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Allergic Rhinitis (Nasal Allergies, Hay Fever)

Allergic rhinitis, commonly known as hay fever, is the most common allergic disorder affecting approximately 20% to 25% of the population. The most frequent symptoms are nasal congestion, itchy runny nose, itchy runny eyes, and fits of sneezing. Other frequently accompanying symptoms are headache around the eye area, drainage in the throat, fatigue, and lack of energy. There can also be intense itching of the throat and deep in the ears. The term hay fever is really a misnomer in that it is rarely due to hay, and there is no fever associated with it even though patients feel feverish as the result of the effects of histamine on the blood vessels causing them to dilate and feel warm.

Allergic respiratory symptoms are a result of histamine release along with other chemicals that are either preformed or formed in allergy cells as a result of an antigen antibody interaction.

The job of the allergist is to determine whether the above symptoms are due to allergies or not. Allergic rhinitis is typically classified as seasonal (intermittent) or perennial (persistent), or both. Frequent triggers of true hay fever symptoms include the pollens from grass, tree, and weeds, house dust mite, mold spores, and animal dander. If the above described symptoms are triggered by cleaning one’s home, playing with pets, mowing the grass, etc., then there is high likelihood that symptoms are due to allergies. If your doctor cannot make a correlation of your symptoms with the above triggers, then you need to start thinking outside the allergy box.

The correct diagnostic term for nasal symptoms not due to allergies is non-allergic or vasomotor rhinitis. We don’t understand the mechanism of this condition totally. As the name applies, it is not on an allergic basis, that is to say an antigen antibody interaction. Triggers of non-allergic rhinitis include irritants such as tobacco smoke, chemical odors, cold air, strong perfumes, etc.

Other conditions to consider in people with symptoms of a stuffy nose are hypothyroidism (low thyroid), nasal polyps, tumors (cancer), foreign bodies, infection, and deviated nasal septum. There is also another condition that goes by the acronym N.A.R.E.S. which stands for nonallergic rhinitis with eosinophilia. This means that a person can have all of the symptoms of allergies but are skin test negative, and yet paradoxically have an abundance of allergy cells called eosinophils in their nasal mucus. This condition responds nicely to intranasal steroid sprays.

The nose is the center of the universe to an allergist. If a person does not describe classic nasal symptoms, and for instance only complains that ears or eyes bother them, then the likelihood of symptoms being due to allergies is lessened.

Recent News

Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies
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Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies

The Asthma and Allergy Foundation of America (AAFA) released Feb. 23 its annual Allergy Capitals™ report for 2021 which identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the United States. Oklahoma City was ranked ninth. Scranton, Pennsylvania took the top spot for 2021.

Cities are ranked based on three factors: spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists. Richmond, Virginia held the #1 title in 2020. The top 20 Allergy Capitals™ for 2021 are: 1. Scranton, Pennsylvania; 2. Richmond, Virginia; 3. Wichita, Kansas; 4. McAllen, Texas; 5. Pittsburgh, Pennsylvania; 6. Hartford, Connecticut; 7. Springfield, Massachusetts; 8. New Haven, Connecticut; 9. Oklahoma City, Oklahoma; 10. Bridgeport, Connecticut; 11. Albany, New York; 12. Virginia Beach, Virginia; 13. Buffalo, New York; 14. San Antonio, Texas; 15. Dayton, Ohio; 16. Riverside, California; 17. Las Vegas, Nevada; 18. Memphis, Tennessee; 19. Dallas, Texas; and 20. Louisville, Kentucky. Tulsa, Oklahoma was ranked 21.

“Allergies are a serious public health concern. More than 24 million people in the U.S. have seasonal allergic rhinitis, more commonly referred to as hay fever. Pollen allergies are a major cause. AAFA’s Allergy Capitals™ report helps more Americans make sense of the impact on individual and community health,” says Kenneth Mendez, CEO and president of AAFA. “Two notable parts of our 2021 report include the effect of COVID-19 and climate change on seasonal allergies. In 2020, fewer people felt the impact of pollen allergies. This is likely due to COVID-19 restrictions with more people staying indoors. But climate change continues to cause longer and more severe allergy seasons. If we don’t slow down the cycle, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Seasonal pollen allergies cause nasal, sinus, and other symptoms each spring through fall. Pollen can also trigger asthma attacks. Tree pollen season starts as early as January in some parts of the U.S. and continues through summer. In the fall, weed pollen including ragweed, causes symptoms. But relief is possible with the right treatment and by managing contact with pollen. Oklahoma City just had several allergy alert days in March for cedar and elm tree pollen which is always problematic in the winter months.

“It’s important people with seasonal allergies prepare. They should try their best to reduce exposure to pollen,” says Dr. Mitchell Grayson, chair of AAFA’s Medical Scientific Council and Director of the Division of Allergy and Immunology at Nationwide Children’s Hospital and The Ohio State University. “Schedule an appointment with your allergist to work on a treatment plan together to help reduce allergy symptoms when prevention is not enough.”

Treatment options include over-the-counter or prescription allergy medicines. Medications are most effective when started before allergy season begins.

“If medicines are not helping, it is important to establish care with an allergist to discuss what treatment options are best to reduce your allergy symptoms and attacks,” said Oklahoma Allergy & Asthma Board Certified Allergist (OAAC) Dr. Laura Chong.

The Allergy Capitals™ ranking is an annual research and educational project of AAFA, designed to help patients recognize, prevent and safely treat allergy symptoms. Through this ranking, AAFA raises awareness about the impact of seasonal allergies and provides helpful information designed to improve the quality of life for people who experience them. The ranking is based on local spring and fall pollen levels, use of allergy medication and the number of board-certified allergists in each metro area. Visit allergycapitals.com to see the full list, study methodology and learn more about allergy diagnosis, prevention and treatment.

To see the complete, 100-city list go to allergycapitals.com. The report lists overall annual rankings and breaks down a seasonal ranking for spring and fall.

The post Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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