(This is one in a series of rotating columns on health and medicine by representatives of Medcenter One and St. Alexius Medical Center.)

What can I do to control my fall allergies?

Ragweed is the primary irritant in late summer and autumn, but I also see a lot of sage and tumbleweed allergies among my patients. Staying indoors as much as possible, especially on sunny, windy days and early in the morning during peak pollen times, will decrease symptoms. Close your windows and use the air conditioning. Antihistamines may also help decrease symptoms.

What are antihistamines and how should I use them?

Antihistamines, as the name implies, fight histamines, the substances your body releases that cause allergies. Many antihistamines that once were prescription-based are now available over the counter at your drugstore.

Even when you purchase a non-drowsy option, begin by taking your first dosage in the evening when you do not plan to drive to see how it affects your alertness. I generally recommend Zyrtec as a good starter; if you don't experience relief, try one of the other options to find the one that works best for you. Most people experience about 50 percent improvement in symptoms; however, antihistamines tend to be less effective for people with severe allergies.

What if antihistamines don't work for me?

If your symptoms are prolonged or you can't live with the degree of severity, it's time to make an appointment with an allergy specialist.

Steroid nasal sprays, which require a prescription, are the single most important new medication in the battle against allergies. These sprays provide about 90 percent improvement and can be used safely on a long-term basis. It's very important to use them as instructed to achieve desired results.

Should I be tested for allergies?

Skin or blood tests can identify the specific allergens that plague you, but whether or not it's worth the cost depends on several factors. An important first step in that determination is a complete patient medical history. If a parent was allergic to ragweed and you have fall allergies, having a skin test is only going to tell you that you also have a genetic predisposition to this allergy. If your nose begins to run or your eyes itch whenever you are in a home with pets, a skin test will simply reinforce that animal dander is a problem for you. The way we treat allergies is similar regardless of what the allergy is, so skin tests are advantageous only as a diagnostic tool if you have no idea what is causing your symptoms.

Do allergy shots work?

If you experience severe symptoms or multiple episodes of symptoms throughout the year, allergy shots, also called immunotherapy, decrease sensitivity to allergens by introducing you slowly to increasingly larger doses of the substance to which you're allergic. Generally, a complete immunization program lasts three to five years and you must take the shots year-round to effectively end allergy symptoms. Of my patients who have completed the program for at least four years, 85 percent no longer have any symptoms. This is the only treatment I know that will change your sensitivities so significantly.

(Dr. James Larson is a board-certified specialist in allergies and immunology at Medcenter One's Bismarck Family Clinic North. He and his wife, Shannon, and their son live in Bismarck.)