Understanding the Mental Health Burden of Chronic Allergies and Early Diagnosis: Insights From Thermo Fisher's Gary Falcetano

Gary Falcetano, PA-C, AE-C, features insights on how unaddressed chronic allergy symptoms contribute to mental health burdens and the critical role of early Immunoglobulin E trigger identification in managing both physical and psychological wellbeing.

Gary Falcetano, PA-C, AE-C, US Scientific Affairs Manager for Allergy at Thermo Fisher Scientific, discussed the significant mental health burden associated with unaddressed chronic allergy symptoms and the importance of early diagnosis of specific immunoglobulin E (IgE) triggers. Falcetano highlighted a strong association between seasonal allergies and an increased likelihood of mood disorders, anxiety disorders, and eating disorders.

Falcetano emphasized that confirming allergies is crucial for effective treatment. Conversely, if allergies are confirmed and specific triggers are identified, clinicians can provide personalized exposure reduction strategies and appropriate pharmacological treatments.

This interview was lightly edited for clarity.

The American Journal of Managed Care® (AJMC®): How do you articulate the cumulative mental health burden imposed by the unaddressed physical symptoms of chronic allergies?

Falcetano: I would say probably the best way to articulate that cumulative mental health is from the authors of a 2018 publication. It was published in the International Journal of Environmental Research and Public Health, titled “Seasonal Allergies and Psychiatric Disorders in the US,”1 and this was an interesting study. They used a multivariable logistic regression analysis to look at the relationship between lifetime allergies and lifetime psychiatric disorders.

What they found was [that] a history of seasonal allergies was actually associated with greater odds of mood disorders, anxiety disorders, and even eating disorders. When we looked at that whole population that was studied, there was a 28% greater chance of reporting mood disorders, a 43% greater odds of reporting anxiety disorders, and a 38% [increase in] reporting of eating disorders in that allergic population when compared with individuals who didn't have allergies. They did adjust for different demographics.

The take-home [message] from that study was really that individuals complaining of seasonal allergies should be screened for early signs of mental health problems and referred to specialized services appropriately.

AJMC: How critical is early diagnosis and identification of specific IgE triggers in not only managing physical allergy symptoms but also in proactively safeguarding mental wellbeing?

Falcetano: Our allergy colleagues have long ascribed to the approach that to effectively treat allergy-like symptoms, we must first confirm that allergy is indeed causing the symptoms, because we know that symptoms from nonallergic triggers can really mimic, even overlap, with allergic triggers. After conducting an allergy-focused patient history, they perform diagnostic testing and then correlate the 2 to confirm or rule out the diagnosis of allergy.

Once we know that allergies are ruled out, then that can inform appropriate medication selection, which does not include antihistamines. If you're not allergic, antihistamines will not work. Besides therapeutics, you can also guide recommendations around reducing your exposure to those nonallergic triggers.

The flip side of that is, if allergies are confirmed, knowing those specific triggers, those specific allergens that are involved, allows clinicians to provide personalized exposure reduction recommendations and, of course, appropriate pharmacology as well. By reducing exposure, at least somewhat, and especially in the bedroom, even can make a big difference. What we see is [that] symptoms are better controlled, the efficacy of medications can be improved, and we achieve that symptom control with a minimum effective dosage of medications.

References

1. Oh H, Koyanagi A, DeVylder JE, Stickley A. Seasonal allergies and psychiatric disorders in the United States. Int J Environ Res Public Health. 2018;15(9):1965. Published 2018 Sep 8. doi:10.3390/ijerph15091965