Will Moving to a Different Region Help my Allergies?

It’s summer, and that means moving season. Recent data from the U.S. Census Bureau showed that about 32 million people move per year, and the vast majority of those moves occur during peak season (May to September). Moves are driven by any number of reasons—including health.

If you are experiencing severe allergies where you are currently living, you may have considered moving so that you can feel good gain. We can’t blame you. The ongoing sneezing, stuffed-up nose, itchy eyes, and sinus infections are enough to make anyone consider their options.

Consider the example of one of my patients from San Antonio, Texas. He had such strong mountain cedar allergies in the Lone Star State that he lost all quality of life for weeks on end. He found himself dreading the mountain cedar season as it approached every year and cancelling major events in his life because the pollen made him so sick that he could hardly function. He was ready to pull up roots and go anywhere but Texas.

Won’t the Desert Save Me?

Back in the day, people used to flock to hot, dry states like Arizona to escape allergies. The problem is that they brought plants—and pollens—with them. After all, they wanted the health benefits of Arizona, but they didn’t want their front yard to look like a parched, dry wasteland, punctuated only by a stolid cactus or two.

Today, about 1/3 of the people in the Phoenix area report having allergic rhinitis (runny nose, itchy eyes, sneezing—all of those symptoms bundled into the term “hay fever”). They react to a wide variety of non-native trees (olive and mulberry to name a couple), imported grasses (such as Bermuda) and even some native trees (mesquite). Ragweed, one of the most potent allergens of all, is also very common in Phoenix. In other parts of the country, it peaks in fall, but in Arizona, it hits its stride in spring, accounting for widespread misery.

Due to a transient population and all kinds of plant and tree transplants, there is really no corner of the country that is hypo-allergenic. There are, however, certain areas that may agree better with your allergies than others.

The Best and Worst Cities to Live in

This very topic is the center of a yearly study commissioned by the Asthma and Allergy Foundation of America. They recently released their 2020 rankings of American cities that are most and least affected by spring and fall allergies. The rankings are based on the following criteria:

• Pollen counts
• Use of allergy medicine
• Number of board-certified allergists

And the results are (drum roll, please):

Most challenging places to live with allergies:

• Richmond, Virginia
• Scranton, Pennsylvania
• Springfield, Massachusetts
• Hartford, Connecticut
• McAllen, Texas
• New Haven, Connecticut
• San Antonio, Texas
• Bridgeport, Connecticut
• Oklahoma City, Oklahoma
• Pittsburgh, Pennsylvania

Least challenging places to live with allergies:

• San Jose, California
• Boise, Idaho
• Portland, Oregon
• Fresno, California
• Milwaukee, Wisconsin
• Stockton, California
• Salt Lake City, Utah
• Seattle, Washington
• Provo, Utah
• Durham, North Carolina

Making an Educated Decision

Before you pull up roots and move to…say…Provo, Utah or Durham, North Carolina, you should do a couple of things first.

• Get allergy tested. Talk to your allergy doctor about what’s making you so miserable. You might have a pretty good idea already based on pollen counts and how they coincide with your level of discomfort. An allergy test can give you a better idea of specific allergens that your body is sensitized to. You can then compare notes with prospective areas. For example, if you learn from the test that you are highly allergic to mulberry trees, make sure that they are not common in the area you are considering moving to.

Watch out for pollens that know no borders. If ragweed is your kryptonite, a move probably won’t help you much. Ragweed is found in most parts of the country, and even if it’s not growing abundantly in a certain city, it is a very light type of pollen that can travel for hundreds of miles. As a result, the wind may deliver it to you from other ragweed-rich cities.

• Rule out non-seasonal allergies. Your allergy test will be helpful in letting you know whether you’re allergic to seasonal pollen or to things like dust or pets. Imagine moving to escape allergies only to find out that you’re allergic to house dust, which is just as likely to accumulate in one state as another.

• Seek treatment. This is our biggest and best piece of advice. Many people think that they have to limp along with a litany of allergy pills and inhalers, but there’s a better way. Allergy immunotherapy is the only treatment that has been shown to change the underlying allergy for long-term relief, and it can really work.

Some people write treatment off because they don’t have time to get shots (or they hate needles), but there is a relatively new treatment known as sublingual immunotherapy that sidesteps this problem. It works much like allergy shots, desensitizing the body so that it won’t react to allergens in the environment. However, instead of being administered through injections, it is dispensed as liquid droplets under the tongue that absorb into the bloodstream. The drops are safer than shots so they can be taken at home. So essentially, you’re getting the proven benefits of immunotherapy without the pain or hassle.

A Few Additional Ideas

Immunotherapy works for the vast majority of people, so you may find that you can scrap your plan to relocate once your body becomes desensitized. If you are in the small minority that it doesn’t work for, or if you’re just plain ready to relocate, here are a few more tips:

• Try a visit. You could try visiting your desired destination for two to four weeks during different seasons before you move there. Be aware, though, that this does not come with a guarantee. It often takes your body a couple of years to become sensitized to allergens in your new environment, so even if you don’t react during your visits, you could react when you get acclimated to your surroundings.

For example, with the aforementioned mountain cedar, many people who move to cedar-heavy areas of Texas report no symptoms the first year. Then after a year or two in their new area, they start to feel a barrage of “cedar fever” with its attendant misery.

• Consider a vacation. If your allergies only last for a few weeks, consider taking a yearly vacation during that time. The challenge is that pollination is weather-dependent, so you never know exactly when those pollens are going to start filling the air. If your schedule is flexible, though, you could leave at the first hint of allergy season.

The Takeaway…

If you’re in a particularly allergy-heavy area and are ready for a change of scenery, there might be some merit to switching locations, but remember that allergens lurk in most parts of the country. You’ll want to make sure that you’re not just trading one brand of misery for another.

Talk to a sublingual immunotherapy doctor before you make any major decisions, and consider testing and treatment. You may find that with allergy immunotherapy, you can desensitize your body so that pollens that once made you miserable aren’t an issue anymore.