Rising Ragweed Pollen: Why Fall Allergies in the U.S. Are Getting Worse
Every fall, ragweed pollen has long been a familiar culprit behind sneezing, congestion, and itchy eyes. But lately, it’s not just the symptoms that are changing—it’s the season itself. Rising ragweed pollen levels are making allergy season longer, more intense, and harder to escape.
What the Data Show
- Since about 1995, the ragweed pollen season has lengthened in 10 out of 11 studied locations in the central U.S. and Canada. In northern areas, the increase has been especially large: Winnipeg has seen the season grow by approximately 25 days, Fargo by 21 days, and Minneapolis by 18 days.
- Research also finds that warmer temperatures and higher carbon dioxide levels lead ragweed (and other seasonal allergens) to produce more pollen and to start earlier and end later.
- A recent investigation in Michigan linked high ragweed pollen exposure to increased respiratory mortality in older adults; the effect could persist for up to two weeks after exposure.
How This Affects Americans in the Fall
- Longer exposure: Ragweed pollen, which traditionally peaks in mid-September and lasts through October in many regions, is now beginning earlier and lingering later into fall.
- More severe symptoms: With more pollen in the air over a longer time, people with seasonal allergic rhinitis (“hay fever”) and asthma are experiencing worse flare-ups.
- Broader impacts on health and well-being: Beyond just discomfort, there are effects on sleep, school and work productivity, increased healthcare visits, and elevated risks for those with chronic respiratory conditions.
What’s Driving the Increase?
- Climate change: Warmer average temperatures delay the first frost in fall, extend the growing season for ragweed, and allow for earlier flowering in spring.
- Higher CO₂ concentrations: Plants respond by producing more pollen, and sometimes pollen that is more allergenic.
- Urban heat islands and environmental changes: Cities tend to stay warmer, which can magnify these effects. Land disturbance, changes in land use, and soil exposure contribute to ragweed spread.
What Can Be Done
- Awareness and monitoring: Check daily pollen counts; be alert for early season symptoms.
- Preventive measures: Starting allergy medications before symptoms flare can help. Using air filtration, keeping windows closed on high-pollen days, and rinsing off pollen after outdoor exposure all help.
- Seek professional help: For people with severe allergy or asthma symptoms, getting evaluated by a medical provider may be important—immunotherapy might reduce the severity long-term.
- Find a provider near you: If you think you might benefit from allergy testing or long-term treatment, you can use this tool:
Takeaway
Fall allergies aren’t what they used to be. With ragweed pollen seasons getting longer and stronger, more Americans are suffering for more of the year. But by understanding what’s changed, staying informed, taking preventive steps, and connecting with medical providers when needed, it’s possible to reduce the burden and breathe a little easier.
Allergy Services for Primary Care Physicians: Expanding Access to Long-Term Allergy Relief
Allergies affect more than 100 million people each year. Yet despite their widespread impact, allergies often go untreated due to the scarcity of specialist care. That’s why United Allergy Services is focused on introducing allergy treatment and immunotherapy to primary care practices—the first and often only point of contact for patients suffering from allergies. Let’s look at how UAS is making allergy care part of primary care.
Allergies are among the most common chronic conditions in the United States. Yet, despite the prevalence of food and environmental allergies and the associated health complications—including allergic asthma, sinus infections, and even anaphylaxis—many patients never receive proper diagnosis or treatment. Instead, they rely on over-the-counter medications that only mask symptoms rather than addressing the root cause.
Allergy Care Is Primary Care
Primary care physicians (PCPs) are often the first and only point of contact for patients suffering from allergies. By incorporating allergy testing and immunotherapy into their practice, PCPs can offer their patients a comprehensive, long-term solution, without the need for frequent specialist referrals. Allergy immunotherapy is the only treatment proven to modify the immune response to allergens, providing lasting relief rather than temporary symptom control.
United Allergy Services: Bringing Allergy Testing & Treatment to PCPs
United Allergy Services (UAS) partners with primary care providers to offer in-office allergy testing and customized immunotherapy treatment, enabling them to expand their scope of care with minimal additional workload. Since 2009, UAS has successfully partnered with over 2,500 practitioners across more than 20 states.
How UAS Supports PCP Practices
UAS offers two models for PCPs: a UAS-staffed Allergy Center or a self-managed Testing & Immunotherapy Kit package.
The UAS Allergy Center is fully supplied, staffed and managed by UAS. It is designed to integrate seamlessly into the practice with minimal disruption or outlay. This program includes:
- Clinical Allergy Specialists (CAS): Trained, onsite professionals who educate patients, conduct allergy testing, and coordinate immunotherapy.
- Comprehensive Food and Environmental Allergy Testing: Identifies sensitivities to pollen, dust mites, mold, and pet dander as well as certain foods (e.g. peanuts, lactose).
- Custom Immunotherapy Plans: Based on proprietary protocols, personalized allergy treatment options include subcutaneous (allergy shots) and sublingual (allergy drops) to maximize patient convenience and adherence.
- Full-service Supply & Compliance Management: UAS handles all allergy center supplies, from test extracts to patient education materials, ensuring a seamless experience.
- Insurance & Billing Support: Our team assists with reimbursement processes, making allergy services accessible and affordable for both patients and practices.
With the UAS Testing & Immunotherapy Kits, practices can enhance patient care while maintaining flexibility in how allergy services are incorporated. The Kit option includes:
- Environmental Allergy Testing Kit: Screens for 54 regionally relevant allergens, including trees, grasses, weeds, molds, and pet dander.
- Food Allergy Testing Kit: Identifies sensitivities to 23 common food allergens with panels tailored for adult and pediatric patients.
Both kits include personalized subcutaneous or sublingual immunotherapy options through UAS’s prescription-based formulations.
The Value of Experience
United Allergy Services has an unequalled record of success in delivering effective allergy treatment:
- UAS has more patients on our protocol than any other allergy service provider in the United States.
- We have partnered with more than 2,500 providers in 20+ states to provide allergy testing and immunotherapy services.
- Since 2011, UAS has conducted over 575,000 allergy and food sensitivity tests and served over 350,000 patients with 36+ million immunotherapy treatments in our allergy care clinics.
Enhancing Allergy Care in Primary Practices
With limited access to allergy specialists, many allergy sufferers and their doctors are forced to rely on medications that only mask allergy symptoms, increasing the risk of patients developing long-term respiratory conditions such as asthma.
By partnering with United Allergy Services, primary care practices are able to provide convenient, in-office testing for the full range of allergies and food sensitivities along with safe, well-proven immunotherapy.
Patients enjoy dramatic improvements in quality of life while PCP practices achieve higher levels of patient care and overall satisfaction.
Allergy Testing Kits & Immunotherapy from UAS: A Flexible Solution
Adding allergy care allows healthcare providers to address a common patient need and create a new income stream within the existing framework of their practice. However, we know that every medical practice has different requirements. For practitioners looking to integrate allergy testing and treatment without committing to a fully staffed and supplied UAS allergy center, we offer a flexible alternative: allergy testing kits and immunotherapy.
Expanding patient services with ancillary offerings such as allergy testing and immunotherapy is an effective way for medical practices to counter the stiff financial headwinds many are facing. Adding allergy care allows providers to address a common patient need, improve satisfaction, and create a new income stream, all within the existing framework of their practice.
However, every practice operates differently, with unique workflows, staffing models, and space considerations. For providers looking to integrate allergy testing and treatment without committing to a fully staffed and supplied UAS allergy center, we offer a flexible alternative. UAS Allergy Testing Kits & Immunotherapy enables practices to incorporate in-house allergy care while maintaining operational efficiency and clinical control.
Allergy Testing Kits Designed for Clinical Flexibility
UAS offers comprehensive allergy test kits for both environmental and food allergy testing, equipping providers with everything needed to administer skin prick allergy tests in-office. Each allergy testing kit includes test materials, patient education resources, and virtual training to ensure staff readiness. Ongoing customer support is available for clinical guidance, operational questions, and prescription fulfillment.
- Environmental Allergy Testing Kit: Screens for 54 regionally relevant allergens, including trees, grasses, weeds, molds, and pet dander.
- Food Allergy Testing Kit: Identifies sensitivities to 23 common food allergens with panels tailored for adult and pediatric patients.
Comprehensive Immunotherapy Options
Practices offering allergy treatment can provide personalized immunotherapy through UAS’s prescription-based formulations:
- Subcutaneous Immunotherapy (SCIT): Allergy shots available in single or dual-vial sets for long-term symptom relief.
- Sublingual Immunotherapy (SLIT): Allergy Allay Drops® offer a convenient, at-home alternative to injections.
A Scalable Approach to Allergy Care
With the UAS Allergy Testing Kits & Immunotherapy, practices can expand their services in a way that aligns with their needs—whether through occasional in-office testing or a more structured allergy treatment program. This solution allows providers to enhance patient care and practice growth while maintaining flexibility in how allergy services are integrated.
For more information on how the UAS Allergy Testing Kits & Immunotherapy can fit into a practice, contact United Allergy Services.
Oral Allergy Syndrome
Delicious, ripe, mouthwatering fruits and vegetables are more plentiful during these summer months. However, that that summer breeze may carry more than just excitement for the season. Some people with environmental allergies may notice that certain fruits, vegetables, or nuts give them distinct allergic symptoms, typically confined to the lips, mouth and throat. This phenomenon is known as oral allergy syndrome (OAS).
Oral Allergy Syndrome
Oral allergy syndrome, or pollen food allergy syndrome, occurs when there is a cross reaction or a confusion in the body. Some fruits, vegetables, and nuts have a similar protein to the allergy-causing protein on the surface of the pollen grain. According to the American Academy of Allergy, Asthma, and Immunology (AAAAI), "These proteins can confuse the immune system and cause an allergic reaction or make existing allergy symptoms worse, which is referred to as cross-reactivity." It is a contact allergic reaction, but it also considered a mild food allergy.
Cross Reactivity
During the summer season, cross reactivity with grass and weed pollen most commonly triggers OAS. Timothy grass, orchard grass, and ragweed pollen tend to cause more reactions. Other grasses and weeds may also contribute to OAS symptoms. People with allergy to timothy grass and orchard grass may experience OAS when consuming foods like peaches, oranges, and tomatoes. Those allergic to ragweed pollen can experience symptoms when eating foods like banana, cucumber, zucchini, and some melons such as honeydew and cantaloupe. Watermelon and white potatoes can trigger a response in both grass and weed pollen sufferers equally.
Symptoms and Treatment
Typically, oral allergy syndrome symptoms present as itching or swelling in the mouth and throat. Symptoms can also be present on the face, lips, or tongue. While the symptoms usually appear immediately after eating raw fruits or vegetables, in rare cases the reaction can occur more than an hour later. Eating the food in the rawest or purest form usually triggers the more severe symptoms. Peeling, cooking, or baking the food can greatly reduce or eliminate a reaction all together.
For most people, the allergy symptoms are localized to their mouth and are uncomfortable or annoying. However, up to 9% of people have reactions that affect a part of their body beyond their mouth. About 1.7% can suffer a life-threatening allergic reaction or anaphylaxis. For this reason, it is crucial for people to determine what might be causing their symptoms with allergy testing and food journals. Avoid eating that allergy-causing food (especially in that foods peak allergy season). It is also beneficial to consider treating the underlying pollen allergy with immunotherapy.
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter.
Eosinophilic Esophagitis (EoE)
Eosinophilic esophagitis (EoE) is a recognized diagnosis that produces symptoms related to dysfunction of the esophagus. In EoE, large amounts of white blood cells, specifically eosinophils, collect in the inner lining of the esophagus resulting in inflammation. Typically, the esophagus is free from eosinophils and resulting inflammation, and so in EoE, a patient will begin to notice a difference in the way they can eat and swallow food. This condition can be difficult to diagnose as other conditions can present with eosinophils in the esophagus, and historically EoE has not been a common or well-known disease. Awareness has significantly improved however in the last decade, and patients are being recognized and diagnosed much earlier. This week, the FDA has approved the first ever treatment for EoE.
Symptoms of EoE
Many EoE patients also have symptoms of one or more allergic disorders like asthma, allergic rhinitis, atopic dermatitis (eczema) and food allergy. It is important for EoE patients to be properly assessed and tested for potential allergens as well as properly diagnosed for their atopic conditions. Similar to proper diagnosis, it is crucial that any and all allergic aspects of EoE can be properly treated in conjunction with management of the EoE. Patients benefit from a team of providers working together such as a primary care provider, allergy specialist, and gastroenterology specialist.
Early diagnosis of this chronic condition is important so patients can be educated and properly managed, sparing them from discomfort, malnutrition, and even life-threatening situations. An emergent situation can arise if inflammation becomes too great and causes narrowing in the esophagus, trapping swallowed food. In younger children, EoE typically presents with poor feeding, failure to grow properly, vomiting, reflux symptoms, and abdominal pain, whereas in adolescents and adults EoE most often presents with dysphagia (trouble or painful swallowing) and emergent esophageal food impactions.
Allergy Correlation
Airborne allergies can play a role, however adverse immune responses to food are the main cause of EoE in many patients. It can be more difficult to properly diagnose food allergies in EoE patients because many do not present with the typical symptoms associated with IgE mediated food allergy. Instead of immediate itching, flushing, hives and vomiting after ingestion of the offending food, the reactions can be delayed over hours or days. Milk, egg, soy and wheat are recognized as the most common triggers for EoE, however, conventional allergy tests often fail to detect sensitivity to the foods causing EoE. This is because most food allergy reactions in EoE are delayed and caused primarily by immune mechanisms other than classical IgE-mediated food allergy.
Diagnosis
Other than proper identification and diagnosis of atopic conditions, EoE must also be properly diagnosed itself as a disease. If EoE is suspected, a specialist performs an upper endoscopy, where a small tube with embedded camera is passed down the esophagus. The tube not only has a camera and light for inspection, but a small device to take samples, or biopsies of the esophagus. The biopsies of the esophagus are examined under a microscope for eosinophils and inflammation and are necessary to diagnose EoE. A provider looks for appropriate symptoms that were described above, visual inspection of the esophagus, and examination of tissue biopsies to make the final diagnosis of EoE.
Managing EoE
There are many viable options to managing EoE effectively. Food sensitivities or allergies can be managed by removing those offending foods from a person’s diet, but only under the direct guidance and supervision of a provider. A provider can advise eliminating a specific food, or a food group based on individual history, examination, and diagnosis. This elimination approach can be helpful to some, but it is important to only remove what is advised, and a medical provider will closely monitor a person and regularly discuss nutrition and intake. Many times, a dietician is added to the medical care team to make sure a person is still receiving all the necessary nutrients. A provider’s goal is to carefully add back any foods that can in fact be tolerated and are proven not to incite eosinophils in the esophagus.
Aside from adjustments to a person’s diet, there are some medications providers use to help provide symptom relief and management of the EoE. It is important to note that aside from the first medication being approved by the U.S. Food and Drug Administration (FDA) to treat EoE, typical options for treatment include proton pump inhibitors and steroids. Proton pump inhibitors (PPIs) reduce acid production in the stomach and have also been found to be able to reduce esophageal inflammation in some patients with EoE. PPIs are very commonly used as a frontline therapeutic for EoE patients. If PPIs do not work for a patient, another option may be swallowed topical corticosteroids. Swallowing small prescribed doses of corticosteroids so they come in direct contact with and treat the inner lining of the esophagus is the most common treatment.
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.