Many of you are experiencing seasonal allergy symptoms around this time of year. So what are your options for treatment? With many of the nonsedating antihistamines available over the counter you need to know which will work for you, and how you should use them.

Allergic Rhinitis is the term for the runny nose associated with allergies. and is the most common complaint from patients. The fatigue, headache, and nasal symptoms of allergic rhinitis can have a tremendously negative impact on quality of life and productivity. The MOST EFFECTIVE therapy for patients with nasal symptoms related to allergies is topical intranasal steroids. These are prescription only and include Nasonex, Flonase, Nasocort AQ among others. The nice thing about these is they have very few side effects (no fatigue, jittery feeling, etc). Other therapies include oral antihistamines and the nonsedating (don't make you tired) ones. The best over the counter options now available are Claritin and Zyrtec. The mixture of those antihistamines WITH Sudafed gives it the "D" name and may be more effective (Claritin-D, Zyrtec-D, Allegra-D) for nasal congestion--though some feel jittery on them.

If your allergy symptoms also include watery itchy eyes, runny nose, wheezing and chest tightness, then the oral antihistamines mentioned above are worth a try. You can buy them, see if they relieve your symptoms, and possibly avoid a doctor visit if they do. A prescription option that is great for allergies AND asthma symptoms is the leukotriene modifier Singulair. Over the counter nasal decongestant sprays should NOT be used for routine treatment of allergic rhinitis.

Are there any complementary therapies that work for treatment of allergy symptoms? There are some alternative medicine treatments that have good evidence for use in seasonal allergies. Several studies using different herbal medicines (phytotherapy) have yielded positive results, specifically a Chinese herb formulation biminne and another using 100 mg of butterbur extract. Additionally positive results have been described for seasonal allergies using nasal and oral homeopathic remedies like dilutions of grass and pollen, Luffa compositum Heel, and homeopathic grass, trees and weeds mix.

How can you prevent allergies? Allergen avoidance is the main way you can alleviate your symptoms. For example people allergic to pollen can minimize indoor pollen exposure including keeping the windows of homes and cars closed. Though we occasionally suggest that those of you allergic to dust mites encase your mattresses, pillows and duvets in impermeable covers recent studies have shown that impermeable bed covers showed NO benefit in seasonal allergy symptoms. High-efficiency particulate air (HEPA) filters may lead to symptom improvement in those with allergies to dust mites.

Remember you are not alone: 10 to 30 percent of adults in the United States suffer from allergy symptoms, and the rates are increasing in urban areas.

Dr O.