Doc: Best to identify your problem allergen
Dear Dr. Roach: I live in extreme northeast Texas, so allergies are a given. Every morning, 24/7/365, my nose runs. Sometimes hot liquid runs out of my nose before I can even grab a tissue. I have taken Allegra, Claritin, Xyzal, etc. Nothing seems to help. Benadryl DOES help, but my eyes hurt when I take it. Neo-Synephrine and Afrin are for a congested nose, which is the opposite of my problem. Can you suggest an over-the-counter nasal spray I can use to stop this?
Dear Anon.: It could indeed be allergies causing the problem. We call that chronic perennial allergic rhinitis (“perennial”’ since it occurs the whole year). However, it also could be non-allergic rhinitis, and the treatments for the two may be different.
Allergies tend to get worse over time, and tend to (60 percent of the time) affect the eyes as well, leading to physical findings that an experienced doctor can see on exam.
If it is allergic, then sometimes finding the particular allergen (what it is you are allergic to) may be help, since you may be able to cut your exposure to it. An allergist can do this via either skin testing or blood tests. Additionally, knowing your allergen may lead to immunotherapy to help symptoms.
To answer your question directly, there are treatments, and you can try them, even if I think confirming the diagnosis and identifying the allergen is useful. All the pills you have tried are antihistamines. Although they are effective for some people, nasal steroids are effective for more people (but I have quite a few patients who hate and won’t use nasal sprays). Three nasal steroids are now available over the counter: fluticasone (Flonase), budesonide (Rhinocort) and triamcinolone (Nasacort). These all are effective treatments, any of which might work best for you.
These medications need to be used every day for them to be most effective, and they take at least a week before they start working best. I’ve seen some people get nosebleeds after using them for a prolonged period.
If the nasal steroid doesn’t work, I’d suggest a visit with an allergist or an ear, nose and throat doctor.
Dear Dr. Roach: Please describe the health benefits of consuming organic acai berry extract daily, and what daily dose one should be taking.
Dear D.B.: Acai berries are grapelike berries cultivated in Brazil. I’ve had them, and I think they are delicious. They have high quantities of many substances that are known or thought to have beneficial properties found in other healthy fruits, such as blueberries or mangos.
Acai berries often are described as a “superfood,” but I don’t really know what that means, and I don’t believe that eating large quantities of these will lead to any miraculous health benefit. They have been reported to help with weight loss, arthritis, cholesterol and general health, but there is no reliable scientific evidence to support any of these claims.
Acai extracts, in my opinion, are less likely to have benefit than eating the actual fruit. Save your money on these extracts and use it for a diverse diet of fresh fruits and vegetables; it’s much more likely to improve your health in the long term.
Email questions to ToYourGoodHealth@med.cornell.edu.