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Allergies

Seasonal allergies, hay fever, allergic rhinitis, environmental allergies

Chronic condition

An immune overreaction to harmless things in the environment, such as pollen, dust mites, mold, or pet dander.

Illustration of blood cells: red blood cells, four kinds of white blood cell, and platelets
Illustration: Servier Medical Art, CC BY 4.0 (resized; some images adapted)

For education only — this guide can't diagnose you. If these signs sound familiar, talk with a healthcare provider. Book a consult 

What happens

In allergies, the immune system makes IgE antibodies against a harmless substance. On the next exposure, those antibodies signal mast cells to release histamine and other chemicals, causing sneezing, itching, swelling, and congestion. Mast cell activation syndrome is a separate, uncommon diagnosis with strict criteria. It's sometimes suggested without testing, so ask how it was confirmed.

Who gets it

Allergies often start in childhood but can begin at any age. They're more common with a family history of allergies, asthma, or eczema. Some women notice symptoms change with their cycle or pregnancy.

Signs worth getting checked

  • Sneezing and a runny or stuffy nose
  • Itchy, watery, or red eyes
  • Itchy throat, ears, or roof of the mouth
  • Postnasal drip and a lingering cough
  • Dark circles under the eyes
  • Fatigue or poor sleep during allergy season
  • Itchy skin, hives, or eczema flares
  • Wheezing or chest tightness

Labs to ask about

  • Skin prick testing or allergen-specific IgE blood tests
  • CBC with differential (eosinophils)
  • Total IgE
  • Serum tryptase after a severe reaction or if a mast cell disorder is suspected
  • Spirometry if you wheeze or cough often

Treatments your doctor may discuss

  • Avoiding known triggers where possible
  • Steroid nasal sprays and non-drowsy antihistamines
  • Allergy shots or under-the-tongue tablets (immunotherapy), which can reduce allergies over time
  • An epinephrine auto-injector for anyone with a history of severe reactions

Supportive steps to discuss with your provider

  • Rinse your sinuses with saline. Use distilled or boiled water.
  • Use dust mite covers and a HEPA filter in the bedroom.
  • Shower and change clothes after time outdoors on high-pollen days.
  • Fix leaks and damp areas at home to limit mold.
  • Ask whether you're a candidate for immunotherapy if medicines aren't enough.

See a doctor promptly if you have

  • Swelling of the tongue or throat, trouble breathing, or feeling faint after an exposure: use epinephrine if prescribed and call 911
  • Wheezing or shortness of breath
  • Facial pain, thick discharge, and fever lasting more than 10 days
  • Symptoms that disrupt sleep, work, or school despite treatment
Dr. Lesher, ND

Ready to find the root cause?

Dr. Lesher is a Naturopathic Doctor who focuses on autoimmune and chronic conditions in women. Since 2020, she's helped hundreds of patients stop managing symptoms and start healing.

Book a consult now