Fall Allergies – Alabama Nasal & Sinus Center
Well, sports fans, as we look forward to Fall Saturdays spent cheering for our favorite college football team, many of us will be facing the prospect of suffering the other days of the week with seasonal allergies. Yes, ragweed, pigweed, Goosefoot, Lamb’s quarter (yummy!), and Russian thistle (oh, my!) are filling the air this month. Symptoms of seasonal allergic rhinitis include sneezing, watery eyes, nasal congestion and runny nose. You may also experience headaches and blurred vision as a result of the onslaught of histamine, as your body reacts to the numerous unseen particles of pollen floating in the air or carried on clothing. All of these symptoms, in addition to hormonal changes triggered by the allergic response, make sleep difficult. The end result is a person walking around in a fog, with decreased productivity at work and diminished capacity for life at home.
Most people who suffer from seasonal allergies are well aware of medications that work for them during their toughest seasons. Many frontline allergy treatments, which were once by prescription only, are now over-the-counter. These include all of the non-sedating antihistamines like Claritin, Zyrtec, and Allegra. There are newer versions of all of these medicines out on the market, but they require a prescription from your doctor and often are more expensive, as a result. Older traditional medications, such as Benedryl or chlorpheniramine, are effective, but lead to significant drowsiness.
Allergies are best treated in a multi-tiered fashion, especially when symptoms are at their worst. The first tier of treatment is avoidance and/or environmental control. If you know that your allergy triggers are certain foods or animals, you can completely avoid exposure and thus have no allergic reactions. If you have seasonal allergies, it may be hard to completely avoid your allergen, but you may be able to minimize outdoor activities during the peak season. People with allergy to molds or dust mites suffer symptoms year-round. Environmental control, such as frequent washing of sheets in hot water, air filters and removal of dust collecting fabrics helps to some degree. The first line of medical treatment when I see patients for allergy problems is usually a nasal steroid spray. There are several brands on the market today, all of which work by inhibiting the cascade of inflammatory reactions triggered by presentation of an antigen into the nasal cavity and upper respiratory tract. The commercially produced nasal steroids are not absorbed into the blood stream to any appreciable extent, so that patients should not worry about systemic steroid side effects. The medication works only in the nasal mucosa (tissue lining the nasal cavity and sinuses). As such, however, the most common adverse side effect is thinning of the nasal mucosa and nose bleeds. These problems usually only occur after prolonged use and can be reversed easily with cessation of the spray.
The next step in medical therapy of allergies usually includes oral anti-histamines. There are good over-the-counter options in this category, which we discussed above. Finally, leukotriene inhibitors, such as Singulair can be a valuable adjunct medication for patients who do not respond to the combination of anti-histamine and nasal steroid. Short courses of oral steroids are also frequently given to seasonal allergy sufferers, but these need to be limited due to the adverse side effects possible with such therapy. The final step in therapy may be allergy testing and immunotherapy – either shots or drops. We perform both allergy testing and immunotherapy guidance for patients who have either failed medical therapy or who cannot tolerate medications. We would be glad to discuss this very interesting, complex issue with you further. Please call 980-2091 to schedule an appointment.
God bless.
Kris Lay, M.D.
Last modified on Friday, October 04, 2013