The Management of Hay Fever

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As warmer temperatures bring spring flowers, tree blossoms and increased outdoor activity, they also bring suffering from hay fever and spring allergies.

You might be one of the more than 20 million Americans each year who suffer through the itching, sneezing and sniffling. Because medical research has found more effective ways to deal with allergy symptoms, hay fever doesn’t have to put a stop to your springtime enjoyment.

Research has found numerous oral and topical medications that control symptoms selectively, with minimal side effects.

Histamine: The Culprit Behind Hay Fever

Histamine is released by mast cells in your body in response to allergens. It stimulates blood vessels, resulting in dilation and swelling. It also stimulates sensory nerve endings in the nose, resulting in itching, sneezing, and nasal secretion.

First-Line Treatment: Antihistamines

Antihistamines do exactly what the name implies-they work contrary (anti) to the effect of histamine. They do this by binding to the histamine receptor and not allowing stimulation. That’s why antihistamines can reduce symptoms such as nasal itching, sneezing, and a runny nose. They work especially well when taken as a preventive measure before the onset of symptoms. One drawback is that they have little effect on nasal blockage.

Although a mainstay of treatment for hay fever symptoms, antihistamines have had the disadvantage of causing drowsiness in most people. In recent years, four types of antihistamines that cause little or no drowsiness have become available around the world. under the brand names Claritin, Hismanal, Seldane, and Semprex-D.

There are some differences among them, which you can discuss with your physician to help you decide which is best for you. Hismanal lasts longer in your system (a 10-day half-life in your bloodstream and 6 to 8 weeks in your skin) thereby making compliance easier. However, it doesn’t act quite as quickly to abate symptoms and can cause weight gain in some people. Claritin, Seldane, and Semprex-D are faster acting and last 2 to 4 days in your system. Claritin is taken once per day and its fast action delivers relief starting within 1 to 3 hours, reaching a maximum at 8 to 12 hours after ingestion.

Although these new antihistamines cost more than their predecessors, they are taken less often and have fewer side effects. An important warning: serious cardiac side effects have been observed with Hismanal and Seldane when the recommended dose is exceeded or when they are taken with certain antibiotics (e.g., erythromycin) and some oral antifungal medications (e.g., ketoconazole). These combinations should be avoided if you have liver disease. Discuss all drug actions, interactions, and side effects with your physician.

More Treatment Methods: Decongestants and Mast Cell Stabilizers

Antihistamines have minimal effect on the congestion and stuffy nose caused by hay fever. Decongestants, which can be taken orally or topically, are what’s needed to improve your ability to breathe. A drug that can stabilize the mast cell, actually blocks allergies by preventing chemical culprits like histamine from being released from the mast cells in your body. Nasalcrom is a mast cell stabilizer that may prevent itchy, runny, sneezy, or stuffy noses.. Like many allergy medications results are best if taken prior to exposure to allergens. Sometimes your physician will prescribe an antihistamine ,a decongestant ,or a corticosteroid along with a mast stabilizer if you are suffering with significant symptoms.

Additional Relief: Corticosteroids

Corticosteroids are some of the most effective drugs for relieving hay fever and allergy symptoms. Taken intranasally, they can reduce all symptoms from sneezing to itching. Note, however, that their advantages can be outweighed by serious side effects when taken orally. Inhaled corticosteroids have been found to be safer, while still giving you relief.

One of the earlier nasal corticosteroids (found under the brand names Vancenase or Beconase) was introduced in 1973. It is absorbed slowly yet metabolized quickly, thereby limiting its toxicity. Others followed, including ones sold under the brand names Nasalide, Rhinocort, Nasacort and Flonase. They are applied once or twice daily using an aerosol canister or a pump spray, depending on which type your physician prescribes.

Unlike antihistamines and decongestants, intranasal corticosteroids are capable of relieving all phases of allergic symptoms, including nasal blockage, sneezing, itching, and runny nose. Even eye itching is improved. Because the medication is a topical nose spray, it is helpful to first clear a very congested nose with a topical decongestant (such as oxymetazoline) before the first 3 to 5 days of treatment.

Some minor side effects include dryness inside your nose, crusting, mild nose bleeds, and discomfort from the forcefulness of the spray. Fortunately, all forms of the medication’s delivery are relatively equal in potency. You can work with your physician to find which works best for you with the least discomfort.

Remember that only one or two applications won’t help-inhaled corticosteroids take 3 to 5 days to be fully effective.

Will You Improve?

That depends on what causes your hay fever and allergy symptoms. Sometimes, these stuffy noses are not brought on by allergies, but rather by such things as structural problems (such as septal deviations) or swelling of certain bones or glands. Your physician can best determine what’s causing your symptoms, and which medication or treatment will help you feel better.

The springtime ritual of new blossoms and warmer weather doesn’t have to mean stuffy noses and sniffles.

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