Fall Allergy Questions Answered by Carah Santos, MD, Allergist at National Jewish Health

Dr. Carah Santos, allergy and immunology doctor at National Jewish Health answers questions including: What allergy symptoms do we experience in the transition from summer to fall? What time of day is the pollen count highest? What medications are recommended for fall allergies?


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Alyssa Paschke: Good afternoon and welcome to our September Facebook live broadcast. My name is Alyssa Paschke and today I'm joined by Dr. Carah Santos. She's an allergist and immunologist here at National Jewish Health. As the season transitions from summer to fall, a lot of us will experience allergy symptoms. Today, we're gonna discuss that a little bit further and talk about ways that you can stay well during this time of year. If you have questions, feel free to type in a comment and if you'd like to share this video, feel free to do so as well. To get started, Dr. Santos, could you describe why the fall season can be triggering for some people's allergies?

Dr. Santos: Yeah. Absolutely. You know, when a lot of people think about seasonal allergies, the first thing that comes to mind is spring allergies.

Alyssa Paschke: Right.

Dr. Santos: We often call that hay fever. What a lot of people don't ... sometimes underestimate or don't realize is that the fall season can also be a major time of year that our allergies are bad.

Alyssa Paschke: Mm-hmm (affirmative).

Dr. Santos: The two biggest categories of things that we're allergic to in the fall are weed pollens and mold. When it comes to weed pollens, one of the most prevalent ones is ragweed. There's also some other ones like sage brush that are privy ... pretty prevalent in the area. You can find weeds growing anywhere from the side of the road or the highway-

Alyssa Paschke: Sure.

Dr. Santos: Or even in your back yard. When the weeds pollinate, the wind carries their pollen out to the air. Even if there's not a lot of weeds where you live or near your home, weed pollen from hundreds of miles away can blow into wherever you are and cause a lot of the nasal symptoms and eye symptoms that are so bothersome.

Alyssa Paschke: Wow.

Dr. Santos: Yeah. When it comes to mold, we often think about mold as existing year round, indoors and outdoors. Particularly for the outdoor molds, fall is a really bad time of year, just because the weather is getting more cool and damp. We start to worry about mold allergy wherever we have decaying, fallen leaves on the ground, leaves in your gutter, and also areas like pumpkin patches and corn mazes and hayrides we often like to visit during the fall months.

Alyssa Paschke: Yeah. Absolutely. I definitely think the hay and the dust-

Dr. Santos: Yeah.

Alyssa Paschke: And everything kicks up during that time. To describe the pollen, specifically, what time of day or is there a certain time of day that the pollen counts are higher than others?

Dr. Santos: There sure is. When it comes to weed pollen, mid morning to mid afternoon tends to be when the pollen count is highest.

Alyssa Paschke: Okay.

Dr. Santos: Pollen counts can also vary day to day. There are a lot of local newspapers, local websites that can tell you what the pollen count is for the day. You can sort of adjust the times that you're gonna be leaving the house around that time.

Alyssa Paschke: Okay. That definitely makes sense. For people that do suffer from fall allergies, what are some of the treatments or medications that you might recommend for people to maybe start taking early or when they're experiencing symptoms, that sort of thing?

Dr. Santos: Yeah. When it comes to environmental allergies, the first thing that I always tell my patients is we have to undertake avoidance measures-

Alyssa Paschke: Okay.

Dr. Santos: In addition to thinking about medications. When it comes to weed pollen or any pollen allergy, the best way to try to avoid it is to prevent all of that outdoor pollen from coming inside. Some ways to get around that is first, trying to avoid being outside when the pollen count is highest, which, as we mentioned, is mid morning to mid afternoon.

Alyssa Paschke: Okay.

Dr. Santos: If you are gonna be outside during times of high pollen counts, right when you get home, changing out of your clothes and immediately showering because all of those microscopic pollens can get stuck in your hair and on your skin-

Alyssa Paschke: Yeah.

Dr. Santos: And on your clothes. We really wanna make sure we change pretty quickly.

Alyssa Paschke: Okay.

Dr. Santos: Trying to keep your windows closed in your car and in your home, particularly during that time of day when the pollen count is highest, can help prevent all that pollen from coming into the home. If you let ... hang your clothes out to dry on a clothes line, trying to avoid doing that just because
all of that pollen can get trapped right in the clothes.

Alyssa Paschke: Sure.

Dr. Santos: Even though some people may or may not also be allergic to cats and dogs or their furry pets at home, it's important to know that those animals, when they go outside and come back inside, can track a lot of those pollens indoors. When it comes to mold allergy, it's really avoiding a lot of those damp areas in the home, such as places where there's been a leak or water damage. When it comes to the outdoor molds, trying to avoid those piles of dead leaves, trying to avoid areas of the pumpkin patch where the pumpkins might be decaying,
for example.

Alyssa Paschke: Okay.

Dr. Santos: If you are going to be the one raking the leaves or blowing the leaves, trying to wear a mask to try to prevent inhalation of all those mold spores can be quite effective too.

Alyssa Paschke: Yeah. That definitely makes sense 'cause I know some people can't avoid the fall yard work, but may wanna prevent their allergies.

Dr. Santos: Exactly.

Alyssa Paschke: I just wanted to pause for a second, see if we have any questions that have come in from the audience.

Speaker 3: Yes. We have a question from Samantha. She asks, "Is it better to get healthy, fresh air in my house or stay sealed up and block out the allergens?"

Dr. Santos: Thanks for that question, Samantha. That's a great question. As we mentioned, all of those pollens can definitely fly into the home if we keep our windows open. In that situation, it is recommended that we keep those windows closed and keep the house as sealed up as we can to prevent pollens and mold spores from outside from coming inside.

Speaker 3: Okay. We have another question from [Arina 00:05:25]. "Can allergies be completely treated?"

Dr. Santos: Thanks, Arina, for that question. Yes, absolutely. I think that's something that we were gonna talk about next, too. In addition to those avoidance measures, there are several medications that can be very, very
effective yet still safe for treating allergies. A lot of these medications are available over the counter. It's always important that you talk to your primary care provider or a specialist before deciding which medications to take. Some of the common categories of medications, the first are oral anti-histamines, cetirizine and loratadine are some names that you might see on the shelves. Taking that medication once a day as needed can really help prevent and treat a lot of the nasal sniffles, the drainage, the sneezing involved with allergies. Another category of medications that's very effective are intra nasal steroids,=like fluticasone, a very common one that you see on the shelves now. That type of a nasal spray, when taken every day, is really effective to treat and prevent
nasal congestion and mucous production and can also help your eye symptoms, too.

Alyssa Paschke: Awesome. With those medications, is there a time of day that you recommend taking those? Is it morning or night that's most effective?

Dr. Santos: For most of them, it really doesn't matter.

Alyssa Paschke: Okay.

Dr. Santos: Whatever time is most convenient for you to remember to take it-

Alyssa Paschke: Yeah.

Dr. Santos: And for certain medications, like the nasal steroid sprays, they have to be taken every single day in order for them to be effective.

Alyssa Paschke: Okay.

Dr. Santos: As long as we're taking it at a time of day that we can remember, that's really the best way to do it.

Alyssa Paschke: Great. That seems easy enough. Do you have advice for anybody out there that has fall allergy symptoms and then also might have a respiratory condition like asthma?

Dr. Santos: Yeah, so often times allergies and asthma go hand in hand. Many of our patients who have those seasonal allergies also suffer from asthma. In those asthmatic patients, a lot of those same triggers that cause their nose and eye symptoms can also make their asthma worse. Really making sure that we are doing all of those avoidance measures this time of year with the weed pollen and the mold and also making sure that you're up to date with all of your inhalers or whatever other prescription that your doctor has recommended for your asthma, making sure that your rescue inhalers are available at all times, just in case you're out on a run on a windy day and your allergy symptoms and asthma symptoms
start to get worse.

Alyssa Paschke: Absolutely. Okay. Well, I just wanted to pause and see if there's any other questions that have come in.

Speaker 3: Yes. There's a new question from [Bev 00:07:51]. "Do children outgrow out of allergy-induced asthma?"

Dr. Santos: Hi, Bev. That's a great question. It's hard to tell. I think it's most important that we are following these children regularly over time. Asthma severity can certainly change over time. Some kids may get better. Some may get worse. Some may stay the same. Often times, even when you change in severity
once, you may change again. There are some children, absolutely, that may eventually seemingly outgrow their symptoms, but a lot of the kids, of course, that we see, may still have some type of asthma symptoms as we go along. I will say that those asthmatic children that also have allergies are more likely to have more lifelong symptoms.

Alyssa Paschke: That definitely makes sense. Any other comments? Okay. I think that we wanna wrap it up. Thank you so much for speaking with us today. I hope everyone watching got some helpful tips and information. If you'd like to receive more information from National Jewish Health, feel free to follow us on our social media channels and visit our website at www.njhealth.org to sign up for our monthly health newsletter.

Speaker 4: You know what? We just got a couple more questions-

Dr. Santos: Oh, great.

Speaker 4: If we have a little bit more time.

Alyssa Paschke: Oh, yeah. I think we do have a little bit more time. No problem.

Speaker 3: Okay. Here's a question from Matt. "Are there preemptive measures we can take with allergy-induced asthma and hay fever?"

Dr. Santos: Yeah. Matt, thanks for the question. I think a lot of that has to do with some of the avoidance measures that we talked about earlier, trying to avoid being outside during mid morning to mid afternoon when pollen counts can be at their highest, trying to keep the windows closed when you're hanging out in the home. If you do have allergen-induced asthma, especially when you're outdoors, making sure you have quick access to your rescue inhaler in case you develop sudden asthma symptoms due to your allergies.

Speaker 3: Here's a question from [Doris 00:09:45]. "Is there a way to introduce peanuts and other foods to young children to minimize their reactions?"

Dr. Santos: Hi, Doris. Thanks for the question. Yeah. Food allergy in younger children is definitely a topic that we treat frequently and discuss frequently. We definitely know that introduction of peanuts when children are young, anywhere from six to 12 months, could potentially prevent the development of food allergies as they get older. We have a lot of good evidence that shows that. Early introduction is great. If you've got any other further questions on food allergy, please feel free to make an appointment with us and we'd be happy to discuss further and potentially do some testing.

Speaker 3: She has a ... Doris has a follow up question. "Do you see more
incidents of allergies?"

Dr. Santos: In general? It really depends on the region. For example, for patients that have specific allergy to dust mites, we don't have a lot of dust mites here in Colorado fortunately, because the air is so dry. If you have dust mite allergy and suddenly move to somewhere more humid like Florida, you may have more symptoms. The incidents really depends on your family history and whether you have parents or grandparents or siblings who also have allergies, and potentially also where you live and what kind of triggers you're surrounded by.

Speaker 3: We have another question from Arina. She has a daughter who's eight years old and that's been struggling with allergies most of her life. "Is there a change she ... Is there a chance she can outgrow it?"

Dr. Santos: Hi, Arina. That's a great question. There is a possibility. Sometimes our allergies just get better over time. Unfortunately, there isn't really a good way for us to predict what kind of symptoms you'll have in five, ten, or fifteen years. It's just important that, while we're still having symptoms, that we undertake those avoidance measures and take those medications. It's always helpful to see an allergist if you have any question on what it is in the environment or the air that you might be allergic to. We can get a better history from you and potentially consider doing something called allergy skin testing, which can help us confirm what it is you're allergic to and we can further, then, tell you ways to avoid those allergens and recommend the right medications for you.

Alyssa Paschke: Awesome. Well I think, again, with some of the questions, feel free to visit our website www.njhealth.org. We have a lot of health resources for allergies, including seasonal and food allergies, as well as ways that you can contact a nurse, make an appointment, and contact us for more information in general. Thank you all for watching and for your questions. We appreciate it. I hope everybody has a great rest of their day.

Dr. Santos: Thanks for tuning in.

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