Ask The Doctor: End Springtime Allergies

I always have a runny nose, but every spring it gets worse, and my eyes water and itch. Is this just allergies or something else?
By Jane Hart, MD

It sounds as though you have a condition known as rhinitis—inflammation of the mucous membranes in the nose. This inflammation leads to a runny nose, sneezing, and a feeling of being stuffed up. Rhinitis may result from a cold, allergies, or nonallergenic irritants in the environment, such as dust, cigarette smoke, or pollution. Your first step is to figure out which of these culprits is behind your runny nose. Symptoms that manifest year-round, as in your case, are most likely caused by irritants in your daily surroundings, rather than an infection, such as a cold. If the rhinitis worsens in the spring, you may also have seasonal allergies.

Step two involves becoming aware of your environment and what you can do to reduce your exposure to the irritants and allergens it contains. While antihistamines or nasal sprays may curb symptoms, regular use of them can cause dryness, drowsiness, and nasal irritation. What’s more, these medications usually fail to fully control symptoms and, more importantly, ignore the source of the symptoms. For long-lasting relief, you have to identify and manage your runny nose triggers (for help pinpointing them, see “Know Your Triggers,” below).

Here are some tips for cutting down on your exposure to the most common irritants and allergens:

To control dust, have someone less sensitive to her environment dust and vacuum the house twice a week, or wear a mask and gloves. Don’t use fans, which stir up dust, and get your air ducts cleaned once a year.

Dust mites live in dust particles, and their feces can trigger rhinitis. For these ubiquitous critters, follow the same suggestions above, but also try the following measures to decrease mite populations: Dehumidify your house to below 50 percent, and keep the temperature lower than 70 degrees; choose low-pile carpet or hardwood floors instead of rugs or shaggy carpet; avoid buying overstuffed furniture or down-filled blankets and pillows; and wash linens once a week. You may also want to consider applying tannic acid—found in oak bark, coffee, and cocoa—to your furniture and carpet once a month, since it helps neutralize mite allergens. (You can buy tannic acid at many home-living stores.) Air cleaners and filters can help some, but they may not be worth the high cost.

If mold is one of your triggers, keep bathrooms, basements, and crawl spaces as dry as possible; use dehumidifiers to keep humidity below 50 percent; promptly dry wet laundry; store firewood outside; and limit houseplants, since the soil attracts mold.

For seasonal allergies, check the daily pollen counts in your local newspaper, online, or on the news; on high-count days, limit your time outside, keep the windows closed, and use the air conditioner sparingly or put cheesecloth over the vents. To determine the specific plants to which you’re allergic, have your doctor test you for a variety of pollens.

To reduce pet dander, wash your pets once a week, and keep them out of the bedroom (definitely off the bed) and off the couches.

Avoid cigarette smoke, and minimize exposure to outside air pollution by exercising away from high-traffic areas and rush-hour-packed roads. Both smoke and pollution irritate the sinuses.

Even with these steps, you may still occasionally be exposed to triggers. Fortunately, a variety of remedies can alleviate rhinitis symptoms. Irrigating your nasal passages with saline water from a neti pot each day, for example, can clear your nasal passages and reduce the need for medication. Nasal and deep diaphragmatic breathing exercises (in which you slowly breath in and out through your nose, using your diaphragm) help with this, too.

Research has shown that some individuals find significant relief from rhinitis with weekly or twice-a- month acupuncture sessions as well. Although herbs such as butterbur, quercetin, and stinging nettles also show promise for reducing symptoms, you should first and foremost address indoor and outdoor triggers, rather than relying on supplements. Too frequently, people reach for medications and supplements and never address the source of their symptoms. Many people also let the symptoms of chronic rhinitis continue for a long time before seeking medical help, so if you have chronic symptoms, it’s important to see a doctor. Left untreated, chronic rhinitis may increase the rate of upper respiratory and sinus infections, so it’s important to take control of your environment early on.

Know Your Triggers
With rhinitis, people usually have triggers that make their symptoms flare up. Once you identify them, you can work to minimize exposure. Ask yourself:

1. Do you notice that your nose becomes more congested at night when you lie down to sleep? Allergies to pet dander, dust mites, or mold spores in the home may be to blame.

2. Do you notice the symptoms more when you’re outside? The culprits could be pollens, fungus, or mold.

3. Does someone at work or in your house smoke, or do you live in a highly polluted area? Smoke and air particulates from cars and industrial smog definitely can worsen symptoms.

Jane Hart, MD, is a clinical instructor at Case School of Medicine in Cleveland, Ohio.

3 Ways to Snuff Sniffles

Although for long-term relief from seasonal allergies you need to identify and minimize your triggers, in the short term, why endure the sneezing, congestion, and teary eyes? Here are three time-tested remedies to let you breathe easy.

1. Stinging nettles. Particularly good for relieving itchy eyes and sneezing, stinging nettle extracts are most potent in freeze-dried form. Take 300 mg a day, in divided doses, when symptoms flare.

2. Quercetin. Found in yellow onions, garlic, citrus fruit, and buckwheat, quercetin helps prevent allergies by stemming the production of histamine from overreactive immune cells. Starting six weeks before allergy season, take 400 mg of quercetin extract twice a day, between meals, and continue through the season.

3. Butterbur. Studies show that this herb, an anti-inflammatory, may reduce allergy symptoms as well as antihistamine drugs. Take 50 to 100 mg twice a day with meals during allergy season, making sure to choose a product free of pyrrolizidine alkaloids, which can damage the liver (check the label).