How to cure hay fever

I hope you’ve got tissues handy… the Melbourne hay fever season has started.

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Do you need to top up your supply? Image via Flickr

The Melbourne Pollen Count and Forecast has just started to notice grass pollen in the air around the Melbourne CBD, which is bad news for the majority of hay fever sufferers. What’s more, we are expecting a particularly severe season. 2016 hosted a very rainy winter, and the result is lots of flourishing plants with flowers absolutely brimming with pollen, ready to drift right across Victoria and assault our noses.

If this frightens you personally or if you’re tired of hearing your co-workers sniffling and complaining all day, wouldn’t you want to cure it? I’m sure many of you have taken active steps to do this, perhaps unsuccessfully. But rest assured, there are quite a few things that are worth a try.

Hay fever, also called allergic rhinitis (allergic nasal inflammation) is an example of an allergic disease. Allergic diseases are all caused by an immune over-reaction to something harmless. And in the case of allergic rhinitis those harmless things are fungal spores, dust mites and, in particular, pollen. Due to the seasonal nature of flowering and pollen release (this is called phenology) and the way this is closely related to daily weather patterns means we can often predict the amount of pollen in the air for upcoming days.

Individuals can use this prediction to help inform their individual management. This prediction comes as a ‘Low’, ‘Medium’, ‘High’ or ‘Extreme’ rating.  These medications are called antihistamines. Their action is in their name, they work against histamines. But what are histamines? Histamines are released by immune cells that trigger the body to respond to an invader (a virus or bacteria for example) with inflammation.

Since hay fever is an immune disease, in which the invader is pollen in our nasal passage, inflammation is also triggered. This inflammation leads to the runny nose, redness, sneezing, itchy eyes and sometimes rashes – all of which we associate with hay fever. Taking antihistamines will work to stop the action of histamines and thus stop inflammation.

Another option is to use nasal sprays. Most people think that nasal sprays work by clearing mucous out of the nostrils, but the relief is actually due to corticosteroids. Corticosteroids work by addressing the source of conjestion, which are the dilated blood vessels (also a consequence of inflammation). They reduce the blood vessel diameter, leading to less swelling, sneezing and itchiness.

Corticosteroid sprays don’t work immediately, in fact, they take several days to come into effect. They can sometimes alter the nasal lining negatively and you should monitor their use very closely with your GP.

However both of these options are merely symptomatic relief, meaning that they address the symptoms but not the cause of the hay fever. And since the cause is the immune system, the only way to cure it is to rewire the immune system. This is possible through immunotherapy, or more commonly called desensitisation.

Desensitisation has a very long and somewhat questionable history, and is an interesting example of a currently effective conventional therapy being initially founded in poor science. Immunotherapy involves being regularly exposed to the allergen you are allergic to, with the dose increasing over time (when I say, ‘over time’ I mean three to five years). These reactions can sometimes be uncomfortable or painful (trust me). The eventual result is the generation of immunological tolerance, meaning the patients won’t respond to the original allergen anymore. If it works, this is essentially a cure for hay fever, your symptoms are gone and you won’t need the other drugs anymore.

It is important to remember that immunotherapy should only be undertaken with supervision of a doctor and a clinical allergist. This is because it is a long-term therapy and it is important to understand every allergen you are allergic to. Excluding even  a single allergen will result in incomplete desensitisation and you will still have symptoms. Missing that single allergen is like fishing four of the chillis out of nice mild curry and leaving one in there – all your hard work has gone to waste and you’re sitting there crying because you’re very very white and don’t like spicy things and the most adversity you’ve ever faced is when you run out of tissues on a particularly windy October day  (this happens to other people right?).

But in all seriousness, hay fever is actually quite a life limiting condition with quite a significant financial burden for individuals and for the economy. And when coupled with other respiratory disease like asthma, it can even result in mortality. So if you find that your antihistamine medication isn’t working anymore, it is really worth a trip to your GP who can prescribe other medication like nasal sprays or they refer you to a clinical allergist. There are effective treatments and there’s even a cure. You don’t just have to put up with being miserable all Spring. Breathing easy, it’s that simple. Go see your GP.

 

Some more information:

https://theconversation.com/whats-the-link-between-hay-fever-and-asthma-and-how-are-they-treated-64740

http://www.allergy.org.au/patients/allergy-treatment/immunotherapy

http://www.allergy.org.au/images/pcc/ASCIA_PCC_Allergen_immunotherapy_2014.pdf

https://www.choice.com.au/health-and-body/conditions/hayfever-and-allergies/articles/hayfever-treatment

Many people believe the myth that hay fever season starts when they see wattles coming into flower: http://www.abc.net.au/news/health/dont-blame-the-wattle/6791396

 


4 Responses to “How to cure hay fever”

  1. trishfishkoh says:

    Awesome post, Lachie! You should write brochures you find at medical centres

  2. Alina says:

    Thanks for an interesting read- my parents wouldn’t let me take anti-histamines when I was younger but unfortunately I haven’t seemed to become desensitised to hay fever allergies

  3. Lachlan Tegart says:

    Hi Amy!
    Not that I know of. But desensitisation is an effective therapy, it is a long term option though, and it is quite uncomfortable in the short term. But it is currently the best long term option.
    This is a good option, in my opinion, because it involves visiting an allergist who is able to tell you what you are actually allergic to, based on a skin-prick test. It helps you to know what to avoid. You might even find that you’re allergic to indoor allergens or animals you didn’t know about.
    I’ll direct you to this article I referenced: https://www.choice.com.au/health-and-body/conditions/hayfever-and-allergies/articles/hayfever-treatment
    It talks about some of the other options out there, but I do reckon it’s worthwhile seeing a doctor

    I visited one in Year 10 and we found out that I was also really allergic to dust mites. This meant that I had to dust and vacuum my room more regularly, it helped a lot!

  4. Amy LeBlanc says:

    This was a great article, and very relevant to me at the moment as I’m currently sitting here sniffling (from hay fever, not chilies: just to be clear). Desensitization sounds like a good idea, but a bit complex. Are there any new therapies in development or under investigation?