1. It is possible to develop allergies later in life.
An allergy develops when your immune system goes haywire in reaction to a foreign substance, such as grass, pollen or pet hair. As you age, immunity naturally begins to wane, and some people who have suffered for years may find that they can breathe more easily when spring rolls around. But occasionally people develop an allergy later in life. Raymond Slavin, professor emeritus of internal medicine at St. Louis University and an expert on allergies in older adults, recalls one 60-year-old patient who developed an allergy when he started changing the cat litter box. Something similar can happen if you relocate to another part of the country with, say, heavy ragweed levels. In both cases, the new, high exposure to the allergen is what sets off symptoms.
2. Allergies in older adults can be underdiagnosed.
Frequently, doctors may think of a runny nose and sneezing fits as minor issues and put more energy into treating chronic diseases common in older adults, such as high blood pressure or diabetes, the Annals of Allergy, Asthma & Immunology noted in 2016. "These symptoms may be put on the back burner, but they're still important. Allergies can negatively affect your quality of life, ability to be active and appetite," says Derrick Ward, M.D., of Kansas City Allergy & Asthma Associates.
3. Treatments can be tough to figure out.
Some allergy drugs can affect existing problems. For example, oral corticosteroids, which can help reduce inflammation, can also make psychiatric problems, diabetes and blood pressure worse, says Richard F. Lockey, M.D., director in the division of allergy and immunology at the University of South Florida College of Medicine. Antihistamines like diphenhydramine or chlorpheniramine can be sedating, and they can decrease reaction times and lead to dry mouth and eyes. Decongestants like pseudoephedrine may increase blood pressure and irritability and cause insomnia, Ward says.
On the flip side, some of the medications you're taking to manage your chronic conditions may be causing an allergic reaction. Many medications — including beta blockers, ACE inhibitors, calcium channel blockers, NSAIDs (like ibuprofen) and aspirin — can trigger nasal inflammation, Ward says. "Have a runny nose? Think about if it started with a new medication, and bring that up at your next appointment," he advises.
4. You may not need to pop a pill.
If you have bothersome symptoms, Lockey recommends this step-up method:
Step 1: For mild problems, try a nasal antihistamine, which works to relieve congestion, sneezing and runny nose.
Step 2: More moderate issues? Tap a steroid nasal spray, like Flonase or Nasonex, to reduce swelling in your nasal passages.
Step 3: If that doesn't work, try a combination steroid nasal and antihistamine spray, like Dymista.
Step 4: For stuffiness that's keeping you up at night, turn to Afrin, a decongestant spray. However, you should only use it regularly if you're also taking a steroid nasal spray, to diminish the likelihood of side effects.
5. You may be most allergic to household allergens.
Specifically, dust mites or cockroaches. Since your immune system becomes less robust as you age, an allergic reaction is more likely to be set off by triggers you're around all the time, Slavin explains. For dust mites, wash bedding at 130 degrees every 7 to 10 days and use dust-mite-proof mattress covers. If that doesn't quell symptoms, you may need to try allergy medications. You might also consider a series of immunotherapy injections that desensitizes you to the allergen. "Many sufferers prefer this over taking medications every day," Lockey says.
6. Allergies may increase your risk of stroke.
People who have a history of hay fever have an 87 percent higher risk of stroke compared with folks without hay fever, according to a study of nearly 10,000 adults who were 45 or older. An allergy attack sets off an inflammatory response, and it may be that this systemic inflammation can increase the risk of stroke.
7. Some allergy meds could make you more prone to dementia.
Some allergy meds fall under the umbrella of anticholinergic drugs, and two recent studies, published in the journals JAMA Neurology and JAMA Internal Medicine, suggest a link between these drugs and a greater risk of dementia or Alzheimer's disease. Most allergy medications are overwhelmingly safe for older adults, but talk to your doctor if you're concerned; he or she may be able to recommend an alternative.
8. You don't have to get rid of Bella or Buddy.
"I've had loads of patients joke that their spouse and kids can go, but their pet stays no matter what," says Gillian Shepherd, M.D., a specialist in allergy and immunology at Weill Cornell Medical College in New York. The problem is, many older adults are in denial about having animal allergies at all, out of fear of having to give up a beloved companion. "No one is going to tear the cat out of your hands, but denying it only delays treatment," she says. You can take simple steps, such as not having the dog or cat sleep in your bed or bedroom. A steroid nasal spray can also be an option.
9. A runny nose and watery eyes may not be an allergy at all.
If you have a chronically runny nose, you (and your doctor) may suspect seasonal allergies, but you might actually have what's called nonallergic rhinitis, Ward explains. The condition, common in older adults, is similar to seasonal allergies, but the triggers are different. Weather changes, air quality, strong smells, exercise and even eating may set off symptoms. As for treatment, Ward says generic over-the-counter nasal antihistamine sprays tend to work well. Because these two conditions are so frequently confused, it's important to see a board-certified allergist for testing to make sure you get the correct diagnosis.
10. Congested? Don't immediately run to allergy medicine.
"As you get older, your body's ability to moisturize the lining of the nose decreases, which leads to thickening of mucous and congestion," Shepherd explains. Being stuffed up might have you reaching for antihistamines — but wait! These can actually dry out nasal passages, exacerbating the problem. To start breathing easy, she recommends that patients first use saltwater nose sprays and try to increase the humidity in their home to thin out mucous.
The 5 best and worst cities to live in if you have Spring allergies
Out of 100 cities analyzed, here are five places that rank as least bothersome in terms of spring allergies, according to the Asthma and Allergy Foundation of America — and five that are most bothersome
- Daytona Beach, Fla.
- Provo, Utah
- San Diego
- Palm Bay, Fla.
- Jackson, Miss.
- Memphis, Tenn.
- Syracuse, N.Y.
- Louisville, Ky.
- McAllen, Texas
No need to put your house up for sale, though. "We don't ever recommend people move because of allergies," says Richard F. Lockey, M.D., of the University of South Florida. "We have medications that are safe and extraordinarily effective."