Are your allergies particularly bad this season?
I thought this would be a great and timely issue to bring back my Healthy Actions column, a monthly chat with a local medical expert. I had to pause the columns during the height of coronavirus coverage.
My expert is Dr. Matthew Mivsek, a family medicine doctor with Unity Health Network’s Hudson office.
Also check out an accompanying video with Mivsek, where we answer some reader questions.
Q: Typically, when is allergy season?
A: Tree pollination is early spring, grass pollination is late spring and summer and ragweed is late summer and early fall.
Q: Is this season worse and why?
A: Yes, there are quite a few patients coming into the office and calling the office with allergy symptoms, more so than usual this year. The likely reason is the unseasonal weather early in the year, both with warmer-than-usual temperatures early on and an unexpected snowstorm in May. The amount of precipitation has increased pollination and overall pollen counts.
The fluctuations of the temperatures led to both tree and grass pollens starting to come at the same time, which has really sent a lot of individuals’ allergies into overdrive.
A useful app to track the potential to aggravate allergy symptoms when spending time outside and the overall pollen counts is Weather.com. It will show breakdowns of tree pollen, grass pollen and ragweed pollen. If you know which type of pollen you are most allergic to, you can try to avoid days when the specific counts are higher.
Q: Some people say this is the worst season ever and others say they’re doing OK or had some mild issues a few weeks ago. Why?
A: What everyone is allergic to is different. I’ve had people saying the same thing. It does vary from year to year and unless you know exactly what you’re allergic to, it’s hard to say.
Q: Could stay-at-home orders keeping us inside have helped with allergies?
A: That’s a reasonable theory. Generally, staying inside in air conditioning or with the windows closed helps with allergies.
Q: Does the wind or rain affect allergies?
A: Wind can definitely make allergies worse by circulating pollen in the air. I’ve heard that rain can make things worse. It may not be that day, but a few days later with the humidity. Sometimes also when the raindrops fall, they’re throwing pollen in the air.
Q: How can I tell if this is allergies, a cold, the flu or COVID-19?
A: The most important symptoms to be aware of regarding COVID-19 are fever (over 100.4 degrees Fahrenheit), cough and shortness of breath.
Allergies typically present with runny nose or nasal congestion, itchy, watery eyes and scratchy throat, predominantly. A cough is usually caused by post-nasal drainage in the setting of allergies that are not controlled.
A cold/flu/coronavirus symptom presentation can be similar, so I can understand the concern regarding this matter. A major difference between allergies and cold, flu, coronavirus is the presence of a fever.
Q: So what over-the-counter relief is there?
A: There are several options. In the category of oral antihistamines or pills, the least potent are Claritin (generic name loratadine) and Allegra (fexofenadine), moderately potent are Zyrtec (cetirizine) and Xyzal (levocetirizine) and most potent is Benadryl (diphenhydramine), but Benedryl, that does make you pretty tired and make it difficult to function throughout the day.
For nasal sprays, there are steroid nasal sprays such as Flonase, Nasacort and Rhinocort that are going to be most effective; antihistamine nasal sprays such as Astelin and saline nasal sprays such as Simply Saline and Ocean mist.
Be sure to use the nasal spray properly. Lean slightly forward and point the spray in your nose toward the outer corner of your eye. Lightly sniff. If you sniff too much and can taste the spray, it wasn’t used correctly and has gone down your throat instead of into your sinuses.
For eyedrops, there are antihistamine ones, such as Zaditor, Pataday, Naphcon and Alaway.
Q: Is it preference to take a pill versus nasal spray?
A: Yes, rather than use an oral medication that goes throughout the body and can have potential side effects, if you want to directly treat the problem, you can use a nasal spray.
Q: Is it better to do something preventive and take allergy medications before the season starts instead of waiting for an attack?
A: There certainly is benefit to practicing preventive medicine in all aspects of medication, and preventative measures to alleviate allergy symptoms is no different. If you know that your allergy symptoms are the worst in the spring, beginning to take an oral antihistamine toward the end of winter can help to alleviate symptoms moving through peak allergy seasons.
Q: Is it safe to layer other medications on during a flare-up?
A: Yes, it’s OK to layer treatments. Taking an oral antihistamine can be paired with any nasal spray and eyedrops. You want to be careful about the decongestant part, or “D” portion of a pill, especially for someone with high blood pressure because it can elevate blood pressure. Those with high blood pressure should take Coricidin HBP.
Q: When should I call or ask a doctor for a prescription instead of trying over-the-counter remedies?
A: If you’ve maxed out therapies over the counter or you’re uncomfortable with what you’re layering, call for an appointment or telehealth appointment. You can also ask the pharmacist at the store.
Q: What about shots?
A: That’s usually done by an allergist through a referral. Before allergy shots or immunotherapy, they would do a prick test to find out which allergen is causing the response.
Q: Can wearing a mask help?
A: A mask certainly won’t hurt to protect against allergens and can help with airborne pollen, just like viruses. Cloth masks are going to be the least effective, followed by surgical masks and health-grade N-95 masks. We haven’t necessarily used masks for treatment of allergies, but they can help, especially for those who may want to wear masks when they’re mowing the grass or doing yard work.
Beacon Journal consumer columnist and medical reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.beaconjournal.com/topics/linfisher
For more information
On BeaconJournal.com: watch a video of Dr. Matthew Mivsek and Betty Lin-Fisher answering some reader questions about allergy season.
This column is part of the Healthy Actions series, which is exploring different health topics. To see previous topics and videos, go to www.tinyurl.com/HealthyActionsABJ.
