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How to Fight Allergies in February

You may think just because the leaves aren’t on the trees that you don’t have to worry about springtime allergies.

Think again.

Avoiding the worst of spring’s hay fever symptoms means taking action before the pollen starts swirling. The exact timing of that magic window depends on how mild the winter was, but it’s usually a safe bet in the Southeastern U.S. to start taking an over-the-counter (OTC) antihistamine in February.

While most antihistamines start working in an hour or two, they don’t reach peak efficacy for several days or even weeks. “They’re most effective when taken before you have symptoms,” says Dr. Marc Cromie of Chattanooga Allergy Clinic. “Once the pollen starts everything gets inflamed and it can be really difficult to catch up.”

It is possible to get a handle on springtime sneezing. As with most things, the best strategy is a multi-tiered approach including medicine, homeopathic methods and prevention, including allergy immunotherapy for persistent cases.


Antihistamines are the mainstays of over-the-counter therapy, says Dr. Cromie. They’re less expensive, safer and more effective than ever, with limited side effects such as drowsiness. Avoid “D” formulations however. They contain a decongestant, which you won’t need if you start early enough.

If you’re still experiencing hay fever symptoms in the peak of the pollen, experiment with other brands. Some may work better for you than others.

Here are a few options:

  • Loratadine (Claritin, Alavert) – One of the first non-drowsy antihistamines on the market, Loratadine takes up to three hours to take effect.
  • Cetirizine (Zyrtec Allergy, others) – Starts working within one hour. Also available in liquid gel.
  • Fexofenadine (Allegra Allergy) – Allegra is the only fast-acting formula (within an hour) that doesn’t have a “may cause drowsiness” warning label.
  • Diphenhydramine (Benadryl) – Effective but can make you drowsy, so recommended to take at night.


Nasal irrigation, such as a neti pot, can be tremendously helpful for sinus sufferers. The saltwater mixture flushes pollen and other irritants out of the nasal passages and helps clear thick mucus that causes congestion. It’s a good idea to only use for a few weeks at a time when feeling stuffy. A study by the American College of Allergy, Asthma and Immunology suggests that prolonged use can wash away beneficial mucus and its antiviral properties.

There are several different products on the market such as a bulb syringe, squeeze bottle or neti pot. All serve the same basic function, so experiment and stick with whichever method you prefer.


In Chattanooga, pollen can begin in February or March. It’s microscopic and often goes unnoticed – the yellow pollen we see is larger particles and usually too heavy to be allergenic. Here are some ways to prevent exposure:

  • Change clothes after outdoor activities and be sure to shower each night to wash off pollen and other irritants.
  • Keep your pets from tracking in trouble by wiping your dog or cat with a damp towel before they come inside.
  • Wear a mask when mowing the lawn or doing other yard work. Or better yet, delegate to someone else. (“That’s my favorite trick,” jokes Dr. Cromie.)
  • Avoid early morning outdoor activities when pollen counts are the highest.
  • Keep windows closed at home and in the car. Set your car’s air conditioner on recirculate so allergens don’t hitch a ride.


If you take all these steps and still have allergy symptoms, it’s time to see an allergist. Prescription medicines such as nasal sprays that are antihistamine or corticosteroid based can be helpful, and many now come in generic form.

Finally, allergy shots (immunotherapy) are an excellent option for persistent cases. “It’s more of a cure,” says Dr. Cromie. “You retrain the immune system through a series of injections containing small amounts of the allergen. It’s almost like a desensitization protocol. In Europe they call them ‘allergy vaccines’ because of their preventative qualities.”

Immunotherapy can take up to five years, but relief is usually found within three to six months. Shots are given weekly for four to six months, then gradually spaced out to every two weeks, called the maintenance dose. Chattanooga Allergy Clinic also offers an accelerated option, called rush. This protocol drastically speeds up the process, allowing you to reach the maintenance dose in anywhere from several visits to three months.

Allergy shots are the only proven method to actually cure allergy symptoms rather than cover them up like daily medicines do. Plus, recent studies have shown that immunotherapy can prevent asthma from developing by 50 percent.

And that’s nothing to sneeze at.

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CAC Named Finalist for Chamber's Small Business Award

Administrator · 02/06/2013 ·

The Chattanooga Area Chamber of Commerce announced the finalists for the 2013 Small Business Awards this morning at an AM Networking event.  Chattanooga Allergy Clinic was named a finalist in the 51-200 employee category.

The recipients and finalists will be honored on March 13 during the Small Business Awards Luncheon celebrating small business and entrepreneurial excellence in Chattanooga.  The event will take place at the Chattanooga Convention Center from 11:30 a.m. – 1 p.m.

To qualify for a Small Business Award, companies must have owned and operated a business in the Chattanooga MSA for a minimum of three years, have shown exemplary success within their industry and have displayed a high level of community involvement and corporate citizenship. Nonprofit organizations must be committed to ethical practices, engage in community service and exert a positive impact on the community. Candidates for the awards come from the Chattanooga Chamber membership.

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Dr. Cromie Named North GA Best of the Best

Administrator · 01/18/2013 ·

Congratulations to our own Dr. Marc Cromie! He has won the North Georgia Times Free Press Best of the Best for the 3rd year in a row!

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New Gal Alpha Gal Allergy

Administrator · 01/11/2013 ·

Chattanooga has a richly deserved reputation as one of the country’s best spots for spending time outdoors. Our lush landscape beckons Chattanoogans to go outside and play, often in the woods. Unfortunately, this area is also home to several species of ticks. One of these ticks, the Lone Star tick, found mostly in the Southeast, has contributed to a new problem. When these ticks bite people, a chain reaction occurs that can lead to an unusual meat allergy. Some of the proteins from the tick’s saliva can trigger the development of allergic antibodies against galactose alpha 1,3 galactose (Gal Alpha Gal).

Dr. Todd Levin, a double board certified Allergy-Immunologist at Chattanooga Allergy Clinic, says that these allergic antibodies are found in mammalian meats such as beef, pork, lamb, goat, buffalo and venison. The reaction is not like typical allergic reactions to foods such as peanut, where the reaction occurs immediately after exposure. In Mammalian Meat Allergy Syndrome (otherwise known as Gal Alpha Gal allergy), the reactions are delayed, occurring anywhere from 3 to 6 hours after ingestion.  “Since attending a conference by the people that discovered this new allergy 2 years ago, Chattanooga Allergy Clinic has seen nearly twenty patients with Gal Alpha Gal allergy,” says Levin. “Our experience with this type of allergy has allowed us to make this often difficult diagnosis, by asking the right questions about diet and tick exposure.” Mammalian Meat Allergy can develop within a few weeks of a tick bite, but the diagnosis may take longer to sort out. In fact, there may be other potential causes yet to be discovered. To speed up the diagnostic process, the physicians at Chattanooga Allergy Clinic take a detailed history of the allergic reaction, focusing on the timeline of when each food was ingested. Once Gal Alpha Gal allergy is suspected, Levin says that cutting edge lab tests developed by researchers at the University of Virginia can confirm the diagnosis.

These patients can experience typical symptoms of food allergies including hives, itching, and swelling. Some patients may even have anaphylaxis, a severe allergic reaction that includes nausea, vomiting, diarrhea, shortness of breath, drops in blood pressure, and rarely, passing out.

Gal Alpha Gal can be found in nearly all routinely eaten mammalian meats, but it is not present in fish or poultry. People and primates do not have Gal Alpha Gal. It can be found in small amounts in cow’s milk and gelatin, which is made from animal products. Gelatin is found in some pill capsules, marshmallows, candies, and of course, Jello. “Even though there have been some reports of people reacting to milk or whey containing protein powders,” Levin says, “most patients that have Gal Alpha Gal can tolerate dairy products.” Interestingly, many patients will initially only react to one type of meat, most commonly beef, but later on, may become sensitive to other red meat.

As far as treatment goes, Dr. Levin says that the best advice is avoidance of red meat since there is currently no cure. Patients should always carry an epinephrine auto-injector such as EpiPen in case of accidental exposure. Research looking at the course of this syndrome is ongoing, but it looks like some patients can “outgrow” this allergy if they avoid the trigger foods strictly and don’t get any more tick bites.

Chattanooga Allergy Clinic is now accepting new patients. Please call (423)899-0431 for an appointment.

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