If the thought of blossoming spring flowers makes you think of sneezing, congestion, watery eyes, or itchy skin, this article is for you.
The good news is that you have options, and you can feel better! Making some key changes to your daily diet and lifestyle and taking specific nutrients can help tone your entire immune system and reduce allergy symptoms long-term. My recommendation is for people who have allergic tendencies to implement a three-week protocol at least once or twice yearly to support their overall health and diminish overall symptom severity. Chronic cases of allergies may benefit from additional approaches.
Histamine: the Allergy-Mediating Molecule
Histamine is the immune molecule responsible for kicking off the allergy cascade. When histamine is released, we experience the inflammation that creates itchy skin, watery eyes, and congested sinus passages. However, in addition to its role in allergies, histamine also has a wide variety of other roles in the body like regulating stomach acid, stimulating the central nervous system/brain, boosting libido, and assisting in ovulation and reproductive hormone balance. This explains why some people feel uncomfortable or notice subtle systemic changes when taking certain antihistamines.
Medications
Let’s discuss some of the conventionally available anti-allergy medications.
Antihistamine medications work by blocking the histamine receptor to prevent downstream symptoms. However, it’s important to know that antihistamines do have side effects and risks. The safety of newer classes of antihistamines (2nd generation meds like Zyrtec, Claritin, and Allegra) has been studied more thoroughly than older classes (1st generation meds like Benadryl).
1st-generation antihistamines cross the blood-brain barrier more thoroughly. Studies show these medications increase the likelihood of early onset dementia, memory issues, and diminished cognitive function. Often used ‘off-label’ for insomnia, their use has been shown to disrupt the architecture of healthy sleep. In addition, these meds lead to reduced reflex responses, which can lead to dizziness and balance issues. These medications are not a great choice long-term if they can be avoided, but pose special risks for the elderly, athletes, and those at risk of falling.
2nd generation antihistamines do not cross the blood brain barrier as completely and are considered a slightly safer option. These drugs are often well-tolerated but can contribute to insulin resistance and abdominal weight gain even without prediabetes or abnormal blood sugar levels. They may also have other effects such as impairing digestion, reducing libido, and lowering mood.
Do not abruptly discontinue a prescribed medication without guidance from your doctor.
Other classes of drugs used to control allergy symptoms have other side effect profiles. Another common pharmaceutical option includes intranasal corticosteroids (fluticasone / Flonase).
Steroid nasal sprays may work to diminish acute symptoms and suppress local inflammation in the sinus passages (important), but may mask an underlying infection (including fungal infections), suppress the immune system increasing susceptibility to further infection, disrupt the stress response system (hypothalamic-pituitary adrenal axis), decrease bone density, and delay wound healing. Do not abruptly discontinue Flonase as this may cause rebound inflammation.
Alternative Supports for Managing Allergy Symptoms
Specific botanical constituents help tone the immune system, pulling back on allergic tendencies long-term.
Quercetin (an extract that is found in certain plants like nettles) helps prevent mast cells from releasing histamine so readily. More stabilized, less leaky mast cells reduce the tendency for histamine to spill out into the tissues in the first place, reducing the chance of kicking off an allergic reaction.
Vitamin C supports specific enzymatic pathways involved in breaking down histamine so your body can get rid of it.
Certain forms of Vitamin B6 (P-5-P) and Magnesium help the body clear excess histamine, making tissues less reactive over time.
Natural Decongestants
N-Acetyl Cysteine (NAC) is a naturally-occurring compound that thins the mucus and protects the lungs. As a side benefit, NAC is a precursor to the biggest antioxidant in the body (glutathione). That means while NAC is helping to reduce allergic congestion, it is also supports the body in multiple ways: it helps your body respond to stress, detoxify toxins (which we are always bombarded with), balance hormones, and process physiological reactions.
Therapeutic Dietary Guidelines for People with Allergies
If you have allergies, cleaning up your diet can help diminish symptoms. The following foods groups inflame allergy symptoms acutely and increase long-term allergic tendencies.
Sugar – suppresses the immune response;
Dairy – stimulates histamine, promotes mucus production;
Fermented foods – sauerkraut, kimchi, miso, pickled foods, aged meats and other ferments are high in histamines; these may be healthy in small doses but drive a spike in symptoms if over-consumed;
Alcohol – inflammatory; burdens detoxification pathways; and high in both sugar and ferments, so has both these effects.
Hormonal Impacts
Research shows that allergic conditions may peak during times of hormonal transition such as during puberty and perimenopause for women. Studies show women and girls’ allergy symptoms are slightly more pronounced in hormonal environments with low relative levels of DHEA, an androgen. This may be why you may see a resurgence in your teenage eczema or asthma symptoms during perimenopause. It also speaks to the relative prevalence of allergies in women compared to men and in overall lower androgen environments.
Additionally, estrogen stimulates mast cells to release histamine. You may notice spikes in allergic reactivity at the estrogen high points of your cycle (ovulation and just prior to onset of menses), or in estrogen-excess conditions such as heavy cycles, endometriosis, irregular cycles, or if you have issues with impaired estrogen detoxification (e.g. chemical exposures, long term use of OCPs, alcohol use).
Labwork
In the case of allergies, labwork may include assessments of:
The overall immune system
Nasal culture: microbiome assessment of the nares (bacterial, fungal, and biofilm elements)
Allergy testing
Hormone balance
Mold/mycotoxin and mold allergy testing
Labs should be individually tailored to each individual. Check in for a virtual appointment if you would like to explore underlying causes of your symptoms and work to establish more lasting results.
REFERENCES
❍ Kanda N, Hoashi T, Saeki H. The Roles of Sex Hormones in the Course of Atopic Dermatitis. Int J Mol Sci. 2019 Sep 20;20(19):4660.
❍ Simons FE, Simons KJ. H1 antihistamines: current status and future directions. World Allergy Organ J. 2008 Sep;1(9):145-55.
❍ Zaitsu M, Narita S, Lambert KC, Grady JJ, Estes DM, Curran EM, Brooks EG, Watson CS, Goldblum RM, Midoro-Horiuti T. Estradiol activates mast cells via a non-genomic estrogen receptor-alpha and calcium influx. Mol Immunol. 2007 Mar;44(8):1977-85.