Seasonal allergies: tips and remedies

While this time of year usually brings cheerful weather and the growth of beautiful plants, millions of people will be gearing up once again to do battle with a problem that recurs every year. Itchy eyes, repetitive sneezing, a permanently runny nose - the symptoms of seasonal allergies.

In the US, around 7.8% of people aged 18 and above are estimated to have hay fever.

For many people, the emergence of marauding ticks at this time of year is the least of their worries. The real struggle for these people is with seasonal allergies, also referred to as hay fever or allergic rhinitis.

If these common symptoms seem to develop for weeks and months on end at the same time each year, it is likely that you could be affected by seasonal allergies. The condition affects many in the US; in 2010, around 11.1 million visits to physicians' offices led to a primary diagnosis of hay fever.

Thankfully, despite how infuriating and disruptive seasonal allergies can be, there are many steps that can be taken to lessen their impact. In this Spotlight, we take a look at what seasonal allergies are and what the best strategies are for handling them.

What causes such allergies?

People develop allergies when their body's immune system reacts to a substance as though it is a threat like an infection, producing antibodies to fight it. These substances are referred to as allergens.

The next time that the body encounters the allergen, it produces more antibodies in anticipation, releasing histamine and chemical mediators in the body that lead to an allergic reaction. It is these chemicals that typically cause symptoms in the nose, throat, eyes and other areas of the body.

Jan Batten, a British Lung Foundation (BLF) Helpline nurse, explained to Medical News Today that as the summer months approach, certain allergies begin to cause more problems, such as allergies to flower pollen, grass pollen, tree molds and fungi. The drier days around this time of year help the allergens to remain in the atmosphere for longer.

"Summer allergies start to pick up around May and those affected will usually get itchy and runny eyes, a runny nose and inflamed, swollen sinuses. Breathing through your nose can be difficult too, and you might have a cough," she explained.

The American College of Allergy, Asthma & Immunology (ACAAI) report that allergies are the sixth leading cause of chronic illness in the US. According to the American Academy of Allergy, Asthma & Immunology (AAAAI), around 7.8% of people aged 18 and above have hay fever. Worldwide, the condition affects 10-30% of the population.

Most people with hay fever understand that their symptoms are set off by pollen, the fine powder released from flowering plants in order to reproduce. Pollens are spread by the wind and can be inhaled or land in the eyes or on the skin.

The most common trigger of seasonal allergies is pollen, though they can also be triggered by grasses and mold. Dealing with seasonal allergies, however, is not merely a matter of knowing when these airborne allergens are most prevalent and trying to avoid them. There are a few added complications to keep you on your toes.

Avoiding triggers - be aware of what sets you off

"People focus on the highs and lows of pollen counts," says Dr. James Sublett, president of ACAAI. "What they don't realize is that a high total pollen count doesn't always mean you will have allergy symptoms. The pollen from the plant you are allergic to may not be high. The key is to know what you're allergic to, and how to treat your particular symptoms."

Different kinds of pollen are prevalent at different times of the year, as well as varying from location to location. Between January and April, pollen is typically released from trees including pine, ash, birch, elm and poplar. During the summer months, grass pollens dominate, and in the fall, weed pollen is most prevalent.

People can determine whether they have an allergy or not by consulting their primary care physician and undergoing allergy testing. Dr. Andrew S. Kim, an allergist from the Allergy & Asthma Centers in Fairfax and Fredericksburg, VA, told MNT that sometimes people confuse having allergies with the flu or common cold.

Pollen is the cause of most seasonal allergies and is produced by flowers, trees, grasses and weeds alike.

"Allergies may share some similarities with sneezing and sniffling but the length of time is a big difference. Allergy symptoms usually last for weeks and months and patients typically complain of itchy nose, throat and eyes as well," he said.

"Allergy patients usually do not have fever. They do have dry cough and clear nasal drainage versus infectious cough which is characterized by yellow, or greenish nasal drainage. Some people may have asthma symptoms, such as cough, wheeze and chest tightness."

Once an individual knows that they have a seasonal allergy and is aware of what triggers it, they are in a much better position to avoid debilitating allergic reactions. Keeping track of pollen forecasts is a good place to start. It is good to remember that these change by the hour, and can be boosted when it is warm, dry and windy.

To reduce the chances of an allergic reaction, it is recommended that you stay inside when pollen counts are at their highest. These usually peak around the morning hours and maintain high levels during the afternoon.

If you do need to go outside, there are a number of steps that can be taken to reduce the chances of coming into contact with allergens. Wearing wraparound sunglasses offers protection to the eyes, and applying a small amount of petroleum jelly to the insides of the nostrils can prevent some allergens from reaching the sensitive lining of the nose.

Delegating outdoor chores to people that do not have seasonal allergies is a sensible approach. If there is no escaping lawn mowing or weed pulling, however, wear an NIOSH-rated (National Institute for Occupational Safety and Health) 95 filter mask to keep allergens out.

Laundry should not be hung to dry outside, despite the conditions being perfect for it. Pollen can stick to sheets and towels and be brought into the home - normally a haven from pollens. In fact, when tackling seasonal allergies, ensuring that your home is your castle is a great strategy.

Minimizing the risk indoors

It is impossible to remove all allergens from the air inside the home, but there are certainly steps that can help reduce levels of exposure. Keeping the windows shut is a simple strategy that should be one of the first to be adopted.

Shutting the windows might be the last thing on your mind when temperatures start to rise. To stay cool without the threat of pollen looming large, use air conditioning in the house and car. It is preferable that high-efficiency air filters are used and that units follow regular maintenance schedules.

Whenever you venture outside, there is the chance that you will bring pollen back inside with you on your clothes and hair. For this reason, people should wash their hair and clothes more regularly during periods when the pollen count is high.

If you are drying clothes indoors and keeping the windows closed, you may need to use a dehumidifier to keep the indoor air dry. Keeping the air dry indoors helps prevent the growth of other allergens such as molds.

Keeping the home clean with a vacuum cleaner that has a high-efficiency particulate air filter and using a damp duster to stop pollens moving about the home also helps to clean up any allergens that are present, reducing the chances of them getting onto and into the body.

"Simple changes like wearing wraparound sunglasses, washing your clothes and hair more regularly, keeping your home clean, avoiding open, grassy spaces where possible and keeping your windows shut can help lessen the effect of summer allergies," Jan Batten told.

All of these measures are relatively simple to take and can go a long way toward protecting the body from seasonal allergies. However, as stated before, it is nigh-on impossible to completely avoid exposure to allergens. Particularly for people who experience severe reactions to pollen, the best route to ease symptoms is often a medical one.

Medicine and other treatment

People tend to have unique allergic responses, so the treatment that works best for each individual will vary accordingly. While some people will be able to cope with seasonal allergies with over-the-counter medication and being careful about their exposure to allergens, others may require personal treatment plans drawn up by specially trained allergists.

Oral antihistamines are a form of nonprescription medication that alleviate many of the symptoms of seasonal allergies.

There is a wide range of nonprescription medication available for people who have seasonal allergies. Oral antihistamines relieve symptoms such as sneezing, itching and runny noses. Decongestants relieve nasal stuffiness and come in both oral and nasal form. Some medications contain a combination of the two.

Two types of immunotherapy are available to those who require relief from severe symptoms. These are allergy shots and tablets, and they are provided and prescribed by allergists. Allergy testing will need to be carried out first to determine precisely what allergens trigger symptoms.

Allergy shots consist of injecting a patient with diluted extracts of an allergen. Increasing doses are administered until a maintenance dose is established. This process helps the body to build up a form of resistance to the allergen and reduces the severity of symptoms.

Tablets can currently be used to treat allergies to grass and ragweed pollens. Beginning at least 3 months before the relevant pollen season begins, patients take one tablet daily, with the treatment continuing for as long as 3 years.

Dr. Kim told MNT that one of the best ways to reduce the influence of seasonal allergies is to start taking medication - such as topical nasal steroids - about a week before the beginning of the allergy season:

"Don't wait until symptoms kick in and you're already feeling bad before taking allergy medication. Instead, prepare by taking medications just before the season starts to minimize the symptoms of seasonal allergies."

A number of alternative treatments are also available, including natural remedies that feature extracts of butterbur and spirulina. It is recommended that any use of alternative treatments is discussed with a physician first, as some remedies may not be entirely safe for use.

There are many options for alleviating seasonal allergies

Allergies can be worrying, especially for people who are otherwise healthy and unused to experiencing sudden debilitating symptoms. If left unchecked, seasonal allergies can often turn an otherwise enjoyable time of year for many into misery.

Thankfully, there are many routes available for people with seasonal allergies to alleviate their symptoms. As ever, if there are any concerns or worries, it is best to speak with a health care professional who will be able to offer advice, provide treatment or refer on to a specialist.

Although there is no cure at present for seasonal allergies, the multiple options for treatment should hopefully provide some relief until winter rolls around again and we can shiver together, happy in the fact that pollen has gone for another year.

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Close To One-Third Of Children With Food Allergies Are Bullied

Food allergies can pre-dispose children to being bullied at school, suggests a new study published today in Pediatrics.

The study examined 251 families from a New York City food allergy clinic and discovered that nearly one-third of kids have been bullied because of their food allergy.

The bullying happened on school grounds and resulted in teasing.

In most instances, the kids reported that classmates threatened them with the food to which they were allergic. They would wave it in front of them, throw it at them or promised they would put it in their food undetected.

Of the families who were surveyed, 45.5 percent of the kids and 36.3 percent of their parents reported that the child had been bullied or tormented for any reason. Besides that, 24.7 percent of the parents and 31.5 percent of the kids confirmed they had been bullied specifically because of their food allergy.

Results of the study showed that bullying is associated with reduced quality of life as well as increased distress in parents and children, regardless of the severity of the food allergy. Parents were aware about the bullying in just 52.1 percent of the cases. When parents knew about the bullying, the children's quality of life improved.

The authors conclude that bullying is frequent in children with food allergies. They point out when parents are aware their children are being bullied, the kid's quality of life is better.

The research team believes that pediatricians and parents should screen for bullying in children with food allergies in order to decrease stress and better the standard of life for these kids.

In 2011 a study presented at the Food Allergy and Anaphylaxis Meeting by the European Academy of Allergy and Clinical Immunology reported that food allergies are associated with anxiety and loneliness in children. In fact, one out of five allergic children do not attend classmates' parties and one in four always bring "safe food" with them.

The burden of food allergies increasing to a life-threatening situation can be worrisome for a child. Normal activity and social lifestyles can be limited due to the constant requirement of avoiding certain foods.

A separate study from 2010 says that children with food allergies are bullied and teased in school, even by teachers. This study correlates with the current one, saying that being diagnosed with a food allergy is emotional for a child. The researchers emphasized adding bullying to the stress already felt by an allergic child is "downright dangerous."

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Child's Allergy Risk Higher If Parent Of Same Sex Has It

Researchers have discovered an interesting fact about the genetic basis of childhood allergic diseases: a child is more likely to have a particular allergy if his or her same-sex parent has it.

So for example, a girl's chance of having asthma is higher if her mother has it, and a boy's is higher if his father has it.

And the same appears to be true of eczema and other childhood allergies.

This is the conclusion of a study by Professor Hasan Arshad, a consultant in allergy and immunology at Southampton General Hospital, and colleagues, that is published in the August issue of The Journal of Allergy and Clinical Immunology.

What The Researchers Did

For the study, the researchers used data from the Isle of Wight (IOW) Birth Cohort Study, which collected information on just under 1,500 children that were followed up to the age of 18. During that time, the children were examined at age 1, 2, 4, 10 and 18.

The Isle of Wight, which lies off the South coast of England, is ideal for carrying out long-term prospective epidemiological studies because it has a stable resident population, so most of the participants did not move away during the course of the study, and were thus available for follow-up.

Arshad was one of the initiators of the The IOW cohort study, which was set up with the aim of prospectively studying a whole population (about 130,000 people live on the IOW) for the development of asthma and allergic diseases and identify any relevant genetic and environmental risk factors.

The data on the cohort contains detailed information on heredity and environmental exposures, collected from birth and updated at each follow-up, where detailed questionnaires were completed with the parents for each child, about asthma and any other allergies, for example eczema and rhinitis.

At ages 4, 10, and 18, the children also underwent skin prick tests to 14 common food and airborne allergens.

Other examinations included spirometry and bronchial provocation tests, and collected blood samples to measure Immunoglobulin E (IgE) at ages 10 and 18. IgE is an antibody that is often screened for in testing for allergies.

The parents also underwent assessments. For example, shortly after the children in the cohort were born, the researchers found out whether his or her parents had allergies, and the mother's IgE level was also measured.

What They Found

When they analyzed the results the researchers found that maternal asthma was tied to asthma in girls but not to boys, and paternal asthma was linked to asthma in boys but not to girls.

They found the same pattern for eczema: if a child's mother had eczema, then the chances of the child having it was higher if it was a girl but not a boy, and if the father had it, the chance was higher for his son but not his daughter.

Similar patterns were found for other allergies, as the authors explain:

"Similar trends were observed when the effect of maternal and paternal allergic disease was assessed for childhood atopy and when maternal total IgE levels were related to total IgE levels in children at ages 10 and 18 years."

Possible Implications

The authors suggest the findings may change the way childhood allergies are assessed and prevented. For instance, in diagnosis, it may be useful to find out the allergy history of the mother in girl patients and of the father in boy patients.

The study may also open new avenues for studying sex-dependent effects in hereditary diseases, with the prospect one day of finding ways to prevent them.

The National Institutes of Health in the US funded the study.

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Tablets Help Relieve Symptoms Such as Runny Nose, Congestion, Watery Eyes

For many allergy sufferers, getting shots is a pesky, even painful part of ragweed season. Now, researchers report success testing an under-the-tongue tablet as an alternative to injections in people with ragweed allergies.

In a study of more than 500 people with ragweed allergies, people who took the experimental tablets had less nasal congestion, eye tearing, and other allergy symptoms than those who took a placebo. Those given the new pills also needed fewer antihistamines and other allergy medications for relief.

The treatment is a type of immune therapy, the most common form of which is the allergy shot. Tiny amounts of the proteins to which you are allergic are injected to weaken the immune system's response to ragweed, grass, or other allergy triggers.

The new treatment works much the same way, but instead you put a tablet containing tiny extracts of allergens -- in this case ragweed proteins -- under the tongue each day until tolerance develops.

Immune therapy is the only treatment that's been proven to modify the natural course of the allergic disease, "actually turning it off and keeping it suppressed over time," says Johns Hopkins' Peter Creticos, MD, who led the new study.

Shots may work, "but some people are afraid of the needle or don't have time to go to the doctor's office [two to four times a month] during allergy season to get them," he says.

Also, "3% to 6% of people on allergy shots have systemic [throughout the body] allergic reactions that can be severe or life-threatening," Creticos tells WebMD.

That makes the tablets a welcome option, he says.

Merck & Co., which makes the new tablet and funded the study, plans to apply for FDA approval of tablets for both ragweed and grass allergies next year. The grass tablets are already in use in Europe.
The new study was presented here at the annual meeting of the American Academy of Allergy, Asthma, & Immunotherapy.

10 Signs Your Allergies Are Out of Control

Tablets Relieve Ragweed Allergy Symptoms

The new study involved 565 adults with ragweed allergy, some of whom also had asthma. They were given one of two doses of either the once-daily tablet or a placebo for 52 weeks.

During ragweed season, which runs for about four to six weeks in August and September, everyone recorded their symptoms and need for relief medications in electronic diaries.

During the peak two weeks of the season, the tablet reduced symptoms -- including sneezing, runny and itchy noses, congestion, and gritty and watery eyes -- by 17% and 14% at the higher and lower doses, respectively, compared with placebo.

It also reduced the need for standard allergy medications at the two doses vs. placebo.

The most frequent side effects were throat irritation and itching of the mouth. No one died.

Two patients did need epinephrine, an injectable drug used to treat serious allergic reactions. However, one case was due to an unrelated reaction to peanuts.

Some Patients Welcome Alternative to Shots

Asked whether the tablets are as effective as shots, Creticos says a head-to-head comparison of the two is needed to really answer the question.

Mitchell Grayson, MD, an allergy specialist at the Medical College of Wisconsin in Milwaukee, tells WebMD that he welcomes a tablet, as some of his patients find shots annoying or painful. "And the tablets seem to be less likely to cause [life-threatening] reactions than the shots," he says.

One advantage to shots is that many different allergies can be treated at once, Grayson says.

"Most Americans are allergic to many different things, and with injections, you can pretty much cover all of them. So far, the tablets are each directed at different allergies -- one for grass, one for ragweed, for example. That wouldn’t be very convenient for a person with [a lot of] allergies," he says.

Allergy shots typically are taken for about two to five years, after which many people can stop them and feel relief for years afterward, according to Grayson. It's not yet known for how long people will have to take the new tablets.

If approved, the tablets would only have to be taken for four months before, and during the four to six weeks of, ragweed season, Creticos says. They were given for 52 weeks in the study so the researchers could better assess their safety.

About 60 million Americans suffer from seasonal allergies, also referred to as hay fever and allergic rhinitis.
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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