When Seasonal Allergies Get Serious

By Lacie Glover for U.S. News

Spring is finally here, and many regions in the U.S. are beginning to thaw after a treacherous winter. Many of us are eager to get outside to welcome back warmer weather.

But if you’re one of 50 million Americans with seasonal allergies, you might be dreading spring as much as others look forward to it. Spring allergy season is the worst time of year for most allergy sufferers, although some regions experience allergy-inducing weather year-round.

For most people, seasonal allergies are not severe, and over-the-counter medications are sufficient to deal with occasional flare-ups of sneezing, watery or itchy eyes and runny nose. Even so, downplaying the condition can make it easy to ignore signs of serious allergies, such as chest tightness and difficulty breathing, which require medical attention. Knowing when to call your doctor about allergies can spare you some serious discomfort.

What’s Happening in Your Body

If you have seasonal allergies, your immune system responds to certain types of mold and pollen as though they were dangerous invaders to your body. And as a result, they become dangerous. Your body releases a flood of chemicals, including histamine, to fight off the invader once it enters.

“Warning signs of an allergy attack can be as common as a runny nose, sneezing, nasal congestion, itching and progress to much more serious symptoms like trouble breathing, tightness in the lungs and chest,” says Dr. Robert del Junco, medical director of the Nasal & Sinus Center at St. Joseph Hospital in Orange, California. Symptoms may persist for up to an hour or so, subside, and then return a few hours later.

Taking an antihistamine like Benadryl stops the effects of histamine so inflammation and other symptoms are curbed. Antihistamines work by binding to the same receptors as histamine on cells, thereby competing with histamine and blocking it from binding to cells.

Medication Options

Antihistamines are fine on occasion, but should not be abused and may be mildly addictive. “Long-term use often affects mental cognition, especially in the elderly. Confusion, inability to focus or concentrate and anxiety are some symptoms experienced, as are agitation, moodiness and impatience,” del Junco says. Depression, fatigue, hallucinations, nightmares and coordination problems may also occur with long-term use.

“Other medications like Nasacort, Claritin or Zyrtec are designed to be taken daily, especially during the season when your allergy symptoms are worse,” says Tonya Winders, CEO of the Allergy & Asthma Network. “If you’re taking more than two over-the-counter allergy medications or if you are on other prescription medications, it is important to talk with your health care professional or pharmacist." Some medications may interact badly and cause unintended side effects or internal damage, she says.

Mild to Moderate Allergies

In most people with seasonal allergies, symptoms are not severe enough to interrupt daily life. If this is true for you, it’s fine to spot-treat your flare-ups with over-the-counter antihistamines and other drugs so symptoms subside faster. To avoid symptoms in the first place, avoid going outside in dry, windy weather as much as possible.

Moist air, especially right after a storm, is best because the moisture clears allergens from the atmosphere. You can also check air quality and pollen counts online by going to airnow.gov or pollen.com, where the ratings will give you an idea of your allergy outlook for the day.

If your allergies are exacerbated frequently, keep a log to identify specific triggers. Note the time of day they occur, weather conditions and where you are when they flare up. Del Junco suggests recording answers to questions such as:

  • When symptoms occur, how long do they last?
  • Do your symptoms happen when you're outdoors or indoors, like when you clean your house?
  • Do they get worse when you're around pets?
  • Around cigarette smoke?
  • What makes your symptoms better?
  • What types of treatments have you tried?

Warning Signs

If you’re doing your best to control allergies and they’re still interfering with your life, it may be time to see a doctor. “If seasonal allergy symptoms are not resolved with over-the-counter medications and environmental control measures like keeping your windows shut or removing pollens from you hair, skin and clothes, then it is time to seek medical attention from a health care professional,” Winders says.

If you’re taking over-the-counter medication every day, or if symptoms become too severe, it’s also time to see your doctor, del Junco says. “Symptoms like a runny nose or sneezing are not dangerous, but if the symptoms progress to include any problems breathing, then you should be examined by a professional."

And if you’re aiming for true relief, come prepared. When seeing your primary care physician or an allergist for the first time, “it is important to share how allergies are negatively impacting your life,” Winders says. “Lack of sleep, exercise limitations and difficulty focusing are just as important as the sneezing, coughing and itchy eyes,” she adds.

Also come with a list of what medications you’ve been using, and what, if anything, relieves symptoms. If you have notes or a log of symptoms, tell your doctor any details about where you are and what you think triggers your symptoms. And of course, ask your doctor any and all questions you have ahead of time or during the visit.

When Seasonal Allergies Get Serious was originally published on U.S. News & World Report.

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