a burden and causes understandable anxiety but ‘Knowledge is Power’ and with the right help and support you can live a well-rounded, happy life.