It is possible that your daughter has post-nasal drip that is irritating her throat, or less likely, there could be swelling in her throat. I suggest you have an allergist evaluate her before you try any new medications. Although Zyrtec (cetirizine) is a wonderful medicine and can be conveniently purchased over-the-counter, it is not doing the trick! She might benefit from a different antihistamine and the addition of a nasal steroid spray and even pretreatment with a saline rinse. If you find that she also has wheezing in her chest, then an inhaler such as a bronchodilator (with or without an inhaled steroid) would be added. Q2. I have had a lot of allergies all my life - to dust, molds, trees, weeds, ragweed, and cockroaches. I am constantly clearing my throat because of “tickles,” and it’s annoying to those around me. I suck on lozenges and take Singulair, Nasacort, and albuterol but nothing seems to stop the constant tickle and phlegm in my throat. Any suggestions? I have a couple of suggestions. I think of “tickling” sensations as being similar to itching sensations, which reflect the release of histamine. You didn’t list an antihistamine among your medications. I would try taking a nonsedating one, without an added decongestant (which can be drying), for a month straight to see if the tickle gradually subsides. Loratadine (Claritin), fexofenadine (Allegra), or cetirizine (Zyrtec) are good choices. Next, if you think that the tickle is related to residual postnasal drip from your sinuses, then try sinus rinsing with salt water once a day in the morning. There are many ways to do this, although I like the NeilMed kits, which are available in many pharmacies and online. They cost about $12 and are easy to use for most people. This is a helpful nondrug treatment for many people with allergies. Are your other allergic symptoms fully controlled? If not, you may simply be someone who needs stronger allergy treatment to feel well. Allergy injection immunotherapy is usually the next step for someone who has tried a reasonable combination of medications but still has symptoms. Another possibility to consider is that you have acid reflux that you are not aware of. This can cause chronic throat irritation. If you think my other suggestions don’t apply, then talk to your doctor about this one. Sometimes people try three months of prescription-strength antacid therapy to sort this out, but you should consider the other possibilities first. Q3. Both of my sons had an ImmunoCAP [allergy test] recently, and the results showed high levels of IgE [immunoglobin E antibodies] to soy, egg, and peanut. However, both of them have been drinking soy milk and eating noodles since they were little. Should I be worried? — Anh, Pennsylvania For those who are not familiar with ImmunoCAP testing, it is a type of blood test for allergies. Older versions of this testing were called RAST (short for radioallergosorbent tests). The important thing to realize with any type of allergy testing, including ImmunoCAP or skin testing, is that a positive test really means that the person has the potential to react to that allergen. Not all people with a positive test will actually have symptoms when they are exposed to that allergen, for there are other important factors in determining whether someone reacts. Unfortunately, these other factors are not fully understood and cannot be measured. Therefore, when making a diagnosis of food allergies, for example, allergists put a lot of importance on what has happened when the person was exposed in the past. Another point is that for some food allergens, such as egg, a person could have a positive test and still be able to eat fully cooked eggs (such as those found in noodles), but not eat eggs that are not as well cooked (such as scrambled eggs). The ImmunoCAP test cannot distinguish those types of details. In the case of your sons, I wonder if these tests were ordered to evaluate eczema (atopic dermatitis). Sometimes children with eczema have positive blood tests for food allergies and can eat those foods without getting the symptoms usually associated with food allergies (hives, flushing, swelling, vomiting, or passing out). The only symptom may be a worsening of the eczema, and it can occur one to two days after ingestion. If your sons do not have this skin condition, then the test results are probably falsely positive. The person’s ability to eat a food always trumps the test results. I hope some of this information helps. Learn more in the Everyday Health Allergy Center.
