Article updated December 2018

Allergy misdiagnosis is common in the UK, so it’s time to clear things up

Around one in four people in the UK now suffer from seasonal allergic rhinitis, or hay fever. This equates to 16 million people, compared to just one in eight during the 1980s. Indeed, according to experts from Allergy UK[i], this number may reach 30 million by the year 2030. In particular, it seems that there has been an explosion in the number of children and middle-aged people suffering from the condition. However, despite its common nature, detailed information about the condition remains hard to find.

Professor of the Royal Brompton allergy clinic in London[ii], Stephen Durham, says: “Family members, GPs, even patients themselves can dismiss hay fever as just a bit of sneezing, but for about 10% of sufferers it causes abject misery.”

Misdiagnosis is also common when it comes to hay fever, says Dr Adrian Morris of the Surrey Allergy Clinic: “Many go to the GP complaining of sinus problems and end up on antibiotics, when they really have hay fever and need antihistamines and nasal spray.”

However, Durham points out that the reverse is also true, saying that there are also many people convinced that they have hay fever when in fact they are suffering from a different allergy.

Allergy diagnosis

Often, it becomes easier to determine what kind of allergy you are suffering from once you determine the time of year that your allergy peaks. Of course, the question might not be “Do I have hay fever” at all, if there are other potential triggers for your allergy. But here are some of the most common sources of allergic reactions that can be defined as hay fever or display similar symptoms to hay fever:

Grass: Grass pollen is undoubtedly the most common and well-known of hay fever triggers. The typical pollen season lasts from the first week of May to the second week of September, with a peak from the first week in June to the last week in July.

Birch: Around 25% of allergy sufferers have an allergy to birch trees. This birch season is earlier than the pollen season, lasting from mid-March to the first week in June and peaking from late March to mid-May.

Mould: These allergies are the result of various common kinds of mould, such as Cladosporium and Alternaria. Mould allergies usually flare up in early autumn and late spring, particularly after a rain shower when the mould spores attach to water molecules in the air.

Oak: Oak allergies are usually mild, though can be more severe in some cases. The allergy season lasts from the first week of April to mid-June and peaks from the end of April to early June.

Nettle: Everyone remembers nettles for their painful stinging potential, but they can also be a source of mild allergic reaction. The season lasts from the beginning of May to the end of September and peaks from the end of June to the beginning of August.

Oilseed rape: Like grass, oilseed rape allergies come about as a result of airborne pollen. This allergy season for oilseed rape is earlier than that of grass pollen allergies, lasting from the end of March to mid-June. It peaks from mid-May to the end of June.

Pets: Unlike the other allergies listed, pet allergies are not dependant on the time of year. Cat allergies and dog allergies are the most prevalent causes of allergies in the UK, simply due to the proximity of these animals to us in our daily lives. As our pets shed hair and skin cells, these materials make their way into the air, carpets, bedding and furniture – providing a significant risk to those whose immune system is particularly responsive to these particles. Horse allergies are also not uncommon for those who come into contact with these animals.

Given the wide range of pollens and particles in the air throughout the year, it is not surprising that many people find that they suffer from year round hay fever – with allergies that can become particularly debilitating if left untreated.

In addition to the tree pollens referenced above, it is also possible to experience hay fever symptoms relating to:

  • Alder pollen
  • Ash pollen
  • Hazel pollen
  • Sycamore pollen
  • Willow pollen
  • Plantain pollen
  • Sorrel/dock pollen
  • Mugworth pollen

Which medication is right for you?

If you do determine that hay fever is responsible for your allergies, there are several treatment options for you to consider.

Fexofenadine: This is a popular unbranded hay fever medication which is medically equivalent to branded options but is more cost effective. It acts as an effective non-drowsy antihistamine by preventing the release of chemicals which cause hay fever symptoms.nasonex

Mometasone: This is another popular unbranded medication for allergy relief, this time in the form of a nasal spray. It can help tackle symptoms like itchy eyes, sneezing and congestion.

Telfast: Telfast is the branded equivalent of fexofenadine, acting in exactly the same way to tackle hay fever symptoms.

Nasonex: Again, Nasonex is the branded equivalent of mometasone. It works to treat seasonal hay fever and year-round allergic rhinitis.

Each of these treatments can be prescribed by Express Pharmacy, depending on symptoms and your individual requirements. However, in cases where medication is not proving to be effective, it can be beneficial to request an allergy test. Allergy tests can take two forms and can be requested with an immunologist through your GP. They include:

Allergy skin prick test – small amounts of allergen extracts are applied to the skin surface in order to ascertain, whether the body has an allergic reaction. This test can be applied to not only pollen but also dust mites and animal hairs. Skin tests are also commonly used to diagnose nut allergies.

Allergy blood test – by taking a small sample of blood from a vein in the arm, it is possible to test for the Immunoglobulin E (IgE) antibody – the defence mechanism produced when pollen is detected.[iii]

Dust and dust mite allergy

dust mitesDust is a common culprit for allergy sufferers whose symptoms flare up in colder months, although symptoms can be present all year. Dust allergies tend to be worse indoors in winter due to central heating. While dust mites are a very different source of irritation to pollens, the symptoms of the human body’s allergic reaction can be very similar.

Dust mites are close relatives to ticks and spiders but are too small to see without the aid of a microscope. When dust mites are released into the atmosphere they may trigger inflammation of the nasal passageways, leading to the same type of sneezing and runny nose found in hay fever sufferers. Indeed, those who are susceptible to hay fever may also be inclined towards a similar reaction to dust and dust mites in the air.

Why are more people suffering from hay fever?

It is not known precisely why more people are suffering from hay fever today than were 30 or 40 years ago. However, it is thought that there could be a few contributing factors. One view is that the increasingly hygienic and sanitised world that we now live in tends to expose us to fewer threats to our immune system than would have been the case in previous generations. Anecdotally it appears that more people are suffering from hay fever onset in mid-life than ever before. And this has been attributed by some experts to people enjoying a cleaner environment in later life resulting in a sensitised response to pollen in later life.

Another factor which is thought to have contributed to the rise in hay fever sufferers is the documented increase on pollen count around the UK. While it may appear that cities are less likely to feature high pollen counts, traffic fumes have been found to help spread pollen and ensure that it is hard for city workers to escape the effects of hay fever.

Article updated December 2018


[i] https://www.allergyuk.org

[ii] https://www.rbht.nhs.uk/our-services/allergy

[iii] https://www.nhsinform.scot/illnesses-and-conditions/immune-system/hay-fever#diagnosing-hay-fever