Seasonal Allergy Relief

It's Spring - let our expert tell you how to get allergy relief

by Murray Grossan, M.D.

This year we have had lots of rain and so the deserts are blooming and there is more pollen everywhere. The pharmaceutical companies are all expecting big boost in sales of medication! For sure, allergy sufferers can expect a miserable season.

But there is hope. Lots of my patients do well, even during the worst of allergy seasons. Here is what you can do:

INFO LINKS Pollen and Hayfever Solution Guide - a quick buyers guide of the best recommended products to solve airborne allergen problems Mold Solution Guide - a quick buyers guide of the best recommended products to prevent and control mold allergy problems Cat Allergy Solution Guide - a quick buyers guide of the best recommended products to prevent and control pet allergy problems Dust Mite Solution Guide - a quick buyers guide of the best recommended products to prevent and control dust mite allergies

Read The Pollen Calendar and the pollen count usually reported in your newspaper or at www.weather.com.

Nasocrom If you know which plant is your pollen allergy, you can start over the counter Nasocrom 4-6 weeks before the pollen gets high and this will often prevent symptoms. Nasocrom is a 2% solution of Cromolyn Sodium, a natural allergy blocker. It blocks the release of chemicals from mast cells that cause sneezing and wheezing. It is available OTC in the nasal solution. Nasocrom Instructions: For nasal use, spray each nostril 4x a day. There are almost no side effects and it can be used with an antihistamine. The downside is that it must be started 4 - 6 weeks before the pollen season and continued during the pollen season. If you are using Nasocrom and Hydro-Pulse irrigation, irrigate first, then wait an hour to use the Nasocrom. That way you get better contact where you need it.

Hydro-Pulse Irrigation For Allergy. Regarding Hydro-Pulse irrigation for allergy relief: Used daily or twice a day, Hydro-Pulse Irrigation can be beneficial during the pollen season. This irrigation removes pollen from the nose, removes the IgE that is on the nose and combines with the pollen to make symptoms, and most importantly restores the "lazy" nasal cilia so they can defend you against infection. Even though the irrigation feels good, it is best not to use the HydroPulse irrigation more than twice a day.

In Allergy Reactions , Arithmetic Counts. Allergy is "arithmetical." That is, pollen plus dust, plus fatigue, plus iced drinks, plus perfumes add up to "ten" with symptoms.

For example, when your particular pollen count is LOW, you can use perfume and drink iced drinks and eat spicy foods.

As the pollen count increases, now iced drinks give you symptoms, but you can still eat spicy foods.

As the count goes higher, now you have symptoms - a ten - even when you take all the precautions. Fortunately the pollen count isn't a "ten" all the time.

 

Rules For Reducing Allergy Symptoms:

• On high pollen count days, try to stay at home.
• When you drive keep windows closed and air conditioning on. Have the air recirculate. Do not drive with windows open.
• Avoid spicy food, hot peppers, etc. No iced drinks.
• Use unscented lipstick. Avoid odorous lotions and perfumes.
• The moth flakes in your bedroom closet can add to make a "ten" so keep those closet doors air tight. Room deoderizers add to the allergy symptoms.
• Let someone else do your gardening.
• Drink hot tea BEFORE getting out of bed in the morning. Yes, breakfast in bed.
• Don't drive behind a diesel truck or bus.
• Avoid smoke.
• Anything with an odor is like tiny spikes that rub your nose when it is swollen due to allergy. Any odor can make the allergy worse.
• Even though your allergy may be only to a flower pollen, and even though your skin test was negative to dust, dust can add to your "pollen level" and make a ten. You need to pay attention to dust proofing.
• You do need to change your clothes when you come in from out of doors. You can bring a Huge amount of pollen in just on your clothes and shoes. Don't forget, pollen is in the air and in your hair.

Pets: During pollen season it's you or the cat. The cat easily adds a "five" to make an early "ten". Cat dander and allergy triggers from cats stay around for months even after the cat is away and the house is scrubbed. Pehaps you don't have symptoms with the cat ordinarily, but when the pollen comes, BAM!

• If you still want to keep the cat, at least keep him out of the bedroom.
• Rugs accumulate animal dander and must be washed.
• Keep an air purifier in the room your pet is usually in. Especially use an air cleaner in your bedroom. Most HEPA filters take out the animal dander.
   

Ionizers: Consumers union, American Academy of Allergy, and most pulmonologists feel that "ionized air" makes the symptoms worse. The ozone generators can be highly irritating to the allergic person. In Bottom Line, one author recommended using an ionizer that doesn't make ozone. I have no idea how you could make that selection properly.

Dust Mites are everywhere. It helps to wash things in the bedroom with very hot water about every week. Hepa air purifiers help, but if you are producing dust mites they can only do so much. Dust mite encasings on your mattress and bedding are also recommended.

Plants Polinate at 5 AM and 5 PM.

• So you must have windows closed at 5 AM and must not drive in an open car at 5 PM.
• During heavy pollen season, change air conditioning filters and vents frequently.
• In most areas there is less pollen in the air when night falls so do your shopping in the evening.
   

The Crooked Thermostat. When you have allergy, you don't accommodate to temperature changes well. Instead of the body warming as needed, you sneeze and hack. This does warm the body, but it starts the cascade of sneezing and it is difficult to stop.

• So, hot tea before you get out of bed.
• The allergy person MUST carry a jacket or scarf with them. Going into an air conditioned store will start the symptoms unless you put on the jacket. Movie theaters can be deadly when you sit in a draft.

Windows Closed. The faster you drive the more pollen hits your windshield. Therefore you MUST drive with the windows closed. You MUST NOT drive behind a diesel truck. That can easily cause allergy symptoms when the pollen is high.

Cold Or Allergy Or Sinusitis? How can you tell an allergy from a cold? Both have cough, congestion, headache, watery eyes, sneezing and dripping. But a cold only lasts a week, if you are sneezing after 5-7 days, its no longer a cold. Probably allergy, but could also be a sinus infection. If its sinus, you will have more local pain, fever and feeling sick. Drainage is colored green or yellow.

With allergy, the nasal membranes are pale and boggy. Drainage is watery and clear.
 

What About Mold? Mold is everywhere and usually is not a factor, unless there is an overwhelming exposure. Instead of calling a mold remediator, call a plumber and a roofer to fix any leaks. If the closet is still "moldy", keep a light on in the area that looks suspicious. Worst source of mold is the sprinkler system that waters at the house or under the house. Fix the sprinklers.

Breakfast In Bed During allergy season you MUST have breakfast in bed! Again, your body thermostat is "crooked", and when your warm body hits the cold floor, you warm up "incorrectly", by sneezing and hacking and will continue to do so. But if you have hot tea before getting out of bed, you can avoid this.

Should I Move? Although moving from one location to another MIGHT be beneficial, often what happens is that you change allergens and become allergic to the local pollen. For example, persons fled New York and moved to Miami. They soon became allergic to the local pollen. As a rule, moving is not the answer.

Will Daily Use Of Hydro-Pulse Cure My Allergy? No. Although use of the Hydro-Pulse Nasal Sinus irrigator during pollen season is beneficial, it is not a cure. What happens is that with Hydro Pulse irrigation you do remove the pollen from the nose and you also remove your nasal local IgE that is the allergy factor- less pollen, less IgE, less symptoms. But, no matter how much benefit you get you still have the allergy. Dr Subiza reported that not only did pulsatile irrigation lower the nasal IgE, it also lowered the blood IgE. Less IgE, less symptoms. Dr Ramadan reported recently that simple irrigation won't remove bacteria with Biofilm. Pulsatile irrigation helps remove these.

Antihistamines? Antihistamines attach themselves to histamine receptors on cell surfaces. This competitive inhibition prevents histamine molecules from attaching to the receptors consequently inhibiting activation of the cell and interrupting the sequence of the allergic reaction. Histamine is a messenger substance released by the mast cell. Mast cells are the lynch pin cell in the type of allergic reaction called immediate hypersensitivity. This is the type of allergic reaction that characterizes hay fever, asthma, hives, and anaphylaxis.

Mast cells release histamine and other substances that control local blood flow and attract other cell types of the immune system to the area. Mast cells can be activated by a variety of mechanisms. IgE antibodies are a special class of antibody that attaches itself to receptors on the mast cell. If a foreign substance (an antigen) attaches itself to the bound IgE antibody, the mast cell becomes activated leading to histamine release and initiation of an allergic reaction. Everyone makes some IgE antibodies but allergic persons make much larger amounts of them. They make them to many different but otherwise innocuous substances in our environment. Antihistamines do not prevent the development of IgE antibodies or even the activation of mast cells. They block the action of histamine, a primary effector substance released by the mast cell. Since mast cells release many other active chemicals, antihistamines cannot completely block an allergic reaction; they simply diminish it.

Fortunately today there are excellent antihistamines available over the counter including Chlortrimeton and Claritin. For most persons Claritin has fewer side effects. But by the same token, it might not work for you.

Chlortimeton is an old one that has been used for decades. It usually works, but may leave you with a dry mouth and some drowsiness. Benedryl is NOT to be taken by seniors. It has a major side effect of drowsiness. It is the main ingredient in Nyquil. Sometimes I deliberately recommend it for nighttime use to help my patient sleep.

On prescription antihistamines, there is a new one out almost every day. The newer ones by prescription include:

• Clarinex
• Zyrtec
• Allegra

They all work and have few side effects but individual patients vary as to how these work for them. Essentially you have to try them and see if you like them. People try to avoid them because of the dryness, drowsiness, and their side effects.

Caution. If you have glaucoma you must not take antihistamines. If you have prostate problems, speak to your doctor before taking these. Men with enlarged prostate gland should not take antihistamines .

Cortisone Nasal Sprays Even I get confused by the names: Flonase, Nasacort, Nasarel, etc. These are available by prescription. Which one is best? Each manufacturer can show you a dozen studies that show that theirs is best. In a recent article, the researcher showed that they all can work and you should prescribe whichever one is cheaper. Occasionally my patient has tried several and insists that brand X works best. That is certainly reasonable. However many "failures" of cortisone sprays has to do with not following instructions, including head position.

If there is thick mucus in the nose, the spray may not penetrate. Simply rinsing out the thick mucus with saline can make a huge difference.

When you spray, aim straight up between the eyes. Then lean far forward to prevent the solution from going down the throat. Check the spray instructions that come with the package.

Non-steroidal sprays. Afrin will open your nose nicely. However it is easy to get a rebound, and now the nose is more plugged than before. During bad allergy, using it just at night to sleep may work. Many of my patients have responded nicely to Astelin nasal spray. Astelin is essentially an antihistamine in spray form. It is non steroidal and if it works for you, has the advantage of reducing the amount of steroid you use. The first time you use it, it has an unpleasant taste, but most persons get accustomed to that and continue to use it. Saline sprays that contain preservatives such as benzalkonium will add to your symptoms. ( Breathe.ease XL for spray does not contain benzalkonium)

Chronic Fatigue. Is It Sinus?

The CDC in Atlanta gives a figure of 32 million people in the U.S. that suffer from sinusitis; fatigue is a common symptom. For people who do not respond to medications as a treatment for their sinusitis, 80% remain fatigued, and out of these cases, fatigue is severe in over 20%. Because of persisting symptoms approximately 200,000 sinus surgeries are performed each year.

At the seventh International conference on Chronic Fatigue, Dr Alexander Chester presented his study of chronic fatigue related to chronic sinusitis. In his research, nearly every published study of sinus surgery showed a decrease in chronic fatigue after sinus surgery. In my practice, I regularly see patients who have been diagnosed Chronic Fatigue and are being "treated" by chronic fatigue specialists. The ones who have chronic sinusitis are cleared of their fatigue when the source - the sinus infection - is cleared up. Any person with a chronic fatigue problem should include a sinus infection evaluation as part of their workup, as well as a dental evaluation for dental infection.

Up to now, we have recognized fatigue as a part of a chronic sinus condition. After Dr Chester's presentation we will be more aware of fatigue as a primary symptom.

Allergy Does Not Cause Sinusitis

In Acute Allergy, the nose runs and drips and the nasal cilia move rapidly - hence there is no infection. However in the late or what I call the exhaustion stage of allergy, then the cilia slow down, mucus thickens and may turn yellow. In this stage, infection can occur. But it can be prevented by attention to restoring cilia function - lots of hot tea, warm compresses to the sinus area, and pulsatile irrigation as with the Hydro Pulse.

If Nothing Works?

A common question I get is: " I took prednisone, singular, cortisone spray, etc and still my allergy symptoms are incapacitating. What should I do?"

Before we had cortisone, prednisone, singular, etc we learned that if we put a patient to bed rest, both physical and mental, they often got well. So when nothing works, total bed rest often does.

Patients Ask:

My Asthma Is Worse. What Should I Do?

This is a common and tragic complaint we hear almost every day. "I have been doing fine and today I am wheezing badly and the medications aren't working."

Things to rule out are:

• New infection - dental, sinus, chest
• Extreme fatigue - not sleeping, overexercising.
• Emotional upset - stress and depression may be a factor
• Not enough liquid intake
• New food allergy
• You have become allergic to the cat
• There is mold in the air ducts
• You are using an Ionizer

Of course a complete MD evaluation is best; these are just some ideas to consider. For example, if your nasal irrigation has been clear and now is yellow or green, probably there is a sinus infection present. But if asthma is worse, see your doctor.

For more information on the Hydro-Pulse Irrigator, please see our product page.

First Published: Late April 2005
Updated: February 2007

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