Hounded by Hay Fever?



Itchy nose and throat, watery eyes and the sniffles? It's likely to be seasonal rhinoconjunctivitis. Otherwise known as 'hay fever', it's triggered by various types of pollen - which can also aggravate symptoms of asthma and cause skin irritation, all linked via the immune IgE response.


Histamine is a natural part of the immune response, making blood vessels more permeable, in order to allow immune cells and fluid into an area of inflammation. When the body tries to expel what it perceives to be harmful substances like pollen, it does so via fluid. This is why you experience watery eyes, and a runny nose. However, too much histamine in the body can have negative effects and aggravate symptoms.


I've had asthma since childhood, but I've been more susceptible to hay fever symptoms over the last few years.


This could be due to levels of diamine oxidase (DAO) and HNMT, two enzymes which help breakdown and clear histamine from the body. Both naturally decline with age and certain prescription dugs can also interfere with levels (1). In addition, we may have genetic modifications which reduce the effect of these enzymes. This can lead to histamine building up in the body, as both breakdown and clearance of it is slower. You can supplement with DAO and HNMT but they won't have any effect unless you're shown, via genetic testing, whether you have a need for either.


Increased symptoms may also be due to climate change: with increased levels of carbon dioxide, scientists are predicting a rise in pollen by over 200% (2), due to higher plant yields and longer growth seasons.


The increased 'sensitivity load' can also be the result of food sensitivities and cross-reactions of certain foods. For example, those sensitive to birch pollen may find their symptoms increase when eating apples, hazelnuts, carrot and celery (3).


But don't reach for the anti-histamines just yet. Anti-histamines work by blocking the effect of histamine, but can make you sleepy, lose concentration, cause stomach upsets and leave a bitter taste in your mouth (4). So, how about trying to reduce your overall histamine load or your inflammatory response to pollen, in the first place?


There are some foods which are naturally high in histamine. Whilst the list isn't definitive for everyone, the main ones are aged cheeses, cured meats, fermented foods, fish which isn't fresh and leftovers. Histamine develops over time and bacteria can produce histamine - but you'll probably notice that this list includes foods which are considered as 'healthy'. So be mindful about which foods you might reduce during the allergy season, as you may also be cutting out other important nutrients contained within them.



Another approach is to increase micronutrients to help moderate inflammation, to reduce your symptoms. Whilst these are naturally available via food, the amount needed by the body may mean supplementation is useful.

  • Quercetin is an anti-oxidant flavonoid and has been shown to inhibit the release of histamine (5). It's naturally found in red grapes, red onions, citrus fruits and tomatoes. The effect of quercetin may be increased when taken at the same time as bromelain (6).

  • Bromelain, found naturally in the stem of pineapple, is a natural anti-histamine, anti-inflammatory and decongestant, with specific anti-allergic activity in the lungs and airways (7).

  • Curcumin is the active ingredient in turmeric and its anti-inflammatory effects are well documented especially with regards to pollen (8).

  • Other anti-inflammatory foods include garlic, ginger and rosemary, oregano and cinnamon.

  • Supplementing with butterbur has been shown to have similar effects to cetirizine in patients with seasonal allergic rhinitis (9).

  • Vitamins D and C play a vital role in immune response and inflammation.

There are a number of supplement complexes targeted at hay fever symptoms which combine micronutrients for ease as well as efficacy: the ingredients are in the right proportion to each other and are thus safe to use. However, if you take prescription medications, you should always check for possible negative interactions with your doctor or health professional first.


And finally, contrary to what you might think, exercise can help your symptoms. By increasing your blood flow, this can help to move the allergens through the body more efficiently, decreasing inflammation and irritation. Make sure your exercise is light (swimming, yoga and pilates are perfect) and don't over-exert yourself. Consider the weather and time of day, as pollen levels increase first thing in the morning and early evening. Exercise indoors or wear sunglasses if out walking, cycling or jogging. And if you do take anti-histamines or supplements, you might want to take these about 20 minutes before your activity.



References.

  1. https://www.medicalnewstoday.com/articles/322543

  2. Zhang, Y., Steiner, A.L. Projected climate-driven changes in pollen emission season length and magnitude over the continental United States. Nat Commun13, 1234 (2022).

  3. Wuthrich B, Straumann F. Pollen cross-reactivity can we establish a link between the in vitro results and the clinical situation? Allergy. 1997;52(12):1187–93

  4. https://www.webmd.com/allergies/antihistamines-for-allergies

  5. Yang D, Wang T, Long M, Li P. Quercetin: Its Main Pharmacological Activity and Potential Application in Clinical Medicine. Oxid Med Cell Longev. 2020;2020:8825387. Published 2020 Dec 30.

  6. Taussig S. the mechanism of the physiological action of bromelain. Med Hypothesis 1980; 6.

  7. Secor ER et al. Oral bromelain attenuates inflammation in an ovalbumin-induced murine model of asthma. Evid Based Complement Alternat Med2008; 5.

  8. Wu S, Xiao D. Effect of curcumin on nasal symptoms and airflow in patients with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2016 Dec;117(6):697-702.e1. doi: 10.1016/j.anai.2016.09.427. Epub 2016 Oct 24.

  9. Schapowal A; Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002 Jan 19;324(7330):144-6.