Both Dr. Joshua Jacobs, with offices in San Ramon and Walnut Creek, and Dr. Wendy Tong, medical director for CareMore Health Plan in Pleasanton and San Jose, say to prepare for the worst.
"We had very mild weather after the first of the year," Jacobs said. "When we don't have any rain, we get higher, more sustained levels of pollen in the air and higher levels of pollen lead to more symptoms."
He said tree pollen is rising now, and that grasses will likely pollinate starting near the middle of the month and through June.
But it's not just pollen, Tong said. She said smog, smoke and other pollutants can make allergies worse.
"Allergies are a combination of factors. One part is the pollen count and the amount of airborne allergens in the environment," Tong explained. "Allergies are the body's natural defenses to fight off infection as well as what's foreign to it. An allergy is the act of an exaggerated and out-of-control immune system."
Both both doctors said there are things to do that can reduce symptoms for allergy sufferers.
While outside, people can decrease their exposure to pollen by wearing sunglasses.
"Pollen directly in the eyes is responsible for eye symptoms," Jacobs said. He said some people might choose to wear a mask for outdoor tasks like gardening.
"When you're driving, use your air conditioner and the recirculation on your car," he added.
Jacobs also suggested people might want to shower and wash their hair at night to remove pollen that might have gathered through the day.
Tong said there are simple steps people can take to minimize allergens in the home. Some people, she said, might want to switch from drapes, which can trap pollen, to blinds. A more drastic action would be to swap out carpets for hardwood floors, she added.
On the less expensive side, Tong said, people should remember to change the filters on their heating and air conditioning system more frequently, using HEPA filters that can trap pollen.
People should vacuum more often, too, and use a vacuum cleaner that also has a HEPA filter.
"You can also buy HEPA filters that plug into the wall," she said.
Tong recommended keeping windows -- especially bedroom windows -- closed and using an air conditioner instead, along with asking smokers to step well away from the house.
She said pets, especially cats, can cause or aggravate allergy symptoms.
"Or course people aren't willing to get rid of their pets, but keeping them in certain parts of the household, having them groomed or trimmed down can help," Tong said. She said brushing can exacerbate symptoms, so people might want to consider a professional groomer.
Both Tong and Jacobs said there are a host of prescription and over-the-counter medications that can provide relief to some. Those include oral antihistamines like loratadine, the drug contained in Claritin, fexofenadine, the chief ingredient in Allegra, and cetirizine, which is used in Zyrtec.
Jacobs suggested people steer clear of antihistamines like diphenhydramine, the drug in Benadryl, that can cause drowsiness, pointing out that police can issue a DUI-type ticket for anyone caught driving while taking it.
But, he said, only about 17% of people actually get relief through oral medications.
There are over-the-counter medications that can help with eye symptoms, although Jacobs said people should not use vasoconstrictors -- those that "get the red out" -- because they can make symptoms worse.
Tong said over-the-counter medicated nasal sprays containing oxymetazoline, used in products like Afrin and phenylephrine, the key component in Neo-Synephrine are widely available, but use of these should be limited to no more than three consecutive days since overuse can actually worsen symptoms.
Jacobs said prescription nasal sprays can work for many people, and Tong said there's one over-the-counter medicine that's inexpensive, effective and has been used for decades: saline.
She said it's available as a pressurized spray and is also widely used as a liquid in a Neti pot, a nasal douche that's poured directly through the sinuses.
"Salt is a natural astringent, it'll dry up the membranes in the nasal passages," Tong said. "It'll work and with no side effects."
She said many people also add baking soda as an added astringent.
While many people say eating local honey can help, Jacobs said that's unlikely.
"There's nothing to substantiate those claims," he said, explaining that the pollen that causes allergies are from plants that are wind pollinated.
"Generally, those pollens are not picked up by bees," he said.
Both Jacobs and Tong said people who suffer severe or prolonged allergy symptoms should check with a doctor; Jacobs added that people with allergies that return every year might also consider immunotherapy, which has now been used by doctors for a century.
"People may be sensitive to specific pollens," he said. "By taking what you're allergic to, starting in very small doses and building up to and effective dose, that shuts down the body's response to the pollen."
Both doctors agreed that people should anticipate allergy season and start taking medications at the very start, or even before symptoms show up.
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