Why Are Seasonal Allergies So Bad in East Tennessee?

East Tennessee is beautiful in the springtime, with its bountiful blooms and flowering trees. But the beauty of the greater Knoxville area is sometimes harder to appreciate when seasonal allergies also bring squinted eyes and tattered tissues.  

“It’s evident that while our unique combination of a temperate climate, moisture and biodiversity make East Tennessee a wonderful place to call home, they can also make it a difficult place for allergy sufferers,” says Nick Panella, MD, Ear, Nose and Throat Consultants of East Tennessee. 

Knoxville is listed among the 2023 allergy capitals by the Asthma and Allergy Foundation of America, and it seems everyone knows someone who is struggling this time of year. Dr. Panella provides some answers about the cause of seasonal allergy suffering and how to contend with it.  

When Is Allergy Season in East Tennessee?   

You may find that walking through Knoxville on a beautiful day in the spring can turn into a nightmare of allergy symptoms, but for some people, enjoying a football game outdoors in the fall can be tough to tackle too. 

So when is allergy season in East Tennessee? The short answer is, always.  

“Unfortunately, in East Tennessee, we have allergens in our environment year-round,” Dr. Panella says, adding that constant allergens can include molds, dusts, pet dander and more. “In East Tennessee, the big peaks occur in the fall and spring due to blooming plants such as trees, grasses and weeds.” 

Seasonal allergy symptoms can be made worse by the weather. According to the U.S. Department of Agriculture (USDA), recent research has shown that pollen seasons start 20 days earlier and are 10 days longer than in 1990.  

What Are Common Symptoms of Allergies?  

The most common form of seasonal allergy symptoms is allergic rhinitis. You may have heard it called “hay fever.” It shows up most commonly as inflammation inside the nose. 

If you feel your allergy in your eyes, you likely have what’s called allergic conjunctivitis. It happens when exposure to an allergen triggers inflammation in the lining of the eye. Allergic conjunctivitis is a symptom for more than half the people who have allergic rhinitis.  

Common seasonal allergy symptoms include: 

• Sneezing
• Stuffy nose 
• Runny nose 
• Red, watery eyes
• Itching of the nose, eyes, ears or mouth
• Swelling around the eyes

Allergies and Asthma  

Allergens are also the most common trigger for asthma. For a person who has allergic asthma, allergens can set off inflammation and swelling in the airways which can lead to an asthma flare-up or even a full-on asthma attack.

Along with the typical allergy symptoms, people who have asthma should pay attention to these signs:

• Shortness of breath
• Cough
• Chest tightness or pain
• Wheezing (whistling sound while breathing)

Be on the alert if symptoms wake you up at night. If you use a peak flow meter, watch for a drop in your reading.  

Asthma can lead to a medical emergency, so follow the advice of your doctor and know when to call for help. 

Why Does Pollen Cause Allergies?   

Pollen grains are tiny particles that come from plants, trees, grass and weeds. No one knows for certain why any allergy happens, but researchers do know that the symptoms come when the body thinks an allergen is dangerous. Antibodies are released and that’s what prompts the symptoms.  

Where Does Pollen Come From?   

Treating seasonal allergies can be complicated because there are several different types of pollen allergens peaking at different times during the year. Tree pollen commonly occurs in spring and grass pollen appears in summer, while weed pollen favors summer and fall. 

So if you’re sneezing in early spring, tree pollen is a likely culprit (most commonly from oak, maple and pine trees). If you suffer more at the end of summer, grass pollen may be coming into play. In the fall, weed pollen may be the cause of those watery eyes.

The Asthma and Allergy Foundation says the proteins in some produce and nuts are similar to some tree, grass or weed pollen, and your immune system can’t tell the difference. If eating certain fruits or vegetables leaves you with an itchy throat, your body may be having an allergic reaction that can happen any time of the year. 

What to Know About Pollen Count   

Pollen count has become a helpful tool for managing allergy symptoms. It’s calculated by capturing pollen from the air and measuring the average number of pollen grains per cubic meter.  

It’s best if you can find a source with multiple pollen counts to break down the readings for different types of pollen. Pollen counts are usually highest in the middle of the day or early afternoon, but if the pollen count is extremely high, there may be a risk of lingering pollen causing problems any time of day. In urban areas. pollen counts tend to hit their highs and lows later in the day.  

If you have seasonal allergies, days when pollen counts are low are better for being outdoors. If the pollen count is high, it’s a good day to be indoors instead. Dry, windy weather means a greater likelihood of a high pollen count. Rain makes airborne pollen more manageable.  

Seasonal allergies aren’t one-size-fits-all. There may be days when your allergy symptoms are at odds with the pollen count you see on TV or online. Most pollen reports and forecasts focus on common types of pollen that trigger symptoms in the greatest number of people. Those reports might not include the specific pollen count that sends you sneezing into the day. 

Who Is at Risk for Seasonal Allergies?  

Anyone with a healthy immune system can be vulnerable to allergy symptoms. Symptoms arise from the body overreacting to allergens that are inhaled through the nose. Dr. Panella says the worst symptoms typically occur in older children and young adults, but symptoms can occur at any age.  

How to Cope with Seasonal Allergies  

There is no cure for allergies, but they can usually be managed so sufferers have fewer symptoms or symptoms that are less severe. Dr. Panella says in most cases it’s best to start by treating symptoms with the least invasive options. He recommends using a nasal saline several times a day, or more often if you’ve been exposed to known allergens (after mowing the lawn, brushing a pet, etc.).

“If you aren’t experiencing relief with saline alone, the next step is to try over-the-counter medications such as a nasal steroid or a nasal antihistamine spray,” Dr. Panella says. “These options are topical, applied inside of the nose rather than ingested, so they are extremely safe and have a strong effect on reducing symptoms.” 

The next step Dr. Panella recommends is trying allergy pills. He cautions that while antihistamines are useful, they can cause dryness or be too sedating for some patients. If these options don’t work and you’re unable to live a life free of allergy symptoms, it may be time to see an ear, nose and throat specialist or allergist to be considered for allergy immunotherapy. 

Allergy Shots and Drops 

Allergy shots have become a common tool for helping chronic allergy sufferers, but a newer option has come on the scene that’s proving effective and convenient. Similar to the shots, allergy drops (sublingual immunotherapy) help the body build tolerance to the sources of allergy symptoms. The drops are placed under the tongue and are pain-free. 

Like an allergy shot, each dose of the drops introduces a very small amount of the allergen that triggers the patient’s allergy symptoms. In time, the body builds up immunity to the allergen.  

“While both are effective for treating allergies, the newer, safer allergy drops can be given at home without weekly visits to the doctor’s office,” Dr. Panella says.  

Avoiding the Allergens 

Prevention is great medicine, so follow these tips to avoid exposure to pesky pollen and the allergy symptoms it brings. 

When to Avoid Being Outdoors: 

• When the pollen count is high
• When the weather is very dry or windy
• Times during the year when you’ve normally suffered symptoms in the past

More Tips for Coping During Allergy Season:

• Consider wearing a mask outdoors
• Wash clothes, take a shower and wash your hair after being outdoors
• Keep doors and windows closed and use air conditioning
• Avoid hanging laundry outdoors 
• Vacuum with a high efficiency particulate (HEPA) air filter

Pollen and seasonal allergies are destined to be a part of life in the greater Knoxville area for years to come, but treatment for them is constantly improving. If you’re suffering and nothing seems to work, contact an ear, nose and throat specialist or an allergist to find the treatment that will be the most effective for you.