Allergy Meds Not Working? It May Not Be Allergies at All
Health and Well Being
January 30, 2023
Allergy Meds Not Working? It May Not Be Allergies at All
Woman on couch wrapped in a blanket

Between the runny nose, sneezing, watery eyes and scratchy throat, allergies are no fun. To make matters worse, North Texas has had a longer-than-usual allergy season this year.

However, if you’ve been taking allergy medications with no relief in sight, the brand or type of medication may not be to blame — it may not even be allergies at all. The culprit might be something known as nonallergic rhinitis.

What is Nonallergic Rhinitis?

Allergies are caused by an overactive immune system that sends your body into defense mode when harmless substances, such as dust or pollen, are mistaken for germs. Your body releases chemicals known as histamines to attack the allergens — just as it does when fighting a cold. This can cause swelling in your nasal passages, a runny nose, coughing, sneezing and itchy, watery eyes, which many associate with an allergic response.

On the other hand, if there is nothing to cause your immune system to go into defense mode, then there is no reason for your body to release histamine. Therefore, if there is no histamine present in your body, antihistamines can’t relieve symptoms.

If you’re taking antihistamines and not finding any relief from symptoms, it may not be a “bad allergy season,” or that something is wrong with the brand of medication you chose. Instead, it may be something nonallergic that you’re reacting to, especially since nonallergic rhinitis shares the same symptoms as seasonal allergies.

What Causes Nonallergic Rhinitis?

So, if it’s not allergies, what’s causing it? There can be various triggers, including environmental, such as pollution, changes in weather or cigarette smoke, or occupational, such as cleaning chemicals. Strong perfumes, colognes or fragrances can also trigger symptoms.

Additional triggers can include:

  • Infections: Viral infections such as a cold or the flu commonly cause nonallergic rhinitis.
  • Foods and beverages: Hot or spicy foods or drinks can trigger symptoms, as well as drinking alcohol.  
  • Certain medications: Medications that can cause nonallergic rhinitis include aspirin, ibuprofen (Advil, Motrin IB, others) and high blood pressure medications, such as beta-blockers. It can also be triggered in some people by sedatives, antidepressants, oral contraceptives or drugs used to treat erectile dysfunction. Overuse of decongestant nasal sprays can cause a type of nonallergic rhinitis called rhinitis medicamentosa, or rebound congestion.
  • Hormone changes: Hormonal changes due to pregnancy, menstruation, oral contraceptive use or other hormonal conditions such as hypothyroidism may cause nonallergic rhinitis.

While your body isn’t allergic to the items listed above, these things can irritate your sinuses, triggering symptoms.

How to Treat and Prevent Symptoms

Since symptoms between allergic rhinitis and nonallergic rhinitis are so similar, it can sometimes be difficult to pinpoint the difference, and therefore use the appropriate treatment to find relief. In fact, 65% of people are wrongly prescribed antihistamines by their healthcare provider for nonallergic rhinitis.

If you believe your symptoms are the result of certain triggers like perfumes or smoke, treatment may be as simple as avoiding those items as much as possible.

Some people find using a humidifier at home or at work may also ease symptoms, as well as regularly rinsing your nasal passages with a saline (salt water) solution to clean out your nose and nasal cavities (nasal irrigation).

It's important to note that, according to the CDC, if you are irrigating, flushing, or rinsing your sinuses, use distilled, sterile, or previously boiled water to make the irrigation solution. It’s also important to rinse the irrigation device after each use and leave it open to air dry.

You may also be able to find relief using over-the-counter medications to help ease your symptoms. However, long-term decongestant use is discouraged due to its tendency to make congestion worse in the long run.

If you still can’t find relief, talk with your primary healthcare provider to find a treatment plan that will work for you.

While often frustrating, nonallergic rhinitis is rarely harmful and often gets better on its own without extreme measures.

Finding a physician who can partner with you for your health is essential. We can help find a physician that’s appropriate and convenient for you. Call 1-877-THR-WELL (847-9355) or visit TexasHealth.org/FindaProvider today.

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