Shannon Wiedener doesn't have to watch weather reports to be warned of high pollen counts. With most of her family suffering from seasonal allergies, the 37-year-old mom, who lives in Burlington, Ont., says their bodies are allergy barometers. "Humid days are bad, as well as windy ones during pollination season," she says.
While Shannon's husband, Mark, receives shots for his grass allergy, she relies on over-the-counter medications to soothe her sinus pain and itchy eyes. Meanwhile, her eight-year-old son, Keegan, swallows a daily dose of Aerius to manage his nosebleeds and itchy, swollen eyes, while younger brother Ty, 5, takes over-the-counter medications when he really needs them for his runny nose and irritated eyes. Ty also uses a puffer for his asthma, which is aggravated by his allergies.
Where can you start looking for allergy relief? And is all this runny nose and itchy eye business preventable? We took these queries – and more – to health professionals across Canada to answer your questions about seasonal allergies.
What are common allergy triggers?
The main indoor allergens in Canada are dust mites, pets and some types of mould, while the common outdoor allergens are pollen, ragweed, grass, trees and mould, says Dr. Harold Kim, an allergist in Kitchener, Ont., and an assistant professor of immunology and allergy at McMaster University in Hamilton. Many moulds grow under field grasses and release spores into the air. They're in high counts throughout the spring, summer and fall. In early spring, the first allergens to hit the air are from trees blossoming. Grass triggers symptoms in late spring and early summer, and ragweed is a big problem from mid-August until the first frost.
What makes my eyes itch and nose run?
Histamine is a chemical in everyone's body, but when you have allergies, your body produces extra, says Kim. This causes symptoms such as congestion, sneezing, a runny nose and itchy, watery eyes.
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Can my allergies come back even worse every year?
"We don't know why people are more allergic at certain times in their lives," says Kim. Though once you've developed allergic rhinitis – more often known as hay fever – you may have symptoms for years if you don't treat your allergies. It's believed that, over time, your immune system may become tolerant to allergens, so your symptoms lessen. But it also depends on the person; many women say their allergies worsened or started during or after pregnancy. The role of hormones is still being investigated, says Kim. Gender also comes into play. Boys are more likely to have allergic asthma before puberty; girls, after puberty.
Did my six-year-old inherit his allergies from me?
Genetics are involved. If you have allergies but your husband doesn't, your kids have about a 30 per cent chance of developing allergies during their lifetimes. If both parents have allergies, there's a 60 to 80 per cent chance that your children will develop them.
Kim adds that, genetics aside, doctors have seen an increase in most allergic conditions over the past few decades. And research shows that higher levels of greenhouse gases in the atmosphere can lead to a boost in pollen production, making allergies more severe.
What new medicaions are available to treat my symptoms?
"While there’s nothing really revolutionary, we've recently seen more use of nasal saline – a combination of sodium chloride and distilled water – for allergic rhinitis," says George Murray, a pharmacist in Sackville, N.B., and past president of the Canadian Pharmacists Association."It's an effective way of cleansing the tissues. We've also seen less use of traditional decongestants and antihistamines, especially in children." (In 2008, Health Canada recommended that children under six years not be given over-the-counter cough and cold medicine, since it had little effect and kids were sometimes being given too much.)
Murray adds that a few years ago nondrowsy antihistamines were a breakthrough. You can take these medications and not be impaired when carrying out your daily activities. In any case, it's always best to talk to your doctor or pharmacist before you or your children start any medication.
Page 2 of 5 - Learn what to look for in different antihistamines on page 3
What's the difference between the varouis antihistamines?
Traditional antihistamines – such as Benadryl, Chlor-Tripolon and Dimetapp – dry up secretions, relieving your runny nose and itchy eyes, says Murray. But they also cause drowsiness.
For long-term treatment, over-the-counter medications such as Claritin and Aerius are better, Murray says. They block the receptors throughout your body, so when an allergen comes into your body, you don't have a reaction. If you know you're going to have some allergy issues, says Murray, start taking a blocker a week or two before the season starts, to make sure your allergy symptoms don't "turn on."
Should I take a combined antihistamine and decongestant?
It's better to treat a single symptom, because you may end up taking something you don't need, says Murray. Say you're hit with hay fever and you start using a combination medication; the decongestant takes away some congestion, but after a few days your congestion will be gone, so you shouldn't use a decongestant anymore. If you keep taking the combination medication, you're taking a drug that you don't need, says Murray, and that could increase your heart rate and blood pressure or affect your thyroid function.
What else can I do to alleviate my child's runny nose?
"We've really been promoting saline use for children," says Murray. The saline helps flush allergens and mucus out. But if your child has severe symptoms, says Murray, she may need to take a blocker. Talk to your pharmacist or an allergist.
You can also give her honey that's made locally if she is over two years old, says James Christian, a medical herbalist in Victoria. The idea behind this remedy is that bees collect pollen in the area, and by introducing it in local honey or bee pollen, it helps her body decrease its immune response when she breathes in the pollen.
Page 3 of 5 - Read about precsription medicine that can help with your allergies on page 4
Are there prescription medications that can help with my symptoms?
If you're having moderate or severe symptoms, you can try a steroid nasal spray. Occasionally, if a patient has terrible symptoms and isn't responding to other medications, short courses of oral steroids can be used, says Kim. They're effective, but there are significant side-effects if they're used over a long period of time (such as increased blood pressure and blood sugar levels). "We do have some patients with asthma who are on daily oral steroids such as prednisone, but we try to avoid prescribing them," adds Kim. It's safer to use inhaled steroids, and they usually control the symptoms.
Another family of medications to try – especially if antihistamines aren't working – are the leukotriene receptor antagonist medications, such as Singulair. They work for hay fever and eye symptoms, but you have to be 18 or older for a doctor to prescribe them for allergy treatment. Instead of blocking histamine, these medications block leukotriene, the molecule in your body that's causing the symptoms.
"For itchy eyes, prescription eye drops are excellent," adds Kim. "My favourites are Patanol and Zaditor. I wouldn't recommend buying eye drops off the shelf. Some just constrict the blood vessels and can lead to more problems in the long term.'
What medication side-effects do I need to know about?
Inhaled steroids sometimes create a little irritation (such as a slight sting in your nose or sinuses) or a funny taste in your mouth, says Murray. And you can develop a fungal infection called thrush in your mouth if you don't rinse properly after inhaling. Nasal and topical decongestants, such as Otrivin, are OK to use for up to five days. They constrict the blood vessels in your nose and can cause rebound congestion if you use them for longer than that.
Nondrowsy antihistamines are safe, adds Murray, but if you have a chronic medical condition, talk to your pharmacist or family doctor, or an allergist about the pros and cons of taking them, says Kim. "Generally we try not to use oral decongestants because of the stimulant side-effect," adds Kim. "They can also react with other medications, such as asthma and cold medications."
Page 4 of 5 - Learn how herbal remedies can help with your allergy symptoms on page 5
How do I know if I need allergy shots?
If you don't want to take drugs on an ongoing basis, or your symptoms are persisting while you're taking medications, consider allergy shots.
"We first identify what patients are allergic to and then we give them injections of it, starting with very low doses," says Kim. "We build up the doses gradually until we get up to maintenance doses. So within six to 12 months, your body becomes tolerant of the shots."
Generally, allergy shots are given to kids who are six and older. But there are exceptions. If a child or adult has a significant medical condition, such as heart disease or cancer, shots aren't a good idea, says Kim. "And we don't recommend shots for patients on some medications, especially beta-blockers [drugs used for hypertension, heart disease, migraine headaches and tremors]." As well, doctors won't start you on shots if you're pregnant. But if you're on a maintenance dose and become pregnant, you can continue the shots.
Will surgery treat my allergies?
Turbinate surgery is an option, but patients rarely have to go that route. This surgery enlarges the space in your nose by removing or decreasing the size of the turbinates (the bones in your nose). "If the symptoms are significant enough and we're not improving them with medical therapies," says Kim, "then we refer the patient to an ear, nose and throat surgeon to be considered for surgery."
What herbs could I take to treat my symptons?
It's best to consult with an alternative health practitioner, such as a medical herbalist or naturopath, to understand why you are suffering from allergies before you try natural products, says Christian. "That said, herbs such as stinging nettle (Urtica dioica) and ginkgo biloba can help prevent an allergic response," he adds. Goldenseal (Hydrastis canadensis) and eyebright (Euphrasia officinalis) have the ability to heal mucous membranes and prevent them from making too much mucus. You could also try a tea of eyebright or a tincture of goldenseal, says Christian, or talk to a herbalist for a product and dose recommendation.
Are herbal remedies safe for my child?
Yes – with the help of a herbalist, naturopath or pharmacist at a herbal pharmacy. Talk to one of these individuals about adjusting the dosage depending on the age of your child and the recommended form of remedy. Herbalists usually use capsules, tinctures or teas. Tinctures can have a strong taste and contain alcohol, so they're not necessarily the desired option for children. "We've blended dried herbs to make a tea, then you mix the tea with fruit juice to make into frozen treats," says Christian. "If you give kids two or three a day, they're getting a certain amount of the medicinal value of the plant."
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