Seasonal Allergy Assists

How to help when pollen strikes.

Climate change strikes again—this time, by making spring, and the period of seasonal allergies, longer.

That’s according to a new study from the University of Cambridge, which used a citizen science database with records going back to the mid-18th century to show that plants in the U.K. are flowering one month earlier under recent global warming (1). So while we all work to combat climate change, your customers may also need help managing their allergies, starting earlier than ever. There are several science-backed options you can offer. Here’s a rundown.

Bromelain. According to Dr. Josh Axe, DC, DNM, CNS, this pineapple enzyme may help modulate the entire immune system (2). Dr. Axe pointed to a 2013 study, summarizing the results: “it was observed in the study that CD11c (+) dendritic cells and DC44 antigen-presenting cells were kept at bay when supplementing with bromelain, a sign that this enzyme is capable of targeting the underlying cause of asthma and allergies. This is why it helps most people suffering from symptoms like a stuffy/runny nose, itchy eyes, swollen lymph nodes, congestion and trouble breathing.” Dr. Axe further notes that, since this enzyme breaks down proteins, it should be taken on an empty stomach for use in allergies—otherwise it’ll just help break down a meal. It’s commonly combined with quercetin and vitamin C (discussed below).

Butterbur. “It’s perhaps the most underrated herb for controlling seasonal allergies in all of my research,” Jason DuBois, PharmD, Founder and COO of Hybrid Remedies, told WholeFoods. “There have been several well-designed clinical trials conducted with butterbur in the treatment of both seasonal and perennial allergic rhinitis from Germany: Not only was the butterbur shown to be superior to placebo in a controlled trial, the ingredient was as effective as popular OTC allergy medications. Butterbur is thought to have beneficial effects on mast cell stability and the formation and release of leukotrienes, both of which are linked to asthma and allergies.”

One 2005 study performed on 330 patients compared Ze 339, a standardized butterbur extract, to fexofenadine (sold under the brand name Allegra, among others) and a placebo (3). The dose: 8mg, one tablet three times daily of Ze 339, compared to one tablet once daily of fexofenadine. The researchers found that both active treatments was individually superior to placebo (p<0.001) in improving symptoms of intermittent allergic rhinitis, with no difference between the butterbur extract and fexofenadine (p<0.37). Symptoms improved both during the day and at night. The researchers concluded: “Despite being a herbal drug, Butterbur Ze 339 has now been subject to a series of well controlled trials and should be considered as an alternative treatment for [intermittent allergic rhinitis].”

Magnesium. While it doesn’t have as much data as other allergy assists, it may well be worth a try—especially for those who are low on dietary magnesium. A 1987 study published in Drug-Nutrient Interactions fed rats diets with different levels of magnesium, and found that in the magnesium-deficient rats, histamine levels “increased rapidly” after four days, hitting a high point by the eighth day; feeding the rats high-magnesium diets rapidly reduced histamine content after two days (4). Looking at human studies, a 1990 placebo-controlled trial published in Magnesium Research considered 38 hay fever subjects who were given either 1.5g magnesium pidolate three times a day for a month or a placebo; the study found that the magnesium was effective in controlling seasonal allergic rhinitis symptoms (5). While these studies aren’t particularly robust, they’re worth keeping in mind as another potential benefit of this multifunctional supplement.

Seasonal Food Allergies?

Those who have hay fever, seasonal pollen allergies, or other similar allergies may also suffer from Pollen Food Allergy Syndrome (PFAS). According to the American College of Allergy, Asthma, & Immunology, PFAS is caused by cross-reacting allergens found in both pollen and raw fruits, vegetables, and some tree nuts (10). The immune system recognizes the proteins that it is allergic to, and has an allergic response, one that typically is confined to the mouth—it’s rare that this would cause anaphylaxis, and an allergic reaction that progresses beyond the mouth may be a sign that this is a worse allergy than just PFAS. Good news, though: Once cooked, the proteins that cause the allergic reaction are distorted, and the immune system doesn’t recognize them—so while fresh, raw apples, bananas, peaches, and more may be off the table, pies, breads, preserves, and other cooked forms of these foods are good to go. Customers curious about more can search for PFAS on www.acaai.org.

Microbiome Modulators. There are probiotics that can help—but keep an eye on the strain, because not all of them are useful for allergies. One review called out Bacillus claussi; Bifidobacterium longum; Clostridium butyricum; Lactobacillus paracasei; and L. plantarum LP14 as having scientific backing, which, you will note, is only a few strains out of many, many probiotics, suggesting that probiotics for allergies is an area that could see more research and growth in the near future (6). Also in the microbiome sphere: EpiCor, a yeast-based fermentation product and a postbiotic. One 12-week randomized, double-blind, placebo-controlled trial gave 78 adults either 500mg EpiCor per day or a placebo (7). The participants kept a diary recording their symptoms, and found that nasal congestion, runny nose, and average number of days with nasal congestion were all reduced in the EpiCor group, as was use of rescue medication for allergies.

Quercetin. Found in foods including onions, kale, tomatoes, and broccoli, this flavonoid is an anti-allergy staple. One 2020 review article summarized: “It has anti-allergic functions that are known for inhibiting histamine production and pro-inflammatory mediators. Quercetin can regulate the Th1/Th2 stability, and decrease the antigen-specific IgE antibody releasing by B cells. Quercetin has a main role in anti-inflammatory and immunomodulatory function which makes it proper for the management of different diseases” (8). The review considered several in vivo and in vitro studies and concluded that a dose of 25mg/kg quercetin seems to help inhibit the symptoms of allergic rhinitis.

Vitamin C. Top of the immune system charts, one study found that intravenous vitamin C significantly decreased allergy symptoms, and noted that 50% of patients on vitamin C didn’t need to take any other allergy-related medication (9). A review article further noted that two-week use of nasal applications of vitamin C may reduce mucus secretions and nasal obstruction (6).

Vitamin D. We know how useful vitamin D is for the immune system, and since allergic reactions are immune-related, this one shouldn’t be a surprise. A 2018 study performed on 30 subjects with allergic rhinitis measured serum vitamin D levels and nasal symptom scores (10). The researchers found, specifically, that participants without allergic rhinitis had significantly higher levels of vitamin D than the participants with allergic rhinitis. The cut-off levels: 12.83ng/mL. A blood test can help your customers determine their vitamin D levels, which are important to their immune health and overall health regardless—but seasonal allergies may be the immediate push they need to test and address, if necessary, their vitamin D levels. WF

References

  1. Ulf Büntgen et al., “Plants in the UK flower a month earlier under recent warming,” The Royal Society. 289(1968). 2022. https://royalsocietypublishing.org/doi/10.1098/rspb.2021.2456
  2. Bromelain: Josh Axe, “7 Bromelain Benefits, Uses & Best Food Sources,” DrAxe.com. Posted 10/26/2018. Accessed 2/1/2022. https://draxe.com/nutrition/bromelain/
  3. Andreas Schapowal, “Treating Intermittent Allergic Rhinitis: A prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339,” Phytotherapy Research. 19(6). 530-537 (2005). https://pubmed.ncbi.nlm.nih.gov/16114089/
  4. Magnesium in rats: A. Nishio et al., “Specific change of histamine metabolism in acute magnesium-deficient young rats,” Drug-Nutrient Interactions. 5(2). 89-96(1987). https://pubmed.ncbi.nlm.nih.gov/3111814/
  5. Magnesium in people: C. Cipolla et al., “Magnesium pidolate in the treatment of seasonal allergic rhinitis. Preliminary data.” Magnesium Research. 3(2). 109-112(1990). https://pubmed.ncbi.nlm.nih.gov/2133624/
  6. Janice Pellow et al., “Health supplements for allergic rhinitis: A mixed-methods systematic review,” Complementary Therapies in Medicine. 51. 2020. https://www.sciencedirect.com/science/article/abs/pii/S0965229920307615?via%3Dihub
  7. Moyad, M. A., et al. Immunogenic yeast-based fermentation product reduces allergic rhinitis-induced nasal congestion: a randomized, double-blind, placebo-controlled trial. Adv Ther 2009, 26 (8), 795-804. Online reference: https://www. ncbi.nlm.nih.gov/pubmed/19672568
  8. Quercetin: Morteza Jafarinia et al., “Quercetin with the potential effect on allergic diseases,” Allergy, Asthma & Clinical Immunology. 16. 2020. https://aacijournal.biomedcentral.com/articles/10.1186/s13223-020-00434-0
  9. Vit C IV: Claudia Vollbracht et al., “Intravenous vitamin C in the treatment of allergies: an interim subgroup analysis of a long-term observational study,” Journal of International Medical Research. 2018. https://journals.sagepub.com/doi/10.1177/0300060518777044
  10. Vitamin D: Lia Restimulia et al., “The Relationship between Serum Vitamin D Levels with Allergic Rhinitis Incidence and Total Nasal Symptom Score in Allergic Rhinitis Patients,” Open Access Macedonian Journal of Medical Sciences. 6(8). 1405-1409(2018). https://pubmed.ncbi.nlm.nih.gov/30159065/
  11. PFAS: “Pollen Food Allergy Syndrome,” ACAAI. Reviewed for accuracy 3/21/2019. Accessed 2/1/2022. https://acaai.org/allergies/allergic-conditions/food/pollen-food-allergy-syndrome/