Explain seasonal allergy treatments like I am 4.
June 2, 2023 9:05 AM Subscribe
I've been a seasonal allergy person most of my life, but this past season has knocked me out and made me sicker than ever. I am here to learn from your combined wisdom.
What I already do:
Neti pot up to 2x daily, then Flonase and Astropro;
take Zyrtec and Chlortrimeton;
early morning exercise, Neti pot and shower after, shower before bed;
hot washed all my linens;
have air purifiers with new filters running 24/7;
occasional nasal steaming;
stay indoors as often as possible;
morning tonic of local honey and lemon;
daily psuedoephidrine if I'm super stuffed;
deep cleaning of all surfaces for dust, dander etc.
This year it's the worst ever. I had COVID in February and my daily symptoms are massive congestion with constant runny nose, when I Neti pot one side is fine but one side sort of refuses to drain well and I can't fully blow out of that side, headaches and exhaustion. It's been ongoing for about 4 weeks now and it really sucks.
What am I doing wrong? Please share how you manage allergies.
What I already do:
Neti pot up to 2x daily, then Flonase and Astropro;
take Zyrtec and Chlortrimeton;
early morning exercise, Neti pot and shower after, shower before bed;
hot washed all my linens;
have air purifiers with new filters running 24/7;
occasional nasal steaming;
stay indoors as often as possible;
morning tonic of local honey and lemon;
daily psuedoephidrine if I'm super stuffed;
deep cleaning of all surfaces for dust, dander etc.
This year it's the worst ever. I had COVID in February and my daily symptoms are massive congestion with constant runny nose, when I Neti pot one side is fine but one side sort of refuses to drain well and I can't fully blow out of that side, headaches and exhaustion. It's been ongoing for about 4 weeks now and it really sucks.
What am I doing wrong? Please share how you manage allergies.
Have you ever been to an allergist? My inexpert opinion is that you're taking far too many concurrent OTC treatments that obviously aren't working. And I say this as a person who takes two allergy drugs daily and tops off with a third when times are bad.
When you go to an allergist they can do a panel test to see what you're actually allergic to, and then give you drugs that actually target those allergen responses you're having.
For instance I am on 10mg OTC loratadine in combo with a prescribed 10mg montelukast, which delivers a 1-2 punch of both antihistamine and antileukotriene to target the two main allergic response types I have. I am not being melodramatic when I say this changed my life. For me this works to keep my allergy symptoms at bay all but maybe a dozen days out of the year.
You're doing too much on your own that's not working. You deserve professional help.
posted by phunniemee at 9:19 AM on June 2, 2023 [20 favorites]
When you go to an allergist they can do a panel test to see what you're actually allergic to, and then give you drugs that actually target those allergen responses you're having.
For instance I am on 10mg OTC loratadine in combo with a prescribed 10mg montelukast, which delivers a 1-2 punch of both antihistamine and antileukotriene to target the two main allergic response types I have. I am not being melodramatic when I say this changed my life. For me this works to keep my allergy symptoms at bay all but maybe a dozen days out of the year.
You're doing too much on your own that's not working. You deserve professional help.
posted by phunniemee at 9:19 AM on June 2, 2023 [20 favorites]
From what I understand this particular spring has just sucked for allergies. I had a day like that myself.
But - it was only one day. The biggest reason that I haven't seen an allergist for my own case is because my own symptoms respond to OTC stuff - so I have a mild enough case that it's almost not worth it. You sound like you have a much, much stronger allergic reaction, and it indeed may be time to speak to an allergist to get some help managing this.
posted by EmpressCallipygos at 9:23 AM on June 2, 2023
But - it was only one day. The biggest reason that I haven't seen an allergist for my own case is because my own symptoms respond to OTC stuff - so I have a mild enough case that it's almost not worth it. You sound like you have a much, much stronger allergic reaction, and it indeed may be time to speak to an allergist to get some help managing this.
posted by EmpressCallipygos at 9:23 AM on June 2, 2023
This is likely related to having Covid (or long Covid and increased MCAS reactions) and would be a good place to start looking for solutions. There is a lot of research and literature going on now. If you do see a doctor, see someone who is taking Covid seriously and has an understanding of long Covid. Importantly, wear a mask and try to avoid future infection.
posted by Crystalinne at 9:24 AM on June 2, 2023 [3 favorites]
posted by Crystalinne at 9:24 AM on June 2, 2023 [3 favorites]
From personal experience: sugar, sugar and milk, ice cream. These all make my seasonal allergies much worse. Perhaps they’re already excluded from your diet? Worth a try if you are still consuming ‘em.
posted by xaryts at 9:32 AM on June 2, 2023
posted by xaryts at 9:32 AM on June 2, 2023
Get thee to an allergist. They can test you and tell you what common (or perhaps even uncommon) allergens are your particular triggers, they can prescribe medications for your specific needs, and they can offer you shots (covered by insurance) or drops you put under your tongue (not covered by insurance IME) that will (eventually) reduce your sensitivity.
Under an allergist's guidance, I take Cetirizine (brand name: Zyrtec) at night and Fexofenadine (brand name: Allegra) in the morning. I also have a prescription for Fluticasone (brand name: Flonase) that I can't take regularly because nasal steroids all inevitably lead to unending nosebleeds for me, but when things get really bad I can take it for a couple weeks just to get over the hump. I can also take Pseudoephedrine when I'm desperate, but it's like being constantly overcaffeinated, with jitters, sweatiness, and increased insomnia (extra fun on top of my chronic sleep disorder) so I reserve that for things like plane flights where the sinus headaches can be crippling.
I kind of lived with my symptoms and that array of medications until I also had eczema set in. At that point I swung around to getting allergy shots, and they've made a huge difference for me. Go see an allergist and find out what your options are. It's like a two year commitment to visit the allergist every week or (eventually) every other week, but I'm glad I did it.
Bonus tip: when I had FSA money to burn in a hurry I bought a "nasal irrigation system" (essentially a neti pot with an aquarium motor, or a low pressure Water-Pik with a soft tip for your nose) and I find it useful. It's harder to maintain than a neti pot, but you don't have to try as hard to find the one angle where the neti pot is effective so it's more comfortable to use and the (mild) pressure of the pump seems pretty effective at getting past the problem of complete blockage on one side only. Using it when you recover after acute sinusitis can be really alarming, though.
posted by fedward at 10:33 AM on June 2, 2023 [1 favorite]
Under an allergist's guidance, I take Cetirizine (brand name: Zyrtec) at night and Fexofenadine (brand name: Allegra) in the morning. I also have a prescription for Fluticasone (brand name: Flonase) that I can't take regularly because nasal steroids all inevitably lead to unending nosebleeds for me, but when things get really bad I can take it for a couple weeks just to get over the hump. I can also take Pseudoephedrine when I'm desperate, but it's like being constantly overcaffeinated, with jitters, sweatiness, and increased insomnia (extra fun on top of my chronic sleep disorder) so I reserve that for things like plane flights where the sinus headaches can be crippling.
I kind of lived with my symptoms and that array of medications until I also had eczema set in. At that point I swung around to getting allergy shots, and they've made a huge difference for me. Go see an allergist and find out what your options are. It's like a two year commitment to visit the allergist every week or (eventually) every other week, but I'm glad I did it.
Bonus tip: when I had FSA money to burn in a hurry I bought a "nasal irrigation system" (essentially a neti pot with an aquarium motor, or a low pressure Water-Pik with a soft tip for your nose) and I find it useful. It's harder to maintain than a neti pot, but you don't have to try as hard to find the one angle where the neti pot is effective so it's more comfortable to use and the (mild) pressure of the pump seems pretty effective at getting past the problem of complete blockage on one side only. Using it when you recover after acute sinusitis can be really alarming, though.
posted by fedward at 10:33 AM on June 2, 2023 [1 favorite]
+1 to the suggestions to see an allergist.
Also feel free to disregard if you've already done this, but have you asked for a referral to an ENT doctor to check your sinuses? You're assuming it's allergies, but it could be a nasty post-viral infection in there somewhere (or a combination of both). I know multiple people who came out of COVID with lingering sinus and chest infections, it can really mess up your tubes.
posted by fight or flight at 10:44 AM on June 2, 2023 [2 favorites]
Also feel free to disregard if you've already done this, but have you asked for a referral to an ENT doctor to check your sinuses? You're assuming it's allergies, but it could be a nasty post-viral infection in there somewhere (or a combination of both). I know multiple people who came out of COVID with lingering sinus and chest infections, it can really mess up your tubes.
posted by fight or flight at 10:44 AM on June 2, 2023 [2 favorites]
Nthing going to your doctor. I use montelukast as well and it helps alongside daily OTC treatment. Additionally, I also did a course of steroids recently just to knock down all of the sinus inflammation that the OTC treatment didn't touch; it really helped.
And also getting a referral to an ENT who migh thave other ideas.
posted by TwoStride at 10:53 AM on June 2, 2023
And also getting a referral to an ENT who migh thave other ideas.
posted by TwoStride at 10:53 AM on June 2, 2023
- Check your laundry detergent. Get one that's fragrance free and, yes, avoid propylene glycol - even in people not "sensitive" to it, it *increases absorption of other substances*.
- Check your freshly-washed clothes to make sure all detergent is rinsed out - fill the sink with water, immerse some wet laundry - maybe a light shirt - swish it around, then hold it up so water falls from it into the sink water. Are there bubbles? You know what that means ... rinse again. Make sure you're not using too much detergent. With some washers (especially HE ones), it can take three cycles to rinse out all detergent with some loads. I'm not kidding! Check!
- Fabric softener? Beware.
- Scented deodorant, shampoo, hair product, people? Avoid. You don't know what's in those scents. I'm talking about even mild, "it smells like clean" smells.
- Check cosmetics and anything that goes on your skin, especially near your nose. I think if your immune system is triggered anywhere it can increase symptoms generally, but that's a hazy maybe memory. Anyway, if you put something on and notice more sniffles a few minutes later, that could be a clue.
- Change your pillowcase every day.
- Cover your bed with a flat sheet, and change it as often as you need to, maybe every day.
- If you have pets, wipe them down.
- When you go out, wear a mask. When you return, damp wipe your hair, maybe wash it before bed.
- LOOK FOR MOLD
- When it rains outside, be sure run the air purifiers - that causes mold outside. Good, healthy biome mold, but not healthy for you.
- Any textiles that don't get washed as frequently as clothes -- curtains, jackets, bedspreads, sofas - wipe down with a damp cloth or seriously clean them, or cover them (I have a lot of large sheets for emergencies).
- I'm not gong to check this, but you can: does using a neti pot too much lead to more vulnerability to allergens, since the mucous membranes aren't protected by mucous?
- Avoid propylene glycol generally - again, it *increases absorption of other substances*.
- Did you wipe your walls? Your ceiling? Wiping the walls with a damp cloth makes me feel _amazing_. Sooooo clean. I think the moisture helps, but it also traps dust in the air - and how long since your walls were cleaned, really?
- The ceiling is a candidate too.
posted by amtho at 10:56 AM on June 2, 2023 [1 favorite]
- Check your freshly-washed clothes to make sure all detergent is rinsed out - fill the sink with water, immerse some wet laundry - maybe a light shirt - swish it around, then hold it up so water falls from it into the sink water. Are there bubbles? You know what that means ... rinse again. Make sure you're not using too much detergent. With some washers (especially HE ones), it can take three cycles to rinse out all detergent with some loads. I'm not kidding! Check!
- Fabric softener? Beware.
- Scented deodorant, shampoo, hair product, people? Avoid. You don't know what's in those scents. I'm talking about even mild, "it smells like clean" smells.
- Check cosmetics and anything that goes on your skin, especially near your nose. I think if your immune system is triggered anywhere it can increase symptoms generally, but that's a hazy maybe memory. Anyway, if you put something on and notice more sniffles a few minutes later, that could be a clue.
- Change your pillowcase every day.
- Cover your bed with a flat sheet, and change it as often as you need to, maybe every day.
- If you have pets, wipe them down.
- When you go out, wear a mask. When you return, damp wipe your hair, maybe wash it before bed.
- LOOK FOR MOLD
- When it rains outside, be sure run the air purifiers - that causes mold outside. Good, healthy biome mold, but not healthy for you.
- Any textiles that don't get washed as frequently as clothes -- curtains, jackets, bedspreads, sofas - wipe down with a damp cloth or seriously clean them, or cover them (I have a lot of large sheets for emergencies).
- I'm not gong to check this, but you can: does using a neti pot too much lead to more vulnerability to allergens, since the mucous membranes aren't protected by mucous?
- Avoid propylene glycol generally - again, it *increases absorption of other substances*.
- Did you wipe your walls? Your ceiling? Wiping the walls with a damp cloth makes me feel _amazing_. Sooooo clean. I think the moisture helps, but it also traps dust in the air - and how long since your walls were cleaned, really?
- The ceiling is a candidate too.
posted by amtho at 10:56 AM on June 2, 2023 [1 favorite]
I don't think this will help given all you already doing, but a recent article in the NY Times, "How an Allergist Gets Through Allergy Season," has a few more ideas you didn't list (I'm sharing a few in case this article is paywalled for you):
Look at online pollen trackers (pollen.com and the National Allergy Bureau), to see how bad the pollen is in your area. If the forecast is bad, take allergy meds proactively. Use a HEPA filter, not just a few regular filter. Wear sunglasses and a hat outside. In addition to showering and bathing yourself, toss all your clothes in the hamper when you come in from outside or else you might be bringing all that stuff into the house.
Having said all that, I agree that this seems to be such a high level of allergies it really justifies a visit to the doctor or allergist. Have you ever taken an allergy test to identify what you're allergic too?
I have mild seasonal allergies and my kid has really bad seasonal allergies, so I have seen the difference. When you're as sick as you are for that long, and this is impacting your life so dramatically, it's appropriate to visit the doctor. As folks said, it could be you're allergic to something inside your house, so all the tree pollen avoidance won't help at all.
posted by bluedaisy at 11:12 AM on June 2, 2023
Look at online pollen trackers (pollen.com and the National Allergy Bureau), to see how bad the pollen is in your area. If the forecast is bad, take allergy meds proactively. Use a HEPA filter, not just a few regular filter. Wear sunglasses and a hat outside. In addition to showering and bathing yourself, toss all your clothes in the hamper when you come in from outside or else you might be bringing all that stuff into the house.
Having said all that, I agree that this seems to be such a high level of allergies it really justifies a visit to the doctor or allergist. Have you ever taken an allergy test to identify what you're allergic too?
I have mild seasonal allergies and my kid has really bad seasonal allergies, so I have seen the difference. When you're as sick as you are for that long, and this is impacting your life so dramatically, it's appropriate to visit the doctor. As folks said, it could be you're allergic to something inside your house, so all the tree pollen avoidance won't help at all.
posted by bluedaisy at 11:12 AM on June 2, 2023
As a longtime extreme allergy-haver and also someone with a full sinusitis punchcard (though NAD!), your symptoms sound way more like a sinus infection than regular old allergies, even bad ones. Go to an ENT or allergist. If you live in Chicago I can tell you about the world's greatest allergist.
posted by goodbyewaffles at 11:48 AM on June 2, 2023 [1 favorite]
posted by goodbyewaffles at 11:48 AM on June 2, 2023 [1 favorite]
ENT with allergy specialty. Montelukast and allergy immunotherapy has been a wonder combo for me.
posted by cobaltnine at 12:54 PM on June 2, 2023
posted by cobaltnine at 12:54 PM on June 2, 2023
How much vitamin D are you eating? 50µg daily will do you no harm, and if you are actually a bit vitamin D deficient from being indoors a lot, might well do good things for your immune system.
posted by flabdablet at 1:17 PM on June 2, 2023
posted by flabdablet at 1:17 PM on June 2, 2023
I suffered with miserable congestion for decades. When I started using a CPAP machine for sleep apnea, the congestion improved by about 90%--in one night, and the benefit lasts through the day. Life is so much better. This might not have any relevance to your situation, but it's worth a thought.
posted by Corvid at 1:57 PM on June 2, 2023
posted by Corvid at 1:57 PM on June 2, 2023
A minor thing I would mention is that you can become resistant to allergy medications; my pulmo recommended occasionally switching. I tend to use Zyrtec during high allergy season and switch to Allegra for a while when irritants are lower.
posted by Preserver at 1:58 PM on June 2, 2023
posted by Preserver at 1:58 PM on June 2, 2023
I don’t really have any advice, but just so you don’t feel so alone, I have similarly terrible allergies and a similar regime of only sort of helpful strategies. It always blows my mind when people get relief from just taking a single antihistamine or adding a nasal spray. And yes, I have been under the care of an allergist forever and had many tests and yes it really is just that my allergies are particularly bad.
I have found allergy shots helpful but I inevitably fall off the wagon. I have gotten to “maintenance” 3 times but never stayed there.
posted by chocotaco at 2:50 PM on June 2, 2023 [1 favorite]
I have found allergy shots helpful but I inevitably fall off the wagon. I have gotten to “maintenance” 3 times but never stayed there.
posted by chocotaco at 2:50 PM on June 2, 2023 [1 favorite]
One more:
Eye wash saline is GREAT. There are also special towlettes in packets to help clean your eyes, plus of course artificial tears / non-medicated eye drops (get the ones in individual daily ampules to avoid preservatives, which can be irritating). Your eyes are always moist, always out there collecting dust, and they connect to your sinuses.
posted by amtho at 4:26 PM on June 2, 2023
Eye wash saline is GREAT. There are also special towlettes in packets to help clean your eyes, plus of course artificial tears / non-medicated eye drops (get the ones in individual daily ampules to avoid preservatives, which can be irritating). Your eyes are always moist, always out there collecting dust, and they connect to your sinuses.
posted by amtho at 4:26 PM on June 2, 2023
Like xartys, my seasonal allergies diminished dramatically after I stopped eating dairy ie zero dairy, not a spoon in coffee, not a drop here or there. I don't think it was immediate, but I used to be debilitated by hay fever & pollen allergies and now have almost none.
posted by lulu68 at 5:27 PM on June 2, 2023
posted by lulu68 at 5:27 PM on June 2, 2023
Wearing even a surgical mask while outdoors has helped my seasonal allergies a lot. I don’t do it every day, but on days when I know I’d rather not arrive at events puffy and sensitive, it helps a lot.
Changing pillowcases more often has helped.
A home routine of alternately running an air purifier with HEPA filter, then a humidifier to replace the lost moisture in the air and protect my skin and nasal mucous (and plants!), has helped. A roomba to vacuum more often has helped.
Hard to isolate a factor, but my allergies are worse when I’m underslept, eating poorly, stressed etc. When I’m rundown overall I try to cancel things and catch up on sleep, take a long bath, hold off on sugary groceries etc.. Not accessible to everyone but I’ve had more success taking stress off my body than staying at the same pace but adding more meds. (Nothing wrong with meds, I take a bunch and it sounds like you could use professional guidance on strengthening or streamlining your routine! I just haven’t been able to outrun compounding allergy misery with meds alone and straight up rest has worked better for me.)
posted by pickingupsticks at 5:58 PM on June 2, 2023
Changing pillowcases more often has helped.
A home routine of alternately running an air purifier with HEPA filter, then a humidifier to replace the lost moisture in the air and protect my skin and nasal mucous (and plants!), has helped. A roomba to vacuum more often has helped.
Hard to isolate a factor, but my allergies are worse when I’m underslept, eating poorly, stressed etc. When I’m rundown overall I try to cancel things and catch up on sleep, take a long bath, hold off on sugary groceries etc.. Not accessible to everyone but I’ve had more success taking stress off my body than staying at the same pace but adding more meds. (Nothing wrong with meds, I take a bunch and it sounds like you could use professional guidance on strengthening or streamlining your routine! I just haven’t been able to outrun compounding allergy misery with meds alone and straight up rest has worked better for me.)
posted by pickingupsticks at 5:58 PM on June 2, 2023
They say some current covid strains mimic allergies...make sure you are not testing positive.
posted by tiny frying pan at 6:30 AM on June 3, 2023
posted by tiny frying pan at 6:30 AM on June 3, 2023
Response by poster: So, yes. I forgot that I actually HAVE had allergy testing and my birch allergy is off the charts. Turns out this season has been extraordinarily bad with birch because the trees bloomed, then froze slightly, then exploded. I also forgot that the birch allergy means I cannot really chomp apples, cherries, celery or carrots, which were the mainstays of my diet.
So. Many thanks to all, I shall show myself out quietly.
(I did COVID test daily and I do appreciate that response!)
posted by yes I said yes I will Yes at 6:04 AM on June 4, 2023
So. Many thanks to all, I shall show myself out quietly.
(I did COVID test daily and I do appreciate that response!)
posted by yes I said yes I will Yes at 6:04 AM on June 4, 2023
You might consider allergy immunotherapy. I did it for two years, and my previously debilitating allergies are nearly gone now. I did injections, but there are other options, and it's worth exploring with your allergist, especially if it could eventually let you safely and comfortably play outside and eat foods you love.
posted by decathecting at 4:59 PM on June 7, 2023
posted by decathecting at 4:59 PM on June 7, 2023
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I find that wearing a good-fitting N95 helps me with acute allergies... not fun, but effective. It's an air purifier for your face. This was my allergy-meltdown technique pre-pandemic. (I discovered it because I noticed that my allergies got better when I was wearing an N95 as PPE for certain construction site tasks.)
Also, I find montelukast (a leukotriene inhibitor) a helpful complement to an anti-histamine. Leukotrienes and histamines interact with different molecular pathways, so taking two medicines to inhibit both relieves more symptoms for me than just taking one or the other. Maybe ask your doc if this could help? I take montelukast at night (a leukotriene inhibitor) and then do a azelastine nasal spray in the morning (an antihistamine). I'm not sure if azelastine works better or worse than the oral anti-histamines like Zyrtec, or if you can combine them potentially?
This all sounds really miserable. Have you talked to your doc about allergy shots or other options? (I did a weird experimental treatment for a different autoimmune disease that had the bonus side effect of attenuating my allergies, which we can PM about if you want to know more, although I'd assume you'd want to try more traditional and FDA-approved things like allergy shots first.)
posted by cnidaria at 9:18 AM on June 2, 2023 [1 favorite]