Unlike some of my classmates in medical school, diseases themselves are not something I often feel a passion to study. I find philosophy, theology, politics, literature, history, psychology, and so many other subjects much more interesting. But when I see a person suffering and looking for answers and relief, I am motivated to learn all that I can to help.
So while the topic of allergies is not something that really revs my jets, I think it’s worth writing about since it’s affecting so many Austinites right now. Indeed, I don’t recall ever seeing so many congested, itchy-eyed, hoarse, coughing, rhinorrheic people all at once.
So what exactly is occurring when people suffer from allergies? In response to airborne particles such as cedar, inflammation occurs, causing sneezing, itching, and fluid buildup. There are 4 major categories of allergens, or substances that causes allergies: Pollens, Insects, Animal Allergens, and Molds.
The ideal response to allergies is identifying the offending allergen and avoiding it. So in the cedar fever season, affected individuals should close the windows of their car and home, stay indoors when possible, and shower every night before bed to removes cedar from their skin and hair. But, of course, remaining inside all day is pretty impractical and lame.
The next step, then, is to take steps to reduce the inflammation that the allergens cause. Here are some steps for doing so.
Rinse Your Nose
This is particularly useful for treating drainage down the back of your throat, sneezing, nasal dryness, and congestion. It helps by rinsing out allergens and irritants from the nose. Do it once or twice daily. Saline nasal sprays and irrigation kits can be purchased over-the-counter.
Steroid Nasal Sprays
These are the first-line treatment for allergies. I most commonly prescribe Flonase (Fluticasone) since it’s generic and cheap. These drugs have few side effects and significantly relieve symptoms in most people. You may need to use a nasal decongestant like Sudafed for a few days before starting the nasal spray to reduce nasal swelling. Be patient as it can take days to weeks for these sprays to have their full effect.
Think Allegra, Zyrtec, Claritin. These relieve itching, sneezing, and runny nose, but doesn’t help with nasal congestion. Antihistamine nasal sprays such as Astelin, Astepro, and Patanase are also available and work quickly.
I add this medication when people are not receiving sufficient relief from the other treatments. Some people find it to be quite effective.
Steroid Pills or Shots
If you’re really struggling, a short course of Prednisone or a corticosteroid shot can provide quick, dramatic relief. However, your symptoms are likely to quickly return unless you get on a maintenance treatment. Because of their side-effects, steroid pills are not a viable long-term strategy for managing allergies.
Allergy Shots or Drops
If all else fails, I send people to an allergist for allergy shots or drops. They contain solutions of the allergens to which a person is allergic. By receiving them, your immune response to the allergen lessens over time. The downside of this approach is that it can be time-consuming and somewhat expensive.
Good luck with your allergies!
January 25, 2014 at 5:24 pm
Dear Dr. M, Thanks for your timely article. I have lived in the Austin area since 1997 and this is the first year when the cedar pollen has gotten to me. I would also like your common sense insight in to how to deal with sinus infections and the common cold to hopefully avoid needing antibiotics. I take Zyrtec when necessary, use the NetiPot, take Coricidin Chest and Cough liquid gels when I get a persistent cough. My question is what to take for fever? As a child I was given aspirin for fever. Over the years I’ve been taking Tylenol . I read the latest from the FDA which said not to take Tylenol, if I understood them correctly. So should I take Aspirin for a fever? When should I come to see you? In the past when I had a lumpy throat that persisted and darkening nasal discharge I assumed it was time for antibiotics.
January 25, 2014 at 9:39 pm
-Tylenol is fine for fever. The FDA is just concerned about people taking too much Tylenol since it’s present in so many prescription and OTC meds. The upper limit of daily Tylenol intake is 4,000 mg daily, although just to be safe I tell people to keep it at 3,000 mg or less.
-Allergies shouldn’t cause an actual high temperature. If that’s present, there is likely an infection, either viral or bacterial. If the fever lasts several days and is not getting better, it may be a bacterial infection so that it’s worth seeing a doctor to be evaluated.
January 25, 2014 at 10:02 pm
One question about the cholesterol guidelines. Is it OK to eat an egg every once in a while or should I stay with egg whites only ?
January 26, 2014 at 1:23 am
I think an egg every once in a while is just fine. Thanks for bringing up diet. When addressing cholesterol to lower the risk of heart disease and stroke, diet and exercise are just as important as medications.
January 26, 2014 at 2:14 am
Thanks again! I really like your blog and I’m happy that you are interested in such a variety of intellectual pursuits.
Hope you are having a nice weekend.