Q

Dear Beth,

Thanks for asking about allergy symptoms and allergy shots in the elderly.

Allergy may occur at any age from birth until death. Last week, I helped a 93 year-old grandmother with her terrible tree pollen allergies.

It is most important to make an accurate diagnosis in order to treat patients correctly. Diagnostic allergen skin testing can help to make an exact diagnosis, even in the elderly.

It is unfair to discriminate against someone on the basis of their age!

I rarely use allergen immunotherapy injections in patients above 60 years, since they respond very well to available medications.

There is no reason not to test a patient with allergy symptoms. After all, you miss more by not looking than not knowing.

A more common condition that affects seniors is Non-Allergic Rhinitis, also known as Vasomotor Rhinitis. This is a condition of hypersensitivity in the nose, sinuses and eyes, which is associated with a runny nose and eyes without any itching when exposed to irritants including cold air, ozone or perfumes.

People with Vasomotor Rhinitis also have cold hands and cold feet. It is not due to their immune system or an over-reaction to allergens; Vasomotor Rhinitis is due to your autonomic (automatic) nervous system over-reacting to noxious stimuli. Importantly, Vasomotor Rhinitis is treatable – even if you are 93 years old!

I hope this brief response helps you and your grandmother.

Good luck.

Steve Kagen, M.D.