Seasonal Allergies
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Springtime has officially arrived. The days are getting longer and warmer, and the songbirds are returning, the trees and flowers are starting to bloom. And for many, the nose starts getting stuffy, their eyes get itchy, they begin to sneeze, and their head feels congested. Roughly 35 million Americans live with seasonal allergic rhinitis, or what we commonly call hay fever. While it can occur at any time of the year, springtime is generally one of the worst seasons for allergy sufferers. Â
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For some, when they inhale pollen, a rather innocuous substance, it gets trapped in the mucus lining of the nose and causes an immune reaction. When activated by an allergen, mast cells release histamine, causing your nose to swell and itch, eyes to water and cause you to feel generally lousy. There are over-the-counter and prescription antihistamines and decongestants, as well as low dose steroids that can be used intra-nasally. These are often necessary for those who suffer from moderate to severe allergies. But for those with milder symptoms or those who do not tolerate the pharmaceutical options, there are numerous natural remedies you can use to ease your symptoms.
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Dietary Suggestions
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Stay hydrated. Yes, I say this all the time, but it is so true. Throw some lemon or lime in a pitcher of water and drink it throughout the day. Follow an anti-inflammatory style diet, which means keeping the sugar and highly processed foods/carbs to a minimum. Good advice any time of the year but especially when your body is dealing with allergies.Â
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Load up on foods high in flavonoids, compounds in plants that help lower inflammation. There are many, but a few particularly rich sources include onions, garlic, apples, berries, tea, chocolate, and wine. Papaya and pineapple contain enzymes (e.g., papain and bromelain) that are powerful inflammation fighters. Many of these foods are also high in vitamin C, which acts as a natural anti-histamine.Â
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Ginger and turmeric are two of my most favorite spices, and they are simply amazing for reducing inflammation, thinning mucus, easing congestion and relieving headaches. Ginger tea with lemon and local honey is delicious and incredibly symptom-relieving. You can use it fresh or dried. Traditional Medicinals Organic Ginger tea is convenient and high quality. Turmeric powder can be added to morning smoothies. I use Mega Food’s Daily Turmeric powder pretty much daily. One scoop provides 500 mg of organic turmeric with a little black pepper to aid absorption, holy basil leaf, an herb that is excellent for relieving colds/allergies while protecting the body from stress; and tons of fruit and food-based vitamin C.Â
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Foods rich in omega 3 fatty acids can also be helpful. Now is the time to add more flax and chia seeds to your smoothies and cold water oily fish, like salmon or tuna, to your meals. If you don’t like eating fish, you might consider taking fish oil supplements for 6-8 weeks to see if they help. Store them in the refrigerator (once opened) and take with the largest meal of the day.
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Some people find that taking a little local raw honey can help ease their symptoms. This depends on what you are allergic to as bees don’t typically forage for airborne pollens, which are mostly what people the most. Raw, unfiltered honey may reduce inflammation, however, which may be why people report feeling better!Â
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The Saline Solution
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You may not realize it, but many allergists recommend washing your nasal passages daily to remove pollen, dust, etc. A review of the studies found that on average people experience a 27% improvement in nasal symptoms and a 62% reduction in medicine consumption! Impressive! Invest in a neti-pot, a container that looks a little like Aladdin’s magic lamp or purchase one of the newer machines like the Navage Nasal Irrigation, which many people find easier to use. You can purchase a pre-made saline solution or make your own by pouring 8 ounces of distilled water, or water that has been boiled for 10 minutes, over 1/4 tsp non-iodized kosher salt and 1/8 tsp baking soda. Stir well until salt and baking soda has dissolved. Make fresh daily.
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Note: I prefer using a buffered saline over normal saline solution as a nasal rinse. A study found in children that it worked better for relieving allergic rhinitis symptoms and was better tolerated! Baking soda takes away the sting. If you could only do ONE thing for your allergies, nasal irrigation is probably one of the most important.
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Herbs and Dietary Supplements
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Stinging Nettles (Urtica dioica)
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The dreaded “stinging” nettle can pack quite a punch if you rub up against it while out hiking. However, cooking, drying or making an extract from nettles will take away the sting. A randomized double-blinded study of 90 people found that 600 milligrams a day of freeze-dried fresh nettle was more effective than placebo for relieving allergy symptoms. Forty-eight percent of the participants stated that nettles equaled or surpassed previous medications that they had taken for seasonal allergies in terms of effectiveness. Not surprising, researchers have found that nettle leaf contains compounds that inhibit histamine release. There are no known safety issues. I love Eclectic Institute’s Freeze Dried Nettles; the product originally used in the clinical trial!
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Quercetin
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Quercetin, a natural compound found in many plants, including onions, turmeric, citrus fruits, dark berries and red wine; has been shown to stabilize the membranes of mast cells and reduce the release of histamine. I have found quercetin supplements to be very useful if taken regularly at the start of the allergy season. The dose is generally 300-500 two times per day. While considered safe, the use of quercetin in pregnancy at these doses is not recommended.Â
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Note: I often recommend Eclectic Institute’s Freeze Dried Nettle Quercetin product as it contains two of my favorite allergy answers! Most effective if you start taking it early in the season!!!Â
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Probiotics
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Studies have shown that probiotics can be useful in reducing seasonal allergy symptoms. In fact, a review of 22 randomized, double-blind, placebo-controlled studies found that 17 showed a significant benefit of probiotics clinically, while eight trials showed significant improvement in immunologic parameters. All five studies that included Lactobacillus paracasei strains demonstrated clinically significant improvements compared with placebo. I think many people benefit from the addition of probiotics into their diet in the form of fermented foods (e.g., yogurt, sauerkraut, kefir, kimchi) and if allergies are a problem, you might want to consider looking for a probiotic product that contains L. paracasei.Â
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Butterbur (Petasites hybridus)
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Researchers have found the herb butterbur (Petasites hybridus) to be as effective as prescription anti-histamine medications for relieving hay fever symptoms. Clinical trials conducted in Europe have shown that butterbur is as effective as a leading prescription allergy medication. Look for a product standardized to provide a minimum of 15% petasin per 50 milligrams of extract and FREE of harmful pyrrolizidine alkaloids (PA), compounds that are naturally present in the herb but removed during extraction. Generally, 50 mg is taken twice daily.Â
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Note: There have been some studies that show not all butterbur products are free of PA. These compounds can cause liver damage. Health Canada requires all products to be tested to ensure the absence of these compounds. There is less regulation in the US. Petadolex is one product that has been used in clinical trials and contains zero detectable pyrrolizidine alkaloids and is the one I generally recommend. Safety in pregnancy is not known and its use is not recommended.
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Conclusion
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There are lots of things you can do to help you get through allergy season. In addition to the recommendations made above, try to limit your time outside when the pollen counts are high, especially if it is dry and windy. We use a vacuum with a HEPA filter in it to help keep airborne pollen under control in the house, as well live in a cabin without air conditioning and we often open the windows on hot days. Some people use HEPA filters in their homes, especially if they have pets. Different things work for different people. Figure out what works for you!
References:
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Guvenc IA, et al. Do probiotics have a role in the treatment of allergic rhinitis? A comprehensive systematic review and meta-analysis. Am J Rhinol Allergy 2016 Sep 1;30(5):157-175
Hermelingmeier KE, et al. Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis. Am J Rhinol Allergy. 2012 Sep-Oct;26(5): e119-25.
Käufeler R, et al. Efficacy and safety of butterbur herbal extract Ze 339 in seasonal allergic rhinitis: postmarketing surveillance study. Adv Ther. 2006 Mar-Apr;23(2):373-84.
Kawamoto Y, et al. Prevention of allergic rhinitis by ginger and the molecular basis of immunosuppression by 6-gingerol through T cell inactivation. J Nutr Biochem 2016 Jan; 27:112-22
Kelly GS. Quercetin: Monograph Alternative Medicine Review 2011; 16(2):172-94
Malizia V, et al. Efficacy of Buffered Hypertonic Saline Nasal Irrigation for Nasal Symptoms in Children with Seasonal Allergic Rhinitis: A Randomized Controlled Trial. Int Arch Allergy Immunol 017;174(2):97-103.
Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis Planta Medica 1990; 56(1): 44-7
Roschek B, et al. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytotherapy Research 2009; 23(7): 920-6
Schapowal A: Petasites Study Group Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339. Arch Otolaryngol Head Neck Surg. 2004 Dec;130(12):1381-6.
Weng Z, et al. Quercetin is more effective than cromolyn in blocking human mast cell cytokine release and inhibits contact dermatitis and photosensitivity in humans. PLoS One 2012; 7(3): e33805
Can children take these doses listed or should they be 1/2 of an adult dose?
Daily Turmeric can be used in smoothies by anyone in the family but for kids under 12, no more than one scoop per day. Kids can drink ginger tea, though some find it too strong. Probiotics are available specifically made for kids. Butterbur is half the dose used for adults and is not recommended for children under 6. Stinging nettles are used by peoples of all ages. Not enough research on quercetin in kids, though I use it in teenage patients.
Can children take these doses listed for seasonal allergies or should they be 1/2 of an adult dose?