This post was originally published in spring 2017. Since I'm hearing people complain about horrendous allergies right now, I thought it would be a good time to repost this.
Every year, allergy season gets worse. Seasonal allergies are now so common that it's estimated between 10% - 25% of people worldwide suffer from them. Evidence suggests that this percentage is increasing. Approximately 40 million people in the US experience significant seasonal allergy symptoms, and it’s even more prevalent in younger populations, affecting up to 40% of children and adolescents. People who have never had seasonal allergies are sneezing away this year. Antihistamines and decongestant sales are out-of-control, too.
Is it a higher-than-normal pollen count? Our compromised immune systems? Pollution? Global warming?
Most likely it's all of the above, but the real question is: How do you get relief?
What causes seasonal allergies?
Seasonal allergic rhinitis, otherwise known as hay fever, occurs during pollination season, primarily in the spring, summer, and/or fall (as opposed to perennial allergic rhinitis with mostly year-round symptoms caused by indoor allergens such as dust mites, animal dander, and mold spores). But global warming has extended the usual pollination seasons. Along with persistent air pollution, you may never get a break.
When pollen or another pathogen is inhaled, histamine is released as part of the body's immune process. As the histamine does its work expelling the foreign invader, it induces an inflammatory response. This inflammation manifests in what we think of as the classic allergy symptoms: runny nose, sneezing, watery eyes, congestion, and sometimes hives.
Unfortunately, allergies can have a wider effect on our quality of life. Feeling like a zombie or in perpetual brain fog is a common association with seasonal allergies. Trying to function at work or even socially becomes stressful and exhausting. Your energy tanks. If allergies continue untreated, they can go on to trigger asthma and respiratory or ear infections, as well.
Most of us can't stand it. We seek relief and the easiest, most accessible way is to pick up some Claritin, Zyrtec, or other OTC pill.
Antihistamines + decongestants can help, but at what cost?
These were created to inhibit the effects of histamine at the receptors and provide relief of the classic seasonal allergy symptoms listed above. (By the way those are considered "early reactions." Nasal obstruction is a "late reaction" and is only minimally relieved by antihistamines.
First generation antihistamines are highly lipophilic. This means they readily cross the blood-brain barrier, leading to sedation, drowsiness, and decreased cognitive processing. In other words, if you didn't feel like a zombie before, you definitely will while taking these.
Second and third generation antihistamines are less able to cross the blood-brain barrier, making them less sedating than those first ones. They also tend to stay in your system longer, so you don't have to dose as frequently.
These don't act on histamines but help shrink the blood vessels in the nose so air can flow through more easily. (This is what you'd take for the "late reaction" nasal obstruction symptoms.)
Because they're chemically related to adrenaline, decongestants' side effects are a jittery, anxious feeling, difficulty sleeping, and an elevated blood pressure and pulse rate.
Even though you can get these meds over the counter, there are real dangers in taking antihistamines and decongestants.
As described above, decongestants are stimulants that raise blood pressure and pulse rates, so anyone who has an irregular heart rhythm, high blood pressure, heart disease, or glaucoma should not use them.
Besides the obvious "don't operate heavy machinery" advice while taking antihistamines, the National Capital Poison Center cautions you to not take extra doses or double up with another antihistamine. Also, taking them with other sedatives (even alcohol) can cause seizures and hallucinations.
Then what about when you combine antihistamines and decongestants, as many products do? It sounds good in theory, as one is a stimulant and the other a sedative, but that's not how it plays out in reality.
Common side effects of combo treatments
Thickness of the bronchial secretions
Difficult or painful urination
Dryness of mouth, throat, and nose
Loss of appetite
Ringing or buzzing in ears
Stomach upset or pain (more common with pyrilamine)
Unusual excitement, nervousness, restlessness, or irritability
Unusual sleepiness, weakness or drowsiness, or extreme tiredness
A Different Way of Treating Seasonal Allergies
Even if you decide to occasionally use an OTC pill to alleviate a particularly bad period of symptoms, you should know that there are other ways to take care of yourself during hay fever season.
Focus on prevention
Avoid inhaling pollen in the first place.
To do this, find out when pollen counts and pollutants are at their worse and stay indoors, if possible. Keep your windows closed during this time. Check out the Weather Underground app for listings in your area.
Ease up on your immune system
It’s working overtime to clear the pollen out of your system. If you also eat foods that you’re sensitive to, you’re adding another burden to its heavy load.
You can read all about food sensitivities by clicking here. Either eliminate any foods that you suspect you might be sensitive to, or get tested and know for sure. I highly recommend EverlyWell for reliable home testing.
Eat low histamine-releasing foods during allergy season.
In addition to avoiding foods that you’re sensitive to, foods that are high in histamine can tax your immune system when it’s already struggling. This article takes a deeper dive into this subject than I'll go into here.
Remember: You don't need to rigidly adhere to this diet. Eat more from the "Enjoy" list and less from the "Avoid" list to help ease your symptoms. Also, you won't need to eat like this forever--just while your allergies are problematic.
Low histamine foods to enjoy
Freshly cooked pastured or wild animal protein
Gluten-free grains, such as rice or quinoa
Fresh fruits and vegetables
Dairy substitutes, such as nut milks
Healthy fats, such as olive oil and coconut oil
Fresh herbs and herbal teas
High histamine foods to avoid
Fermented foods and drink, such as wine, sauerkraut, yogurt, kombucha, vinegar, cheese, chocolate (yes, chocolate is a fermented food)
Certain vegetables, such as avocados, eggplant, spinach, tomatoes
Nuts, such as cashews, walnuts, peanuts
Soothe with saline
Who knew the substance you sprinkle on food to make it taste good could be so comforting? Using a rinse or spray with salt helps to physically remove allergens in your nose, while calming down and moisturizing the inflamed passageways.
Make your own solution to use with a neti pot (this one's actually charming) or nasal aspirator--or buy a pre-made spray (this one uses xylitol which appears to have an even greater effect than saline alone).
Sniff some essential oils
Do you remember Vick's VapoRub? You can harness its power (without smearing its other synthetic ingredients on yourself) by inhaling eucalyptus essential oil. Other helpful EOs for hay fever are peppermint, lavender, and lemon.
You can use any of these in a room diffuser, mix a few drops into some epsom salts for your bath, shake a drop or two onto a hankie and inhale, or even just take a whiff directly from the bottle. Of course, there's always a pre-made option, but it's much more expensive.
I push this advice regularly, but it's even more important during allergy season. Being dehydrated leads to greater histamine release, which means worse symptoms. And mild dehydration negatively affects our mood and cognitive processing--not good when you're already feeling like a zombie.
Drink a glass every hour, if possible. Expect to pee more. Isn't that better than being a stuffed-up mess?
Bonus: An easy morning practice that really helps!
Did you know that breathing through your mouth causes nasal blood vessels to become inflamed and enlarged? That's a recipe for discomfort even before histamine-release symptoms get involved.
I learned this exercise in The Oxygen Advantage by Patrick McKeown. Doing this every morning--along with cleaning up my diet--has greatly reduced my allergy symptoms. Greatly. This practice is very simple and doesn't take any extra time (you do it while going about your usual a.m. routine).
Nose Unblocking Exercise
Please don’t practice this exercise if you're struggling to breathe (go to your doctor!), or if you have high blood pressure or other cardiovascular issues, diabetes, or pregnancy, or any other major health concerns.
This is best done first thing in the morning, on an empty stomach.
Inhale and exhale normally through your nose
After exhaling, gently pinch your nose with your fingers to hold your breath
Walk or move with your breath held
When you feel the need to inhale, release your nose and exhale through it--it should already feel more clear
Allow your breath to calm down as you continue to breathe through your nose. If your breathing doesn't return to normal within a few breaths, you held it for too long
Wait 1-2 minutes before repeating the breath hold
Repeat for a total of 6 breath holds, seeing if you can hold your breath a bit longer each time
You can repeat this throughout your day, whenever you need some relief. If you're in public and don't want to hold your nose, you can just hold your breath without using your fingers. The more you practice this nose unblocking exercise, the longer you'll be able to hold your breath, and the better and more enduring your results will be.
Don't feel like you have to do every single one of the above things to get through this season--but if you can, lucky you! Like with anything, some practices will be easier and more effective for you than others. Experiment.
For me, avoiding most of the high-histamine foods, staying hydrated, and practicing the nose unblocking exercise daily keeps me from suffering for now. As the pollen count increases, I'll pay more attention to when I take my walk and I plan on trying the Xlear spray.
I'd love to hear from you. Are you doing any of these things? Any helpful hints that I missed?