Q: I am bothered terribly by itchy, tearing eyes and clear runny nose every spring and summer; my doctor advised me to try one of the anti-allergy medications that can be purchased without a prescription. They do seem to help, but I have to take them for more than a week before they seem to start working. Is there any better way to manage this problem?

A: It certainly sounds as if you are suffering from typical seasonal allergic conjunctivitis and rhinitis, the medical terms for the symptoms that you are reporting. These symptoms are caused by the release of histamine from mast cells that are found in the inner lining of the eyelids and nose, when those areas are exposed to the substance to which you are allergic, usually pollens, mold, or other microscopic airborne particles from various plants.

Once you begin taking the antihistamines that have been recommended to you, it takes about a week for the levels of the medication to reach a high stable level in the tissues causing the problem, and then begin to stabilize the mast cells so that they don’t release histamine as easily.

The best solution to the delay in onset of activity, as you may have already guessed, is to note the date you have started having symptoms over the last several years and start the medication about 10 days prior to that date. What with milder winters and gradually earlier spring weather, it would be advisable to even start your antiallergy mediation 2-3 weeks before you anticipate onset of your allergy symptoms. This allows the mast cells to already be resistant to the allergens, when they do come along, preventing the symptoms altogether. This delay is something that all medications share, because of how the body metabolizes drugs, meaning that it takes five doses of any medication before its full effect can be assessed. If the medication is a once-daily drug, don’t decide it isn’t working until about one week after starting it. Similarly, a medication taken four times daily will be at its full therapeutic level and activity in about a day and a half.

I want to thank Cindy and Tim T. for this question. If you have any particular topic you would like to hear more about, please message me at paulmdake@ gmail.com.

To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website familydoctor.org, where you can search for your topic of interest.

Dr. Paul Dake, a Newberry native, is a retired family physician. He lives in Pinconning, Michigan.