Understanding Allergies

More Americans and their family members are at an increased risk of getting allergies, according to a new study.

In fact, more than 50 million Americans have allergies, according to the American College of Allergy, Asthma and Immunology (ACAAI)

The first step in determining an allergy is understanding what it is, according to Dr. Stanley Fineman, allergy & asthma specialist, with the Atlanta Allergy & Asthma Clinic. “An allergy is a situation where someone has a sensitivity to something that causes a reaction that normal people don’t have a reaction to,” said Fineman. “If you notice that you have the same reaction to a substance and no one else is reacting to it, then you should be tested for allergy.”

Physicians should get a detailed analysis of the patient’s medical history along with a physical to get a proper diagnosis of sensitivity to inhalants like pollen, dust, animal dander and mold spores, as well as foods that may be ingested or certain types of insects.

The doctor can then determine the specific allergy by conducting an allergy skin test, where a small drop of extract containing a suspected allergen is put on the skin. If the patient is allergic, there will be a reaction at the test site that looks like a mosquito bite within 10 to 20 minutes. The allergy skin test is very sensitive and very specific, according to Fineman. “There are very few false positive if it is done properly.”

An allergy blood test, also referred to as a RAST test, may also be conducted instead of the skin test. The blood test measures the amount of allergy antibody, Immunoglobulin E (IgE), produced when your blood is mixed with different allergens. The higher the IgE level in the mixture of blood and allergen, the more allergic you are to that substance. This test is performed in a laboratory, so it takes longer to get the results.

There are some specific instances in which the blood test is preferable over a skin test, particularly when a patient:

Takes a medicine that may interfere with skin testing and they can’t stop the medication. Suffers from a skin condition like eczema or psoriasis. Is a baby or very young child, and a single needle prick is a better alternative than several skin tests.

Keep in mind that conditions like HIV, and skin diseases also elevate IgE levels, so the results of a blood allergy test are not always conclusive. Doctors will need to compare the results with a patient’s allergy symptoms and medical history. Once the diagnosis has been made, allergies can be controlled, said Fineman. Treatment is dependent upon a patient’s symptoms.

For patients who are experiencing severe symptoms that impact their lifestyle, Fineman said that they could be treated with desensitizing therapy also known as immunotherapy. This involves a series of injections in which the patient is exposed to small doses of the allergen at first. As the dosage is increased, the patient builds up a tolerance for the allergen so that eventually they will no longer be sensitive to it. This treatment is available for inhalants and insect type allergies. However, the Food and Drug Administration (FDA) hasn’t approved it for the treatment of food allergies.

If you plan to use over-the-counter remedies, they can be very helpful according to Fineman. However, the effectiveness of the medication depends upon how you personally react to it. “There are some medications that are relatively sedating, and some that are non-sedating. Some people fall asleep when they take Benadryl or Claritin, while others don’t.”