Seasonal allergies (aka, "allergic rhinitis") are truly a drag. A congested, runny, itchy nose together with frequent sneezing and watery eyes can make you feel miserable, and also doesn’t do much to bolster your sense of personal attractiveness. Unfortunately, pollens from trees, grasses and weeds, and sometimes mold spores, appear seasonally along with allergic rhinitis. But why do some people suffer from this type of allergy, while others do not?
The allergic response
An allergy is an overreaction of the immune system to a substance called an antigen, which is foreign to the body, but otherwise harmless1 (i.e., the aforementioned pollens). In some individuals the harmless antigen is perceived by the immune system as a dangerous foreign invader, evoking an excessive immune response by a type of antibody that plays an important role in allergies.2 Now that erstwhile harmless antigen becomes an allergen that combines with the antibody, causing mast cells to release histamine and leukotrienes. It is the histamine and leukotrienes that lead to the common allergic symptoms.
Conventional allergy treatment
So what can you do about it? From a conventional medicine perspective, there are different medications used to help attack the problem and control symptoms. These include:
- Antihistamines (inhibits the release or action of histamine),
- Decongestants (relieves nasal congestion),
- Corticosteroids (steroid hormones that can help neutralize allergic reactions),
- Mast cell stabilizers (stabilizes the cell and prevents the release of histamine),
- Leukotriene inhibitors (blocks the synthesis or action of leukotrienes), and
- Immunotherapy (helps the body become desensitized to the allergens).
Of course, these conventional treatments have their own bevy of side effects and adverse reactions. Just go to your local library and look them up in the latest copy of Physicians’ Desk Reference. You’ll see what I mean.
Complementary and alternative allergy treatment
Complementary and alternative medicine (CAM) also offers treatment strategies for the treatment of seasonal allergies, including dietary supplements, acupuncture and HEPA filters. Typically, these treatments tend to have a much lower risk of side effects and adverse reactions than conventional medicine treatments, although they can sometimes take a bit longer to produce the desired result. Following is review of these CAM therapies.
Vitamin C has antihistamine activity, and supplementation has been shown to help people with seasonal allergies.3,4 reducing their symptoms of allergic rhinitis and improve the responsiveness of the bronchial tubes for breathing.6 It’s interesting to note that people with seasonal allergic-type symptoms who had the lowest intakes of vitamin C had more than five-fold increased risk of bronchial reactivity (e.g., asthma).7 In addition, it helps to increase corticosteroid production and decreases the body’s sensitivity to the antigen.8,9 About 2000 mg of vitamin C daily is a good dose.
Decongestant AlternativesPoteolytic enzymes (i.e., protein-digesting) help thin out mucous as well. Such enzymes include trypsin, chymotrypsin, serratia peptidase, and bromelain. For example, when given at a dose of 30 mg daily for four weeks, serratia peptidase significantly thinned out nasal mucous.13,14,15
Aside from natural pseudoephedrine found in the herb Ephedra (which is no longer available in the United States), there is no true herbal decongestant. Nevertheless, the amino acid N-acetylcysteine (NAC) can also help to thin out mucous secretions and thereby help reduce congestion.10 NAC can be used orally for sinusitis as it has been shown to be effective for chronic bronchitis.11 Doses of 200 mg twice daily to 600 mg twice daily have been used in research.12
The adrenal glands are also capable of producing corticosteroid hormones, which have some of the same anti-allergy properties as corticosteroid drugs; specifically they reduce the body’s sensitivity to the antigen or allergen.16 In fact, a deficiency of the B-vitamin pantothenic acid causes a decrease in the ability of the adrenal glands to produce corticosteroid hormones, while supplementation with this vitamin significantly increased the production of corticosteroids.17, 18 This role in corticosteroid production was clearly demonstrated in a study where pantothenic acid was one of the agents found to be effective found in reducing children’s reaction to vaccines.19 Typically, doses ranging from 300–2000 mg daily are considered effective.
Natural Mast cell stabilizers
Quercetin is a plant flavonoid with well-documented evidence showing inhibitory action on mast cells and allergic symptoms.20, 21 In a study of mast cells from nasal mucosa of individuals with allergic rhinitis, quercetin significantly inhibited histamine release. Quercetin’s effect was almost twice that of the drug sodium cromoglycate at the same concentration.22 Quercetin can also decrease the formation of leukotrienes.23 A good dose is 1,000 mg.
The herb Stinging Nettles may also have a mast cell stabilizing action, although this may be due to the fact that it contains high, natural quantities of quercetin.24 In addition, Stinging Nettles have anti-inflammatory properties, which may also contribute toward its anti-allergy effect.25 In any case, research on individuals with allergic rhinitis demonstrated a significant reduction in allergic symptoms after taking it for one week.26,27 Based on this study, at least 600 mg daily is recommended.Tinospora cordifolia is a commonly used Ayurvedic medicine. Research shows that taking 300 mg three times daily of a specific extract (Tinofend) can decrease allergic rhinitis symptoms, including sneezing, nasal itching, and nasal discharge. Tinospora cordifolia appears to work by decreasing mast cell release of histamine and possibly through its immunostimulatory effects as well.28
Natural Leukotriene inhibitors
Butterbur is an herb that exerts anti-inflammatory effects by inhibiting leukotriene synthesis.29 As a proprietary extract called Ze 339, the herb Butterbur has been shown to be clinically efficient in the treatment of allergic rhinitis (hay fever).30 Research has demonstrated that Butterbur is effective in reducing allergic symptoms, as well as significantly reducing histamine and leukotrienes levels after only five days of use.31 As a matter of fact, Butterbur was found to be equally effective as the antihistamine drug cetirizine drug for the treatment of allergic rhinitis, but without the sedative effects of the antihistamine.32
Echinacea has been shown to promote innate immune response.33 It is this property that suggests a positive role for Echinacea in modulating immune function in allergies,34 and offers support to Echinacea’s widespread use for this purpose.35 Specifically, the concept is that if the immune system can do a better job at correctly identifying harmless antigenic substances (such as pollens) as being harmless rather than identifying them as foreign invaders (allergens), then the whole allergic process may be staved off in the first instance. A good dose would be 200 mg daily of an extract standardized for four percent total phenolics. Note: Individuals who are sensitive to ragweed, chrysanthemums, marigolds and daisies may experience an allergic reaction to Echinacea since it is in the same plant family.36
Acupuncture for allergies
Although it may surprise you, acupuncture is also effective in the treatment of allergies, including allergic rhinitis. When acupuncture was used in addition to conventional care, rather than just conventional care alone, significant and persistent benefits were seen in patients with allergic rhinitis.37,38 Similar results were also obtained when acupuncture was used alone.39 One study even noted a 91.1 percent effective rate.40 DNA data suggest the effectiveness of acupuncture may be due to balance certain aspects of the immune system and reduced inflammation.41
HEPA filters and low humidity
A high efficiency particulate air or HEPA filter is a type of high-efficiency air filter that can remove at least 99-97 percent of airborne particles, including many allergens. Studies have shown that HEPA filtration is able to significantly reduce the amount of airborne allergens.42,43 In a study44 with patients who had allergic rhinitis and/or asthma during the fall and winter months, they had an Enviracaire room air cleaner (with HEPA filter) placed in their bedrooms for eight weeks. The results were that the HEPA filter helped reduce allergic symptoms.
There are many CAM options you can try if you suffer from seasonal allergies. Any of the aforementioned dietary supplements may help to provide you with significant relief from your allergic symptoms. It may be possible to find many, though not all, of the natural substances in a single product. In addition, the use of HEPA filters is a smart thing to do to reduce the total load of allergen exposure, and if you haven’t tried acupuncture before I highly recommend it.
- Silbernag S, Lang F. "Color Atlas of Pathophysiology" Stuttgart: Thieme;2000:52.
- Lippincott’s Illustrated Reviews: "Immunology." Baltimore, MD: Lippincott Williams & Wilkins; 2007.
- Holmes HM, Alexander W. Hay fever and vitamin C. Science 1942;96–497.
- Ruskin SL. High dose vitamin C in allergy. Am J Dig Dis 1945;12:281.
- Podoshin L, Gertner R, Fradis M. Treatment of perennial allergic rhinitis with ascorbic acid solution. Ear Nose Throat J 1991;70:54–5.
- Bucca C, Rolla G, Oliva A, Farina JC. Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis. Ann Allergy 1990;65:311–4.
- Soutar A, Seaton A, Brown K, Thorax (1997) 52(2):166–70.
- Kodama M, et al, In Vivo (1994) 8(2):251–7.
- Cathcart RF 3d, "Med Hypotheses" (1986) 21(3):307–21.
- Majima Y. Mucoactive medications and airway disease. Paediatr Respir Rev 2002;3:104–9.
- Grandjean EM, Berthet P, Ruffmann R, Leuenberger P. Efficacy of oral long-term N-acetylcysteine in chronic bronchopulmonary disease: a metaanalysis of published double-blind, placebo-controlled clinical trials. Clin Ther 2000;22:209–221.
- Majima Y, Inagaki M, Hirata K, et al. The effect of an orally administered proteolytic enzyme on the elasticity and viscosity of nasal mucus. Arch Otorhinolaryngol 1988;244:355–9.
- Nakamura S, Hashimoto Y, Mikami M, et al. Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease. Respirology 2003;8:316–20.
- Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo. J Int Med Res 1990;18:379-388.
- Kutsky R, "Handbook of Vitamins and Hormones" (1973) Van Nostrand Reinhold Company, New York. pp. 208.
- Tarasov IuA, Sheibak VM, Moiseenok AG, Vopr Pitan (1985) 4:51–-4.
- Fidanaza A, Floridi S, Lenti L, Boll Soc Ital Biol Sper (1981) 57(18):1869–72.
- Fedorova OE, Kostinov MP, Zh Mikrobiol Epidemiol Immunobiol (1990) 5:90–3.
- Theoharides T.C.; Bielory L. Mast cells and mast cell mediators as targets of dietary supplements. Annals of Allergy, Asthma and Immunology 2004; 93(2 SUPPL 1):S24–S34.
- Rygwelski JM. Allergic rhinitis: A sampling of complementary therapies.Clinics in Family Practice 2002; 4(4):791–815.
- Otsuka H, Inaba M, Fujikura T, Kunitomo M. Histochemical and functional characteristics of metachromic cells in the nasal epithelium in allergic rhinitis: studies of nasal scrapings and their dispersed cells. J Allergy Clin Immunol 1995; 96:528–536.
- Yoshimoto T, et al, Biochem Biophys Res Commun (1983) 116:612–18.
- Anon. Quercetin. Alt Med Rev 1998;3:140-3.
- Brinker F. Herb "Contraindications and Drug Interactions." 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Med 1990; 56(1):44–7.
- Brinker F. "Botanical Research Summaries 1989." Eclectic Dispensatory of Botanical Therapeutics, Portland, Oregon, pp. 4–36.
- Badar VA, Thawani VR, Wakode PT, et al. Efficacy of Tinospora cordifolia in allergic rhinitis. J Ethnopharmacol 2005;96:445-9.
- Anon. Petasites hybridus. Altern Med Rev 2001;6:207–9.
- Brattstrom A. A newly developed extract (Ze 339) from butterbur (Petasites hybridus L.) is clinically efficient in allergic rhinitis (hay fever). Phytomedicine 2003; 10 (Suppl 4):50–2.
- Thome OAR, Schapowal A, Heinisch IVWM; Wiesmann UN, Simon H-U. Anti-inflammatory activity of an extract of Petasites hybridus in allergic rhinitis. International immunopharmacology 2002; 2(7):997–1006.
- Schapowal A. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ (Clinical research ed.) 2002; 324(7348):144–6.
- Bauer R, Hoheisel O, Stuhlfauth I, Wolf H. Extract of the Echinacea purpurea herb: an allopathic phytoimmunostimulant. Wiener medizinische Wochenschrift 1999 ; 149(8-10):185–9
- Mills S, Bone K. "Principles and Practice of Phytotherapy." Edinburgh: Churchill Livingston; 2000:354.
- Bielory L. Complementary and alternative interventions in asthma, allergy, and immunology. Annals of allergy, asthma & immunology 2004; 93(2 Suppl 1):S45–54.
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42–51.
- Brinkhaus B, Witt CM, Jena S, Liecker B, Wegscheider K, Willich SN.Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial. Ann Allergy Asthma Immunol 2008;101(5):535–43.
- Witt CM, Reinhold T, Jena S, Brinkhaus B, Willich SN. Cost-effectiveness of acupuncture in women and men with allergic rhinitis: a randomized controlled study in usual care. Am J Epidemiol 2009;169(5):562–71.
- Xue CC, An X, Cheung TP, Da Costa C, Lenon GB, Thien FC, Story DF. Acupuncture for persistent allergic rhinitis: a randomised, sham-controlled trial. Med J Aust 2007;187(6):337-41.
- Chen ZX. [Clinical observation on acupuncture for treatment of allergic rhinitis] Zhongguo Zhen Jiu 2007;27(8):578–80.
- Shiue HS, Lee YS, Tsai CN, Hsueh YM, Sheu JR, Chang HH. DNA microarray analysis of the effect on inflammation in patients treated with acupuncture for allergic rhinitis. J Altern Complement Med 2008;14(6):689–98.
- Bernstein JA, Levin L, Crandall MS, Perez A, Lanphear B. A pilot study to investigate the effects of combined dehumidification and HEPA filtration on dew point and airborne mold spore counts in day care centers. Indoor Air 2005;15(6):402–7.
- Green R, Simpson A, Custovic A, Faragher B, Chapman M, Woodcock A. The effect of air filtration on airborne dog allergen. Allergy 1999;54(5):484–8.
- Reisman RE, Mauriello PM, Davis GB, Georgitis JW, DeMasi JM. A double-blind study of the effectiveness of a high-efficiency particulate air (HEPA) filter in the treatment of patients with perennial allergic rhinitis and asthma. J Allergy Clin Immunol 1990;85(6):1050–7.
Complementary And Alternative Treatments for Seasonal Allergy
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Gene Bruno, MS, MHS
Gene Bruno is the Dean of Academics and Professor of Dietary Supplement Science for Huntington College of Health Sciences (a nationally accredited distance learning college offering diplomas and degrees in nutrition and other health science related subjects. Gene has two undergraduate Diplomas in Nutrition, a Bachelor’s in Nutrition, a Master’s in Nutrition, a Graduate Diploma in Herbal Medicine, and a Master’s in Herbal Medicine. As a 32 year veteran of the Dietary Supplement industry, Gene has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines, and peer-reviewed publications. Gene's latest book, A Guide to Complimentary Treatments for Diabetes, is available on Amazon.com, and other fine retailers.