Community Conversation: Michael Gerardi, MD
Itchy eyes, runny nose, plugged sinuses: seasonal allergies are in full effect! Maybe you’ve lived with allergies your whole life, or maybe they are something new this year. Either way, you don’t have to suffer in stuffy silence. In a Community Conversation on May 5, 2022, Michael Gerardi, MD, an emergency medicine physician with Atlantic Medical Group, answered allergy-related questions and shared how a visit to your doctor or local urgent care center could leave you breathing easier when it comes to fighting seasonal allergies.
What causes seasonal allergies?
One of the most potent causes of seasonal allergies in the spring is the presence of pollen in the air. Dr. Gerardi described a typical allergy day: “It's sunny, the trees are blossoming, and our cars are all yellow and green right now. You don't have to go to a pollen count website on a day like today…(to) know it's bad.” Tree pollen often begins to aggravate allergies beginning in March, but Dr. Gerardi also noted that grasses in June, ragweed in the fall and mold, mildew, animal dander and dust mites in the winter all cause reactions for those who have allergies.
If you suffer from allergies in one season, does that mean you will suffer in other seasons as well?
Dr. Gerardi said all allergies are different. They come in different forms and our bodies react in different ways. Some allergies develop when we are children and others develop in young adulthood. New environments come with new stimulants and allergens. People could develop allergies in their mature years as well.
Can moving to a new geographic area provide relief from allergies?
Moving to a new area won’t necessarily provide relief. New stimulants and allergens can cause other issues. “People go out west to Arizona to get away from asthma triggers or algae triggers and the cedar out there and other trees really cause a lot of problems,” explained Dr. Gerardi. It is difficult to escape every cause of allergies.
How can I avoid the worst effects of seasonal allergies?
Masking is one way to control how much pollen you breathe in during the spring allergy season. Limiting your exposure by staying indoors in the morning and evening when the pollen count is at its highest is another option. The middle of the day is the safest time to be outside. Dr. Gerardi noted that allergy irritants are worse than they were 30 years ago.
What are the symptoms of seasonal allergies?
Symptoms of seasonal allergies include itchy eyes, teary eyes, a burning sensation in the eyes, runny nose, difficulty breathing, wheezing, throat irritation and coughing. Children may exhibit behavior that points to these symptoms, including rubbing their eyes and nose as well as chewing with their mouth open. Dark circles under the eyes and a red crease across the nose may also occur from constant rubbing. Dr. Gerardi noted that many of these symptoms are also COVID-19 symptoms. If you have additional symptoms such as fever and body aches, that may be an indication of a viral infection. “If you don't have body aches and fevers and whatnot, you could be dealing with this terrible pollenosis.”
Can allergies affect your hearing?
Dr. Gerardi explained that when your body reacts to allergens, it produces excess mucus that can drain to the back of your throat, eventually making its way to the eustachian tubes, the small passageway that connects your throat to the middle ear. The inner ear gets inflamed, your ears feel clogged, and your hearing is decreased.
How do you develop allergies as an adult?
If you are exposed to a new pollen or a new type of grass that you've never been exposed to before, you could develop acute allergies in middle age or in your mature years. According to Dr. Gerardi, this may occur if you move into a new geographic area.
Can the use of a neti pot or nasal irrigator help relieve allergy symptoms?
The use of a neti pot or other nasal irrigators can be an effective way to treat allergies without medication. Dr. Gerardi said they are especially useful for pregnant women who want to avoid certain decongestants that may cause birth effects in the first trimester.
What are other ways to treat allergy symptoms?
Dr. Gerardi outlined a number of options to treat allergy symptoms. First, he said it is important to try to avoid being outdoors when pollen counts are at their highest. Direct treatment options include using a prescription steroid nasal inhaler twice a day to help suppress the allergens stimulating your immune response. Over the counter oral antihistamines taken in the morning or prescription medication can help treat symptoms all day. Specialized eyedrops can also be helpful for inflamed eyes. Finally, Dr. Gerardi mentioned allergy shots for those that need further treatment.
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What kind of doctor should I see to discuss my allergic condition and treatment options?
Most patients start by seeing their family physician, pediatrician, or an urgent care center to rule out conditions that share common symptoms with allergies, but are really something else. If you develop sinusitis, seeing an ENT (Ear, Nose, Throat) specialist is the next step. If you have a family history of allergies or have chronic symptoms, seeing an allergist is an option.
What is sinusitis and how is it treated?
Sinusitis is an infection of your sinuses. Those with sinusitis can experience headache, facial pain, runny nose, and nasal congestion. Some patients are treated with antibiotics while others need surgical procedures to open up the sinuses to increase the drainage of fluids.
Are there homeopathic remedies to relieve allergy symptoms?
Dr. Gerardi said he was not familiar with specific homeopathic remedies, but mentioned eating local honey as a way to avoid pollens from outside your geographic area. He also debunked claims that Vitamin D will help suppress allergies. Vitamin D has proven to be ineffective.
Can foods make your allergies worse?
Non-environmental conditions, such as food allergies, during pollen season tend to exacerbate symptoms. “Your immune system's getting inflamed, it's like pouring kerosene on a fire. People tend to have tougher times with their baseline allergies…during pollen season because everything gets…all worked up” said Dr. Gerardi. He recommended oral steroids and anti-itching medicine to alleviate mild symptoms. Anyone having a severe allergic reaction should call 911.
Do allergies get worse for women who are pregnant?
Dr. Gerardi said allergy symptoms tend to get worse when women are pregnant. An expectant mother may also experience pregnancy rhinitis, a condition where her nasal passages get swollen. Dr. Gerardi said that it is important for women to talk to their doctor about what kinds of treatments are safe. He included a neti pot and certain antihistamines as treatment options but warned against the use of decongestants though the first trimester.
Do seasonal allergies end after the first frost of the year?
Seasonal allergies can occur throughout the year. Although spring may be the worst season for some allergy sufferers, indoor allergies can cause symptoms and reactions in every season. Dr. Gerardi was not optimistic about the future of allergies: “Unfortunately because of increased CO2 and the rising temperature, for whatever reason I think we're going to worse and worse allergy seasons, more and more pollen and extended allergies season.”