Health Watch/Portage Health/Sharon Stoll, MD, Family Medicine Practitioner

It is spring, the time of year when April showers bring May flowers, and children hunt for Easter eggs on manicured green lawns; or at least I’ve read about these things in books. For those of us living above the 40th parallel, it is the season sump pumps become overwhelmed by run-off, gravely snow piles keep their strong hold on north facing slopes, and you look around your yard wondering how one dog made all that mess. I would like to add, to the list of springs’ rites of passage, the start of the outdoor allergy season. It begins every year in late April. The add-on slots in clinic quickly fill with stuffed up patients exclaiming “Sinus infection!”, or worse, those with red, watery eyes who have been ostracized by coworkers for fear of the dreaded “pink eye,” (though actual bacterial conjunctivitis is exceedingly rare). Often a quick review of these patients’ charts show they have the same set of symptoms every April, helping to identify the real culprit: environmental allergies.

Environmental allergies occur at somewhat predictable times every year: molds in April and May, followed quickly by grass and then tree pollens. There’s some brief reprieve in midsummer before ragweed appears around late August. The severity varies from year to year, depending on moisture, south winds and so forth, but the symptoms are predictable: Itchy, red, watery eyes, stuffy or runny noses, and for some, a worsening of asthma and cough. If this sounds like you or a loved one, read on for some cost-saving solutions and advanced treatment options.

Log your allergy symptoms and seasons. This will help guide targeted therapy, and also help identify possible cross-reactive foods, which may cause oral allergy symptoms (think really itchy mouth). For example, ragweed peaks in August, so if you find yourself with gooey eyes every August, ragweed is the likely culprit. And ragweed can be cross-reactive with foods like parsley, beans, celery and several others.

Use single-ingredient over the counter remedies geared at allergies. For itchy red eyes, over the counter antihistamine drops like Zaditor, Alaway, Zyrtec Itchy Eye Drops, Claritin Eye or generic ketotifen work wonders, at a fraction of the cost of prescription antihistamine eye drops. For stuffy or runny noses and itchy mouths, consider a non-sedating oral antihistamine like generic fexofenadine or loratadine. For nasal or sinus congestion, consider a decongestant like generic pseudoephedrine. Avoid multi-ingredient cough and cold formulas, which may have ingredients you don’t need.

Consider immunotherapy. Allergy shots are the best-known form of immunotherapy in this country, but for those not interested in the high costs, time commitment or needles involved with allergy shots, sublingual immunotherapy (SLIT) may be a better option. Instead of injecting allergens into the skin to promote tolerance, allergen drops or tablets are held under the tongue to reprogram the over reactive immune system. This method has been around since the early 1900s, and was recognized by the World Health Organization as a viable alternative to shots in 2006. It is a mainstay of treatment throughout the European Union, and available in Canada. In the US, it has been used as an off-label treatment with good success. The general idea is this: when you place antigens (protein particles that cause allergic reactions) under the tongue, immune cells take them up, and train the immune system to stop generating an allergic reaction when exposed. It makes good intellectual sense: holding something under the tongue for a minute is an intentional act, and the immune system wouldn’t want to react to things your higher-ranking brain has chosen as acceptable for ingestion. This is probably how raw local honey also helps combat environmental allergies, as the unprocessed pollens in the honey serve as a sort of immunotherapy.

Not sure what to make of all this? Come see your friendly local doctor. We’ll help you sort it out. And however you deal with spring allergies, just remember you were shoveling in minus 20 winds a few weeks ago, so maybe some red eyes and runny noses are a small price to pay for spring. Consider this your prescription to celebrate by manning the barbeque grill in shorts when it’s nary 40 degrees out.

Editor’s note:?Sharon Stoll, MD, is a family medicine practitioner providing a full spectrum of primary care to her friends and neighbors out of the new Calumet Family Health Center, which is located in the Mine Street Station in Calumet. Dr. Stoll is accepting new patients now. Call 483-1777 to make an appointment.