Spring is fast approaching, and if you are a seasonal allergy sufferer, you likely associate this time of year with chronic sneezing, sniffling, and coughing. Your immune system is armed and ready to defend against harmless pollens, sending histamine soaring in your body triggering sneezing, runny nose, stuffy nose, watery eyes, and itching. Identifying the cause of your allergy symptoms before you start sniffling and sneezing can make them more manageable. Allergy testing can determine the specific allergens that trigger your reactions, and the results can help you try to avoid triggers and prepare ways to treat your symptoms before they occur.

Although many allergy sufferers turn their attention toward allergy care in the spring months, the winter months can be a great time to plan ahead and do allergy testing. A clinical evaluation, with allergy skin prick testing now can prepare you for the tougher months ahead in the spring, summer, and fall, and can potentially lessen the burden you will carry. Another key reason to have testing in the winter is that people may not be taking antihistamine medications in the off season. There are fewer potential pollen allergens outside during cold months, so many people are less likely to need their allergy medicine. First and second generation oral antihistamines, as well as nasal antihistamines and ocular antihistamines are typically recommended to be held for one week or 5-7 days to allergy testing (although some could as short as 3 days and some as long as 11 days). This can be particularly challenging for people during the peak of their worst allergy symptoms in the spring. Winter can provide a stable window for allergy testing prior to someone starting their medication or while symptoms are mild enough to discontinue without major episode or discomfort.

When preparing for an allergy skin prick test, it is important to share any and all medications you are taking with your provider. As discussed above, certain medications like antihistamines, can interfere with the development of a wheal and/or flare and negatively affect the accuracy of the allergy test. Many people understand the importance of temporarily withholding allergy medication or specifically oral antihistamines prior to testing, however antihistamines can be found in unsuspecting cases.  Antihistamines are found in many over the counter medications, including Tylenol Allergy, Actifed Cold and Allergy, Alka-Seltzer Plus Cold with Cough Formula, and many others. Make sure you read and check the ingredients carefully. Other medications your doctor may recommend temporarily stopping include tricyclic antidepressants, atypical antidepressants, benzodiazepines, and sedatives. Tricyclic antidepressants have the longest recommended wash out period ranging from 10-14 days. Benzodiazepines are recommended to hold for roughly 7 days, and most sedative and atypical antidepressants can be held for as little as 5 days. It is crucial to have direct guidance from your provider regarding temporarily withholding your medication and for how long. Never discontinue a medication without first discussing with your provider.

There are also few natural supplements worth withholding to ensure the accuracy of the allergy test results. Licorice, green tea, saw palmetto, St. John’s wart, turmeric, and feverfew can falsely reduce or eliminate positive results. Alternatively, astragalus and milk thistle can falsely increase or create positive results.

In preparation for an allergy test, it is equally important to know what medications should not be discontinued as it is to know which ones should. Intra nasal steroids such as Flonase, Nasonex, Veramyst, Nasacort, Rhinocort, and QNasal can be continued as directed prior to and during an allergy test. A nasal decongestant spray, Afrin, can also continue to be utilized. Although some stomach acid reducers such as Pepcid or Zantac do need to be discontinued due to their antihistamine properties, proton pump inhibitors such as Nexium, Prevacid, Prilosec, and Protonix can continue to be used. Similarly, although tricyclic antidepressants and atypical antidepressants can negatively affect the accuracy of allergy skin test results, other medication used for the treatment of depression such as selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are fine to continue taking as directed and do not impact the accuracy of skin test results. Singulair and all asthma medications can continue to be taken regardless of an upcoming allergy skin prick test, as well as common medications like Mucinex or Sudafed. Always make sure to discuss any and all medications (over the counter or prescribed) with your provider at least 1-2 weeks ahead of your scheduled test.