Why fall allergies can be so frustrating

'Tis the season for the flu — but you should also be wary of allergy flare-ups.

The fall is a big allergy season, according to Dr. Purvi Parikh, NYU Langone Health allergist and immunologist.

"So in the spring, there's tree and grass pollen in the air. In fall, the ragweed pollen is the big culprit," Parikh said. "This is important because a lot of times people think they're sick — they're coming down with a cold or bronchitis — when it's actually their allergies or asthma flaring up."

The Role of Fallen Foliage in Causing Allergies

The foliage this time of year further complicates things, according to Dr. Dean Mitchell, a clinical assistant professor with Touro College of Osteopathic Medicine.

"We've had a tricky fall — we've had sort of like this Indian summer. So that gives it more time for the mold to increase in the air," Mitchell said. "Typically, when mold when freezes, it's gone. A lot of people don't realize when the leaves are on the ground this time of year and they start to decompose, they spew up mold spores in the air and mold spores cause a lot of allergic reactions and respiratory issues."

Mitchell said many things can happen with mold.

"These type of molds that are outdoors tend to cause allergic reactions. They're not, fortunately, dangerous molds, but they can cause uncomfortable symptoms. The dangerous molds that I see in my practice tend to be the indoor molds when people have had water damage, like when we have those hurricanes or nor'easters and people get water damage in their home," Mitchell said. "They should really pay attention because when water sits around for any amount of time, some of the really bad molds accumulate and that causes a more toxic reaction."

If you have an allergy or are sensitive to mold, you want to avoid raking leaves and using leaf blowers because you can even have a respiratory reaction like asthma. So you might want to even consider staying inside.

"The tricky thing is with mold, it can be delayed," Mitchell said. "But a few hours later that night, you may be having trouble breathing and saying, 'What's going on? I don't have a fever. I don't feel well.' And it's due to that mold exposure." 

Do You Have Allergies or an Infection?

It is an altogether tricky time of year trying to avoid COVID and the flu. Here's how you know you are dealing with allergies. 

"One of the main differences, typically, is fever," Mitchell said. "You tend to get a fever with the infections where you don't get with the allergies. So that's an important differentiator." 

Parikh added that you should stay up-to-date on your vaccines, keep washing your hands, and — believe it or not — staying masked actually helps for both allergies and infections. 

"One rule of thumb is usually allergies are a little bit more itchier — meaning itchy ears, throat. A lot of the symptoms are very similar — like nasal congestion," Parikh said. "Sore throat, coughing. Usually the cough with allergies is dry but if you have an infection, you cough stuff up." 

How to Get Allergy Relief

If you are dealing with allergies, relief is available. 

Parikh recommended an over-the-counter nasal spray, such as Flonase, and an over-the-counter antihistamine like Cetirizine, Zyrtec or LevoCetirizine, which are longer-acting than Benadryl and also don't cause drowsiness.

"But if you're having any chest symptoms like coughing, wheezing, or chest tightness, don't try to remedy or cure or treat that on your own because those could be signs of asthma, which can be very dangerous — even be deadly," Parikh said. "We still have 10 deaths a day for asthma in this country."