This is one of my favorite pics i stole from my friend Dr Neu at Neucare in Lawrence, KS. The original meme said, “Coincidence? I think not!”
So it is March 3rd today and every one of you here in OK should begin your allergy therapies. Actually should have started them already. What do we do about allergies these days, you ask? Well let me tell you.
Allergies, in short, are an immune system reaction to foreign proteins in our environment. You and I both know that grass/plant/flower pollen isnt really dangerous, but our bodies see those foreign proteins like they would see a virus or a bacteria. So the immune system gets wound up to attack the foreign “invaders.” Also since the whole country blooms at the same time, we get exposed to a massive amount of this plant material. I explain to my pts that even folks that dont REALLY have allergies, still have a response to all the junk in the air. For example, I am not allergic to cigarette smoke, so if I was sitting next to a single smoker, it would stink but i wouldnt have respiratory difficulties. However, if i was in a smoky bar, I would start wheezing, coughing, and eyes would water. So am I allergic or just getting irritated by the smoke? (thankfully my bar hopping days are long gone!)
Whether you actually have allergic rhinitis or just get irritated by all the stuff in the air, treatment is the same. Some nonpharmacologic treatments would be taking doses of local honey, saline rinses, duct cleaning, filter changing. Local honey exposes you to small amounts of local allergens, so you become desensitized. Saline rinses keeps your mucous membranes moist and clean out the junk you breath in daily. Having carpets cleaned, a/c ducts cleaned, and changing filters makes a big difference with the particles in your house.
When we talk about meds the first line therapy is the antihistamines (claritin, zyrtec, allegra, xyzal or their generics are the nonsedating ones. benadryl is sedating so it’s great at night for sleep AND allergy therapy). Next level therapy would be nasal steroids. Flonase and Nasonex are otc. These are EXCELLENT therapies with little risk for side effect. Other pills, like singulair, which block what we call leukotrienes and nasal antihistamine spray (azelastine) are also excellent therapies. In severe cases some folks get allergy shots.
We recommend and prescribe all of the above. So if youre my pt, get your refills going. I say EVERY year, “the whole state doesnt get a sinus infection all at the same time in March! That’s allergies.”
Fyi here at OFM the antihistamines mentioned are $4-7 for 100 pills, flonase is less than $5/bottle. singulair is $4 for 100 pills. These are the prices we have on allergy meds in a Direct Primary Care office. This is how we save pts maoney. Come check us out.
Dr D
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