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Seasonally Well

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After a long cold winter, springtime is most welcome—except for those who endure allergy symptoms.

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“So, what brings you to us today?” you ask. “Um, I really don’t know … but I’m sneezing a lot and my throat is scratchy … and my head is stuffy…” stammers your client/patient. The calendar may help pinpoint what’s going on here. But if you are practicing for awhile, you know how confused your client/patient can be if springtime allergies are somewhat new to him or her. After all, it could be a nasty cold, or, as the recent and ongoing pandemic can make one wonder if it’s COVID-19.

Bringing up springtime allergies as a possibility may also elicit a declaration of, “I’ve never had allergies before!”

Health psychologist and author Nicole Avena, PhD, explained, “Within the past five years there’s no doubt that outdoor allergies are becoming more prevalent, most likely due to our environment. With a slight increase in temperatures, increased CO2, and longer duration of tree pollen season with greater quantities, the prevalence of allergies is surely affecting many more Americans now than in the past few years. Naturopaths may expect prolonged allergy symptoms from patients/clients for the late spring of 2023 as the pollen season may last longer than years past,” she predicted.

Pennsylvania-based Boiron research shows that the pollen season is starting much earlier and lasting longer than it had in the past, according to Product Manager Haley Washington. Nationwide pollen amounts have increased with the greatest numbers recorded in Texas and the Midwest, mostly attributed to tree pollen, she reported.

Indeed, validated Hank Cheatham, vice president, California-based Daiwa Health Development, rising temperatures from climate change are causing the spring allergy season to start earlier and last longer in many regions of North America, according to a report released recently by Climate Central, an environmental research organization.

“Seasonal allergies alone can often be complex,” commented Daina Parent, ND, naturopathic liaison, Standard Process, Wisconsin. “There have been many changes over the past several years that influence how the immune system interacts with the outside environment. These changes include the environment itself as recent research suggests that levels of pollen have gradually increased over time due to changes in climate. This could lead to significant allergy and respiratory impact for many patients and individuals.”

Liz Smith, RN, co-founder, Natural Path Silver Wings, Tennessee, believes that ever-increasing air impurities and generational processed food exposure have impacted the immune systems in a much higher percentage of the population versus years past. She explained, “With so many airborne impurities, chemicals, additives, fillers and ingredient substitutes, our bodies are simply puzzled trying to digest needed nutrients all while filtering out harmful ingestibles.”

An allergy is a vigorous immune response to relatively benign substances (e.g. pollen), and noted Cheatham, those who have allergies are genetically susceptible to them and their allergies are also exacerbated by nutritional and environmental influences. “While heredity has been emphasized in the past, it is clear that genetics alone cannot account for the worldwide increase in asthma and allergy prevalence,” he said.

Cheatham added that the International Study of Asthma and Allergies in Childhood and the European Community Respiratory Health Surveys have shown some striking patterns. Asthma is more common in Western countries than developing countries and has increased in incidence in developing countries as they become more “Westernized.” This trend seems to be showing that the environment and lifestyle in Westernized countries encourage the production of allergies in the population.

Smith commented, “Over the past few years, the harmful substances (pollutants, chemicals and additives) have increased the effects of allergies to a broader range of the population.”

Practitioner Jaquel Patterson, ND, MBA, IFMCP, founder and medical director, Fairfield Family Health (Fairfield, CT), observed that this winter has been somewhat mild, which is likely to increase the severity and duration of allergies. Further, “this past year many have also been impacted by several viruses. Researchers have written, ‘viral respiratory infections can initiate, maintain and activate exacerbation of allergic conditions in respiratory tract.’ There are both innate and inflammatory responses to these acute infections which play an intricate role with allergic reactions.”

The COVID Factor

Beyond being confused about symptoms pointing to either a cold or allergies, your client/patient population now worries about their symptoms being the start of COVID. While they can, of course, perform at-home testing if they want, the specter of that illness may likely weigh heavily upon those who are susceptible to springtime allergies. For example, they may fear that they may be more susceptible to it.

“This is a common question that comes up with patients in discerning the difference between an allergen and cold,” observed Dr. Patterson. “Coughing, sneezing, runny nose and fatigue are common shared symptoms; allergic coughs tend to be dry, less productive and they will rarely have a sore throat. Allergen sufferers are also more likely to have itchy eyes or ears; and they are unlikely to have a fever, or body pains compared to a cold. There will be a clear periodicity for allergies during certain times of year and symptoms will often last a few weeks longer than the average cold.”

Christophe Merville, DPharm, director of education and pharmacy development, Boiron USA, reassured, “There is no evidence that COVID interferes significantly with an allergic response based on the differences of biologic processes. People who have COVID will not be affected by allergic pollinosis, as these symptoms are mild compared to COVID symptoms. There are a few studies that seem to show that people affected by allergic rhinitis are protected against COVID, to a certain extent, probably because their nasal mucosa is already teaming with cytokines, and immune cells, or simply covered with a thicker mucus.”

According to Cheatham, while some spring allergy symptoms overlap with COVID symptoms, there are some simple ways to help your clients/patients discern the difference. Spring allergies rarely cause breathing problems, though a person may be at higher risk if one has asthma or another respiratory condition. COVID symptoms also include: new loss of taste or smell, fever, nausea, vomiting, diarrhea, muscle/body aches and fatigue.

According to Dr. Avena, allergies also tend to follow a pattern of symptoms and may last longer—your clients/patients may experience itchiness of the eyes, throat or nose, without a fever. Compared to a cold where eyes may be watery, runny nose, sore throat but no itchiness present, and fevers are rare but possible.

However, recent research apparently has linked pollen counts to higher cases of COVID. “A recent study published in the Proceedings of the National Academy of Sciences showed an increase in coronavirus infections in areas that saw a spike in pollen,” reported Cheatham. Researchers found that COVID transmissions increased in areas around the world—the study used data on pollen concentrations from 31 countries across 5 continents—and saw an up to 30 percent increase.”

He added that the researchers stressed the virus does not spread specifically from the pollen. While they did not give a firm conclusion as to why there was an increase, one theory put forth is that allergy season simply causes people to sneeze and cough more, and also some allergies can weaken the immune system, increasing susceptibility to colds and other viruses.

“The body has to work harder to counterbalance the negative effects of the allergy,” Cheatham commented. “This concern over possible compromised immune response does not mean people concerned with contracting COVID should avoid the outdoors during allergy season, but simply continue following mask guidelines, washing hands and social distancing.”

Dr. Avena added that there is compelling evidence from the Journal of Allergy and Clinical Immunology to suggest that cold exposure through the nose may affect seasonal variation of respiratory infections, including seasonal allergies. “Hopefully in 2023 we will see advancing research for therapeutic agents to combat this finding, as allergy season follows the cold winter months,” she remarked.

Key Products to Recommend

There are, of course, numerous dietary supplements and homeopathic remedies to recommend to your clients/patients. Among them, Dr. Avena likes the Zicam family of products, because of the zinc, an element she feels is superb at supporting the immune system during times when symptoms make their very first appearance.

Wisconsin-based EuroMedica’s Quercetin plus Vitamin C supplement is an “excellent addition to allergy-focused regimens and offers excellent overall immune support. Quercetin has been a favorite with practitioners for some time now,” described Cheryl Myers, chief of scientific affairs and education.

Quercetin, a flavonoid polyphenol compound found in apples, grapes, onions, teas, tomatoes and various herbs, can have notable immune-strengthening and allergy-relieving effects. Myers explained that studies show that pretreatment with quercetin is a viable way to stop viruses from replicating and in some research, it has effectively blocked H1N1 within 48 hours. Other in-vitro work found that quercetin inhibited rhinovirus replication within 24 hours. Other laboratory research has found that quercetin reduces bronchial inflammation and moderates the immune response to prevent it from going into overdrive. “Quercetin is considered a valuable natural antiviral in cases of influenza A virus, and most likely, can help stop many others as well,” she reported.

Quercetin activates T-helper cells (Th-1) that produce interferon-gamma (INF-y), a cytokine that, in turn, activates macrophages that hunt down and destroy viral and bacterial invaders. Quercetin also balances Th-2 cells to keep the immune responses helpful, and not too severe.

For allergies, quercetin inhibits mast cell and eosinophil activation (which otherwise trigger allergic symptoms), reduces histamine release, relaxes the trachea, and reduces inflammatory compounds in cells that line the inside of the lungs. It can balance the production of immunoglobulin-E (IgE) production in the lymph nodes, preventing—or least moderating—the inflammatory effects of IgE in tissues throughout the body.

In another scientific study, human peripheral-blood CD4+T cells were treated with quercetin for 24 hours. Those treated cells inhibited IL-5 and IL-13 production by suppressing their transcription and mRNA expression, so quercetin addressed causal factors behind allergic reactions, rather than simply suppressing symptoms.

Vitamin C, Myers explained, modulates allergic or immune responses. Its ability to scavenge cellular reactive oxygen species (ROS) allows it to intercept or preempt the ROS-required signals that fire up pro-inflammatory cytokines.

“With its multitude of duties, vitamin C is in high demand by tissues throughout the body, a consistent dosage of at least around 200 mg per day may be ideal for immune responses,” she said. Additionally, any client/patient entering an allergy season may want to consider adding that level of vitamin C to their regimens before they notice allergy symptoms start so they may prep the system for the challenges ahead.

“Interestingly, quercetin and vitamin C appear to work better as a duo than they do individually,” Myers emphasized. A randomized, double-blind clinical study found that a combination of quercetin and vitamin C was more effective in reducing C-reactive protein levels and the inflammatory marker IL-6, than either nutrient used alone. The individuals in this study were non-professional athletes who, in the course of their workouts, typically generated a lot of free radical activity that could result in oxidative and inflammatory damage. Granted, that particular work was far afield from allergy concerns, but I think it illustrates a good point about the duo of quercetin and vitamin C working together as supplemental nutrients, probably much the same way they do when found in foods.

As to why both nutrients worked better together than they did separately, one answer may be in the way that vitamin C regenerates quercetin. Once quercetin becomes oxidized during its work in the body, it splits into metabolites which can be recycled as quercetin again and return to the bloodstream to prevent free radical damage once more. This is one way that vitamin C can help make quercetin more bioavailable. But it’s not the only way—quercetin can also benefit from an added push to make it more bioavailable with gamma cyclodextrin.

Gamma cyclodextrin is an oligosaccharide that envelops fat-soluble nutrients in an open-ended microscopic structure, which has been described as bucket-shaped, or as a truncated cone, Myers described. The exterior of this molecule is water soluble, which allows it to escort ingredients through intestinal walls for better absorption. “Essentially, it gives a fat-soluble nutrient the absorption qualities of water-soluble one. That is why we combine our quercetin with GammaSorb in this supplement, for (as the label says) ultra absorption.”

Daiwa Health Development provides BRM4, shown in clinical research to increase the activity of the natural killer (NK) cells, according to Cheatham. Besides being the first line of defense in immunity and eliminating antigens, NK cells have anti-inflammatory properties that help to relieve allergy symptoms and respiratory issues by reducing inflammation.

The active ingredient in BRM4 is Rice Bran Arabinoxylan Compound (RBAC), which Cheatham said can reduce the symptoms of allergies. It achieves this, he said, through its anti-inflammatory property and by suppressing the degranulation of mast cells, the storehouses of histamine, which causes the symptom of allergy.

He reported that a study completed at Hamamatsu University School of Medicine, Japan, found that RBAC suppresses the allergic response in asthmatic mice and helps improve the respiratory function. Allergic diseases and symptoms occur because of an overactive immune system that reacts to things that are usually harmless such as pollen, pet dander or food. He explained, “Since RBAC is a true immune modulator, it will bring an overactive immune system into balance thereby reducing the immune response to the allergy triggers. For example, many people have reported taking antihistamines during ‘hay fever’ season. Since they began taking BRM4, however, their allergy symptoms have been reduced significantly, and they were able to stop using antihistamines.”

Colloidal silver, said Smith, may also be considered for your clients/patients concerned about alleviating allergy symptoms in springtime. Natural Path Silver Wings’ Colloidal Silver is an elemental mineral that provides a broad-spectrum immune support. The product is a mixture of pharmaceutical grade, ultra-fine silver particles suspended in pure water. “Colloidal silver supports the effectiveness of the body’s inflammatory response. It charges the immune system for a more efficient response time.”

Smith added that dosing recommendations include 50 ppm suitable for year-round daily immune maintenance and in cases of allergies or other immune impacts, doses of 250 ppm and 500 ppm can help support resilience.

Boiron’s AllergyCalm is a multi-symptom formula made from homeopathic medicines traditionally used for symptoms caused by airborne allergens that affect the eyes, nose and throat. It is not meant for food allergies or allergic reactions of the skin, described Washington. Non-drowsy AllergyCalm meltaway tablets targets specific symptoms of hay fever or other upper respiratory allergies and work best when taken at the first sign to relieve itchy, watery, burning and irritated eyes; sneezing; runny nose; and itchy throat and nose.

Allergy support can also be managed by supplementing with vitamin A. “Vitamin A supports the body’s ability to handle environmental challenges and helps maintain healthy mucous membranes,” said Dr. Parent. “It also supports lung and respiratory function.”

Allerplex by Standard Process contains vitamin A in a blend of ingredients, such as Pneumotrophin PMG, Drenatrophin PMG, Cataplex A-C, Betacol and Antronex, as well as herbs such as alfalfa, buckwheat and fenugreek, grown on Standard Process’ certified organic farm.

AllergCo by MediHerb (available from Standard Process) was launched in 2021 and contains albizia, Chinese skullcap and nigella, known to support a healthy response to seasonal stresses and maintain normal respiratory tract function, according to Dr. Parent. “The herbs in this formula have been traditionally used in herbal preparations to help the body respond normally to occasional seasonal stressors, maintain skin and immune system health, and assist in maintaining healthy breathing passages to support normal breathing,” she explained.

According to Vanessa Pavey, ND, education scientist, Florida-based Life Extension, one of the trends she has seen recently is a growing interest in the role of dried yeast fermentate (a fermentation process of S. cerevisiae) in promoting a healthy immune response during times of seasonal challenges. Dried yeast fermentate appears to work by promoting NK cell activity and encouraging the production of secretory IgA.

For example, in a clinical study of people with a history of seasonal allergies, participants took 500 mg of dried yeast fermentate once daily or placebo for 12 weeks. The first half of the 12-week study took place during the year’s highest pollen-count period. Compared to the placebo group, the yeast fermentate group had a median of 43 percent fewer days with nasal congestion.

In an eight-week study, healthy subjects given 500 mg of the yeast fermentate daily had significant increases in secretory IgA levels, Dr. Pavey reported. “Although starting early in the season is ideal, there is one study showing more rapid results. When given a single 500 mg dose of dried yeast fermentate, volunteers had significantly increased levels of markers of natural killer cell activity within two hours; so, the immune supporting benefits may be seen in the same day.”

Yeast fermentate and the probiotic strain Lactobacillus rhamnosus CRL1505 are featured ingredients in Life Extension’s FLORASSIST Immune & Nasal Defense. According to Dr. Pavey, this combination encourages a healthy immune response to help prepare for seasonal challenges. “This product was formulated for those looking to include a clinically effective probiotic and yeast fermentate into their daily regimen as a proactive way to support a healthy immune response while moving into springs seasonal challenges,” she said.

Allergies from springtime pollen and grasses may indeed dampen the type of spring fever that everyone loves—the sheer joy and brighter mood that spring brings. You can help ensure your clients/patients are better equipped to enjoy the outdoors after a long winter cooped up inside.

Healthy Take Aways

• Nationwide pollen amounts have increased with the greatest numbers recorded in Texas and the Midwest.
• Research suggests that levels of pollen have gradually increased over time due to changes in climate.
• Research shows that cold exposure through the nose may affect seasonal variation of respiratory infections, including seasonal allergies.

For More Information:

Boiron USA, www.boironusa.com
Daiwa Health Development, www.dhdmed.com
EuroMedica, www.euromedicausa.com
Life Extension, www.lifeextension.com
Natural Path Silver Wings, www.npswsilver.com
Standard Process, www.standardprocess.com