For the allergic, spring can be a roller coaster ride as pollen counts dip then spike, sometimes in reaction to fluctuating weather patterns. For the puffy, red-eyed and itchy, this year’s ride has begun.

Pollen counts had been far below normal because of a colder-than-usual February, but they made up for it as temperatures rose, spiking to above-average levels in March, said Susan Kosisky, a microbiologist for the U.S. Army Centralized Extract Laboratory in Silver Spring, Md.

The seasonal trek is especially bumpy for those who have more than allergies — people who often have no idea they have another problem. How do you tell if your allergy-like symptoms are being caused by allergies, another condition or both?

With allergies, the body’s immune system produces excess antibodies that attack what it perceives as invaders. This response causes inflammation and irritation of the eye and/or nose, among other symptoms, said Michael Kletz, an allergist/immunologist whose practice has offices in McLean and Washington.

Jill King, a 38-year-old Gaithersburg resident, had allergies for years. When her symptoms worsened during her pregnancy, she figured it was because she had chosen not to take antihistamines while carrying her child. She improved a little after the baby was born, but by her second pregnancy she had to use an inhaler.

“I was wheezing, and my whole face felt full,” she said. “It was even worse during my third pregnancy.”

The allergist who later prescribed antihistamines for King noticed a polyp, so it was on to an ear, nose and throat doctor.

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Jeffrey R. Ungvary President