I'm Dr. Shuba Iyengar, MD, MPH - Allergist, Physician and Co-Founder and Chief Medical Officer at Allermi. It's Asthma and Allergy Awareness Month and I'm here to answer any questions about your allergies that has got you feeling itchy, stuffy, and uncomfortable all year long.

Proof - https://imgur.com/0tO9ifN

I am an Allergist/Immunologist working in the Bay Area, by San Francisco. After graduating from UC Berkeley, I completed medical school at Duke University, earning my MPH in tandem at the University of North Carolina. After a research fellowship at the National Institutes of Health, I completed my residency at Stanford, then fellowship in allergy-immunology at Stanford and Boston Childrens/Harvard. I cofounded Allermi, a direct-to-consumer Allergy Telehealth platform dedicated to making expert allergy care more accessible . As an allergy sufferer myself and outdoor enthusiast, I realize that nature is not always kind to our immune system. Our team is passionate about helping people suffering from chronic environmental allergies live their best lives possible by developing expert treatments and delivering them right to your door.

EDIT: Thank you to everyone for participating - great questions, comments, and discussions! Make sure you follow us on IG to keep up for future content and AMA's! https://www.instagram.com/getallermi/

Disclaimer: The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Comments: 112 • Responses: 47  • Date: 

jcsf32114 karma

Hi dr iyengar? Im one of your patients? You have improved my life immensely with your treatment? Thank you? Question marks are so my post doesn't get deleted?

allergydoctor6 karma

Thanks so much! Happy Friday! I am so glad that you are doing better. I hope that you have a wonderful weekend!

memoryleaves67 karma

Why does my nose drip all year long?? It can't be allergies if it's literally every day of the year, right? I can't go anywhere without a tissue in my pocket and I feel like an old man lol

allergydoctor12 karma

I am sorry to hear this. You can have symptoms all year round with allergies. Although many people suffer the most symptoms during the spring and summer, when the trees and grasses pollinate, you can also have a dust mite or animal dander allergy. This can cause symptoms year round. Dust mites are little microscopic creatures that like to live in very humid environments, like bedding and other upholstery. They are especially in high concentrations when it is humid outside, like during the rainy season or winter. Using the allergen encasements for the pillow and mattress, and washing bedding in hot water weekly can be hugely effective. This may help with your symptoms if you have this allergy.

littlepastel2 karma

You should try her company Allermi the nasal spray has an ingredient called ipratropium that completely stopped my runny nose

memoryleaves64 karma

I'm actually on it now. First month didn't help with runny nose at all but I'm waiting for my next prescription which they adjusted a little.

allergydoctor3 karma

Please stay in touch and let us know how you do. We want you to do well and can reformulate your spray if needed.

allergydoctor3 karma

Hi. I am glad that you are doing better with your nasal allergies. We have found, as you have, that ipratropium can be very effective for nasal drip/runny nose.

lildobe5 karma

Why does my ProAir RespiClick inhaler seem so much less effective than my Ventolin HFA inhaler?

When I'm having an Asthma attack, the Ventolin seems to act much faster and I get more symptom relief from it than I do with the RespiClick, even though they are both Albuterol.

allergydoctor8 karma

As you know, they are both different formulations of the same medication. However, the Ventolin is an HFA and the RespiClick is a dry powder inhaler. Many people tell me that they do better with the HFA formulations, while others do not notice any significant difference. I would, however, definitely recommend using a spacer with the Ventolin . You can lose significant amounts of medication without a spacer, and you will also probably notice that the medication works much more effectively.

lildobe2 karma

Thank you for your reply! I do use a spacer when I'm having a severe attack (Which, thankfully, these days is rare).

I'm going to ask that my doctor specify the Ventolin next time he writes my refill so I don't have to deal with the RespiClick again

allergydoctor7 karma

Great idea! Have a great weekend.

spiritual_tuning415 karma

I feel like I'm not the only one that's going through this.... but why are my allergies so bad this year? I never had allergies and now it's just come out of no where!

allergydoctor10 karma

I am so sorry that your allergies are so bad this year! You are definitely not alone. Many people (including myself) are having worsening allergies or even new allergies. Studies have demonstrated that climate change and increasing pollution in the environment has contributed to the worsening and increasing allergies that people are having: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9606573/#:~:text=The%20rising%20incidence%20of%20respiratory,and%20climate%20change%20(1)).

The pollen seasons have been shown to be longer and with higher pollen counts in most areas across the country.

MissBearBear5 karma

I recently had a turbinate reduction surgery. It's had such a positive impact on my life! I've heard that the results only last for a few months for some people. Can you recommend any best practices to help prolong this improvement?

allergydoctor8 karma

Some of our patients have had turbinate reductions, and the procedure has really helped them. However, I would consider also seeing an allergist and getting evaluated for possible environmental allergies as well. This is because if you also have environmental allergies, over time, the inside of your nose will start to swell back up again after the procedure (possibly from the pollen exposure). The allergist can help you determine if you have environmental triggers, and what some good long-term strategies might be for you.

littlepastel4 karma

ive been telling everyone I know about allermi - it changed my life and my husband’s? he has SEVERE issues since he was a child and Allermi has been the only thing that works for him (and for me)? 🥲 Is this a common thing, severe nasal problems? And also does it run in families?

Question makrs so I don’t get deleted!?

allergydoctor3 karma

I am really glad that you and your husband are doing better after starting Allermi. My cofounders and medical team at Allermi are really passionate about making expert allergy care accessible to everyone, so it is so wonderful to hear this. I have found in my own practice that the number of people with more severe nasal allergies has increased over time. Also, the tendency to be allergic can be inherited. Here is some additional information about this through the American College of Allergy, Asthma, and Immunology:

https://acaai.org/allergies/allergies-101/who-gets-allergies/

allergydoctor3 karma

I am really glad that you and your husband are doing better after starting Allermi. My cofounders and medical team at Allermi are really passionate about making expert allergy care accessible to everyone, so it is so wonderful to hear this. I have found in my own practice that the number of people with more severe nasal allergies has increased over time. Also, the tendency to be allergic can be inherited. Here is some additional information about this through the American College of Allergy, Asthma, and Immunology:
https://acaai.org/allergies/allergies-101/who-gets-allergies/

littlepastel2 karma

Also — how custom is it really? My husband and I got diff formulas and he got his changed twice but someone else said he and his wife got the same formula?

allergydoctor3 karma

Thanks for the question. All of our physicians carefully review the medical information that you send us. We use this information to determine which medications to put in your nasal spray formula and in what concentrations. There is so much variability in how a given person responds to a particular medication, and so we are diligent about following up to see how you are doing with your individual formula. If there is something that can be further optimized, we will reformulate your ingredients based on your individual symptoms.

Testa_Dura4 karma

Just received and started my Allermi yesterday! I have a constant post nasal drip which leads to excessive throat clearing, anything else I can do in conjunction with Allermi to help relieve this??

deliciousrhinoceros4 karma

I had this it got better after a couple months on Allermi and also they changed my formula a few times to address it better. Also SALINE!! A lot of it

allergydoctor3 karma

So glad that you are doing well! This has definitely been a tough allergy season so far!

allergydoctor4 karma

Great! Hopefully, this will help you with your allergy symptoms. You could also consider using a few rounds of the Salinity Spray before using the Super Spray. You would squirt a few mists of the Salinity Spray, then blow out, and then repeat 1-2 times before using the super spray. This will help rinse out your nasal and sinus passages well, so the the Super Spray can get farther back into your nasal passages.

active_university294 karma

I've tried so many medications, both OTC and prescription. Nothing has really worked for me except Flonase from time to time, but it really depends on the day. Any advice for what else I can try to help get rid of these allergies?

allergydoctor4 karma

I am sorry that most medications have not worked for you. Many people share this same problem. Flonase, as you probably already know, is an OTC anti-inflammatory spray. It works well in some people, but works very slowly, often taking 2 weeks or more to have an effect. In many people, it's not enough. I usually recommend adding on a fast acting allergy medicine spray like azelastine or olopatidine in addition to the anti-inflammatory (you can take the sprays back to back). The combination of a very fast acting nasal spray with a slow acting nasal spray is helpful for most people. I usually try and switch people off of fluticasone, since it can be super irritating for some people. I find triamcinolone or budesonide nasal sprays (with are in the same family) are much less irritating.

MissBearBear4 karma

What are your thoughts on how diet impacts allergies? I've heard that reducing dairy helps chronic allergy sufferers by reducing the amount of dairy produced in the body.

If my allergies are a constant issue, do you think it's time to consider dietary changes?

allergydoctor2 karma

Unfortunately, there are not many studies out there looking at the relationship of how diet impacts allergies. I found one study published some time ago on this topic:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125959/

However, that being said, I have anecdotally found that some people have improvement in their nasal congestion when they decrease the amount of dairy and gluten in their diets.

webbedlifeblood964 karma

i have a question! i've never had ANY food allergies or allergies in general when i was little...until this year! all of a sudden i'm allergic to some fruits and this spring has been so bad with just even stepping outside. any reason why i can develop allergies at an older age?

allergydoctor3 karma

I am sorry to hear this. I wonder if you might have an oral allergy. An oral allergy is when you have pretty significant pollen allergies, and you get "cross-over" reactions where your immune system now starts reacting to fruits and vegetables that "look like" the pollen to your immune system. For people who have this, they often get itchy wherever the fruit/vegetable touches. Usually if the food is cooked or processed, they immune system does not recognize the protein in the same way, and they no longer react. Here is some additional information on oral allergy syndrome:

https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/oral-allergy-syndrome-(oas))

I have found that treating the environmental/nasal allergies for people who have this often helps them tremendously.

TransplantedFern2 karma

I have oral allergies in that my mouth breaks out in blisters with certain fruits and vegetables. So not itchy, just instant painful blisters. Is there anything I can do other than avoid those foods?

allergydoctor7 karma

I have found that treating the environmental/nasal allergies for people who have this often helps them tremendously. Anecdotally, some people do very well after start allergy immunotherapy.

MaliciousMe874 karma

Hi Dr. Iyengar, I started Allermi 3 months ago after seeing an ad on Instagram. It's literally the only thing that has beaten my allergies in Arizona, which make me react like most people do to tear gas. I've gifted it to family members and they've all had the same reaction - total relief.

Okay, I have three questions:

  1. I've read about antihistamine poisoning. My prescription nasal spray from you guys has 3 different medicines listed. Is there a risk of poisoning because there are more medicines in the nasal spray?

  2. Could someone just take Claritin and Zyrtec with similar results?

  3. I don't know how this started, but my family now assumes that any runny nose, watery eyes, or cough are allergies and need an antihistamine, even if the person also clearly has a cold or the flu. My questions are: are all runny noses related to allergies? Are allergies activated by a cold, and therefore solveable by antihistamines? If so, is it dangerous to take antihistamines with cold/flu medicine?

allergydoctor7 karma

Hi. Thanks for your questions. I am really glad to hear that your allergies are better with Allermi.

  1. I am not familiar with antihistamine poisoning, so I cannot comment on that.
  2. In my experience, nasal sprays usually work better for environmental allergies and have less side-effects because they are not absorbed by all parts of the body, like oral anthistamines are. Because nasal sprays go right to where the "action is", or where the symptoms are occurring, they tend to be much more effective.
  3. As you alluded to in your question, not all runny noses are the same. The cause can be different, and can include upper respiratory infections and allergies, depending on the symptoms.

Jetztinberlin3 karma

I have had terrible hayfever for years, and the only thing that really helps me without serious side effects is Goldenseal tincture. Do you know of any background for why it works? Given that it primes the immune system, it's potentially counterintuitive...

allergydoctor8 karma

Goldenseal tincture

Hi. Hope that you are well. Sorry, I am not familiar with this treatment. However, I am glad that you found something that works well for you.

goretooth3 karma

Hello! My allergies have got worse as I've got older and become a more outdoorsy person.. A couple years ago I started taking Fexofenadine and it was night and day vs. the over the counter drugs you could get in the UK, but seems to not quite be as effective as it once was.

  1. What other drugs might you recommend - prescription or otherwise?
  2. Some of my colleagues have got the annual injection and swear by it. What's your thoughts on that being an alternative to dailies?

allergydoctor9 karma

In my experience, nasal sprays usually work better for environmental allergies and have less side-effects because they are not absorbed by all parts of the body, like oral antihistamines are. Because nasal sprays go right to where the "action is", or where the symptoms are occurring, they tend to be much more effective. Most of my patients are able to wean off of oral allergy medications once we find the right nasal spray formula that works for them.

Regarding the injections, the injections that we usually recommend are allergy immunotherapy, or allergy shots. These, however, are multiple shots that are administered over the course of several years. The once a year shot that you are referring to might be an injectable steroid, which can be riddled with side-effects and can be quite harmful in some people. We usually do not recommend this course of treatment.

Wendy07273 karma

My son has season allergies and also a severe allergy to peanuts. Last lab check in 2021 had peanuts around 40. Tree nuts are less than 5. He’s never had skin testing, only labs with one oral reaction at 11mo. Is there any way to desensitize to peanuts? I’m pretty sure his throat was closing. I see this new patch out but don’t know much about it. Thank you. :)

allergydoctor11 karma

I would recommend that you discuss with his allergist the best treatment options for him, since I am not his allergist and am not privy to the specific details of his case. If you have not already discussed oral immunotherapy (OIT) with his allergist, you can consider doing that. Here is some additional information on OIT:

https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/the-current-state-of-oral-immunotherapy

Shrinker113 karma

An ENT told me to get turbinate surgery bc I’d never be able to avoid everything I’m allergic to (pretty much all trees, dust, some weeds, cats/dogs, etc). My allergist said I should get immunotherapy shots. Which is the more long term solution? I don’t want to go through the expense and time of either one, only to have to do something else 10 years later.

allergydoctor8 karma

I can only make general comments, since I am not privy to the particulars of your case. However, I have found that, in the right person, allergy shots, or allergy immunotherapy, can be very helpful in the long-term. I use skin testing to help determine what the probability is that allergy shots will be helpful for a particular individual. Here is additional information on allergy immunotherapy, in case it is helpful for you:

https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-shots-(immunotherapy)#:~:text=Allergen%20immunotherapy%2C%20also%20known%20as,allergy#:~:text=Allergen%20immunotherapy%2C%20also%20known%20as,allergy))%20or%20stinging%20insect%20allergy.

Ok-Feedback56043 karma

Do sprinting affect asthmatic breathing badly?

allergydoctor2 karma

This is a difficult question to answer, since there are so many variables that play into exercise tolerance and asthma. That being said, cold air and exercise can trigger wheezing symptoms in susceptible people.

Ok-Feedback56043 karma

Besides inhaler are there any other ways to improve breathing in asthma?

allergydoctor2 karma

Thanks for your question. The mainstay of treatment in people with asthma are inhalers. However, many people with asthma are also seen and evaluated by allergists to see if environmental allergies could also be contributing to their symptoms.

TheGiantKorean3 karma

Why is it that I can feel out of breath but still seemingly able to take full breaths? Is this my asthma or something else?

allergydoctor7 karma

I would recommend seeing a pulmonology specialist or allergy specialist so that they can examine you and help determine what could be contributing to your symptoms.

TheGiantKorean3 karma

As an adult I have multiple food allergies and seem to continue getting more. Is there anything I am doing that might be causing this, or something I can do stop it?

allergydoctor4 karma

There are different reactions to foods, which include immediate anaphylactic reactions as well as late reactions (including intolerance type symptoms). I would recommend checking in with your primary doctor to see which type of specialist (an allergy specialist or GI specialist) would be best to address your particular symptoms.

TheGiantKorean2 karma

Thanks. Already seeing an allergist and a gastro. I've had IgE tests and skin prick tests done that confirm they're allergies (I know that neither test is 100% accurate, but the findings seem to line up with my symptoms). My allergist just says that he's not sure and that it's just how I am. My gastro just asks me to ask my allergist.

allergydoctor7 karma

That is good that you have both specialists involved. Hopefully, both can communicate with one another to help with the complexities of your case.

designfellowSOH3 karma

Why am I allergic to some cats and not to others? lol

allergydoctor7 karma

That's a really difficult question to answer. It could depend on the breed of the cat, the dander, where the cat is coming in contact with you (sleeping on your bed), etc. Whether or not you are having ongoing nasal allergy symptoms prior to coming into contact with the cat can also effect your reaction.

smallio3 karma

Why is my Vagus Nerve so much more sensitized than anyone else I know?

For example, I'll get a weird nauseated feeling, then sneeze, then the nausea immediately goes away. I seem to be the only person I know that has this, as no one else seems to get what I'm experiencing.

allergydoctor8 karma

I am sorry to hear this. I would definitely recommend seeing an allergy specialist and also ENT specialist in clinic if you have not already done so.

pscrilla3 karma

Hello Dr! I have had a cough with phlegm in the mornings for the last 6 months, sometimes pretty severely. I had done a bunch of tests and everything seems normal. My doc wanted me to try zirtec for 30 days to see if it would help, and it didn’t. Next step is going to an allergy doc. Any idea what this could be?

allergydoctor7 karma

You should definitely discuss with the allergist what the best evaluation and course of treatment should be for you. In general, I have found that a persistent cough in the morning can oftentimes be associated with a dust mite allergy. Dust mites are little microscopic creatures that like to live in very humid environments, like bedding and other upholstery. They are especially in high concentrations when it is humid outside, like during the rainy season or winter. Using the allergen encasements for the pillow and mattress, and washing bedding in hot water weekly can be hugely effective. This may help with your symptoms if you have this allergy. Also, I have found that a regimen of nasal sprays usually works better than oral antihistamines.

Remarkable_Pie_13532 karma

Is there research evidence that using a neti pot to rinse sinuses is effective in reducing cold or allergy symptoms?

allergydoctor7 karma

Is there research evidence that using a neti pot to rinse sinuses is effective in reducing cold or allergy symptoms?

Here is an article through the FDA regarding the safety of neti pots, in case you want to check this out: https://www.fda.gov/consumers/consumer-updates/rinsing-your-sinuses-neti-pots-safe.

In my practice, I have found the use of neti pots and saline rinses to be effective in helping people with sinus congestion. They help loosen up the mucus so that the mucus stuck in the sinus cavities can come out through the nose instead of back-dripping into the throat.

However, if the nose is very swollen on the inside, the saline rinses and neti pot often do not help decrease the swelling on the inside of the nose ( a common symptom in nasal allergies). I usually recommend doing a saline rinse or neti pot first, and then using a combination of an allergy medicine nasal spray (like azelastine or olopatidine) followed by an anti-inflammatory spray (like triamcinolone). This combination tends to work well in most people.

deliciousrhinoceros2 karma

Why did you start a company? I feel like not many doctors go that route

allergydoctor11 karma

Thanks for asking. My cofounders and I really wanted to make expert allergy care accessible to everyone. There are many parts of the country where there are shortages of specialists, like allergists. We hope that we can make a significant impact in this realm.

whiteboxpc2 karma

I had 2 ENT’s state to immediately stop Afrin and it should never be taken daily, let alone multiple times a day. They said they don’t understand how it remains an OTC medication as it shrinks the turbinates and patients get rebound swelling in as little as 3-5 days. This leads to an addiction because it creates a bigger problem as you need to use it more often and frequently for it to keep working.

I am curious how you justify using Afrin in your ‘SuperSpray’ and what studies you can link that may counter what both my ENT’s have told me?

allergydoctor2 karma

Allermi contains a prescription-only micro-dose of oxymetazoline that is a fraction the dosage of what is in over-the-counter oxymetazoline products such as Afrin. At this tiny dosage, oxymetazoline gently decreases the size of capillaries in the nose, relieving the feeling of congestion and allowing the other medications in your formula better access to the deep reaches of the nasal passages - without the rebound symptoms. We also combine that micro-dose of oxymetazoline with anti-inflammatory medications in the same formula, which even further reduces the risk of rebound. With these two customizations, rebound congestion is not something we see in the 30 years our allergists have been prescribing Allermi formulas. If you'd like to review the data behind these conclusions, you can do so here:

https://www.allermi.com/pages/scientific-index

.

Lemonio2 karma

Are there any actually useful tests for food sensitivities as opposed to food allergies?

allergydoctor1 karma

Great question. I have not found any useful tests for late reactions to food that have been thoroughly backed by literature. That being said, I have referred quite a few of my patients to see the Gastroenterology specialist for a well-rounded evaluation, and this has been helpful.

Sensitive_Ad84922 karma

I’ve been using Allermi for a few weeks with good results. Are there any concerns with long term use of oxymetazoline?

allergydoctor3 karma

Hi there, thanks for your question! Allermi contains a prescription-only micro-dose of oxymetazoline that is a fraction the dosage of what is in over-the-counter oxymetazoline products such as Afrin. At this tiny dosage, oxymetazoline gently decreases the size of capillaries in the nose, relieving the feeling of congestion and allowing the other medications in your formula better access to the deep reaches of the nasal passages - without the rebound symptoms. We also combine that micro-dose of oxymetazoline with anti-inflammatory medications in the same formula, which even further reduces the risk of rebound. With these two customizations, rebound congestion is not something we see in the 30 years our allergists have been prescribing Allermi formulas. If you'd like to review the data behind these conclusions, you can do so here: https://www.allermi.com/pages/scientific-index.

BlueCenter772 karma

Hi Dr. Iyengar, my wife has allergies and terrible post nasal drip that causes her to vomit and dry heave almost every day. OTC and prescription nasal sprays and meds don't work for her. Is there anything we can do to mitigate this?

allergydoctor9 karma

I am so sorry for your poor wife. I am not sure what she has tried already, but I have found in my own practice that a combination of nasal sprays or a compounded nasal spray (like the Allermi Super Spray) can be very beneficial to people who have significant post nasal drip symptoms. Also, if you have access to an allergy specialist, seeing one and getting allergy testing might also be helpful for her.

chiknnguyen2 karma

why can’t our bodies adapt to allergens, and do you think in the future gene therapy or another form of therapy can be used to permanetly cure one’s allergies?

allergydoctor3 karma

The answer to your question is rather complicated and has to do with immune tolerance and desensitization, or the ability of the immune system to, over time, not react to an allergen it has reacted to in the past. This is essentially the basis behind allergy immunotherapy, or allergy shots, which has been used for over 100 years. If you are curious about the mechanisms behind allergy immunotherapy, here is an article that you might find interesting: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430874/

I hope this is helpful for you.

Particular_Ad_59012 karma

I’ve never had allergies in my life! This is the first time ever. Is this common for someone in their late 20s?

allergydoctor6 karma

Hi! I am sorry that you are developing new allergies. We have been seeing more and more people develop allergies as adults. The good news is that there are multiple different treatment modalities available to help you. Hopefully you will feel better soon!

Indian_Doctor2 karma

How many times did you figure out the exact allergen?

What was your most funny interaction?

allergydoctor1 karma

When available, skin testing to environmental allergens is helpful to guide long-term treatment of pollen and environmental allergies. Here is some additional information on skin testing through the AAAAI:

https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-testing

However, we are able to successfully treat nasal allergies in the short term without immediate testing. I have found that the most effective and safe treatment options involve a combination of nasal sprays.

trashpr1nc3ss2 karma

Hi Dr Iyengar, I have had mild food and environmental allergies my entire life? After a period of taking the costco brand Zyrtec for about 6 months, I quit it and I feel that my environmental allergies and congestion are almost worse than they were before? I have read about antihistamine “addiction” before, do you think this could be the cause and what can I do to remedy this? It has been about a year since quitting and while my symptoms have eased at times, they have not gone away?

Sorry for the question marks lol?

allergydoctor1 karma

I am sorry to hear this. I have found that the most effective and safe treatment options involve a combination of nasal sprays. The oral antihistamines tend to make one feel " less itchy" but are not aimed at the root of the problem, which is the nose. The also are generally associated with more side-effects than nasal sprays because they are systemically absorbed.

Here is more information about the different types of nasal sprays through the AAAAI:

https://www.aaaai.org/tools-for-the-public/drug-guide/nasal-sprays

And through our educational content on the Allermi website:

https://www.allermi.com/blogs/allergy-101/why-are-nasal-sprays-better-than-oral-antihistamines

staskamaev2 karma

What types of allergies are most common?

allergydoctor1 karma

Thanks for the question. There are many different types of allergies. Some people are allergic to dust, pet dander, pollen or mold. Others are allergic to latex, or certain drugs or insect stings. In case there is a particular trigger that you wanted to learn more about, here is a great resource through the AAAAI:

https://www.aaaai.org/conditions-treatments/allergies

doublehappi9192 karma

Dr iyengar, thank you for the AMA. May I know why you built allermi ? What’s the problem you are looking to solve ? Is it to make allergy medication accessible to people who cannot afford it ? Or to people who have not heard of it or to people who are unable to find quality care near them ? I am an aspiring digital health entrepreneur myself and I struggle with some of my assumptions myself.

allergydoctor2 karma

My cofounders and medical team at Allermi are really passionate about making expert allergy care accessible to everyone, There are many places throughout the country where it is extremely difficult to get an appointment with an allergist. In addition, the wait time is several months. Also, the cost of insurance and copays make healthcare affordable to some and not many. Most of our Allermi team, myself included, suffer from severe allergies. We truly understand how the chronic nasal congestion, sneezing, sinus symptoms, sleep problems can drastically effect your ability to take care of yourself and the people most important to you. We want to help you live your best life. That is what motivates us to do what we do.

atheyism2 karma

is immunotheraphy available for all sorts of allergies? I react heavily on antihistamines and my nose clogs up every time I go to bed. I clean the sheets more often and have an anti-allergic mattrass and sheets. I also open the windows evey night. what else can I do?

allergydoctor1 karma

I am sorry that you are having such significant symptoms. I have found that the most effective and safe treatment options involve a combination of nasal sprays. If you have not already tried a regimen of nasal sprays, I would recommend that as a possible next step. Also, nature is not kind to the immune system of many people with allergies. I would not recommend opening your bedroom window, and having all that outdoor pollen get all over your bedsheets. This will contribute to more persistent symptoms. I have found that sometimes just shutting the bedroom window and running an air purifier can often cut the medication use by over 50%.

GoodGoodGoody1 karma

Allergy serum. How sensitive is it to warm (room) temperatures vs fridge?

Even refrigerated, I’ve been told it’s essentially water by it’s 1 year expiry.

allergydoctor2 karma

The allergy extracts used for allergy immunotherapy are kept at a cool, constant temperature in the clinic fridges. They generally last about a year after mixing. The consensus recommendations on allergy immunotherapy are that they should be administered in the safety of an allergist's office or other clinic under the supervision of a qualified medical doctor. Here is additional information:

https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-shots-(immunotherapy))

https://www.jacionline.org/article/S0091-6749(09)01975-7/fulltext01975-7/fulltext)

deliciousrhinoceros1 karma

Why does it seem like allergies are only a thing in the USA and not in other countries?? Like as widespread? I feel like everyone here has allergies and abroad it’s more rare?

Jetztinberlin6 karma

Eh, I moved from NYC to Berlin (Germany) and plenty of people have them here! Interestingly, my East Coast hayfever disappeared when I moved here, and then my symptoms gradually returned as my system figured out the new territory 🙃

allergydoctor7 karma

Yes. It's called a honeymoon period and usually lasts about 2-5 years. You initially feel better when you move to a new place (with different pollens) and then start to get sensitized and develop new allergies over time.

allergydoctor4 karma

Great observation. There have been studies that have demonstrated that allergies are more prevalent in more urbanized, or industrialized countries:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9606573/#:~:text=The%20rising%20incidence%20of%20respiratory,and%20climate%20change%20(1)).

https://www.aaaai.org/About/News/For-Media/Allergy-Statistics

littlepastel1 karma

the rate of peanut allergy is really low in israel because they have a popular snack called bamba that babies suck on from an early age when teething - what do you think of this and why don’t we do that in the US to prevent allergies? also is there a way to do this to prevent environmental allergies not just peanut?

allergydoctor7 karma

Great question. There are some landmark studies looking at the rate of peanut allergy in Israel and the relationship with the bamba snack done by researcher Gideon Lack. Here is a link to the summary in the journal Nature: https://www.nature.com/articles/d41586-020-02782-8

and through the NIH:

https://pubmed.ncbi.nlm.nih.gov/19000582/

Regarding prevention, there are multiple studies also supporting that sensitization to allergens can also occur through the skin:

https://onlinelibrary.wiley.com/doi/full/10.1111/all.14304

I often recommend the use of really good creams routinely after baths to help possibly prevent sensitization through the skin. I do this for myself and my twin boys as well!