The allergy antidote: forty million Americans suffer from seasonal rhinitis. Learn to avoid the triggers, treat your symptoms, and enjoy a sneeze-free spring

Natural Health, April, 2005 by Kathleen Doheny

IN SPRING, blooming flowers and lush green trees can make you feel lucky to be alive--or hopelessly miserable, if you're one of the nearly 40 million people who will sneeze and sniffle their way through the next few months.

Allergies are year-round nuisances, but spring packs an especially powerful wallop for those susceptible to tree and grass pollens, mold, and dust mites. Since living in a sterile bubble is impractical, it's best to discover what's new--and what's natural--in allergy relief.

watch on the rhinitis

SEASONAL allergic rhinitis affects about 20 percent of American adults and accounts for nearly 17 million office visits a year to health-care providers, according to the American Academy of Allergy, Asthma & Immunology. Symptoms include nasal stuffiness; sneezing; and itching of the nose, roof of the mouth, and ears. Rhinitis sufferers are also prone to allergic conjunctivitis, an inflammation of the eyes that makes them red, itchy, and watery.

In addition, chronic rhinitis may potentially progress to asthma, according to the World Health Organization. "The inflammation that occurs with allergy and asthma is very similar," explains AAAAI spokesman Gailen D. Marshall, M.D., Ph.D., director of the division of clinical immunology and allergy for the University of Mississippi Medical Center in Jackson. If you have allergies, tell your doctor about any new symptoms, such as frequent coughing (especially during exercise or at night), excessive shortness of breath, or wheezing.

Allergic diseases in general have increased substantially in recent years. Researchers have yet to determine what exactly accounts for the rise--"but it's not genetic," says Marshall, because it's happening too quickly. Likely culprits include environmental issues such as indoor and outdoor pollution, excessive use of antibiotics, and a jump in levels of psychological stress.

And to what do all these allergy patients react? Pollens, mostly.

the inside, and outside, scoop

"CLASSICALLY, spring is tree-pollen season," says Marshall. "As trees bloom and pollinate, all this pollen is in the wind." Then there are grass pollens, which become plentiful in the late spring and early summer. Next come weed pollens, at their highest levels in the late summer and early fall. (Pollen seasons occur earlier in warmer climates, later in colder ones.)

Many people with allergic rhinitis are also sensitive to other allergens, such as mold or dust mites found in common house dust. "It's more and more common that if someone has an allergy to one [substance], they acquire allergies to others," Marshall says. "If the only time you have problems is in the spring, it's likely pollen, and you can focus on that. But if you go up in the attic and start to sniffle, there's a good chance you also have mold and/or dust-mite sensitivity."

So on those blustery or attic-visiting days when you're sneezing, blinking, and bemoaning, what's going on inside? In response to an offending allergen, the immune system thinks it's under attack and produces a certain type of antibody, called IgE. ("Think of 'E' for 'evil,'" Marshall tells his patients.)

The IgE antibody arms white blood cells known as mast cells, which are located in your nose, lungs, eyelids, and other areas. "With continuous pollen exposure, the antibody triggers mast cells to release chemical mediators--the histamines and leukotrienes--that cause you to itch, sneeze, drain, and get congested," says Marshall.

home and other remedies

THE EASIEST WAY to sidestep an attack is to avoid the allergen. If pollen is your nemesis, don't go outside when it peaks--usually between 10 a.m. and 4 p.m. If you have to roam on a high-pollen day, take a shower when you return home, as pollen can collect on your skin and hair, and make symptoms worse.

While at home, try to reduce humidity levels, because dust mites and mold spores thrive in a damp environment. "Ideal is less than 50 percent humidity," says Marshall. "The outside mold, you can't control--the inside mold you can."

Once a reaction occurs, the following therapies can offer relief:

Antihistamines that were formerly prescription--only have become available over-the-counter, says Jeffrey S. Goldsmith, M.D., an internist at Santa Monica-UCLA Medical Center and assistant clinical professor of medicine at UCLA David Geffen School of Medicine. These are often the preferred treatment for mild and intermittent symptoms; choose a non-sedating antihistamine, such as Ioratadine (Claritin, Alavert).

Decongestants are effective at unstuffing noses, but oral decongestants should be used with caution, advises Marshall, who cites possible side effects, such as insomnia and increased blood pressure. Topical decongestants--nasal sprays like Afrin--don't have these risks, but after three or four days they can cause "rebound" congestion.

Cromolyn sodium is a mast-cell stabilizer that's sold over-the-counter as a nasal solution; brand names include Nasalcrom and Intal. It's not as immediate-acting as an antihistamine, but still quite useful at preventing cells from secreting histamine, says Goldsmith; administered prior to allergen exposure, nasal cromolyn may reduce the initial allergic reaction. Side effects are uncommon and usually mild.