Also indexed as: Allergic Rhinitis, Allergy (Hay Fever), Pollen
Allergy, Seasonal Allergy
Hay fever is an allergic condition triggered by the
immune system’s response to inhalant substances (frequently pollens).
Researchers have yet to clearly understand why some people’s immune systems over-react to exposure to pollens while
other people do not suffer from this problem. Symptoms of hay fever are partly a result of
inflammation that, in turn, is activated by the immune system.
What are the symptoms of hay fever?
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 onset of the pollen season. Tearing, sneezing, and clear,
watery nasal discharge soon follow the itching. Headaches and irritability may also occur.
Medical treatments
Over the counter topical nasal decongestants such as oxymetazoline (Afrin®) and
phenylephrine (NeoSynephrine®) may provide relief from nasal congestion, but they should
only be used for a few days. The oral decongestant
pseudoephedrine (Sudafed®) may help relieve nasal congestion, while antihistamines
such as diphenhydramine (Benadryl®), brompheniramine (Dimetapp®), chlorpheniramine (Chlor-Trimeton®), and loratadine (Claritin®) might help dry excess mucous and
reduce sneezing. Cromolyn sodium (Nasalcrom®)
is used as a nose spray to prevent hayfever symptoms.
Prescription antihistamines are often prescribed for relief of hay fever symptoms. These
include cetirizine (Zyrtec®), desloratadine
(Clarinex®), and fexofenadine (Allegra®).
Inhaled corticosteroids, such as flunisolide
(Nasalide®), triamcinolone (Nasacort®), fluticasone (Flonase®), and mometasone
(Nasonex®) may also be suggested to prevent and treat nasal symptoms.
Dietary changes that may be helpful
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 supplements that may be helpful
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.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
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 two to three times per day, or a 2–4 ml tincture three times per day
for people suffering from hay fever.
The Japanese herbal formula known as sho-seiryu-to has been shown to reduce symptom, such
as sneezing, for people with hay fever.13 Sho-seiryu-to contains licorice, cassia bark,
schisandra, ma huang (ephedra), ginger, peony root, pinellia, and asiasarum root.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
References
1. Speer F. Multiple food allergy. Ann Allerg
1975;34:71–6.
2. Buczylko K, Kowalczyk J, Zeman K, et al. Allergy to food in children
with pollinosis. Rocz Akad Med Bialymst 1995;40:568–72.
3. Ogle KA, Bullock JD. Children with allergic rhinitis and/or bronchial
asthma treated with elimination diet. Ann Allergy 1977;39:8–11.
4. Holmes HM, Alexander W. Hay fever and vitamin C. Science
1942;96:497.
5. Ruskin SL. High dose vitamin C in allergy. Am J Dig Dis
1945;12:281.
6. Fortner BR Jr, Danziger RE, Rabinowitz PS, Nelson HS. The effect of
ascorbic acid on cutaneous and nasal response to histamine and allergen. J Allergy Clin
Immunol 1982;69:484–8.
7. Balabolkin II, Gordeeva GF, Fuseva ED, et al. Use of vitamins in
allergic illnesses in children. Vopr Med Khim 1992;38:36–40.
8. Cazzola P, Mazzanti P, Bossi G. In vivo modulating effect of a calf
thymus acid lysate on human T lymphocyte subsets and CD4+/CD8+ ratio in the course of
different diseases. Curr Ther Res 1987;42:1011–7.
9. Kouttab NM, Prada M, Cazzola P. Thymomodulin: Biological properties
and clinical applications. Med Oncol Tumor Pharmacother 1989;6:5–9
[review].
10. Marzari R, Mazzanti P, Cazzola P, Pirodda E. Perennial allergic
rhinitis: prevention of the acute episodes with Thymomodulin. Minerva Med
1987;78:1675–81.
11. Gopalakrishnan C, Shankaranarayan D, Nazimudeen SK, et al. Effect of
tylophorine, a major alkaloid of Tylophora indica, on immumopathological and inflammatory
reactions. Ind J Med Res 1980;71:940–8.
12. Mittman P. Randomized double-blind study of freeze-dried Urtica
diocia in the treatment of allergic rhinitis. Planta Med 1990;56:44–7.
13. Baba S, Takasaka T. Double-blind clinical trial of sho-seiryu-to
(TJ-19) for perennial nasal allergy. Clin Otolaryngol 1995;88:389–405.
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purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
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before making any changes in prescribed medications. Information expires March 2005.
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