When the tree pollen starts blowing in the spring, Joe Craighead runs for the tissue box. His nose runs, his eyes water and he sneezes repeatedly, with symptoms continuing until the grasses go dormant in the fall. His nasal allergies are so much a part of his life that the Denver resident has accepted the annoying symptoms.
“It’s almost like a background irritation,” said Craighead, 57.
But he still wonders what life would be like without them. He’s participating in a Denver study by National Jewish Medical and Research Center that might change how allergies are treated in this country, potentially providing relief that’s more convenient and safer than allergy shots and without the drowsy side effects of some over-the-counter medications.
In sublingual immunotherapy, or SLIT, allergy sufferers place an allergen-filled drop under the tongue every day. It works like an allergy shot minus the poke, exposing sufferers to allergens to reduce sensitivity to specific irritants. And it can be done without a visit to the doctor’s office.
In Europe, where SLIT is popular, the method has been used with one allergen at a time. In the Denver study, multiple allergens are tested simultaneously, similar to when people receive multiple allergens in one shot, said Harold Nelson, an allergist at the National Jewish Medical and Research Center in Denver. The mixture is based on the person’s allergy history and skin tests to determine significant allergens.
“It’s a fairly important study because it answers a question about whether you can treat multiple allergies at the same time or whether you can (just) treat one allergy,” Nelson said.
It’s also an important study, he said, because European extracts have not been approved in the United States and allergy extracts used for injections are not approved for sublingual use.
Each day, Craighead pumps several drops under his tongue and leaves it there a few minutes before swallowing.
The trial started in June, with researchers following participants allergic to grass pollen through the grass season, recording their symptoms and medications and taking skin testing and blood tests. Starting in September, some participants were given a dose of grass allergen and others the same amount of grass allergen mixed with nine other allergy extracts. Others took placebos. Their reactions this allergy season will be noted through diary entries and blood and skin tests.
Reactions from SLIT are less severe than those from injections, such as itching in the mouth rather than breaking out in hives, Nelson said, but it’s only about 50 percent as effective as injection therapy.
Depending on the study results, it could be as early as three to four years before the method is approved for use in the United States, Nelson said.
Washing your nose
It’s been around for decades, but since Oprah Winfrey and her medical expert, Dr. Oz, touted it, it’s the newest craze for those suffering from the nasal effects of allergies.
Called a nose bidet, Neti Pot or nasal wash, it works by pouring a saline solution through the nose with a pot that resembles Aladdin’s lamp. The solution goes in one nostril and comes out the other nostril. The process is then repeated with the other nostril.
“Nasal washes have been the chicken soup at National Jewish long before I got here, and I have been there for 22 years,” Nelson said. Still, most people haven’t heard of it, unless they have been to an allergist, he said.
“It is a very effective treatment for those who have a lot of junk in their sinuses and nose,” he said.
The process flushes mucus from the nose, removes allergens and irritants and makes medicated nasal sprays more effective. It also removes bacteria and viruses from the nose, reducing the frequency of infections and decreasing nasal swelling.
Another way to irrigate the nose is to use a solution in a squeeze bottle, such as Neilmed Sinus Rinse. There also are smaller bottles that one can carry in a purse.
“Any type of nasal irrigation is better than none if you have sinus allergy problems,” said Todd Kingdom, director of rhinology and sinus surgery at the University of Colorado Hospital.
Nasal washes can be bought at most pharmacies and grocery stores.
To see a video about how to use the Neti Pot, Click here.
Over the counter
Some prescription drugs that combat allergies will gain over-the-counter status in the next few years, following Claritin, an antihistamine that once was a prescription drug, Kingdom said.
Although those drugs will be available without a prescription, read the directions and cautions carefully before taking them and discuss other medications you are taking and your other medical conditions with your pharmacist, he advised.
