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Getting ahead of fall allergies with allergist and immunologist Dr. Shoban Davé

Dr. Shoban Davé is a board-certified allergist-immunologist in private practice. He has completed his Allergy & Immunology Fellowship at Mayo Clinic, earning board certification from the American Board of Allergy & Immunology. He has been recognized as a Top Allergist-Immunologist by US News & World Report Magazine.


Although this year has been anything but predictable, if there's one thing we can count on arriving with the cooler weather, it's fall allergies. Allergy sufferers know that months of watery eyes, sneezing, itchy throat, and more could be looming ahead of them. But this fall season, we're trying to help you be one step ahead of allergies.

We sat down with Dr. Shoban Davé, a board-certified Allergist and Immunologist. He has completed his Allergy & Immunology fellowship at Mayo Clinic, earning his board certification from the American Board of Allergy & Immunology. He also happens to be a fan of the great outdoors. In his free time, Dr. Davé enjoys spending time with his family and exploring Colorado's natural beauty.

In this article, we'll cover a major allergen to look out for this fall, how to reduce your symptoms, differentiating COVID-19 and allergies, and more.


With the weather cooling off in parts of the country, people may begin to participate in more outdoor activities. What are the main allergens that may cause symptoms in the fall?

A major allergen to look out for in fall would be ragweed. Other allergens present in the fall include other weeds as well as some molds, which can be found on fallen leaves, decaying vegetable matter, and in soil. So, for example, if you were participating in a fall activity like raking leaves, you could make those particular allergens airborne and that could result in more allergy symptoms for yourself.

What about ragweed makes people so allergic to them?

Ragweed is a major allergen because each ragweed plant can produce up to 1 billion pollen grains per season, ragweed pollen can travel for hundreds of miles, ragweed’s small pollen size can deposit in the lower airways, and ragweed pollen can be highly sensitizing in the right climatic conditions in a person with the right genetic disposition to develop allergies.

The fall may bring seasonal allergies, but it also brings cold and flu season as well–and now we have to worry about COVID-19. How can we tell if it’s just allergies?

It certainly can be challenging to tell the difference between symptoms of allergies and COVID-19, especially as COVID-19 can have a somewhat variable presentation of symptoms.

With that said, people suffering from allergies typically will experience more itching, runny nose, and sneezing, while people suffering from COVID-19, will more frequently experience fever, chills, coughing, shortness of breath, muscle aches, sore throat, loss of taste and smell, abdominal pain, and diarrhea. It is recommended that patients suffering from any of these symptoms be evaluated by a physician.

Can an increase in stress affect allergy symptoms?

It is suggested that there is interaction in behavior, the hormonal system, the immune system, and health. And in this regard, stress can certainly exacerbate allergy symptoms by amplifying the immune response to allergens. Studies have found that stress can increase allergy skin test reactivity as well as increase the release of allergic inflammatory mediators.

How can people reduce the chances of having respiratory issues or symptoms due to allergies in the fall?

There are generally three ways of treating allergies: avoiding the things you're allergic to, taking medications, or pursuing immunotherapy.

Avoidance measures can include keeping windows closed with AC on, taking nightly showers after being outdoors as well as wearing a mask and goggles when outdoors. There are several classes of medications, both over the counter and prescription, that under the guidance of your physician can be started a couple of weeks before your allergy symptoms typically begin. For the possibility of long-lasting treatment for allergies, people can visit with an Allergist to discuss immunotherapy options which include allergy shots as well as sublingual allergy tablets.

Allergies can feel like a mystery to allergy suffers, what are a few interesting things people may not know about allergies?

As we talked about ragweed earlier, it’s interesting to note that some patients with ragweed allergy can experience oral allergy syndrome. This is because some pollen such as ragweed can cross-react with certain fruits and vegetables that can result in itchy mouth and throat as well as swelling and rarely anaphylaxis. Ragweed allergy can result in such symptoms after ingestion of some melons, banana, cucumber, zucchini as well as white potato.

Another interesting allergy is a condition termed “Pancake Syndrome.” This condition describes the development of severe allergic symptoms including anaphylaxis after ingestion of flour contaminated with dust mite in patients with dust mite sensitivity. For this reason, it may be beneficial to store wheat refrigerated in low humidity.

What are the benefits of testing for allergies?

Indoor and outdoor allergens can variably result in eye, nasal, and skin allergy symptoms as well as asthmatic symptoms. And if you know what you're specifically sensitized to, then you can treat these symptoms with a more specific treatment plan which can include, avoiding your triggers, treating with allergy medications before you expect exposure to increase with the season, or immunotherapy to result in possible long-lasting benefit.


We hope you feel a bit more prepared for the upcoming fall allergy season. No matter what time of the year, you can test for 40 common allergens with our Indoor & Outdoor Allergy Test, so you can always stay one step ahead of allergies.


References

1. Four Things You Might Not Know About Fall Allergies. American College of Allergy, Asthma & Immunology. URL. Accessed August 2020.

2. Seasonal Allergies. American College of Allergy, Asthma & Immunology. URL. Accessed August 2020.

3. Brandt O, Zuberbier T, Bergmann KC. Risk of sensitization and allergy in Ragweed workers - a pilot study. Allergy Asthma Clin Immunol. 2014;10(1):42. Published 2014 Aug 8. doi:10.1186/1710-1492-10-42

4. Oswalt ML, Marshall GD. Ragweed as an example of worldwide allergen expansion. Allergy Asthma Clin Immunol. 2008;4(3):130-135. doi:10.1186/1710-1492-4-3-130

5. Ghiani A, Ciappetta S, Gentili R, Asero R, Citterio S. Is ragweed pollen allergenicity governed by environmental conditions during plant growth and flowering?. Sci Rep. 2016;6:30438. Published 2016 Jul 26. doi:10.1038/srep30438

6. Coronavirus Symptoms. American College of Allergy, Asthma & Immunology. URL. Accessed August 2020.

7. Dave ND, Xiang L, Rehm KE, Marshall GD Jr. Stress and allergic diseases. Immunol Allergy Clin North Am. 2011;31(1):55-68. doi:10.1016/j.iac.2010.09.009

8. ORAL ALLERGY SYNDROME (OAS) OR POLLEN FRUIT SYNDROME (PFS). American Academy of Allergy, Asthma & Immunology. URL. Accessed August 2020.

9. Sánchez-Borges M, Suárez-Chacon R, Capriles-Hulett A, Caballero-Fonseca F, Iraola V, Fernández-Caldas E. Pancake syndrome (oral mite anaphylaxis). World Allergy Organ J. 2009;2(5):91-96. doi:10.1186/1939-4551-2-5-91