Allergies: Nature or ...?

Spring allergy season is upon us, and in Middle Tennessee it’s the time of year with the most acute allergy misery. All the sneezy, itchy, runny noses drive many patients to the allergist where they often wonder aloud, “I never had problems like this until I moved here. Would it simply be better for me to move somewhere else?” One recent study suggests the answer to that question is “No.”

No one is born with allergies. Whether people develop them, like most medical problems, depends on the combination of genetics and environment, nature and nurture. Certain people are born with a tendency – the genetic component – to develop allergies. At some point they become exposed to allergens like tree pollen, cat dander or peanuts – the environmental component. If a person’s genetic tendency is strong and the exposure has the right amount, timing and route of administration, then a clinical allergy may develop.

If your body has an allergic tendency, it's going to find an allergen to react to no matter where you live or what you try to avoid.

The genetic side of this formula is set in stone. You can’t pick your parents. The exposure side, however, is variable. Tennessee has more tree pollen than Phoenix. Humid areas (Mississippi) have more dust mites than arid climates (Colorado). Urban areas (Baltimore) have more cockroaches and cat dander than rural areas (Beaver Dam, KY). So you would think that the prevalence of allergies would be higher in areas with a greater environmental allergy loads. But, you’d be wrong.

A recent study looked at the prevalence of positive allergy tests in all areas of the U.S. and found that the numbers were pretty much the same wherever you live. A whopping 44.6%(!) of U.S. adults are sensitive to at least one allergen. In kids ages 1-5, that number is 36%. Interestingly, the rates didn’t vary from region to region, though they were a little higher in urban areas, 50%, vs. rural areas, 40%. Rates of sensitization to individual allergens did differ. For example, the South had more dust mite allergy and the West had more pollen allergy, but the overall rates remained constant.

So what does this all mean? It suggests that the genetic component of allergies is much more important than the environment. If your body has an allergic tendency, it’s going to find an allergen to react to no matter where you live or what you try to avoid. You can avoid specific allergens, but you can’t avoid all of them, and you can’t run from your genetics.

This is where the allergist comes in. We actually have the tools to make you less allergic to your specific allergens. We can teach your immune system to ignore your triggers, which will shut off your allergies at the source and give you systemic relief, fewer symptoms and fewer complications while using fewer or no medications. So before you pack up for Denver, try giving you local, board-certified allergist a visit first.

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Mail-in Allergy Testing

By Dr. Nicholas Cline • May 27, 2026

If you spend any time browsing the internet or social media, you’ve likely seen advertisements for mail-in allergy kits. They promise to test for hundreds of food intolerances and environmental sensitivities using just a few strands of your hair or a quick saliva swab. It sounds incredibly convenient, painless, and comprehensive. But if it sounds like a gimmick, it probably is. While these mail-in tests are heavily marketed, they often lack scientific backing and can leave patients feeling more confused than comforted. The Science of Allergy Testing. What Are We Looking For? To understand why hair and saliva tests don't work, we have to look at how the immune system reacts to allergens. When you have a true allergy, your body produces a very specific type of antibody called IgE (Immunoglobulin E) . These antibodies bind to mast cells (allergy cells), which are on high alert to protect you from perceived invaders like pollen, dust mites, or specific food proteins. The fundamental flaw with mail-in hair and saliva kits comes down to basic biology: Wrong Locations: Mast cells and IgE antibodies are not traditionally found in your hair follicles or saliva. Unreliable Results: Because these testing methods are looking in the wrong place, they are highly unstandardized and unvalidated. You are highly likely to get a flood of false positives or false negatives that are impossible to interpret accurately. What the Experts Say: Major medical organizations strongly advise against these methods. The National Institute of Allergy and Infectious Diseases (NIAID) explicitly recommends against using hair analysis for food allergy evaluations due to a lack of diagnostic value. Furthermore, the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI) have issued strong practice guidelines stating that hair analysis should not be used to evaluate food allergies. The Big Misconception: IgE vs. IgG Many mail-in companies charge anywhere from $150 to upwards of $600 for "sensitivity" panels. When patients produce these multi-page reports, the testing is almost always checking for IgG (Immunoglobulin G) antibodies, not IgE. There is a massive difference between the two: