It’s That Time of Year Again: Seasonal Allergies Part 1

By George Gillson MD PhD CCFP

Spring brings sneezing, sniffling, watery, itching eyes, and worsening asthma.  You know the drill. There are multiple approaches to controlling seasonal allergic symptoms but in order to have a proper discussion (albeit a one-sided discussion, since I’m doing the writing and you’re doing the reading) I need to break things down a bit.

Pollen particles from trees and grasses are the main culprits, with tree pollen hitting the streets first and grass pollens following and lasting into midsummer.

Certain cells in the immune systems of allergy-prone people are trained by pollen exposure, early in life, to create IgE antibodies. These antibodies can bind on to the surface of specialized cells called mast cells, present in a wide variety of tissues throughout the body including the airways, nasal mucosa, the surface of the eyes and the skin.  This binding of IgE “arms” or sensitizes the mast cells and the process is akin to cocking the trigger of a revolver.

So what? Well…the mast cells contain sacs or granules of histamine molecules which are the “bullets”. When pollen binds to or “bridges” two adjacent antibodies on the sensitized mast cells, the granules discharge their histamine into circulation where it can cause the symptoms of hay fever through its actions on different types of histamine receptors.

Note that histamine isn’t all bad.  In fact, it’s essential to life as it is a neurotransmitter involved in energy, sleep/wake/alertness (arousal), sex drive, food intake, pain regulation and political preference, just to name a few.

Oddly enough, I prescribed histamine-containing skin cream to several hundred patients with Multiple Sclerosis circa 1999, for the alleviation of the crushing fatigue that these patients can experience. This was the subject of a randomized, placebo-controlled clinical trial published in the well-respected journal: Multiple Sclerosis (Gillson 2002).

Given that background, you can now understand the various medications used to treat Seasonal Allergies. (Note that desensitization therapy with injections retrains the immune system to tolerate antigens including pollen, but also dust mites, cats, Monday mornings, etc.)

Antihistamines block the action of histamine at the relevant receptors; mast cell stabilizers prevent the mast cell granules from releasing their stores of histamine; corticosteroids block the inflammation that arises from histamine release but doesn’t block access to histamine receptors. More specifically, corticosteroids interfere in the NFkappaB signaling pathway that leads to inflammatory cell-signaling molecules such as the IL-1 family. In case you were wondering…

In addition to these time-tested and effective pharmaceuticals, there are various natural remedies which may offer fewer side effects.  I’ll delve into those remedies in the second part of this post following later this month.  I want to spend the rest of this post talking (again) about my pet supplement: MSM, short for methylsulfonylmethane.

MSM is a small sulfur-containing pyramidal-shaped molecule found everywhere in our bodies, including our brains. The bacteria in our colon make MSM when we eat plant sulfur (Allium family: garlic, onions, leeks, scallions et al, and also mushrooms).

I’ve written previously about the sleuthing I did to find Stan Jacob and Robert Herschler, considered to be the Ground Zero scientists for MSM research. I also wrote previously about how MSM intervenes to cool off inflammation in the very same way that prescription corticosteroids do. MSM is less potent than corticosteroids but has none of their side effects.

Without getting into the organic chemistry and the biochemistry, suffice it to say that MSM is the molecular equivalent of what would result if a Swiss Army Knife conjugated with a Gerber Multitool: i.e. MSM is a pretty handy, versatile molecule to have wandering around your body.

MSM has a wide range of potentially beneficial effects on the following:

• Acid reflux aka Heartburn
• Atopic complaints (Seasonal allergies: nose, airways, eyes, skin)
• Cancer (breast, colon cancer)
• Constipation
• Inflammation (osteoarthritis, other inflammatory joint conditions, liver, skin, colitis)
• Fatigue
• Glutathione-sparing (reduces the need for the body to use up its glutathione, a critical inflammation-fighting and detoxification-supporting natural molecule)
• Hair and nails (improved lustre, strength)
• Liver (supports detoxification in general and prevents liver inflammation due to chemical exposure)
• Skin (texture, suppleness)
• Stress tolerance (https://patents.google.com/patent/US4973605A/en)
• Scars (regression of scars, prevention of keloid formation)
• Snoring

I know, I know. The list looks completely bogus, but I’ve been researching this molecule for 25 years and have dozens, if not a few hundred, patient anecdotes. I reckon I’ve ingested a pile of MSM weighing roughly 1/5^th of my body weight over that time. The fact that MSM helped virtually every patient I ever gave it to, in some fashion, lends support to the notion that most of us are staggering around with a flaming MSM deficiency. Even if I consumed the entire “1/5^th of my body weight” pile in one go, probably nothing would happen.  Rat studies indicated that MSM is about as toxic as water.

Because of its biochemical versatility, MSM is most likely acting to ameliorate Seasonal Allergies by blocking NF-kappaB signaling as mentioned (corticosteroid effect) but it may also speed up the clearance of histamine released from mast cells and that is an effect unique to MSM.

I put the following bit in here because, to my knowledge, I was the first one in the community of Functional Medicine educators to research and lecture about how MSM fought inflammation. Here are a couple of slides from a lecture I gave many times. MSM works down in the bottom left of the following diagram, preventing the scissors from doing their job in the same way that the pharmaceutical corticosteroids work.

Anyway, I apologize for the digression, but you might have gathered that I’m pretty stoked on MSM. Let’s get back to the Seasonal Allergies.  Years ago, when I first learned about MSM, I ran my own double-blinded, placebo-controlled trial on a small number of my Family Practice patients:

• 17 patients with significant Seasonal Allergies: one month of 1000 mg MSM twice daily crossing over to one month of identical placebo, or one month of placebo crossing over to one month of MSM.
• Subjects rated the severity of allergy symptoms before, after one month and after the two-month trial, on a numeric scale.
• 15/17 MSM recipients had a significant or complete response when receiving MSM, e.g. were able to stop antihistamines
• Well tolerated.

Granted, this was a fairly rudimentary trial and lacked statistical power (to few subjects) but the results seemed encouraging to me.  I was gratified to see the following paper appear in print a few years later, verifying that what I had seen was actually real!

• Take MSM with meals.
• Increase the dose every 2-3 days.
• Start with 500 mg once daily, then 500 mg twice daily, then 1000 mg in the morning and 500 mg at supper, then 1000 mg twice daily.
• As mentioned, I have taken 4000 mg/day for more than 20 years. Doses ranging from 2000 to 7000 mg/day are reported in the literature.
• Some patients starting MSM experience transient flu-like symptoms: fatigue, nausea, muscle aches, and headache.
• Manage this by cutting back the dose and then increasing it again more slowly.
• Occasionally, a patient will develop a rash on MSM, especially if alcohol intake is excessive.

MSM is available at EvolveWell in the form of a powder that readily dissolves in water, juice, etc. Some people may perceive a faint bitter taste, but most don’t notice it. I don’t recommend taking MSM/glucosamine preparations.  All the literature that I have collected only deals with pure MSM.

Well, I think I’m done for now. As threatened, next post I’ll talk about some of the other natural products available to deal with Seasonal Allergies. I’ll also talk about the possible influence of diet on these types of allergies.

References

Bohlooli S, Mohammadi S, Amirshahrokhi K, Mirzanejad-Asl H et al. Effect of Methylsulfonylmethane Pretreatment on Acetaminophen Induced Hepatotoxicity in Rats. Iran J Basic Med Sci. 2013 Aug;16(8):896-900.

Gillson G, Richard TL, Smith RB, Wright JV. A double-blind pilot study of the effect of Prokarin on fatigue in multiple sclerosis. Mult Scler. 2002 Feb;8(1):30-5. doi: 10.1191/1352458502ms777oa. PMID: 11936486.

Sharma S, Litonjua A. Asthma, allergy, and responses to methyl donor supplements and nutrients. J Allergy Clin Immunol. 2014 May;133(5):1246-54. doi: 10.1016/j.jaci.2013.10.039. Epub 2013 Dec 19. PMID: 24360248; PMCID: PMC4004707.

Note:

Mast cells were first reported in 1863 in connective tissues from various species, including the tails of tadpoles. In 1878 the cells were named by Paul Ehrlich. Because of the storage granules he saw, Ehrlich initially thought that these cells had ingested large amounts of nutrients, and therefore, he gave them the name ‘Mastzellen’, meaning “well-fed cells”. Mastzellen was eventually shortened to “mast” cells. (https://onlinelibrary.wiley.com/doi/full/10.1111/all.12197)
In case you care.