Q & A With Dr. Joseph Shapiro, Allergy & Asthma Expert:

Spring allergy season. Three words that inspire intense dislike. What's causing these pesky allergies?
Dr. Shapiro: Spring allergies are the result of pollen released by local trees, grasses, and weeds. These pollens are released into the air and eventually land, sometimes miles away from where they were released, on your clothes, hair, eyes, and skin. You can also inhale the pollen into your respiratory tract. Pollen is very sticky, so once it lands on the body, it will often stay there for some time. Depending on where the pollen lands will determine the type of symptoms an allergy sufferer will have.
How can we do our best to minimize its effects this year?
Dr. Shapiro: Important steps to minimize your allergies include changing your clothes after spending time outdoors and bathing and washing your hair after time outdoors. When indoors, keep your windows closed to prevent the pollen from entering your home. You should also have an air purifier running indoors to clear the air of pollen the does make it inside. Leave your shoes at the door when you come inside so you don't track the pollen through the house. Also, there are also certain times of the day that pollen counts are highest, usually the morning, so try to limit your outdoor activities then.
Are allergies more prevalent now vs. 10 years ago? If so, why?
Dr. Shapiro: Allergies are increasing in prevalence. Although we don't know why for sure, there are several theories as to why this is happening. One of the leading theories is the hygiene hypothesis which suggests that we are raised in too sterile of an environment. The idea is that our bodies are born to develop allergies, but due to infections we should be exposed to at a young age, the allergies are ignored while the immune system deals with infections. Because of the generally germ free environment we are now raised in (think of all the hand sanitizers we use on our kids), the immune system doesn't have to deal with infections in early life and can instead focus its attention on allergies. As a result, more kids are developing allergies.
Whenever my wife and I are sick, we pooh-pooh it as "just allergies". But we're sick. How can one really tell the difference?
Dr. Shapiro: It is not always easy to tell the difference between allergies and colds in the early stages. But if you are having runny nose, sneezing, and itchy eyes at the same time of the year for several weeks or months at a time, that is generally a good indication it is allergies. Allergies don't generally cause fevers or body aches, so if you are having these symptoms, think infection. If you're not sure, your doctor can usually tell with a simple exam.
What's been the best medical advance in the treatment of allergies in the past few years?
Dr. Shapiro: There are many new medications that have been introduced to the market in the last several years for treatment of allergies. These include nasal sprays that treat the problem directly at its source as well as allergy pills that give a whole body approach to reducing allergy symptoms. And although not new, allergy immunotherapy, better known as allergy shots, are still very effective at retraining the body to not be allergic. And of course there is always avoidance, the most important first step to treating allergies.
How can you tell if you live in a "hot spot" for allergies?
Dr. Shapiro: Hot spots vary depending on what a person is allergic to. If you suffer from pollen allergies, you can get pollen updates on your smart phone or computer to determine if pollen counts are high near your home.
When is it time for someone to consult a doctor about their allergies?
Dr. Shapiro: There are some good medications for treatment of allergies that are available over the counter. If you have tried these and find they are not effective, it is a good time to ask for a referral from your doctor to an allergist.
What's a more effective treatment in the long run for allergies: allergy shots or oral medication?
Dr. Shapiro: Allergy medications treat symptoms. As long as a person continues to take the medication, they will generally find their allergies are under good control. Once the medication is stopped though, symptoms will return. Allergy shots treat the underlying problem. By injecting a person with the allergens they are allergic to, the body is trained to tolerate the allergen. Therapy lasts for about 3-5 years resulting in sustained relief of symptoms after the shots are stopped for 10-15 years. Both are good options, but the shots are going to give relief for the long run.
What's the surest sign you or your child may have asthma?
Dr. Shapiro: Asthma is an inflammatory condition of the lungs. It results in coughing, wheezing, shortness of breath, and chest tightness, although a person may have only one or a few of these symptoms. One symptom to look out for is coughing with exercise. That is often a strong indication of asthma.
What's the biggest misconception people have about asthma?
Dr. Shapiro: There are two misconceptions I deal with often regarding asthma. The first is that if you haven't had an "asthma attack," you don't have asthma. But asthma can be present in many ways including a persistent cough or coughing with running. Just because a person doesn't have severe wheezing, shortness of breath, and chest tightness doesn't mean they don't have significant asthma.

The other misconception is that if you have asthma, you can't be physically active. There are many professional athletes that live with asthma and have accomplished great physical success despite their asthma. There are many great medications available for asthma today. When taken regularly, most people are able to be as physically active as a non-asthma sufferer, doing all the same activities as everyone else.
How does our diet play into the severity of the allergies or asthma we suffer from?
Dr. Shapiro: It is important to eat healthy and remain physically active if you have allergies and asthma. Obesity has been shown to worsen asthma symptoms, so it is important to maintain a healthy lifestyle. This will also help boost your immune system, further reducing infections that can worsen your existing allergies. Of course it is also important to avoid foods a person is allergic to as these can trigger an asthma or allergy attack.
Finally, can allergies outright be prevented?
Dr. Shapiro: We haven't figured out a way yet to prevent allergies, but the research is ongoing.
Dr. Joseph Shapiro

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