Allergy relief all in your head

Springtime in the Northwest.

It’s a reason to celebrate, right? Yes, unless you’re an allergy sufferer. For many of them, the spring bloom brings with it sneezing, runny nose and itchy, watery eyes.

If you’ve ever seen someone having a serious allergic response and heard him say “My head is like a faucet,” that’s actually pretty accurate.

“A normal nose produces about one liter of fluid a day,” said Dr. Robert Lawrence, an allergist with Kaiser Permanente Northwest. “A person having an immediate allergic reaction can produce 12 liters of fluid in a day.”

So, when it comes to treatment and relief, what’s an allergy sufferer to do?

According to Dr. Lawrence, the choice of treatment depends on the source of the allergy, and the frequency and severity of symptoms. “If you have symptoms one day per week, you don’t need to use medicine every day. But if you have symptoms four times a week, you probably ought to be on some medication.”

People allergic to dust mites and animal danders from pets can reduce their contact by thorough cleaning, but Dr. Lawrence said “as long as the animal is in the house you’re going to have pretty good exposure.”

As for medications, Dr. Lawrence says there are three basic groups: antihistamines, nasal cortisone sprays, and leukotriene blockers (the Singulair group). “All of them have shown to be effective,” said Dr. Lawrence. “Most people do well with antihistamines. They probably work in 70 percent of the people, and they reduce about 70 percent of the symptoms.” The Singulair group offers approximately the same effectiveness, according to Dr. Lawrence. As for nasal cortisone sprays, Dr. Lawrence says they give around 80-85 percent improvement from symptoms.

Other tools

Dr. Lawrence says there are other medications in the allergist’s toolkit: eyedrops, which can come as a decongestant, a decongestant-antihistamine combination, and an antihistamine/anti-inflammatory combination. There is also cromolyn, a

so-called mast cell inhibitor, meant to be taken prior to exposure.

When choosing a medication, Dr. Lawrence advises patients to consider their lifestyle. For example, a driver or a pilot would not want to take a medication that can have a sedative effect.

Another medication option is the allergy injection, a shot of a substance to which the patient is allergic. The idea is that the body, exposed to a low dose of the allergen, will build up a tolerance to that substance. “For pollens, they work pretty well,” said Dr. Lawrence. “For cats, dust mites, a couple of molds, they work pretty well. For other items, there’s no great evidence they make much of a difference.” The buildup period for allergy injections is six to eight months on allergy shots and you can start to see improvement in that time frame, but maximum benefit takes about two to three years to reach.

Alternative methods

Many allergy sufferers have turned to nontraditional methods to relieve their suffering. One of the most popular methods is the saline irrigation, either in sinus rinse bottle form or the Neti Pot. Each version washes mucus out of the nose, and many users swear by them. Dr. Lawrence says they can be great for relieving minor symptoms, “but for a true immediate allergy response, they’re not going to do a lot for you.”

There are some herbal alternatives as well, including stinging nettle and local bee pollen. Dr. Lawrence says stinging nettle has a decongestant in it that does work temporarily. As for bee pollen, Dr. Lawrence says that well-controlled studies have shown no benefit, since the amount of pollen in the dose is so small.

Still, allergy sufferers will tell you: if they find something that works, that’s all that matters. Because when the reaction is intense and the nose is producing three gallons of fluid, the most important thing is to turn off the faucet.

David Northfield is media relations manager for Kaiser Permanente Northwest. He can be reached at david.t.northfield@kp.org. Follow Kaiser on http://twitter.com/KPNorthwest.