What you can try when the antihistamines stop working
MANY people could get better relief from their symptoms — but aren’t aware of the options, says Stephen Durham, a professor of allergy and respiratory medicine at Imperial College London.
‘There is an unmet need out there though where some people just don’t get control of their symptoms even if they take medication,’ he says.
‘Over-the-counter antihistamines work well for people with mild hay fever, but in the 50 per cent of patients with moderate to severe issues, and symptoms that affect their sleep and work, corticosteroid nasal sprays are needed.’
Some are now available over the counter. ‘ However, many sufferers are unaware these sprays exist, ’ says Professor Durham, adding that stronger types of antihistamine are also available on prescription.
Furthermore he says ‘up to 10 per cent’ of those with severe hay fever could benefit from immunotherapy, where patients are exposed to minute amounts of their pollen allergen either by injection or tablets which dissolve under the tongue.
These can temporarily stop or reduce the symptoms for years.
‘The advantage of giving immunotherapy via tablets is that only the first dose has to be taken in hospital and the rest of the tablets can be taken at home,’ says Professor Durham. Some patients prefer injections because they are given in hospital and they feel reassured that if they suffer a reaction, help is at hand.
To qualify for immunotherapy on the NHS you must have tried, and failed, on antihistamine treatments, and the symptoms must be having a significant impact on your life.
For Jenny Argyle, 46, a teacher from Oakenshaw, County Durham, who has had hay fever for the past 27 years, it has been transformative.
Before starting the treatment, in November 2016, Jenny had a streaming nose, sneezing and itchy eyes that disrupted her sleep.
‘I’d also suffered from a blotchy, swollen face and been forced to cover my arms and legs as I develop hives after coming into contact with grass,’ she says. ‘It restricted when I could go out.’
Over-the-counter antihistamines did nothing and a stronger version from her GP, fexofenadine, led to dizziness and liver issues. Then she found out about immunotherapy.
‘One of my pupils suffered so badly she’d had to miss lessons, but one high pollen count day, I noticed she was suddenly symptom-free when everyone else — including myself — was having a bad day,’ says Jenny.
‘I found out she had been treated with immunotherapy.’
In July 2015, Jenny’s GP referred her for the treatment. She had to wait over a year before starting it — four injections a week apart, each year for three years.
‘I felt well enough to go back to school afterwards and carry on teaching,’ she says.
‘In the first year I stopped having major reactions to grass cutting. I now use a nasal spray for a few weeks in peak pollen months. My skin reactions, wheezing and sneezing fits have gone.’
Professor Durham said that the treatment is more widely available than previously.