Allergies, a cold, or something more? Sorting out the symptoms and treatments with Dr. Farah Kahn, immunologist and allergist at Nationwide Children’s Hospital and a spokesperson for the American College of Allergy, Asthma, and Immunology.
Helping Your Kids Survive Fall Allergy Season
Andy Meyers, CEO, HealthDay
So today we are excited to be joined by Dr. Farah Khan.
Dr. Khan is an allergist and immunologist at Nationwide Children's Hospital and a spokesperson for the American College of Allergy, Asthma, and Immunology.
Thank you so much for joining us.
Farah Khan, MD, Spokesperson, American College of Allergy, Asthma, and Immunology, , Nationwide Children’s Hospital
Thanks for having me.
Andy Meyers, CEO, HealthDay
So here we are, it's kind of the fall. Fall is one of the two big allergy seasons, but it's also back to school, right? So, it's obviously a tense time for parents.
A lot of people have young kids, you know, and they see the runny nose and the sniffles and it's like, is this allergy, seasonal allergies? Is this a cold? How do they know? What advice can you give for parents in that kind of situation?
Farah Khan, MD, Spokesperson, American College of Allergy, Asthma, and Immunology, , Nationwide Children’s Hospital
So, one, it is very confusing because you're like, what's happening? Do I reach for the oral antihistamine like cetirizine or loratadine? Or is this like viral crud that my kid has picked up from daycare or school? There are some distinguishing features.
One thing that I'll say, the easiest thing that you can look for, if there's a low-grade temperature or any fevers, it's probably not seasonal and environmental allergies. They don't cause fevers generally.
The other thing is that seasonal and environmental allergies typically sort of come up over time and you end up seeing a pattern. So, it's, “You know, last year we had the same issues as we were cooling back down or you know what, last spring we had the same thing with lots of itching and sneezing and congestion,” and viral illnesses really tend to be a little bit more limited and they can sort of pop up whenever.
So, chronicity of symptoms and sort of the overall pattern can be really helpful.
And the other thing is sometimes you just have a runny nose and you're like, I don't know where this is coming from.
And sometimes you do reach for the over-the-counter stuff, including things like the antihistamines just to see if it works. And if it's not working, it's probably not environmental allergies. So even though the symptoms look and feel the same from a viral illness or an environmental allergy, if it's the runny nose from a viral illness, the antihistamines aren't going to do anything.
Andy Meyers, CEO, HealthDay
And on that topic, what are your kind of go-to medications and approaches?
Farah Khan, MD, Spokesperson, American College of Allergy, Asthma, and Immunology, , Nationwide Children’s Hospital
Yeah, so I'm biased, but I'm going to say come talk to an allergist because sometimes just identifying the triggers can help you figure out what am I dealing with and how am I going to approach this?
Like if you have a ragweed pollen allergy and ragweed is very high in the fall time as we're sort of going back into in the school year, it can just be really helpful to figure out like are there some simple avoidance measures that I can put into place that don't even have anything to do with medicines like showering after I'm done being outside, keeping the windows closed at home or when I'm driving around.
Just those small things sometimes can limit the amount of pollen burden that you're seeing to help minimize and reduce symptoms.
And then some of the stuff that I really, really like is just some good old nasal saline, whether it's a little nasal saline spray that we use for young kids and then helping them to blow their nose.
If it's a really young toddler who's not really able to blow their nose and getting like a bulb suction, if they'll tolerate it, just to get all that mucus out otherwise it just sits in their nose.
And if it's an older kiddo or an adult, then like a good sinus wash.
So. all the videos that you see with all this stuff coming out, it's satisfying because it literally is to clear the mucus and congestion and it's sort of a natural remedy as well. There's no medicine in it.
So, I do appreciate the nasal rinses and washes and then for environmental allergies, can use some nasal steroids as well, and then some antihistamines, obviously. You can use some eye drops and things like that, too.
The one thing that I will say is as an allergist, I don't like old antihistamines and the old antihistamine that is available over the counter is a diphenhydramine and it's just, it's not great.
Andy Meyers, CEO, HealthDay
Switch topic a little bit to food allergies because that's certainly another back-to-school stressor that people talk about. I'm curious if you can just clarify a little bit the difference between food intolerance and allergy.
Farah Khan, MD, Spokesperson, American College of Allergy, Asthma, and Immunology, , Nationwide Children’s Hospital
Yes, so a food allergy is mediated by a very specific cellular immune response. So, there's a very specific antibody that's involved with very specific targets on things called mast cells, these allergy mast cells that release their contents and then cause the symptoms that we hear about in the news after a peanut or an egg allergy reaction or something like that with the lip and tongue swelling, the trouble breathing, the hives, the vomiting.
Food intolerances sometimes can be really frustrating, both for us as providers and patients navigating them, because you are obviously having symptoms… like if you sit down and eat a giant bowl of mac and cheese and you're like, man, it's either the dairy or the gluten or something like that that's leading to the abdominal discomfort and the constipation and bloating, your symptoms are still very, very real. It's just frustrating for us even because there's no objective validated testing to do to it.
Andy Meyers, CEO, HealthDay
So, do you think parents should be rushing out and testing?
Farah Khan, MD, Spokesperson, American College of Allergy, Asthma, and Immunology, , Nationwide Children’s Hospital
So, the way that I approached testing for any reason and the way that I practice is if you have had symptoms that are concerning, then yeah, let's try to figure it out. Unfortunately, like I said, with the food intolerance, there's no validated testing. And the food sensitivity tests that are a few hundred or several hundred dollars that are marketed, unfortunately, to patients and families that are trying to figure out what to do with these symptoms, they don't really give you the information that their marketing suggests or claims.
I've never ordered them and I never recommend them.
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