Hay Fever

Only medication can help relieve symptoms associated with hay fever.

There are proactive steps one can take naturally to help relieve symptoms associated with hay fever.

What is hay fever?

Hay fever is an allergic condition triggered by inhaled substances (frequently pollens).

Inhaled allergens trigger sneezing and inflammation of the nose and mucous membranes (conjunctiva) of the eyes. The nose, roof of the mouth, eyes, and throat begin to itch gradually or abruptly after the pollen season begins. Tearing, sneezing, and clear, watery nasal discharge soon follow the itching. Headaches and irritability may also occur.

Hay fever, like all allergic reactions, is caused by allergens, foreign "invaders" that enter your body by inhalation, by swallowing, or through your skin.

In hay fever, the allergens are airborne substances that enter your airways (mouth, nose, throat, and lungs) via your breathing and the linings of your eyes and sometimes ears via direct contact.

Most of the time it is difficult to identify a specific allergen.

Once these allergens come in contact with your airway, the white blood cells of your immune system produce antibodies to the offending substance. This overreaction to a harmless substance is often called a hypersensitivity reaction.

The antibody, called immunoglobulin E, or IgE, is stored on special cells called mast cells.

When the antibody comes in contact with the corresponding antigen, they promote release of chemicals and hormones called "mediators." Histamine is an example of a mediator.

It is the effects of these mediators on organs and other cells that cause the symptoms of the allergic reaction, in this case hay fever.

The most common allergens in hay fever are pollens.

Pollen is small particles released by flowering plants. It is moved around by wind to other plants of the same species, which it fertilizes so that the plant can bloom again. Pollens from certain types of trees, grasses, and weeds (such as ragweed) are most likely to cause reactions. Pollens from other types of plants are less allergenic.

The time of year when a particular species of plant releases pollen, or "pollenates," depends on the local climate and what it normal for that species. Some species pollenate in the spring and others in the late summer and early fall. Generally, the farther north a plant is, the later in the season it pollenates. Variations in temperature and rainfall from year to year affect how much pollen is in the air in any given season.

The other common allergens in hay fever are molds. Molds are a type of fungus that has no stems, roots, or leaves. Mold spores float through the air like pollen until they find a hospitable environment to grow. Unlike pollen, however, molds do not have a season. They are present throughout the year in most of the United States. Molds grow both outdoors and indoors. Outdoors, they thrive in soil, vegetation, and rotting wood. Indoors, molds (usually called mildew) live in places where air does not circulate freely, such as attics and basements, moist places such as bathrooms, and places where foods are stored, prepared, or discarded.

The amounts of pollen and molds in the air are measured daily in many areas around the United States and reported by the National Allergy Bureau. The pollen and mold counts at which people develop allergic symptoms vary quite a lot by individual.

Pollen and mold counts are not very helpful in predicting how a specific person will react.

Risk factors for hay fever

• Family members with hay fever
• Repeated exposure to the allergen
• Other allergic conditions such as eczema or asthma
• Nasal polyps (small noncancerous growths in the lining of the nose)
• The allergens that cause symptoms in an individual as he or she ages. Symptoms decrease in some allergy sufferers, but not all, as they grow older.
• Bodily changes of pregnancy may make hay fever worse.

Oral antihistamines are often prescribed for relief of symptoms. These include diphenhydramine (Benadryl®), chlorpheniramine (Chlor-Phen®), brompheniramine (e.g., Dimetapp®), cetirizine (Zyrtec®), clemastine (Tavist®), and others. Oral non-sedating H1-blockers are also recommended, including loratidine (Claritin®), terfenidine (Seldane®), and astemizole (Hismanal®). Sympathomimetic agents (e.g., phenylpropanolamine, phenylephrine, pseudoephedrine) are sometimes combined with antihistamines to counteract their tendency to cause drowsiness. Cromolyn sodium nasal spray (e.g., Nasalcrom®) may be recommended when antihistamines are ineffective. When nasal symptoms are not relieved by antihistamines, inhaled corticosteroids may be recommended.

Self Help:

Key nutritional supplements

• None

• Thymus extract*: The oral administration of a thymus extract known as Thymomodulin® has been shown in preliminary and double-blind clinical studies to improve the symptoms and course of hay fever and allergic rhinitis. Presumably, this clinical improvement results from restoring proper control over immune function.

• None

• Tylophora (Tylophora indica, T. asthmatica): 200–400 mg of the dried herb daily or 1–2 ml of the tincture per day for a maximum of 14 days.
• Nettle (Urtica dioica) leaf*: 450 mg capsules or tablets of freeze-dried leaf two to three times per day, or a 2–4 ml tincture, three times per day.

Dietary changes that may be helpful

• Avoid food allergens: People with inhalant allergies are likely to also have food allergies. A hypoallergenic diet has been reported to help people with asthma and allergic rhinitis, but the effect of such a diet on hay fever symptoms has not been studied. People with hay fever who are interested in exploring the possible effects of a food allergy avoidance program should talk with a doctor. Discovering and eliminating food allergens is likely to improve overall health even if such an approach were to have no effect on hay fever symptoms.

• Nasal irrigation: Pouring warm salt water or saline through the nose may help relieve some of the irritation associated with rhinitis. A special pot, called a “neti lota” pot, can be used to administer the solution. Fill the pot with warm salt water, tilt the head to one side (over a sink), and pour the water into the upper nostril, allowing it to drain through the lower nostril. A little water may also be gently snuffled into the back of the throat and spit out. When finished, gently blow the nose to expel excess remaining water. Repeat on the opposite side. This procedure can be done several times a day.

People with inhalant allergies are likely to also have food allergies.1 2 A hypoallergenic diet has been reported to help some people with asthma and allergic rhinitis,3 but the effect of such a diet on hay fever symptoms has not been studied. Hay fever sufferers interested in exploring the possible effects of a food allergy avoidance program should talk with a doctor. Discovering and eliminating offending food allergens, should they exist, is likely to improve overall health even if such an approach has no effect on hay fever symptoms.

Nutritional Supplement Treatment Options

Although vitamin C has antihistamine activity, and supplementation, in preliminary research,4 5 has been reported to help people with hay fever, 2,000 mg of vitamin C per day did not reduce hay fever symptoms in a placebo controlled trial.6 Thus, while some doctors recommend that hay fever sufferers take 1,000–3,000 mg of vitamin C per day, supportive evidence remains weak.

Quercetin is an increasingly popular treatment for hay fever even though only limited preliminary clinical research has suggested that it is beneficial to hay fever sufferers.7

The oral administration of a thymus extract known as Thymomodulin® has been shown in preliminary studies and double-blind trials to improve the symptoms of hay fever and allergic rhinitis.8 9 10 Presumably this clinical improvement is the result of restoration of proper control over immune function.

Contraindications

Refer to the individual supplement for information about any side effects or interactions.

Botanical Treatment Options

Tylophora is an herb used by Ayurvedic doctors in India to treat people with allergies. It contains compounds that have been reported to interfere with the action of mast cells, which are key components in the process of inflammation responsible for most hay fever symptoms.11 Mast cells are found in airways of the lungs (among other parts of the body). When mast cells are activated by pollen or other allergens, they release the chemical histamine, which in turn leads to a wide number of symptoms familiar to hay fever sufferers—itchy eyes, runny nose, and chest tightness. Ayurvedic doctors sometimes recommend 200–400 mg of the dried herb daily or 1–2 ml of the tincture per day for up to two weeks.

In an isolated double-blind trial, nettle leaf led to a slight reduction in symptoms of hay fever—including sneezing and itchy eyes.12 However, no other research has investigated this relationship. Despite the lack of adequate scientific support, some doctors suggest taking 450 mg of nettle leaf capsules or tablets BID–TID, or a 2–4 ml tincture TID for people suffering from hay fever.

Ephedra sinica (ma huang) is an herbal remedy for hay fever in traditional Chinese medicine.13 The popular nasal decongestant pseudoephedrine is an active constituent of ma huang.14 It is has largely replaced the use of the herb in modern medicine.

The Japanese herbal formula known as sho-seiryu-to has been shown to reduce symptom, such as sneezing, for people with hay fever.15 Sho-seiryu-to contains licorice, cassia bark, schisandra, ma huang, ginger, peony root, pinellia, and asiasarum root.

Contraindications

Refer to the individual herb for information about any side effects or interactions.