Spring is the season of love and renewal, when the earth is bursting with new life and hope after the cold and dark of winter. Lured from our houses by the warm spring breezes, we run smack into the beginning of allergy season.

Unfortunately for the allergy-prone among us, plants and trees engage in their own springtime mating ritual. We’re the hapless victims of male trees and plants casting their pollen to the winds in search of a fertile resting place.

One of five Americans suffers from seasonal allergies caused by pollens and molds. Such allergies actually occur as the result of a mistake by the body’s immune system that erroneously identifies a harmless substance such as pollen as a dangerous invader.
When we breathe in pollens and molds the immune system of allergic individuals activates antibodies, known as IgEs. IgE antibodies then lock onto mast cells signaling them to release histamines. It’s the release of histamines that causes the sneezing, runny noses, watery eyes and itchiness associated with seasonal allergies.

Allergy season kicks off in the spring with the release of tree pollens, followed shortly thereafter by grass pollens that carry through into the summer. Weeds pick up the pace into the fall with the grand finale executed by ragweed pollens in September and October. It’s not until winter hits and plants go dormant that those who suffer from plant allergies can breathe freely again.

If your symptoms are seasonal and occur with exposure to certain plants and trees on high pollen count days, a simple first step is to try to avoid the allergen as much as possible. If you suffer from allergies year round, you may be allergic to animal dander, dust mites or chemicals found in the home or workplace and should get a diagnosis from your doctor.

• Listen to your local weather report during allergy season or call or log onto the American Academy of Allergy, Asthma and Immunology (1-800-9POLLEN or www.aaaai.org) to check the pollen count for the day.
• Try to avoid being outside between 6 and 10 a.m. and at dusk when pollen counts are most likely to be high.
• Pollen counts are higher on dry, windy days. Plan outdoor activities such as exercise on still days and after rain. Better still, run or walk on a treadmill or on an indoor track.
• Stay indoors when possible and use an air conditioner in your home, car and workplace.
• Install a HEPA (High Efficiency Particulate Air) filter on your furnace, air conditioner and air filter system.
• If you’re working outdoors, wear a hat and sunglasses to prevent pollen collecting on your hair and skin.
• Avoid rubbing your eyes with your hands.
• Try to have a non-allergic family member mow the grass or hire someone to do it.
• Take off clothes worn for yard work when you come inside and have a shower.
• Avoid hanging laundry on the line where it can collect pollen.

Medications Offer Relief
As well as lifestyle measures there are a number of over-the-counter (OTC) and prescription medications that can relieve allergy symptoms.

If your symptoms are relatively mild and you get relief with occasional use of OTC drugs, that may be all you need. If you have more serious and persistent symptoms, you should make an appointment with your physician who can best advise you about OTC and prescription drugs.

If you’re going to be using allergy medication for an extended period it’s important to identify the specific allergen and symptoms to be treated.

Nipping symptoms in the bud is a key concern as 20 percent of persons with allergies go on to develop asthma, a serious respiratory condition. Medication can be tailored to treat specific symptoms

Oral antihistamines are available either OTC or by prescription. As their name suggests, they counter the action of histamines produced by the body during an allergic reaction. Older antihistamines such as Benadryl can cause drowsiness. Newer drugs such as Claritin, Clarinex and Allegra are effective with fewer unwanted side effects. Claritin, in the past a prescription drug, has recently been approved for OTC sales.

Decongestants that help relieve stuffiness are sometimes used in combination with antihistamines. Allegra-D is available by prescription and contains both an antihistamine and a decongestant. Claritin-D and Zyrtec-D have long-lasting decongestan action. Decongestants shouldn’t be used by people with high blood pressure or heart disease unless they are prescribed and supervised by a doctor.

Nasal corticosteroids are effective in opening up blocked nasal passages. They are used by inhaling or spraying into the nose. Rhinocort, Flonase and Nasonex all belong to this group of drugs. These are all prescription drugs and should be used according to your doctor’s instructions.

Immunotherapy. Some people with persistent allergies may opt for a more permanent solution. Immunotherapy begins with identification of specific allergens, followed by a prolonged course of injections of the allergen so your body will develop an immunity to it. The shots typically are given twice a week for the first few months and then monthly for up to five years. Within a year of starting the shots, about 80 percent of people begin to notice a significant decrease in symptoms.

The shots are obviously expensive because of the number of office visits involved and require a significant commitment from the patient. Patients also need to be carefully selected. In order for the shots to be effective the patient must have a specific IgE response to the allergen. Allergy shots are used for birch, grass and ragweed pollen allergies.

A new form of immunotherapy that doesn’t require shots is used in Europe and is gaining support here. Sublingual therapy involves placing drops of the allergen extract under the patient’s tongue. Clinical trials conducted in Europe show the technique is as effective as injection therapy and it has been endorsed by a panel from the World Health Organization.
So when the pollens begin to waft in on warm spring winds, be ready to defend yourself with a little knowledge and perhaps a few medications. By making a few lifestyle changes and consulting with your physician about the most effective drugs to keep your symptoms in check, you’ll be able to revel in the joys of spring this year.

REFERENCES:
“Allergy-Proofing Activities,” Immunotherapy Weekly, July 10, 2002.
“Are Our Gardens Making Us Sick?” Natural Life, May-June 2002.
Alicia Bartz, “The Facts of Allergies and Asthma,” MPLS-St Paul Magazine, April 2002.
Christine Le Beau, “Pollen Counts,” Family PC, June 2001.
Brenda Goodman, “Drink Your Shots,” Scientific American, April 2002..
Nicola Jones, “Don’t Sneeze At It,” New Scientist, June 22, 2002.
K. Kowal et al, “Allergen Immunotherapy: How to Get the Best Results,” Journal of Respiratory Diseases, May 2002.
James Li, “Allergy Testing,” American Family Physician, August 15, 2002.
Barbara Loecher, “Enjoy the Great Outdoors...Even If You’re Allergic To It,” Prevention, April 2001.
Michelle Meadows, “Itching for Some Allergy Relief,” FDA Consumer, May-June 2002.
Pamela Peeke, “Coping with Seasonal Allergies,” National Women’s Health Report, April 2002.
“Solutions for Seasonal Allergies,” Better Nutrition, April 2001.
“Things That Can Cause Asthma and Allergies,” American Family Physician, August 1, 2002.