By Sara Walters, NP
Family Medicine Nurse Practitioner in Somerville, Mass.
Pollen in the air can cause unpleasant allergy symptoms, but remedies are available.
The changing seasons bring beautiful fall leaves – and allergies, as sufferers at our clinic know all too well. If you’re raiding the medicine cabinet in a desperate hunt for relief, you may benefit from the seasonal allergy tips below.
Tip 1: Recognize allergy symptoms
Seasonal allergies mainly affect the eyes, nose, sinuses, and mouth, but not everyone will experience the full array of symptoms. An itchy roof of the mouth, hives, and watery eyes are classic allergy symptoms, but others can mimic signs of infection. If your symptoms – like a stuffy or runny nose, sneezing, cough, red or watery eyes, or sinus congestion and pain – don’t go away after a week or two, you may be reacting to seasonal irritants.
These irritants vary from person to person. What triggers one person’s allergies may not trigger them in another. And they can vary by the time of year. Knowing when your symptoms are at their worst can help you get an idea of what you may be allergic to.
In early spring, tree pollens are the most likely culprits. In later spring and the beginning of summer, grass pollens are at their highest point. Weed pollens like ragweed hit people hardest in late summer. If your symptoms are bad all year round, they may be the result of allergens in your home or work environment, like dust, mold, or pet dander.
A persistent cough or sore throat are two of the most common allergy-related complaints patients report in our practice. But these symptoms also are red flags for infections like the flu or strep throat. Come see us to determine if you have allergies or an infection if you experience a persistent cough, sore throat, or one of these symptoms:
- Body aches
- Difficulty or pain with breathing
- Eye pain or vision changes
- Fever or chills
- New rashes
Tip 2: Know your pills
In terms of effectiveness, all of the newer over-the-counter antihistamine medications are considered equal. However, many patients find that one type works better for them than another, and many patients find they have to alternate medications or try new types from year to year to relieve their symptoms.
We suggest beginning with loratadine (Claritin) 10mg daily for adults and 5mg daily for children. Other options include cetirizine (Zyrtec) at the same dose or diphenhydramine (Benadryl). Loratadine and cetirizine won’t cause drowsiness for most people, but diphenhydramine can be sedating and can even cause a morning “hangover” effect when taken before bed. Do not take diphenhydramine before driving.
If you’ve exhausted the over-the-counter options at the pharmacy, schedule an appointment with your provider to discuss prescription allergy medications or a referral to an allergy specialist.
Tip 3: Start early, and stay consistent
If you only begin your allergy medications after symptoms develop, and if you only use them on “bad” days, you’ll find yourself chasing the problem rather than preventing it. Take your antihistamine at a consistent time each day (before bedtime if you have asthma as well as seasonal allergies) and continue for the duration of the season.
Next year, get a jump start by taking your antihistamine daily for at least a week before pollen season begins. The first day of spring falls around the third week of March, so try to start your antihistamine regimen around the first or second week to be safe – possibly earlier in years when winter is mild and temperatures start rising sooner. Your nose will thank you!
Tip 4: Use nasal sprays and steam
For many people, pills will not be enough to manage the many symptoms of seasonal allergies. Nasal sprays, both medicated and nonmedicated, are an important part of managing congestion and post-nasal drip. Nasal steroid sprays relieve inflammation and swelling in the nasal passages caused by allergies. This can help make breathing easier. Saline sprays moisturize dry nasal passages and loosen mucus congestion.
Try a daily steroid nasal spray like fluticasone (Flonase) or triamcinolone acetonide (Nasacort), and consider adding a regular saline nasal spray or a moisturizing spray like Pretz that can be used multiple times per day as needed. Steroid sprays will take a few days to kick in, so consider starting these early along with your antihistamine.
Severe congestion also may warrant the use of steam from a humidifier or steam machine (check out the facial steamer Conair makes) or a neti pot to really clear up accumulation in the nasal cavities and sinuses.
Tip 5: Use medications properly
Some commonly used medications do more harm than good when used incorrectly – and you may not know that you’re doing so.
The popular nose spray Afrin (phenylephrine) can work great for clearing up nasal congestion, but if used for longer than three to four days, the nose can become “addicted,” resulting in a bad rebound congestion that will leave you miserable. Save Afrin for once-in-a-while use, like an hour before a plane flight, which can help with air-pressure changes and their effects on your sinuses and airways. Use other sprays for daily control.
The popular decongestant pill pseudoephedrine (Sudafed) has moved behind the counter due to medication abuse, so you’ll have to ask a pharmacist to dispense this for you. And people with high blood pressure or heart problems should think twice before taking pseudoephedrine or phenylephrine, since it can raise blood pressure and cause anxious, jittery feelings similar to a caffeine overdose. Treat it like coffee, and avoid using it after midday. You also should drink plenty of fluids to avoid dehydration.
Talk to your doctor or nurse if you have questions or concerns about any allergy medications you use.
Tip 6: Keep an eye on eyedrops
Flonase helps with itchy eyes, but if your allergies come with excessive tear production or red, itchy eyes that are dry or irritated, you may need to add eyedrops to your regimen. Ketotifen fumarate (Zatidor) and Pataday are antihistamine options, but regular lubricating drops also can provide comfort.
Try the lubricating drops three to five minutes prior to antihistamine drops to avoid stinging. Warm or cool washcloths wiped gently or laid over the eyes also can help remove irritants and soothe inflamed tissues.
Tip 7: Sweeten the deal with honey for cough
You may have heard that consuming raw local honey can help protect you against seasonal allergies, and many patients in our practice elect to try this as a natural remedy. Preventing allergies with honey has not been proven by research, but research suggests that honey is as effective as over-the-counter cough remedies to relieve symptoms.
Go ahead and mix honey into tea or hot water, or eat it by itself if you can’t shake that tickle in your throat. Farmers’ markets are a great resource for raw local honey in the Somerville area. A word of caution: Honey is not safe for babies younger than 1. Their immune systems aren’t equipped to handle bacteria that may be present in honey.
Managing seasonal allergies can feel like a part-time job, but these suggestions can help you breathe easy – literally!
Tags: family health, family medicine, Somerville