Allergies age

With one, they disappear over the years. They only arise with the other: allergies are not a question of age

Allergic in old age: Experts advise that allergies be precisely diagnosed and treated. Otherwise, they can develop into chronic diseases

© W & B / Dr. Ulrike Möhle _istock / Dimitris66

Either you belonged or not and could consider yourself lucky. Because whether one had an allergy or was spared from the pathological immune reaction was long considered fate that was certain early on. It is now clear: anyone can develop allergies, at any age. And they always have to be treated - depending on the patient's situation.

The most common is hay fever, followed by food allergies, eczema and hives. Almost every third adult in Germany reports of a diagnosed allergy in the course of their life. But that doesn't mean that 30 percent of all Germans are currently suffering.

Allergies can occur at different times

If you ask the same person about allergic symptoms in the past twelve months, it is a good 19 percent, according to a large-scale study by the Robert Koch Institute (RKI). Because it happens that allergies become weaker with age or even disappear completely.

Hormones during pregnancy or menopause also often have an effect. "However, we cannot predict in which direction - whether the allergy will get better or worse," says Professor Jörg Kleine-Tebbe from the German Society for Allergology and Clinical Immunology.

In addition, contrary to widespread perception, the number of people with an allergy is not increasing. According to the RKI, the diagnoses of contact allergies and hives even decreased significantly in the period from 1998 to 2013. Probably because allergenic substances such as nickel in costume jewelry or formaldehyde in cosmetics are rarely used. But maybe also because light cortisone ointments are now available without a prescription and those affected go to the doctor less often.

Grandparents suffering from allergies

On the other hand, there is an experience that more and more allergists are having in the treatment room: "We are increasingly seeing older allergy sufferers," says Kleine-Tebbe. "On the one hand, because the patients are now simply getting older. On the other hand, we are also diagnosing the disease for the first time in more and more people at retirement age."

A new allergy in grandparents' age - that seemed unthinkable in the past. And that's a problem: "Many doctors and patients are considering this option," explains Torsten Zuberbier, Professor of Allergy at the Charité in Berlin and head of the European Foundation for Allergy Research. "That is why we need a lot more research into how allergies develop and arise in old age."

Symptoms of typical age-related diseases

The fact that doctors often find it difficult to diagnose is also due to the fact that the symptoms often resemble typical age-related illnesses: infections, for example, symptoms caused by rising stomach acid, so-called age rhinitis, in which external stimuli such as a change in temperature trigger watery rhinitis, but also chronic lung diseases COPD.

Allergy or not?

  • Allergic rhinitis comes in attacks and goes back just as quickly if one is no longer exposed to the allergens. In the pollen season, a prolonged runny nose that is not accompanied by a general feeling of illness suggests an allergic cause.
  • Typical of an allergy are also itchy eyes, not necessarily burning or watery ones.
  • Nocturnal coughing and shortness of breath as well as wheezing noises during exertion can indicate asthma.
  • Anyone who suspects they are allergic to something should note the time after the suspected trigger the symptoms occurred and when they stopped.

"The knee-jerk diagnosis of COPD in people who have never smoked or who have inhaled harmful substances to a large extent is often wrong," complains Jörg Kleine-Tebbe. "I would like more attention from my colleagues. A doctor has to ask the right questions."

Incompatibilities more common in old age

So far, science does not know how many people are newly diagnosed with allergies at an advanced age. Individual studies provide evidence: every tenth allergic asthma does not occur until after the age of 60, for example, an Argentinian study in 2018 in the specialist journal showed Asthma Research and Practice.

Most of those affected also reported hay fever in their younger years. So it is probably mostly about the dreaded change of floor: when the allergic complaints slide from the nose one floor deeper into the lungs.

Swiss researchers from the University Hospital Zurich report in an overview study in Allergo JournalSeniors are one to three times more likely to be allergic to medication than younger people. Usually antibiotics were the cause, but also pain killers, heparins (anticoagulants) or anti-epileptics.Non-allergic food intolerances such as those against lactose (milk sugar) also occur much more frequently in old age.

Fit immune system and thin skin

There are various theories as to why more and more seniors are getting sick. For an allergy, the body needs an active immune system. And the immune system of today's retirees is on average much fitter than that of retirees 30 years ago.

On the other hand, the skin becomes thinner and drier with age. This allows allergens to penetrate more easily. The proton pump inhibitors that are widely prescribed to reduce stomach acid are also suspected of promoting allergies. Researchers suspect that food proteins, due to the reduced acid content, get undigested into the intestine and from there into the metabolism. So they can trigger allergies.

Take allergies seriously

Patients should have their allergy thoroughly diagnosed and treated. "If allergic asthma is not treated properly, it can become chronic and then, regardless of the allergy triggers, occur during exercise or infections," warns Jörg Kleine-Tebbe. "This is a really serious illness that usually lasts for life."

Torsten Zuberbier warns that minor allergies should also be taken seriously: "In a study recently published by us, seven percent of the hay fever patients surveyed blamed their allergy for a traffic accident or a near-accident. If you sneeze, you cannot really react for a moment."

No age limit for allergy therapy

The allergist emphasizes that there have long been allergy tablets (antihistamines) that do not make you tired, or only slightly. Or cortisone nasal sprays, which are considered to be well tolerated even after prolonged use. Specific immunotherapy, known as desensitization, is also one of the treatment options in old age.

"In contrast to the past, there is no longer an age limit today," explains Jörg Kleine-Tebbe. "Studies indicate that people affected in old age also benefit from it, especially if they have developed a new allergy."

However, experts only recommend the injection or tablet cure if conventional medication does not help enough and other prescribed medications, such as beta-blockers, do not prevent it.

So far, it has not been possible to prevent allergies in adulthood. Those who do not yet belong to those who sniff and cough can still consider themselves lucky - but with reservations.