The following do’s and don’ts are suggested by the American Academy of Allergy, Asthma & Immunology (AAAAI) to help lessen exposure to pollens and molds that could trigger allergy symptoms.

• DO a thorough spring cleaning. Windows, bookshelves and air conditioning vents collected
  dust and mold throughout the winter that can provoke allergy symptoms.
• DO keep windows closed at night to prevent pollens or molds from drifting into your home. Instead, if needed, use air conditioning, which cleans, cools and dries the air.
• DO minimize early morning activity. Pollen is usually emitted between 5 a.m. and 10 a.m.
• DO keep your car windows closed when traveling.
• DO shower and wash your hair every night before going to bed.
• DO try to stay indoors when the pollen count or humidity is reported to be high, and on windy days when dust and pollen are blown about.
• DO view the pollen count in your area. Visit the National Allergy Bureau (NAB) website.
• DO take a vacation during the height of the pollen season to a more pollen-free area, such as the beach or sea.
• DO take medications prescribed by your allergist/immunologist regularly, in the recommended dosage.

• DON’T take more medication than recommended in an attempt to lessen your symptoms.
• DON’T mow lawns or be around freshly cut grass. Mowing stirs up pollens and molds.
• DON’T rake leaves, as this also stirs up molds.
• DON’T hang sheets or clothing outside to dry. Pollens and molds may collect in them.
• DON’T grow too many, or over water, indoor plants if you are allergic to mold. Wet soil encourages mold growth.

Dust mites are microscopic creatures that thrive in warm, humid environments. They are common in homes and can be a significant cause of allergies. Dust mite allergies occur when the immune system reacts to proteins in the waste and body parts of dust mites.

Symptoms of Dust Mite Allergy:

• Sneezing
• Runny or stuffy nose
• Itchy or watery eyes
• Itchy skin or throat
• Coughing
• Postnasal drip
• Asthma symptoms (wheezing, difficulty breathing, chest tightness)

Diagnosis:

If you suspect a dust mite allergy, consult with a healthcare provider. Diagnosis typically involves…

• Medical history review
• Physical examination
• Allergy testing (skin prick test or blood test)

Avoidance Strategies:

Reducing exposure to dust mites is key to managing allergies. Here are some effective strategies…

Bedroom:

1. 1. Encasements: Use allergen-proof mattress and pillow encasements.
   2. Wash Bedding: Wash sheets, pillowcases, and blankets weekly in hot water (at least 130°F / 54°C).
   3. Minimize Clutter: Reduce items that collect dust, such as stuffed animals and decorative pillows.

Vacuuming:

Vacuum carpets and upholstered furniture weekly using a vacuum with a HEPA filter.

Humidity Control:

1. 1. Dehumidifiers: Use dehumidifiers to maintain indoor humidity below 50%.

   2. Air Conditioning: Use air conditioning during humid months to help control humidity.

Cleaning:

1. 1. Dusting: Dust surfaces regularly with a damp or treated cloth to avoid scattering dust.
   2. Flooring: Opt for hardwood, tile, or linoleum floors instead of carpet. If carpet is necessary, choose low-pile options and clean them regularly.
   3. Curtains and Blinds: Use washable curtains or blinds and clean them regularly.

Furnishings:

1. 1. Upholstery: Choose furniture with smooth surfaces like leather, wood, or vinyl instead of fabric.
   2. Stuffed Toys: Wash stuffed toys weekly in hot water or freeze them overnight to kill dust mites.

Air Quality:

1. 1. Air Purifiers: Use HEPA air purifiers to reduce airborne allergens.
   2. Ventilation: Ensure proper ventilation in the home to reduce humidity and airborne allergens.

Personal Care:

1. 1. Showering: Shower before bed to remove allergens from your body and hair.
   2. Clothing: Store clothing in enclosed wardrobes or dressers.

Medication and Treatment:
If avoidance strategies are not enough, consider the following treatments…

1. 1. Antihistamines
   2. Nasal Corticosteroids
   3. Allergy Shots (Immunotherapy): The most effective treatment, and the only treatment that addresses the underlying allergy.

What is Pollen-Food Allergy Syndrome?

Pollen-Food Allergy Syndrome (PFAS), also known as Oral Allergy Syndrome (OAS), is a type of food allergy that causes allergic reactions typically in the mouth and throat. It occurs when certain proteins in fresh/raw fruits, vegetables, and nuts cause a reaction in people who are allergic to pollen. This happens because the proteins in these foods are similar to the proteins found in pollen.

Typical symptoms of PFAS:

• Itch or tingle of the lips, mouth, tongue, and/or throat

These symptoms typically appear within a few minutes of eating the offending food and usually resolve within an hour. Severe reactions are rare but can occur, including life threatening allergic reactions. In some cases epinephrine (e.g. epi-pen), may be used to treat serious allergic reactions.

Common Pollen and Cross-Reactive Foods (examples, not comprehensive):

• POLLEN TYPE: Birch
  CROSS-REACTIVE FOODS: Apples, Carrots, Celery, Cherries, Hazelnuts, Kiwi, Peaches, Pears, Plums
• TYPE: Ragweed
  FOODS: Bananas, Cucumbers, Melons (watermelon, cantaloupe, honeydew), Zucchini
• TYPE: Grass
  FOODS: Celery, Melons (watermelon, cantaloupe, honeydew), Oranges, Peaches, Tomatoes
• TYPE: Mugwort
  FOODS: Carrots, Celery, Coriander, Fennel, Parsley, Peppers, Sunflower seeds

* Of note being reactive to one of these foods, does not mean you will necessarily react to others in the same column.

Managing PFAS:

• Avoidance: The best way to manage PFAS is to avoid the foods that trigger symptoms.
• Cooking or Processing: Cooking the food can break down the proteins that cause the reaction. Canned, baked, or microwaved fruits and vegetables may be safe to eat.
• Immunotherapy (Allergy Shots): Treating the underlying allergy to pollen can often treat the corresponding food allergy.

Conclusion:

Pollen-Food Allergy Syndrome can be managed with careful avoidance and preparation of foods. Understanding which foods may cross-react with your pollen allergies is key to preventing uncomfortable symptoms. If you have any questions or concerns about PFAS, please speak with your healthcare provider.

Note: This page is for informational purposes only and should not replace professional medical advice. Always consult your doctor for personalized guidance and treatment.

***Please notify your allergist of all medications and/or supplements you are currently taking. Some medications, such as antihistamines, will need to be held for one week prior to allergy testing.

Types of allergy tests:

• Skin Prick Test (SPT):
  Small drops of allergen placed on the surface of the skin (performed on the upper back), then
  lighted scratched allowing that substance to enter the body. You may develop an itchy red bump, known as a wheal, at that area within about 15 minutes
• Intradermal Skin Test (ID):
  Similar to the SPT, however the allergen is injected under the skin instead of being placed on the surface. ID testing is commonly used once a SPT has not caused a reaction. This test is performed on the upper portion of the arms and like the SPT you may develop an itchy red bump within about 10 minutes.

• Oral Food Challenge (OFC)
  Often used to confirm the results of skin test and/or clear food allergies. The test involves ingesting a small amount of allergen to watch for signs and symptoms of reaction. If no adverse symptoms arise, you will be given increasing amounts of the allergen and observed for a set amount of time.
  • OFC – What To Bring
    • Please bring in the food item being tested as well as a vehicle to mix it in
      and/or aid in its consumption, such as pudding, yogurt, or applesauce.
    • Plan to be in the office for at least 3 hours. We recommend you bring something to occupy your time, e.g. quiet activities such as books, coloring, puzzles, etc.

Antihistamines and certain other medications interfere with the accuracy of allergy skin testing.

The following is a list of common antihistamines. In addition, many cold/sinus preparations and eye drops contain antihistamines.

Some herbs, plants and supplements (including naturopathic/homeopathic) may also decrease the accuracy of allergy skin testing, and therefore all such products should be withheld for one week prior to testing.

Examples of Antihistamines / Do not take for this number of days before test date:

• Zyrtec (Cetirizine) / 6 days
• Xyzal (Levocetirizine) / 6 days
• Clarinex (Desloratidine) / 7 days
• Claritin/Claritin-D, Alavert (Loratadine) / 5 days
• Allegra (Fexofenadine) / 4 days
• Most older antihistamines / 3 days:
  • Benadryl (Diphenhydramine), Actifed, Allerest, Nyquil, Chlor-Trimeton, Triaminic, Dimetapp, Drixoral, Tavist, etc.
• Medications ending in “PM” / 3 days:
  • Tylenol PM, Advil PM, Motrin PM
• Mucinex Allergy / 4 days
• Thera-Flu (Pheniramine), Ny-Quil / 3 days
• Periactin (Cyproheptadine) / 4 days
• Atarax (Hydroxyzine) / 6 days
• Astelin Nasal Spray (Azelastine), Astepro, Dymista / 5 days
• Patanase / 4 days

* IMPORTANT: Do not stop any meedication with a * without consulting the prescribing physician.

• *Tricyclic Antidepressants / *6 days:
  • *Elavil (Amitriptyline), *Pamelor (Nortriptyline) , *Tofranil (Imipramine) , *Sinequan (Doxepin), *Desipramine
• Meclizine (Antivert, Bonine, Dramamine) / 4 days

• *Remeron (Mirtazapine) / *8 days
• *Abilify (Aripiprazole) / *8 days
• *Seroquel (Quetiapine) / *7 days
• Midol / 3 days
• Topical Doxepin cream / 13 days
• Optivar and Elestat Ophthalmic Solution / 4 days
• All other allergy eye drops
  • Patanol, Pataday, Bepreve, Opcon A, Naphcon-A, Zaditor / 3 days

IF you are experiencing hives or other allergy symptoms that will make you uncomfortable
when antihistamines are withheld, DO NOT STOP your medication prior to the doctor’s office
visit.