Allergic Rhinitis symptom treatment with natural herbs, vitamins, supplements, is there a natural cure? by Ray Sahelian, M.D.
April 22 2014

Allergic rhinitis is a common condition affecting individuals of all ages. It's estimated that up to 30 percent of people in the Western suffer from allergic rhinitis. This condition is not an infection. It occurs when the body’s immune system over-responds to specific, non-infectious particles such as plant pollens, house plants, molds, dust mites, animal hair, industrial chemicals (including tobacco smoke), foods, medicines, and insect venom. During an allergy attack, antibodies, primarily immunoglobin E (IgE), attach to mast cells (cells that release histamine) in the lungs, skin, and mucous membranes. Once IgE connects with the mast cells, a number of chemicals are released. One of the chemicals, histamine, opens the blood vessels and causes skin redness and swollen membranes. When this occurs in the nose, sneezing and congestion are the result. Since the histamine releases causes many of the symptoms of allergic rhinitis, anti-histamines are often prescribed. Symptoms of allergic rhinitis may develop within minutes after breathing in an allergen, or they may come hours later. The most common immediate allergic rhinitis symptoms include:

Complications of allergic rhinitis and other conditions associated with it
Those afflicted with this condition often suffer from associated inflammatory conditions of the mucosa, such as rhinosinusitis, asthma, otitis media with effusion, and other atopic conditions, such as eczema and food allergies. Lack of treatment or treatment with suboptimal therapy may result in reduced quality of life and compromise productivity at work or school. Although environmental controls may prove difficult to implement, and not all controls appear adequately to mitigate symptoms of allergic, they continue to represent a foundation for treatment. A growing body of evidence has disclosed that AR is a systemic inflammatory disease. Inflammatory mediators and cells involved in AR have also been reported to be implicated in the process of atherosclerosis, which is relevant to the occurrence of erectile dysfunction. Patients with AR appeared to be at higher risk of future ED.

Natural Supplements, herbs and vitamins for Allergic Rhinitis treatment
Research is quite limited in this area of alternative therapy:
Butterbur offers some promise.
Spirulina may also help.

Quercetin
is an interesting flavonoid worth reading about.
Stinging nettle herbal extract may be helpful for allergic rhinitis.
Grapeseed extract has not been found helpful in the treatment of fall seasonal allergic rhinitis.

   For more information on allergy treatment with natural supplements, see also
natural antihistamine.

Allergic Rhinitis natural treatment emails
I was very interested to read your information about the perilla frutescens Absorption, metabolism, degradation and urinary excretion of rosmarinic acid after intake of Perilla frutescens extract in humans. Eur J Nutr. 2005 on your website. I have been using perilla extract against my seasonal allergic rhinitis and allergy-induced asthma for about three years with great success. I am wondering if you know of any studies that have been done about the affect of perilla extract on human fertility, especially any negative impact it may have on male sperm. My wife is pregnant and was conceived while I was taking Allermin 150mg two times a day.
   We did a search on Medline using the two keys words perilla and fertility and did not come across any studies regarding the relationship.

Review article regarding the use of herbs
Herbal medicines for the treatment of allergic rhinitis: a systematic review.
Ann Allergy Asthma Immunol. 2007. Department of Complementary Medicine, Peninsula Medical School, University of Exeter, England.
To evaluate the efficacy of herbal medicines for the treatment of allergic rhinitis (AR). Six randomized clinical trials studied Petasites hybridus (butterbur) extract for AR and suggest that P hybridus is superior to placebo or similarly effective compared with nonsedative antihistamines for intermittent AR. Two randomized clinical trials studied an Indian herbal combination, Aller-7, in patients with AR and reported positive results. Single RCTs were identified for 8 other herbal products as treatments for AR, reporting positive outcomes, except for grape seed extract. The median methodological quality score was 4 of a possible maximum of 5. There is encouraging evidence suggesting that P hybridus may be an effective herbal treatment for seasonal (intermittent) AR. However, independent replication is required before a firm conclusion can be drawn because of the financial support from the manufacturer of P hybridus extract to the 3 large trials. There are also promising results generated for other herbal products, particularly Aller-7, Tinospora cordifolia, Perilla frutescens, and several Chinese herbal medicines. Although these results are confined to the paucity of data and the small sample size, confirmation in larger and more rigorously designed clinical trials is warranted.

ISRN Allergy. 2013. Complementary therapies in allergic rhinitis. In this prospective study, patients who were diagnosed with perennial allergic rhinitis were questioned about their use of natural products/herbal therapies for their symptoms. Results. In total, 230 patients were enrolled. Overall, 37.3% of the patients stated that they had used natural products/herbal therapies at least once. Women were more likely than men to use herbal supplements (38% versus 32%). Ten different types of herbal supplements were identified, with stinging nettle (Urtica dioicath), black elderberry (Sambucus nigra), and Spirulina being the most common (12%, 6%, and 5%, resp.). Conclusion. This study found a high prevalence of herbal treatment usage for the relief of allergic rhinitis symptoms in Turkey. The herbal products identified in this study and in the literature are discussed.

Seasonal allergic rhinitis
This is often called "Hay fever". Tree and grass pollens and some fungi trigger seasonal allergic nose and eye allergy during springtime and early summer (March to June). Symptoms include nasal and eye itching with explosive sneezing, watery eyes and nose and itchy palate and ears with profuse post-nasal drip. Seasonal allergic rhinitis patients do not develop the typical "allergy face" but have seasonal puffiness of the eyes and eyelids with associated nasal membrane swelling.
   Seasonal allergic rhinitis affects more than 23 million Americans annually, and current epidemiologic studies indicate that its prevalence within the United States is increasing. One option is MSM supplement.

Allergic Rhinitis treatment
Potential approaches to the treatment of allergic rhinitis are the avoidance of allergens and medication with chromone compounds, antihistaminics and glucocorticosteroids. The sole causally effective treatment is specific immunotherapy. Leukotriene receptor antagonists, anti-IgE antibodies and monoclonal CD-4-molecules, as also soluble cytokine receptors are potential therapeutic options, the value of which currently remains unknown. The occasional use of a nasal decongestant such as pseudoephedrine is acceptable, if used in the morning by those who have not heart problems. Omnaris (ciclesonide) nasal spray is a new drug for the treatment of nasal symptoms associated with seasonal and perennial allergic rhinitis, commonly known as hay fever, in adults and children 12 years of age and older.
  
Shining a combination of ultraviolet (UV) A and B and visible light into the nasal cavities suppresses the itchiness and runny nose caused by allergic rhinitis.

Expert Opin Pharmacother. January 15 2014. Pharmacotherapy of allergic rhinitis: current options and future perspectives. In this article, the authors summarize the current status of pharmacotherapy of AR, its possible options and the future perspective. In most cases of AR, pharmacotherapy must be considered the cornerstone intervention. Particularly, antihistamines and intranasal corticosteroids should be the first-line agents. Other agents to be considered, depending on clinical features in single patients, are systemic corticosteroids, antileukotrienes, anticholinergics, nasal decongestants and mast cell stabilizers. Specific immunotherapy is able to reduce the drugs consumption and was shown to be effective in severe rhinitis uncontrolled with drugs. The future perspective include combination therapy with intranasal antihistamines and corticosteroids, the anti-IgE antibody omalizumab, histamine H3 and H4 receptor antagonists, cytokine inhibitors and toll-like receptors targeted treatment.

Perennial allergic rhinitis
This is usually caused by indoor allergens such as house dust mite and pet skin flakes. Perennial allergic rhinitis is similar to hay fever - the allergen causes inflammation and irritation of the delicate linings in the nose and eyes. However, the allergic rhinitis goes on throughout the year as opposed to seasonal allergic rhinitis which occurs only during certain seasons.

Allergic Rhinitis and Asthma
Good asthma management requires appropriate treatment of persistent stuffy nose or "allergic rhinitis. Treating allergic rhinitis as part of asthma treatment leads to controlling asthma with a lower dose of inhaled steroid.

Allergic Rhinitis and Sleep
This condition affects all aspects of sleep. Patients with severe symptoms may have more sleep disturbances than those with a mild form of the disease. Compared to people with mild allergic rhinitis, those with severe allergic rhinitis have significantly impaired sleep. They use significantly more sleeping pills and alcohol than those with clear noses. Archives of Internal Medicine, September 2006.

Grass Pollen Allergy
Children who have this condition are prone to develop asthma. Specific grass pollen immunotherapy appears to be a safe and effective treatment for children with seasonal allergic asthma who react to grass pollen. Several reports have shown specific immunotherapy to safely reduce the symptoms of hayfever in children and adults. Good candidates have summer asthma and often hayfever. They should have a positive skin prick test to the grass pollen allergen and positive serum specific IgE to it. The children should have no significant asthma symptoms from other allergens or unstable asthma during the winter when treatment tapering occurs.

Allergic Rhinitis from houseplants?
Symptoms of up to 20 percent of people with allergic rhinitis may be due to exposure to house plants, according to Dr. Olivier Michel of the Free University of Brussels in Belgium. The weeping fig tree, a type of ficus tree that exudes latex, could be a source of inhaled allergens. Michel and his team tested 59 allergic rhinitis sufferers and a control group of 15 healthy individuals for sensitization to ficus, yucca, ivy, palm tree and other common ornamental plants using a skin prick test. Seventy-eight percent of the patients were sensitized to at least one of the plants. No one in the control group was sensitized to the test plants. Sensitization doesn't necessarily mean a person's allergic symptoms are due to a particular substance. For two patients in the study who were allergic to ficus, removing the plant from their environment stopped their symptoms completely. Allergy, September 2006.

Repeated sneezing. This can occur upon waking up in the morning especially during hayfever season.
A runny nose. The drainage from a runny nose caused by allergies is usually clear and thin but may thicken and become cloudy or yellowish if a nasal or sinus infection develops.
Postnasal drip, which often feels like a tickle in your throat. It can trigger a cough as you try to clear your throat.
Watery, itchy eyes. Some people may confuse this as an eye infection.
Itchy ears, nose, and throat are other symptoms of allergic rhinitis..

Research
Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339.
Phytother Res. 2005.
Intermittent allergic rhinitis causes patients distress and impairs their work performance and quality of life. Prospective, randomized, double-blind, parallel group comparison study of Butterbur extract (Ze 339; 8 mg total petasine; one tablet thrice-daily), fexofenadine (Telfast 180, one tablet once-daily) and placebo in 330 patients. Protocol and analysis were according to the latest guidelines on new treatments for allergic rhinitis. FINDINGS: Both active treatments were individually significantly superior to placebo in improving symptoms of allergic rhinitis, while there were no differences between the two active treatments. Superiority to placebo was similarly shown during the evening/night, by physicians' own assessment and by responder rates. Both treatments were well tolerated. Butterbur and Fexofenadine are comparably efficacious relative to placebo. Despite being a herbal drug, Butterbur has now been subject to a series of well controlled trials and should be considered as an alternative treatment for allergic rhinitis.

Allergic rhinitis or non allergic?
Chronic rhinitis symptoms are among the most common reasons patients visit their doctors. The difficulty presenting a doctor is to diagnose and find out the cause of this runny or stuffy nose. Is the cause of the rhinitis allergic, nonallergic, or perhaps an overlap of both conditions? This is very difficult to determine since symptoms of allergic rhinitis, nonallergic rhinitis or mixed rhinitis (a situation where both are present) are similar.
   Although the prevalence of nonallergic rhinitis has not been studied definitively, it appears to be very common with an estimated prevalence in the United States of approximately 20 million. In comparison, the prevalence of mixed rhinitis is approximately 26 million, and allergic rhinitis ("pure" and "mixed" combined) 58 million.
 
Cause of Nonallergic rhinitis
These patients are often older than age 20, are mostly women, have nasal hyperactivity, perennial symptoms, and nasal eosinophilia. Positive tests for relevant specific IgE sensitivity in the setting of rhinitis do not rule out "mixed rhinitis" and may not rule out nonallergic rhinitis.
   Causes of nonallergic rhinitis are infectious rhinitis, hormonal rhinitis, vasomotor rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES), certain types of occupational rhinitis, and gustatory and drug-induced rhinitis.

Would you consider wasabi found in Japanese restaurants to be a natural decongestant?
   Wasabi will temporarily congest and clear the nose but it is not a practical substance to use as a natural decongestant.