Allergies and hay fever Archive

Fighting back against tiny allergens before they strike can help you avoid or reduce symptoms.

Image: iStock

The spring allergy season begins next month, and if you want to avoid symptoms, you must act now. "Pretreating allergies will lead to better control of symptoms, and maybe prevent symptoms from showing up," says Dr. Ahmad Sedaghat, an ear, nose, and throat specialist at Harvard-affiliated Massachusetts Eye and Ear Infirmary.

Automatic defenses

When spring allergens—typically pollen from oak, elm, birch, poplar, or maple trees, depending on where you live—float through the air and reach the nose, the body sometimes overreacts. Mast cells in the lining of the nose mistake the harmless tree particles for dangerous invaders, and summon help by releasing chemicals such as histamine and tryptase, which then recruit more immune system cells to the battle.

People with allergies to grass pollen may have cheered last year when the FDA approved a no-needles treatment —a daily tablet you dissolve under your tongue. These tables deliver low doses of grass pollen to the bloodstream. This is done to “teach” the immune system not to wage war on grass pollen. It turns out that these tablets don’t work that well. An analysis of 13 controlled clinical trials indicates that dissolvable tablets are only slightly more effective than placebos in curtailing classic symptoms of grass pollen allergy—runny nose, itchy eyes, and tickly throat. To make matters worse, more than 60% of people who used the tablets experienced irritating side effects.

Allergies can cause great misery. Luckily, there are options to help manage symptoms and continue doing the things you enjoy. The goal is to find the treatment that best suits your allergies, your lifestyle, and your wallet. Here are three of the most common ways to find relief from allergy symptoms.

Antihistamines

These medications are the mainstay for treating the sneezing, runny nose, and itchy eyes that come with allergies. Antihistamines also relieve hives and other symptoms of some food allergies.

Many people who suffer from hay fever (seasonal allergic rhinitis) are familiar with the older antihistamines such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton). While these drugs work well, they leave many people feeling groggy, sleepy, or just "out of it." Thankfully, the newer generation of antihistamines, including cetirizine (Zyrtec), desloratadine (Clarinex), fexofenadine (Allegra), and loratadine (Claritin), are far less likely to cause drowsiness at recommended doses. Their effects are also longer lasting, so usually you need to take them only once a day instead of every four to six hours.