Hay Fever

Also indexed as: Allergic Rhinitis, Allergy, 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.

Checklist for Hay Fever

Rating Nutritional Supplements Herbs
2Stars Thymus extracts  
1Star Quercetin
Vitamin C		 Ephedra
Nettle
Sho-seiryu-to (contains licorice, cassia bark, schisandra, ma huang, ginger, peony root, pinellia, and asiasarum root)
Tylophora
See also:  Homeopathic Remedies for Hay Fever
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

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.

How is it treated? Oral antihistamines are often prescribed for relief of hay fever symptoms. These include diphenhydramine (Benadryl®), chlorpheniramine (Chlor-Phen®), brompheniramine (e.g., Dimetapp®), cetirizine (Zyrtec®), clemastine (Tavist®), and others. Oral nonsedating H1-blockers, including loratadine (Claritin®), are also recommended. To counteract the tendency for antihistamines to cause drowsiness, they are sometimes combined with sympathomimetic agents (e.g., phenylpropanolamine, phenylephrine, pseudoephedrine). Cromolyn sodium nasal spray (e.g., Nasalcrom®) may be recommended when antihistamines are ineffective. When nasal symptoms are not relieved by antihistamines, inhaled corticosteroids may also be suggested.

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.

Ephedra sinica (ma huang) is an herbal remedy for hay fever in traditional Chinese medicine.13 The popular nasal decongestant pseudoephedrine is an active constituent of ma huang.14 It is has largely replaced the use of the herb in modern medicine.

The Japanese herbal formula known as sho-seiryu-to has been shown to reduce symptom, such as sneezing, for people with hay fever.15 Sho-seiryu-to contains licorice, cassia bark, schisandra, ma huang, 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. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988, 219 [review].

14. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988, 219 [review].

15. Baba S, Takasaka T. Double-blind clinical trial of sho-seiryu-to (TJ-19) for perennial nasal allergy. Clin Otolaryngol 1995;88:389–405.