Editor's note: This popular story from the Daily Briefing's archives was republished on March 28, 2019.
Slate's Brian Palmer ponders the "real midlife crisis": Allergy symptoms that lay dormant for decades before returning in a person's 30s, only to diminish around retirement age.
Infographic: 6 ways your pharmacist can save the day
Allergy experts have a basic understanding of how allergies work: Sufferers produce the antibody Immunoglobulin E (IgE) when exposed to things like cat dander or peanuts, which results in sneezing, sniffling, and red, itchy eyes.
However, experts are less clear on why the condition comes and goes. People tend to experience more severe symptoms from ages five to 16, then get nearly two decades of relief before the condition returns in the 30s, only to have symptoms disappear for good around age 65.
Palmer writes that three types of hypotheses—environmental, infectious, and psychological—attempt to explain the diminution of allergy symptoms in your 20s:
Meanwhile, the remission of allergy symptoms in the golden years is due to a decline in immune function, which diminishes a person's IgE response to allergens. Other people with weakened immune systems, including women in late pregnancy and people on medications that suppress immunity, may also experience fewer allergy symptoms.
There is little research on how to stave off the re-emergence of allergy symptoms in one's 30s, Palmer writes.
"It appears that the best advice to stave off the return of allergies is either difficult or unpalatable," Palmer writes. On the one hand, "You could live the life of a vagabond, constantly on the run from the substances that trigger your hyperactive immune system," or, "You could forgo children, in hopes of avoiding the midlife surge of infections that kids seem to bring," he suggests.
Realistically, the best solution is to follow standard protocol. "We have drugs to treat allergies," says Mitchell Grayson, an associate professor of allergy and immunology at the Medical College of Wisconsin, adding, "They work pretty well" (Palmer, Slate, 4/14).
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