Annoying Allergies – Beyond Decongestants

Spring is finally here and the gorgeous weather beckons. Unfortunately, an all too-common flare of seasonal allergies can hamper participation in outside activities. Trees, grasses, and weeds have bombarded the air with pollen, making it difficult to see, breathe, and enjoy the outdoors.

Background

Allergies are the most common cause of nasal congestion and sinus pressure. The Asthma and Allergy Foundation of America defines “allergy” as an overreaction of the immune system to substances that usually cause no reaction in the majority of individuals.1 Allergies are estimated to affect more than 50 million people in the United States, are the fifth-leading cause of chronic disease in all persons, and are the third-leading cause of chronic disease in children under the age of 18.1

Allergic rhinitis refers to inflammation of the nasal passages, which can cause any number of annoying symptoms, including sneezing, watery eyes, nasal congestion, runny nose, and postnasal drip.  Allergic rhinitis is caused by an immune-mediated response to tiny airborne substances called allergens. Essentially, what is normally a benign substance, is treated by the body as a foreign invader. The allergic reaction progression is prompted by the activation of inflammatory cells including mast cells, basophils and eosinophils. These cells produce substances, such as histamine and interleukins, which cause fluid to build up in the nares, instigating the itching, sneezing, and runny nose that allergy sufferers know so well. Over several hours, these substances activate other inflammatory cells that can cause more persistent symptoms. These complex series of chemical messages and reactions can cause an out-of-control situation every time someone is exposed to the allergen.

Allergens can appear in various forms: food, environment, animal dander, chemicals, lotions, medications, and even natural substances. According to the U.S. Department of Health and Human Services, allergic rhinitis affects approximately 20 percent of the population.2 However, this is on the rise, affecting approximately 30% of adults and 40% of children in the United States.3 The risk of developing allergic rhinitis has been found to be higher in those who experience asthma or eczema and in individuals who have a significant family history of asthma.

When treating allergies and rhinitis it is important to identify the causative agents or any additional triggers and address these specifically. For example, individuals who have a reaction to dust or dust mites can use dust mite covers on their bedding to reduce dust mite exposure while they are sleeping and a HEPA filter in their bedroom to help reduce circulating dust from the air.

Conventional Approach

Reducing exposure to the specific allergens and triggers in combination with pharmaceutical therapy is often the standard regimen. Decongestant medications may help to reduce the swelling in the nasal passages, ease the stuffiness and reduce sinus pressure. Decongestants are often combined with antihistamines in oral, over-the-counter allergy medications. These treatments are also available in the form of a nasal spray.  It is important, however, not to use decongestant nose drops and sprays for an extended period of time because long-term use can lead to what is referred to as “rebound” congestion. Furthermore, oral decongestants may elevate blood pressure and therefore may not be appropriate for people with high blood pressure or certain cardiovascular conditions. It is always important to consult your medical professional before utilizing these medications.

Herbal therapies

Many people reach for over-the-counter allergy medications, which can be effective in relieving symptoms but may often result in adverse effects. However, there are treatments beyond pharmaceuticals that can profoundly relieve symptoms and help to decrease frequency of allergic episodes. Herbal remedies offer a supportive solution while helping to eliminate symptoms, yield fewer adverse effects, and improve overall functioning of the body’s immune mechanism.

Botanical therapies can enhance the quality of life for those experiencing seasonal allergies or hay fever. It is often recommended to begin herbal treatment for seasonal allergies six weeks before the season begins and continuing treatment throughout the season. The best way to address individual needs is to consult a naturopathic or integrative medical professional who has knowledge of the therapies presented in this article.

Euphrasia officinalis, or eyebright, is often used in acute mucous-related ailments of the eyes, nose, and ears because it is great at reducing congestion and secretions.4 Euphrasia is often used as an anti-inflammatory agent for hay fever, sinusitis, upper respiratory tract infections, and inflammation of the mucous membranes.

Curcuma longa, popularly referred to as turmeric, is widely known for its anti-inflammatory abilities. A recent study found that turmeric, as an anti-allergic agent, showed immune regulatory effects through balancing the immune system,5 making it useful to ameliorate immune-mediated allergic disorders such as food allergy, atopic dermatitis, and asthma.6

Achillea millefolium, also known as yarrow, is a valuable decongestant and expectorant. Achillea exhibits a drying effect and can improve cough symptoms and sinus infections by clearing sputum formation. Achillea is especially helpful with allergies where nasal secretions and watery eyes are caused by molds, dust, pollen and dander because of the anti-allergic capacity of its 82 active constituents.7

Urtica diocia, or stinging nettle, can sound daunting by name but carries powerful antihistamine and anti-inflammatory effects. The bioactive components identified in urtica diocia alleviate symptoms by acting to inhibit the pro-inflammatory pathways activated in allergic rhinitis.8,9

Furthermore, it has been found that urtica has the ability to reduce the amount of histamine the body produces in response to an allergen.

Nutrient supplementation

In addition to botanical therapies, proper nutrient supplementation can further benefit the pathways and organ systems involved in the allergic response. Bioflavonoids, such as quercetin and hesperidin, are natural antihistamines and tremendously anti-allergenic.10,11 Bromelain and vitamin C can enhance the action of bioflavonoids and serve to stabilize the histamine response.10 These substances can be found in combination capsules or as nasal sprays to support healthy mucous membranes to prevent further discharge.

Other methods

Steam inhalation, which involves combining steam and essential oils, such as eucalyptus, creates a potent treatment for the upper respiratory tract, nose and sinus conditions.

Hydrotherapy, or the use of water in various forms and in various temperatures can produce different effects on different system of the body and is widely used to improve immunity and circulation.

Proper hydration is essential to any level of health. Dehydration has many adverse effects on the body. During allergy season, not being properly hydrated may lead to more frequent and more intense allergy symptoms.

Tolle causam (treat the cause) – considering the role of the gastrointestinal (GI) tract

In naturopathic medicine, we often discuss intestinal permeability in relation to the immune system and allergies. While there is still need for more clinical research to confirm this, we do know that food sensitivities and intolerances can result in inflammation along the gut mucosa, decreasing the integrity of the intestinal lining. Substances can, therefore, pass from the gut into the bloodstream, where the immune system will create a reaction to these agents. The use of mucilaginous herbs can help soothe digestive inflammation. Some herbs to consider are Althaea officinalis (marshmallow), Ulmus fulva (slippery elm), Glycyrrhiza glabra (licorice). The balancing of gut flora could be the topic of an entire article because it is so vast and complex. However, simply working to restore the human microflora Lactobacillus acidophilus and Bifidobacterium bifidum is an easy place to begin restoring balance.

Conclusion

Naturopathic medicine has many tools to help with symptoms of seasonal and everyday allergies. Most importantly, naturopathic physicians look deeper to the cause and evaluate the whole person to deliver individualized care. Whenever possible, it is best to avoid an offending allergen. When avoidance is not possible, it is recommended to institute some level of supportive influence, and often the key is to remember the power of healing the GI tract.

  1. Asthma and Allergy Foundation of America. Allergies. http://www.aafa.org/page/allergies.aspx. September 2015.
  2. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (EPR-3 2007). U.S. Department of Health and Human Services.
  3. American Academy of Otolaryngology — Head and Neck Surgery. Clinical Indicators Compendium. Alexandria, Virginia: American Academy of Otolaryngology; 1999:23.
  4. Felter HW. The Eclectic Materia Medica: Pharmacology and Therapeutics. Sandy, OR: Eclectic Medical Publications; 1994.
  1. Shin HS, See HJ, Jung SY, Choi DW, Kwon DA, Bae MJ, Sung KS, Shon DH. Turmeric (Curcuma longa) attenuates food allergy symptoms by regulating type 1/type 2 helper T cells (Th1/Th2) balance in a mouse model of food allergy.J Ethnopharmacol. 2015 Dec 4;175:21-9.
  2. Ammon HP, Safayhi H, Mack T, Sabieraj J. Mechanism of antiinflammatory actions of curcumine and boswellic acids. J Ethnopharmacol. 1993;38(2-3):113-119.
  1. Ehrlich, Steven D. “Yarrow.” University of Maryland Medical Center. 26 June 2014. Web. 25 Mar. 2017.
  2. Roschek B Jr, Fink RC, McMichael M, Alberte RS. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis.Phytother Res. 2009 Jul 23(7):920-6.
  3. Roschek B Jr, Fink RC, McMichael M, Alberte RS. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytother Res. 2009; 23(7): 920-926.
  4. Yazdani Shaik BD, Conti P. Relationship between Vitamin C, Mast Cells and Inflammation. J Nutr Sci. 2016; 6:456.
  5. Park HH, Lee S, Son HY, et al. Flavonoids inhibit histamine release and expression of proinflammatory cytokines in mast cells. Arch Pharm Res. 2008; 31(10):1303-1311.

 

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