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Manage Hay Fever

Strategies for Managing Allergic Rhinitis

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First published: 13. Jan.2025

Overview

There are different strategies for managing allergic rhinitis. Changing your diet, exercising, managing your indoor and outdoor environment, nasal sprays and medication are tools that can help relieve the nasty symptoms of hay fever.

In this Article (Index)

woman blowing nose in a field with yellow flowers
Hay Fever.

Allergic Rhinitis

Hay Fever (Seasonal allergic rhinitis) is an inflammatory nasal condition that affects 25% of Americans and its prevalence continues to grow.

Allergic rhinitis happens when the body's immune system reacts to allergens like dust mites, animal dander, or pollen causing an itchy runny nose, watery eyes, and sneezing.

When it encounters an allergen, the immune system releases an antibody known as immunoglobulin E (IgE) which unleashes a potent immunologic cascade that acts immediately and continues with late-stage reactions after several hours.

The following sections will explore options for managing allergy symptoms.

Diet Changes

Food Allergies

For people with food allergies, the key element is avoiding foods that contain the allergen (nuts, wheat, eggs, milk, etc.), even trace elements can cause an allergic reaction. Read every ingredient label, every time.

The ingredients will mention the allergens if present, and they also may appear in advisory statements on the label such as "May contain…", "Made in a facility that also processes…", "Made on shared equipment with…, or "Contains traces of…."

Eat a Healthy Balanced Diet

Plant-based diets could be effective in reducing allergic symptoms (6).

Nutrients in food and bioactive compounds like vitamins A, D, and E, trace minerals like zinc (Zn), iron (Fe), Selenium (Se), dietary fiber, antioxidant and anti-inflammatory phytochemicals, and healthy fatty acids act upon allergic symptoms by suppressing inflammation.

On the other hand, the typical Western diet has pro-inflammatory effects (saturated fatty acids, sugars, animal protein, lack of dietary fiber).

A balanced diet with whole grains, fruits, vegetables, healthy oils, and legumes is associated with a reduction of inflammation.

Polyunsaturated Fatty Acids (PUFAs)

A Mendelian randomization study (7) done in 2022 found that "higher PUFA concentrations (omega-3, DHA) and lower omega-6:3 ratios were associated with a lower risk of some allergic diseases... The strongest evidence concerned the protective effect of omega-3," the effect was stronger for atopic dermatitis and allergic conjunctivitis.

>> Learn more about Omega (ω) 6 and 3 Fatty Acids

Honey

Eating local honey could help improve immunity to local pollen allergies, reducing the severity of allergic reactions. Though controversial, studies have shown that it can be effective. A randomized study (5) followed 40 patients with allergic rhinitis (AR) for 4 weeks. Half of them received 1 g/kg of body weight of raw honey daily while the placebo group received the same dose of honey-flavored corn syrup. All subjects were also treated with a second-generation antihistamine (loratidine, 10 mg once daily). They were all checked after 4 weeks, and both groups showed progressive improvement in the symptoms. However, a second checkup after 8 weeks, one month after therapy had stopped showed that the placebo group's symptoms worsened while the honey-eating group showed continuous improvement of their symptoms even one month after they stopped eating honey. The authors concluded that: "Honey ingestion at a high dose improves the overall and individual symptoms of AR, and it could serve as a complementary therapy for AR."

>> Learn more about Honey, its health benefits, risks, and uses.

Lifestyle Changes

The lifestyle changes aim at avoiding or minimizing contact with allergens.

Outdoors

Avoid going outdoors when allergen counts are high. The National Allergy Bureau is a very useful resource with accurate pollen and mold counts from stations located across the United States.

Pollen concentration in the air tends to peak in the early to mid-morning, and on hot, dry, and windy days. Try going out in the late afternoon, or staying indoors during peak pollen count hours.

Indoors

Lower the indoor allergen count by vacuum cleaning your car and home, use High-efficiency particulate air (HEPA) filters on your vacuum cleaner to trap allergens.
Take a shower and change clothes after being outdoors.
Use furnace filters and dehumidifiers.

Use HEPA filters on your air conditioner.

Hot and humid places promote the growth of dust mites and mold. Keep your home's temperature around 70°F (21°C) and maintain the relative humidity around 50%.

Use "allergy bedding" such as hypoallergenic sheets and a mattress cover. Wash bed linens in hot water to eliminate any dust mites. For better mite control, avoid wall-to-wall carpets.

Keep your pets (cat, or dog) out of your bedroom.

Cockroaches cause allergic reactions so keep them under control. Don't leave food or garbage uncovered. Use poison baits, and traps instead of toxic chemicals which could irritate and worsen your symptoms.

Remove mold immediately, mold spores are allergens. Repair leaks to avoid damp spots. Wear a face mask when removing mold.

Damp-mop flooring, vacuum carpeting. Wash the curtains and small carpets. Use a damp cloth to clean windowsills, doors, and furniture. If you have allergies wear a dust mask when cleaning.

Exercise Reduces Allergy Symptoms

Exercise can significantly improve health and has positive effects on immune function, a study (8) reported that "moderate intensity exercise appears to have beneficial effects for allergic rhinitis patients." It also found that allergy symptoms decreased and that it induced an increase in antiinflammatory cytokines and a decrease in proinflammatory cytokines.

A study involving children with persistent allergic asthma found that those who exercised twice a week for 50 minutes had lower IgE levels and mite-specific IgE levels than those who didn't exercise: "Training did not increase inflammation in children with persistent asthma, and may have decreased both total and allergen-specific immunoglobulin E levels." (9)

Exercise also helps relieve stress and boost mood, counteracting some of the negative side effects of allergies.

Allergies can cause depression, anxiety, sleep disorders, and behavior changes that affect your mental health. "Allergic Mood" affects almost 1 out of 3 people suffering from allergic rhinitis.

>> Learn more about Allergies and Mood.

Saline Nasal Irrigation

Nasal saline irrigation is an effective and safe home remedy for reducing the allergen load to the nasal mucosa, it removes allergens and helps improve symptoms.

Use nasal irrigation devices like a neti pot, a bulb syringe, or a squeeze bottle. It should be used and cleaned properly.

Use distilled, sterile, or previously boiled water (boiled for 3 to 5 minutes, then cooled until it is lukewarm). Don't use tap water as it may contain microbes or spores.

Dissolve 1/4 teaspoon of non-iodized salt in 8 oz. of warm water. Use this solution to irrigate your nostrils once or twice a day.

Wash and dry your hands before irrigating, and check that the device is clean and completely dry before using it. After using it, wash the device, and dry it with a paper towel.

Medicine for Allergies

Find a medicine that works for you. There are different options to ease mild symptoms and bring short-term relief. Severe allergies may require prescription medications.

Antihistamines

How do antihistamines work?

The body releases histamines as part of its immune response to fight against infection by foreign pathogens.
Histamine is an organic compound containing nitrogen atoms.

It causes blood vessels to expand to allow white blood cells and certain compounds to reach the invading germs and attack them; it causes the skin to swell and also acts as a neurotransmitter.

When the body mistakenly reacts to an allergen as if it were a pathogen, the histamine immune response causes the typical allergy symptoms (runny nose, watering eyes, itch, sneezing, skin rash, and inflammation.

Antihistamines can prevent this from happening if taken before you encounter the allergen. Or they can reduce the severity of the symptoms if taken afterward.

Antihistamines are medicines used to relieve the symptoms of allergies. Most can be bought at drugstores as over-the-counter medication, others require a prescription.

Some antihistamines can make you feel sleepy. These are based on drugs like chlorphenamine, diphenhydramine, hydroxyzine, and promethazine. There is another group of "non-drowsy" antihistamines (acrivastine, cetirizine, fexofenadine, and loratadine). Both appear equally effective at relieving allergy symptoms.

Your healthcare provider can help you define which one is better for you, as not all antihistamines are suitable for everyone. Pregnant or breastfeeding women, older people, and children should consult a physician before taking any medication. (4)

Side effects of antihistamines

Antihistamines, like all medicines, have side effects.
You should not drive or use machinery after taking antihistamines as they cause sleepiness. They can also have adverse reactions if taken with other drugs like antidepressants, ulcer medication, or alcohol.

Allergy immunotherapy (AIT)

Allergy immunotherapy (AIT) also known as allergen desensitization or hypo-sensitization offers long-term relief from allergy symptoms.

This therapy was developed by Leonhardt Noon (1878–1911) and John Freeman (1877–1962) who were the pioneers of allergen-specific immunotherapy.

AIT is the administration of slowly increasing doses of a relevant allergen to a patient until their symptoms improve or they are free of symptoms. (2)

It has proven effective in IgE-mediated allergic reactions, which can be identified with a blood IgE test or a skin test. It is recommended for moderate to severe allergic rhinitis, allergic asthma, allergic conjunctivitis, atopic dermatitis, and IgE-mediated food allergy.

Risks and Adverse Effects

This therapy involves administering an allergen that a patient is already known to be allergic to. So there is the risk of local reactions, skin rashes, and anaphylaxis. Although rare, even fatal reactions to subcutaneous allergy immunotherapy can occur. (3)

References and Further Reading

(1) Postolache TT, Komarow H, Tonelli LH., (2008). Allergy: a risk factor for suicide?. Curr Treat Options Neurol. 2008 Sep;10(5):363-76. doi: 10.1007/s11940-008-0039-4. PMID: 18782509

(2) Ring J, Gutermuth J., (2011). 100 years of hyposensitization: history of allergen-specific immunotherapy (ASIT). Allergy 2011; 66: 713–724.

(3) Persaud Y, Memon RJ, Savliwala MN., (2023). Allergy Immunotherapy. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535367/

(4) The National Health Service (NHS), (2023). Antihistamines . Accessed: Jan 12, 2025

(5) Asha'ari ZA, Ahmad MZ, Jihan WS, Che CM, Leman I., (2013). Ingestion of honey improves the symptoms of allergic rhinitis: evidence from a randomized placebo-controlled trial in the East coast of Peninsular Malaysia. Ann Saudi Med. 2013 Sep-Oct;33(5):469-75. doi: 10.5144/0256-4947.2013.469. PMID: 24188941

(6) Zhang P., (2023). The Role of Diet and Nutrition in Allergic Diseases. Nutrients. 2023 Aug 22;15(17):3683. doi: 10.3390/nu15173683. PMID: 37686715

(7) Li Y, Li Q, Cao Z, Wu J., (2022). The causal association of polyunsaturated fatty acids with allergic disease: A two-sample Mendelian randomization study. Front Nutr. 2022 Sep 9;9:962787. doi: 10.3389/fnut.2022.962787. PMID: 36159460

(8) Tongtako W, Klaewsongkram J, Jaronsukwimal N, Buranapraditkun S, Mickleborough TD, Suksom D., (2012). The effect of acute exhaustive and moderate intensity exercises on nasal cytokine secretion and clinical symptoms in allergic rhinitis patients. Asian Pac J Allergy Immunol. 2012 Sep;30(3):185-92. PMID: 23156847

(9) Moreira A, Delgado L, Haahtela T, Fonseca J, Moreira P, Lopes C, Mota J, Santos P, Rytilä P, Castel-Branco MG., (2008). Physical training does not increase allergic inflammation in asthmatic children. Eur Respir J. 2008 Dec;32(6):1570-5. doi: 10.1183/09031936.00171707. Epub 2008 Aug 6. PMID: 18684843

About this Article

Manage Hay Fever, A. Whittall

©2025 Fit-and-Well.com. First Published: 13.Jan.2025. Update scheduled for 13.Jan.2028. https://www.fit-and-well.com/wellness/manage-hay-fever.html

Tags: allergies, antihistamines, hay fever, exercise, diet

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