Beth Husted, PharmD - Dover location (inside Buehler's Fresh Food Market)
Q: How do I know if I have seasonal allergies or just a cold?
A: Seasonal allergies and the common cold can have similar symptoms that may make you wonder if you have a cold or just allergies, for example: a runny nose, nasal congestion, dry cough, and sore throat can all be symptoms of both allergies and a cold. However, there are some key differences. Usually, allergy symptoms occur in a seasonal pattern; the symptoms are worse during a particular time of year, whereas, the common cold can occur anytime, most often during the winter months.
Symptoms of seasonal allergies also include itchy nose and eyes, sneezing, and a scratchy throat. They do not typically include a fever, and nasal discharge is usually clear. A thick or colored nasal discharge, a wet cough, or an accompanying fever may be more indicative of a cold.
Q: I'm miserable. What can I take to feel better during allergy season?
A: There are a variety of products, both traditional and homeopathic, that can be taken to relieve the pesky symptoms that can plague you during allergy season.
Antihistamines can be used for the prevention and treatment of sneezing, itchy or watery eyes, and runny nose and most often only need to be taken once daily. Benadryl® (diphehydramine) is a very effective antihistamine, but has the side effect of drowsiness and should be reserved for nighttime use.
Other non-drowsy antihistamines choices, for daytime relief, are Claritin® (loratadine) and Allegra® (fexofenadine). Although Zyrtec® (cetirizine) is considered to be a non-drowsy antihistamine, it has been shown to cause more sedation than the other available over-the-counter (OTC) products in the same class. Oral decongestants such as phenylephrine or pseudoephedrine can both help with congestion. Phenylephrine may not be quite as effective as pseudoephedrine, but pseudoephedrine must be purchased behind the pharmacy counter, can cause a fast heartbeat, and can keep you awake at night if taken too close to bed. Patients on blood pressure medications should only take pseudoephedrine if their blood pressure is normally well-controlled and only for a short period of time.
Nasal sprays, such as Afrin®, also help control congestion associated with allergies, with less side effects when compared to oral decongestants. However, these nasal sprays should not be used more than 3 to 5 days continuously as they can cause rebound congestion, meaning the nasal stuffiness can actually be worse after use than before. Saline nasal spray can be used as needed in order to moisturize nasal passages that have been irritated by allergy symptoms. NasalCrom® (cromolyn sodium) is an OTC nasal spray that can be used to prevent and relieve nasal allergy symptoms such as sneezing, runny or itchy nose, or nasal congestion. The relief is not immediate with this product, so it is suggested that it be started 1 to 2 weeks prior to your normal allergy season or contact with a specific allergen.
Cough suppressants containing dextromethorphan, such as Delsym® or Robitussin DM®, can be used to stop a dry cough but can cause drowsiness, so many people use these at bedtime. Cough drops can also help soothe a cough or a scratchy throat.
Natural products can also be used to help you feel better during allergy season. Because homeopathic remedies are natural, and not considered medications, they can be taken with traditional remedies and do not have side effects. Grape Seed Extract, Pycnogenol, and Vitamin C are all considered to have antihistamine actions to help with a runny nose and sneezing. Bitter Orange, Quercetin, and Stinging Nettle Leaf, can also help reduce nasal symptoms. Spirulina and Butterbur are other homeopathic products often used to treat allergies as well.
There are a variety of natural "combination" products that can help too. Sabadil® and Hylands Seasonal Allergy Relief® treat all the pesky allergy symptoms. Optique I®, made by Boiron, and Similisan Allergy Eye Relief®, are products that specifically target redness, itching, and watering of the eyes. Chestal® and Hylands Cough Syrup® treat coughs associated with allergies without the side effects associated with more conventional OTC cough suppressants.
There are truly many options for managing seasonal allergy symptoms, so whether you prefer a homeopathic regimen or an OTC product, you will be armed with treatment choices to make yourself feel better during allergy season.
Q: Is there anything I can do to prevent seasonal allergy symptoms?
A: The best way to prevent seasonal allergy symptoms is to totally avoid the allergen that causes the symptoms; however, this is nearly impossible, as we can't live in a bubble! Since seasonal allergies are caused by wind born pollen, it is important to know in which season your allergy symptoms are at their worst and attempt to spend less time exposed to that allergen. Tree allergies often present late March to May, grass starts late May to July, and ragweed is usually at its peak mid-August to the first heavy frost.
If antihistamines or other homeopathic products are started 2 to 4 weeks prior to the normal allergy season and taken throughout, allergy symptoms can be greatly diminished. Also, using air conditioning, rather than opening windows in the home or car, changing clothes and showering after allergen exposure, and washing bed sheets weekly in hot water can all help to prevent severe seasonal allergy symptoms.
A Neti pot is also a good tool to help prevent seasonal allergy symptoms. The pot is filled with water or an approved nasal wash, and the contents are then poured into one nostril and come out the other. This helps clean out sinus passages, ridding them of allergens which can cause many of the seasonal allergy symptoms.
Natural products can also help prevent many allergy symptoms. Echinacea as well as Vitamin C can boost the body's immune system, enabling it to fight the allergens that can cause seasonal allergy symptoms. Also, Sambucol®, a black elderberry extract, can help provide immune support. Although seasonal allergies cannot truly be prevented, there are a variety of measures that can be taken to almost completely counteract many of the associated symptoms.