Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
Since I've been discussing histidine and histamine today (how's that for a segue to an entirely different topic?), it seems like the perfect time to mention a story I saw yesterday about the ten worst cities for fall pollen, such as ragweed, according to the Asthma and Allergy Foundation of America (AAFA).
I was amazed to see that none of the cities is located anywhere near where I live. Few of them are where I guessed they might be. Perhaps one of them is where you live, or nearby.
In any case, every year in the late summer and into fall I can look forward to a life of continual snot, with a constant runny nose, sneezing, and coughing due to a nasty postnasal drip. Antihistamines and decongestants have only a mild effect, unfortunately, and I can generally expect more than a month of suffering, depending on the duration of the season. Every year, I swear I'll finally go to an allergist, but, like many physicians, every year I decide to muddle by again one more time with over-the-counter solutions. I also have spring allergies, but they're usually nowhere near as bad.
I wonder if homeopathically diluting and succussing ragweed pollen and then drinking it could help. Naaaah. But if ever there were a test of "like cures like," this would be it.
Medicine & Health
Comments
Yeah, try convincing a homeopath that their system ought to be consistent with itself - I've debated homeopaths (on the JREF board) who insisted such examples were "isopathy" and not homeopathy at all, and they couldn't be expected to work. Of course, that doesn't stop them selling remedies as homeopathic under other circumstances, in fact, I wouldn't be surprised to find allergy remedies just as you describe.
Posted by: Zombie | September 3, 2008 4:05 PM
Well, if there's one place in the medical world where 'like cures like' has some tiny sliver of hope of making sense, it's immunology. I mean, a vaccine is 'like prevents like' after all.
Posted by: Q | September 3, 2008 4:32 PM
My area has a well-deserved reputation, but the worst is apparently ann arbor. Ugh...cant...breathe...oy...
Posted by: PalMD | September 3, 2008 5:09 PM
Q, vaccines are more "like prevents like" than "like cures like'. I can't imagine giving someone with active polio a polio vaccine is very helpful.
Although oddly, I believe allergy shots are small quantities of the allergen that are gradually increased as the body adjusts and stops attacking itself at every bit of ragweed.
Posted by: Natalie | September 3, 2008 5:33 PM
Do what I do: Take Echinacea.
It doesn't work worth a darn for preventing colds, but it suppresses the histamine producing cells in the mucus membranes and minimizes the rhino-allergies.
Posted by: Tsu Dho Nimh | September 3, 2008 6:22 PM
I have the same problem. Nasal steroids fix it remarkably well. :-)
Posted by: Despard | September 3, 2008 7:05 PM
Astelin is the new wonder drug in my opinion. It's hard to get it to stay in your nose and tastes like a slice of hell if it gets down into your throat, but it works a treat. The price tag will make you pass out and forget your snot as well.
Posted by: Suze | September 3, 2008 7:21 PM
Well, homeopathy is just an extremely expensive way to get extra fluids...
And no kidding about the Astelin, Suze. Ugh. Works, but just ugh, yet better than the alternative. >snuffle
Posted by: Rjaye | September 3, 2008 7:33 PM
Move to another climate.
You'll have significantly less allergic response- for a couple of years anyway. Sadly then you'll resensitise to whatever's in the new environment.
Posted by: NM | September 3, 2008 7:37 PM
Sometimes you just need to flush the gunk out. But use a neti pot instead of one of them squirt bottles. A steady flow gets more stuff.
(No, it doesn't do all the neat crap the package says it should, but sometimes all you need is to get that clogged up mucus out of your nasal passage.)
Posted by: Alan Kellogg | September 3, 2008 9:14 PM
Lovely. As if I needed a reminder.
When it's this bad, I ramp up on diphenhydramine (Benadryl) and take it regularly enough to build some tolerance to the CNS sedative effects. The expensive, non-sedating antihistamines just don't cut it for me. Nasal steroids work okay but I worry about my nose getting big (rim shot). The neti pot is a good adjunct although a bit disgusting in the shower.
Posted by: Abel Pharmboy | September 3, 2008 10:30 PM
Two, maybe three words: Nasal roto-rooter. The surgical kind, not the homeopathic, naturally.
Posted by: Liesl | September 3, 2008 11:51 PM
I prefer the Neilmed sinus rinse system to a neti pot, personally - it just works better for me - but either way, nasal saline rinses seem to help keep my "indoor allergies" in check (dust, mold, mildew,etc)
Posted by: CanadianChick | September 3, 2008 11:54 PM
Allergy immunotherapy the repeated administration of a specific (live) allergen(s) to patients with IgE - mediated conditions for the purpose of providing protection against the allergic symptoms and inflammatory reactions associated
with natural exposure to the allergen(s). Other terms that have been used for allergen immunotherapy are
hyposensitization, allergen-specific desensitization, and the common terms allergy shots or injections beginning on a weekly basis x 3-6 months, then bimonthly x 3-6 months, then once monthly for to reach maintenance therpy. IOW: the entire process from start (testing) to desensitization is estimated to last 1 year. But if it works, it is well worth the time and effort so you can throw those OTC pills and nasal sprays in the garbage. Check with your insurance company first to find out if they cover this service, as it can be costly.
Posted by: brendy | September 4, 2008 2:55 AM
Yes, the steroid sprays (Flonase is an example) work quite well for me and they don't make you groggy. You do have to use them every day and it takes several days to feel the effect but what a difference.
Posted by: sea creature | September 4, 2008 8:24 AM
Ragweed is proof that there is a god and he/she is evil. Or that my immune system stinks at being able to distinguish dangerous parasites from harmless plants. One or the other. Either way, I became a convert to the wonders of Big Pharma the day the first nonsedating antihistamine came out. Claritin is the only thing that makes life worth living during allergy season (which for me is the entire growing season...I love winter.)
Posted by: Dianne | September 4, 2008 8:50 AM
The same homoeopaths are quite happy to use trials of isopathy with positive results as evidence that homoeopathy works, of course. It seems that the main criterion for determining whether a trial was a proper test of homoeopathy is the outcome, not the method or type of treatment.
Posted by: Mojo | September 4, 2008 9:10 AM
The worst thing about ragweed allergies is that they make you WANT the summer to end. My own (non-scientific) observation is that my allergies have gotten much worse since Toronto (where I lived) banned pesticide use. Giant ragweeds everywhere! One blocked nostril for the last two weeks of August and most of September!
I agree with Dianne. Big Pharma can continue to be evil as long as they keep supplying me with generic Reactine.
Posted by: Kmh | September 4, 2008 9:54 AM
@PalMD:
A2 gets interesting sometimes. I live near County Farm Park and since it's been so dry lately it seems like the air has been saturated with pollen from all the pine trees within it. At least it rained last night and knocked some of the pollen down...
@brendy:
Allergy therapy is very expensive. I did it for 4 years when it was covered by my insurance (and it really helped), but had to stop when I needed a new stock of antigens made (~$1200 each antigen) and no longer had that insurance. As for how it works, I favor that frequent low-level high-affinity activation of allergen-specific T and B cells that make the IgE that primes the mast cells induces a state of anergy and eventually death. Even so, in the absence of allergy therapy, reactive T or B cells clones to some epitope, not necessarily the same as before, will be regenerated. From a theoretical standpoint, it seems to me that if you could just block IgE production in B cells it'd be convenient, but doing so would probably require knocking out RAG in TH2 cells, which would in turn probably cause all kinds of unpleasant effects.
Posted by: Toaster | September 4, 2008 11:02 AM
Allergies is one thing I know. If you want your nasal spray to stick you really should do a salt water flush first. Just feel a wide rimmed glass with warm salt water and snort away. Its disgusting, but then when you use your spray its not wasted on the mucus and first sneeze.
I tell you that was simply the best recommendation ever given to me by a Doctor. As I have nearly year round allergies (I should have bought stock in Zyrtecs manufacturer) I live by this when I have to start using my nasal sprays.
Posted by: Evinfuilt | September 4, 2008 1:15 PM
I also get those nasty nasal drips every autumn and spring. I know how you feel. ^_^ Hey, maybe it is not the pollen, maybe it is the toxing in the pollen of the flowers. *bam bam bam* ^_^
Posted by: IBY | September 4, 2008 2:52 PM
When the anti-histamines don't work you may not have real allergies. I suffer every fall but when I was tested for allergies I got 0 results. The Doc said I have adverse reactions. The results are the same but medications don't really help. The only relief I've found is the bed tilted above 10degree for drainage at night to get some solid sleep. I have not really been sick for over 50yrs and if a fall sinus problem is the only payment I concider that a good thing.
Posted by: CybrgnX | September 4, 2008 3:54 PM
Hmmm...
Over here in the UK some of our big main street pharmacies (and, more disturbingly, the trained pharmacists they employ) don't seem to think there is any difference betweeen immunotherapy and homeopathy. Start here and read down if you're interested. Might make you grateful for CVS.
Posted by: Dr Aust | September 4, 2008 4:07 PM
I never had allergies until I moved to OK. But mine appear to be worse in the spring (tree pollen, even though I grew up in a forest).
rage...
Posted by: ERV | September 4, 2008 8:51 PM
Atlanta is horrid for spring allergies, Greensboro for fall. No wonder I had a miserable childhood--and allergic to cats in a cat-breeding family! I consider myself lucky my sinuses haven't given up and fallen out.
Posted by: Patience | September 7, 2008 8:23 AM
Oh, and NM, I only wish that had helped. Moving to Australia made me miserable, because I had no resistance to any of their horrible allergens. My plant allergies had never been worse.
Posted by: Patience | September 7, 2008 8:28 AM
I know everyone will treat this as the anecdote that it is, but I used to have bad hay fever and used to have to take stuff for it every day during the summer. Since I have started my nitric oxide "experiment", I haven't had to take anything either acutely or chronically.
I was surprised because I didn't expect it to have that effect. That was before I had read up on how NO inhibits NFkB and tones down mast cell degranulation. In retrospect it is clear that the bacteria I am working with are the agent of the hygiene hypothesis. These bacteria are the reason that there are essentially no allergies in the rural undeveloped world.
Posted by: daedalus2u | September 7, 2008 10:28 AM