Allergies 101: What Happens in the Body During an Allergic Response (and what we can do)
By: Jenna Jorgensen
Seasonal allergies have a way of sneaking up on us, and pollen counts can come up slowly so it's easy to get caught off guard as symptoms slowly creep in. Here in the Pacific Northwest tree pollen allergy season is in full swing and I’ve been seeing the symptoms more regularly in my office.
Allergies are no small bother, they are estimated to effect 60 million people in the US, with about 10-30% of adults and 40% of children suffering from some sort of allergic symptoms. They are the 6th leading cause of illness in the US and the incidence has been steadily rising over the years.
So, what’s actually happening in the body during an allergic response? Allergen processing happens primarily in the cells of the mucous membranes that line the nasal, respiratory, and digestive tracts as well as in the cells of the skin. When those cells get exposed to an allergen (also known as an antigen) the body has special cells that grab on to that antigen and take it to other immune cells to be processed. These immune cells (T-cells) produce several types of inflammatory cytokines that lead to the production of IgE antibodies, mast cells, and white blood cells specific to allergies (eosinophils.) Mast cells are the first immune cells to show up to the scene to cause an allergic symptom response within 30 minutes of the initial exposure. They release histamine, prostaglandins, and leukotrienes that cause early symptoms such as sneezing, itchy and runny nose and eyes, and also signal the secondary allergy response from the white blood cells, This secondary allergy response is called the late reaction and can take up to 6 hours to develop with the characteristic symptom being congestion.
It is not well understood what makes immune cells decide to react with an allergic response to foods or environmental allergens with allergy symptoms in some folks while not in others. Research has however discovered that well-developed countries have significantly higher incidence of allergies than developing countries where allergies are not common.
One theory about this is called the hygiene hypothesis which essentially says that developed countries are too clean and sanitary. There is far less exposure to parasites and bacteria and the immune system is inherently primed to fight more of these bugs, so it gets bored in their absence and finds other, non-lethal, antigens to “fight.” According to this theory, in individuals with allergies the immune system has decided that pollen, certain foods, dust, molds, dander, etc… are dangerous and warrant a strong immune response, hence allergy symptoms arise.
Another theory behind allergies is the total body burden. In environmental medicine, total body burden is used to describe all of the exposures the body has to deal with such as toxins, allergens, and stress. In this theory the body is thought of as a bucket into which all exposures are thrown, when the bucket gets too full (ie pollen levels increase) the bucket “overflows” in the form of symptoms.
The number of chemicals and toxins has dramatically increased in our environment (according to the National Institute of Health 2,000 new chemicals are introduced per year) and we are finding an increase in genetic mutations that hinder detoxification pathways in the body. This combination makes it easier for the body to get overwhelmed by exposures in some people more than in others. If you add a pro-inflammatory diet low in proper plant nutrients, high stress levels, and poor stress management, you have a recipe for overwhelm that burdens the body and confuses the immune system.
As with most things, I think the cause of the rise in allergies likely a combination of the 2 theories. Child immune systems are not getting primed and challenged in an ever increasing germ-phobic society and this makes it even harder to manage the onslaught of exposures and stressors into adulthood.
So what can we do about it? Below you will find a comprehensive overview of allergy support. Be sure to work with your doctor for proper dosing and selection of allergy management for you and your specific presentation of allergies.
ANTIHISTAMINES
These are used most commonly for allergy relief and are most effective for runny noses, sneezing, itching, and eye symptoms, but not as much for nasal congestion.
Naturopathic Antihistamines
Buffered Vitamin C reduces histamine levels by preventing histamine release and promoting histamine breakdown.
Quercetin, hawthorn, hesperidin, and omega-3 fatty acids prevent histamine release by stabilizing mast cells.
Vitamin B12 and Folate along with vitamins B6 and B1 are not histamine blockers but are necessary for breakdown of histamine. Regular B-vitamin injections can be very effective for this during allergy season.
Reducing high histamine foods in the diet: Beer, wine, cheese, fermented foods, pickled foods, smoked meats, sauerkraut, sour cream, sour milk, yogurt, processed meats, sardines, smoked fish, tuna, and tomatoes.
Reducing histamine releasing foods in the diet: alcohol, chocolate, eggs, fish, milk, shellfish, strawberries, tomatoes.
Conventional Antihistamines
There are 2 generations of pharmaceutical antihistamines, the first generation of antihistamines (Benadryl) can increase drowsiness, while second generation antihistamines (Zyrtec & Claritin) do not. Second generation antihistamines are currently more commonly used for this non-drowsy effect. A research study done by the University of Washington found that folks who regularly took Benadryl (diphenhydramine) for 3 consecutive years had a 54% increased risk of developing dementia so while this medication is great in a pinch and for emergency situations it is a good idea to have more natural alternatives to manage daily allergies.
DECONGESTANTS AND MUCOLYTICS
Decongestants stimulate constriction of blood vessels in the nasal passageways, which reduces congestion while mucolytics break down mucous.
Naturopathic Mucolytics
N-acetyl Cysteine (NAC) works to thin mucous so the body can more easily remove it. NAC is also used for detox in the liver so take note that high doses could make you feel like you’re over detoxing (headache, brain fog, nausea, fatigue, achiness.)
Proteolytic enzymes such as bromelain work to “digest” and breakdown mucous.
Proper hydration: the more hydrated you are the more thin and watery your mucous, making it easier to excrete than thick, dried mucous.
Steam inhalation with and neti pot nasal lavage.
Conventional Decongestants
Sudafed is an example of a decongestant and can be used in a pinch, however long term use of nasal decongestions may cause damage to the cilia in the nasal pathways which may lead to irreversible rhinitis or sinusitis. There can also be a rebound congestion when the medication wears off.
LEUKOTRIENE INHIBITORS
Leukotrienes work along the same lines as histamine and are pro-inflammatory. Inhibition of leukotrienes can help reduce inflammation associated with allergies.
Naturopathic Leukotriene Inhibitors
Licorice root: Can be used in tea, tincture, or solid extract form and is also anti-viral, gut healing, and adrenal support.
Feverfew
Quercetin: Strong anti-oxidant found in many plants, in particular nettles and onion and is extracted and used in capsules or as a powder.
Conventional Leukotriene Inhibitors
Singulair: most commonly used with allergies are associated with asthma.
OTHER CONVENTIONAL TREATMENTS
Intranasal corticosteroids (ie Fluticasone): Corticosteroids bind to DNA inside the cells and inhibit early and late stage allergic reactions. Side effects of steroid inhalers, especially with long-term use, include elevated blood glucose, adrenal (stress management) suppression, weight gain, immune suppression, osteoporosis, type 2 diabetes, glaucoma, cataracts, and impaired wound healing.
Immunotherapy: This therapy has shown some significant success for many people, it involves injecting increasing amounts of antigens (allergens) until a person is desensitized and has no reaction or a reduced reaction to them.
OTHER NATUROPATHIC TREATMENTS
Reduce total body burden by reducing the amount of exposures the body has to process. The top 3 ways to do that include:
Use a high quality HEPA air filter such as the Austin Air Purifier to remove allergens from the air that you breathe the most such as in your bedroom.
Reduce exposure to food allergens or sensitivities by determining and removing foods from the diet that cause inflammation.
Detox with the help of therapies such as sauna, fiber, and probiotics.
Heal the gut and balance the microbiome: the microbiome is all of the bacteria that live in the body, particularly in the gut, and they interact directly with the immune system. If there is an imbalance in the microbiome it can create an imbalance in the immune system as well, so the right probiotics promote a healthy immune system.
Adrenal support: the adrenal glands are in charge of helping the body manage stress. Stress comes in many forms: emotional, mental, and physical stress such as allergies. Any allergic reaction takes “energy” and the adrenal glands produce cortisol to help cope with the energy it takes to manage allergies. Our world is not without its stress so many folks struggle with tired adrenal glands and supporting them can help the body better battle allergies.
Homeopathic desensitization: homeopathic dilutions of allergens can be used in a similar fashion as immunotherapy to help desensitize the body to allergens.
Cheers,
