Sneezy? Wheezy?

How to find relief for seasonal allergies.Ah, springtime in New Hampshire. Gloomy darkness and biting winds morph into glorious sunshine and caressing zephyrs. Birds chirp and green shoots erupt from the earth. Hope and renewal fill the air. Only problem is, pollen also fills the air, making countless heads and noses feel as full as Granite State rivers and streams overloaded with snow melt. If you’re tired of witnessing spring’s wonders with a box of tissues as your constant companion, take heart. Relief is as close as the nearest bursting bud.Take the spring backAllergies occur when a person’s immune system responds to a normally harmless substance in a hypersensitive way, says Barbara L. Deuell, M.D., an allergist and immunologist with Allergy Associates of New Hampshire and Portsmouth Regional Hospital. Why some immune systems overreact while others do not remains a mystery, although genetics predispose people to be allergic, Deuell says.There are a variety of treatment options for seasonal allergies:Steer clearAs a rule of thumb, allergy treatment begins with avoidance, Deuell says, but when pollen is the culprit – given the fact that it’s in the air we breathe – avoidance is easier said than done. At a minimum, allergy sufferers can close windows and turn on air conditioning to help minimize the amount of pollen in their home and car.Go on medsWhen avoidance isn’t enough, consider choosing from an array of allergy medicines, including newer formulas that promise not to leave you looking for the nearest couch and blanket. Options include allergy eyedrops, oral antihistamines and prescription allergy nose sprays. “Cortisone nose sprays are the most effective allergy medicine out there,” says John N. Kalliel, M.D., an allergist and immunologist at Manchester Allergy Incorporated, Elliot Hospital and Catholic Medical Center. They are a bit slow to work, though, so they must be taken every day during the months when symptoms appear, he says, rather than on an as-needed basis.Bite the bulletIf your symptoms are bothersome enough, you might decide that you want the allergy itself – not just the symptoms – gone for good. Allergy shots can achieve that goal, but require a long-term commitment. Typically, they entail weekly visits to the allergist for five or six months to receive injections that contain increasing amounts of the target allergen, which is what you are allergic to. Eventually the injections reach a more concentrated maintenance dose level, and then only a monthly shot is required, Kalliel says. Typically, after about five years of monthly injections, the shots can be stopped altogether.Although most seasonal allergy sufferers stick to medicinal treatments, allergy shots are “a great alternative” for those who find that their quality of life is substantially affected by allergies, such as people who have to take vast quantities of medicine before they can go out and play baseball or golf, Kalliel says. “Allergy medicines always work,” he says. “It’s a matter of how much you need to take so that they work.”Skip the diet strategySome allergy sufferers swear by a sort of hair-of-the-dog-that-bit-you approach, a homemade desensitization program that involves regularly ingesting a known allergen so that the immune system grows accustomed to it, resulting in toned-down immune system reactions to the allergen. Some advocates of this approach believe that eating pollen-derived honey lessens allergy symptoms. Others think that loading up on certain herbs or a Mediterranean diet heavy on foods like grapes, tomatoes and hummus will help. Alas, “a lot of that is wishful thinking,” Kalliel says. Part of the problem is that digestive enzymes make the success of a dietary approach difficult, he says. Scientists continue to study the effectiveness of diet-based ideas, and food-based methods might turn out to be useful in some way, Kalliel says, “but it’s much more complicated than simply eating hummus or honey.”Running in cyclesMost of us have heard allergy sufferers say that the effectiveness of their allergy medication varies from year to year, or that some years, pollen is “worse” than it is in others. What accounts for the variation? In reality, there isn’t any – at least not in the medication or the atmosphere. There will be less pollen in the air on a rainy day, Kalliel says. But in general, “the amount of pollen in the air is the same each year. Things that pollinate [do so] based on length of day,” he says. “When you have x minutes of sunlight, things will start to pollinate.”The immune system is the variable in the equation that determines our comfort level, Kalliel says. “Some years you will have more allergy symptoms than other years. In someone else, it will be the opposite,” he says. Although it is not really known why the immune system changes this way, illness, hormones and stress are believed to affect the severity of allergy symptoms, he says. There is no scientific evidence, however, to support the common notion that allergies run in seven-year cycles.In addition, where medications are concerned, user error can be to blame. “People don’t always take medications properly,” Deuell says. For example, to correctly treat a moderate to severe seasonal allergy, “you really want to get ahead of the game. You want to start medications before the season is actually upon us,” she says.Don’t under-treatAlthough most seasonal allergy sufferers have mild to moderate symptoms, Deuell says, those who are severely affected find that their allergies seriously impair their ability to function. “People get very sick from this,” she says, so get help if you need it.Under-treatment of even moderate allergies can result in sinusitis, chronic ear infection in kids and asthma, she warns. NHDon’t fault the flowersContrary to what some people believe, flowering plants generally do not cause seasonal allergies, says John N. Kalliel, M.D., an allergist and immunologist at Manchester Allergy Incorporated, Elliot Hospital and Catholic Medical Center. Non-flowering plants, such as grass and ragweed, are the most common allergy triggers. “Things that make a flower generally do not make a lot of pollen,” he says, since they rely on insects to do their pollinating. “But non-flowering plants do not attract insects.” Instead, they rely on the wind to inefficiently disperse billions of pollen granules in the air, which is why we end up breathing in so much pollen, he says.

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