The Sneezin' Season

By Linda B. White, M.D.

Spring has sprung. And it may seem that your nose has sprung a leak. It’s that hay fever time of year. You know the symptoms: itchy, watery eyes; sneezy, drippy nose. If you only have these symptoms a couple of months, consider yourself lucky. Some people have sniffles and sneezes year-round because they’re allergic not just to pollens but to molds, dust mites, animal dander, and other airborne offenders. Others develop allergic skin conditions such as hives and eczema. And some people take it in the lungs in the form of asthma.

Most allergies, including seasonal ones, occur because the sufferer’s immune system over-responds. In fact, another term for allergy is hypersensitivity. The immune system detects a speck of ragweed pollen and reacts as if an army of streptococci had invaded. White blood cells produce a type of antibody known as IgE, which binds to a type of cell called a mast cell, which then secretes histamine and other inflammatory chemicals. These chemicals are to blame for your symptoms. It’s like seeing a cockroach in your kitchen, calling for help, and instead of a guy in uniform showing up with a nontoxic roach repellant, you get a platoon from the National Guard breaking down the door to take aim at the hapless insect.

Conventional medical doctors treat allergies such as hay fever with antihistamines, drugs that block the action of histamine. Older antihistamines—the ones you can find over the counter—help relieve symptoms, but they also cause sedation and excessive drying of the mouth, nose, and throat. Newer prescription antihistamines, such as loratadine (Claritin) and fexofenadine (Allegra), tend to be less sedating.

Another type of drug, cromolyn sodium, blocks the release of histamine from mast cells. It’s available as a prescription or over-the-counter nasal spray (Nalcrom, Nasalcrom) or a prescription inhaler (Intal) for the treatment of hay fever and asthma. To be effective, however, cromolyn sodium must be used daily during the hay fever season. If you wait for symptoms to appear to use it, you won’t see benefits.

If your drippiness transforms into stuffiness, you might be tempted to use over-the-counter decongestants such as phenylephrine (Dimetapp) and pseudoephedrine (Sudafed). These drugs work, but they can cause jitteriness and insomnia. Last year, the Food and Drug Administration issued a warning that the decongestant phenylpropanolamine, an ingredient in many over-the-counter cold remedies, had been linked to an increased risk of stroke and advised consumers to stop taking drugs that contained it.

Healing from a different angle

If you’re a regular hay fever sufferer, you’re probably looking for a reliable, safe way to stop the drip when it occurs. But according to Francis Brinker, N.D., author of Herb Contraindications and Drug Interactions (Eclectic Medical, 1998), no herb is known to act in the same way that pharmaceutical antihistamines do to block histamine’s action after its release.

Test-tube studies suggest, however, that some herbs may work similarly to cromolyn sodium—in other words, they may help inhibit the release of histamine from mast cells in the first place. Studies haven’t been done in humans to confirm that such herbs, taken by mouth, work in this way; you simply have to try them to see whether they give you relief. Fortunately, most of them are safe and mostly free of any side effects and interactions.

A second class of herbs may be helpful for allergies because they reduce the inflammation caused by the other chemicals released in allergic reactions. Some herbs may exert both actions. Herbs don’t work the same way as antihistamines, but herbalists believe they may help symptoms by blocking histamine release.

Food to silence a sneeze

Berries of all kinds, along with other fruits and flowers, are rich in plant pigments called flavonoids. In test-tube studies, various flavonoids inhibit release of histamine and other inflammatory chemicals. These plant chemicals also have antioxidant and anti-inflammatory properties to help contain the havoc that your immune system is wreaking during allergy season. Deborah Wiancek, N.D., author of The Natural Healing Companion (Rodale, 2000), recommends that her allergic patients eat up to 1 cup of fresh or frozen berries or ¹/₃ cup of dried berries per day. She also recommends drinking rose-hip tea because it contains both flavonoids and vitamin C, another natural antihistamine (see “Supportive supplements” on page 58).

Onions are a good source of quercetin, the most abundant flavonoid in the diet as well as a potent antioxidant. Quercetin has actually been tested on the cells of people with year-round nasal allergy symptoms at Japan’s Nippon Medical School; it proved to significantly block histamine release. Onions also contain thiosulfinates, a group of substances that seem to have anti- inflammatory activity and can inhibit constriction of the bronchial passages.

Wiancek recommends eating about a quarter of a medium-sized onion a day. The quercetin concentration is greatest in the skin and outer rings, so there are tricks to cooking onions that can maximize their benefits. James A. Duke, Ph.D., author of The Green Pharmacy (Rodale, 1997) and Dr. Duke’s Essential Herbs (Rodale, 1999), starts out by putting the whole onion—peel and all—in a soup stock. After the onion has simmered until it’s soft, he squeezes it out of its skin, dices it, returns it to the pot and discards the skin. Other food sources of quercetin include grapefruit, red wine, apples, garlic, cayenne pepper, cabbage, and black tea.

The problem with quercetin is that, apparently, the body doesn’t absorb it very well. One study found that 52 percent of the quercetin in a meal of fried onions was absorbed compared to 24 percent of a quercetin supplement. Moreover, it’s not easy to get a therapeutic dose of quercetin from food. As Duke puts it, “You’d have to eat a kilo of outer onion rings to get 345 mg of quercetin.”

For those who want to try quercetin supplements, Wiancek recommends 1,000 mg of a quercetin supplement twice a day. Some quercetin products also contain bromelain, an enzyme from pineapple that has its own anti-allergy and anti- inflammatory properties.

Herbal inflammation fighters

Chamomile (Matricaria recutita) contains flavonoids and two other anti-allergy substances, azulene and chamazulene. Rob McCaleb, president of the Herb Research Foundation in Boulder, Colorado, and coauthor of The Encyclopedia of Popular Herbs (Prima, 2000), says azulene and chamazulene are among the substances that may block the release of histamine. Chamomile also has anti-inflammatory activity.

You can take 10 to 40 drops of tincture three times a day. To make tea, steep a teaspoon of dried flowers in a cup of hot water for five to ten minutes. Strain, and drink 3 to 4 cups a day. You can also use chamomile externally. Simply dampen a clean cloth with cool tea and apply to inflamed skin, whether that’s a red, itchy nose or allergically provoked hives. Or try a commercial chamomile-containing cream. McCaleb notes that a very small number of allergies to chamomile have been reported.

Ginkgo (Ginkgo biloba) contains quercetin and other flavonoids, plus ginkgolides. Ginkgolides inhibit the action of the body’s platelet activating factor (PAF), a chemical involved in the biochemistry of allergies and asthma. In people who have asthma, PAF causes airways to constrict, making breathing more difficult. Preliminary studies show that ginkgolides reduce airway constriction in response to inhaled allergens or exercise. If you’re going to take ginkgo, you’ll need to take a standardized extract; the compounds in ginkgo leaves need to be highly concentrated. Duke recommends a dosage of 80 mg of standardized extract one to three times a day. Because of ginkgo’s blood-thinning actions, don’t combine this herb with a prescription blood thinner.

Stinging nettle (Urtica dioica), particularly the leaves’ stinging hairs, are rich in histamine and other chemicals that modify the inflammatory response. This herb also contains anti-inflammatory substances, flavonoids, and a host of vitamins and minerals.

You may well wonder how histamine actually improves a condition caused by histamine. Brinker explains that, theoretically, additional histamine can inhibit some aspects of the body’s inflammatory response. Other plant components probably contribute to the end result, he says.

Contradictory as it might seem, research does suggest that nettle works. In a double-blind, placebo-controlled study of sixty-nine patients with hay fever, 58 percent rated freeze-dried, encapsulated nettle effective, and 48 percent said the herb was as good as or better than previously used medicines. Wiancek sees similar results in her clinic in Vail, Colorado. “It works in about 50 percent of my patients, but for that 50 percent it does wonders,” she says.

If you want to try using nettle, seek a product made from the fresh freeze-dried herb, says Brinker. The reason is that the leaves lose their histamine upon air drying. He recommends one to two 300-mg capsules every three to four hours as needed. Don’t use nettle during pregnancy.

Last year, the Food and Drug Administration issued a warning that the decongestant phenylpropanolamine (PPA), an ingredient in many over-the-counter cold remedies, had been linked to an increased risk of stroke.

Sniffle-stopping fungus

Reishi mushroom (Ganoderma lucidum) has been used for thousands of years in Oriental medicine to treat respiratory disorders, including asthma. It contains triterpenes, which are anti-inflammatory and have been shown to inhibit histamine release from human mast cells. Christopher Hobbs, L.Ac., author of Medicinal Mushrooms (Botanica, 1995), says that, in his clinic, he finds reishi useful for reducing symptoms of respiratory allergies. This mushroom also has antiviral and immune-enhancing effects—beneficial in discouraging cold and flu viruses from taking hold in boggy nasal linings.

Hobbs recommends taking reishi as a tea, in a dose of 1 cup morning and evening, or as a powdered, encapsulated extract in a dose of 2 to 3 “00” capsules or 2 to 3 tablets, morning and evening with meals.

Hobbs also recommends combinations of Chinese herbs for help in combatting allergies. He includes gentian, astragalus, codonopsis, magnolia bud, and small amounts of red ginseng in formulas that he blends for patients. Wiancek often uses a Chinese patent remedy for hay fever and allergies called Bi Yan Pian, a blend of xanthium fruit, magnolia flower, licorice root, phellodendron bark, platycodon root, schisandra fruit, and other herbs. She recommends 3 to 4 pills three times daily.

Traditional herbs for fighting allergies

Sage (Salvia officinalis) and eyebright (Euphrasia officinalis) are two herbs that Sunny Mavor, A.H.G. and coauthor of Kids,Herbs, & Health (Interweave, 1998), recommends for drying excessive nasal secretions. Chinese sage (Salvia miltiorrhiza), also called dan shen, has been shown in test-tube studies to inhibit release of histamine from mast cells. Whether the same holds true for garden sage remains to be seen, but you can try all three of these herbs in teas or tinctures.

David Bunting, staff herbalist at Herb Pharm, a supplement manufacturer in Williams, Oregon, likes to use eyebright as a tincture in combination with the mucous-membrane tonic goldenseal (Hydrastis canadensis), astringent and anti-inflammatory yarrow (Achillea millefolium), and decongesting, antimicrobial horseradish (Armoracia rusticana). Wiancek recommends blending equal parts of sage, eyebright, and stinging nettle tincture; take 40 drops of this blend three times a day.

Licorice (Glycyrrhiza glabra) has a sweet taste that belies its potent anti-inflammatory and anti- allergy power. It contains glycyrrhetic acid, which acts in two ways. First, it simulates the body’s own cortisol, a multi-function hormone that suppresses inflammatory response. Second, glycyrrehtic acid blocks the enzyme that degrades cortisol. As a bonus, it’s demulcent and expectorant. No surprise, then, that this herb often shows up in both Asian and Western herbal blends for asthma and hay fever.

Because licorice can cause retention of sodium and water and loss of potassium, do not use it internally for more than six weeks without your doctor’s supervision. Don’t use it if you’re pregnant or nursing or if you have high blood pressure, kidney or liver disease, or diabetes.

For allergic skin conditions such as eczema and hives, licorice can also be applied externally as a compress. To use it this way, brew a tea from the dried, chopped root and let it cool. Dampen a clean cloth in the tea and lay the cloth atop the affected area.

Treating symptoms at the source

Herbs can help relieve symptoms, but no single remedy will cure allergies. Those inescapable basic principles of health—eating well, exercising, and getting enough rest—are even more crucial during allergy season. It helps as well to avoid the thing that you’re allergic to, but it’s not always possible.

“With allergies,” says Hobbs, “a one-remedy-fits-all approach is rarely successful.” His strategy is to make a Traditional Chinese Medicine diagnosis, then track down and eliminate food allergies. He finds that many of his clients who have respiratory allergies also have food allergy symptoms, usually due to incomplete digestion—a deficiency that results in the release of IgE, the antibody that triggers mast cells to release histamine. While removing this potential source of irritation, Hobbs corrects imbalances with acupuncture and Chinese herbs. “I find patients have much better results with this deeper process,” says Hobbs. He suggests that people take action to reduce seasonal allergies a month before the season begins and continue treatment through its end.

Linda B. White, M.D., is a freelance writer and editor. She is the coauthor of Kids, Herbs, & Health (Interweave, 1998) and The Herbal Drugstore (Rodale, 2000).