Allergic Rhinitis (Hay Fever) Causes, Symptoms, Diagnosis, Treatment, Prevention, Home Remedies, Nutrition, Herbs

Allergic Rhinitis (Hay Fever) Causes, Symptoms, Diagnosis, Treatment, Prevention, Home Remedies, Nutrition, Herbs

What is Allergic Rhinitis (Hay Fever)?

Allergic rhinitis, often called allergies or hay fever, occurs when your immune system overreacts to particles in the air that you breathe-you are allergic to them. Your immune system attacks the particles in your body, causing symptoms such as sneezing and a runny nose. The particles are called allergens, which simply means they can cause an allergic reaction.

People with allergies usually have symptoms for many years. You may have symptoms often during the year, or just at certain times. You also may get other problems such as sinusitis and ear infections as a result of your allergies.

Over time, allergens may begin to affect you less, and your symptoms may not be as severe as they had been. Allergic rhinitis is common, affecting about 1 in 5 Americans. Symptoms can be mild or severe. Many people who have allergic rhinitis also have asthma.

Read more:

Allergy (Allergies) Causes, Types, Symptoms, Diagnosis, Treatment, Prevention,Home Remedies

Causes of Allergic Rhinitis (Hay Fever)

An allergen is something that triggers an allergy. When a person with allergic rhinitis breathes in an allergen such as pollen, mold, animal dander, or dust, the body releases chemicals that cause allergy symptoms.

Hay fever involves an allergic reaction to pollen.

Plants that cause hay fever are trees, grasses, and weeds. Their pollen is carried by the wind. (Flower pollen is carried by insects and does not cause hay fever.) Types of plants that cause hay fever vary from person to person and from area to area.

The amount of pollen in the air can affect whether hay fever symptoms develop.

  • Hot, dry, windy days are more likely to have a lot of pollen in the air.
  • On cool, damp, rainy days, most pollen is washed to the ground.
Hay fever and allergies often run in families. If both of your parents have hay fever or other allergies, you are likely to have hay fever and allergies, too. The chance is higher if your mother has allergies.

Signs and Symptoms of Allergic Rhinitis (Hay Fever)

Allergic rhinitis can cause many symptoms, including the following:
  • Stuffy, runny nose
  • Sneezing
  • Post-nasal drip
  • Red, itchy, and watery eyes
  • Swollen eyelids
  • Itchy mouth, throat, ears, and face
  • Sore throat
  • Dry cough
  • Headaches, facial pain or pressure
  • Partial loss of hearing, smell, and taste
  • Fatigue
  • Dark circles under the eyes

How is Allergic Rhinitis (Hay Fever) diagnosed?

To find out if you have allergies, your doctor will ask about your symptoms and examine you. Knowing what symptoms you have, when you get them, and what makes them worse or better can help your doctor know whether you have allergies or another problem.

If you have severe symptoms, you may need to have allergy tests to find out what you are allergic to.

Your doctor may do a skin test. In this test your doctor puts a small amount of an allergen into your skin to see if it causes an allergic reaction.

Your doctor may order lab tests. These tests look for substances that put you at risk for allergies.

How is Allergic Rhinitis (Hay Fever) treated?

The most effective treatment for any allergy is simply to avoid the allergen. Air conditioner filters remove 99% of airborne pollen. Facemasks, similar to those worn by surgeons, also can greatly reduce the amount of allergen inhaled while outdoors. For some people, wearing a mask provides enough protection when doing yard work. For others, masks and other precautions are not enough. They need medication to control their symptoms.

Effective drug therapies include antihistamines, topical nasal steroids, and certain decongestants, many of which are available over-the-counter. Antihistamines are effective at treating allergic rhinitis because they block the actions of the histamine produced by the allergic reaction. Most of the older generation that are available over-the-counter, however, can cause drowsiness. For this reason, do not take them when you plan on driving a car, operating heavy equipment, drinking alcohol, or taking other drugs that also cause drowsiness.

The newer antihistamines are less sedating. Loratidine, (Claritin®) and cetirizine (Zyrtec®) are available over-the-counter. Fexofenadine (Allegra®) is the least sedating and is now available over the counter.

The other major effective drug therapy for allergic rhinitis, particularly stuffiness, is nasal steroids. These medications relieve symptoms because they counteract the inflammation caused by the allergic reaction. Prescription nasal steroids include such drugs as fluticasone (Flonase®), mometasone (Nasonex®), budesonide (Rhinocort®), and others.

Decongestants such as phenylephrine (Neo-Synephrine®, et al.) and pseudoephedrine (Sudafed®, et al.) can help to unblock nasal passages and improve breathing. These drugs, however, work only for a few days because they eventually become counterproductive and actually begin to make congestion worse. They can also be associated with adverse side effects including rise in blood pressure. Therefore, these are not recommended for patients who have elevated blood pressure. Do not use decongestants to treat any allergic reaction that persists for more than a few days. Afrin® is an over-the-counter decongestant spray (not a nasal steroid) that can clear your nose temporarily. It is very addictive, and should not be used for more than three days in a row.

Prevention for Allergic Rhinitis (Hay Fever)

The best way to control your symptoms is to avoid being exposed to the allergens that trigger your symptoms. These steps may help.

If you have hay fever, during days or seasons when airborne allergens are high:

  • Stay indoors, and close the windows.
  • Use an air conditioner in your home and car.
  • Avoid using fans that draw in air from outdoors.
  • Don't hang laundry outside to dry.
  • Bathe or shower and change your clothes after being outside.
  • Use a HEPA air filter in your bedroom.

If you have year-round allergies:

  • Cover your pillows and mattress with dust mite covers.
  • Remove carpet and install tile or hardwood floors. Use area rugs and wash them often in very hot water.
  • Use blinds instead of curtains.
  • Keep pets out of the bedroom.
  • Use a HEPA filter on your vacuum.
  • Use an air purifier.
  • Wash bedding and toys such as stuffed animals in very hot water once a week.

Lifestyle and home remedies for Allergic Rhinitis (Hay Fever)

Although you can't stay indoors during all pollen and ragweed seasons, avoiding peak exposure times can help. Use your air conditioner in your home and car, and wear a dust mask when working in the yard.

For year-round allergies, you can take the following measures.

  • Get rid of carpets and upholstered furniture.
  • Wash bedding every week in very hot water.
  • Keep stuffed toys out of the bedroom.
  • Cover pillows and beds with allergen-proof covers.

To reduce mold:

  • Clean moldy surfaces. Mold is often found in air conditioners, humidifiers, dehumidifiers, swamp coolers, and refrigerator drip pans.
  • Use a dehumidifier indoors to reduce humidity to less than 50%.
  • Fix water leaks and clean up water damage immediately.
  • Make sure kitchens, bathrooms, and crawl spaces have good ventilation. Installing exhaust fans can help. Vent laundry dryers to the outside.
  • Put flooring in crawl spaces.

Nutrition and Dietary Supplements for Allergic Rhinitis (Hay Fever)

Some people with allergic rhinitis also have food allergies. If you have any food allergies, eliminate those items from your diet.

Lactobacillus acidophilus

One small study suggests that L. acidophilus, a type of "friendly" bacteria, might help reduce allergic reaction to pollen. More study is needed.


Quercetin is a flavonoid, a plant pigment that gives fruits and vegetables their color. In test tubes, it stops the production and release of histamine, which causes allergy symptoms such as a runny nose and watery eyes. However, there is not yet much evidence that quercetin would work the same way in humans. More studies are needed. Quercetin can potentially interfere with many medications so speak with your physician.


Preliminary test tube and animal studies suggest that spirulina, a type of blue-green algae, may help protect against harmful allergic reactions. Spirulina stops the release of histamine, which contribute to symptoms of allergic rhinitis. But researchers don’t know whether it would work in people.

Vitamin C (2,000 mg per day)

Vitamin C has antihistamine properties and some preliminary research suggested it might help reduce allergy symptoms. But another placebo-controlled trial failed to show any effect.

Herbs for Allergic Rhinitis (Hay Fever)

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care practitioner.

Butterbur (Petasites hybridus, 500 mg per day)

Butterbur has been used traditionally to treat asthma and bronchitis and to reduce mucus. Several scientific studies suggest it can help with allergic rhinitis. One study of 125 people with hay fever found that an extract of butterbur was as effective as Zyrtec. Another study compared butterbur to Allegra with similar findings. Both studies were small, however, so more research is needed. Researchers don’t know whether taking butterbur longer than 12 - 16 weeks is safe. Butterbur can cause stomach upset, headache, and drowsiness. Pregnant and breastfeeding women, and young children, should not take butterbur. If you take any prescription medications, ask your doctor before taking butterbur.

Stinging nettle (Urtica dioica, 600 mg per day for one week)

Stinging nettle has been used traditionally for treating a variety of conditions, including allergic rhinitis. But studies so far are lacking. Only one small study suggested that stinging nettle might help relieve symptoms of allergic rhinitis. Pregnant women and young children should not take stinging nettle. Talk to your doctor before taking stinging nettle if you take blood pressure medication, blood thinners, diuretics or water pills, or have diabetes.

Tinospora cordifolia (300 mg three times daily)

In one study, people with allergic rhinitis who took a specific formulation of tinospora (Tinofend) for 8 weeks had many fewer symptoms than those who took placebo. But some researchers have questioned the results of the study, and more research is needed. People who have diabetes or an autoimmune disease such as rheumatoid arthritis or Crohn’s disease should not take tinospora. Pregnant or breastfeeding women should not take it, either. Tinospora can interact negatively with diabetes medications and drugs that suppress the immune system.

Astragalus (Astragalus membranaceus, 160 mg two times per day)

One preliminary study suggested that a specific formulation of astragalus (Lectranal) standardized to contain 40% polysaccharides reduced symptoms of allergic rhinitis including runny nose, sneezing and itching. People who have autoimmune disease such as rheumatoid arthritis or Crohn’s disease should not take astragalus without asking their doctor. People who take lithium or drugs that suppress the immune system should not take astragalus.

Allergic Rhinitis (Hay Fever) in Pregnancy

If you are pregnant or breastfeeding, avoid the following:
  • Decongestants, unless you ask your doctor
  • Stinging nettle
  • Chinese skullcap
  • Butterbur (Petasites) extracts
  • High doses of vitamin C
  • Tinospora cordifolia
  • Astragalus

Warnings and Precautions

Do not take stinging nettle without talking to your doctor first if you take blood pressure medication, anticoagulants (blood thinners), diuretics (water pills), or have diabetes.

Do not take tinospora cordifolia is you have diabetes or an autoimmune disease such as rheumatoid arthritis or Crohn’s disease.

Do not take astragalus if you have an autoimmune disease such as rheumatoid arthritis or Crohn’s disease should not take astragalus. People who take lithium should not take astragalus.

Butterbur may interact with some medications that are processed by the liver. If you take any prescription medications, ask your doctor before taking butterbur.

Skullcap can make you sleepy, and should be used with caution or not at all with antihistamines that also make you drowsy.

What is immunotherapy?

Allergen immunotherapy, commonly known as allergy shots, is a technique designed to increase your tolerance to the substances that cause allergy symptoms. It makes you less sensitive to your allergens, allowing you to tolerate the offending agents. Physicians usually recommend it for people who either do not get good results with medications or do not tolerate them.

During the treatments, an allergen is injected periodically into your body in increasingly larger amounts until an effective dose, called the maintenance dose, is reached. The maintenance dose is given at intervals over three to five years to induce a tolerance to the allergen. In most cases, immunotherapy is very effective at reducing or preventing the development of allergy symptoms whenever you come into contact with the allergen. It usually reduces and often eliminates the need for medications. The effects are long-term for most people who complete an adequate course of allergen immunotherapy.

Prognosis and Complications

You can treat symptoms of allergic rhinitis, but they will appear each time you are exposed to an allergen.
Although perennial allergic rhinitis is not a serious condition, it can interfere with your life. Depending on how severe your symptoms are, allergic rhinitis can cause you to miss school or work. Medication may cause drowsiness and other side effects. Your allergies could also trigger other conditions, such as eczema, asthma, sinusitis, and ear infection (called otitis media). Seasonal allergies may get better as you get older.
Immunotherapy or allergy shots may cause uncomfortable side effects, such as hives and rash. Rarely, it may have dangerous side effects such as anaphylaxis. It usually works in about two-thirds of cases, and may require years of treatment.