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Common allergy questions and answers

August 27, 2013

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Allergies got you down? Wondering how to get relief? Learn how to sort out the causes and cures for your annoying runny nose.

We asked Makeba Felton, MD, a nurse practitioner at Duke Primary Care in Knightdale to give us the low down on runny noses, sniffles, and other common allergy concerns.

The older I get, the more my nose runs. Can you develop seasonal allergies as an adult that you didn’t have as a child?

Yes, adults can develop environmental allergies at any age. Asthma can develop during adulthood as well. A runny nose isn’t always a sign of allergies, though. Older individuals may experience runny nose due to age-related physical changes—some people, as they age, develop overactive tear ducts and nasal secretions (it’s called cholinergic hyperactivity). Also, some medications taken for other conditions such as high blood pressure, prostate enlargement, or erectile dysfunction can cause a runny nose as a side effect.

How do I know when it’s just a cold? When should I consider seeing an allergy specialist?

A common cold is usually associated with a variety of symptoms in addition to a runny nose: cough, body aches, fatigue, and occasional yellow nasal discharge. All of these symptoms usually resolve in one to two weeks. Allergies occur immediately after contact with the allergens that provoke them. They’re associated with clear discharge from the nose, nasal congestion, and itchy eyes, and the symptoms persist as long as contact with the allergens continues. Body aches are unlikely, but fatigue may occasionally occur with allergies. Your primary care physician can usually help treat your allergies, but if specific testing is required to identify the cause for your allergies—or if symptoms are not adequately controlled with medicines prescribed by your doctor—then a consultation with an allergist is probably needed.

Is it safe to take an over-the-counter allergy medication every day?

I strongly recommend consulting with your physician. There are several types of over-the-counter allergy medications. Antihistamines, such as Benadryl (diphenhydramine) can cause sedation and performance impairment, so I don’t recommend taking this particular one on a daily basis.  Zyrtec (cetirizine),Claritin (loratadine) and Allegra (fexofenadine) may also cause sedation, but if taken at night, this side effect can be minimized.  These three antihistamines are safe to take on a daily basis. Over-the-counter decongestants such as pseudoephedrine (found in Sudafed) and phenylephrine should be used very carefully—they can cause elevated blood pressure, heart palpitations, difficulty falling asleep, and irritability. I don’t recommend them for patients who have heart conditions, high blood pressure, or hyperthyroidism.

Can certain foods give me a runny nose?


Food allergies are not likely to cause a runny nose. They usually cause scratchy, itchy mouth and throat; or you may develop hives, a skin rash, nausea, vomiting, diarrhea, or stomach cramps, or have difficulty breathing. Some older individuals experience a runny nose when they eat spicy, hot foods. That’s called gustatory rhinitis, and the quickest cure is to finish eating—or order something else.

Sometimes I wheeze a little. How much wheezing is OK?

Always consult your doctor when you experience wheezing. Wheezing can be due to allergies or asthma, but sometimes it’s a sign of a heart problem. It’s better to be safe and check in with your physician.

What about natural remedies, like eating local honey or pollen?

There is no scientific evidence to support the theory that eating local honey or pollen will cure allergies. Practically speaking, most people’s seasonal allergies are caused by airborne pollen from grass and ragweed, and those aren’t the plants that honeybees are visiting. So it’s unlikely that the pollen you’re allergic to is the pollen you’ll find in honey. What’s more, some people can have allergic reactions to impurities in some honey. It’s fine to eat honey if that’s part of your diet, but adding honey as an allergy treatment doesn’t have any scientific rationale behind it.

I’m afraid that I’m allergic to my beloved dog. I love him too much to give him up. Is there anything I can do besides investing in Visine and Kleenex stock?

Avoidance is the best defense against allergies. But if you can’t get away from your allergen—or, more specifically, if you can’t bear to give up your dog, or cat, or  gerbil—and your symptoms can’t be helped by over-the-counter medications, see an allergist. For some patients (ask your doctor) a custom-made allergy shot can be designed to desensitize you to your four-legged allergen friends.

 

Learn more about allergy treatment at Duke

Allergies
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