Saturday, June 2, 2018

Herbs Used For Hay Fever - The Acute Situation

We examined herbs used to prevent hay fever in the part four hay fever post. These same herbs that were used to prevent hay fever can continue to be used through-out hay fever season. In general, they are not herbs that provide immediate instantaneous relief, but they will help alleviate hay fever symptoms when used over time during hay fever season. If used ahead of time and then used during hay fever season (or similar herbs), an individual will often find a great relief of symptoms and some people will find they disappear.  These are supportive herbs and will serve as a source of necessary nutrients and organ trophorestoratives. Some forms of the herbs indicated for an individual should be continued through-out hay fever season on a daily basis, along with life-style and diet changes. Additional herbs are taken for acute symptomatic relief if needed.

The strengthening and long term herbs to consider continuing, as needed by the individual, would be immunomodulating herbs, liver and digestive herbs, adaptogens and nervous system herbs as well as herbs used for general respiratory support. Not all of these will be necessary. It will depend on the needs of each individual.

The acute herbs that are used for hay fever are generally anti-inflammatories, anticatarrhals, astringents and sometimes expectorants.


Herbs for Acute Assistance

Anticatarrhals

Anticatarrhal herbs are almost always thought of in relation to hay fever. They are considered when there is congestion, and the mucus gets out of hand. The respiratory tract makes mucus to protect the body from pollen. It becomes thin and excessive in order to remove the pollen. In the bodies attempt to protect an individual from an invader, it overreacts to the situation. The excessive mucus is annoying and when the irritation continues, the tissues can become very inflamed and edematous, causing congestion.

The groups of herbs used as anticatarrhals decrease congestion by a variety of methods. Anticatarrhals are generally anti-inflammatory, expectorant and/or astringent in nature. When focusing on acute relief of hay fever we are generally looking at herbs that are astringent and anti-inflammatory. Decreasing inflammation sounds pretty straight forward, but what does it mean to astringe a tissue?


Astringents – Defining An Astringent And How it Works
  
Astringent herbs have a drawing and drying effect. They decreases congestion and rid the area of excess edema, inflammation and mucus. When used topically on mucous membranes they cause contraction of the mucous membranes, thus causing expulsion of excess fluid and mucus.  Astringents can give acute relief from flaccid, boggy or edematous tissues by this secretion restraining and tissue constricting activity. This astringing action is due to the tannin content in the herb.


Because mucus is a natural and necessary body defense, mucus should not be stopped unless it is chronically in excess, and the cause can’t be eradicated, such as may take place acutely with hay fever.


When a person with congestion and mucus ingests an astringent herb, they will usually notice their nose and sinuses open up. The mucus decreases and their breathing becomes easier.  For acute use, when an individual wants instant effect, I often use yarrow. It is both anti-inflammatory and super astringent. It works quickly too. I usually have people put a few drops of Yarrow tincture under the tongue and it works almost immediately. However, Yarrow is contraindicated for long term use or in large doses. Other anticatarrhal herbs that can be used are Oregon grape root, Geranium root, Hawthorne flowers/leaves and berries, Ladies mantle leaves, Yerba mansa root, Calendula flowers, Strawberry leaves or Raspberry leaves. These all provide astringency and help decrease edema and inflammation. Which herb or herbs to pick depends on other needs of the individual. 


Another way to open up the nasal passages and sinuses is to use a stimulating herb such as horseradish or wasabi. You can also use steam inhalations to open the airways. Steam inhalations with herbs high in menthol such as peppermint are useful in keeping sinuses open. If infection is a concern, an antimicrobial herb such as Oregano or Thyme can be added to the steam inhalation.

  
Astringent herbs can also be used for irritated and inflamed eyes.

A cold compress over the closed eyes is beneficial. A cold, water compress is helpful, but even better is a cooled, astringent herbal tea compress. If you are unsure how to make an herbal compress, see this post on making them. Calendula is wonderful as a compress for inflamed eyes. Geranium can be added if the individual wants even more astringency. Keep the tea or tincture a bit on the diluted side as the eyes are delicate organs. You can also use them in an eye cup and wash the eye. Make sure you use sanitary methods when washing the eyes with any type of liquid. Be aware that if you make the wash too strong it can become irritating rather than healing.

Inflammation

Congestion is caused by inflammation, so ingesting anti-inflammatory herbs to decrease histamine, cytokines and other causes of inflammation is highly beneficial. Decreasing  systemic inflammation and local inflammation are both important.

Local inflammation in the nasal passages can be decreased with vulneray & astringent herb washes that are applied with a neti pot or similar methods. (Directions for neti pot here.)  The same combination previously mentioned as an eye-wash can do double duty as a nasal wash. I am referring to the use of Calendula, with the possible addition of Geranium for extra astringent activity.

There are many choices of herbs that are used internally to decrease inflammation associated with hay fever. I will share some of my favorite anti-inflammatory herbs below.


Anti-inflammatories

Some anti-inflammatory herbs to consider would include Licorice – Glycyrrhia spp., Calendula – Calendula officinalis, Marshmallow – Althaea officinalis, Peppermint – Mentha piperita, Turmeric – Curcuma longa, Yarrow – Achillea millefollium, Yucca – Yucca spp,  Forsythia Forsythia suspense.
 .
Yarrow Achillea millefolium - Reduces congestion and excess secretions. This is a wonderful herb to use acutely for any kind of nasal, or sinus congestion. It works great for acute hay fever as well as other acute forms of rhinitis and sinusitis. It can be a life saver. Just a few drops of tincture on the tongue and in seconds nasal passages are clear and sinuses are better.  I usually give this as temporary, acute, quick fix. Yarrow is not an herb for chronic use but short term use can be very helpful.

Yerba mansa – Anemopsis californica – Another herb that will reduce congestion and excess secretions in the upper respiratory tract. This is a warming herb while the yarrow I mentioned is more cooling. Yerba mansa has a pungent and pleasant taste, while Yarrow has a bitter taste.

Calendula – Calendula officinalis is soothing and healing. When nasal tissues are raw and, friable, crusty, or otherwise super irritated and healing is needed, this anti-inflammatory/vulneray/astringent can be used as a wash to assist the body in creating new, revitalized nasal tissue. It is also anti-inflammatory when ingested.

Licorice – Glycyrrhiza glabra/spp. Previously, in part 4, I shared how Licorice is used for liver support. Review this for additional data.

The constituent glycyrrhizin and it’s active aglycone glycerrhetic acid have been shown to inhibit several features of the allergic inflammatory response including histamine synthesis and release.

In Japan, glycyrrhizin has been used as an injection for allergic inflammation since 1948.
Licorice helps retain moisture in the body which is good for allergy sufferers who tend to be dry from excess loss of fluid, always thirsty and pee a lot. However, for someone with edema or high blood pressure, or chronic kidney failure this is an herb that would not be good for them.

Licorice in general helps decrease inflammation.  For this reason you will see it used in many herbal formulas. It can be used as a tea, as a capsule, as a tincture or powder. One cup of tea 2-3 times per day or 20-60 drops of tincture 2-3 times per day should be good for people who do not have any predispositions to side effects from Licorice.

Make sure you look up the side effects of Licorice, in case this herb is not appropriate for a given individual. The extensive list of side effects can be found in my new book, Herbal ABC’s as well as “Herbal Medicine From theHeart of the Earth”. You will also find various lists on the internet.

Turmeric – Curcuma longa This herb was also discussed for liver support in the hay fever prevention blog. It is used by many people for active hay fever symptoms and if taken every day can be very beneficial. It can be used liberally in food or taken in a capsule. It can also be used as a powder. Two teaspoons - One tablespoon, 2 times per day of powder should do the trick. It needs to be followed by a water chaser, and most people I admit will get tired of the taste. Often people add it to food and take capsules rather than the straight powder. The powder is much less expensive though. In food it works well as a curry, sprinkled on many different foods or the powder can be mixed into shakes, smoothies, or honey.  A nice tea with ginger can be made with turmeric. This tea is a great anti-inflammatory combination. The Ginger in the tea has been shown to lower IgE levels in people with hay fever. The longer people in the study took the ginger capsules the better the outcome. Many of the hay fever symptoms were significantly reduced.

A 2015 research study with an active constituent of Turmeric called curcumin was used in the nose of mice prior to exposure to lipopolysaccharide (causes an allergic response) showing, the curcumin had a protective effect, decreasing the airway irritation. Additionally, I found another study where the absorption of curcumin was studied in an intranasal application in mice, where they examined the amount of absorption and found it had good absorption and at doses lower than the drug disodium cromoglycate effected histamine release. Curcumin usually has poor absorption by itself so, the researchers were delighted it absorbed better nasally. It made me wonder if using Turmeric or curcumin as a neti pot wash to irrigate the nasal passages and reduce inflammation would be helpful, however it can stain the skin temporarily so this may never become a popular vehicle of application. Perhaps snorting the powder might also work but may still stain the skin. Let me know if any of you have experimented with an intranasal application of turmeric for hay fever relief. I would love to see a comparison of the Turmeric powder with the curcumin powder.

Turmeric’s constituent curcumin, has been shown to reduce histamine as well as decrease other avenues of bodily inflammation. Many people take the constituent curcumin by itself. One product that I have used with good results is called Meriva. Curcumin has been shown to have low solubility, be poorly absorbed by the intestines and have low systemic bioavailability. Another constituent in Turmeric called turmerone has been shown to facilitate absorption. (Once again proof of the whole herb being better than individual constituents).  Piperine in black pepper appears to make curcumin much more bioavailable. One of the ways the piperine helps is by decreasing glucuronidation. Glucuronidation is a pathway used to remove toxins, and as I explain in my book, "Herbal ABCS's" this may have repercussions. I am not comfortable with taking piperine or large doses of black pepper on a chronic basis.

I would also point out curcumin has been shown to be heat sensitive in research. It can start to disappear when temperatures are above 190 degrees C. 

Often anti-inflammatory herbs used for hay fever turn out to lower histamine or prevent the release by stabilizing mast cells. I thought I would share some methods to do this.

Mast cell stabilization

During hay fever season it is helpful for many people susceptible to pollen reactions to limit foods with high histamine content as well as foods/supplements/drugs that may increase histamine. See hay fever blog part II. 

Foods high in flavonoids are able to assist in decreasing mast cell activation and reduce histamine in the body. The individual should be eating high flavonoid foods continually through-out hay fever season as an additional long-term plan to decrease hay fever symptoms by decreasing histamine and lowering of other inflammatory mediators. These flavonoids include quercetin and catechin which are found in herbs such as Green tea, Chamomile, Hawthorne and Gingko. Quercetin is found in many foods/herbs and some good choices for quercetin content are garlic, onions, capers, fruits with dark red or blue colors such as blueberries and cranberries.  Elderberries are high in quercetin as well as Lovage and kale. Quercetin’s anti-inflammatory activity appears to be due to its antioxidant effects and inhibition of cyclooxygenase and lipoxygenase, which in turn regulate the inflammatory mediators leukotrienes and prostaglandins. Quercetin has been shown to stabilize mast cells, which inhibits release of histamine.

Some of the constituents found in herbs that have been studied and found to stabilize mast cells besides quercetin are listed below.

Epigallocatechin gallate found in Green teaCamellia sinensis can inhibit the release of histamine from mast cells. 

Theanine is another constituents found in Green tea - Camellia sinensis. This amino acid has been shown to prevent histamine release from cells at low concentrations.

Ellagic acid found in fruits such as raspberries, strawberries, walnuts and pomegranate  inhibit histamine release as well as proinflammatory cytokines such as TNF-alpha and Il-6.

Khellin from KhellaAmmi visnaga has been shown to stabilize mast cells. This is also an herb that is used to prevent Asthma attacks. I have found it especially useful in the past for exercise induced asthma. For some people hay fever can lead to an asthma attack. Much better to control hay fever with long term herbs that support the liver and digestion rather than acute use if herbs or even long term use of Khella. (Khella is not an herb that is used for immediate relief, and high doses may cause side effects such as liver damage.)

Silibinin from Milk thistle- Silybum marianum prevents histamine release as well as other inflammatory cytokines from mast cells.

Reservatrol found in Japanese knoteweed - Polygonum cuspidatum, grapes, peanuts, and blueberries, was found to suppress inflammatory cytokines linked to mast cell disorders, specifically tumor necrosis factor and interleukins.

Curcumin from TurmericCurcuma longa prevents release of histamine by stabilizing mast cells and inhibits  cytokines IL-4 and TNF-alpha.

Parthenolide from FeverfewTanacetum parthenium stabalizeds mast cells.

Indoline from  Woad - Isatis tinctoria stabilized mast cells

Estragole from Basil Ocimum basilicum reduces inflammation due to edema and arachidonic acid

Additional foods/herbs that might be useful to stabilize mast cells/decrease histamine release are Holy Basil, Thyme, Watercress, Pea sprouts, Onions, Garlic, Black cumin, Peppermint, Chamomile, Tarragon, Nettle, Ginger, Turmeric, Apples, Pomegranate, Peaches, and Quince.

Remember these are all ideas for acute relief when the individual is in the thick of hay fever season. It is better to start a couple months prior and make sure the body is in good shape and less likely to need acute assistance.

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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