Remedies for Seasonal Allergy

Keep It Clean

You can reduce your allergic misery if you take steps to keep the culprits out of your house. For seasonal allergies caused by plants and trees, keep windows shut and the air conditioner on. Purchase an air filter to clean out pollens, molds and dust. Use a dehumidifier in damp areas like the basement. Install wood, tile or vinyl floors rather than carpet because they can be mopped regularly. If you do have carpets, have someone else do the vacuuming or buy a machine designed to reduce dust emissions.

Minimize clutter, book collections, and bric-a-brac, which collect dust and pollens. Keep pets outside or bathe them regularly if they're indoors, and don't let them sleep in your bed. Wash your hair every day to rinse off dust and pollen, and if you've been in the yard, leave shoes at the door and wash your clothes in hot water as soon as possible.

Since many hay fever sufferers are also allergic to dust mites, "The most cost effective thing is to buy a mattress cover and pillow covers can provide a barrier between you and the dust mites in your bed, where they live and breed. In addition, treat carpets with an anti-allergen spray that kills dust mites.

You won't be able to eliminate every allergen from your home, but with these steps you can make it a comfortable place even during the peak of allergy season.

Over-the-Counter and Through the Pharmacy

Hay fever strikes some 10-30% of Americans, and more than half of them turn to over-the-counter medications instead of a doctor's prescription to control their symptoms. Pharmacy aisles are crowded with dozens of individual allergy drugs featuring various combinations of the half dozen active ingredients approved by FDA for allergy relief. Given the variety, consumers may find themselves posing some common questions:

Q: My hay fever strikes every spring and fall. I sneeze, my eyes water, and my throat itches. How do I choose the best medicine?

A: For typical hay fever symptoms, three over-the-counter options can help: oral antihistamines, decongestants (both oral and nasal sprays), and a nasal spray containing cromolyn sodium.

Brands such as PediaCare, Robitussin, Comtrex, and Benadryl, as well as generic store brands, contain antihistamines, either chlorpheniramine or diphenhydramine. These drugs are effective for runny noses, sneezing, and itching, but can make you drowsy.

If the OTC antihistamines are effective in relieving symptoms but are too sedating, a newer less sedating antihistamine can be obtained by prescription. Antihistamines work on a runny nose, but not as well on a stuffy one, so many brands combine an antihistamine with a decongestant (for example, pseudoephedrine). Decongestants can also be found in fast-acting nasal sprays, but these may have a rebound effect and after about three days they'll make your nose even more congested. They are better used for a short-lived cold than an ongoing allergy. One nasal spray that doesn't cause a rebound effect is Nasalcrom (cromolyn sodium). This drug is helpful to prevent your symptoms if started a few days before the allergy season begins and taken continuously. It causes few side effects and will not make you drowsy.

Remember that it's the active ingredient that is important, and many products contain more than one. Read the labels to make sure you're not combining drugs with the same ingredients. Look at the ingredients in the drug product and choose the type of ingredient that will best treat the symptoms you have.

Q: My job requires a lot of driving. Is it safe to take an antihistamine in the morning before I go to work?

A: Probably not. Antihistamines may affect your ability to drive or use machinery even if you don't feel sleepy.

"Drowsiness is the most common side effect of antihistamines and may be a problem for users who need to remain alert," says Hu. "Also, alcohol should be avoided because it may increase the drowsiness caused by antihistamines. If you need to be alert, some prescription antihistamines are less sedating."

Q: I have emphysema and high blood pressure. Can I take an over-the-counter allergy medicine?

A: Antihistamines should not be used by anyone with breathing problems such as emphysema or bronchitis, anyone with glaucoma, by those taking sedatives or tranquilizers, or anyone with difficulty in urination unless directed by their doctors. These drugs dry up secretions and may cause urinary retention and drowsiness, according to Hu.

Antihistamines may also cause dryness of the mouth and eyes and blurred vision.

Decongestants, which are in many OTC allergy medicines, can raise blood pressure. Ask your doctor what, if anything, you can take. Decongestants should not be used by people with heart disease, thyroid disease, or diabetes unless a doctor says it's OK. If you're taking a drug containing an MAO inhibitor, which is sometimes used to treat depression, never use a decongestant.

Q: I've tried every medicine on the shelves, and I'm still miserable each spring. What else can I do?

A: See your doctor. There may be prescription drugs that are more helpful to you, you may need allergy testing or shots, or your symptoms may be caused by something else entirely.

Extracts for Allergy Serum

FDA has been working to standardize the biological extracts used to test and treat patients with allergies. Extracts prepared from natural sources such as pollens, animals and foods that trigger allergic reactions will vary in potency if they are not standardized. Without standardization, each extract is an unknown. One batch could be stronger than the next. It makes it more difficult to treat patients and it also raises safety concerns."

Manufacturers are working to standardize extracts so they are consistent in potency from lot to lot. Currently, FDA has approved standardized allergy extracts for short ragweed, bee and other stinging insect venoms, dust mites, and cats.

Moreover, FDA is requiring that eight grass and pollen extracts be standardized. The availability of the grass and pollen extracts will enhance their safe and effective use in diagnosis and treatment of grass allergies. Non standardized extracts of cockroach (an important cause of inner-city asthma), giant ragweed, mold, peanuts, dog dander, and feathers are proposed for future standardization.

No allergy extracts are approved for sensitivity to foods, latex, or chemicals such as hair sprays, perfumes or cigarette smoke.

Spring and Pollen Are in the Air

With a bit of planning, effort and common sense, many people can limit their suffering or perhaps even avoid it altogether. For the most part, seasonal allergies are caused by airborne pollens -- very fine powder released by trees, grasses and weeds as they pollinate and fertilize other plants of the same kind. Molds in outdoor air can also contribute to seasonal allergies.

Although outdoor allergens can be present year-round in warmer climates, allergy season generally begins in late winter or early spring and runs through late summer or early fall. As the season progresses, different types of pollens are present to trigger allergic reactions.

Below are important steps that help prevent or relieve symptoms when pollen or mold counts are peaking:

1. Use over-the-counter antihistamines for relief. For some people, these drugs are very effective at reducing the classic symptoms of seasonal allergies, including sneezing, runny nose, itchy eyes and scratchy throat. Be aware that some older-generation antihistamines, such as Benadryl, can cause sleepiness and the impairment of thinking and driving. More recent formulations tend to cause no drowsiness (Claritin, for example) or less drowsiness (Zyrtec).

2. Keep your home's doors and windows closed. You can't completely seal off your home, but keeping doors and windows closed can help prevent pollens and outdoor molds from entering. As the weather turns nicer, use the air conditioner rather than opening a window to bring in "fresh" air.

3. Limit outdoor activity, particularly in the morning. Avoid being outdoors, especially to exercise, when pollen counts are high, or on windy days when pollen and molds are being blown about. In general, pollen counts are highest from about 5 a.m. to 10 a.m.
When traveling by car, keep the windows up. Again, this helps keep out pollens, dust and mold.

4. Take a shower and change clothes. Pollen can collect on clothes and in your hair, so when you've been outside for any significant amount of time, shower and change into fresh clothes as soon as you get home.

If you've followed those steps and you're still suffering, then it is time to see a doctor.

A variety of prescription medications can help reduce or block seasonal allergy symptoms, he said. These include other oral antihistamines and several classes of nasal sprays. Nasal sprays tend to be the most effective at relieving symptoms by helping reduce inflammation and counteracting the allergic response.

For harder-to-treat cases, many patients benefit from allergy immunotherapy -- a long-term series of shots to desensitize a patient from specific allergens.

The good news is there's a lot you and your doctor can do to help relieve or prevent suffering caused by allergies.

Pets & Animals

Many people think animal allergies are caused by the fur or feathers of their pet. In fact, allergies are actually aggravated by:

• proteins secreted by oil glands and shed as dander
• proteins in saliva (which stick to fur when animals lick themselves)
• aerosolized urine from rodents and guinea pigs

Keep in mind that you can sneeze with and without your pet being present. Although an animal may be out of sight, their allergens are not. This is because pet allergens are carried on very small particles. As a result pet allergens can remain circulating in the air and remain on carpets and furniture for weeks and months after a pet is gone. Allergens may also be present in public buildings, schools, etc. where there are no pets.

Preventive Strategies

• Remove pets from your home if possible.
• If pet removal is not possible, keep pet out of bedrooms and confined to areas without carpets or upholstered furniture.
• If possible, bathe pets weekly to reduce the amount of allergens.
• Wear a dust mask and gloves when near rodents.
• After playing with your pet, wash your hands and clean your clothes to remove pet allergens.
• Avoid contact with soiled litter cages.
• Dust often with a damp cloth.

Mold

Several molds that grow both indoors and outdoors, produce allergenic substances. These allergens can be found in mold spores and other fungal structures (e.g. hyphae). There is no definite seasonal pattern to molds that grow indoors. However outdoor molds are seasonal, first appearing in early spring and thriving until the first frost.

Indoor molds are found in dark, warm, humid and musty environments such as damp basements, cellars, attics, bathrooms and laundry rooms. They are also found where fresh food is stored, in refrigerator drip trays, garbage pails, air conditioners and humidifiers.

Outdoor molds grow in moist shady areas. They are common in soil, decaying vegetation, compost piles, rotting wood and fallen leaves.

Preventive Strategies

• Use a dehumidifier or air conditioner to maintain relative humidity below 50% and keep temperatures cool.
• Vent bathrooms and clothes dryers to the outside, and run bathroom and kitchen vents while bathing and cooking.
• Regularly check faucets, pipes and duct work for leaks.
• When first turning on home or car air conditioners, leave the room or drive with the windows open for several minutes to allow mold spores to disperse.
• Remove decaying debris from the yard, roof and gutters.
• Avoid raking leaves, mowing lawns or working with peat, mulch, hay or dead wood. If you must do yard work, • wear a mask and avoid working on hot, humid days.

Dust Mites

Dust mites are tiny microscopic relatives of the spider and live on mattresses, bedding, upholstered furniture, carpets and curtains.

These tiny creatures feed on the flakes of skin that people and pets shed daily and they thrive in warm and humid environments.

No matter how clean a home is, dust mites cannot be totally eliminated. However, the number of mites can be reduced by following the suggestions below.

Preventive Strategies

• Use a dehumidifier or air conditioner to maintain relative humidity at about 50% or below.
• Encase your mattress and pillows in dust-proof or allergen impermeable covers (available from specialty supply mail order companies, bedding and some department stores).
• Wash all bedding and blankets once a week in hot water (at least 130 - 140°F) to kill dust mites. Non-washable bedding can be frozen overnight to kill dust mites.
• Replace wool or feathered bedding with synthetic materials and traditional stuffed animals with washable ones.
• If possible, replace wall-to-wall carpets in bedrooms with bare floors (linoleum, tile or wood) and remove fabric curtains and upholstered furniture.
• Use a damp mop or rag to remove dust. Never use a dry cloth since this just stirs up mite allergens.
• Use a vacuum cleaner with either a double-layered micro filter bag or a HEPA filter to trap allergens that pass through a vacuum's exhaust.
• Wear a mask while vacuuming to avoid inhaling allergens, and stay out of the vacuumed area for 20 minutes to allow any dust and allergens to settle after vacuuming.

Pollen

• Ragweed Pollen
• Grass Pollen
• Tree Pollen
• Ragweed and other weeds such as curly dock, lambs quarters, pigweed, plantain, sheep sorrel and sagebrush are some of the most prolific producers of pollen allergens.

Although the ragweed pollen season runs from August to November, ragweed pollen levels usually peak in mid-September in many areas in the country.

In addition, pollen counts are highest between 5 - 10 AM and on dry, hot and windy days.

Preventive Strategies

• Avoid the outdoors between 5-10 AM. Save outside activities for late afternoon or after a heavy rain, when pollen levels are lower.
• Keep windows in your home and car closed to lower exposure to pollen. To keep cool, use air conditioners and avoid using window and attic fans.
• Be aware that pollen can also be transported indoors on people and pets.
• Dry your clothes in an automatic dryer rather than hanging them outside. Otherwise pollen can collect on clothing and be carried indoors.

Grass Pollen

As with tree pollen, grass pollen is regional as well as seasonal. In addition, grass pollen levels can be affected by temperature, time of day and rain.

Of the 1,200 species of grass that grow in North America, only a small percentage of these cause allergies. The most common grasses that can cause allergies are:

• Bermuda grass
• Johnson grass
• Kentucky bluegrass
• Orchard grass
• Sweet vernal grass
• Timothy grass

Preventive Strategies

Specifically:

• If you have a grass lawn, have someone else do the mowing. If you must mow the lawn yourself, wear a mask.
• Keep grass cut short.
• Choose ground covers that don't produce much pollen, such as Irish moss, bunch, and dichondra.

In General:

• Avoid the outdoors between 5-10 AM. Save outside activities for late afternoon or after a heavy rain, when pollen levels are lower.
• Keep windows in your home and car closed to lower exposure to pollen. To keep cool, use air conditioners and avoid using window and attic fans.
• Be aware that pollen can also be transported indoors on people and pets.
• Dry your clothes in an automatic dryer rather than hanging them outside. Otherwise pollen can collect on clothing and be carried indoors.

Tree Pollen

Trees are the earliest pollen producers, releasing their pollen as early as January in the Southern states and as late as May or June in the Northern states.

Trees can aggravate your allergy whether or not they are on your property, since trees release large amounts of pollen that can be distributed miles away from the original source.

Of the 50,000 different kinds of trees, less than 100 have been shown to cause allergies. Most allergies are specific to one type of tree such as:

• catalpa
• elm
• hickory
• olive
• pecan
• sycamore
• walnut

or to the male cultivar of certain trees. The female of these species are totally pollen-free:

• ash
• box elder
• cottonwood
• date palm
• maple (red)
• maple (silver)
• Phoenix palm
• poplar
• willow

Some people, though, do show cross-reactivity among trees in the alder, beech, birch and oak family, and the juniper and cedar family.

Preventive Strategies

• If you buy trees for your yard, look for species that do not aggravate allergies such as crape myrtle, dogwood, fig, fir, palm, pear, plum, redbud and redwood trees or the female cultivars of ash, box elder, cottonwood, maple, palm, poplar or willow trees.

• Avoid the outdoors between 5-10 AM. Save outside activities for late afternoon or after a heavy rain, when pollen levels are lower.

• Keep windows in your home and car closed to lower exposure to pollen. To keep cool, use air conditioners and avoid using window and attic fans.

• Be aware that pollen can also be transported indoors on people and pets.

• Dry your clothes in an automatic dryer rather than hanging them outside. Otherwise pollen can collect on clothing and be carried indoors.

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