A Functional Medicine Protocol for Seasonal Allergies

Do you dread the change in weather? The change in weather can mean a spike in allergy symptoms. This comes with discomforts like sneezing, runny nose, itchiness, and watery eyes. Allergies, including seasonal allergies, are the 6th leading cause of chronic illness in the United States. Many suffering from seasonal allergies rely on over-the-counter nasal sprays and anti-histamines, but what if there was a more root-cause approach to addressing your discomforts? A functional medicine approach can assist you in looking at the root causes of your allergies and provide integrative approaches to relieve symptoms and potentially put you at ease once and for all. This article goes into the aspects of seasonal allergies and a functional medicine approach to care. 

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What Are Seasonal Allergies?

Seasonal allergies are an allergic response to environmental changes from natural elements. This includes mold spores, trees, weeds, and grasses pollinating and fertilizing at peak times of the year. You may also hear this reaction called “hay fever” or “allergic rhinitis.” An overactive immune response to these seasonal antigens is what drives symptoms. Depending on your type of allergy, you may be reactive only during certain times of the year. The most common allergies start in March- April from tree pollen. Followed by the uptick in grass pollen in June through July and ending with ragweed and mold allergens highest in the fall. Some people have multiple allergies, which can make allergy season feel like a year-round dilemma. 

What Are The Signs and Symptoms of Seasonal Allergies?

If you are susceptible to seasonal allergies, here are some common reactions you may have:

• Runny nose 
• Itchy nose (Rhinitis)
• Sneezing
• Watery eyes
• Itchy and swollen eyes
• Hives or rashes
• Itchy skin
• Nasal congestion
• Coughing
• Post-nasal drip
• Headaches

What Are The Possible Causes of Seasonal Allergies?

The symptoms you experience from seasonal allergies are due to an adverse response to histamine. Histamine is a chemical molecule released from mast cells and basophils when your immune system responds to foreign particles. When you have seasonal allergies, exposures to your triggers, like grasses, weeds, and tree pollen, will cause a release of histamine that leads to a cascade of symptoms. 

Some people develop seasonal allergies, and others do not, due to genetic factors and system overload that impact your ability to excrete histamine. If you think of histamine as a bucket that needs regular emptying through liver detoxification and lymphatic drainage, we find that some individuals' buckets overflow, which leads to systemic effects. When histamine is not naturally broken down, the body will manifest the above-mentioned symptoms, with each person displaying different variations and severity. 

There is emerging evidence on the gut microbiome and seasonal allergies. Microbial diversity in the gut is essential in maintaining optimal health, especially when it comes to modulating immune responses. One study found that in adults with allergic rhinitis, there was an overall decrease in microbial diversity, with an increase in particular microbes. Evidence shows that as society has progressed to more sterile living, our microbial diversity has been negatively impacted. In times when farming life, more vaginal deliveries were occurring, unpasteurized milk was utilized, family sizes were larger, and there was less early antibiotic use, there was a wider variety of microbial diversity and fewer allergic diseases. This concept falls under the hygiene hypothesis and how certain aspects have been detrimental to our internal ecosystem. 

Functional Medicine Labs to Test for Root Cause of Seasonal Allergies

Root cause analysis through functional laboratory testing can provide valuable information. Taking this data and combining it with clinical presentation allows for a better understanding of your overall health and the impact that it has on developing seasonal allergies. Here is a list of tests to consider in those with hay fever symptoms. 

Allergen Testing

Seasonal allergies are outdoor allergens that an allergist can test. You can have concomitant inhalants and food allergies contributing to increased histamine production. Access Medical Labs has a foodANALYZER and allergE+ test to examine the most common food and respiratory culprits. These include but are not limited to dust mites, tree nuts, cows' milk, and eggs. 

Histamine Testing

Assessing your histamine levels can indicate the severity of your allergic response. These makers indicated that an inflammatory reaction is occurring, but it is not specific to what is causing the histamine release or how it impacts the body. You can also order an Advanced Intestinal Barrier assessment, looking at histamine, DAO (Diamine Oxidase), LPS, and Zonulin. This comprehensive look will provide insight into histamine levels and whether your body is breaking down histamine. It also assesses gut permeability for insight as to whether increased histamine is causing a leaky gut. 

Microbiome Assessment

Looking at overall microbiome diversity can be done through a few comprehensive stool analyses. One new option is the BiomeFx test by Microbiome Labs. This stool test looks for both pathogenic and beneficial microbes in the gut. It then takes the data and correlates it to how the microbiome present can impact symptoms and areas of your health. This can provide valuable information when assessing if microbial diversity is an issue that needs to be addressed. 

Micronutrient Testing

Dysbiosis in the gut can lead to decreased absorption of nutrients, which can impact your immune system responses. Specific vitamins, like Vitamin C and Vitamin D, are essential for decreasing a histamine response and inflammation. Utilizing a test like SpectraCell's Micronutrient Test can assess 31 essential nutrients for optimal health. This is a great way to identify and support nutrients while addressing the root cause of the allergic response.

Additional Lab Tests 

The skin prick test is commonly done with an allergist. Depending on what is being tested, sets of allergy antigens are administered by pricking the skin surface so it barely penetrates the skin. There is a 15-20 minute waiting period to see if you have a skin reaction, which will appear as small red wheals or itchy bumps. 

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Conventional Treatment for Seasonal Allergies

When it comes to conventional treatment of seasonal allergies, there are different tiers of intervention based on severity. The top recommendation is the avoidance of allergens. When pollen counts are high, outdoor activity is discouraged. For those 12 years and older, monotherapy with a glucocorticoid nasal spray like Nasacort™ is often recommended. For those with more severe seasonal allergies, the recommendation may include both a glucocorticoid spray and an oral anti-histamine. 

Utilizing anti-histamines is the general recommendation during allergy season. In individuals with intermittent seasonal allergies and household allergens (pet dander, dust mites, etc.), immunotherapy may be a better fit. Allergen immunotherapy is a low-dose subcutaneous injection of the person’s allergen, with increasing dosages until the immunological tolerance is reached. Some people decide to do one of these therapies or a combination, depending on what is recommended by their doctor. 

Integrative Medicine Protocol for Seasonal Allergies

Addressing seasonal allergies from a complementary and integrative perspective can address the root causes while also providing symptomatic relief. Here are a few key ways to approach this:

Therapeutic Diet For Seasonal Allergies

Creating a lifestyle that reduces inflammation in the body will help mitigate the immune response associated with the release of histamine. An anti-inflammatory diet can help reduce the immunological and gastrointestinal responses associated with histamine. Following this nutrition plan would include eliminating ultra-processed foods, added sugar and artificial ingredients, inflammatory fats, and alcohol. There is an emphasis on vegetables, low-glycemic index fruits, complex carbohydrates, high-quality sourced protein, and omega-3-rich fats. Evidence has suggested that a Mediterranean-style diet can be beneficial for allergies. 

Reducing high-histamine foods or foods that stimulate histamine release can assist in reducing symptoms of seasonal allergies. Fermented foods like sauerkraut, hard cheeses, mushrooms, chocolate, spinach, tomatoes, pineapples, avocados, and leftovers are high histamine-regulating foods, which can add to the already overstimulated histamine release from the allergens. Foods that are low in histamine include fresh fish, poultry, cooked eggs, apples, watermelon, unbleached whole grains, and dairy alternatives like almond milk. 

Best Supplements For Managing Seasonal Allergies

Those who are unable to manage their symptoms through diet alone may find relief through supplementation. 

Quercitin

Antioxidant and anti-inflammatory reach plant medicines are great options for managing seasonal allergies. Quercetin has proven to be an effective product due to it’s ability to suppress pro-inflammatory cytokines, which are part of the histamine release cascade. A dose of 50mg twice a day has shown to be effective in reducing pollen allergy symptoms. 

Ginger

Zingiber Officinalis, commonly known as ginger, has been traditionally and clinically used as a natural anti-inflammatory. An interesting study showed that ginger extract was just as effective as loratadine in those with allergic rhinitis. Both interventions result in reduced nasal symptoms and an improvement in the participants' quality of life. One distinguishing feature was that ginger did not cause adverse side effects, such as fatigue, constipation, and dizziness, that loratadine caused. The dose used in this study was 500 mg daily of ginger extract.

DAO 

There are specific supplements that are geared at decreasing histamine by providing the body with DAO, which is the enzyme needed to break down histamine. If histamine intolerance is part of your seasonal allergy picture, taking DAO may help reduce symptoms. Designs for health makes an easy-to-use product called HistaGest, which provides the body with bovine-sourced DAO. It is meant to be taken before meals to assist in breaking down histamine in foods. The combination of histamine in foods with seasonal allergies could be compounded and benefit you. 

Vitamin C

Vitamin C plays a significant role as an antioxidant and immune-modulating agent in the body. Making sure your vitamin C is optimal can support these biochemical pathways. Studies have shown that both oral and intravenous administration of vitamin C can reduce symptoms of allergic rhinitis. One study found that a dose of 2000 mg/day, with exercise, helped decrease symptoms of sneezing, nasal congestion, nasal itching, and blood flow to the area. 

N-Acetyl Cysteine (NAC)

NAC is a form of the amino acid cysteine. It is a precursor to the “master antioxidant” glutathione. Its primary mechanism of action is thinning mucus that forms in mucus membranes of the respiratory and gastrointestinal tract. Regarding seasonal allergy responses, this can help decrease congestion and mucous build-up. One small-scale study showed that a prophylactic application of topical NAC reduced nasal reaction to the late-phase response to ragweed. 

When To Retest Labs

Once you have addressed the areas contributing to your seasonal allergies, you can retest your allergens and concomitant factors. The Advanced Intestinal Barrier Assessment could help determine if your histamine response and gut health improve. For patients who are consistently improving, retesting may not be necessary. 

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Summary

Functional medicine takes a comprehensive approach, looking extensively at extensive labs that can provide valuable insight into overall health. This type of investigation into your health can complement or replace your conventional medicine approach to seasonal allergies. If you have suffered for years and are looking for a different approach, working with a functional medicine practitioner could be a great match. Through a more holistic approach, they will incorporate dietary modifications and natural evidence-based supplements to address your concerns.