Hay fever

D

dr_john

Veteran
 Barrow Upon Soar
It's here again, dry throat blocked nose and sinuses. Strikes every year at this time, last year it didn't stop until around mid-June. I never used to have a problem with it until about 10 years ago. Antihistamines give slight relief but not enough.

The local GP is frickin' useless, just smiles and says put up with it, there's nothing you can do.

Anybody got any solutions? :(
 
YES!

I've suffered badly for years, and got to the point where I was taking two of the one a day loratadine, one in the morning, one in the afternoon.

Then, about 18 months ago, I saw an advert for Prevalin - OMG, what a revelation. It contains no drugs, but is a thixotropic liquid spray. Basically it turns to a consistency of water when shaken, but then thickens when sitting. It coats the inside of the nasal passages to prevent irritation and IT WORKS like a charm. Tree pollen is the killer for me, and since using it, I can happily wander about forests and all sorts without so much as a snivel!

http://www.prevalin.com/uk/

It's not cheap, £11.99 for the one I use but Boots had it on offer last year as did Tesco, so I stocked up. Comes in 2 different types, Allergy and Allergy Plus which contains a desensitiser in the form of a therapeutic oil. I have only ever used the "plus"

Only downside is that it's a bit of a weird feeling spraying it up your nose, but I only need one dose for a full day..

Highly recommended by me!

Mike
 
Ducklakeview said:
YES!

I've suffered badly for years, and got to the point where I was taking two of the one a day loratadine, one in the morning, one in the afternoon.

Then, about 18 months ago, I saw an advert for Prevalin - OMG, what a revelation. It contains no drugs, but is a thixotropic liquid spray. Basically it turns to a consistency of water when shaken, but then thickens when sitting. It coats the inside of the nasal passages to prevent irritation and IT WORKS like a charm. Tree pollen is the killer for me, and since using it, I can happily wander about forests and all sorts without so much as a snivel!

http://www.prevalin.com/uk/

It's not cheap, £11.99 for the one I use but Boots had it on offer last year as did Tesco, so I stocked up. Comes in 2 different types, Allergy and Allergy Plus which contains a desensitiser in the form of a therapeutic oil. I have only ever used the "plus"

Only downside is that it's a bit of a weird feeling spraying it up your nose, but I only need one dose for a full day..

Highly recommended by me!

Mike
Click to expand...

+1 on this product.
 
Oh, and forgot to add, make sure you use it in front of a mirror, otherwise it looks like you've been snorting coke, I kid you not.. As one of my customers pointed out to me last year!

Mike
 
I used to suffer from hay fever really badly. On occasion I couldn't see to drive. However, for me there have been two benefits of getting older. I no longer get hay fever at all and despite immense provocation from time to time, l also no longer get hangovers! :)

Thanks for the tip about Prevalin. Mrs R suffers badly from "birch pollen" which is what's around right now - up your noses and on your cars. I'll pass the tip onto Mrs R.
 
RickRob said:
I used to suffer from hay fever really badly. On occasion I couldn't see to drive. However, for me there have been two benefits of getting older. I no longer get hay fever at all and despite immense provocation from time to time, l also no longer get hangovers! :)

Thanks for the tip about Prevalin. Mrs R suffers badly from "birch pollen" which is what's around right now - up your noses and on your cars. I'll pass the tip onto Mrs R.
Click to expand...

Same with me. One of the few benefits of age that I've slowly grown out of it and now laugh in the face of grass pollen that used to near kill me
Piriton works well for the odd times I get too close to cats, dogs, rabbits, that still destroy me
 
If you are a fellow sufferer, I have found the "Clarityn App" to be quite useful, tells you not only the pollen levels for where you are or are going, but also the type of pollen - Android link (not sure if it's available on crApple devices :) )

https://play.google.com/store/apps/details?id=com.oosocial.clarityn

Mike
 
I'll look into Piriton then, thanks for the tip.

Strange that a couple of you have found relief with age, just the opposite with me.
 
I know a wee bit about this subject -I run a medical rhinology service in ENT and sit on the international WHO guidelines commitee for allergic rhinitis [aka hay fever]
If youre getting hay fever symptoms at this time of eyar its due to tree pollen -most likely Birch
Grass pollen usually doesnt kick in until June
First thing is to establish the cause so ask your GP to do a blood test to measure the allergic antibodies (ie IgE) in your system the -ie total IgE and RAST specific IgE to relevant allergens which enter through your nose incl :tree and grass pollen as well as house dust mite and any pets you might have like cat or dog .The reason for doing this is that you then know exactly what your allergic to and at what level your allergy is ,and also because the more allergens you are sensitised to the more likely your symptoms will be more severe -eg if you are sensitised to say both house dust mite and tree pollen then you are proably going to need more treatment than if just sensitised to one allergen .The total IgE tells you about your overall allergic burden .
Next is what treatment - there is a stepwise approach :
Oral antihstamines -loratadine is the least potent -i use either cetirizine which you get OTC or fexofenadine which needs a scrip from your GP .
Generic Cetrizine 10mg tabs are cheap as chips -about 2 quid for 28 tabs from Lidl when i last looked -5% of people get some drowsniness with cetrizine -in which case i then switch fexofenadine at the right dose ,which is 180mg once daily increasing to twice daily if required .
If you arent controlled oral antihstamines alone -then add either a nasal steroid spray like generic beclometasone 1-2 squirts each nostril twice a day which costs about £5 for 100 doses as OTC -or if you dont like taking sprays then add in in an anti-leukotriene like montelukast -once daily tablet -in conjunction with the anti-histamine -the combination is highly effective and will sort out 80% of symptoms -the steroid spray tends to be more effective than the tabs at treating blockage . Then the way you use the nasal spray device is crucial here -the nozzle needs to be 90 degrees to your face and avoid the bone in the middle which is often tender and once the nozzlle is fully in the nostril aim for the left ear on the left side and the right ear on the right side . If you spray the nostril vertically it wont reach the area where the allergic inflammation is [called the inferior turbinates which run a t 90 degrees to your face ] .
The other option is a combined steroid and antihistamine spray called Dymista which is twice daily and very effective -ie delivering the antihistamine directly to the site of action in the nose is more effective than taking an antihistamine tablet -only down side is that it tastes horrible but that wears off after a few days -i use this myself every day .
If none of above works then you need to be referred to someone like me in ENT to have a nasal telescope [endoscopy ] exam to see if there is any other pathology like nasal polyps [caridnal symptom being loss of smell ] ,and other causes of nasal airway obstruction which can seen with the scope . In some cases a CT scan will be required to image the sinuses .
Allergen immunotherapy is another possibility either via tablet or injection but that needs to before the onset of the pollen season -ie youve missed the boat for that option and it only reduces symptoms by about 30% .I rarely need to use this treatment .
Hope that helps ...
 
I used to get Hayfever really badly as a child, symptoms are quite mild now and I can get by with 1 Certirizine tablet a day
(Piriton used to put me to sleep by mid afternoon)
My wife works in a hospital Pharmacy and they are allowed to buy the tablets - I thought they were a bargain at £1.50
I found out last year that you can buy Certirizine on Amazon - 79p for 30 tablets :thumbsup:

https://www.amazon.co.uk/Hayfever-A...TF8&qid=1493393505&sr=1-1&keywords=cetirizine
 
Mad professor thank you that is a wealth of info which I will read again and try to fully understand as Hayfever for many years has annoyed the hell out of me. You do not mention any shelf Brand names, is that because what you list above is their ingredient? Benadryl Plus is the only thing so far which works for me but I've needed to take it regularly for the last approx 6 weeks. I've suffered for 22 years with Hayfever a runny nose like a tap is my specific issue and I don't like the idea of regularly taking Benadryl Plus - should I not be concerned and just take the pills when I feel I have to? Many thanks.
 
Wow, I never ceased to be amazed at the variety of good advice to be found on this forum :)
I know a wee bit about this subject -I run a medical rhinology service in ENT and sit on the international WHO guidelines commitee for allergic rhinitis [aka hay fever]
Click to expand...
Thanks Mad Professor very good overview. Personally I find loratadine works better than cetirizine for my grass based hayfever, I guess there is a certain amount of person to person variation in responses to all drugs. I will give cetirizine another go though based on your advice.

My top tip - wear close fitting wrap around sunglasses when driving with the roof down. It helps keep pollen out of my eyes and stop the late afternoon snuffles. 8)
 
Molinites said:
Mad professor thank you that is a wealth of info which I will read again and try to fully understand as Hayfever for many years has annoyed the hell out of me. You do not mention any shelf Brand names, is that because what you list above is their ingredient? Benadryl Plus is the only thing so far which works for me but I've needed to take it regularly for the last approx 6 weeks. I've suffered for 22 years with Hayfever a runny nose like a tap is my specific issue and I don't like the idea of regularly taking Benadryl Plus - should I not be concerned and just take the pills when I feel I have to? Many thanks.
Click to expand...

Its cheaper to get non sedating 2nd generation once daily generic antihistamines like cetirizine or loratadine over the counter -we dont use 1st gen drugs like benadryl or piriton or phenergan any more as they are too sedtating in most cases .In fact we use phenergan as a sleeping pill in the elderly .You wont become tolerant to antihistamines so safe to take long term if you need to .If your symtpoms are daily then a once daily antihistamine is way to go -or if intermittent then just take them on demand -they have a fast onset of action within 1-2 hours .
 
obewan said:
I used to get Hayfever really badly as a child, symptoms are quite mild now and I can get by with 1 Certirizine tablet a day
(Piriton used to put me to sleep by mid afternoon)
My wife works in a hospital Pharmacy and they are allowed to buy the tablets - I thought they were a bargain at £1.50
I found out last year that you can buy Certirizine on Amazon - 79p for 30 tablets :thumbsup:

https://www.amazon.co.uk/Hayfever-A...TF8&qid=1493393505&sr=1-1&keywords=cetirizine
Click to expand...
Thats very cheap indeed
 
NickDE said:
Wow, I never ceased to be amazed at the variety of good advice to be found on this forum :)
I know a wee bit about this subject -I run a medical rhinology service in ENT and sit on the international WHO guidelines commitee for allergic rhinitis [aka hay fever]
Click to expand...
Thanks Mad Professor very good overview. Personally I find loratadine works better than cetirizine for my grass based hayfever, I guess there is a certain amount of person to person variation in responses to all drugs. I will give cetirizine another go though based on your advice.

My top tip - wear close fitting wrap around sunglasses when driving with the roof down. It helps keep pollen out of my eyes and stop the late afternoon snuffles. 8)
Click to expand...
If loratadine works well for you then my advice is dont change it and as you say they can be considerable inter-individual variablity in the way the body metabolises drugs . Wearing wrap around sunglasses is also a good idea when out and about as long as you look cool in them -actually on relfection you'll always look cool in the Z .
 
dr_john said:
I'll look into Piriton then, thanks for the tip.

Strange that a couple of you have found relief with age, just the opposite with me.
Click to expand...

If youre going to take piriton [chlorphenamine ] then my advice is def dont drive as its one of the older 1st gen sedative type antihistamines and only has a short duration of action cf to the 2nd gen non sedating drugs like cetirizine ,loratadine and fexofenadine
 
Mad Professor said:
actually on relfection you'll always look cool in the Z .
Click to expand...
My Z is a coupe so relatively hayfever free zone. You're right though, it is hard not to feel cool in a Z4C, that is until you try to get out and end up on hands and knees trying to make a graceful exit !
My E30 convertible though is very hayfever inducing. No pollen filters etc, and a lot of turbulence with the roof down. Hence it is equipped with wraparounds and a pack of loratadine in the glovebox
 
As the OP must say thanks Mad Professor for a great in depth reply.

A bit late at night to take it all in, and I'm feeling not too bad at present after some Lorotadine this morning and Otrivine spray this afternoon.

A couple of pints down the local this evening seemed to have helped as well :thumbsup:
 
Great info from the Prof!

Never thought you could be off work with hay fever until the summer of 2005, when I was sent home in bits by my boss. Dr asked me to systematically try everything, and in the end it was fexofenadine that sorted me out. Completely... I mean, I think that once I'd found something that worked I was actually a bit better off than colleagues with mild symptoms.

Right now, cetirizine seems to working ok, but every year is an adventure!
 
dr_john said:
As the OP must say thanks Mad Professor for a great in depth reply.

A bit late at night to take it all in, and I'm feeling not too bad at present after some Lorotadine this morning and Otrivine spray this afternoon.

A couple of pints down the local this evening seemed to have helped as well :thumbsup:
Click to expand...

Need to be careful with otrvine which works by constricting the blood vessels -because if taken on a regualr basis ,tolerance rapidly developes and you also get rebound congestion in the nose -which can makes things worse -this tolerance and rebound with regular otrivine use can be overcome by also taking with a nasal steroid . Also if you are going take otrivine regularly then take otrivine first ,wait 5 min for the nose to decongest and take the steroid spray second .This way you decongest the turbinates allowing better pentration of the steroid spray to where it needs to act . I usually tell my patients when i start them both together to stop the otrivine after 1-2 weeks once the steroid spray has kicked in .Also never use the otrivine more than once a day -i tend to use it at before bedtime so that the nasal airway remains open allowing to breathe through the nose while sleeping .The nose is there to humidify and warm the air delivered downstream to the bronchial tree .
 
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