The Importance of Allergy Testing

I was recently visiting with some docs at a local walk-in clinic, talking about allergies and asthma, making sure our clinic was doing a good job handling their referrals, etc.  During our chat, one of the docs remarked, “Well, really, the only reason we send a patient to you is to start shots.”  This, of course, is a gross oversimplification.  Allergists see lots of patients who aren’t immunotherapy candidates, such as people with food allergies, hives, and eczema, and not everybody who’s allergic needs immunotherapy.  The most glaring problem with this physician’s statement was this: she felt she could accurately diagnose people based on history alone.  Any allergist will tell you that accurate diagnosis of allergies is just not possible without testing.  One of the most important things we do is answer the basic question: Are you or are you not allergic?

Several years ago I went through a random sample of my clinic charts and found that about 35% of patients who came to me for nasal and sinus symptoms wound up being non-allergic.  Since then, I periodically pull charts to reassess this and the percentage has remained the same.  That number may be surprising to many people, especially since 100% of the people who came to me thought they had allergies and were sick enough to seek treatment.  This illustrates some important points:  First, there are huge numbers of people who are being needlessly treated for allergies.  Second, history is not a good predictor for allergies.  Proper diagnosis is critical to prevent people from wasting money on improper medications and to prevent them from wasting time and quality of life feeling sick.

A recent study in the Journal of Allergy and Clinical Immunology bears out my old chart review.  In this study, British subjects were asked whether they were sensitive to 5 common allergens: dust mites, cat, dog, tree pollen and grass pollen.   They were then had a standardized formal allergy history taken focusing on the same allergens.  The results prove that patient reports and history alone are very poor predictors of true allergy.  The number of falsely identified sensitivities to the individual allergens were: cat- 32%, dog- 27%,  grass- 48%, tree- 54%, and dust mites- 75%.  These are remarkable findings and they tell us that large numbers of people are wasting time, energy, and money avoiding things they really aren’t allergic to.

As you can see, wanting to start shots is not the only reason to visit an allergist.  Allergy testing is critical to making proper avoidance recommendations and in guiding the proper selection and timing of medications.  It also may tell you you’re not allergic at all!  Don’t waste time guessing what you’re allergic to, visit your local allergist and find out for sure.  It will save you time and money and help you feel better faster.

Dr. O

The Allergy Capital of the Country

I attended the Annual Meeting of the American Academy of Allergy, Asthma, and Immunology in Washington D.C. this past weekend.  I was reading a copy of USA Today and noticed that their Life-Health section focused on the topic of allergies. 

In their article, they list the top 10 cities in the country to live if you have Spring allergies.  The rankings were based on pollen counts, use of allergy medications, and the number of board-certified allergists in the region.  The work was compliled by the Asthma and Allergy Foundation of America.   The top 3 cities were, in descending order, Louisville, KY, Knoxville, TN, and Charlotte, NC. 

What I noticed was the close proximity that all of these cities had to Middle Tennessee. 

So the next time you hear somebody tell you that Nashville is the worst place to live for people with allergies, you can tell them that we are sitting right right in the lap of the most allergic region in the country.

Dr. Norvell

Tree Pollen is Here

If your nose hasn’t told you already, it’s officially tree pollen season in Middle Tennessee.  The puddles in my driveway this morning had the telltale yellow sheen of pine pollen.  Pine pollen granules are relatively large and so they’re easier to see.  They’re also what gives your car that yellow, dusty haze.

If you live in Middle Tennessee, you don’t have to guess what the pollen count is.  You can check for yourself at the Nashville Metro Government’s pollen count and air quality website. As you can see, the predominant early season tree pollens of cedar and pine are present at levels deemed heavy.

If you’re suffering from tree pollen allergies, try to avoid prolonged outdoor activity during the morning hours when pollen counts are the highest. If you must be outside, a mask can be helpful especially when mowing or gardening. If medications and avoidance aren’t controlling your miserable itchy, watery eyes, sneezing and runny nose, then it’s time to see your local allergist, get tested, and see if immunotherapy can let you enjoy springtime again.

Dr. O