Allergies
Seasonal allergies, hay fever, allergic rhinitis, environmental allergies
Chronic conditionAn immune overreaction to harmless things in the environment, such as pollen, dust mites, mold, or pet dander.
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.
Common signs
- 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
How it's usually treated
- 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
Related conditions
Asthma
Long-term inflammation of the airways that makes them swell, tighten, and fill with mucus in response to triggers, causing wheezing and shortness of breath.
Learn more →Skin conditions
Common long-term skin conditions that cause breakouts, rashes, redness, or itching. Hormones, immune activity, and the skin barrier all play a role.
Learn more →Chronic spontaneous urticaria
Hives that appear on their own, without a clear trigger, most days for 6 weeks or longer. In many people, autoantibodies drive the reaction.
Learn more →
Wondering if your symptoms fit a pattern?
Dr. Lesher is a naturopathic doctor who specializes in women's autoimmune and chronic conditions. Since 2020, she has helped more than 900 patients overcome and heal from their conditions.