Why Aren’t My Allergies Improving?

You have an allergy treatment plan -- and you stick to it -- but your symptoms aren’t getting any better. It may be time to see a doctor if your over-the-counter medicines no longer do the trick. Or you may need a new strategy altogether.

These may be reasons why your allergies are worse. Think about how you can work with your doctor to get control of your symptoms.

New allergens are to blame. Allergens are things in the environment that make your immune system overreact. They cause symptoms like sneezing, a stuffy or runny nose, congestion, and itchy eyes, nose, or throat.

There are many kinds of tree, grass, and weed pollens, and you may be allergic to more than one of them. Notice when and where symptoms strike. Are you indoors or out? Is it morning or evening? Are you at home or work? This can tell your doctor a lot.

You’re taking the wrong meds. When you have a stuffy nose, it’s time to reach for a decongestant, right? They do help in the short run. But take them longer than a few days, and you may be in for a case of what doctors call rebound congestion. Antihistamines help symptoms like a runny nose and sneezing, but they may not do much to ease congestion. It might be better to use a nasal corticosteroid, which treats symptoms like stuffiness, sneezing, and runny nose safely long-term.

You’re not taking meds at all. Even though they work, many people stop using nasal corticosteroids because pills are, well, easier. It’s important to take your allergy meds as directed. Some treatments are long-acting, and you’ll need to start them before allergy season kicks off.   If money is an issue, talk to your doctor. She may be able to prescribe something that costs less. If you don’t want to use medicines at all, rinsing your sinuses can help, but realize this may not work for all your symptoms.

It’s your pet. Most doctors don’t expect you to get rid of furry friends when you’re diagnosed with a pet allergy. But it is a good idea to keep them out of your bedroom. You’ll need to clean and vacuum your home often, too. You’ll also have to bathe your pet regularly to keep dander down. And even that may not help with cats. Proteins that cause allergies are especially long-lasting on their fur.

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You can’t avoid the triggers. Most likely, it will take a mix of medicine and changes to your behavior and environment to help keep your symptoms at bay. You may not be able to do it all, but every little bit helps.

To limit exposure to pollens or outdoor mold:

  • Change the filter in your home’s heating and cooling systems often.
  • Keep doors and windows closed.
  • Stay indoors when it’s dry and windy or at the times of day when pollen counts are highest.
  • Run the air conditioning in your car and at home.
  • Try a dehumidifier in rooms that get swampy.
  • Use a HEPA filter air cleaner in your bedroom.
  • Wear a mask when you rake or mow, or hire someone else to do it.

To keep allergens in check indoors:

  • Allergy-proof your bed clothes, mattresses, and pillows.
  • Keep pets off the furniture.
  • Vacuum often. Better yet, remove carpeting throughout your home, especially in the bedroom.
  • Wash linens frequently in hot water.

You relocated. Did you move or change jobs? A new address might also come with new pollens. If you live near a highway or have a long commute, you’ll be exposed to exhaust for longer periods, too. Even the cleaning products at your office or the dust and mold in an older building can cause a condition known as occupational allergic rhinitis. 

You’re a party animal. Smoking and exposure to secondhand smoke can make your allergies worse. Smoking only in certain rooms, opening windows, or using fans and air fresheners won’t help. Only stopping or being in smoke-free places will ease your symptoms. Alcohol can also boost your response to pollen.  That’s because beer, wine, and liquors have high levels of histamines, the chemicals your immune system releases that cause allergy symptoms. Drink less or not at all when pollen counts are high.

You may need immunotherapy. If you don’t get relief from medicines alone, it might be a good option for you. This long-term treatment exposes you to what you’re allergic to. Over time, it can reduce or prevent your allergy symptoms. It could stop your body from overreacting to allergens all together.

It’s something else. Your nose may be built in a way that leads to congestion. Or you may have a chronic sinus infection. It could even be nasal polyps -- growths inside your nose. If your doctor can’t find an outside trigger, she may refer you to an ear, nose, and throat specialist. These doctors diagnose and treat sinus and related conditions.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on February 01, 2017

Sources

SOURCES:

Victoria Smith, MD, associate medical director, St. Charles Parish Hospital and primary care, Ochsner Medical Center, Kenner, LA.

Sandra Hong, MD, staff allergist, Cleveland Clinic, Cleveland, OH.

PubMed Health: “Hay Fever and Dust Mite Allergies: Overview.”

Asthma UK: “Pollen,” “Sensitivity to Histamine and Other Vasoactive Amines.”

Mayo Clinic: “Allergy Medications: Know Your Options,” “Hay Fever.”

American College of Allergy, Asthma & Immunology: “Allergies: Who Has Allergies,” “Types of Allergies: Allergic Rhinitis.”

National Institute of Environmental Health: “Cigarette Smoke.”

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