FAQs

1) What is an allergy? The word allergy is often misused by physicians and the general public. When we talk about an individual having an allergic reaction, we are referring to a reaction that occurs as a result of a specific immune response. There are different types of immune responses that can occur depending on the allergic reaction. However, when we are talking about allergies in terms of upper and lower respiratory symptoms, we are referring to an "IgE-mediated (allergic antibody)" reaction. People genetically susceptible for developing allergies produce specific IgE antibodies in direct response to different "allergens" such as tree, grass, ragweed pollens, dust mite, cockroach, mold spores, cat or dog allergens.

2) What is an allergen? An allergen refers to a substance such as a protein that can cause an allergic reaction. For example, dust mite, cockroaches, mold spores, cats and dogs all produce allergens that can cause nasal allergies and asthma. Allergens are microscopic meaning they are very small and cannot be seen by the naked eye.

3) What is allergic rhinitis? Allergic rhinitis (hayfever) refers to a clinical condition where people have constant upper respiratory symptoms consisting of all or some of the following symptoms: nasal congestion (stuffiness), post-nasal drip, sneezing, runny nose, itching of the eyes, ears, nose, throat, headaches or sinus pressure, ear popping and fatigue. People with allergic rhinitis make specific allergic antibodies (IgE) to allergens that lead to their clinical symptoms. Allergic rhinitis may be seasonal such as during the spring, summer or fall or it may occur year round (perennial). Allergic rhinitis can lead to several complications such as sinusitis, ear infections and asthma.

4) What is an allergist? An allergist is a medical doctor who has completed three years of residency training after medical school in the fields of pediatrics or internal medicine. After residency training, to become a board-certified allergist, you must attend an accredited fellowship training program in allergy. Completion of a two or three year allergy training program makes you eligible to take a certification examination. If you pass this exam you are considered board-certified. Doctors who complete an allergy training program but do not take the certification exam are referred to as "board eligible" as they can take the exam if they choose. There are many doctors such as ear, nose and throat surgeons, pulmonologists (lung doctors), pediatricians and family medicine doctors who practice allergy after taking supplemental training but do not go through a formal allergy training program. All doctors who practice the specialty of allergy are encouraged to follow consensus practice parameters that outline the "state of the art" approach to treatment of allergic diseases.

5) What kind of diseases does an allergist treat? An allergist is also referred to as a clinical immunologist. They treat many types of diseases such as allergic and non-allergic rhinitis, asthma, sinusitis, recurrent ear infections, hives with or without soft tissue swelling (referred to as angioedema), drug reactions, different forms of eczema, immunodeficiencies in addition to many other less common immunologic disorders (for example, vasculitis).

6) I went to see an allergist with symptoms of constant nasal congestion and drainage in the back of my throat. These symptoms were making me very tired and causing me to snore which was bothering my wife at night. The allergist told me I'm not allergic because my skin testing was completely negative. He told me I have non-allergic rhinitis. What is this? Non-allergic rhinitis is a chronic (lasting many weeks, months or years) nasal condition characterized by constant nasal congestion and post-nasal drip. These symptoms typically occur year round and may be associated with ear popping, sinus pressure or headaches, sore throats but very little if any itching and sneezing. Non-allergic rhinitis, if not treated with the proper medications can lead to recurrent sinus and ear infections. Common triggers of non-allergic rhinitis include weather changes, barometric/atmospheric pressure changes, temperature changes, postural changes, irritants such as tobacco smoke, chemical solvents and paints, cleaning agents, perfumes, potpourris, incense, cosmetics and other fragrances, car exhaust fumes, Christmas trees and smoke from burning wood to name a few. Allergy skin testing is usually negative. There are two types of non-allergic rhinitis. One type is called "vasomotor rhinitis" which is more difficult to treat with medications. The other type is called "NARES" which stands for "non-allergic rhinitis eosinophil syndrome" and responds better to topical nasal corticosteroids sprays. Your allergist should be able to help you distinguish between these conditions and recommend an effective treatment regimen. The mechanism for non-allergic rhinitis, unlike allergic rhinitis, is unknown.

7) If my mom and dad both have allergies and asthma, what is my risk of developing allergies? If one parent has a history of allergies then the risk for an offspring to develop allergies is about 25-30%. If both parents have allergies then the risk of an offspring to develop allergies increases to 50-60%.

8) What is asthma? Asthma is a chronic lung condition characterized by inflammation and swelling of the bronchial airways. Patients with asthma often present with wheezing, chest tightness, shortness of breath or coughing. Some patients with asthma are totally symptom-free meaning they don't even know they have asthma. Often patients are incorrectly told they have "reactive airways", "asthmatic bronchitis" or recurrent "pneumonia" when in fact their condition is "asthma". The three characteristic features that define asthma are: 1) inflammation; 2) improvement in lung function after a bronchodilator medication such as albuterol (Proventil, Ventolin, Maxair, Alupent) and; 3) airway hyperresponsiveness which means that lung function goes up and down depending on exposure to various triggers. Airway hyperresponsiveness directly correlates with the amount of inflammation in the bronchial airways. It is important to make a definite diagnosis of asthma because if an individual\0xD5s asthma goes undiagnosed or is treated improperly, he/she can develop "airway remodeling" which results in permanent loss of lung function.

9) What are warning signs that my asthma is getting worse? If you have been diagnosed as having asthma, it is important that you are periodically monitored by your doctor to make sure your lung function has not decreased. Your doctor may give you an instrument called a peak flow meter that you can use to monitor your own lung function. If your peak flow rates are decreasing, this may be an early warning sign before the onset of symptoms that your asthma is getting worse. Other warning signs that your asthma is not well controlled may be overuse of a bronchodilator medication (i.e., albuterol) during the day or night and/or waking up in the middle of the night or early morning to use a bronchodilator medication. If you are experiencing some or all of these signs, you should immediately see your doctor who can adjust your medications appropriately.

10) My doctor told me I have asthma. She put me on different inhalers and told me to come back in three months. What else should I do? Asthma is a chronic inflammatory disease of the lungs with superimposed sudden onset (acute) flare ups. If the underlying chronic inflammation is well controlled then these sudden flare ups should be markedly reduced or prevented altogether. The National Institute of Heart, Lung and Blood Institute along with the Joint Task Force of the American Academy and College of Allergy, Asthma and Immunology and American Thoracic Society have issued consensus guidelines to be used by physicians who treat and manage asthma. These guidelines emphasize the importance of assessing and monitoring asthma over time, treating asthma with medications that control airway inflammation, educating the patient and their family members about asthma and finally understanding the important relationship between environmental triggers and asthma. In order to understand the role of the home and work environment on asthma, it is important that patients with asthma undergo a detailed environmental history with allergy skin testing to assess their allergic status so effective recommendations for avoidance measures in the home and work can be made.

11) What are dust mites and why should I be concerned about them? Dust mites are microscopic spider like creatures that have been demonstrated to be powerful allergens. The major allergens of dust mites come from their fecal waste particles and glandular secretions. Dust mites thrive in humid environments and feed off the scales of our skin. They are most commonly found in bedding (pillows, mattresses, boxsprings, comforters), carpets and upholstered furniture. It is estimated that about 90% of people with allergies are sensitized (meaning they have a positive skin test response) to dust mites and over 70% of asthma patients are sensitized to dust mites. Many studies have confirmed the relationship between dust mites and the development of asthma. Other studies have shown that when you reduce levels of dust mite allergen to very low levels, you can prevent sensitization to dust mites and the development of asthma symptoms.

12) What can I do to avoid or reduce my exposure to dust mites? There are many effective strategies to reduce exposure to dust mites. These should focus on the bedroom and other rooms where you spend the most time when not in the bedroom.

13) I read an ad in the newspaper about duct cleaning. Should I get this done? No! Unless you have experienced water damage or airflow restriction of your ducts, air duct cleaning is not recommended. In fact, duct cleaning can stir up dust and make things much worse. Many duct cleaning services sterilize the ducts with a chemical which has been reported to cause or aggravate asthma in some cases. A recent study has looked at the effectiveness of duct cleaning and found it to be of very limited effectiveness. The investigators conducting this study found very little dust mite growth in air ducts suggesting that conditions in air ducts are not suitable for dust mite growth. Furthermore, although they have found large amounts of dog and cat allergen in ducts, most is trapped by furnace filters and very little allergen is released from the outflow ducts into the room.

14) My allergist told me I am allergic to cats and to get rid of my cat. If I do not want to get rid of my cat, what other options do I have? We agree with your allergist that the best treatment for allergies and asthma triggered by cats is to remove the cat from the home. Unfortunately, many people with cats, dogs and other furry pets do not want to comply with this recommendation. It is estimated that over a third of the population has at least one or more cats in their home. This domestic pet has overtaken the dog in popularity probably because they are low maintenance. Cat allergen is primarily released from the sebaceous (sweat) glands in their skin. It is a very light allergen that can stay suspended in the air for five to six hours at a time. It sticks to walls, clothing, carpets, bedding and furniture and is difficult to get rid of completely. Even after removing the cat from the home, cat allergen levels can be measured up to five months later. Interestingly, some recent studies have reported significant levels of cat allergen in homes where there are no cats indicating that cat allergen is brought in from outside sources on shoes and clothing. If patients are unwilling to get rid of their cats we recommend they compromise and at least keep the cat out of the bedroom. Reducing reservoirs for cat allergen levels in the bedroom such as eliminating couches and carpets may be helpful. Frequent vacuuming with a HEPA vacuum or standard vacuum with double layered bags will help reduce cat allergen in carpets. Recently, HEPA free standing filters have been demonstrated to reduce airborne cat allergen levels in the bedroom and living room. The reduced levels of cat allergen resulted in improved lung function and reduced asthma symptoms in patients with cat-induced asthma symptoms. Washing the cat with water has been shown to reduce cat allergen levels on their pelt but reduced levels are not sustained after one week. Therefore, cats need to be washed at least twice a week to reduce the amount of allergen they release. There are agents that are as effective as water (such as Aller-pet) in reducing cat allergen levels on their pelt. The advantages of these agents may be that they are less irritating to the cat's skin compared to repeated washing with water and that cats are more receptive to grooming with these agents as opposed to repeated immersions water baths. Using many of the same interventions recommended for dust mite control also helps to reduce cat allergen levels in the home.

15) What can I do to avoid mold and mildew in the home? The most effective things to do to avoid mold growth in the home is to keep the indoor relative humidity below 45% year round. Monitoring with a humidity gauge and using a dehumidifier during humid times of the year are recommended. If there is direct leakage of water in the basement or through walls, then these structural problems should be fixed. Any materials that have been contaminated with mold such as carpets, clothing, books, boxes and upholstered furniture should be discarded if they cannot be adequately cleaned to remove mold. Molds are not only powerful allergens, some molds release toxins that can cause health related problems. If you feel your house is contaminated with mold, we recommend you begin with the "Allergy Alert Kit" to see what is the extent of this problem. HEPA air cleaners are effective at reducing mold spores in the home but should not be substituted for the above remediation recommendations.

16) If I am allergic to feathers, does this mean I have to get rid of my down pillows and comforter? Not necessarily. Placing dust mite protective covers over the pillows and comforter will prevent feather allergen from coming through. Interestingly, if you are also allergic to dust mites, recent studies have shown that dust mites do not grow as well in feather pillows compared to polyester pillows. Another option is Hypodown bedding that has the same feel and comfort of down but contains syriaca clusters that is effective at reducing feather allergen levels.

17) I have two children with asthma that are allergic to cockroaches. What can I do to reduce cockroach levels in my home? Cockroach management and control is best accomplished by removing sources of food and household food wastes. Foods should be stored in sealed containers. Every attempt to reduce access to water should be made such as fixing leaking faucets or preventing condensation on pipes. Improving ventilation to eliminate damp areas is helpful. Caulking or sealing cockroach access and entry points is also helpful. Spraying cockroach runways around kitchen cabinets and drawers with insecticides known to kill cockroaches will kill the parent cockroach but will not kill their eggs. Therefore repeated spraying with bait stations every one to two months is necessary to effectively control cockroach populations. Finally, thorough and frequent housecleaning to remove dust and cockroach byproducts is necessary. If these interventions are maintained, recent studies have shown that cockroach allergen levels will decrease in the home after 6-12 months.

18) I was told that an ionizer is the best type of air cleaner to get for the home. What do allergists recommend and why? Allergists do not recommend ionizers or electronic air cleaners for home use because these units emit ozone. Ozone is a major outdoor pollutant which has been demonstrated to trigger and in some cases cause asthma and upper respiratory symptoms. Allergists recommend HEPA air cleaners which clean room air continuously. If you have a problem with odors, many of these units come with carbon and zeolite that absorbs unwanted odors. These units do not release ozone and are believed to be the most effective means of air filtration currently available. For furnace use, there are central HEPA filters now available for the whole house. If this is not in your budget then we recommend an electrostatic filter that is effective at filtering allergens and other air particles from the air coming through the furnace. Electrostatic filters do not release ozone.

1	What is an allergy?
2	What is an allergen?
3	What is allergic rhinitis?
4	What is an allergist?
5	What kind of diseases does an allergist treat?
6	What is non-allergic rhinitis?
7	If my mom and dad both have allergies and asthma, what is my risk of developing allergies?
8	What is asthma?
9	What are warning signs that my asthma is getting worse?
10	My doctor told me I have asthma. She put me on different inhalers and told me to come back in three months. What else should I do?
11	What are dust mites and why should I be concerned about them?
12	What can I do to avoid or reduce my exposure to dust mites?
13	I read an ad in the newspaper about duct cleaning. Should I get this done?
14	My allergist told me I am allergic to cats and to get rid of my cat. If I do not want to get rid of my cat, what other options do I have?
15	What can I do to avoid mold and mildew in the home?
16	If I am allergic to feathers, does this mean I have to get rid of my down pillows and comforter?
17	I have two children with asthma that are allergic to cockroaches. What can I do to reduce cockroach levels in my home?
18	I was told that an ionizer is the best type of air cleaner to get for the home. What do allergists recommend and why?

FREE SHIPPING for any order that exceeds $50!!!