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Wildflowers & ah-choos: Tips from an allergist

Postdoctoral scholar Progga Sen reflects on her love of flowers and talks with physician Chitra Dinakar to learn more about the allergies they can cause.

I love viewing wildflowers, but now I can't look at them without thinking about pollen and allergies. I still recall the disastrous effect of the pollen from the Indian cotton flower tree -- bearing large and bright red flowers -- on a close relative in India a couple of years back, the tree having flowered profusely that year. Her symptoms were aggressive: hives on the mouth, swelling of face, lips and tongue, itchy eyes and throat. The first episode was a nightmare and it subsequently led to her adverse reactions to certain fresh vegetables and fruits, along with grains.

While enjoying the abundance of the beautiful flowers in Northern California this spring, an unbelievably beautiful color palette, I could not help but remember this past incident.

Surely, I thought, this floral abundance is bad news for those who have allergies. Given the floral profusion, I suspected a jump in airborne pollen count.

To learn more, I spoke with Chitra Dinakar, MD, clinical chief of allergy, asthma, and immunodeficiency at Stanford Health Care, and she confirmed my suspicions. "There is an overall increase in airborne allergens attributed to global climate change, which alters plant life-cycle patterns including pollination. Particulate matter in the air and smoke exposure also contribute to worsening allergy symptoms," she said.

Those who receive allergy shots -- which contain a small dose of the allergen, such as pollen -- are getting nearly a "double dose" thanks to the high level of allergens in the air. And allergic asthma, the most common type of asthma, is also aggravated by pollen, Dinakar said. "When pollen count is higher, people become more prone to asthma attacks."

Pollen-mediated allergy (hay fever or allergic rhinitis) occurs when the body mistakenly considers pollen as a harmful invader. It kicks off a full-fledged biological attack, causing certain immune cells to release histamines, among other chemicals. These chemicals, in turn, cause the cascade of physiological symptoms including itchy and watery eyes, runny nose, sneezing, rashes/hives, and even trouble breathing, if the condition gets worse.

I was keen to know about preventive measures. Although difficult to manage when outdoors, Dinakar recommends "avoiding pollen exposure early in the morning and the time when one's symptoms are aggravated." She also suggests keeping doors and windows closed during the triggering pollen seasons, using HEPA filters and installing central air-conditioning rather than window units.

It is difficult to avoid allergens altogether. The key is to know the right course of action, Dinakar said. To that end, "antihistamine sprays, steroid nose sprays and nasal irrigation soothe nasal symptoms, whereas cold compresses and over-the-counter eyedrops effectively reduce eye symptoms. Also, oral histamines can bring much needed relief to many. Importantly, it is prudent to consult an allergy specialist to know about one's sensitivity towards certain allergens, individualized allergy shots and prescribed medications."

Therefore, as much as I'm excited about the flowers, I know I need to exercise precautions to keep the feisty pollen allergies at bay.

Progga Sen is a postdoctoral research fellow in endocrinology, gerontology and metabolism at Stanford Medicine with interests in scientific writing and science education. 

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