You can opt out of allergies

Rattengift

My friends are starting to sniffle and sneeze every time we speak, signalling it's finally the worst part of the year: The latter half of Spring, where most of the allergens that you'll be dealing with for the year are finally starting to make themselves apparent.

Did you know that you can opt out of allergies? Well, seasonal ones, anyway. In four months, for about a thousand dollars,^[1] it just... won't be an issue anymore. Mostly.

The most common method in the US (because it's covered consistently by insurance) is subcutaneous allergy shots (subcutaneous immunotherapy, SCIT), but if you're afraid of needles, there's also tablets and drops you can take (sublingual immunotherapy, SLIT). Some of the tablets can be covered by insurance in the US, but at the present time drops don't seem to be. You can get drops via Amazon's primary care service, apparently, but I haven't tried it, and don't know what the costs associated would be.

SLIT, despite its relative lack of acceptance by the US FDA, is effective: SLIT has been fairly standard in Europe for a long time, to good success.^[2] It's not necessarily better than SCIT, but it doesn't seem significantly worse for most cases.

If you're particularly adventurous, the same principle ("expose yourself to small, but ramping, amounts of the allergen until you no longer have a reaction to it") seems to work for food allergies, too,^[3] including for relatively significant ones, like peanut allergies.^[4] However, the severity of most food allergies, and the extremely low dosages required to cause a significant reaction with many of them, is such that you probably shouldn't try to self-administer this. Some people have had success with it, though.

Given costs and inconveniences are relatively low (the price of a new laptop, or a sufficiently-cute synthesizer), and seasonal allergies are so severely life-affecting on a daily basis, you should probably consider it. If you do thought-intensive work, the increase in productivity will likely pay for itself, to say nothing about the reduction in suffering.

^{^}
In America, assuming subcutaneous immunotherapy and two shots per week during the dosage ramp-up.
^{^}
https://pmc.ncbi.nlm.nih.gov/articles/PMC10788274/pdf/main.pdf
^{^}
https://ajcn.nutrition.org/action/showPdf?pii=S0002-9165%2823%2917380-1
^{^}
https://www.jacionline.org/article/S0091-6749(10)00726-8/pdf

I've been doing SLIT for the last 3 months. It was relatively convenient to sign up for, a single video call and then they mail you a little bottle for 3mo of liquid. The drops are reasonably pleasant, sweet tasting.

They do ask you to hold them under your tongue for 2min, which is a bit annoying (especially to have to do every day), but my guess is net it's still much easier than shots.

I'm not sure if my pollen allergies have dropped much yet - apparently it's the second shipment where they ramp up the pollen concentration, and the whole thing takes 6 to 12mo to be effective.

In the meantime, I've been also using Flonase, which I think is also pretty good (better than Zyrtec).

How did you come to your belief that sniffling and sneezing and having watery eyes because of pollen and such cognitive lowers performance?

The correlation between impaired breathing, seasonal allergies & lowered cognitive performance seems fairly well documented.

I can certainly say that for me, personally, my thinking (and mood!) got much better each time I improved my breathing. Allergy shots, ipatropium nasal spray, living in newer buildings, nasal and sinus surgery, eating less industrially processed foods. Working in a clean room and/or hiking at >8k ft also seem to help, but those are not long term solutions.

I'll just add that inflammation should on theoretical terms mess with brain function, and that it subjectively seems to.

I'll also add that air purifiers (run high enough) have cured my mild allergies at home.

This is true, they do help me as well. Agreed on both points. Poor breathing also interferes with sleep quality.

inconveniences are relatively low

I disagree with that.

I got injections for a few allergies:

After the first few shots I was extremely sleepy for the reminder of the day, i basically would go to bed
In my case I got a whole lot of shots (for a few years every few weeks I think

This did reduce severity of my symptoms a lot, and was worth the hassle. But it didn't remove them completely.

you're the only other person I know who gets sleepy from allergies. Are you interested in comparing notes?

There is not much for me to share:

I got extremely sleepy after the first few allergy shots,
After tea I get very tired, I think I'm sleepy and I have trouble actually falling asleep (similar to being tired and stressed)
- I don't think it's problem with tea - I love tea and with some I don't have any issues so sometimes I try some and sometimes I don't have any issues
All the other times I don't get sleepy and I get other stuff like running nose, teary eyes etc.

In the comments it seems like SLIT takes 6-12 months, and SCIT needs tons of office visits. This is more than ”opting out" implies, but good to know!

I'll mention again that running adequate air purification dramatically reduces allergies at home.

And yes this should improve your brain's performance, through improved airflow and reduced inflammation, although I haven't done an actual lit review to verify that the theoretical effects produce large empirical effects.

It seems like the injection version requires a ridiculous number of office visits and is probably not worth it unless you live right next to your doctor's office?

Once or twice a week for the first few months, depending on how quickly you want to be done with it, before tapering off into maintenance injections (which eventually stop being necessary), which makes sense if you live in a city. I think for many people the trade-off would be worth it of even a decent drive, given the cognitive benefits of being able to breathe and reduction in suffering over time.