What is an allergy?

We've all heard the word allergy, right? But you may be wondering what exactly an allergy is and why it occurs.

Simply put, an allergy is when our body's defense system, the immune system , overreacts to something that normally doesn't harm us. Think of it like the guards in our bodies. Their job is to protect us from enemies like germs that cause disease. But what happens in an allergy is that these guards get a little nervous and start attacking something that isn't really an enemy. This is because the immune system is overreacting and we experience various symptoms when we have an allergy.

What causes allergies? We call these allergens.

We call these things that cause allergies allergens . There are many allergens around us. While some people may not be bothered by them, for someone with allergies, they can be a big problem.

Now let's see what these common allergens are:

• Things that enter when you breathe:
• Pollen : You may have noticed that sometimes when flowers bloom, small powdery things are released into the air from trees. That is called pollen. Many people are allergic to this pollen.
• Dust mites: These are tiny creatures that are too small to see. They live in the dust of our homes, in bedding, pillows, and mattresses.
• Pet dander: Some people are allergic to these things that come from animals like cats and dogs.
• Mold: Mold that forms on walls in damp places can also cause allergies.
• Food and drink types:
• Some foods can also cause allergies. For example, milk, eggs , nuts like peanuts, cashews, soy, wheat, fish, shrimp, and squid are the main ones. However, allergies can occur to any other food besides these.
• Insect bites:
• Some people also develop severe allergies to venom from animals, such as bees and wasps.
• Types of medicines:
• Some medications, such as antibiotics like penicillin, can also cause allergies.
• Things that are touched:
• Some chemicals , such as latex (found in things like gloves), and metals like nickel (found in some jewelry), can also cause allergies when they come into contact with the skin.

What happens inside the body when you have an allergy?

Now you're probably wondering how this reaction happens when an allergen enters the body.

Here's what happens: When an allergen (e.g. pollen) enters the body of a person with allergies, our immune system thinks it's a big enemy. It then makes a special type of antibody called IgE against this 'enemy'. These IgE antibodies go and attach to a type of cell in our body called mast cells .

The next time the same allergen comes into contact with the body, it binds to the IgE antibodies on the mast cells. The mast cells then 'explode' and release a lot of chemicals like histamine . That histamine is responsible for many of the symptoms of an allergy, such as itching, redness , runny nose, and watery eyes.

Simply put: allergen -> IgE antibodies -> mast cells -> histamine -> allergy symptoms

What are the symptoms of an allergy? See if you have these too

The symptoms of an allergy can vary from person to person. They also vary depending on what the allergen is and how it entered the body. Let's take a look at some of the most common symptoms:

• Respiratory Symptoms:
• Frequent sneezing .
• Runny nose (even without a cold).
• Nasal congestion.
• Cough, chest tightness, difficulty breathing (these can also be related to asthma ).
• Itchy throat, voice changes.
• Some people also call this Hay Fever or Allergic Rhinitis .

• Skin Symptoms:
• Itchy skin.
• Itching and redness of the skin ( Urticaria or Hives ).
• Dry, peeling, and blistering skin (these can also occur with conditions like eczema ).

• Eye Symptoms:
• Redness of the eyes.
• Itchy eyes.
• Tears flowing from the eyes.
• Swelling, darkening under the eyes.

• Gastrointestinal Symptoms – (especially in food allergies):
• Nausea, vomiting.
• Stomach ache, bloating.
• Bloating (diarrhea).
• Swelling, itching of the mouth, lips, tongue or throat.

• Other features:
• Itchy ears, feeling of pressure inside the ears.
• Headache.
• Tiredness, fatigue.

The most dangerous allergic reaction: Anaphylaxis

Sometimes an allergic reaction can be very severe. We call this anaphylaxis . This is a life-threatening emergency. What happens is that the whole body reacts at once.

The symptoms of anaphylaxis are:

• Sudden swelling of the face, lips, tongue, and throat.
• Shortness of breath, chest tightness.
• Fainting/dizziness, feeling like you're about to lose consciousness.
• Heart palpitations.
• Cold skin, sweating.
• Nausea, vomiting, stomach cramps.

Anaphylaxis is a medical emergency. If you experience these symptoms, you should go to the hospital immediately. Doctors advise people with some severe allergies to keep an adrenaline injection (like an EpiPen) handy for use in such cases.

How can a doctor find out if you have an allergy?

If you suspect you have an allergy, the best thing to do is see a doctor. The doctor will ask you questions about your symptoms, such as when they occur, what you do, and whether they get worse. They will also ask if anyone in your family has allergies, as allergies can sometimes run in families.

Then, some tests can be done to find out exactly what the allergy is:

• Skin Prick Test: This involves applying a very small amount of a suspected allergen to your skin (usually your arm or back) and pricking it with a small needle. If any of the areas become red, swollen, or itchy within 15-20 minutes, you are allergic to that allergen. This is a quick and easy test.
• Blood Test: Sometimes, for people who cannot have a skin test (e.g., those with severe skin conditions or those taking certain medications), a blood test is done. This tests to see if your blood has the IgE antibodies mentioned earlier against specific allergens. This is also called a RAST test (Radioallergosorbent test), or a Specific IgE test .

By combining the results of these tests and your symptoms, the doctor can tell you exactly whether you have an allergy, and if so, what it is.

What can we do if we have allergies? How can we control this?

Don't panic if you find out you have an allergy. Although it's difficult to completely cure allergies, there are many ways to reduce the discomfort they cause and live a better life.

1. Avoidance of the allergen:

This is the most important thing. If you know exactly what you are allergic to, the best treatment is to avoid it as much as possible.

• If you are allergic to dust, keep your home clean and wash your bedding frequently in hot water.
• If you are allergic to pollen, wear a mask when you are outside in high pollen counts, and take a shower when you get home.
• If you are allergic to a food, avoid eating anything containing that food. Read the ingredients label carefully when buying food at the store.

2. Medications:

Doctors prescribe various medications to control allergy symptoms.

• Antihistamines: These are the most commonly prescribed medications for allergies. They reduce the itching, runny nose, and sneezing caused by histamine. They come in the form of pills, syrups, nasal sprays, and eye drops.
• Corticosteroids: These are powerful medications that reduce inflammation. They come in the form of nasal sprays, inhalers (for asthma sufferers), topical creams, and sometimes short-term pills. These should be used exactly as directed by your doctor.
• Decongestants: Medicines that relieve nasal congestion. However, it is not recommended to use these continuously for more than a few days.
• Leukotriene modifiers: Another type of medication used for asthma and hay fever.

3. Immunotherapy:

This is a long-term treatment. This involves starting with a very small amount of the allergen you are allergic to and gradually increasing the amount, either by injecting it into your body ( allergy shots ) or by giving it as tablets under your tongue ( sublingual immunotherapy – SLIT ). Over time, your body becomes accustomed to the allergen and reacts less. This doesn't work for everyone, but it is very successful for some. This should be done under the supervision of a specialist.

4. Emergency Treatment:

As mentioned earlier, in the event of a severe anaphylactic reaction, an adrenaline injection (like an EpiPen) is a lifesaver. It is very important for people with severe allergies to keep this on hand and know how to use it.

When should I see a doctor? Who is an allergist?

It's a good idea to see a doctor if you have any of these:

• If you have frequent allergy symptoms that interfere with your daily activities.
• If you want to find out exactly what you're allergic to.
• If you have asthma-like symptoms (cough, wheezing, chest tightness).
• If you have a severe reaction to a food.
• If you get bitten by an insect and have a severe reaction.

A general practitioner can treat basic allergy conditions. But sometimes, if the allergy is more complex, difficult to diagnose, or severe, you may be referred to an immunologist . These doctors are specially trained to diagnose and treat allergies. They can do things like skin tests and immunotherapy.

So, what are the things we need to remember from all of this? (Take-Home Message)

Okay, we've talked a lot about allergies now, haven't we? Finally, here are the most important things you need to remember:

• Allergies are not something to be afraid of, but they are important to be aware of. An allergy is simply an overreaction of our immune system to something that is harmless.
• The first step is to find out what you're allergic to.
• Avoiding allergens is the best defense. Stay away from things that are bad for you whenever possible.
• There are good medications to control symptoms. Use them as directed by your doctor.
• Be aware of a severe reaction called anaphylaxis. It is an emergency. In such a case, go to the hospital immediately. If you have a severe allergy, keep an adrenaline injection nearby.
• It's possible to live a normal, happy life with allergies. It just takes managing it properly.

If you have any further questions or concerns, talk to a doctor. They are there to help you.