Friday, March 30, 2018

Hay Fever Treatment Alternatives, The What, How and Why – Part I

Spring has sprung and hay fever season is just around the corner in my neck of the woods. This amazingly vibrant time of the year filled with endless rain, beautiful colors and wondrous smells of nature can be a real bear for hay fever sufferers in the Pacific N.W.  Hay fever season, in one form or another, seems to linger here all summer due to the many kinds of grass, trees and weedy plants that can set an individual’s immune system off.

What is a person to do? 

Some give up and move, while others dig their feet in and find methods to relieve the onslaught of pollen. In this series of articles, we will examine some of the common sense methods used to avoid pollen and some other allergens, prevent reactions, as well as treat the reactions to pollen. This first article will look at common sense lifestyle methods to prevent or reduce hay fever reactions. Additional articles will be available in the next couple of weeks covering dietary changes and supplements that help as well as herbal remedies.

Hay fever, also known as allergic rhinitis, it is a type I hypersensitivity reaction mediated by IgE antibodies that are set off by grass, weed and tree pollens. Pollens effects the ears, eyes, nose and throat. The eyes are itchy and watery, the person has a runny or stuffed up nose and the sneezing is obnoxious. It may interfere with sleep, work, recreation, cause a person to feel irritable and may also be associated with asthma and in severe cases induce anaphylaxis in susceptible individuals. Over the long-haul, these seasonal attacks on the person's sensitive mucous membranes may cause structural damage of the respiratory tract and can lead to nasal polyps, and vasomotor rhinitis which can cause nasal congestion all year round as well as repetitive upper respiratory tract infections.

Pollen lodges into the mucous membranes of the eyes, the nose and throughout the respiratory tract. The first time an allergy-prone person meets up with pollen, a white blood cell, called a B-cell is alerted to what it sees as an intruder. This B-cell is transformed into a plasma cell and makes large quantities of immunoglobulin E (IgE) that is specific to recognizing and attacking that pollen. The IgE made for this pollen will attach to mast cells and the next time the person comes into contact with that pollen again, the mast cells with this specific IgE on them will perceive an invasion and release powerful substances called vasoactive amines. The most powerful and the one most talked about with hay fever is histamine. Histamine is synthesized by mast cells, basophils, platelets, histaminergic neurons, and enterochromaffine cells, where it is stored intracellularly in vesicles and released on stimulation. This is what is primarily responsible for the runny/stuffy nose and watery eyes, itching and sneezing. This is an overreaction of the body due to a weakness on the part of the upper respiratory mucosa with an overreaction of the immune system. So support of the upper respiratory system and modulating the immune system are in order.

The mainstream treatments for hay fever involve antihistamines targeting H1 receptors. They have a lot of side effects and some of them with long-term use can actually exacerbate the symptomology. So what is a person to do?


Common Sense Allergen avoidance

Reducing exposure is the smartest idea, although not always practiced. Additionally, decreasing exposure to other environmental allergens, food allergens, sensitivities and toxins in the environment will help decrease the over-all inflammatory load on the body. Decreasing the pollen load starts with simply spending less time outside during high pollen counts. Since you can’t live your whole life inside though, there are some specific actions that will help you feel better during hay fever season. We will get to them after looking at some smart methods of avoidance.

• Keep your doors and windows of your house shut when there is offending pollen in the air.

• Run a good air filter in your house to remove pollen that gets inside.

• After being outside, take your clothes off and immediately put the clothes in the washer. Wash your face. Better yet, take a shower, including washing your hair. Definitely, do not go to bed with pollen on your hair.

• After coming in from outside rinsing your eyes with water is helpful. (Keep boiled cool water available during the hay fever season for this purpose. Make sure it is kept covered and clean. Renew it often.)

• If you are unable to shower or change clothing, even rinsing off your face helps a lot.
Use cold water.

• A cold compress over the closed eyes is beneficial. Better yet, is a cooled, astringent herbal tea compress. If you are unsure how to make a compress, stay tuned and I will post this easy skill soon. You can also find directions in my book Herbal Medicine from the Heart of the Earth on page 361. Most astringent herbs will be helpful but Geranium root is one of my favorites.

• Using a neti pot with salt water to rinse the nasal passages is also helpful. The warm, sterile, salty water flushes out debris and mucus and the salightly salty water also pulls congestion out of the nasal tissues. Isotonic salt water is useful as a general tonic to the nasal passages and will decrease inflammation to the nasal tissues. There are saline sprays available that can also be used in this way. An additional method to get the salt water onto the nasal tissues is to simply pour it into your hand and snort it into each nostril while occluding off the other nostril. See directions below for making a salt water rinse, using it in a Neti-pot, as well as contraindications for using it.

• When driving your car, shut the outside vent off in your car and keep the windows rolled up.

• When outdoors, wear a mask when the pollen is bothersome.

• Do not dry your clothes outside on a line when there is pollen in the air.

• Don’t mow the grass and avoid areas where others are mowing the lawn.

• If you have a yard, choose plants that do not bother you. Remove those that do.

• Pet dander can make you sneeze and wheeze. You may need to keep your pet outside or bathe the pet since it is their dander or skin cells that cause the reaction. At least keep them out of your bedroom at all times. 

• Make sure your house is as free of mold and dust mites as possible or these may add to your reactions. Reducing dust mites is easily accomplished by removing dust in the house. Become a bit of a clean freak. Change your pillow at least once per year and use a pillow protector and clean it often.  Clean your pillowcase and bedding as often as possible. Some people find feather pillows or feather bedding adds to their inflammatory reaction. Don’t put anything from outside of the house on your bed. If your mattress is old, you may need a new one.

• If there is carpet in the house this can be a source of pollen, mold, dust mites etc. If you notice feeling worse after lying on your carpet, you might want to consider a different type of flooring.


Contraindications to Salt Water Rinses/Irrigations

Although salt water rinses can be beneficial to the allergy sufferers during hay fever season, using this method routinely could cause irritation due to the disruption of normal protective mucus and removal of other protective elements. This may increase the risk of sinus infection. So be careful about using it repetitively for prolonged periods of time or adding excessive amounts of salt to the water. Saltwater irrigations should not be used on infants.


Isotonic Irrigation Solution

Isotonic solutions contain enough dissolved solids to match the concentration of solutes dissolved in the blood. An isotonic solution is considered to be 0.9% salt. You can add 9 grams sodium chloride dissolved in one liter of sterilized water for an isotonic solution. Nasal irrigation should not be attempted with tap water or distilled water. Sterility is essential for safety, and salt prevents the uncomfortable burning sensation associated with the use of non-isotonic solutions. Boiling the water should suffice to sterilize it. Although many people use isotonic solutions for general irrigation of the nasal mucosa, sometimes a hypertonic solution is necessary to remove mucoid secretions of long standing such as in chronic sinusitis. In these cases people often use a 5-percent saline solution, which is stronger than what I am advocating for general rinsing here.


How Neti pots are Used

Fill the neti pot with sterilized isotonic water. Lean over the sink and turn your head 45 degrees, so one nostril is above the other. Gently insert the tip of the pot into the upper nostril. Breathe through your mouth and raise the handle so the water enters the upper nostril and then drains from the lower nostril.

When the neti pot is empty, exhale through both nostrils to remove excess solution and mucus. Gently blow your nose.

Repeat with your other nostril.

Look for the next part of the Hay Fever Series. It will cover additional supportive lifestyle changes with a focus on dietary suggestions to decrease histamine and inflammation. Sign up for the email list or on blogger to get the next Hay Fever Series installments automatically.



The Other Hay Fever Blogs
Hay Fever, The What, How and Why - part I
Hay Fever, The What, How and Why - part II
Hay Fever and Diet 
Prevention with herbs
Treating The Acute Situation