As the trees begin to turn, for some that’s a reminder that fall allergy season has returned. If you are one of the many people affected by seasonal allergies, what are you planning to do about it?
There are many medications that people use to reduce the occurrence and severity of seasonal allergies. The most common are antihistamines (H1 receptor blockers), which include first-generation antihistamines (such as diphenhydramine, chlorpheniramine and promethazine) that often are used acutely, but cause drowsiness and impaired cognition and memory because they cross the blood brain barrier. Despite being used for more than decades, they have a paucity of data on their long-term safety.
Second-generation antihistamines (such as cetirizine, fexofenadine and loratadine) are used either orally or intranasally, cause less sedation and have more safety data behind them. They can be used for up to 18 months. Intranasal corticosteroids are another frequently used treatment for seasonal allergies and have limited systemic absorption, and hence lower side effects than oral steroids. They are associated with an increased risk of nosebleeds, and more rarely, nasal perforation or candidiasis.
Certainly when symptoms are unbearable, there is a role for these medications. However, over the long term, the use of these medications is merely masking the body’s signs of distress. If we consider symptoms as messengers of the body, then the presence of allergies can be viewed as an expression of an immune system burdened by a pro-inflammatory environment.
When the body’s allergic responses are suppressed, without changing the internal environment that promotes inflammation in the first place, the imbalance tends to be expressed more aggressively or through another outlet, either rendering medications (whether pharmaceutical or natural) less effective, or worse, contributing to the manifestation of deeper and more serious conditions.
From a naturopathic perspective, the question is, what is provoking and perpetuating an inflammatory state? The cause of allergies is multifactorial: Irritating factors add up to reach a threshold at which an inflammatory response is provoked. These factors might include inhaled, ingested or topically absorbed substances. Additionally, nutritional status, detoxification pathways, psycho-emotional states and familial predisposition also determine one’s susceptibility.
The good news is that because many factors contribute to allergic states, there are many approaches to treating them:
While it may not be possible to change all of the factors that contribute to allergies, reducing one’s overall inflammatory burden can make a profound impact in altering one’s propensity for seasonal allergies.
— Bridget Grusecki, ND, naturopathic doctor and resident at Bastyr Center for Natural Health.
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