Allergies: Seasons, reasons and remedies
By Dr. Michael Dostrow
“O, how this spring resembleth the uncertain glory of an April day.” -William Shakespeare, “The Two Gentleman from Verona”
Spring. The snow recedes, the Earth returns to life. Birds sing, bees buzz, happy pollinators flit about. But for some this wondrous time can be as uncomfortable as it is uplifting. Springtime is allergy season and as many as 20 percent of Americans will experience some symptoms in the coming months. In fact, up to 10 percent of doctor’s office visits can be attributed to acute and chronic conditions generally considered to be allergic in origin.
Allergies occur when our immune system reacts to foreign proteins (allergens).
Our body creates antibodies that “attack” the invaders. As a result, special cells called “mast cells” release a cascade of chemicals including histamine, which cause the symptoms associated with allergies. Allergic reactions can cause a variety of symptoms ranging from mild to severe.
Mild but annoying symptoms of allergic rhinitis are myriad and include dry, itchy eyes, runny nose and scratchy throat. Allergic asthma can cause trouble breathing. Urticaria and atopic dermatitis can cause skin reactions of varying severity.
On the other end of the spectrum are anaphylactic allergic reactions caused by a variety of substances from foods and medications to bee stings. These reactions can be rapid and may cause death in a matter of minutes. Prolonged allergies can cause more ominous symptoms such as fatigue, headache and even gastrointestinal distress.
Allergies may be intermittent or regional and are termed “seasonal.” Common “triggers” in this area include the much dreaded rabbit brush, ragweed and pine pollen. More chronic symptoms may be due to an allergen that is always present in your environment, which can include animal dander, second-hand smoke, mold, mildew and “dust.” Interestingly enough, dust is as complex in composition as it is ubiquitous in distribution. Common household dust can contain multiple allergenic substances including, (brace yourself) human skin cells, feline and canine hair and salivary protein residue, insect (dust mite and cockroach) exoskeleton remnants, as well as mold, mildew and whatever might be lurking in our pristine yet arid environment.
Conventional medical treatment for allergies includes medications, allergen avoidance and immunotherapy. The first line of therapy recommended is usually oral antihistamines such as Benadryl (diphenhydramine), Claritin (loratadine) and Zyretec (cetirizine), which are over the counter or prescription Allegra (fexofenadine). Antihistamines, especially Benadryl, can cause sedation and dry mucous membranes. Another commonly prescribed medication is intranasal steroids which don’t make your nose more buffed but do reduce inflammation and sensitivity to allergens. These nasal sprays are used daily and are most effective if administered for longer periods of time. More severe allergic symptoms require additional therapy such as oral leukotriene inhibitors (Singulair and Accolate) and even short courses of prednisone. Prolonged allergies can contribute to developing sinus and respiratory infections which may require antibiotic therapy. Dry, itching and burning eyes are common for allergy sufferers and can be treated effectively with artificial tears, ocular antihistamines (Naphcon and Opcon) and Voltaren (diclofenac) eye drops.
Allergen avoidance involves identifying and avoiding the substances, which affect you the most, certainly easier said than done. Measures which can be taken to reduce exposure to indoor allergens include air filtration and humidification, hypoallergenic pillows and mattress covers, elimination of rugs and carpets and more frequent dust elimination and washing of bedding. Cool mist humidifiers can be cleaned easily and don’t require filter replacement, which can be costly and inconvenient. Air filtration devices, which meet Food and Drug Administration requirements, include electrostatic filters and high-efficiency particulate air (HEPA) filters. Elimination of household pets may not be an option (especially in our home!) so separate quarters or the aforementioned precautions may be helpful.
Outdoor allergen avoidance, unless you live in a plastic bubble, is extremely difficult. In the Eastern Sierra, we are constantly exposed to a cornucopia of airborne allergens. Indeed, for some of us, the very reason we reside here, the diversity of flora and fauna, can be a “blessing and a curse.” It may be prudent on days with high pollen counts or during yard work or other possible increased allergen exposure to wear a mask. Allergens are large particulates so specialized masks are not necessary. Pollen counts are higher in the morning and on windy days, so break out the mask to filter out those airborne beasties.
Immunotherapy or “allergy shots” require weekly injections for up to two years. A specialist uses skin testing or blood tests to determine what affects a patient the most and then injects small amounts of those substances to elicit a response from the immune system. After some time, the patient becomes less sensitive to those allergens and symptoms decrease. Allergists claim that up to 90 percent of patients will benefit from this arduous and expensive procedure. These treatments are rarely covered by insurance.
Non-medical or “natural” approaches to allergy treatment are not as well researched as their more synthetic counterparts but are supported by a considerable amount of anecdotal evidence. The cornerstone of a non-pharmaceutical allergy regimen is nasal irrigation and regular use of nasal saline sprays. Saline (salt water) solutions such as “ocean spray” can add much needed moisture to dry irritated nasal tissue as well as diluting and washing away offending allergens. Nasal saline has the added benefit of shrinking swollen engorged mucous membranes, and this therapy can be used multiple times throughout the day. Staying well hydrated (as described in my prior Sheet series “Aqua Impura”) might be the number one most important naturopathic intervention for treating allergies.
Practitioners of chiropractic and acupuncture utilize a novel therapy termed N.A.E.T. (Nambudripad’s Allergy Elimination Techniques) and many people receiving these treatments report reduction of symptoms.
There are multiple herbal formulas, which claim to have immunological effects. Few, however, have any scientific evidence to back up their claims. It does appear that butterbur, nettle, rice-bran arabinaxolyn and multiple Chinese medicinal mushrooms seem to confer some immunological benefit. Grapeseed extract and a compound known as quercetin have received some attention recently in some of the naturopathic journals. Chinese physicians often utilize food as their first line of therapy and recommend spicy foods to thin nasal secretions.
Remember that herbs and medications do interact and just because it’s “natural” does not necessarily mean it’s safe. It is not wise to self medicate even with common remedies without authoritative credible advice, preferably from a practitioner of some form of medicine. Never base important health decisions solely on information derived from the internet and with that in mind go to Medline plus allergy and pollen.com for more on allergies and pollen counts.
“Maladies, melodies …
Allergies to dust and grain
Maladies, remedies …
Still these allergies remain.”
-Paul Simon, “Allergies”
