Health Chats
Allergies - How to Manage and Find Relief
Tuesday May 24, 2011, 01:00PM - 02:00PM (EST)
Associate Staff Physician
Cleveland Clinic
Pulmonary, Allergy and Critical Care Medicine, Cleveland, OH
Allergic disorders affect an estimated 1 in 5 adults and children (40 to 50 million people) and are the sixth leading cause of chronic illness in the United States, according to the Allergy Report from the American Academy of Allergy, Asthma and Immunology (AAAI). With allergy season here in full bloom, take this opportunity to chat with an expert on how you can properly manage your allergies and find some much-needed relief.<br><br> Allergists at Cleveland Clinic’s Department of Allergy and Immunology have unparalleled expertise in the diagnosis and treatment of all diseases encompassed by their specialty. This expertise and experience attracts patients from all over the world who seek a definitive diagnosis or state-of-the-art treatments, from respiratory diseases allergy problems. Dr. Koelsch, a Cleveland Clinic allergist, will provide answers to your questions about allergies during this online chat.
Rachel Koelsch, MD:
I am not sure if the Gamma GT levels are related to an allergy. I suggest you find out if you have an allergy to the avocados (an allergist can test you). You should follow up with your doctor about the blood work results. Metabolic problems can sometimes cause rashes.
For the past five months, I've noticed these redish brown spots that have been apearing, there along my bra line, on my shoulders and now I notice them starting on my arm, they seem to have a dry flakiness to them and look almost like a scar, slightly shiny. they itch sometimes, they turn red when I shower or if I'm running. I am of a good weight and I'm only 25. Would you have any idea what this might be or how to get rid of it?
Rachel Koelsch, MD:
It can be a superficial fungal infection (ring worm) or eczema. A dermatologist should be able to help you figure this out.
Sandy M:
Our 7 year old son just developed "seasonal" allergies.  He has been sneezing and has watery eyes for the past 2 weeks. Is there a product for children that does not induce sleepiness? Also, is it possible that he might outgrow these allergies?
Rachel Koelsch, MD:
Most children have no problem with over the counter Zyrtec or Allegra or Claritin. All of these have children's doses which are typically 1/2 that of the adult dose (depending on the age and weight of the child). They come in liquid, chewable, or dissolvable forms.
I have issues with my sinus. However, when I take my allergy medicine, I can't stop coughing or wheezing. The mucus stops but not the cough or wheezing. & I had asthma before, but I thought it was only triggered whenever I excercised or extremely excited. However, that was rarely because I been on the dance team for the last 3 or 4 years. Plus, I was a majorette for 8 years. & haven't had an asthma attack yet! & the only time I get these coughing & wheezing spells is when I lay down on my back to go to sleep & my nose is stuffy. & if I laugh or get really hot, I'll start to cough & wheeze. & it's fusturating because I can't have a good laugh or get a full night of sleep without coughing & wheezing. is this some kind of allergic asthma attack?
Rachel Koelsch, MD:
It sounds as if you have asthma that is definitely not controlled. Wheezing and coughing at night, with exercise, when laughing, etc are all signs of asthma. You don't have to get a classic "asthma attack" to have uncontrolled asthma. You need to see your doctor or an asthma specialist right away so you can get on a daily controller inhaler to prevent these symptoms. You will get a rescue inhaler too. Allergies, illness, smoke, weather changes can all trigger asthma flares.
Hello this question is for my mom. I am very concern for my mom, she suffers from excessive mucus in her throat, which REALLY bothers her!!! It all started when she got a cold, and ever since she has been plague with this, she developed insomnia from this condition!! Is there a cure??? Many people tell her it's some kind of allergy or post nasal drip, they all have different names for this, but where is the cure??? I know it's not a allergies because she and I been living in PA since 2007, and since the three and a half years she never, ever got any allergies. We are originally from Brooklyn, NY, and moved here in 2007. She tried all kinds of allergies meds, and DID NOT TAKE HER CONDITION AWAY!!! Just a WASTE of MONEY!!! My mom is diabetic, and has hypertention, and high cholesterol. She could have risk her health problems taking these med; like those Mucus over the counter meds, etc. She is desperate to have this condition resolve, please help her, thank you very much.
Rachel Koelsch, MD:
I think your mother needs a sinus CT scan to see if she has an infection that is causing her symptoms. Diabetics that don't have well controlled blood sugars are prone to infections. Also, a cold that doesn't go away could be a bacterial sinus infection. Some high blood pressure and diabetes medications also cause stuffy noses and postnasal drip. I suggest starting with an ENT and sinus CT scan. Good luck.
Hi,I am a 69 year old female with High Blood Pressure.  I have constant coughing and clearing of my throat for two weeks. I am also expectorating large amounts of thick phlegm from my nose and mouth, and my left nostril moderately bleeds upon the forceful coughing. The bleeding stops when I pinch the top of my nostril for a few minutes. I use a saline nasal spray as needed and, I take Coricidin HBP which is an expectorant and suppressant. It stops the cough for some time but, the expectorant causes me to start coughing again. I feel dripping at the back of my throat.Difficult to sleep through the night.  What can I take to dry up the nasal drip so I can stop this cough?      
Rachel Koelsch, MD:
If you are taking a blood pressure medication called an ACE inhibitor (anything ending in "pril"), then this could be causing your symptoms. If you are taking it, get a different, non-ACE inhibitor medication, from your doctor. If the cough and congestion doesn't go away, then you will need to be evaluated for a different cause. In the mean time, plain antihistamines without decongestants should not raise your blood pressure. Also, saline sinus rinses are safe.
When I get bitten by mosquitoes, the bites swell up quite a bit - to about 2 inches in diameter. I saw an allergist about this, but he said that because the reaction is localized, it's not considered an allergy. It's just a hyperinflammatory nuisance. He prescribed Xyzal and Fluocinonide on an as needed basis. Do you agree with his assessment or do people get allergies to bug bites? Thanks!
Rachel Koelsch, MD:
What you are describing is indeed a local reaction and not considered a true allergic reaction. The good news is that it is not life threatening. The bad news is the only way to prevent the reaction is to avoid getting bitten by mosquitos. The medications he recommended probably will help a litte. People do get true allergic reactions to bee and wasp stings and fire ant stings that can be life threatening. Allergy shots can be helpful in treating this sort of allergic reaction.
is there are an allergy shot that can take away all your allergies?
Rachel Koelsch, MD:
No. Intramuscular injections of steroids were often given to relieve the symptoms of allergies for several weeks to months but it is not good for you to receive these repeatedly. There are desensitization shots for environmental and bee sting allergies but these require a series of injections over months and years.
What is the difference between a skin prick test and a blood  test for allergy?
Rachel Koelsch, MD:
Skin prick test is done on the skin and a blood test requires you to get your blood drawn. Generally speaking, allergists rely on skin testing because it can check for more allergies faster. You get the results in 15 minutes. I have had allergy patients with blood work that shows "no allergies" but their exam and skin testing are consistent with real allergies. So, I rely on skin tests more than blood tests.
I am a 46 yr old female and have recently noticed a stuffiness in my head, mainly behind my nose and in my ears. Can this be allergies?
Rachel Koelsch, MD:
It can be allergies. It could also be a sinus infection or a condition called non-allergic rhinitis.
Can you describe the difference between a sensitivity and a true allergy in terms of symptoms.?  Thank you.
Rachel Koelsch, MD:
A true allergy means you make an allergic antibody to a substance. As soon as you encounter this substance you get a reaction, typically within a few minutes. Hives, swelling, flushing, generalized itching, vomiting, diarrhea, dizziness, loss of consciousness are symptoms of a severe, life threatening allergic reaction called anaphylaxis.
Rachel Koelsch, MD:
Environmental allergies, such as pollen allergies, will cause sneezing, runny nose, watery eyes, itching, etc upon contact with the substance. Again, this is pretty immediated. A sensitivity can manifest in so many ways. For instance, you can get bloating or loose stools hours to a few days after eating something. Or you can get large swelling after a mosquito bite (around the area of the bite).
I woke up this morning and noticed that my palms of my hands are bright red. The backs are not, and they do not burn or itch. Could this be allergy? I have no thyroid.
Rachel Koelsch, MD:
Well, I think you should call your doctor, particularly the one that manages your thyroid condition. Bright red palms that itch can be a symptom of allergy, but usually you would have other symptoms as well.
I am having running and then a blocked nose and itchy throat when I return home from a walk.  I live in Germany and now its spring, early summer with lot of pollen in the air... could that be a reason?? I am a lactating mom... Pls help me!
Rachel Koelsch, MD:
Yes, you definitely could have pollen allergies. Check with a german pharmacist or doctor but cetirizine and loratidine have been approved in pregnancy and are considered OK in breastfeeding too.
3 of my 4 children are severely allergic trees, grasses, and weeds.  It's awful.  They even get hives from grass.  They  take all sorts of otc and prescrip meds during the season and as they've gotten older, have outgrown them somewhat.  How does a person "Outgrow" allergies?  
Rachel Koelsch, MD:
You don't outgrow allergies, but the symptoms will change and fluctuate throughout the years. You might notice the symptoms worsening again in a few years (hopefully not!).
I REALLY like cats, but I'm definitely allergic to them and my allergies flare up every time I go to a cat owner's house. Is a cat allergy lifelong?
Rachel Koelsch, MD:
Yes, cat allergy is generally life long. You could take an antihistamine about one hour before you visit the cats OR consider allergy shots to desensitize you. You should be able to tolerate the cats longer and have a lot less symptoms around them with a course of good immunotherapy (high dose allergy shots given by a board certified allergist).
Is it okay to use flonase permanently? I have been on it for about 3 years now and it has saved my life!! There is no medicine that works for me that doesn't give me horrible side effects.
Rachel Koelsch, MD:
Flonase is a topical medication and is generally safe to use long term. The only side effect you should worry about is irritation of the nasal septum (middle of the nose) which could lead to perforation, or a hole in it. All you need to do is have your nose looked at once or twice a year by the doctor who prescribes your Flonase.