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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Hay fever nothing to sneeze about

Dr. Stacie Bering The Spokesman-Review

My front-yard garden looks better than it ever has. It’s the wet spring we’ve had. And did you notice how there seem to be more flowers on the trees, bushes and plants? And have your eyes been itching and has your nose been running faster than Asmae Leghzaoui at Bloomsday? You shouldn’t feel alone. You’re one of the 10 percent of Americans who suffer from allergic rhinoconjunctivitis or allergic rhinitis, more commonly known as hay fever.

Some health-care providers may look on allergic rhinitis as no more than a nuisance, but anyone who suffers from it knows that it can significantly affect one’s quality of life. In fact, allergic rhinitis is the sixth most common chronic illness, accounting for $1.8 billion in health care spending annually. Allergic rhinitis impacts energy levels, school and work performance, and behavior, especially in children. More critically, poorly controlled allergic rhinitis can lead to the onset or worsening of asthma. In fact allergic rhinitis and asthma are so intimately entwined that allergic rhinitis is a common trigger for an asthma attack in both children and adults.

Allergic rhinitis is another example of an over-zealous immune system. An innocuous visitor, like a piece of pollen, is inhaled. The immune system recognizes it, and produces an overabundance of IgE, the antibody responsible for what is termed “the allergic cascade.” The IgE antibody, specifically made to react to the allergen in question (ragweed for example), attaches itself (more accurately its selves) to special white blood cells called mast cells. Once attached, the IgE causes the mast cells to release the chemicals — histamines, prostaglandins and leukotrienes — that cause the symptoms we’ve come to associate with allergic rhinitis. Together, these compounds cause the red, itchy and watery eyes, runny and stuffy nose, sneezing, and postnasal drip we identify with this time of year. Chronic exposure to low doses of allergens can prolong the misery.

Susceptibility to allergies runs in families. If you sneeze and sniffle at this time of year, it’s likely that your children will, too.

So how does a sufferer cope? The mainstays of treatment are allergen avoidance, symptomatic drug therapy and immunotherapy.

Pollen counts are highest in the early morning. Staying indoors during that time of day, between 5 a.m. and 10 a.m., particularly in a house that has a high efficiency particulate air (HEPA) filter, can help. Weather forecasts now include pollen forecasts, so that you can plan to do indoor activities on particularly heavy pollen days. (Check out

When the symptoms hit, drugs that hit the symptoms help. Non-sedating antihistamines like loratidine (available as Claritin and generic) are available over the counter. They also have the advantage of once-a-day dosing, so you don’t have to remember to keep taking them throughout the day.

Steroid nose sprays are quite helpful in taming the nose’s reaction to allergies. These sprays differ in taste and smell, with most users, rather obviously, preferring those that have neither. If you don’t care for the one your doctor recommended, ask if there’s another you can try (there usually is). These nose sprays don’t work if you don’t use them because you don’t like them!

Another nose spray, cromolyn sodium (available over the counter), helps prevent allergic reactions. My husband takes it when he skates out on the Centennial Trail, because there’s something out there that makes his eyes itch and his lungs wheeze.

Allergy shots are the only treatment available that can possibly reduce allergy symptoms long term, but this treatment requires lots of shots over a long time, and can be quite costly. Some exciting research involves drugs that block IgE production. Studies show they work great to reduce symptoms, with few side effects, but they aren’t a permanent fix. As soon as the volunteers stopped taking the medication, the symptoms returned.

Still, if you’re only in agony seasonally, these drug treatments may be the way to go — without being accompanied by your runny, sneezy nose and red, itchy eyes.