I've been seeing a lot of confused patients recently.
Their symptoms — runny nose, sneezing, itchy/watery eyes, congestion, and cough or wheezing — are familiar enough to the allergy-prone. What's baffling, however, is how early in the year they have arrived.
Many sufferers who found themselves wheezing through Christmas dinner and New Year's Eve assumed they had a cold.
But this early allergy season looks to be the new normal. Our climate is changing. We are living in a warmer and different world.
With less and less of a true winter season in Florida, trees started blooming and sending out pollen in late December. Tree pollen season, historically, began in late February. But it has been coming earlier in recent years.
Some scientists are finding that warmer weather and more carbon dioxide in the air places stress on plants, which leads them to release far more pollen and pollen that is more potent. Current climate models speculate that pollen counts will double by 2014.
So those symptoms you felt in December might have been a common cold. But if you've suffered from tree pollen allergies in the past, chances are you can't blame an infectious disease for your misery.
It is not often easy to tell the difference between cold symptoms and allergy symptoms. If you have a runny nose, but the discharge is clear, along with itchy/watery eyes, sneezing but no fever, it might be allergies. Your physician can also help distinguish whether allergies are playing a role in your symptoms by looking for a few classic physical findings.
Once you know that pollen seasons are starting earlier, lasting longer and will be more severe, you can make lifestyle changes to help cope. Consider the following when you know pollen counts are high:
• Keep your home and car windows closed.
• Avoid outdoor activity between 5 and 10 a.m., when pollen counts are highest.
• Do not hang clothes outdoors to dry.
• Bathe before getting into bed if you've been outdoors to keep pollen from collecting in your sheets.
When patients suffer from allergic rhinitis (the medical term for hay fever), the vast majority of symptoms come from our bodies releasing chemicals such as to fight the perceived intruders.
Antihistamine medications are great for treating runny, sneezy, itchy symptoms. The older antihistamines (like Benadryl and ChlorTrimeton) work very well but tend to make you very sleepy.
Newer drugs like Claritin (loratadine) and Zyrtec (cetirizine) offer similar benefits without the sedation. Both now have generic equivalents available over the counter.
Decongestants are added in to address nasal congestion and sinus pressure, but must be used cautiously in people with hypertension. Over-the-counter nasal sprays can offer some relief, but patients often become dependent on them.
If just itchy red eyes are the problem, there are newer over-the-counter eye drops that can offer some relief.
Sometimes allergy symptoms are just too severe to be handled through lifestyle changes and over-the-counter remedies. That is when you should consider seeing an allergist, who can identify the source of your symptoms and better target your treatment. Relief might be as simple as proper use of a prescription drug. For instance, nasal steroid sprays are the best treatments we have for rhinitis symptoms but must be used as prevention, not when you're in full-fledged misery.
Many patients require more aggressive treatment of their allergies, in the form of allergy shots. Allergen immunotherapy is the only FDA-approved treatment for allergies that can offer long-term benefits for your symptoms. It's a commitment of time and money, requiring you to see your allergist regularly. But the payback is that over time, the therapy changes the way your immune system deals with allergens, making your reactions less severe and in many cases cutting your need for medication.
Dr. Mona V. Mangat is a board-certified allergist and immunologist in St. Petersburg at Bay Area Allergy & Asthma. You can find her at www.bayallergy.com.