The Pollening

It sounds like the description of a horror movie. For some people, when the trees, grass, and weeds start to release their pollen and fungi send out their spores, it can certainly feel like it. If you’re among the roughly one in four adults who deals with seasonal allergies, whether mild or severe, you may just be wondering why this is happening. Though annoying, it’s quite interesting what our bodies are doing. An allergy is the immune system’s response to contact with a foreign substance that it deems harmful, even though it isn’t. Pollen is just one of several innocuous particles that triggers our immune systems to release antibodies to combat the invaders we inhale. This typically results in an itchy nose, sneezing, watery eyes, congestion, and other bothersome symptoms that can sap the joy out of an otherwise delightful season.

One of the reasons spring allergies have such a widespread effect is because, currently, trees are producing massive amounts of pollen to ensure reproduction. Since trees can’t move, they rely on the wind to carry their multitudes of minuscule grains to other trees to complete the fertilization process. Kind of feels like we’re having “The Talk” right now, doesn’t it?

Just when the trees are about done doing their thing, then the grass kicks in and goes through a similar process. That’s why allergy season lasts so long for some. The reasons why some people are affected, and others aren’t—or their response to pollen changes as they age—are varied and complex. The important question isn’t so much why we get seasonal allergies, but how we can alleviate some or all of the discomfort associated with them.

To get some answers, we talked with Dr. Ted Kelbel, a board-certified allergy/ immunology physician with Corewell Health.

It’s good to start by identifying the symptoms, he says, and ruling out first that it’s not a viral infection—which can be tricky at the onset. The difference is that allergies generally make people itch, whether it’s irritated, watery eyes, an itchy nose, or sneezing. And, if these symptoms come on seasonally and correlate with heavy pollen counts, it’s often easy to conclude what’s the culprit.

Treatment typically starts with over- the-counter medications. Recommended to try first are second-generation oral antihistamines, which tend to have longer-lasting relief and are not as sedating. These include Cetirizine (Zyrtec®), Loratadine (Claritin®), and Fexofenadine (Allegra). These offer transient relief and generally start working quickly.

For those with more chronic symptoms, nasal steroids, like Fluticasone (Flonase) and Triamcinolone (Nasacort AQ ), can help. These are also available over the counter and can be used to calm overactive immune responses to allergens. From there, consulting with
a primary care physician or getting a referral to a board-certified allergist
are options, as they can prescribe medications that could be added,
such as nasal antihistamines, ocular antihistamines, or leukotriene blockers.

Still struggling? For those with more significant symptoms who don’t respond very well to more traditional medications, it may be time for allergen immunotherapy. Allergy shots can be helpful in getting the immune system to stop reacting to the allergen. The goal with these shots is, over time, for the immune system to essentially forget how to react to allergens—and for the patient to eventually be able to discontinue the shots and still maintain the benefit for years to come.

Seasonal Allergy FAQs

How does someone know when it’s time to see an allergist?
I always recommend having a discussion with your personal physician about when you need a referral. If you’re not doing the things you want to do because of your allergies; if you’re not going outside
when the weather is nice or you’re really suffering from symptoms when you do, it’s very reasonable to think about seeing a board- certified allergist. There, you can have testing done and consider treatment options.

Why is it important to treat and not just tolerate allergies? For one, allergic rhinitis is the number one cause of presenteeism: You go to school or work or but you’re not functioning
at your best. There are also real consequences for uncontrolled allergies over time. You not

only have to deal with the symptoms in the moment, but if they’re chronically uncontrolled, you’re going to be at increased risk to get sinus infections and need oral steroids.

All of those have side effects and long-term consequences. It’s far better to be proactive and try to get the symptoms under control.

The Scoop on Natural Remedies and Alternative Tactics
For those who prefer not to use allergy medicine, let’s talk about the buzz around local honey.

It’s been debunked by the medical community because bees make honey from the pollen in flowers, which is much bigger and stickier, and humans are not typically allergic to it. “It’s the really tiny pollens from the trees and the grass and the weeds that cause the trouble,” Dr. Kelbel says. “I’m very pro bee and I support local honeybee farmers, and local honey is

great for a number of other reasons, but it’s not probably going to make a big difference in someone’s allergies.”

Still, some seasonal allergy sufferers say consuming local honey helps, and even if it’s because of the placebo effect, at least you’re supporting local bees!

What Dr. Kelbel does get behind is the use of neti pot rinses and other forms of nasal saline irrigation. It’s crucial to use sterile water to prevent infections, mixed with a specific ratio of salt (often sold in packets at a pharmacy). This technique removes pollen and other debris, loosens up mucus, and relieves other nasal symptoms related to seasonal allergies.

There are also avoidance strategies. Closing windows, using the air conditioning and a high-quality air purifier with a HEPA filter can help. Finally, consider taking oral antihistamines before going outside, and/or waiting to go outside until later in the day, as pollen counts are highest early in the morning.