Attack Your Allergies

Simple things you can do (and take) to control your allergy symptoms.

Every year, an estimated 10 million of us visit the doctor complaining of allergic rhinitis, the most common nasal allergy. The good news is that you don't have to suffer.

Besides the obvious discomfort, seasonal allergies can impact quality of life. Allergies can affect memory and attention, and if left untreated, can lead to ear infections, sinus problems, and asthma.

There are medicines you can take and simple things you can do to protect yourself. But first you need to know what you're up against.

Allergies happen when your immune system -- which normally protects your body against invading agents -- reacts to a false alarm. When an allergic person inhales pollen or mold spores, the immune system falsely identifies these foreign particles as a threat and mobilizes to attack by producing large amounts of antibodies called IgE.

Each IgE antibody is specific for one allergy-producing substance, such as ragweed or oak, and stands guard in nasal and eye tissues.

Unleashes Chemicals

When the antibody encounters its specific allergen, it signals the body to unleash a host of protective chemicals, including histamine. Within 30 minutes, the small blood vessels in your nose widen and engorge tissues, causing a stuffy nose. Glands act up by producing mucus, resulting in the sniffles. Four to six hours later, additional chemicals and proteins signal other inflammatory cells to join in the action. The result: thick mucus and nasal congestion that can last for 24 hours.

"You can have symptoms all night even if you were exposed in the morning," says Dr. Alkis Togias, associate professor of medicine at the Johns Hopkins Asthma and Allergy Center.

Here are ways experts recommend keeping the invisible invaders at bay.

At home, limit exposure to pollen and outdoor mold spores in your house by keeping all doors and windows shut (even at night) and the air-conditioning on. "There's a fivefold decrease in pollen particles if you keep your windows closed," says Dr. Tim Sullivan, a professor of medicine at Emory University School of Medicine. A high-efficiency electrostatic filter or air-cleaning system on your central air conditioner, or a portable High-Efficiency Particle Accumulating (HEPA) filter in your bedroom (or other rooms where you spend a lot of time), can trap mold spores and pollen.

When driving, keep the car windows up and put the air conditioner on recirculate mode so air doesn't come in from the outside. Because mold loves the dark, moist air in your car's air-conditioning system, run the air for a few minutes before you get in and go, says Dr. Donald Pulver, an assistant professor of medicine at the University of Rochester. This will blow out any mold spores that may be growing.

Dehumidifier May Help

Most seasonal allergy sufferers are also allergic to indoor mold, dust mites, and pet dander. To reduce mold, buy a dehumidifier and put it in the basement to reduce dampness. Just make sure you change the water reservoir regularly to prevent mold growth on it. Dust mites -- microscopic insects that feed on dead skin cells -- love carpets and bedding. To lessen their impact, wash bedding in hot water and install hardwood floors in your home.

As for pets, try to keep them outdoors. If that's not an option, keep them clean and brushed. Some studies have shown that a weekly bath reduces airborne levels of pet allergens.

Because allergens are transported by wind currents, warm, dry, breezy days tend to have higher pollen counts than cool, wet, windless ones. And while no study has shown the best time of day for the least pollen exposure, early morning right after sunrise is probably the sneeze-free zone, says Dr. Harold Nelson, of the National Jewish Medical and Research Center in Denver.

Listen to the local pollen count, even though samples are taken 24 hours before reported. If the count is down, you may still have problems. That's because your nose and eyes become increasingly hyperreactive after encountering pollen day after day during allergy season, so eventually it doesn't take much to get a reaction.

Lawns harbor mold and pollen from trees and the surrounding environment, so have someone else mow your lawn. If you can't find someone to tackle this chore for you, wear a mask over your nose and mouth. A regular dust mask won't do much because it doesn't block the tiny offensive particles. Dr. James Thompson, director of the Botanical Technical Services at Bayer Corporation, recommends finding a mask that excludes particles sized from 12 to 25 microns. Also, what you plant in the yard can affect your symptoms. Oak, ash, birch, and olive trees produce massive amounts of pollen, says Dr. Pulver.

Applying cold compresses on your eyes can work wonders at alleviating red, itching eyes that make allergy season seem unbearable. Many experts recommend using eyedrops that have been chilled in the refrigerator for added relief. If your eyes are irritated, don't wear contact lenses; they can trap pollen against your eye. (Check with an eye-care professional first before using eyedrops while wearing lenses.) Tear substitutes used several times a day may help wash away and dilute allergens.

Drugs are trusty allies. Nasal decongestants work in minutes to shrink dilated blood vessels in the nose and, therefore, improve swollen nasal tissues. Oral decongestants also reduce nasal congestion, though they take a bit longer to be effective. Antihistamines, by virtue of countering histamine, combat a runny nose and itchy eyes, but do little to battle nasal congestion.

Drugs Have Downside

Whichever medication you choose, be aware that most over-the-counter medicines have a downside too. Decongestant nasal sprays can only be used for a few days before they also produce a rebound effect, clogging up your nose all over again. Oral versions can cause insomnia and nervousness, and may not be safe for anyone suffering from an abnormal heart rhythm, high blood pressure, and heart or thyroid disease.

Nonprescription antihistamines can cause drowsiness and impair thought processing and alertness during the day -- even when taken at night.

"People frequently don't sense that their driving performance is impaired from these medications," says Dr. Mark Dykewicz, associate professor of Internal Medicine in the Division of Allergy and Immunology at St. Louis University. Studies show that even if you don't feel sleepy from these drugs, driving and thinking are often negatively affected.

Newer prescription antihistamines, such as Claritin, Zyrtec, and Allegra, provide relief from common allergy symptoms, but may make you less sleepy if you take the standard dose.

If you have chronic symptoms during the entire allergy season, regularly taking an antihistamine may be more effective than taking a pill every so often. Because oral antihistamines do little to relieve nasal congestion, your doctor may suggest using a nonsedating antihistamine-decongestant combination or combining an antihistamine with a steroid nasal spray.

The gold standard of treatment recommended by many allergists is nasal steroid sprays. Dr. Pulver found that newer prescription drugs -- such as Nasonex, Rhinocort, Flonase, and Nasacort -- were four times more effective than older antihistamines at preventing and treating symptoms. Particularly good for severe cases, these sprays relieve itching, sneezing, runny nose, and nasal congestion -- mainly through an anti-inflammatory effect. Researchers have also found that nasal steroids can improve sleep and reduce daytime fatigue among people with year-round allergic rhinitis. Many allergists recommend patients use a combination of a steroid nasal spray with an oral antihistamine.

Saline nasal spray is another potent weapon against allergies. A spray can loosen nasal mucus and moisten nasal passages. Antihistamines can now be directed at the nose, thanks to Astelin, the first antihistamine nasal spray approved in this country. Like the oral varieties, this medication is more effective when used regularly. But unlike oral antihistamines, Astelin seems to also improve nasal congestion.

Whichever medication you take, it's best to start a couple of weeks before allergy season begins. "Premedication blocks allergic reactions," says Dr. Pulver. For best results, use an antihistamine (oral or nasal) or a nasal steroid daily. And be patient. Give your treatment course up to four weeks before raising the white flag.


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