Maybe you’ve been a loyal pet parent your entire life even though the dander makes your eyes a little itchy. Lately, though, it seems like your symptoms are getting worse. Or you’ve lived through decades of allergy seasons without so much as a sneeze — until this year. Perhaps you develop an allergy to a medication you’ve taken for years.
What gives?
“People are often surprised to learn that allergies can develop at any time in life — either because of a new allergy or a new exposure from moving to a new location,” said Lee Sommerfeld, DO, a family medicine specialist with Banner Health. Allergies can affect people of any age, and they may affect older people differently.
Allergies happen when your immune system reacts to substances (allergens) that are typically harmless to most people. Reactions could be mild, like sneezing and itching or severe, like anaphylaxis, which can cause trouble breathing and be life-threatening.
As you get older, your immune system changes. So you could develop new allergies or need different ways to manage allergies you’ve had for a long time.
Allergies can complicate other health conditions you may have, like asthma or heart disease. It can be harder for you to recover from severe allergic reactions when you’re older. And allergy symptoms may be more likely to be mistaken for something else in seniors.
Which allergies are common in older adults?
“Common allergies can include indoor allergies like dust or pet dander, or outdoor seasonal allergies including pollens,” Dr. Sommerfeld said. A lot of the allergens that strike younger people are common in seniors as well:
- Pollen: Seasonal allergies caused by pollen from trees, grasses and weeds can lead to sneezing, nasal congestion and itchy eyes.
- Dust mites: These microscopic creatures thrive in household dust and can be a problem in places where dust builds up easily. They can cause sneezing, coughing and itchy skin.
- Mold: Mold spores can be found in damp or humid indoor areas. They can lead to breathing issues, such as coughing and wheezing and can make conditions like asthma worse.
- Pet dander: Allergies to dander from cats and dogs are common. They can cause itchy eyes, runny nose and trouble breathing.
- Certain foods: Food allergies often start in childhood, but older adults can develop them too. Common culprits include shellfish, nuts and dairy.
- Medications: Some older adults may become allergic to medications they have taken for years, or to new medications prescribed for them.
How can allergies be different in seniors?
Aging and changes in the immune system can mean allergies look and feel different in older adults.
- Different symptoms: Older adults may have less-typical symptoms, like fatigue or digestive issues instead of sneezing or itchy eyes. This can make it harder to spot an allergy.
- Worsening chronic health problems: Allergies in older adults can make conditions like asthma, cardiovascular disease or diabetes worse.
- Reduced immune response: The immune system may get weaker with age. That can change allergy symptoms and make it harder to recover from severe allergic reactions.
- Multiple medications (polypharmacy): Many older adults take multiple medications, which can interact with each other or cause new allergic reactions. It can be hard to tell the difference between the side effects of medications and true allergic responses.
- Allergies that start later in life: Allergies that develop later can lead to confusion and a delay in diagnosing them.
What older adults should know about allergy medications
Older adults can generally use many of the same allergy medications as younger people. But if you’re older, you should be aware of possible interactions or side effects. “Treatments can be systemic or focused on the specific symptoms,” Dr. Sommerfeld said.
- Antihistamines: These medications help with sneezing, itching and runny nose. Common types include loratadine (Claritin), cetirizine (Zyrtec) and diphenhydramine (Benadryl). Older adults should be careful with antihistamines, since they may interact with medications like blood pressure treatments and sleep aids.
- Nasal corticosteroids: These reduce inflammation in the nasal passages and include medications like fluticasone (Flonase) and budesonide (Rhinocort). Corticosteroids are generally safe, but they can interact with medications that affect the immune system or blood sugar levels, such as arthritis or diabetes medications.
- Decongestants: These relieve nasal congestion and include medications like pseudoephedrine (Sudafed) and phenylephrine. Decongestants can raise your blood pressure and interact with medications for high blood pressure, heart conditions and depression.
- Leukotriene receptor antagonists: Medications such as montelukast (Singulair) are used to manage allergies and asthma. They are generally safe but can interact with other medications that affect the liver, such as some antibiotics and antifungals.
“Older adults should keep in mind that some over-the-counter (OTC) allergy medications can increase the risk of falls or over-sedation, particularly medications like diphenhydramine and other allergy medications that are not specified as nondrowsy. Even nondrowsy allergy medications can occasionally cause mild drowsiness, so you should take them with caution,” Dr. Sommerfeld said.
You should talk to your health care provider before you start taking any allergy medication, even OTC options. Your provider can review your medications and health conditions to check for any concerns or possible interactions.
If you have other medical conditions, it can help to:
- Keep an updated list of all medications, including OTC drugs and supplements, to share with your provider.
- Carefully read labels and instructions on allergy medications so you’re aware of possible interactions and side effects.
- Watch for new symptoms or side effects after starting a new allergy medication.
- Fill all prescriptions at the same pharmacy, if possible. Pharmacists can review your medications for potential interactions and provide advice.
- Consider options like lifestyle changes or home remedies to manage allergies and help reduce the need for medications.
How to lower your exposure to allergens
When you don’t come in contact with allergens, you won’t have allergy symptoms. It can help to:
- Keep track of when and where your allergy symptoms occur. Note if symptoms get worse in certain areas or during certain activities.
- Regularly clean your home to reduce dust, mold and pet dander. Use a vacuum with a HEPA filter. Clean floors, carpets and upholstery frequently. Wash bedding and curtains in hot water. Clear clutter to reduce dust.
- Use an allergen-proof or hypoallergenic mattress, pillow covers and bedding. Wash your bed linens weekly in hot water. Use dust mite covers on pillows and mattresses.
- Keep indoor humidity levels below 50% to prevent mold. Dehumidify damp areas and ventilate bathrooms and kitchens. Check for mold in basements, bathrooms and kitchens. Address any water leaks or moisture issues promptly.
- Consider using air purifiers with HEPA filters in rooms where you spend a lot of time, such as the bedroom or living room.
- If you have pets, try to keep them out of bedrooms and off furniture. Groom and bathe them regularly.
- During high pollen seasons, keep your windows closed and use air conditioning with a clean filter. Avoid outdoor activities during peak pollen times and change your clothes and shower after spending time outside.
- Have your air ducts cleaned regularly to keep dust and allergens from circulating throughout your home.
The link between hearing loss and allergies
Allergies can affect your ears’ structure and function. They can lead to temporary hearing loss or make existing hearing problems worse. They can cause:
- Inflammation and swelling of the Eustachian tube, which connects the middle ear to the back of the throat. Blockage can cause fluid buildup in the middle ear, leading to temporary hearing loss and a feeling of fullness in the ear.
- Inflammation in the middle ear due to your body’s response to allergens, such as pollen or dust mites. This may lead to symptoms like earache and muffled hearing.
- Sinus congestion, which can lead to pressure changes and fluid buildup that affects hearing.
- Worsening of pre-existing ear conditions like chronic ear infections (otitis media) or tinnitus.
You can take these steps to lower the impact of allergies on your hearing:
- Identify and avoid triggers like pollen, dust mites or pet dander. Keeping indoor air clean with air purifiers and regular cleaning can help.
- Treat hay fever (allergic rhinitis) to reduce inflammation and congestion that can affect the Eustachian tube and middle ear.
- Visit an audiologist or ear, nose and throat (ENT) specialist to monitor and manage any hearing changes related to allergies and prevent complications.
- Stay hydrated and use nasal saline sprays to help keep nasal passages clear and reduce congestion and pressure on the ears.
- Develop an allergy management plan with your health care provider.
How health care providers can help seniors who have allergies
Your provider can review your allergy management plan to see how well it’s working and watch for signs of complications or side effects. If your symptoms or health change, your provider can make adjustments.
Let your provider know about any new medications, health conditions or changes in your living environment that may affect your allergies.
The bottom line
As you get older, you can develop new allergies or changes in allergies you’ve had for a long time. Changes in your immune system mean your body may react differently to allergens.
If allergy symptoms are bothering you, your health care provider or an expert at Banner Health can help you put together a management and treatment plan to help get your symptoms under control.
