When to talk to your doctor about allergies

Suffering from allergies? Gundersen Family Medicine provider Christopher Tookey, MD, explains how you can find relief.

Most people would agree that spring in Tri-state Region is a beautiful time of year. Many of us are trading snowblowers for lawn mowers and are enjoying everything the Driftless area has to offer. For about 10 percent of people, however, spring kicks off the arrival of itchy, watery eyes and a runny nose.

What causes allergies?

Seasonal allergies offer all the fun of feeling under the weather without having an actual infection. Allergens such as pollen trigger the immune system to ramp up a defense that normally protects you from invading bacteria and viruses. Tree pollen is the most common culprit early in the year. As spring turns to summer, grass and weed pollen take over. Some people though are unlucky enough to suffer year-round from allergies to certain molds or pet dander.

What are allergy symptoms?

People can experience a wide range of allergy symptoms that vary in severity:

• Sneezing
• A runny/stuffy nose
• Watery/itchy eyes
• Pressure behind the ears and face
• Problems with hearing
• A headache
• A sore throat from mucus draining from the nose

What are the best ways to manage symptoms without medication?

Allergy symptoms can leave a person feeling quite miserable. Some tips for managing them naturally include:

• Trying to do any outdoor activity (e.g., exercise or yard work) early in the morning before the wind kicks up large amounts of pollen.
• Avoiding touching your face while working outside to reduce pollen getting into your eyes, ears and mouth.
• Showering after activities outside to wash off allergens.
• Keeping the windows closed both at home and while driving to reduce your exposure to irritating pollens.

What are some over-the-counter options for managing allergy symptoms?

When looking to medicines, an over-the-counter nasal spray containing a steroid such as fluticasone (Flonase) can help with congestion, a sore throat and even itchy/watery eyes. I recommend this treatment first, as it is targeted to the most involved area of the body and has the lowest possible side effects overall. Note: I would recommend looking at YouTube for instructional videos or asking your pharmacist how to take this nasal spray safely and effectively.

If a nasal spray is unappealing or doesn't alone control your allergy symptoms, you may want to add a second-generation antihistamine. Cetirizine (Zyrtec), fexofenadine (Allegra) or loratadine (Claritin) are great over-the-counter options.

Note: Diphenhydramine (Benadryl) is a first-generation antihistamine. Unlike the second-generation members above, it can cause some drowsiness, so I typically don't recommend it for use during the day.

What allergy medicines should I watch out for?

There are a few over-the-counter medications that work well in the short term but overtime they can make nasal congestion worse. Oxymetazoline (Afrin) is notorious for causing worsening nasal congestion long term and I wouldn't recommend it for allergies. Pseudoephedrine is a decongestant that I would also use with caution.

In addition to causing similar risk of continuing worsening congestion, it can spike your blood pressure and heart rate. Unfortunately, many people don't realize that pseudoephedrine is inside many over-the-counter medications. Any product with "-D" on the label—like Allegra-D or Claritin-D—has pseudoephedrine in it. I would stay away from these without consulting your healthcare provider.

When should I contact my provider?

At any point if you feel your allergies aren't responding to some of the safer over-the-counter medications mentioned above or if you wonder if you could have something other than allergies (such as an infection, a deviated septum or even heart burn) you should make an appointment with your healthcare provider.

This person can review your medical history and perform an exam to confirm if you're having allergies. Together, you can then review over-the-counter options and discuss prescription medications. Your provider can even discuss if you would be a candidate for allergy testing and shots.

Note: Bring to your appointment whatever medications you have tried before the visit. Nothing helps providers help their patients feel better faster than knowing what they've already used.

Usually, by about two weeks after a visit to discuss the management of your allergies, you'll be feeling much better and able to enjoy all the amazing outdoor activities in our area.