Is Fatigue an Allergy Symptom?

As we head into fall, there are all kinds of illnesses going around—COVID-19, colds, flu and seasonal allergies. Fatigue can be a symptom of all of the above.

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Why do allergies cause fatigue?

When most people think of allergies, they think of hay fever—not fatigue. And yet, in my 40 years of clinical practice, I discovered that fatigue was one of the most commonly reported allergy symptoms.
People often experience allergic fatigue in the form of a “fuzzy head” or “brain fog” that makes it hard for them to concentrate. It can affect school and work performance and leave you feeling too exhausted to do the things you want to do. One of my patients described having to leave work to take a nap on a daily basis. Allergic fatigue disrupts life.

Here are a few factors that may contribute to allergic fatigue:

• Sleep disruptions from medications. Many allergy patients are on a steady dose of allergy medications like antihistamines, which can cause them to be drowsy, or decongestants, which may make it hard to fall asleep. These medications may tame allergy symptoms, but they wreak havoc on the body’s sleep rhythms.
• Difficulty breathing. Stuffed-up or runny noses and coughs (all of which are common with allergies) make it hard to fall asleep and stay asleep.
• Chemicals. When the immune system unleashes its barrage of chemicals to “fight off” allergens, it just ends up depleting the body. Fatigue is a by-product of this “chemical warfare.”

How do I know if my fatigue is allergy-related?

Allergic fatigue is usually longer-lasting than viral fatigue. It could stretch on for a full season or even much of the year, depending on what a patient is allergic to. It is often accompanied by other allergy symptoms. However, it will rarely be joined by fever (as is common with viruses). You may notice that it improves when you take allergy medications.

What can I do if I suspect that my fatigue is allergy-related?

Talk to your doctor.

As you try to get to the bottom of your fatigue, you can start by talking to your physician. Make sure to explain all of your symptoms in detail—including ones that might seem out of the box. Most people think that allergies only cause hay fever, but they can cause headaches, chronic cough, chronic ear and sinus infections, eosinophilic esophagitis, irritable bowel-type symptoms), and more. The confluence of multiple allergy symptoms can help your doctor diagnose your allergies. Your doctor may also perform a physical examination, looking at your eyes, up your nose and listening to your breathing.

If your doctor thinks that you are a good candidate for allergy testing and treatment, they may be able to help you in-house. Programs like AllergyEasy provide a turnkey allergy treatment program that helps primary care physicians test and treat their patients without having to refer them out. If your primary care physician does not feel comfortable managing your allergies, they may refer you to an allergist.

Identify your triggers.

You may already have an idea of what you are allergic to. Maybe you have a beautiful oak tree in the backyard that makes you miserable every time it pollinates, or perhaps you notice that you feel bad whenever you eat certain foods. Your doctor can use an allergy test kit to help you understand the full scope of your allergies.

Be mindful that allergy tests are not foolproof. They may give both false positives and false negatives. I have had patients come to me with overwhelmingly obvious allergy symptoms and still test negative. In these cases, we do not turn these patients away and tell them to live with their misery. If their symptoms clearly indicate allergies, we proceed with treatment.

Avoid allergens if possible.

Hopefully, your testing will give you a better idea of what you are allergic to, and you can make some behavior modifications to avoid these allergens. This might mean limiting your outdoor activities in certain seasons or at certain times of day when pollen counts are at their highest. It could also mean avoiding certain types of food if you have food allergies. If you have dust allergies, HEPA filters may help limit your exposure to dust indoors, and you can also try washing your bed linens more frequently.

Seek treatment.

If avoidance is working for you, great! If not, you may need to get allergy treatment. If your allergy symptoms only last for a few months of the year, your doctor may prescribe medications that can help mask your symptoms so that you can function well. But if your allergies last for more than a few months of the year—or last for a shorter amount of time but are severe—your doctor may prescribe allergy treatment in the form of allergy immunotherapy. This can be delivered as allergy shots or sublingual allergy drops (dispensed as droplets under the tongue). Allergy immunotherapy is the only treatment that can change the underlying allergy—not just its symptoms. It can desensitize your body to allergens in the environment so that you stop reacting to them with uncomfortable symptoms.

If your fatigue is allergy-related, you don’t have to live with it. You don’t have to be like my patient who could hardly get out of bed in the morning and couldn’t stay awake at the office. You can get relief through the appropriate allergy treatment. Talk to AllergyEasy for a referral to an allergy doctor in your area.