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.

Andrea Piacquadio/Pexels

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.

A man sneezes into his elbow at work.
Allergies can make it hard to focus. Pexels/Edward Jenner

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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  • The Good Life – by Robert Waldinger, MD, and Marc Schulz, PhD

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    For any who have thought “there must be some middle-ground between entirely subjective self-help books advising how to feel better, and sifting through clinical data on what actually affects people’s moods“, this book is exactly that middle-ground!

    Drs. Waldinger and Schultz went through the 80-year-long Harvard Study of Adult Development with a fine-toothed comb, and this book details—more readably—what they found.

    There are frequent references to data from the study. Not just numbers, though, people’s answers to questions, too. And how different factors about people’s lives affected their answers to the same questions.

    We hear from all ages, from young adults to octagenarians, and learn how attitudes (including: of the same people) change over time. Not because people are fickle, but because people grow… or become disillusioned. Or sometimes, both.

    We learn about the importance of money… And where that importance ends.

    We learn importance of relationships of various kinds, and this is certainly a recurring theme throughout the study—and thus, throughout the book.

    The book doesn’t just present data, though, it also presents actionable insights along the way.

    Bottom line: the combined wisdom and life-experiences of a lot of people provide a very “big picture” view of life, and what makes us happy, really. We highly recommend it!

    Pick up The Good Life from Amazon Today!

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  • Avoid Knee Surgery With This Proven Strategy (Over-50s Specialist Physio)

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    A diagnosis of knee arthritis can be very worrying, but it doesn’t necessarily mean a knee replacement surgery is inevitable. Here’s how to keep your knee better, for longer (and potentially, for life):

    Flexing your good health

    You know we wouldn’t let that “proven” go by unchallenged if it weren’t, so what’s the evidence for it? Research (papers linked in the video description) showed 70% of patients (so, not 100%, but 70% is good odds and a lot better than the alternative) with mild to moderate knee arthritis avoided surgery after following a specific protocol—the one we’re about to describe.

    The key strategy is to focus on strengthening the quadriceps muscles for joint protection, as strong quads correlate with reduced pain. However, a full range of motion in the knee is essential for optimal quad function, so that needs attention too, and in fact is foundational (can’t strengthen a quadriceps that doesn’t have a range of motion available to it):

    Steps to follow:

    1. Improve knee extension:
      • Passive knee extension exercise: gently press your knee down while lying flat, to increase straightening.
      • Weighted heel props: use light weights to encourage gradual knee straightening.
    2. Enhance knee flexion:
      • Use a towel to gently pull the knee towards the body to improve bending range.

    Regular practice (multiple times daily) leads to improved knee function and pain relief. Exercises should be performed gently and without pain, aiming for consistent, gradual progress.And of course, if you do experience pain, it is recommend to consult with a local physiotherapist for more personalized guidance.

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    Treat Your Own Knee – by Robin McKenzie

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  • No, COVID-19 vaccines don’t cause ‘turbo cancer’

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    What you need to know

    • COVID-19 vaccines do not cause “turbo cancer” or contain SV40, a virus that has been suspected of causing cancer.
    • There is no link between rising cancer rates and COVID-19 vaccines.
    • Staying up to date on COVID-19 vaccines is a safe, free way to support long-term health.

    Myths that COVID-19 vaccines cause cancer have been circulating since the vaccines were first developed. These false claims resurfaced last month after Princess Kate Middleton announced that she is undergoing cancer treatment, with some vaccine opponents falsely claiming Middleton has a “turbo cancer” caused by COVID-19 vaccines.

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    Read on to learn how to recognize false claims about COVID-19 vaccines and cancer.


    Do COVID-19 vaccines contain cancer-causing ingredients?

    No. Some vaccine opponents claim that COVID-19 vaccines contain SV40, a virus that has been suspected of causing cancer. This claim is false.

    A piece of SV40’s DNA sequence—called a “promoter”—was used as starting material to develop COVID-19 vaccines, but the virus itself is not present in the vaccines. The promoter does not contain the part of the virus that enters the cell nucleus, so it poses no risk.

    COVID-19 vaccines and their ingredients have been rigorously studied in millions of people worldwide and have been determined to be safe. The National Cancer Institute and the American Cancer Society agree that COVID-19 vaccines do not increase cancer risk or accelerate cancer growth.

    Why are cancer rates rising in the U.S.?

    Since the 1990s, cancer rates have been on the rise globally and in the U.S., most notably in people under 50. Increased cancer screening may partially explain the rising number of cancer diagnoses. Exposure to air pollution and lifestyle factors like tobacco use, alcohol use, and diet may also be contributing factors.

    What are the benefits of staying up to date on COVID-19 vaccines?

    Staying up to date on COVID-19 vaccines is a safe way to protect our long-term health. COVID-19 vaccines prevent severe illness, hospitalization, death, and long COVID.

    The CDC says staying up to date on COVID-19 vaccines is a safer and more reliable way to build protection against COVID-19 than getting sick from COVID-19.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Hot And Sour Shiitake Soup

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    This is a popular, easy, and delicious soup that nonetheless is not found in many western kitchens, despite being enjoyed in restaurants/take-out. Best of all, making it at home means that you know all the ingredients, can account for quality, and also can customize it per your preferences (i.e. how much heat/sourness you like).

    You will need

    • 3 cups shiitake mushrooms, sliced
    • 3 cups bok choy, chopped
    • 2 cups cherry tomatoes, quartered
    • 1 cup carrot, grated
    • 3 spring onions, chopped
    • 2 shallots, sliced lengthways
    • 2 serrano chilis (or similar), sliced thinly
    • 2 tbsp apple cider vinegar
    • 1 tbsp lemon juice
    • 1 tbsp fresh ginger, sliced into 1″ strips
    • 1 tsp black pepper, coarse ground
    • ½ bulb garlic, crushed
    • 6 cups low-sodium vegetable stock. Ideally you will have made it yourself from vegetable cuttings that you saved in the freezer until you had enough to make stock from, but if that’s not an option, then low-sodium vegetable stock cubes can be purchased and used.
    • Garnish: ¼ cup (or 4 tbsp) cilantro, chopped, or if you have the soap gene, then this time we recommend chopped basil as the subsitution

    Method

    (we suggest you read everything at least once before doing anything)

    1) Put the ginger in a big pot with the stock; cover and simmer for about 20 minutes (otherwise the ginger flavor will remain mostly concentrated in the ginger strips).

    2) Bring it to a boil and add the bok choy, mushrooms, shallots, chili peppers, and the carrot; simmer for another 5 minutes

    3) Add the remaining ingredients except for the garnish, and simmer for another 5 minutes

    4) Serve, adding the garnish

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Elderhood – by Dr. Louise Aronson

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    Where does “middle age” end, and “old age” begin? By the United States’ CDC’s categorization, human life involves:

    • 17 stages of childhood, deemed 0–18
    • 5 stages of adulthood, deemed 18–60
    • 1 stage of elderhood, deemed 60+

    Isn’t there something missing here? Do we just fall off some sort of conveyor belt on our sixtieth birthdays, into one big bucket marked “old”?

    Yesterday you were 59 and enjoying your middle age; today you have, apparently, the same medical factors and care needs as a 114-year-old.

    Dr. Louise Aronson, a geriatrician, notes however that medical science tends to underestimate the differences found in more advanced old age, and underresearch them. That elders consume half of a country’s medicines, but are not required to be included in clinical trials. That side effects not only are often different than for younger adults, but also can cause symptoms that are then dismissed as “Oh she’s just old”.

    She explores, mostly through personal career anecdotes, the well-intentioned disregard that is frequently given by the medical profession, and—importantly—how we might overcome that, as individuals and as a society.

    Bottom line: if you are over the age of 60, love someone over the age of 60, this is a book for you. Similarly if you and/or they plan to live past the age of 60, this is also a book for you.

    Click here to check out Elderhood, and empower yours!

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  • No, beetroot isn’t vegetable Viagra. But here’s what else it can do

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Beetroot has been in the news for all the wrong reasons. Supply issues in recent months have seen a shortage of tinned beetroot on Australian supermarket shelves. At one point, a tin was reportedly selling on eBay for more than A$65.

    But as supplies increase, we turn our attention to beetroot’s apparent health benefits.

    Is beetroot really vegetable Viagra, as UK TV doctor Michael Mosley suggests? What about beetroot’s other apparent health benefits – from reducing your blood pressure to improving your daily workout? Here’s what the science says.

    What’s so special about beetroot?

    Beetroot – alongside foods such as berries, nuts and leafy greens – is a “superfood”. It contains above-average levels per gram of certain vitamins and minerals.

    Beetroot is particularly rich in vitamin B and C, minerals, fibre and antioxidants.

    Most cooking methods don’t significantly alter its antioxidant levels. Pressure cooking does, however, lower levels of carotenoid (a type of antioxidant) compared to raw beetroot.

    Processing into capsules, powders, chips or juice may affect beetroot’s ability to act as an antioxidant. However, this can vary between products, including between different brands of beetroot juice.

    Is beetroot really vegetable Viagra?

    The Romans are said to have used beetroot and its juice as an aphrodisiac.

    But there’s limited scientific evidence to say beetroot improves your sex life. This does not mean it doesn’t. Rather, the vast number of scientific studies looking at the effect of beetroot have not measured libido or other aspects of sexual health.

    How could it work?

    When we eat beetroot, chemical reactions involving bacteria and enzymes transform the nitrate in beetroot into nitrite, then to nitric oxide. Nitric oxide helps dilate (widen) blood vessels, potentially improving circulation.

    The richest sources of dietary nitric oxide that have been tested in clinical studies are beetroot, rocket and spinach.

    Nitric oxide is also thought to support testosterone in its role in controlling blood flow before and during sex in men.

    Beetroot’s ability to improve blood flow can benefit the circulatory system of the heart and blood vessels. This may positively impact sexual function, theoretically in men and women.

    Therefore, it is reasonable to suggest there could be a modest link between beetroot and preparedness for sex, but don’t expect it to transform your sex life.

    What else could it do?

    Beetroot has received increasing attention over recent years due to its antioxidant and anti-tumour effect in humans.

    Clinical trials have not verified all beetroot’s active ingredients and their effects. However, beetroot may be a potentially helpful treatment for various health issues related to oxidative stress and inflammation, such as cancer and diabetes. The idea is that you can take beetroot supplements or eat extra beetroot alongside your regular medicines (rather than replace them).

    There is evidence beetroot juice can help lower systolic blood pressure (the first number in your blood pressure reading) by 2.73-4.81 mmHg (millimetres of mercury, the standard unit of measuring blood pressure) in people with high blood pressure. Some researchers say this reduction is comparable to the effects seen with certain medications and dietary interventions.

    Other research finds even people without high blood pressure (but at risk of it) could benefit.

    Beetroot may also improve athletic performance. Some studies show small benefits for endurance athletes (who run, swim or cycle long distances). These studies looked at various forms of the food, such as beetroot juice as well as beetroot-based supplements.

    How to get more beetroot in your diet

    There is scientific evidence to support positive impacts of consuming beetroot in whole, juice and supplement forms. So even if you can’t get hold of tinned beetroot, there are plenty of other ways you can get more beetroot into your diet. You can try:

    • raw beetroot – grate raw beetroot and add it to salads or coleslaw, or slice beetroot to use as a crunchy topping for sandwiches or wraps
    • cooked beetroot – roast beetroot with olive oil, salt and pepper for a flavour packed side dish. Alternatively, steam beetroot and serve it as a standalone dish or mixed into other dishes
    • beetroot juice – make fresh beetroot juice using a juicer. You can combine it with other fruits and vegetables for added flavour. You can also blend raw or cooked beetroot with water and strain to make a juice
    • smoothies – add beetroot to your favourite smoothie. It pairs well with fruits such as berries, apples and oranges
    • soups – use beetroot in soups for both flavour and colour. Borscht is a classic beetroot soup, but you can also experiment with other recipes
    • pickled beetroot – make pickled beetroot at home, or buy it from the supermarket. This can be a tasty addition to salads or sandwiches
    • beetroot hummus – blend cooked beetroot into your homemade hummus for a vibrant and nutritious dip. You can also buy beetroot hummus from the supermarket
    • grilled beetroot – slice beetroot and grill it for a smoky flavour
    • beetroot chips – slice raw beetroot thinly, toss the slices with olive oil and your favourite seasonings, then bake or dehydrate them to make crispy beetroot chips
    • cakes and baked goods – add grated beetroot to muffins, cakes, or brownies for a moist and colourful twist.
    Three squares of beetroot/chocolate cake with white icing and nuts sprinkled on top
    You can add beetroot to baked goods. Ekaterina Khoroshilova/Shutterstock

    Are there any downsides?

    Compared to the large number of studies on the beneficial effects of beetroot, there is very little evidence of negative side effects.

    If you eat large amounts of beetroot, your urine may turn red or purple (called beeturia). But this is generally harmless.

    There have been reports in some countries of beetroot-based dietary supplements contaminated with harmful substances, yet we have not seen this reported in Australia.

    What’s the take-home message?

    Beetroot may give some modest boost to sex for men and women, likely by helping your circulation. But it’s unlikely to transform your sex life or act as vegetable Viagra. We know there are many contributing factors to sexual wellbeing. Diet is only one.

    For individually tailored support talk to your GP or an accredited practising dietitian.

    Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Lecturer, Southern Cross University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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