Allergic Rhinitis (Hay Fever)

According to Allergy UK, the UK has some of the highest prevalence rates of allergic conditions in the world, with over 20% of the population affected by one or more allergic disorder.

In the UK, allergic diseases across all ages costs the NHS an estimated £900 million a year, mostly through prescribed treatments in primary care, representing 10% of the GP prescribing budget.

Seasonal allergic rhinitis (AR) is the most common form of non-infectious rhinitis, affecting between 10% and 30% of all adults and as many as 40% of children. AR accounts for 16.7 million physician office visits annually. The percentage of children diagnosed with allergic rhinitis have trebled over the last 30 years.

What is Hay Fever?
Hay fever is a common allergic reaction which occurs at particular times of the year. It is known as seasonal allergic rhinitis, sharing symptoms with perennial (year-round) allergic rhinitis, but occurring as a reaction to pollen from grass, trees and weeds during the early spring and summer months. While hay fever frequently begins at a young age, it can affect both adults and children. Sometimes seasonal allergy symptoms fade over the years, only to reoccur later in life. For some, moving to a new location with different types of flora can alleviate symptoms or even eliminate them.

What Causes Hay Fever?
It is caused when the body makes antibodies (IgE) to certain substances, such as pollen, which are known as allergens.

Grass pollen is the most common allergen (May to July), but tree (February to June) and weed (June to September) pollens can also cause the allergic reaction we know as hay fever.

What are the symptoms?
• Itchy eyes/throat
• Sneezing, blocked/runny nose
• Watering, red eyes (allergic conjunctivitis)
• Headaches, blocked sinuses
• Shortness of breath
• Tiredness
• The sensation of mucus running down the back of the throat, which can also be a symptom, and is called ‘post-nasal drip’.

Symptoms will vary depending on the pollen count.

Conventional treatment
Usually involves avoidance of the allergic triggers – such as staying indoors when pollen counts are high. Wearing sunglasses when going outside to prevent pollen getting into your eyes. Keeping the car windows closed when driving. Avoiding cutting grass, and playing or walking in grassy areas – particularly in the early morning evening and at night when pollen counts are highest. Not drying clothes outside, this helps to prevent pollen coming into the house.

With the above sufferers also use medication called antihistamines, although they don’t cure allergies they work by treating the symptoms. In fact, many antihistamines are not recommended for people with high blood pressure, heart disease, kidney or liver disease, glaucoma, thyroid problems, or women who are pregnant or breastfeeding.

Risk Factors
Unhealthy Gut Microbiome
The human gut microbiome and its role in both health and disease has been the subject of extensive research, establishing its involvement in human metabolism, nutrition, physiology, and immune function. For example, over 70% of the immune system resides in the gut. Microbial communities provide defence against pathogens from ingested foods. Dysregulated gut flora has been linked to specific diseases including allergies. Antibiotics destroy supportive as well as causative bacteria throughout the whole body, leading to a loss of diversity and density, both of which are essential for a healthy microbiome. It is recognised that the gastrointestinal system plays a central role in immune system homeostasis (balance). In addition, early-life environmental influences that are known to disrupt the microbiota, such as antibiotic use, caesarean birth, and formula feeding, are all associated with increased susceptibility to asthma and allergies later in life.

Histamine is a major component of the immune response and thus a key mediator in allergic reactions. A disturbance in the gut microbiome can have a role in creating histamine intolerance. Taking probiotics that contain histamine-degrading strains such as Bifidobacterium infantis, Bifidobacterium longum and Lactobacillus rhamnosus is recommended for those with histamine intolerance. It is not surprising, therefore, that there appears to be a link between the severity of allergies and the health of the gut and its corresponding immune system and therefore, restoring a healthy balance of gut flora is the best long-term solution to resolving a histamine issue.

Nutrient Deficiencies
Vitamin D: Lower levels have been associated with more allergic disease and elevated serum IgE

Bromelain: is a proteolytic enzyme derived from pineapple which can help to enhance absorption of quercetin. It has also been shown to possess anti-inflammatory and a natural antihistamine, helping relieve the pain and congestion of inflamed tissues, especially the nasal and respiratory pathways

Quercetin: has been shown to inhibit production and release of histamine, making it an important consideration in those with hay fever and allergies.

Omega-3 fatty acids: can help to support a healthy balanced immune system. The increased incidence of allergic conditions has recently been associated with the over-consumption of pro- inflammatory omega-6 fatty acids in relation to anti-inflammatory omega-3 fatty acids – an unhealthy imbalance, which is very common in a typical Western diet. Research suggests that a balanced intake of fatty acids may have a powerful, positive effect in certain patients with allergic conditions

Dietary Support
A low-histamine, anti-inflammatory diet can often reduce the severity of allergy symptoms.

Foods high in histamine include: fermented foods, aged cheese, citrus fruits, fish, shellfish, avocados, spinach, cocoa, leftover meat or fish, fermented alcohol like wine, champagne, and beer.

Foods low in histamine include: freshly cooked meat, poultry (frozen or fresh), freshly caught fish, eggs, rice, quinoa, fresh fruits, fresh vegetables (except tomatoes, spinach, avocado and aubergine), olive oil, coconut oil, leafy herbs and herbal teas.

Certain foods can make symptoms much worse, so knowing those triggers is an important part of an overall plan.

Thank you for reading my Newsletter. Before making any changes or taking supplements please discuss with a healthcare professional.