What Do I Do If I Have Allergies and Asthma?

If you have allergies and asthma, avoid the substance you are allergic to. Here are some tips to help you avoid some of the most common allergens and prevent asthma attack symptoms.

Dust Mites

• Encase pillows, mattresses, and box springs with allergen-proof, zippered covers.
• Wash all bedding in hot water once a week.
• Non-carpeted flooring is best. If you cannot get rid of your carpeting, vacuum often with a multi-layer, allergen-proof vacuum bag. Wear a mask while vacuuming. If your child has asthma, do not vacuum while he or she is in the room. Products that eliminate dust mites from carpeting (such as Acarosan) can be purchased. Your asthma care provider can give you information about these products.
• Avoid curtains and drapes. Use plain window shades instead of mini-blinds. Washable curtains should be washed in hot water every two to four weeks.
• Dust all surfaces with a damp cloth often, including lampshades and windowsills.
• Keep clutter under control. Toys and books should be stored in enclosed bookshelves, drawers or closets.
• Replace traditional stuffed animals with washable stuffed animals.
• Keep all clothing in drawers and closets. Keep drawers and closets closed.
• Cover air ducts with filters or cheesecloth. Change these when soiled.
• Pillows and bedding should not contain feathers.
• Keep indoor humidity low (25%-50%). Use a dehumidifier.
• Regularly change filters on heaters and air conditioners.

Mold and Mildew

• Air out damp, humid areas frequently. Run a dehumidifier to keep humidity between 25% and 50%.
• Use air conditioners when possible.
• Clean bathrooms regularly using products that kill and prevent mold. Use exhaust fans to vent steam. Do not carpet the bathroom.
• Keep indoor plants out of bedrooms.
• When painting, add mold inhibitor to paint to prevent mold from growing.
• Avoid sources of outdoor molds, such as wet leaves or garden debris.
• To clean visible mold use a cleaning solution containing 5% bleach and a small amount of detergent.

Insects
 
Many homes and apartments have cockroaches and other insects. Some people with asthma are allergic to a protein in their droppings. To control these allergens in your home:

• Use roach baits or traps.
• Insect sprays can be used, but should only be sprayed when no one is at home. Before you or your child returns home after spraying, make sure that your home has been aired out for a couple of hours.
• Because cockroaches survive in high humid environment, fix water leaks in and around your home.
• Cover food in lid containers and clean dishes after eating and sweep floors after you have eaten.

Pollen
 
Pollen is a tiny egg shaped cell from flowering plants. Pollens are difficult to avoid because they cannot be eliminated from the atmosphere. Plants have different periods of pollination, which varies little from year to year. Yet, the type of weather affects the amount of pollen in the air with hot, dry, and windy weather causing more pollen in the air. In general pollen season starts from February to October.

You can lessen your or your child's exposure to pollen by:

• Limiting your or your child's outdoor activities during times of high pollen, such as early morning.
• Staying indoors during humid or windy days when pollen counts are high.
• Keeping windows closed during pollen seasons.
• Using air conditioning if possible.

Pet Dander

• It is best not to own any pets if you or your child is highly allergic to pet dander.
• Long visits to friends and family who own pets should be avoided. If you do visit, make sure you or your child takes asthma or allergy medicines before the visit. Exposure to the pets should be kept to a minimum when visiting.
• If you must have a cat or dog in the home, restrict its living area. It should not be allowed in your or your child's bedroom at any time. If possible, keep the pet outside.
• Wash your pet weekly.
• Remove as much carpeting as possible. Animal dander deposits in the carpet and stays there, even after the pet is gone from the home.

Food Allergies

If you have allergies, avoiding food triggers can be challenging. It is important to always read food labels and, when dining out, ask how foods are prepared.

Consider Allergy Shots

You can train your immune system to not overreact to allergy triggers. Doctors do this by giving you allergy shots (immunotherapy) for asthma. An allergy shot is a small amount of the substance that causes your allergy. By giving repeated shots of the substance over a period of time, your immune system eventually stops causing the allergic reaction. Ask your doctor if you are a candidate for allergy shots for preventing asthma.

What Do I Do If I Have Allergies and Asthma?

The Most Common Food Allergies

Food allergies occur when a sensitive person eats, inhales, or comes into contact with even tiny amounts of certain foods or food additives. These allergic reactions can be very mild or may be life-threatening.

Food allergies are becoming more and more common. There has been an increase in severe food allergy cases in the last 10 years, mostly driven by peanut and tree nut allergies.

In children, the most common food allergies are:

• Cow's milk
• Hen's eggs
• Peanuts
• Tree nuts
• Soybeans
• Wheat

In adults, the most common food allergies are:

• Peanuts
• Tree nuts
• Fish
• Crustaceans (such as shrimp, crabs, and lobster)
• Mollusks (such as clams, oysters, and mussels)
• Fruits
• Vegetables

In children, the foods most likely to cause severe allergic reactions -- anaphylaxis -- are peanuts, other legumes, tree nuts, fish, shellfish, milk, and eggs.

In adults, the foods most likely to cause anaphylaxis are peanuts, tree nuts, fish, and shellfish.

Symptoms tend to occur just after eating. They may include reddening of the skin, hives, itchy skin, swollen lips or eyelids, tightness of the throat, wheezing, difficulty breathing, coughing, vomiting, or diarrhea.

If you or your child has symptoms soon after eating, it's time to get tested.

Testing is the most controversial aspect of food allergy treatment. Just getting a skin test or a blood test isn't enough, says guidelines chief editor John J. Oppenheimer, MD, of the UMD-NJ New Jersey Medical School in New Brunswick.

"My pet peeve is now we have these blood tests and skin tests but without a patient's or a parent's help, they may provide misinformation," Oppenheimer tells WebMD. "So when a reaction occurs, try to figure out what you or your child ate over the last several hours. And then tell the doctor your story. Doing testing blindly can result in more problems than it solves."

The problem is that tests for food allergy are very sensitive. This means that if you do have a food allergy, the tests are very likely to catch it. But the tests aren't very specific. This means that the tests often are positive when there's no food allergy.

"People get 100 tests, and many are false positives and they end up chasing their tails," Oppenheimer says.

The new guidelines help doctors use food allergy tests in the best possible way. And when used properly, Portnoy says, testing works.

"Don't just assume you have a food allergy. If you suspect one, get it confirmed," Portnoy says. "You have to make sure you really are allergic. I have seen people with nutritional problems due to avoiding foods they're not really allergic to."

It's very rare for a person to be allergic to more than one or two foods, Oppenheimer and Portnoy say. So if testing is used to confirm or reject suspect foods, it is more likely to give meaningful results.

Once a food allergy is found, Muñoz-Furlong says, the real work begins.

"You have to learn how to manage the allergy on a day-to-day basis," she says.

FAAN has a web site -- which both Oppenheimer and Portnoy recommend -- to help parents and adult patients manage their food allergies.

"Unfortunately, the only treatment we have is avoidance," Oppenheimer says. "But I have several suggestions that help. One is to wear a medical alert bracelet or necklace. And for restaurants, I am big fan of giving the server a card that shows what you are allergic to, and having the chef sign the card to make sure you aren't given anything you're allergic to."

Outgrowing Food Allergy

The new guidelines stress repeated testing to see whether a food allergy fades over time.

Many children with food allergies become tolerant to those foods over time. This is most likely to happen with allergies to cow's milk, hen's eggs, wheat, and soybeans. It's least likely to happen with peanut, tree-nut, and seafood allergies.

"So it's necessary to recheck patients to see if they are still allergic," Portnoy says.

When a person becomes less sensitive to a food to which they have been allergic, doctors call it "tolerance." It's hoped that scientists will one day learn how tolerance develops -- and how to induce tolerance.

"Why tolerance occurs is the million-dollar question in food allergy," Oppenheimer says. "We are working on it."

The Most Common Food Allergies