Ah-ah-ah-choo! This is the time of year when many folks are sneezing. If it isn’t a cold, it might be allergic rhinitis, also known as hay fever.

Nasal allergies tend to flare every spring from plant pollens in the air.

With hay fever, the symptoms show up as a runny nose, nasal congestion, teary eyes and fatigue. These allergy symptoms are not a mere nuisance.

Beside being a health threat in their own right, nasal allergies are often associated with other allergic conditions. Many people with hay fever also suffer from eczema, and nearly half of the people who have hay fever may eventually develop some form of asthma.

A recent study shows that 75 percent of people with asthma aged 20 to 40 and 65 percent of those ages 55 and older have at least one allergy. The results were published last month based on an analysis of 2,600 people enrolled in the U.S. National Health and Nutrition Examination Survey.

Allergy-related conditions

Exactly how are allergies and asthma connected? Recent studies have demonstrated cross talk between the upper and lower airways of the respiratory tract. When a person who has hay fever but not asthma is exposed to ragweed or house dust, inflammation flares up not only in the nose but also in the lungs.

Similarly, introducing an allergen into the lungs of a person who has asthma but not hay fever unleashes inflammatory substances in the lungs and upper airways, including the nose and sinuses that are completely untouched by the allergen.

This close communication between the upper and lower airways is what scientists mean when they refer to asthma and allergies as being “one airway, one disease.”

I think the concept helps explain some seemingly unrelated facts and figures: People with allergies are more prone to having problems with sinusitis, nasal polyps, ear infections and inflamed eyes. They tend to get bronchitis and pneumonia more easily.

Those with eczema are susceptible to developing secondary bacterial infections of the skin.

Allergy treatment beneficial

Allergies deserve to be carefully assessed and controlled in order to help prevent progression to asthma and other allergic conditions. Studies indicate that treatment of hay fever can also help resolve symptoms in patients who have both allergies and asthma. A number of remedies are available to help bring your allergies under control.• Allergen avoidance. Record your symptoms in a diary then try to avoid allergy triggers that you identify. For indoor allergies, this may mean washing sheets weekly in hot water and keeping carpets and pets out of the bedroom. For outdoor allergies, staying indoors when pollen levels are highest between 5 a.m. and 10 a.m. can ease symptoms.

• Natural remedies. Dietary change, essential oils, herbal remedies, dietary supplements and mind-body therapies are among the alternative approaches that can help your immune system unlearn allergic reactivity.

• Antihistamines. Available in over-the-counter and prescription forms, this mainstay of treatment for hay fever helps relieve nasal itching, runny nose and sneezing. Ask your pharmacist about less sedating brands.

• Nasal sprays. Over-the-counter cromolyn sodium or prescription steroid sprays can treat nasal drainage and stuffiness.

• Allergy shots. Getting weekly or monthly injections for several years can cut the risk of developing asthma in half, according to some studies. Allergy sufferers who should consider consulting a doctor about the shots include those who fail to get relief from drugs as well as children and anyone with both hay fever and asthma.


By Elizabeth Smoots, MD
May 21, 2013