It is that time of year when pollen in the air brings about watery eyes, scratchy throats, itchy ears and stuffy congestion. Allergy season. As a board certified emergency physician, I am shocked how many people suffer so much when there are often simple solutions. From lifestyle choices to medication, here are ways to reduce your suffering this year, and how to keep it from coming back next year.
The first step is prevention. Seasonal allergies are caused by exposure to pollen or spores that irritate our bodies. With time, allergic reactions get stronger so prevention is key. After spending time outdoors, make sure you shower and change clothes immediately. Pollen, by its nature is sticky, so it can stay on your clothes and hair for a long time, exacerbating symptoms.
Hydration is paramount. Part of the allergic cycle (as well as a component of asthma attacks) is thickened mucous secretions. Increasing fluids is the best way to thin your secretions, which allows the body to clear them more effectively. This is why when attacks are severe enough to land you in the hospital, we typically start intravenous fluids. Additionally, as the weather warms, we begin to lose more fluid through sweating compounding the problem. Most people need about an ounce of water per day for every two pounds of body weight. So, if you weigh 180 pounds, you would need 90 ounces of water, just over 11 cups. A good way to measure (and one my kids especially love) is to monitor the color of your urine. Other than your first void of the day, your urine should be almost clear. If you see any yellow tinge in the toilet water after urination, you know you need to drink more water. However, every person is different so do check with your physician about the right amount for you, especially if you have been placed on fluid restriction or take medications.
If you want relief, you need to ask for it. One of the best decongestants on the market is pseudoephedrine. However, because it can be used in making methamphetamine, it is kept behind the counter at the pharmacy and you must ask a pharmacist, and show identification to purchase. It does take a few extra minutes, but if you are congested, this is the medication you want. Those items in the aisle that appear to be the same as pseudoephedrine, are not. Many times they contain an ingredient called phenylephrine (often written PE on the front of the box). Although this may benefit some people, it is typically not as effective as clearly congestion as pseudoephedrine.
An antihistamine may also be of benefit. The antihistamines work to mitigate your allergic reaction. One of the most common over the counter antihistamines is diphenhydramine (Benedryl). However, it is effective for just six hours. There are other brands, such as cetirizine (Zyrtec) that can be effective for twenty-four hours. One of the major side effects of antihistamines is they can make you sleepy, so use this to your advantage. For my seasonal allergy patients, I suggest they take a Zyrtec around dinner time so that by bed time, they can use the side effect to their advantage. Antihistamines can work for symptoms like sneezing, and itching, and for many they can even help relieve minor headaches. Like all medications, though, it is important to speak with your doctor first before starting a new medication, even over the counter.
Prevention is the sweetest solution. There is decent data to indicate you may be able to quell chronic allergies by eating a teaspoon of local honey each day. The theory is there are minute amounts of pollen in the honey, so it acts like an allergy shot, giving you tiny doses to help build tolerance. This is why you need local honey, because you want it to contain pollen from the allergens in your region. This may take weeks to months, so it is never too early to start. It doesn’t have to be plain, you can mix it in a smoothy or spread on toast. However, hot tea is not a good idea to mix it in for this purpose as the hot water has the potential to destroy the pollen. So, best to eat is plain or mix it with your breakfast, like my daughter’s favorite, yogurt topped with all-bran, blackberries and honey. Never give honey to a baby less than a year of age due to the risk of botulism, and if you are diabetic, check with your doctor if this is right for you.
Realize your body is miraculous. Seasonal allergies can be a challenge for many, but realize it is this same part of your immune system (immunoglobulin E, IgE) that keeps parasites at bay. So while you may suffer from oak or cedar pollen, hopefully that same mechanism is keeping your body free of parasitic worms like Schistosoma and Trichinella.
Know when to seek help. If you haven’t been evaluated by a physician regarding your allergies, it is important to do so. Many other conditions, from asthma to migraines, even infection, can mimic seasonal allergies so a check-up is in order. If you ever feel short of breath, have a new type of headache or a headache worse than usual, feel your throat is closing or develop a rash, you need to seek immediate medical attention. Hopefully, by visiting your doctor and using the steps above, you can prevent that from occurring.