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Why Can It Take Years For People To Develop Cedar Allergies In Central Texas?

CedarFeverIllo_LaurenIbanez.jpg
Lauren Ibanez for KUT
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Why don't some people develop cedar allergies until years after they move to Central Texas?

There’s something in the air.

You can’t see it. You can’t smell it. You can’t taste it. But — for many of us — you sure can feel it. That something is cedar pollen. If you’re allergic, it brings on the dreaded cedar fever, a varying degree of flu-like symptoms that can be all-consuming this time of year in Central Texas.

But have you ever noticed some people don’t develop cedar allergies until years after they move here? One listener wanted to know why and sent in the question to our ATXplained project.

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A Scourge On This Earth

I was eager to pick up the story because, well, I’m one of those people.

It wasn’t until this year — after nine years of living in Austin — that I was hit with such a severe case of cedar fever I was sure it was something more.

There’s the endless runny nose that feels like it could fill a bathtub. But somehow, like some cruel joke, your entire nasal passage is also completely blocked. Then there’s the incessant sneezing. One after another, after another. Finally, there are the itchy, watery eyes. The other day I was scratching my right eye so hard, I was convinced I’d torn out every single one of my eyelashes.

(Yes, it sounds a lot like COVID-19, but there are ways to spot the differences.)

For this project, we ask you what you want us to investigate and what stories you'd like us to tell.

On my worst days, these minuscule floating grains became my sworn enemy — and I’m not alone.

“I don’t know if it’s too early in 2021 to bust out a C-3PO joke from Star Wars, but you remember that line, ‘We seem to be made to suffer, it’s our lot in life,’?" said Ryan Turner, who lives in Austin. “I don’t know, maybe that’s just what it’s like to live in Central Texas.”

Turner says he’s had his bad days but nothing he couldn’t handle on his own. The same wasn’t true for Gabriel Estrada. He learned he had a cedar allergy after he became so stuffed up his eardrum burst and he landed in the ER.

“It’s like one of those bad sci-fi movies, like, ‘Oh my goodness, the cedar is out to attack you,’” he said. “In my case, it literally was out to attack me.”

Winona Youngblood-Sultze said her allergies caused so many sinus infections she ended up having to get a sinuplasty. Doctors inflated her sinuses with a balloon because they were almost completely blocked from inflammation and mucus.

"It was straight up like, 'Oh, I don’t have oxygen in my brain,'" she said. "'This is what it’s like to breathe.'"

Turner, Estrada and Youngblood-Sultze are all lifelong Austinites. While our cedar fever experiences vary, we do all have one thing in common: Our allergies didn’t show up for years.

Much like our question-asker, I’ve always wondered why cedar allergies hit people at different times. For some, it happens right away. For others, it can take years.

But why?

It Should Be Called 'Juniper Fever'

First, we need to understand where cedar pollen comes from and why there’s so much of it in Central Texas.

It turns out cedar pollen does not come from a cedar tree. What we commonly refer to as "mountain cedars" are actually Ashe juniper trees. These are a completely different species from cedar trees, and there are a ton of them in Central Texas.

AsheJuniper_GP_1-28-21.jpg
Gabriel C. Pérez/KUT
Ashe juniper trees, which cause cedar fever, in Leander.

“We have millions upon millions upon millions of Ashe juniper,” says Robert Edmonson, a biologist with the Texas A&M Forest Service.

He says what makes these trees unique is that they pollinate in the winter — roughly mid-December to mid-February, with January being the peak. It’s this time of year when every male Ashe juniper tree releases pollen from the thousands of pollen cones in its crown.

“You’ll see these trees, they look like they literally explode,” he said.

A few years back, the Forest Service did an inventory of Austin — sort of a tree census. It found that Ashe juniper was the most common tree in the city. In fact, there are about seven male Ashe juniper trees for every human in Austin.

They look like they literally explode.
Robert Edmonson, Texas A&M Forest Service biologist

But this wasn’t always the case.

As recently as about 250 years ago, Edmonson says, Central Texas had exponentially fewer trees than we see today. The area was more like a savannah because periodic wildfires would burn back the brush. But, Edmonson said, over time, more people moved in and changed the landscape completely.

More development, fewer fires.

“So we’ve created pretty much what we have today,” he said. “In a weird sense, I guess you could say we kind of brought cedar fever onto ourselves.”

A Not-So-Satisfying Answer

If that isn’t enough to bum you out, wait until you find out the reason why it takes some people years to develop cedar allergies. According to Dr. Elizabeth Matsui, a pediatric allergist and immunologist at UT’s Dell Medical School, there’s no clear answer.

“There are likely so many factors,” she said. “We can’t put our fingers on, ‘Well, this is the big difference between the person who started to develop allergies two years in and the person who started to develop allergies nine years in.’”

I didn’t like this answer, so I got a second opinion from another allergist in town, Dr. Binaca Gaglani. She basically told me the same thing.

“Just like in science,” she said, “we don’t know if we know the true answer to it.”

Both doctors made clear there is no definitive answer. But there are theories.

AsheJuniper_GP_1-28-21.jpg
Gabriel C. Pérez/KUT
Ashe juniper trees release pollen from their thousands of pollen cones.

First, you need to understand that people who get allergies do so because they’re genetically predisposed. This means your parent, grandparent, etc., had allergies and passed down those genes to you.

These genes then make special antibodies, called Immunoglobulin E, or IgE antibodies.

This is where things can get a little wonky, so let’s use the nose as an example. (But this can also happen in your eyes and lungs.) There are these things called mast cells that live on the lining of your nose. The mast cells have IgE antibodies on their surface, and when the cedar pollen hits your nose, those antibodies are hardwired to capture it.

"Think about it like a venus fly trap, and so it recognizes that allergen and says 'ah-ha!'" Matsui said. "Then they lock together, and then that sends a signal through that IgE antibody that’s on the surface of the mast cell that’s like a danger signal."

The mast cell then starts freaking out and releases a bunch of nasty stuff, like histamine. This is when the inflammation reaction happens in your mucus membrane and you start feeling all those common symptoms: sneezing, drainage, congestion. It’s essentially your allergic immune response kicking into high gear.

Now, you only start producing these IgE antibodies once you’ve been exposed to an allergen, which usually happens in the first year.

“Then the second year is when it’s ready [to fire] on the mucus membranes of eyes, nose, sinuses,” Gaglani said. “So, usually it is in the second year that most patients present.”

We get a question about why is it so variable, and I come back with an answer: because people are so variable.
Dr. Elizabeth Matsui, allergist and immunologist

While that’s the average, it doesn’t explain why it takes symptoms in some people like myself up to a decade to show up.

Matsui and Gaglani tell me they can't know the answer for sure because there are just too many factors at play. What’s your family history? Do you live near the greenbelt? How high is the pollen count that day? Are you pregnant? It’s really hard to know exactly why cedar affects one person differently than another because everyone is just so different.

“We get a question about why is it so variable, and I come back with an answer: because people are so variable,” Matsui said. “Which is not satisfying, but that’s the way it is.”

No, it’s not satisfying, but that’s life sometimes.

We do know one thing for sure: Cedar isn’t going anywhere. Neither is the collective anxiety that comes with it every year.

All we can do is take care of ourselves. If your symptoms are really bad, see your local allergist. For the rest of us: Take your antihistamines, grab your nasal spray and hope for the best.

Got a tip? Email Nadia Hamdan at nhamdan@kut.org. Follow her on Twitter @nadzhamz.

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