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Posted by on Jul 7, 2011 in Clinical Medicine

Allergic Rhinitis and the Athlete: Part 2

Allergic Rhinitis and the Athlete: Part 2


Hi Folks,

This is a continuation from yesterday’s post about allergic rhinitis in athletes. 

4. Oral anti-histamines 

These products are great for symptoms but do have some side effects. The newer anti-histamines like Zyrtec or Allegra are designed to not cause drowsiness in the usual patient. Drowsiness is possible, though, on these medications. As the name suggests anti-histamines blocks the histamine receptors that propagate the allergic reaction. Taking an oral medication will obviously cause this to occur throughout your body. It would be a good idea to see how you react to these medications before competition. I tend to do very well with little drowsiness, but I have noticed that on days with high pollen counts after taking the anti-histamine that I am just a little slowed than normal. I think this could be a by-product of both the allergic reaction and the medication together. The medication also tends to be more effective if used BEFORE you are exposed to the allergen.

Either way for me the side effect is definitely worth being able to get on my bike for a long ride or to crank out some run/row intervals as we did earlier this week at Ute CrossFit.  

Both Zyrtec and Allegra are now over the counter with generic counter-parts. I use both in a somewhat alternating pattern depending on whichever is cheapest at the time of purchase!

5. Nasal Decongestants

If the above 4 steps are still not cutting it and you have an important workout, race or performance scheduled then it is time to turn to the decongestants. For short term use nasal decongestants work well to simply open up your nasal passages. Decongestants work by closing down your blood vessels in the tissues. This will then decrease the size of the tissues by decrease the release of fluid into the soft tissues surrounding the blood vessels. Due to the topical action there are decreased side effects compared to using oral decongestants. 

This biggest concern in using these powerful medications is a condition called rhinitis medicimentosa. If you use these medications for longer than 3-4 days then you risk rebound congestion. That is obviously not good for athletic performance! 

6. Oral Decongestants 

This first product that comes to mind in this category is Sudafed. Sudafed is actually a brand name for several different products. These all act in the same way by globally constricting blood vessels. The major side effect in an increased heart rate in some people.  Pseudoephedrine is the most powerful, but can only be purchase from the pharmacist (though without a prescription) due to fact that it can be used to make a nasty street drug. Phenylephrine is not as powerful, but is now more widely available. Any product that has a big D next to its name has this in it. For example, NyQuil D. 

This class medication should really be used as a last resort, but people will generally go to them first. 

7. Allergy Immunotherapy

Another option that is available is immunotherapy. This is a process in which the body is gradually desensitized to the specific allergic causes. Usually this process is done with sub-lingual tabs or shots. This is an option of those that cannot get any relief from any of the above therapies. This option might actually become more widespread in the next few years, but I would hold off if something else above works for you. 

Allergies and athletics are a bother. I hope some of the above information can help you meet your goals. The above material as is all material on this site is not intended as a treatment plan, but is only for educational use. Follow at your own risk. Ask your provider for help

Does anyone else have any good ideas for when they get bad allergies?