Allergies – Hay Fever, Asthma, Hives and More in Hamburg-Harvestehude

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Attending Doctors

Dr. med. Carina Borkowski

Specialist in Dermatology, Phlebology, and Laser Medicine

Dr. med. Annika Opitz

Specialist in Dermatology and Allergology

Allergies – Hay Fever, Asthma, Hives

Allergies are exaggerated immune responses in which the body mistakenly identifies harmless environmental substances as dangerous and reacts defensively. An allergy typically begins with sensitization — the first contact with the allergen. Allergies are classified into four types.

The most common are immediate-type allergies (Type I), which include hay fever, allergic asthma, and hives (urticaria). In these cases, allergens bind to antibodies, triggering the release of histamine and other inflammatory mediators.

Contact allergies, on the other hand, belong to the delayed-type (Type IV). Here, inflammation occurs 12 to 72 hours after exposure to the allergen.

Less common are Type II and Type III allergies, which include, for example, transfusion reactions. In these types, antibodies bind to cell-bound antigens, forming immune complexes that can block small blood vessels and cause tissue damage.

Your questions, our answers

What are the most common allergens?

The 14 most frequent allergy-triggering substances are: egg, peanuts, fish, gluten-containing grains, crustaceans, lupins, cow’s milk, tree nuts, sulfur dioxide and sulfites, celery, mustard, sesame seeds, soybeans, and mollusks. In pollen allergies, sensitizations most often occur to birch, alder, and hazel, as well as meadow fescue, rye, mugwort, and ragweed.

How is an allergy diagnosed?

If an immediate-type allergy is suspected, we first perform a prick test with standardized allergens. Blood tests can also detect IgE antibodies, confirming specific sensitizations and overall allergy tendency. An essential diagnostic step is provocation testing, where allergens are applied via nasal spray or eye drops — however, this is only done for Type I allergies. For insect venom allergies, sting provocation tests, and for food allergies, oral provocation tests are performed exclusively in hospital settings under emergency supervision. Contact allergies (Type IV) are identified using a patch test: allergen patches are applied to the back and evaluated after 48 and 72 hours.

What is the difference between food allergy, intolerance, and sensitivity?

Unlike allergies, intolerances and sensitivities are dose-dependent and do not require prior sensitization.

Can allergies be prevented?

Studies show that children breastfed until at least the 4th month of life are significantly less likely to develop allergies later on.

How is hay fever treated?

Symptoms of hay fever can often be effectively managed with antihistamine tablets, nasal sprays containing corticosteroids and antihistamines, and antihistamine eye drops. If symptoms persist, a desensitization (specific immunotherapy) should be considered to prevent progression from the upper to the lower airways (i.e., allergic asthma).

What helps with a house dust mite allergy at home?

For example, cover all duvets and pillows with suitable protective covers. To reduce the presence of house dust mites in the bed, mattresses, duvets, and pillows can also be treated with a spray containing mahalin. It makes the skin flakes on which mites feed inedible. As a general rule: wash or clean bedding every three months at a minimum of 60 degrees Celsius. It is also helpful to keep the bedroom relatively cool at around 18 degrees and to avoid open dust collectors such as shelves or carpets.

What is desensitization (specific immunotherapy)?

For confirmed Type I allergies, we administer allergen extracts either as injections under the skin or as sublingual drops/tablets in increasing doses to build immune tolerance. Treatment usually extends over three years.

What is histamine intolerance?

Histamine intolerance is not an allergy. It occurs when the enzyme diamine oxidase (DAO), which breaks down histamine, is deficient or impaired. Histamine is produced naturally by the body (e.g., under stress) and is also found in many foods. Intestinal inflammation can further disrupt DAO production, as the enzyme is formed by intestinal cells (enterocytes).

What symptoms occur with histamine intolerance?

Due to the impaired breakdown, the histamine concentration in the blood serum increases, leading to the following symptoms: diarrhea, stomach pain, flatulence, “red wine intolerance,” headaches and joint pain, menstrual cramps, itching, hives, swelling of the lips, hands, and feet (angioedema), and worsening of atopic dermatitis.

Which foods should be avoided in histamine intolerance?

To reduce histamine levels, avoid or limit:

Aged cheeses (Camembert, Gouda, Parmesan, Emmental, Cheddar)
Fermented foods (sauerkraut), tomatoes, spinach, eggplant, spring onions
Smoked/pickled fish (herring, sardines, tuna, mackerel)
Cured meats (salami, ham, aged beef)
Alcoholic beverages (wine, beer, champagne, vinegar)
Yeast-based and soy products
Chocolate and cocoa-containing foods
Black tea
Legumes and some nuts (beans, chickpeas, peanuts)
Certain fruits (strawberries, citrus fruits, banana, pineapple, kiwi)

Tolerated foods usually include yeast-free bread, potatoes, rice, pasta, milk products, eggs, fresh meat, fresh or frozen fish, herbs, and most vegetables (except those listed above). Because individual reactions vary, keeping a food diary or using intolerance apps can help identify personal triggers.

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