Can I take antihistamines everyday? More than the recommended dose? What if I’m pregnant? Here’s what the research says
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Allergies happen when your immune system overreacts to a normally harmless substance like dust or pollen. Hay fever, hives and anaphylaxis are all types of allergic reactions.
Many of those affected reach quickly for antihistamines to treat mild to moderate allergies (though adrenaline, not antihistamines, should always be used to treat anaphylaxis).
If you’re using oral antihistamines very often, you might have wondered if it’s OK to keep relying on antihistamines to control symptoms of allergies. The good news is there’s no research evidence to suggest regular, long-term use of modern antihistamines is a problem.
But while they’re good at targeting the early symptoms of a mild to moderate allergic reaction (sneezing, for example), oral antihistamines aren’t as effective as steroid nose sprays for managing hay fever. This is because nasal steroid sprays target the underlying inflammation of hay fever, not just the symptoms.
Here are the top six antihistamines myths – busted.
Myth 1. Oral antihistamines are the best way to control hay fever symptoms
Wrong. In fact, the recommended first line medical treatment for most patients with moderate to severe hay fever is intranasal steroids. This might include steroid nose sprays (ask your doctor or pharmacist if you’d like to know more).
Studies have shown intranasal steroids relieve hay fever symptoms better than antihistamine tablets or syrups.
To be effective, nasal steroids need to be used regularly, and importantly, with the correct technique.
In Australia, you can buy intranasal steroids without a doctor’s script at your pharmacy. They work well to relieve a blocked nose and itchy, watery eyes, as well as improve chronic nasal blockage (however, antihistamine tablets or syrups do not improve chronic nasal blockage).
Some newer nose sprays contain both steroids and antihistamines. These can provide more rapid and comprehensive relief from hay fever symptoms than just oral antihistamines or intranasal steroids alone. But patients need to keep using them regularly for between two and four weeks to yield the maximum effect.
For people with seasonal allergic rhinitis (hayfever), it may be best to start using intranasal steroids a few weeks before the pollen season in your regions hits. Taking an antihistamine tablet as well can help.
Antihistamine eye drops work better than oral antihistamines to relieve acutely itchy eyes (allergic conjunctivitis).
Myth 2. My body will ‘get used to’ antihistamines
Some believe this myth so strongly they may switch antihistamines. But there’s no scientific reason to swap antihistamines if the one you’re using is working for you. Studies show antihistamines continue to work even after six months of sustained use.
Myth 3. Long-term antihistamine use is dangerous
There are two main types of antihistamines – first-generation and second-generation.
First-generation antihistamines, such as chlorphenamine or promethazine, are short-acting. Side effects include drowsiness, dry mouth and blurred vision. You shouldn’t drive or operate machinery if you are taking them, or mix them with alcohol or other medications.
Most doctors no longer recommend first-generation antihistamines. The risks outweigh the benefits.
The newer second-generation antihistamines, such as cetirizine, fexofenadine, or loratadine, have been extensively studied in clinical trials. They are generally non-sedating and have very few side effects. Interactions with other medications appear to be uncommon and they don’t interact badly with alcohol. They are longer acting, so can be taken once a day.
Although rare, some side effects (such as photosensitivity or stomach upset) can happen. At higher doses, cetirizine can make some people feel drowsy. However, research conducted over a period of six months showed taking second-generation antihistamines is safe and effective. Talk to your doctor or pharmacist if you’re concerned.
Myth 4. Antihistamines aren’t safe for children or pregnant people
As long as it’s the second-generation antihistamine, it’s fine. You can buy child versions of second-generation antihistamines as syrups for kids under 12.
Though still used, some studies have shown certain first-generation antihistamines can impair childrens’ ability to learn and retain information.
Studies on second-generation antihistamines for children have found them to be safer and better than the first-generation drugs. They may even improve academic performance (perhaps by allowing kids who would otherwise be distracted by their allergy symptoms to focus). There’s no good evidence they stop working in children, even after long-term use.
For all these reasons, doctors say it’s better for children to use second-generation than first-generation antihistimines.
What about using antihistimines while you’re pregnant? One meta analysis of combined study data including over 200,000 women found no increase in fetal abnormalities.
Many doctors recommend the second-generation antihistamines loratadine or cetirizine for pregnant people. They have not been associated with any adverse pregnancy outcomes. Both can be used during breastfeeding, too.
Myth 5. It is unsafe to use higher than the recommended dose of antihistamines
Higher than standard doses of antihistamines can be safely used over extended periods of time for adults, if required.
But speak to your doctor first. These higher doses are generally recommended for a skin condition called chronic urticaria (a kind of chronic hives).
Myth 6. You can use antihistamines instead of adrenaline for anaphylaxis
No. Adrenaline (delivered via an epipen, for example) is always the first choice. Antihistamines don’t work fast enough, nor address all the problems caused by anaphylaxis.
Antihistamines may be used later on to calm any hives and itching, once the very serious and acute phase of anaphylaxis has been resolved.
In general, oral antihistamines are not the best treatment to control hay fever – you’re better off with steroid nose sprays. That said, second-generation oral antihistamines can be used to treat mild to moderate allergy symptoms safely on a regular basis over the long term.
Janet Davies, Respiratory Allergy Stream Co-chair, National Allergy Centre of Excellence; Professor and Head, Allergy Research Group, Queensland University of Technology; Connie Katelaris, Professor of Immunology and Allergy, Western Sydney University, and Joy Lee, Respiratory Allergy Stream member, National Allergy Centre of Excellence; Associate Professor, School of Public Health and Preventive Medicine, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Outsmart Your Pain – by Dr. Christiane Wolf
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Dr. Wolf is a physician turned mindfulness teacher. As such, and holding an MD as well as a PhD in psychosomatic medicine, she knows her stuff.
A lot of what she teaches is mindfulness-based stress reduction (MBSR), but this book is much more specific than that. It doesn’t promise you won’t continue to experience pain—in all likelihood you will—but it does change the relationship with pain, and this greatly lessens the suffering and misery that comes with it.
For many, the most distressing thing about pain is not the sensation itself, but how crippling it can be—getting in the way of life, preventing enjoyment of other things, and making every day a constant ongoing exhausting battle… And every night, a “how much rest am I actually going to be able to get, and in what condition will I wake up, and how will I get through tomorrow?” stress-fest.
Dr. Wolf helps the reader to navigate through all these challenges and more; minimize the stress, maximize the moments of respite, and keep pain’s interference with life to a minimum. Each chapter addresses different psychological aspects of chronic pain management, and each comes with specific mindfulness meditations to explore the new ideas learned.
The style is personal and profound, while coming from a place of deep professional understanding as well as compassion.
Bottom line: if you’ve been looking for a life-ring to help you reclaim your life, this one could be it; we wholeheartedly recommend it.
Click here to check out Outsmart Your Pain, and recover the beauty and joy of life!
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Top 10 Causes Of High Blood Pressure
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As Dr. Frita Fisher explains, these are actually the top 10 known causes of high blood pressure. Number zero on the list would be “primary hypertension”, which means high blood pressure with no clear underlying cause.
Superficially, this feels a little like the sometime practice of writing the catch-all “heart failure” as the cause of death on a death certificate, because yes, that heart sure did stop beating. But in reality, primary hypertension is most likely often caused by such things as unmanaged chronic stress—something that doesn’t show up on most health screenings.
Dr. Fisher’s Top 10
- Thyroid disease: both hyperthyroidism and hypothyroidism can cause high blood pressure.
- Obstructive sleep apnea: characterized by snoring, daytime sleepiness, and headaches, this condition can lead to hypertension.
- Chronic kidney disease: diseases ranging from diabetic nephropathy to renal vascular disease can cause high blood pressure.
- Elevated cortisol levels: conditions like Cushing’s syndrome or disease, which involve high cortisol levels, can lead to hypertension—as can a lifestyle with a lot of chronic stress, but that’s less readily diagnosed as such than something one can tell from a blood test.
- Elevated aldosterone levels: excess aldosterone from the adrenal glands causes the body to retain salt and water, increasing blood pressure, because more stuff = more pressure.
- Brain tumor: tumors that increase intracranial pressure can cause a rise in blood pressure to ensure adequate brain perfusion. In these cases, the hypertension is keeping you alive—unless it kills you first. If this seems like a strange bodily response, remember that our bodily response to an infection is often fever, to kill off the infection which can’t survive at such high temperatures (but neither can we, so it becomes a game of chicken with our life on the line), so sometimes our body does kill us with one thing while trying to save us from another.
- Coarctation of the aorta: this congenital heart defect results in narrowing of the aorta, leading to hypertension, especially in the upper body.
- Pregnancy: pregnancy can either induce or worsen existing hypertension.
- Obesity: excess weight increases blood flow and pressure on arteries, raising the risk of hypertension and associated conditions, e.g. diabetes etc.
- Drugs: certain medications and recreational drugs (including, counterintuitively, alcohol!) can elevate blood pressure.
For more information on each of these, enjoy:
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Want to learn more?
You might also like to read:
Hypertension: Factors Far More Relevant Than Salt
Take care!
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Give Your Adrenal Glands A Chance
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The Hats Of Wrath
Your adrenal glands are two little hat-shaped glands that sit on top of your kidneys (like your kidneys are wearing them as hats, in fact).
They produce adrenaline, as you might have guessed, and also cortisol and aldosterone, which you might or might not have known, as well as some miscellaneous corticosteroids that are beyond the scope of today’s article.
Fun fact! For a long time, doctors thought adrenal glands were much larger than they usually are, because of learning anatomy from corpses that were dissected, but invariably the corpses were those of poor people, especially criminals, whose adrenal glands were almost always overworked and swollen.
You don’t want yours to be like that.
What goes wrong
Assuming you don’t have a rare disorder like Addison’s disease (in which the adrenal glands don’t produce enough of the hormones they’re supposed to), your adrenal glands will usually not have trouble producing enough adrenaline et al.
However, as we learned from the Victorian vagabonds, they can also have no problems producing too much—much like any organ that gets overworked, however, this has consequences.
Hopefully you’re not living a life of stressful crime on the streets, but maybe you have other reasons your adrenal glands are working overtime, such as any source of chronic stress, bad sleep (can’t recharge without this downtime), overuse of stimulants (including caffeine and/or nicotine), and, counterintuitively, alcohol. All these things can tax the adrenal glands considerably.
When this happens, in the extreme we can get Cushing’s syndrome, characterized by the symptoms: hypertension, cortisol-based fat distribution i.e. especially face and abdomen, weakness, fragile easily irritable skin, hair loss and/or hirsutism, paradoxically, and of course general fatigue.
In the non-extreme, we get all the same symptoms just to a lower level, and experience what the medical profession is begging us not to call “Adrenal Fatigue Syndrome” because that’s not an official diagnosis, whereas if it gets a name then they’ll be expected to treat it.
What keeps things going right
Obviously, the opposite of the above, for a start. Which means:
Manage chronic stress; see: How To Manage Chronic Stress
Get good sleep; see: Why You Probably Need More Sleep
Go easy on the caffeine; see: Caffeine Mythbusting
Skip the nicotine; see: Nicotine Benefits (That We Don’t Recommend)!
Avoid alcohol; see: How To Reduce Or Quit Alcohol
There are specific vitamins and minerals that support adrenal health too; they are: vitamins B5, B6, B12, C, & D, and also magnesium and zinc.
Good dietary sources of the above include green leafy things, cruciferous vegetables*, nuts and seeds, avocados, olive oil, and if you eat fish, then also fatty fish.
In contrast, it is good to cut down (or avoid entirely) red meat and unfermented dairy.
*Unsure how to get cruciferous vegetables in more often? Try today’s featured recipe, superfood broccoli pesto
Want to know more?
A large part of adrenal health is about keeping cortisol levels down generally (except: for most of us, we can have a little hormesis, as a treat), so for the rest of that you might like to read:
Lower Your Cortisol! (Here’s Why & How)
Take care!
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South Indian-Style Chickpea & Mango Salad
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We have a double-dose of chickpeas today, but with all the other ingredients, this dish is anything but boring. Fun fact about chickpeas though: they’re rich in sitosterol, a plant sterol that, true to its name, sits on cholesterol absorption sites, reducing the amount of dietary cholesterol absorbed. If you are vegan, this will make no difference to you because your diet does not contain cholesterol, but for everyone else, this is a nice extra bonus!
You will need
- 1 can white chickpeas, drained and rinsed
- 1 can black chickpeas (kala chana), drained and rinsed
- 9 oz fresh mango, diced (or canned is fine if that’s what’s available)
- 1½ oz ginger, peeled and grated
- 2 green chilis, finely chopped (adjust per heat preferences)
- 2 tbsp desiccated coconut (or 3 oz grated coconut, if you have it fresh)
- 8 curry leaves (dried is fine if that’s what’s available)
- 1 tsp mustard seeds
- 1 tsp cumin seeds
- 1 tsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
- Juice of 1 lime
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a skillet over a medium heat. When it’s hot but not smoking, add the ginger, chilis, curry leaves, mustard seeds, and cumin seeds, stirring well to combine, keep going until the mustard seeds start popping.
2) Add the chickpeas (both kinds), as well as the black pepper and the MSG/salt. Once they’re warm through, take it off the heat.
3) Add the mango, coconut, and lime juice, mixing thoroughly.
4) Serve warm, at room temperature, or cold:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- What Matters Most For Your Heart?
- Can Saturated Fats Be Healthy?
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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It Didn’t Start with You – by Mark Wolynn
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There is a trend in psychology to “blame the parents” for “childhood trauma” that can result in problems later in life. Sometimes fairly, sometimes not. This book’s mostly not about that.
It does touch on our own childhood trauma, if applicable. But mostly, it’s about epigenetic trauma inheritance. In other words, not just trauma that’s passed on in terms of “the cycle of abuse”, but trauma that’s passed on in terms of “this generation experienced trauma x, developed trauma response y, encoded it epigenetically, and passed it on to their offspring”.
So, how does one heal from a trauma one never directly experienced, and just inherited the response to it? That’s what most of this book is about, after establishing how epigenetic trauma inheritance works.
The author, a therapist, provides practical advice for how to do the things that can be done to rewrite the epigenetic code we inherited. Better late than never!
Bottom line: it is well-established that trauma is inheritable. But unlike one’s eye color or the ability to smell asparagus metabolites in urine, we can rewrite epigenetic things, to a degree. This book explains how.
Click here to check out It Didn’t Start With You, and put things to rest!
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Broccoli vs Asparagus – Which is Healthier?
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Our Verdict
When comparing broccoli to asparagus, we picked the broccoli.
Why?
Both are great! But broccoli does distinguish itself:
In terms of macros, broccoli has slightly more protein, carbs, and fiber. The two vegetables have the same glycemic index. We’ll call this a slight win for broccoli based mainly on the higher fiber, but it’s not by a huge amount.
When it comes to vitamins, broccoli has more of vitamins B5, B6, B9, C, K, and choline, whereas asparagus has more of vitamins A, B1, B2, B3, and E. This would already be a 6:5 marginal win for broccoli, but it’s worth bearing in mind that broccoli’s margins are greater, especially with broccoli having around 15x the amount of vitamin C. So, a clear win for broccoli, respectable as asparagus may be.
In the category of minerals, broccoli has more calcium, magnesium, manganese, phosphorus, potassium, and selenium, while asparagus boasts more copper, iron, and zinc. A 6:3 win for broccoli here.
Both vegetables also contain generous amounts of antioxidant polyphenols and other beneficial phytochemicals, often a little different from each other, so that’s a case for enjoying both.
Still, if you’re going to pick just one, we recommend the broccoli!
Want to learn more?
You might like to read:
Take care!
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