This is my story:

10yrs old, I moved to Bakersfield Ca which is surrounded by agriculture farms. I started getting sick on a periodic basis and knew something was off when I broke in hives when I ate some local unfiltered honey. Immediately trialed several nasal sprays and stayed with Flonase. My life was somewhat manageable.

Moved backed to Houston, took an allergy test and it surprisingly came back negative for all samples. COVID lockdown started and so I stopped with the Flonase. Life was still good.

Post COVID lockdown, went back to work and found myself offshore right when the Saharan dust storm came through. Found myself with two ear infections and pink eye in both eyes. I got back on Flonase again and life was good again

Two months later (today), my Flonase ran out and I drove out to the ranch right after heavy rain. As result ranch was ver overgrown with high grass. I immediately started getting sick with a head cold

So long story short, I think I have an allergy problem but something that is that's usually tested. Is there something else that I can do to help with this? Polyps in my sinus cavity maybe?

I can't really follow your travels from the story, but your travails are obvious.
Allergy testing is regional. You would typically only be tested for the trees, grasses, weeds, etc. common to a particular area when allergy testing. Also, there are tons of things that are irritants but not allergies which cannot be tested for but which can give you all of the same symptoms as typical allergies. Included are things like changes in temperature, barometric pressure or humidity, chemicals, fragrances, etc.
IN GENERAL, the year round things that cause allergies are dust, dust mites (live in your bedding), pets, molds, etc. Spring is trees, late spring to early summer is grasses, and fall is weeds.
I would start with a good OTC regimen of Flonase Sensimist daily, Astepro at night, and Xyzal or Zyrtec or whichever antihistamine you like. Using sprays in the proper technique is important. In general, look down at your toes, aim slightly towards the outside (away from your septum), and gently breathe in. If you sniff forcefully, you just swallow the product. If nothing is helping, you could ask your PCP to order a total serum IgE to see if your allergen load is high. If it is, consider re-testing, especially if you are in a different part of the country from when you were previously tested. And make sure you are off of antihistamines for at least a week (including antihistamine sprays, which Astepro is) prior to skin testing.

Thanks bud

I was tested in Houston so what you said makes sense; also interesting about the irritants.

I got off the ranch on Sunday And I took Sudafed, and immediately started feeling better. I'm all dried up now, no more sinus pressure and I'm back on Flonase. I'll do what you suggested by taking the other otc drugs and will talk to a pcp about that other test

Giant ragweed bomb is dropping right now in Texas. I can feel my body react to it when I go outside and breathe heavily. I tolerate Claritin well and it is a 24 hours dose and doesn't make me drowsy.

A couple questions, if I may, as I use both of these:

1) Is there a big difference between Flonase and Flonase Sensamist? Or rather, what is the difference, other than the form? Is one absorbed easier, or something?

2) Astepro is Azelastine, correct? Why do you recommend that one at night?

Jackal99 said:

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A couple questions, if I may, as I use both of these:

1) Is there a big difference between Flonase and Flonase Sensamist? Or rather, what is the difference, other than the form? Is one absorbed easier, or something?

2) Astepro is Azelastine, correct? Why do you recommend that one at night?

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There are a bunch of different formulations of Flonase (fluticasone) since it went generic long ago. Some have alcohol and a floral type scent to them, and are a bit more aqueous. I like the Flonase Sensimist formulation because it doesn't have all that. Also, there are other OTC nasal steroids that work quite well, but fluticasone has a very low systemic bioavailability. Just a fancy way of saying very little of it gets into your bloodstream, especially if used properly (don't sniff in forcefully because you'll just swallow it, which increases systemic absorption).

Astepro is Astelin (azelastine) but 50% more concentrated. Azelastine tastes pretty nasty. Astepro basically has Sucralose and sorbitol in it to take the nasty taste away. It's now OTC, and it's always been dosed daily. It is probably a bit more sedating than azelastine, so taking it at night is recommended.

You can have an allergist do the full panel of 64 ( I think) tests. It will test for all sorts of stuff, including things that probably are not regional. Explain to them what you've said here to see if the full test is going to cover those things.

The full battery will help them formulate an appropriate allergy antigen immunotherapy, but be aware that process can last 3-5 years. The benefit is it will change your life. I know firsthand how beneficial it can be.

Thanks guys for the responses