Cold, allergy, flu, virus: sniffing out differences

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Spring, welcome on so many levels, also brings with it sniffles, itchy eyes and allergies, with many a pharmacy assistant facing a customer eager for some form of relief.

The hard part now, though, is that when people hear a sniffle, there’s often a knee-jerk reaction into social distancing out of the fear that it must be contagious.

The truth of the matter is that the sniffle, often with an underlying runny nose, coughing, sneezing and congestion, might well be simply a sign of an allergy, rather than something contagious.

In this month’s issue of the magazine, Accredited Practising Dietitian Geraldine Georgeou tells Retail Pharmacy Assistants that 90 per cent of the time allergic responses, such as rhinitis (stuffy nose) and allergic rhinitis (hay fever), are seasonal and environmentally triggered.

“Interestingly, though, a person becomes more sensitive if they’re an allergic type with a gut dysbiosis that makes their body produce more histamine,” she explains.

“These people can test their gut microbiome to see if it’s triggering a histamine response – by taking a ‘Microba Insight’ test that provides detailed insights into what is taking place there.”

From there, she says, it’s easy for patients to get a correct diagnosis and further dietary assistance from accredited practising dietitians.

“Often people who suffer more from allergies are actually suffering from hives or eczema,” Ms Georgeou says.

“In my book, The Australian Healthy Skin Diet, there’s a section about hives and eczema that’s tied in with histamine responses.

“When this comes up, it’s really beneficial to look at low-chemical foods and other foods that could be triggering a histamine response.”

Ms Georgeou says the issue can also be a non-coeliac gluten sensitivity.

“Some people have a wheat allergy, precipitating airways in rotation and necessitating that the gut microbiome is supported to reduce the response,” she says.

“But we must be mindful that if a patient presents with allergic, cold or flu-like symptoms, they could indicate coronavirus, meaning they must get immediate medical advice.”

Health officials in the NSW Riverina region recently requested that anyone experiencing hay fever symptoms should undergo Covid-19 testing, even if they felt they were suffering from an allergy.

Murrumbidgee Local Health District CEO Jill Ludford says the local network was equipped to test more people for Covid-19 if required.

Dexamethasone

“Coronavirus can have very vague and general symptoms, and it can get out of control if people go out with what they think is hay fever,” she said.

For people who catch colds frequently, Ms Georgeou advises that it’s important for healthcare professionals to consider their immune system and iron and vitamin C levels.

“People can be iron deficient, which can definitely [weaken] their immune system and put their health at risk,” she says.

“Patients should be advised not to chew vitamin C supplements like lollies and wear down their tooth enamel and ruin all that orthodontic work.

“Iron supplements off retail shelves can also not be the solution, as some of my patients have taken these supplements thinking they’re iron deficient when in fact they have an iron overload.

“So, it’s always a good idea to check in with GPs, who should be seen as mechanics who open up the bonnet and find out what’s going on with the engine, and then look to accredited practising dietitians who can help the driver drive the car.”

Mark Webster, owner of Stay Well Pharmacy in Christchurch, New Zealand, tells Retail Pharmacy Assistants he often finds that when patients remove dairy from their diets they suffer less from allergies.

He adds that differentiating between a cold and an allergy “really boils down to taking a patient’s history”.

Colds versus allergies

Generally, while symptoms and severity may vary, colds have some basic characteristics in common with allergies, Mr Webster says.

Colds usually come with sneezing and a runny and stuffy nose, as do allergies.

Colds also usually come with a cough, which is experienced at times with an allergy. Both developments at times bring on weakness and tiredness.

Moreover, a differentiating fact to note is that sore throat is usually experienced with a cold and only rarely with an allergy.

General aches and pains sometimes come with a cold but never with an allergy, whereas itchy eyes are rarely experienced with a cold but usually with an allergy.

Allergies, Mr Webster says, are caused by a hyperactive immune system’s adverse reaction to certain substances, such as dust mites, mould, pollen, animal dander, foodstuffs (milk and eggs, and tree nuts), pollen or medications.

When exposed to these substances or triggers, the immune system releases chemicals – histamines – to fight off the triggers, which results in allergy symptoms.

Mr Webster points out that while allergy symptoms in general are similar to the common cold in the form of congestions, a sore throat, coughing, a runny nose and sneezing, the culprit for a sore throat in allergies is a post-nasal drip.

This drip is extra mucus felt in the back of the nose and throat, caused by the glands in these areas. A person clearing their throat more than usual is a sign of a post-nasal drip. The excess mucus can also cause some other symptoms.

Mr Webster says allergies can result in itchy eyes and rashes, whereas fevers are not an indication of an allergy. And even though seasonal allergies are most common, in some people they’re triggered by certain substances throughout the year, he adds.

Colds naturally self-limit

Associate Professor Rebekah Moles of the University of Sydney School of Pharmacy’s Faculty of Medicine and Health says a big tell-tale sign that a person is suffering from an allergy over a cold is the fact that the allergy won’t naturally self-limit, but will continue unless medication is taken or the trigger is removed.

She adds that an allergy could also lead to a cold, as ongoing allergies that aren’t treated effectively weaken the immune system, making a person more susceptible to cold onslaughts in the form of viruses and germs.

To read the full feature as it appears in the September issue of Retail Pharmacy Assistants magazine, visit: rpassistants.com.au/magazines/retail-pharmacy-assistants-september-2020/