It is that time of year: sniffling, sneezing and snorting because of allergies. Such symptoms didn’t used to be a big deal. During a time of COVID-19, though, people look at you with anxiety and trepidation if you sneeze or cough within 20 feet of them. What can you do to ease those symptoms and stop the stares? You’ve probably never heard of NasalCrom nasal spray for allergies. It doesn’t get the kind of attention that many other allergy treatments receive. But it is surprisingly effective.
The BIG Money is on Antihistamines and Steroids:
Chances are good that you have seen television commercials for a wide variety of symptomatic treatments. There are oral antihistamines such as loratadine (Claritin), cetirizine (Zyrtec) and levocetirizine (Xyzal).
The Claritin commercials promote spring as the “Most Wonderful Time of the Year.” As the family comes rushing downstairs to embrace the great outdoors, the announcer says:
“Claritin provides non-drowsy symptom relief from over 200 indoor and outdoor allergens day after day.”
The Xyzal owl tells allergy sufferers that “bedtime means it’s time to take Xyzal.”
“be wise all, take Xyzal.”
The commercials make it seem as if such products are the ideal solution to solving allergy symptoms. There is one drawback to using some antihistamines for the entire allergy season. Stopping them suddenly after months of use can lead to unbearable itching that may last six weeks or longer. Read more about this unexpected reaction at this link.
Corticosteroids Seem Ideal:
Then there are corticosteroid nasal sprays. Products such as fluticasone (Flonase) and triamcinolone (Nasacort) have been joined on over-the-counter shelves by mometasone (Nasonex).
In the Flonase commercial, an enormous green monster rises out of the earth, while the narrator tells us:
“allergies don’t have to be scary.”
Apparently one person on earth got that message. He watches with interest while the others scream and flee. That’s because he sprayed Flonase in his nose before leaving home.
Such steroid nasal sprays are effective against allergy symptoms. However, they can cause side effects of their own, including changes in the sense of smell or taste. Long-term use may increase the risk for cataracts.
What About NasalCrom? Cromoloyn for Allergies:
One kind of allergy medicine that you probably won’t see advertised on television is cromolyn (NasalCrom). This drug works differently from steroids as well as antihistamines.
Rather than counteracting histamine after its release or calming chemicals in the nose with cortisone-like compounds, cromolyn stabilizes mast cells. That keeps them from reacting to allergens and discharging inflammatory agents.
The origins of this medication are in a natural remedy called bishop’s weed (Ammi visnaga). The prescription drug NasalCrom was introduced in 1983. It went over the counter in 1997. Not all pharmacies stock NasalCrom, but it is available online.
The drug is considered quite safe, although some people experience temporary sneezing or irritation. The biggest downside is that the instructions say it should be used three or four times a day, which can be inconvenient.
One reader reports:
“I’ve been using NasalCrom very successfully for a few years now, ever since my pharmacist recommended it. It clears up my spring and fall allergies with one spritz a day in the a.m. The trick is to start it before the season begins.”
“I had suffered severe seasonal allergies for years. Then a few years ago I tried NasalCrom. At first, I had to use it three or four times a day, but it worked quickly and now during allergy season I need it only once in the morning and again at bedtime.”
NasalCrom is Different!
To quote the famous Apple computer ad from decades ago: “Think Different.”
Q. I read in a health newsletter a few years ago that OTC NasalCrom would help allergies. My husband suffered with runny nose and nasal congestion for years.
After using NasalCrom, his allergy totally disappeared. I didn’t have to iron many handkerchiefs after that, so I was delighted!
Another reader wondered what her husband could do for his allergies. His throat clearing was driving her crazy:
Q. My 66-year-old husband clears his throat too much. He says he has drainage that has to be cleared in order to breath. He has tried many products and techniques with no relief.
The allergist tested and found the usual culprits: dust mites, ragweed and dogs. I keep the house as free of allergens as possible.
The prescription allergy nose spray didn’t help. Now an ENT doc wants to do an invasive test for GERD. That doesn’t make sense to me. We’d appreciate a solution.
A. We heard recently from a man whose wife had somewhat similar symptoms:
“She has long bouts of coughing due to congestive heart failure and allergies that cause a lot of sinus drainage. The trouble is she reacts badly to most antihistamines. What can we try?”
We mentioned NasalCrom (cromolyn). This OTC nose spray is used preventively and reduces the inflammatory response to allergens.
Later, we heard back from him:
“NasalCrom had a prompt effect. The postnasal drainage is significantly reduced. Her cough gradually improved and then dramatically disappeared. Her cardiac rehab is going well, with attention to exercise, diet and sleep.”
Mast Cells Cause a LOT of Mischief:
Mast cells are found in your eyes, nose and lungs (and other places in your body) that are highly sensitive to allergens.
Think of mast cells as floating mines. When they come into contact with allergens like ragweed pollen or dust mite poop, a switch gets thrown on these cellular “mines” and all hell breaks loose.
Mast cells start releasing histamine and other chemicals called kinins (pronounced KYE-nins), which then turn on a cascade of other nasty things like leukotrienes and prostaglandins. The end result is sneezing, itching, inflammation, and congestion.
Stabilizing Mast Cells:
If you can stabilize mast cells and make them less sensitive to allergens they appear to be less likely to trigger the release of all those nasty chemicals described above. That way you can prevent symptoms at the source of the problem.
We think such an approach may be more logical than trying to block the effect of histamine with antihistamines. And we think it is safer than squirting steroids in your nose on a regular basis. Some of the corticosteroid is absorbed into your body.
Shutting the Barn Door BEFORE the Horses get Out:
Think of it this way. If your mast cells are like a barn holding in a bunch of wild horses (histamine molecules), then what would be more efficient–reinforcing the door and walls of the barn to keep those wild histamines inside or trying to protect all the grass in your pasture from having those histamine “horses” nibbling away at it?
Antihistamines are like a chemical barrier that tries to protect your grass once the horses are out of the barn. But they are not 100 percent efficient, and some histamine will always find a target and wreak havoc. Keeping the barn closed tightly (or the mast cells stabilized) seems to us to be a more effective approach.
Nasalcrom to the Rescue:
The compound cromolyn stabilizes highly sensitive mast cells in the lining of the nose and lungs so they can better resist the onslaught of pollen. It won’t cause drowsiness or cognitive impairment and, if used regularly, it is quite effective. It can be taken for up to twelve weeks. Unlike decongestant nose sprays, there is no need to fear developing dependency.
Side Effects of NasalCrom:
Cromolyn is very safe and does not cause drowsiness or rebound nasal congestion the way OTC nasal decongestants can. Some people may experience temporary sneezing, nasal burning, or a bad taste in their mouth. You can read more about the long-term use of cromolyn at this link.
The official instructions suggest using NasalCrom three or four times a day to really benefit. Some experts believe it is less effective than intranasal corticosteroids. We suggest that it is safer and worth a try if you are the kind of person who can spritz your nostrils three to four times daily. As mentioned above, some people get by with one or two sprays.
Share your own experience with cromolyn below in the comment section. You may want to listen to our podcast about allergies with Dr. David Peden and Dr. Tieraona Low Dog. They offer practical information and nondrug options for controlling symptoms. Here is a link to managing the misery of allergies.
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