Story highlights Louisville, Kentucky, tops the list of the worst cities for allergy sufferers

Texas and Tennessee both have three cities in the list's top 20

The blend of winter and spring weather may make allergies worse

If you're cursing Mother Nature right now, we understand. The official start of spring was March 20, and yet signs of winter abound.

There's snow on the ground in the North, and the South is being tossed between 40-degree and 70-degree weather like a pingpong ball.

Yet "even in the throes of what feels like a 2014 Ice Age, millions of Americans have begun showing up in doctors' offices with the tell-tale signs of allergies," the Asthma and Allergy Foundation of America says.

Fantastic.

It may be even worse for allergy sufferers in certain cities across the country. The foundation has released its annual list of the worst places for spring allergies. Topping the list this year are Louisville, Kentucky; Memphis, Tennessee; and Baton Rouge, Louisiana.

These so-called allergy capitals are ranked based on pollen levels, use of allergy medications and the number of board-certified allergists in the area.

Louisville has moved up the list from No. 5 last year because of higher-than-average pollen counts, high use of allergy medications and too few allergy specialists, according to the foundation.

New York; Columbia, South Carolina; and San Antonio are new to the top 20. Only Los Angeles residents can breathe a sigh of relief; the city fell 39 places from No. 38 last year to No. 77 this year.

Here are the worst cities for spring allergies in 2014:

1. Louisville, Kentucky

2. Memphis, Tennessee

3. Baton Rouge, Louisiana

4. Oklahoma City

5. Jackson, Mississippi

6. Chattanooga, Tennessee

7. Dallas

8. Richmond, Virginia

9. Birmingham, Alabama

10. McAllen, Texas

Why, you may ask, would lingering winter weather affect spring allergy season?

"Allergy and asthma patients already have a chronic sensitivity to things like pollen, mold and other airborne allergens, but they can also be more susceptible to rapid changes in temperature and moisture," Dr. Clifford Bassett, medical director of Allergy and Asthma Care of NY and an ambassador for the Asthma and Allergy Foundation of America, said in a statement. "A blending of the winter and spring means these patients are at risk of multiple symptoms simultaneously."

And in case you were keeping a close eye on this type of thing, here is last year's list of spring "allergy capitals":

1. Jackson, Mississippi

2. Knoxville, Tennessee

3. Chattanooga, Tennessee

4. McAllen, Texas

5. Louisville, Kentucky

6. Wichita, Kansas

7. Dayton, Ohio

8. Memphis, Tennessee

9. Oklahoma City

10. Baton Rouge, Louisiana