The wetter-than-normal spring has led to plenty of sneezing in my home state of Arizona. Arizonans seem to particularly resent the hay fever season, perhaps because many moved here to escape the pollen blizzard that assaulted them in other states. That strategy worked a few decades ago, but by now -- particularly in Phoenix and Tucson -- homesick immigrants, longing for greenery, have planted endless acres of allergen-spewing lawns and ornamentals. The desert's traditional hypoallergenic advantage is waning, if not entirely gone.
Wherever you happen to be sneezing, wheezing, honking, tearing up or otherwise suffering, here's some information on both conventional and natural ways to help alleviate allergic rhinitis -- the technical term for inflammation and swelling of the mucous membrane of the nose, characterized by a runny nose and stuffiness and caused by an allergy.
Allergic rhinitis, like all symptoms of allergies, reflects misplaced immunity. Allergic reactions are inappropriate, but otherwise normal responses of the immune system to substances that it identifies as posing a threat. In most cases, however, the things we encounter in our environment that prompt allergic reactions aren't harmful, such as plant pollen, dog hair, dust and mold. But when someone has an allergy to one of these substances, his or her immune system treats the irritant as a foreign invader and produces antibodies to it. These antibodies induce immune cells to release inflammatory compounds including histamine, which in turn cause allergic symptoms.
About 15 to 20 percent of Americans have allergic reactions to airborne substances which trigger the classic condition known as allergic rhinitis. The pollen-induced variety of allergic rhinitis is usually called "hay fever," or "seasonal allergy" (because it tends to peak in the spring, when pollen counts are high). Allergies to dust, mold and pet dander can also elicit allergic rhinitis, and I'll discuss ways to reduce those kinds of allergic responses as well.
What are the symptoms?
- Runny nose (clear nasal discharge)
- Itchy, bloodshot, or runny eyes
- Irritated nose or throat
- Nasal congestion
- Blocked ears
- Dark circles under the eyes
- Trouble breathing
What are the causes?
Many different irritants can provoke allergic rhinitis, including perfumes, powdered cosmetics, culinary spices and smoke. Common allergens include:
- Pet dander
Who is likely to develop allergic rhinitis?
The tendency to have allergies is often hereditary, although allergies to specific substances are not, as these are acquired by exposure to the irritant. Allergic rhinitis and other symptoms of allergy usually develop by age 10 and peak in a person's early twenties; allergies often become less severe or disappear in older adulthood.
How is it diagnosed?
Allergic rhinitis is readily diagnosed by its symptoms. Physicians or allergists can determine the specific irritant with several different tests. These include:
- Skin testing, in which a small amount of the suspected allergen is placed on the skin; the skin is then scratched and observed for signs of an allergic reaction, such as redness and swelling. This is the most common and most accurate type of allergy test.
- RAST (radioallergosorbent). This blood test measures the levels of specific allergy-related substances circulating in the bloodstream.
- Blood tests for levels of antibodies.
What is the conventional treatment?
People with allergic rhinitis may be able to prevent reactions by avoiding known allergens. In addition, conventional medicine often treats allergies with medications such as:
- Antihistamines: These drugs prevent histamine from binding on the receptors of immune cells and can help prevent and treat allergic symptoms, including sneezing and runny nose, but can also cause side effects such as drowsiness and dry mouth. Prescription antihistamines are less likely to cause these side effects.
- Cromolyn sodium: This over-the-counter nasal spray contains a natural product that helps stabilize the cells that release histamine, and can help avoid the cascade of allergy symptoms. For best results, start using it two to four weeks before allergy season.
- Decongestants: Pills and nasal sprays typically work by blocking the effects of histamine on nasal passages, and often can help ease nasal congestion, but their effects are only temporary. Overuse of decongestants can actually worsen congestion over time. These drugs should not be used by people with high blood pressure.
- Eye drops: Over-the-counter and prescription eye drops can help relieve itchy eyes caused by allergens.
- Steroid sprays: Steroids tone down the immune response, and prescription nasal steroid sprays combat swelling in the nose, which helps ease congestion. They often can take about two weeks to start working effectively.
In some cases, conventional doctors may recommend allergy shots, also called immunotherapy. With immunotherapy, patients receive regularly scheduled injections of small amounts of allergens. The goal is to release histamine triggered by the allergen gradually, and thus desensitize the patient so that he or she no longer reacts to the irritant. Although allergy shots are said to work in about two-thirds of cases, they can require years of treatment to become effective. Allergy shots may also elicit more severe reactions such as hives, rash and sometimes anaphylactic shock.
What therapies do I recommend?
A good first step is simply to limit exposures to common allergens as much as possible.
- Dust-proof homes by eliminating wall-to-wall carpets, down-filled blankets, feather pillows and other dust catchers.
- Substitute window shades for Venetian blinds, which can trap dust; be sure to wash curtains regularly in hot water to kill dust mites.
- Encase mattresses in an airtight, dust-proof plastic cover; dust furniture with a damp cloth; and damp-mop floors regularly to pick up dust.
- Consider buying an air filter. I recommend a HEPA (high-efficiency particulate air) filter, which removes particles in the air by forcing it through screens containing microscopic pores.
Aside from taking these mechanical measures, keep in mind that the immune system bridges the mind-body connection, and addressing daily stress and a negative mindset towards irritants can completely resolve long-standing allergies. (Sneezing a few times during allergy season is normal and simply the body's way of clearing irritants from the upper respiratory tract. If this is the extent of your symptoms, don't adopt the mindset that you need treatment, or be convinced by TV ads that would have you believe you suffer from allergies.) Diet can also have profound impacts on allergies, as the vigilance of the immune response is influenced heavily by the consumption of pro-inflammatory or anti-inflammatory fats. I suggest the following:
- Follow a low-protein diet (along the lines of my anti-inflammatory diet) and try to eliminate milk and milk products. Excessive protein can irritate the immune system and keep it in a state of over-reactivity. The protein in cow's milk is a frequent offender.
- Try hypnosis, which can lessen or completely prevent allergic reactions and facilitate the immune system's unlearning of its pointless habits (in this case, an inappropriate response to pollen, dust, mold or animal hair or other substances that cannot really hurt us).
- Consider whether stress impacts your allergies and, if so, take steps to reduce it.
- Try nasal douching with a warm saline solution to rinse pollen grains off nasal tissues and soothe irritated mucus membranes.
- Control symptoms with the herb stinging nettle (Urtica dioica): Take one to two capsules of a freeze-dried extract every two to four hours as needed. (Children under 12 should take no more than one capsule a day.)
- Take 500 milligrams of quercetin every day for at least six to eight weeks before the expected start of the pollen season. This bioflavonoid may stabilize the cells that produce histamine and act as a preventative.
I don't recommend moving specifically for allergy relief; after all, as Arizona's cities have shown, a region's pollen count can change over time. However, if you need to relocate anyway, you might factor in this 2009 survey of the nation's "Allergy Capitals" compiled by the Asthma and Allergy Foundation of America. Of 100 cities surveyed, McAllen, Texas was ranked number one -- meaning it was the worst place for those with Fall allergies to live. Portland, Oregon ranked at number 100, meaning it was the best locale surveyed for allergy sufferers. Phoenix came in at a middling 65th -- but I'm guessing that by the time this year's totals are compiled, the city will have moved several notches up toward McAllen's unenviable position.
Andrew Weil, M.D., invites you to join the conversation: become a fan on Facebook, follow him on Twitter, and check out his Daily Health Tips Blog. Dr. Weil is the founder and director of the Arizona Center for Integrative Medicine and the editorial director of www.DrWeil.com.