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May 15, 2014

Nutritional approach to the treatment of allergic rhinitis

by Helene van den Berg

INTRODUCTION:

There is a difference between allergic rhinitis and nonallergic rhinitis.

NONALLERGIC RHINITIS does not involve the immune system. It’s symptoms (postnasal drip, runny nose, sneezing, stuffy nose) resembles an allergy, but it occurs without a known cause (environmental irritants can trigger it). It has the same complications as allergic rhinitis e.g. sinusitis, Eustachian tube dysfunction, chronic ear infection, loss of smell, asthma, obstructive sleep apnea. Because the two are similar, it’s necessary to perform allergy tests and blood tests to tell them apart.

ALLERGIC RHINITIS is a group of symptoms that affect the nose. Allergic rhinitis occurs when the immune system overreacts to normally harmful substances that you have inhaled (allergens). Allergic rhinitis may be seasonal or perennial. Seasonal (outdoor) allergic rhinitis, known as hay fever, are caused by pollens. Perennial (year round and indoor) allergic rhinitis are caused by dust, mites, pet dander and mold. An allergic reaction begins when the IgE antibodies (on surface of mast cells), encounter an allergen. These antibodies cause the mast cells to release histamine in large quantities. Excess histamine causes an extreme inflammatory response, or an allergic reaction. 

The symptoms of allergic rhinitis resemble those of a cold:

SYMPTOMS: (shortly after contact with allergen)

  • Itchy nose, mouth, eyes, throat
  • Problems with smell
  • Runny nose
  • Sneezing
  • Watery eyes

SYMPTOMS : (develop later)

  • Stuffy nose (nasal congestion)
  • Coughing
  • Clogged ears and decreased sense of smell
  • Sore throat
  • Dark circles under eyes
  • Puffiness under eyes
  • Fatigue and irritability

Allergy TESTING involves skin testing, blood test (IgE RAST) tests, complete blood count (eosinophil count).

TREATMENT:

  • Reduce exposure to allergen
  • Saline solution (for mild cases): e.g. one cup of water, ½ ts salt, pinch of baking soda.
  • Antihistamine nasal sprays – work well for allergic rhinitis.
  • Nasal corticosteroid sprays – MOST EFFECTIVE treatment for!. Use nonstop; safe for adults and children.
  • Nasal decongestants – use not for more than 3 days.
  • Leukotriene inhibitors
  • Allergy shots/immunotherapy – pollen allergies.

Most symptoms of allergic rhinitis can be treated. More severe cases need allergy shots. Children may outgrow an allergy as the immune system becomes less sensitive to the trigger. BUT once a substance, such as pollen/food, causes allergies, it has a long-term effect on the person.

FOOD ALLERGIES – NUTRITIONAL/SUPPLEMENT TREATMENT:

Nutritional factors can help prevent and control allergic rhinitis. Breast-feeding and avoidance of early introduction of potentially allergenic foods (cow’s milk, eggs, fish, nuts, cocoa) reduce the likelihood that infants will develop allergies in the first year of life. Breast-feeding mothers should limit dairy products and avoid eggs in their own diets as well as avoid exposure to other sources of allergens e.g. smoking, day care attendance prior to age 2.

DIET FOR RELIEVING ALLERGIC RHINITIS:

Vitamin C and E, omega-3 fatty acids, rosmarinic acid, quercetin, probiotic bacteria and the antioxidant mineral selenium, should play a key role in any diet aimed at reducing symptoms associated with sinusitis, perennial allergic rhinitis, and seasonal hay fever.

  • Add omega-3 fats to your diet, limit intake of omega-6 fats: most modern diets in Western countries- where allergenic rhinitis is most prevalent- include too much of the inflammatory omega-6 fatty acids and not enough of the anti-inflammatory omega-3 fatty acids. Simply consuming less refined vegetable oils (omega-6 fatty acids) and increasing intake of omega-3 fats (by eating flax seeds, walnuts, soybeans and cold water fish like salmon, cod and halibut) can ease symptoms of allergic rhinitis.
  • Include herbs rich in Rosmarinic acid in your diet: rosmarinic acid suppress allergic immunoglobulin responses and inflammation caused by leukocytes. Rosmarinic acid is found in herbs such as oregano, thyme, rosemary, sage, peppermint and lemon balm.
  • Consume foods with quercetin: it is a bioflavonoid and has anti-histamine and anti-inflammatory properties and helps ease allergic symptoms. Foods with quercetin include apples, capers, cherries, raspberries, cranberries, red grapes, citrus fruits, red onions, broccoli, and red wine.
  • Foods with vitamin C: is a potent antioxidant and reduce inflammation responsible allergic reactions. High levels of vitamin C (1000-2000mg) help reduce histamine release in the body, which is involved in allergic rhinitis. The positive effects of vitamin C on allergic rhinitis, may be more pronounced, when vitamin C is consumed with vitamin E, because these two vitamins work together and protect each other.
  • Foods with vitamin E: it suppresses allergic reactions, including symptoms associated with allergic rhinitis. After a ten week trial, participants who received 800 IU of vitamin E per day, had significantly less nasal symptoms (sneezing, itching, congestion and runny nose). However eye symptoms (watery, redness, itchiness and swelling) did not react to the vitamin E supplementation.
  • Eat plenty of selenium-rich foods: selenium is a powerful anti-allergy mineral! Selenium is the key component of several enzymes responsible for antioxidant defense and may therefore ease allergic rhinitis symptoms. Combine selenium rich foods with vitamin E foods (work synergistically).
  • Add probiotic bacteria to your diet: Lactobacillus acidophilus (L. acidophilus) and Bifidobacterium bifidum (B. bifidum) are beneficial (probiotic) bacteria in the gastrointestinal tract, where they aid digestion and control the growth of harmful bacteria. These may be effective in alleviating symptoms associated with allergic rhinitis. Foods with these probiotic bacteria include natural yoghurt with these live cultures, bacteria enriched milk and sour milk, tempeh and miso (also offers protection against antibiotic medication).

FOODS THAT FIGHT ALLERGIC RHINITIS (hay fever):

  • Turmeric – it has strong anti-inflammatory properties and prevent/alleviate allergic reactions. Uses are in curries and to flavor fish, meat, vegetable rice and pasta dishes.
  • Garlic – effective at preventing cardiovascular problems, cancer, high blood pressure etc. It is beneficial for allergic rhinitis due to it’s ability to inhibit the activity of certain enzymes that generate inflammatory prostaglandins and thromboxanes. Fresh garlic contain a fair amount of vitamin C and is a good source of selenium.
  • Sweet potatoes – it is one of the foods that are least likely to cause allergic reactions (safest first food for babies!). It has vitamin C and have strong antioxidant properties.
  • Apples – the polyphenols in apples are highly effective in reducing symptoms of allergic rhinitis like sneezing, nasal discharge and swelling. Apples are one of the best foods sources for quercetin (prevents release of histamine).

NOTE: hay fever patients at risk of developing an oral allergy to apples include those who are sensitive to birch pollen (cook the apples).

  • Horseradish – it help fights a stuffy nose!. Eat grated horseradish immediately or mix it with vinegar- otherwise it lose it’s pungency.
  • Rosehips – they contain a phytochemicals that inhibits enzymes that produce histamine and help relief the distressing symptoms of hay fever.
  • Sunflower seeds – they are among the seeds and nuts that are least likely to cause allergic reactions and are loaded with vitamin E and selenium.
  • Rosemary – the rosmarinic acid in rosemary , a natural polyphenol, suppresses allergic immunoglobulin responses and inflammation. Rosemary are used to flavor roast meats, fish and sauces and oranges.
  • Flaxseeds- have been used to treat and prevent ailments and diseases like cancer, heart disease, joint pain and constipation. It alleviates symptoms associated with hay fever and allergic rhinitis due to their high concentration of selenium (one cup provides 60% of selenium). Flaxseeds and the oil are one of the best plant- based sources of omega-3 fatty acids.
  • Anchovies – they are very high in selenium and an excellent source of omega-3 fatty acids. They contain low levels of mercury, compared to many other fish.
  • Mushrooms – are packed with selenium.
  • Mustard greens – fresh mustard greens, with their pleasant peppery flavor, is one of the best sources for beta-carotene and provide a good amount of vitamin C and E. The nutrients in mustard greens can fight free radicals, inflammation and help break down histamine.
  • Butterbur (Petasites hybridus) – this botanical treatment significantly reduces both histamine and leukotriene production in sufferers of allergic rhinitis (same benefits as cetirizine, without sedative side effects).
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