Seasonal Allergies Healthch@t


Dr-Rossi-98point6-physician headshot

Avoiding seasonal triggers isn’t as easy as say, staying away from cashews if you have a nut allergy (you can’t exactly stop Mother Nature from “decorating” your car with pollen). But you can take steps to manage your symptoms in order to make the most of your time outdoors.

We asked 98point6 physician Jennifer Rossi, MD some of our most pressing seasonal allergy questions.

 

 Q: How do I know if I have seasonal allergies or just a bad cold?

Dr. Rossi, MD: Sometimes they can be hard to tell apart! Both can have runny nose, sore throat, sneezing and fatigue. But symptoms of allergies will typically hit you really quickly in a matter of hours, while colds generally build over a day or two. There are other key differences. Itchy and watery eyes are nearly always from allergies, but even bad allergies won’t cause a fever. If you have body aches, you probably have a cold. The duration of symptoms is also key: allergies will last longer (sometimes weeks), whereas colds usually run their course in 7-14 days. If your symptoms are severe or persist longer than 2 weeks, it’s a good idea to check in with a doctor.

Q: How do I know which OTC treatment is best for me?

Dr. Rossi, MD: A nasal steroid like fluticasone is typically recommended as the first choice of medication. If that’s not enough, try an oral antihistamine. Active ingredients like fexofenadine, loratadine and cetirizine are less sedating than treatments containing diphenhydramine.  

Q: The OTC tablets I used to take aren’t working anymore. Is it possible to become immune to a particular treatment if I take it often?

Dr. Rossi, MD: Some allergy sufferers complain that their medications stop working for them over time. This could actually be because your allergy symptoms are getting worse; it’s the natural course of the disease for your body to have a bigger immune system response with each progressive allergen exposure. Your body may also develop a tolerance to a particular medication, meaning that you need more to get the same effect. This is particularly true of certain steroid nasal sprays. If you think you may have developed a drug tolerance, talk to your doctor about taking a “drug holiday” for a few days, weeks or months. The length of time needed can be different for each person. You may find that the medication works for you again when you reintroduce it.  

Q: Are OTC allergy meds safe to take during pregnancy?

Dr. Rossi, MD: It depends on the drug. First and foremost, make your best effort to avoid the allergens that trigger symptoms. The next option would be a nasal spray containing fluticasone or cromolyn sulfate; these have great safety profiles, with minimal absorption into the pregnant person’s circulation. An oral antihistamine can help if the spray is not enough. Loratadine and certrizine also have excellent safety profiles; their use is generally the same for pregnant and non-pregnant individuals. Aim to use the lowest dose you can.

In general, stay away from decongestants like pseudoephedrine and phenylephrine. Pregnant individuals should not use pseudoephedrine in the first trimester because it might be associated with birth defects, and safety in the second and third trimesters is uncertain. It’s also important to stay away from herbal remedies as these are not carefully regulated.

Q: Are there any drug interactions I should be concerned about when taking OTC allergy meds?

Dr. Rossi, MD: As the nasal steroids are not absorbed much systemically, they are safe with nearly all medications.

The oral antihistamines (fexofenadine, loratadine and cetirizine) have more drug interactions. First, you should be careful with or even avoid alcohol when taking these as they can both make you drowsy. Antihistamines can worsen the sleepiness of any drug that makes you sleep, including opioids and hydroxyzine. You should not take them if you have an ipratropium inhaler/nebulizer. Talk to your doctor or a pharmacist if you have any concerns.

Q: How are allergy shots different than medications? How do I know if I’m a candidate?

Dr. Rossi, MD: Individuals receive allergy injections over a period of a few years. Rather than treat symptoms (as the medications do), shots actually modify your disease to make you less allergic.

Injections are an option for people who can’t avoid their triggers, don’t get relief from medications or are simply tired of taking (and purchasing) medications regularly—for some, allergy shots can indeed be more cost-effective! If these scenarios sound familiar to you, consider making an appointment with an allergist, who specializes in this field of medicine and can discuss allergy shots as a treatment option.

Do you have a seasonal allergy question? Get answers, diagnosis, treatment or just peace of mind with 98point6. No appointments, no travel, no waiting. Start a visit now.

 

Download the app

98point6 delivers on-demand primary care via secure in-app messaging.

Get the App