Suffering From Allergies? Tailor Treatment to Your Symptoms

January W. Payne

A professional allergist can perform tests to determine exactly what's causing your misery

Some allergists say the allergy season may be worse than in recent years because of the heavy late-winter snowstorms in parts of the U.S. That precipitation served as a "turbocharge" for early tree pollen, which, combined with grass pollen, means allergy sufferers may be especially miserable this year, says Clifford Bassett, chair of the American Academy of Allergy, Asthma, and Immunology's Public Education Committee.

You can calm your allergy symptoms if you choose the right products. But despite the wide array of options available, about 60 percent of people with allergies say they have a hard time getting relief during the spring, according to a new survey by Consumer Reports. About 18 percent of those surveyed feel so lousy from allergies that they've missed work. Of those who saw a doctor for treatment of allergies, 59 percent reported improvement in their symptoms.

For one thing, an allergist can perform testing to determine what you're sensitive to, says Robert Fisher, the medical director at a Wisconsin-based practice called Allergy Research and Care and an AAAAI fellow. For example, "if it's just grasses and trees and ragweed, (you'll know) it's good to close your windows and run the A/C and use a HEPA filter."

If you're allergic to mold, you should realize it's a bad idea to open your windows when it's cool and damp -- conditions that promote mold growth outdoors. A doctor also can offer allergy shots or medicines available only by prescription.

But overall, the key to dealing with allergy symptoms is to tailor treatment to your symptoms. So if you...

...have itchy, watery eyes, consider allergy eyedrops. If this is your only symptom, "you may not need to take systemic medication" such as Claritin or Zyrtec, Fisher says. Instead, you may be able to use antihistamine prescription eyedrops, such as Patanol, or over-the-counter eyedrops, such as Zaditor (formerly a prescription medication).

...are sneezing or have a stuffy or runny nose, there are a few options. Nasal steroids, such as Flonase, can help calm inflammation in the nose, relieving stuffiness. Nasal antihistamines, such as Astelin and Asterpro, can help relieve runny noses and sneezing. If you don't want to take a daily nasal spray, you can probably get by using nasal antihistamines, which provide relief within minutes, when you experience symptoms. But nasal steroids should be taken daily in order to experience the medicine's full effect.

Avoid using decongestant allergy sprays, such as Afrin, for longer than three days, doctors warn, because overuse can result in a rebound effect, caused by narrowing and constriction of the blood vessels in the nose.

Saltwater nasal rinses are a non-drug option that "can help with congestion and runny nose and sneezing," says Ujwala Kaza, a New York City-based allergist and a member of American of the American College of Allergy, Asthma, and Immunology. A 2007 study found that nasal irrigation is more effective than using saline nasal sprays.

...have symptoms all over, try nonsedating oral antihistamines, such as OTC Claritin or Zyrtec, or prescription options like Allegra, Clarinex, or Xyzal, which can help relieve allergy symptoms throughout the body without making you sleepy. And the mainstay allergy medication Benadryl, known to cause drowsiness, still serves its purpose. "It's what we use for an allergic reaction for allergies or hives because it has a quicker onset," Kaza says.

A final tip for those with allergies: As hard as it may be to do, avoiding your allergic triggers is key. "The best thing to do is on nicer days, stay indoors if you can and try to keep windows closed," Kaza says. If you must go outside for long periods of time, take your allergy medicine before heading outdoors and avoid high-pollen areas, especially places with a lot of trees, Kaza advises.

GOT ALLERGIES OR ASTHMA? TRY TAKING PHOTOS

Dealing with a diagnosis of asthma or allergies can be tough -- and figuring out what is worsening your symptoms isn't easy, either. Might taking photographs of your home -- your bedroom, bathroom, basement, and other areas -- help your doctor reach conclusions? Perhaps, suggests a new study, which found that arming patients with a disposable camera and a list of areas in the home to take photos of was as useful as a professionally done environmental assessment -- and a whole lot cheaper.

Many people struggle with outdoor and indoor allergies to mold, pollen, cockroaches, fur, dust, or feathers. But eliminating the triggers from the home is often easier said than done, says the study's lead author, Rita Mangold, asthma program coordinator at Truman Medical Centers in Kansas City, Missouri.

For example, people are commonly not aware that what looks like grime in their bathroom or basement is actually mold, Mangold says. And when the doctor looks at a picture of a kitchen with open boxes of cereal or food lying around, he or she may spot a rusty pattern that is actually cockroach droppings.

"A lot of (the) time, if you do a thorough history with a patient and ask about exposure to mold (and) dust in the home, they may say no, and it's because they don't recognize what that is," Mangold says.

The study -- which involved 50 participants randomly assigned to get either a professional environmental assessment (a $300-to-$400 cost) or to take photos of their homes themselves (a $13 cost) -- is being presented today at the American College of Chest Physicians' meeting in Philadelphia.

"I think that anything that enhances the patients' participation in their own care and identifies potential triggers in the home environment is beneficial," says LeRoy M. Graham, an Atlanta pediatric pulmonologist in private practice who was not involved with the new study. "Oftentimes it's not very easy for doctors to discern all the triggers."

Tips for doing your own photography project:

Check with your doctor.

Find out if he or she is interested in seeing photographs of your home before you go through the trouble of taking the pictures. Also consider getting the images put onto a CD so that the doctor can view them on a computer and zoom in closely, Mangold suggests.

Don't clean up your house first.

The doctor needs a realistic portrayal of what your home normally looks like, Mangold says.

Explore the inside of your home -- and the outside.

Photograph the bedroom, bathroom, kitchen, basement, and dining room, Mangold suggests. "We spend more time in our bedroom than any other single location in our home," Graham says. Also, take pictures of the outside of your home, especially in areas where water tends to pool.

Get behind closed doors.

The inside of cabinets below sinks should be photographed as a check for mold, Graham says.

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Health Ailments - Suffering From Allergies? Tailor Treatment to Your Symptoms