Hay Fever Misery – How can you treat it?
Oh. My. God. Hay fever. It’s terrible hasn’t it? After being cooped up for so long, spring sunshine and warmth finally arrives and you're too miserable to enjoy any of it. Eyes swollen shut, asthma attacks, sneezing until the nose bleeds, lethargy and itchy itchy itchy! everywhere are for many the hallmarks of Spring/Summer. In my house, my son and I both suffer, he especially. Ever since he was a baby, there's a fortnight each year where his eyes are practically glued shut.
Of course, we can blame the weather. Warm weather in spring, interspersed with plenty of rain in the form of (most, although not this one!) April showers, provides ideal growing conditions. Then, in May, lots of dry weather with light winds allows the pollen to lift into the air and remain suspended. Billions of microscopic particles dancing through the sunshine.
Which pollen gets us? The answer is literally blowing in the wind. When we see articles about hay fever, they’re normally accompanied by a photo of pretty flowers and bees. But in truth the insect-pollinated plants are not the ones that cause hay fever; that heavy, sticky pollen doesn’t travel in the air as well and needs to be transported by the bugs. It’s the innocuous looking green plants and grasses that are our nemesis.
In the UK, at least 1 in 5 people suffers from hay fever. Even pets can get hay fever. There is no cure, but there are plenty of ways you can tackle it to reduce its symptoms and their impact on your life.
So what exactly is hay fever?
The medical term for hay fever is seasonal allergic rhinitis, an allergy to airborne pollen and fungal spores which affects the eye, nasal passages and lungs. If a person is allergic to a particular substance (allergen), the immune system mistakenly believes that this normally harmless substance, e.g. pollen, is in fact harmful to the body. The symptoms are caused when the body makes allergic antibodies (Imunoglobulin E) to fight off the spores. The allergen binds to the IgE antibodies. When this happens, the mast cell breaks open to release inflammatory substances, in this case histamine, which quickly travels through the body to fight off what it senses as harmful. The histamine affects the body tissue and causes an inflammation.
There are three main categories of pollen which people react to: tree, grass and weed. 95% of people who suffer from hay fever in the UK are affected by grass pollen, but within the three main categories there are around 30 different types of pollen that cause hay fever symptoms and people tend to be allergic to more than one type of pollen.
The “season” runs from March to August, but for some, can start earlier and finish later. Grass pollen is common in late spring and early summer, and there are more than 150 grass varietals in the UK. Tree pollen tends to be released during spring and affects around 25% of people. Weed pollen can be released at any time from the early spring to the late autumn. The Met Office have a great chart to help you see which might be affecting you, but of course the weather can sometimes delay or speed up the emergence of a particular pollen.
What are the symptoms of hay fever?
There are the obvious ones of course. Sneezing, red and runny eyes, itchy throat.
Then we go up a level of discomfort with post nasal drip, a persistent cough, asthma attacks, breathlessness, itching inner ear canals, ear blockages and nose bleeds.
But worst of all, there are other symptoms that people don’t always link to the hay fever and can have a huge impact: anxiety, lethargy and an inability to sleep. One of my good friends was told by her doctor that her bout of debilitating vertigo could very well be linked to pollen. People miss work and school. Exam results can be severely affected.
When I think back to my exams 20 years ago, I can see what a massive effect my hay fever had. I stumbled through both my final A’Levels and my 3rd year university exams in a kind of daze, both from the symptoms themselves and the antihistamine I used to treat them. My mum didn’t believe in allergies back then, they were considered fad-ish and American. In misery, and following a bout of pneumonia, I ended up going through the the private health sector and having a series of skin-prick tests. The right arm was subjected to all kinds of pollen. It blew up like a blimp. It was official then, that I had hay fever. But what next?
I’m miserable, what can I do to treat my hay fever?
As I said above, there is no cure for hay fever. The approach is to avoid where possible and treat the symptoms.
No-one should be locked up indoors when the weather is lovely. I certainly wouldn’t keep my son inside, even though his hay fever is far worse than mine. But there are ways to avoid the worst of it:
Check the pollen count and try to limit time outdoors when levels are high. Pollen levels are highest early in the morning when the pollen is being released and again in the evening the air is cooling and the pollen is falling to ground level.
Do not cut grass or work in the garden on days when pollen levels or high. If you must, consider wearing a filter mask.
Wear wraparound sunglasses outside.
Don’t camp in grassy fields.
Shower when entering the house at the end of the day and change clothes.
Wash bedsheets regularly in hot water.
Don’t hang washing out to dry.
Consider a pollen filter for car airvents and use the internal circulation button when in the car.
Buy or hire an air filtration device for your home.
Don’t hang washing out to dry.
Over the counter remedies:
As I said above, I was zombiefied in the springs of my late teens as a result of the antihistamines that were supposedly helping me. Nowadays, there are far better products on the market:
Antihistamines – no longer the knock-out pills of old, a one-a-day pill can calm your symptoms without the drowsiness. Although the older chlorphenamines are still available and will make you sleepy, a bonus if you’re struggling at night, look for the newer non-drowsy cetirizine, loratadine and fexofenadines.
Steroid nasal sprays – can work on all symptoms is started early enough in the season by controlling the inflammation in the nose and in return the response across the body.
Steroid antihistamine combination nasal sprays
Decongestants – can be taken until a nasal spray starts to have an effect.
Decongestant nasal sprays – may be useful on the worst days or for additional relief of congestion for an exam or special occasion but should not be used regularly because after a few days use, they can make symptoms worse by causing a rebound effect.
Nasal saline douches
For some people, hay fever symptoms are so severe that OTC medicines aren’t enough. Among the GP’s arsenal:
Inhalers – for asthma symptoms, one or both of a preventative steroid inhaler and/or a reliever inhaler may be prescribed.
Oral steroids – can also be given but only for severe cases and in short doses.
Immunotherapy – for those who are extremely affected by hay fever and who have not seen relief by the correct and continued use of normal medication, a course of specific allergen immunotherapy (or desensitisation)can be prescribed. It’s only for the long haul though; it involves regular application of the allergen, either under the tongue daily or by injection at intervals, continuing for at least 3 years.
If medications aren’t for you, there are some alternative therapies to try to limit your symptoms:
Rub vaseline inside the rim of your nose. There are also specific allergen barrier balms on the market that amount to the same thing.
Eat local honey from within a five mile radius of your home
Try nasal saline douching to clear the air passages
Limit mucus inducing foods such as dairy products
Avoid alcohol which contains histamine and exacerbates symptoms
Herbal teas such as licorice and nettle can help by reducing respiratory tract inflammation
The herb Butterbur has been proven by scientists to work as effectively as some antihistamines but you’ll need to talk to a herbal specialist to get the right dosage for you.
Acupuncture is said to be an effective alternative therapy.
What effect will climate change have on hay fever in the future?
Still suffering? There’s bad news. The changing climate means hay fever is here to stay, and could get worse as scientists say that the potency of pollen could increase. Changing climates can lengthen the pollen season, and make pollen counts higher. The plants that can affect us will also change in geographical spread as the climate changes with more invasive species arriving in the UK.
But… I see a light at the end of the tunnel. My son and I meet in the hallway, have we taken our loratadine? Did you use your inhaler? Can you put my eyedrops in? We have honey on toast. We give the ice cream (and the wine) a rest. Just breathe. Just breathe.