Suffering from allergies? You’re not alone. Millions of kids and adults in the United States experience seasonal allergies. In this episode of HEALTH Yeah!, experts from Stony Brook Medicine dive into some of the causes, symptoms, treatment options and more.
The Experts
What You’ll Hear in This Episode
- 00:00 Opening and Introductions
- 1:30 When is allergy season?
- 2:08 Allergies in children versus adults
- 2:58 Signs and symptoms of seasonal allergies
- 3:38 Severity of allergies and varied treatment recommendations
- 4:36 Allergies versus a cold, virus or sinus infection
- 7:28 Pollen on Long Island
- 9:33 Air purifiers
- 10:15 Blood panel versus skin testing
- 11:44 Holistic treatment versus allergy avoidance
- 13:10 Allergen immunotherapy and other treatments
- 15:55 Can allergies change over time?
- 18:36 Closing Remarks
Full Transcript
00:00 Opening and Introductions
Announcer
Welcome to HEALTH, Yeah!, where experts from Stony Brook Medicine come together to discuss topics ranging from the complex inner workings of an infectious disease to tips and tricks for staying safe and healthy all year long.
Timothy Brown
Spring is in the air and so are pollen, molds and other common allergens. Now, if you’re one of the millions who start sneezing as soon as the seasons change, this episode is for you. Today on HEALTH, Yeah!, we’re talking all things allergies, from what causes them to how you can find real relief, whether it’s itchy eyes or runny nose or more serious reactions. We’ve got expert insight to help you breathe easier this season.
Joining us are Dr. Brianne Navetta-Modrov and Dr. Susan Schuval, both experts on allergies. And I’m going to have each of you, if you don’t mind, introduce yourselves to our audience and tell us a little bit about what you do here at Stony Brook Medicine.
Brianne Navetta-Modrov, MD
Thank you, Tim. I’m Dr. Brianne Navetta-Modrov. I’m on the adult side of allergy and immunology here at Stony Brook and so I take care of adults who have allergic disease and immunodeficiency.
Susan Schuval, MD
I’m Susan Schuval from the Pediatric Allergy Division here at Stony Brook. I take care of children with many types of allergies, food allergies, eczema, hay fever and primary immune deficiency.
1:30 When is Allergy Season?
Timothy Brown
So we were just chatting about this right before we started the program. But what actually is allergy season? When does that start for us here on Long Island?
Brianne Navetta-Modrov, MD
Yeah, good question, Tim. We get asked that a lot in clinic, actually. So allergy season traditionally on Long Island is March until October, with March, April and May being traditional tree season, June and July being grass season, and then August, September and October being weed season.
And usually we say it ends around the first frost. And so that’s one of the things we tell our patients when they ask us, “when can I stop taking my allergy medication?” So that’s one of our kind of landmarks for them.
2:08 Allergies in Children Versus Adults
Timothy Brown
Is it any different for children?
Susan Schuval, MD
No, it’s the same pollen that affects children and adults. But it’s definitely starting earlier, the pollen season. So I think this year it started in February and then it’s definitely going longer because of climate change.
Timothy Brown
I think oftentimes when we think of allergies, we say just exactly what we’ve been talking about already, the kind of things that impact are not something you’re putting into your system. But particularly when we talk about children, sometimes we need to think a little bit differently.
Nut allergies, food allergies, things like that. How big of an issue is that?
Susan Schuval, MD
Well, we see plenty of food allergies, and that’s probably the main thing we see these days because there’s so much food allergy. But we do see plenty of hay fever. And this time of year we’re very busy with kids and adults who are suffering.
2:58 Signs and Symptoms of Seasonal Allergies
You know, I was telling you this before we started. I got up this morning and I sneezed a few times and I don’t really consider myself to be an allergy sufferer, but at this time of year, sometimes I do already get those symptoms.
What should people look for other than just sneezing?
Brianne Navetta-Modrov, MD
So the traditional allergy symptoms are generally nasal congestion, post nasal drip, watery, itchy eyes, sneezing or in some more severe cases, patients will also have coughing, wheezing and more like asthma or respiratory-like symptoms. So it can vary based on the patient.
Timothy Brown
And are symptoms similar with children as well?
Susan Schuval, MD
Very similar symptoms we see in children – all the symptoms that Dr. Navetta-Modrov said.
3:38 Severity of Allergies and Varied Treatment Recommendations
Timothy Brown
So when you get to the point where it’s beyond a nuisance to an issue that can be maybe not debilitating, but something that impacts your life or or even dangerous, do we get to that stage?
Brianne Navetta-Modrov, MD
Yeah. So that can be patient dependent, and so there are some patients, for example, that will have significant pet allergy. And so something like that is a year round issue, especially kids that go on playdates, families, homes that have pets.
But then the seasonal issue, it really can vary based on the patient. Like if you woke up this morning with sneezing a few times and it wasn’t debilitating your everyday life, then you would not necessarily be someone that I would say, you should consider allergy shots, but a Claritin, if that’s bothering you, would do it.
So our recommendations will vary based on how much the patient’s suffering and how much it’s impacting their quality of life.
4:36 Allergies Versus a Cold, Virus or Sinus Infection
Timothy Brown
So with children or even adults, how do you tell the difference between allergies and just a cold or something?
Susan Schuval, MD
Runny noses are very common in kids, especially children in daycare. But kids who have allergies, they’re sneezing, they’re itchy, They have ocular symptoms. Their eyes are red and tearing, their asthma can be exacerbated by the pollen. So similar kinds of symptoms as the adults, but we do see colds and allergies can coexist as well.
Timothy Brown
I would imagine, in particular with younger children who can’t verbalize what’s happening or what’s going on with them, you have to be even more careful and you have to worry about sinus infections and things like that as well.
How do you tell the difference?
Susan Schuval, MD
Right. Well, sinus infection can be a complication of ongoing untreated allergies. So people with sinus infections have, you know, chronic nasal discharge, yellowish discharge, coughing fever. They’re a little bit sicker than people with allergies.
Timothy Brown
And that’s when they need to come see you. How about adults?
Brianne Navetta-Modrov, MD
Yeah. So sometimes, honestly, it will start like that where patients were like, ”I just thought it was my allergies that were acting up.”
And then they’re like, “Now I have a fever and I feel like this is not an allergic disease and maybe more something like a sinus infection or turning into bronchitis.” So it can be difficult, to be quite frank, the time of year and the exposure history is often helpful.
So if they start to have worsening allergy symptoms and they’re like, “I just bought a new pet,” then it might not be an illness, it might be the new pet, or it’s March and all of a sudden I started sneezing all over, you know, all of the time. And so that can be helpful information.
Susan Schuval, MD
Also allergies can run the families, too. So if a parent has hay fever, they might see the child having similar symptoms and then make the connection that the child might have allergies as well.
Timothy Brown
So that brings me to actually two questions. So you mentioned hay fever. How can you tell what the different allergy potentially is in a child or an adult?
Susan Schuval, MD
That’s where we’ve come in. So these patients should come in and get tested and see exactly what they’re allergic to so they know what their triggers are. They know what time of year they’ll have problems and they know when to start the medicine. Because we know that if you start your medicine ahead of your season, you’d do a lot better than if you wait until you’re really, really suffering.
Brianne Navetta-Modrov, MD
Yeah. So, you know, by the time of year you can loosely tell them, okay, you’re having these symptoms in March and April. This is probably tree pollen allergy. You’re having these symptoms in the fall – this is probably wheat allergy or even mold allergy or similarly, you are exposed to a pet and now you have symptoms. So you’re probably allergic to that pet.
But a definitive diagnosis would be made by either skin testing or blood work, which could point to it specifically Birch Tree or it’s specifically ragweed, that kind of thing.
7:28 Pollen on Long Island
Timothy Brown
So I’m relatively new to the island, and I have found since I’ve moved here, I’m going into my third summer now, I cannot believe the amount of pollen that falls. The yellow pollen is from trees, I’m assuming.
Susan Schuval, MD
Yeah, that’s usually the tree pollen.
Timothy Brown
And so if you are allergic to that, you’ve got to be suffering terribly, I would imagine.
Brianne Navetta-Modrov, MD
Yeah. There are some patients that, that is when they will come in, when they start to see that they’re like no, I know that’s my trigger to come to the office. And so, yes, it’s quite abundant here on Long Island.
Timothy Brown
Is there anything you can do for that?
Brianne Navetta-Modrov, MD
Besides controlling your symptoms, you can do allergen immunotherapy, which is known as allergy shots, but there is also sublingual immunotherapy, which a lot of patients don’t actually know about, but that’s only available for three allergens. But grass pollen and ragweed are two of the options. And so depending on what season’s bothering you, Tim, we could have a discussion about that.
Timothy Brown
Well, I would imagine staying inside. Not that it’s fun to stay inside, but during that period, maybe it’s better.
Susan Schuval, MD
We tell patients about allergen avoidance measures. So if you’re allergic to pollen, you know, don’t go outside in the early morning hours when the pollen counts are the highest.
When you come in the house, take off your shoes so you don’t track the pollen through the house, or wash your dog or cat so they don’t track the pollen, jump in the shower, get the pollen off of your hair.
Don’t leave the windows open in the house or the car because the pollen will blow in. Those are the basic kind of things. Wear a hat, wear sunglasses.
Timothy Brown
That’s interesting because I’d never even thought about actually, you know, you’re bringing that with you.
Brianne Navetta-Modrov, MD
It’s very sticky. That’s one of the things that we try to tell patients that it stays on you. And so don’t lay in your bed after you cut the grass, you know, Then you have it on your sheets, your pillow.
Susan Schuval, MD
And then the children are outside playing sports, so they’re playing soccer and lacrosse and baseball, and they’re surrounded by the pollen. So that can be very tough for them during the pollen season.
9:33 Air Purifiers
Timothy Brown
So you see people are purchasing those air purifiers that they put in their house. Do those things work?
Susan Schuval, MD
I mean, you can only use it in the house, so it’s not going to help you with the pollen so much, but, you know, for indoor kinds of allergens, it might be helpful for dust mite and animal dander.
Brianne Navetta-Modrov, MD
That’s usually something we say to put in your bedroom or in areas where there’s a lot of upholstery or potentially mold exposure. It’s focused more on indoor environmental allergens than controlling outdoor allergens.
Timothy Brown
And I would imagine if you’ve got a really serious situation, vacuum probably a lot.
Susan Schuval, MD
Yeah, vacuuming with the child out of the room because there might be some dust mite flying around them.
10:15 Blood Panel Versus Skin Testing
Timothy Brown
So what would make somebody need a blood panel instead of a skin test? What ‘s the difference between those and what do those tests entail?
Brianne Navetta-Modrov, MD
Sure. So skin testing is the gold standard for diagnosis of allergic disease, but there are certain nuances that would make you decide to do blood work. I’ll let you speak to pediatrics, Susan, but in the adult world, for example, there’s a lot of medications that patients take that impact the ability to have successful skin testing. And so then sometimes I may decide to do blood work or a patient may have really significant allergic disease where they can’t stop their allergy medication. And in order to do skin testing, you have to be able to be off your allergy medication for a certain number of days.
Lastly, they may have severe asthma and you can have an allergic reaction to allergy testing, although that risk is minimal, it’s there. And so in someone who has severe asthma, you may say maybe I should do blood work prior to skin testing. But technically skin testing is the gold standard.
Timothy Brown
And that can get pretty specific in telling you exactly what your allergic to?
Susan Schuval, MD
Yeah. That tells you what the child or the adult is allergic to. And in kids a lot of times kids have eczema along with their allergies so their skin’s just not clear enough to put the skin tests on. So in that case, we have to do a blood test.
11:44 Holistic Treatment Versus Allergy Avoidance
Timothy Brown
Interesting. So how about home remedies? Because people are always, you know, on the Internet, Doctor Google and all that kind of thing, Any of that stuff work?
Brianne Navetta-Modrov, MD
So, people ask this a lot. So the thing that you probably hear the most about is local honey. And that does actually work.
So you buy honey that’s made in the area where your allergens are because theoretically, those allergens should be in the honey. And then you ingest and sort of desensitize yourself in a way or expose yourself repeatedly.
It seemingly does work. But a lot of what we talked about previously is the holistic stuff that I recommend, really the environmental changes that you can make. I have honestly had a few patients tell me that things like acupuncture have helped them. Obviously not something that I know about, but I do often share that with patients because there are patients that don’t like to take antihistamines or it makes them too drowsy or things like that. And so any information you could provide that might be helpful.
Timothy Brown
And with children and antihistamines, I know sometimes you have to do it.
Susan Schuval, MD
Right, usually we recommend the holistic methods or the allergen avoidance measures for kids.
13:10 Allergen immunotherapy and other treatments
Timothy Brown
So medical treatments like allergy shots, we’ve talked a little bit about the over-the-counter stuff that seems to be most common, but what are the shots?
Brianne Navetta-Modrov, MD
So allergen immunotherapy, whether it’s allergy shots or sublingual tablets, are meant to desensitize you or trick your allergic cells to be able to tolerate repeated exposure to your allergens.
And so you repeatedly get injections or take sublingual tablets to make your body be able to tolerate exposure to whatever allergen is.
And so it’s quite extensive, particularly the allergy shots. You have to come to the office once a week for many months. And then you come once a month for 3 to 5 years to maintain that tolerance after you go through what’s called the buildup phase.
Sublingual therapy works a little bit differently. For the dust mites, you will take a sublingual tablet every day at home for 3 to 5 years, whereas for the grass tablets or the ragweed tablets, you take those for three months prior to your allergy season. But then you do that a few years in a row. But the pathophysiology behind it is the same – to repeatedly expose yourself to then hopefully gain some kind of tolerance to exposure to that allergen.
Timothy Brown
Do children have similar treatments like the shots and that sort of thing?
Susan Schuval, MD
Right. But usually try medication first. So we do have tons and tons of medication, both over-the-counter and prescription medicine. So we have antihistamines, we have decongestants, which we don’t really like so much in pediatrics, but we have them. We have nasal sprays, steroid nasal sprays, antihistamine nasal sprays, saline. We have eye drops.
Brianne Navetta-Modrov, MD
Yeah, depending on if there’s respiratory symptoms, then you would also get an inhaler or sometimes there’s a medication called Singulair that we use as well.
But yes, Susan’s point is well taken. Depending on how much the patient is suffering, allergy shots are a big commitment. And so that’s a discussion that you have with your patient. When is the right time for me to consider something like this?
Timothy Brown
So if you have a patient or child, for example, with asthma in conjunction with the allergies, do they play off of each other?
Susan Schuval, MD
Yeah, they are all connected and the pollen can make your asthma worse and your allergies can get worse when your asthma is exacerbated. So we have to treat everything.
And you know, patients always ask, what’s the best allergy medicine? You know, which one’s the best? So there’s no one best allergy medicine, so whatever works for you. Sometimes we have to try and go through a couple of medications to find the right regimen.
15:55 Can Allergies Change Over Time?
Timothy Brown
So final question. I’m curious as you get older, do you have that ability to develop allergies or do they get worse, or do they change?
Susan Schuval, MD
So anyone can develop allergies to anything at any time. Even my kids know that because I say that all the time. But we see a lot of adults who develop allergies as adults.
But it can change. So you could be terrible one season and the next season can be better. So it’s very variable from season to season and people can lose their allergies as well.
Timothy Brown
Do we know why?
Brianne Navetta-Modrov, MD
So it depends on the situation, but oftentimes it’s related to exposure, so repeated exposure or lack of exposure. For example, we will probably both sometimes see college kids who have pets at home and then go to college and they have removed exposure from their pets and then they come back home and they’re like, “I can’t breathe in my house.”
So it will often have to do with exposure. And just like yourself, you moved here and so your allergens changed. So it really does depend on, you know, what you’ve been exposed to in the past and now what you’re being exposed to.
But the good thing that Susan said is people forget they can also go away. And so sometimes, you know, I’ll see adults who are like, “I knew it was time to come in because it’s been four bad years in a row” and then they come back in as opposed to, you know, the patients who actually get better over time. They’re not going to be the ones that come in because they’re feeling better over time. And so it can go both ways.
Timothy Brown
So this has been 100 percent about seasonal allergies. We haven’t even touched on food allergies. We could have another whole show on that because that is fascinating as well and I think would be very valuable to our listeners and viewers.
But you guys were great. Did we miss anything that we need to remind our listeners?
Susan Schuval, MD
No. It’s just always valuable to see an allergist and find out what you’re allergic to because it really can help you have a better season, and know when to start your treatment and when you can stop your treatment. Because sometimes people take their allergy medicine year round and they don’t need it year round.
Brianne Navetta-Modrov, MD
I would just add to that, on the adult side, there’s a lot of decongestants that are over-the-counter now – Sudafed, Afrin, those kinds of things. And those are not a good long term treatment through the duration of allergy season. And so I would just caution that if you find yourself regularly using things like decongestants, that would also be a time where you would consider seeing an allergist for some additional guidance.
Timothy Brown
Yeah, there’s no reason to suffer when we have folks like you here. So they can come and visit you and hopefully get it all taken care of.
18:36 Closing Remarks
Well, you guys were fantastic. Thanks so much. I appreciate it. That’s it for today’s episode of HEALTH, Yeah!. Thanks for tuning in and learning all about allergies and how to fight them.
If you found this episode helpful, and I’m hoping you did, share it with a friend and please make sure you subscribe for more health tips that keep you educated and empowered. Until next time, stay informed and stay healthy.
Announcer
Stony Brook Medicine is Long Island’s premier academic medical center. We transform lives through scientific discovery, education and care, and we bring together innovative research, advanced education and extraordinary health care expertise to set the standard for how healthy communities thrive. For more information, visit Stony Brook Medicine or follow us on social media.
*DISCLAIMER: The information provided in this podcast is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you think you may have a medical emergency, call your doctor or emergency services immediately.
