Hayfever

Couple of thoughts, as a doctor with really bad hayfever myself. I am worse in the spring and early summer, I was tested when I was a kid and I am most allergic to some of the tree pollens. This year I am already over the worst. Other people can be more allergic to other tree pollens and grass pollens and will have their worst symptoms later in the summer.

Everyone is different obviously. I have tried most of the newer generation antihistamines - Loratadine (Clarityn), desloratadine (NeoClarityn), Cetirizine (zirtek), fexofenadine etc. For me, Clarityn and neoclarityn are the most effective, and I didn’t find any difference between them. From the clue in the name, the two drugs are very similar molecules, desloratadine is the active metabolite ie. the liver converts loratadine into desloratadine which is what actually has the effect. Some people’s livers are better at this than others, which is why some people do better with neoclarityn.

The important thing with oral antihistamines is to take them as soon as symptoms start, every day. The effect builds up over a few days or weeks, so taking them now and again doesn’t work if symptoms are severe. I usually take Clarityn daily for a couple of months and then stop later in the summer.

Steroid nasal spray is very effective, Fluticasone (flixonase) is better for most people, but I use betamethasone (beconase) because it works for me. Again, taking it regularly 2 sprays each side twice a day, is the important thing. Effect builds up over a few days / weeks as with oral drugs. You’re not really supposed to but I take it 3 times a day when symptoms are bad and it doesn’t seem to do any harm.

The older antihistamines, Piriton (chlorphenamine) and phenergan (promethazine) are also very effective but cause drowsiness / grogginess. I take Piriton at night when symptoms are really bad, as well as the other drugs. Not a great idea to take these regularly in combination, but once in a while is ok.

I find cromoglycate eye drops very useful, they really help eye symptoms and can be used up to every four hours. If I’m wearing my contact lenses I use them morning and evening. Sunglasses while cycling are vital!

Nasal irrigation can be helpful but is a bit of a pain, I don’t really bother with this but I wash my face every couple of hours when things are bad and every time I come in from outside. Vaseline around the nose helps for some people too.

I looked at air purifiers a couple of years ago, they are so expensive, and to work properly you would need to keep all windows closed, so didn’t bother.

I have been thinking about desensitisation treatment for a few years. Your GP can refer you for this, it’s a series of injections that is apparently very effective. Every year I struggle through and then when symptoms improve after a few weeks is forget about it. Really should get round to it, maybe next year!

Maybe the most annoying thing about hayfever is how little non-sufferers understand about it. To them, it’s a kind of comedy non-illness, but if you have it badly, it’s at least a couple of weeks of absolute misery until symptoms subside. Also, it sucks that cycling definitely makes it worse when pollen counts are high!

Sorry for the epic post. Tl;dr - take tablets and nasal spray religiously for a week or 2 and they will make a difference.