Hay Fever
Hay fever is nothing to sneeze at
Hay fever is the fifth most prevalent chronic condition in the United States; more than 25 million people suffer from it. Despite its name, hay fever is not caused by contact with hay and has nothing to do with increased temperature. It's an allergic response to airborne seasonal substances like pollen from weeds, flowers, grasses, and trees, as well as substances like mold, dust mites, animal dander, and tobacco smoke.
Synonyms
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- Seasonal allergic rhinitis, otherwise known as an allergic reaction of the lining of the nose caused by the change of seasons
- Pollinosis
Detailed Description
When pollen, or another particle in the air that can cause an allergic reaction, enters the nasal passage of someone who suffers from allergic rhinitis -- or hay fever -- it reacts with immunoglobulin E ("IgE") antibodies of immune cells known as mast cells and basophils. When an allergen and the IgE antibodies in your blood stream combine, the cells release chemicals, such as histamine, that produce or control inflammation of the nose and throat. These chemicals, also known as mediators, are responsible for symptoms like itching, watery eyes, sneezing, and coughing.
The mediators produce an immediate response -- within two to 10 minutes of exposure to the allergen -- in more than 90% of people susceptible to hay fever. The reaction lasts up to 90 minutes. And four to eight hours later, the symptoms usually occur again in approximately 50% of those with seasonal hay fever. If the exposure to pollen is severe enough, the symptoms become persistent throughout the pollination season.
Many of the drugs used to treat hay fever stop the body from releasing mediators or block the effects of the mediators, and stop you from feeling an itchy throat, watery eyes, and don't allow your body to react to irritating pollen, dust, or animal fur as it normally would.
Some characteristics of hay fever include:
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- Nasal stuffiness and congestion
- Pale, swollen mucous membranes
- Sneezing
- Watery eyes
- Sensation of plugged ears
- Sleeping difficulties
- Voice change
- Postnasal drip
- Itchy nose, eyes, ears, and palate
The symptoms of hay fever can be controlled with prescription and nonprescription drugs, and by avoiding contact with allergens. Without treatment, people with hay fever will continue to feel its cold-like symptoms, while under care of prescription drugs and your health professional, your daily life will be more comfortable and more productive. Left untreated, hay fever symptoms could result in ear infections, sinus infections, and asthma attacks.
Once people with hay fever know what triggers their allergic reactions, there are actions they can take. They can rid their homes and offices of the offending material (such as dust, animal fur, etc.) in the case of indoor allergies to prevent further reactions. If the trigger is seasonal pollen, people can limit their exposure by avoiding high pollen levels. For many people with hay fever, over the counter medications relieve some of the symptoms, and many people can live with their condition without seeking further medical expertise. However, if over the counter drugs do no provide sufficient relief, see your doctor.
How Common Is Hay Fever?
More than 25 million Americans are affected by hay fever, making this the most common of all allergies. About 17 million are people under 45, and more people in the South than in any other region have the condition. On average, allergies develop before age 30, but children around age 10 commonly feel the onset of the condition. However, allergies may develop at any age. The incidence of hay fever is equivalent in men and women.
Established Causes
Hay fever is a response to airborne allergens that irritate the nose, throat, ears, or sinuses.
Some of these allergens are seasonal, and include the following:
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- Tree pollens (especially in springtime, when leaves unfold)
- Grass pollens (more prevalent in summertime)
- Ragweed pollens (the most common offender, present in the fall)
Other allergens are present year-round, such as:
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- Dust mites
- Molds
- Animal dander (dry scales shed from the skin of pets)
Risk Factors
If your parents had hay fever, you are at a higher risk for the development of this allergy. Asthma sufferers also have a tendency towards hay fever. People frequently exposed to allergens may, over time, develop an allergic reaction.
Risk factors are traits or behaviors that may make you statistically more likely than others in the general population to have a certain condition. They are not necessarily "causes" of the condition.
Treatment Overview
The goals of treating hay fever are to control the symptoms of hay fever while allowing normal daily activities. Avoiding allergens that trigger a reaction and treating symptoms with over the counter or prescription drugs will improve the quality of life for people susceptible to the condition.
In extreme cases of unpleasant suffering from allergy effects, hay fever sufferers should visit their primary care physician or an allergy specialist. These professionals can give serum shots to desensitise sufferers from the allergens that trigger nuisance allergic reactions. Usually after two to four months of allergy serum shots, people begin to have noticeable relief from their hay fever symptoms. However, most sufferers need to continue the shots for 12 to 36 months or longer to experience prolonged relief.
Treatment Considerations
The first step in treatment is to avoid or remove airborne allergens from your environment, if possible -- not always an easy task, although it can be done for indoor allergens.
Exercise can also play a role in treatment. A regular routine of vigorous exercise has been found to help reduce hay-fever-related inflammation. However, if you exercise outdoors, don't expose yourself to pollens or molds that can onset a hay fever attack.
Drug Therapy
Over-the-counter and prescription medications are used to control symptoms. They include antihistamines, decongestants, eye drops, and nasal spray. Saline nasal sprays and drops can also help soothe irritated nasal tissues. If you're highly susceptible to allergens, medications may only bring limited relief. The severity of the symptoms may be reduced, but you'll probably have to tolerate more side effects.
Drugs most commonly prescribed
If your conditions are mild, you can start with over-the-counter medical treatment:
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- Nonprescription decongestants like oral Sudafed (pseudoephedrine) or Neo-Synephrine (phenylephrine)
- Oral nonprescription antihistamines like Benadryl (diphenhydramine) or Tavist (clemastine)
- Newer oral antihistamines, which have few or no sedating effects, are available by prescription (Allegra, Claritin, Zyrtec)
If symptoms persist or are severe, a physician can prescribe a combination of drugs, including antihistamine, corticosteroid nasal spray, decongestant, or eye drops.
Second choices
Immunotherapy (allergy shots) may be used. Physicians use this technique to help build immunity to the offending allergen. Your doctor will introduce increasing doses of the allergen on a weekly basis, and the body will eventually become desensitized and have a reduced response to the allergen.
Surgery
If your nasal septum is deviated (distorted) enough to significantly interfere with the benefits of medication, surgery may be performed to correct the deviation.
Possible Complications
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- Sleeping difficulty
- Chronic fatigue
- Sinus infection
- Ear infection
- Nasal polyps
Quality of Life
If you have a mild or moderate case of hay fever, you should be able to maintain your quality of life with the use of medications, or improve the quality of your life with desensitizing shots. While most hay fever sufferers don't find the condition debilitating, it can be annoying. Luckily for most people, there are many over the counter and easily-prescribed solutions to prevent onset and reduce suffering.
Adults who develop hay fever will probably retain the condition. However, the allergies may stop if they move to an area where the substances causing the allergies are not present.
Considerations for Women
The physiological changes that take place during pregnancy may aggravate hay fever.
Considerations for Children and Adolescents
Children with seasonal allergies may continue to have hay fever as they grow older, or the allergies may go away as they age. Other factors, such as genetics, and conditions of their living environment and region, will effect their susceptibility to hay fever
Considerations for Older People
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- Older people may experience more side effects of medication
- The number and specific types of allergies may change
- Symptoms may eventually decrease as a person ages
Supplements
Vitamin C is a natural antihistamine. In one study, people had their blood histamine levels measured and then took vitamin C (1,000 mg/day) for three days. Afterward, they had lower histamine levels in their blood. [1]
Herbs
Stinging nettle is a traditional herbal treatment for respiratory problems. In one study, herb researchers gave 98 hay fever sufferers either a placebo or nettle (600 mg of freeze-dried leaves). The nettle users reported milder hay fever symptoms. [2]
Homeopathy
Homeopathic medicine is based on the idea that some conditions can be cured by administering small amounts of drugs or substances that, in a healthy person, would produce symptoms like that of the disease -- thereby working with, not against, the body's natural defense systems.
Purchase commercially prepared homeopathic medicines, or visit a professional; do not attempt to mix your own, as many of the substances are dangerous in more than tiny amounts.
Experts are divided over whether there is a basis for homeopathy. In a University of Glasgow, Scotland, study, researchers gave either a placebo or a homeopathic medicine (a microdose of grass pollens) to 144 people with hay fever. The homeopathic group felt significantly less need for antihistamines. [3]
Relaxation
Many hay fever sufferers notice that in times of stress, their allergies get worse. A relaxation program may help. Practice the relaxation therapies that appeal to you: meditation, deep breathing, massage, hot baths, yoga, or imagery/visualizations. Exercise also confers similar benefits.
Sources
1 Werbach, M. Nutritional Influences on Illness. Tarzana, CA: Third Line Press, 1994.
2 Mitman, P. "Randomized, Double-Blind Study of Freeze-Dried Urtica Dioica in treatment of Allergic Rhinitis," Nat. Coll. of Naturopathic Med., Portland, 1988.
3 Reilly, D., et al. "Is Homeopathy a Placebo Response? Controlled Trial of Homeopathic Potency with Pollen Hay Fever as a Model," Lancet Oct. 10, 1986.
Websites & Organizations
American Academy of Allergy, Asthma & Immunology
611 East Wells St.
Milwaukee, WI 53202
Phone: 414-272-6071
American Academy of Otolaryngology - Head and Neck Surgery
Public Service Brochure
Allergy and Asthma Network
2751 Prosperity Avenue, Suite 150
Fairfax, VA 22031
Phone: 800-878-4403
Fax. 703-573-7794
American Institute of Preventive Medicine
Asthma & Allergy Foundation of America
1717 Massachusetts Ave., Suite 305
Washington, DC 20036
Phone: 800-7-ASTHMA (800-727-8462)
National Institute of Allergy and Infectious Diseases
9000 Rockville Pike
Building 31, Room 7A-03
Bethesda, MD 20205
The National Institutes of Health
Phone: 800-644-6627
Sources for This Article
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