Per year, the plant mating season impacts a more significant number of people. Spring is the exciting time of year when flowers bloom, trees leaf, and billions of pollen grains take off in the hopes of fertilizing another crop. However, all of these tiny plant sperms end up in our mouths, triggering an allergic response known as seasonal allergies.
Around 25 million Americans have them, and all of them take an over the counter drug to cure their aversion to the plant acts as the climate change worsens. There are several myths regarding allergies, possibly because we know very little about how they affect, in fact. Our understanding has burst (much like pollen in May) in the last decade or so, but we still don’t understand plenty.
So it’s understandable if we have any questions that we feel the need to preface with “this might be a dumb question, but…”
To begin, consider the following: Is it true that taking the allergy medications all of the time prevents my body from developing an immunity to allergens? Is it possible that I’m exacerbating my allergies? If the season continues or as you grow older, it can feel like the allergies are getting worse and worse.
So it’s unlikely that the medications are to blame. Clifford Bassett, the Medical Director of Allergy & Asthma Care of NY and an allergist at New York University, says, “Every year during pollen season, I see hundreds of sufferers who believe their allergy medications aren’t doing the job for them.” However, he explains why there are other reasons why such medications aren’t working. Any of that may just be the result of becoming older—many people develop allergies as the adults (though across the population, adults have fewer allergies than children do).
It’s entirely possible that it’s only a matter of taste. According to Sarena Sawlani, Medical Director at Chicago Allergy and Asthma, “each responds differently to each allergy treatment,” but “the causes are complicated and not well understood.” This is true with every form of allergy drug.
There are two types of allergy medications, and they aren’t created alike.
Let’s take a step back for a moment. Antihistamines and corticosteroids are the two significant types of allergy medications (excluding immunotherapy, which aims to change the immune system).
Antihistamines, which include Benadryl, Claritin, and Zyrtec, are used by the majority of citizens in the United States. Since their effects could extend through the blood-brain barrier, the first antihistamines, such as Benadryl (the generic name: diphenhydramine), left people very sleepy. Histamines bind to a receptor in the brain that controls the allergic responses and helps facilitate wakefulness during the normal sleep-wake cycle. Because of its capacity to reach the blood-brain barrier and indiscriminate binding, diphenhydramine puts most people to sleep. When the second generation (and later, the third generation) antihistamines that didn’t get into the brain were conceived, it was a significant victory for the seasonal allergy sufferers. The Second generation antihistamines have a subtly different molecular structure that helps them to bind to related receptors more directly, as well as being lipophobic or “fat-averse.” The blood-brain membrane blocks many lipophobic molecules, so Claritin or Zyrtec won’t get in.
Even if they’re potentially less powerful than corticosteroids, these non-drowsy tablets have become the norm (more on those in a bit). As the name suggests, antihistamines act by blocking histamines, which helps with allergies because histamines are the signaling molecules produced by your body in reaction to the pollen (or cat dander, or whatever else you’re allergic to).
When a mast cell detects an allergen, it emits a large amount of histamine. These histamines aim to combat the potential danger by expanding your blood vessels and increasing the permeability of your nasal mucous membranes. While the mucous membrane permeability appears to be insignificant, it is actually the most essential aspect of the reaction! This is what makes your nose itch and your eyes wet (in part). Runny noses are caused by the plasma portion of your blood leaking through your nasal membranes, as well as excessive mucus formation by the cells lining your nasal cavity.
On the other hand, antihistamines obstruct the histamines that the body produces, so they avoid the effects but not the mechanism.
On the other hand, the corticosteroids stop the infiltration of inflammatory cells well before the histamine portion begins. You’re probably more familiar with these as the nasal sprays like Flonase. The Intranasal sprays seem to be more effective than antihistamines in meta-analyses of several studies on allergy drug effectiveness, most likely because they deter a reaction from occurring in the first place. They have the disadvantage of taking longer to take effect. The Corticosteroids perform well after two to four weeks of use because they help modulate the immune system.
Isn’t it true that if allergy medications interfere with my immune system, they will alter how my body reacts?
In one rat study, the Antihistamines were proposed to deter an animal from developing an allergy tolerance to allergens. Still, the study was focused on poison, not pollen or other natural allergens, and it was also a rodent study. There have been no findings to say humans have the same problem. Antihistamines, nasal sprays, and undoubtedly eye drops, according to Sawlani, “do not have a direct therapeutic effect on the immune system.”
It’s unlikely that the medications are to blame, according to Bassett.
As the season continues, it takes fewer grains of pollen to induce a reaction. It takes less than an initial spark to set off the whole cascade of histamines since the immune system has been pre-programmed to respond to various allergens. He recommends taking allergy medication a few weeks before the pollen levels are expected to peak and consulting an allergist if you continue to treat the symptoms better. In-office allergy tests could help you figure out how to reduce your susceptibility to allergens—or simply tell you which plant or animal to blame when you start sneezing like a snot monster.