Q: What causes my allergies to flare up in the spring?
Dr. Jim Mumper: Pollen is the most likely cause. Your immune system has mistakenly learned to remember the pollen released by various plants as potentially harmful, and responds with the familiar allergic symptoms. Each species of plant releases pollen at about the same time every year. Trees are usually the first plants to release pollen, usually in the early spring. Grasses come next in the spring and early summer. Weeds generally release their pollen in late summer and fall. The specific types of pollen and the time of their release depend upon the local climate and vary around the country.
In Virginia, during the spring, pollinating trees are responsible for causing hay fever. Over the summer, grasses and weeds are the main producers of pollen. In the fall in Virginia, weeds are mostly to blame, with ragweed being the main culprit. Hay fever can also be caused by mold releasing its spores, from approximately late March until November, usually peaking in late summer and early fall.
Q: How do I know it's allergies versus a cold?
Dr. Virginia Kladder: It is sometimes difficult for people to know whether they have a cold or if they are suffering from allergies because allergies and colds share some of the same symptoms. They are, however, very different diseases.
Seasonal allergies are an immune system response triggered by exposure to an allergen. This response can induce symptoms that are similar, but not identical, to the common cold. The most common signs and symptoms of seasonal allergies are itchy eyes and a runny or stuffy nose. Signs and symptoms may sometimes include fatigue, cough and sore throat, but never fever or general body aches and pains. Seasonal allergies cannot be passed from person to person and usually last for several weeks. The only way to truly know if you have allergies is to be tested for them in your doctor's office.
Signs and symptoms of a "common cold" — which is caused by a virus — usually include cough, sore throat, runny or stuffy nose, and sneezing. You may also feel tired and, occasionally, experience body aches and pains. Rarely, you may have a mild fever. One typically does not experience itchy eyes with a cold. A common cold is easily spread from person to person and usually lasts from three to 14 days.
Q: What are some over-the-counter medicines that are able to provide me some relief? Are there any side-effects with these?
Dr. Stuart Solan: There are a number of over-the-counter medications available to help relieve symptoms of allergy. One such category of drugs is known as antihistamines. The allergic reaction triggers the release of a substance called histamine contained in cells in the body known as mast cells. Histamine causes nasal congestion, increased mucus production and can cause itching of the nose, throat and eyes. Antihistamines help block the ability of allergens to trigger the release of histamine. Examples of over-the-counter antihistamines include Chlor-Trimeton, Benadryl, Dimetane and Tavist which all share drowsiness as a potential side effect. Also these older antihistamines can block the ability of the urinary bladder muscle to squeeze to some extent which can result in difficulty voiding in men with enlarged prostates. Claritin is largely free of those two side effects just mentioned. The antihistamine brand names mentioned above are available as less expensive generics.
Decongestants are classes of medications that work by making the muscle that surrounds blood vessels constrict thereby occupying less space in the mucous membranes in the nose. This results in a temporary shrinkage of the thickness of the nasal mucous membranes resolving in greater ease of breathing through the nose. Sudafed is a brand name decongestant which generically is known as pseudoephedrine. There are a variety of antihistamines available that are combined with a decongestant. Some of these products will indicate they contain a decongestant by adding the letter D after the product such as Claritin-D. Dimetane contains just an antihistamine while Dimetapp contains the antihistamine plus a decongestant. Over-the-counter nasal spray decongestants such as Afrin and Neo-Synephrine are available but use for 3 days or more can cause rebound congestion of the nasal mucous membranes. Most otolaryngology's (ear, nose and throat specialists) recommend avoidance of nasal decongestant sprays for allergic rhinitis. Decongestants cause insomnia in some patients and have the potential for elevating blood pressure. Also decongestants can cause constriction of one the muscles at the base of the bladder making voiding difficult for men with enlarged prostates.
Those patients who have itching of their eyes from allergy have what is called allergic conjunctivitis. One product available over-the-counter for allergic conjunctivitis is an antihistamine eye drop called Ocu-Hist.