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Adult allergies can strike you down anywhere, anytime

Last week, a friend claimed the crab he had for dinner almost choked and killed him. Just as I conjured up an angry crab grabbing his scrawny neck with its giant pinchers, he explained what almost killed him was a sudden allergic reaction to crab shell that constricted his airways and left him gasping over his seafood platter. Sanchita Sharma writes.

health and fitness Updated: Dec 05, 2010 00:39 IST
Sanchita Sharma

Last week, a friend claimed the crab he had for dinner almost choked and killed him. Just as I conjured up an angry crab grabbing his scrawny neck with its giant pinchers, he explained what almost killed him was a sudden allergic reaction to crab shell that constricted his airways and left him gasping over his seafood platter.

Like Hrithik Roshan, he claimed he was rushed to an ER (emergency room) where he was pronounced to have seafood allergy.

I doubt if the chain of events were anywhere as dramatic as his oxygen-starved brain made them out to be, but the fact remains that he developed an acute seafood allergy at the age of 43 after gnawing on fishbone all his life.

Food is not the only thing people react to. Apart from pollen, dander (tiny scales shed from animal skin or hair) and the usual air pollutants that cause wheezing and asthma, allergy triggers can be found in medicines, hair-colour, metals and cleaning agents such as soaps and disinfectants.

I got up on Friday morning with a strange rash on my face. I have no idea how it got there. I hadn't done anything different the day (or night) before than any other day or night of the week. Since the rash wasn't red or itchy enough to be measles or chicken-pox, I popped an anti-allergy pill and headed for work.

When it comes to anti-allergy drugs, I self-medicate without remorse. What's the worse drug reaction that can happen to an anti-allergy pill? An allergy? Well, the drug will take care of that. On a more serious note, the only precaution I take is that I don't take the pills at a stretch.

The fact is that allergies to things well-tolerated even hours ago can occur at any time your life. And sensitivity to new triggers is rising in adults, just as it is in children, the world over. While the acute symptoms are throat constriction and difficulty in breathing, milder symptoms include skin rash, nasal congestion, sneezing, runny nose, itchy throat and eyes, headache, sinus pain or ear pain.

People with allergies have three times the risk of developing asthma as those who are allergy-free. They are also more prone to ear infections and chronic sinusitis.

The reason is that adult allergy sufferers have a genetic predisposition to certain sensitivities that can flare up at any point of their life. The immune systems may take years to become sensitive to an allergen, but when it does, it may reach to it without warning.

Stress, changes in lifestyle, a cleaner environment and changes in the body's hormonal balance are thought to be the main triggers of adult allergy. New thinking is including hormones as triggers as women are more likely to develop allergies at puberty, after pregnancy and at menopause point to hormonal causes, as does stress, which impacts hormones again.

The advocates of the hygiene hypothesis claim that the increased use of antibiotics, vaccines and sterilised food and water prevent the body's natural immune systems from becoming robust enough to fight allergens. The body produces T helper cells, which are white-blood cells at the core of the immune response.

These T cells develop into T helper 1 cells (TH1), which primarily respond to infection, and TH2 cells, which mediate allergic response. In people under-exposed to environmental hazards, the TH1 arm of the immune system does not develop properly, tipping the balance in favour of TH2, which causes allergies.

Early childhood has a role to play. Having siblings, starting preschooling or daycare at a very young age, keeping a pet or living on a village protects people from allergies. Frequent infections before six months of age actually increases risk of skin allergies, which goes against urban legends that infectious diseases early in life actually protect against allergies.

Allergies in adults are treated with medications like antihistamines, antileukotrienes and nasal corticosteroid sprays to reduce the inflammation in the nasal cavities and airways; oral immuno-therapy vaccination for long-term treatment; and a series of anti-allergy shots for those who do not respond to the first two.

But shots are rarely needed. What works is avoiding the allergens, which in my friend's case, means staying away from seafood for life. He, I'm sure, would rather be shot.