Frequently Asked Questions about Fall Allergies

What causes allergies in the fall?

In the Birmingham area, ragweed pollen and outdoor mold cause most fall allergy symptoms. Ragweed is a plain green plant with small, dull flowers that grows in disturbed soil along roadsides and at the edges of fields. It's often confused with goldenrod, the bright yellow plant that blooms along roadsides at the same time of year. Goldenrod rarely causes allergy symptoms, though. Its pollen grains are heavy and sticky, so bees carry them from flower to flower, and very little of that pollen gets into the air you breathe.

Ragweed pollen travels by wind instead. The plant starts releasing pollen in mid-to-late August, when the nights begin to grow longer. Its flowers open in the morning, and as the air warms and dries, they release pollen grains light enough for wind to carry long distances. As a result, you can react to ragweed even when there aren't ragweed plants close to your home.

Outdoor mold grows in soil and decaying plant matter, and it needs moisture to thrive. Alabama's humidity often lasts well into the fall, and piles of fallen leaves hold that moisture close to the ground, so mold has both food and water through most of the season. As it grows, mold releases tiny spores into the air to reproduce, and those spores trigger allergy symptoms the same way pollen does.

How long does fall allergy season last in Alabama?

Fall allergy season in Alabama starts before the official first day of fall and usually ends shortly before Thanksgiving. Ragweed starts flowering at about the same point every year because it responds to shorter days rather than temperature. As an annual plant, it lives for a single growing season and keeps releasing pollen through each temperature swing until the first frost kills it. The date of that first frost varies from year to year, so some fall allergy seasons end earlier than others.

Mold can stay active for a few weeks after that frost if the weather stays damp, though colder temperatures slow its growth. Once outdoor allergens subside, indoor allergens such as dust can keep causing symptoms through the winter.

Can seasonal allergies cause a sore throat or cough?

Seasonal allergies can cause a sore throat and a cough when mucus drains from the back of your nose into your throat. During an allergic reaction, the lining of your nose makes extra mucus that's often thicker than usual. It drains down the back of your throat, especially while you're lying down at night. The mucus coats the back of your throat and irritates its lining, so you may wake up with a scratchy, sore throat that feels like the start of a cold. The same irritation sets off your cough reflex as your body tries to clear the mucus.

Because these symptoms overlap with cold symptoms, a few differences help you tell them apart. Allergies tend to cause itchy eyes, nose, or throat, and symptoms continue as long as you're around the allergen. Colds, however, can cause a fever, and symptoms usually improve as your body clears the virus.

Are my seasonal allergies making me tired?

Fatigue is complicated and can have any number of potential causes. However, seasonal allergy symptoms can contribute to fatigue. When your immune system treats pollen as a threat, mast cells release histamine, which causes sneezing and congestion, along with cytokines, which are proteins that call other immune cells into the response. Cytokines also signal your brain to slow down and conserve energy, creating the same heavy, worn-out feeling that comes with a cold.

Allergy symptoms can also break up your sleep. When the lining of your nose swells, breathing through it at night gets harder, and mucus draining down your throat can wake you with a cough. You may wake briefly many times without remembering it, so you get less restful sleep even after a full night in bed.

Some allergy medications also cause drowsiness. Histamine helps keep your brain alert, and older antihistamines, including many nighttime allergy and cold formulas, cross into the brain and block that signal. Newer antihistamines reach the brain less easily, so they tend to cause less drowsiness.

If your fatigue lasts or makes it hard to get through your day, talk with your primary care doctor. Your provider can help sort out whether allergies, a medication, or something else is behind it.

Why are my seasonal allergies worse in the morning and at night?

During the day, gravity helps mucus drain from your nose and sinuses. When you lie down, that mucus pools in your nasal passages or drips onto the back of your throat, so congestion and throat irritation begin to build as soon as you get into bed or settle in for a nap.

Your bedroom also keeps you close to allergens for hours at a time. Dust mites live in pillows and bedding. Pollen collects on your hair and clothes during the day and comes into bed with you, and on the first cool nights of fall, open windows let more pollen drift inside. By morning, you're feeling the effects of all that nighttime exposure. Ragweed pollen counts also run highest in the early-to-mid morning, so stepping outside can bring on symptoms right away.

You can cut down on nighttime exposure by washing your sheets and pillowcases regularly, showering before bed to rinse off pollen, and raising your head slightly while you sleep so mucus drains more easily.

Are my allergies turning into a sinus infection?

Allergies that cause ongoing congestion can lead to a sinus infection. Your sinuses are air-filled spaces in the bones of your face, and they drain mucus into your nose through small openings. During an allergic reaction, the lining of your nose swells. That swelling can narrow or block those openings, so mucus gets trapped in the sinuses and gives bacteria a place to grow.

A sinus infection feels different from allergies. Pain and pressure build around your cheeks and forehead, and you may have a headache or a fever. Allergy drainage tends to stay clear and thin, while drainage from a sinus infection often turns thick and yellow or green.

See your doctor if your symptoms last longer than 7 to 10 days, or if they start to improve and then get worse again. You should also visit an urgent care clinic or call your primary care doctor if you have a high fever, severe facial pain, or discomfort that keeps you in bed for more than a day or two.

Do allergy symptoms get worse when you turn on the heat?

Your heating system can make allergy symptoms worse, especially the first few times it runs each fall or winter. In Alabama, the first morning cold enough to switch on the heat feels like a small celebration, because it means that summer is finally over. That first run often brings a burnt, dusty smell from dust and debris that settled on the heating system over the summer and burns off as the system warms up. Unfortunately, if you can smell it, you're also breathing it. At the same time, the system pushes out dust and mold spores that collected in the ducts and on the filter, sending them through your house all at once. A fresh air filter before the first cold snap cuts down on what the system blows into your home.

Forced-air heat keeps air moving through your home as long as it runs. Dust, pet dander, and pollen stay airborne instead of settling onto floors and furniture, so you keep breathing them in.

Heated air is also dry. Your nasal lining relies on a thin, moist layer of mucus to trap particles before they reach deeper into your airways. Dry air dries out that layer and irritates the tissue underneath, so your nose reacts more easily and traps allergens less effectively.

The first heat of the season usually arrives while ragweed pollen is still in the air. As a result, you're potentially dealing with outdoor and indoor triggers at the same time.

When should I see a doctor about my allergies?

You can see a doctor any time allergy symptoms concern you. An urgent care doctor can see you when your symptoms flare up, and your primary care doctor can see you by appointment.

You can also see your doctor before allergy season begins. If you're dreading another season of switching between over-the-counter medications, talk with your primary care doctor before symptoms peak. Your doctor can evaluate your symptoms, check for other conditions that cause similar problems, and build a treatment plan around your specific needs.

Your primary care provider is a good place to start. If your symptoms are severe or persist despite treatment, your doctor can refer you to an allergist. Allergy testing identifies the specific pollens, molds, or other substances that trigger your reaction, so treatment can target them directly.

At MedHelp, our primary care and urgent care doctors help patients sort out what's behind their symptoms and find relief that fits their needs, whether that means treating a sinus infection today or planning ahead for the next allergy season.