“I am allergic to the planet Earth,” says Kathy Klotz, who is a project manager for a software consulting firm.
Klotz says she had mild allergies to grass, pollen and cats for most of her life but didn’t take anything for them. “But when I moved from New York to Toronto, that all changed.” She says that at least twice a year, she spent weeks when she could not breathe through her nose and would go days without sleep.
Klotz tried various over-the-counter medications and supplements, but she finally got her allergies under control after a doctor prescribed a combination of three different medications—Singulair (montelukast), Reactine (cetirizine) and Symbicort (budesonide/formoterol fumarate dihydrate). According to Klotz, the combination of medications changed her life.
She is one of the lucky ones. In 2006, an American College of Allergy, Asthma and Immunology (ACAAI)-endorsed telephone survey of more than 30,000 households nationwide found that 1 out of every 7 adults who were contacted had been diagnosed with airborne nasal allergies. But only 35 percent of allergy sufferers said they were very satisfied with their nasal spray treatments. About 50 percent complained that their allergy medications lost effectiveness during the day and didn’t last up to 24 hours, and a majority of those patients kept switching medications to try to find better symptom relief.
A similar telephone survey in 2009 that was organized by a panel of noted pediatric allergy specialists found similar dissatisfaction with over-the-counter and prescription medications that were used to treat nasal allergies in children ages 4 through 17 years.
NOTHING TO SNIFF AT. Suffering from allergies is not merely a matter of dealing with sneezing, itching and a runny nose. In a 2008 study, Dr. Hirsh D. Komarow, who is a staff clinician in National Institutes of Health’s allergy division, and researchers at University of Maryland School of Medicine reported that peak pollen levels were associated with an increase in patients’ memory problems, mood changes, anxiety and depression—all of which place patients at risk for suicide. (The group’s preliminary findings suggest that springtime peaks in airborne allergens correlate with springtime peaks in suicide rates.)
“We don’t understand the mechanism fully, but I think it’s pretty clear that the allergic response to airborne allergens is not just limited to the nose and eyes and breathing,” Komarow says. “It’s also an effect on mental status, thinking, cognition and mood.”
Ubiquitous TV commercials might show that swallowing a little pill or spraying some mist up your nose is all that it takes to conquer airborne allergies, but clearly there is a lot more at stake: Allergic rhinitis—hay fever and similar airborne allergies—was estimated in 2007 to affect about 60 million Americans, and that number is growing, according to American Academy of Allergy, Asthma and Immunology (AAAAI). The monetary costs also are growing: Department of Health and Human Services in August 2008 reported that the cost of treating allergic rhinitis in the United States was $11.2 billion in 2005 (the latest year that data were available). More than half of that was spent on prescription medications.
If you’re among those who suffer from allergic rhinitis, you’ll find some relief from improved medications and new treatment combinations. Unfortunately, there isn’t anything that is truly revolutionary on the horizon—that is, anything that Food and Drug Administration has approved for use in the United States. An immunotherapy that is used in Europe and by a few U.S. physicians that replaces allergy shots with under-the-tongue drops or tablets appears promising, but it’s uncertain when that will be ready for FDA approval.