Approximately one out of every five people, however, will have their enjoyment of the season dampened by the presence of nasal congestion, watery drainage, sneezing, and watery itchy eyes. For them, seasonal allergic rhinitis, better known as hay fever, will have reared its ugly head.

Hay fever, whether due to tree pollen in the spring or weed and grass pollen in the fall is the most common form of allergy. Allergy is the term used to describe a condition in which the immune system overreacts to a challenge. The immune system is designed to attack invaders such as viruses and bacteria. If it did not we would not survive. The immune systems of allergic individuals overreact to foreign stimuli, zealously attacking substances called allergens that should be viewed as harmless.

An allergic reaction can take many forms. It can present as hives, intensely itchy whelps on the skin. It can cause generalized itching or a localized rash. Cough or wheezing may be present. An allergic response may simply be annoying, such as a drippy nose, but a severe allergic reaction, called anaphylaxis, can be potentially fatal due to swelling of the throat, spasm of the airways, and a drop in blood pressure.

I am often asked how to tell whether symptoms such as nasal congestion and drainage are due to a cold or to an allergy. One of the keys is the presence or absence of itching in the throat – something that is quite characteristic of allergic conditions. Itching of the throat is so specific to hay fever that the diagnosis can often be made simply by asking an individual if he or she knows how to “scratch your throat”. Hay fever sufferers immediately respond “yes” having mastered the art of contracting the throat muscles in a manner that brings relief while others reply with a blank stare or an expression that clearly asks, “Are you crazy?”

The number of things that can cause allergic reactions is endless. Nasal allergies are commonly caused by pollens, house dust, and animal dander. Metals such as nickel, dyes and tanning agents, and latex are leading causes of skin rashes. Foods such as nuts and shellfish, medications, and insect stings lead the list of allergens responsible for anaphylaxis.

There are two broad types of allergic reactions. Each is triggered by an immune substance called an immunoglobulin. The most commonly recognized allergies are immunoglobulin E (IgE) reactions. Hay fever, hives, localized rashes, and anaphylaxis are all caused by IgG hypersensitivity. IgE reactions are immediate, often dramatic, and can be identified by placing a drop of the offending substance on the skin and pricking the skin lightly, a technique known as skin testing.

A second, less well recognized, type of hypersensitivity is due to immunoglobulin G (IgG). Unlike IgE reactions, IgG effects are delayed, subtle, and cannot be detected by skin testing. IgG allergies are usually triggered by foods that are eaten more than twice a week. Rather than triggering the itchy eyes, runny nose, and skin rashes associated with IgE allergies, IgG reactions typically cause headaches, abdominal pain or bloating, tiredness, difficulty concentrating, mood and behavior changes, and sleep disorders. IgG reactions have even been demonstrated to cause elevations of blood sugar in some individuals.

Most physicians recognize and treat only IgE allergies. This is especially true of medical doctors called allergists who specialize in the diagnosis and treatment of allergy. Allergists’ reliance on skin testing and allergy shots, which are ineffective in diagnosing and treating IgG allergies, may explain why they ignore IgG challenges.

One of the most effective tools in dealing with allergies is learning what is causing them. This can often be determined by observing what substances one has been exposed to prior to the onset of the reaction. A common misconception is that an allergic reaction has been caused by something that a person has been exposed to for the first time. The truth is just the opposite; the only thing someone cannot be allergic to is something that he or she is experiencing for the first time. This is because the body’s immune system must be exposed to an allergen at least once before it can produce antibodies against it.

Some allergens are easily determined. For instance, a child who becomes congested and begins to sneeze while petting a cat is almost certainly allergic to cat dander. If a person breaks out in hives shortly after eating shrimp a shellfish allergy should be suspected. If the condition is worse in the spring it is most likely due to various tree pollens, if it is more common during the summer grasses are generally to blame, if symptoms appear in the fall weeds such as ragweed and goldenrod are the most likely culprits, and if the symptoms occur year-round or are worse in the winter house dust may be responsible. When the source of the allergen is in doubt, allergy testing is worthwhile. Skin tests can accurately determine the presence of IgE allergens, but a blood test, called a RAST test, is necessary to identify IgG allergens. (RAST testing can also identify IgE allergens.)

The reason that it is helpful to identify the allergens responsible for the allergy symptoms is that the first principle of allergy management is avoidance. Although pets often become part of the family it may be easier in the long run to give Fluffy to another family than to try to treat the reactions her presence in the home is causing. If someone breaks out when eating shrimp it is safer to avoid shrimp entirely than to treat an anaphylactic reaction.

Avoidance is particularly helpful in dealing with IgG allergies. When the offending foods are avoided for four to six months they can often be safely returned to the diet as long as they are not consumed more than twice weekly. Rotation diets that divide foods into families and limit each group to every fourth day are often highly effective in preventing IgG reactions.

Refined sugars and flours should be avoided. These destabilize the immune system. It is not uncommon for an individual who has been tolerating a high level of pollen to suddenly begin sneezing after eating a cookie or having an ice cream cone.

A number of nutritional supports are helpful in lessening the impact of allergens. OPCs (oligoproanthocyanidins, such as grape seed extract and pine bark extract) stabilize elements of the immune system called mast cells. Under the influence of IgE antibodies, mast cells release potent substances including histamine. Drugs that block the effects of histamine, called antihistamines, are one of the leading allergy treatments. OPCs act to slow or prevent histamine release, negating the need for antihistamines. One to two milligrams of OPC per pound of body weight daily is generally effective in this regard.

Because allergies occur when the immune system is out of balance, immune system modulators can bring significant improvement. One of the most effective is N-N-dimethylglycine, a substance that provides entities called methyl groups to the body. When an ample number of methyl groups are available the immune system becomes more balanced and less likely to react inappropriately to innocuous substances. It is important to note that N-N-dimethylglycine does not suppress the immune system in the manner of steroid medications, which are commonly prescribed for control of allergy symptoms. Rather than suppressing the immune system, methyl groups calm overactive aspects and stimulate underactive ones to achieve a properly balanced immune response.

Herbs can be helpful in alleviating allergy symptoms when they are present. The most effective in my experience are stinging nettle and coleus. Improvement is often noted within minutes, without the side effects commonly associated with antihistamine drugs.

Enzymes are also helpful. Systemic enzymes, which are taken apart from meals and distributed throughout the body can significantly reduce the inflammation associated with IgE reactions. Digestive enzymes, which are taken with meals, are helpful in preventing the development of new IgG allergies, as completely digested proteins do not trigger an allergic response.