Are Doctors Too Quick to Blame Allergies?
Updated: Aug 12
One of the reasons I started this blog is the frustration of lack of investigatory work from GPs in the UK. I can only write from my own experience, but being constantly offered allergy medication when complaining about my sinuses is starting to get pretty boring.
Now, I'm not denying that it's not a factor or a co-factor for many, but I strongly believe that my sinus issues come from an internal factor such as my hormones an immune response or some sort of structural defect. All three of which will not be maintained by an antihistamine. If questions such as 'Do weather changes affect your symptoms?', 'Have histamines ever helped?', 'Do you react to perfumes or cleaning products?' were asked I would not only feel more listened to but it would help the GP or the patient find a useful pathway to diagnosis. Guessing or assuming allergies frustrates both parties. I'll admit that the patient doctor dynamic regarding sinus issues and diagnosis is tricky, just because there is so little information on the issue in general and currently, there seems to be a trend to label yourself with something like an allergy. So, although annoying from a personal perspective I can see why that's the first-place people go.
My ideal goal would be to find the root cause and to either fix it or manage it but there is a reluctance to press further. Maybe because it's not life threatening or causing me too much distress, who knows? But I take the view that every symptom is your body's way to let you know that something is wrong and I like to fix the small things before they turn into big things.
Research although limited and complicated, seems to be on my side with a June 2024 paper (linked below) that recognises that non-allergic sinus symptoms are common. However, non-allergic rhinitis, mixed rhinitis and chronic rhinitis can be difficult to distinguish. One study looked at people who believed they were suffering from allergies. Among 219 patients evaluated, almost half (45.2%) were also found to have chronic rhinosinusitis. There is a problem with the fact that symptoms such as congestion and sinus pressure can lead to confusion between allergy and sinus disease so to me, there seems to be a need for more up-to-date process to diagnose these issues.
Mixed forms of rhinitis patients may benefit from antihistamine protocol but could still have symptoms, meaning they would need to marry other regiments. Some patients on strong medications for decades and only fixing part of the problem whilst struggling with another part that could potentially be more pressing. Medicine can be quick and slow to change depending on the area.
If allergies aren’t the whole story, then what else could be going on?
A lot to be honest, environmental factors such as heat (read Why Do Heatwaves Make Your Sinuses Worse post for more) pollution, humidity, general weather, hormones, immunity, facial structure and probably more that has yet to be identified and I will be delving into these in future posts. One reason I've become interested in alternatives to the allergy explanation is that there are many other factors that can affect the nose and sinuses, including structural issues. Reading Breathe by James Nestor completely changed the way I think about the relationship between facial development, nasal breathing and long-term respiratory health, although that's a topic deserving of its own article
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