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Why Seasonal Allergies Are So Miserable
April 19, 2024
4 min read
Why Seasonal Allergies Are So Miserable
Plants are just trying to reproduce; immune systems are just trying to keep us safe
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Allergies
Flowers and trees are in bloom—and so are pollen allergies.
The sneezes, runny noses and itchy eyes that typically come with seasonal allergies are both miserable and extremely common. About one in four U.S. Adults reported having seasonal allergies in 2021, according to the U.S. Centers for Disease Control and Prevention. And symptoms are getting worse and lasting longer: climate change is lengthening the growing season and exposing plants to higher carbon dioxide levels, causing them to produce more pollen. The tiny particles are not produced to hurt humans, so why do many of us react so poorly to them? It's all an unfortunate consequence of our immune system's attempts to navigate the world we live in.
"The immune system is very complex, and it has a pretty tough job," says Mansi Kanuga, an allergist at Mayo Clinic Health System. "It needs to be able to recognize things that can be dangerous to us and know when to fight those things off, and it also needs to know when to settle down."
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A human immune system has two parts: One mounts a general reaction to any foreign substance. Meanwhile the other responds to specific substances that the body has encountered before. The immune system will remember and develop dedicated resources to fight off those previous threats if the body runs into them again in the future. Allergies are such a target-specific immune response, and any substance that causes this kind of reaction is dubbed an allergen. "We can become allergic to any protein, really," says Maya Jerath, an allergist at the Washington University School of Medicine in St. Louis and Barnes-Jewish Hospital.
How an allergy develops in the first place is still a bit of a mystery—but researchers have some solid theories. Scientists know babies aren't born with specific allergies, Kanuga says, and they can come and go throughout someone's life. Evidence also suggests genetics plays a role: children of parents with allergies are more likely to have them, too.
Allergy formation is also determined by how reactive the immune system happens to be during the first exposure to a substance. If the system is particularly reactive, it's likely to deem the substance a threat to watch out for in the future. Different exposure routes can also affect the likelihood of developing allergies. For example, a person's immune system is more accustomed to seeing new substances pass through the gut, so it is less likely to respond to such substances than it might be to compounds first encountered through the skin—which rarely lets in outside material.
But why is the immune system so markedly sensitive to pollen? After all, plants have dedicated defense mechanisms against herbivory, such as thorns and bitter-tasting chemicals, which don't trigger seasonal allergies. Pollen is merely a substance plants use to reproduce—the botanical equivalent of sperm—and didn't evolve to fend off humans. "You are not the target; they're not trying to make the allergy," says Nabarun Ghosh, a biologist at West Texas A&M University, who specializes in studying allergens.
Unfortunately, your immune system may not be willing to listen to reason about this. Pollen is difficult to acclimate to because it's seasonal rather than consistently present in the environment. In addition, the tiny, airborne pollen grains that cause allergies can easily make their way past the nose and deeper into the respiratory tract. In general, however, allergies develop because the immune system is reactive when it first meets an allergen; the conditions don't arise from any specific characteristic of the pollen itself.
Environmental allergies are mediated by a protein called immunoglobulin E, or IgE. Such an allergy's initial development triggers the production of IgE molecules that are able to bind to the specific allergen. When the immune system detects the allergen again, it churns out IgE proteins, which bind to the surface of the body's protective mast cells as scouts. When a scout IgE binds to the allergen, the mast cell releases a cocktail of chemicals—including histamines and other inflammatory substances that trigger the congestion, watery eyes and sneezing that we associate with allergies. An allergic response tends to remain strongest in the body part where the allergen was mainly encountered—so inhaling pollen might make your nose run, whereas getting it in your eyes might make them water.
While it might be tempting to hate on IgE and mast cells, this branch of the immune system has a long history of protecting people from parasitic infections. Modern humans don't encounter these threats as often, so it's easy to paint allergies as an overreaction.
Allergies are "your body's immune system thinking that it's doing the right thing," says Emily Weis, an allergist at the University of Rochester Medical Center. "The immune system is always trying to differentiate between self and not self. That's what has kept us alive."
That's cold comfort for allergy sufferers, of course. "We really recognize that seasonal allergies take a big toll on our quality of life for those of us who suffer with them," Kanuga says. She, Weis and Jerath offer a three-pronged approach to living with allergies.
First, reduce exposure to known allergens when possible. This can include monitoring local pollen levels to determine when to spend time outside and leaving your windows closed to keep your house pollen-free. When you do have symptoms, antihistamines and other over-the-counter medicines can help manage itching, sneezing and watery eyes.
If these approaches aren't sufficient, consider talking to an allergist about immunotherapy, which most commonly means allergy shots. These shots contain a personalized mixture of your allergens at low doses and act to desensitize your immune system, teaching it to tolerate these materials rather than unleash mast cells in their presence. In the U.S., immunotherapy is also available in tablet form for grass and ragweed pollens, as well as dust mites.
It does take time to see results: treatment with allergy shots can take about six months to improve symptoms and five years to complete, Jerath says. Still, she says, this approach is an impressive way to actually diminish allergies instead of just treating their symptoms. "It's a little bit mind-blowing," she adds, "to think about the fact that you can actually retrain the immune system."
10 Mind-blowing Facts About Peanut Allergies That Every Parent Should Know
More than six million people in the U.S. Have an allergy to peanuts, according to Food Allergy Research and Education (FARE).
Nearly 1.6 million of these sufferers are kids and teens.
"The recent news of deaths and peanut allergies reminds us that consumers are choosing avoidance over cutting-edge therapies that might have saved their lives," said Dr. Rani Maskatia, a pediatric and adult allergist and immunologist in California.
Maskatia, who is also medical director with Latitude Food Allergy Care, a network of clinics providing testing and treatment for food allergies, shared with Fox News Digital 10 surprising facts about peanut allergies.
1. A peanut allergy results from an immune system reactionA peanut allergy develops when the immune system reacts to major proteins found in peanuts as if they are harmful invaders, according to Maskatia.
"The immune system fights off the proteins, resulting in a wide range of symptoms, sometimes impacting multiple systems of the body — skin, gastrointestinal, respiratory or cardiovascular," she said.
Peanut allergies have become more prominent across the United States. Tanawut – stock.Adobe.Com 2. It's unclear why peanut allergies are becoming more commonCases of peanut allergy have steadily increased in recent history, Maskatia said.
"This may result from many variables in our society — from environmental changes to shifts in our diets over the generations and even decades of (now outdated) recommendations to avoid peanut-based foods altogether in very young children," he said.
3. Peanut allergy reactions are usually the result of accidental ingestionDespite increased awareness, accidental exposures continue to occur, Maskatia noted.
Accidental exposure to peanuts are still a major concern. Pormezz – stock.Adobe.Com"Even if a certain food does not intentionally contain peanuts, cross-contact (i.E., accidental contact with peanuts) can still result in an allergic reaction," she warned.
4. There are varied symptoms of peanut allergiesAn allergic reaction to peanuts can manifest in a wide range of symptoms, from mild discomfort to severe life-threatening anaphylaxis, according to Maskatia.
Symptoms can include hives; skin redness or swelling; itching or tingling in the throat or mouth; runny nose; red, watery eyes; swelling of the tongue and/or lips; eye swelling; nasal congestion; stomach cramps and/or abdominal pain; diarrhea; nausea or vomiting; difficulty breathing and/or wheezing.
5. Children and adults with peanut allergies are at risk for anaphylaxisPeanut allergy is the most common allergy associated with anaphylaxis, which is a severe, potentially life-threatening allergic reaction.
It is reccomended to test children when they are younger. Triocean – stock.Adobe.ComSigns of anaphylaxis can include pale or bluish tint on the skin, throat constriction, shortness of breath and/or wheezing, difficulty breathing, confusion and/or dizziness, and a weak and rapid pulse.
"Although fatalities are very rare, if anaphylaxis occurs, access to immediate medical treatment is critical," Maskatia advised.
"Everyone with a doctor-diagnosed peanut allergy should create an emergency anaphylaxis plan to minimize response time, including carrying two epinephrine auto-injectors accessible at all times."
6. Testing and diagnosis can begin in infancyBabies as young as four months old can be tested for peanut allergies, Maskatia noted.
"Testing that includes blood work and skin testing can ensure that diagnoses are as accurate as possible," she told Fox News Digital.
Other nuts are often safe to eat, even if you can't eat peanuts. Shutterstock / Mantana Boonsatr"Blood work may consist of specific IgE tests and component testing, which help distinguish which proteins in the peanut a patient might be most likely to react to."
7. A peanut allergy diagnosis doesn't always mean all nuts must be avoidedPeanuts are actually legumes, which means other types of nuts — such as walnuts, almonds, hazelnuts and cashews — are often safe to eat, according to Maskatia.
"However, since it is possible to be allergic to both peanuts and to tree nuts and seeds, a clinical evaluation with an allergist is advised," she said.
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"Once the patient has clarity about which foods are allergies, they should freely eat the foods they are not allergic to, ensuring diversity of diet and reducing the risk of future sensitizations to other foods."
8. An allergic reaction could be triggered by non-food itemsPeanut proteins can also be present in vitamins, medications, skin creams, cosmetics, sunscreen, craft materials, toy stuffing, pet food, bird feed and even ant baits or mousetraps, Maskatia warned.
9. An allergy can be outgrown over timeIf you suspect you've outgrown a peanut allergy, follow-up testing with an allergist is recommended, Maskatia said.
There are many treatments emerging, including immunotherapy. Getty Images/iStockphoto"If an allergist suspects through blood work and skin tests that you might have outgrown the allergy, an oral food challenge may be recommended," she said.
An oral food challenge is a step-by-step process in which the patient — under the supervision of a trained clinician — consumes small amounts of a suspected allergen over a period of three to four hours.
"This is done with the expectation that you'll be able to consume the peanuts safely," Maskatia said.
"Conversely, because peanut allergies can have severe or life-threatening reactions, failing to obtain a clinical diagnosis when there is a suspected history of reaction can present significant health and safety risks," she warned.
10. Peanut allergies can be treatedMaskatia recommends a treatment called oral immunotherapy (OIT), which she said is approximately 85% effective for single or multiple food allergies and is safe for all ages.
The FDA recently approved Palforzia, a drug to treat peanut allergies. Nanda – stock.Adobe.Com"Over time, the OIT process continually exposes the patient to increasing amounts of an allergen," she said.
"The body is gradually desensitized and learns to adapt to the allergen. This decreases dietary restrictions and increases protection against severe or life-threatening reactions due to accidental exposure."
Palforzia is an FDA-approved drug for peanut allergy treatment, Maskatia pointed out, and the FDA also recently approved Xolair (omalizumab) for treating all food allergies, including peanut allergy.
"It is expected that in the next decade, there will be more treatment options for people with peanut allergies," she said.
What Makes Allergies Worse At Night?
Due to a combination of factors, it's not uncommon to experience allergy flare-ups at night. Medications and changes in your cleaning routine may be able to help.
Allergies can cause symptoms such as watery eyes, sneezing, and coughing all day long. However, many people also experience symptoms at night that can interrupt sleep and leave them worn out the next day.
Factors such as sleeping position and indoor irritants such as pet dander, dust, and mold are common reasons allergies can feel worse at night.
Treating allergies and taking steps such as changing your sleep position and taking steps to remove allergens from your bedroom can help relieve nighttime symptoms.
It's common to experience allergies that get worse at night. There are a few reasons this can happen. These include:
Finding the right allergy medication can be a good step for managing any allergy symptoms. You can also take steps to help relieve allergy symptoms that are worse at night. For instance, you can:
Beyond allergies, there are a lot of things that might be causing you to get poor sleep.
Learn more about ways to improve your sleep hygiene here.
What is the best position to sleep in with allergies?Changing your sleeping position can be one of the best ways to relieve allergy symptoms at night. Laying flat tends to make allergies worse. It can help to elevate your head and upper body.
You can try using an extra pillow under your head and shoulders or purchasing a back wedge or body pillow.
Check out our picks for the best wedge pillows here.
It's common for allergies to feel worse at night. This can happen because of in-home irritants such as mold, dust, and pet dander. Sleeping position is another common cause of nighttime allergy symptoms.
It can help to treat your allergies with OTC or prescription allergy medications and to take steps such as changing your sleeping position, closing your windows at night, changing the filters in your humidifier, vacuuming regularly, showering before bed, and not having your pet sleep in your bed.
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