Dear Dr. Garner,
My allergies are killing me. I am afraid to go outside because every time I do, my eyes start burning, I start sneezing and get a terrible headache.
Please tell me if there is anything new for allergies. I have taken antihistamines, gotten shots, and even tried steroids. Is there anything you can think of to help me?
I love your Ask the Doctor TV show, but can never get through to you.
Allergies Woes in Astoria

Dear Allergy Woes,
Because of the severe winter we have had, allergy-related problems are on the rise. I can see from your letter that you have tried many different treatments. I am not sure how much of each type of treatment you have had, but would like to review what is available and then give you some specific ideas for your case.
The major goal in the fight of hay fever is to make your life as normal as possible, realizing that it is impossible to totally eliminate some of the symptoms you may experience.
Pollen causes some to feel miserable because the body mistakenly interprets it as a serious enemy and makes chemicals known as histamines to fight it. Unfortunately, the histamines can make you feel sick and cause all allergic symptoms you are experiencing. A major key to the treatment is to try to avoid exposure to pollen as much as possible.
This can be done by going out at times when the pollen is low, removing heavy drapes from your house which collect pollen, getting a HEPA filter air purifier for the house and a static electricity filter for you car’s air conditioning system (ask your car dealer).
Your dog or cat can bring pollen into the house and frequent baths and hair cuts for the pets may be helpful.
The air conditioner should be on in the house to further reduce pollen concentration. Nasal salt water rinses and irrigation may also help with allergy symptoms. A nasal rinse “washes out” pollen that is deposited in the nose and opens it up. Irrigation systems may help to clean the sinuses.
Let’s look at some of the treatment options available:
• Antihistamine tablets or liquid medicine – this is the simplest treatment. These reduce all the symptoms of hay fever, cutting down on congestion, itchy eyes and runny nose. The older ones like Benadryl can make you very sleepy, but the newer ones like Claritin are just as good without the drowsiness.
• Decongestants – These help by reducing swelling in the nose and eyes, and can be in the form of pills, eye drops or nose drops. It is essential that the drops not be used for more than three days in the nose, as they can cause worsening of symptoms if used for more than that amount of time.
• Steroids – may be in the form of pills, eye drops or nose drops. The pills and eye drops can be dangerous if used too long, but the nasal spray is safe and may be used for a long period of time. It may be the best defense against allergies.
• Bronchodilators – These are inhaled drugs that are used to control asthma symptoms which may be related to allergies.
• Mast Cell Stabilizers – mast cells are immune system cells which release histamine. These medications can stabilize mast cells, reducing their release of offending histamines.
• Leukotriene Modifiers – a fancy name for chemicals that the body produces when you suffer allergies. These pills prevent the chemicals from making you sick. An example of such a medication is Singulair.
• Immunotherapy – These are allergy shots and may be the most effective form of treatment if you suffer from allergies more than three months of the year. These shots expose you to gradually increasing levels of the offending allergen to help your immune system build tolerance to them.
A key to success with the pills and sprays is to start them early in the season. With the steroid nasal spray it is even better to start just before the allergy season begins.
Allergy shots may take up to three years to work.
I would suggest visiting your doctor and asking about getting started on nasal steroid spray, and a non-drowsy antihistamine such as Claritin.

*Reprinted with permission of The Tablet