Ah, spring is in the air. But unfortunately, so are billions of pollen particles that make millions of stuffed-up Americans suffer through weeks and months of sneezing, coughing, and wheezing. Even if spring and summer allergies never bothered you before, it's possible for symptoms to suddenly appear now in your 60s or 70s.
"Your immune system changes over time. Although most allergies begin early in life, it's possible to develop seasonal allergies at any age," says Dr. Mariana Castells, an allergist and immunologist in the department of Allergy, Rheumatology, and Immunology at Harvard-affiliated Brigham and Women's Hospital.
Pollen are tiny grains that fertilize plants. The primary culprits for spring and summer allergies are pollens from trees, grass, and ragweed.
When pollen is inhaled, your immune system turns on and recruits special cells to make a type of antibodies called IgE to "fight" it. These antibodies sit on top of mast cells in places the pollen reaches -- the nose, eyes, throat, and lungs -- and are commonly produced as part of an allergic reaction.
Upon encountering the pollen particles, IgE antibodies attach to them and trigger mast cells to release inflammation-fighting chemicals, such as histamine, leukotrienes, and prostaglandins.
These chemicals produce any combination of the traditional allergy symptoms like sneezing, runny and itchy nose, nasal congestion, watery and itchy eyes, scratchy throat, coughing, and wheezing. Sometimes a very brisk immune response, too much pollen exposure, and individual sensitivity, can make symptoms more severe and last longer.
Change of the season
Whether you are a new or recurring allergy sufferer, it's best to see an allergist for testing, suggests Dr. Castells.
"Skin and blood tests can confirm your specific pollen allergens and maybe find ones you didn't know about, which can help make treatment more effective." (Also, see your doctor if your allergy symptoms only affect one side, like one nostril, ear, or eye. This could be a red flag for something else not related to allergies.)
Your reaction to pollen also can vary from year to year. Weather has much to do with it. "Pollen increases when it's drier and goes down when there is more rain," says Dr. Castells.
Another variation is what's known as the priming effect. This occurs at the start of allergy season
when pollen first appears: small amounts can lead to inflammation in the body, but not enough to cause problems. "Eventually, this inflammation builds up and triggers full-blown symptoms, which are often worse than usual and harder to treat with medication," says Dr. Castells.
Her advice: begin treating symptoms at the first sign of a sniffle, scratchy throat, or itchy eyes. "This way, you can help manage inflammation before it rages out of control."
Time for medication
Over-the-counter allergy-fighting drugs can help treat most symptoms. "If you've had success with certain brands, stick with them," says Dr. Castells. "But it's possible a certain medication or product will lose its effectiveness, in which case try something else."
The most effective medications fall into three main categories. (Always check with your doctor or pharmacist before taking any new medication, and always follow the label's dosage recommendation.)
Non-drowsy antihistamines. These come in pills and nasal sprays and work to block the effects of the excess histamine that causes itchy and watery eyes, sneezing, and a runny nose. Sprays also help with congestion and postnasal drip.
Decongestants. These are available as pills, liquids, and nasal sprays. They shrink tiny blood vessels, which decreases fluid secretion in the nasal passages, helping to relieve a stuffy nose. Check with your doctor if you have heart or blood pressure problems, as decongestants can raise heart rate and blood pressure.
Nasal steroid spays. Sprays lower inflammation that causes congestion, runny or itchy nose, and sneezing. People with glaucoma should take these with caution, as they can raise eye pressure which can lead to vision loss.
You should always take steps to lower your exposure to pollen. First, keep your windows closed whenever possible, and occasionally run the air conditioner to remove pollen from the indoor air. Try to restrict outside time to the afternoon or evening when the pollen count tends to be lower. (Pollen is usually highest from about 4 a.m. to noon; sign up for high pollen alerts at www.pollen.com.) If you have to be outside when pollen is high, wear a mask, as they can block about 70% to 80% of particles.
Take a shot at allergies
For severe allergies, or when over-the-counter remedies don't work, another option is allergy shots. Here, you receive regular injections of small amounts of your allergens, with the dose gradually increasing over time. "Allergy shots do not eliminate your allergy, but they change your immune response to better tolerate it," says Dr. Castells.
Shots are done in two phases: buildup and maintenance. The buildup phase involves increasing amounts of the allergen once or twice a week for three to six months. After this comes the maintenance phase, when you get monthly injections for as long as three to five years. "When you're finished, the protective effect can last for several years," says Dr. Castells.
Allergy shots don't work for everyone, but one study found that they helped adults ages 65 to 75 reduce their symptoms by 55% and cut the amount of medication needed for symptom relief by 64%. Also, some people are not good candidates for shots, such as those with cardiovascular disease, a heart arrhythmia, or severe asthma. Beta blockers that treat high blood pressure can sometimes block the shot's effects.
If you are uneasy about injections, tablets that you place under the tongue are available for some types of allergies. (Check with your immunologist to find out if they are an option for you.) You take the tablets daily for a few weeks before and during pollen season.