Seasonal Allergies
Ah, spring. It does seem to finally be here. Many years it feels like we skip right over spring here in NYC. But when it does happen, it is beautiful - not too hot, not too cold, many blue skies, mixed with many rainy days…which of course produce lovely flowers, budding trees, and lush grass. I especially love the tulips and beautiful cherry blossoms right outside my window along the Park Avenue medians.
But sadly these beauties also bring pollen, and thus allergies. Allergies come from our immune system, specifically immunoglobulin E (IgE) antibodies and mast cells, overreacting to innocuous things like pollen since they are no longer fighting parasites. In my eleven years in practice, it feels like more and more people are reporting allergy symptoms. Is it my imagination?
Tulips of many colors and pink cherry blossom trees line the medians of Park Avenue
Apparently not. According to CDC reports released in 2021 18.9% of children and 25.7% of adults have seasonal allergies. That seems significant, but what was the incidence before? This took me down a rabbit hole into one of my favorite subjects in med school - the history of medicine. Beginning in the latter part of the 19th century improved hygiene, changes in agriculture, and our indoor lifestyle combined to create the seasonal allergies we know today. In 1870 0.2% of the population was estimated to have seasonal allergies. By 1920 that was 2%, and by 1930 seasonal allergies had reached epidemic levels with 13% of the population affected.
T. A. E. Platts-Mills. The Allergy Epidemics: 1870-2010. J Allergy Clin Immunol. 2015 July; 136(1): 3–13
Fast forward to the 21st century, and it appears climate change may be causing allergy symptoms to worsen in severity and last longer. Summer-like weather lingers well into the fall, and buds sprout long before the spring equinox. The frost-free season in the mainland US has lengthened by two weeks since the early 1900s. This gives plants two extra weeks to produce pollen. In addition, with higher carbon dioxide levels in the atmosphere plants don’t have to use as much energy to pull in carbon dioxide for photosynthesis. They instead use that energy to produce more pollen. From 1990 to 2018, pollen counts in the US rose 21%.
Well, Dr. Dilling, this is all very depressing; so now what? First, pay attention to symptoms. Common ones include:
Itchy, watery eyes
Runny nose
Nasal and/or sinus congestion
Sore throat
Cough
Secondly, try environmental control measures (ECM) during the spring pollen season. The general end-date is two weeks after car windshields are no longer yellow.
Take off shoes when you come in (find me a New Yorker who doesn’t do this anyway.)
Change clothes after coming indoors.
Rinse your sinuses at the end of the day. Be sure to use distilled water to create the saline solution.
Wipe dog paws when coming indoors too, and bathe dogs more often.
Vacuum and mop often.
Pay attention to pollen counts.
Mask when outdoors: especially on high count days, or if you plan to be in a park.
Close windows.
Use a HEPA filter.
Avoid flowering plants indoors.
Thirdly, if ECM isn’t sufficient, you may try over-the-counter (OTC) medications like antihistamines, nasal steroid sprays, or allergy-specific eye drops based on your particular symptoms.
If despite all of the above you are still miserable, it may be time to consider immunotherapy. I can refer members to several excellent allergists in the city who offer both subcutaneous and sublingual treatments.
I hope you enjoyed my very first blog post (not counting a travel-on-a-shoestring blog from college). Members of Dr. Dilling Internal Medicine & Pediatrics have access to a newsletter that digs even deeper:
Why some people are affected by allergies and others aren’t
Even more history of allergies in America, and specifically here in NYC:
When were shoes required?
When was the last parasitic worm vanquished?
Where could one go to escape the ragweed?
What did Captain Kangaroo have to do with it? (Are you seeing why I loved this class?)
Symptoms of seasonal allergies that are less obvious
Over-the-counter medications that actually help, with dosing instructions included
Please head over to the Contact Page or give me a call if you’d like to learn more about joining the practice.
