Hudson Allergy

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Do you have allergies? The answer may surprise you.

allergies, allergy testing, seasonal allergies

Deciding if you are experiencing an allergic reaction and need to get tested for allergies can be tricky. In peak allergy season, many of our patients commonly think that they have a cold or the flu before realizing their symptoms were a result of having allergies.

Do you have allergies?

With ragweed season quickly approaching, we thought we’d let you in on some tips straight from our experts, Dr. Julie Kuriakose and Dr. Tim Mainardi.

Check out our Q & A to see if it’s time to see your allergist:

Q: What’s the most common reason it takes people so long to actually get tested for allergies?

Dr. Mainardi: Many people think that because they have never had a history of allergies before they are immune to all allergies, and many people do not know that you can develop an allergy at any time. So even if you got tested when you were very little, it’s probably wise to get tested again later in life.

Q: You can really develop an allergy at any point in your life?

Dr. Kuriakose: Yes, you absolutely can. We see it a lot in patients who have recently moved to New York City and are suddenly exposed to a variety of new environmental allergens. Pollution, changes in the food we eat, even changes in how we are exposed to food allergens may all be factors in developing allergies.

Q: What are the main differences between cold symptoms and seasonal allergy symptoms?

Dr. Mainardi: It really depends, but if your “cold” is lasting longer than seven to ten days and doesn’t seem to be subsiding with over the counter meds, you are going to want to see a doctor no matter what.

Q: Any signs to look for at the onset of new symptoms?

Dr. Kuriakose: Usually allergy sufferers experience nasal congestion, sneezing, runny nose, and itchy and watery eyes as their main symptoms, along with a scratchy throat.

Q: Is there a rule of thumb for determining when it could be something like the flu verses allergies?

Dr. Mainardi: It really just depends on what each individual is allergic to, however, there are always peak allergy seasons based on your location when you should stop and ask yourself: “Do you have allergies?”. People allergic to tree pollen, for example, will usually experience the worst reactions in spring or fall when the flu is less common, so sometimes time of year can offer a small hint as to what the real problem is. Certainly the presence of a fever is more suggestive of an infection and not something you would typically see in an allergic reaction.

Think you might be experiencing allergy symptoms? Come in to get tested today.

We’re experts who care, on your schedule, around the corner. Just walk in.



photo credit: I’m sick. via photopin (license)

Food Challenges

Patients may be asked to undergo a food challenge if blood tests and skin prick tests don’t yield a definitive diagnosis, or if the history of allergy is highly questionable. Oral Food Challenges (OFC) are the gold standard for ruling out a food allergy. Food challenges have the potential to cause a serious reaction in patients, which is why it’s critical that these tests are only performed by experienced medical staff at a medical facility. There are comprehensive guidelines that the medical community has created for food allergy testing.

In a food challenge, an allergist will provide the patient food in controlled doses, beginning with small amounts. The patient is observed after each dose for any signs of an allergic reaction. If no symptoms are present, the patient will receive increasingly larger doses of the food with subsequent monitoring. If a patient shows signs of an allergic reaction, the food challenge stops and the patient will be given medication to relieve symptoms. If there are no symptoms during the food challenge, that particular food is ruled out as an allergy. If your allergist confirms a true food allergy, they will prescribe any necessary medications and discuss food safety and food avoidance techniques.

Rush Immunotherapy

Rush immunotherapy is a variation on more traditional immunotherapy in that it “rushes” the first phase of treatment. A single “rush day” is chosen, and over four hours, the patient receives the equivalent of 3-4 months of immunotherapy. The procedure is as safe as traditional immunotherapy, but much cheaper for the patient. This process speeds along the initial build up phase, but patients still need to continue their regular allergy injections. Allergy shots will be given for a period of 3 to 5 years as determined by your allergist.

A complete evaluation by a physician is needed before rush immunotherapy can begin, as there are some conditions that might prevent a patient from undergoing the procedure. After scheduling rush immunotherapy the physician will review a patient’s allergy test results and decide which allergens will be included in the shot serum prior to scheduling rush immunotherapy. The allergy serum will be mixed specific to each patient.

It’s Ragweed Season – Here’s What You Need to Know

The late summer season has brought an unwelcome guest for allergy sufferers: ragweed.


Ragweed is a flowering plant whose pollen causes up to 50% of all cases of pollen-related allergic rhinitis in North America, according to a peer-reviewed article in Swiss Medical Weekly. A single ragweed plant can produce nearly one billion pollen grains in a single season. The pollen is transported by the wind and has even been found two miles into the atmosphere and 400 miles out at sea.

As such, it can be difficult for allergy sufferers to avoid ragweed pollen. There are 17 different species of the plant in the United States and, while it is most common in the rural Midwest and the East, it is found throughout the country.

Ragweed season begins in August and lasts until mid-October. This year, ragweed pollen was detected in NYC as early as August 11th! Did it affect you?

Ragweed allergies occur when the body’s immune system mounts an overzealous response to the harmless grains of ragweed pollen. Immune cells release antibodies to the proteins found in ragweed pollen, which causes histamine to flow into the blood stream. Histamine causes symptoms that are very familiar to allergy sufferers – itching, sneezing, nasal congestion, disrupted sleep, hives, and red or puffy eyes. If the ragweed allergy is severe it can lead to chronic sinusitis or asthma.

Because it is so widespread it can be difficult to avoid ragweed pollen altogether, but here are a few tips to minimize exposure:

1. Stay indoors when pollen counts are at their highest (if possible). Pollen counts are typically higher in the morning and late afternoon. Downloading pollen tracker apps for cell phones and mobile devices allows allergy patients to know when counts will be at their highest and take extra measures to avoid it.

2. Keep windows closed. Use an air conditioner to cool your house instead – but first make sure the air conditioner’s filter is new and properly installed. A HEPA filter will help remove pollen from the air in your home.

3. Change your clothes after coming in from outside and, if possible, shower immediately and wash your hair to remove pollen.

4. Don’t dry your clothes on a line outside. The clothes will collect pollen that will then be transferred into your home.

5. Regularly wash your pets to remove accumulated pollen from their fur.

6. Have someone else take care of the yard work. Outdoor activities like mowing the lawn or raking leaves can stir up pollen. Avoid this by hiring someone to perform your outdoor chores (or cash in on a favor from a friend or neighbor).

If you’re interested in being tested for seasonal allergies or have questions about resources available to people with allergies, give us a call. Or, if you are looking for an allergist, we’d love to meet you. We can be reached at 212-729-1283 or send us an email at

What’s the Difference Between an Allergist and an ENT?

Are allergists just for allergy season? The answer is no!

When the traditional allergy season winds down and people begin to experience symptoms affecting their noses and throats, they may debate whether to book an appointment with an allergist or an ENT. How do you know which doctor to visit? And what exactly is the difference between an allergist and an ENT?

An allergist is a physician who specializes in the medical management of nasal inflammation, asthma, and food reactions.

ENT doctors specialize in structural problems that can be corrected with surgery, such as cartilage or bone defects. In general, an ENT is considered a surgical specialist because their medical training begins with general surgery and then they continue on to training in head and neck medicine.

An otolaryngologist (or “Ear Nose and Throat doctor”) treats conditions that affect the ear, nose, throat, head, and neck, that may or may not be allergy related. These issues include speaking, hearing, swallowing, balance, nasal passages, and sinuses. A patient with nasal breathing difficulties, a sore throat, or trouble hearing would visit an ENT.

Board certified allergists receive years of training in the diagnosis, treatment and management of allergic conditions in addition to their internal medicine and/or pediatric accreditation.

Allergies may affect many parts of the body and organ systems, including the skin, lungs, gastrointestinal system, eyes, ears, and sinuses. Allergists receive substantial training in treating all of a patient’s allergic symptoms regardless of what parts of the body are impacted. Allergists can carefully, knowledgeably, and holistically guide patients through allergy treatment.

Seasonal allergies cause approximately 20% of allergic rhinitis cases and 40% are chronic rhinitis, according to an In-Depth Report from The New York Times. The remaining cases are mixed.

Allergic rhinitis is caused by both indoor and outdoor allergens. Outdoor allergens usually cause seasonal allergic rhinitis while indoor allergens can cause year-round allergic rhinitis. If rhinitis lasts for a longer period of time, it is called chronic rhinitis. Chronic rhinitis is often caused by allergies, but can also be related to infections or structural problems.

Nasal allergies and inflammation are a chief cause for many sinus difficulties and their associated symptoms, it is beneficial to make an appointment with an allergist first. If your allergist detects sinus structural issues along with allergy symptoms, they will refer you to an ENT for further treatment.

If you’re interested in being tested for allergies or have questions about resources available to people with allergies, give us a call. Or, if you are looking for an allergist, we’d love to meet you. We can be reached at 212-729-1283 or send us an email at

Understanding the Triggers of an Alcohol Intolerance

Do you experience flushed skin, nasal congestion, or hives after you consume alcohol? Or, do you experience sickness after only one or two drinks? You may have an alcohol intolerance.

A true alcohol allergy is rare and most allergic reactions are in response to other ingredients. In some cases, the reaction may be caused by something else in an alcoholic beverage, such as preservatives, grains, yeast, or organic materials.

The most common symptoms include facial redness, hives, nasal congestion or a runny nose, headache, nausea, vomiting, and the worsening of a pre-existing asthma condition.

Here are some common triggers of alcohol intolerance that patients should be aware of:

Wine contains more than one potential allergen source, including proteins, bacteria, yeast, and organic compounds. Specifically the protein allergen LTP is found in the skin of grapes, making red wine more likely to cause an allergic reaction than other types. (White wine is fermented without grape skins.) The most common symptoms of a wine allergy or intolerance are flushed or itchy skin, runny nose, diarrhea, a rapid heartbeat, shortness of breath, and swelling of the lips, throat, and mouth.

The gluten protein is found in numerous grains, including barley, rye and wheat, which are commonly used in the beer brewing process. People with a gluten intolerance may experience a reaction after drinking beer, as the body will mount a time-limited response to the protein with a cascade of inflammatory mediators. Many breweries are becoming more responsive to those with gluten sensitivities and are now brewing gluten-free or gluten-removed beers, as we discussed in our previous blog post, 5 Gluten Free Beers You Need to Know About.

Sulfites and other preservatives
Preservatives like sulfites are added to alcohol to keep it fresh and stop the product from spoiling. They can worsen asthma in some patients and may cause hives or even anaphylaxis.

Produced by yeast and bacteria during fermentation, histamine may be present in some alcoholic beverages. Histamine is a chemical released by mast cells during allergic reactions. It may cause hives, itching, or sneezing.

Tree Nuts
Alcohols with nut flavorings may contain certain condensed extracts that can cause a reaction in patients with a nut allergy. Patients with a nut allergy should exercise caution with distilled liqueurs that may contain nut extracts.

Tree Pollen
If bourbon or whiskey is your drink of choice, you will want to check how they were fermented, as some of these liquors are fermented in oak or other tree barrels. This could cause a reaction in those with a pollen allergy, or you may experience Oral Allergy Syndrome (OAS), a series of allergic reactions near the mouth such as itching, burning, swelling, or tightness in the throat.

If you suspect you have an alcohol intolerance and want to be tested or have questions, give us a call. We can be reached at 212-729-1283 or send us an email at

Interested in learning more about alcohol intolerance? Click here to view our infographic, “Understanding the Triggers of an Alcohol Intolerance & the Allergens That Can Cause a Reaction.”

Allergy Testing

To determine if you are allergic to different substances, allergy skin testing may be necessary.  A skin prick test uses diluted amounts of a common or suspected allergen and punctures the skin on the arm or back with the substance. If you are allergic, you will develop a raised bump, or a wheal, at the test location on your skin.  This positive reaction will take about 20 minutes.

While the skin prick test sounds scary this test is relatively painless and no blood is drawn. Allergy skin testing rarely produces false negatives or inaccurate results that indicate you are not allergic even though you actually are.  Negative results almost always mean you are not allergic to the substance. However a positive test is not 100% conclusive.

Please schedule an appointment to discuss your allergies and see if allergy skin testing is an option for you.