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Column originally published Apr 24, 2018

Spring Allergy And Asthma

Question: Every spring, my teenage daughter and I have bad allergies. Both of us have itchy eyes, and get very congested in the nose; we sneeze constantly. We cannot do any jogging or running outside without getting out of breath or have a bad cough. We have tried Benadryl, but it makes us tired, and only gives temporary relief. My doctor gave me a blue puffer for cough, but it doesn’t help very much. I always wonder why are we so miserable in spring. What is the reason, and what can we do about it?


Spring allergy is a very common condition; some people have more serious problem than others. Most of Canada is covered with snow every winter. The fallen leaves and grass undergo decomposition throughout fall and winter, underneath the snow. This decomposition is achieved by moulds that grow on them; it is nature’s way of breaking down organic matters and recycling nutrients back into the soil.

In the process, moulds multiply in large quantities and produce spores. When the snow melts in early spring, the moulds and spores are released into the air and dispersed by wind. For those who are allergic to these outdoor moulds, they affect the eyes and the respiratory tract. Some have mild symptoms with itchy eyes and itchy nose. Others, like your family, are miserable in spring, and sometimes in fall also. A small number of individuals can have severe reaction that land them in hospital.

Sneezing and nasal congestion are probably the most common symptoms of spring allergy. When you breathe in the moulds and spores, they trigger an allergic reaction in the nasal passage, resulting in itchy, running nose and congestion. Sometimes, the congestion can be very severe, and leads to sinusitis.

For some, their lungs can react in the same way, with swelling of the bronchial tubes and production of mucus. Chest congestion and cough can happen, especially when you run and jog outside. This is actually asthma, triggered by moulds in the environment. Staying indoors may reduce some of the symptoms, but that is not the preferred solution.

Benadryl is an antihistamine that can counteract allergic reaction; unfortunately it is short-acting, and can make people drowsy. Some children have the opposite effect: they can become hyperactive after taking Benadryl. There are several over-the-counter long-acting antihistamines that your pharmacist can recommend to you. They work better and longer, with very little side effect.

Sometimes, even long-acting antihistamines are not effective enough. You may have to add a nasal steroid spray that can reduce inflammation and swelling. These nasal steroid sprays require a physician prescription. An antihistamine eye drop can be used for itchy eyes.

When the lungs are involved, you will need treatment to reduce inflammation and swelling in the bronchial tubes. Your blue puffer is likely salbutamol; it is a bronchodilator that relaxes the muscle around bronchial tubes. This is symptomatic treatment only; it can reduce cough and make it easier to breathe. You need an inhaled steroid that reduces swelling and inflammation of the bronchial tubes.

If you get the puffer type of bronchodilator and inhaled steroid, you would need a chamber to improve delivery of puffer medications into the lungs. Without the chamber, most of the medicine lands in your throat, and not in your lungs. As a result, the puffers may appear to be ineffective.

There are also inhaled medications that come in powder form, which can be delivered effectively into the lungs without the use of a chamber. You should discuss this with your doctor about the pros and cons of different delivery systems. With the combination of inhaled steroid and bronchodilator, you can enjoy outdoor activities in spring and fall like everyone else.