Not only is it kickoff time for college football season, but it’s also prime time for fall allergies. For the 50 million Americans who suffer from ragweed allergy, the late summer and early fall signal the onset of runny noses, sneezing, congestion, cough, itchy watery eyes, and in more severe cases, sinus infections and asthma exacerbations.

Seasonal allergies are a huge source of frustration and fatigue for many of us, causing symptoms beginning as early as late July in the southern U.S. states and continuing through October or later.

Here are eight fascinating facts about ragweed allergy:

1. Ragweed is found in 49 out of the 50 US states, including Hawaii, and there are 17 different types of ragweed!

2. Ragweed pollen levels peak in the morning. Keeping your bedroom windows closed overnight and car windows closed on your drive to work can be helpful to decrease exposure.

3. Unlike the spring pollen season, which begins based on temperature, ragweed pollination is triggered by the length of daylight. This means you can set an alert in your calendar to remember to start your allergy medications early before ragweed season starts.

4. Ragweed is an annual, meaning plants only live for one season, but each plant can release up to 1 billion pollen grains! These grains are lightweight and can stay airborne, traveling up to 400 miles.

5. Many people think that they are getting less exposure to pollen by living in the city, but this is an urban myth! Urban areas are warmer with up to 30 percent more carbon dioxide, resulting in the formation of “urban heat islands.” One study, in particular, showed that cities could have up to 7x more ragweed pollen than the surrounding rural area!

6. Several studies have demonstrated that climate change has caused longer pollen seasons and higher pollen levels. Additionally, an increase in carbon dioxide causes ragweed plants to produce more pollen. This effect becomes more prominent further north.

7. Some people with ragweed allergy may experience mouth itching or swelling when eating certain foods called oral allergy syndrome. Bananas, melons, cucumbers, zucchini, white potatoes, and sunflower seeds are the most common culprits. Often, peeling and cooking these foods can decrease symptoms.

8. Local honey is not a substitute for allergy shots. Although honey does have some anti-inflammatory properties and is quite helpful for sore throats and coughs, it does not contain sufficient amounts of the pollens we become allergic to in order to create an immunologic response.

And more importantly, here are five quick tips for symptom control:

1. Corticosteroid nasal sprays are most effective for nasal congestion but require 2 to 4 weeks of use to reach their full effect. Technique is also critical. Point your nose toward your toes, aim the nozzle toward your ear on the same side as your nostril, and don’t sniff or snort the medication. Dab any excess.

2. Over-the-counter antihistamines come in tablets and nasal sprays now. Allergists by and large recommend avoiding 1st generation antihistamines (diphenhydramine) due to safety concerns. Loratadine, cetirizine, fexofenadine, and now azelastine nasal spray are all great alternatives.

3. Decongestants are great in a pinch, but remember they have more medication interactions and side effects. Additionally, they should not be used long term due to the concern for developing rebound congestion (rhinitis medicamentosa).

4. Don’t forget about eye drops. These are great to add on for those extra tough days. Keep them in the fridge to minimize burning and stinging and provide a bit of soothing relief.

5. Don’t overlook the power of sinus saline rinses or sprays. These can help flush out mucus and pollen. Think of these as a shower for your nasal passageways. It can take a bit of trial and error to find which formulation and technique is best for you.

Last but not least, if you are ready to tackle ragweed allergy for the long term, chat with your local board-certified allergy-immunology physician to see if immunotherapy is an option. Although most commonly, immunotherapy comes in the form of allergy shots, more and more practices are offering sublingual and intralymphatic immunotherapy too, which eliminate needles and/or speed up the immune-modulating process.

Kara Wada is a board-certified academic adult and pediatric allergy, immunology, and lifestyle medicine physician, Sjogren’s patient, certified life coach, TEDx speaker, and Dr. Midwest 2023. She can be reached at Dr. Kara Wada and on Instagram, YouTube, Facebook, and LinkedIn. She is a national expert, sought-after speaker, advisor, and host of the Becoming Immune Confident Podcast. She is CEO and founder, The Crunchy Allergist and the Demystifying Inflammation Summit, and serves as the director of clinical content for Aila Health.