Climate Change Has Made Allergy Season Worse. How Do We Cope?

IRA FLATOW: This is Science Friday. I’m Ira Flatow with Flora Lichtman. Spring has sprung in many parts of the country. Those first buds bursting, flowers opening. They’re all welcome signs of the season, right.

FLORA LICHTMAN: Absolutely.

IRA FLATOW: Well, not if you– listen to my voice, Flora. Not if you have allergies. I can tell you, it’s the endless sneezing, the watery eyes, the runny noses. You get the picture. You can hear it.

FLORA LICHTMAN: I can hear it. I can hear it. Yeah.

IRA FLATOW: Well, if misery loves company, you’re not alone. Because according to the CDC, 1/4 of US adults deal with seasonal allergies. And if you think they’re getting worse, it’s not just in your stuffed head. Because climate change does play a big role. Joining me to talk about the science of seasonal allergies is my guest, Dr. Neeta Ogden, Director of the Allergy, Asthma, and Sinus Center in Edison, New Jersey. She’s right here with us in the studios. Welcome to Science Friday.

NEETA OGDEN: Thank you for having me.

IRA FLATOW: So it’s allergy season. Are allergies are on the rise?

NEETA OGDEN: Very much so. This is a trend that it’s been ongoing. We’re talking about it a lot now because climate change is very much a topic in the news and the headlines for many reasons. But this has been ongoing for, I’d say, the last two decades, where we’re seeing rising pollen counts, worsening seasons, and yes, climate change is figuring into it.

Because why? Warmer temperatures, higher carbon dioxide levels. These are really the ideal– and climate associated with more moisture. These are the ideal elements leading to robust plant growth, which then in turn leads to soaring pollen counts.

IRA FLATOW: Yeah. And the season starts earlier.

NEETA OGDEN: Yes, we’re seeing season starts earlier. Actually, recent studies are showing that they start almost three weeks earlier. So there have been stories that I’ve done where people, especially in the southeast, the season starting in late February.

IRA FLATOW: Wow.

NEETA OGDEN: Yeah. It’s crazy.

IRA FLATOW: Let me give our listeners a chance to ask questions. Our number is 877-925-9174. 877-925-9174 If you’re suffering like I am or you have questions about seasonal allergies. Now is your time to ask those questions. OK, I’ve known over the years for my allergies that there seem to be certain plants that I’m allergic to more than others, right?

NEETA OGDEN: Definitely. In the spring season, especially in early spring, it’s trees. Trees are causing those really intense, itchy eyes and really intense spring season symptoms. That’s followed by later spring by grass. And that goes from about May, mid May, into June. And then come late summer, we’re talking about ragweed into early fall. So there definitely are certain plants. And if you really make the effort and start realizing that you’re allergic to springtime pollens, you might see an allergist and get tested who can then actually share which trees are a problem for you.

IRA FLATOW: All right. Let’s go to the phones. Let’s go to Lucy in Cleveland. Hi, Lucy. Welcome to Science Friday.

AUDIENCE: Hey, Ira. Thank you. Listen, I can tell you that they do still do those scratch tests, because I had one done two years ago. And the doctor came back in the room 15 minutes after she put the grass mix on my back, and she said, wow, you are super allergic to the grass mix.

So I wanted to share for your listeners that because I choose not to use over-the-counter or prescription medication, there is a natural substance. Is called quercetin, and it’s spelled Q-U-E-R-E-C-I-T I’m not sure if I’m spelling it correctly. It’s a natural over-the-counter supplement that I take. If you have blood pressure issues, I don’t think you can take it, but it’s very effective.

I also want to share that we had a pet for almost 18 years who had severe grass and other allergies. We had him tested, and once his blood test came back as severely allergic, we put him on immunotherapy drops. That worked for him really, really well for 10 years.

IRA FLATOW: Let me get a reaction from Dr. Ogden.

NEETA OGDEN: Yeah, there are studies that show that quercetin, which I believe is related to turmeric, is an anti-inflammatory and can be helpful with allergies. And in my experience as a physician, I see that as an adjuvant therapy, that can help people who are already potentially on medications or immunotherapy. So that’s one way certainly. And then the drops you’re talking about are something that are being used in the treatment of allergies. And they’re not FDA approved, but they’re definitely out there.

IRA FLATOW: Yeah, OK. Let’s go back to the phones. Eden in Manhattan. Hi, welcome to Science Friday.

AUDIENCE: Hi.

IRA FLATOW: Hi, there.

AUDIENCE: Can you hear me?

IRA FLATOW: Yeah. Go ahead.

AUDIENCE: OK, well, just kind of following up on your last guest and then this one as well. Ira, by the way, I love you. Never called. But I was just wondering about the seasonal allergies thing, because I grew up in the country and I was exposed to everything. And your last guest was talking about exposure therapy. And I still do get seasonal allergies and also dust. And I did take one of those tests when I was an adult and I did come up positive for dust mites. Is it mites? That’s what I’m asking.

NEETA OGDEN: It is dust mites.

IRA FLATOW: Is it the mites or is it the dust?

NEETA OGDEN: It’s dust mite is typically what– it’s the allergen is dust mite.

IRA FLATOW: I had a lot of allergies, as my listeners know. When I was a kid, I was allergic to pollen, grasses, and weeds. I couldn’t sit in the grass. And I would just that night. But I grew out of it. Is that common?

NEETA OGDEN: Yes, that can happen for sure. And in fact, we see, especially with allergic asthma, we can see a bimodal thing where you have it in your childhood, it goes away, and then it comes back in your early adulthood, maybe your 30s. But if they’ve gone away completely, that’s great for you. I often see it return in adulthood, especially with these intense seasons. It ends up being an issue again.

FLORA LICHTMAN: Can you microdose for seasonal allergies?

NEETA OGDEN: So the way we actually do it is called not microdosing, but immunotherapy. And so the main way that we’ve traditionally done it is through allergy shots.

IRA FLATOW: Me.

NEETA OGDEN: Those wicked allergy shots.

IRA FLATOW: Looking at me. So I had them for years when I was a teenager.

NEETA OGDEN: Oh, I should have asked you that. Because that typically ends up with the scenario where people are kind of essentially cured of their allergies. So allergy shots, if you can stick with them, they can take three to five years a week, monthly, weekly, then monthly appointments. But that’s a form of microdosing where we’re taking increasing amounts of the allergen and injecting it so that the immune system begins to tolerate it. Yeah.

IRA FLATOW: Yeah. You’ve done some research on one of my favorite topics, the microbiome. And probiotics are possible treatments?

NEETA OGDEN: Again, similar to the caller, probiotics without a doubt, we know the gut microbiome has a very big role in our immune system, especially in infancy and communicating with T cells and our immune system as it matures to tolerate things, to regulate the immune response so that it’s not over reactive.

And so probiotics have come in in that way to see if they can help how we respond to allergens. And it has shown promise, especially for an allergic condition in children, atopic dermatitis or eczema. But in terms of seasonal allergies, it’s got potential, but no studies definitively say, yeah, take it. So again, it might be something that’s helpful. Just about maintaining a good environment in the gut microbiome.

IRA FLATOW: All right. Phones again. Lots of great calls. Let’s go to Annapolis and Fran. Fran, did I lose you? I think I lost Fran. What do you see as the biggest common mistake people make?

NEETA OGDEN: I think people make the mistake of waiting too long to take care of their allergies. Preparation is so key, especially now when seasons are starting earlier because of climate change. So if you are known allergy sufferer, having your medications, especially if you have allergic asthma, checking in with your doctor so that your inhalers, for example, are not expired and being ready and taking these medicines even before the season starts can be extremely helpful.

Because once that season hits, and we’re really headed towards that in New York, because it’s been these kind of wet, cold days with that sunny, hot day. It will start, and it can create a vicious cycle that can be hard to reverse, that can take stronger medications if you’re not prepared.

IRA FLATOW: All right. Let’s try to go to Vermont in Marlborough. Andy, hi, welcome to Science Friday.

AUDIENCE: Hi there. How are you?

IRA FLATOW: Fine. Go ahead.

AUDIENCE: Good. So I have an interesting history with allergies. When I was a teenager, I had really bad allergies for ragweed and all kinds of things. I would go away for the weekend and just be miserable in the country. When I was 28 years old, I was in an antique rug store and I got a horrible asthma attack. And ever since that asthma attack, I have never had any issue with any allergy. I am literally allergy free.

IRA FLATOW: Can you tell us where that store was? We’d all like to go there.

AUDIENCE: Peterborough, New Hampshire. But my asthma has become so mild, it’s almost a non-issue. So I would take that trade every day of the week. And I’m just curious, is there any medical explanation for that?

IRA FLATOW: Could it be coincidence?

NEETA OGDEN: Yeah, I mean, honestly, I feel like you should count yourself as a lucky one. This isn’t very common. And so without taking a longer history, did you move or maybe out of an environment that has the allergens to which you were very allergic, that might have played an issue. Otherwise, this is kind of a unique scenario.

FLORA LICHTMAN: Can you make your allergies worse by using the wrong medication? I’m asking because I feel like I live on Visine. It’s like an IV drip for me during allergy season.

NEETA OGDEN: Oh my God.

FLORA LICHTMAN: You’re cringing.

NEETA OGDEN: Right. I’m so glad you asked that, because what I end up seeing in my office often is people who are navigating the massive allergy aisles in the pharmacy that are full of medications that have multiple ingredients and they’re trying to guess at what’s going to make them feel better. And so they can make things worse. And Visine is one of those things that I do end up feeling is a culprit there, because it’s really not treating the ocular allergy.

FLORA LICHTMAN: What’s the problem with it?

NEETA OGDEN: I mean, it’s more that it’s like taking the red out. Exactly what it says. But with overuse, it can cause rebound symptoms. So it’s never really effectively going to treat the source.

IRA FLATOW: Yeah, but there are so many antihistamines.

NEETA OGDEN: Right.

IRA FLATOW: Are there good ones and bad ones?

NEETA OGDEN: I really believe the literature shows us that these newer antihistamines are called second generation antihistamines because they have fewer side effects than the old school things. Those are the best place to start, and the generics.

IRA FLATOW: Do they have a name?

NEETA OGDEN: Yeah. Allegra, which is fexofenadine. Zyrtec, desloratadine.

IRA FLATOW: These are new generations, you say? They work differently?

NEETA OGDEN: They’ve been around for a long time. They’re a little different from Benadryl, which everyone seems to reach for.

IRA FLATOW: I do it when I go to sleep.

NEETA OGDEN: Right. That’s the thing. It has that. And it also lasts four to six hours. These last for 24 hours. And then intranasal steroid sprays. That’s another cornerstone of treating seasonal allergies, like the Nasonex, Nasacort, Flonase. And finally, the right drops. So these are drops that have antihistamine as a component. Pataday, Zaditor, Alaway. These are names to look for in the pharmacy.

FLORA LICHTMAN: I’m writing them down. Let’s go to the phones. Let’s go to Laura in South Dakota. Hi, Laura. Are you there.

AUDIENCE: Hi. Yes. Can you hear me?

FLORA LICHTMAN: Yeah go ahead.

AUDIENCE: I am wondering about actually about microdosing and with EOE. I have a child that has EOE and a sesame allergy. And I’m wondering about microdosing with an EOE.

IRA FLATOW: Can you tell us what an EOE is, Doctor?

NEETA OGDEN: Yeah, eosinophilic esophagitis. And honestly, the word microdosing, I feel like it might fall into things that people are trying at home. And I don’t know if that’s what you’re talking about. I think EOE–

AUDIENCE: No, I’m talking about more like in a clinic setting, expose him to sesame.

NEETA OGDEN: Oh, OK. So like immunotherapy, which would be giving smaller doses of sesame. I don’t know that there isn’t a protocol for sesame that might be widely used. I think in certain academic and clinical settings, it is something that you would find. So I would definitely speak to your allergist about it, which you probably already have. And with EOE, I know that the biologic like dupilumab has actually been recently shown to be helpful as well.

IRA FLATOW: All right, let’s go to another call. Queens, New York. Susan in Queens, welcome to Science Friday.

AUDIENCE: Hi, Ira. Hi, Flora.

FLORA LICHTMAN: Hi there.

AUDIENCE: So I’m interested in knowing or I’ve read studies where they’ve shown that Amish children have fewer dairy allergies, environmental type allergies, which I think is related to the fact that they milk cows. They play in hay. And I’ve noticed that even my young grandchildren, nobody plays really outside in the dirt anymore.

NEETA OGDEN: I think this is– yeah.

AUDIENCE: And I just wanted to comment that I think that maybe that has something to do with this rise in all kinds of environmental allergies.

IRA FLATOW: All right, Susan, let’s get an answer.

NEETA OGDEN: You’re touching upon a pretty hot topic in allergy, which is called the hygiene hypothesis, which very much speaks to exactly what you’re talking about, that people on farms or even in underdeveloped countries who maybe don’t have this hyper clean environment with the antibacterial soaps and all the vaccine schedules that we are following, which is actually helpful. I’m not putting that down.

But there are things that have led toward a shift in more industrialized, westernized countries where we aren’t playing with mud or having exposure to, like you said, farm animals, that actually there’s some thinking build up the immune system away from the allergic arm. So it is something that if you’ve seen it, there’s thought that that is part of the reason why there is an increase in allergy, especially in these countries.

IRA FLATOW: Well, I want to thank you, Dr. Ogden, for taking time to be with us today.

NEETA OGDEN: Thank you so much for having me.

IRA FLATOW: Fascinating stuff. Dr. Neeta Ogden, Director of the Allergy, Asthma, and Sinus Center in Edison, New Jersey.

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