While concerns about swine flu abound, it’s easy to push a seemingly simple ailment like seasonal allergies to the bottom of your priority list. But before making your regular one-second Claritin purchase at your drug store this fall, it’s important to better understand what your symptoms could mean, and whether or not the product you’re picking up off the shelf is what you really need.
“A lot of times people just pick up [a medication] and don’t know that an antihistamine is used for people who have itchy eyes, postnasal drip or sore throat … and a decongestant is for someone who is stopped up, when there’s no drainage going on,” says Christopher Jones, PharmD, CSPI, a lieutenant in the U.S. Public Health Service.
Antihistamines (such as Benadryl, Claritin and Zyrtec) fight the histamine released in your body that causes runny noses and watery eyes, and decongestants (such as Sudafed and Claritin-D) break up congestion when you have the opposite problem. It’s important to read labels, know all the components of your over-the-counter medications and understand the potential risks to make sure your drug not only works, but doesn’t cause you harm.
Decongestants should not be taken by individuals who are on blood pressure medication. Cough and cold medications are not created equal: They may be antihistamine-based or decongestant-based, and may even contain painkillers, so it’s important to read the label. Ask your doctor or your pharmacist about how different drugs may interact with your other medications or with medical conditions.
Still, taking an over-the-counter allergy medication around the clock, day in and day out, can result in side effects of that medication while neglecting the underlying cause of the symptoms. Untreated allergies in very young children, for example, can lead to ear infections and even hearing loss. Seeing an immunologist or allergist would help you to assess the true problem.
Finding the culprit
» Dr. Talal Nsouli recommends seeing a specialist who can help you conduct the “detective work” necessary to identify the offending substance. The doctor will perform an allergy evaluation that includes a careful medical history, an allergy skin test and maybe blood testing: The ImmunoCAP blood test will assess how your immune system reacts to a variety of allergens, and you’ll need to go to the doctor to order one.
“I saw a patient last year who was having sinus infection after sinus infection. He had been suffering from nasal allergies for two to three years and had never been treated,” says Dr. Talal Nsouli, director of the Watergate and Burke Allergy and Asthma Centers and personal allergist to President Clinton during his eight years in office. “The complications [that came of these allergies] were these recurrent sinus infections, and eventually asthma.”
Nsouli says 45 percent of patients who leave hay fever untreated can develop asthma, a condition that kills about 3,600 people in the United States every year. An additional 150 individuals die from severe food allergies every year, Nsouli says. It is especially important to see an allergist or immunologist if you develop a reaction to an insect sting or bite, or to a type of food or medication. These allergens are often the offenders that can lead to anaphylaxis, a life-threatening whole-body allergic reaction that can cause a person’s throat and airways to close up.
Even if you can’t avoid the problem substance, your doctor will help you find strategies for minimizing your exposure and treating the symptoms of your reaction properly. For example, Nsouli tells patients who are allergic to pollen to close their bedroom windows and car windows, and to jog in the evenings when the pollen count is down. For a dust mite allergy, he tells patients to get a mattress protector, a pillow protector and a high-efficiency particulate arrestor, or HEPA, air filter.
