While millions of Americans brace themselves each spring for sneezing, itchy eyes, and runny noses, allergy experts are warning that seasonal allergies can manifest in far more unexpected ways—often mimicking illness or other medical conditions.
“Allergies aren’t just about sneezing or watery eyes,” says Dr. Purvi Parikh, an allergist and immunologist at NYU Langone Health. “They can look like sore throats, chronic coughs, or even extreme fatigue.”
One surprising symptom is a sore throat. Though often mistaken for a cold or strep, throat irritation during allergy season is commonly caused by post-nasal drip, where mucus drains down the throat, leading to hoarseness and constant throat-clearing. Unlike infections, allergy-related throat discomfort tends to develop gradually and lacks accompanying fever.
Other under-recognized symptoms include clogged ears and nosebleeds. Congestion in the nasal passages can affect the ears due to their shared anatomy, resulting in a plugged-up sensation. Children in particular may experience nosebleeds from excessive nose blowing or rubbing—something experts say can often be remedied with proper nasal spray technique.
“We often see a nasal crease—a horizontal line across the nose—caused by frequent upward rubbing,” says Dr. Jeffrey Chambliss of UT Southwestern Medical Center. He adds that some patients even develop dark under-eye circles due to restricted blood flow from nasal inflammation, which can resemble bruising.
Perhaps more disruptive than physical symptoms is the exhaustion that many allergy sufferers endure. Dr. Karen Kaufman, who runs a private allergy practice in Virginia, says fatigue is one of the top complaints. “People are choking on mucus at night, breathing through their mouths, and not sleeping well,” she explains. “It impacts their ability to function at work or school.”
Less commonly linked symptoms include skin rashes, bad breath, and even behavioral changes in children. “Parents are often amazed when their child’s focus and mood improve after allergy treatment,” says Dr. Cindy Salm Bauer of Phoenix Children’s.
Some food-related symptoms can also be allergy-related. Oral allergy syndrome, where the body reacts to raw fruits and vegetables due to similarities with pollen proteins, can cause tingling or mild swelling in the mouth. “Most people don’t connect the dots because the symptoms go away when the food is cooked,” Chambliss explains.
As the allergy season peaks, doctors urge those with unusual or persistent symptoms to seek professional advice. “If you’re not getting better with typical treatments, or your symptoms are affecting your quality of life,” says Parikh, “it might be time to see an allergist.”
