Are allergies making you feel sick? Here’s how to find out

(CNN) — Sniffling a bit more than usual? Welcome to spring allergy season in the Northern Hemisphere. Even if you don’t think you have allergies, it’s worth paying attention to those sniffles.

More than 1 in 4 adults and nearly 1 in 5 children have seasonal allergies, according to the US Centers for Disease Control and Prevention. And our allergies may be sticking around longer, because allergy season is starting earlier and lasting longer than before as a result of multiple factors, including climate change.

And it’s getting worse: The pollen count is projected to increase by 200% by the end of this century, according to a 2022 study published in the journal Nature Communications.

With all the changes affecting allergy season, it’s good to confirm what symptoms are associated with seasonal allergies and how to find out if you have allergies to pollen.
Are there other substances that can cause seasonal allergies? Can some people have more of a reaction than others? How should people treat their allergies? And what’s the difference between allergies and viruses, since symptoms can overlap?

To answer these questions, I spoke with CNN wellness expert Dr. Leana Wen, who (like me) has allergies. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

Allergy symptoms

Dr. Leana Wen: Seasonal allergies, also called allergic rhinitis or hay fever, occur when your immune system reacts to something in the environment, such as pollen from plants. Symptoms include runny or stuffy nose, sneezing, coughing, and itching in the nose, throat, eyes and mouth.

CNN: How do I know if my symptoms are due to allergies or a virus?

Wen: It’s not always easy to tell, as the symptoms of allergies can mimic those of a cold.

Generally, allergies follow a seasonal pattern and flare up at certain times of the year.
The symptoms tend to persist for at least a week. People often have similar symptoms when seasonal allergies strike. Itchiness in the nose and throat and red, watery eyes are usually more indicative of allergies than colds.

Colds, on the other hand, are generally shorter-lasting. They tend to be more common in the winter than in fall or spring when allergies tend to peak.

Seasonal allergies do not cause fever. If you have a fever, it is unlikely to be an allergy. Seasonal allergies also tend not to cause a wet cough or body aches and fatigue.

Does testing help to differentiate between seasonal allergies and a cold?

Wen: There are tests to help determine if you have specific viruses. For instance, you can take a rapid home test for COVID-19, and doctors’ offices may recommend testing for influenza or the respiratory syncytial virus, also known as RSV. Patients who are hospitalized also may receive more thorough viral testing, but these viral panels tend not to be recommended for people who are experiencing mild cold symptoms.

Can people find out if they have allergies to pollen, for example?

Wen: Yes. In fact, there are different types of pollen. The common pollens that cause allergies come from trees, grasses and weeds.

Your health care provider can refer you to a specialist physician trained in allergy and immunology to test for these specific allergens. One form of the test is a skin prick test, when a nurse or doctor puts a small drop of the possible allergen on your skin and then pricks or scratches that spot with a needle to see if that induces a reaction. Another form is a blood test looking for antibodies to the allergen.

What else can cause seasonal allergies?

Wen: In addition to pollens, molds also can trigger seasonal allergies in some people. Skin and blood tests can diagnose mold allergies.

CNN: It’s a good thing you mentioned mold because I have a mold allergy. I’ve also tested positive for allergies to dust and milk.

Wen: People allergic to dust are actually allergic to dust mites, which are tiny organisms that feed on house dust and air moisture. They are a very common type of indoor allergen and can trigger symptoms year-round. I, too, have this allergy, as well as seasonal allergies to pollen.

I’m glad you mentioned your milk allergy because we haven’t yet brought up the issue of food allergies. These are not seasonal allergies, as they aren’t related to environmental exposures and can happen year-round. Food allergies also are common. According to the CDC, 6.2% of adults and 5.8% of children have food allergies.

Food allergies can range from mild to extremely severe, even life-threatening. There are also food intolerances, which aren’t actually allergies but colloquially get lumped into this category. For example, as many as 36% of Americans and 68% of the world’s population have lactose malabsorption, characterized by a reduced ability to digest the lactose in milk products. Many people with lactose malabsorption will experience symptoms such as an upset stomach, bloating and gas after drinking milk. These reactions, though, are not immune responses and need to be distinguished from a true milk allergy.

Can some people have a stronger reaction to allergens than others?

Wen: Yes, absolutely. Some people with seasonal allergies may have very mild symptoms for a short time, while others have symptoms that are so severe they interfere with daily life. In addition, patients with asthma and eczema may have their symptoms exacerbated with seasonal allergies.

What are the options for over-the-counter and prescription medications?

Wen: Several treatments can help alleviate the symptoms of seasonal allergies. Common treatments include antihistamine pills that block histamine, a chemical the immune system releases that can cause a variety of symptoms like itching, and nasal corticosteroids, which are sprays that can help with stuffiness.

Some of these medications are available over the counter, and others are available only by prescription. I advise people to check with their health care provider before starting any new medication. It may be that a prescription medication is the best option.

For instance, diphenhydramine, also known by the brand name Benadryl, is an over-the-counter antihistamine that can help relieve some allergy symptoms, but it also causes drowsiness. Other antihistamines do not lead to as much drowsiness and may be better options. There are over-the-counter nasal decongestants like pseudoephedrine, also known by the brand name Sudafed, that can be good for relieving temporary nasal congestion, but they may interact with certain medications and should not be used long-term.

Some individuals may benefit from allergy shots. These can be good options for people whose symptoms are not controlled by pills or allergy avoidance alone, and for people who have especially severe allergic reactions. A specialist in allergy and immunology can advise on whether allergy shots are the right course of treatment for the individual patient.

As for nonmedical treatment, it’s important to reduce exposure to the allergen. If the issue is seasonal allergies due to pollen, pay attention to pollen counts, close windows and reduce time outdoors during peak pollen season. If dust mites are the problem, remove clutter and items that collect dust in the home and wash sheets, pillowcases and blankets at least once a week. There are many online resources for reducing allergens in your home that can help to decrease the impact of seasonal allergies.

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