Oh, the sneezing! About 35 million Americans suffer from upper respiratory tract symptoms due to airborne allergies. One of the most common is hay fever, which results from a reaction to pollen.
Pollen enters the nasal cavity and triggers a cascade of reactions that lead to the release of histamine and other inflammatory chemicals. This can cause sneezing, coughing and postnasal drip, a runny or congested nose and itchy, watery red eyes with dark circles underneath. Hay fever can keep you awake at night, making you feel fatigued and generally terrible all day long.
The most widespread pollen allergen is ragweed. One plant can generate a million grains of pollen a day. Other offenders include sagebrush, redroot pigweed, lamb's quarter, Russian thistle (tumbleweed) and English plantain.
Even if none of the plants that cause hay fever are found in your area, you are still susceptible to exposure because the small, Iight, dry pollen grains are easily transported by wind. Scientists have found ragweed pollen two miles high in the air and up to 400 miles away from its original source.
PREVENTION STRATEGIES
Pollen season occurs during the spring, summer and fall, when pollen is released by trees, grasses and weeds. Pollen counts tend to be highest in the morning, especially on warm, dry breezy days, and lowest during cool, rainy periods. The pollen concentration is available for most urban areas-check your newspaper. Another resource for pollen counts is the American Academy of Allergy, Asthma and Immunology's National Allergy Bureau at uuu.aaaai.org. You can monitor pollen levels and plan accordingly. For example, allergy sufferers should try to stay indoors with the windows closed when pollen levels are high.
You can wear a dust and pollen mask designed to stop pollen from entering the nasal passageways (available at most pharmacies). You can use a high-efficiency particulate air (HEPA) purifier in your house, especially in your bedroom since pollen counts increase during the night.
DRUG THERAPIES
Several pharmaceutical medications can be used to treat hay fever, all of which can have side effects.
We all know about antihistamines, which are used to control excess mucus and reduce itching and sneezing. Examples include the prescriptiondrugsfexo-fenadine(Allegra), desloratadine (Clarinex) and cetirizine (Zyrtec) and the over-the-counter (OTC) medications loratadine (Claritin) and diphenhydramine @enadryL). Cromolyn sodium (Nasalcrom) is an OTC nasal spray antihistamine.
Potential side effects of oral medications include drowsiness and impaired coordination. The nasal spray can cause cough, nasal congestion or irritation, nausea, sneezing, throat irritation and wheezing.
Decongestants are used for nasal congestion. A common OTC oral form is pseudoephedrine (Sudafed). Phenylephrine (Neo-Synephrine, Sinex) is a widely used nasal spray. Decongestants may raise blood pressure, cause insomnia and irritability, and inhibit urinary flow. They should be avoided by people with high blood pressure and/or glaucoma (they can increase the eye's intraocular pressure). Decongestants should be taken for only a few days-long-term use causes increased blood vessel constriction, which worsens blood pressure.
Corticosteroid treatments contain small doses of steroids to reduce nasal inflammation and swelling. They prevent and treat most allergy symptoms. Common examples of prescription nasal corticosteroids include fluticasone (Flonase), mometasone (Nasonex) and triamcinolone (Nasacort). These nasal corticosteroid sprays can cause fungal infection of the sinuses and mouth.
Sometimes oral steroids are used for severe allergies. These are very powerful prescription medicines that should be used for only a short time (up to a few weeks). Short-term side effects may include weight gain, water retention, high blood pressure, mood swings and depression. Long-term side effects include increased risk for diabetes, cataracts, osteoporosis and muscle weakness.
I know firsthand the miseries of hay fever. Fortunately, the natural approaches I describe below have worked extremely well for me and for my patients…
NASAL RINSE
An effective technique for people prone to hay fever and/or sinusitis is nasal irrigation. This involves rinsing the nasal passages with a warm saline solution to reduce the concentration of pollen, dust and other allergens. It also helps to clear excess mucus from the nasal passageways. This is typically done with a neti pot, a small ceramic container with a narrow spout that allows you to pour water into your nostrils and sinus cavities. Neti pots arc available at health-food stores for about $20.
To use a neti pot, mix one-quarter teaspoon of salt in a cup of warm water. Pour the solution into the neti pot. Tilt your head to the side, and insert the spout into the upper nostril. The solution will flow into the upper nostril and out the lower nostril. After a few seconds, remove the pot. \X/ith your head still tilted, blow through both nostrils. Do not cover one side of your nose-this will force the mucus and bacteria up into your sinuses. Repeat the rinse on the other side. It's messy, but it works. Use once daily for low-grade allergies and twice daily for acute allergies.
An easier alternative is Sinus Rinse. You open a packet of premeasured saline and baking soda, pour it into the bottle that comes with the kit and add warm water. Push the rip of the bottle into one nostril, and squeeze the bottle so the solution comes out the other nostril. Repeat with the other nostril. Do this once or twice daily. A kit containing 50 premixed packets is available from Allergy Solutions for $12.95 (800-491- 4300, www. allergysolution.com).
Important: To avoid introducing bacteria into your nasal passageways, clean the tip of the neti pot (or Sinus Rinse bonle) with alcohol between uses.
HOMEOPATHIC HELP
Homeopathy treats hay fever by desensitizing the immune system to the offending pollen(s)- or the symptoms they trigger. This is based on the principle that "like cures like"-that is, substances that cause allergy symptoms can be used in a highly diluted form to alleviate those same symptoms.
For example, ragweed, oak and grasses can be taken as individual remedies or as part of a combination remedy. If you know that you are allergic to ragweed pollen, you can take homeopathic ragweed to minimize your response. An allergist can do skin testing to determine which allergens affect you.
Homeopathic remedies are somewhat similar to conventional allergy shots, in which minute doses of the substances you're allergic to are injected under the skin. The advantage of the homeopathic approach is that it is convenient (it requires dissolving some pellets or a liquid solution under your tongue) and relatively inexpensive ($10 to $20 a month).
Researchers at the Southwest College of Naturopathic Medicine and Health Sciences in Tempe, Arizona, conducted a four-week, double-blind clinical trial comparing homeopathic preparations with a placebo during the regional allergy season from February to May. Participants included 40 men and women, ages 26 to 63, diagnosed with moderate to severe seasonal allergy symptoms. Those taking the homeopathic preparations had a 38% reduction in symptoms, such as watery eyes and sneezing, compared with a 25% decline for those using the placebo.
There are two homeopathic remedies that I recommend for the treatment of hay fever. \)7hich one you take depends on your symptoms. They are available at most health-food stores. The dosage is two pellets of a 30C potency twice daily.
- Allium cepa (from onion) is for those with watery and burning eyes...runny nose... sneezing.
- Euphrasia (from the eyebright plant) is for hay fever that mainly affects only the eyes, causing burning, tearing and redness. If you don't know which homeopathic remedy to use, try Sabadil Allergy by Boiron, available at health-food stores for about $9. This formula contains six remedies commonly used for hay fever. The typical dose is two tablets dissolved in the mouth every 15 minutes for one hour, then two pellets three times daily.
CHOOSING SUPPLEMENTS
The right supplements also help control hay fever. My recommendations…
- Quercetin, a type of plant pigment known as a flavonoid, is nature's antihistamine, with anti inflammatory and antioxidant properties. It is found in onions, apples and green tea. It works best at a starting dosage of 1,000 mg three times daily for five days, followed by a maintenance dosage of 500 mg two or three times daily. Quercetin is very safe, and side effects are uncommon. Quercetin also works well when combined with vitamin C, which may help reduce allergy symptoms in some individuals. A typical dose for hay fever is 3,000 mg to 5,000 mg of vitamin C daily. Reduce the dosage if you develop loose stools. If you have a history of kidney stones, consult your doctor before taking vitamin C supplements.
- Stinging nettle leaf is a popular herbal treatment for the relief of hay fever. I have seen it help some patients when used at the first sign of hay fever symptoms. A randomized, doubleblind study conducted at the National College of Naturopathic Medicine in Portland, Oregon, involved 59 people with hay fever who took 300 mg of a stinging nettle leaf supplement or a placebo daily. Researchers found that after one week, 58% of those who took stinging nettle leaf had a reduction in symptoms, such as sneezing and itchy eyes, comparedwith 37% of those who received a placebo.
Interestingly, nettle leaves are a nattJral source of vitamin C and quercetin. Stinging nettle leaf supplements should be avoided by those with kidney disease because they have a diuretic (water-excreting) effect. The type of stinging nettle leaf used in the study mentioned above is available from Eclectic Institute and can be found at health-food stores.
- N-acetylcysteine (NAC) is a great supplement to use if you are suffering from postnasal drip or coughing as the result of mucous formation. I find that 500 mg twice daily is helpful for patients. Side effects, such as nausea, constipation and diarrhea, are rare.
GETTING STARTED
When using homeopathic remedies and supplements, it's best to start two weeks before allergy season and then continue until the end of the season if the treatment is helping. Try quercetin first. If you do not get relief within one week, try stinging nettle leaf, NAC and,ior a homeopathic treatment.
A book that I especially like is Sinus Survival: A Self-Help Guide, by Rob Ivker, DO (Tarcher).
