13+ Things Allergists Won’t Tell You

The meds that are a waste of money, the truth about hypoallergenic dogs, the natural remedy all allergists swear by, and more insider tips for surviving another allergy season without feeling totally miserable.

By Lauren Gelman
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Is every year really “the worst one yet” for allergies? Possibly.

There’s admittedly some role of PR and marketing in that, but climate change does seem to be making allergies worse. Allergenic plants are bigger and produce more pollen, and seasons are starting earlier and lasting longer.

—Richard Weber, MD, president of the American College of Allergy, Asthma and Immunology, and professor of medicine at National Jewish Health in Denver

Don’t assume you know what you’re allergic to.

Two-thirds of people with any allergies also have year-round allergies to things like dust mites, mold, or pets. You may assume you’re allergic to your cat, for example, but testing may reveal that it’s actually something else. Also, many people experience delayed reactions to allergens, which makes them harder to recognize. You could be outside mowing the lawn and sneeze a little bit, but experience more significant wheezing and coughing six hours later when you’re inside getting ready for bed.

—James Sublett, MD, chair of the American College of Allergy, Asthma and Immunology Indoor Environment Committee and section chief of pediatric allergy at the University of Louisville School of Medicine

Those OTC decongestants are a waste of money.

Over-the-counter decongestants without pseudoephedrine [the ingredient used to make crystal meth] have very little effect. Patients are basically getting ripped off. In terms of efficacy, you’re better off getting the ones you have to sign your life away for at the pharmacy counter.

—Michael Blaiss, MD, clinical professor of pediatrics and medicine at the University of Tennessee Health Sciences Center and an allergist in private practice in Memphis

Antihistamines don’t work as well as you think.

Oral antihistamines are the most common allergy medication, but prescription steroid nasal sprays work much better. People use the over-the-counter drugs so they don’t have to go to the doctor.

—Richard Weber, MD, president of the American College of Allergy, Asthma and Immunology, and professor of medicine at National Jewish Health in Denver

Make sure your medication treats your symptoms.

There are so many over-the-counter options now, it’s common for people diagnose and treat themselves. So read the label and know what you’re getting. For example, many antihistamines come in a “D” variety, for decongestant. But if you’re not congested, don’t take this kind—it could increase your blood pressure.

—Michael Smith, MD, chief medical editor for WebMD

Allergy shots help a lot, but they’re not right for everyone.

If you have only spring or fall allergies, allergy shots probably aren’t going to be worth your while. But if you have multi-season or year-round symptoms, they can help long-term with amazing results. The biggest issue is that they are time consuming—for the first few months, you have to go once a week, get the shot, then wait 30 minutes to make sure you don’t have a reaction.

—Michael Smith, MD, chief medical editor for WebMD

You’re starting treatment too late.

If you know you have bad pollen allergies, start treating them even before you have symptoms. Watch the counts, and as soon as they start to rise, start taking your usual medication. Once your body ramps up its release of histamines and inflammatory chemicals, they’re that much harder to treat.

—Michael Smith, MD, chief medical editor for WebMD

You don't want to hear this from me, but you’re getting too fat.

Allergies and asthma are closely linked, and being heavy makes asthma and lower respiratory tract symptoms worse. Overeating increases reflux, and tiny particles of acid can aspirate back into the lungs, causing irritation. Another possibility is that acid in the lower esophagus damages nerve endings, which sends a message to the brain that also tightens your airways. And a physically large belly presses on the lungs, so they can’t expand as much. When patients lose weight, we can see their lung function is much better.

—Richard Weber, MD, president of the American College of Allergy, Asthma and Immunology, and professor of medicine at National Jewish Health in Denver

If you tell me that you’re allergic to your pet, then I know you’re really suffering.

Most people will deny their pet is giving them trouble until their dying breath. So if they do admit it, their symptoms must be pretty bad. I would never tell someone to get rid of their pet, but keeping them out of your bedroom will make a big difference. Also, get an air puifier with a HEPA filter. Pet dander tends to stay in the air longer than other allergens, so this is the one case where I feel a filter would actually be helpful.

—Richard Weber, MD, president of the American College of Allergy, Asthma and Immunology, and professor of medicine at National Jewish Health in Denver

If you’re allergic to dust mites, use those bedding covers.

Pillowcase and mattress encasings really do help dust mite allergies, because they prevent mites from migrating in and out. But make sure the packaging says how many microns the fabric is—the smaller the number, the tighter the weave and the more mites it will block. It should be at most 4 to 5 microns and ideally 2 or below. If the product doesn’t tell you a number, I’d consider that a red flag.

—James Sublett, MD, chair of the American College of Allergy, Asthma and Immunology Indoor Environment Committee and section chief of pediatric allergy at the University of Louisville School of Medicine

Neti pots are weird, but they work.

I tried a neti pot out of curiosity so I would know whether to recommend it to my patients. It was a little scary at first, but now it works like a charm. Many allergists like to use nasal irrigation themselves as a natural remedy.

—Michael Smith, MD, chief medical editor for WebMD

Your adult-onset allergies may have been around longer than you think.

If you had recurrent chronic bronchitis as a child, chances are it could have been asthma. Adult-onset symptoms of allergies and asthma are more common today, but in some cases you just didn’t recognize symptoms you had during childhood.

—Michael Blaiss, MD, clinical professor of pediatrics and medicine at the University of Tennessee Health Sciences Center and an allergist in private practice in Memphis

Sorry, Bo, but …

There’s no such thing as a real hypoallergenic dog. Just because an animal doesn’t shed doesn’t mean it won’t cause allergies. What you’re allergic to is the animal’s saliva or dander, not their fur.

—Michael Smith, MD, chief medical editor for WebMD

There’s no need to suffer through allergy season.

No one dies from allergic rhinitis, but bad cases can make you pretty miserable. Leaving symptoms untreated can lead to sinus infections or ear infections. I have patients who literally can’t fall asleep because their allergies are so bad. Don’t sit around waiting for symptoms to pass, because there are lots of treatment options out there.

—Michael Blaiss, MD, clinical professor of pediatrics and medicine at the University of Tennessee Health Sciences Center and an allergist in private practice in Memphis

Don’t move across the country just because you have allergies.

Allergies can happen to anyone at any time, at any age, and in any place. I don’t want someone moving from Georgia to Arizona, only to start getting other symptoms there. If you’re allergic to one kind of pollen, you’re more likely to be allergic to other kinds.

—Michael Smith, MD, chief medical editor for WebMD

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