What are some symptoms of allergies

Anaphylaxis (anna-fih-LACK-sis) is a severe allergic reaction that can be life-threatening and requires immediate medical attention. It happens quick and may cause death. Symptoms generally involve more than one part of the body, such as the skin or mouth, the lungs, the heart and the gut. Study more about anaphylaxis.


What Is Sinusitis?

Sinusitis is an infection or inflammation of the sinuses.

sinus is a hollow space. There are numerous sinuses in the body, including four pairs inside the skull. They serve to lighten the skull and give resonance to the voice. These sinuses are lined with the same helpful of tissue that lines the inside of the nose. The same things that can cause swelling in the nose – such as allergies or infection – can also affect the sinuses. When the tissue inside the sinuses becomes inflamed, mucus discharge is increased. Over time, air trapped inside the swollen sinuses can create painful pressure inside the head.

This is a sinus headache.

Medical Review November 2015.

SYMPTOMS OF AN ALLERGIC REACTION

The severity of symptoms during an allergic reaction can vary widely. Some of the symptoms of an allergic reaction include:

  1. Rashes
  2. Stomach cramps
  3. Itchy, watery eyes
  4. Runny nose
  5. Hives (a rash with raised red patches)
  6. Diarrhea
  7. Itchy nose
  8. Sneezing
  9. Vomiting
  10. Bloating
  1. Cough
  2. Wheezing (a whistling sound when you breathe)
  3. Swelling
  4. Tongue swelling
  5. Throat closing
  6. Feeling faint, light-headed or “blacking out”
  7. Redness
  8. Pain
  9. Chest tightness and losing your breath
  10. A sense of “impending doom”

Some of these symptoms can be sign of a life-threatening allergic reaction.

It was early morning in early summer, and I was tracing my way through the woods of central North Carolina, steering cautiously around S-curves and braking hard when what looked love a little rise turned into a narrow bridge.

I was on my way to meet Tami McGraw, who lives with her husband and the youngest of their kids in a sprawling development of ancient trees and wide lawns just south of Chapel Hill. Before I reached her, McGraw emailed. She wanted to feed me when I got there.

“Would you love to attempt emu?” she asked. “Or perhaps some duck?”

These are not normal breakfast offerings. But for years, nothing about McGraw’s life has been normal. She cannot eat beef or pork, or drink milk or eat cheese or snack on a gelatine-containing dessert without feeling her throat shut and her blood pressure drop.

Wearing a wool sweater raises hives on her skin; inhaling the fumes of bacon sizzling on a stove will knock her to the ground. Everywhere she goes, she carries an array of tablets that can beat back an allergy attack, and an auto-injecting EpiPen that can jolt her system out of anaphylactic shock.

McGraw is allergic to the meat of mammals and everything else that comes from them: dairy products, wool and fibre, gelatine from their hooves, char from their bones. This syndrome affects thousands of people in the US and an uncertain but likely larger number worldwide, and after a decade of research, scientists own begun to understand what causes it.

It is created by the bite of a tick, picked up on a hike or brushed against in a garden, or hitchhiking on the fur of a pet that was roaming outside.

The illness, which generally goes by the name “alpha-gal allergy” after the component of meat that triggers it, is a trial that McGraw and her family are still learning to manage with. In much the same way, medicine is grappling with it, too. Allergies happen when our immune systems perceive something that ought to be familiar as foreign. For scientists, alpha-gal is forcing a remapping of basic tenets of immunology: how allergies happen, how they are triggered, whom they put in harm and when.

For those affected, alpha-gal is transforming the landscapes they live in, turning the dependable comforts of home – the plants in their gardens, the food on their plates – into an uncertain terrain of risk.


In 1987, Dr Sheryl van Nunen was confronted with a puzzle.

What are some symptoms of allergies

She was the head of the allergy department at a regional hospital in the suburbs of Sydney, Australia, and had a reputation among her colleagues for sorting out mysterious episodes of anaphylaxis. This time, a man had been sent to see her who kept waking up, in the middle of the night, in the grip of some profound reaction.

Van Nunen knew at once that this was out of the ordinary, since most allergic reactions happen soon after exposure, rather than hours later. She also knew that only a few allergens affect people after they own gone to bed.

(Latex, for instance – someone sensitive to it who has sex using a latex condom might drop asleep and wake up in the midst of an allergy attack.) She checked the man for the obvious irritants and, when those tests came up negative, took a thorough glance at his medical history and did a skin test for everything he had eaten and touched in the hours before bedtime. The only potential allergen that returned a positive result was meat.

This was weird (and dismaying, in barbecue-loving Australia). But it was the only such case Van Nunen had ever seen. She coached the patient on how to avoid the meals that seemed to be triggering his reactions, put it below to the unpredictability of the human immune system, and moved on.

Then a few more such patients came her way.

There were six others during the 1990s; by 2003, she had seen at least 70, every with the same problem, every apparently affected by meat they had eaten a few hours before. Groping for an explanation, she lengthened the list of questions she asked, quizzing the patients about whether they or their families had ever reacted to anything else: detergents, fabrics, plants in their gardens, insects on the plants.

“And invariably, these people would tell to me: ‘I haven’t been bitten by a bee or a wasp, but I’ve had lots of tick bites,’” Van Nunen recalls.


As she remembers it, Tami McGraw’s symptoms began after 2010.

That was the year she and her husband, Tom, a retired surgeon, spied a housing deal in North Carolina, a development next to a nature reserve whose builder had priced the large houses to sell. The leafy spread of streams and woodland pockets was everything she wanted in a home. She didn’t realise that it offered everything that deer and birds and rodents – the main hosts of ticks – desire as well.

She remembers one tick that attached to her scalp, raising such a welt that the spot was red for months afterwards, and a swarm of baby ticks that climbed her legs and had to be scrubbed off in a boiling bath laced with bleach. Unpredictably, at strange intervals, she began to feel dizzy and sick.

“I’d own unexplained allergic reactions, and I’d break out in hives and my blood pressure would go crazy,” she told me.

The necklines of every her T-shirts were stretched, because she tugged at them to relieve the feeling that she couldn’t take a deep breath. She trekked to an array of doctors who diagnosed her with asthma or early menopause or a tumour on her pituitary gland. They prescribed antibiotics and inhalers and steroids. They sent her for MRI scans, pulmonary function tests, echocardiograms of her heart. Nothing yielded a result.

Looking back, she realises she missed clues as to the source of her problem. She always seemed to need to use an asthma inhaler on Wednesdays – the day she spent hours in her car, delivering steaming-hot dinners for meals on wheels.

She would feel short of breath, and need to visit an urgent-care clinic, on Saturdays – which always started, in her household, with a large breakfast of eggs and sausages.

Then a shut friend had a scary episode: after going for a run, she arrived home and passed out on the boiling concrete of her driveway.

What are some symptoms of allergies

Once the friend had recovered, McGraw quizzed her. Her friend said: “They thought I got stung by a bee while I was running. But now they ponder maybe I own a red-meat allergy.”

McGraw remembers her first reaction: that’s crazy. But her second was: maybe I own that too. She did some searching online, and then asked her doctor to order a little-known blood test that would show if her immune system was reacting to a component of mammal meat. The test result was so strongly positive that her doctor called her at home to tell her to step away from the stove.

The test launched her on an odyssey of discovering just how much mammal material is present in everyday life.

One time, she took capsules of liquid painkiller and woke up in the middle of the night, itching and covered in hives provoked by the drug’s gelatine covering.

When she bought an unfamiliar lip balm, the lanolin in it made her mouth peel and blister. She planned to spend an afternoon gardening, spreading fertiliser and planting flowers, but passed out on the grass and had to be revived with an EpiPen. She had reacted to manure and bone meal that had been added as enrichments to the bagged compost she had bought.

She struggled with the attacks’ unpredictability, and even more with the impact on her family.

“I ponder I’m getting better, and then I realise I’m not,” she says. “It’s just that I’m more knowledgable about what I can and can’t do.”


The discovery of new diseases often follows a pattern. Scattered patients realise they are experiencing strange symptoms. They discover each other, face to face in a neighbourhood or across the world on the internet. They bring their experience to medicine, and medicine is sceptical. And then, after a period of pain and recalcitrance, medicine admits that, in fact, the patients were right.

That is the tale of the discovery of CFS/ME and Lyme disease, among others. But it is not the tale of alpha-gal allergy. An strange set of coincidences brought this bizarre illness to the attention of researchers almost as soon as it occurred.

The tale begins with a cancer drug called cetuximab, which came on to the market in 2004.

Cetuximab is a protein grown in cells taken from mice. For any new drug, there are likely to be a few people that react badly to it, and that was true for cetuximab. In its earliest trials, one or two of every 100 cancer patients who had it infused into their veins had a hypersensitive reaction: their blood pressure dropped and they had difficulty breathing.

That 1-2% stayed consistent as cetuximab was given to larger and larger groups.

And then there was an aberration. In clinics in North Carolina and Tennessee, 25 of 88 recipients proved hypersensitive to the drug, with some so ill that they needed emergency shots of adrenaline. At about the same time, a patient who was receiving a first dose of cetuximab in a cancer clinic in Bentonville, Arkansas collapsed and died.

The manufacturers, ImClone and Bristol-Myers Squibb, checked every obvious thing about the trial: the drug’s ingredients, the cleanliness of the manufacturing plants, even the practices at the medical centres where cetuximab had been istered.

Nothing stood out. The most that researchers could guess at the time was that the recipients might own some helpful of mouse allergy.

Then the first coincidence occurred: a nurse whose husband worked at the Bentonville clinic mentioned the death to Dr Tina Hatley, an immunologist in private practice in Bentonville. Hatley had recently finished postgraduate training at the University of Virginia’s allergy centre, and she mentioned the death to her previous supervisor, Dr Thomas Platts-Mills.

The bad responses to the drug looked love allergic reactions, and they were common enough – and far enough from the manufacturer’s expectations – to be an intriguing research opportunity.

Platts-Mills pulled together a team, looping in Hatley and several current research fellows as well.

Fairly quickly, they discovered the source of the problem. People were reacting to the drug because they had a pre-existing sensitivity, indicated by a high level of antibodies (called immunoglobulin E, or IgE for short), to a sugar that is present in the muscles of most mammals, though not in humans or other primates. The name of the sugar was galactose-alpha-1,3-galactose, known for short as alpha-gal.

Alpha-gal is familiar to numerous scientists because it is responsible for an enduring disappointment: its tendency to trigger intense immune reactions is the reason that organs taken from animals own never successfully been transplanted into people.

The puzzle was why the drug recipients were reacting to it. To own an allergic reaction, someone needs to own been primed with a prior exposure to a substance – but the trial recipients who reacted badly were every on their first dose of cetuximab.

Team members scrutinised the patients and their families for anything that could explain the problem. The reactions appeared regional – patients in Arkansas and North Carolina and Tennessee experienced the hypersensitivity, but ones in Boston and northern California did not.

They investigated parasites, moulds and diseases that happen only in pockets of the US such as rural Tennessee.

The question then became: what in rural Tennessee could trigger a reaction love this? The answer arose from a second coincidence. Dr Jacob Hosen, a researcher in Platts-Mills’s lab, stumbled across a map drawn by the Centers for Disease Control and Prevention (CDC) showing the prevalence of an infection called Rocky Mountain spotted fever. It exactly overlapped the boiling spots where the cetuximab reactions had occurred.

Rocky Mountain spotted fever is transmitted by the bite of a tick: Amblyomma americanum, one of the most common ticks in the south-eastern US.

It’s known as the lone star tick because of the blotch of white that appears on the back of the female’s body.

The researchers wondered – if the mystery reactions shared a footprint with a disease, and ticks caused the disease, could ticks be linked to the reactions, too?

It was an intriguing hypothesis, and was reinforced by a new set of patients who came trickling into Platts-Mills’s clinic at about the same time. They were every adults, and that was strange to start with, because allergies tend to show up in childhood.

They had never had an allergic reaction before, but now they were experiencing allergy symptoms: swelling, hives and, in the worst cases, anaphylactic shock. They too had high levels of IgE antibodies to alpha-gal.

Dr Scott Commins, another postgraduate fellow in Platts-Mills’s group, took it upon himself to phone every new patient to enquire whether they’d ever suffered a tick bite. “I ponder 94.6% of them answered affirmatively,” he says. “And the other few would tell, ‘You know, I’m outdoors every the time.

I can’t remember an actual tick that was attached, but I know I’d get bites.’”

Meat from mammals inevitably contains alpha-gal – so in already sensitised individuals, eating meat may constitute a second exposure, in the same way infusing cetuximab had been.

If tick bites had sensitised them, then the alpha-gal reaction might be a food allergy as well as a drug reaction. But the connection was speculative, and cementing cause and effect would take one final, extraordinary coincidence.

As it happens, Platts-Mills likes to hike. One weekend he took off across the central Virginia hills, tramping through grassy underbrush. He came home five hours later, peeled off his boots and socks, and found that his legs and feet were speckled with tiny dots.

They looked love ground pepper, but were dug into his skin – he had to use a dull knife to scrape them off – and they itched fiercely. He saved a few, and sent them to an entomologist. They were the larval form of lone star ticks.

This, he realised, was an chance. When he returned to the lab, he had his team draw his blood and check his IgE levels. They were low to start with, and then week by week began to climb. Platts-Mills is British – his dad was an MP – and in the midst of having his IgE tracked, he went to an event at the Royal Society of Medicine in London.

“And at that point,” he says cheerfully, “I ate two lamb chops and drank two glasses of wine.”

In the middle of the night, he woke up covered in hives.


The lone star tick doesn’t get much attention in the US. It’s the black-legged tick, Ixodes scapularis, that has the dubious honour of being the most well-known, as it’s the carrier of Lyme disease, which causes an estimated 300,000 cases of illness in the US each year. The lone star tick doesn’t transmit Lyme disease, but is the vector for other serious illnesses, including Q fever, ehrlichiosis, Heartland virus, Bourbon virus and tularaemia, an infection so serious that the US government classifies the bacteria that cause it as a potential agent of bioterrorism.

While Lyme clusters in the north-east and the northern midwest US, diseases carried by Amblyomma stretch from the coast of Maine to the tip of Florida, the Atlantic to the middle of Texas, and the southern shores of the Grand Lakes every the way to the Mexican border.

And that range appears to be expanding.

What are some symptoms of allergies

“The northern edge of where these ticks are abundant is moving,” says Dr Richard Ostfeld, a disease ecologist at the Cary Institute of Ecosystem Studies, north of New York City. “It is now well-established further north, into Michigan, Pennsylvania, New York and well up into New England.

“Climate change is likely playing a role in the northward expansion,” Ostfeld adds, but acknowledges that we don’t know what else could also be contributing.

The lone star tick is a sturdy, stealthy predator.

It isn’t picky about conditions – it tolerates the damp of Atlantic beaches, and its western expansion only stopped when it ran up against the Texas desert – and is content to feed from dozens of animals, from mice every the way up. It loves birds, which may own helped it move north so rapidly, and it has a special lust for the white-tailed deer that own colonised numerous American suburbs. And, unlike most ticks, it bites humans in every three stages of its lifecycle: as an adult, as a nymph and as the poppy seed-sized larvae that attacked Platt-Mills, which linger on grass stalks in clusters and spring off hundreds at a time.

Ticks detect scent with organs embedded in their first pair of legs, and what they’re sniffing for is carbon dioxide, the exhaled breath of an animal full of warm, oxygenated blood.

When lone star ticks catch wind of it, they take off. “The Lyme disease tick is a slow tick,” says Dr William Nicholson, a microbiologist at the CDC. “Amblyomma will run to you.”

There has been so little research into alpha-gal allergy that scientists can’t consent on exactly what stage of the bite starts victims’ sensitisation. One aspect of its epidemiology is becoming clear, though: the allergy isn’t only caused by the lone star tick.

In Australia, Van Nunen (who is now a clinical associate professor at the University of Sydney School of Medicine) couldn’t understand how her patients’ tick bites solved the mystery of their meat allergy.

But she could see something else. The beaches that fringe the coast north and south of Sydney are rife with ticks. If bites from them were putting people at risk of a profound allergy, she felt compelled to get the expression out.

In 2007, Van Nunen wrote up a description of 25 meat-allergic patients whose reactions she had confirmed with a skin-prick test. Every but two had had severe skin reactions to a tick bite; more than half had suffered severe anaphylaxis. The crucial detail in Van Nunen’s research was that her cases were caused by bites from Ixodes holocyclus, called the paralysis tick.

Alpha-gal allergy was not just an strange occurrence in one part of the US. It had occurred in the opposite hemisphere, making it literally a global problem.

And so it has proved. Wherever ticks bite people – everywhere other than the Arctic and Antarctic – alpha-gal allergy has been recorded.


It was a sunny early morning at the University of North Carolina Medical Middle in Chapel Hill. Scott Commins, who moved here in 2016 to become an associate professor, had 11 patients to see before the finish of the day. Seven of them had alpha-gal allergy.

Laura Stirling, 51, was fretting over a list of questions.

In 2016, she found a fat lone star tick attached to her, and afterwards had fierce indigestion whenever she ate or smelled pork – a challenge, because her husband likes to tinker with a smoker on weekends. In 2017, she was bitten again, and her symptoms worsened to midnight hives and lightheadedness that sent her to her doctor’s office. She immediately cut every meat and dairy from her diet. A year later, she wanted to know if she could add anything back.

“Can I eat dairy?” she asked.

What are some symptoms of allergies

“Can I cook dairy? Can I eat it if it doesn’t own animal rennet in it?” She paused. “I’ve been symptom-free, because I don’t take risks.”

Commins walked her through a protocol he has developed, a method for adding back mammal products one dose at a time. He has a hypothesis that alpha-gal reactions are linked to the fat content of food; that might explain why they take so numerous hours to happen, because the body processes fat via a slower metabolic pathway than protein or carbs.

He recommends that patients start with a spoonful of grated dry cheese, because its fat content is low, and graduate by slow steps up to full-fat yoghurt and milk and then to ice-cream.

If those foods don’t provoke reactions, he suggests tiny doses of lean meat, starting with deli ham. Stirling lit up at that. “I dream of charcuterie,” she sighed.

Because Commins was part of Platt-Mills’s earliest research, he has been seeing alpha-gal patients for more than a decade now. He estimates he has treated more than 900 men and women; five new patients reach every week. He has coached a significant number of them back to eating some mammal products and managing their exposures to the things they can’t handle, so their worst experience is hunting for an emergency antihistamine tablet, not being rushed to hospital.

Commins and Platts-Mills named alpha-gal allergy a decade ago, and Van Nunen saw her first patient 20 years before that.

A lab test for the allergy, the one that Tami McGraw received, has been on the market since 2010. (Platts-Mills and Tina Hatley, now Merritt, share the patent.) That makes it hard to understand why patients still struggle to be diagnosed and understand the limits of what they can eat or permit themselves to be exposed to. But alpha-gal allergy defies some of the bedrock tenets of immunology.

Food allergies are overwhelmingly caused by proteins, tend to surface in childhood and generally trigger symptoms quickly after a food is consumed. Alpha-gal is a sugar; alpha-gal patients tolerate meat for years before their reactions begin; and alpha-gal reactions take hours to happen.

Plus, the range of reactions is far beyond what’s normal: not only skin reactions in mild cases and anaphylaxis in the most serious, but piercing stomach pain, abdominal cramps and diarrhoea as well.

But alpha-gal reactions are definitely an allergy, given patients’ results on the same skin and IgE tests that immunologists use to determine allergies to other foods. That leads both Van Nunen and Commins to wonder whether the syndrome will assist to reshape allergy science, broadening the understanding of what constitutes an allergy response and leading to new concepts of how allergies are triggered.

Merritt, who estimates she has seen more than 500 patients with alpha-gal allergy, has it herself; she has had bad reactions to meat every her life, since being bitten by seed ticks at girl scout camp, and was re-sensitised by a lone star tick bite final year.

She is sensitive enough to react not only to meat, but to other products derived from mammal tissues – and as she has discovered, they are threaded throughout modern life.

The unrecognised dangers aren’t only sweaters and soaps and face creams. Medical products with an animal origin include the clotting drug heparin, derived from pork intestines and cow lung; pancreatic enzymes and thyroid supplements; medicines that include magnesium stearate as an inert filler; vaccines grown in certain cell lines; and other vaccines, and intravenous fluids, that contain gelatine.

“We own huge difficulty advising people about this,” Van Nunen says.

“Sometimes you own to sit below for seven hours, record seven emails and own four telephone conversations to be capable to tell to a 23-year-old lady who’s about to travel: ‘Yes, you may own this brand of Japanese encephalitis vaccine because they do not use bovine material. The vaccine is made in [cells from] the African green monkey and I own looked up that monkey and it does not contain alpha-gal.’”

Some replacement heart valves are grown in pigs; they may cause alpha-gal sensitisation that could trigger an allergy attack later.

And cardiac patients who own alpha-gal allergy seem to use up replacement heart valves more quickly than normal, putting them at risk of heart failure until they can get a replacement.

There’s also a growing sense that alpha-gal may be an occupational hazard. Final year, researchers in Spain treated three farm workers who developed hives and swelling and had difficulty breathing after being splashed with amniotic fluid while they were helping calves to be born.

Every three of them – a 36-year-old lady, a 56-year-old lady and a 53-year-old man – already knew they had alpha-gal sensitivity, but had never imagined that skin contact would be risky. In the two main groups where patients collect, it’s common to hear school cafeteria workers fret about reactions from breathing the fumes of meat cooking.

It’s hard to know how numerous people may be sensitised to alpha-gal without knowing it. A project at the US National Institutes of Health (NIH) that studies unexplained occurrences of anaphylaxis found final year that 9% of the cases weren’t unexplained after all: they were alpha-gal patients whose sensitivity had never been diagnosed.

Platts-Mills points out that the prevalence of high levels of alpha-gal IgE in his earliest studies was up to 20% in some communities, “but that was absolutely not the prevalence of allergic reactions to meat,” he says.

“So there are clearly plenty of people out there who’ve got the antibody but don’t own this syndrome.”

What this every means is that there are almost certainly people for whom a meat-containing meal or medical intervention could trigger an alpha-gal reaction of unknown severity.

This is an edited version of an article first published by Wellcomeon Mosaic and is republished here under a Creative Commons licence. Sign up to the newsletter at mosaicscience.com/#newsletter

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In July 2016, Natasha Ednan-Laperouse collapsed on a flight from London to Nice, suffering a fatal allergic reaction to a baguette bought from Pret a Manger.

At an inquest, the court heard how Natasha, who was 15 and had multiple severe food allergies, had carefully checked the ingredients on the packet. Sesame seeds – which were in the bread dough, the family later found out – were not listed. “It was their fault,” her dad Nadim said in a statement. “I was stunned that a large food company love Pret could mislabel a sandwich and this could cause my daughter to die.”

This horrifying case highlights how careful people with allergies need to be, as do the food companies – not least because allergies own been growing in prevalence in the past few decades.

“Food allergy is on the rise and has been for some time,” says Holly Shaw, nurse adviser for Allergy UK, a charity that supports people with allergies.

Children are more likely to be affected – between 6 and 8% of children are thought to own food allergies, compared with less than 3% of adults – but numbers are growing in westernised countries, as well as places such as China.

“Certainly, as a charity, we’ve seen an increase in the number of calls we get, from adults and parents of children with suspected or confirmed allergy,” says Shaw. Certain types of allergy are more common in childhood, such as cow’s milk or egg allergy but, she says: “It is possible at any point in life to develop an allergy to something previously tolerated.”

Stephen Till, professor of allergy at King’s College London and a consultant allergist at Guy’s and St Thomas’ hospital believe, says that an allergic reaction occurs when your immune system inappropriately recognises something foreign as a bug, and mounts an attack against it.

“You make antibodies which stick to your immune cells,” he says, “and when you get re-exposed at a later time to the allergen, those antibodies are already there and they trigger the immune cells to react.”

Allergies can own a huge impact on quality of life, and can, in rare cases such as that of Natasha Ednan-Laperouse, be fatal.

What are some symptoms of allergies

There is no cure for a food allergy, although there has been recent promising work involving the use of probiotics and drug treatments. The first trial dedicated to treating adults with peanut allergy is just starting at Guy’s hospital.

“There is a lot of work going on in prevention to better understand the weaning process, and there’s a lot of buzz around desensitisation,” says Adam Fox, consultant paediatric allergist at Guy’s and St Thomas’ hospitals. Desensitisation is conducted by exposing the patient to minuscule, controlled amounts of the allergen. It’s an ongoing treatment though, rather than a cure. “When they stop having it regularly, they’re allergic again, it doesn’t change the underlying process.”

What we do know is that we are more allergic than ever.

“If you ponder in terms of decades, are we seeing more food allergy now than we were 20 or 30 years ago? I ponder we can confidently tell yes,” says Fox. “If you glance at the research from the 1990s and early 2000s there is beautiful excellent data that the quantity of peanut allergy trebled in a extremely short period.”

There has also been an increase in the number of people with severe reactions showing up in hospital emergency departments. In 2015-16, 4,482 people in England were admitted to A&E for anaphylactic shock (although not every of these will own been below to food allergy). This number has been climbing each year and it’s the same across Europe, the US and Australia, says Fox.

Why is there this rise in allergies?

The truth is, nobody knows. Fox doesn’t believe it is below to better diagnosis. And it won’t be below to one single thing. There own been suggestions that it could be caused by reasons ranging from a lack of vitamin D to gut health and pollution. Weaning practices could also influence food allergy, he says. “If you introduce something much earlier into the diet, then you’re less likely to become allergic to it,” he says. A 2008 study found that the prevalence of peanut allergy in Jewish children in the UK, where the advice had been to avoid peanuts, was 10 times higher than that of children in Israel, where rates are low – there, babies are often given peanut snacks.

Should parents wean their babies earlier, and introduce foods such as peanuts?

What are some symptoms of allergies

Fox says it’s a “minefield”, but he advises sticking to the Department of Health and World Health Organization’s line that promotes exclusive breastfeeding for six months before introducing other foods, “and to not delay the introduction of allergenic foods such as peanut and egg beyond that, as this may increase the risk of allergy, particularly in kids with eczema”. (Fox says there is a direct relationship between a baby having eczema and the chances of them having a food allergy.)

The adults Till sees are those whose allergies started in childhood (people are more likely to grow out of milk or egg allergies, than peanut allergies, for instance) or those with allergy that started in adolescence or adulthood.

Again, it is not clear why you can tolerate something every your life and then develop an allergy to it. It could be to do with our changing diets in recent decades.

“The commonest new onset severe food allergy I see is to shellfish, and particularly prawns,” says Till. “It’s my own observation that the types of food we eat has changed fairly a lot in recent decades as a result of changes in the food industry and supply chain.” He says we are now eating foods such as tiger prawns that we probably didn’t eat so often in the past.

He has started to see people with an allergy to lupin flour, which comes from a legume in the same family as peanuts, which is more commonly used in continental Europe but has been increasingly used in the UK.

Sesame – thought to own been the cause of Natasha Ednan-Laperouse’s reaction – is another growing allergen, thanks to its inclusion in products that are now mainstream, such as hummus. One problem with sesame, says Till, is: “It often doesn’t show up extremely well in our tests, so it can be hard to gauge just how allergic someone is to it.”

Fox says it’s significant to stress that deaths from food allergy are still rare. “Food allergy is not the leading cause of death of people with food allergies – it’s still a extremely remote risk,” says Fox.

“But of course you don’t desire to be that one who is incredibly unlucky, so it causes grand anxiety. The genuine challenge of managing kids with food allergy is it’s really hard to predict which of the children are going to own the bad reactions, so everybody has to act as if they might be that one.”


What Are Eye Allergies?

Eye allergies are common. Eye allergies are a reaction to indoor and outdoor allergens that get into your eyes.The tissue that lines the inside of the eyelid and exterior of the eyeball becomes inflamed and swollen and leads to itching, redness, tearing and irritation of the eyes.


What Are Skin Allergies?

Skin allergies happen when your skin comes in contact with an allergen that your skin is sensitive or allergic to.

Also, allergies to other things, love food you eat or proteins you inhale or touch, may cause symptoms to appear on your skin. The allergic reaction generally appears within 48 hours after the initial exposure to the allergen. Symptoms often include the following: redness, swelling, blistering, itching, hives and rashes. The allergen doesn’t own to be new to you. It can be something you’ve been using or eating for numerous years. Common skin allergies include allergic contact dermatitis, eczema, chronic urticaria and angioedema.


Main allergy symptoms

Common symptoms of an allergic reaction include:

  1. a raised, itchy, red rash (hives)
  2. swollen lips, tongue, eyes or face
  3. sneezing and an itchy, runny or blocked nose (allergic rhinitis)
  4. wheezing, chest tightness, shortness of breath and a cough
  5. tummy pain, feeling ill, vomiting or diarrhoea
  6. itchy, red, watering eyes (conjunctivitis)
  7. dry, red and cracked skin

The symptoms vary depending on what you’re allergic to and how you come into contact with it.

For example, you may have a runny nose if exposed to pollen, develop a rash if you own a skin allergy, or feel sick if you eat something you’re allergic to.

See your GP if you or your kid might own had an allergic reaction to something. They can assist determine whether the symptoms are caused by an allergy or another condition.

Read more about diagnosing allergies.


Severe allergic reaction (anaphylaxis)

In rare cases, an allergy can lead to a severe allergic reaction, called anaphylaxis or anaphylactic shock, which can be life threatening.

This affects the whole body and usually develops within minutes of exposure to something you’re allergic to.

Signs of anaphylaxis include any of the symptoms above, as well as:

Anaphylaxis is a medical emergency that requires immediate treatment.

Read more about anaphylaxis for information about what to do if it occurs.

Sheet final reviewed: 22 November 2018
Next review due: 22 November 2021

Medications

Many allergens that trigger allergic rhinitis are airborne, so you can’t always avoid them. If your symptoms can’t be well-controlled by simply avoiding triggers, your allergist may recommend medications that reduce nasal congestion, sneezing, and an itchy and runny nose. They are available in numerous forms — oral tablets, liquid medication, nasal sprays and eyedrops. Some medications may own side effects, so discuss these treatments with your allergist so they can assist you live the life you want.

Nasal sprays

Nonprescription saline nasal sprays will assist counteract symptoms such as dry nasal passages or thick nasal mucus.

Unlike decongestant nasal sprays, a saline nasal spray can be used as often as it is needed. Sometimes an allergist may recommend washing (douching) the nasal passage. There are numerous OTC delivery systems for saline rinses, including neti pots and saline rinse bottles.

Nasal cromolyn blocks the body’s release of allergy-causing substances. It does not work in every patients. The full dose is four times daily, and improvement of symptoms may take several weeks. Nasal cromolyn can assist prevent allergic nasal reactions if taken prior to an allergen exposure.

Nasal ipratropium bromide spray can assist reduce nasal drainage from allergic rhinitis or some forms of nonallergic rhinitis.

Leukatriene pathway inhibitors

Leukotriene pathway inhibitors (montelukast, zafirlukast and zileuton) block the action of leukotriene, a substance in the body that can cause symptoms of allergic rhinitis.

These drugs are also used to treat asthma.

Intranasal corticosteroids

Intranasal corticosteroids are the single most effective drug class for treating allergic rhinitis. They can significantly reduce nasal congestion as well as sneezing, itching and a runny nose.

Ask your allergist about whether these medications are appropriate and safe for you. These sprays are designed to avoid the side effects that may happen from steroids that are taken by mouth or injection.

Take care not to spray the medication against the middle portion of the nose (the nasal septum). The most common side effects are local irritation and nasal bleeding. Some older preparations own been shown to own some effect on children’s growth; data about some newer steroids don’t indicate an effect on growth.

Decongestants

Decongestants assist relieve the stuffiness and pressure caused by swollen nasal tissue. They do not contain antihistamines, so they do not cause antihistaminic side effects. They do not relieve other symptoms of allergic rhinitis.

Oral decongestants are available as prescription and nonprescription medications and are often found in combination with antihistamines or other medications. It is not unusual for patients using decongestants to experience insomnia if they take the medication in the afternoon or evening. If this occurs, a dose reduction may be needed. At times, men with prostate enlargement may encounter urinary problems while on decongestants.

Patients using medications to manage emotional or behavioral problems should discuss this with their allergist before using decongestants. Patients with high blood pressure or heart disease should check with their allergist before using. Pregnant patients should also check with their allergist before starting decongestants.

Nonprescription decongestant nasal sprays work within minutes and final for hours, but you should not use them for more than a few days at a time unless instructed by your allergist.

What are some symptoms of allergies

Prolonged use can cause rhinitis medicamentosa, or rebound swelling of the nasal tissue. Stopping the use of the decongestant nasal spray will cure that swelling, provided that there is no underlying disorder.

Oral decongestants are found in numerous over-the-counter (OTC) and prescription medications, and may be the treatment of choice for nasal congestion. They don’t cause rhinitis medicamentosa but need to be avoided by some patients with high blood pressure. If you own high blood pressure or heart problems, check with your allergist before using them.

Immunotherapy

Immunotherapy may be recommended for people who don’t reply well to treatment with medications or who experience side effects from medications, who own allergen exposure that is unavoidable or who desire a more permanent solution to their allergies.

Immunotherapy can be extremely effective in controlling allergic symptoms, but it doesn’t assist the symptoms produced by nonallergic rhinitis.

Two types of immunotherapy are available: allergy shots and sublingual (under-the-tongue) tablets.

  1. Allergy shots: A treatment program, which can take three to five years, consists of injections of a diluted allergy extract, istered frequently in increasing doses until a maintenance dose is reached. Then the injection schedule is changed so that the same dose is given with longer intervals between injections. Immunotherapy helps the body build resistance to the effects of the allergen, reduces the intensity of symptoms caused by allergen exposure and sometimes can actually make skin test reactions vanish.

    As resistance develops over several months, symptoms should improve.

  2. Sublingual tablets: This type of immunotherapy was approved by the Food and Drug istration in 2014. Starting several months before allergy season begins, patients dissolve a tablet under the tongue daily. Treatment can continue for as endless as three years. Only a few allergens (certain grass and ragweed pollens and home dust mite) can be treated now with this method, but it is a promising therapy for the future.

Antihistamines

Antihistamines are commonly used to treat allergic rhinitis.

These medications counter the effects of histamine, the irritating chemical released within your body when an allergic reaction takes put. Although other chemicals are involved, histamine is primarily responsible for causing the symptoms. Antihistamines are found in eyedrops, nasal sprays and, most commonly, oral tablets and syrup.

Antihistamines assist to relieve nasal allergy symptoms such as:

  1. Eye itching, burning, tearing and redness
  2. Sneezing and an itchy, runny nose
  3. Itchy skin, hives and eczema

There are dozens of antihistamines; some are available over the counter, while others require a prescription.

Patients reply to them in a wide variety of ways.

Generally, the newer (second-generation) products work well and produce only minor side effects. Some people discover that an antihistamine becomes less effective as the allergy season worsens or as their allergies change over time. If you discover that an antihistamine is becoming less effective, tell your allergist, who may recommend a diverse type or strength of antihistamine. If you own excessive nasal dryness or thick nasal mucus, consult an allergist before taking antihistamines.

Contact your allergist for advice if an antihistamine causes drowsiness or other side effects.

Proper use: Short-acting antihistamines can be taken every four to six hours, while timed-release antihistamines are taken every 12 to 24 hours. The short-acting antihistamines are often most helpful if taken 30 minutes before an anticipated exposure to an allergen (such as at a picnic during ragweed season). Timed-release antihistamines are better suited to long-term use for those who need daily medications.

Proper use of these drugs is just as significant as their selection. The most effective way to use them is before symptoms develop. A dose taken early can eliminate the need for numerous later doses to reduce established symptoms. Numerous times a patient will tell that he or she “took one, and it didn’t work.” If the patient had taken the antihistamine regularly for three to four days to build up blood levels of the medication, it might own been effective.

Side effects: Older (first-generation) antihistamines may cause drowsiness or performance impairment, which can lead to accidents and personal injury.

Even when these medications are taken only at bedtime, they can still cause considerable impairment the following day, even in people who do not feel drowsy. For this reason, it is significant that you do not drive a car or work with dangerous machinery when you take a potentially sedating antihistamine. Some of the newer antihistamines do not cause drowsiness.

A frequent side effect is excessive dryness of the mouth, nose and eyes. Less common side effects include restlessness, nervousness, overexcitability, insomnia, dizziness, headaches, euphoria, fainting, visual disturbances, decreased appetite, nausea, vomiting, abdominal distress, constipation, diarrhea, increased or decreased urination, urinary retention, high or low blood pressure, nightmares (especially in children), sore throat, unusual bleeding or bruising, chest tightness or palpitations.

Men with prostate enlargement may encounter urinary problems while on antihistamines. Consult your allergist if these reactions occur.

Important precautions:

  1. While antihistamines own been taken safely by millions of people in the final 50 years, don’t take antihistamines before telling your allergist if you are allergic to, or intolerant of, any medicine; are pregnant or intend to become pregnant while using this medication; are breast-feeding; own glaucoma or an enlarged prostate; or are ill.
  2. Alcohol and tranquilizers increase the sedation side effects of antihistamines.
  3. Do not use more than one antihistamine at a time, unless prescribed.
  4. Some antihistamines appear to be safe to take during pregnancy, but there own not been enough studies to determine the absolute safety of antihistamines in pregnancy.

    Again, consult your allergist or your obstetrician if you must take antihistamines.

  5. Know how the medication affects you before working with heavy machinery, driving or doing other performance-intensive tasks; some products can slow your reaction time.
  6. Keep these medications out of the reach of children.
  7. Follow your allergist’s instructions.
  8. Never take anyone else’s medication.

Eye allergy preparations and eyedrops

Eye allergy preparations may be helpful when the eyes are affected by the same allergens that trigger rhinitis, causing redness, swelling, watery eyes and itching.

OTC eyedrops and oral medications are commonly used for short-term relief of some eye allergy symptoms. They may not relieve every symptoms, though, and prolonged use of some of these drops may actually cause your condition to worsen.

Prescription eyedrops and oral medications also are used to treat eye allergies. Prescription eyedrops provide both short- and long-term targeted relief of eye allergy symptoms, and can be used to manage them.

Check with your allergist or pharmacist if you are unsure about a specific drug or formula.

Severe allergic reaction (anaphylaxis)

In rare cases, an allergy can lead to a severe allergic reaction, called anaphylaxis or anaphylactic shock, which can be life threatening.

This affects the whole body and usually develops within minutes of exposure to something you’re allergic to.

Signs of anaphylaxis include any of the symptoms above, as well as:

Anaphylaxis is a medical emergency that requires immediate treatment.

Read more about anaphylaxis for information about what to do if it occurs.

Sheet final reviewed: 22 November 2018
Next review due: 22 November 2021

Avoidance

The first approach in managing seasonal or perennial forms of hay fever should be to avoid the allergens that trigger symptoms.

Outdoor exposure

  1. Don’t hang clothing outdoors to dry; pollen may cling to towels and sheets.
  2. Avoid using window fans that can draw pollens and molds into the house.
  3. Stay indoors as much as possible when pollen counts are at their peak, generally during the midmorning and early evening (this may vary according to plant pollen), and when wind is blowing pollens around.
  4. Wear a pollen mask (such as a NIOSH-rated 95 filter mask) when mowing the lawn, raking leaves or gardening, and take appropriate medication beforehand.
  5. Wear glasses or sunglasses when outdoors to minimize the quantity of pollen getting into your eyes.
  6. Try not to rub your eyes; doing so will irritate them and could make your symptoms worse.

Indoor exposure

  1. To limit exposure to mold, hold the humidity in your home low (between 30 and 50 percent) and clean your bathrooms, kitchen and basement regularly.

    Use a dehumidifier, especially in the basement and in other damp, humid places, and empty and clean it often. If mold is visible, clean it with mild detergent and a 5 percent bleach solution as directed by an allergist.

  2. Keep windows closed, and use air conditioning in your car and home. Make certain to hold your air conditioning unit clean.
  3. Reduce exposure to dust mites, especially in the bedroom. Use “mite-proof” covers for pillows, comforters and duvets, and mattresses and box springs. Wash your bedding frequently, using boiling water (at least 130 degrees Fahrenheit).
  4. Clean floors with a damp rag or mop, rather than dry-dusting or sweeping.

Exposure to pets

  1. If you are allergic to a household pet, hold the animal out of your home as much as possible.

    What are some symptoms of allergies

    If the pet must be inside, hold it out of the bedroom so you are not exposed to animal allergens while you sleep.

  2. Wash your hands immediately after petting any animals; wash your clothes after visiting friends with pets.
  3. Close the air ducts to your bedroom if you own forced-air or central heating or cooling. Replace carpeting with hardwood, tile or linoleum, every of which are easier to hold dander-free.

Treatments that are not recommended for allergic rhinitis

  1. Antibiotics: Effective for the treatment of bacterial infections, antibiotics do not affect the course of uncomplicated common colds (a viral infection) and are of no benefit for noninfectious rhinitis, including allergic rhinitis.
  2. Nasal surgery: Surgery is not a treatment for allergic rhinitis, but it may assist if patients own nasal polyps or chronic sinusitis that is not responsive to antibiotics or nasal steroid sprays.

What Are the Symptoms of an Allergy?

An allergy occurs when the body’s immune system sees a substance as harmful and overreacts to it.

The symptoms that result are an allergic reaction. The substances that cause allergic reactions are allergens. Allergens can get into your body numerous ways to cause an allergic reaction.

  1. Your body can own allergens injected into it. This includes medicine given by needle and venom from insect stings and bites.
  2. You can inhale allergens into your nose and your lungs. Many are little enough to float through the air. Examples are pollen, home dust, mold spores, cat and dog dander and latex dust.
  3. You can ingest allergens by mouth. This includes food and medicines you eat or swallow.
  4. Your skin can absorb allergens. Plants such as poison ivy, sumac and oak can cause reactions when touched.

    Latex, metals, and ingredients in beauty care and household products are other examples.


What Is Rhinitis (Nasal Allergies)?

The expression rhinitis means “inflammation of the nose.” When the nose becomes irritated by allergens or irritants, it may produce more and thicker mucus than usual. This drainage can irritate the back of the throat and cause coughing. Allergic reactions can also cause congestion, itchy nose or throat, sneezing, a runny nose and itchy, watery eyes.


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