When to talk to your doctor about seasonal allergies

Springtime in the Midwest is a beautiful time of year. Snowblowers get stowed away in favor of lawn mowers. Flowers start to bloom. But for about 10 percent of people, spring welcomes back hay fever and the pesky allergens that appear during allergy season.

What causes allergies?

Seasonal allergies offer all the fun of feeling under the weather without having an actual infection. Allergies develop when your immune system recognizes and reacts to an irritant such as pollen. The response from your immune system can cause hay fever – otherwise known as allergic rhinitis – to develop.

"Your immune system, which protects you from invading bacteria and viruses, gets a little confused and starts ramping up the defense when exposed to normal environmental factors. Examples can be tree pollen, pet dandruff and even certain molds. People can feel miserable with their immune system all angry and irritated when it really gets going from allergens," explains Christopher Tookey, MD, Family Medicine, Gundersen Sparta Clinic.

When are seasonal allergies most common?

Allergy season varies depending on your location. In the Midwest, tree pollen is the most common culprit early in the year. As spring turns to summer, grass, ragweed and other weed pollen take over. How you react to those allergens is unique to you.

"Some people are allergic to only one or two allergens and find that they only have allergy symptoms during certain times of the year. These are the people that notice their symptoms coming at the same time every year or when certain seasonal events happen," says Dr. Tookey. "Other people are unlucky enough that they are allergic to more than one thing or allergic to something that is around year-round and suffer all year. Most people notice their symptoms most in the spring and fall here in our area."

How do you know if you have seasonal allergies?

People can experience a wide range of allergy symptoms that vary in severity, including:

• Sneezing
• A runny/stuffy nose
• Watery/itchy eyes
• Pressure behind the ears and face
• Problems with hearing
• A headache
• A sore throat from mucus draining from the nose

What are the best ways to manage allergy symptoms naturally?

Dealing with allergic rhinitis and other allergy symptoms can leave a person feeling quite miserable. Here are some tips for surviving allergy season and managing seasonal allergies:

• Try to do any outdoor activity (e.g., exercise or yard work) early in the morning before the wind kicks up large amounts of pollen. Pollen counts are normally highest in the late afternoon and early evening.
• Avoid touching your face while working outside to reduce pollen getting into your eyes, ears and mouth.
• Shower after activities outside to wash off allergens.
• Keep the windows closed at home and while driving to reduce your exposure to pollens.

What are over-the-counter options for managing allergy symptoms?

When looking to medicines for seasonal allergies, an over-the-counter nasal spray containing a steroid such as fluticasone (Flonase) can help with congestion, a sore throat and even itchy/watery eyes. It’s best to try this treatment first, as it is targeted to the most involved area of the body and has the lowest possible side effects overall. Note: It’s best to ask your pharmacist how to take this nasal spray safely and effectively. 

If a nasal spray is unappealing or doesn't alone control your allergy symptoms, you may want to add a second-generation antihistamine. Cetirizine (Zyrtec), fexofenadine (Allegra) or loratadine (Claritin) are great over-the-counter options. Note: Diphenhydramine (Benadryl) is a first-generation antihistamine. Unlike the second-generation members above, it can cause some drowsiness, so it is not recommended for use during the day. 

What allergy medicines should I watch out for?

There are a few over-the-counter allergy medications that work well in the short term but over time can make nasal congestion worse. Oxymetazoline (Afrin) is notorious for causing worsening nasal congestion long term and isn’t recommended for allergies.

Pseudoephedrine is a decongestant that can be used with caution. It can cause similar risk of continuing worsening congestion and also spike your blood pressure and heart rate. Unfortunately, many people don't realize that pseudoephedrine is inside many over-the-counter medications. Any product with "-D" on the label — like Allegra-D or Claritin-D — has pseudoephedrine in it. It’s best to consult a healthcare provider before using these products.

When should I contact my healthcare provider?

If you feel your allergies aren't responding to some of the safer over-the-counter medications mentioned above – or if you wonder if you could have something other than allergies like an infection, a deviated septum or even heart burn – you should schedule an appointment with your primary healthcare provider.

"As with all medical concerns, any time you have any questions or feel that you aren’t getting good symptom response. Sometimes, other medical conditions mask as allergies and having a visit can help look for this," explains Dr. Tookey. "There are also some great new treatment options your provider can go over with you."

Your provider can review your medical history and perform an exam to confirm if you're having seasonal allergies. Together, you can then review over-the-counter options and discuss prescription medications. Your provider can even discuss if you would be a candidate for allergy testing and shots.

Note: Bring to your appointment whatever medications you have tried before the visit. It’s easier for your provider to help you feel better faster when they know what you've already used.