This year allergy season seems more potent and early in many areas of the United States. The vigorous bloom of pollens has been bothersome for more than six weeks. In the Northwest we have seen many patients this season who have well known allergies struggling with symptoms more than they have in several years. Many clients who historically have not had allergies have also been affected this year. Most people are familiar with seasonal allergy symptoms and how bothersome they can be. It is not always clear which specific allergens are in the air at any given time. This time of year is a very fluid situation which plants are in bloom spewing pollen in the air. The amount of dust, mold and pollutants in the air can vary air quality greatly depending on the wind, humidity, and temperature of your locale.
The real challenge with seasonal allergies is that avoidance is not a choice. You have to breathe. Consulting an allergist may be necessary to identify potential allergens if your symptoms are severe. Having said that, there are several fundamental tools your health care provider can offer to find a solution tailored to your individual needs.
#1 Antihistamines: Still the foundation and first line treatment in managing allergies. Fortunately the two best ones in this category are sold over the counter without a prescription at the same strength as by prescription. Claritin also sold in a generic at very affordable prices as Loratidine is conveniently dosed once a day and is unlikely to cause any drowsiness compared to one of the older favorites Benadryl (generic: diphenhydramine). Another good option is Zyrtec (generic: cetirizine). This is also a once daily medication that causes very little drowsiness in most people. It is also available in pediatric liquid form for children two years of age and older.
#2 Steroid nasal spray: These are prescription only. However in conjunction with a daily oral antihistamine, steroid nasal spray provides satisfactory results for a large majority of people who suffer with the common allergy symptoms. The prototype is Flonase or fluticasone spray used only once daily in each nostril. The convenient dosing and efficacy makes this part of the fundamental therapy for seasonal and environmental allergies. Both of these options have to be used daily on a preventive basis. The proactive approach is very successful in controlling the common symptoms.
#3 Singulair tablets: These are probably not familiar to most people who suffer with allergies. This medication has been used for many years to treat stubborn intractable asthma when there was a strong allergy component. It has been approved and used successfully to treat seasonal allergies without asthma as well. It is dosed once daily and typically does not involve any sedation. Even though it is by prescription only and can be a higher priced medication it has been a very helpful addition to the regimen in people whose symptoms are more difficult to control. It works in a way to block the effect of leukotrienes which, like histamines, act to drive the reactions in our body in response to allergen exposure.
#4 Systemic steroids: Can have a profound effect on symptoms but are typically reserved for very severe symptoms that remain unresponsive to the first line treatments. A short course of oral steroid tablets like prednisolone or even a long acting injection of methylprednisolone can be very effective in diminishing symptoms. More aggressive therapy always has greater risks of side effects thus should remain an option for intractable cases.
#5 OTC meds: Other than the previously mentioned antihistamines that have a very good record of benefit supported by credible research, there are not a lot of other options. Cromolyn sodium nasal spray is useful for some as a preventive application but is not very effective for most people. Liberal use of plain saline nasal spray is an inexpensive adjunct to the other therapies. It can provide some comfort from dryness while aiding in control of congestion. It is safe and very inexpensive.
Don’t be discouraged by allergy symptoms. Consult your health care provider today to find a regimen tailored to meet your personal needs. Relief is very accessible.