People who suffer from allergies rarely get the respect they deserve. Complain about arthritis, chest pain or migraines and you will get lots of sympathy. Describe your drippy nose or ask about effective allergy treatment and you will hear about antihistamines or steroid nasal sprays. But NasalCrom is a forgotten allergy treatment that can be surprisingly effective. It is not always easy to find, but it is available.
Fall is the Hardest Season…for Allergy Sufferers:
This is a tough time of year for people with allergies. Fall pollen can trigger symptoms that make people miserable. Until a hard freeze comes along, ragweed pollen and other allergens can stir up a mess of misery for millions.
Sneezing is a tip off that your nose will soon start running. Eyes turn red and itchy. Then there is the congestion that makes it hard to breathe, especially at night. When it’s hard to breath it’s hard to sleep.
Allergies Can Make You Stupid:
Many people also complain of spaciness. Allergies frequently make it hard to concentrate. You feel foggy and sluggish. Driving is more hazardous when your allergies are acting up. If you have to sneeze frequently, you lose control of your vehicle for seconds at a time.
Allergies Can Make You Dangerous:
In a moment you will read about the dangers of drugging and driving. What you will learn is that allergy treatment with antihistamines can affect driving ability. So can untreated allergies!
Scientists performed a brilliant little study (Allergy, July, 2014). They wanted to determine how patients with AR (allergic rhinitis aka runny nose caused by allergies) performed on a driving test. Here is what they reported:
“The driving performance of patients when symptomatic and not treated was significantly impaired compared to the placebo condition. When engaging in a secondary memory task during driving, their performance deteriorated further. The magnitude of impairment was relevant and comparable to that seen at a blood alcohol level of 0.05%, the legal limit in many countries. Treatment of AR symptoms partially counteracted the effect of AR on driving.
“Untreated AR can impair driving ability and put patients at risk. Drug therapy reduces this impairment, and AR patients should therefore be advised to always treat their condition.
Antihistamines Can Be As Risky As Booze:
Allergy treatments also carry risks. Older antihistamines such as chlorpheniramine (Chlor-Trimeton, etc) or diphenhydramine (Benadryl) are sedating. They can make you feel spacey, dizzy and drowsy. Driving can be dangerous after taking a medicine containing diphenhydramine (Human Psychopharmacology, May, 2016).
Newer antihistamines such as levocetirizine (Xyzal) and fexofenadine (Allegra) are less likely to impair driving ability. That’s the good news. There is one disconcerting issue with some nonsedating antihistamines, however. It has to do with the process of stopping.
The Cetirizine Itch:
Several years ago we heard from readers that stopping ceterizine (Zyrtec) suddenly sometimes led to an unexpected symptom. You can read an article (and 120 comments) at this link:
Here are just a few comments about cetirizine and levocetirizine from visitors to this website:
Heather in Washington had a long withdrawal:
“I took Zyrtec for many, many years for allergies. I did a long tapering off process. It has been four months since my last dose. I’ve itched the whole four months although it is gradually decreasing.”
Josh in London has an interesting hypothesis in response to our readers’ comments:
“I am experiencing this cetirizine withdrawal right now myself. I have had some truly agonizing days exactly as many of the commenters on this website describe. I am also an immunologist and I have spoken to some of my colleagues about my problem. What we agreed should be fairly comforting for people who are suffering with the same problem as I am right now.
“Cetirizine inhibits the histamine response. However, it does not stop antigens from binding to your skin mast cells. If you take cetirizine for 4 weeks straight and you are exposed to a large quantity of antigen you will get a huge build up of antigen-bound mast cells.
When you stop taking the histamine inhibitor, your body reacts violently to the huge backlog of antigen in your system. This results in the severe reaction people experience.
“To alleviate this problem I would advise you to wean yourself off the drug like many people have described; a step wise reduction in the dose every couple of days. Try to avoid contact with further antigens wherever possible. I would also highly recommend taking the dose before you go to bed, so that your sleep isn’t disturbed by itching or constant awakening.
“Your mast cells do not live much longer than a month, so if you are very careful this problem should take about a month to resolve. Good luck with this difficult process.”
The explanation that Josh has offered seems plausible, but it is only a hypothesis at this point. Some people suffer longer than a month.
Another reader reacted to levocetirizine, a chemical cousin of Zyrtec.
“I tried to stop Xyzal after taking it for ten years for allergies. Every time I stopped, I’d itch like crazy and break out in hives. I thought I was nuts! Whenever I try to stop I feel like I can’t live without it.”
Steroid Sprays Are Powerful Allergy Treatment:
Corticosteroid nasal sprays have become hugely popular. Drugs such as beclomethasone (Beconase), fluticasone (Flonase) and triamcinolone (Nasacort) do not come with a drowsiness warning and should not affect driving ability. That’s the good news.
Corticosteroid allergy treatment does carry other risks, however. The label warns patients to be alert for nosebleeds or changes to vision. Some people have reported that steroid nasal sprays lead to a loss of smell.
Here are some stories from readers:
Pat in Pennsylvania shared this experience:
“I used Flonase for a number of years when it was a prescription medication. My doctor’s orders were to use it once daily from Nov. 1st. to April 1st. I did well until I was bothered more than usual with upper respiratory allergies. I used the spray during Nov., Dec., and Jan. Unexpectedly, I had a horrible nosebleed which was treated two different times in the E.R. The first time, the bleed was cauterized. Within a day, another, heavier nosebleed occurred.
“I returned to the E.R. and my nose was packed until I could get in to see an ENT specialist, who had to cauterize both sides of my nose. The nosebleeds were attributed to my use of Flonase and I had to discontinue using it.
“I was advised to start using a Neti Pot, Fall and Winter and I haven’t had a nosebleed since then. I also take one ginger root capsule daily and my upper respiratory allergies, sinus pain and infections have disappeared. I have also been able to discontinue the allergy shots I took for many years. These things were done with the approval of my PCP, who was amazed at my success.”
Avaline in Washington had a similar reaction to steroid allergy treatment:
“I used a steroid nasal spray for more than ten years for year-round allergies. Then I suddenly started to have frequent nosebleeds.
“I was diagnosed with an ulcerated nasal septum that was close to perforating. It took several months to heal and, needless to say, I haven’t used nasal steroids since. I use other methods to control allergy symptoms.
“I once worked with someone who developed cataracts in both eyes in her twenties after years of using inhaled corticosteroids for asthma. Patients need to be aware of these risks. Prescribed corticosteroids should never be abruptly stopped without permission from the prescriber.”
SENSE OF SMELL:
Gary in Villa, Texas had a different problem:
“I lost my sense of taste about 18 months ago. I realize now from reading comments on this website that steroid nasal sprays may have caused the problem. I was a fairly heavy user of different brands during mountain cedar season.
“My ENT doctor thought it might be caused by one of my cranial nerves but an MRI on my brain revealed all cranial nerves were fine. I just wish my sense of taste would come back.”
We have heard from others who have lost their sense of smell after relying on steroid allergy treatment for long periods of time. One woman did not realize that she had left the gas on her stove on. Her son smelled it upstairs and came rushing down to turn off the stove. She was next to it but could not detect the smell of gas.
An eye surgeon connects cataracts to corticosteroids allergy treatment:
“As a cataract surgeon, I have seen several patients over the years with posterior subcapular cataracts that I thought were attributable to steroid nasal sprays. It is quite common to see them in asthma or COPD patients. They rely on inhaled steroids in order to breathe freely.
“The nasal sprays are not so likely to cause cataracts as the inhalers, but some of the drug is getting into the bloodstream and circulating throughout the body from either route of administration.”
Susan on the upside of her cataract surgery:
“When I was 50 I got cataracts in both eyes and my doctor told me I was her youngest patient. Thanks Flonase; the positive side was I no longer needed glasses which I wore since I was 8. I can drive and go to the movies without wearing glasses! I can see my computer and read without glasses. So there is a crazy upside to the use of Flonase!”
NasalCrom Is a Different Allergy Treatment:
A different kind of nasal spray that has received little attention involves a drug called cromolyn (NasalCrom). It is neither a corticosteroid nor an antihistamine. This drug was originally derived from a plant called Bishop’s weed (Ammi visnaga). It has historically been used to treat asthma symptoms.
Cromolyn works by stabilizing mast cells in the nose. When allergens such as ragweed pollen come in contact with these cells they release histamine and other inflammatory chemicals. Cromolyn makes mast cells less likely to react to allergens.
One allergy victim says:
“An allergist told me about NasalCrom back in the 1970s. I tried it for a short time, but I started in the middle of allergy season. It didn’t seem to work, so I went on to many other remedies, none of which worked completely.
“I’ve had terrible ragweed allergy for 61 years, since I was 13. I developed tree allergies about 25 years ago. Last spring I read about NasalCrom again and gave it another try. This time I stuck with it. It has been the most amazing allergy remedy I’ve ever used. I could not even tell when the ragweed started pollinating. Previously I was sensitive to the slightest trace of it. I’ve had no symptoms whatever.
“I usually use it only twice a day, sometimes in midday if I think of it. I have experienced no side effects. This year I slept with the windows open in September for the first time since I was a child.”
Cromolyn works best when it is used before allergies take hold. In this regard it is more a preventive treatment than other medications. People who are sensitive to cats or dogs tell us that the medication works best if they use it several hours (or days) before visiting a friend with pets.
Cromolyn also has to be sprayed in the nose two or three times a day. That said, it is one more arrow in the quiver of allergy treatments. You may have to ask your pharmacist to stock it or shop online. Many drugstores do not carry NasalCrom for reasons that are mysterious to us.
Learn more about NasalCrom here:
In case you are wondering, we have no financial or other reason to write about NasalCrom as an allergy treatment. We hold no stock in drug companies and accept no payments from the pharmaceutical industry.