Many of us have been there: Spring and fall seasons are a time of misery when one experiences an itchy nose and eyes, a running nose and congestion in the nose and face. You feel tired, run-down and are not sleeping well. It’s allergy season! Up to 30 percent of us dread its arrival.
The formal term is allergic rhinitis, although it’s commonly called hay fever. In the United States, allergies are largely lumped into seasonal and perennial (year-round). In Europe, allergies are categorized by the severity of the symptoms and how long the symptoms are present. The distinction is probably not important for allergy sufferers, although the U.S. approach makes it easier to identify what people are allergic to, and the European approach helps guide treatment.
What most people may not understand is that allergies, particularly seasonal allergies, can have a significant impact on quality of life. Difficulty sleeping and chronic fatigue are common problems in allergic patients. However, some of the other known effects may be less obvious. Decreased work productivity has been well substantiated, both because of missed days of work and “presenteeism,” defined as attending work while sick. Recent studies have also shown that allergic rhinitis can have a negative impact on sexual drive and activity. Chronic fatigue with nasal blockage, decreased smell and a drippy nose do not lead to amorous feelings.
Spring allergies are caused by tree pollens; early summer allergies are triggered by grasses; fall allergies tend to come from weeds (ragweed) and molds. There are clear geographic differences. Ragweed allergies are mostly in the North-Central region, and allergies caused by the Mountain Cedar tree are found predominantly in the South-Central region. Molds like a moist environment can be year-round in parts of the South. Certain allergies caused by pets and dust mites are fairly common throughout the country.
Knowing what you are allergic to can help steer a major part of the treatment, which is avoidance or environmental control. In some cases, the offending allergen is obvious, but in many cases, allergy testing is needed to identify the culprit.
What can you proactively do?
Avoid the offending allergens. If they are outdoor and seasonal, keep windows and doors closed as much as possible. Keep track of pollen counts, and stay inside on high pollen days. The National Allergy Bureau tracks pollen levels and offers a pollen/mold app.
If you have dust mites or pet allergies, look for ways to reduce the indoor allergens in your home. In other words, “allergy proof” your home! For instance, vacuum frequently to remove pet hair, dust and clean carpets, as they can sustain allergens. Keep your pet out of your bedroom. Air purifiers may also be helpful. Click here for more cleaning tips.
Avoidance is helpful, but it’s usually not enough to manage significant allergies. Fortunately, there are many very good home remedies, over-the-counter and prescription medications. Saline rinses or irrigations, either with a rinsing device or neti (Sanskrit for “nasal cleaning”) pot, can clear the offending allergens from the nose and saline can actually reduce swelling in the nose.
Over-the-counter non-sedating antihistamines such as fexofenadine (Allegra), loratadine (Claritin) or cetirizine (Zyrtec) are great for managing sneezing, itchy eyes and reducing nasal drip, but are not very effective with nasal congestion. If congestion is not a problem for you, try these first. I recommend some caution with the sedating antihistamines, like diphenhydramine (Benadryl). They should probably be used primarily at bedtime, as they can affect function because of the sedation. There is some evidence that long-term use of these, particularly in older adults, may be associated with increased memory loss.
If congestion is a big problem, you may want to try one of the intranasal steroid sprays. Since they are now over-the-counter (fluticasone “Flonase” and triamcinolone “Nasacort”), they might be a reasonable first treatment. These are very effective and are even more so if the treatment is started a few weeks before the onset of the allergic season.
If you’re still having bothersome symptoms, it might be worth seeing a specialist such as an ENT (otolaryngologist) or allergist. They can recommend other prescription medications and immunotherapy if necessary. Traditionally known as “allergy shots,” the immunotherapy treatment is now available in tablets and drops that can go under the tongue (sublingual immunotherapy or SLIT). At present, Food and Drug Administration-approved products for SLIT are only for grass and ragweed, but others are on the way.
The good news is that with avoidance, hygiene and treatment, most people can live with their allergies and manage them.
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Itching, Sneezing and Tearing: It’s Allergy Time originally appeared on usnews.com
