Pollen Allergy
Pollen allergy, also known as "hay fever" is one of the most common triggers of seasonal allergies. Experts usually refer to pollen allergy as “seasonal allergic rhinitis.”
What are Symptoms of Pollen Allergies?
People with pollen allergies only have symptoms when the pollens they are allergic to are in the air. Symptoms include:
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Runny nose (also known as rhinorrhea – this is typically a clear, thin nasal discharge)
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Stuffy nose (due to blockage or nasal congestion – one of the most common and troublesome symptoms)
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Sneezing
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Itchy nose, eyes, ears, and mouth
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Red and watery eyes
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Swelling around the eyes
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Brain fog
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Sinus headache
If you have asthma and pollen makes your asthma worse, you may have allergic asthma. It is the most common type of asthma.
Immunotherapy for Allergies
Symptom causing allergens are introduced to the immune system slowly from low to higher doses to adapt and acclimate the immune system to the offending allergen. This is called immunotherapy. SLIT therapy stands for sublingual immunotherapy.
What are some Types of Allergies?
What are some Types of Pollen?
Typically produced by species of trees, grass and weeds.
The most common allergens are listed below.
Tree
Alder, Ash, Aspen, Beech, Birch, Box elder, Cedar, Cottonwood, Elm, Hickory, Juniper, Maple, Mulberry, Oak, Olive, Pecan, Poplar, Walnut, Willow.
Grass
Bahia, Bermuda, Fescue, Johnson, Kentucky blue, Timothy.
Weed
Ragweed, Burning bush, Cocklebur, Lamb’s-quarters, Mugwort, Pigweed, Russian thistle, Sagebrush, Tumbleweed.
Mould
Types of fungi caused by excessive water and humidity. They’re typically found in poorly ventilated areas like bathrooms and basements.
Pet dander
Flecks of dead skin shed by pets with fur or feathers like dogs, cats and birds. Dander floats in the air of your home and is the main source of pet allergies.
Dust mites
Tiny, microscopic bugs that live in your home. They can collect on humid, dust-prone furnishings like pillows, mattresses, carpets and stuffed toys.
Seasonality of Pollen Allergies
Mould, Pet dander, Dust mites
Weed
Tree
Grass
January
February
March
April
May
June
July
August
September
October
November
December
For more information: https://www.kleenex.com/en-ca/tips-advice/allergies/pollen-calendar
Oral Allergy Syndrome
Pollen Food Allergy Syndrome (PFAS), also known as oral allergy syndrome (OAS), is caused by a cross reaction in our immune system where our immune system becomes sensitized to proteins found in both pollen and raw fruits, vegetables, or some tree nuts. In other words, the immune system recognizes the pollen and similar proteins in the food and directs an allergic response to it.
This may show up on a food sensitivity test, in which case when these patterns are seen, an assumption can be made that the individual actually has PFAS/OAS. Typically cooking these foods denatures the pollen, and the individual should not react to it any longer.
Symptoms: Itching and swelling of mouth, lips, tongue, and throat when you eat certain fruits, vegetables, or nuts.
Pollens and their food cross-reactivity counterparts additions to the document to the right:
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Grass pollen: celery, melon
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Ragweed pollen: melons, sunflower seeds.
What can I expect from my visit centred around my allergies?
The VISIT
The first step is identifying your allergies as well as other road blocks to your health by acquiring a thorough history.
Typically one initial 50 minute visit is carried out along with 2 follow-up visits at minimum, all spanning about 6 months.
TESTING
MSP permits a maximum of 5 allergens per patient per year with an MD, unless ordered by an allergy specialist.
Patients must have one or both of the following to qualify:
1) History of life-threatening or severe allergic reaction
2) Presence of generalized skin diseases
With an ND, there is an out of pocket cost, but no limitations on number of allergens.
Note that the IgE allergen test below is different from food sensitivity testing which is IgG mediated. These are IgE mediated and cover more than foods.
Testing not included as part of the visit and treatment.
Each box is $22.00
Sublingual Immunotherapy for Allergies Treatment
Allergy desensitization therapy is best initiated 6-12 weeks BEFORE the allergy season.
January/ February is a good time to get started.
What is SLIT and who can benefit?
Sublingual immunotherapy (SLIT) involves placing a diluted allergen under your tongue for one to two minutes and then swallowing it.
SLIT is a great alternative to costly injections. No need to wait to see an immunologist. Great for individuals with extreme sensitivities and children. The World Health Organization has endorsed SLIT as an alternative to injection therapy (allergy shots).
What are some precautions or contraindications?
It is not recommended for pregnant women to start taking allergy drops. However, if a woman is already taking sublingual immunotherapy drops and becomes pregnant, she can continue SLIT at a stable dose throughout pregnancy.
Do not use sublingual immunotherapy if you have open sores, cuts or ulcers in your mouth, or if you are undergoing dental procedures that cause bleeding (oral surgery, tooth extraction, etc.), because the allergen in the medication could enter your bloodstream too quickly and cause a reaction.
How does treatment work?
The idea is to slowly acclimate the immune system to the offending allergen over time.
Treatment includes 1 or 2 or 3 max of the following allergens. If choosing 3 at the same time, they must be of the same class.
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Dust mite mix
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Tree mix - 10
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Tree mix - 2
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Ragweed mix
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Weed mix - 6
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Grass mix - 5
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Mould mix - 4
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Dog mix
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Cat mix
1 mL of the diluted allergen(s) will be placed under the tongue daily for 6 weeks.
Week 1: Most diluted vial 6x dilution
Week 2: Diluted vial 5x dilution
Week 3: Diluted vial 4x dilution
Week 4: Diluted vial 3x dilution
Week 5: Diluted vial 2x dilution
Week 6: Most potent diluted vial 1x dilution
Instructions: Patient would use a needle and syringe and extract 1 mL of solution from the vial every morning 30 minutes before food and place under the tongue. Leaving the needle inside the vial for the week and only attaching and detaching the syringe.
WHAT ARE THE COSTS TO EXPECT?
Initial ($180) and 2 follow-up visits ($90 ea): $360
Cost per IgE allergen test: $22.00 + $32 Req fee
Average cost per SLIT allergen: $50.
Cost of concurrent supplements targeted to allergy control: $210.00
What are some conventional treatments often prescribed by medical doctors?
Typical medications prescribed in the conventional model for allergies
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Nasal corticosteroid sprays to reduce inflammation (swelling) in the nose and block allergic reactions. Nasacort®, FLONASE®, and RHINOCORT®
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Antihistamines come in pill, liquid, or nasal spray form. They can relieve sneezing and itching in the nose and eyes. They also reduce a runny nose and, to a lesser extent, nasal stuffiness. Look for a long-acting, non-drowsy antihistamine. ZYRTEC®, Claritin®, Allegra®, CLARINEX®
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Decongestants are available as pills, liquids, nasal sprays, or drops. They help shrink the lining of the nasal passages and relieve nasal stuffiness. They generally are only used for a short time. SUDAFED®, Vicks Sinex™, Afrin®. Check with your doctor before using decongestants if you have high blood pressure, glaucoma, thyroid disease, or trouble urinating. They may cause issues if you have any of these conditions and they may interact with other prescription medicines.
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Leukotriene receptor antagonists (or modifiers) block the action of important chemical messengers (other than histamine) that are involved in allergic reactions. SINGULAIR®, Zyflo CR®, ACCOLATE®
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Cromolyn sodium is a nasal spray that blocks the release of chemicals that cause allergy symptoms, including histamine and leukotrienes. This medicine has few side effects, but you must take it four times a day. NasalCrom®
Resources
Using CERTIFIED asthma & allergy friendly® products in your home can help you have a healthier indoor environment, as well as reduce allergens.
Find out more here.
References
1- https://aafa.org/allergies/types-of-allergies/pollen-allergy/
2- https://asthma.ca/get-help/allergies-and-asthma/
3- https://acaai.org/allergies/allergic-conditions/food/pollen-food-allergy-syndrome/
4- PreMedline Identifier: 18727478
Preventive effects of sublingual immunotherapy in childhood: an open randomized controlled study.
Ann Allergy Asthma Immunol. 2008; 101(2):206-11 (ISSN: 1081-1206)
Marogna M ; Tomassetti D ; Bernasconi A ; Colombo F ; Massolo A ; Businco AD ; Canonica GW ; Passalacqua G ; Tripodi S
Pneumology Unit, Cuasso al Monte, Macchi Hospital Foundation, Varese, Italy.
BACKGROUND: Sublingual immunotherapy (SLIT) has been proved to be effective in allergic rhinitis and asthma, but there are few data on its preventive effects, especially in children.
OBJECTIVE: To evaluate the clinical and preventive effects of SLIT in children by assessing onset of persistent asthma and new sensitizations, clinical symptoms, and bronchial hyperreactivity.
METHODS: A total of 216 children with allergic rhinitis, with or without intermittent asthma, were evaluated and then randomized to receive drugs alone or drugs plus SLIT openly for 3 years. The clinical score was assessed yearly during allergen exposure. Pulmonary function testing, methacholine challenge, and skin prick testing were performed at the beginning and end of the study.
RESULTS: One hundred forty-four children received SLIT and 72 received drugs only. Dropouts were 9.7% in the SLIT group and 8.3% in the controls. New sensitizations appeared in 34.8% of controls and in 3.1% of SLIT patients (odds ratio, 16.85; 95% confidence interval, 5.73-49.13). Mild persistent asthma was less frequent in SLIT patients (odds ratio, 0.04; 95% confidence interval, 0.01-0.17). There was a significant decrease in clinical scores in the SLIT group vs the control group since the first year. The number of children with a positive methacholine challenge result decreased significantly after 3 years only in the SLIT group. Adherence was 80% or higher in 73.8% of patients. Only 1 patient reported systemic itching.
CONCLUSIONS: In everyday clinical practice, SLIT reduced the onset of new sensitizations and mild persistent asthma and decreased bronchial hyperreactivity in children with respiratory allergy.