By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

TREE AND GRASS POLLEN COMMON SOURCES OF SPRING ALLERGIES

Question: It is spring and I am sneezing and my eyes are watering. I have had this in the late summer before, but never in the spring. What am I allergic to? How do I know if this is a cold or an allergy? My head is all plugged up. Is there anything I can take?

Answer: What you describe sounds a lot like “allergic rhinitis.” Some people call this hay fever, when they get it in the late summer or early fall. A runny nose due to allergies is the most common chronic disease in the United State. It affects over 35 million people and causes adults to miss work and children to miss school. Allergies commonly start in childhood and early adolescence, but they can start at any age.

An allergy develops when you come into contact with an allergen, that is, a protein that causes an allergic reaction. These include pollens from trees and various grasses as well as mold, pet dander and dust mites.

Pollens typically cause seasonal allergic rhinitis that lasts for a few weeks. In the northern and eastern parts of the country, spring allergies are usually due to pollen from trees or spring grasses. In the fall, culprits are often the pollen of fall flowering native grasses that are frequently described by the derogatory term “weeds.” Molds, animal dander and dust mites can cause problems all year round.

From whatever source, these allergens cause problems by the same basic mechanism. Your immune system, sensing more danger than these allergens actually present, revs up and produces antibodies that circulate in the blood and attach to mast cells. These cells -- located in greater number in common allergy sites like the nose, throat, lungs and GI tract -- then release histamine and other chemicals. It’s the histamine that causes the symptoms like sneezing, runny nose with clear mucus, nasal congestion, itchy eyes, nose and throat, and watery eyes.

Allergies tend to run in families. It is not uncommon to see other allergic medical problems like eczema and asthma in people with allergic rhinitis.

It’s likely that you have developed an allergy to additional pollens, and that’s why you are having symptoms in the spring this year. I would recommend, however, that you make a trip to your doctor to rule out other possible causes and confirm the diagnosis.

Physical findings of allergic rhinitis are fairly straightforward, such as bluish circles under the eyes (allergic shiners) plus the heavy, clear nasal discharge. But there can be other illnesses that cause a similar runny nose that should be excluded. Allergic rhinitis is not usually associated with thick, or highly colored nasal discharge, sore throat or fever. Problems such as nasal polyps, pregnancy and low thyroid can cause nasal symptoms similar to allergic rhinitis. Many medications, such as aspirin, beta blockers, and oral contraceptives can cause similar symptoms.

Once you and your doctor have decided that you have allergic rhinitis, using antihistamines or nasal steroids can control or prevent many symptoms. Of course, you want to avoid the allergen that is causing the reaction when possible. In some cases, getting “allergy shots” or desensitization therapy is indicated.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.