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Hay Fever

Also indexed as: Allergic Rhinitis, Allergy (Hay Fever), Pollen Allergy, Seasonal Allergy

Sniffling, sneezing, and wheezing? It must be pollen season. If you suffer from hay fever, you can find relief through a number of treatments. According to research or other evidence, the following self-care steps may be helpful:

Try butterbur
To help with symptoms, take an herbal extract standardized to contain 8 mg of petasin per tablet two or three times a day for two weeks

Get relief with nettle leaf
Ease symptoms by taking 450 mg of nettle leaf capsules or tablets two to three times a day

Go on a low-allergen diet
Work with a knowledgeable health professional to find out if dropping certain foods from your diet will help your hay fever

Take an allergy test
Make an appointment with your healthcare provider or an allergist to find out what airborne agents you may be allergic to and how you can reduce their effects

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full hay fever article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About hay fever

Hay fever is an allergic condition triggered by the immune system’s response to inhalant substances (frequently pollens).

Researchers have yet to clearly understand why some people’s immune systems over-react to exposure to pollens while other people do not suffer from this problem. Symptoms of hay fever are partly a result of inflammation that, in turn, is activated by the immune system.

Product ratings for hay fever

Science Ratings	Nutritional Supplements	Herbs
		Butterbur
	Probiotics (Bifidobacterium longum strain BB536) Thymus extracts Vitamin E	Horny goat weed Tinospora cordifolia
	Quercetin Vitamin C	Nettle Sho-seiryu-to (contains licorice, cassia bark, schisandra, ma huang, ginger, peony root, pinellia, and asiasarum root) Tylophora
See also: Homeopathic Remedies for Hay Fever
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

Inhaled allergens trigger sneezing and inflammation of the nose and mucous membranes (conjunctiva) of the eyes. The nose, roof of the mouth, eyes, and throat begin to itch gradually or abruptly after the onset of the pollen season. Tearing, sneezing, and clear, watery nasal discharge soon follow the itching. Headaches and irritability may also occur.

Dietary changes that may be helpful

People with inhalant allergies are likely to also have food allergies.¹ ² A hypoallergenic diet has been reported to help some people with asthma and allergic rhinitis,³ but the effect of such a diet on hay fever symptoms has not been studied. Hay fever sufferers interested in exploring the possible effects of a food allergy avoidance program should talk with a doctor. Discovering and eliminating offending food allergens, should they exist, is likely to improve overall health even if such an approach has no effect on hay fever symptoms.

Vitamins that may be helpful

Although vitamin C has antihistamine activity, and supplementation, in preliminary research,⁴ ⁵ has been reported to help people with hay fever, 2,000 mg of vitamin C per day did not reduce hay fever symptoms in a placebo controlled trial.⁶ Thus, while some doctors recommend that hay fever sufferers take 1,000–3,000 mg of vitamin C per day, supportive evidence remains weak.

In a double-blind study of people with hay fever, adding 800 IU of vitamin E per day to regular anti-allergy treatment during the pollen season significantly reduced the severity of hay fever symptoms by 23%, compared with placebo plus regular anti-allergy treatment.⁷

In a double-blind trial, supplementation with a specific probiotic strain (Bifidobacterium longum strain BB536) during the pollen season significantly decreased symptoms such as sneezing, runny nose, nasal blockage, compared with a placebo.⁸

Quercetin is an increasingly popular treatment for hay fever even though only limited preliminary clinical research has suggested that it is beneficial to hay fever sufferers.⁹

The oral administration of a thymus extract known as Thymomodulin® has been shown in preliminary studies and double-blind trials to improve the symptoms of hay fever and allergic rhinitis.¹⁰ ¹¹ ¹² Presumably this clinical improvement is the result of restoration of proper control over immune function.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful

Two double-blind studies have compared butterbur extract to standard antihistamine drugs in people with hay fever. The first compared it with the drug cetirizine (Zyrtec) and found the drug and butterbur extract relieved symptoms equally well. However, cetirizine caused significantly more adverse effects, including a high rate of drowsiness.¹³ The second study compared butterbur extract with fexofenadine (Allegra) and placebo. Butterbur extract was as effective as fexofenadine at relieving symptoms, and both were significantly better than placebo.¹⁴

People with hay fever had better symptomatic relief and reductions in levels of immune cells associated with allergic reactions (eosinophils) when treated with an herbal formula containing horny goat weed compared with a formula without horny goat weed and another herb by itself.¹⁵ Traditionally 5 grams (1 tsp) of horny goat weed is taken three times per day, usually after being simmered (decocted) in 250 ml (1 pint) of water for 10 to 15 minutes.¹⁶

In a double-blind study, an extract of the butterbur plant (Petasites hybridus) was significantly more effective than a placebo at improving symptoms in people suffering from seasonal allergic rhinitis.¹⁷ The study used a preparation standardized to contain 8 mg of total petasin per tablet. One tablet was administered either two or three times a day for two weeks; the larger amount was found to be more effective than the smaller amount.

Tinospora cordifolia is an herb used in traditional Indian (Ayurvedic) medicine for increasing longevity, promoting intelligence, and improving memory and immune function. In a double-blind trial, an extract of Tinospora cordifolia was significantly more effective than a placebo at relieving symptoms of allergic rhinitis, including sneezing, runny nose, nasal obstruction, and nasal itching. The study used 300 mg of a standardized extract three times a day for eight weeks.¹⁸

Tylophora is an herb used by Ayurvedic doctors in India to treat people with allergies. It contains compounds that have been reported to interfere with the action of mast cells, which are key components in the process of inflammation responsible for most hay fever symptoms.¹⁹ Mast cells are found in airways of the lungs (among other parts of the body). When mast cells are activated by pollen or other allergens, they release the chemical histamine, which in turn leads to a wide number of symptoms familiar to hay fever sufferers—itchy eyes, runny nose, and chest tightness. Ayurvedic doctors sometimes recommend 200–400 mg of the dried herb daily or 1–2 ml of the tincture per day for up to two weeks.

In an isolated double-blind trial, nettle leaf led to a slight reduction in symptoms of hay fever—including sneezing and itchy eyes.²⁰ However, no other research has investigated this relationship. Despite the lack of adequate scientific support, some doctors suggest taking 450 mg of nettle leaf capsules or tablets two to three times per day, or a 2–4 ml tincture three times per day for people suffering from hay fever.

The Japanese herbal formula known as sho-seiryu-to has been shown to reduce symptom, such as sneezing, for people with hay fever.²¹ Sho-seiryu-to contains licorice, cassia bark, schisandra, ma huang, ginger, peony root, pinellia, and asiasarum root.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

References
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1. Speer F. Multiple food allergy. Ann Allerg 1975;34:71–6.

2. Buczylko K, Kowalczyk J, Zeman K, et al. Allergy to food in children with pollinosis. Rocz Akad Med Bialymst 1995;40:568–72.

3. Ogle KA, Bullock JD. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet. Ann Allergy 1977;39:8–11.

4. Holmes HM, Alexander W. Hay fever and vitamin C. Science 1942;96:497.

5. Ruskin SL. High dose vitamin C in allergy. Am J Dig Dis 1945;12:281.

6. Fortner BR Jr, Danziger RE, Rabinowitz PS, Nelson HS. The effect of ascorbic acid on cutaneous and nasal response to histamine and allergen. J Allergy Clin Immunol 1982;69:484–8.

7. Shahar E, Hassoun G, Pollack S. Effect of vitamin E supplementation on the regular treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2004;92:654–8.

8. Xiao JZ, Kondo S, Yanagisawa N, et al. Probiotics in the treatment of Japanese cedar pollinosis: a double-blind placebo-controlled trial. Clin Exp Allergy 2006;36:1425–35.

9. Balabolkin II, Gordeeva GF, Fuseva ED, et al. Use of vitamins in allergic illnesses in children. Vopr Med Khim 1992;38:36–40.

10. Cazzola P, Mazzanti P, Bossi G. In vivo modulating effect of a calf thymus acid lysate on human T lymphocyte subsets and CD4+/CD8+ ratio in the course of different diseases. Curr Ther Res 1987;42:1011–7.

11. Kouttab NM, Prada M, Cazzola P. Thymomodulin: Biological properties and clinical applications. Med Oncol Tumor Pharmacother 1989;6:5–9 [review].

12. Marzari R, Mazzanti P, Cazzola P, Pirodda E. Perennial allergic rhinitis: prevention of the acute episodes with Thymomodulin. Minerva Med 1987;78:1675–81.

13. Schapowal A, Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ 2002;324:144–6.

14. Lee DK, Gray RD, Robb FM, et al. A placebo-controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis. Clin Exp Allergy 2004;34:646–9.

15. Yu YJ. Effect of tian-huang-ling granule in the treatment of allergic rhinitis. Zhong Xi Yi Jie He Za Zhi 1989;9:720–1, 708 [in Chinese].

16. Chen JK, Chen TT. Chinese Medical Herbology and Pharmacology. City of Industry, CA: Art of Medicine Press, Inc., 2003.

17. Schapowal A; Petasites Study Group. Butterbur Ze339 for the treatment of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized, double-blind, placebo-controlled study. Arch Otolaryngol Head Neck Surg 2004;130:1381–6.

18. Badar VA, Thawani VR, Wakode PT, et al. Efficacy of Tinospora cordifolia in allergic rhinitis. J Ethnopharmacol 2005;96:445–9.

19. Gopalakrishnan C, Shankaranarayan D, Nazimudeen SK, et al. Effect of tylophorine, a major alkaloid of Tylophora indica, on immumopathological and inflammatory reactions. Ind J Med Res 1980;71:940–8.

20. Mittman P. Randomized double-blind study of freeze-dried Urtica diocia in the treatment of allergic rhinitis. Planta Med 1990;56:44–7.

21. Baba S, Takasaka T. Double-blind clinical trial of sho-seiryu-to (TJ-19) for perennial nasal allergy. Clin Otolaryngol 1995;88:389–405.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2009.

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About hay fever

What are the symptoms?

Dietary changes that may be helpful

Vitamins that may be helpful

Herbs that may be helpful