House Call: Training for Bloomsday? Prep for spring allergies, too
Blooming trees and flower buds have arrived. Sneezing, watery eyes and runny noses have, too. Just as we’re emerging outdoors and thousands of people are training to run, jog or walk in Bloomsday, Spokane’s allergy season is in full spring swing.
Common symptoms include sneezing, watery and red eyes, a stuffy nose with congestion and a runny nose with post-nasal drip that can lead to cough or sore throat. Seasonal allergies can make you feel tired and give you puffy eyes, a headache or even itchy ears.
It can be difficult to tell if it’s allergies or a common cold, flu or COVID-19 infection. Typically, allergies don’t cause a fever or body aches. If your symptoms include fever, loss of sense of smell, severe sore throat or cough with shortness of breath, it is recommended that to get tested for COVID-19 and influenza and follow appropriate safety precautions until the results are known.
If you are one of the more than 24.4 million Americans with seasonal allergic rhinitis, what can you do to get ready and protect yourself? It’s a little like training for a 12K run: You can prepare your body and take precautions like regular stretching and graduated conditioning to ensure that you don’t suffer a sprain or get too sore.
Each person is different and needs to know their own strengths and limits and find a training program that works for them. Controlling allergies works best if you can identify your own triggers and plan ahead to prevent allergic reaction and symptoms before your immune system is in full inflammatory response.
Understanding triggers
Some people’s immune systems react strongly to certain triggers in their environment, responding as if to fight off a threat. It’s helpful to know if it’s blooms, dust bunnies or cats that set you off. Allergic rhinitis can be triggered by outdoor allergens like pollen and indoor allergens such as dust mites or dander from pets, both furry and feathered.
Timing can help you figure that out. Allergies are incredibly individual, and people are allergic to different pollens at different times. Early spring brings out tree pollens like birch and cedar, and then flowering pollens and grasses emerge later in spring.
June brings yellow pine pollen season in Spokane, and for many misery with it. In the late summer and fall, harvest time can stir up wheat or barley chaff and dust, which triggers some people. This may be where the term hay fever came from even though it’s not actually the hay causing the allergy.
We tend to think of spring, but I commonly hear allergy complaints as we move into winter. When colder weather hits and people move indoors, their nose gets plugged up, and they start sneezing and coughing, often worse at night. In winter, dust mites and mold can trigger indoor allergies.
When I ask if they changed out their furnace filter or cleaned the dust bunnies out from underneath their bed, they usually say, “No, it’s been awhile, I think over a year!” House dust mite is ubiquitous and gets kicked up and circulated in the bedroom, triggering allergic reactions.
Get ahead of it
Sometimes once you start sneezing, it’s difficult to stop. Those sneezes are a reaction to a protein that triggers an immune response in your mast cells. They produce a histamine response causing your blood vessels to dilate and a runny nose, watering eyes, sneezing or other symptoms.
Ideally, you want to stop that reaction before it starts. There are three main ways for doing that:
Avoid triggers
Limit your time outdoors when you know the pollens you are allergic to might be present in full force, especially on dry, windy days. It’s a good excuse to delegate the yard work to someone else.
Wearing an N95 mask outdoors can help with seasonal allergies. You can track local pollen counts with an app or through your local weather report. Take simple steps to avoid your trigger, whatever it is: Stay away from cats if you are allergic, and wash your bedding frequently in hot water if it’s dust mites that set you off.
Reduce exposure
Getting outside is good for you in lots of other ways, so don’t let allergies make you give up that healthy running or walking. You can reduce the chances of reacting to pollen or other allergens by reducing your contact, too.
Many people find using a nasal saline irrigation helps, such as a saline mist spray, which you can buy over the counter, or using a device called a neti pot. These flush out the nose, reducing contact between the pollen and the mast cells. Saline mist sprays can be kept in your pocket or purse and used throughout the day when outdoors or otherwise triggered. Just don’t overuse saline irrigation and create more irritation.
Showering after you’ve been outdoors or at the end of the day can help reduce allergen contact. You can also improve your indoor air quality, so you aren’t dealing with allergens when you’re not out running. Humidifiers, air filters and replacing your furnace filters regularly can all reduce allergens. You can find furnace filters that are made to filter out fine allergen particulates at your hardware store.
Block the response
Using nasal steroid medication on a regular basis will help stop the hyperactive immune response before it blooms and minimize the cascade of inflammatory responses to pollen like a runny nose and itchy eyes. These over-the-counter medications, such as fluticasone, work directly on the mast cells that trigger the histamine response and can be used even in kids as young as 12. Like regular training, using them regularly during allergy season is most effective.
Managing your allergies before you’re having a reaction works the best. Once the horse is out of the barn, so to speak, you can only treat symptoms. Taking antihistamines blocks the activity on cells in mucous membranes, but the histamines have already been released into your system, so your body is still coping with the immune response.
Decongestants, both nasal sprays and pills, can be effective at easing a stuffy nose in the short term, but can cause a rebound effect where you end up as bad or worse once they wear off. If you have persistent nasal runniness or rhinitis, you also may want to get evaluated by a primary care provider to talk about other causes such as infectious diseases and senile rhinitis.
It’s a great time of year to get outside, enjoy Spokane’s outdoors and get in shape, whether that’s Bloomsday or taking a bike ride around the Centennial Trail. You don’t have to be restricted due to allergies if you take the appropriate precautions and strategies outlined here.
Take care of yourself while doing so by wearing gear like a helmet and reflective clothing, following community standards around coronavirus precautions and minimizing your spring allergy reactions by getting ahead of the symptoms. Good luck with safe and symptom-free training!
Dr. Jeff Markin is a family medicine physician practicing at Kaiser Permanente’s Veradale Medical Center.