Ragweed Allergy – How to Recognize It and How to Keep Symptoms Under Control

September is here, and with it two respiratory problems that often appear at the same time: seasonal viral infections and ragweed allergy. Because the symptoms can look alike, a natural question comes up: how do we know whether we have a simple viral infection or an allergic reaction?

And, more importantly, when is it enough to ask a pharmacist for advice, and when should we see an ENT specialist or an allergist?

Ragweed, an increasingly common allergen

Although legislation exists on controlling and eradicating ragweed, the plant continues to grow in many areas, and people with allergies face sometimes very troublesome symptoms year after year.

In Romania, the legal framework is set by Law no. 62/2018, with subsequent amendments and additions, which provides measures for controlling ragweed. When we notice land where the plant has not been removed, complaints can be filed with the Local Police, the environmental departments of local councils, or the National Environmental Guard.

The most widespread ragweed species is Ambrosia artemisiifolia, known locally by names such as iarba de paragină, iarba pârloagelor, or floarea pustei.

The plant can reach 50 to 100 centimetres in height, sometimes even more, and has a bushy appearance due to its heavily branched stem. The root system is very well developed, and the entire plant is covered in fine hairs.

The problem is not just the plant's appearance, but above all the pollen it releases. For sensitive individuals, this pollen can trigger significant allergic reactions.

Some epidemiological data point to a growing number of people affected by ragweed allergy in Romania, as measures to control the plant remain insufficient.

How does ragweed allergy present?

Symptoms can vary from person to person, but the most common are:

• Nasal symptoms: repeated sneezing, watery nasal discharge, a blocked nose, and an itching sensation;
• Eye symptoms: tearing, allergic conjunctivitis, itching, and irritation of the eyelids;
• Respiratory symptoms: dry cough, a feeling of breathlessness, or worsening of existing respiratory conditions;
• General symptoms: fatigue, headaches, and sleep disturbances.

One important point is that symptoms can persist for entire weeks, throughout the period of pollen exposure.

Allergy or viral infection? How to tell the difference

At first glance, an allergy and a cold can look very similar. Sneezing, a runny nose, and general discomfort appear in both cases. There are, however, a few clues that can help us tell them apart.

If itching in the nose and eyes, repeated sneezing, and watery nasal discharge are the main features, with no fever, an allergy is the more likely cause.

On the other hand, fever, muscle aches, a general feeling of being unwell, and a sore throat point more toward a respiratory infection.

These clues are no substitute for a medical consultation when symptoms are intense, persistent, or unusual.

How can we reduce contact with pollen?

During ragweed season, avoiding pollen entirely is almost impossible, but we can significantly cut down our exposure.

A few simple steps can make a real difference:

• air out your home, preferably in the second half of the day or after rain;
• Use an air purifier with a hepa filter if possible;
• after walks in the park or in areas with vegetation, rinse your nose with a saline solution;
• wear sunglasses and, in areas with high pollen concentrations, consider wearing a protective mask;
• wash your hands frequently;
• vacuum and clean your home regularly;
• for drying clothes, prefer indoor drying during periods of high pollen concentration;
• if you have pets, clean their paws after walks in nature;
• in the car, keep the windows closed and use the air conditioning system with air filtration.

What do we do when symptoms appear?

Even with all these precautions, contact with pollen is hard to avoid. That is why people who know they are allergic can discuss a symptom management plan in advance with their doctor or pharmacist.

Antihistamines such as loratadine, cetirizine, or bilastine are used to reduce sneezing and the itching sensation in the nose and eyes. For people with known seasonal allergies, preventive use may be considered on the advice of a doctor or pharmacist.

Another important category is intranasal corticosteroids, such as fluticasone, mometasone, or budesonide. These are considered very effective in controlling nasal inflammation and congestion.

It is important to know that their effect does not always appear immediately, which is why correct and consistent use, following the recommended guidance, is essential. Nasal decongestants such as xylometazoline or oxymetazoline can be useful in the short term for a very blocked nose, but prolonged use is not recommended.

For eye symptoms, anti-allergic eye drops can be used, containing, for example, olopatadine, ketotifen, or sodium cromoglicate.

When symptoms are persistent, severe, or significantly affect quality of life, a consultation with an allergist is recommended. For certain patients, the allergist may recommend allergen-specific immunotherapy, also known as desensitisation. This is a long-term treatment carried out only under medical supervision and can be administered, depending on the situation, sublingually or by injection.

Can diet or supplements help?

Alongside treatment recommended by a doctor, diet can help maintain a good general state of health. Some natural substances have been studied for their potential effects on inflammation and the allergic response. However, these should be seen as adjuncts, not replacements for anti-allergic treatment.

Quercetin

Quercetin is a flavonoid found naturally in many plants and foods. Experimental studies have identified a potential anti-inflammatory effect and a role in modulating histamine release.

In the diet, quercetin can be found in red onions, broccoli, apples eaten with the skin, berries, lovage, and dill.

The amount obtained from food is, however, much smaller than that found in standardised supplements. Foods also provide other beneficial substances, such as vitamins, minerals, and antioxidants.

Quercetin supplements should be used with care, especially by people on long-term medication. Drug interactions are possible, including with certain anticoagulant treatments, so advice from a doctor or pharmacist is recommended.

Omega-3

Omega-3 fatty acids, particularly EPA and DHA, are well known for their role in modulating inflammatory processes.

They can be obtained from oily fish such as salmon and sardines, flaxseeds, and walnuts, as well as from certain oils.

With omega-3 supplements, it is important to check the actual amount of EPA and DHA, as well as the quality and origin of the product.

Vitamin C

Vitamin C has an important antioxidant role and contributes to the normal functioning of the immune system. It can easily be obtained from foods such as sea buckthorn, kiwi, blackcurrants, bell peppers, fresh parsley, and citrus fruits.

Propolis

Propolis contains many bioactive compounds that have been studied for their effects on inflammation and the immune response. It can be used as an adjunct, but people with allergies, especially those sensitive to bee products, should be cautious.

Curcumin

Curcumin is the main active compound in turmeric and is known for its anti-inflammatory properties. Some supplements combine curcumin with piperine to improve its absorption.

Here too, choosing a quality product and checking its origin matters. People with digestive sensitivity or those on medication should ask their doctor or pharmacist before taking it.

When is it time to ask for help?

For mild, familiar symptoms, a pharmacist can offer guidance on the options available without a prescription. If symptoms are persistent, recur every season, or do not respond to the usual measures, a medical consultation is advisable.

An allergist can identify the responsible allergen, assess the severity of the allergy, and determine whether immunotherapy is appropriate.

In the case of significant respiratory symptoms, such as a feeling of suffocation or difficulty breathing, these should not be left to pass on their own. Prompt medical assessment is necessary.

Ragweed allergy should not be treated as a minor seasonal nuisance. With a combination of prevention, proper treatment, and medical evaluation when needed, the ragweed flowering season can be much easier to get through.