Feeling so stuffed up that you need to keep a stash of tissues in your pocket can be more than a little annoying, especially if you can’t figure out what’s behind your congestion. If you’re not sick and you don’t have allergies, what’s going on? Well, it turns out that there are a handful of surprising reasons you’re congested, some of which are more obvious than others.
Meet the expert: Gerald B. Lee, M.D., an assistant professor of allergy and immunology at Emory University School of Medicine.
Here, an allergy and immunology specialist explains the other possible causes behind your constant congestion, plus what you can do to un-stuff your nose and your sinuses once and for all.
Surprising reasons you’re stuffed up
There’s something in the air
About one-third of people who have inflammation in their nasal passages have what’s called nonallergic rhinitis, which is the technical term for a stuffy nose without a clear cause, per the Mayo Clinic. “If you’ve been tested for allergies and you’re negative, that’s probably what you have,” said Gerald B. Lee, M.D., an assistant professor of allergy and immunology at Emory University School of Medicine. One common form, nonallergic rhinopathy, tends to occur when your body is irritated by something in your environment, like cigarette smoke, perfume, or dry air. Temperature fluctuations can also spell trouble. Your best bet is to try to figure out your triggers and avoid them as much as you can. If that doesn’t help enough, ask your doctor about using a decongestant or a nasal spray containing an antihistamine or corticosteroid.
Pregnancy
Swollen belly aside, you go through an awful lot of changes while you’re growing a baby. The hormonal shifts are major, plus there’s more blood circulating throughout your body. While most people have heard that being pregnant can bring on swollen ankles, you might be surprised to learn that the membranes in your nose may swell as well. Known as pregnancy rhinitis, this can make you feel very stuffy during pregnancy even though you’re not sick. (Nosebleeds are also common when you’re expecting.) Running a humidifier, drinking plenty of fluids, and using a saline nasal spray can all help. Be sure to consult your ob-gyn before trying any OTC medication.
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Using too much nasal spray
A decongestant nasal spray (like Afrin) can work wonders when you’re suffering from a bad cold or allergies. But beware: If you don’t follow the instructions on the bottle—you’re not supposed to use it for more than three consecutive days—you could end up with rebound congestion. What does that mean? When you use these nasal sprays for too many days in a row, you can start to feel even more stuffed up each time you try to stop using it, so you simply don’t stop (some people say they’re “addicted”). Unfortunately, breaking the cycle isn’t easy. “You’ll feel awful for a while,” said Dr. Lee, but it does eventually get better. If you can’t manage to quit the spray on your own, talk to your doctor or an allergist. “Some people need to use oral or nasal steroid medications while they’re getting off the nasal decongestants,” Dr. Lee said.
An underactive thyroid
Hypothyroidism—a condition in which your body doesn’t produce enough thyroid-stimulating hormone (TSH)—can lead to nasal congestion (other signs you may have a thyroid problem include fatigue, constipation, thinning hair, dry skin, and feeling cold). If you suspect there might be something up with your thyroid, ask your doctor to check your TSH levels. According to the Columbia Thyroid Center, at least 10% of women under 50 and 17% of women under 60 have hypothyroidism. Receiving a diagnosis and getting the treatment you need should help relieve symptoms like congestion.
A bacterial sinus infection
Have a cold that just won’t quit? Most viral infections, including colds, are on their way out within a week or two. If you’ve been sick for longer than that—or if you feel like your cold started to diminish only to flare up again with a vengeance—see your doctor. You may have developed a bacterial sinus infection, which requires treatment with antibiotics. Other signs of a bacterial infection include fever, nasal discharge that contains pus, and severe pain in the sinuses, said Dr. Lee.
Nasal polyps
Another reason for a “cold” that never ends: nasal polyps, which are small, soft growths in the nose or sinuses, according to the National Library of Medicine (NLM). These noncancerous growths aren’t dangerous, but they can physically obstruct your sinuses or airways and make you feel pretty terrible. Polyps are most likely to crop up in people who have allergies, asthma, or chronic sinus infections, per the NLM. If you constantly feel like your nose is blocked and your senses of smell and taste have diminished, see a doctor to get checked out. Polyps can be removed, but they tend to grow back, said Dr. Lee. You might be better off using a nasal steroid spray, which can help shrink polyps and relieve your symptoms. Allergy or steroid medication may also be used to help prevent polyps that have been removed from returning.
This article was originally published in 2016 and has since been updated.
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