Cold or allergy? Symptoms can be deceptive

Matthew Clark

One of the most common questions I get this time of year relates to the experience of runny nose and cough.

“Doc, is it a cold or my allergies?”

For some, it can be hard to tell. This year, we seem to have more springtime viral illness locally. Some viruses, more commonly seen in winter or early spring – including flu and RSV – are still circulating in low numbers along with viruses that cause the common cold.

Yet we also are at the junction of spring and summer allergy seasons. A trip outside to my front porch last week confirmed this to me in no uncertain terms. Perhaps you also noted the thick layer of yellow-green pollen on everything? When I was looking, a quick wind gust created a cloud of the stuff 10-feet high.

Tree and grass pollens are tiny airborne particles entering the eyes, nose and mouth that create an allergic response in some people. It is estimated that 10 percent to 30 percent of children and adults in the U.S. suffer from seasonal allergies. The symptoms can range from mild to severe.

Common symptoms of seasonal allergies include runny nose, sneezing, nasal obstruction, congestion, post-nasal drip and cough. Tiredness can accompany allergy symptoms.

The challenge for some is common cold symptoms are quite similar. While treatment of very mild symptoms also may be similar for both, it can be useful to distinguish the two both to tailor treatment to the more specific cause as well as to establish the diagnosis, since seasonal allergies tend to persist, recur and even progress.

There are clues to distinguishing viral colds from seasonal allergies. First of all, fever is not a symptom of mild seasonal allergies but may be present in the initial stages of a cold, though not always.

Allergies are not infectious. Recent exposure to someone with similar symptoms may imply an infectious source.

Allergies result from exposure to an allergen. Onset of symptoms after gardening or mowing the lawn implies a pollen exposure.

Time is a powerful diagnostic tool. Most colds last several days – rarely exceeding seven to 10 days. Yet seasonal allergies usually occur throughout a season of exposure and may last weeks or months. (I should note that some people, such as small children in day care, may experience successive viral colds that may give the impression of a single prolonged illness.)

Histamine release is a prominent component of allergy and contributes to itching and sneezing, but these symptoms also can occur with colds.

Of course, medical providers are trained to evaluate both symptoms and physical exam findings that can more readily distinguish between a cold and allergies. For those with severe, progressive or prolonged symptoms, a trip to the doctor’s office is warranted.

Sometimes, it’s also nice to know the answer to the question and get a tailored treatment plan, so you can have some relief.

Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.

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