Sniffling, sneezing, feeling run-down? Colds, flus, and seasonal allergies can all share symptoms, making it tough to determine the cause for your malaise.
Yet there are some telltale differences. Figuring out what’s ailing you can help you best treat it and recover more quickly — and prevent spreading it to others.
“This question comes up every year as the seasons change,” says Ken Redcross, MD, an internal-medicine physician in New Rochelle, N.Y., and a spokesperson for the homeopathic medicine company Boiron USA.
“Colds and the flu are both caused by viruses and are contagious, which means they can spread easily from person to person. Allergies, on the other hand, are caused by an overactive immune system reacting to triggers such as pollen, dust, or pet dander, and they are not contagious,” he explains. “All three can cause congestion, fatigue, and a runny nose, which makes them easy to confuse.”
So how do you tell them apart?
“It can be difficult to distinguish between them, but there are a few ways you can tell,” says Purvi Parikh, MD, an allergist and immunologist with Allergy & Asthma Network and a clinical assistant professor in the Department of Medicine at NYU Grossman School of Medicine.
While seasonal allergies may cause many of the same symptoms as a cold or flu, they do not make you “sick” in the traditional sense of having an infection, she explains.
“Allergies usually last much longer, often weeks to months, and typically follow a predictable seasonal schedule. The most classic allergic signs are itchy eyes, nose, or throat,” Parikh says.
“Viruses tend to bring more full-body symptoms, such as aches, fatigue, and sometimes fever or stomach pain,” she adds. “A cough with a virus may also produce colored mucus or phlegm, which is uncommon with allergies.”
Viral infections like a cold, flu, or even COVID-19 are generally short-lived, running their course in about seven to 10 days.
Sneezing, a runny nose, or a sore throat can be present in both allergies and viruses — and these symptoms can also trigger asthma symptoms, explains Parikh. “So, paying attention to the duration and whether you feel that itchiness [of allergies] is the clearest way to figure it out.”
Still, certain symptoms can be revealing, says Redcross.
“The key difference is that allergies usually do not cause fever or body aches,” he notes. “Colds tend to develop gradually, while the flu strikes suddenly and with more intensity, often including fever, chills, and muscle pain. Allergies also bring more itching, particularly in the eyes, nose, and throat.”
One further caution: Seasonal allergies can make you more susceptible to viral and bacterial illnesses due to chronic inflammation and an overstimulated immune response, Parikh explains.
“Allergies can also disrupt sleep and cause stress, which predisposes you to illness,” she says. “Those who suffer from asthma due to their seasonal allergies are also more likely to catch upper-respiratory viruses and infections. Due to the lung involvement, these respiratory illnesses tend to be more severe for asthma sufferers.”
If you aren’t certain what’s ailing you — and whether it’s contagious to others — Parikh recommends using a rapid flu or COVID test, “as even physicians can be fooled, thinking something is allergies when it may be a virus.”
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