Naturopathic treatment of allergies can involve multiple pathways including treating alterations to the gut micro biome, using supplements, instituting sublingual immunotherapy, implementing dietary considerations, and environmental modifications.
Balancing the gut microbiome
In humans, the gastrointestinal tract is inhabited by a large, complex group of microbes that play a distinguished role in maintaining health. Collectively, this group includes trillions of bacteria, fungi, parasites, and viruses that are known as the microbiome. A person is first exposed to microorganisms as an infant, during delivery in the birth canal and through the mother’s breast milk.10 As time goes on, the microbiome evolves with the individual and exposures to various environmental factors as well as variations in diet can impact the microbiome leading to improved health benefits or increased risk of disease. The microbiome has numerous important functions including producing various nutrients such as vitamin K, prevention of colonization by intestinal pathogens, and modulation of the immune response to name a few.11 The diverse role of the micro biome has led to the idea that its modification may be a target used to restore and maintain balance of the overall individual. Introducing probiotics and prebiotics are a means to accomplish this. Probiotics and prebiotics may be consumed in the form of raw vegetables and fruit, fermented pickles, or dairy products. Another source may be supplemental formulas and functional food. Studies examining the use of probiotics in patients with allergic rhinitis (hay fever) found that adjuvant use of probiotics resulted in improvement in quality of life.12 Probiotic use has also resulted in increased symptom control as evidenced by decreasing scores on questionnaires designed to assess control of allergic rhinitis and asthma symptoms.12 Additionally, a meta study examining the use of probiotics in the treatment of allergic rhinitis examined 22 double-blind, placebo-controlled studies. Seventeen trials showed significant benefit of probiotics clinically, whereas eight trials showed significant improvement in immunologic parameters compared with placebo.13 All five studies with Lactobacillus paracasei strains demonstrated clinically significant improvements compared with placebo.13
Supplements can provide targeted therapeutic options for the treatment and prevention of allergies. Supplements can address many different factors involved in the expression of allergies and asthma including immune system dysregulation, high levels of inflammation, and oxidative stress among many others. Some examples of supplements commonly used in treatment of allergies and asthma include:
Stinging nettles (Urtica dioica) is also commonly called simply “nettle.” Nettle has a significant research profile as a treatment for allergies and allergic rhinitis.14 National College of Naturopathic Medicine (now National University of Naturopathic Medicine) published a double-blind, placebo-controlled randomized study examining the use of freeze dried nettle leaf for treatment of hay fever, asthma, and seasonal allergies found that the freeze-dried preparation was rated higher than placebo in relieving symptoms after just one week’s time.15 Further studies on the use of nettle in preventing the lung inflammation associated with asthma have also been promising. Studies using an experimental model of allergic asthma have shown positive benefit in both immune modulation as well as reduction in inflammatory markers with administration of an aqueous extract of stinging nettle.16
Omega 3 fatty acids
The omega 3 fatty acids docosohexaenoic acid and eicosapentaenoic acid, better known as DHA and EPA respectively, are found in fish oil and are known for their anti-inflammatory properties and protective effects in inflammatory diseases including asthma and allergies.17 Studies examining fish oil supplementation during pregnancy and lactation have shown to reduce both the prevalence and severity atopic dermatitis and food sensitization during the first year of life for the offspring with a possible persistence until adolescence with a reduction in eczema, hay fever, and asthma.17 A six month study conducted by Johns Hopkins University examined the role of omega 3 fatty acids in the prevention of environmentally triggered asthma symptoms and found that having more omega-3 fatty acids in the diet results in fewer asthma symptoms triggered by indoor air pollution.18
Quercetin is among the most abundant polyphenols representing the flavonoid subgroup. It is naturally occurring in plant foods such as onions (the most studied quercetin containing food), broccoli, capers, apples, berries, and grapes, herbs like dill and is also found in tea and wine.19 Quercetin has been utilized in a number of studies examining factors underlying the development of allergies. Quercetin is known for many different properties including its anti-allergic properties such as inhibition of histamine release, decrease in pro-inflammatory compounds, immune system modulation, and inhibition of antigen-specific IgE antibody formation.19 All of these mechanisms can contribute to addressing the underlying cause of allergy symptoms and asthma. In an experimental model of allergic rhinitis, quercetin has been shown to reduce antigen specific IgE levels and well as mitigate the expression of allergic rhinitis symptoms.20
In years past, allergy sufferers were often subjected to extensive series of allergy shots. These were injections designed to aid in reducing the expression of allergy symptoms. Sublingual immunotherapy is a method of allergy treatment that does not involve injections, rather small tablets or liquid drops containing small amounts of specific allergens to build up tolerance and reduce symptoms. This type of immune modulation aims to decrease the pathologic immune response rather than to cause a return to an immunologically naive or unresponsive state.21 Numerous studies have shown that sublingual application of allergen specific immunotherapy is an adequate, safe and efficient substitution to the injection route of allergen administration in the treatment of IgE-mediated respiratory tract allergies.22 Meta analysis studies have shown that sublingual immunotherapy reduces both the symptoms of allergic diseases and the use of medications, and improves the quality of life of children with the diseases.22
The diet constitutes an important source of nutrients and non-nutrient components with multiple properties that present a potential opportunity to modulate the risk of asthma and allergies. Elimination diets wherein the offending food is completely avoided can be difficult to follow long term. Contemporary studies have shown that nutrition trends during the early childhood years may produce changes that have a lasting impact on human health at later ages particularly on the respiratory, GI, and immune systems.23 Western diets are characterized by the consumption of highly refined, overly processed, energy-rich foods and beverages, typically high in fat, sugar, and salt but low in dietary fiber and other nutrients. Changes in dietary habits mainly the decreased intake of fresh fruit and vegetables and a higher intake of processed foods have previously been linked to an increasing prevalence of asthma and allergies.24Multiple studies have highlighted evidence of a beneficial effect of fresh fruits, and antioxidant vitamins on asthma.25 Additional studies have specifically looked at the quality and quantity of dietary fats as a source of allergenic response. Research has shown that a high fat diet potentiates food-induced allergic responses associated with dysregulated intestinal effector mast cell responses, increased intestinal permeability, and gut dysbiosis.26 The quality of fat has also been shown to play a role in increased risk of allergenic response. In a pediatric asthma study, researchers found that for each additional gram of omega 6 fats consumed, children had a whopping 29% increased risk of being in a more severe asthma category.18 Fiber is another nutrient that is consistently lacking in the standard American diet as well as many dietary patterns of many other developed/“Westernized” countries.27 Consistent with the reported health benefits on other immune cells, dietary fiber (especially polysaccharides and oligosaccharides) and its metabolites (SCFAs) have been shown to regulate mast cell function and mast cell activation can be downregulated by pretreatment with these substances.27 Mast cells play a central role in initiating and maintaining inflammation, particularly in allergies and asthma.28
Some parts of our environment are out of our control, particularly outside the home. We cannot control the amount of mold, pollen, or other allergenic inhalants that are in outdoor air. But there are steps we can take inside the home to manage our exposure indoors.
- Rugs, drapes, wall-to-wall carpet, and even overstuffed, upholstered furniture are tremendous collectors of dust and pollen. Removing them or changing styles can help reduce exposure.
- Using specialized air filters like HEPA filters particularly in the bedroom can be helpful. In some cases, whole house filtration systems may also be recommended.
- Avoiding toxic inhalants like perfumes, body sprays, scented candles, room sprays, air fresheners, dryer sheets, and other scented products, especially those with synthetic ingredients.
- Have your home tested for the presence of mold and remediate the source if mold is detected and found.
- Use zippered, allergen resistant covers on mattresses and pillows. According to the Asthma and Allergy Foundation of America, encasing mattresses works better than air cleaners to reduce allergy symptoms.28
Dr. Dazey shares a patient success story
“One of my patients suffered from severe, debilitating spring allergies that started each April, and lasted until the end of August. Since he was a young boy, he used an inhaler for asthma, antihistamines daily, and avoided physical activity and being outdoors. This was not enough to stop the symptoms, as he still suffered miserably with irritated eyes, constant dripping nose, sneezes, headache, and generalized fatigue. His allergy symptoms became inseparable from his moderate depression. As an adult, he began looking forward to a Prednisone prescription each June, but dreaded when the effects wore off. He began to notice changes to his body, his mood, and how less effective and long-lasting it seemed each time. When he learned about the long-term health risks of Prednisone, he sought alternative management approaches. He came and saw me at age 55. The first thing I did was to let him know he could continue using all the conventional medications he needed to function and feel comfortable. He was about 50 pounds overweight, with high blood pressure, high cholesterol and triglycerides, high fasting blood sugar, and mild benign prostatic hypertrophy (BPH). We began with the standard protocol of fish oil, nettles, and quercetin, as well as soup broth that was simmered with Astragalus membraneceus root, Ganoderma lucidum powder, and Pacific bull kelp. Since he was a regular soup eater, this was more agreeable than tea, and he was motivated to use the broth in a variety of different soup recipes. The first season that he tried this protocol, he reported much reduced symptoms in April and May. When June came, he got his prescription for Prednisone but later decided it was not needed – he never filled his prescription! He also used an herbal tincture formula that relaxes the airway and found it unnecessary for weeks at a time to use his inhaler. (I am reluctant to list the herbs in the formula because they should be dispensed correctly and used under a physician’s care). He began walking outdoors with his dogs every day and eventually did not need the inhaler at all.”
To learn about natural approaches to combating allergies and asthma, contact your local naturopathic doctor. Click here to find an ND in the US and Canada.