Allergy and the Voice

Weekly Teaching Tip – Jan. 28, 2013

I  would like to briefly give an over view of allergy and then discuss its affects on the voice.  I will not discuss much about food allergy because it comprises only 20% of the allergy  picture and has less affect on the voice than inhalant allergies. We break inhalant allergy down into Perennial and Seasonal  groups.  Perennial allergy is “ year round allergy and is comprised of grasses , trees , and weeds.  Seasonal  allergy would be things like feathers, dander , molds , and dust mites etc.  In the Mountain West  we find trees pollinating in March through May , Grasses pollinate May to mid July with a brief resurgence in early August  and lastly the Weeds are a problem in general from August  through October when it freezes.  These  are  general  guidelines that give us an idea of what might be causing our allergy symptoms  in each season. One should note that alfalfa (hay) is a weed along with Sagebrush.

We consider the nose to be the target organ where the pollens are inhaled and the allergy process begins.  The pollens attach to the nasal lining cause certain chemicals in the blood to be released such as histamines, cytokines and leukotrienes.  These in turn cause swelling of the airway tissue and blood vessels and make the blood vessels leaky, allowing fluids to go into the surrounding tissues.  In turn we get swelling (edema) , mucous production and itching

We try to teach people with allergies to avoid what they can, such as dogs , cats , feather pillows and down comforters etc.  Common antihistamines are Cetirizine (Zyrtec) , Loratidine (Claratin) and Allegra (Fexofenidine) .  The most common antileukotriene is Singulair.  Used sparingly and in combination with Guiafenisin ( a mucolytic) one will not experience a great deal of mucous on the vocal folds. Typically for singers the safest and most effective   allergy medication is a nasal steroid.  Don’t be alarmed with the mention of steroids.  Nasal steroids have been used for over 50 years and side effects are very minimal, if any.  The downside is they have to be used daily for maximal effectiveness. Nasal steroids do not dry the mucosal blanket of the vocal folds.  Oral steroids in short tapering doses can be used very effectively for severe debilitating allergy, by decreasing vocal fold swelling and moisturizing.  When taking antihistamines remember to hydrate well and take mucolytics such as Mucinex,  Humibid and the generic name is guiafenisin.  Don’t force the voice or over sing if allergies are out of control, you may do harm to your vocal folds and create poor singing habits.

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