First gasp

Ah, spring. The stark winter landscape has been rolled up and stashed away, replaced by buds and blossoms that transform the world into a riot of color, perfume — and pollen.

For allergy sufferers, that last little element is what turns the glory of spring into a season of sneezes, sniffly noses, itching eyes and all-around general misery.

Estimates suggest that allergies plague more than 50 million people in the United States. Pollen allergy — more commonly known as hay fever — affects about 26 million Americans, or nearly 10 percent of the population (not including those with asthma), according to the Centers for Disease Control.

Just ask Anne Campbell of Swannanoa, whose symptoms used to reach a fever pitch each May.

“The eyes and the throat — I’d want to scratch myself black and blue,” recalls the retired schoolteacher.

Friend Bonnie Tritt, a senior research nurse at Mountain Allergy & Asthma Associates in Asheville, suggested that Campbell should be tested for allergies. A screening showed her to be allergic to a host of allergens, principally grasses, weeds, trees, mold, mildew and dust.

As a child, Campbell was told that she suffered from a lot of colds, but she now thinks her “colds” were probably allergies instead.

Campbell eliminated as much contact as possible with those sneeze-inducers and now takes allergy shots every two weeks.

The result? “I don’t have as much drainage or the nose or down the back of the throat,” Campbell says. “I don’t have that in May where I itch so bad.”

Anatomy of a sniffle

We’ve all seen those hugely magnified photos of ragweed-pollen grains, which resemble giant, prickly golf balls. Who wouldn’t be irritated with those things up your nose?

The actual biological response is a little more complex. An allergy is an abnormal reaction to a very tiny amount of a certain substance, called an allergen, according to Allergy Plants That Cause Sneezing and Wheezing, by Dr. Mary Jelks (World-Wide Publications, 1994).

Most allergic individuals inherit only the capacity to become allergic. And usually, the mucous membranes along the respiratory and intestinal tracts do a good job of keeping out foreign materials. But inflammation caused by infections or air pollution disrupts the membranes, allowing the allergens (foreign proteins) to enter the body intact.

The body’s immune system then manufactures antibodies to fight those particular allergens. And when exposed to those same allergens later on, the immune system stimulates specialized mast cells to produce agents that can counter the invasion. Those agents, in turn, produce the swelling, congestion and what Jelks delicately calls “watery secretions.”

Pollen grains, by the way, are the small male reproductive parts of plants. And it’s the plain plants (such as the lowly ragweed and pigweed) that generally produce the pollen that’s so bothersome to allergy sufferers. That’s because they produce lighter, more buoyant pollen that’s whipped along by the wind. Showy flowers, on the other hand, produce large, heavy pollen that’s transferred to other plants by insects attracted to the plant’s color and nectar.

Pollen paradise

Western North Carolina’s exceptional biodiversity means our region is home to an abundance of pollen-producing plants, according to Connie Wilson, a registered nurse at the Great Smokies Medical Center in Asheville.

“Every tree represents a new opportunity to react,” she notes.

And even if you don’t have a pollen-spewing tree in your back yard, that doesn’t mean you won’t be exposed to pollen from far afield, says Wilson, adding, “Pollen will literally blow for hundreds of miles.”

And each season represents a chance to sneeze over something different. The tree pollens (such as pine and maple) kick in from March through June, followed by the grass pollens throughout the summer months, explains Tritt. Ragweed and other weeds emit their pollen from August right on up to the first frost. (See www.pollen.com for weekly pollen updates by zipcode.)

“People who have allergies suffer from beautiful, lush greenery,” notes Tritt.

Paradoxically, the scientific name of ragweed — one of the most allergenic plants in the country — is ambrosia, known as the “food of the gods” in Greek and Roman mythology. Jelks, however, labors under no such delusions: “It is a plant which is coarse, hairy, has a noxious odor and no pretty flowers,” she intones.

Unfortunately, simply avoiding the usual suspects is no guarantee of relief. Many East Coast allergy-sufferers get the bright idea of relocating to arid desert climes to ease the symptoms. Say, for example, you move to Arizona: You might have one good, allergy-free year. But then you’d probably develop allergies to whatever pollens are out there, such as juniper, Wilson reveals.

And aside from seasonal allergens, there are the year-round ones that are even harder to escape, including dust, dust mites, cockroaches, mold and animal allergens produced by dogs, cats and any other warm-blooded animal, Tritt points out.

“Cats are the worst allergen out there,” she says, mentioning the feline dander, saliva and urine that routinely cause allergic reactions.

And even apart from the discomforts of allergies themselves, the more often one is exposed to an allergen, the greater the odds are that they will develop asthma, notes Tritt.

The counterattack

At Mountain Allergy & Asthma, an allergist performs a skin test to identify what’s causing the allergic reaction. The treatment may begin with a physician prescribing something on the conservative end, such as steroids or antihistamines, says Tritt.

Antihistamines (such as Claritin) reduce the amount of nasal secretions by blocking the histamine response that causes the symptoms. Nasal steroids reduce swelling and mucus production.

“The goal is to get the symptoms under control,” she emphasizes.

If the patient is still miserable, the next step may be immunotherapy, administered via shots, she says. The patient is prescribed a tiny amount of the offending allergen to let her body become desensitized to it.

At the Great Smokies Medical Center, practitioners employ both conventional and alternative treatments.

After conducting a skin-prick test, a physician may recommend an herbal supplement (such as stinging nettle) in the form of capsules or a tincture. They may also suggest a nutritional supplement or homeopathic treatments. In high enough doses, Vitamin C can work as an antihistamine, says Wilson.

Homeopathic treatments follow the principle of “like curing like.” For example, red onion (which can produce red, burning, watery eyes), taken in homeopathic form may be used to treat those same symptoms in allergy sufferers, she notes.

Practitioners may also suggest allergy desensitization. Unlike conventional allergy shots, however, Great Smokies prescribes droplets taken orally to counteract pollen, cat dander, dust and mold.

Environmental protection

Though conventional and alternative treatments may differ, practitioners can agree on one thing: Avoid the thing that makes you sick.

Pollen: Limit outdoor activities when the pollen count is high — usually between 5 and 10 a.m. Run the air conditioning, and keep windows closed at home and in the car. Even though it may be tempting to open a window at night, Wilson advises against it if you have a pollen allergy.

“In this case, it’s cool breezes that will keep your immune system quite challenged all night long,” she notes. Washing your face and hands can also help to keep pollen at bay, she says.

Dust mites: Minimize the use of rugs (wood or tile floors are best); replace or clean the air filters in heating systems regularly; avoid overstuffed or upholstered furniture; use shades instead of venetian blinds; wash stuffed animals; wash bedding and curtains once a week in hot water; use a mite-proof mattress cover (check out www.nationalallergy.com); vacuum your mattress once a month; and buy a new Dacron pillow every couple of years (don’t forget to house it in a mite-free pillowcase).

Since people tend to spend a lot of time in the bedroom, it deserves the most attention.

“I picture the ideal bedroom of an allergic person would be quite Spartan,” says Wilson. (For more tips on creating a dust-free bedroom, check out www.niaid.nih.gov/publications/allergies.htm.)

Pets: If you can’t (or can’t bear to) avoid contact with pets, at least keep them out of the bedroom, advises Tritt. An air filter may be helpful as well. If you start cats early enough, you can accustom them to baths. (Just don’t bathe a kitten at too young an age, since they can be susceptible to colds.) And finally:

Mold: Install exhaust fans in bathrooms and kitchens; use a dehumidifier; don’t store old books in your bedroom.

So, snifflers, take heart. Armed with a few tricks of your own, maybe this year you can take on the pollen-popping display called spring — and come through it breathing easy.

For still more allergy info, check out www.aaaai.org, the Web site for the American Academy of Allergy, Asthma and Immunology.

Free allergy testing

Mountain Allergy & Asthma Associates offers a free allergy evaluation at its Asheville office — including a modified skin test, asthma information and pulmonary function testing — on March 28 and April 4.

The tests involve breathing into a machine and having your skin pricked. To register, call 254-5366, ext. 344 or 345.

Mountain Allergy also participates in research studies, which may be helpful for people who don’t have the money or insurance to pay for allergy care, notes Bonnie Tritt, a senior research nurse at the practice.