Many people associate fall allergies with piles of wet leaves. Truth is, the barrage of runny, stuffy and itchy noses and eyes, sneezing and wheezing that make millions of Americans miserable each fall begins at the end of summer when the ragweed blooms. Ragweed pollen is by far the most common autumnal culprit, although mold spores that grow in piles of wet leaves also prove troublesome for many. When plant growth is "supersized" by extra wet and rainy summers, the fall discomforts that follow are even worse.

While many people turn to the array of conventional treatments of prescription or over-the-counter antihistamines, there are a growing number of allergy sufferers who would prefer to avoid the use of pharmaceutical drugs. For tips on how to cope with fall allergies pharmaceutical free, I consulted Robert S. Ivker, DO, past president of the American Holistic Medical Association and author of Sinus Survival: The Holistic Medical Treatment for Allergies, Colds and Sinusitis (Tarcher/Putnam). He shared a wealth of strategies for beating nasty allergy symptoms...

For those who want to avoid the uncomfortable side effects of antihistamines, Dr. Ivker recommends a wide variety of supplements that act as "natural antihistamines." Work with your doctor or someone properly trained in natural treatments to find the combination that works best for you. According to Dr. Ivker, those that are most highly effective are...

Euphorbium nasal spray. According to Dr. Ivker, this homeopathic remedy may help reduce sinus pressure and allergy related headaches while it improves breathing as part of a natural treatment plan. It is available at most health food stores.

Vitamin C. Take as ester C or the ascorbate form at high levels (3,000 to 6,000 mg/day) to help reduce inflammation caused by allergies.

Grape seed extract. This herb, with strong antioxidant and anti-inflammatory properties -- should be taken in dosages of 100 mg to 300 mg daily, though sometimes more may be used depending on the individual. It is best taken first thing in the morning on an empty stomach.

Stinging nettle. An average dose consists of 300 mg of the freeze-dried herb in capsule form three times daily.

Quercetin. This bioflavonoid, which is usually found in red wine and onions, should ideally be started before the allergy season begins and continued throughout the season. For optimal absorption, take it with the digestive enzyme bromelain and on an empty stomach. The total daily dosage of quercetin is 1,000 to 2,000 mg divided into three to six doses.

Homeopathic remedies. There are several homeopathic "allergy" remedies in tablet form that can be taken in conjunction with some or all of the above. These are also best taken on an empty stomach several times a day.

Nazanol and Sinupret. These products are combinations of Chinese herbs that are highly effective in reducing inflammation of the mucous membranes, which lessens hypersensitivity and decreases allergy symptoms, explains Dr. Ivker. Both are available through health-care practitioners and should be used under their supervision.

Caution: Because these therapeutic doses often exceed standard recommendations, it is best to consult your health-care practitioner before taking them.

Good nasal hygiene can also help reduce allergy symptoms by removing the pollen and reducing inflammation and hypersensitivity of the mucous membrane. Dr. Ivker recommends the following daily practices...

Saline spray. Saline spray -- preferably one containing aloe vera - can be used frequently throughout the day, especially in the early morning when the pollen counts are highest. Pollen particles rise during the heat of the day and allergy symptoms are generally not quite as severe.

Steam inhalation. Steam acts as an effective decongestant and is best delivered with a device called a steam inhaler that can be found in most pharmacies. Adding a medicinal eucalyptus oil to the steam helps to reduce inflammation. Practice three or four times daily, preferably followed by nasal irrigation.

Nasal irrigation. There are a wide variety of irrigation methods -- Neti Pot, SinuCleanse and perhaps the most effective is the HydroPulse Nasal Irrigator. Irrigation is best after steaming, three to four times daily.

• Reduce or eliminate milk and dairy products, which can often increase mucus drainage.
• Avoid sugar, which multiple studies have shown can weaken immunity.
• Eat a variety of fresh fruits and vegetables, organic non-gluten whole grains (brown rice, quinoa, millet, amaranth), beans, legumes, nuts and seeds. Choose nondairy sources of protein such as fish and organic chicken or turkey.
• Drink plenty of bottled or filtered water. Increased water intake helps hydrate the mucous membranes and thin the mucous, making it easier to drain, explains Dr. Ivker. The average daily recommended amount for adults is a half-ounce per pound of body weight.