Top findings for neck pain suffers

- Stay as active as you can, exercise and reduce mental stress.
- Don't expect to find a single "cause" for your neck pain.
- Be cautious of treatments that make "big" claims for relief of neck
pain.
- Trying a variety of therapies or combinations of therapies may be
needed to find relief - see the therapies for which the Task Force
found evidence of benefits.
- Once you have experienced neck pain, it may come back or remain
persistent.
- Lengthy treatment is not associated with greater improvements; you
should see improvement after 2-4 weeks, if the treatment is the right
one for you.
- There is relatively little research on what does or does not prevent
neck pain; ergonomics, cervical pillows, postural improvements etc.
may or may not help.

Neck pain, including whiplash-related pain, be classified and treated in a common system of 4 grades:

Grade 1: neck pain with little or no interference with daily activities
Grade 2: neck pain that limits daily activities
Grade 3: neck pain accompanied by radiculopathy ("pinched nerve" - pain
weakness and/or numbness in the arm)
Grade 4: neck pain with serious pathology, such as tumor, fracture,
infection, or systemic disease.

Are Natural Therapies And Alternative Treatments Useful For Arthritis Patients?

Why should arthritis patients consider using natural therapies and alternative treatments? When is it the right time for an arthritis patient to consider using natural therapies and alternative treatments? Can traditional treatments and natural therapies be used together? As a rheumatologist, what alternative treatments and natural therapies have you seen patients have success with for treating arthritis?



Natural Therapies And Alternative Treatments

Increasing numbers of patients who have chronic conditions choose alternative treatments when conventional therapies are of concern or have not provided acceptable results.

Although more clinical studies are needed to assess the long-term and short-term risks and benefits, alternative medications including herbs, supplements, and nonpharmacologic measures have been helpful for symptomatic relief of musculoskeletal pain.


Herbal Remedies And Dietary Supplements

Patients electing to try alternative herbs or supplements need to understand that many have not been extensively studied and are not approved by the FDA.

Furthermore, they should try to obtain the product from a reputable source as the amount of active ingredient may not be up to standard. Some pain relieving herbal and dietary products include:

primrose oil
devil's claw
capsaicin
avocado/soya

Omega-3 Fatty Acids

Dietary omega-3 polyunsaturated fatty acids (e.g. alpha-linolenic acid) has anti-inflammatory properties. Foods high in this substance include:


vegetables
beans
fruits
as well as canola, wheat-germ, and walnut oils


Anti-Inflammatory Diet -
You may be familiar with the antiinflammatory medications, but have you heart of antiinflammatory foods? The foods you eat really do have an affect on how you feel.

What is Inflammation?
Inflammation is defined as a localized reaction of tissue to irritation, injury, or infection. Symptoms of inflammation include pain, swelling, red coloration to the area, and sometimes loss of movement or function. We commonly think of inflammation as the painful component of arthritis. Inflammation is also a component of chronic diseases such as heart disease and strokes.

Medical Anti-Inflammatory Treatments
Common medical antiinflammatory treatments include rest, light exercise, weight maintenance, stretching, and medications designed to reduce the inflammation and control the pain. These medications include Non Steroidal Anti-Inflammatory Drugs (NSAIDs), steroid medications, and perhaps ultimately joint replacement surgery. The NSAIDs are widely used as the initial form of therapy.

For the most part NSAIDs are tolerated fairly well, although they can irritate the stomach and lead to ulcers. In some instances, long term use can lead to kidney problems.

Avoid Pro-Inflammatory Foods
Pro-inflammatory foods will increase inflammation, increase your pain from the inflammation and may also raise your risk for chronic disease. Loading up on junk foods, high-fat meats, sugar and fast foods will increase inflammation in your body. This is partially due to the unhealthy fats used in preparing and processing these foods, especially trans fats and saturated fats. Processed meats such as lunch meats, hot dogs and sausages contain chemicals such as nitrites that are associated with increased inflammation and chronic disease.

Saturated fats are also found in meats, dairy products and eggs. While all of these foods are important source of minerals and vitamins, you don't need the extra saturated fat. These foods also also contain fatty acids called arachidonic acid. While some arachidonic acid is essential for your health, too much arachidonic acid in the diet may make your inflammation worse. Be sure to choose low fat milk and cheese and lean cuts of meat, which will not promote inflammation.

Diets high in sugar have also been associated with inflammation, obesity and chronic disease such as diabetes. Eliminate high sugar foods such as sodas, soft drinks, pastries, presweetened cereals and candy.

Another possible source of irritation comes from the nightshade family of plants. Whole fruits and vegetables are important to eat for their vitamins, minerals, and natural antioxidants, however some vegetables like potatoes, tomatoes, and eggplant may actually make pain from inflammation worse. These vegetables are part of the nightshade family of plants and contain a chemical alkaloid called solanine. Solanine can trigger pain in some people. While there isn't any formal research findings that back the claim about nightshade plants, you can avoid them for a few weeks to see if your pain and symptoms of inflammation improve.

Choose Antiinflammatory Foods
Adding foods that reduce inflammation will improve how you feel and help to decrease your risk for chronic diseases. Here are some suggestions.

Fats and Oils
The right types of fats in your diet will impact pain and inflammation in a positive way. Omega-3 essential fatty acids are very powerful antiinflammatory agents. They are found in cold water oily fish, walnuts, flax seeds, canola oil and pumpkin seeds. Adding omega-3 fatty acid supplements from flax oil or fish oil may also help reduce inflammation, just be sure to speak with a doctor or nutritionist before taking larger, therapeutic doses of any supplement, or follow label instructions.
Olive oil is another type of oil that will reduce inflammation. In fact, olive oil has been shown to reduce the risk of cardiovascular disease, and will help to reduce pain. Other healthy oils include rice bran oil, grape seed oil, and walnut oil.

Protein
Your body needs protein to build healthy body tissues. Good protein sources include lean poultry, fish and seafood, nuts, legumes and seeds. Red meats may trigger inflammation, so cut back on fatty red meats. When you do eat red meat, choose lean cuts of bison, venison and other game meats, or the lowest-fat cuts of beef, preferably grass-fed beef.

Soybeans, tofu, and soy milk are three great sources of soy proteins that may help to reduce your pain and inflammation.

Carbohydrates and Fiber
Most of your carbohydrates should come from whole grains, vegetables and fruits. The bread, cereal and pasta in your diet should be mostly be 100% whole grain products. Whole grains are excellent sources of fiber, and a high fiber diet will reduce your inflammation.

Choose green leafy vegetables, green and brightly colored vegetables and lots of fresh whole fruits. You should eat at least five and preferably more servings of fruits and vegetables each day. Green vegetables and whole fruits are also important as sources of dietary fiber.

Berries are also a great food choice, especially blueberries and strawberries which are packed with anti-inflammatory phytochemicals and anti-oxidants. The pigments in brightly colored fruits, vegetables and berries contain many phytochemicals that have antiinflammatory properties. One example is quercetin, which is found in apple and red onion skins and has strong antiinflammatory properties.

Healthy Beverages
Your body needs water in the form of foods and beverages every day. The simplest and maybe best form of water is fresh drinking water. Other good fluid sources include 100% fruit juices, herbal teas, vegetable juices and low fat milk. About 20% of the water you need every day will come from the foods you eat.

Antiinflammatory Diet Tips
Over all, when you are choosing antiinflammatory foods to help reduce your inflammation and pain, choose fresh foods instead of heavily processed foods. Here are some tips:Breakfast could be oatmeal served with fresh berries and walnuts, with a cup of soy milk. Snack on whole fruits, nuts, seeds, and fresh vegetables throughout the day instead of cookies and candy.

Eat more fish and less fatty red meat.
Stay away from deep fried foods and bake or stir fry your meals instead.
Choose green, orange, and yellow vegetables for your side dishes.
Drink plenty of water, fresh 100% fruit and vegetable juices, herbal teas and green tea.

Fish Oil Helps Protect The Brain From Alzheimer's Disease

The December 26, 2007 issue of The Journal of Neuroscience reported the finding of Greg Cole and colleagues at the University of California, Los Angeles of a mechanism by which the omega-3 fatty acid docosahexaenoic acid (DHA), found in fish oil, helps prevent Alzheimer's disease. Research has suggested a protective effect for fish oil against Alzheimer's disease and dementia, but the mechanisms responsible for this benefit had not been determined.

Dr Cole, who is a professor of medicine and neurology at UCLA's David Geffen School of Medicine, and his colleagues found that DHA increases the production of a protein known as LR11, which is reduced in Alzheimer's disease patients. LR11 decreases the formation of beta amyloid, a protein that forms brain plaques which characterize the disease.

Dr Cole's team was able to confirm DHA's effect by adding fish oil or DHA to the diet of rodents, or applying it to rat neurons. "We found that even low doses of DHA increased the levels of LR11 in rat neurons, while dietary DHA increased LR11 in brains of rats or older mice that had been genetically altered to develop Alzheimer's disease," Dr Cole stated. DHA was also shown to increase LR11 when administered to cultured human neurons.

What the research team has yet to determine "is what the optimal dose should be," Dr Cole noted. "It could be that a smaller amount might be helpful, especially in a place like the south of France, where people are already on a Mediterranean diet."

However, in the United States, where fish consumption is low, a greater dose may be needed. "There's a deficiency of DHA to begin with," Dr Cole stated, "and this may contribute to the low LR11 seen in many Alzheimer's patients."

FIGHTING CALORIES WITH GRAPES

An article published online on November 14, 2007 in the Journal of Agricultural and Food Chemistry revealed the discovery of researchers at the University of Rochester and Cornell University that polyphenols in red grapes may reduce the ability of bacteria to cause tooth decay.

Hyun Koo, DDS, PhD, who is an assistant professor of Dentistry in the Eastman Department of Dentistry and Center for Oral Biology at Rochester University Medical Center, and his associates extracted polyphenols from several varieties of red wine as well as from pomace, which consists of fermented seeds and skins that are discarded after grapes are pressed. The extracts were tested for their ability to reduce the virulence of Streptococcus mutans, the bacteria that causes cavities.

All of the polyphenol extracts tested were found to inhibit glucosyltransferases (GTFs) B and C, bacterial enzymes that produce glucans which attach bacteria to tooth surfaces to form the dental biofilm known as plaque. Polyphenols derived by Cabernet Franc extracts were found to be the most effective by inhibiting 85 percent of these enzymes. Additionally, polyphenols reduced the ability of Streptococcus mutans to secrete acid, which enhances its survival. "Overall, the phenolic extracts disrupt essential virulence traits for a widespread, destructive oral pathogen, but without killing it," commented research team member Olga I. Padilla-Zakour, PhD, of Cornell. "We are excited about the potential application of active compounds from wine grape by-products in the control of biofilms as part of the precise targeting of bacterial disease."

“Most foods contain compounds that are both good and bad for dental health, so the message is not ‘drink more wine to fight bacteria,’” Dr Koo advised. “We hope to isolate the key compounds within the winemaking waste that render bad bacteria harmless, perhaps in the mouth with a new kind of rinse.”

IS BOTOX UNSAFE

You may have noticed some alarming headlines about Botox, when a U.S. consumer group called Public Citizen released a petition asking the FDA for stronger warnings for Botox and Myobloc, the two forms of botulinum toxin currently approved in the United States.

But before you write Botox off, take note: All the safety concerns Public Citizen raises are already addressed in the drug's labeling. These concerns are nothing new.

First, let me clarify an important point about Botox: While it is most commonly known as a wrinkle treatment, it also has many important medical uses. In fact, medical and cosmetic Botox are sold in different packages. The Botox Cosmetic® used to treat wrinkles is a much lower dose than that used to treat medical problems.

Bottom line: Botox Cosmetic® is safe for cosmetic use when used by experienced doctors. If you are interested in trying Botox treatments for cosmetic purposes, ensure that the they are performed as safely as possible by following a few important steps:

1. Always get your Botox injections from a dermatologist, plastic surgeon, facial plastic surgeon, or oculoplastic surgeon.

2. Make sure your doctor is board-certified. To find a board-certified dermatologist in your area, visit http://www.aad.org/.

3. Ask your doctor how many patients he or she has treated with Botox. If the number is under 100, go to someone else.

These products have been used for over 17 years worldwide, and I have never heard of a complication after cosmetic treatment by an experienced doctor.

Several other forms of botulinum toxin are expected to be approved soon, and I absolutely agree that patients should have as much information at their disposal as possible.

HEALTHY FOODS FOR HEALTHY SKIN

You can invest half your paycheck in serums and creams - even splurge on dermal fillers and pricey facials - but none of it will get you far without a skin-friendly diet.

Of course, your skin (and the rest of you, for that matter) is best served by a well-rounded diet, including healthy fats, sufficient protein, and lots of fruits and vegetables. But there are a few nutritional standouts that make particularly important contributions to strong, glowing skin:

1. Fish: Fatty fish like salmon, tilapia, and cod are rich in omega-3 fatty acids. And that's a good thing, because our bodies cannot produce those essential lipids naturally. By adding omega-3s to your diet, though, you can bolster your skin barrier - that is, the layer of lipids that holds onto moisture and keeps irritants out.

There is even evidence that the skin-strengthening effects of omega-3s can improve chronic skin conditions like rosacea and atopic dermatitis, but more research is necessary to confirm that link.

Furthermore, many types of fish (like, once again, salmon and cod) are rich in vitamin D - as dermatologists increasingly emphasize sun avoidance, we also need to emphasize the importance of finding other sources of this vitamin, which is produced during sun exposure.

Don't eat fish? Many eggs are now fortified with omega-3 fatty acids, and plant sources include flax seed and flax seed oil, walnuts, pecans, and hazelnuts. And a daily vitamin D supplement is a good idea for vegans and meat-eaters alike.

2. Green Tea: It's inexpensive, easy to add to your routine, and one of the best-researched and most powerful antioxidants around. That's why green tea is my go-to antioxidant: I drink at least three cups a day to fight aging and inflammation. Some studies even suggest that the antioxidants in green tea reduce one's risk of skin cancer. So put down that soda and start drinking your way to healthier skin!


3. Broccoli: Rich in vitamins A, C, and K (among many other nutrients), this veggie does more than its fair share of nutritional work. Vitamin A decreases oil production, vitamin C is a powerful antioxidant, and vitamin K can help prevent bruises. So whatever ails you, this green wonderfood might be just what the doctor ordered.

4. Safflower or Sunflower Oil: Omega-3s get a lot more talk, but omega-6 fatty acids - like the linoleic acid in these two oils - are also important for healthy skin. Like omega-3s, they help prevent dry skin and inflammation; they're also essential for the formation of prostaglandins, hormones that keep all the cells of the body functioning well.

While many diets are actually quite high in omega-6s - sometimes even too high - the key is to get the good ones and not unhealthy versions, like hydrogenated oils. So try sautéing your salmon or broccoli in a little safflower or sunflower oil and double those skin-soothing benefits!

5. Almonds: When it comes to boosting skin's defenses against aging, inflammation, and even skin cancer, antioxidants are so important that I'm going to add another to my list: A handful of almonds every day boosts your levels of vitamin E, one of the most important antioxidants for skin health. Studies also suggest that consuming vitamin E orally can increase the levels of this moisturizing vitamin on your skin's surface - great news for anyone prone to dry skin.

ALLERGY SHOTS THE PROS AND CONS

An allergy shot every month for several years certainly isn't your idea of fun — much less your child's. But it might be a worthwhile investment in the long run.

When persistent allergies don't respond to medication — or the medication side effects are intolerable — allergy shots may offer the best relief.


How do they work?

Allergy shots (immunotherapy) are a series of injections meant to desensitize you to specific allergens — the substances that trigger an allergic response.

To be effective, allergy shots are given on a schedule. Typically you'll receive a shot once or twice a week for about three to six months. After that, you'll need a shot about once a month for three to five years. For the first three to six months, the allergen dose is gradually increased with each shot. This helps your body accept the allergen as the harmless substance it is.


Are allergy shots recommended for everyone with allergies?

Allergy shots are commonly used to treat allergic rhinitis (hay fever) and asthma. If you have seasonal hay fever or asthma, you may be allergic to pollens released by trees, grasses or weeds. If you have year-round hay fever or asthma, you may be sensitive to indoor allergens such as dust mites, cockroaches, mold or pet dander. Allergy shots may also control allergic reactions to stinging insects, such as bees, yellow jackets, hornets and wasps.

But the shots don't work on all allergies or on all people with allergies. For example, they're not effective for food allergies. Allergy shots may not be good for you if you have severe asthma, and you shouldn't get allergy shots for hay fever or asthma if you take a beta blocker for heart problems.


Are any tests needed ahead of time?

Yes. Before starting allergy shots, your doctor may use a skin test to confirm that your reactions are caused by an allergy and determine which specific allergens cause your signs and symptoms. During a skin test, a small amount of the suspected allergen is scratched into your skin and the area is then observed for about 20 minutes. Swelling and redness indicate an allergy to the substance.


How long does it take to get relief?

Allergy symptoms won't stop overnight. You'll probably enjoy some improvement in your symptoms during the first year of treatment, but the most noticeable improvement often happens during the second year. By the third year, most people are desensitized to the allergens contained in the shots.

If your symptoms don't improve after one year of regular allergy shots, your doctor will evaluate the situation. Perhaps the allergen dose needs to be adjusted or additional allergens must be added to the shots. Sometimes, allergy shots may be stopped in favor of other treatments.


How long will relief last?

It varies. For some people, successful treatment leads to a life without allergy symptoms. For others, shots must continue on a long-term basis to keep allergy symptoms at bay.


What about reactions?

Allergy shots are usually safe. But they contain the very substances that give you grief —so reactions are possible.

Local reactions. You may notice redness, swelling or irritation at the site of the injection. These normal reactions typically clear up within four to eight hours.
Systemic reactions. These widespread reactions are less common — but potentially more serious. You may notice sneezing, nasal congestion and hives. More severe reactions may include throat swelling, wheezing or chest tightness. The most severe reactions — known as anaphylaxis — can be life-threatening.
The possibility of a severe reaction is scary — but you won't be on your own. You'll be observed in the doctor's office for up to 30 minutes after each shot, when the most serious reactions are likely to occur. If you have a reaction after you leave, return to your doctor's office or go to the nearest emergency room.


Are there special considerations for kids?

For children with allergies, allergy shots may prevent allergy-related asthma later in life. Allergy shots may keep kids from developing new allergies as well. Allergy shots can begin as early as age 5.


Weighing the pros and cons

If you wonder whether allergy shots are right for you — or your child — there's plenty to consider. Ask yourself these questions:

How severe are your symptoms? Allergy shots might be most worthwhile if your symptoms are severe or tough to manage. If you have seasonal allergies, the length of the season that gives you the most trouble might influence your decision.

Are you happy with your current allergy medication? Shots are uncomfortable — or even frightening, especially for kids. But shots might be appealing if your allergy medication isn't working as well as you'd like or if you're struggling with significant side effects.

Can you avoid your allergens? If the allergens that trigger your symptoms are unavoidable, allergy shots might offer an alternative to medication.
Are you prepared for long-term treatment? Allergy shots require frequent clinic visits for at least several years.

Is cost a concern? Find out whether allergy shots are covered by your health insurance plan. Work with your doctor to better understand the pros and cons of allergy shots. Together, you can develop the best allergy management plan for you.

Allergy medications.... all you need to know

Allergy treatment usually starts with avoiding the substances (allergens) that cause your signs and symptoms. If you can minimize your exposure to allergens — which may include everything from pollen, mold, pet dander and dust mites to certain foods, drugs and chemicals — you'll have less sneezing, coughing and itching.

But because you can't always avoid everything that triggers your allergies, your doctor may prescribe allergy medication. The right medication or combination of medications depends on the allergy symptoms you have. Allergy medications are available in pill, liquid, nasal spray, eyedrop and topical (applied to the skin) forms, some over-the-counter and others by prescription only. To make the best choice, get advice from your doctor, and find out which medications are best for different symptoms.

The main types of allergy medications are:

Corticosteroids. These medications help prevent and treat the inflammation associated with allergic conditions.
Antihistamines. These drugs block histamine, an inflammatory chemical released by your immune system during an allergic reaction.
Decongestants. These drugs relieve nasal and sinus congestion.
Leukotriene modifiers. These medications block the effects of leukotrienes, inflammatory chemicals released by your immune system during an allergic reaction.
Mast cell stabilizers. These preparations prevent the release of histamine.

Corticosteroids

Corticosteroids help prevent and treat the inflammation associated with most allergic conditions, although the site and severity of inflammation varies. Except for some over-the-counter skin creams, corticosteroid medications usually are available only by prescription. They include:

Nasal sprays. Corticosteroid medications sprayed in the nostrils are the preferred treatment for hay fever because they help prevent and relieve nasal stuffiness, sneezing and an itchy, runny nose. Examples include budesonide (Rhinocort), mometasone (Nasonex), fluticasone (Flonase) and triamcinolone (Nasacort). Although these medications aren't usually immediately effective, you may start to notice improvement after you've used them regularly for days or even a week or two. Nasal corticosteroids are generally safe for extended use. Mild side effects may include an unpleasant smell or taste, or irritation, crusting and bleeding in your nose. Nasal irritation may be especially noticeable during the winter. Rarely, more serious side effects can include sinus damage and infection. Unlike steroids taken by mouth or inhaled deeply through an inhaler or nebulizer, most nasal steroids don't appear to reduce bone density or affect growth in children. Still, to be on the safe side, doctors usually prescribe the lowest effective dose of nasal corticosteroids.

Eyedrops. Corticosteroid drops formulated for the eyes relieve the redness, tearing and itching caused by hay fever and allergic conjunctivitis. Examples include dexamethasone (Decadron, Dexair, others), fluorometholone (Eflone, Fluor-Op, others) and prednisolone (AK-Pred, Econopred, others). They shouldn't be used if you have glaucoma or an eye infection. They can cause side effects such as blurred vision. Because they've been shown to cause birth defects in animals, you may be advised to avoid them if you are pregnant or plan to become pregnant. Also, if you wear contact lenses, corticosteroid eyedrops increase your risk of eye infections, so you may be advised to switch to eye glasses during treatment.
Skin creams. Best for relieving the scaling and itching caused by eczema (atopic dermatitis), corticosteroid skin creams come in different strengths. Low-potency skin creams include hydrocortisone (Allercort, Dermacort, others). Medium to very high potency skin creams include triamcinolone (Aristocort, Flutex, others). Although such skin creams are usually safe, they can sometimes cause skin irritation and discoloration.

Pills, liquids. Oral corticosteroids such as prednisone (Cordrol, Dexasone, others) are sometimes used to treat severe allergy symptoms. Because the long-term use of such medications can cause severe side effects such as cataracts, osteoporosis and muscle weakness, they're usually prescribed only for short periods of time.

Antihistamines

Antihistamines block the action of histamine, an inflammatory chemical released by your immune system during an allergic reaction. Blocking histamine reduces such symptoms as redness, swelling, runny nose, itchy, watery eyes, and hives (urticaria). Prescription and over-the-counter antihistamines include:

Pills, liquids. Over-the-counter oral antihistamines include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton) and clemastine (Tavist). Because these older, first-generation antihistamines may make you sleepy, avoid using them before driving or operating heavy machinery. Newer, second-generation antihistamines — such as loratadine (Claritin), which is available over-the-counter — are less likely to cause sedation. Fexofenadine (Allegra) is a nonsedating prescription antihistamine. Another prescription antihistamine, cetirizine (Zyrtec), has an intermediate risk of causing drowsiness or driving impairment.

Nasal sprays. The prescription antihistamine azelastine (Astelin) is effective for hay fever, but may cause drowsiness.
Eyedrops. Prescription eyedrops include emedastine (Emadine), levocabastine (Livostin) and olopatadine (Patanol). Side effects may include redness, tearing, headache and mild stinging or burning. Antihistamine eyedrops increase the risk of eye inflammation for contact lens wearers, so you're safer wearing glasses during treatment.

Decongestants

Decongestants relieve nasal and sinus congestion caused by hay fever, as well as eye congestion caused by allergic conjunctivitis. Usually available over-the-counter, they include:

Pills, liquids. Many decongestants contain pseudoephedrine (Sudafed, Actifed, others), sometimes in combination with another drug. Medications such as Claritin-D, for example, combine pseudoephedrine with an antihistamine. Because oral decongestants elevate blood pressure, you should avoid them if you have high blood pressure (hypertension). Oral decongestants can also exacerbate the symptoms of prostate enlargement, making urination more difficult.
Nasal sprays. Examples include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). Don't use a decongestant nasal spray for more than two or three days at a time because, after longer use, you may develop severe congestion as soon as you stop.

Eyedrops. Examples include tetrahydrozoline hydrochloride (Visine). Although these eyedrops are generally safe, your eyes may become persistently red if you overuse them.

Leukotriene modifiers

These drugs block the effects of leukotrienes, inflammatory chemicals released by your immune system during an allergic reaction. Such medications have proved most effective in treating allergic asthma, but they also relieve hay fever. Leukotriene modifiers are only available by prescription. They're produced in pill and chewable tablet form. Examples include montelukast (Singulair), zileuton (Zyflo) and zafirlukast (Accolate). Headache is the most common side effect of montelukast, and nausea or upset stomach is the most common side effect of zileuton. Headache and nausea are sometimes side effects of zafirlukast.


Mast cell stabilizers

Mast cell stabilizers prevent the release of histamine, the same inflammatory chemical that antihistamines stop from binding to cells in the mucous membranes. Mast cell stabilizers may also reduce inflammation associated with hay fever and allergic conjunctivitis. They include:

Nasal spray. Available over-the-counter, the nasal spray cromolyn sodium (NasalCrom, Children's NasalCrom) has no serious side effects but may make the nasal passageways sting and burn, causing increased sneezing. Cromolyn sodium works best when you take it before your symptoms develop. Some people need to use the spray three or four times a day.
Eyedrops. Several different mast cell stabilizer eyedrops are available by prescription, but none are sold over-the-counter. Cromolyn sodium (Crolom) is available in eyedrop form, as are slightly different mast cell inhibitors, including lodoxamide (Alomide), pemirolast (Alamast) and nedocromil (Alocril). Cromolyn sodium and lodoxamide may make the eyes burn and sting, while pemirolast may cause chills, coughing, sneezing and sore throat. Nedocromil may cause blurred vision or dry, itchy eyes.

If you are taking any other medications or you have a chronic health condition, talk to your doctor or pharmacist before starting any treatment for allergies, to be sure you're not at risk of a drug interaction or other adverse effect.


When allergies trigger asthma

If you have the type of asthma triggered by allergies, your doctor may recommend medications such as inhaled corticosteroids, inhaled mast cell stabilizers, bronchodilators and allergy desensitization shots (immunotherapy). Omalizumab (Xolair), an anti-IgE monoclonal antibody, may help you if you have severe allergic asthma. Administered by injection every two to four weeks, omalizumab blocks the IgE antibodies that your immune system produces to attack substances that generally cause no harm, such as pollen, dust mites and pet dander.


Immunotherapy: An option if medications are ineffective

If you have hay fever symptoms that don't improve with medications or if you aren't able to take allergy medications without side effects, your doctor may recommend allergy shots (immunotherapy). Over a period of three to five years, you receive regular injections containing allergen extracts. The goal is to desensitize you to specific allergens and decrease or eliminate your need for medications.

Immunotherapy may be especially effective if you're allergic to cat dander, dust mites or pollen produced by trees, grass and weeds. In children, immunotherapy may help prevent the development of asthma. Rarely, immunotherapy injections can cause a severe allergic reaction (anaphylaxis).


Injectable epinephrine: First aid for severe allergic reactions

If you're highly allergic to certain foods, such as peanuts, or to bee or wasp venom, you may be at risk of anaphylactic shock — a sudden, life-threatening allergic reaction. To be on the safe side, your doctor may suggest that you carry an injectable dose of epinephrine (adrenaline). Epinephrine can help slow the reaction while you seek emergency medical treatment. You may be able to administer the drug by yourself, after being taught how to use a self-injecting syringe and needle. A friend, family member or medical professional called in response to a severe anaphylactic reaction also may administer the medication.



Allergy medications vary as much as allergies themselves. By understanding how such medications work, you can help your doctor develop a treatment plan that's best for you.