WHILE the warm weather heralds picnics and ploughman’s for many, it can spell misery for the millions of people in the UK who suffer with hay fever.
Many different types of pollen can exacerbate the allergy, turning sufferers into sneezy, itchy, red-eyed zombies.
But many do not realise that hay fever is related to other symptoms, such as achy limbs or hair loss.
GP Dr Thomas Matthew (mbewellness.com) tells Sun Health: “As babies, we are gradually exposed to naturally occurring pollens and develop antibodies to them called IgEs.
“In people with hay fever, pollen can cause an excessive spike in these antibody levels.”
This leads to an exaggerated immune response.
Dr Thomas says: “The antibodies bind to a type of white blood cell called a mast cell, part of our immune system.
“This leads to the release of excessive amounts of histamine and pro-inflammatory chemicals called cytokines.”
Mast cells are in the lining of our nose, eyes and lungs, which are the source of typical hay fever symptoms.
But they are found elsewhere in the body, too.
“Pro-inflammatory chemicals are released into the bloodstream which travel to other areas of the body.
“This, combined with the fact that IgE antibodies can also affect mast cells in other organs, results in some unexpected symptoms.”
Clare O’Reilly looks at some lesser-known hay fever symptoms and suggests what you can do if you fall victim.
ASTHMA and hay fever are similar in that both are caused by an immune response to allergens, such as pollen, dust mites and pet dander.
During hay fever, Dr Matthew says: “The lining of the airways, from the windpipe to the branches of the airways in the lungs, become swollen.
“That means they narrow and become constricted.
“It becomes harder to breathe as there is less room for oxygen to pass through our lungs, resulting in a wheezy chest.”
Asthma and hay fever can coexist, causing asthma symptoms to worsen.
Treatment for hay fever can decrease the risk of it triggering an asthma attack.
HAY fever is more than just the sniffles, it can feel like a whole attack of the face.
Dr Matthew says: “In our skull there are some small empty pockets called sinuses.
“These are designed to make the skull lighter and so easier to carry around.
“Mast cells also line these sinuses, meaning inflammation and mucus release occurs here.
“This causes a runny and blocked nose as the sinuses drain through our nostrils.
“But it also causes facial pain, especially in the cheeks, under the eyes or in the upper teeth.
“Imagine if all the excess mucus caused by hay fever filled up your sinuses, like rising water levels.
“On average we produce between one and two litres of mucus a day throughout our body.
“But if suffering from hay fever this can double to four litres.
“Having to carry some of this excess in your sinuses can leave you feeling very heavy-headed.”
FOR some, a pollen bomb can cause itchiness.
Dr Matthew says: “The circulating histamine can result in a generalised pruritus, otherwise known as a general itching of the skin, and mast cell destabilisation in the skin results in raised bumps known as hives.”
Histamine causes the blood vessels to dilate and become more flexible.
This increases blood flow as well as fluid leakage into tissues, resulting in swelling and itching.
It is not good news for those with eczema.
While hay fever is not considered a direct cause of eczema, they share the base of a dysregulated immune system, so a person with one may be more likely to have the other.
Pollen can also seep into the broken skin barrier of those with eczema, worsening itching.
THOSE pesky mast cells can also be found in the digestive system, in the gut lining and in the lymphatic tissues deep in the tummy button, says Dr Matthew.
He says: “This causes swelling, excess watery mucus production in the bowel, and a leakier colon that can’t absorb water as well, resulting in diarrhoea.”
Bloating can also be a symptom of stress – which could be triggered by persistent hay fever – and hay fever medications that cause dry mouth.
IN both rheumatoid arthritis and hay fever, the immune system is super fired up.
For the former, the immune system mistakenly attacks the tissues around the joints, while in the latter, it overreacts to pollen.
While they affect different parts of the body, both lead to inflammation.
Dr Matthew says: “Hay fever can cause a flare-up of other chronic inflammatory or autoimmune conditions such as arthritis and joint pain.”
The extra strain the body is under while batting hay fever may also exacerbate the perception of pain.
And pain can also be brought on as a secondary response to wheezing or sneezing.
Dr Matthew adds: “Inflammation triggers a stress response in the body which is energy consuming resulting in fatigue, a general malaise and myalgia – better known as aching muscles.”
STRESS, genetics, hormones and vitamin deficiencies could be the cause of hair loss.
But have you ever considered it a sneaky side-effect of hay fever?
Dr Matthew says: “Mast cells also collect around hair follicles, and the inflammatory response triggered can destabilise the follicle.
“It can result in the hair on the head – or anywhere on the skin – falling out and if the inflammation persists, impeding new hair growth.”
ARE your summer nights spent tossing and turning?
You may blame it on the hot weather, but Dr Matthew says: “If you’re experiencing any symptoms of hay fever then this can, of course, affect your ability to get a good night’s sleep, either stopping you from getting to sleep or causing disrupted sleep.
“‘Hay fever sleep’ is a very real thing.”
And a foggy brain or lack of concentration the next day is an unfortunate knock-on effect.
Dr Matthew adds: “Inflamed and swollen airways can lead to less oxygen reaching your lungs at night.
“And because of this, your brain is supplied with less oxygen too, which is a form of sleep apnoea.
“People think they have slept OK, at least in terms of duration, but the quality of sleep has been poor.
“This can lead to people feeling unrefreshed and not as cognitively sharp as normal, as the prefrontal lobe of their brain lacks energy.”
ANTIHISTAMINES: Independent pharmacist Rita Ghelani tells Sun Health: “These calm down hay fever symptoms by reducing or blocking the amount of antihistamines produced by the body.
“People often have to try different ones to find the antihistamine that best suits them.
“Take your oral antihistamine daily. Don’t wait until you get symptoms, proactively managing your hay fever is better.”
Rita advises you to identify your key hay fever symptoms and treat them directly.
She says: “Using two or even three different combinations of medications may help to control your symptoms more effectively.
“Seek advice from your pharmacist.”
FOR NOSE: Use saline nasal sprays for sneezing, painful sinuses and congestion.
Rita says: “Try Xlear nasal spray, which contains xylitol, and has anti-bacterial properties and keeps the nasal lining moist.
“If symptoms are more severe, then try an anti-inflammatory nasal spray – sometimes referred to as a steroid nasal spray – which can take a few days to work.
“Start with one that contains beclomethasone, which is used twice a day, in the morning and at night.”
Rita also advises cleaning the nose with a saline nasal spray before a steroid spray, saying: “It will remove sticky mucus from the nasal passage, thus improving the effectiveness of the medication.”
FOR FATIGUE: For many, the tiredness is what makes a high-pollen day so unbearable.
Rita says: “Some antihistamines can cause drowsiness, for example chlorphenamine. It may be better to take it in the evening.
“Headaches are also a side effect, but they are more common due to nasal congestion.”
FOR EYES: If itchy eyes are your primary concern, Rita says: “Try using sodium cromoglicate eye drops.
“These make the eyes less sensitive to allergens such as pollen and reduce irritation.
“They need to be used four times a day to keep the levels of the active ingredient high enough to be effective.
“Keep using them even if symptoms improve.
“Using a good eye drop to lubricate the eyes may also help with dry eyes during the summer months.”
HAY fever sufferers are always on the lookout for the “cure,” but Rita warns they should be treated with caution.
Relatively new to shelves are hay fever wipes, but Rita says: “The wipes contain natural oils, such as tea tree, which have a cooling effect.
“These will help to reduce the pollen on the skin, but will not directly help with easing symptoms related to the nose and eyes. I don’t recommend them.”
So-called “hay fever injection” Kenalog, is no longer recommended by the NHS due to concerns over side effects, like high blood pressure. But it is still sold privately.
Rita says: “It temporarily suppresses the immune system to take away the symptoms of hay fever, but there is not enough evidence to show that it is effective.”
YOU may be going into another summer fearing the worst, having “tried everything”.
Pharmacist Rita Ghelani says: “For people with severe debilitating symptoms, a GP may prescribe a short course of steroids.
“If they are not effective then you may be referred for immunotherapy, also known as desensitisation.
“It involves administering small amounts of pollen via an injection or tablets, and slowly increasing the amount of pollen.
“This will allow your body to gently build up an immunity to pollen and not react to it when you are exposed to it in the environment.”
Rita also recommends:
