It is coming into the summer of 2006 at the time of writing this article. For 25% of the population the sunshine and warm weather is not a welcome sight namely those people who suffer from hayfever. In the summer time those allergic to grass pollen which is 95% of hayfever sufferers have to deal with many symptoms such as itchy eyes, throat, ears and blocked up sinus's, headaches, breathlessness, sleep disturbances, mood disturbances, sneezing, fatigue, cough, loss of sense of smell, earache, lack of concentration, runny or congested nose, conjested chest etc. Asthma symptoms can be made worse by allergens including pollen. Some people only suffer asthma during the hay fever season and this is sometimes referred to allergic reactive asthma. For an unfortunate number of people (25%) hayfever (or as it should properly be called pollinosis) symptoms can develop in early april if allergic to tree pollen or even as early as january if allergic to alder or hazel tree pollen. Others are allergic to fungal spores which occur between september and november.
Surprisingly it is commonly reported in benzo withdrawal that people get hayfever for the first time in benzo withdrawal. Whether runny nose and histamine like effects are just a withdrawal symptom in itself or whether the withdrawal process can trigger people to become allergic to various allergens is unknown. It may just be that some people had a mild sensitivity to grass or dust or whatever and the withdrawal process heightens the various allergic effects so hayfever is experienced for the first time. As far as I am aware it has never been studied medically and is just something commonly reported anecdotally in the 'benzo community'. I had hayfever symptoms before benzo's. I have suffered it since I was 14 or 15 or so.
Some people in the benzodiazepine withdrawal or recovery process become very anxious at the prospect of introducing a new drug into their system so I have added some alternative non-drug methods to this Allergy F.A.Q.
Pollen
Some people ask why do I get pollinosis and other people don't?
Pollen grains which are released by the male plant are very small and invisible to the naked eye measuring about 0.5 microns in diameter. They come in various shapes and sizes depending on the plant species. Some pollen are more allergenic than others. Pollen is made up of several proteins. It is these proteins that our body is allergic to. The allergic proteins are often known as 'antigens'. When these antigens come into contact with us our body thinks the pollen is an invading virus and the immune system goes on the attack and tries to neutralise the 'infection' and it is the immune reaction to pollen which causes the unpleasant symptoms of hayfever. It is just how your body responds to the allergens and whether it correctly recognises the allergen/antigen as harmless or mistakenly thinks it is an invader. Genetics do play a role and also what time of year you were born. Having a family history of hayfever or allergic disease and being born into hayfever season does not do you any favours for your risk of developing hayfever.
It can sure be a stressful time for anyone but someone already suffering withdrawal symptoms the stress of having to deal with additional symptoms is not welcome news. So what can you do to deal with pollen allergies? Well I as a hayfever sufferer have over the years developed several methods which make the hayfever season a lot less of a stressful time of year. I will share this information with you below. I will also list common medications as well as drug free ways of dealing with pollinosis. I will start off with therapies offered by the medical community and then I will follow on with alternative strategies which can be put in place instead of or in conjunction with drugs.
Dust
Dust allergy is a common allergy. The allergens in dust are mostly produced by the faeces of dust mite or dead dust mite particles but also cockroaches. This can cause all year round "hayfever" like symptoms. It is usually at its worst in october in the U.K. This can be a cause of or can worsen asthma conditions.
Food and Drug Allergies
Food and drug allergies can cause anything from a minor nuisance to life threatening anaphylaxis. Usually avoidance of the food or drug to which the person is allergic to is the best method. It is important to seek a medical opinion due to the sometimes serious nature of food and drug allergies.
Wasp and Bee Allergies
Like food and drug allergies venom allergy can cause anything from a minor rash to life threatening anaphylaxis. Wearing fragrances or bright colours on dark background will attract bees and wasps as will sweet foods or drinks. It is important to follow your doctors advice if you suffer from this allergy.
Animal or Pet allergy
Another allergy that can cause year round "hayfever" like symptoms is animal dander allergy. Avoidence of animals to which you know you allergic to is the best way of dealing with this condition, unfortunate for animal lovers. This can be a cause of or can worsen asthma conditions.
Other Allergic conditions
There are numerous other allergic conditions which are beyond the scope of this article. At the bottom of this page there will be referenced and recommended pages which can be visited for more information on allergies. Also speaking to your doctor is recommended.
Diagnostic Tests
Skin scratch or prick test
This is where a small amount of allergen is placed just under the skin and the area is monitored for about 30 minutes to see if any swelling or redness occurs.
UNIcap RAST
This is a test which involves taking a blood sample and it is then sent to a laboratory for measurement of immunoglobulin E (IgE for short). Antigens either food or inhalant are then added to the blood and IgE levels are measured to see if they increase when the allergen is added to the blood.
Diagnosis based on Symptomatology
This is by far the most common method of diagnosing allergies. Based on when the symptoms occur and if the symptoms are classical symptoms of allergy and response to allergy avoidence or treatment methods can be all that is required for a diagnosis. If symptoms are all year round the likely cause is dust or animal allergy or perhaps food allergy. If they are seasonal, pollen or mould allergy is more likely. Talking over your symptoms with your doctor and pharmacist can help get an accurate diagnosis quickly and advice on treatment or allergen avoidence can begin.
Medications
There are several different medications which can be used for hayfever and other allergies. Some can be bought over the counter (O.T.C) in pharmacies or chemists. Others are prescription only medicines (P.O.M).
Antihistamines.
Piriton (chlorphenamine maleate) (O.T.C.) or Phenergan (Promethazine hydrochloride) (O.T.C.)
NOTE:- Antihistamines bind to histamine receptors and not benzodiazepine receptors.
These two antihistamines are very good at relieving hayfever symptoms particularly symptoms such as itching. They do however have the draw back of causing marked sedation and drowsiness.
Claritin (loratadine) (O.T.C.) or zirtek (cetirizine) (O.T.C)
These two antihistamines are also excellent relievers of hayfever particularly itchiness. They have the added advantage of not readily crossing the blood brain barrier and therefore symptoms such as drowsiness and other CNS effects occur only rarely. They are however more expensive.
levocabastine (Livostin) and azelastine (Rhinolast)
These are nasal antihistamine sprays for administration intranasally which should help reduce itchiness. They have no effect on nasal congestion though. They have an unpleasant taste.
Nasal corticosteroids
Fluticasone (Flixonase), Triamcinolone (Nasacort) and Mometasone (Nasonex)
These cortico-steroid sprays help control and reduce the underlying inflammatory process. The above preparations can be used once daily. These corticosteroids can also help treat polyps in the nose.
Occasionally oral steroids are required to treat a severe bout of asthma during hayfever season or at other times. Oral corticosteroids do have numerous side effects and should generally only be used in cases of severe disease or symptoms. They should never be combined with a quinolone antibiotic due to increased risk of full body permanent peripheral neuropathy and also increased risk of achilles tendon tears which occasionally causes permanent disability (I know of a 14 year old girl who has to spend the rest of her life in a wheel chair because of this drug combination hence the strong warnings).
Decongestants
Oxymetazoline (Dristan) and Xylometazoline (Otrivine)
These preparations come in spray form and are ideal for relieving nasal congestion however they are recommended only for 7-10 days use or occasional use.
Ephedrine sprays
These types of spay can also relieve congestion. They should be gradually stopped as sudden withdrawal can cause a rebound in congestion known as "rhinitis medicamentosa".
Pseudoephedrine (Sudafed and Galpseud) (O.T.C.)
This drug can be taken orally however it is a stimulant and can cause anxiety, insomnia and psychic disturbances. It is also risky for anyone with a heart condition or glaucoma. There may be a risk of dependency with this drug.
Other medications
There are other medications and classes of medications beyond the scope of this article. For more detailed information please refer to the referenced web sites and or speak to your doctor or pharmacist.
Non-drug Alternatives
Immunotherapy
Injection Desensitisation Immunotherapy
This involves injecting the allergen which the patient is allergic to into the blood over a period of 3 years. Gradually the dose of the allergen is increased and over time the body becomes accustomed to the allergen and allergic symptoms decline and tolerance to the allergen develops. It is initially started with an injection once per week and over time this is reduced to once per month and then treatment is finished after 3 years. This treatment is only available at specialised allergy clinics and usually only for people who do not respond adequately or cannot tolerate medications.
Sublingual Immunotherapy (SLIT)
This is very similar to injection desensitisation only it involves drops of the allergen being applied under the tongue with the dose slowly increasing until tolerance develops as explained above. It is not available at the time of writing in the U.K. however it may provide a much simpler way for desensitisation therapy than the injection therapy as it can be carried out at home.
Dealing with dust allergies
Specialised anti dust mattresses and blanket covers can be purchased to make the bedding less friendly to dust and easing the symptoms of dust allergy and asthma. Also there are specialised vacume cleaners for cleaning and removing dust and special powders and cleaning fluids which can be applied to surfaces such as carpeting to reduce dust causing organisms.
Dealing with Fungal Allergy
The treatment and recommendations for fungal allergy is much the same for pollen allergy. The only additional advice is to clean any sign of growing mould and to throw out any moulding materials e.g. moldy food or molding carpets or chairs etc.
Pollen Masks
If a good quality tight fitting mask is worn it can be better than drugs in relieving or even eliminating allergic symptoms. They act by trapping the allergen in the masks HEPA filter so that it never reaches the bodies mucosa lining (throat, lungs, nasal areas). They may however be impractable for many people as a mask may be more of a nuisance than the pollen itself. Another problem is they are inpractable for wearing out in public unless you are immune to what other people think of you. See bottom of this page for references for places to purchase pollen masks.
Air filters units
These are an excellent technology for allergy sufferers. Many people report great success with these devices. They can be better than drugs in relieving allergy symptoms as they remove the allergen from the air before you can inhale it. There are numerous air filters on the market. Some are better than others. Some boast of the claim of having ionizing features which bind to the allergen neutralising it in the air. However the ions produced are in effect ozone. Ozone is a toxic substance which may exacerbate asthma and allergy symptoms however most of the ionising filters do have the option to turn off the ionizing feature and just use the HEPA filter feature alone. My personal recommendation is the ESSA air filter which uses high grade filter materials to trap the allergens and also a high voltage electrostatic core which attracts and destroys allergens in the air. It is also remarkably quiet. I can sleep quite easily with it on moderate speed setting.
The other alternative is to buy a HEPA filter although if it comes with an ionizing feature I would recommend that you disable the ionizing feature manually. See bottom of the page for further details on where to purchase these air filter units. The main draw back is the expensive cost of air purifying units.
Other things that can be tried
Their are various other things that can be tried e.g. pollen screens for windows, goggles for eye symptoms or wearing glasses etc. Some people swear by alternative therapies e.g. herbs or acupuncture etc.
Monitoring the pollen count
Another important thing to do is to know when the count is high. Visit websites which give a daily pollen count forecast. A few minutes searching of google for pollen forecasts for your country or state will surely track down a web site which will give a pollen forecast for you. If you live in the U.K. a good, accurate and reliable pollen forecasting web site is http://www.zirtek.co.uk/Support/Pollen_Forecast.aspx
Sensible precautions
Sensible precautions include avoiding going outside when the pollen count is very high which is on windy and or hot dry days. The pollen count is at its highest in the morning when the plants release most of their pollen spores and also during the evening when the cooler evening air causes the pollen to fall down from the atmosphere. Try to Keep windows and doors closed as much as possible.
Recommended allergen Air Cleaner http://www.essaeu.co.uk
Recommended for pollen masks http://www.respro.com/home.php
Recommended for products for dust and pollen allergies http://www.healthy-house.co.uk
Recommended for U.K. residents for pollen forecasts http://www.zirtek.co.uk/Support/Pollen_Forecast.aspx
References
http://www.allergyadvice.co.uk
http://www.allergy-clinic.co.uk
http://www.bcnc.org.uk/drugs.html
http://www.consumerreports.org/cro/appliances/ionizing-air-cleaners-505/overview.htm
Hayfever Information Site
http://www.hayfeverexpert.co.uk/
Page disclaimer
This allergy F.A.Q. was not written by someone who is medically qualified however it was reviewed by a medically qualified doctor who believed the content on this page to be accurate. The information on this page is not meant to replace that of your medical practitioner. It is always recommended that information from our site or given by our organisation is used in conjunction with and to supplement that of your doctor. Please click on our disclaimer option below to read BCNC's organisation full disclaimer.
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