With the weather getting cooler, you may be thinking your seasonal allergies are behind you.
Not so fast.
Many patients suffer from fall allergies, making them as miserable as those who suffer during the spring allergy season.
What triggers fall allergies? What are some ways to cope? And how can you tell the difference between allergies, the flu, a cold and COVID-19?
Fall Allergy Triggers
There is science that suggests that we have more carbon dioxide in the air than we've had in the past. Also, we have warmer temperatures overall. The result? Longer pollinating seasons for the fall, and people noting an uptick in their allergy symptoms.
Allergies are an immune response to a trigger. When the immune system sees certain proteins, such as pollen, it reacts by producing antibodies that can trigger the release of histamines. This release of histamines causes allergy symptoms.
Ragweed: The ragweed plant is the most common trigger of fall allergies. One ragweed plant can release 1 billion pollen grains, more than enough to cause allergy symptoms. Lamb's-quarters, pigweed, sorrel and dock weeds also cause a lot of fall seasonal allergies. The fall elm is another trigger because it pollinates this time of year.
Mold: Mold also can cause significant fall allergies. Mold grows fast in high humidity and wet conditions, and often accumulates on wet piles of leaves that have fallen from trees. The mold releases spores that become airborne; the most common outdoor mold species are Cladosporium and Alternaria.
Symptoms of Fall Allergies
Symptoms of fall allergies look a lot like symptoms of spring allergies. Symptoms may include:
- Sniffles
- Sneezes
- Runny nose
- Watery and/ or itchy eyes
- Cough
- Congestion
- Scratchy throat
- Dark circles under the eyes (chronic)
Many allergy symptoms are similar to those of the colds, flu, COVID-19 and other viruses. I often get asked how to tell the difference. I tell my patients at Kaiser Permanente that fever is a key differentiator. Allergies do not cause a fever, so if you have a cough, and a fever, you probably have a viral infection. Another distinction is that allergies don't lead to a loss of taste or smell. That symptom is more commonly associated with COVID-19. Allergies also don't cause chills or body aches.
Allergies tend to develop in the first couple of decades of life, so if you are in your 40s, for example, and are experiencing what may be fall allergies for the first time, talk with your physician. More likely, your symptoms are connected to a viral infection.
If you have flu or COVID-19 symptoms and don't have a history of seasonal allergies, get tested for these viruses. It's important to get vaccinated against flu every year and make sure you're up to date with your COVID-19 vaccine and boosters. My colleagues have great tips for managing arms soreness.
Coping with Fall Allergies
There are some simple strategies – what I like to call "home hacks" – that patients with fall allergies can do at home to feel better.
- Keep windows closed. You may feel tempted to let in a nice, cool fall breeze, but opening windows will allow pollen and mold spores to enter the home.
- Shower at night so any pollen that may have gotten on your body during the day is washed off before you get into bed.
- Wear sunglasses outside, even on overcast days. Sunglasses help keep pollen out of the eyes.
- Change into fresh clothes after spending time outdoors.
- Wear a mask outside. An N-95 mask covering the mouth and nose filters out pollen.
- Try a HEPA filter in your vacuum cleaner. Vacuuming with a HEPA filter helps suck up pollen, dust mites and dander in the home.
- Use a dehumidifier. Keep the humidity level below 50 percent.
For many patients, these strategies work well. Others, however, may need to try medications or a saline sinus spray or rinse to get relief. A saline spray is a very gentle approach. When you squeeze it up your nose, it will wash out the pollen pollution in the nose along with mucus while keeping the nasal passages moisturized.
Over-the-counter intranasal steroid sprays are very effective. They take a couple of days to work, so expect to feel better about two or three days after starting to use them. Flonase, Rhinocort and Nasacort are among the common brands.
Antihistamines can help alleviate allergy symptoms. Antihistamines can be taken orally or sprayed up the nose. Claritin, Allegra and Zyrtec are common brands. Most people will not become drowsy when taking these medications since they are considered non-sedating.
Decongestants, such as Sudafed, can help a stuffy nose, but are better used on a limited basis.
Ragwitek is an immunotherapy that we can use to treat ragweed allergy in those with severe allergy. Patients take this medication by placing it under the tongue and allowing it to dissolve before swallowing. A common side effect is an itchy throat for the first week of using it but taking this immunotherapy will greatly reduce their ragweed allergy symptoms. We generally start this 12 weeks before the ragweed season begins and continue it throughout the pollen season. Allergy shots are another form of immunotherapy that can help.
Ragweed Allergy and Food
Some people with a ragweed allergy develop oral allergy syndrome, also called pollen food syndrome. When people are sensitive to certain outdoor pollen, they may experience an itchy mouth, lip or throat after eating certain raw fruits or raw vegetables; some people also experience swelling and inner ear itching.
That is because the proteins in these raw fruits and vegetables look so similar to the pollen protein that when the patient eats the raw fruits or vegetables, the immune system thinks that pollen is being consumed. This reaction is usually immediate but is generally not life threatening.
People who are allergic to ragweed may have allergy symptoms after eating cantaloupe, honeydew, watermelon, zucchini, cucumber or banana. The allergy is worse when ragweed pollen is more prevalent in the air. Immunotherapy will often clear up this problem with raw fruits and vegetables.
When to See An Allergist
Many people are well able to manage fall allergies on their own by trying home remedies. But reaching out to a doctor is a good idea if you are curious about whether you have allergies; whether you find your allergies debilitating and affecting your quality of life; and whether you are trying to determine whether you have allergies or are sick.