It’s Hay Fever Season In Canada. Here’s How To Fight Your Allergies

If you're suffering from a runny nose and itchy eyes this spring, you're not alone. “Somewhere between 25 to 40 percent of the Canadian population will probably have symptoms of hay fever at one point in their lives,” explains Dr. Anne Ellis, president of the Canadian Society of Allergy and Clinical Immunology. As for why some of us are sensitive to pollen in the first place, there could be many causes of allergies, with genetic predisposition and environmental factors among the usual suspects.

What causes hay fever?

An allergic reaction happens when your immune system overreacts to something otherwise benign. Hay fever, also known as allergic rhinitis, is generally triggered by environmental allergens from wind-pollinated plants. While the “hay” in hay fever refers specifically to grass pollen, the term is used colloquially for all types of seasonal allergies, such as tree and ragweed pollen, which all share similar symptoms.

When is hay fever season in Canada?

In Canada, tree pollen season typically starts earlier in spring, from March to May; grass pollen season runs from May to July; and ragweed season debuts in late August and lasts into September. British Columbia usually sees the worst tree pollen concentrations, while Ontario and Quebec get the most ragweed pollen.

But climate change is changing the timeline and intensity of allergy season, according to Ellis. “Because we've had a colder spring, we're having a later start to the tree pollen season. Because the tree pollen season is starting later, that means it's more likely to overlap with grass pollen season. So May can be a tough month for people who suffer from both tree and grass allergies,” she says. Higher temperatures and CO2 levels also increase the amount of pollen created, while increasing the allergenic qualities of that pollen—which translates to more intense symptoms for allergy sufferers.

What are the symptoms of hay fever?

Hay fever can come with wide-ranging symptoms: watery, itchy and red eyes, congestion or a runny nose, post-nasal drip, ear pain (the ear connects to the back of the nose, so sinus pressure and congestion can impact the ears) and lung issues. Asthma can flare up during peak allergy season.

What are the current allergy medication options?

Hay fever medications include antihistamines, available both over the counter and by prescription, which you can take during flare-ups. For over-the-counter options, Ellis recommends opting for newer (also called second-generation) antihistamines—such as Reactine, Claritin, Aerius, and Allegra—over older first-generation medications like Benadryl. The newer medications, says Ellis, usually last longer and are safer.

If the over-the-counter route just isn’t working, Ellis recommends two prescription options: Rupall, which is effective at targeting nasal congestion, or Blexten, which won’t make you drowsy. Traditionally, prescription allergy treatment follows a “ladder system,” explains Lee: if one drug doesn’t help, you move up the dose, and if that’s still not enough, you try a nasal spray (such as a nasal antihistamine or nasal corticosteroid). If needed, you can also add prescription eye drops (most over-the-counter versions aren’t appropriate for long-term use).

To understand the pros and cons of all your medication options, and what would work best for you, talk to your allergist or family doctor.

Are there any effective non-prescription treatments?

Beyond taking medications, avoid allergen exposure when possible by closing windows, avoiding drying laundry outside on lines, washing hands as soon as you get home, showering before bed, cleaning air ducts and wearing wraparound sunglasses to block pollen.

Some alternative-health adherents advise eating unpasteurized, unfiltered honey to get small doses of allergen (basically, DIY immunotherapy). But according to Jason Lee, a Toronto doctor and specialist in clinical immunology and allergy, this won’t expose you to the same grass pollen that causes hay fever—in other words, it’s not effective. And in the worst-case scenario, self-treating in this way—with allergens that aren’t measured or controlled—could cause an anaphylactic reaction. Similarly, although popping quercetin (a compound found in apples, onions and other plants, and also in supplements sold in health-food stores) has become popular, research backing it as a natural source of allergy relief is scarce. “We haven’t done human trials, so you don’t know the side effects,” Lee says.

Should you regularly switch up the type of allergy meds you’re taking?

Tachyphylaxis—the technical term for developing a tolerance to a drug—isn’t supposed to happen with antihistamines. Nevertheless, Lee says that patients tell him all the time that their medication has just stopped working. So if you’re taking your daily Reactine to no avail, ask your allergist about other options.

Do allergy medications have long-term side effects?

“All antihistamines have the potential to cause a degree of sedation, but it's usually quite low,” says Ellis. “Headache and dry mouth will occasionally be reported. But typically speaking, they're very well tolerated.”

While it’s safe to take antihistamines over a lifetime, your treatment should be a joint decision between you and your doctor, based on what potential side effects you’re okay with.

Is there a cure for seasonal allergies like hay fever?

Immunotherapy is the closest thing to a cure. How it works: Through a series of injections, or tablets you take under the tongue, you’re exposed to small, controlled doses of your specific allergen(s) over the course of three to five years, depending on the allergen. The goal is to fundamentally alter how your immune system reacts to these substances, easing symptoms in the long run.

Traditionally, immunotherapy has been done through injections: typically weekly injections over the course of six months, and then monthly injections for five years. There is a low risk of an anaphylactic reaction with the injections—about 1 in 1,000, according to Ellis—which is why all shots are done at the doctor’s office. The tablet option, which is newer but more expensive and doesn’t carry the risk of anaphylactic response, is a little easier: the first dose is taken at the doctor’s office, and the remaining dosages are taken at home. The timing of these dosages will depend on what allergy is being targeted.

While immunotherapy doesn’t work for everyone, about 70 percent of patients get some benefit from it. “Immunotherapy can also prevent the development of new allergies and may prevent the progression from seasonal allergies to asthma in at-risk children. [But] it does require a significant time commitment and may not be suitable for everyone,” says Dr. Stephanie Liu, a family physician and assistant clinical professor at the University of Alberta. Those who don’t end up sticking to their treatment plan can experience symptoms again, she says.

“Immunotherapy is the only thing that offers the chance to actually change your allergic condition. The antihistamines and the nasal steroids help treat the symptoms but they don't treat the root cause of your allergies,” says Ellis. It’s what Lee considers “the only disease-modifying option”—the one allergy treatment that can lower your need for medication, even after you finish your treatment.