Do you suffer from allergic rhinitis, asthma, or food allergies? Read on to find out what you can do to manage your symptoms.
In the following sections, we’ll outline complementary approaches that may help you deal with allergies. The below strategies are not meant to replace your standard medical treatment. Make sure to consult with your doctor before making any significant changes to your day-to-day routine.
Allergy immunotherapy consists of administering a dilution of the allergen (such as pollen, dust mites, or dog dander) to help develop tolerance. This treatment can be injected (allergy shots) or oral (under-the-tongue allergy tablets) and is especially indicated for allergic rhinitis, asthma, and conjunctivitis [1, 2, 3, 4, 5].
Research suggests that immunotherapy may also help with food allergies, although only one treatment (for peanut allergy) has been approved so far [6, 7, 8, 9, 10].
Bee sting therapy is recommended as the first-line treatment to prevent severe allergic reactions in people allergic to the venom of bees and other insects of the same order (Hymenoptera), owing to its ability to induce an immune shift from Th2 to Th1 [11, 12, 13].
Multiple trials attest to the effectiveness and safety of this therapy. Unfortunately, the venom must be repeatedly administered at 3-month intervals to maintain its effects on the immune system [14, 15, 11, 16, 17, 18, 19, 20, 21].
Nose irrigation with salt solution is often recommended as an add-on to conventional therapy for allergic rhinitis. Two meta-analyses concluded that, since this therapy effectively improves the symptoms and quality of life, it can be used as a cheap, safe, and easy-to-use alternative to steroid medication [22, 23].
Several clinical trials suggest that acupuncture may be a safe and valid way to improve the symptoms of allergic rhinitis [24, 25, 26, 27].
A meta-analysis of 13 studies concluded that light therapy (with UV, blue, red, and infrared radiation) applied through the nose can relieve allergic rhinitis symptoms and improve quality of life. However, the authors warned about the heterogeneity and low quality of the studies .
A Cochrane review involving 15 clinical trials found moderate-quality evidence supporting that practicing yoga, especially the variations that focus on breathing techniques, may improve quality of life and reduce symptoms and medication usage in asthmatic patients .
The Buteyko Breathing Technique is an alternative therapy with breathing exercises for asthma and other respiratory conditions. Several trials show this technique can improve asthmatic symptoms and reduce the need for conventional medication [30, 31, 32, 33, 34, 35].
Vitamin D deficiency has been associated with asthma and allergies in children [36, 37].
Healthy exposure to sunlight is the best way of increasing your blood vitamin D levels. In addition, you can eat food sources of this vitamin (such as fatty fish, liver, egg yolks, and dairy) or take supplements .
Avoid Air Pollution
Research has associated exposure to air pollution with higher odds of allergic conditions, especially asthma and allergic rhinitis [39, 40, 41].
Try spending more time in nature and non-industrialized environments to prevent and relieve allergies.
While any food can cause allergy, only a few foods account for the vast majority of allergies overall. Milk and egg allergies are most common in children, while peanuts, shellfish, wheat, and nut allergies are common in adults .
The only proven therapy for food allergies is still the elimination of the allergen. If you’re allergic to certain foods, you know the importance of reading food labels and inquiring about what goes into restaurant meals .
Fortunately, tolerance develops to most offending foods over time except, in most cases, for peanuts, nuts, and seafood [42, 43].
Several studies have associated high intake of vitamin E with a reduced incidence of asthma, while a diet poor in this vitamin increases the risk. Similarly, some people with asthma have lower levels of this vitamin in the blood and lungs [44, 45, 46, 47, 48].
Food sources of vitamin E include wheat germ, nuts, sunflower and sesame seeds, and their respective plant oils .
A meta-analysis associated adherence to a Mediterranean diet with a slightly reduced incidence of asthma and wheezing .
Several trials show that feeding newborns with formula containing hydrolyzed whey protein or its most abundant protein casein prevented the development of allergies during their first years of life, especially in those with a family history of allergic diseases [51, 52, 53, 54, 55, 56].
Moreover, hydrolyzed casein is a safe alternative to conventional milk formula for children with cow milk allergy [57, 58, 59].
In 2 small clinical trials of people with allergic rhinitis, taking apple polyphenols reduced sneezing attacks, nose discharge, and turbinate swelling, especially in those taking the highest dose. Apple polyphenols may work by reducing histamine release [60, 61].
Importantly, people who are allergic to birch pollen may react to apples because these fruits contain proteins similar to those found in birch pollen (this is called cross-reactivity). In a small clinical trial, gradually increasing apple consumption induced birch pollen tolerance. However, the effect disappeared when the participants stopped eating apples [62, 63].
In a clinical trial on people with allergic rhinitis, the ingestion of honey for 8 weeks improved the symptoms and was suggested as a complementary approach to rhinitis. However, honey was ineffective in another trial [64, 65].
Probiotics such as Lactobacillus paracasei, L. acidophilus, L. plantarum, L. casei, L. gasseri, Bifidobacterium longum, and B. animalis improved allergic rhinitis in multiple trials. Moreover, L. rhamnosus, L. johnsonii, and Clostridium butyricum enhanced the effectiveness of immunotherapy for allergy to pollen and dust mites [66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78].
In people with asthma, L.salivarius and B. breve reduced the production of inflammatory cytokines while Clostridium butyricum helped improve the symptoms when combined with immunotherapy [79, 80].
Preliminary research in adults and children with allergy to cow milk suggests that the immunomodulatory activity of L. rhamnosus may help prevent allergic responses. This probiotic also enhanced the effectiveness of immunotherapy for peanut allergy [81, 82, 83].
Other probiotics may help by fermenting the food proteins that cause allergies. For instance, L. helveticus, L. delbrueckii, and L. fermentum successfully reduced the allergenic potential of cow milk and propolis in several studies [84, 85, 86, 87].
A standardized butterbur extract (ZE 339) was safe and effective at reducing allergic symptoms in multiple trials of people with both seasonal and permanent allergic rhinitis. A different extract (Petaforce) was similarly effective in people with allergy to pollen [88, 89, 90, 91, 92, 93, 94]
Butterbur extract also improved the symptoms of asthma when added to conventional medication in 2 clinical trials [95, 96].
However, butterbur itself may cause allergic symptoms such as rhinitis, conjunctivitis, and eczema in people allergic to Compositae or Asteraceae plants (such as ragweed, daisies, and chrysanthemums) as it belongs to this plant family.
In 2 clinical trials on people with different allergic diseases (allergic rhinitis, asthma, and eczema) oral supplementation with black seed improved the symptoms and subjective well-being. Black seed also enhanced the effectiveness of immunotherapy for dust mite allergy in another study [97, 98, 99].
Both the oil and extract of black seed reduced the frequency of asthma attacks, relieved wheezing, improved lung function, and reduced the need for inhaled medications when taken for 2-3 months [100, 101].
Pycnogenol improved eye and nose symptoms in people with allergy to birch pollen, especially when taken 7-8 weeks before allergy season [102, 103].
Pycnogenol also reduced blood inflammatory markers (leukotrienes) and the use of inhalers in adults and children with asthma [104, 105, 106].
The anti-allergic effects of pycnogenol may arise from its ability to inhibit histamine release by mast cells .
According to a review of 7 clinical studies, caffeine can help open the airways and relieve bronchitis symptoms including wheezing, coughing, and breathlessness. The effect is similar to that of the anti-asthmatic drug theophylline. Theophylline and caffeine are very similar in structure but caffeine’s effects are shorter-lived (they last only up to 4 hours) [108, 109].
Conjugated Linoleic Acids (CLA)
Supplementation with conjugated linoleic acids (CLA) 8 weeks before pollen season reduced sneezing and improved the overall feeling of well-being in a clinical trial of people with allergy to birch pollen .
CLA also reduced inflammation and airway hyperresponsiveness in people with allergic asthma [111, 112].
Six-month choline supplementation brought a significant symptom relief and reduced inflammation in 3 clinical trials on asthmatic patients [113, 114, 115].
In animal models of asthma, choline reduced inflammation and oxidative stress while improving lung function [116, 117].
Importantly, most manufacturers source choline from soybean and eggs. People allergic to these foods should read the labels carefully to avoid unwanted reactions.
In 2 clinical trials on children with food allergies, supplementation with thymus extract reduced allergy symptoms and the production of specific antibodies during an oral challenge [118, 119].
In a small trial on people with seasonal allergic rhinitis, thymus extract reduced the number of allergic episodes .
Both freeze-dried stinging nettle leaves and root extract improved the severity of allergic rhinitis in 2 clinical trials [121, 122].
Scientists believe that stinging nettle helps with allergies through its ability to reduce histamine production by mast cells and inflammatory markers [123, 124].
However, stinging nettle (especially the leaves and hairs) contains histamine and some people may experience an allergic reaction to raw puréed nettle or nettle juice .
Supplementation with perilla extract (enriched for rosmarinic acid) improved symptoms such as itchy nose or itchy and watery eyes, as well as the number of white blood cells (neutrophils and eosinophils) in the nose airways, in a clinical trial of people with seasonal allergies .
In a small clinical trial, people with asthma who consumed perilla oil had improved lung function. They also had decreased levels of the inflammatory compounds leukotriene B4 and C4 .
Oral forskolin was more effective than an asthma drug (sodium cromoglycate) and as effective as another one (beclomethasone) at preventing asthma attacks in two clinical trials [127, 128].
Oral astragalus improved allergic rhinitis symptoms and quality of life in a small trial of people with seasonal allergy to weed pollen .
Astragalus also played a role in preventing the recurrence of asthma in children. A combination of astragalus and standard treatment showed even better effects .
Ginkgo biloba extract decreased the infiltration of inflammatory cells (eosinophils and lymphocytes) into the airways and relieved inflammation in a clinical trial on asthmatic people .
Compounds isolated from ginkgo improved respiratory conditions such as asthma and allergy through their anti-inflammatory activity in animals .
Although ginkgo supplements are generally considered as safe, they have been reported to cause allergic reactions in rare cases .
Quercetin is a plant flavonoid and antioxidant recognized as one of the best natural antihistamines. In one human trial, quercetin even outperformed Cromolyn, a mast cell-stabilizing drug, in reducing histamine release and improving dermatitis [134, 135].
Preliminary clinical research shows that a formulation with quercetin added to conventional therapy reduced the symptoms of asthma and rhinitis, and the need for medication .
Food sources of this flavonoid include vegetables such as capers, onions, eggplant, celery, and asparagus, fruits such as berries, apples, and oranges, nuts, and tea (both green and black) .
Boswellia has traditionally been valued for its effect on the respiratory system and used in steam inhalations, baths, and massages to treat cough, the common cold, bronchitis, and asthma .
Gum resin of boswellia improved the symptoms of bronchial asthma—such as difficulty breathing, wheezing lung sound, and the number of attacks—in a clinical trial .
In people with allergic rhinitis and vitamin D deficiency, supplementation improved the symptoms. This improvement was not significant at 4 weeks, suggesting that symptom improvement might not occur until vitamin D has been adequately replenished .
Agaricus blazei (reishi mushroom) extract given before birch pollen season reduced allergic and asthmatic symptoms, medication use, and the levels of specific antibodies during the season in a clinical trial .
In asthmatic mice, Agaricus extract reduced specific antibodies and corrected the skewed Th1/Th2 balance .
Powdered moringa seed kernels reduced asthmatic symptoms, lung function, and airway flow after 3 weeks in a small clinical trial .
Moringa seeds also relieved airway inflammation, reduced Th2 overactivity, and reversed Th1/Th2 cytokine imbalances in asthmatic animals [144, 145].
In a clinical trial on people with allergic rhinitis, supplementation with Korean red ginseng reduced runny nose, nose and eye itching, and the blood levels of antibodies, eosinophils, and IL-4 .
In a clinical trial on people with allergic rhinitis, treatment with the milk thistle compound silymarin improved the symptoms better than the placebo .
In one clinical trial, spirulina decreased all measured symptoms of allergic rhinitis including runny and stuffy nose, sneezing, and itching .
However, rare cases of allergy to spirulina have been reported .
Both upper (a runny nose, watery and itchy eyes, stuffy nose, sneezing), and lower respiratory symptoms (coughing, shortness of breath) were reduced in people with seasonal allergic rhinitis after one month of methylsulfonylmethane (MSM) supplementation in a small trial. However, MSM worsened the allergic symptoms in rare cases .
Although these theories remain unproven, some researchers hypothesize that MSM alleviates allergies through its anti-inflammatory and antioxidant properties, as well as by binding to the mucosa to block host-allergen contact [151, 152].
A clinical trial suggests that two months of curcumin supplementation can reduce hay fever symptoms like sneezing, itching, runny nose, and congestion. The authors proposed that curcumin helps balance the immune response .
Curcumin is generally safe when taken by mouth but can cause allergic contact dermatitis if applied on the skin [154, 155].
In a clinical trial on people with persistent allergic asthma, supplementation with saffron capsules decreased asthma severity and the frequency of symptoms such as shortness of breath during day- and nighttime, waking up, activity limitation, and use of inhaled medication. Saffron also reduced white blood cells (basophils and eosinophils) in the airways .
However, some people may exhibit allergic reactions to the carotenoids found in saffron. These reactions usually take form as hives, nasal congestion, or difficulty breathing .
In a clinical trial of ragweed allergy sufferers, supplementation with beta-glucans reduced the incidence and severity of the symptoms, but not the levels of specific antibodies, and improved overall physical health and well-being .
Beta-glucans are also found in cereals (such as oats and barley), medicinal mushrooms (such as reishi, shiitake, and maitake), brewer’s yeast, and seaweeds.
A botanical product combining cinnamon bark, acerola fruit, and Spanish needles leaves and stems reduced the symptoms in people with seasonal allergic rhinitis [159, 160].
Although oral doses of up to 6 g/day for 6 weeks have been proven safe for most people, cinnamon may cause allergic reactions in rare cases.
Other Forms of Supplementation
Multiple studies have found that single, high doses of both injected and inhaled magnesium can relieve symptoms of asthma, especially in children [161, 162, 163, 164].
In 2 preliminary trials on adults and children with allergic rhinitis, resveratrol nose sprays improved symptoms such as runny and stuffy nose, itching, and sneezing. Resveratrol also reduced blood levels of antibodies, eosinophils, IL-4, and TNF-alpha [165, 166].
Injected colforsin daropate, a water-soluble forskolin derivative, prevented the tightening of the airways, suggesting its potential to prevent asthma attacks faster than oral forskolin .
A spray with cinnamon bark extract reduced allergic rhinitis symptoms and improved quality of life in a clinical trial .
Ginkgo biloba eye drops improved symptoms such as blood buildup, eye discharge, and swelling in people with seasonal allergic conjunctivitis .
In a small study of people with seasonal allergies, topical shea butter was equally effective in relieving stuffy nose as xylometazoline, a decongestant drug .
In a clinical trial of people with allergy to birch pollen, topical application of capsaicin in the nose reduced the symptoms during 2 months. However, this treatment was ineffective in another trial on people allergic to dust mites [170, 171].
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