Do you suffer from seasonal allergies? Do you take antihistamines and decongestants to help you cope? Many people with seasonal allergies self-medicate and know very little about the medications they take and whether they are the most effective treatment option. Effectively controlling your allergies often requires planning and patience.

Like most medications, allergy pills, nasal sprays and eye drops all have side effects that can affect your ability to work safely. For example, some allergy medications can make you drowsy, while others can make it difficult for you to go to sleep. Both of these side effects can leave you tired at work and make it more dangerous to operate or be around construction equipment.

Allergy medications can also interact with other medications, including some that treat common conditions like high blood pressure, anxiety and sleep disorders. Allergy shots, which hold the promise of permanently decreasing symptoms, can also have drawbacks. To find the treatment that best addresses your allergy symptoms, it’s important to understand what a seasonal allergy is and how common allergy treatments work. An allergist with specialized training may also be necessary, particularly if your allergy symptoms are severe.

What Is a Seasonal Allergy?

A seasonal allergy is an overreaction of the body’s immune system to a naturally occurring harmless substance. Tens of millions of Americans are allergic to tree, grass and weed pollen. When this substance or trigger is encountered, the immune system produces chemicals called histamines that attack the allergen. This can cause wheezing, congestion, runny nose, watery eyes and other symptoms that can range from mild to serious or life-threatening. People with a family history of allergies are at higher risk for having allergies of their own.

Common Allergy Treatments

Antihistamines

Antihistamines, the key ingredient in allergy medications, reduce congestion, runny nose, itchy eyes and other symptoms by blocking the production of histamines. Antihistamines work best when started several weeks before exposure to the allergen. In other words, before the beginning of your allergy season. Common antihistamines include cetirizine (Zyrtec), clemastine (Tavist) and fexofenadine (Allegra).

Potential side effects include:

• Drowsiness, which can make it hazardous to drive or operate machinery
• Headache
• Stomachache

Decongestants

Decongestants have a stimulant effect similar to adrenaline. They can bring quick, temporary relief for nasal and sinus congestion by shrinking the blood vessels in the nasal membranes and allowing air passages to open. Common decongestants include oxymetazoline (Afrin, Dristan) and phenylephrine (Suphedrine).

Potential side effects include:

• Jittery or nervous feeling
• Difficulty getting to sleep
• Elevated blood pressure
• Worsening allergy symptoms when nasal sprays are used for more than three days

Allergy Shots

Allergy shots (allergy immunotherapy) are tailored to each patient’s allergens. Injections contain gradually increasing amounts of the substances the patient is allergic to. The goal is to increase tolerance so exposure does not cause an allergic reaction. The length of time required varies depending on how many allergens are involved.

Allergy shots are initially given one to three times a week at a health care provider’s office, then decrease to once a month and for some patients become unnecessary. These injections are often covered by insurance. Typical out-of-pocket costs include a co-pay or a percentage of the cost.

Potential side effects include:

• Minor pain, redness or swelling at the injection site
• Itchy, runny nose, wheezing (rare, but it’s why patients are observed for at least 30 minutes after receiving a shot)

Note: Patients with asthma may need to take extra precautions and always have their rescue inhaler on hand.

The pros of allergy immunotherapy include improved quality of life and more control over health. It may also prevent the development of new allergies. The cons include the time it takes to build up tolerance, the obligation of several visits to the doctor, the cost and the lack of a guarantee the shots will be effective.

Which Treatment Is Best?

Allergy treatment is by no means one size fits all. However, discussing all of the treatment options with your health care provider and letting them know about your job responsibilities can help you choose the treatment that is best for you while also ensuring you can work safely. For example, if an antihistamine makes you drowsy and affects your job, your health care provider may recommend you take it at night or try another medication instead. Allergies can make life miserable, but when properly diagnosed and treated, they can be effectively managed.

[Janet Lubman Rathner]