As spring temperatures rise, around 82 million Americans are starting to sneeze, wheeze, drip and itch, as they scan pollen reports through reddened eyes. Climate change has lengthened allergy season by as much as three weeks in some areas of the country, and warmer temperatures accelerate pollen and mold reproduction.
Seasonal allergies are not just a nuisance. They can worsen asthma, increase risks of sinus and ear infection, impact sleep and diminish quality of life. They also have significant economic impacts — not just treatment costs, but on worker productivity. Flare-ups can also lead kids to miss school.
Seasonal allergies shouldn’t be confused with allergies to foods. In the latter, the body misidentifies certain food proteins as harmful and produces antibodies to fight them. The next time it encounters these proteins, it mounts a systemic immune response that can affect multiple organs and, in severe cases, lead to anaphylaxis. Reactions to seasonal allergens, by contrast, are typically localized, with symptoms confined mostly to the nose, eyes and throat, although for some they can affect the airways.
Most seasonal sufferers self-manage their symptoms. The most commonly used OTC allergy medications include oral antihistamines and decongestants, various nasal rinses and sprays, and eye drops. But as board-certified allergist Jane Krasnick of Warren Asthma and Allergy Care explains, the pharmacy aisle can be confusing. People may not match the right drug to their symptoms, she says, or not realize that some brand and generic drugs are identical. A 2018 study found only 17% of allergy sufferers chose the right drug for their dominant symptom when they didn’t consult with their doctor or pharmacist.
Even when the right medication is used, it can be done so inconsistently or incorrectly. For example, some medications work best when taken daily and preventatively before allergy season. Certain decongestant sprays, when overused, create rebound congestion, making symptoms worse.
It’s also important to recognize when not to head to the drugstore. It’s reasonable to self-treat with isolated ocular and nasal symptoms, according to Krasnick, “but I think if it’s ever involving their chest, that should be evaluated.”
Standard drugstore antihistamines people reach for “are not a good primary treatment for asthmatic symptoms as they don’t provide broad enough effects.”
Different allergens pervade throughout the warmer months, and individual reactions vary. Tree pollen predominates in spring, followed by grass pollen through mid-July. Then weed and ragweed follow, sometimes extending into November until the first frost.
Krasnick notes that overlapping these four types of pollen is mold. You can’t really see it, she says, but as the weather starts to warm up, and especially after heavy rain, it collects on the grass and other vegetation. It is also pulled up when we rake fallen leaves come September.
What steps can the average person take to minimize these exposures? Start with simple pollen-tracking apps. When counts are high, limit time outdoors and keep windows closed with the air conditioner running. Vacuums and portable air purifiers with HEPA filters can trap allergens, and keeping indoor humidity down prevents mold growth.
Grass-cutting can be a major symptom trigger, and Krasnick suggests wearing a mask to avoid “inhaling massive amounts of mold and pollen spores up into the nose.” When you head back indoors, it’s a good idea to remove shoes and throw clothing in the wash, and she recommends showering in the evening to avoid taking spores to bed on your skin and in your hair. On super-high pollen count days, when symptoms flare, “take a beat, go inside. Don’t try to push through it.”
Sometimes people sensitive to seasonal allergens experience what’s called “oral allergy syndrome,” not to be confused with standard food allergies. Take an apple, says Krasnick, it comes from a tree, and the two share common proteins.
“When you bite into that apple, your mouth can’t tell the difference between eating the innocent apple versus a boatload of tree pollen.” This can cause oral burning, itching and even lip swelling and stomachaches. Oral allergies tend to develop during adolescence, and often cooking the food — say, baking those apples into a pie — will alter the protein structure enough for the person to tolerate it.
For those who don’t get relief through the normal channels, immunotherapy can help. Immunotherapy desensitizes the immune system by small, repeated exposures to offending allergens. The process typically lasts three to five years, with weekly exposures at first, followed by monthly “maintenance.” Immunotherapy can be highly effective and offer long-term relief instead of temporary symptom control. In children, it may lower their risk of developing asthma.
“But for any patient, I always offer a trial of medications just to prove yay or nay if something helps before jumping into it,” Krasnick says.
Struggling with seasonal allergies has become normalized for millions of Americans. Fortunately, with a few tweaks to their routines, many begin to feel better.
A good place to start is by identifying medication mismatches, maintaining proper and consistent drug use, and taking steps to manage allergen exposure both indoors and outdoors. When these steps fail or when asthma is triggered, it can help to consult a provider. While seasonal allergies are annoying and inconvenient, allergy sufferers may have a bigger toolbox to combat symptoms than they realize.
Kelly Rogers Victor, Ph.D., MPH, MPP is a writer and consultant on nutrition, health policy and public health. Her columns appear regularly in The Detroit News. Reach her at Kelly@upstreamhealthconsulting.com.
This article originally appeared on The Detroit News: There are ways to get better relief from seasonal allergies | Rogers Victor
Reporting by Kelly Rogers Victor / The Detroit News
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