Q: I have terrible hay fever. My nose runs, my eyes itch and I sneeze all the time. What medication can the doctor prescribe that won't put me to sleep?
A: Traditionally, non-sedating antihistamines such as Allegra, Claritin or Clarinex have been used in these situations with excellent results. If you have already tried these and have had problems with drowsiness despite the decreased incidence in these medications, you may want to consider drops for the eyes and nose. For the eyes, antihistamine drops such as Emadine or Livostin do not cause drowsiness and act within minutes. Mast cell stabilizing drops such as Crolom, Opticrom and Alomide are effective in preventing allergic eye symptoms, but must generally be used four times per day for one to two weeks before it takes effect. Patanol is a combination antihistamine and mast cell stabilizer eye drop which is very effective, and one of my favorites. Nasal sprays can be highly effective for itchy, runny noses. The best is steroid nasal sprays. The second-generation sprays have minimal absorption into the body and include Flonase and Elocon. These can be used in conjunction with oral antihistamines or eye drops.
Other helpful hints include “washing” the nasal passages daily with warm salt water. This technique involves breathing the water in through the nostrils and spitting it out of the mouth. Sounds awful if you've never tried it, but it can be done, and studies show that washing out the pollen that accumulates in the nasal passages can significantly decrease the amount of medication needed.
Q: I found your Q & A from the March-April 2005 issue about hyperthyroidism and goitrigens very interesting. I am a 39-year-old male in good health, but now in my third episode of hyperthyroid in ten years. I am currently under a physician's care, and taking Tapozole. All the vegetables you listed in your article are precisely the vegetables that I have always hated and have never eaten in any significant quantity. Can the active ingredients in goitrigens be found in a supplement? Is it possible that the complete lack of goitrigens for almost 40 years has produced or significantly contributed to the hyperthyroid? Are you aware of any information on long-term use of Tapozole?
A: The specific actions of goitrigens on the thyroid haven't been well studied. There may be thousands of compounds in a plant or herb, most or all of which work in concert with one another. Sorry, there is no magic pill for you. And remember, it's the raw – not cooked or fermented – cruciferous vegetables that suppress the thyroid. I suppose it's possible that the lack of goitrigens in 40 years may have some contribution, but this also hasn't been studied. Hyperthyroidism is considered an autoimmune disease, meaning the body is making antibodies that, in this case, are revving up the thyroid. Long-term use of Tapozole isn't seen as much these days because most patients either opt for surgery or radioactive iodine. It can suppress white blood cells (agranulocytosis), which is rare but dangerous. It may also cause acne or actually worsen the condition of the thyroid.
Q: I tend to get depressed in the winter, usually beginning in January. I don't feel better until around the middle or end of May. I've had a number of friends with similar symptoms say that they've been prescribed antidepressants, but I've read that there are many side effects, which I want to avoid. Are there any natural treatments?
A: Absolutely! Many people tend to get depressed in the latitudes further away from the equator because of months without adequate sunlight. This is termed Seasonal Affective Disorder (SAD). If you can't move to the equator and don't want to take drugs, a natural way to avoid the winter blues is light therapy. Many studies have shown that light therapy lamps from 2000-10,000 lux can have a significant impact on mood, libido and carbohydrate cravings, as well as hypersomnolence (sleeping too much) in patients with SAD. It can be used once or multiple times per day at home or at work. St. John's Wort, an herbal remedy has also been found effective, but it has so many interactions with drugs that I am hesitant to prescribe it. Melatonin and Tryptophan are being researched for this condition, but would not be recommended until further trials are done.
Disclaimer: The information contained in this column is not meant to diagnose or treat any condition. Seek the advice of a medical professional before making any changes to your diet, supplements or medication.
Tanya Edwards, M.D., M.Ed., is the Medical Director for the Center for Integrative Medicine and is a staff member in the Department of Family Medicine at the Cleveland Clinic. As a Family Practice physician, she sees patients at the Cleveland Clinic Independence Family Health Center, and will begin wellness consultations at the new Cleveland Clinic Wellness Center. For the past seven years, she has been teaching complementary and alternative medicine courses at the Case Western Reserve University School of Medicine.
