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What causes your fall allergies? It could be ragweed, mold

With cooler temperatures and the return of students to school, come those dreaded fall allergies.

But fall allergy triggers are different than spring, the season known for runny noses and watery eyes.

In and around the Columbus area, fall allergies start showing up in mid-August, said Premier Allergy & Asthma allergist Dr. Summit Shah. Spring allergies are particularly severe due to grass and tree pollen, while fall allergies due to weed pollen are increasingly mild.

“We are in the valley and we have a lot of trees,” he said. “Also, as we become more industrialized, we remove a lot of ragweed plants, so I feel like our falls are getting a little milder than our spring symptoms.”

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Ragweed in particular is a big trigger in this area at this time of year, along with mold that isn’t seen as much in the spring, Shah said.

“We see patients suffering not only from ragweed, but also from Russian thistle, pigweed… goldenrod, many types of mold, and then also with the fall of the temperature, it’s a really bad trigger for asthmatics,” Shah said.

But the severity of seasonal allergies also depends on the individual, said Dr. Chris Brooks, assistant professor and physician specializing in allergies and immunology at Ohio State University’s Wexner Medical Center. Some people are allergic to things like dust mites, cat and dog hair, and indoor mold all year round. Others may have more severe symptoms in the spring, summer, or fall.

“Symptoms are determined by how each person reacts to the allergen,” said Brooks, who practices at Wexner Center’s Eye and Ear Institute near Grandview Heights. “A person can have bad allergies in the fall, but not so bad in the spring and vice versa. That’s why it’s really helpful to figure out what specific thing you’re allergic to.”

While spring allergies tend to be more severe in Greater Columbus, fall allergies are also prevalent, said Dr. Summit Shah, allergist at Premier Allergy & Asthma.

Doctors recommend comprehensive allergy testing to better understand and treat symptoms, which can include sneezing; coughing or wheezing; runny nose and watery eyes; congestion; itchy eyes, nose, throat or skin; drainage; and tired.

“If you have mild to moderate symptoms, you can usually get away with just over-the-counter medication,” Shah said. “But if you have persistent symptoms in the fall, like many of the patients we see, we recommend allergy testing.”

An allergist can administer allergy skin testing, which involves placing a small amount of allergenic substances on the skin all at once and checking for allergic reactions. The skin test does not involve needles. Instead, the provider will use a small plastic device that applies allergens with a small scratch or prick.

Allergists also offer spirometry and blood tests to diagnose symptoms.

Treatments can also vary. There are several options for severe symptoms, including prescription medications, allergy shots, and immunotherapy, which can completely eliminate an individual’s allergies. Shah said 30% to 40% of Premier patients undergo immunotherapy treatment.

“Once we find out what you’re allergic to, we can actually make your body ‘non-allergic’ to it by giving you small doses,” Shah said. “You can actually get small increases in the thing you’re allergic to over time and over the course of a few months.”

Treatment consists of receiving injections and can be done in one or more appointments over six months up to a year.

Immunotherapy may be an option for people who dislike taking medication or the side effects that come with it, Brooks said. Wexner Medical Center also offers sublingual immunotherapy, which is administered orally and can be completed at home.

As seasonal allergies appear, there are also things you can do to reduce your symptoms at home. Brooks recommends showering after exposure to outdoor allergies and reducing outdoor exposure.

“It’s not that we want people if they’re indoors all the time, but if you can spend more time indoors it can be helpful, especially with the windows closed,” he said. Brooks.

He also suggests oral and nasal antihistamine medications and nasal irrigation devices..

“They can either use different devices to wash their nose and sinuses with things like distilled water or boiled water that’s been cooled to room temperature,” he said. “And it can clean up different pollens and debris.”

Shah also suggests using nasal sprays and allergy medications before symptoms start.

“It’s always good to be one step ahead of the game,” he said.