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Allergic Rhinitis (Nasal Allergies, Hay Fever)

Allergic rhinitis, commonly known as hay fever, is the most common allergic disorder affecting approximately 20% to 25% of the population. The most frequent symptoms are nasal congestion, itchy runny nose, itchy runny eyes, and fits of sneezing. Other frequently accompanying symptoms are headache around the eye area, drainage in the throat, fatigue, and lack of energy. There can also be intense itching of the throat and deep in the ears. The term hay fever is really a misnomer in that it is rarely due to hay, and there is no fever associated with it even though patients feel feverish as the result of the effects of histamine on the blood vessels causing them to dilate and feel warm.

Allergic respiratory symptoms are a result of histamine release along with other chemicals that are either preformed or formed in allergy cells as a result of an antigen antibody interaction.

The job of the allergist is to determine whether the above symptoms are due to allergies or not. Allergic rhinitis is typically classified as seasonal (intermittent) or perennial (persistent), or both. Frequent triggers of true hay fever symptoms include the pollens from grass, tree, and weeds, house dust mite, mold spores, and animal dander. If the above described symptoms are triggered by cleaning one’s home, playing with pets, mowing the grass, etc., then there is high likelihood that symptoms are due to allergies. If your doctor cannot make a correlation of your symptoms with the above triggers, then you need to start thinking outside the allergy box.

The correct diagnostic term for nasal symptoms not due to allergies is non-allergic or vasomotor rhinitis. We don’t understand the mechanism of this condition totally. As the name applies, it is not on an allergic basis, that is to say an antigen antibody interaction. Triggers of non-allergic rhinitis include irritants such as tobacco smoke, chemical odors, cold air, strong perfumes, etc.

Other conditions to consider in people with symptoms of a stuffy nose are hypothyroidism (low thyroid), nasal polyps, tumors (cancer), foreign bodies, infection, and deviated nasal septum. There is also another condition that goes by the acronym N.A.R.E.S. which stands for nonallergic rhinitis with eosinophilia. This means that a person can have all of the symptoms of allergies but are skin test negative, and yet paradoxically have an abundance of allergy cells called eosinophils in their nasal mucus. This condition responds nicely to intranasal steroid sprays.

The nose is the center of the universe to an allergist. If a person does not describe classic nasal symptoms, and for instance only complains that ears or eyes bother them, then the likelihood of symptoms being due to allergies is lessened.

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Winter Allergies: What Causes Them and How You Can Get Relief

From EverydayHealth.com

Yes, you can suffer symptoms of seasonal allergies in winter, too.

Most people don’t associate winter with allergies, but allergies persist into and through the cold months. Though it’s important to know that winter allergies do pose slightly different problems than they do during other seasons. (And knowing how to avoid them or minimize triggers can help keep you feeling your best all winter long.)

 

What Causes Allergies During the Winter

“You don’t have pollens in winter,” says Douglas H. Jones, MD, of the Rocky Mountain Allergy, Asthma, and Immunology Group in Layton, Utah. So outdoor winter allergies aren’t such a cause for concern. “But you still have the indoor [allergens].” And if you’re spending more time indoors during cold weather, you might notice an increase in allergy symptoms, such as sneezing, wheezing, and itchy, watery eyes. According to the American Academy of Allergy, Asthma, and Immunology, common indoor allergens (that might trigger symptoms in winter) include: (1)

  • Dander It’s the dander (dead skin flakes), not the hair of household pets such as cats and dogs, that can cause acute or chronic allergic reactions in people.
  • Dust Mites These microscopic bugs might be the most common cause of year-round indoor allergies, notes the Allergy and Asthma Foundation of America. (2Dust mites thrive in bedding, carpeting, and the upholstered furniture inside your home.
  • Indoor Mold We all breathe in mold spores, but for those with an allergy, exposure can trigger sneezing, congestion, and itchiness. Mold and mildew favor damp areas, like basements and bathrooms.
  • Cockroach Droppings These persistent pests can live anywhere, and while they’re not a sign of an unhygienic or unsanitary household, it’s important to keep food well-contained and be vigilant about cleaning up crumbs. Fixing leaky faucets and pipes and sealing up cracks and crevices in your home can help keep cockroaches away.

Matthew A. Rank, MD, an allergy expert with the Mayo Clinic in Phoenix, Arizona, says that although specific data is hard to pin down, roughly 5 to 20 percent of Americans suffer from some form of winter allergy.

What You Can Do to Prevent Winter Allergies

A big problem with winter allergies is that cold-weather lifestyles can turn a simple allergic reaction into something worse, says Dr. Jones.

“People are turning up their heaters, which makes the indoor air even drier,” he says, “and that leads to dry noses, which increases the incidence of nosebleeds and skin cracking” — which in turn boosts infection risk when someone’s nasal passages are already inflamed from allergies. Jones recommends using nasal saline rinses to lower the risk of contracting a secondary viral infection.

It may not be possible to get rid of winter allergies entirely, but you can reduce exposure to allergens, at least in your own surroundings. Jones, Dr. Rank, and other allergy experts offer these tips for minimizing indoor allergen exposure in winter:

  • Use a humidifier to reduce dryness in the air, but don’t turn your home into a rain forest: Dust mites thrive in humidity over 60 percent and temperatures of 60 to 85 degrees Fahrenheit. Mold also grows faster in high humidity. Rank recommends a maximum humidity of 50 percent.
  • Avoid wall-to-wall carpeting, which provides a favorable environment for dust mites. Use area rugs instead.
  • Clean, dust, and vacuum regularly, using a vacuum with a high-efficiency particulate air (HEPA) filter.
  • Wash sheets weekly in hot water — at least 130 degrees Fahrenheit — to kill dust mites, and use hypoallergenic cases for mattresses and pillows to keep dust mites trapped.
  • To minimize dander, bathe pets once a week — though not more often, as more frequent bathing can dry out a pet’s coat and skin — and keep animals out of the bedroom of anyone in the house who has allergies.

If you’ve done all you can to allergy-proof your home but you still have symptoms, it might not be your fault, Jones adds. Public areas, such as workplaces, can have the same allergy-inducing conditions as your home: dry air, dust, and dust mites. In addition, pet owners often get dander on their clothes and unwittingly transport it into public places. The level of cat dander in public places is high enough to trigger allergy, Jones says.

Winter Allergies Versus a Cold

During the winter, it can be difficult to distinguish an allergy from a cold. Both share symptoms, such as sneezing, runny nose, and congestion. But colds are viral infections, while an allergy is your body’s immune system response to an irritant or trigger.

According to the National Institutes of Health (NIH), colds don’t usually last more than a couple of weeks, while allergies will continue as long as the allergen is present. (3) And symptoms like itchy, watery eyes are typically a sign of an allergy, not a cold or the flu, while aches and fever are not associated with allergies. A cough sometimes comes with allergies but is more commonly a sign of a cold, and when it’s more severe, the flu.

 

Treatment Options for Winter Allergy Symptoms

To treat allergy symptoms, Jones cautions against older over-the-counter (OTC) medicines, which, he says, can do more harm than good.

“Some of these drugs have too many side effects,” he notes, “and people don’t really understand how to match their symptoms to the product. They just know they feel bad and want to feel better.”

For example, some OTC allergy drugs contain decongestants, like pseudoephedrine, which can raise a user’s heart rate. The active ingredient in the antihistamine Benadryl — diphenhydramine — causes some tissues to dry out and promotes urinary retention, Jones says. “So people with prostate problems, who may have trouble urinating, find that that condition worsens when they take diphenhydramine.”

Jones says that better options are decongestants that contain loratadine (such as Claritin) and cetirizine (like Zyrtec), two drugs that moved from prescription to OTC status in recent years. Prescription steroid nasal sprays (some of which are also now available over-the-counter) tend to be more effective than antihistamine tablets, adds Rank, though individual responses vary and the two types of drugs are often used in combination.

Talk to your doctor and your pharmacist before taking any over-the-counter medication, to discuss whether it’s appropriate for your symptoms and potential side effects.

The American Academy of Allergy, Asthma, and Immunology notes that if you have a pet allergy, you might consider immunotherapy ­— allergy shots or tablets — that can potentially desensitize you to the allergen and provide lasting relief. (4)

The post Winter Allergies: What Causes Them and How You Can Get Relief appeared first on Oklahoma Allergy and Asthma Clinic.

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