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Approximately 65 percent of patients diagnosed as having allergic rhinitis and prescribed a nonsedating antihistamine are not allergic.4,8 As allergic rhinitis and non-allergic rhinitis have such similar symptoms but different management, it is imperative to correctly diagnose the cause and select the correct management.9 A blood test can help detect sensitization to hundreds of potential allergic triggers, including pollen, mold, food, and animal dander.
Symptoms can change from day to day, depending on the weather. For example, high humidity can make mold grow quickly, while pollen counts can surge when it’s warm and windy. Other allergic triggers may be involved, too. Learn more about the symptom threshold.
Allergy season depends on where a person lives and what he or she is allergic to. For example:
Spring allergies: In some parts of the United States, spring allergy season can start as early as February and last through the summer. It all depends on geographic location and when grasses, trees, and weeds begin pollinating. March and April tend to be known as high spring allergy season months when most people experience the worst of their symptoms.
Summer allergies: Spring allergy season can continue into the summer months, as grasses and weeds continue to produce pollen.
Fall allergies: The fall season can be especially difficult for people who have allergic sensitizations to mold, as mold spores thrive in damp locations such as fallen leaves, dirt, and rotting wood.10 This time of year is also challenging for those with ragweed sensitization, as ragweed usually begins to pollinate in mid-August and may continue until a hard freeze.11
Winter allergies: Winter allergies can occur if a person is allergic to indoor allergens, such as mold, dust mites, and animal dander, and may worsen during the months of November through January due to increased exposure to these indoor allergens.
A common cold has similar symptoms to seasonal allergies. However, a reaction to a cold is caused by a virus while a reaction to an allergen is the result of the immune system responding to a substance it has deemed a threat. Learn more about head, eyes, ears, nose, and throat symptoms.
Five ways to tell your seasonal allergies from a cold:12
It’s been shown that uncontrolled allergic rhinitis can lead to:13-15
Poorer asthma control in people with asthma (wheezing, breathlessness, nighttime awakenings, limiting daily activities)
Reduced physical, mental, and emotional wellbeing
Reduced sleep quality (waking up at night)
Being constantly tired, and tiring easily, which leads to lowered concentration at work or school and needing more time off, all of which affects job performance or school work
Reduced quality of everyday life, including social life and daily activities
Irritability and social problems in children
It is important to consider testing for allergic rhinitis in people with asthma, eczema (atopic dermatitis), conjunctivitis, sinusitis, polyposis, upper respiratory tract infections, otitis media, and sleeping disorders, as well as in children with learning and attention impairments.
More than 80 percent of people with asthma also suffer from rhinitis, suggesting the concept of “one airway, one disease.”4,16,17 The presence of allergic rhinitis commonly exacerbates asthma, increasing the risk of asthma attacks, emergency visits, and hospitalizations for asthma. It is not clear whether allergic rhinitis represents an earlier clinical manifestation of allergic disease in atopic patients who will later develop asthma or whether rhinitis itself is causative for asthma.17-20
If a patient suffers from allergic rhinitis triggered by pollen and has an allergic reaction that typically occurs upon ingestion of certain foods, he or she may be experiencing Pollen Food Allergy Syndrome (PFAS), also known as Oral Allergy Syndrome (OAS).21
Depending on your unique symptom threshold, i.e., the point at which a person experiences symptoms after being exposed to multiple triggers, some allergy symptoms may occur only at certain times throughout the year. For example, common indoor allergens, such as animal dander and mold, may only trigger symptoms in the fall when a person is also exposed to a seasonal allergen, such as ragweed.
While an insect venom allergy is not technically seasonal, there may be periods of higher exposure to stinging insects during certain times of the year in different geographical locations. It may take several uneventful stings from an insect—such as a bee, wasp, hornet, yellow jacket, or fire ant—for manifestations to appear.
After an initial sting, the immune system of an affected patient may respond by producing Immunoglobulin E (IgE) antibodies. Any subsequent stings can trigger a systemic inflammatory response.22 It is important to correctly identify the culprit insect, as patients can be allergic to one or several species of stinging insects.22 Testing can be used to identify the insects to which a patient is sensitized, which will aid in the selection of the most appropriate treatment.23
It is important to use testing for allergen sensitization to identify the cause of seasonal allergies and help decipher allergic from non-allergic rhinitis. Test results, along with a physical exam and medical history, can ensure that people receive appropriate treatment sooner, as well as helping to reduce avoidable antihistamine use.21,24
The management of allergic rhinitis consists of three major categories of treatment:
A blood test—together with an allergy-focused medical history—may help identify underlying allergen triggers.