Many allergy sufferers have experienced an early start to their 2012 outdoor allergy symptoms. The unusually warm and shortened winter ushered in a wave of late winter pollen and mold. Although spring officially started March 20^th this year, allergy symptoms from outdoor triggers began several weeks prior to this date. What does this mean for the rest of the year?

Predicting how bad seasonal allergies will be is not that easy since heavy rain can rapidly cleanse the air and foster brief periods of relief for those with seasonal allergies. But the combination of an unseasonably warm winter, wide swings in temperature, and brief stints of rain can spell trouble for millions of people who have pollen or mold allergies.

Yes, if you haven't started taking your allergy medications for seasonal allergic rhinitis (SAR) it's time to start. Allergy experts have previously advised starting antihistamines and prescribed nasal sprays several days before outdoor triggers show up. For many areas in the Midwest and Northeastern United States it means starting daily allergy medications by the middle of March, in preparation for tree pollen.

Such a plan failed to work this year for reasons stated above. My office was busier in February likely because of the early emission of Elm tree pollen (one of the first trees to pollinate in the spring). What isn't realized is that we may currently be experiencing the set-up punch (tree and mold pollen). The knock-out punch will come in late April when grass pollen bursts on to the scene (for those allergic to grass pollen). The early spring triggers may be priming you for worse allergy symptoms when grass begins to pollinate (usually by May in the Midwest, but possibly earlier this year).

What Can You Do to Avoid the Knock-out Punch?

Although many people missed the opportunity to use preventive measures to avoid early spring allergies, an early start in preparing for grass season may avert further suffering. Here are some tips on what you can do:

• If you are already taking a long-lasting antihistamine (for example Allegra or Zyrtec or Claritin), avoid missing daily doses or taking them as needed (just when you have active allergy symptoms such as sneezing or runny nose). Regular daily dosing may better block the effect of histamine release when allergy triggers are inhaled.

• 2) A prescribed nasal spray steroid (for example Flonase, Nasonex, Nasacort, Rhinocort Aqua, Veramyst or Omnaris) is cornerstone to SAR management in this millennium. Ask your doctor for a prescription if you don't have one. An alternative would be an antihistamine based nasal spray (such as Astelin, Astepro or Patanase). Occasionally both types of nasal sprays are recommended.

• 3) Have your nasal spray technique checked at least twice each year. I can almost always identify flaws in the use of nasal sprays which may considerably impact the effectiveness of the medication.

• 4) Review the results of your allergy skin test with your doctor in order to assure that you have taken adequate steps to reduce the impact of indoor triggers (dust mites, mold, pet dander...). If you have not had allergy tests ask about getting them.