The South is a great place to live. But ask any Southerner what the worst part about living in this region of the United States is, and they will most likely say it’s the seasonal allergies, which some years feels like they last all 365 days. And with the various almanacs, wives’ tales and other almost folklore-like advice that supposedly predicts how good or bad an allergy season will be, it’s so easy to get our hopes up for a good one only to be sneezing from March till October! To get to the bottom of what’s fact, what’s fiction and what we can really expect during any given year, we chatted it up with an ENT pro who knows, Dr. Matthew Speyer of Saint Thomas Health in Nashville, TN.
StyleBlueprint: Everything we’re reading says it’s shaping up to be a really bad allergy season. Is that the case, and if so, why?
Dr. Speyer: It’s a matter of weather patterns and geography. Weather patterns are more favorable for pollen in the air … clear, dry days with winds. We don’t have an extended winter, and there’s not a lot of freezing ground, so the early burst of warmth … that’s the problem.
SB: What’s the reason for the sneezin’?
MS: In the spring, it’s tree pollen. In the summer, it’s grasses. And in the fall, it’s ragweed. So pretty much from Easter to the first freeze, there’s something that is causing the allergies. And then in the months in between—December, January and February—it’s the indoor allergies … dust mites, animal dander, cat allergies, mold spores.
SB: Are there times of day, types of weather, etc., that allergy sufferers should avoid going outside or opening windows?
MS: If someone knows they’re triggered by spring pollen, well, pollen is released in the morning hours, so you’ll want to jog in the afternoons. If it’s after a fresh rain, you’re at an advantage because the pollen’s been washed away. Pollen counts are almost always bad in the morning hours and then taper off. Of course, if the winds are breezy in the afternoon, there’s likely no good time at all unless it’s just rained. The other issue is where you are—if you’re in an urban environment with a lot of pollution, that air isn’t very pleasant either.
SB: What expert pointers can you offer people who are new to the South and may be experiencing allergies for the first time?
MS: Consult with a physician. Aside from that, some layperson tips would be to take medication to block reaction, keeping in mind that some are more safe than others. I direct my patients to choose one of three common antihistamines over the counter and one of two nasal steroid sprays over the counter. Claritin, Zyrtec and Allegra (or their generic equivalents), and the nasal sprays are Flonase and Nasacort (or their generic equivalents). Antihistamines will work their best after the third day of regular use, but some antihistamines will work as early as 45 minutes after taking it.
SB: What can you do until the allergy meds kick in to help alleviate the symptoms?
MS: Not much.
SB: Is there any merit to the idea that dietary changes could improve or affect people’s allergies?
MS: It’s mostly directed by their skin testing results. Don’t eat tree fruit if you’re allergic to tree pollen. Hold off on anything that has weeds and grass in it during summer months … that sort of thing. And when people have ragweed allergies, don’t eat melon—just don’t eat what’s blooming during the allergy season. If they have mold allergies, we can have them hold off on mushrooms and moldy cheeses.
SB: Are there any nonmedical things people can do to help or alleviate symptoms … wives’ tale-type treatment options that you think actually work?
MS: There are no general recommendations I would make. When that nasal stuffiness or blockage won’t open back up, that’s when we talk about surgery and opening them back up. It won’t cure their allergies, but they’ll be able to breathe again.
SB: Are there any tools or resources people should know about to help them navigate allergy season?
MS: AAAAI website, WebMD, Medscape, their local news channel’s weather report, which will almost always have some sort of allergy report.
SB: When can we start to see some relief?
MS: You’ll get relief of trees come summer, grass come fall and leaves come first freeze. Ultimately, it’s a matter of if you want to be fixed. Allergy testing opens the door to find out if you want to do the allergy shots or drops under the tongue. Patients take them for about three to five years, and about 90 percent of patients will be done with them. They get desensitized … not cured. We kind of stop it, but they always have a potential in their lifetime for that to get sparked.
SB: Who should go that extra mile and get tested for allergies?
MS: Anyone who thinks they’re allergic is a candidate to get tested. You can get skin tested or blood tested. The blood tests are more convenient and higher cost and can occasionally be a false negative. But within 45 minutes, we’ve figured out whether the patient is allergic or not.
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Here are the key take-aways to keep in mind as we continue in our allergy season adventure this year:
Dr. Speyer says that while insurance companies consider sublingual treatments still investigative and therefore often don’t cover them, there are new immunotherapies out this year that prove otherwise. A grass sublingual treatment and a ragweed option are both newly available from Merck this year as prescriptions. So if you go the allergy treatment route, your options are ever-expanding: drops, shots or, now, prescriptions.
On the alternative treatment side, Dr. Speyer says that he hasn’t seen much in the way of results from bee pollen, echinacea, acupuncture or other alternative treatment options. “We don’t get our patients saying ‘yes, this worked.’”
And lastly, he urges allergy sufferers to steer clear of palliative treatments that can lead to abuse, such as Afrin and other over-the-counter sprays that don’t treat allergies, but only open the nasal passages. “Those aren’t long-term solutions.” And steer clear of Sudafed, which Speyer says can wreak havoc on the thyroid, blood pressure, prostate (in men) and can cause heart and rhythm problems.
The bottom line? As with most things related to our health, Dr. Speyer advises, “Pay attention to your body, and when the symptoms are chronic and nagging, seek an expert.”
And stock up on tissues! Happy spring!
Special thanks for the medical advice from our expert today, Dr. Matthew Speyer, Otolaryngology-Head and Neck Surgeon, ENT Surgeon at St. Thomas Medical Group and Clinical Instructor for the Department of Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center School of Medicine.
