Integrative Medicine Hints for a Healthy Allergy Season

 

 

 

 

 

 

 

Spring Has Sprung. Unfortunately, So Has the Pollen!¹

Here in New York, many of my clients are gearing up for allergy season.¹ Most are pleasantly surprised to see that the work we did on supporting their overall health has led to less symptoms and drippy noses this season.

How can it be that by addressing their lifestyle, toxic load, gut health (including loving on their microbiome), mitochondrial function, circulation, hormones, and body structure could lead to less ahchoos?

Let’s dive into this. First, we will look at what happens in the body when someone has an allergy or respiratory symptoms. Then I’ll give some examples of how the body’s immune response is intricately connected to all systems. Specifically, I will be looking at the impact of digestive system and nervous system on allergies and immune function. I will also explore various other triggers. Finally, I’ll provide natural resources that you may want to consider with your healthcare partner for supporting your respiratory and immune health.

 

What is an Allergy?

According to the Academy of Allergy Asthma & Immunology (AAAI):

An allergy is a chronic condition involving an abnormal reaction to an ordinarily harmless substance called an allergen.

If you have an allergy, your immune system views the allergen as an invader and a chain reaction is initiated. White blood cells of the immune system produce IgE antibodies. These antibodies attach themselves to special cells called mast cells, causing a release of potent chemicals such as histamine. These chemicals cause symptoms such as:

• Itching in the nose, roof of the mouth, throat, eyes
• Sneezing
• Stuffy nose (congestion)
• Runny nose
• Tearing eyes
• Dark circles under the eyes²

WebMD reports the following statistics on allergies:

• Number of people in the U.S. who have either allergy or asthma symptoms: one in five.
• Percentage of the U.S. population that tests positive to one or more allergens: 55%.
• Rank of allergies among other leading chronic diseases in the U.S.: 5th.
• One estimate of the annual cost of allergies to the health care system and businesses in the U.S.: $7.9 billion.
• Number of workdays lost each year as a result of hay fever: 4 million.
• Number of weeks by which the ragweed pollen season has increased in the last 10 to 15 years, likely as a result of global warming: four.
• Odds that a child with one allergic parent will develop allergies: 33%.
• Odds that a child with two allergic parents will develop allergies: 70%.
• Number of ER visits in the U.S. caused by food allergies each year: 30,000.
• Percentage of the people in the U.S. who believe they have a food allergy: up to 15%.
• Percentage of the people in the U.S. who actually have a food allergy: 3% to 4%.

….

• Percentage of people in the U.S. that have asthma: 8%…
• Number of people with chronic allergy-like symptoms — runny nose, congestion and cough — but who have nonallergic rhinitis instead: one out of three³

Still, how does one develop allergies and immune imbalances? The following article had a great summary on the mechanism and triggers:

A New Paradigm: The Iceberg Model

The iceberg provides a useful metaphor to understanding how allergies develop.  The tip of the iceberg represents the observable clinical traits seen in children, including skin rashes (eczema), vomiting (reflux), runny noses (rhinitis) and coughing (asthma).  What lies beneath the surface is a complex matrix of genetic predisposition and resulting immune and metabolic dysregulation, all triggered under certain environmental conditions.  These triggers include airborne, food and water contaminants (tobacco smoke, pesticides, heavy metals, pet and pest dander, food allergens), infectious agents (viruses, molds), and stress.(3-8)  Under these conditions, cracks in the ice develop, as certain immune cells are over stimulated relative to others, resulting in an imbalance between Th1 dominant and Th2 dominant immune responses.(9)  Even prenatal factors (mothers’ nutrition and other environmental exposures) can greatly affect this immune balance, making certain babies more likely to develop allergies than others.(10,11)  Perhaps, then, we can intervene prenatally, or even pre-conceptually, to prevent the inevitable sequence of events.  Th2 dominance leads to an immune dysregulation marked by a heightened allergic response and a proliferation of inflammatory cellular mediators (e.g. cytokines, interleukins, leukotrienes).  Inflammation involves excess mucous production and other clinically-observable phenomena we call “allergies.”⁴

 

 

 

 

 

 

Geek Alert Explanation!

For the geeks out there, another study defines allergies in a more scientific way. The authors explain the concepts of allergy, atopy, and “entopy”. Entopy is defined as IgE-mediated diseases that occur in those not genetically predisposed. They also discuss that there are many mechanisms that make the immune system over-respond to the environment (allergies). The study states:

Allergy is defined as an immediate hypersensitivity type I immunological disease, which can be IgE or non-IgE driven, and in the latter case may be antibody or cell mediated. Atopy is a term used to describe individuals with a genetic predisposition for developing IgE-mediated allergic disease. But more recently, it has become evident that IgE-mediated disease can occur in non-atopic subjects. While it is now generally accepted that mucosal local IgE has a role in the expression of atopic allergic disease, the concept of ‘local allergy’ in non-atopic subjects has been proposed, with the term ‘entopy’ given to this condition. Although there is increasing evidence supporting this paradigm, entopy is only applicable to a proportion of non-atopic patients, suggesting that other disease mechanisms exist to explain non-atopic disease. This review considers the evidence for local mucosal allergy in atopic and non-atopic individuals with an emphasis on diseases affecting the upper airways and eye. Furthermore, the diagnosis, treatment and relationship between local allergy and conventional (systemic) allergy are discussed, and alternative disease mechanisms predominantly involving antibodies or their sub-components (free light chain Igs) are postulated to explain the ‘entopy’ paradigm. This review is intended to provide an improved understanding of the mechanisms and causes of local mucosal hypersensitivity.⁵

Now that we have a little explanation of what allergies are and how they impact our nation, let’s look at the connection to your gut.

 

 

 

 

 

 

 

 

 

 

The Gut- Respiratory Connection

Many are now familiar with the importance of a healthy gastrointestinal tract for overall health. It’s estimated that 60-80 percent of the immune system and over 70 percent of our neurotransmitters are produced in our gastrointestinal tract.^6-7

Studies have found an association between gastrointestinal inflammatory reactions and respiratory symptoms, including birch pollen allergies,⁸ asthma,⁹ and atopy.¹⁰ An article in the Journal of Clinical Immunology states:

Birch pollen exposure triggered a local inflammation with an increase in duodenal eosinophils and IgE-carrying mast cells in patients with allergy. Our study gives evidence for the interplay between immunologically active cells in the airways and the gut.⁸

Another study specifically sought to determine the immune response occurring in subjects’ small intestines and  allergic reactions (intestinal biopsies and IgE antibody profiles) to birch pollen in the presence or absence of gastrointestinal symptoms occurring during and outside of pollen season. In the study there were thirty-two patients with birch pollen allergy. Of these, twenty had gastrointestinal symptoms and twelve did not. The authors included sixteen healthy individuals with no allergic conditions as controls. The authors concluded:

Patients allergic to birch pollen have clear signs of an ongoing allergic inflammation in their intestinal mucosa, which is aggravated during the pollen season. The magnitude of the allergic intestinal inflammation is not associated with subjective gastrointestinal symptoms of the individual patient.¹¹

Interesting, even if the patients didn’t experience intestinal issues, there was still inflammation present in the intestine. This makes for the case how gut health isn’t measured just by digestive symptoms…I’ll get to the connection of intestinal permeability and health later.

The authors also found evidence of the cross-reaction of foods and birch. They reported, “birch pollen is often accompanied by oral symptoms to fruits and vegetables, the so-called oral allergy syndrome (OAS).”

The article reports:

We found that IgE levels against the major birch allergen rBet v 1 as well as birch pollen related food items, are clearly increased during the birch pollen season in both groups of birch pollen allergic patients. In addition we observed that the IgE levels to some of the birch-pollen related foods like apple and peach, but also peanut, were significantly higher in patients with OAS. These findings support the hypothesis that ingestion of food items that are related to birch pollen might have a significant role in the allergic inflammation of the intestinal mucosa [19,25].¹¹

Dr. Kara Fitzgerald, well-respected, international allergy expert and functional medicine presenter, defines oral allergy symptom in the following way:  “OAS is caused by a cross-reactivity between foods and pollens, and people who experience OAS usually also have seasonal hay fever symptoms as well.”¹² She lists the following foods in connection to OAS:

Birch pollen: apple, almond, carrot, celery, cherry, hazelnut, kiwi, peach, pear, plum
Grass pollen: celery, melons, oranges, peaches, tomato
Ragweed pollen: banana, cucumber, melons, sunflower seeds, zucchini¹²

The Academy of Allergy Asthma & Immunology also has a good chart of cross reactions and OAS here. ¹³

I have seen this response in ny allergic and sensitize clients. Specifically, I noticed that if a client is already inflamed and having symptoms of food sensitivities or gastrointestinal issues, they tend to have increased symptom manifestation during a particular season and are also more reactive to certain foods.

This is most often related to intestinal permeability.^14-16 In fact, in one research article the authors concluded:

In this review, we describe the importance of properly balanced intestinal permeability in oral tolerance induction and address the processes involved in damaging the intestinal barrier in the sensitized epithelium and during allergic reactions. We conclude by speculating on the effect of increased intestinal permeability on the onset of sensitization towards dietary antigens.¹⁴

Therefore, for a healthy immune and respiratory tract, it’s important to pay attention to your belly. Below are some gut supporting tips for the allergy season (and always).

 

Tips to Support the Gut-Allergy Connection

1. Avoid cross reactive foods during allergy season. By avoiding these foods, you will decrease intestinal inflammation and this could decrease allergic symptoms.

2. Support intestinal integrity. Continually bombarding the gut with triggers (foods, infections, chemicals, traumas) can lead to increased intestinal permeability increasing inflammation and allergic stimulation. This could lead to even more sensitivities and reactions. So avoid these triggers as best you can.

3. Love Your Microbiota Inhabitants. How can we forget our buggy friends that are so important for all things health and wellness, including immune function? Here is an article I wrote on how to keep your bugs happy and healthy.

Have you heard of the hygiene hypothesis? It’s a theory that is linked to our microbiome and our obsession with getting rid of the “germies” which may have actually balanced out our immune response. Therefore, a little dirt could be in order. One review reports:

According to the ‘hygiene hypothesis’, the decreasing incidence of infections in western countries and more recently in developing countries is at the origin of the increasing incidence of both autoimmune and allergic diseases. The hygiene hypothesis is based upon epidemiological data, particularly migration studies, showing that subjects migrating from a low-incidence to a high-incidence country acquire the immune disorders with a high incidence at the first generation. However, these data and others showing a correlation between high disease incidence and high socio-economic level do not prove a causal link between infections and immune disorders. Proof of principle of the hygiene hypothesis is brought by animal models and to a lesser degree by intervention trials in humans. Underlying mechanisms are multiple and complex. They include decreased consumption of homeostatic factors and immunoregulation, involving various regulatory T cell subsets and Toll-like receptor stimulation. These mechanisms could originate, to some extent, from changes in microbiota caused by changes in lifestyle, particularly in inflammatory bowel diseases. Taken together, these data open new therapeutic perspectives in the prevention of autoimmune and allergic diseases.¹⁸

Speaking of cleanliness, dogs and cats can be good sources of soil transfer from the outdoors to the indoors. There is research that shows that having our four legged friends around could have protective effect on allergies, but a definitive positive conclusion can not be supported in all the literature.¹⁸

4. Learn more. In my book, BreakFree Medicine, I review a whole array of factors to consider for gut health. You can preview my book here. You can also still sign up for my presentation at One Big Roof on March 23, 2016. I will be discussing healthy gut tips, among many other things.

5. Love Plants! We can’t forget essential oils! Here’s one of my articles on how they modulate gut health and improve digestion. Even though they are microbe-inhibiting, there is still some evidence that they may not harm our buggy friends as they get rid of the “critter haters” in our gut.

 

The Nervous System Connection

Stress has been shown to effect the immune system. I continue with this on my Saratoga.com blog. Read about this connection here.

 

 

 

 

 

 

 

 

 

Essential Oils

Essential oils are secondary metabolites produced by the plant for supporting their immune system. These oils do the same for us. They have been shown to be incredible at microbe inhibition, which can assist with supporting the body through virus and bacterial infections.

Here are six specific essential oils that may be of benefit in supporting someone who struggles with respiratory health from various causes.

 

1. Lavender

Lavender was shown in a mice model to suppress airway inflammation and immune reactivity. The experiment should lavender worked to suppress the Th2 response, which is the “side of the immune system” most associated with allergic response.¹⁹

Lavender oil was also found to inhibit histamine release from mast cells and slowed immediate-type allergic reactions in vivo and in vitro. A group of poor little mice were induced to ear swelling and then tiny rats were induced to a passive cutaneous anaphylaxis (PCA) reaction. Lavender seemed to mitigate the negative allergic-created conditions by topical and intradermal application. The authors stated:

The present study showed that lavender oil potently inhibited compound 48=80-induced ear swelling response in mice and anti-DNP IgE-induced PCA reaction in rats by both topical and intradermal application. Topical application of lavender oil tended to be more effective in both reactions than intradermal application. Lavender oil also inhibited the compound 48=80 and anti-DNP IgE-induced histamine release from peritoneal mast cells. There is no doubt that stimulation of mast cells with compound 48= 80 Initiates the activation of a signal-transduction pathway that leads to histamine release.

It was concluded that, “These results indicate that lavender oil inhibits immediate-type allergic reactions by inhibition of mast cell degranulation in-vivo and in-vitro.”²⁰

You can read more about lavender and it’s immune supporting, calming, and brain health here.

 

2. Lemon

Lemon and citrus oils contain limonene which is very beneficial for the immune response.

 

3. Frankincense and Myrrh

These oils have been shown to modulate immune response which I reviewed in this highlighted article.

 

4. Peppermint

One study reported:

Topical preparations of peppermint oil have been used to calm pruritus and relieve irritation and inflammation.²¹

However, peppermint can cause contact sensitivity, even if it relieves itchy skin. So, be sure to check the quality. You can always use a carrier oil to decrease skin sensitivity.

Peppermint has also been shown to effect exercise performance and respiratory function. One study concluded:

To our knowledge, this is the first study that explored the effect of oral supplementation with peppermint essential oil on the exercise performance. Our results strongly support the effectiveness of peppermint essential oil on the exercise performance, respiratory function variables, systolic blood pressure, heart rate, and respiratory gas exchange parameters. Differences in duration of study and oral supplementation instead of inhalation of peppermint aroma could be the important characteristics of this study compare to the previous researches. Further investigations are required to unravel the mechanism underlying the effectiveness of peppermint on the exercise performance and respiratory parameters.²²

You can read more about it here.

Finally, peppermint oil essential oil, along with several others, were shown to support lung surfactant and compliance in vitro and in vivo:

Volatile aromatics, eucalyptol, eucalyptus oil, camphor and menthol were spread on synthetic DPL films and pulmonary surfactants; the initial surface pressure of the surfactants was measured and the additional surface pressure increment recorded. Eucalyptol was allowed to be inhaled by rabbits and lung compliance was monitored. Under our experimental conditions the volatile aromatics exhibited surfactant-like effects, namely a decrease in surface tension between water and air and thus improved lung compliance values in vivo.²³

 

5. Eucalyptus

Eucalyptus oil has a variety of applications and contains 1,8-cineole, which has a wide array of health benefits.

 

6. Copaiba

This essential oil is very high in the sequiterpene beta-caryophyllene. Several studies have shown benefit for modulating inflammation and various other pathways, this is important for calming the airways. You can read more about these studies here.

 

Conclusion

There are many other oils that can be used for the allergic and immune responses, in fact in my upcoming talk on the Natural Cancer Prevention Summit, I review many of the mechanisms on how essential oils work. As with any issue, getting to the root cause is most important. Looking at infections, food sensitivities, gut health, environmental exposures, and stress are key components to assess as the foundation for immune health. You also want to address sleep, as this is important for healing and health in a variety of ways and how to get better zzzs was discussed here.

Check out my essential oils database and see how one essential oil can produce so many positive health benefits!

 

 

 

 

 

 

 

 

Upcoming Events:

• March 23, 2016- I’ll be presenting on my new book, BreakFree Medicine in Saratoga, NY. Learn more.
• May 14, 2016- I’ll be presenting on Lyme Disease. Read the press release here.
• May 18, 2016- My interview on the Natural Cancer Prevention Summit will air. Register here!
• If you’re interested in learning more about using essential oils for respiratory health, Terry Quigley will be giving a workshop this subject this month!

 

Disclaimer: This information is applicable ONLY for therapeutic quality essential oils. This information DOES NOT apply to essential oils that have not been tested for purity and standardized constituents. There is no quality control in the United States, and oils labeled as “100% pure” need only to contain 5% of the actual oil. The rest of the bottle can be filled with fillers and sometimes toxic ingredients that can irritate the skin.

This material is for information purposes only and is not intended to diagnose, treat, or prescribe for any illness. You should check with your doctor regarding implementing any new strategies into your wellness regime. These statements have not been evaluated by the FDA.

 

 

References:

1. Robinson KR. How to Survive Spring Allergy Season. WebMD. https://www.google.com/search?q=allergy+season&ie=utf-8&oe=utf-8
2. Academy of Allergy Asthma & Immunology (AAAI). Allergy. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/allergy
3. WebMD. Allergy Statistics and Facts. November 27, 2015. http://www.webmd.com/allergies/allergy-statistics
4. Rosen D. Seasonal Allergies: An Integrative Approach to Atopic Disorders. Integrative Practitioner. http://www.integrativepractitioner.com/topics/environmental-health/seasonal-allergies-an-integrative-approach-to-atopic-disorders/
5. Powe DG, Bonnin AJ, Jones NS. ‘Entopy’: local allergy paradigm. Clin Exp Allergy. 2010 Jul;40(7):987-97. doi: 10.1111/j.1365-2222.2010.03536.x.
6. Brandtzaega P, Valnesa K, Scotta TO, Rogunma K, Bjerkea K, Bakliena K. The Human Gastrointestinal Secretory Immune System in Health and Disease. Scandinavian Journal of Gastroenterology. 1995; 20(114): 17-38. https://sci-hub.io/10.3109/00365528509093765
7. Lysa Silverstein (summary). Possible Environmental Triggers Associated with Autoimmune Diseases: Adapted from a presentation given at the SLE Workshop at Hospital for Special Surgery. Presented March 30, 2012, Posted September 25, 2012. http://www.hss.edu/conditions_environmental-triggers-associated-with-autoimmune-diseases.asp
8. Magnusson J, Lin XP, Dahlman-Hoglund A, Hanson LL, Telemo E, Magnusson O, Bengtsson U, Ahlstedt S. Seasonal intestinal inflammation in patients with birch pollen allergy. J Allergy Clin Immunol. 2003;112(1):45–50. doi: 10.1067/mai.2003.1604.
9. Wallaert B, Desreumaux P, Copin MC, Tillie I, Benard A, Colombel JF, Gosselin B, Tonnel AB, Janin A. Immunoreactivity for interleukin 3 and 5 and granulocyte/macrophage colony-stimulating factor of intestinal mucosa in bronchial asthma. J Exp Med. 1995 Dec 1;182(6):1897-904. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2192256/pdf/je18261897.pdf
10. LILLESTØL, K., HELGELAND, L., ARSLAN LIED, G., FLORVAAG, E., VALEUR, J., LIND, R. and BERSTAD, A. Indications of ‘atopic bowel’ in patients with self-reported food hypersensitivity. Alimentary Pharmacology & Therapeutics. 2010. 31: 1112–1122. doi: 10.1111/j.1365-2036.2010.04261.x
11. Rentzos G, Lundberg V, Stotzer PO, Pullerits T, Telemo E. Intestinal allergic inflammation in birch pollen allergic patients in relation to pollen season, IgE sensitization profile and gastrointestinal symptoms. Clin Transl Allergy. 2014 May 30;4:19.
12. Kara Fitzgerald. Oral Allergy Syndrome: What It Is + 6 Ways To Improve It. February 12, 2016. http://www.drkarafitzgerald.com/2016/02/10/oral-allergy-syndrome/
13. Pongadee T. Oral Allergy Syndrome (OAS). Academy of Allergy Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/outdoor-allergies-and-food-allergies-can-be-relate
14. Perrier C, Corthésy B. Gut permeability and food allergies. Clin Exp Allergy. 2011 Jan;41(1):20-8. doi: 10.1111/j.1365-2222.2010.03639.x. Epub 2010 Nov 11.
15. Rapin JR, Wiernsperger N. Possible Links between Intestinal Permeablity and Food Processing: A Potential Therapeutic Niche for Glutamine. Clinics. 2010;65(6):635-643. doi:10.1590/S1807-59322010000600012.
16. Arrieta MC, Bistritz L, Meddings JB. Alterations in intestinal permeability. Gut. 2006;55(10):1512-1520. doi:10.1136/gut.2005.085373.
17. Okada H, Kuhn C, Feillet H, Bach J-F. The “hygiene hypothesis” for autoimmune and allergic diseases: an update. Clinical and Experimental Immunology. 2010;160(1):1-9. doi:10.1111/j.1365-2249.2010.04139.x.
18. Salo PM, Zeldin DC. Does exposure to cats and dogs decrease the risk of developing allergic sensitization and disease? The Journal of allergy and clinical immunology. 2009;124(4):751-752. doi:10.1016/j.jaci.2009.08.012.
19. Ueno-Iio T, Shibakura M, Yokota K, Aoe M, Hyoda T, Shinohata R, Kanehiro A, Tanimoto M, Kataoka M. Lavender essential oil inhalation suppresses allergic airway inflammation and mucous cell hyperplasia in a murine model of asthma. Life Sci. 2014 Jul 17;108(2):109-15. doi: 10.1016/j.lfs.2014.05.018. Epub 2014 Jun 5.
20. Kim HM, Cho SH. Lavender oil inhibits immediate-type allergic reaction in mice and rats. J Pharm Pharmacol. 1999 Feb;51(2):221-6. http://sci-hub.io/10.1211/0022357991772178
21. Herro E, Jacob SE. Mentha piperita (peppermint). Dermatitis. 2010 Nov-Dec;21(6):327-9.
22. Meamarbashi, A & Raiabi, Al. The effects of peppermint on exercise performance. Journal of the International Society of Sports Nutrition 2013, 10:15 doi:10.1186/1550-2783-10-15. http://www.jissn.com/content/10/1/15
23. Zänker KS, Tölle W, Blümel G, Probst J. Evaluation of surfactant-like effects of commonly used remedies for colds (abstract). Respiration.1980;39(3):150-7. PMID: 6893231