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Allergies are a seasonal headache for nearly 50
million Americans* with approximately 16.7 million office visits to
health care providers each year attributed to allergic rhinitis (
nasal symptoms caused by allergies).
Allergies are caused by a reaction of
the immune system to a substance ( cat dander, pollen, dust mites,
etc.) in the environment that is usually harmless to most people.
Over time, susceptible individuals develop a sensitivity to one of
these substances. Once this happens allergy symptoms will usually
recur every time there is sufficient re-exposure to the same
substance. Because allergies are the result of repeated exposure, a
person can develop allergies at any age. Contrary to popular opinion
you can get allergies for the first time as an adult, in fact
this is very common.
When most people think of allergy
symptoms they think of sneezing, runny nose, and watery eyes. While
these symptoms are common, allergies can cause many other symptoms.
Nasal congestion, cough, headache, pain around the eyes, and even fatigue
can be common symptoms in many people. Someone with allergies can
have all of the above symptoms or a few or just one. This wide
variation in symptoms is why people and their doctors sometimes
don't think of allergies or confuse allergy
symptoms with a cold.
Cold and allergy symptoms overlap a
lot. Below is a list of some of the differences between allergies
and colds.
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- There is no fever and no muscle ache with
allergies
- Itchiness in nose, ears, and throat (especially
the palate or roof of the mouth) is present in allergies
- Symptoms of seasonal allergies usually last
longer than the typical duration of a cold, which is usually 7
to 10 days.
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So
now I have allergies. What should I do?
There's actually quite a bit you can do to relieve
your symptoms. Unfortunately most allergies are due to substances
that are not easily removed from our environment like pollen and
dust. You can try to minimize your exposure by staying indoors in
air conditioned rooms on days with high pollen
counts. Dust or more
accurately Dust Mite allergies are a problem all year round, but are
worse in the winter months. This is because dust mites are
microscopic animals that live in our bedding and feed on dead skin
cells. When they die, their bodies become part of the dust in the
air and we inhale them. In the winter when the air is very dry we
shed more skin cells, in addition, the dust in our home becomes airborne
more easily. There are much higher concentrations of
these in our beds and pillows than anywhere else in the house.
Sometimes sealing the bedding with a special cover can reduce the
amount of dust mite allergens we ultimately inhale.Medications:
There are four main categories
of medication that can help allergy sufferers
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- Antihistamines -
sedating vs. nonsedating
- Decongestants
- Nasal Sprays -
Decongestant sprays, and corticosteriod sprays
- Leukotriene inhibitors
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1) Antihistamines - There are two
types of antihistamines those which cause sedation and those which
don't.
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Antihistamines work by blocking the effects of
a substance called histamine. Histamine is produced by the body
in response to an allergic reaction. It has several effects on
the tissues in the body. The end result is the production of
symptoms associated with allergies. |
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Sedating - i.e. Benadryl
(
diphenhydramine), Chlortrimaton, and most over the counter
drugs except Claritin. Most other over the counter allergy
medications that are "non drowsy" have
pseudoephedrine added to them to try and counteract the
effects of the antihistamine, but this usually doesn't
work.
Non-sedating - Clarinex, Claritin
( Loratadine), and Allegra are the only true non-sedating
antihistamines. Clarinex and Allegra require a
prescription while Loratadine is now available over the
counter
2) Decongestants - Nearly all
decongestants have the same ingredient - pseudoephedrine.
Whether
you take Actifed, Tylenol sinus,
Sudafed or Claritin-D ( the D stands for decongestant), they all
have pseudoephedrine in them. Pseudoephedrine works by causing
constriction of blood vessels throughout the body. In the nasal
tissues, this constriction causes the tissues to shrink and
opens up the airways. Some people have a hard time tolerating
these medications because they make them feel "racey"
or "hyper". Pseudoephedrine can also cause
insomnia and can raise blood pressure or cause rapid or
irregular heart beat.
3) Nasal Sprays - These also can be
broken down in to two types. Nasal decongestant sprays and Nasal
corticosteroids
Nasal Decongestant Spray
- Afrin, Neo-Synephrine and similar over the counter
sprays which contain oxymetazoline or phenylephrine work
by constricting the blood vessels in the nasal tissues and
shrinking them. They can be very effective for short term
use, but after even a few days the body can become "
dependant" on this medication. When you stop these
sprays after prolonged use you may go through a period of
rebound where you have more severe congestion than you had
before you started the spray.
Nasal Corticosteroids
- These medications are completely different than the over
the counter sprays. They all require a prescription and
all contain some form of "cortizone like"
medication as their active ingredient. The active
ingredients in these medications are targeted at the
underlying problem - the inflammation, which is the
hallmark of allergic reactions. They don't work as fast as
decongestant sprays, but they can be used for prolonged periods
of time without any risk of dependency. Examples of these
drugs are Flonase, Nasacort AQ, Nasonex, Nasarel,
Vancenase, and others.
4) Leukotriene Inhibitors
- Leukotrienes are something most people have never heard of. They
are another type of inflammatory substance
that the body makes and they are involved in allergies and
asthma. There is only one drug in this class currently. It is
called Singulair. Singulair was originally developed for the
treatment of asthma and has been around for several years. It
was recently approved for use in the treatment of allergies. It
has several advantages over antihistamines. One significant
advantage is that it can be used in men with enlarged prostates
who can't take most antihistamines.
* National
Institute of Allergy and Infectious Diseases web site
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