Should you crank up your early allergy strategies this year?

This is normally the time of year to think about taking medications to ward off spring allergies. Starting treatment about a month before the season (which begins in February in some parts of the country) gives the drug time to achieve its full effect and prevent symptoms.

But the pandemic may have you questioning that approach: is an early regimen necessary if you’re isolating and you’re not going outside very often? The answer is yes. “Even a short walk around the neighborhood, sitting on a patio, or simply opening the windows for fresh air could expose you to allergens,” says Dr. Anna Wolfson, an allergist and immunologist at Harvard-affiliated Massachusetts General Hospital.

The allergen effect

Spring allergies are usually triggered by tree pollen. If you’re allergic, then when you breathe in pollen (or another allergen), the body mistakes it as a threat. Immune system cells in the nose sound a warning, releasing chemicals that cause allergy symptoms: itchy, watery eyes; sneezing; a runny nose; congestion; or a sore throat from postnasal drip.

As the battle is waged, immune cells call for backup to continue the fight. The longer your defenses are engaged, the worse your symptoms become.

Use these in advance

To head off the alarm sounded by the immune system, Dr. Wolfson recommends that you use two medications about three or four weeks before you’d normally experience symptoms.

A steroid nasal spray to fight inflammation, such as fluticasone propionate (Flonase). “It’s meant to be used every day, not just when you have symptoms. It builds up in your system to decrease inflammation and symptoms over time,” Dr. Wolfson explains. “The key is using the spray correctly. People have a tendency to aim the spray straight up, toward the bridge of the nose. You need to point it off to the side, toward your eye, to avoid the middle of the nose, which has a tendency to bleed when exposed to the medication.”

Antihistamines to counteract histamine, a body chemical involved in allergic reactions. “I recommend long-acting antihistamines like cetirizine [Zyrtec] or fexofenadine [Allegra]. They are generally taken daily. I find most people can’t tolerate diphenhydramine [Benadryl] because of very sedating side effects. Another thing to avoid is any drug labeled as a decongestant, since decongestants can increase heart rate and blood pressure, and aren’t meant for long-term use,” Dr. Wolfson warns.

Will these medications reduce the immune response to COVID-19? “No,” says Dr. Wolfson. “Oral steroids dampen the immune system. But the amount of steroid absorbed through a nasal steroid spray is so small that it would not affect the immune response. And antihistamines block histamine receptors, but that won’t block your ability to fight COVID.”

Use these when the season beginsOnce allergy season is officially under way, doctors advise using two more treatments.Nasal saline rinses, which can be used as needed.Antihistamine eye drops, if you have itchy or watery eyes. Examples of over-the-counter options include ketotifen (Zaditor) and olopatadine (Patanol).Other steps you can takeThese pill-free steps may also help you manage your allergies:Keep windows closed to avoid allergens.Avoid going outside when pollen levels are high.Clean air conditioning ducts and filters.Wear a mask any time you’re outside — to block allergens as well as the COVID virus. But if you’re outside and frequently lowering your mask when others aren’t around, it will be less effective at keeping allergens out.

An added benefit

If your allergy symptoms are controlled, you’ll be better able to discern signs of COVID. That’s important, because allergies and COVID share many of the same symptoms.

A big difference between the two: allergies do not cause fevers, shortness of breath, muscle aches, diarrhea, chills, headaches, fatigue, loss of appetite, or loss of taste and smell, the way COVID does. “You can imagine that if you have bad allergies you might not realize you have early symptoms of COVID,” Dr. Wolfson says. “It’s better not to have to second-guess symptoms. Control your allergy symptoms, and you’ll be more likely to recognize COVID symptoms.”

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Acts 4:18-31 And when they had summoned them, they commanded them not to speak or teach at all in the name of Jesus. But Peter and John answered and said to them, “Whether it is right in the sight of God to give heed to you rather than to God, you be the judge; for we cannot stop speaking about what we have seen and heard.”     

2 Chronicles 25:19 “You said, ‘Behold, you have defeated Edom.’ And your heart has become proud in boasting. Now stay at home; for why should you provoke trouble so that you, even you, would fall and Judah with you?”

1 Samuel 2:3 “Boast no more so very proudly, Do not let arrogance come out of your mouth; For the LORD is a God of knowledge, And with Him actions are weighed.

Proverbs 11:2 When pride comes, then comes dishonor, But with the humble is wisdom.

Proverbs 16:5 Everyone who is proud in heart is an abomination to the LORD; Assuredly, he will not be unpunished.

Micah 2:3 Therefore thus says the LORD, “Behold, I am planning against this family a calamity From which you cannot remove your necks; And you will not walk haughtily, For it will be an evil time.

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