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Living Well

How To Tame Fall Allergies: Start Treating Them Early

Last updated: Sep 12, 2016

 

Allergy specialist Kerry S. LeBenger, MD, FAAAAI, FACAAI, offers this advice for people who suffer from seasonal allergies, "Start treating them early," before symptoms show up.  Those who wait could end up with sinusitis or worse. 

Fall is not the peak season for allergies, that honor goes to spring, Dr. LeBenger said during a recent interview. "But, because we go into flu and cold season, people tend to get worse," in the fall than they do in the spring.

Ragweed is now in full bloom, along with a lot of other fall flowers and weeds. Mold becomes an issue as humidity picks up and the leaves start falling down. It might be time to hit the drugstore and update your supply of over-the-counter (OTC) antihistamines and nasal steroid sprays, before the sneezing, congestion, itchy eyes and coughing start.

Cases of sinusitis, "a very common disease effecting ten to twenty percent of the population," increase in the fall, said Dr. LeBenger. Sinusitis is a swelling in the nasal passages or nasal sinuses that produces the familiar stuffy nose, post-nasal drip, headache, and, sometimes even what seems to be a toothache.1 What many people don’t realize is that one of the largest causes of sinusitis is underlying allergies. Treating the underlying allergies keeps the incidence and severity of sinusitis down, is relatively easy, and starts with taking OTC antihistamines.

"Most things that were prescription are OTC," and should be taken early in the season and "used for the period of time you are suffering, not intermittently, until usually the end of October," Dr. LeBenger said. There are many choices available when it comes to antihistamines, including Claritin and Zyrtec in tablet form. But Antihistamines are less effective for the main complaint of congestion than the OTC nasal steroid sprays.

As for nasal steroid sprays, such as Flonase, Nasacort and Rhinocort, "when used appropriately, they are generally safe," for treating nasal and sinus congestion.

"The truth is, allergies are getting worse for a lot of reasons," including tight-fitting buildings, the "fact that people's immune systems don't have to fight infections as newborns," which causes them to go in a more allergic direction and even global warming, he said.

As for what causes an allergy, that happens when the body makes an antibody called immunoglobulinE (IgE) when it first encounters an allergen. The IgE latches on to a specific type of white blood cell and a similar cell in tissue.  The first time someone is exposed to an allergen, a sensitivity is created. The next time the person is exposed the cells with the IgE react and produce histamines and other substances that cause what are now recognized as allergic reactions --  stuffed nose, itchy eyes and other types of inflammation. The reaction continues and can be merely annoying or life-threatening. 2

Usually this happens when one is young, but people do develop allergies later in life.

One consequence of having an allergic reaction is that your immune system isn't quite ready to take on another assault. In the fall, when people, adults and children, are just back from vacation and the children are heading back to school for the first time in months, it's possible for an active allergy attack to leave its victim open to another infection.

If there is a lot of congestion, Dr. LeBenger suggested "help yourself with steam inhalation, saline or saltwater sprays, humidifiers, decongestants or muclytics" such as Mucinex or Robitussin, to help thin the mucus. As with all medications, make sure you check with your doctor before taking them, especially any decongestants, which could affect blood pressure. 3

If the allergy symptoms persist, seem to be getting worse, and there is colored discharge while coughing or blowing your nose, see your doctor, said Dr. LeBenger.  Your doctor may prescribe an antibiotic, if necessary.

The point is to make the congestion go away, but you don't want to over-treat it by using antibiotics when they aren't needed. "The biggest issue in all of medicine is resistant bacteria, so avoid antibiotics," unless absolutely needed, he said.

Source: Interview with Kerry S. LeBenger, Friday, Aug. 26, 2016

Resources:

1.”Sinusitis,” American Academy of Allergy Asthma & Immunology, https://www.aaaai.org/conditions-and-treatments/library/At-a-glance/sinusitis

2. “Merck Manual, Consumer Version,” http://www.merckmanuals.com/home/immune-disorders/allergic-reactions-and-other-hypersensitivity-disorders/overview-of-allergic-reactions

3.  "Seasonal Allergies and Hypertension,” By Abigail Meisel for Summit Medical Group http://www.summitmedicalgroup.com/news/smg-news/seasonal-allergies-and-hypertension/

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