AHHHH Choo! My Allergies are Back…

My nose is running, my eyes are itching, I can’t breathe through my nose, and if I sneeze one more time I am going to scream! Yup, I have awful allergies. Unfortunately, I live in an area where allergy season starts in January and progressively worsens throughout the year. I wake every morning with a headache and puffy eyes. Allergies make my life miserable!

Allergies are so common now, it has been estimated that 10-30% of adults and children have seasonal allergies (even my dog has seasonal allergies). We spend $1.1 Billion a year on over-the-counter allergy medications and $2.4 billion in allergy prescriptions, that’s billion with a B!!! It accounts for 2 million lost school days and 6 million lost work days each year. These numbers are staggering, and yet it only accounts for 2.5% of physician visits. While your typical seasonal allergies may not be shortening your lifespan, they certainly are reeking havoc on your life.

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So what are allergies? An allergic response is your bodies immune system attacking a substance it interprets as harmful. With seasonal allergies, your immune system has come to believe that pollen, mold spores, dust mites, etc… are harmful, despite their truly benign nature. It is not completely understood why some people have allergies and others don’t. There is a genetic component and there are environmental factors that trigger these genes, but it is not clear what all these factors are. Some develop allergies early in life, while others can be ok most of their life and suddenly develop an allergy later on. The bottom line is that we are not clear on the process of why your body starts attacking benign substances.

To start, your first step is to visit your doctor, especially if these symptoms are new or exacerbating other health conditions like COPD or asthma. Your physician will discuss symptoms, severity, and causes as well as perform an exam of your eyes, ears, nose, and mouth. If needed, you may be referred to an allergy specialist if your doctor feels you need allergy testing. Typical symptoms include, itchy, watery eyes, runny nose, repetitive sneezing, itchy throat, and congestion. Fever, chills, and sore throat are not symptoms of allergies and are usually indicating an infection.

So how can we lessen this burden and make you breathe easier? Lets start with lifestyle changes. Learn to recognize your triggers. We spend most of our time in our bedroom and on our beds. Invest in allergen reducing pillow covers and mattress covers. Wash your bedding at east once per week. You should consider switching your house air filters that reduce allergens and mold spores. When buying whole house filters, look for filters with MERV (minimum efficiency reporting values) levels of at least 11-13. If selecting a filter for just one room, you should select a HEPA (high-efficiency particulate air) filter and ensure that your filter is large enough for the room by looking at the CADR (clean air delivery rate). Disposable filters are typically changed every three months, or when they appear full. To check pollen counts in your area, you can visit http://www.aaaai.org/global/nab-pollen-counts?ipb=1.

So I did all of these things and I still can’t breathe. Great, now what? Medications! To decide the best route of medications, start with your symptoms and severity. Do you only get allergies when you go over to your aunt’s house with her 10 cats? This is considered intermittent or episodic and you really only need to treat on an as needed basis. It is best to take a OTC (over-the-counter) anti-histamine like cetirizine (Zyrtec), loratadine (alavert or Claritin), or fexofenadine (Allegra or Mucinex Allergy). The important thing to note is that these medications should be taken 2-5 hours prior to exposure as these medications PREVENT symptoms!

If your symptoms are persistent and moderate to severe, your best treated with a intranasal glucocorticoid like fluticasone (Flonase) and mometasone (Nasonex). These are not to be used on an as-needed basis and are to be used every day, taking 2-3 days before becoming effective. While you can find these medications over-the-counter, I would recommend getting it as a prescription for cost effectiveness! If you are still having symptoms, there are several options at this point. Now, you should have already seen your doctor for your allergies at this point. If you are not getting complete relief with a nasal glucocorticoid, it is time to go back to the doctor’s office. At this point your doctor may add an oral anti-histamine, intranasal cromolyn, montelukast, or an intranasal anti-histamine. If your symptoms include itchy, watery, red eyes, it would be best to add an anti-histamine eye drop.

Hopefully this helps you improve your symptoms and provides a good starting point for asking the right questions of your doctor. As for my allergies, I am best helped with a nasal glucocorticoid that I end up having to use 6-9 months out of the year. Spike, my dog, gets Claritin for his allergies! (I am not a veterinarian and this statement is not intended to be used as treatment for your pet).

*The information here is intended to be used as a guide. You should always speak to your doctor before starting a new medication, develop new symptoms, or your symptoms are not relieved by your current therapy.

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