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Getting ahead of seasonal allergies.
Last year, I interviewed allergy specialist Dr. Lacey Robinson to discuss my own tree pollen allergies—allergies which typically convert spring, my favorite time of year, into a histamine-induced slog.
The interview was so life-changing for me that I decided I’d edit and republish it this year (and maybe every year, with changes as needed).
The key life-changing insights are actually easy to summarize. I didn’t have to add anything to my allergy regimen that I was not already doing. But I did change how I do what I do and when. The difference was amazing for me last year, and so far it has worked well this year too.
Start your usual treatments early—ideally before your symptoms show up.
You can take probably take daily allergy pills like Claritin, Zyrtec, or Allegra (or the generic versions) more than once per day for a period of time.
Decontaminating your skin and clothes after being outside really works.
There’s much more below. As always, consult your own doctor (especially to consider drug-drug interactions you may have or if you’re considering upping your dose on any medication), but here’s the general advice from the interview…
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Which antihistamines should I use?
Use 2nd generation antihistamines like Allegra (fexofenadine), Zyrtec (cetirizine), or Claritin (loratadine). These are now available without prescription. The generic forms are just fine. There’s no need to use 1st generation antihistamines, such as Benadryl (diphenhydramine), because they probably do not work as well, and they certainly have more side effects like drowsiness.
Currently, I am using loratadine, but I chose that at random. Dr. Robinson says it’s possible that the other options would be more effective. So I may switch at some point. I’ve used Allegra in the past and found it helpful. Bottom line: Use 2nd generation antihistamines like Allegra (fexofenadine), Zyrtec (cetirizine), or Claritin (loratadine).
Can I take a 2nd generation antihistamine more than once per day?
Yes. Even though the bottles often say “24-hour relief,” they tend to wear off after 12 hours, and it is totally safe to take a 2nd dose of most of these products. In fact, for severe allergic reactions, we often put patients on 4 doses per day for a few days—albeit those are more acute cases. I’d been taking loratadine (10 mg) twice per day because I read that it might help a bit. That said, I’d been feeling guilty that I was maybe doing something wrong. But it turns out that twice per day (and even three times per day) is completely fine. So, I’ve been doing twice daily without any guilt, and I am finding that helpful. Bottom line: 2nd generation antihistamines can be taken twice or even three times per day routinely. In some cases, four times per day is fine, too, temporarily. (Again, please run this by your physician if you take other medications. Also, if you are breastfeeding, realize that these meds work so well that they can and do decrease milk supply).
When should I take nasal sprays?
Flonase (fluticasone) is a steroid that works well. But I’m always concerned that by the time I am spraying it up my nose, my runny nose (“allergic rhinitis” being the official term) is basically negating the effect. I spray it up there, and 2 minutes later I have to blow my nose. Did the spray even have time to work? Probably not, says Dr. Robinson. So it might be best to take a hot shower and clear your nose out (and maybe take your antihistamine first) and then spray once you’re cleared up a bit. But the really important insight that I had not realized is daily fluticasone spray use should begin weeks before allergy season. That way, my body is actually ready to fend off the allergens. So rather than waiting until the tree pollen explodes next year (usually April and May), I’ll be following Dr. Robinson’s advice and starting in the middle of March. Saline rinses are also great. I don’t use them, but many people swear by them. Bottom line: Take steroid nasal sprays like fluticasone before allergy season starts. Once your symptoms do begin, take it after you’ve cleared things out up there so that it actually works.
How often can I take my eye drops?
I use Patanol (olopatadine) eye drops. One formulation says once per day. Another says twice per day. Can I take them more often? No, probably not, according to Dr. Robinson. But using rewetting drops (I use Systane) can help in between doses. (Don’t use Visine; allergists and eye doctors hate Visine, but I’ll leave that aside.) Also keep your rewetting drops/artificial tears in the fridge. It feels so good when they’re cold. (No need to keep olopatadine cold, though.) Bottom line: Don’t take olopatadine eye drops more than the bottle says. But you can get some relief from cold rewetting eye drops.
Decontamination. After I spend time outside, does it matter if I shower?
Yes. Yes. Yes. I really had not thought of this, but when you’re outside for a while, the pollen gets all over your body. Then, even after you’re inside, your eyes, mouth, and nose are continually getting re-exposed to that pollen. So, just like you’d remove clothes and shower after being exposed to poison oak or poison ivy, do the same after being outside when there’s tons of pollen. I started doing this after talking to Dr. Robinson and—oh my goodness—the difference has been massive. I also do this before I lie on the couch or bed. I don’t want to turn my house into a pollen convention! No need to rinse your contact lenses, though. They actually do a nice job of creating a barrier for your eyes.
Should I bathe my outdoor pets more during my tree pollen allergy season?
Yep! They also harbor allergens. So, the more you can remove pollen from your indoor life, the better.
Do allergy shots work?
Yes, and many people are literally cured of their allergies after they’ve had allergy shots. That said, it’s a time commitment because it is not a one-and-done type of thing. I keep putting this off. But it’s an option for the future that I may consider.
If you have tips or questions, leave them below. I’ll try to get Dr. Robinson or another allergy specialist to chime in.