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Allergy Review:
Nutritional Support for Springtime Allergies
Plants to Avoid, Plants to Consume
 




Nita Bishop, Clinical Herbalist
Seasonal changes usher in the spring regalia, but along with the grass and flowers comes sneezing, wheezing, and sniffling. Ironically, although May is designated as Clean Air month, it is also the time when pollen counts and allergy symptoms are at their peak for 50 million Americans annually.

While the common allergy was relatively rare during the nine-teenth century in Europe, it has increased dramatically over the last 50 years, more so in industrialized countries. Allergic rhinitis (hay fever) is now the most common seasonal allergy in the United States, and it is estimated that one person in three suffers from allergies.

The term "allergy" is relatively new and has only existed for approximately 100 years. C.H. Blackley, a homeopathic physician from Scotland, identified pollen as the cause of hay fever in 1871. The symptoms that we experience (sneezing, red eyes, stuffy nose and congestion) are the result of abnormal reactions to various causative agents - for example, tree pollens in the the spring, grasses and weeds in summer and fall. The immune system generates histamine in response to these allergen invaders (in this case pollen). However, the body's immune system can have an overreaction to histamine, which is then manifested in the exaggerated responses of excessive sneezing, congestion, and headaches.

The Cause of an Allergic Reaction

Allergic reactions tend to be the result of repeated exposure to a foreign protein/antigen, such as pollen, triggering IgE, an immuno globin, production. Once IgE antibody production begins, it can persist for months, even years. These IgE antibodies remain active and on alert in the body waiting for the next allergen encounter. Allergic rhinitis (hay fever) and allergic bronchial asthma are triggered by antigen/IgE binding to sensitized mast cells and basophils which cause a decrease in cyclic Adenosine MonoPhosphate (cAMP). Eosinophilic chemotactic factor and histamine are released, which bind to H1-receptors and a complex cascade of events follows, causing a "hypersensitivity" reaction, ultimately resulting in nasal congestion with watery discharge, sneezing, and itching eyes.

The main focus of traditional allergy practice is to address the IgE-histamine response of patients with "atopies," or hereditary allergies, typically seen in hay fever and asthma. The challenge for doctors is to desensitize the patient to the allergenic substances and block the body's over-reaction. Decongestants and antihistamines, are the conventional drug treatments of choice for these seasonal allergies. Mainstream allergists often use allergy shots, known as immunotherapy, in which increasing amounts of allergen extract are injected subcutaneously over time to lessen the clinical symptoms of allergen exposure. In Chinese medicine, as well as natural healing, allergies are viewed as "energy imbalances" that can be corrected with acupuncture and herbs. Since allergic reactions are inflammatory processes, treating the immune system is paramount. Herbalists and naturopathic physicians use normalizing herbs called "adaptogens," which function via hormone regulation. The discipline known as Clinical Ecology focuses on our interaction with the environment and its effect on human health and disease. Clinical Ecology typically seeks to isolate the patient from allergens and institute dietary changes often coupled with nutritional supplements. Indeed, nutritional and herbal regimens can provide relief and support the immune system without the toxic side effects of many prescription medications.

Melatonin produced by the pineal gland regulates the circadian rhythms and the sleep-wake cycle. When there is no sunlight, melatonin is secreted. Increased melatonin levels in the body have been associated with increased drowsiness. This sets up a corresponding feedback loop since sleep can induce or reverse many of the functions of the hypothalamus.

In addition to melatonin, the pineal gland also produces the neurotransmitter serotonin, which produces a heightened sense of calm, lowering stress and anx-iety and inducing sleepiness. Serotonin is a derivative of tryptophan, an amino acid that is present at low levels in the bloodstream. During the short days of winter, this neurotransmitter reaches its lowest concentrations in key parts of the brain. The body produces less serotonin in winter, and low serotonin levels are believed to be one of the primary causes of clinical depression. Serotonin also inhibits the stress-induced increase of cortisol secretion and "stress" hormones. Cortisol has an inhibitory effect on the immune system, which could explain some of the physiological changes in depression.

Flavonoids and Carotenes

Bioflavonoids are a complex family of naturally-occurring compounds found in many plants, especially fruits and vegetables.

Quercetin
-
a flavonoid found in fruits, flowers, and herbs - may reduce IgE formation, inhibit the release of histamine, and reduce or eliminate allergy symptoms. Additionally, quercetin works to control asthma as an antioxidant and an anti-inflammatory compound. For optimal absorption, quercetin is usually combined with bromelain, the anti-inflammatory enzyme from pineapple. Bromelain can also be beneficial taken by itself.

Parsley

(Apium petroselinum) also has a bioflavonoid content and is considered by herbalists as an excellent anitoxidant.

Carotenoids,
found in fruits and vegetables, are powerful antioxidants and in part act to reduce leukotriene production and strengthen the respiratory tract lining. A diet high in carrots, yams, pumpkins, greens and other foods high in carotenoids and xanthophylls reduces allergic reactivity.

Additional Antioxidants

Antioxidants can reduce allergic reactions. Specifically, vitamin C is a powerful antihistamine with both preventive and therapeutic properties. It also suppresses broncho-constriction, which is important for those suffering from allergic symptoms.

High levels of vitamin C, with supportive bioflavonoids, is an important part of any good daily dietary regimen. A common allergy recommendation for vitamin C is 1,000 - 2,000 mg three times a day. Garlic has also been shown to suppress the overproduction of IgE. Garlic is also a potent antioxidant herb and immune system stimulator and contains relatively large levels of quercetin.

Vitamin A and Zinc may also alleviate allergy symptoms and prevent sinusitis infections. They help to heal the gastrointestinal mucosa, in turn improving or normalizing the antibody response to antigens, which is often misappropriated in people with allergies.

Herbal Intervention in Allergies

A number of studies show positive effects of herbs on bronchodilation, clearance of mucus, pulmonary function tests, and antagonism of asthma mediators such as histamine, platelet activating factor, and corticosteroid levels.

There is no known botanical whose mechanism of action exactly matches antihistamines, however, IgE antibody formation alone does not constitute an allergic reaction. Antihistamines do not address the underlying problem since blocking histamine only provides temporary relief. Consequently, herbs can help address these underlying problems, as well as other inflammatory mediators involved in the allergic process. For example, much of the allergic response in allergic bronchial asthma, and the inflammation which presents has been traced from a pathway which begins with arachidonic acid and follows with the formation of lipoxygenase. The unstable compounds that are then formed become leukotrienes which produce bronchoconstrictive actions. Recent studies in the treatment of allergy and asthma have suggested creating lipoxygenase antagonists in order to treat such conditions.

Ephedra sinica (Ma huang)

Ma huang, a rigid tufted plant, has been used since ancient times in China to treat asthma and hay fever. It is the original source of the decongestant pseudoephedrine and is still considered to be the most effective herbal decongestant. The alkaloids in ma huang have similar actions to the common asthma drugs known as beta agonists, which dilate the bronchial tubes and ease breathing.. The alkaloid found in the leaves may increase blood pressure, but paradoxically the ephedra root contains a compound known to the Chinese as mao-kon, which acts to lower blood pressure. Therefore, use of the whole plant produces a balanced action. However, much of the marketed ephedra is made from the leaves only, and will stimulate the nervous system and can cause increased heart rate, insomnia, and agitation. Consequently, it should not be given to children under 13 years of age, pregnant women, or anyone with high blood pressure.

Urtica dioica (Stinging Nettles)

The fresh stinging hairs and leaves of Stinging Nettles contain histamine, serotonin (5-hydroxytrypta-mine)*, choline, acetylcholine, betaine, and formic acid. Serotonin, acetylcholine, and histamine modulate the immune system by activating adenylate cyclase, which stimulates the conversion of adenosine triphosphate (ATP) to cAMP, thus preventing antigen-induced release of histamine and extracellular fluid by sensitized basophils and mast cells. A randomized, double-blind study of 98 individuals using freeze-dried Urtica dioica for subjective amelioration of hay fever symptoms (allergic rhinitis) found that patients rated it higher than the placebo. A 300 mg dosage was administered at the onset of symptoms, with a daily dosage ranging from 1 to 7 doses. Fifty-seven percent rated it effective in relieving their symptoms, and 48% found it to be equally or more effective than their previous medicine. Interestingly, the epicatechins of green tea also work along the same mechanism of cyclic AMP conversion and therefore drinking green tea can be beneficial for allergies.

Euphrasia officinalis (Eyebright)

Euphrasia is used to treat the congestive conditions of the eye, specifically, the profuse lacrimation that often accompanies allergies. Euphrasia is effective for problems of the mucous membranes of the head and chest and helps to vasoconstrict the vessels of the nasal and conjunctival mucous membranes, which further contributes to its anti-catarrhal effects. Taken internally it also alleviates hay fever symptoms.

Scutellaria (Chinese Skullcap)

Another herb high in bioflavonoids is Scutellaria baicalensis (Chinese skullcap root), which inhibits histamine and leukotrienes and is a potent antioxidant. Scullcap has anti-inflammatory qualities comparable to NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin or ibuprofen, yet with no adverse effects.

Cayenne frutescens (Capsaicin)

Cayenne is a stimulant that contains the pungent compound, capsaicin. Short-term treatment with capsaicin activates tracheo-bronchial afferent C neuron release of substance P and can cause bronchoconstriction, mucus secretion, and congestion. However, long term treatment depletes substance P from the afferent C fibers and causes desensitization of the airways to exogenous irritants. A single high dosage capsaicin pretreatment in neonate rats was also shown to induce long lasting desensitization of the airways to cigarette smoke, histamine, and bradykinin. It significantly reduced the vascular permeability and edema caused by these substances in the respiratory tract. Capsaicin pretreatment reduced vagally-induced bronchospasm in guinea pigs and pulmonary airflow obstruction induced by aerosol histamine. It also blocked the enhanced bronchoconstrictor response to histamine induced by leukotrienes and reduced histamine and SRS-A release during antigen challenge. Short term and long term pretreatments with capsaicin both activate antioxidant enzyme systems and stabilize lung membrane lipids, protecting against edema and lipid peroxidation caused by gaseous lung irritants.

Balancing Essential Fatty Acids:

As previously discussed, the leukotrienes of the arachidonic acid cascade are intimately involved in allergic inflammation. The effect of omega-3 fatty acids on bronchial responsiveness was studied in 7 atopic patients suffering from seasonal asthma due to airborne allergens. After 30 days of dietary supplementation, bronchial responsiveness was significantly improved (maximum fall in FEV 1 was -11% vs -28% before treatment and maximum increase in airway resistance was +37% vs +265% before treatment). The data strongly supports the hypothesis that dietary supplementation with 3 g/day omega-3 EFAs results in the production of unique 5-lipoxygenase and cyclooxygenase products which are biologically less active and may inhibit the production or actions of other eicosanoids. Concurrently avoiding excessive omega-6 oils in the diet, using olive-oil dressings instead of trans-fatty acid rich salad dressings is also advised.

Essential Oil Blends for Hayfever and Allergies:

An alternative to bronchodilatorsis the volatile oils in aromatherapy applications. The oils are extremely soothing for respiratory irritations and are antimicrobial.

German Chamomile
(Matricaria recutita)

essential oil is well known for its anti-inflammatory effects and its flavonoids suppress histamine release, while its A-bisabolol promotes granulation and tissue regeneration.

Tea tree
(melaleuca alternifolia)
oil contains terpenes, alcohols, and 1,8-cineol, all of which purify the respiratory system, strengthen breathing, relieve sinus infections, drain lymph, stimulate elimination through the throat and lungs, increase and liquify mucus production, and act as an expectorant. Another important herb for the respiratory system is

Thyme
(Thymus vulgaris)
an aromatic disinfectant for excessive mucous discharge. Thyme stabilizes mast cells and reduces histamine-mediated allergic reactions.

Since the body secretes hormones from the adrenal glands to control inflammation, adrenal builders are important.

Borage
(Borago officinalis)
which contains essential fatty acids, is an adrenal restora-tive and anti-inflammatory herb.

Licorice root
(Glycyrrhiza glabra)
is one of the best known plants for supporting the adrenals in the world. Licorice prolongs the effect of cortisol, allowing it to maintain longer anti-inflammatory action.


 

Summing Up Approaches to Allergic Treatment

Nutritional and herbal medicine may offer benefits for the allergic person by improving general well-being and reducing allergic symptoms. In addition to proper diet, herbs and supplementation can help support the immune system, strengthen the lungs, and help maintain a more controlled response to allergens. Detoxification programs are often beneficial. A body that is less congested is less allergic. Reduced intake of mucous producing foods, such as dairy, wheat, citrus or gluten may prevent the production of catarrh, a thick mucus secretion in the nose and lungs. Reduction of stress may also play an important role in the treatment of allergies. In general, seasonal allergies are fairly predictable. A proactive approach using a variety of proven anithistamines, combined with herbal and nutritional supplements, as well as minor lifestyle changes, may offset the worst symptoms.

*Note: Whenever possible, avoid foods and products containing tryptophan which is converted to serotonin, and is a bronchoconstrictor.

References:

Batchelder H, Mitchell B, et al. "Therapeutic Approaches to Allergies (Immediate-Type Hypersensitivity)." The Protocol Journal of Botanical Medicine. Autumn 1995;53-91.

Bielory L, Lupoli K. "Herbal Interventions in Asthma and Allergy.", J Asthma 1999;36(1):1-65.

Bourne H.R., Lichtenstein L.M, Melmon K.L, Henney C.S., Weinstein Y. & Shearer G.M.. "Modulation of Inflammation and Immunity by Cyclic AMP." Science. 1974;184:19-28.

Burney P, Chinn S, Malmberg E., et al. "The Distribution of Total and Specific Serum IgE in the European Community Respiratory Health Survey." J Allergy Clin Immunol 1997;99:314-22.

Brinker, F. Eclectic. Dispensatory of Botanical Therapeutics. 1989; Eclectic Medical Pub., Portland, OR: .6.119.

Brinker, F. "Treatment of Respiratory Allergies with Pharmaceutical and Botanical Medicines.", J Naturopath Med. 1993;V.4,N.1:64-68.

Chand N., Diamantis W., Pillar J. & Sofia R.D. "Modulation of Allergic and Nonallergic Histamine Secretion by Lipoxygenase Inhibitors." Res. Comm. Chem. Path. Pharmacol. 1987;55:49-57.

Erasmus, U. Fats that Heal, Fats that Kill. 1993, Alive Books, Burnaby, BC Canada. Fetrow C, Avila J. Professional's Handbook of Complementary and Alternative Medicines. 1999, Springhouse Corporation, Springhouse, PA.

Fuller R.W, Dixon C.M.S, & Parnes P.J. "Bronchoconstrictor Response to Inhaled Capsaicin in Humans." J Appl Physiol. 1985;58:1080-1084.

Gentilini G, Franchi-Micheli S, Ciuffi M, Bindi D, & Zilletti T. "Capsaicin and Anaphylactic Reactions in the Guinea-Pig Airways." Agents Actions. 1990;30:92-4.

Janowiak J and Hawthorne G. "A Comprehensive Approach to Controling Allergies and Asthma." Alternative and Complementary Therapies. October 1999;5(5):254- 265.

Khalsa, K.P. "Allergies." The Herbalist, Newsletter of the American Herbalists Guild. 1998.

Kyo et al. "Anti-Allergic Effects of Aged Garlic Extract." Phytomedicine. 1997;4(4): 335-340.

Lett-Brown M.A. & Leonard E.J. "Histamine-Induced Inhibition of Normal Human basophil chemotaxis to C5a," 1977;118:815-18.

Marone, G., et al. Physiological concentrations of zinc inhibit the release of hista-mine from human basophil and lung mast cells. Agent Actions. 18(1-2):103-106.

Mittman P, "Randomized Double-Blind Study of Freeze-Dried Urtica Dioica in the Treatment of Allergic Rhinitis." Planta Medica. 1990;56.

Meserole L, Yarnell E. "Botanical Prevention and Treatment for Hay Fever." Alternative and Complementary Therapies. Spring 1996.

Moore, M. Medicinal Plants of the Desert and Canyon West. 1989, The Museum of New Mexico Press, Santa Fe, N.M.

Potter's NewCyclopaedia of Botanical Drugs and Preparations. 1988, C.W. Daniel Company Ltd, Essex, England.

Roshchin Y.V. & Gerashchenko, G.I. "Anti-Inflammatory Activity of Some Flavonoids." Vopr. Farm. Dal'nem Vostoke. 1973;1:135-35, (C.A. 83;37683q).

Saxena P.R., Pant M.C, Kishor K, & Bhargava K.P. "Identification of Pharmacologically Active Substances in the Indian Stinging Nettle Urtica Parviflora (Roxb.)." Can J Phys Pharmacol. 1965;40:869-76.

Stewart A.G., Thompson D.C. & Fennessy M.R. "Involvement of Capsaicin-Sensitive Afferent Neurons in a Vagal-Dependent Interaction between Leukotriene d4 and Histamine on Bronchomotor Tone." Agents Actions. 1984;15:500-8.

Van Loon, Isis, The golden root; clinical applications of Scutellaria Baicalensis GEORGI Flavonoids as modulators of the inflammatory response. Alternative Medicine Review. 1997;2(6):472-480.

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Written by Nita Bishop, Clinical Herbalist.

Nita Bishop practiced as an herbalist in Phoenix, Arizona before entering the Naturopathic program at Bastyr University where she is in her third year of medical school. Ms. Bishop holds undergraduate degrees from Pepperdine University in Biology and English. Ms. Bishop has an extensive background in natural medicine and working with traditional healers and is actively dedicated to enthusiastically elevating the awareness and validation of herbal medicine via the lecture circuit.






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