How to Outsmart Your Allergies

Allergy season is upon us. Read on for top expert tips to fight the triggers. More people in the U.S. are suffering from allergies than ever before, says John Joseph Costa, M.D., director of allergy services at Brigham and Women’s Hospital in Boston. Some 40 million Americans are stuck dealing with sneezy, sniffly, stuffed-up nostrils, itchy eyes and skin, and even upset stomachs. And it's not easy to find relief. One of the trickiest tasks is figuring out the triggers. Is it airborne pollen grains from grass, weeds, trees and flowers? Mold spores also are suspects. As are indoor allergens like dust mites and pet dander. Plus, cigarette smoke and air pollution can aggravate symptoms. “It’s important to keep track of your symptoms. Knowledge is power,” says Katharine Fast, M.D., an allergy and immunology fellow at University of California, San Francisco. Because once you know what's setting off your misery, it’s easier to come up with a treatment plan. You’ll have to play detective to find out your allergic triggers. But if you can’t, it may be time to visit an allergist for a skin prick test. In this quick procedure, a small amount of a possible allergen is placed on your arm or back with needle pokes. A red, raised bump usually signals an allergic reaction. Through a combination of medical treatments and avoidance strategies, “you should get to a point where allergies aren't interfering with your daily life,” says Sean McGhee, M.D., an allergist at UCLA's David Geffen School of Medicine. Experts suggest these 9 tips to help you deal with allergies: 1. Clean up the house. When you spruce up your home, wear a filter mask to avoid breathing in all that dust. Carpets and furniture are breeding ground for many allergens. Wash bed linens weekly in hot water. Invest in a vacuum cleaner with a true HEPA (high-efficiency particulate air) filter. It traps a lot of minute particles that traditional vacuum cleaners don’t. 2. Give up lawn duty. Find someone else to rake leaves, mow the lawn and do gardening. If you get stuck with the outdoor chores, wear a filter mask. 3. Keep tabs on pollen counts. At www.pollen.com, you can sign up for pollen alerts based on your zip code. On high pollen days, minimize outside activities, use air conditioning, and keep your home and car windows shut. 4. Don’t smoke. And stay away from people who do. 5. Wear wrap-around sunglasses. It will keep allergens out of your eyes. 6. Keep pets out of the bedroom and main living areas. Dogs and cats can bring pollen from outside into your home. Plus, pet dander itself is an allergen. Do your best to keep pets out of your bedroom. 7. Shower and wash hair before bedtime. This will prevent allergens from landing on your clean sheets. 8. Use washable or hypo-allergenic pillows and bed linens. Dust mites and fungi can infest bed pillows, so it's best to buy washable ones and/or to encase your pillows in impermeable covers. 9. Don’t line-dry your laundry outside. While it’s good for the environment, it might aggravate your allergies if your clean clothes are doused with pollen and spores. Pharmaceutical Tools Despite your best efforts to make practical day-to-day lifestyle changes, you’ll probably still need modern medicine to minimize your seasonal suffering. Here are some options: Over-the-counter and prescription oral antihistamines If you have mild allergies, over-the-counter pills may offer relief. Some first-generation antihistamines, such as Benadryl or Tavist, are effective but can cause drowsiness. Newer meds, like Claritin and Zyrtec, are less likely to cause sleepiness. The drugs are “most effective when taken before exposure, so they can sit on the histamine receptor of your cell like a pit bull in a doorway,” says Suzy Cohen, R. Ph., Lifescript’s pharmacist. They prevent allergy triggers (like dander or pollen) from getting on the receptor and sparking all the misery. But beware: Antihistamines can interact with other medications, such as sleeping pills, muscle relaxants and high-blood pressure medications. And people with certain medical conditions, such as overactive thyroid, glaucoma, high blood pressure, diabetes and stomach ulcers, should consult their doctor before taking any antihistamine. So should breastfeeding women. Prescription steroid nasal sprays “For those with more intense allergies, prescription medications can completely suppress seasonal eye and nose symptoms if you start treatment early and use on a consistent daily basis throughout the pollen season,” Costa says. To relieve stuffy noses, doctors often prescribe prescription steroid nasal sprays in combination with an oral antihistamine. They’re usually effective and easy to tolerate. But don’t confuse prescription steroid nasal sprays with over-the-counter decongestant sprays. Although non-prescription sprays may clear your nasal passages at first, when you stop using them you can get rebound congestion and end up feeling more stuffed up than when you started. Prescription eye drops For red, watery, itchy and irritated eyes, antihistamine and steroid drops may help. Doctors often recommend using these drops in combination with another allergy medication. Experts caution against using over-the-counter drops that promise to “get the red out.” These too carry the risk of rebound symptoms: After some temporary relief, your irritated eye might get worse. Allergy shots or immunotherapy This is a long-term option for people whose symptoms don't respond to medications. After determining what your allergies are, you’ll get injections of specific allergen extracts monthly. It may take up to five years to desensitize your body to the allergens and there’s always a chance that the treatment won’t be effective. Nasal lavage This low-tech, natural method of cleaning out the nasal passages has been around for centuries and is enjoying a surge in popularity, thanks to greater promotion and a mention on "The Oprah Winfrey Show." Using a ceramic neti pot or a plastic squeeze bottle, a saline solution (1/2 teaspoon salt in 1 cup of lukewarm water) is poured into one nostril. As the solution exits through the other nostril, it washes out irritants, pollen and mucous. “It’s a very safe and easy thing to do,” McGhee says. “Some studies show it is as effective as steroid nasal sprays.” Avoidance Your fight against allergy symptoms can get a big boost by avoiding triggers, but that isn’t always easy. If, for example, you know you’re allergic to birch tree pollen, pulling up every birch tree in your yard won’t really help. Pollen is a frequent flier and travels miles, so a tree in another neighborhood might be the culprit. Beware of Food Sensitivities People with seasonal allergies should be alert for food reactions, Costa says. Research has found that hay fever sufferers may not be able to tolerate foods that have proteins similar to those in certain pollens. For example, some people allergic to ragweed may react to bananas, melons, zucchini, and cucumber. Sensitivity to birch pollen may cause a reaction to different raw fruits, including apples, pears, peaches, cherries and plums. Typical symptoms of oral allergy syndrome include swelling, itching and irritation of the lips, mouth and throat. Sometimes the offending food can be eaten if it's cooked, because heat alters the protein. But food allergies can be tricky to diagnose. If you suspect an allergic reaction to a particular food, it’s best to avoid it and see your doctor. Could You Have a Food Allergy? Warding Off Vulnerabilities Hay fever sufferers also may be more vulnerable to other ailments, including sinus infections, ear infections and eczema. You may also have a greater chance of developing asthma, a potentially fatal but highly treatable condition that compromises breathing. If you have nasal congestion with a nagging cough that doesn’t go away, see a doctor right away, says Fast, because this can be a precursor of asthma. Don’t ignore wheezing and tightness of the chest either, because these are also asthmatic symptoms. Women may find pregnancy triggers changes in allergic reactions. Some pregnant women find allergy symptoms worsen; others may experience “rhinitis of pregnancy.” “It’s not allergies, but it’s an uncomfortable, stuffy, and sometimes runny nose. It’s part of the natural changes of the body that accompany pregnancy,” Costa says. Or allergic symptoms may lessen after giving birth. Then again, allergies can shift anytime in life. “You can outgrow some allergies and they do change with time,” McGhee says. For more information, visit our Allergy Health Center. What’s Your Allergy IQ? Ignorance may be bliss, but not when it comes to a stuffy, sneezy, scratchy problem like allergies.