Hay fever, a common condition in the United States, affects people of all ages. "Hay fever is a generic term for a pollen allergy," explains Timothy Craig, D.O., an allergy researcher and associate professor of medicine at Pennsylvania State University Hershey Medical Center. People who have hay fever also may experience somnolence (sleepiness), poor sleep, wheezing, and a dry throat. New allergy sufferers may think they have a cold until noticing that the same "cold" reoccurs each spring, summer, or fall.
Allergies develop when the immune system perceives airborne tree, grass, and weed pollens -- items which are normally harmless -- as invaders. The immune system reacts by developing antibodies or sensitized cells that produce a host of protective chemicals, including histamine, to fight off perceived threats. This defense triggers congestion, stuffiness, and sneezing. The more you come in contact with allergens (the substances causing the allergy) the more "sensitized" you become, increasing your odds of suffering an allergic reaction.
Each springtime allergen has a pollinating period that follows the same schedule year after year. "People usually have multiple allergies. If they are bothered in the spring, they will most likely have fall allergies as well," says Norman Edelman, M.D., a pulmonologist and scientific consultant to the American Lung Association.
Common indoor allergens, such as mold, animal dander, or the droppings of cockroaches or house mites, may trigger allergic rhinitis. This condition is called a perennial allergy because it occurs year-round.
Studies show that if your parents have allergies, you may suffer too. Allergies can reappear after years of remission, and they can develop at any time. The severity of the symptoms seems to diminish with age.
Watch the KidsAs the weather gets warmer and your children start to play outside, be sure to watch for allergy symptoms.
Pay attention to your kids this time of year. When children seem irritable or unfocused, they may be reacting to allergens. Pollen causes the most misery in the morning. Windy days can make symptoms worse by stirring up pollen that's already landed on the ground. Rainy days provide a breather by washing the pollen out of the air.
"A lot of children and adults with dust mite allergy have more symptoms during the night and early in the morning," says Michelle Lierl, M.D., an allergist and associate professor of clinical pediatrics at Children's Hospital Medical Center in Cincinnati, Ohio.
Secondhand smoke also is harmful, especially to young children. Many children who have allergies and secondhand smoke exposure may develop sinus and ear infections.
Generally, over-the-counter (OTC) remedies don't come highly recommended for allergy relief. Antihistamines combat histamine, the inflammatory substance released when the immune system comes in contact with an allergen. Unlike their prescription counterparts, OTC antihistamines can cause drowsiness, increasing the risk of car accident.
Allergy sufferers may use decongestants, which alleviate congestion and reduce swelling of the mucous membranes lining the nose.
Nasal sprays, such as Nasalcrom, are sold without a prescription and can reduce reactions to pollen and mold. Decongestant nose drops and sprays should not be used more than several days; if overused, they may cause more congestion and swelling of nasal passages.
OTC eye drops cost less than similar prescription medications and may offer some relief from itching.
Prescription antihistamines, such as Claritin, Allegra, and Zyrtec, provide relief without causing the fatigue, loss of alertness, dry mouth, and coordination problems associated with OTC brands. One dose of Claritin, Allegra, or Zyrtec may last up to a full day. These medications don't appear to lose effectiveness with repeated use.
New prescription corticosteroid nasal sprays, such as Rhinocort, Nasonex, and Flonase, are considered more potent than older brands. These anti-inflammatory drugs usually take a few days to work but are the most effective available therapy.
Time for a Shot?
If controlling your environment and taking prescription medications are not effective, maybe it's time to roll up your sleeve. The National Institute for Allergy and Infectious Diseases reports that about 80 percent of those suffering from allergies find relief from allergy shots, or allergy immunotherapy treatment. These shots can reduce a person's need for supplemental medication within a year of starting treatment.
Allergen immunotherapy entails administering gradually increasing amounts of an allergen to a patient over several months, according to the American Academy of Asthma, Allergy & Immunology. Exposure to small, injected amounts of a particular allergen builds up the body's immunity. The end result is a reduced or minor allergic response and fewer symptoms when the patient encounters these allergens.
The injections are first given on a weekly or biweekly basis. For the first couple of months, a patient usually is asked to stay at the doctor's office after each shot in case a reaction occurs. The patient typically reaches a maintenance dose about four to six months after the initial shot. This maintenance dose usually is administered every three to four weeks. Most patients continue treatment for three to five years or longer.
Not everyone can opt for shots. If you suffer from an unstable heart condition and take beta blockers or if you take monoamine oxidase (MAO) inhibitors, you should not begin immunotherapy without your physician's approval. If you are getting shots, be sure your allergist approves of any supplemental medications for allergies (or any other conditions) that you may be taking. Women considering pregnancy should consult their physician before considering immunotherapy or taking any allergy medication, whether prescription or OTC.
Tips to Minimize Misery
The American Academy of Allergy, Asthma and Immunology suggests these tips to lessen exposure to pollens or molds that trigger allergies:
- Keep windows closed to prevent pollens and molds from drifting into your house.
- Keep car windows closed when traveling.
- Use an air conditioner in your home or car to keep the air dry and cool.
- Try to stay indoors when the pollen count or humidity is high.
- At the height of pollen season, take a vacation to a pollen-free area, such as a beach.
- Don't hang sheets or clothing outside to dry.
- Don't mow the grass or rake.
- Don't grow too many indoor plants or overwater your plants; wet soil encourages mold growth.
If you have allergy symptoms but dread the thought of parting with Puff or Spot, get tested. Your allergist will take a thorough history and use allergy skin testing to determine whether you're allergic to animal dander or dust mites.