Prairie Doc® Perspectives
Plan Ahead for Fall Mold Allergies
By Mark E. Bubak, M.D.
August 23, 2020
Summer and fall are prime seasons for mold allergy problems. Mold spores are smaller than pollen grains allowing them to not only effect the eyes and nose of allergy sufferers, but they can infiltrate the bronchial tubes and cause asthma. If the allergy or asthma is combined with participation in sports or a rhinovirus cold at the start of school, it could result in asthma attack.
Sudden asphyxic asthma is a condition during peak mold time in which younger patients with alternaria mold allergy can go from breathing well on their own to severe asthma on a ventilator in an afternoon. There are methods to be prepared and take steps to avert this situation.
Most mold spores originate outdoors. Staying indoors and keeping the house, office, and car closed is the main avoidance method. The air conditioner with its filter and dehumidification can help a bit more. Additional filters receive some anecdotal praise but are rarely proven clinically helpful.
We cannot stay indoors all the time. For most sufferers, topical corticosteroid nasal or inhaler preventative (controller) sprays must be started prior to the season. And always keep rescue antihistamines and bronchodilators on hand. Oral or injections of steroids may be needed. Allergy shots (immunotherapy) can be immensely helpful if avoidances and medications do not work well. Shots are the only treatment that makes the patient less allergic to the mold and thus reduce symptoms. Unfortunately, under the tongue immunotherapy has not been highly effective for mold allergy. More recently, new medications call biologics have arrived on the market and may be necessary.
Mold is a major contributor to fall allergy and asthma suffering, but the worst reactions are typically brought on by a combination of triggers. Getting your flu shot can make the flares of allergic asthma far less likely to happen. Washing your hands helps prevent colds and other infections which can exacerbate the problem. And, using your albuterol before sports activity can help.
If you suspect you may have a mold allergy, talk to your primary care physician first. Mold allergies can best be diagnosed with a thorough patient history and physical examination. If allergies are suspected, your doctor can refer you to an allergy specialist who can confirm the diagnosis with allergy testing. If confirmed, you and your doctor can work together to create an allergy and asthma action plan.
In the end, much of the responsibility for staying well is up to each of us. The best way to manage mold allergies is to be proactive, ask for help, then follow the prescribed action plan.
Mark E. Bubak, M.D. practicing in Sioux Falls, South Dakota is a contributing Prairie Doc® columnist. He is certified by the American Board of Allergy and Immunology to care for adults and children with asthma and allergies. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook, featuring On Call with the Prairie Doc® a medical Q&A show streaming most Thursdays at 7 p.m. central.
