Just a matter of a week after sending you guys my last email, I realised how many of you were suffering from allergies.

A lot of you came into the pharmacy, asking me how to manage your worsening symptoms. Although I was thrilled to be approached by many of you, it saddened me to realise that allergies affect many of us in ways that non-sufferers can’t imagine. In fact, New Zealand has one of the highest rates of seasonal hay fever in the world. Up to 30% of adults and 40% of children are affected by it.

Pollen sensitivity usually begins at the age of 6 months to 2 years. However, symptoms do not usually develop until children reach 2 to 7 years of age.

One thing I noticed working as a pharmacist for more than 10 years is that hay fever allergies usually have a family link to it. I’ve seen many families -literally, every member of the family suffering from hay fever! Family history plays a huge factor when determining whether you will suffer from hay fever or not.

Also, if you are an asthmatic, I’m afraid luck is not on your side. Because 80% of people with asthma will also suffer from hay fever symptoms. The key, if you suffer from both asthma and hay fever, is to make sure your symptoms are well under control before the start of an allergy season.

As mentioned in my last emails, the best way to control your hay fever symptoms is to avoid the things that can trigger it. During the allergy season, you can have a better chance of surviving it by avoiding going outside when pollen counts are high. The amount of pollen in the air is highest in the morning between 5 am, and 10 am. Unless you are a late riser or work from home, it is virtually impossible to avoid being outdoors during those times.

So, what can we do?

Well, I’m sorry to those who don’t like to take medicines, but medicines treatment is probably the only way out. And you should view them as your partner in crime to tackle down the hay fever villain.

One of my regular patients asked me: “There are many treatment options out there…Which one should I use?…I’m confused.”

Quite frankly, I don’t blame her for getting confused. In fact, there are so many options out there; I can see how most patients can get overwhelmed.

The best way to find the right treatment is to look at the severity of your symptoms.

To make it simple, I like to classify the severity of hay fever symptoms as either:

1) Mild – intermittent symptoms (< 4 days per week) that does not affect normal sleeping and daily activities, or

2) Moderate to severe – persistent symptoms (> 4 days per week) that affect sleeping and impair daily activities (e.g. school, work, sport)

For mild symptoms, there are 2 options:

1) Antihistamine nasal sprays

2) Oral antihistamine tablets

The advantage of antihistamine nasal sprays is that they work faster than the tablet form but usually, they do not last as long in comparison.

Both antihistamine nasal sprays and tablets are equally effective for the runny nose but are not as effective for managing itchy eyes or throat. It is important to point out that antihistamine nasal sprays are not suitable for children under 5 years of age. Hence, oral antihistamines still are a better option for young children.

The oral antihistamine works best if you take it continuously throughout the pollen season rather than intermittently.

As mentioned in my last email, there are different types of oral antihistamine out there in the market (e.g. loratadine, cetirizine, levocetirizine & fexofenadine).

Some of them have a slight advantage over another when it comes to the symptoms you are trying to control.

However, their efficacy ultimately depends on how your body’s response to an antihistamine and the truth is that it is often a trial and error process to determine which is most effective for you.

One thing we know for sure is that sedating antihistamines usually have no place in managing hay fever symptoms unless your sleep is severely affected by your symptoms.

If your symptoms are moderate to severe or when your symptoms are not responsive to oral antihistamines, I would usually suggest trying corticosteroids nasal sprays (Flixonase, Alanase, etc.).

It is the most effective medicine class for controlling the 4 main symptoms of hay fever – sneezing, itching, runny & blocked nose.

Corticosteroid nasal sprays generally take a slightly longer time to work, usually within 12 hours of usage. However, the full effect does not usually occur for up to 1 to 2 weeks of consecutive use. Hence, I usually suggest my patients to start using the nasal spray before the beginning of the hay fever season and regularly use throughout the season is the best way forward to effectively control your allergies.

Some of you might ask me: “Is it safe to use corticosteroid nasal spray long term?”

The answer to this is yes. It is considered safe because even though corticosteroid delivered nasally can be absorbed into our body to some extent, they are generally not associated with adverse effects and are consider safe to use as long term treatment. The only concern is that is can cause nasal irritation and dryness and sometime nosebleeds may occur.

I’ve tried to not bombard you with too much information. However, one last tip I always tell my patient is to use a normal saline nose spray before the corticosteroid nose spray to relieve dryness and clear any mucus present to improve mucosal contact with the steroid and potentially improve the effect.

As always, I suggest you talk to me or one of our team at the pharmacy if you have any questions about hay fever. We’re always happy to help go through treatment options to determine which product is right for you.

To you and your family’s health,

Chris

Pharmacist

The post Is medicine the only way out to control my hay fever symptoms? appeared first on Eastmed Pharmacy.

As I said last week the best treatment for allergies is to avoid the thing that you know to be causing the allergy (e.g. pollen, fur etc.) but as you can imagine this is easier said than done! It’s not practical to lock your self indoors to avoid pollen drifting in the wind!!

This brings me to the variety of antihistamine tablets available in the pharmacy. It can be overwhelming to decide which is the best for you or your family – making the correct choice is crucial to relieve the suffering of allergies – and your wallet ?

But first I just wanted to cover how an antihistamine tablet works to combat allergies.

Allergy symptoms occur when your body wrongly recognises something (such as pollen) as a threat and sends chemicals such as histamine to deal with the perceived intruders.

Histamine can cause the symptoms that you associate with allergic reactions such as itchiness, runny nose and watery eyes. Antihistamine tablets block histamine to reduce allergy symptoms – however, they do not stop allergies from occurring completely as there are a variety of agents involved in the allergy process.

There are two types of antihistamines – sedating and non-sedating.

The most common ones that you can buy direct from a pharmacy are the non-sedating ones. Don’t be fooled by their name though – although most people that take them are fine – some people do find that they can make them drowsy! I always recommend taking a dose when you know that you will be at home and see how it affects you.

Antihistamines are generally a once-daily tablet which makes it convenient to take – especially if you have more than one symptom such as watery eyes and runny nose.

“But which one is the best to treat my allergy symptoms?!” Is a question I get all the time from patients.

The truth is that it is often a trial and error process to determine which is most effective for you.

Loratadine and cetirizine are often a good place to start (some do find cetirizine can cause drowsiness though). They work within 1-2 hours and a best taken regularly to prevent the symptoms (rather than as treatment once you have allergies).

Some people alternate between the two on a monthly basis as they find their body can build a tolerance to them after taking it for a while.

If you are not getting any relief from the above newer agents such as fexofenadine (Telfast) can be trialled. The dose can be increased depending on the severity of your symptoms.

Lastly sedating antihistamines can be taken at night (particularly if your symptoms prevent you from sleeping) but I wouldn’t recommend these routinely.

As always, I suggest you talk to one of our team at the pharmacy or your GP before starting a new medicine as their may be interactions with your current medicines or conditions. We’re always happy to help go through treatment options to determine which product is right for you to prevent wasting time and money on something that may not suit.

To you and your family’s health,

Chris
Pharmacist

The post Which tablet a day can keep allergies away?! appeared first on Eastmed Pharmacy.

When I think about spring, what comes to mind is new growth and new beginnings. The plants are coming to life again, the trees have buds on them and grass is popping right out of the ground like the speed of light – meaning that I’ll have to start mowing the lawn more frequently than every 6 weeks that I have been able to push to over the winter (bad news for some☹).

When you think that everything seems to be starting to go uphill from now, there comes your first sneeze of the season. Yup, you got it right…it is the season for stuffy & runny noses and, weepy & itchy eyes.

You don’t need to follow my emails to realise spring is the prime hay fever season. Approximately 20% of the population suffers from it. Probably the majority of you are an old hand when it comes to managing your hay fever and already have a good general view of what it is, and how it’s caused.

Since the beginning of the week, I have already had some of you asking me about how to manage your hay fever symptoms. As much as I would like to talk about the treatment options for hay fever, I believe the best way to win the war on hay fever is by identifying ways to minimise the chance of triggering it. Because the truth is, hay fever is a disease that can never be cured.

To understand how to best tackle your hay fever, it is crucial to know the type of hay fever you are dealing with. I’m a person who likes to simplify things rather than complicating it. Despite many different types of hay fever, I like to boil it down to just two major types:

1) Seasonal hay fever – when symptoms occur at a certain time of the year (usually during spring & summer)

2) Perennial hay fever – when symptoms occur at any time of the year

Knowing which type of hay fever you suffer from is important because they both are caused by different allergens. The culprits for perennial hay fever are usually dust mites and domestic pets. If you are suffering from perennial hay fever, I’ll be sorry to tell you that your hay fever will never be managed unless you farewell your beloved pet – which I don’t think is possible. However, there are still things you could do to improve your condition:

· Reduce humidity by having a well-ventilated house – house dust mites thrive in a damp environment

· Cover mattresses and pillows with dust mites covers

· Vacuum clean frequently

· Dust with a damp cloth

Wind-borne pollens are usually the cause of seasonal hay fever. There is usually a misconception that people with hay fever should not have flowering plants in their home. This is not true because the majority of flowering plants are unlikely to cause symptoms of hay fever because the pollen grains are too large to be pollinated by wind. Trees, weeds and grasses are what you need to watch out for.

The length of the pollen season depends on the plant species you are allergic to. For those of you suffering from seasonal hay fever, a pollen calendar could be your best friend. A pollen calendar published by Allergy New Zealand can help you single out specific plants that trigger your symptoms based on the month they are active in.

There are many things you could do to minimise your exposure to pollen, for example:

· Avoid early morning activities – pollen count is the highest between 5 am, and 10 am

· Avoid going out on a windy day – strong wind can pollinate pollen

· Keep the window closed in the morning and at night and used the air conditioning unit to filter out the air.

· Use air conditioning on “recycle mode” in the car when driving

· Use a dehumidifier to reduce indoor humidity

· Avoid mowing lawns or raking leaves – if not possible then it would best to do it while you are wearing a mask

· Have lawns mowed frequently to void flowering

· Wear sunglasses outdoors to reduce pollen contact with the eyes

· Avoid drying bedding on the washing line to prevent pollen from settling on it – best to use a clothes dryer to finishing drying bedding

One trick you could do to reduce contact of pollen with the lining of your nose is by dabbing a small amount of Vasaline around the edges of your nose. This barrier created will trap pollen before you breathe it in to prevent the triggering of hay fever symptoms. If you were to use this method, I would strongly suggest only use it sparingly, not rubbing it too far up your nostrils, and not to use within several hours of lying down.

Next week I will be going through some treatment options that could help you stay on top of your hay fever symptoms. So, stay tuned.

To you and your family’s health

Chris Pharmacist

The post Sneezing, stuffiness and itch – spring is here!! appeared first on Eastmed Pharmacy.