Hay fever
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How do doctors diagnose hay fever?

If you're not sure that you have hay fever, it's a good idea to see your doctor.

Many people put up with the symptoms of hay fever because they think they have a cold. But if your symptoms interfere with your life, it's important to find out if you have hay fever because treatments can help.

Doctors can usually tell if you have hay fever by asking about your symptoms and when you get them.
 
 
 
 
 
Source:
Conner SJ.
Evaluation and treatment of the patient with allergic rhinitis.
The Journal of Family Practice. 2002; 51: 883-890.
 
 
 
 
 
1 Your doctor may also look inside your nose and down your throat to make sure you don't have anything blocking them that could be causing your symptoms.

Your doctor may ask if you or people in your family have other types of
 
 
 
 
 
allergy
If you have an allergy to something, your body overreacts when you're around it. The thing you are allergic to is called an allergen. Most allergens are harmless to most people. But if you're allergic to something, your body's system for fighting infection (your immune system) is too sensitive to that allergen. It triggers changes that we call allergic reactions. For example, pollen is an allergen for many people. If you're allergic to pollen, you'll sneeze and have runny eyes when pollen is in the air.
 
 
 
 
 
allergic conditions, such as
 
 
 
 
 
eczema
Eczema is a very itchy rash. It may be dark and bumpy and release fluid. Scratching makes it worse. You can get eczema anywhere on your body, but it is most common on the wrists, the insides of the elbows and the backs of the knees. If you have asthma or allergies you are more likely to get eczema than someone who doesn't have these conditions.
 
 
 
 
 
eczema or
 
 
 
 
 
asthma
Asthma is a long-term disease of the lungs. It makes you wheeze, cough and feel short of breath. Asthma attacks are caused by iflammation and narrowing of the airways, which makes it hard for air to pass in and out of the lungs.
 
 
 
 
 
asthma.
 
 
 
 
 
Source:
Conner SJ.
Evaluation and treatment of the patient with allergic rhinitis.
The Journal of Family Practice. 2002; 51: 883-890.
 
 
 
 
 
1

Allergy tests
Skin-prick tests
Your doctor may suggest that you have a skin-prick test. This test can help your doctor tell:

  • If you have an allergy
  • What's causing your allergy.
If you have this test, your doctor will use tiny amounts of things that cause allergies.
 
 
 
 
 
Source:
Conner SJ.
Evaluation and treatment of the patient with allergic rhinitis.
The Journal of Family Practice. 2002; 51: 883-890.
 
 
 
 
 
1
 
 
 
 
 
Source:
National Institute of Allergy and Infectious Diseases (NIAID). NIH.
Something in the air: airborne allergens.
April 2003. Available at http://www.niaid.nih.gov (accessed on 2 July 2008).
 
 
 
 
 
2
 
 
 
 
 
Source:
National Institute of Allergy and Infectious Diseases.
Allergies: Questions and answers
February 2000. Available at http://www.medhelp.org/NIHlib/GF-490.html (accessed on 1 July 2008).
 
 
 
 
 
3 For example, your doctor may use
 
 
 
 
 
dust mites
Dust mites are tiny creatures that live in dust. You can't see them with your naked eye. Many people have an allergy to dust mite droppings.
 
 
 
 
 
dust mites and pollens found where you live.

You doctor will inject these into the skin on your lower arm or put them on a tiny pinprick made in the skin on your arm or back.

If you're allergic, you may get a small bump around where the test was done. (This is called a wheal.) And the skin around the bump may turn red. If these things happen, you've had a positive reaction.

But it may take some time before you and your doctor figure out what's causing your allergy because these tests aren't always reliable.
 
 
 
 
 
Source:
National Institute of Allergy and Infectious Diseases (NIAID). NIH.
Something in the air: airborne allergens.
April 2003. Available at http://www.niaid.nih.gov (accessed on 2 July 2008).
 
 
 
 
 
2 For example, your skin may not react to the pollen that's causing your hay fever. Or your skin may react to something that doesn't cause hay fever.

Some people may have a reaction but never have any symptoms of hay fever. About half of people with positive skin-prick tests do not get hay fever symptoms. So, you should only have a skin-prick test if you get hay fever. Or you might end up with treatments you don't need.

You can get skin-prick tests done at doctors' offices. But doctors in the US don't recommend testing for everybody. Your doctor will probably only suggest a skin-prick test if it's uncertain whether you have hay fever. Or if your treatment isn't working well, you may need to find out which pollen you are allergic to so you can avoid it or have immunization against hay fever.

Blood tests
You can also have blood tests to help find out if you have an allergy.
 
 
 
 
 
Source:
National Institute of Allergy and Infectious Diseases (NIAID). NIH.
Something in the air: airborne allergens.
April 2003. Available at http://www.niaid.nih.gov (accessed on 2 July 2008).
 
 
 
 
 
2
 
 
 
 
 
Source:
Skoner DP.
Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis.
Journal of Allergy and Clinical Immunology. 2001; 108: 2-8.
 
 
 
 
 
4

The tests can show if you have certain
 
 
 
 
 
antibodies
Antibodies are an important part of your immune system. They are proteins made by white blood cells (another part of your immune system). They help destroy bacteria and other agents that cause infections.
 
 
 
 
 
antibodies in your blood. Your
 
 
 
 
 
immune system
The immune system is made up of the parts of the body that are devoted to fighting infection. The body is constantly being threatened by infections from things like bacteria, viruses and parasites. The immune system fights these infections in different ways. At the microscopic level, the immune system uses antibodies and white blood cells, which travel in the blood and target infectious agents, such as bacteria. These microscopic parts of the immune system either kill the infectious agent directly, or take it to other parts of the body, like the spleen, where it can be dealt with. The lymph nodes are another important part of the immune system. Within them, white blood cells filter through the foreign material that has entered the blood, to see if there are any infections. When you have a swollen gland during a cold, this is actually a lymph node that is reacting to the infection. Unfortunately, it is possible for the immune system to become confused and to use its destructive powers to target healthy parts of the body. Diseases that result from this type of situation are called autoimmune diseases.
 
 
 
 
 
immune system usually releases antibodies to fight
 
 
 
 
 
infection
You get an infection when viruses, bacteria, fungi or other tiny organisms get into your body. These bugs are so tiny that you can't see them without a microscope. For example, an infection in your airways causes the common cold. And an infection in your skin can cause rashes such as athlete's foot.
 
 
 
 
 
infections. But it also releases them if you're having an allergic reaction.

The antibody that your doctor looks for is called specific immunoglobulin E against pollen (or IgE for short). If you have an allergy like hay fever, your immune system makes IgE when you breathe in pollen or mold spores. A blood test can show how much of this antibody is in your blood. An older blood test is known as a RAST test (short for radioallergosorbent test).

Do I need to see a doctor who's specially trained in allergies?
An allergist is a doctor who's had extra training in dealing with allergies. It may be worth seeing an allergist if your symptoms are severe, your treatments don't seem to work well or you have other allergies, too. An allergist may be able to do more tests to find out what's going on and may be able to get your symptoms under control.
 
 
 
 
 
Source:
American Academy of Allergy, Asthma and Immunology (AAAAI)
Control your allergies and asthma. Ask the right questions: FAQ guide to allergies
2003. Available at www.aaaai.org/springallergy/2003/faq.stm (accessed on 2 July 2008).
 
 
 
 
 
5

Sources for the information on this page:
  1. Conner SJ.Evaluation and treatment of the patient with allergic rhinitis.The Journal of Family Practice. 2002; 51: 883-890.
  2. National Institute of Allergy and Infectious Diseases (NIAID). NIH.Something in the air: airborne allergens.April 2003. Available at http://www.niaid.nih.gov (accessed on 2 July 2008).
  3. National Institute of Allergy and Infectious Diseases.Allergies: Questions and answersFebruary 2000. Available at http://www.medhelp.org/NIHlib/GF-490.html (accessed on 1 July 2008).
  4. Skoner DP.Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis.Journal of Allergy and Clinical Immunology. 2001; 108: 2-8.
  5. American Academy of Allergy, Asthma and Immunology (AAAAI)Control your allergies and asthma. Ask the right questions: FAQ guide to allergies2003. Available at www.aaaai.org/springallergy/2003/faq.stm (accessed on 2 July 2008).
This information was last updated on May 01, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
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