Please help me breathe.

May 24, 2006 8:22 AM

I have allergies, I'm constantly congested. I used to take sudafed but can't anymore. What else can I do for relief?

I'm allergic to pretty much everything. I'm under the care of a pretty darn good allergist now, but he insisted I stop taking sudafed because we discovered my blood pressure was abnormally high. My primary care physician agreed. Great, no more sudafed + some other things my pcp recommended and my blood pressure is down.

NOW, however, I can't breathe. Okay, I can, but not much. And I have sinus headaches frequently. I'm getting allergy shots for dust and ragweed (two of my worst + most treatable via shots I guess). I take Zyrtec, which helps a bit. Benadryl at night, and Nasonex twice daily per the doctor (even though you're normally only supposed to take it once daily). Yesterday, at a follow up visit, I was so conjested they gave me a prednisone shot. Holy sweet breathing freedom . . . for a day. But the congestion is coming back.

I have a follow up in 10 days. But in the mean time, any alternative otc treatments, or outside the norm treatment ideas I can bring up to my doctor?

posted by [insert clever name here] to health & fitness (39 comments total)

Claritin works well for me.
posted by Faint of Butt at 8:24 AM on May 24, 2006

I totally empathize-- I have terrible allergies for 10-20 days of the year. Being like that constantly sounds miserable.

I haven't found a magic bullet, but reducing environmentals seems to help. Do you have a good HEPA airpurifier in your bedroom?

Also, try taking showers twice daily to get the allergens off your body.
posted by justkevin at 8:30 AM on May 24, 2006

Yeah, I found a steady dose of Claritin plus Nasarel really helped me out. My doctor put me on this combo when I was complaining about being stuffed up all the time. Works great.
posted by chrisroberts at 8:31 AM on May 24, 2006

I'm allergic to Sudafed, so I feel your pain. About the only thing that ever works for me was Benadryl (the plain pink kind, and if you take it regularly, after a while it doesn't make you sleepy anymore) and Claritin/Clarinex. Steam may help--fill a bowl up with very hot water, and put your head over the bowl and cover your head with a towel. I found that this loosened things up enough so that I could blow my nose and get a lot of the snot out. Hot showers, too.

There is an OTC cold medication on the market that is Sudafed free and is intended for people with high blood pressure. I can't remember exactly what it's called, but it should be near the cold medicines and "HBP" is in the name. I don't know how effective it is, but it may be worth a try--it may be too expensive in the long run, though.
posted by eilatan at 8:33 AM on May 24, 2006

Nasal irrigation. My allergist recommended it to me, and it helps. I use a Water Pik with a Grossan irrigator. It's not the most dignified few minutes, but ahhhhh.....
posted by The corpse in the library at 8:34 AM on May 24, 2006

Claritin D works very well for my congestion. Regular Claritin not so much.
posted by bradn at 8:34 AM on May 24, 2006

My body reacts poorly to most medicine. I've never been able to take benadryl or sudafed as they make me go totally batshit insane (hallucinating, puking, the works). I have my relief in Claritin-D. Its a godsend.
posted by nadawi at 8:36 AM on May 24, 2006

Sleeping alongside an ionizer helped me. Wash your hair a lot (more than once per day). Make sure your clothes are clean, especially shirts. Inhale tea — hold the cup to your face, and breathe the steam through your nose. Eat more frequently, and constantly sip water.
posted by cribcage at 8:37 AM on May 24, 2006

As someone with such severe allergies that I'm told not to dust my own home, eat mushrooms, dried fruit, or cheese, and that anyplace I intend to spend more than a few hours really should have a hepa filter on, I can sympathize.

Neti Pot for the irrigation. What kind of allergy control are they doing for you? shots? Rx? Is there a mold (or insert your culprit here) problem in your home or work?
posted by bilabial at 8:39 AM on May 24, 2006

I can't say I've had much success eliminating my congestion. One thing you might try (which didn't really work for me, but was a really interesting experience) is nasal irrigation. An Indian friend recommended it to me. If nothing else, you'll get to marvel at the sensation of pouring water in one nostril and seeing it come out the other. It's like discovering an orifice you never knew existed.

The allergies, on the other hand, I've had some success with this year. At one point, I was so desperate that I was trying Benadryl, Claritin, and Allegra all at once to no avail.

Then, on my mom's recommendation, I switched to showering at night. After reading an article on green tea, I switched from drinking nothing but fruit juice to drinking nothing but unsweetened iced green tea. Since making these changes, my allergies have been much better. I fell off the wagon a couple days ago (when I ran out of tea), drank juice for a day, and sneezed like crazy the following day. I went back to the tea, and things are normal again.

Oh, and one more thing - I've read that milk makes congestion worse, but it seems that that's not true.
posted by landtuna at 8:43 AM on May 24, 2006

I'm going to be the naysayer and say that recommendations for Claritin and Claritin-D are probably not going to help. The "D" kind uses pseudoephedrine as a decongestant, which is the same as the active ingredient in Sudafed. Claritin itself is seen as a lower-tier allergy medication since, as a pharmacist friend let me know, it's only effective in 25% of the population at default strength. Higher doses are more effective, but then it ceases to be non-drowsy.

Zyrtec is a better allergy medication, but it's possible to gain a tolerance or a change in allergies. I've had lucky with Allegra (the generic, actually) but it's supposedly less effective than what you're taking, Singulair is another that I've heard works well.

At this point, steam and possible sinus irrigation are your best bet. It's possible that you have non-allergy sinus issues, such as an infection or improper sinus drainage due to narrow sinuses. I wouldn't rule these out when you're discussing treatment with your doctor.
posted by mikeh at 8:50 AM on May 24, 2006

Modify your environment as much as you can. A good true HEPA purifier would be an excellent investment to make. Does your vacuum have a HEPA filter? Consider, also, a whole-house filter if you have central heat/conditioning (you can get a Filtrete filter at Home Depot). A humidifier may help.
posted by moira at 8:56 AM on May 24, 2006

Nettles leaf works miracles for my allergies. Buy a bottle of the liquid extract (with a dropper) and put a few drops under your tongue. It kills my attacks instantly. YMMV, and check with your doctor if you can use it with your other medication.
posted by lovejones at 9:27 AM on May 24, 2006

Same problem - spontaneous HTN, had to go off my OTC and Sudafed. I also have a tachycardic reaction to Claritin[ex].

Maintenance: local honey (since it's mostly pollen), nasal irrigation, and then Zyrtec when the pollen count is high and Benadryl for acute spikes in congestion/sleeploss.

I'm sure I'm supposed to vacuum more, but mine died and I haven't bothered replacing it.
posted by cobaltnine at 9:28 AM on May 24, 2006

Ditto on the environmental factors. Get a vacuum that has a HEPA filter (we have the Miele White Star, which is a bit expensive but worth it). Hire someone (or con a friend) to super-clean your whole house. Keep your windows closed. Get rid of any stuffed animals (or have Mom take em for safe keeping). If you don't have a vent fan in the bathroom, get one installed and use it every time you shower to inhibit mold growth. Basically, try to reduce as many things as possible. It's often the accumulation of allergens rather than one specific one that is the problem.
posted by radioamy at 9:45 AM on May 24, 2006

Another vote for controlling environmental factors!

With severe dust allergies, I can't believe how much living in a house without carpeting has helped me.
posted by fellion at 9:54 AM on May 24, 2006

There's now a generic brand of Claritin at Costco, called Allerclear, which works well for me and costs vastly less (300 tabs for ~$12 iirc).

I've also had good results from an OTC nasal spray (was prescription-only till a couple of years ago) called NasalCrom; despite the funky name it's very effective but doesn't kick in till you've used it for two or three days so it isn't instant relief.

When I first got allergies, Nasalcrom in combination with a now-discontinued prescription tablet (seldane, whose late-discovered side effects were deadly) were the only things that brought the symptoms under control. Give Nasalcrom a try, but allow several days for results.
posted by anadem at 9:55 AM on May 24, 2006

I get hyper when I take the pseudoephedrine in Sudafed. However, they've moved all the pseudoephedrine-based products behind the counter now (an ingredient in meth?). And the makers of Sudafed (and related OTC decongestants) are now using phenylephrine. This doesn't have the bad effect the older version of the product had. You might consider that.

Here's Wikipedia's take on this switch of ingredients.
posted by Taken Outtacontext at 10:05 AM on May 24, 2006

I have relatively mild allergies, but I have had great luck with ibuprofin. It helps the swelling to go down so you can drain. For years I took benadryll and sudafed, then finally claratin (which did not work for me at all). Finally I figured out that ibuprofin worked almost as well as benadryll and it didn't make me a zombie.

Just be sure you eat when you take it!
posted by tcobretti at 10:05 AM on May 24, 2006

Run, do not walk, but RUN to your nearest health food store and get a couple of things: Xlear, which is a natural nasal wash (just to help clean out your nose... maybe a more dignified version of sticking a water pik in your nose?) and get some khella turmeric. My boyfriend developed asthma from ragweed two summers ago, and the khella turmeric worked better than anything the doctor had prescribed. Seriously. Get it. Also, I recommend seeing a naturopath. I have had hives my whole life because of my millions of allergies, and since I've been seeing one I'm like a new person. I've lost ten pounds (mostly because of the things I've cut out of my diet), I can breathe, and I'm not itchy. It's amazing. I've supplemented the "cut-outs" I've made with herbs and other hippy-dippy stuff, and I feel awesome. Good luck.
posted by bash at 10:06 AM on May 24, 2006

I have many friends who swear by the neti pot. (Personally, I think they'd sell even more of these without the pictures of people using it; some things are meant to do in private.) But plain saline spray (available at any drug store) probably works just as well and is a little less labor intensive to administer.
posted by j-dawg at 10:09 AM on May 24, 2006

Hot tubs and hot showers help me, at least for a while.
posted by GaelFC at 10:10 AM on May 24, 2006

I have to second anadem's recommendation for NasalCrom. It takes a week or more to really work, but then it works so well I often forget to keep using it. You can also use it at the same time you use antihistamines. This makes it easier to get started with it. Once it starts working, you can lay off the pills. The downside for me: occasional white boogers. On the whole, the most effective thing for me, though.
posted by procrastination at 10:32 AM on May 24, 2006

Rhinocort Aqua changed my life. There was a time when once or twice a year I'd have an allergy attack that would lead to heavy, heavy mucus congestion that triggered uncontrollable coughing. Once the tickle in the throat showed up, I knew I would be in for 4-6 weeks of violent hacking that would eventually lead to a couple of weeks of severe laryngitis. (My friends used to say that I was going from the "Elaine Stritch stage" to the "Harvey Feirstein stage" and so forth.) A couple of times during the winter I actually collapsed on the street from violent coughing. It got so bad that I would have to run out of the Met in the middle of an act of an opera -- it was that noisy. Chugging codeine-based cough syrup helped some, but not much.

About 5 years ago, I tried Rhinocort. I have gone as long as 18 months without any trace of allergy congestion, and on the occasions when I do have an allergy attack, the congestion and coughing last only a couple of days at the most. One or twice since I've started using Rhinocort daily, I've had a very minor nosebleed in the morning -- but that was easily remedied by using a humidifier during the winter.
posted by La Cieca at 10:37 AM on May 24, 2006

My nose used to be congested for one reason or another most of the year because of allergies. I tried nasel sprays, nasel irrigation, pills, shots, etc. They all helped but only temporarilty. They were pretty much useless this past month with the high pollen counts. As a result, my parents had me see an acupuncturist and I haven't taken any allergy medicine since. It's been over two weeks now and my nose is as clear as it's ever been.
posted by blim8183 at 10:43 AM on May 24, 2006

This may or may not help, but i've found that self applied trigger point massage has more or less removed my hayfever. It's not an acupressure thing, it's based on a known tendency for muscles to develop these spots that are locked in tension.

The book i have is 'the trigger point workbook', and the muscle was the sternocleidomastoid in the neck.
posted by lunkfish at 10:49 AM on May 24, 2006

So many different recommendations, it must be hard for you to pick one to try!

I've often found that my allergies are very closely tied to my level of hyrdation; if I don't drink enough water, I get the stuffy nose. If I drink more than one coke a day, I get the stuffy nose.

I didn't use to think much of my hydration levels until I started reading about how chronically dehydrated most folks are. Allergies make it even worse, because once your body is dehydrated, it becomes more sensitive to allergens, which causes it to produce mucous and water from the nose, further dehydrating the body...

Try drinking your recommended levels of water every single day, and stay away from sugary drinks; it may help you as much as it did me.

Good luck!
posted by Cycloptichorn at 11:09 AM on May 24, 2006

I have a hepa filter. It helps, but only so much. I think the trees are what are bothering me right now as I used to go to work and get some relief (our house is dusty and I'm not supposed to clean because of my allergies. But I do anyway). THe house is carpeted though, and I'm sure that doesn't help matters. The vacuum has a hepa filter on it too. I've used claritin before the zyrtec, it worked but not as well. Same for the naselcrom, I used that before switching to the prescription nasonex. Again, it helped but not as much.

I think i'll try the nasel irrigation. Also, any more thoughts on the acupuncture for allergies. My insurance actually covers it but IF and only IF traditional treatments seem to fail.
posted by [insert clever name here] at 11:15 AM on May 24, 2006

There are many approaches to allergic rhinitis. You're doing some of it now. Allergy shots are good, but work better for kids. An antihistamine of sorts, too: benadryl is the best, but as everyone knows, pretty sedating. You could try chlorpheniramine, which is also OTC and also, unfortunately, sedating. Of the non-sedating antihistamines, Zyrtec is supposed to work the best, but is mildly sedating in a small percentage of people. And no, as best I can remember, this isn't drug-rep pep talk: I recall reading an article comparing the non-sedating antihistamines, and Zyrtec came out top. Despite this, it was still inferior to benadryl.

A nasal spray works wonders. Nasalcrom works differently from the corticosteroids such as Flonase and Rhinocort. You may want to ask if you can try both.

Keeping things lubed up will help, too. I don't know too much about neti pots, but have recommended plain ol' saline spray. There's a brand called Simply Saline which produces a very fine, "soft" mist.

Singular has recently been approved for allergic rhinitis. It's typically used for asthma. Drug reps are all over this, saying it's the best thing since flavored cream cheese. I haven't seen any convincing data yet, but you may want to ask your allergist about it.

An anti-inflammatory med might help, too. Motrin or Aleve, minimal dose.

If you've chronically taken sudafed, you might be experiencing a rebound effect. I am not sure about this, and can offer nothing to support this other than a very generalized statement about rebound effects in general.


It sounds like you're already doing most of what could be done. You may want to see an ENT/otolaryngologist, however. If you've got polyps, and you've already gone through prolonged treatment with the above meds, you might benefit from surgery.
posted by herrdoktor at 11:29 AM on May 24, 2006

A friend with pretty severe seasonal allergies swears by Flonase.

I also knew someone with crippling symptoms who received acupuncture as a last resort, nothing-else-worked attempt who seemed to have been cured. Especially if it can be covered by your insurance -- why not?
posted by penchant at 12:01 PM on May 24, 2006

I have had chronic allergies for most of my adult life. I've found two things that work best for me with the fewest side effects:

Allegra 180
Nasonex

You don't need to take both - one is a pill, the other a spray. Both do a good job.
posted by eas98 at 12:10 PM on May 24, 2006

My allergist told me to take zyrtec once a day, and clariin once a day -- 12 hours apart. That makes a huge difference to me.

Also -- and forgive me if this is too obvious -- have you tried buying a new pillow, and/or encasing your pillow and mattress in mite-proof covers? I was skeptical about it, but it has helped a lot.
posted by wryly at 12:48 PM on May 24, 2006

On thing I should clarify. I started on allergy shots when I was in second grade. After about 6 years, we stopped because my family lost our health insurance. About 6 months later, we started with a new doctor, whom I went to for another 10 years, and he seemed to care little about the fact that I wasn't making progress, even though most people are done with shots after a few years. I finally stopped seeing him out of frustration, going shot free for a couple years.

I started seeing my current doctor on the recommendation of a friend, then I was without health insurance. Resumed seeing him a few months ago. He seems genuinely concerned about why my allergies haven't improved with treatment, and that is part of the reason I only am getting shots for two of the many things I am allergic to, apparently its a better approach. He has said he has seen many patients from my former doctor who complained he wasn't trying hard enough. I guess the 20% that don't respond to "regular" allergy treatments get sick of being ignored and end up at my current doctor (my friend had the same problem hence the reason he was recommended to me).

I've also used sudafed for as long as I can remember. At least since I was 12, possibly longer. I suppose a rebound effect is possible, but it seems just as likely that I've just grown used to the way it clears me up. I haven't been taking sutafed for a little over a month. I don't know if it were a rebound effect, how long it would last.

Singular came up at the doctors office the other day. Apparently many insurance companies are now refusing to cover it unless you've been prescribed a prior medicine for asthma. I've been luck, out of all the breathing problems I've had, asthma is not one of them.
posted by [insert clever name here] at 12:48 PM on May 24, 2006

For the first time in 20 years I'm breathing clearly. I'm on the following:

Singulair (24 hour)
Nasonext (1 spray in each nostril 2x per day)
Allegra-D (24 hour)

I also added 1000 mg a day of Quercetin, and it has made a HUGE difference. It is a flavanoid that, among other things, helps to block histamine.
posted by OhPuhLeez at 1:38 PM on May 24, 2006

Um, that would be Nasonex...not Nasonext, but if the Nasonex stops working, well you know what I'll try next...

/badjokefilter
posted by OhPuhLeez at 1:39 PM on May 24, 2006

Wow, so many varied answers. I'm definitely interested in finding out more, as I've also suffer from the deadly chronic rhinitus, allergy season and sinus headache combo. Making sure you have a dust-free environment is a big help, but sometimes you just gotta take a pill.

I'm trying Sudafed now, which seems to be helping with the cold I have. Benadryl and Flonase are ok - these things seem to vary results depending on the individual - but by far the best one I've tried is Reactine, (Cetirizine) which is over the counter in Canada but sadly you need a prescription for it in the States. (Bizarre). Of all the meds I've tried, it's been the best. Definitely check it out (and no, Phizer's not paying me to say that, although they have an easy to understand page about it here. As well, when you do get a sinus headache, having a heating pad on the face for a few hours seems to work wonders in clearing it up - not at a hot temperature obviously, but to relieve some of the sinus pain. Have a humidifier if possible too, on the not-hot days; sometimes more moisure in the air can help. Good luck, and let us know what works...
posted by rmm at 2:35 PM on May 24, 2006

Well you did ask for alternative treatments... I don't have severe allergies like you or - it seems - many of the commenters - but I do get a lot of congestion during Spring and Summer.

First I take a homeopathic remedy every half-hour or so (whenever I feel the congestion worsening). The particular treatment for excessive moisture or congestion is Nat Mur (short for natrium muriate, or sodium chloride). It sounds crazy but you never know if you don't try.

Also - another crazy one which might gross you out I guess - try drinking blood-temperature, slightly saline water... through your nose. I guess this is similar to the "neti pot" (which I've never heard of till now)?

I would try to minimise my sugar consumption too (everything gets worse for me when I have too much sugar).
posted by ajbw at 4:47 PM on May 24, 2006

You might want to try an anti-allergy eye drop. Because of anatomy, eye drops drain down into your nose, so using an eye drop can help both eye and nose symptoms. There have been a couple of different studies that showed that a nasal spray was more effective on nasal symptoms than a systemic, and that an eye drop was (of course) better for eye symptoms than either one. The top allergy doctors I know are all convinced that people should treat topical diseases topically, instead of with a pill. This avoids the side effects you can get with a systemic drug, like drowsiness, dry mouth, and dry eye.

The OTC anti-allergics are short-acting, but you could give them a try. The prescription ones are longer acting and very effective. I'd suggest trying Patanol or Elestat first.

Disclaimer: IANAD, I work for an ocular allergy research group, but I don't have any financial interests in any drug companies.
posted by acridrabbit at 8:38 PM on May 24, 2006

Interesting. I have a prescription for the eye drops already (Optivar), but only occassionally use them as the doctor said as needed (and my eyes are only sometimes itchy). I'll try using them more frequently and see if that helps.

Thanks everyone, I have a lot of things to try and to talk to my doctor about.
posted by [insert clever name here] at 7:20 AM on May 25, 2006