Researchers at the Institute of Food Research in Norwich, have just published a study(1) indicating that probiotics (‘good’ bacteria) may help to keep hay fever symptoms at bay.

The researchers of this small study wanted to investigate whether the ‘good bacteria’ Lactobacillus casei Shirota (found in many probiotic supplements, yoghurts and drinks) played a role in modulating the symptoms of hay fever (seasonal allergic rhinitis).  Hay fever sufferers were given a milky drink, with or without the good bacteria, each day for five months.  The scientists kept track of, and compared the changes in, the immune system of the participants by collecting blood samples before, during and after grass pollen season.  

It was found that the probiotic being tested changed the way the body's immune cells responded to grass pollen.  The hay fever sufferers that had been drinking the probiotic containing drink had lower levels of the chemicals (interleukin 5 and 6 and interferon-gamma) partly responsible for the production of hay fever symptoms in the body.  They also had higher levels of specific antibodies (immunoglobulin G and E) which are associated with playing a protective role in allergy reactions.

The authors of the study conclude that “These data show that probiotic supplementation modulates immune responses in allergic rhinitis and may have the potential to alleviate the severity of symptoms.”

This was only a small study and the authors plan to do further work to further elucidate the role that probiotic ‘good’ bacteria may play in changing the immune status of hay fever sufferers.  As I mentioned in my post dated 19th May the good/friendly bacteria in our digestive system have been linked to positively enhancing the action of our immune system through their production of a variety of substances.  This study adds to the growing body of evidence which suggests that the bacteria in our digestive systems may be very important in affecting our overall health.

(1) Ivory K et al.  2008.  Oral delivery of Lactobacillus casei Shirota modifies allergen-induced immune responses in allergic rhinitis. Clin Exp Allergy. 2008 May 28. [Epub ahead of print]

Written by Ani Kowal

The symptoms of hay fever may well be irritating and even distressing at times.  As I said in Part I I do not suffer from the condition so this may well sound easy for me to say, but trying not to get too upset and stressed about your hay fever could be a great help.  This is important to mention because stress(1) has been linked to the production of inflammatory agents in the body and could hence further aggravate your symptoms thus starting up a vicious cycle.

As discussed previously hay fever is an inflammatory condition.  A natural agent that would be highly useful in mediating the inflammatory reactions in the body is the long chain omega 3 fatty acid, Eicosapentaenoic Acid or EPA.  As well as having a general anti-inflammatory role EPA may actually help to prevent hay fever.  A study in 2003(2) demonstrated that individuals with a high intake of dietary EPA had a 55% reduction in their incidence of hay fever compared with persons who consume low amounts of dietary EPA.

EPA is naturally found in oily fish such as mackerel, salmon, trout and sardines.  As well as aiding the production of potent anti-inflammatory chemicals in the body it is also beneficial to the health of the heart, brain, eyes, nerves, bones, digestive system and skin (and I am sure I will be mentioning omega 3 fatty acids in future blog postings!).  Many of us do not eat these types of fish regularly (two portions per week is usually recommended) and hence a daily fish oil supplement (providing around 300mg of EPA and 200mg DHA) may be very useful for the prevention of hay fever and even to promote optimal health and wellbeing.  For vegetarians and vegans flaxseed oil (1000mg daily) can provide omega 3 fatty acids in the form of alpha linolenic acid which the body then bio-converts to EPA (the long chain form). 

One other natural remedy which can be helpful in the treatment of hay fever is the herb Butterbur (Petasites hybridus). This herb seems to exhibit anti-inflammatory activity and anti-allergic properties.   The British Medical Journal published a study(3) which compared Butterbur supplementation with the conventional antihistamine drug cetirizine (prescribed in the UK under the name Zirtek).  Both treatments were equally effective in reducing hay fever symptoms.  However, the drug cetirizine tended to cause side effects such as fatigue and drowsiness.  The authors of the study concluded that:  “The effects of butterbur are similar to those of cetirizine in patients with seasonal allergic rhinitis.....Butterbur should be considered for treating seasonal allergic rhinitis when the sedative effects of antihistamines need to be avoided”.

As an interesting point antibiotics used in children in their first 2 years of life have been associated with a 2-3 fold increased risk of hay fever(4).  As well as destroying the bacteria that cause illness in the body antibiotics also kill the healthy bacteria that live in the digestive system.  As mentioned in a previous posting these friendly bacteria have been shown to positively affect the immune system, which is responsible for allergic and inflammatory responses in the body, so a prebiotic and probiotic supplement may be useful to anyone who has been recently exposed to antibiotics or as an immune boosting aid (see post dated 19/05/08 for more detail about pre- and probiotics for immune health).

And finally, a study last year (5) found that almost 50% of hay fever suffers seem to be highly sensitive not only to typical allergy triggers like grass, tree pollens, dust and animal hair but also to things like cold air, perfumes, cigarette smoke and household cleaning products.  So, if you find that you often suffer from symptoms like itchy eyes and stuffy or runny nose you may find it useful to take a product containing vitamin C and bioflavonoids (as discussed in Part I) all year around as a preventative, anti-allergic measure.

(1) Maes M et al.  2000.  In humans, serum polyunsaturated fatty acid levels predict the response of proinflammatory cytokines to psychologic stress.  Biol Psychiatry.  47(10):910-920.
(2) Nagel G et al.  2003.  The influence of the dietary intake of fatty acids and antioxidants on hay fever in adults.  Allergy.  58(12):1277-1284.
(3) Schapowal A.  2002.  Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.  BMJ.  324:144-146
(4) Wickens K et al.  1999.  Antibiotic use in early childhood and the development of asthma, hay fever and eczema. Clin Exp Allergy.  29:766-771
(5)Shusterman D and Murphy MA.  2007.  Nasal hyperreactivity in allergic and non-allergic rhinitis: a potential risk factor for non-specific building-related illness.Indoor Air.  17:328-333

Written by Ani Kowal

No excuse is needed for me to get outside and enjoy the warm weather!  I relish spending as much time as possible walking in the countryside amongst the grasses and flowers.  However, it is estimated that up to 25% of the UK population suffer from hay fever, and for affected individuals spring and summer signify the seasons of sneezing, sniffles and stress.

Symptoms of hay fever, which is also known as seasonal allergic rhinitis, can include sneezing, watering and itchy eyes, a runny nose, headaches and skin rashes.  This can seriously affect outdoor enjoyment at a time when everyone else seems to be bathing themselves in the blissful warmth.

These irritating and upsetting symptoms occur when membranes lining the nose and eyes become aggravated and inflamed by airborne pollen.  The pollen triggers a type of immune cell, called a mast cell, to release the chemical histamine in those membranes.  The histamine then stimulates an inflammatory reaction in the body which produces the characteristic symptoms.

Conventional treatment for hay fever is based on antihistamine pills, anti-inflammatory medication such as steroid nasal sprays, and decongestants such as ephedrine. However, an increasing number of people are not content with taking such medications on a long term bases.  Fortunately, there are a number of natural strategies that can offer very real relief from the symptoms of hay fever.

Vitamin C and the bioflavonoid (plant compound) quercetin (naturally rich sources include apples, onions and green tea) both seem to act as natural anti-histamines in the body and supplementation may be useful in helping to control hay fever symptoms(1-6).  500mg of vitamin C taken 3 times a day throughout the hay fever season should prove helpful together with around 300-400mg of quercetin 2-3 times daily.  It is a good idea to take the two supplements together as bioflavonoids appear to protect and enhance the action and absorption of vitamin C (naturally vitamin C is found as a complex molecule bound up with various flavonoids).

Bromelain, an enzyme found naturally in pineapples, also seems to be useful in dampening down the bodily immune response associated with hay fever symptoms(7-9).  Supplements which contains both Quercetin and Bromelain in a capsule form are available and may be useful to try in addition to a vitamin C.

Nettle (Urtica dioica) is a natural herbal remedy which has been traditionally used to treat allergic conditions such as hay fever.  It seems to exhibit anti-allergy properties.  In a double-blind scientific study(10), freeze-dried extract of stinging nettle leaf led to a slight reduction in symptoms of hay fever, including sneezing and itchy eyes. In practice individuals seem to find that nettle in combination with vitamin C and bioflavonoids works well at controlling the worst of their hay fever symptoms and supplements combining all of the aforementioned agents in one product are available.  Taking such a supplement throughout the spring and summer months may well bring some welcome relief.

Remember to check back soon for more advice in Part II

References
(1)Balabolkin II et al.  1992.  Use of vitamins in allergic illnesses in children.  Vopr Med Khim.  38:36-40.
(2)Bucca C et al.  1990.  Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis.  Ann Allergy.  65:311-314.
(3)Cathcart RE.  1981.  Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy.  Medical Hypotheses.  7:1359-1376
(4)Holmes HM et al.  1942.  Hay fever and vitamin C. Science.  96:497
(5)Ruskin SL.  1945.  High dose vitamin C in allergy. Am J Dig Dis.  12:281
(6)Thornhill SM et al.  2000.  Natural treatment of perennial allergic rhinitis.  Alternative Medicine Review.  5(5):448-454.
(7)Gaspani L  et al.  2002.  In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats.  Pharmacology.  65(2):83-86.
(8)Hale, L. P. et al.  2002.  Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation.  Clin Immunol.  104(2):183-190.
(9)Ito C et al.  1979.  Anti-inflammatory actions of proteases, bromelain, trypsin and their mixed preparations.  Folia Pharmacol Japan.  75:227-237.
(10)Mittman P.  1990.  Randomised double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis.  Planta Med. 56:44-47

Written by Ani Kowal