Allergic rhinitis is the most common form of non-infectious rhinitis affecting people all over the world, but it would appear that the UK has one of the highest incidences of hay fever with around 29% of the population affected. This is three times what it was back in the 1970s.
What Is Allergic Rhinitis?
Allergic rhinitis (hay fever) can be broken down into two types: seasonal and perennial. Seasonal hay fever typically occurs during the time of year when plants pollinate and sufferers might react to tree pollen, grass and weeds during Spring, or weeds, fungus and spores during Autumn. Individuals with year-round rhinitis, also known as perennial hay fever, experience symptoms all year round and tend to react to indoor allergens, such as dust mites, animal dander, feathers, fungus spores or mould for example. We typically see that people who suffer from hay fever often suffer from other atopic disorders such as asthma and dermatitis.
Hay fever is the result of your immune system reacting to the proteins in the pollen of trees, grasses, or mould that affect the mucous membrane in the nose, eyes and air passages. These proteins are also referred to as allergens.
Symptoms include itchy, red or swollen eyes, watery thin and clear discharge from the nose, sneezing, coughing, fatigue and irritability. Hay fever sufferers can often feel wiped-out for weeks on end.
WHAT ARE THE TRIGGERS FOR HAY FEVER?
- Tree pollen, common in early spring.
- Grass pollen, common in late spring and summer.
- Ragweed pollen, common in fall.
- Dust mites, cockroaches and dander from pets can be problematic all year-round (perennial).
- Spores from indoor and outdoor fungi and moulds – both seasonal and perennial.
WHAT CAUSES THE SYMPTOMS OF HAY FEVER?
Your body’s immune system is designed to fight off any foreign object or pathogen that it perceives to be a threat to the body. In the case of hay fever, the body views the allergen (pollen, dust and/or dander) as the threat and in response triggers the release of Immunoglobulin E antibody (IgE). This antibody attaches to mast cells and basophils (types of immune cells), which are largely located around areas of the body that are in close contact with the environment, such as the skin, respiratory system (nose, eyes, throat). They can also be found in the intestines.
Further pollen exposure then causes the molecules in the pollen to bind to the antibodies on the outside of the mast cell, which then prompts the mast cells to release a number of chemicals such as histamine and leukotrienes. During the first exposure to the allergen, the body might only produce a small number of antibodies, however this gets much larger during subsequent exposures.
Whilst you might want to blame the pollen/grass/dander for the way that you are feeling, it is actually the histamine that is making you feel so darn awful. Histamine makes the capillaries of your white blood cells more permeable, which enables them to engage and act on the pathogen much more effectively and ultimately expel the allergen out of your body. All these symptoms are meant to protect your body, so whether it causes swelling in your nasal passage to prevent the pathogen from entering, or a runny nose, coughing, sneezing and watery eyes all of these are designed to help your body get rid of this presumably harmful allergen/threat.
Allergies in any capacity are NOT a normal immune response to antigens, in fact they are more of an over-reaction/hypersensitive reaction.
WHEN DOES HAY FEVER TYPICALLY START?
It is believed that hay fever is largely inherited and those born to parents with allergies have a much greater chance of becoming symptomatic during their lifetime. In fact, it is believed that your risk increases from 25% if one parent has allergies, to 75% if both parents has allergies. Hay fever usually presents in childhood, but in my clinical experience I very often see late onset hay fever in those individuals who have immigrated or moved away from their birth environment. This begs the question about the impact of the environment and how well our immune systems are adapting to change?!
As mentioned earlier, there has been a significant increase over the last forty plus years and I can’t help but wonder whether more emphasis needs to be placed on the changes in our environment (less breastfeeding, fewer natural births, greater hygiene and therefore less exposure to a range of microbes) and diet (higher sugar intake, more processed foods, less fibre to feed the good bacteria in the gut)????
WHAT ARE THE COMMON TREATMENT OPTIONS?
Most people rely heavily on over the counter (OTC) antihistamines such as Diphenhydramine (Benadryl) or Chlor-Trimeton (Cholephenamine). Unfortunately, most OTC antihistamines and prescribed antihistamines come with side effects, which mostly include:
- Dry mouth, nose and throat
Whilst some people really don’t have a choice but to use an OTC antihistamine, I have personally seen some positive results in clinic just working on building up the immune system, predominantly through working on gut health, whilst also using a natural antihistamine. Ideally, you want to start at least four-to-twelve weeks before the onset of hay fever, so don’t leave it until you are already plagued with symptoms.
HISTAMINE AND THE GUT
Whilst histamine might well be seen as your enemy, histamine is in fact incredibly important not only for protecting you, but also for mood, muscle cells and secretion of stomach acid. Some people however produce excess histamine or have a deficiency in the diamine oxidase (DAO) enzyme that break histamine down from food. Yes, that’s right, not only does your body produce histamine, certain foods are high in histamine too, which is one of the reasons your histamine might be even higher than you would like it.
In healthy individuals, dietary histamine can be detoxified by DAO, whereas those with low DAO activity may be at risk of histamine accumulation, which can over time result in symptoms mimicking allergic reaction. If you are struggling with histamine, then this can easily be confirmed with a blood test.
Furthermore, certain gut bacteria can convert histidine (an amino acid) in food to histamine via histamine decarboxylase (HCD) enzyme production. The more of these microbes you have, the greater the levels of histamine you will have in your body. Keeping the good bacteria in your gut happy and in balance is key.
Here are my top tips for helping you deal with hay fever this Spring.
Heal your Gut!
This is ideally something that requires the input and guidance of a Registered Nutritional Therapist or Functional Medicine Practitioner. Leaky gut can often exacerbate symptoms and worse still lead to other health complications.
Try a low-histamine diet.
Excluding high-histamine food for long periods of time might not be the best way to support optimal immune function. This can often trigger intolerances to foods that might be eaten more often as a result of restricting other food groups. Personally, I would recommend that you bring some awareness to the high histamine foods (some of these you want to avoid anyway, as they are not overly healthy), and then maybe look to reduce these or try and avoid having too much of them in one meal or day for example. Oxalates can also be a trigger for some people, so again it is very individual, and the key is to find what works for you, but ideally avoid restricting any particular food groups (especially oxalates) for too long.
High histamine food:
- Aged cheese
- Canned foods
- Pickled foods
- Ready meals
- Avocado (ouch, I know a good one!)
- Fermented foods, such as Sauerkraut, Kefir, Kimchi, Kombucha
- Alcohol – Wine and Beer
- Processed Meat
- Leftover food
- Spoiled food (fish and seafood that has been left uncooked) – always opt for fresh fish!
- Bone Broth (yep, this one too!)
Then there are histamine liberators. These foods don’t necessarily contain high levels of histamine, but instead cause the body to release stored up histamine. These are:
- Most citrus fruit
- Cocoa and chocolate (yes, I feel your pain!)
- Beans and pulses
- Wheat germ
- Additives such as benzoate, sulphites, nitrates, glutamate, food dyes
Balance good bacteria in the gut
This can be quite challenging as most of the fermented foods rich in good bacteria are also high in histamine. You can however do this by increasing the diversity of fibres in your diet.
A probiotic might be beneficial and personally I really like this product. Seeking Health HistaminX – https://www.amritanutrition.co.uk/histaminx-60-vcapsules\
Increase your fibre intake through vegetables.
This will help to increase short chain fatty acids (SCFA), which help regulate your immune system and also decrease inflammation. Most of all it will feed the good bacteria in your gut. Happy gut happy you!
Eat foods that are high in quercetin.
Quercetin is a flavonoid that has antioxidant, antihistamine and anti-inflammatory properties. Quercetin can turn off histamine production and help to moderate the inflammatory cascade. Which is most probably the reason it is coined ‘Nature’s Benadryl’.
Quercetin also help to inhibit the production of specific inflammatory molecules, which can result in less itching, redness and swelling. Not only does it seem to have really positive results for people with allergic rhinitis, but also for those suffering with asthma as it helps to minimise bronchial restriction.
I would personally recommend increasing your intake of quercetin rich foods, whilst also taking a supplement. My favourite supplement is Allergy Research Quercetin 300mg https://www.nutri-link.co.uk/shop/quercetin-300mg-x-60-capsules.html.
Quercetin rich food:
- Leafy green vegetables
Eat your berries
Berries are rich in flavonoids, so therefore fall in the same category as quercetin. Whilst raspberries are actually high in histamine, they are also high in quercetin, so offer really good support to the body. The best way that we can support the immune system is through food, so use your food as medicine and make sure to enjoy berries on a daily basis. Ideally choose organic as berries tend be sprayed quite heavily or better still and pick them wild yourself.
Eat zinc-rich foods
Zinc is a key mineral involved in maintaining a healthy immune system. It is also a key nutrient that helps to protect and heal the lining of the gut.
Good sources of zinc include:
- Pumpkin seeds
- Grass-fed beef
- Cocoa Powder
- Cashew nuts
- Kefir or Yoghurt
Eat raw, LOCAL honey
Local honey will introduce trace amounts of the local pollen that has been picked up by the bees from the local plants and will support your immune system to tolerate these local pollens. My advice is to avoid supermarket bought honey, and instead only source local honey from your local health food shop. For those living in and around Macclesfield you can find some delicious local honey at no. 74 Delicatessen in Bollington. https://www.facebook.com/no74deli.co.uk/
Reduce sugar intake
Not only does sugar feed all the bad bacteria in the gut and especially yeast, but it also reduces the absorption of vitamin C, D, calcium, chromium and magnesium.
10. Work on sleep hygiene
Hay fever seems to affect sleep in around 57% of adult patients and 88% of children, leading to day-time fatigue and decreased cognitive functioning.
Limiting screen time and blue light exposure for at least 90-minutes before going to bed can positively impact sleep. If you or your child suffer with allergic rhinitis, then this is a really small step that can hopefully also support overall health and wellbeing. You can also indulge in a warm bath with epsom salts to prepare the body for sleep.
Hope you find some of these suggestions helpful. If you or one of your family members suffer from hay fever and would like to get some support you can contact me to arrange a 15-minute call to discuss how my services can support your health.