Spring Is In The Air — And So Are The Pollens
April 28, 2009
Allergy season is here again, evidenced by the waves of patients coming in to see me complaining of sneezing, nasal congestion, chronic cough, and watery, itchy eyes. Most people have accepted the fact that allergies are one the rise, and that it’s a normal part of living life in the 21st century. Numerous clinical studies confirming this remind us of this fact every day.
But it doesn’t have to this way. Listed below are simple tips to help you lessen the severity of your allergy symptoms, or even prevent it altogether. The more tips you follow, the better your results will be. Not all the tips will apply to everyone, so use common sense in choosing which options to choose from.
Also, before you whole heartedly invest your time and money with these allergy prevention tips, it’s a good idea to make sure you’re actually allergic to seasonal pollens. If you’re not sure, consider seeing an allergist to get tested.
10 Tips For An Allergy Free Season
1. Stay indoors during allergy season or high pollution days, minimizing time spent outdoors. Use air conditioning when indoors.
2. Don’t wear shoes indoors. Allergies, dust, molds and dirt can be brought into your living space. (See my article, An Allergist’s Nightmare: The Micro-Poop Theory).
3. Keep pets out of the bedroom. They can track in dirt, dust, and allergens.
4. Wash your hair or take a shower after you come home or before bedtime. Pollens can settle on your head, which rubs off on your pillow, which you then inhale while sleeping.
5. Try to spend more time at the beach, where there are less pollens.
6. Invest in a HEPA filter for your bedroom (and other rooms as well if you can afford it).
7. When traveling, ask for an allergy-free room. Click here to search for allergy-free rooms.
8. Use saline nasal sprays regularly. Saline flushes out pollens and contaminants, and acts as a mild nasal decongestant. A Neti-pot is one variation. Do this once before bedtime and once in the morning.
9. Consider investing in allergy-free bed sheets (if you’re allergic to dust).
10. Follow the 10 Solutions for Better Sleep I’ve mentioned in this month’s newsletter. Good quality sleep can lower your immune system’s overactivity to allergens.
Deciphering Your OTC (Over the Counter) Meds
If you’ve followed the above and are still suffering, here are some helpful hints regarding over the counter (OTC) and prescription medications. For those of you who are more visual, you can get a print out of an OTC chart organized by symptoms by clicking here.
For simple sneezing, watery, itchy eyes and a runny nose, an antihistamine is your best bet. Three of the newer OTC antihistamines are loratadine (Claritin), fexofenadine (Allegra), and ceftirizine (Zyrtec). In general, ceftirizine is the most potent, as well as having the most potential for drowsiness (about 10% chance). In general, the drowsiness effects wears off after a few doses. It probably safer taken at night. Different people have different rates of effectiveness as well as side effects, so you may have to try all three to see which one works the best for you.
If you have any nasal congestion or sinus pressure, taking one of the above medications that includes the letter "D" can help. The "D" stands for decongestant, which is actually a stimulant that constricts your blood vessels. For some people who are sensitive to oral decongestants (usually stimuoation), it’s not a good idea to take them. If you have high blood pressure or an enlarged prostate, decongestants can sometimes worsen these conditions. Diphenhydramine (Benadryl) is an older antihistamine that’s relatively strong, but has a much higher chance that it can make you drowsy. It’s also the main ingredient in many OTC sleep aids.
If the above OTC medications are not effective, then prescription medications are available. There are a number of topical nasal allergy sprays that contain an anti-inflamatory steroid. These nasal sprays are designed not to enter the bloodstream in significant amounts. The more common brand names are Flonase, Nasonex, Veramyst, Rhinocort, and Nasacort. They’re all essentially the same, but different people with have different reactions, whether it’s how well the allergy symptoms are controlled, to what kind of side effects are seen. Irritation or nosebleeds are two of the most common side effects, but overall, most people tolerate these sprays very well. Your choice is usually made by what’s on your prescription plan’s formulary, and the prescribing doctor’s preferences.
These sprays are meant to be used on a regular basis, which prevents allergy attacks from happening. For example, if you know you have severe spring allergies, then you can start using this on a daily basis a few weeks before the season starts and continue on throughout the season.
Aselastine (Astelin) is a topical nasal antihistamine spray that’s good for acute nasal allergy symptoms. Ipratropium (Atrovent) is also a nasal spray that acts by blocking your nasal nervous system’s signal to cause your nose to produce mucous and congestion. It’s more often given for chronic rhinitis or non-allergic rhinitis, where your nose is overly sensitive to weather changes, chemicals, scents or odors.
If you have severe watery, itchy eyes, and if over the counter eye drops don’t help, then olopatadine (Patanol) eye drops are useful. These are antihistamine eye drops. Studies have also shown that regular use of nasal steroid sprays are almost as effective as topical antihistamine eye drops, but in addition, addresses your nasal symptoms.
Oral steroids are sometimes given for severe allergies or life-threatening allergy attacks. These medications are similar to what your body makes when you’re under stress, and side-effects like weight gain and stomach problems occur more commonly with long-term, high-dose use (such as for asthma or rheumatoid arthritis). A convenient way of taking this is found in a Medrol Dose Pack, which is a moderate dose of steroids that tapers down quickly over 6 days.
If your allergy symptoms are very severe, or you suffer for much longer periods than you desire, then a formal allergy evaluation with testing may be a good option. It’s a good idea to know exactly what you’re allergic to. Your allergist can discuss with you various treatment options, from conservative measures like what I already discussed, to immunotherapy (sublingual or traditional shots).
Some Unconventional Allergy Solutions
If you’re interested in natural options, stinging nettle is a well-known herb that has been shown to help with common allergies. Butterbur is another herbal antihistamine. Both can be found in most health food stores.
Needless to say, a healthy diet rich in fruits, vegetables, omega-3 oils (found in fish), and fiber will help your immune system to function more optimally.
Lastly, eating locally produced honey has been suggested to help with allergies. It’s thought that the honey contains the local pollens that can cause your allergy symptoms. Being exposed to small amounts of pollen on a regular basis is similar to what the allergist does through shots. Use honey as a sweetener on a daily basis before the onset of the allergy season.
If you follow some of the conservative steps I’ve outlined earlier, most of you won’t need to take any medications. However, if you feel the need to take something, hopefully this article can guide you towards making the right choices. You should always talk to your doctor before trying new OTC or prescription medications, as there can be interactions with certain prescription medications.