Allergy? Flu? Sinusitis? How to tell the difference?
Murray Grossan, MD.
About the author: Dr. Grossan is an otolaryngologist and head and neck surgeon with the Tower Ear, Nose, and Throat Clinic at Cedars-Sinai Medical Center in Los Angeles and the founder of the Web-based Grossan Sinus & Health Institute (https://www.grossaninstitute.com). He is the author of Free Yourself from Sinus and Allergy Problems Permanently.
How to tell the difference and the best way to treat it…
Sniffling, sneezing and wiping your eyes? You might assume you have a cold…but not so fast. These symptoms can also come from the flu or allergies…from something that’s similar to an allergy…and even from something else entirely—sinusitis!
Telling these five conditions apart can be tricky—even for doctors and for people who may have developed allergies later in life. But knowing the difference is the key to getting the most effective treatment. To be well, you need to know the difference
Marcie had a constant runny nose. She was referred to me for surgery. “No surgery! You have dust and cat allergy.” With medication, she was fine.
Colds are caused by more than 100 different viruses. Your symptoms will depend on the specific virus you are infected with.
Telltale signs: In addition to common cold symptoms, such as sneezing, a sore throat, congestion and/or a cough, you may also have a low-grade fever, mild body aches and aching, swollen sinuses. Symptoms usually last a week or two.
My favorite cold remedies: Get into bed and rest. If you can, watch a funny movie. Research shows that laughing promotes healing. Also, have chicken soup and decaffeinated green tea with lemon and honey. Chicken soup and green tea have anti-inflammatory properties that help fight infection. If you need help sleeping, try 25 mg to 50 mg of diphenhydramine (Benadryl).
For an immune-boosting herbal cough syrup: Mix one-half teaspoon each of cayenne pepper and freshly grated gingerroot…two tablespoons each of honey and apple cider vinegar…and four tablespoons of water. Take one teaspoon every few waking hours.
The flu will make you feel really awful.
Telltale signs: Symptoms can be the same as a cold, but you will have significant body aches and a fever. Also, the flu comes on more suddenly than a cold.
My advice: Get a flu shot to prevent the flu, but if you do come down with it, stay home for at least 24 hours after any fever is gone. Adults over age 65 and those with heart disease or any other chronic health condition should take an antiviral medication, such as oseltamivir (Tamiflu), to avoid flu complications, including pneumonia. Antiviral drugs work best if taken within 48 hours of starting to feel sick.
Allergic rhinitis (nasal allergy) is caused by a hypersensitive immune system that identifies an otherwise innocuous substance as harmful, then attacks it, causing uncomfortable symptoms.
Telltale signs: Nasal allergies can cause symptoms nearly indistinguishable from a cold—congestion, sneezing, red and runny eyes, scratchy throat, etc.—but allergies do not cause the mild fever or achiness of a cold. With seasonal allergies, you get symptoms from exposure to pollen (trees in spring, grass in summer and weeds in fall). Allergies to pet dander, dust, etc., tend to occur year-round.
Helpful: Use a diary to track your symptoms and the times they occur. It will help you distinguish allergies from other conditions. Compare your dates of symptoms with the allergy calendar; then you will know what pollen you are allergic to.
Dora sneezed from March 30 through April 30. She checked the Pollen Calendar in her newspaper and the ones on line, realized it was Oak Tree Pollen. Next year she vacationed at the beach when the Oak Tree Pollen was high.
Patients vary as to which OTC antihistamine works for them. Many patients are relieved by using antihistamine sprays such as Astelin or Patanase.
If you have bad allergy symptoms, with history of eczema and asthma, I recommend a blood test or skin tests to determine your sensitivity and getting desensitization.
This condition causes virtually the same symptoms as allergies, but it’s not a true allergy that involves the immune system. Rather, it’s triggered by specific irritants, such as certain odors, smoke and exhaust—or even changes in the weather.
Telltale signs: With nonallergic rhinitis, standard allergy medications fail to relieve symptoms, and allergy tests are negative. Postnasal drip, an irritating flow of mucus down the back of the throat, tends to be worse with nonallergic rhinitis than with seasonal allergies.
My advice: Avoid irritants that you are sensitive to, and consider using the prescription nasal spray ipatroprium (Atrovent) every day in a nebulizer. Use every day when exposed to irritant?
Sinusitis can be challenging to diagnose because it often occurs in conjunction with colds and allergies. Reason: The excess mucus from congestion provides an optimal breeding ground for bacteria and viruses.
Most people with sinusitis have slow-moving nasal cilia (tiny, hairlike strands that help clear mucus from the nasal cavity). Slow cilia can lead to nasal irritation and congestion.
Telltale signs: Congestion that’s accompanied by tenderness and a feeling of pressure around the eyes, cheeks or forehead. Also, when you blow your nose, the mucus will usually have a yellow or greenish color. Fever may be present as well. Symptoms can last for several weeks (acute) or even longer (chronic).
My advice: Drink hot tea (green or black), and avoid cold beverages. Tea contains L-theanine, an amino acid that increases ciliary activity. Also, wear a scarf and hat to keep your throat and head warm. Cold temperatures slow the movement of nasal cilia—as mentioned above, this can increase congestion.
Antibiotics are not always needed for acute sinusitis—sometimes a virus is the cause. It will often go away with the self-care measures listed above. Antibiotics may be used for chronic sinusitis, depending on the cause of the infection and medical history.
Most patients with chronic sinusitis have slow moving nasal cilia that no longer move bacteria out of the sinuses. I put my patients on Hydro Pulse® Nasal/Sinus Irrigation in order to restore the nasal cilia. This pulse wave irrigation is at a frequency best to restore nasal cilia that clear the bacteria away. Restoring the cilia helps avoid antibiotics.
Natural Remedies for All Sinus Problems!
When nasal symptoms persist after a cold or allergies, it may be due to slow-moving nasal cilia, which increase nasal irritation and congestion (see above). To stimulate cilia…
• Hum. It may sound far-fetched, but the vibrations from humming break up and thin accumulated mucus. Patients of mine who hum for a few minutes several times a day tend to get fewer sinus infections.
• Keep the nose moist. Dry tissue is more likely to become irritated and crack. You can keep your nose moist by using a preservative-free nasal spray such as Simply Saline, available in drugstores. Or you can make your own saline solution by mixing one-half teaspoon of salt, a pinch of baking soda and eight ounces of boiled or bottled water. Avoid daily irrigation with a neti pot—it can wash away protective elements, and may re-infect due to flowback.