According to the American Academy of Allergy Asthma and Immunology seasonal allergies (aka hay fever) affect over 35 million Americans and results in 16 million visits yearly to the doctor. Symptoms often appear at about the same time every year and can include runny nose, sneezing, congestion and itching in the ears, eyes, nose and throat. Seasonal allergies are usually triggered by airborne pollen from trees grass and weeds and from mold spores.
Allergy
An allergic reaction is the bodies over-reaction to substances in the environment. These substances are often called allergens because they cause the allergic reaction. The symptoms of an allergic reaction are very similar to that of a cold but a cold will usually resolve in 7 to 10 days while an allergic reaction can last for weeks or even months. Also the nasal discharge during a cold is often thick and yellow but in an allergic reaction it is thin and clear.
Treatments
Treatment for allergies can be as simple as using over the counter products or it can include visits to the allergist for allergy skin tests and immunotherapy (allergy shots). This article focuses on over the counter therapy. If you do not find relief from these suggestions you should seek further assistance from your doctor.
Histamine
When exposed to an allergen, the body responds in several ways, including producing extra histamine. Histamine causes inflammation, swelling, a runny nose, sneezing and itching. Histamine also narrows airways in the lungs (constricts bronchi) and increases stomach acid secretion.
Antihistamines
This class of medications is a good starting point for treatment of seasonal allergies. There are several over the counter antihistamines available, many of which were once only available by prescription. They work by blocking the action of histamine in the body.
Antihistamines are generally separated into first and second generation agents. The first generation antihistamines are considered to be sedating while the second generation agents are commonly known as non-sedating. In reality, all antihistamines have the potential to cause drowsiness.
Some of the more popular first generation antihistamines are diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist) and doxylamine (Unisom). Doxylamine and diphenhydramine are so sedating they are commonly marketed as sleep aids. Clemastine is less sedating than these and chlorpheniramine is less sedating than clemastine. A benefit to these antihistamines is their ability to decrease mucus production in the nose due to their strong anticholinergic effects.
The second generation antihistamines include cetirizine (Zyrtec), and loratadine (Claritin). They are much less sedating than first generation antihistamines and are dosed once daily. They also have fewer side effects but as a result they are less likely to dry up a runny nose.
Check with your doctor before using antihistamines if you have glaucoma, prostate problems, emphysema, bronchitis or you are taking sedatives.
Decongestants
Since congestion is one of the symptoms of allergies, it makes sense to use this class of medication to get some relief. There are only two oral decongestants available over the counter. They are phenylephrine (Sudafed) and pseudoephedrine (Sudafed PE). They work by constricting blood vessels. This in turn results in shrinking of the nasal mucosa (the mucus membranes) allowing more air to pass, improving drainage and a less stuffy feeling.
Decongestants can also be found in nasal sprays such as oxymetazoline (Afrin). They can provide more immediate relief oral decongestants but the nasal sprays should not be used for more than 2 to 3 days due to worsening of congestion after stopping. This is known as rebound congestion.
Talk to your doctor before using decongestants if you have high blood pressure, heart disease, thyroid disease or diabetes.
Combination Antihistamine Decongestants
There are many combination products on the market. There may be a benefit to taking a combination product because the two classes of medications work together to improve symptoms. Have your pharmacist help you select a combination product that is right for you. As an alternative, you could buy a decongestant and an antihistamine separately and take both together. An advantage to doing it this way is you can selectively take one or the other or both together depending on your symptoms.
Nasal Irrigation
This is a good alternative therapy for seasonal allergies. It is an ancient technique of using a salt solution to bathe or wash the nasal passages. The theory is by washing away the allergens and mucus you improve normal function and decrease inflammation.
Cromolyn Nasal Spray
Cromolyn nasal spray (Nasalcrom) is a less commonly used medication. It can be used in combination with other treatments. Cromolyn helps stabilize mast cells. These are the cells that over react to pollen or other allergens causing the allergy problems. Buy stabilizing these cells, they release less inflammatory chemicals such as histamine. In order for cromolyn nasal spray to be effective it must be used several times a day. Symptoms may take 1 to 2 weeks before they improve. Do not use to treat sinus infections, asthma or cold symptoms.
Local Honey
An alternative therapy for allergies involves eating 1 to 2 teaspoons a day of local honey. Local honey is defined as honey made within 30 to 300 miles (depending on who you talk to) from where you live. Bees make honey from plant pollen (often the same ones causing allergies). The theory is that continuous daily exposure to the pollen in the honey decreases the chance you will react to it when exposed in the air. Some people swear by this but the studies that have been performed do not support it.
Conclusion
There are lots of treatments available for seasonal allergies. If you suffer from seasonal allergies, start your treatment a few weeks before your symptoms usually start and continue through the allergy season. If the above treatments do not provide relief you will need to seek the advice of a doctor.
