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Gesundheit! How To Cope With Hay Fever
Ladies and gentlemen: grab your tissues! For those who suffer from hay fever,
the sneezing season has begun.
The Mayo Clinic estimates that 20 percent
of Americans suffer from this misnamed malady, which doesn’t cause fever and has
nothing to do with hay. Instead, the problem is an allergic reaction to plant
pollens light enough to be borne on the wind.
The common name came from
British doctors in the early 1800s, who observed that some of their patients
were affected by sneezing, congested or runny noses, and itchy, watering eyes
during the haying season.
Symptoms can also include itching of the nose,
throat, mouth and ears. When nasal congestion is severe, the allergic response
can interfere with sleep. Some allergy sufferers also experience headaches,
fatigue or irritability.
Although we can’t stop Mother Nature from
producing allergens, people susceptible to hay fever can do plenty to minimize
the dripping, sniffing and sneezing. This article provides the tools and
information you need.
The Causes Of Allergic
Reactions
Allergies are a false alarm that occurs when the body tries to
defend itself against substances that aren’t actually dangerous—like pollen,
dust, cat hair and mold.
In susceptible people, the immune system
considers the allergen an invader, as a germ or virus would be, and produces
antibodies to fight it. This response initiates the release of inflammatory
chemicals, including histamine, which causes swelling of mucous membranes in the
nose, eyes and sinuses.
Pollens—the cause of hay fever—are some of the
most common allergens. Of the top-10 allergens in the U.S., five are plant
pollens from ragweed, Bermuda grass, rye grass, white oak and Russian thistle,
says the National Institute of Allergy and Infectious Diseases (NIAID).
Spring isn’t the only time hay fever can strike, the American Lung
Association cautions. Your allergenic season depends on whether you’re sensitive
to trees, grasses or weeds—or all of the above.
Allergens are abundant
in early spring, when trees such as ash, beech, maple, birch, elm, cedar,
hickory, oak and poplar are busy making pollen.
Grass pollens—allergens
for about half of those who suffer from hay fever—circulate in late spring and
early summer.
Weeds can be a problem from mid-summer to late fall. The
worst offender is ragweed, to which 75 percent of plant-allergic people are
sensitive, reports the American College of Allergy, Asthma & Immunology.
Over-The-Counter Medicines Can Help Relieve The Misery
Your
local drugstore’s shelves are full of products that promise to relieve allergy
symptoms. Several of the newer offerings, including loratadine (Claritin) and
cetirizine (Zyrtec), were introduced as prescription medicines but are now
available over the counter (OTC).
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Antihistamines work by blocking the release
of histamine, the immune-system chemical that causes itching, sneezing, watery
eyes, and runny nose. Cromolyn sodium (NasalCrom) is an antihistamine nasal
spray that targets drippy nose and helps prevent sneezing. Some antihistamine
tablets cause drowsiness, so talk to your pharmacist about which ones are safe
to use while working and driving.
These drugs are most effective when taken regularly rather than in response
to an allergy attack. The American Academy of Family Physicians reports that OTC
antihistamines usually work as well as their prescription counterparts.
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Decongestants—whether tablets or nasal sprays—help
shrink swollen nasal membranes and make breathing easier. Decongestant sprays
should be used only for brief periods, though, as they can cause rebound
congestion. In tablet form, these drugs affect the entire body and can cause
nervousness, heart palpitations and sleep difficulties. They may also interact
with prescription medicines, so discuss the options with your doctor or
pharmacist.
Doctors Can Prescribe Treatments
If your
allergies are mild and can be controlled by OTC medicines, there’s probably no
need to see a doctor.
But if your symptoms are severe or persistent and
interfere with your work, leisure activities or sleep, it’s time to visit an
allergist or your general practitioner. Don’t minimize the problem by telling
yourself, “It’s just allergies.”
The National Institutes of Health
states that in some people, allergies can lead to even more serious consequences
such as chronic inflammation of the sinus cavities or even asthma, a lung
disease that narrows the airways.
The treatment plan for allergies may
include prescription medicines, immunotherapy (allergy shots), or both.
Several kinds of medicine are available by prescription, including nasal
sprays, antihistamines, decongestants and leukotriene inhibitors.
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Nasal sprays: Corticosteroid sprays are
often highly effective against hay fever, although you may not notice
improvement for a week or more. They can be used for long periods of time. Nasal
atropine spray helps treat runny nose.
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Antihistamines: Older drugs in this
category often cause sleepiness, but more recent releases, such as fexofenadine
(Allegra), are less likely to make you drowsy. Some antihistamines that were
formerly prescription-only are now available OTC, including loratadine
(Claritin) and cetirizine (Zyrtec). Prescription eye drops are available to help
calm itchy, swollen eyes.
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Decongestants: These medicines come in
liquid, tablet and spray form and in both prescription and OTC formulas. If you
have high blood pressure or an enlarged prostate, oral decongestants may not be
suitable.
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Leukotriene inhibitors: The tablet form of
montelukast (Singulair) can reduce production of histamine and mucous by
interfering with the action of certain immune-system chemicals.
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Allergy shots: In addition to prescribing
medicines, your doctor may wish to try allergy shots, also known as
immunotherapy. The goal is to reduce and perhaps even eliminate allergic
reactions by injecting increasing doses of the target allergens. Eventually the
immune system becomes desensitized to the allergens, so its response becomes
less severe.
Before beginning immunotherapy, you’ll probably be
asked to undergo skin-testing to determine which substances you’re allergic to.
Tiny amounts of purified allergens are injected into the skin of the arm or
upper back. The doctor then checks to see which injection sites show redness or
swelling. Another option is a blood test called the radioallergosorbent test, or
RAST.
If you go the immunotherapy route, shots are typically
administered in two phases. In the buildup phase, often lasting three to six
months or more, shots are given as often as three times a week, with
incrementally larger doses of allergens. The maintenance phase can last several
years but shots are less frequent—perhaps once a month.
Immunotherapy
can be especially useful for people whose allergies act up most of the year and
who don’t respond well to drugs.
Allergy Fact And
Fiction
Medical treatments for allergies are better than ever—but that
doesn’t mean you won’t hear some questionable advice on the street. Here’s the
truth:
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Can locally produced honey reduce symptoms?
Probably not. The theory is that because local honey contains pollen, eating it
could desensitize you to local allergens. But there’s no reputable medical
evidence to back it up. In fact, the Asthma and Allergy Foundation of America
reports that ragweed-sensitive individuals may have intense reactions, possibly
including shock, after eating honey that contains pollen from plants in the same
family.
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What about vitamin C? Researchers have
found no evidence that vitamin C and other food supplements are effective
against allergies, although they may have other health benefits.
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Should people with allergies
exercise?Generally speaking, yes. But avoid exercising outside when pollen
counts are high (check the National Allergy Bureau online at www.aaaai.org/nab).
Pollen generally peaks between 10 a.m. and 4 p.m. and travels farthest on warm,
dry, windy days. If symptoms are severe, take the day off. If you feel overly
fatigued or short of breath while working out, rest for a few minutes and reduce
the intensity. Those who have exercise-induced asthma should seek a doctor’s
advice before beginning a fitness program.
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Does it help to wash the nasal passages with
saltwater? Yes. A 2007 study published by the University of Michigan Health
System found that flushing the nasal passages with a saltwater solution provided
better relief of symptoms than using an over-the-counter saline spray. Ask your
doctor how it’s done.
Hay Fever In The Workplace
Reducing
you and your employees’ exposure to allergens can make the workplace more
comfortable—and the people more productive. Here are some tips:
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During peak pollen seasons, keep doors and windows
closed.
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Use air-conditioning to remove allergens and
humidity from the air, and set the equipment on re-circulate so fresh pollen
isn’t continuously brought in.
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Depending on the size of the office, consider
running one or more air cleaners with a HEPA (high-efficiency particulate air)
filter. These special filters are effective at trapping extremely small allergen
particles.
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Keep the grounds around your building neatly mowed
and free of weeds.
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If employees are also allergic to dust mites, have
the office cleaned frequently, and consider eliminating drapes, silk flowers,
fabric-upholstered furniture, rugs, carpeting and other
dust-catchers.
Finally, if employees are undergoing a regimen
of allergy injections, be flexible to ensure they can meet their appointments.
Immunotherapy works best when shots aren’t missed.
For More
Information
To learn more, visit these government-sponsored and
independent Web sites.
The National Institute of Allergy and
Infectious Diseases
Offers detailed information for consumers, including
free downloadable pamphlets in English and Spanish
www.niaid.nih.gov/
The American College of Allergy, Asthma &
Immunology
Features an allergist locator and extensive patient
information
www.acaai.org/ The National Allergy Bureau of the
American Academy of Allergy, Asthma and Immunology
Check pollen counts
for your area
www.aaaai.org/nab/ Asthma and Allergy Foundation of
America
Contacts for regional chapters and details on coping with
allergies
www.aafa.org/