There are many endocrine conditions that can present with allergic symptoms and signs. Thyroid conditions ranging from fatigue to orbitopathy associated with Grave's disease can be confused with allergic conjunctivitis and angioedema. Autoimmune thyroid disease is commonly associated with idiopathic urticaria. Symptoms of orthostatic hypotension and intolerance often present when least expected and should be considered ahead of time to avoid confusion in treating possible systemic allergic reactions. Flushing is a frequent sign and differentiating from complaints commonly associated with allergic reactions, rosacea, and endocrinopathies is helpful in sorting out some of the more complex conditions associated with this symptom.