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Naturopathic Causes and Treatment of Hayfever & Sinusitis

Hay fever, also known as Allergic Rhinitis, is an allergic inflammation of the nasal passages. It occurs when an allergen such as pollen or dust is inhaled by an individual with a sensitised immune system, triggering an antibody production. The antibody, called immunoglobulin E, or IgE, is stored on special cells called mast cells, which contain histamine. When the mast cells are stimulated by pollen and dust, histamine and other chemicals mediators are released. This causes itching, swelling, and mucus production.

Signs and symptoms include sneezing, runny nose with a clear, thin discharge, congested ("stuffy") nose, postnasal drip, sensation of blocked ears, watery, bloodshot eyes, itching of nose, soft palate, ear canal, eyes, and/or skin, fatigue, trouble sleeping.

Sinusitis is inflammation of the paranasal sinuses due to infection, allergy or autoimmune issues. Most cases are due to a viral infection and resolve over the course of 10 days.

Types of hayfever

There are two types of hayfever including;

1. Seasonal – occurs particularly during pollen seasons. Allergic rhinitis triggered by the pollens of specific seasonal plants is commonly known as "hay fever", because it is most prevalent during haying season.

2. Perennial – occurs throughout the year. People with year-round (perennial) hay fever are usually allergic to one or more allergens found indoors. These include house dust mites, feathers, and animal dander and mould. They are also likely to suffer from food allergy.

Epidemiology

In Western countries between 10—25% of people annually are affected by allergic rhinitis.

Yes, but why me?

Allergies are common and on the rise. This is due to something known as The Hygiene Hypothesis and Molecular Mimicry. Very basically, the overuse of antibacterials combined with the under use of our immune systems due to suppression of the fever with panadol/calpol and vaccination means that our immune systems are not getting the exercise they need to ensure that they do not overreact to everyday triggers such as pollens and moulds and even milk proteins etc. You see, when we have a fever, our immune system is trained to tell the difference between our own bodies cells and external foreign invaders and to not overreact.

Pollens and Moulds

The pollen which causes hay fever varies between individuals and from region to region. Examples of plants commonly responsible for hay fever include trees (in northern latitudes an estimated 15–20% of hay fever sufferers sensitive to birch pollen grains), grasses (an estimated 90% of hay fever sufferers are allergic to grass pollen) and weeds including plantago, nettle and dock. Moulds are also a common trigger in hayfever.

Cross reactivity

Cross reactivity is when your body cannot tell the difference between food proteins and plants pollens. Someone allergic to birch pollen may also find that they have an allergic reaction to the skin of apples or potatoes as is indicated by the occurrence of an itchy throat after eating an apple or sneezing when peeling potatoes or apples. This occurs because of similarities in the proteins of the pollen and the food. These similarities are also much more difficult for the body to distinguish if it has not been exercised and trained by coming in contact with everyday childhood diseases, colds and flus. As I always say, “the day they find a cure for the common cold is the end of the human race”! There are many cross-reacting substances. This is why potential food triggers must be addressed through what is called an Oligoantigenic Diet and Oral food Challenge.

Interestingly, atopic disorders such as eczema, asthma, depression and migraine may and often coexist. Interestingly, several studies have suggested an association between IgE-mediated atopic allergies and depression.

The Liver and Allergy

In Traditional Chinese Medicine (TCM) there is no such thing as allergy! Allergic symptoms are an indication of an underlying liver pathology, usually in TCM terms a, liver blood deficiency generating wind resulting in itching and other allergic symptoms. This Liver connection can also be explained from a western naturopathic perspective.

Histamine is methylated in the liver

"Methylation" is not just one specific reaction. There are hundreds of "methylation" reactions in the body. Methylation is simply the adding or removal of the methyl group to a compound or other element. A "methyl" group is simply one carbon connected to three hydrogen atoms. When a methyl group is received or lost this either turns on or turns off biological reactions in the body.

Like everything in the body, methylation cannot be done out of thin air and requires nutrients. Some of the more relevant methylation reactions would be;

· Getting methyl groups "turns on" detox reactions that detox the body of chemicals.

· Getting methyl groups "turns on" serotonin and melatonin, production. Therefore sleep related disorders and depression are simply a problem with methylation.

· Some people actually are known as over-methylators and this can contribute to aggression or hyperactivity seen in ADD etc.

· Specifically, in relation to hayfever, conditions of excess histamine are due to poor methylation nearby the liver due to lack of nutrients in the diet.

Histamine levels are a good indicator of how someone is methylating

High levels of histamine as seen in Hayfever suffers indicate undermethylation. Supplements that increase methylation to lower histamine are indicated. These supplements include taurine, GABA, folic acid, B12, B6, DMG, TMG (and SAMe)

Low levels of histamine on the other hand, indicate overmethylation. Overmethylation is of partcular importance in mental health. This means that many supplements are contraindicated as they increase methylation and will therefore further lower histamine. These supplements include taurine, GABA,m folic acid, B12, B6, DMG, TMG (and SAMe)

Diagnosis

Allergy testing may reveal the specific allergens an individual is sensitive to. Skin testing is the most common method of allergy testing. This may include intradermal, scratch, patch, or other tests. These are highly ineffective often resulting in high rates of false positives Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. (This test should only be done by a physician, never the patient, since it can be harmful if done improperly).

In some individuals who cannot undergo skin testing (as determined by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity.

Food allergy should ONLY be determined by and Oligoantigenic Diet and Oral Food Challenge under the supervision of a qualified and experieinced naturopath or allergy specialist. There is really no such thing as a machine that tests for food allergy. Save your money!

Medical Management

The goal of rhinitis treatment is to reduce the symptoms caused by the inflammation of affected tissues. In cases of allergic rhinitis, the most effective way to decrease allergic symptoms is to completely avoid the allergen.

Allergic rhinitis can typically be treated much like any other allergic condition. Eliminating exposure to allergens is the most effective preventive measure, but requires consistent effort. Many people with pollen allergies reduce their exposure by remaining indoors during hay fever season, particularly in the morning and evening, when outdoor pollen levels are at their highest.

Closing all the windows and doors prevents wind-borne pollen from entering the home or office. When travelling in a vehicle, closing all the windows reduces exposure. Air conditioners are reasonably effective filters, and special pollen filters can be fitted to both home and vehicle air conditioning systems

Rinsing or nasal douching using a neti poti is very often recommended as part of the healing process after sinus or nasal surgery. For this rinse, boiled or distilled water is only necessary during recovery from surgery, as the entire contents of the bottle is used.

Antihistamines

Several antagonistic drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include antihistamines, cortisone, dexamethasone, hydrocortisone, epinephrine (adrenaline), theophylline and cromolyn sodium. Anti-leukotrienes, such as montelukast, are FDA approved for treatment of allergic diseases. One antihistamine, azelastine, is available as a nasal spray. Many allergy medications can have unpleasant side-effects, most notably drowsiness.

Steroids

Systemic steroids such as prednisone are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side effects of prolonged steroid therapy. Steroid nasal sprays are effective and safe, and may be effective without oral antihistamines. They take several days to act and so need be taken continually for several weeks as their therapeutic effect builds up with time.

Decongestants

Pseudoephedrine is also indicated for vasomotor rhinitis, Topical decongestants: may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa).

Desensitisation

More severe cases of allergic rhinitis require immunotherapy (allergy shots) or removal of tissue in the nose (e.g., nasal polyps) or sinuses.

Complementary Medicine

Nutritional therapy

The following nutrition guidelines should be followed:

· Avoid wheat and milk and excess bananas and peanut butter, all of which are mucous forming and will very likely aggravate the problem.

· Also greatly reduce sugar and alcohol, which reduces immunity.

· Eat lots of fruit and vegetables, of all colours.

· Eat sunflower seeds, sesame seeds, pumpkin seeds, almonds and Brazil nuts (unless you are allergic to these, of course).

· Avoid exposure to pollen and traffic fumes as much as possible

Lifestyle

Steam inhalation with essential oil

Inhaling certain essential oils has shown to be effective against bacterias including Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes and Staphylococcus aureus and can be part of the programme designed to treat hayfever and respiratory tract infections particularly when infection is present as indicated by yellow or green mucous.

My recommendations

Olbas Oil

Olbas is a mixture of essential oils including clove oil, eucalyptus, juniper berry and cajuput. The oils are specifically known as respiratory tract antimicrobials meaning they specifically fight infection in the respiratory system from sinusitis and hay fever to bronchitis. Cajaput and eucalyptus oil, in particular are known as brochodilators which open the bronchioles to relieve shortness of breath.

Instructions to do steam inhalation

Pour hot water into a bowl and 25 drops of Olbas oil and place your head about 12 inches (30 cm) above the bowl and cover your head with a towel so that the sides are totally closed forming a tent over the bowl. Keep your eyes shut and breathe deeply through your nose for 1 to 2 minutes. If you feel that the treatment is getting too much for you, raise the towel so that fresh air is brought into the area and breathe through your mouth a couple of times and then resume the treatment. Should you at any time feel uncomfortable discontinue the treatment.

Friars Balsam

Frairs Balsam has a 600year history of being used to treat upper and lower respiratory tract infections and is useful to relieve hayfever and sinusitis in particular. Ingredients include Siam Benzoin resin, Storax Balsam, Balsam of Tolu, Balsam of Peru, Cape Aloe leaf latex, Myrrh tears and Angelica root. The ingredients are natural respiratory tract antimicrobials and stimulating expectorants. As an inhalant, mix one or two droppersful of the balsam into a pint of hot, steaming (not boiling) water.

Supplement for hayfever and sinusitis

1 x Multivitamin and mineral (e.g. VM75 from Solgar)

2 x Advanced Antioxidant Formula (from Solgar)

3 x Ultra Vitamin C 1000mg plus flavonoids in divided doses (Higher Nature)

Also consider:

L-Methionine 500mg twice a day (Solgar)

1 Quercetin with Bromelain 3 times a day (helps stabilise mast cells, and digests protein which may be involved in tissue sensitivity) (BioCare)

Herbal Medicine

See also Carahealth Antiallergy

Carahealth Antiallergy contains Nettle Urtica dioica, Chamomile Matricaria recutita, Echinacea Echinacea angustifolia, Fennel seed Foeniculum vulgare, Ginger Zingiber officinalis, Golden rod Solidago virgaurea, Eye Bright Euphrasia officinalis & Yarrow Achillea millefolium. It contains herbs known as upper respiratory tract anti-catarrhals which dry mucous combined with immune stimulants and mucous membrane tonics to improve the condition of the upper respiratory tract over time. It is indicated for asthma, eczema, hay fever & sinusitis, urticaria, nose bleeds, breathing difficulties, itching and even allergic headache. It specifically prevents histamine release from the mast cells to alleviate symptoms.

Histamine is a natural chemical produced by the immune system, which increases blood flow to the affected area. Liquid leaks out of the blood vessels, making the mucous membranes lining the nose and throat to swell, and stimulating nearby glands to produce mucus causing symptoms such as itching, swelling, reddening, headaches, sneezing, running nose, itchy or watery eyes and breathing difficulties. This tincture is formulated for conditions affecting the upper respiratory tract such as hayfever, sinusitis and rhinitis. These herbs are natural antihistamines and mimic the action of over the counter antihistamines. Taken over time however, this mix will greatly improve the condition of your upper respiratory tract mucous membranes to prevent future attacks, saving you money on over the counter antihistamines. Safe to be used in conjunction with antihistamines although will reduce the need for medication. Medication will need to be adjusted accordingly.

Carina is available to lecture for your group or institution on this subject.

Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu. is a practitioner of 11 years, complementary medicine lecturer of 4 years and mother of six in Galway, Ireland who practices what she teaches.

For an appointment call Carina directly on 083 34 66 333.

All products are available through www.carahealth.ie. Remember, we are here for a good time not a long time, enjoy your food life!

Carahealth Galway, Acupuncture, Naturopathy, Homeopathy, Herbal Medicine, Nutrition, Nutritional therapy, Flower essences, Iridology, Short Courses, Cosmetic Acupuncture

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