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Allergic Rhinitis
Allergic rhinitis effects approximately 20-25% of the population.
Symptom producing allergens may include pollen, dust mites,
animal dander, feathers, fungus, and many others. For individuals
who enjoy being in the outdoors, symptoms may be mildly debilitating,
decrease the enjoyment of your outdoor experience. In total,
approximately 35 million people in the United States alone
are affected by seasonal allergies.
Allergy Symptoms
Symptoms may include the following: Frequent sneezing, itching
and watery eyes, itching in the back of the throat, tearing,
runny nose, coughing, congestion, sinus pressure, and headaches.
Most individuals feel that these symptoms are more pronounced
in the spring. However, they can also occur in the fall, specifically
with ragweed. Dust mites, for example may affect an individual
all year long.
So what are pollens? Pollens are small, egg-shaped cells
from the flowering plants that are necessary for tree and
weed fertilization. The average pollen particle is less than
the width of a human hair. Wind currents can sweep these pollens
many miles. The most common is ragweed, which, when disbursed
by wind, can travel up to 500 miles. Ragweed is commonly found
along roadsides and in fields. It is very common in the fall
in the Northeast, South and Midwest.
So what are molds? Molds are a microscopic fungus. They are
related to mushrooms. However they do not have stems. Their
spores float in the air, very similar to pollens. Molds are
common in all parts of the country. They are most common after
the first thaw in the springtime, are commonly found in wet
soil and rotting wood. Molds are very common in the house,
attics, in basements and bathrooms.
Outdoor Allergy Guide
Thanks to Shearing Corporation for the following information.
For more information, please visit www.clarinex.com or www.nasonex.com.
Different allergens can be found in different parts of the
United States at different times of the year.
Pacific coast: Ragweed, sagebrush,
Russian thistle and a variety of grasses are common.
Mountain: Ragweed, tumbleweed
and Russian thistle are seen.
Southwest: Ragweed and dock.
Plains: Ragweed and nettles.
South: Ragweed, nettles and
grasses.
Great Lakes: Ragweed and nettles.
Northeast: Ragweed, pigweed
and nettles.
Allergic Reaction
So how does an allergic reaction occur? IgE antibodies are
contained in your nose. These antibodies recognize and react
to the allergens or pollens when you come in contact with
them. These antibodies on Mast cells and Basophils capture
the pollen, and when they do this, they trigger several chemicals,
the main chemical being histamine. When histamine comes in
contact with nerve endings, it causes sneezing and itching,
and when histamine comes in contact with small blood vessels,
it causes redness.
Allergy Treatment
Because it is literally next to impossible to avoid these
allergens, there are many good antihistamines found on the
market that are very effective. Antihistamines act by occupying
the histamine receptors on cells, and they block the binding
on the histamine. For individuals who have chronic nasal congestion,
these anti-histamines are not effective, and they do little
for nasal congestion. For severe nasal congestion, it may
be beneficial to use a decongestant along with the antihistamine.
The most common side effect of antihistamines is mild somnolence.
The three most popular antihistamines currently are:
- Fexofenadine, which is Allegra, and comes in 60 mg. tablets
twice a day and 180 mg. once a day.
- Desloratadine, which is Clarinex, 5 mg. tablets once
a day.
- Cetirizine, which is Zyrtec, 5 and 10 mg. tablets once
a day.
It is important to note that Survive Outdoors does not promote
or receive any benefits from any drug companies. We have reviewed
the literature from allergy and asthma research studies from
2002-2004, and reviewed all three of the above-mentioned medications.
What we have found is that what appears to be the most effective
over a 24-hour period is the Cetirizine or Zyrtec. Even though
there is a greater sedation in terms of being somewhat drowsy
while taking this medication, it appears to have the highest
efficacy over 24 hours. Allegra, 180 mg. tablets, once daily,
came in second. The Allegra 60 mg. tablet was clearly not
as effective as the 10 mg. of Zyrtec once per day. What is
also nice about Zyrtec is that a suspension is available,
which is great for children, the minimum age being 2 years
old. Clarinex matched up fairly well, and had less sedating
properties than Zyrtec.
Allergic Rhinitis
Glucocorticoids is the gold standard for allergic rhinitis.
There are numerous nasal inhalers that have been very effective,
and they have increased their safety profiles and have done
quite well. There are a variety of different brand names.
A few of these include Beconase, Vancenase, Rhinocort, Nasonex
and Flonase. In reviewing the studies, these are all very
similar. Some have a fragrance associated with them, which
is somewhat distasteful, according to some patients. However
they all work very well. There have been concerns in some
studies when using inhaled nasal steroids in children that
there could be some bone growth suppression. However this
has not been confirmed, and the clinical significance of this
has yet to be substantiated.
In closing, if you are an individual with a past history
of allergies and plan on spending a lot of time in the outdoors,
it is highly recommended that you start on some antihistamines,
taking them daily, before going out in the outdoors on extended
trips. They definitely will make you feel more comfortable.
Hunters may especially benefit from this medication as they
specifically are trying to be quiet. One does not want to
be sneezing and coughing while sitting in a deer stand! Antihistamines
will definitely make you more comfortable and suppress your
symptoms, enabling you to be quieter, allowing for greater
success while you hunt.
References
1. Allergies and You, Fall, 2004, Shearing
Corp., 2003.
2. Paul S. Auerbach, Wilderness Medicine
3. Randomized Double Blind Comparison of Cetirizine and
Fexofenadine after Pollen Change, Allergy and Asthma,
Jan.-Feb., 2004, Vol. 25, #1.
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