Sunday, April 8, 2018

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

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Preventing Hay Fever Reactions

The hay fever reaction is due to the immune system identifying pollen as a threat and using the immune system in an all out attack in an attempt to protect the body from the offending pollen intruders.

Supporting healthy respiratory tract tissues and calming down the immune system is key in preventing an explosive reaction that can irritate these sensitive membranes. There are some general behaviors and lifestyle practices that will assist the person with hay fever in living a more comfortable life. You may be surprised to find out that following this simple list I provide below will help tremendously. Dietary and lifestyle changes often negate the use of medicine, herbs or supplements or at least decrease the need for them.

Support the Respiratory System Through Healthy Lifestyle Practices

Eat a nourishing diet of organic foods. General good nutrition that emphasizes antixoidant status and lower inflammation has been shown to be supportive of respiratory health and mucus membranes in general.
• Consume plant polyphenols in  food, herbs or drink. (These are the brightly colored foods.)
• Avoid allergens or food sensitivities and chemicals in food.
•Eliminate the source of chemical sensitivities in your environment.
• Discontinue recreational drug use.
• Decrease prescription drug use as much as possible, under the guidance of a practitioner.
• Do not smoke anything.
• Stay away from passive smoke.
• Get adequate exercise.
• Get adequate sleep.
• Rest and meditation/prayer (This will amazingly quiet the over-reactive body.)
• Drink 6-8 glasses of clean water each day. 
• Breath clean air. Avoid air born toxins such as from mold, volatile organic compounds etc. 
• Get sunshine and if there is lack of sunshine, supplement vitamin 
• Enjoy the benefits of massage and hydrotherapy.
• Include joyful activities in your day and avoid bad attitudes.
The Gut And Digestion Is A Key Factor

Provide probiotics and feed your commensal gut bacteria with prebiotics if needed. There may be altered gut flora from antibiotics, chemotherapy, infectious gastroenteritis or other causes of dysbiosis. In these cases probiotics are almost always helpful. It is imperative that you have healthy gut flora. An inflamed gut ads to inflammation all over the body and will worsen hay fever reactions.

My first choice is to use live fermented foods but since many of them contain histamine, and some allergy sufferers may be bothered by high histamine foods, I would say, try the fermented foods, but be aware if you react to them, it may be due to histamine content in the food and if so, you should avoid them during allergy season and use probiotics as an alternative choice.

Stimulate or replace digestive juices if needed. If the person is not digesting foods due to a lack of enough acid, bile or enzymes, they may not have the necessary nutrients to build resilient respiratory tract mucous membranes, or to make adequate enzymes necessary to degrade histamine. This means hay fever season becomes more daunting. The cause of the person’s lack of appropriate digestive juices needs to be found and addressed, but in the mean-time they may need to take bitter herbs to stimulate their digestion or they made need to replace some key digestive substances with hydrochloric acid and pepsin or pancreatic enzymes or ox bile. Each situation is unique and these digestive helpers are only replaced when needed and only until the cause of their lack is unearthed and remedied. There are tests that can help pin point the causative issues. See your local naturopath or functional medicine practitioner for specific guidance.

The Relationship to histamine and Food

Remove histamine foods if needed. The person with hay fever may find there are foods that do not usually bother them that become problematic during hay fever season. If they react to certain foods, they should stay away from them as these foods will add to the inflammatory burden.

The immune system uses histamine as part of its defense method. It allows people to deliver nutrients and oxygen via the circulation to various areas. It helps you pay attention, digest your food and move your bowels as well as enhances exercise.  However, the poor allergy sufferer has an abundance of histamine being generated in their upper respiratory tract. Generally our body makes enzymes that degrade the histamine as soon as it has done its deed. However, if you do not make an adequate amount of enzymes or if your body is overzealous in its creation of histamine you end up on over-drive. Although not studied enough, it has been noted by some individuals with hay fever that eating foods high in histamine adds to their hay fever reaction.(Yes, even though the food is eaten and not inhaled.)  The ingestion of histamine-rich food or of alcohol or drugs that release histamine or block Diamine oxidase (DAO) or histamine-N-methyltransferase (HNMT)   may provoke diarrhea, headache, rhinoconjunctival symptoms, asthma, hypotension, arrhythmia, urticaria, pruritus, flushing, and other conditions in patients with histamine intolerance. Therefore, it would behoove all hay fever sufferers to learn which foods cause histamine reactions and note if these foods may be adding to their symptoms. If so, avoiding these foods can make their life more enjoyable. (I would also point out here that monoamine oxidase is also involved in processing histamine and it requires vitamin B2 (riboflavin and iron).)

More Details on histamine & diet/digestion

All foods considered to be high histamine should be suspect as they can add fuel to the fire going on in your body. You are reacting to histamine released by your immune system and high histamine foods will bother you if you run out of one or both enzymes (usually diamine oxidase or DAO). Histamine can be metabolized in 2 ways: by oxidative deamination by DAO (former name: histaminase) or by ring methylation by histamine-N-methyltransferase (HNMT). DAO is released into the circulation and  is concentrated in the small intestine where it neutralizes the histamine in food or histamine made by some gut bacteria from histidine in your food. HNMT breaks down histamine in an intracellular level and is found in high levels in the liver and kidney and is important at breaking down histamine in the nervous system. HNMT is also important in the airway, where it protects against histamine in these tissues, including the bronchial epithelium where it protects against histamine induced asthma. Most people make plenty of these enzymes to take care of the incoming histamine, however some people do notice eating these high histamine foods can make them much worse during hay fever season, so take note if you are one of  them. We could theorize why this might take place such as the body running out of the necessary nutrients to make the enzymes that degrade the histamine, or they might have a decreased ability to make these enzymes for genetic reasons or they might just have to much histamine over all for the body to keep up period.

There are both foods high in histamine as well as foods that compete for the same enzymes needed to degrade histamine and foods that trigger mast cell release of histamine. All these categories will add to the histamine load and inflammation in the body for people who are sensitive. Foods high in histamines include alcohol (think red wine, beer), aged meats, spoiled meat, shellfish and fermented products Then there is the fact that histamine is made from the amino acid histidine. A carboxyl group is removed from the amino acid histidine and it becomes histamine. Some bacteria and yeast can change histidine in foods to histamine, which is why fermented foods containing protein can be high in histamine. Some gut bacteria can turn histidine in foods into histamine also. This means a person with dysbiosis (gut bacteria imbalance) may end up making histamine from any high protein food containing histidine. Such foods are beef, bison, pork, parmesan cheese, pork, chicken, turkey, lamb, soy, fish such as tuna, catfish and to a lesser degree seeds, nuts and beans and even lesser degree, grains. Here is a list of foods high in histidine. Note that some cuts of meat are lower than others from the same animal.

There are also some foods that trigger histamine release from mast cells. These include fruits such as chocolate, nutes, shellfish, bananas, tomatoes, kiwi, lime, lemon, pineapple, papaya and plum. Additionally some additives such as MSG, sulfites, nitrites, benzoate and artificial food colorings can increase histamine reactions in the body.

There are some drugs known to block HNMT.

    • Chloroquine (Amodiaquin, an antimalarial))

    • Chloroguanil

    • Folate antagonists such as metoprine (HNMT requires folate for activity)

    • Hydroxychloroquine

    • Pyrimethamine

    • Promethazine

    • Tacrine (anticholinesterase, early Alzheimer’s drug)

DAO deficiency is associated with low B6 and copper deficiencies.

Besides avoiding high histamine foods or foods that induce histamine release, some people take DAO with their meals.

For people who have been diagnosed with histamine intolerance, there are all sorts of things that can be done to support them. Besides making sure the person has the nutrients for DAO, MAO and  HNMT, as well as taking DAO with meals, bifido bacteria (helpful probiotic that does not increase histamine - take after dinner and away from anti-microbials), Fish oil to stabilize cell membranes and decrease inflammation/histamine leakage from mast cells, vitamin C to also stabalize mast cells, phosphatidylcholine to support cell wall membranes, creatine if methylation is not up to par as HNMT won’t work well with decreased methylation (most of your methylation activity goes to produce phosphatidylcholine and creatine, so supplementation helps decrease need for methylation if that is an issue for the individual) 

A study found mung bean sprouts (48 hours of sprout growth) provided significant protection against mast cell degranulation and histamine release due to their high flavonoid content.

There are many herbs that stabalize mast cells and keep histamine from being released. They are discussed in part 5 of the hay fever blog.

If the person has an irritated gut from excess histamine, you may need to consider demulcent herbs to soothe irritation or inflammation such as Licorice, Marshmallow, Calendula, Slippery elm, and Plaintain. Gut healing nutrients such as glutamine, zinc, vitamin A, acetyl-l-carnitine, and alpha lipoic acid help to heal the gut also. If there are pathogens found on testing, they must first be dealt with or no amount of healing activity will give persistent relief. For help with gas and bloating, Ginger, Peppermint or other carminative herbs can bring relief.

Next time, in part III we will look at general dietary measures and specific nutrients that can be used to support the gut and the upper respiratory tract and decrease hay fever symptoms.

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 

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