Seasonal allergies Part 2
By George Gillson MD PhD CCFP
The featured image for this post is a ball and stick model of a histamine molecule and alert readers will recall that histamine featured prominently in Part 1 of our discussion of Seasonal Allergies. For what it’s worth, I’m thinking that this ball and stick model kind of looks like a person (facing us) with a short neck whose left hand is in the mouth of a tailless dog. The dog is kicking up its back legs. Maybe it’s a Police Dog, e.g. German Shepherd whose tail was docked. Or maybe it lost its tail in a fight. I dunno. This is one of the drawbacks to ball and stick models: they can lead to idle speculation and draw attention away from the subject at hand.
Anyway, where was I?
Yes. Seasonal Allergies. Last post I talked about histamine release by mast cells and the role of IgE antibodies in the “priming” of the mast cells to react to various pollens. I talked about the utility of MSM as a first-line supplement to mitigate allergic reactions: sneezing, itchy eyes, runny nose and asthma. I finished by saying I would talk about other natural remedies in this post.
Before I do that, I want to discuss a couple of interesting connections between food and pollen allergies: one is direct and well-studied: the other is indirect and more speculative.
The direct connection is called Pollen Food Allergy Syndrome or PFAS. PFAS involves symptoms including itchy mouth or ear, scratchy throat, swelling of the lips, mouth, tongue and throat and hives inside the mouth. PFAS can occur when individuals with pollen allergies eat certain raw foods. Note that PFAS is more likely to affect teens and older individuals as opposed to young children.
Direct Food Associations
PFAS arises due to cross-reactivity. The molecular structures of the various foods listed below are similar enough to be mistaken for the corresponding pollen structures to some extent, triggering relatively mild, local symptoms. Avoidance of the offending foods usually takes care of the problem as does ingestion of cooked versions of these foods. (Cooking changes the structures enough to minimize cross-reactivity.) Anaphylactic reactions are extremely rare in PFAS patients but are a potential concern in those patients who experience more severe local reactions away from the mouth/ears.
Here are the common cross-reactivities grouped by pollen type:
-Grass pollen allergy: celery, melons, oranges, peaches, tomato
-Ragweed pollen allergy: banana, cucumber, melons, sunflower seeds, zucchini
-Birch pollen allergy: apple, almond, carrot, celery, cherry, hazelnut, kiwi, peach, pear, plum
Indirect Food Associations
The indirect connection between food and Seasonal Allergies involves patients whose pollen reactions, mediated by IgE antibodies, get better when they stop eating reactive foods identified by IgG food antibody testing. (This type of testing has been discussed in a previous post.) The mechanism behind this phenomenon is uncertain but various Integrative/Functional Medicine practitioners I’ve talked to say that it’s not a rare finding.
I did come across one publication documenting case reports on two individuals, followed for almost a year, whose asthma symptoms and use of prescription medications lessened when they eliminated reactive foods identified by IgG food antibody testing and increased when they resumed eating the reactive foods (Virdee 2015). The reactive foods included wheat, dairy, eggs and citrus. Note that these patients had year-round asthma symptoms as opposed to seasonal symptoms so it’s difficult to extrapolate to pollen-related asthma.
The best that can be said is that elimination of IgG reactive foods may allow the immune system to dial back its overall state of vigilance/level of inflammation. We probably don’t know all the nuances of the interactions between the IgE and IgG antibodies. A trial elimination of some foods from the diet can’t hurt.
Now, as promised, I’m going to talk briefly about some supplements routinely recommended by EvolveWell practitioners. Remember that natural products typically exert their effects through multiple pathways simultaneously whereas pharmaceuticals are purified, single-ingredient products, for the most part. I’ve explained the approach to Seasonal Allergies taken by pharmaceuticals. Now let’s see what Ma Nature has to offer…
The following are products favored by practitioners at EvolveWell. For specific advice on how to use these products you need to talk to your Integrative/Functional Medicine practitioner. What follows is a general overview.
This link will allow you to download a fact sheet describing the actions of the various ingredients:. Just click on the “Practitioner Resources” subheading to download a “Product Info” PDF if you want more detailed information.
Sinatrol was formulated specifically to target nose and throat symptoms. Actions of the various ingredients include thinning of mucus and phlegm, increased production of glutathione, gut flora support (a healthy microbiome supports good general immune function), downregulation of the production of various inflammation-promoting signals including NFkappaB (also a target of MSM!), increased blood flow to the spleen resulting in the release of various white cells of the immune system and stimulation of those cells. Sinatrol can certainly play a role in calming some symptoms of Seasonal Allergies but is also effective against respiratory viruses.
This link will allow you to download a fact sheet describing the actions of the various ingredients: Just click on the “Practitioner Resources” subheading to download a “Product Info” PDF if you want more detailed information.
Mechanisms of action of the various ingredients in D-Hist include increased glutathione synthesis, inhibition of mast cell release of histamine, blockage of the action of histamine at receptor sites and decreased levels of inflammatory prostaglandins.
This link will lead to more information on the mechanisms of action: Just click on “Learn More”.
This is an interesting product that contains a blend of various bioflavonoids that collectively have a mast cell modulating effect. The mast cells are not prevented from releasing histamine but the histamine release is modulated into what I call the “Goldilocks Zone”: not too little and not too much histamine. Just right. Remember that histamine is not all bad. Some release of histamine is necessary. There is also some effect at blocking the action of histamine at its receptor sites as is the case for the other products.
In addition to being helpful for Seasonal Allergies, HistaQuel is also helpful for what is known as Mast Cell Activation Syndrome, a situation in which histamine is released systemically and chronically. But that’s a topic for another post!
Well, thank you for staying with me on all this. In summary, these natural products share some of the effects of pharmaceutical products but also exert subtle, broad-based effects on the immune system as a whole. I liken the effect of natural products to making soup: small amounts of many different ingredients can lead to a wonderful-tasting meal, as opposed to large amounts of just a few ingredients that can overwhelm the palate.
I believe that between this post and the previous one, together with the advice of your Integrative/Functional Medicine practitioner, you now have a testing option along with some good natural “arrows” to put in your quiver, to combat the allergies that flare up as Spring arrives.