Is it a cold or allergies that ail you?
It's early spring and you have a runny nose.
Your throat is scratchy and sore, your head aching from sinus pressure.
What's going on here? Is it another cold — or is it allergies? It's so hard to tell.
"You are not alone," says Adam Williams, an allergy specialist with Bend Memorial Clinic. "I think it is even hard for physicians examining and even allergists to make that distinction. It's very hard to distinguish between colds and allergies in the acute setting."
While Williams concedes that it's difficult, he adds that several clues can help people suffering from symptoms — or the doctors trying to treat them — figure out the culprit.
"The biggest one is (looking at) what is pollenating at the time," he said. "I think of the pollens as having a specific season."
For example, right now Crook County and the rest of the Central Oregon region is smack dab in the middle of juniper pollen season, Williams said. It typically starts in March and stretches into late April. Sometimes during a mild winter, such as this one, it can even start in late February, however the pollen levels tend not to be as high.
Right around the time juniper pollen dies down for the year, different deciduous tree pollens such as birch, cottonwood and maple fill the air. Those pollens, which are less prevalent in Central Oregon, tend to stick around through May. But just as they fade away, grass pollen takes its place. More locals tend to be affected by this particular pollen that sticks around from late May until July.
Given these specific seasons and their regularity, Williams said he tends to rule out symptoms if they emerge in months like December. But if a person experiences them during the spring months when certain pollens are prevalent, particularly if it happens the same time of the year every year, allergies are more likely to blame.
However, pinning the symptoms down to a particular time of year is not enough. Duration of symptoms should also be considered.
"Unfortunately, within the first two or three days, (cold and allergy symptoms) can seem very similar," Williams said, "but as the symptoms continue beyond what we typically expect for a cold — seven to 10 days before you start to improve — that argues for allergies."
Also, it helps to scrutinize the symptoms since some tend to suggest allergies over a common cold. Williams notes that some symptoms have a lot of overlap — runny nose, stuffy nose, not feeling well, sneezing, postnasal drip and sinus pressure. However, itchy eyes strongly suggest allergies are to blame.
"Your eyes can be affected if you have a cold, but if there is intense itching, tearing or redness of the eyes, that tends to be more allergy (related)," he said.
But even with all of these clues at his disposal, Williams admits he is often fooled by people's symptoms and needs to conduct a skin test to make an accurate diagnosis.
This spring, Williams said that the pollen levels have been relatively low compared to most years. However, that does not suggest that people are going to suffer less than years when levels are higher.
"Part of the problem is that people have good years and bad years that are independent of the pollen levels," he said. "There are dynamics that can make your body more sensitive in one year versus a previous year."
Those dynamics include higher emotional stress, more time spent outdoors and even the amount of recent illnesses suffered, which Williams said can make a person more susceptible to allergens.
The good news for those who are suffering from allergies is that several medicines are known to provide relief. Refined antihistamines like Claritin, Zyrtec and Allegra work well, although Williams believes the most effective medicines are nasal sprays like Flonase, RHINOCORT or Nasacort.
"When properly used, these nasal sprays really make a difference for allergies," he said.