Newswise — If you spend August sneezing, ragweed may be your allergy enemy. If, like clockwork, you suffer in the spring, tree pollen may be to blame. And if your eyes itch and head feels stuffed up after the first frost should have killed every outdoor allergen, you may have indoor allergies.

While some allergy sufferers can pinpoint the cause of their misery, many are unaware of the trigger that sets off their symptoms. In fact, James Temprano, M.D., assistant professor of internal medicine at Saint Louis University, says many patients are surprised to learn the source of their allergies.

Knowing your allergy triggers gives you information that allows you to practice avoidance measures, like keeping the windows closed during the season that causes your symptoms, and also helps doctors provide treatment.

Allergists use skin tests to determine what substances are causing your symptoms. Doctors conduct skin tests by putting small amounts of various allergens on or below the skin and observing any reactions that occur, offering immediate results.

Once they’ve identified allergens like ragweed, pollen, and grass, doctors often can target the dates you’re most likely to experience symptoms.

Late summer/Autumn: Ragweed season typically begins around mid-August and plagues sufferers until the first frost offers relief. Survival tip: Ragweed pollen counts are highest between 5 a.m. and 10 a.m. on hot, dry, and windy days, so avoid outdoor activities during that time.

Winter: Because we spend more time indoors with windows shut in the winter, indoor allergies like dust and pet allergies can be worse during winter months. Survival tip: Wash bedding weekly in hot water and dry on high heat.

Spring: If you’re a spring allergy sufferer, tree pollen may be causing your symptoms. These allergies typically begin toward the end of February or early March and last through May. Survival tip: Be sure to change your clothes and wash your hair after time outdoors.

Summer: Grass allergies tend to flare up in May or June, or even earlier, and continue most of summer. Survival tip: Keep windows shut to limit your exposure.

For many people, multiple allergic triggers mean symptoms continue throughout much of the year. And, some allergies know no season, like the insidious mold that can strike after a spring rain or in your damp basement.

Treatment for allergies varies depending on the frequency and severity of symptoms. Those with intermittent, mild allergies (fewer than four days a week for fewer than four weeks a year) can start with antihistamines. Those who experience more severe allergies may consider nasal steroids or allergy shots.

Allergy shots, or immunotherapy, increase a person’s tolerance to the allergens that have been causing symptoms. While they require regular shots for around five years, patients can begin to feel improvement within months, and can offer significant relief over the long term. They are also a good solution when avoidance measures aren’t practical, as for a person who works or enjoys regular time outdoors.

It may be time to consider shots, Temprano, says if:

*Medications aren’t working for you.*You suffer side effects from medications.*You also have asthma.*Your symptoms are disturbing sleep or work. *Allergies are affecting your quality of life.

Often patients become accustomed to their symptoms and are unaware of how many days out of the year they are affected by allergies, Temprano says. Fatigue and the inability to concentrate are less frequently recognized symptoms.

“Once they receive treatment, many of my patients say, ‘I didn’t realize how miserable my allergies were making me.’”

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.