Which Allergy Medicine Works Best? with Dylan Timberlake, MD

Podcast Transcript

John Horton:

Hey there, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

If you've ever struggled with the allergy trifecta of itchy eyes, sneezing and that dreaded runny nose, you're not alone. Allergies affect millions of people every year, which explains why there's no shortage of over-the-counter medications promising relief. The question, though, is: Which medication might work best to address your symptoms?

We're going to break that down today with the help of allergist Dylan Timberlake. He is one of the many experts at Cleveland Clinic who pop into our weekly podcast to break down healthcare options. So let's try to make sense of all those allergy meds at the pharmacy and figure out which one belongs in your cart.

Welcome back to the podcast, Dr. Timberlake. It's great to see you again.

Dr. Dylan Timberlake: Thanks, John. It's good to be back.

John Horton:

So I caught this interview with you where you talked about seeing patients who have spent years dealing with uncomfortable allergy symptoms without knowing that they've got all these great options out there. Are there really that many people who just try to soldier through all these issues?

Dr. Dylan Timberlake: Definitely. So I have a lot of people who come and see me and they've tried Benadryl®. They're like, "I take Benadryl when it's really bad, but I suffer through most of the time." And so that's a great patient for me because I'm like, "Here's our whole world of things we have." And so there's lots of options out there.

John Horton: All right. Well, we're going to spend this show talking about some of those options and maybe what people can do. So let's just start, though, with some basics. And sometimes, it's just hard to believe that being around a cat or spring blooms can just make you so miserable. What's happening in our bodies to bring on these allergic responses?

Dr. Dylan Timberlake:

Yeah, it's a great question. So as brief as we can, the allergy part of your body is part of your immune system. So most of us know that you make something called antibodies to help us to fight off infections normally. So that allergy part of your body actually has specific allergy antibodies as part of its immune system effects. So if you're allergic to something, what has happened is your body has made one of these allergy antibodies to something that it's not supposed to, like a tree pollen or cat dander. And then that allergen now is what's activating the rest of that allergy part of your immune system. You release all these chemicals people have heard of histamine, which causes swelling and itchiness, so stuffy nose, runny nose, sneezing, itching, itchy, watery eyes.

John Horton:

So it sounds like basically your body just takes this pollen or, like you said, pet dander or something like that and classifies it as a threat to the system and sends out an alert, and all this internal mayhem then follows.

Dr. Dylan Timberlake:

Absolutely. So at its core, your body is recognizing something that should be a benign stimulus and then reacting to it.

John Horton:

Yeah. And we've all had that where you're like, "Why is this bugging me?" And it sounds like your body just goes a little haywire and classifies something as a threat when it shouldn't.

Dr. Dylan Timberlake:

Absolutely.

John Horton:

All right. So when we've had this, and we've all dealt with it, I think, because allergies are so common, and eventually, I think we all end up going to the pharmacy because we know they've got a bunch of stuff there that might help us. What kind of options should we look at as like a first line of defense? You mentioned histamines. So, obviously, antihistamines are what helps with that. What are they doing? How are they going to help?

Dr. Dylan Timberlake:

Yeah, you got it. So you walk into the pharmacy, you walk into the allergy section, and you're going to see a couple different things. So you're going to see your allergy pills, which are almost all over the counter, going to be antihistamine pills. That's things like Zyrtec®, Claritin®, Allegra®, Benadryl®, which I know you and I have talked off camera about Benadryl. We'll get to that at some point, but those are your antihistamines. Then you have nasal sprays, and there's a couple options for those. You have nasal steroid sprays. Most commonly, people have used or tried Flonase®, but there's a lot of over-the-counter ones: Rhinocort®, Nasacort®. And then a couple years ago, now there is a nasal antihistamine that is also now over the counter called Astepro®.

John Horton:

So much stuff. And this is why it's so confusing when you go to the pharmacy because you're like, "Where do I even get started?"

Dr. Dylan Timberlake:

Right. Yeah.

John Horton:

Now, is there a difference between the various antihistamines? I mean, does it really matter if you're on team Allegra or team Claritin or team Zyrtec? Are they going to work differently?

Dr. Dylan Timberlake:

Yeah, you got it. So Benadryl is one of our older antihistamines, so we call it a “first generation.” All of these other ones that you and I are talking about, Zyrtec, Claritin, Allegra — I normally don't think about Xyzal, but Xyzal's in there, too, over the counter — we call them “second generations” because they're newer antihistamines.

So big first branches, if you're going and you're looking for an antihistamine, typically I'm going to avoid the first generation.

The second generation are going to get you all of the same benefits with less of the side effects that go along with it. To get back to your question then, of like, are they all equal? If you look at them in studies, the answer is yes.

I'll tell you, seeing enough patients, people respond differently to different medicines. So I have some people who see me, and they've tried all three, four of them and they're like, "Claritin's the one that works for me." Same thing: Zyrtec's the one that works. Allegra. So if you're using one and you don't feel like it's overly working well for you, switching to a different one is definitely reasonable.

John Horton:

Do sometimes do people just go back and forth between some of them? Because I don't know if your body gets used to one and then, all of a sudden, it doesn't work as well, but if you throw another one in, all of a sudden, you get better results.

Dr. Dylan Timberlake:

Yeah. I'll say that I have a lot of patients who do that. Once again, it's this hard part of medicine of real world versus what the studies show. And then also, are there really negatives to doing it? And so if you look at studies, typically, we're not seeing a lot of tolerance developing to these antihistamines, but I have plenty of patients who feel like one seems to stop working over time, they switch another one, it seems to work. It really is no harm to doing it. And so if you're for whatever reason, you feel like that is working better for you, great, let's do it.

John Horton:

Sometimes, I wonder with that if it's a little bit of the power of the mind. If you think it's going to work a little bit better, sometimes you just feel a little bit better.

Dr. Dylan Timberlake:

Very well could.

John Horton:

Now, you had mentioned Benadryl, which, it sounds like, is, like you said, the original one, the OG of antihistamines for over the counter. Is it that these other ones are just a little bit new and improved, pack a little more punch, or have there actually been some issues with Benadryl or some concerns that have come up over time?

Dr. Dylan Timberlake:

Yeah. So both. If you look at efficacy, I will say I have some people who see me and they swear that Benadryl works better. It may. What may also end up happening is you may be getting some of the side effects from Benadryl that are helping with allergies.

And so Benadryl can dry you out as well from a negative standpoint. And then, as you can imagine, if your runny nose, that can dry you out from that. But really, more of our worry with Benadryl is the side effects with it. And so, with Benadryl, there's two big things. And so one of them is there was a study that came out that looked at chronic usage of Benadryl, and what we ended up seeing was increased risks for dementia with that. It's a big point to note, we don't see that with the newer antihistamine. So I have a lot of people who see me and they're concerned. They're like, "I've been taking Allegra for five or 10 years. Is this going to happen to me?" And we're not worried about that.

But the other really quick, interesting thing with Benadryl is there was a study that looked at the sedation effects of Benadryl. And so we all know some people, they take Benadryl, they feel like they get knocked out.

John Horton:

It always used to make the kids sleepy. I remember we used to give it to them when they're having allergies or whatever else, and it did, it would.

Dr. Dylan Timberlake:

You got it, right? But there's an interesting cohort of people also who they take Benadryl, and they're like, "I feel fine. It doesn't affect me." But there was a really, really interesting study that looked at giving patients Benadryl and then putting them in a driving simulator, and even those who didn't feel like they were having any of that sedation or any effect were operating at a similar level of sedation or intoxication as someone who's above the legal limit for alcohol driving intoxicated that way.

John Horton:

Wow. That is just not something driving under a DUI for Benadryl just seems a little extreme.

Dr. Dylan Timberlake:

You got it, right? So when we didn't have as good of alternatives, great, you're right. But in this day and age where we have as or better alternatives, we're going to lean on those.

John Horton:

Are these safe to just take over and over and over again? I know a lot of people are on a regimen where you'll pop a Claritin every day. Other people might just do it during certain times of the year or if you feel a little cruddy. I know I'll pop a Claritin every once in a while. I feel like my eyes get itchy or whatever. I swear it's like when my dog needs a bath or something like that. I'll take one, and it instantly goes away. Is that safe to do in any of those options I threw out there?

Dr. Dylan Timberlake:

Yeah, no, the new ones are safe. You can essentially take them as long as you need to. And I don't worry about long-term issues or side effects with them, especially if you're using them at the over-the-counter recommended dosing of just the one pill once a day for most of these, and then they work as needed. So that's the other nice part, too, is most of them kick in fairly quick.

Out of those second-generation that we talked about, Zyrtec does kick in a little bit quicker than the other ones. So if you're someone who gets hives with some of these exposures and you want something to kick in pretty much immediately, Zyrtec's probably your best friend there. But out of all of them, they all work pretty quick. They all are fairly long-acting. So if you're someone who needs something as needed also, any of those are reasonable use as needed.

John Horton:

I got to say, I've toggled back and forth between Claritin and Zyrtec. I don't think I've ever used Allegra. So maybe I need to give it a shot at some point, but I don't know. I also just get the sales.

Dr. Dylan Timberlake:

I will say, too, when we're talking about the little differences now at this point, Zyrtec is considered a less sedating antihistamine, whereas the other ones are non-sedating. So there is a small percentage of the population that'll still notice a little bit of the sedation with Zyrtec, but it's a fairly small percentage. So I honestly, it doesn't bother me. I just tell people, if we're going to use Zyrtec, if you notice it's making you sleepier at all, go ahead and stop that and switch to Claritin or Allegra.

John Horton:

Yeah. I got to say, I've never felt that, but I also drink a lot of coffee during the day, so I don't know what it would take to knock me out.

Dr. Dylan Timberlake:

Coffee's trumping your Zyrtec. No, honestly, the large, large majority is that it's a minority of the population who will have that. So I don't worry about it. I honestly use a lot of Zyrtec in my practice. I use all of them, but I end up using a lot of Zyrtec in my practice. It ends up being a little bit cheaper when you're buying it over the counter than Allegra. I will say anecdotally, a lot of my patients find Zyrtec and Allegra work a little bit better than Claritin. So I land on Zyrtec a lot of times. It's my first line, but this is to say all of them are fine. Try whatever seems to work best for you.

John Horton:

So we've hit the antihistamine. So those little pills that will stop that allergic reaction and that whole histamine response and all of that.

Now, let's talk about nasal sprays, and how do those fit into the picture?

Dr. Dylan Timberlake:

Yeah, great. So there's two different nasal sprays. And I'll say most people, if they're going into the pharmacy and they're going to grab an allergy med, most are grabbing a pill. Our guidelines actually have been updated as allergists where the pills, like if you see me as an allergist, our pills are no longer recommended as our first line in therapy, and it's just because the nose sprays, they're going to be more effective with essentially no significant side effects that go along with them. So if I have someone who comes in and they're like, "What's the first line?" it's always going to point people to your nose sprays.

John Horton:

OK, wow. I think most people usually go right to those little pills. So why are the sprays then now the first line?

Dr. Dylan Timberlake:

So they're more effective and, honestly, it's because they are right there where you're having the problem. And interestingly, the nose sprays with your eyes and nose being so interconnected, the nose sprays can even help with some of those eye symptoms. So if you're looking at it, there's two different types of nasal sprays. So we mentioned already nasal steroids, Flonase, Nasacort, Rhinocort, and then there's another one in antihistamine called Astepro.

The biggest differences there for you is those nasal steroids take a little bit of time to build up in those tissues in your nose. And so you're going to get more slower onset benefit days to weeks before you're hitting your maximum peak benefit. Whereas this Astepro, which is the antihistamine, you use it similar to the pills, pretty immediately, you're going to notice the relief with it.

John Horton:

OK, wow. I did not know that was available. I guess I've used Flonase. And typically, when you start getting a little infection or something like that, I've never really thought of it for allergy relief, but it sounds like it can be effective in that usage.

Dr. Dylan Timberlake:

Right. And this is, once again, that personalized part of medicine you and I have talked about, is like, John, if you come and you see me, and you're like, "Every so often, my eyes are itchy with my pet," I'm not going to put you on Flonase because you need to use it every day to get that good benefit. But if you come and you see me, and you're like, "Every single spring, March through May time, I'm miserable," then we're going to talk about starting a nasal antihistamine like Flonase every single day leaning in, and then continuing that throughout the season because the nasal steroids are probably your most effective, but the downside being you need to use them every single day.

John Horton:

Yeah. It sounds like you should very much look at them as a maintenance medication. It's just something that—

Dr. Dylan Timberlake:

Absolutely. Yeah, absolutely.

John Horton:

Well, that makes a lot of sense.

So if you have people who have allergies and whether it sounds like these are environmental allergies we're talking about. So you said springtime stuff, pet dander, those indoor dust, all of those things that trigger the runny noses and the itchy eyes. If you just get on a regimen of using a little puff in each nostril once a day, you should be good and keep those symptoms down?

Dr. Dylan Timberlake:

Yeah. So I would say the majority of people — and this is partly skewed because I see the people who normally are doing this and they're not getting better — but if you look at the large majority of people with allergies, if they're doing a nasal steroid throughout their bad time of year, potentially add on that nasal antihistamine or an antihistamine pill as needed, most people, that's going to be enough relief for them.

John Horton:

Now, how does that steroid work? Because it sounds like then that's not addressing the allergic response directly, but is it just addressing the symptoms that we get from it?

Dr. Dylan Timberlake:

Great question. So it is actually treating that allergic response. So the steroids are decreasing that inflammation that's in your nose. I want to take a pause here to mention, too, because we keep talking about steroids, and I know steroids get a bad rap, and absolutely they should. If you were on a steroid pill for a long time, we're going to worry about that. These nasal steroids, almost all of that steroid stays locally in your nose. We don't see it getting into the bloodstream. We don't see full-body side effects or concerns with steroids. And so, really, these nasal steroids, they are really, really safe to stay on for however long you need them.

John Horton:

They're not going to help you bench 500 pounds, it sounds like is what you're saying.

Dr. Dylan Timberlake:

Absolutely not. And they're not going to cause any of the scary side effects that come with steroids. So, truly, they're a really safe medicine. They work really well. So what they do is they decrease all that inflammation. We talked about allergies being part of your immune system, so they decrease all that immune system inflammation. And so they're getting as close to treating the core problem as you can without doing something like allergy shots, which is actually making you less allergic.

John Horton:

Yeah. It sounds like they'll make you feel better. And I guess that's the goal everybody has with taking any allergy med.

Dr. Dylan Timberlake:

Yeah. And they should help with all of it, the stuffiness, the runniness, the sneezing, all of those symptoms.

John Horton:

Now, why might you choose the nasal antihistamine versus the steroid? What would push you that way?

Dr. Dylan Timberlake:

Predominantly, it's someone who needs something more as needed. So, by and large, they feel like they're OK or they don't want to have to take something every single day, then I'm going to push them toward that nasal antihistamine Astepro. So they're more effective and, honestly, it's because they are right there where you're having the problem. And interestingly, the nose sprays with your eyes and nose being so interconnected, the nose sprays can even help with some of those eye symptoms.

John Horton:

That makes sense. So you get the immediate quick response, and until you get your dog in the bath and get rid of the allergens that are on them, it'll help you out.

Dr. Dylan Timberlake:

You got it. And these are safe together, too. So a lot of time, I'll have people who do a nasal steroid and a nasal antihistamine together at the same time. They actually have a prescription drug where they put both in the same bottle. But by the time you're doing both of those, we may be talking about, is it bad enough maybe should you be seeing someone and talking about it?

John Horton:

Yeah. I was going to ask that, whether or not you can combine the antihistamine pills and nasal steroid spray. And it sounds like they're actually doing different things. So if you take the antihistamine that's getting to the actual what's causing the issue and then the steroid nasal spray is actually dealing with what it caused.

Dr. Dylan Timberlake:

Yeah. So steroids are decreasing all that inflammation. The antihistamine really, when that allergic reaction happens, you release the histamine chemical. It has to bind to a receptor. So essentially, think of like a key going in a lock and unlocking it, right? Histamine is the key unlocking it. Your antihistamine goes, and it covers up that lock so the key can no longer open it up and cause the symptoms with it.

John Horton:

And I'm assuming then, you can take the antihistamine and like a steroid nasal spray together. I'm assuming you can't take an antihistamine and that nasal antihistamine. That's too much.

Dr. Dylan Timberlake:

Yes, you can. You can, and you can get some additive effect of it. Same thing. So my threshold normally is like, if you're doing one, maybe two of these over-the-counter meds, and you're OK, you're probably OK doing it. Once you're starting to, if you are using two every single day, you're getting into needing more than that, you should at least probably be seeing your primary care doc, if not, one of us as an allergist.

John Horton:

Yeah. No, that makes, it sounds like with any of this stuff, it's probably good to talk with somebody just to get to the bottom of what's going on and whether you really need to be hitting that medicine as much as maybe you are.

Dr. Dylan Timberlake:

Yeah, definitely.

One thing I'm going to mention here, John, too, just because this is a question that I see a lot in my clinic, is people have tried this Astepro. One thing to know with Astepro, it has a very, very bitter bad taste if it ends up in the back of your throat. And we see a lot of people coming in and talking about all we end up needing to do is talk about how to use your nose spray. So if you're OK, I want to put that out there, is that when you use these nose sprays, there's a couple things that can help so that you're not tasting it as much.

And the big things that come with that is we tell people to tilt their head forward and look down. You will have some that ends up running out the front of your nose, and that's OK because what it does is the medicine coats inside your nose, and it's the extra that runs out the front. So all that would have been going down the back of your throat. But the other big one that is notorious is it feels really natural to try to sniff your nose spray when you do it. So you spray and sniff at the same time. We don't want you doing that. If you do that same thing, it's going to just suck all of it in the back of your throat, and you're going to taste more of it.

So if you do your nose sprays and you're having issues with them, look down, tilt your head forward, and when you put the nose spray and you squirt, just keep breathing normal. Hopefully, you're not going to taste it as much, and then you can tolerate these over-the-counter meds better.

John Horton:

See, this is why I love these discussions. This is why I find out what I've been doing wrong because I got to say, when I use the nasal sprays, I'm a big, you go in and you breathe up. I don't know. I always feel like that gets in—

Dr. Dylan Timberlake:

And a gentle breath, and it's fine. But I tell people, even though I notice, if I use my nasal spray, it feels like you go to spray and you're like you're ready to go and you're like, "I'm going to sniff this in." You have to consciously be like every time, "OK, don't do that. It doesn't need to do that," because, yeah, you're just going to swallow a lot of it, and everything that ends up back that you're swallowing is just extra stuff.

John Horton:

Here, I thought I was doing something right. I'll change it the next time.

Dr. Dylan Timberlake:

I'm sure you do a lot right, John. I'm sure.

John Horton:

Trust me, the more I do this podcast, the more I realize I'm doing a lot of stuff wrong, but I'm getting better. That's the point of having these discussions.

Dr. Dylan Timberlake:

I love it.

John Horton:

One more medication I'm going to throw in there. Decongestants, do those have any role when you're talking about allergies and the stuff that follows?

Dr. Dylan Timberlake:

Yeah, they do. And so the biggest decongestant most people know about is Sudafed®, pseudoephedrine. And so something like a Zyrtec‑D® has Zyrtec plus the Sudafed component. I am a fan of not really ever doing a Zyrtec‑D or Allegra‑D®. If you feel like you need a decongestant for some reason in addition, I try to keep them separate just so that you can use your Zyrtec on the days where you need that, and then only using that additional decongestant on the days where you feel like you need it.

The decongestants start to get a little bit more side effects, and I start to worry about it more with people who have high blood pressure, especially the pill decongestants. And so, to be honest, I try to stay away from those from our long‑term use. Short‑term usage, you have a bad allergy flare, you have allergies, and now you've had a viral infection to get you through. I'm OK with that. To be honest, what I like more even than Sudafed or the orals is a nasal decongestant of some kind. So Afrin®'s the one that most people have heard of.

Now, flip side, most people have heard of someone getting addicted to Afrin. And essentially, what happens is if you use Afrin for too long, you can get a really bad rebound congestion. So essentially, every time you're not using it, you get worse congestion than you had beforehand, and it can get pretty bad. So I just tell people, if you're going to use Afrin, no more than three to five days in a row. But to be honest, I love it for those bad periods where you're somebody who has allergies and you're OK most time, and this is a really bad couple of days, use it. It's only going to help for the stuffiness.

It's not going to do much for the runny sneezy side, but if you're really plugged up and you need something to get you through, it's a great over‑the‑counter option.

John Horton:

And just to clarify, too, because I threw it out there, like Claritin‑D, Zyrtec‑D, Allegra‑D, those are the antihistamines with a built‑in decongestant.

Dr. Dylan Timberlake:

Yes.

John Horton:

What you're saying is your recommendations are more, you know what, take your antihistamine, and if you need it at that moment, take a decongestant separate, instead of trying to combine them for regular use.

Dr. Dylan Timberlake:

You got it because then you've separated it out, so that if you don't feel like you need the decongestant, now you're not stuck just taking the antihistamine plus the decongestant. You can use that just when you need it.

John Horton:

Yeah. And when you look at using decongestants, I take it you should probably just lean on those when you do have that extreme stuffiness, and you're having trouble breathing and things like that. It's not something to lean on as more of a maintenance medicine.

Dr. Dylan Timberlake:

Absolutely. Much more short‑term usage. And honestly, most of the time, by the time people see us, if they were to need a decongestant chronically, there's other things that we'll do, prescription‑wise or other treatments and therapies, just because I really, really try to keep people off of the decongestants as a long term.

John Horton:

Yeah. No, and that makes some sense. And I guess you don't always deal with that, and there's other ways to tackle that problem as we've discussed here with the nasal steroid sprays and all of that.

Dr. Dylan Timberlake:

Yep, you got it.

John Horton:

I want to go at it again just because it's such an important thing, and I know people always ask about it, but these products, from what we know, I mean, they are safe, and the side effects, sounds like, are really, pretty minimal.

Dr. Dylan Timberlake:

Yeah, you got it. I honestly, outside of Zyrtec making a low percentage of people sleepy, I don't counsel much when I start these, outside of saying these are safe. You've probably read scary things about antihistamines. That's with Benadryl. I worry about that. These newer ones, I don't worry about these things with. The nasal sprays, the medicine all stays local, so really you shouldn't have any significant side effects that go along with those. Occasionally, some of the nasal steroids can dry you out in your nose a little bit. So occasionally, we'll see some increased nosebleeds, but there's ways we can navigate that if we need to.

John Horton:

And I think the key is always you need to follow those guidelines, which I know nobody likes reading all that fine print around these bottles and the medications, but it is important to make sure you don't overdo it on any of these medications.

Dr. Dylan Timberlake:

Yeah, absolutely. And then the flip side of that is some of these medicines have certain labels, like don't use for more than a month. And so people will come and see me, and they're concerned, and they're like, "You're telling me to use my nasal steroid for year‑round, but the bottle says only for a month." And part of that understanding is just for something they have an over‑the‑counter labeling, that is different than sometimes what our prescriptive labeling is. And essentially what the FDA is saying is, you need this for that period of time, you probably should be seeing someone and talking to someone about it. So, once again, if something is on the back of your bottle that's different than what your provider's talking about, for sure, ask about it. But there's probably a reason why we feel OK using those for longer than it says, too.

John Horton:

Yeah. If you're somebody who is taking, you've self‑prescribed taking Claritin or Zyrtec or any of these medications regularly, is there a point that you should get in then and see a doctor and just figure out what's going on so you're not taking something unnecessarily?

Dr. Dylan Timberlake:

In general, I'm a big proponent of having a primary care physician or provider. And so seeing them for your other routine health maintenance needs. And so you should be seeing someone anyway and then bringing these medication usages up to them. And then they can help to keep a good gauge on, is that OK or is it not OK? And so I guess your question specifically, if you're just taking it, do you need to see someone? Maybe not. But also, I caution to say that because I very much believe preventative medicine is great. And so you should be seeing your primary care provider for other reasons and bringing these things up to them.

John Horton:

And it sounds like, too, if you're taking them and maybe not getting full results, I mean, you're still struggling a little bit, you're having some issues, it sounds like there are other options that you have available to you — prescription options that may also help people, and really get to the root of the problem.

Dr. Dylan Timberlake:

Yeah, absolutely.

And so, once again, once you start to do a couple of these and it's not working, definitely see your primary care provider, or potentially come in and see one of us as an allergist, and we'll help get to the root cause of it. This is not the point of this conversation, but there are things we can do to talk about. If we know what you're allergic to, decreasing exposure to these things. And so while a lot of us are like, "Well, I'm pollen allergic. How am I going to do that?" there's things we can do for most of this, for pet dander, for dust mites, for pollen. And so even if that only gets you 20% of the way better, now doing that, plus one of these medicines or two of these medicines, we might get you all the way there, and just knowing what you're allergic to might be half the battle.

John Horton:

Yeah. And everything fits together so much. And I know we've talked before about stress and sleep and all these things that are part of everyday life, and they can all weigh in on how your immune system's responding and what your reactions are. Sometimes, you need to have a discussion with your doctor just to get to the bottom of what might be causing your reactions.

Dr. Dylan Timberlake:

Yeah, yeah, you got it. And then also potentially talking to your doctor and making sure that there's no other reason why you might have these outside of allergies, right?

John Horton:

Yeah. Well, we talked about that. There could be so many other things that cause these issues that we just tie to allergies, but sometimes you just got to get to the bottom of what's causing a problem.

Dr. Dylan Timberlake:

Yeah, you got it.

John Horton:

All right. Well, Dr. Timberlake, this has been a great discussion. You definitely gave us a little more sense as to all those things that are in the allergy aisle at the pharmacy. If we're going to leave people with one thing that they should take away here, what would it be?

Dr. Dylan Timberlake:

I'd say you have a lot of great options over the counter. Typically, if you need something from a daily usage, I typically rely on our nasal steroids. If you need something more as needed, my preference is typically your nasal antihistamines. But there's all those different options out there, and those second generation — Zyrtec, Claritin, Allegra, Xyzal — they're all really safe as well. And so just find what works for you. And if you're having issues with that, see one of us, see your primary care provider, and we can try to help out with it.

John Horton:

All right. Well, that pretty much gives folks a shopping list if they want to go and take care of those problems.

Dr. Dylan Timberlake:

Perfect.

John Horton:

Well, Dr. Timberlake, thank you again for coming in. You are always fabulous at dropping knowledge on us, and can't wait to have you back.

Dr. Dylan Timberlake:

Thanks, John. It's been great.

John Horton:

Allergies can be super frustrating to deal with, but over‑the‑counter medications may be able to put relief within your grasp. Thanks to Dr. Timberlake, you've got a good idea on where to start to find that help. If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.