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Breathe Easy: How to Prevent and Treat Fall Allergies

Allergies can crop up anytime, even in adults who've never suffered symptoms before. Feel better this fall with these anti-sneeze strategies.

By Beth Howard

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For Lisa Rice, 47, a marketing consultant in Austin, Texas, the trouble started last fall. "At first I was sneezing at all hours of the day," she says. Soon her nose was running nonstop. Then her eyes became red and itchy and were nearly crusted shut most mornings. She was sure it was an infection and was surprised by the doctor's diagnosis: allergies. "I hadn't experienced anything of that nature as a child or young adult," says Rice. "But my doctor said I was reacting to the cedar pollen that bothers people in this area every fall."

Allergists are diagnosing more people for the first time in their 30s, 40s and 50s, says David Rosenstreich, M.D., director of the division of allergy and immunology at Montefiore Medical Center in New York City. In fact, 50% of people with nasal allergies are diagnosed after age 18, with what are referred to as adult- or late-onset allergies.

Long-term exposure to allergens, pollution or even certain viruses can trigger symptoms like sneezing and itching. "People will frequently become allergic after they have had common viral infections like mononucleosis or even a bad cold," says Dr. Rosenstreich. In some cases, a person may have an allergy in childhood, outgrow it, but then develop seasonal allergies as an adult. Others experience allergies for the first time when they move to a place with grasses, trees or pollens that are different from those their immune system is used to.

Allergists have seen an increase in allergies among both adults and kids over the last 30 years. Researchers speculate that thanks to antibacterial soaps, hand sanitizers and other powerful germ-killing products, kids today are less likely to be exposed to the bacteria and viruses that help the immune system shift into gear and prevent them from developing allergies and asthma as they grow up. Climate change could also lead to more pollen production. The good news: Whether you've been battling symptoms your entire life or they're a recent affliction, there are smarter anti-allergy strategies and better treatments than ever before.

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Steer Clear of Pollen

Experts say avoiding the irritants that cause your misery is the first step to surviving fall allergies. "If you can decrease your exposure, there's less fuel for the fire," says Eli O. Meltzer, M.D., a physician with the Allergy and Asthma Medical Group and Research Center in San Diego.

Keep pets out of the bedroom. Animals that go outdoors pick up pollen in their fur, so they may bring on symptoms even if you're not allergic to your pets.

Keep windows closed. Run an air conditioner in your house, and in the car put the AC on the recirculate setting to keep pollen out.

Replace AC and furnace filters. Use high-efficiency filters labeled with a MERV (or minimum efficiency reporting value) rating of 11 or 12, suggests James L. Sublett, M.D., managing partner of Family Allergy & Asthma in Louisville, Kentucky. Change them every two or three months.

Check pollen counts. Visit weather.com to see how high levels are in your area and plan your day accordingly. For instance, exercise indoors when pollen counts are high—especially mid-to-late morning—or wait until early evening when counts are lowest, suggests Jill A. Poole, M.D., an allergy, asthma and immunology specialist at the University of Nebraska Medical Center in Omaha.

Wear sunglasses. They can help protect your eyes from aggravating allergens.

Shower before sleep. You'll transfer less pollen from your hair and skin to your pillow and sheets.

Use a mask for outdoor tasks. If you must be outside at peak pollen times—say, to garden or mow the grass—shield your nose with an N95-rated respiratory mask (available online at allergyzone.com or at home improvement stories), which filters out tiny pollen particles, suggests Dr. Sublett.

Allergy-proof your bed. Place your mattress, box springs and pillows in airtight plastic or allergen-proof fabric covers.

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5 Steps to Better Breathing

Fight symptoms before they strike. Take allergy medicine at least 30 minutes prior to going outside. Since an attack typically is immediate, you want to limit your body's response by making sure a drug is in your system before exposure. It's also smart to start taking meds early in the season, which may lessen symptoms when pollen reaches peak levels. "Even if you don't initially have symptoms, subsequent exposures have a priming effect," says Dr. Poole. "By midseason, it can get quite bad."

Find out exactly what you're allergic to. Your allergist will probably run a skin-prick test and monitor your reactions. From there you can customize treatment. You don't need to hibernate inside on high-pollen days if it's the family guinea pig that's making you sneeze.

Don't tough it out. Half of nasal allergy sufferers deal with regular headaches, 80 percent experience fatigue and 65 percent complain of irritability—all of which can affect productivity at work or school and quality of life. "With the right allergy treatments, you don't have to suffer from these annoyances or the more familiar sneezing and sniffling," Dr. Meltzer says.

Avoid foods that aggravate symptoms. Some people with ragweed allergies can also react to certain fruits and vegetables, like bananas, melons and zucchini. This reaction causes itching of the lips, mouth or throat.

Vacation in a low-sneeze zone. Pollen counts are lower by a body of water, such as a bay, beach or ocean.

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Cold or Allergy?
It's not always easy to tell. Symptoms are similar: sneezing, runny nose and watery eyes. But with a cold, you may also be achy and run a low grade-fever. In addition, a cold typically clears in a week or two, while allergies persist as long as you're exposed to the offending allergen.

What About Allergy Shots?
A large recent study found that immunotherapy—also known as allergy shots—reduced patients' total health costs by 50% in adults and 33% in kids. This treatment alters the body's allergic response, making it less apt to react to seasonal or other allergens. Injections introduce minute amounts of allergens like ragweed and pollen to the patient's body over a period of months to stimulate a better immune response.

Doctor's Orders

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If You Have

Take

Runny, itchy nose; sneezing

Nasal steroids (Rhinocort, Flonase, Nasonex);
nasal antihistamines (Astepro, Astelin)

Itchy, red eyes

Allergy eye drops (Patanol, Optivar, Elestat)

Nasal symptoms; generalized itching; throat tickle

Non-sedating oral antihistamines (Claritin, Zyrtec, Allegra, Xyzal)

Nasal congestion

Decongestants (Sudafed); decongestant/antihistamine combinations (Claritin D, Zyrtec D)

But only about 5 percent of people who would benefit from allergy shots get them, partly due to the hassle of having to visit the doctor every week for several months. But many doctors are offering "cluster" shots, in which patients receive several injections at each visit, altering the body's response to seasonal allergens in just a few weeks.

New Allergy Medications: Coming to a Doc Near You
Several companies are developing sublingual immunotherapy tablets—pills that deliver the same medicine as allergy shots but are placed under the tongue. The tablets have been found to reduce allergy symptoms by 25 percent more than a placebo. Widely used in Europe, sublingual immunotherapy is about a year away from expected FDA approval in the United States.

Also in the pipeline: a new therapy called Pollinex Quattro, which speeds up the injection process. The drug provides the same benefit as weekly injections but is given in a series of just four injections over a six-week period prior to allergy season. The series must be repeated in subsequent years to achieve long-lasting results. In one study, 88 percent of patients had improvement in their symptoms after the first year of shots, and 94 percent reported improvement over 2 to 3 years.

Originally published in the October 17, 2011 issue of Family Circle magazine.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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