Hay Fever Season
British Athletics Science and Medicine Update
Hay fever is more common in athletes and around 60% of our team suffer with some of the common symptoms of blocked or runny nose, sneezing, runny eyes or even just fatigue. It can be associated with worsening of asthma symptoms if you have asthma.
Symptoms are due to an allergy to pollen, and are therefore worse when the pollen count is high. Some people are allergic to grass pollen, some to tree pollen, so different people may suffer at different times of the season (grass in Spring, tree in deep Summer).
General measures such as checking the pollen count for the next day, reducing time outdoors when the pollen count is high, having regular showers, washing hair and changing clothes after being outdoors to remove pollen that may be on your clothes or in your hair, keeping windows closed at night may help considerably. Remember, if you have pets, they can bring pollen into the house on their fur too.
There are also some excellent medications and practices which can control hay fever symptoms, most of which can be bought over the counter at a local pharmacy or department store. We advise purchasing your own stock of medications if you suffer hay fever, and take them whenever you travel to Camps or Competitions as stocks might not always be available.
Always double-check that you do not purchase anything on the Prohibited List by checking on Global DRO.
The following recommendations have helped a number of athletes:
FOR GENERAL SYMPTOMS – SNEEZING, RUNNY NOSE, ITCHY WATERY EYES
There are a number of old antihistamines on the market (such as Piriton) which are sedative and not recommended for treating hay fever in athletes. Telfast however does not pass into the brain and therefore is not sedating in nature and is an ideal anti-histamine for athletes but requires a prescription from your doctor. Cetirizine and Loratidine are over the counter antihistamines that can be helpful and usually are not sedating. There are some reports to suggest that antihistamines can affect heat regulation and possibly reaction times and therefore unless you have tried them before and have had no problem, they are not ideal medications to be taking for the first time on race day.
FOR SNEEZING, RUNNY NOSE
Nasal Corticosteroid Spray
This is the gold standard first line medication. Newer products such as Mometasone (Nasonex) and Flixonase require a prescription but Beconase nasal spray is also effective and can be purchased over the counter. You do not need a therapeutic use exemption (TUE) for these nasal sprays. One/two sprays in each nostril twice daily is a typical initial dose. These are most effective if used before the onset of symptoms, and can be continued throughout the hay fever season, or just on high pollen count days.
Sterimar (Salt Water spray)
Salt water sprays, such as Sterimar, can be particularly useful to rinse pollens and pollution from your nose. These can be used several times throughout the day, particularly if you have recently been training outdoors.
Decongestant Nasal Spray – Otrivine
Otrivine nasal spray contains xylometazoline. This is a decongestant and is not on the prohibited list. It works by constricting blood vessels in the nose and is a very effective decongestant. It can be helpful to enable nose breathing at night or before a race. It should not be used for longer than 3 days continuously as doing so can result in overall worsening of the congestion. We advise AGAINST purchasing this item abroad as we cannot guarantee that it does not have any Prohibited substances in.
FOR ITCHY, WATERY EYES
Sodium Cromoglycate eye drops (Opticrom) can be useful if you have itchy, watery eyes. 1-2 drops in each eye before the onset of symptoms can help prevent this being a problem. Dose can be repeated 2-3 times per day.
IF ASTHMATIC SYMPTOMS – WHEEZE, DRY COUGH, SHORTNESS OF BREATH
Those with hay fever should ensure they get tested for asthma as they commonly occur together and often asthma symptoms are not recognized but still may be negatively affecting performance. See your Doctor
There are some other medications, such as Montelukast (Singulair) which can be a useful addition for some athletes, particularly those with asthma in addition to hay fever. This is worth discussing with your doctor if you are still symptomatic following treatments above.
Skin prick allergy tests for pollens and pets can give good information regarding things to try to avoid. For example, those with duck feather allergy should ensure that their holding camp and championship accommodation has synthetic hypoallergenic pillows or bring their own pillow.
Dr Robin Chakraverty
MBBCh DRCOG MSc DMSMed MLCOM DipSEM FFSEM
Chief Medical Officer British Athletics
National Performance Institute
Tel: 07841 503896
Senior Medical Co-Ordinator – Lauren Bouchard