Talking fall and winter allergies with U of M

MINNEAPOLIS/ST. PAUL (09/21/2023) — As the crisp autumn air ushers in a new season, many people look forward to the beauty of changing leaves and the cozy comforts of fall and winter. However, for those prone to allergies, seasonal changes can bring a different set of challenges. 

John Moore, MD, with the University of Minnesota Medical School and M Health Fairview, shares an introduction to fall and winter allergies, including their causes, common symptoms and effective management strategies.

Q: Can you explain the difference between fall and winter allergies? What are the common triggers for each season?
Dr. Moore: In the fall, the typical allergens are weeds and mold. The most common weed is called ragweed. This usually starts in August and peaks in September. and sticks around until it gets really cold, usually in November or December. The amount of mold in the air can change depending on the weather. If it's rainy, humid or windy, the mold levels can go up. Even thunderstorms can make it worse.

In the winter, when everything outside is frozen, we tend to have allergies to things inside our homes. This includes pets — like cats or dogs — dust mites and cockroaches. Not everyone has to worry about cockroaches—it depends on where you live, though some apartment buildings or schools may have them regardless of your location. 

Q: What is the connection between fall and winter allergies and other respiratory conditions, such as asthma? How do these conditions interact and affect each other?
Dr. Moore: The connection between allergies and asthma is called the “one airway hypothesis.” This means when the nose is inflamed from allergies, it can also inflame the lungs, which can then trigger asthma symptoms. These symptoms might include coughing, feeling out of breath or wheezing. In general, exposure to more allergens makes asthma symptoms worse.

In my work, I aim to manage both allergies and asthma symptoms. If we only address one and not the other, it can still trigger asthma, which is why it’s important to acknowledge the connection between them. About 40% or more of allergy patients also have asthma. When people come in for a diagnosis, we often ask about both conditions because they're often linked.

Q: How can you tell the difference between allergies, colds and COVID?
Dr. Moore: To start, allergies usually bring about itchy eyes, a runny nose, congestion and sometimes a cough. They shouldn't cause a fever. If you have a fever, it's more likely a sign of a viral illness like COVID or a cold. The extreme tiredness that can come with COVID or the flu is uncommon with allergies. While allergies can make you feel a bit tired, it's not the same overwhelming exhaustion you get from viruses. Muscle pains and aches are another sign more associated with viral illnesses like COVID, colds or the flu.

Loss of taste and smell is not something typically seen with allergies. Allergy symptoms also stick around for months if you're consistently exposed, whereas most viral illnesses usually last a week or two before getting better.

Q: What are some strategies for preventing or treating fall and winter allergies? Are there any lifestyle changes or precautions individuals can take?
Dr. Moore: Dealing with fall allergies can be challenging, especially concerning pollen. In the allergy clinic, we suggest using air conditioning instead of opening windows at home and keeping car windows up. If you spend a lot of time outdoors during the fall, it's a good idea to rinse off in the shower before bed to wash away any pollen you might have picked up. 

As for winter allergies, they mainly come from indoor irritants. If you're allergic to dust mites, there are unique covers for mattresses and pillows that can help keep them away. Lowering humidity can also make a difference, as dust mites thrive in humid conditions. Regular cleaning, like vacuuming and using air filters — especially if you're allergic to dust mites or pets — can be beneficial.

There are medications available, many of which you can get over the counter. For example, antihistamines, nasal steroids and eye drops can provide relief. For a more long-term solution, there's allergy immunotherapy — like allergy shots — which work on the root of the problem rather than just easing the symptoms.

Q: What do you find most fulfilling about your role as a doctor and a University of Minnesota faculty member, and how does it contribute to improving your outpatient outcomes?
Dr. Moore: One of the great things about working at M Physicians is the fantastic teamwork among healthcare providers. Thanks to our electronic medical record system, we can easily communicate with multiple providers caring for the same patient. This is especially beneficial for patients with overlapping health issues, as we can tap into the expertise of various specialists. I've been fortunate to receive responses to my messages on the same day, allowing me to make immediate adjustments to their care.

The collaborative effort among specialists, general practitioners and internal medicine providers is truly valuable. Being able to update them on any unexpected findings or changes in a patient's condition helps ensure smooth ongoing care. It can be quite challenging when you're not within the same system, but having a messaging system that allows timely responses has been highly beneficial and rewarding.

Dr. John Moore is an allergy and immunology physician at the University of Minnesota Medical School and M Health Fairview. His clinical interests include asthma, atopic dermatitis and eczema, cough, drug allergy, environmental allergies, food allergies, hives and urticaria and chronic sinusitis. 

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