Hay fever playing up Blame the birch trees and steer clear of celery!
23:35 GMT, 19 March 2012
Sneezing, itchy eyes and runny nose — these are the symptoms that will already be troubling many millions of Britons, with the hay fever season having started even earlier than usual due to the mild winter.
Here, leading experts reveal the things every hay fever sufferer needs to know — and dispel some common myths…
With hay fever, it's the proteins in pollen that are the problem. Pollutants can make the proteins in pollen more potent
THE POWER OF POLLEN
When it comes to hay fever, the UK (along with Belgium) really is the sick man of Europe with around 27 per cent of us affected.
‘The problem is that the UK seems to have much more potent grass pollen than other parts of Europe, although it’s not clear why,’ explains Roy Kennedy, professor of aerobiology and microbial science at the University of Worcester.
He says in 2009, for example, there was a three-fold increase in the potency of grass pollen compared with other sites in Europe.
However, it’s important to note levels vary every year.
Air pollution also plays a role in severity: allergic reactions are caused by the body overreacting to proteins found in allergens.
With hay fever, it’s the proteins in pollen that are the problem. Pollutants can make the proteins in pollen more potent.
‘And if you’re breathing in a lot of fumes, the nitric oxide in them will also slow down the clearing of mucus (and pollen) from the nose by tiny hair-like projections called cilia,’ adds Professor Jean Emberlin, director of research at the charity Allergy UK.
SNEEZING ALREADY BLAME BIRCH TREES
Birch tree pollen is the first pollen to appear in the hay fever season and this year's birch season has started two weeks earlier than usual
Around 25 per cent of hay fever sufferers are allergic to birch tree pollen.
This is the first pollen to appear in the hay fever season and this year’s birch season has started two weeks earlier than usual, says Professor Emberlin.
This is thanks to the mild autumn (which boosted the amount of pollen produced), followed by the recent cold snap (which triggered its release).
The season will spread northwards, reaching the Midlands by March 29, followed by northern England and Northern Ireland by the first week of April, and Scotland by April 11, lasting around four weeks in each location.
Birch trees are particularly problematic because of the way the body reacts to the protein the pollen produces.
‘There are also an awful lot of birch trees which release a vast amount of pollen,’ says Professor Emberlin.
ALCOHOL MAKES SYMPTOMS WORSE
Unfortunately, alcohol can make you extra sneezy. Not only does it dehydrate you, making symptoms seem worse, it may also increase your sensitivity to pollen.
Meanwhile, Danish research has found that drinking more than two glasses of wine a day almost doubles the risk of a woman developing allergies in general.
Those who have more than 14 drinks a week are 78 per cent more likely to develop the sore eyes, runny nose and headaches associated with reactions to house dust mites or animal fur.
One theory is that alcohol has a negative effect on the immune system.
AVOID THE DANGER FOODS
Around half will suffer an itching and/or swelling in the lips or tongue from eating celery
Certain ‘healthy’ foods can cause people with hay fever to suffer other effects too, says Professor Stephen Durham, head of allergy and clinical immunology at Imperial College, London.
This is a particular problem with birch pollen allergy — around half will suffer an itching and/or swelling in the lips or tongue from apples, pears, cherries, apricots, plums, peaches, kiwis, potatoes, carrots, celery, hazelnuts, almonds, walnuts, peanuts and soya beans.
‘The problem occurs because the protein in pollen is similar to proteins in these foods,’ says Marianne Williams, a specialist allergy dietitian. ‘So when you eat them, the body initially thinks it’s birch pollen.’
The condition, known as oral allergy syndrome, is not dangerous, she adds.
‘People always worry it will escalate and become anaphylaxis, but this isn’t the case. The proteins won’t survive stomach acid. Also, cooking the foods breaks down the proteins.’
It’s not just people with birch pollen allergy who are affected —some with a grass pollen allergy may suffer with tomatoes, melon, wheat, barley and rye, oats and soya beans.
MAKE SURE YOU GET SOME SUN
Hay fever may be associated with a lack of vitamin D, says Dr Glenis Scadding, president of the British Society for Allergy and Clinical Immunology.
Indeed, experts are increasingly linking the rise in allergies to a lack of the vitamin, which is made when the skin comes into contact with sunlight.
Children with lower vitamin D levels were significantly more likely to have severe asthma and several other markers of allergy, according to a study published in American Journal of Respiratory and Critical Care Medicine.
‘I remember the Fifties, when we took cod liver oil (which contains vitamin D),’ says Dr Scadding.
‘This stopped shortly afterwards and there was a huge rise — a quadrupling — in hay fever and allergies between the Fifties and Eighties.’
Professor Durham adds: ‘Many people are deficient in vitamin D. However, as yet there’s no evidence that replenishing levels of vitamin D has any benefit for allergy sufferers.’
DON’T BE STINGY WITH NASAL SPRAY
A steroid nasal spray is one of the most effective hay fever treatments, says Dr Scadding.
Look for ones containing fluticasone propionate (available over the counter), mometasone furoate or fluticasone furoate (both prescription-only), and start taking them two weeks before the pollen that affects you comes into season.
‘Don’t be put off by the fact it contains a steroid — the dose is minuscule and usually 99.5 per cent of it won’t get anywhere else in the body,’ adds Dr Scadding.
‘One of the most common mistakes people make is not using their spray every day.
‘Some end up needing steroid injections, which isn’t a good way to manage the condition.’
Professor Durham agrees it’s important to use the spray every day, even when you have no symptoms.
‘Almost all the patients referred to me get through one bottle during the whole summer — but you should be getting through a bottle a month. Two squirts in each nostril once a day for most products, but always read the label.’
Then there’s technique. Professor Durham advises leaning forward and spraying into each nostril — tipping your head back means the medication will just run down your throat.
Also point the nozzle in the direction of the ear on that side of your face.
Another option is nasal air filters — clear, soft rubbery implants worn outdoors to prevent allergens from being inhaled.
THAT ‘COLD’ COULD BE HAY FEVER
Many people don’t realise they’re suffering from an allergy; instead, they blame their runny nose and itchy eyes on a cold, says Professor Emberlin.
And you’re never too old to develop hay fever. It’s estimated half a million more middle-aged people will develop it over the next decade.
Professor Durham says: ‘Without doubt, there’s been a huge increase in tree pollen allergy in the past decade.’
The fact we spend more time indoors exposed to dust mites and moulds could also be a contributing factor.
BEWARE THE RISE OF RAGWEED
The changing global environment may play a role, as plants that release more pollen into the air start to grow in Britain.
The ragweed plant (ambrosia artemisiifolia) is spreading throughout Europe and is highly allergenic, says Professor Kennedy.
Ragweed is already the major allergen in the U.S. and causes havoc in August and September.
WILL THERE BE A HAY FEVER VACCINE
Actually, it’s already available, but not widely known about. Up to 40 per cent of hay fever sufferers don’t respond to treatments such as antihistamines because their allergy is so severe.
If all other treatments haven’t helped, you may be referred to a specialist and offered immunotherapy. This usually involves having injections or tablets of the pollen you’re allergic to over a period of three years.
Patients with grass pollen allergy tend to be given daily tablets rather than injections.
There is one licensed pill — Grazax — although another, Oralair, is soon to become available.
The treatment has to be prescribed by an allergy specialist and it can take a few months to get referred.
The best results are seen four months after treatment begins, says Professor Durham.
‘In trials of patients with a confirmed sensitivity to grass pollen, 80 per cent of people will do well on immunotherapy, and have less need for other treatments such as steroid sprays and antihistamines.
‘However, it must be noted that 40 per cent of patients given a placebo also did well — because they were receiving the best medical care and taking the other medication (i.e. steroid nasal sprays and antihistamines) properly.’
Imperial College is currently recruiting patients with severe hay fever for clinical trials into new treatments.
For more information about taking part, email [email protected]
TRIGGERS TO WATCH OUT FOR
To work out what’s causing your hay fever, use this calendar, which shows the most common triggers and when they’ll strike…
BIRCH: Second week of March to first week of June (peaks last week of March to mid-May).
PLANE: Mid-March to mid-May (peaks last week of April to second week in May).
OIL-SEED RAPE: Last week in March to mid-July (peaks mid- May to end of June.)
OAK: First week of April to mid-June (peaks end of April to first week in June).
GRASS: First week of May to second week of September (peaks first week in June to last week in July).
NETTLE: Beginning of May to end of September (peaks last week of June to first week in August).