About 7% of all Americans suffer from hay fever, an allergic condition that can cause runny nose, sneezing, and teary eyes. It is known officially as
allergic rhinitis, allergic sinusitis,
Here's how hay fever works. In response to the triggers noted above, an individual prone to allergies develops an exaggerated immune response. Substances known as IgEs flood the nasal passages, white blood cells called eosinophils arrive by the millions and billions, and inflammatory substances such as histamine, prostaglandins, and leukotrienes are released in massive amounts. The overall effect is the familiar one of swelling, dripping, itching, and aching.
The mechanism of allergic response is fairly well understood. Why allergic people react so excessively to innocent bits of pollen, however, remains a complete mystery.
Conventional treatment for hay fever primarily involves nonsedating antihistamines and nasal steroids and is usually quite effective.
butterbur is best known as a promising new treatment for
In a 2-week, double-blind, placebo-controlled study of 186 people with intermittent allergic rhinitis, use of butterbur at a dose of three standardized tablets daily, or one tablet daily, reduced allergy symptoms as compared to placebo.
In another double-blind study, 330 people were given either butterbur extract (one tablet three times daily), the antihistamine fexofenadine (Allegra), or placebo.
A previous 2-week, double-blind study of 125 individuals with hay fever (technically, seasonal allergic rhinitis) compared a standardized butterbur extract against the antihistamine drug cetirizine.
Two much smaller studies produced inconsistent results.
For more information, including dosage and safety issues, see the full
An alternative to allergy shots known as
If SLIT is effective, it may require 2-3 years for significant benefit to develop.
One study suggests that SLIT is not only effective for treating allergy, but may be useful in preventing the development of new allergies or mild persistent asthma in children with allergic rhinitis or intermittent asthma.
While SLIT is fairly well accepted in conventional medicine, another form of “alternative” allergy shots remains firmly in the alternative medicine field:
Several natural products have shown potential benefit for allergic rhinitis in one or more preliminary controlled trials. These include a water-extract of
, a freeze-dried extract of stinging
One rather unusual study tested a nasal spray containing capsaicin, the “hot” in
A 12-week, double-blind, placebo-controlled study of 40 people tested the supplement
Test tube studies suggest that flavonoids—biologically active compounds found in many plants—may help reduce allergy symptoms.
Tomato extract has been advocated for the treatment of allergic rhinitis, but the one double-blind study said to demonstrate benefit actually proves almost nothing at all due to major flaws in its statistical analysis.
The last several substances discussed (vitamins E and C, flavonoids, and OPCs) are
It has often been suggested that consumption of
Acupuncture has also shown some promise for allergic rhinitis.
This topic is also discussed in the
6. Ogasawara H, Middleton E Jr. Effect of selected flavonoids on histamine release (HR) and hydrogen peroxide (H2O2) generation by human leukocytes [abstract]. J Allergy Clin Immunol. 1985;75(suppl 1, pt 2):184.
8. Pearce FL, Befus AD, Bienenstock J. Mucosal mast cells. III. Effect of quercetin and other flavonoids on antigen-induced histamine secretion from rat intestinal mast cells. J Allergy Clin Immunol. 1984;73:819-823.
12. Bernstein CK, Deng C, Shuklah R, et al. Double blind placebo controlled (DBPC) study of grapeseed extract in the treatment of seasonal allergic rhinitis (SAR) [abstract]. J Allergy Clin Immunol. 2001;107:1018.
23. Japan's Health Ministry confirms efficacy of another of Tsumura's Kampo drugs. Kampo Today [serial online]. 2000:4. Available at: http://www.tsumura.co.jp/english/kthp/4-1-01.htm . Accessed November 4, 2002.
27. 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;34:646-649.
28. Takano H, Osakabe N, Sanbongi C, et al. Extract of Perilla frutescens enriched for rosmarinic acid, a polyphenolic phytochemical, inhibits seasonal allergic rhinoconjunctivitis in humans. Exp Biol Med (Maywood). 2004;229:247-54.
31. Van Rijswijk JB, Boeke EL, Keizer JM, et al. Intranasal capsaicin reduces nasal hyperreactivity in idiopathic rhinitis: a double-blind randomized application regimen study. Allergy. 2003;58:754-761.
34. Schapowal A. 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;130:1381-1386.
36. Ishida Y, Nakamura F, Kanzato H, et al. Clinical effects of Lactobacillus acidophilus Strain L-92 on perennial allergic rhinitis: a double-blind, placebo-controlled study. J Dairy Sci. 2005;88:527-533.
37. Kobayashi M, Matsushita H, Shioya I, et al. Quality of life improvement with soy sauce ingredients, Shoyu polysaccharides, in perennial allergic rhinitis: a double-blind placebo-controlled clinical study. Int J Mol Med. 2004;14:885-889.
38. Kobayashi M, Matsushita H, Tsukiyama R, et al. Shoyu polysaccharides from soy sauce improve quality of life for patients with seasonal allergic rhinitis: a double-blind placebo-controlled clinical study. Int J Mol Med. 2005;15:463-467.
40. Osakabe N, Takano H, Sanbongi C, et al. Anti-inflammatory and anti-allergic effect of rosmarinic acid (RA); inhibition of seasonal allergic rhinoconjunctivitis (SAR) and its mechanism. Biofactors. 2005;21:127-131.
41. Brinkhaus B, Hummelsberger J, Kohnen R, et al. Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. Allergy. 2004;59:953-690.
45. Montano Velazquez BB, Jauregui-Renaud K, Banuelos Arias Adel C, et al. Vitamin E effects on nasal symptoms and serum specific IgE levels in patients with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2006;96:45-50.
48. Penagos M, Compalati E, Tarantini F, et al. Efficacy of sublingual immunotherapy in the treatment of allergic rhinitis in pediatric patients 3 to 18 years of age: a meta-analysis of randomized, placebo-controlled, double-blind trials. Ann Allergy Asthma Immunol. 2006;97:141-148.
51. Rak S, Yang WH, Pedersen MR, et al. Once-daily sublingual allergen-specific immunotherapy improves quality of life in patients with grass pollen-induced allergic rhinoconjunctivitis: a double-blind, randomised study. Qual Life Res. 2006 Oct 11. [Epub ahead of print]
52. Tamura M, Shikina T, Morihana T, et al. Effects of probiotics on allergic rhinitis induced by Japanese cedar pollen: randomized, double-blind, placebo-controlled clinical trial. Int Arch Allergy Immunol. 2006 Dec 29. [Epub ahead of print]
53. Dunstan JA, Breckler L, Hale J, et al. Supplementation with vitamins C, E, beta-carotene, and selenium has no effect on anti-oxidant status and immune responses in allergic adults: a randomized controlled trial. Clin Exp Allergy. 2007;37:180-187.
57. Giovannini M, Agostoni C, Riva E, et al. A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis. Pediatr Res. 2007 Jun 25. [Epub ahead of print]
60. Segawa S, Takata Y, Kaneda H, et al. Effects of a hop water extract on the compound 48/80-stimulated vascular permeability in ICR mice and histamine release from OVA-sensitized BALB/c mice. Biosci Biotechnol Biochem. 2007;71:1577-1581.
61. Segawa S, Takata Y, Wakita Y, et al. Clinical effects of a hop water extract on Japanese Cedar Pollinosis during the pollen season: a double-blind, placebo-controlled trial. Biosci Biotechnol Biochem. 2007 Aug 7. [Epub ahead of print]
62. Turpeinen AM, Ylonen N, von Willebrand E, et al. Immunological and metabolic effects of cis-9, trans-11-conjugated linoleic acid in subjects with birch pollen allergy. Br J Nutr. 2008 Jan 2. [Epub ahead of print]
63. Mosges R, Bruning H, Hessler HJ, et al. Sublingual immunotherapy in pollen-induced seasonal rhinitis and conjunctivitis: a randomized controlled trial. Acta Dermatovenerol Alp Panonica Adriat. 2007;16:143-148.
65. Hoeks SB, de Groot H, Hoekstra MO. Sublingual immunotherapy in children with asthma or rhinoconjunctivitis: not enough evidence because of poor quality of the studies; a systematic review of literature. Ned Tijdschr Geneeskd. 2008;152:261-268.
68. Pfaar O, Klimek L. Efficacy and safety of specific immunotherapy with a high-dose sublingual grass pollen preparation: a double-blind, placebo-controlled trial. Ann Allergy Asthma Immunol. 2008;100:256-263.
69. Dahl R, Kapp A, Colombo G, et al. Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years. J Allergy Clin Immunol. 2008;121:512-518.e2.
Last reviewed September 2009 by EBSCO CAM Medical Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.