Allergies make many wish it were still cold

By JOE GRAEDON AND TERESA GRAEDON, Ph.D. Published:

Most people look forward to spring. Warm weather means the birds are singing, the flowers are blooming, and the grass is growing ... and pollinating. That's why 36 million Americans may wish it were still freezing cold.

In the winter, there's no pollen in the air. But this time of year the air is filled with allergens. For people who react to them with sneezing, sniffling and red, itchy eyes, May is the cruelest month.

Treating allergy symptoms used to be fairly simple. You went to the doctor for an antihistamine or decongestant. In those days, Benadryl and Sudafed were available only with a doctor's prescription.

Now, you can buy dozens of antihistamines (including Benadryl) without prescriptions. Claritin used to be the most prescribed allergy medicine in America, but when it lost its patent, the manufacturer took it over the counter. Although expensive, it offers symptom relief without drowsiness. There is some controversy, however, as to whether it is as effective as the old-fashioned sedating antihistamines.

Decongestants containing pseudoephedrine are a little trickier to purchase these days because many states have restricted access to this compound. Too many people were using it as an ingredient to make methamphetamine. You can still buy pseudoephedrine, but you will have to ask the pharmacist.

Manufacturers have come up with alternatives such as phenylephrine, which is now available in Sudafed PE. It can't be converted into methamphetamine.

The real action in allergy treatment these days is back in your doctor's office. There are so many prescription allergy options that it is bewildering. Not only are there prescription oral antihistamines such as Clarinex, Allegra and Zyrtec, there are also nasal sprays like Astelin.

Doctors can also prescribe steroid nasal sprays that calm inflammation in the nasal passages. Products such as Beconase, Flonase, Nasarel, Nasonex, Rhinocort and Vancenase ease allergic symptoms, usually without triggering serious side effects. In addition, a totally different type of nasal spray called Atrovent dries up nasal secretions and eases symptoms that way.

Another type of medication reduces inflammation although it contains no steroids. Singulair is a prescription medicine that blocks leukotrienes. These compounds are crucial to the development of inflammation. Unfortunately, a recent study showed that over-the-counter pseudoephedrine is just as helpful for allergy symptoms as Singulair (Archives of Otolaryngology Head and Neck Surgery, February 2006).

If prescription and over-the-counter drugs are too daunting, perhaps an herbal remedy would be appealing. European physicians sometimes prescribe the herb Urtica dioica (stinging nettle) to relieve nasal allergy symptoms.

The Ayurvedic tradition of India encourages nasal washing with a neti pot. This "Aladdin's lamp" device allows salt water to be poured into one nostril and exit the other. This is supposed to clear the nasal passages of pollen and other allergens.

Given how many allergy treatments are available, figuring out which to take can be a challenge. Ask your doctor which ones will be most effective for you and least likely to cause side effects.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer questions. E-mail them in care of this newspaper or e-mail them via their Web site: www.PeoplesPharmacy.com.

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