Get Allergy Relief—No Matter What the Season
By Natasha Persaud
Sneezing, sniffling and feeling miserable? Allergist J. Allen Meadows, M.D., chair of the Public Education Committee of the American College of Allergy, Asthma and Immunology, answers common questions on finding allergy relief.
My antihistamine makes me drowsy. What can I do to reduce the effect?
If you use an antihistamine only intermittently—say, once a week—you're more likely to feel sleepy, have impaired judgment and slower motor function. That's because the medication hasn't reached a steady level in your bloodstream. Similarly, the higher your dose of medication, the greater your chances of sedation.
On the other hand, the more regularly you use an antihistamine medication, say daily, the less drowsy you will feel. Newer antihistamines also tend to be less sedating. Talk to an allergist about your treatment options. Some individuals, such as those who develop hives, need antihistamines, but others may find alternative treatments, such as a nasal steroid spray, effective with fewer side effects.
I usually take an antihistamine to control my allergy symptoms, but this season the medication doesn't seem to be working. Have I built up a tolerance to it?
It's very unusual to build up a tolerance to antihistamine medications. The more likely culprit, according to some studies, is that you're taking your antihistamine less regularly. But if you're sticking to the recommended regimen, it's possible that pollen counts are getting higher in your area or that your allergies are getting worse. You may need more effective medication.
Seeing an allergist can help. Allergists are experts in finding the right treatment. There are many ways of controlling allergies, and each person's treatment must be individualized based on the frequency, severity and duration of symptoms and on the degree of allergic sensitivity.
If your antihistamine seems to lose its effectiveness, your allergist may recommend an antihistamine of a different class or strength. There are also other options. Prescription corticosteroid nasal sprays, for example, are the single most effective drug class for treatment of allergic rhinitis. They can significantly reduce sneezing, itching, and a stuffy nose.
Is it time to consider allergy shots?
Allergy shots, also called immunotherapy, get to the root of the problem. Instead of simply treating your symptoms, they slowly de-sensitize your immune system to the allergen, whether it’s pollen from trees or weeds; molds; dust mites; or pet dander. Over a period of three to five years, you receive tiny but increasing amounts of the allergen until you reach a maintenance dose. That dose is then given at longer intervals. During that time, your allergy symptoms should become less intense. Studies show that immunotherapy also decreases the risk of subsequently developing asthma.
No one with allergies should suffer. If you're missing days from work or feeling unwell, consider allergy shots—especially if medications haven't helped.
My eyes get itchy, watery and red during pollen season, so I usually stop wearing my contact lenses and switch to glasses. Are there better ways to cope?
It's important to find out exactly what's triggering your symptoms. You may have dry eyes—a non-allergic condition that may be treated with artificial tears or rewetting drops—or you may be allergic to one or more substances. See an allergist to get tested for allergies.
If you have a pollen allergy, some simple steps may reduce your exposure to the allergen: Close the windows in your home and car; I tell my patients that leaving a window open for a few hours is like moving your bed to the middle of a pollen field! After spending time outdoors, change your clothing and take a shower.
In addition, treating your nasal symptoms will often lessen your eye symptoms, if both are caused by the same allergen. Oral medications, nasal sprays or allergy shots can offer relief. The FDA approved prescription fluticasone furoate (Veramyst) nasal steroid spray in 2009, which may relieve both nose and eye symptoms.
But a word about eye drops. Over-the-counter eye drops that reduce redness may offer some relief when used short-term, but there is a risk of dependence if you use them regularly. Prescription eye drops may offer more lasting benefits. Talk to an allergist about treatment options. According to a recent study, people who see an allergist are three times more likely to say their treatment was effective. And that can keep you wearing your contacts.
When I eat certain fresh fruits or vegetables, my throat, tongue and lips start tingling and itching. These foods didn't bother me before pollen season. Could it be related to my allergies?
You could have oral allergy syndrome, which is a cross reaction between similar proteins in airborne pollens and the fruits you eat. Up to one-third of allergy sufferers may have oral allergy syndrome.
For most people, the best treatment is to avoid these fruits, especially during pollen season. If you are allergic to tree pollen, for example, avoid apples, cherries, pears, apricots, kiwis, oranges, plums, almonds, hazelnut and walnuts, since they may cause an allergic reaction.
If you're allergic to grasses, avoid peaches, celery, tomatoes, melons and oranges. If you’re allergic to ragweed, which pollinates in late summer and fall, avoid banana, cucumber, melons (such as cantaloupe, watermelon, and honeydew), zucchini, sunflower seeds, dandelions, chamomile tea, and Echinacea.
Cooking the food—by making apple pie, for example—or eating canned varieties may help, but be sure to talk to an allergist first.