What causes allergies? Do you REALLY know?

Why learn what causes allergies?

What if I told you that most doctors don’t even know what REALLY causes allergies.

The result:  67% of people are incorrectly or inappropriately treated!  Stop wasting time and money on the wrong medication and learn what causes allergies today!

Picture of pollen causes allergies
Do you know the cause of allergies? Most doctors don’t!

Do you want to know what REALLY causes allergies?

I used to accept the fact that most people (and most doctors) don’t know what causes allergies.  But I have seen too many patients who have a heartbreaking story like Beth’s to let this continue:

Beth is a woman who came to me after I gave a lecture a few months ago and told me she wished she’d heard what I had to say a year and a half earlier.

It would have saved her  $10,000 and countless hours of hassle.

Her story began when, in her 50s, she started to get severe allergy symptoms to multiple different things that had never bothered her before:  perfumes, smells, old books and dusty buildings.  It got so bad that she was having allergy symptoms whenever the wind blew outside!

She had tried allergy medications, which didn’t work, so she went to get medical help.  After allergy testing, she was told she didn’t have allergies and should use a nose spray.  Total cost at this point:  about $500.

Right here is the time that I could have helped her.

Instead, she felt the medical specialist didn’t diagnose her cause of allergies so she found a holistic practitioner to tell her what causes allergies in general, and what was the cause of allergies for her specifically.  He did additional tests (where he asked her to hold vials of various plants and then noted how they made her feel) and told her that she DID have allergies and they were severe and her cause of allergies needed to be treated daily with their in-shop blend of vitamins/supplements.  This was a cash-only service, and cost her $1500.

Unsurprisingly, this didn’t work.

Beth was getting frustrated that nobody could tell her what was causing her allergies, so she pursued further testing and was eventually told she had a fungal overgrowth (candida) within her GI tract and that this was causing a “mold allergy” (additional $300).  Armed with this advice, she hired a mold-consultant ($700) to find all the “pockets of mold” within her house and then, through a general contractor, replaced the drywall, insulation, and repainted six rooms (cost: $7000, bringing the total cost at this point about $10,000).

She had just decided to replace her carpeted floors with hardwood(Beth felt anything with possible mold causes allergies) to further her symptoms.  At this point, she attended my community lecture.


What is heartbreaking about this story is that many people want to know what causes allergies but are not told one fact that, in Beth’s case, would have saved her thousands of dollars:

Allergy symptoms are not the same as allergies!

But first, a warning:  this is a long post.

It will help you understand the real cause of allergies and how to approach your allergy symptoms better.  But if you don’t have time to read the whole post, you can download it HERE and read it later.

Allergy Symptoms are NOT the same as allergies

I want this fact to be something you understand without question.

When someone has “allergies” they often mean they have allergy symptoms:  itchy, sneezy, runny, or stuffy nose, itchy red or watery eyes, or any combination of these.

If this describes you, I understand.  Most doctors think the same way!

What usually happens is that you start to have nose or eye symptoms and start to think you have allergies.  Or perhaps you are on the fence and you see on of the bazillion allergy commercials on TV about people with the exact same symptoms… so it makes sense that you think you have allergies.

And you might.

But when you take all the people who say they have “allergies” (meaning allergy symptoms), only one-third (33%) ACTUALLY have allergies.

So… one last time…

Allergy symptoms are not the same as having allergies.


What causes allergy symptoms?

I know you want to learn the cause of allergies.

But before we talk about what causes allergies, you first need to know the three main causes of allergy SYMPTOMS:

An illustration showing the cause of allergy symptoms
The 3 causes of allergy symptoms

As you can see, when someone has allergy symptoms, the cause could be:  allergic rhinitis, irritant rhinitis or a combination of both (called mixed rhinitis).

If you’re confused, that’s ok.  Just stick with me a little longer.

What causes allergies:  allergic rhinitis (or, what causes true allergy symptoms)?

The cause of allergies… of allergic rhinitis… is your immune system!


Allergic rhinitis is caused by a component of your immune system called the IgE antibody.

If you have allergic rhinitis, triggers like seasonal pollen, pets, dust mites, or even cockroaches cause the IgE immune system to react just like your immune system would react against a virus or bacteria!

In a sense, your immune system is trying to “protect” you against pollen and cats.  Thanks a lot, right?!
This is important because IF the CAUSE of your allergy symptoms is allergic rhinitis, then you need to TREAT against the immune system or it’s effects:

Allergic Rhinitis Testing:

  • If the cause of allergies is an immune response, then skin testing is usually positive.
  • Or, since the immune system is causing allergies, you can also check a blood test for IgE

Allergic Rhinitis Treatment

  • Nasal steroids and nasal antihistamines block the START of the immune cause of allergies
  • Antihistamines block the EFFECTS of the immune cause of allergies
  • Allergy immunotherapy CHANGES the immune system’s response completely

Knowing what causes allergies… knowing that the cause of allergic rhinitis is an immune response… guides how I would best treat you.

In order to feel your best, you need to get the correct diagnosis so that you can get the correct treatment!


What causes allergies:  irritant rhinitis (or, said another way, what causes non-allergic allergy symptoms)?

The cause of non-allergic rhinitis… of irritant allergy symptoms… is a direct irritation of your nose!

Remember from my illustration above, 1 in 4 people (25%) have allergy symptoms (the EXACT SAME runny, sneezy, stuffy nose or red, watery eyes as those with allergies) but DON’T have allergies!

There is NO WAY to tell them apart by just asking… not even for an allergist!

How does an irritant cause your allergy symptoms?

  • Usually there is something that bothers the inside surface of the nose causing allergy symptoms
  • Sometimes there is a local “dumb” or innate immune response as the cause of allergy symptoms
  • And sometimes it is a nerve response that causes the irritant allergy symptoms

But in each case, the cause of non-allergic rhinitis is NOT the full immune response seen as the cause of allergic rhinitis, but a more local response.

This is important for a few reasons:

Irritant Rhinitis Testing:

  • Testing for the cause of allergies… with skin testing or blood testing… is USUALLY NORMAL/NEGATIVE!
  • As an allergist, if I have a suspicion for irritant rhinitis I want to do a skin test and plan for it to be negative/normal because THAT means that the answer is non-allergic rhinitis

And here… here is where Beth would have been better seeing me and where so many people get confused:

  • If you are having allergy symptoms… you are having allergy symptoms.
  • If the allergy test is negative or normal, that means that you don’t have allergic rhinitis.
  • It DOES NOT mean that you’re not having allergy symptoms!!!
  • It just means that the CAUSE of your allergy symptoms is a non-allergic (irritant) rhinitis!


Please, please… every medical provider everywhere… please read this!

Don’t tell your patient who has allergy symptoms that they “don’t have allergies” and leave it at that!

What’ll happen is exactly what happened with Beth!  Instead, tell them that the negative test means they have irritant allergies or irritant rhinitis!  And then treat the irritant allergies!

Stop letting a negative/normal test make you ignore the symptoms of your patient!

Ok, rant over!

Irritant Rhinitis Treatment

  • Remember, the point of learning this is to pick the right treatment
  • In irritant rhinitis, antihistamines will minimally help (if at all)!  Antihistamines help an immune cause of allergies… not an irritant cause of allergies!
  • Nasal steroids and nasal antihistamines are THE BEST treatment for irritant allergy symptoms.
  • Sinus rinses also help treat an irritant cause of allergies
  • Sometimes, a CT scan of the sinuses may be necessary to make sure there are no structural causes of allergy symptoms.


Putting it all together: why it is important to know the REAL cause of allergies

Summary so far, in case I lost you:

  1. Allergy symptoms are itchy, runny, sneezy or stuffy nose and/or itchy, red, watery eyes.
    • There are 3 main causes of these allergy symptoms:  allergic rhinitis, irritant (non-allergic) rhinitis and mixed rhinitis
    • There is NO WAY to tell which is which based on history alone
  2. Allergy testing (either skin test or blood test) determines which of these is the underlying cause of your allergy symptoms
    • Allergic Rhinitis is an immune system response that has positive allergy tests (either scratch test or blood test).
    • Irritant Rhinitis is a non-immune response that has negative / normal allergy tests
  3. Finally, once know the cause of allergies you can choose the right treatment pathway!
    • Allergic rhinitis is treated with medications that help reduce the immune response
    • Irritant rhinitis is treated with medications that help reduce the topical/local response


So, simply put:  it is important to know what causes allergies to get the right diagnosis so that you can get the right treatment!


It is simple, right?  So now think about how many people are either treating themselves with over the counter medications and how many more people are being given medications by their doctor for “allergies” without knowing whether they are allergies or not!

Ultimately, this is what bothers me.  And what costs people like Beth to waste $10,000!


If you want to download a copy of this post, you can download it HERE.

If you or someone you know has had a similar story to Beth, consider sharing it below. Not knowing the cause of allergies and being pushed down the wrong pathway happens far too often and causes problems with improper medications, unnecessary costs, AND still doesn’t help you feel better.

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