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Allergy Symptoms vs Other Respiratory Illnesses

Allergy Symptoms vs Other Respiratory Illnesses

Written By:
Dr. Shuba Iyengar, MD, MPH
Dr. Shuba Iyengar, MD, MPH
After graduating from UC Berkeley, Shuba completed medical school at Duke University, earning her MPH in tandem at UNC. After a research fellowship at the NIH, Shuba completed her residency at Stanford, then fellowship in allergy-immunology at Boston Childrens/Harvard. Shuba returned to the Bay Area to join Dr. Bocian at a large multi-speciality health system where she helped lead an allergy practice. She cofounded Allermi to make expert allergy care more accessible for all. Shuba lives with her husband, a Stanford cardiologist, and twin boys in the Bay Area.

Oftentimes, people have trouble distinguishing between allergies and respiratory illness. The symptoms that we usually see with an upper respiratory infection can be confused with environmental allergies. With colds, you see nasal congestion, sneezing, and sinus symptom and similar symptoms to environmental allergies as well. It's important to make sure you're properly treating your symptoms whether that is with allergies or with another respiratory illness.

What are some signs of allergies that do not overlap with COVID-19?

With allergies, you can often see itchiness, especially of the eyes and nose, that you usually do not see with COVID. 


What are some symptoms people might not realize are allergies?

Sinus symptoms and hacky cough are often caused by allergies. When that person with allergies gets an upper respiratory infection, like COVID, their nose (that is already mildly swollen from allergies) will swell completely closed due to viral inflammation. With the nose swollen shut, all that mucus that wants to come out of the nose cannot. The mucus then goes backwards into their sinuses, or travels to the back of their throat, causing throat irritation or a hacking cough.

Snoring is often caused by pollen allergies as well. This happens because when a person has an environmental allergy, their nose is always a little bit swollen on the inside. It is called nasal turbinate edema. However, many allergy sufferers do not notice any symptoms initially because they are able to compensate. If one nostril is swollen, they can breathe through the other. But if both nostrils become swollen, they will start to breathe through the mouth, often causing snoring and sleeping problems.

What are the most common symptoms that confuse people when it comes to a correct diagnosis?

Nasal congestion, sneezing, and sinus symptoms can both be seen in the setting of environmental allergies and respiratory infections like COVID. However, people with infections can also have fevers, which is usually not seen with allergies.

Does the season you are experiencing symptoms matter?

Yes. Certain environmental allergens, like dust mite and tree pollen, tend to cause more eye symptoms than other allergens. For example, in the spring, when tree pollen is prevalent, many allergy sufferers have significant eye itching and redness. 

Do you recommend taking an antihistamine to see if it will help? Taking a COVID test if unsure?

If a person has significant nasal/sinus congestion or hacky cough, regardless of whether they are suffering from COVID or environmental allergies, they will likely benefit from using a nasal spray that fights inflammation and safely opens up the nasal passages (like the customized allergy superspray we offer at Allermi). This is because their swollen nasal passages (resulting from either viral or allergic inflammation) is causing mucus to go backwards into their sinuses, causing pain and congestion, or traveling to the back of their throat, causing throat irritation or cough.

Antihistamines are not very effective in preventing sinus inflammation or congestion.

What is the danger in ignoring allergy symptoms? 

Ignoring symptoms can lead to mucus build up in the sinuses or throat. This can become a breeding ground for bacteria, leading to sinus infections or bronchitis.

Anything else you think people should know or that you would like to add?

Using a nasal spray that fights inflammation and safely opens up nasal passages (in combination with a saline nasal spray to wash out the sinuses) can be key in preventing prolonged symptoms with respiratory infections and allergies.