Seasonal Allergies

Allergy season is upon us once again!

That means headaches, sinus pressure, & exacerbated pain. Find out how you can take back control over your symptoms and alleviate your pain!

Knowledge is key to making empowered decisions about your health. We’re dedicated to making your health a priority by keeping you informed on how to achieve your optimal well-being. In this month’s newsletter, we discuss the impact seasonal allergies have on our health and our practice. We also highlight a root cause approach to help you relieve your seasonal allergies once and for all!

Did you know that 24 million Americans suffer from seasonal allergies each year?

The majority of us who suffer from seasonal allergies find ourselves stuck… relying on over-the-counter remedies to try to relieve our persistent and uncomfortable symptoms.

How Seasonal Allergies Impact our Practice:

At the TMJ & Sleep Therapy Centre of Cleveland, we specialize in treating craniofacial pain [pain in the head, face, jaw, and neck] and sleep-related breathing disorders [snoring, adult & pediatric OSA, UARS].

There is no question that seasonal allergies can impact our ability to breathe through our nose. Generally speaking, research shows that there are multiple health benefits associated with nasal breathing, making it far superior to mouth breathing. The nose is designed to filter and humidify air for the lungs while also producing nitric oxide for improved circulation.

Emphasizing proper nasal breathing in our practice is an important component in treating craniofacial pain and sleep issues effectively. If we cannot properly breathe through our nose, the body defaults to mouth breathing (dysfunctional breathing). This increases risk for TMJ pain, sleep breathing issues, and adds to existing conditions. [1]

In cases of TMJ disorders, nasal breathing will help alleviate pain by reducing the strain on the joint and surrounding muscles caused by mouth breathing. [2] 

Proper (nasal) breathing during sleep ensures that your body gets the oxygen it needs while allowing for necessary filtration and conditioning of the air we breathe. This method of breathing has shown to improve sleep quality and lessen nighttime awakenings. It can also reduce sleep-breathing disorders such as sleep apnea and snoring. [3] [4] [5]

What are Seasonal Allergies? 

Seasonal allergies develop when the body’s immune system has a hypersensitive reaction to dust mites, pet dander, or environmental changes, like when certain plants pollinate. You may also hear this type of reaction called “allergic rhinitis” or “hay fever”. The body’s reaction to these allergens causes inflammation and irritation to the nasal passages. Depending on the type of allergy fueling your symptoms, you may only be reactive during certain months of the year, while others may experience an allergy season that lasts practically all year long.

Seasonal Timeline 

Spring (March-May): Tree pollen is the most common culprit of allergies, primarily oak, maple, elm, and birch tree pollen.

Summer (June-August): Grass and weed pollen tend to be the most problematic. Of the grass pollen, rye grass, bluegrass, and bermuda grass are common. 

Fall (September-November): Ragweed, burning bush, and lamb’s quarters are amongst the highest allergens. Other allergens include mugwort, cocklebur, pigweed, and sagebrush. 

Winter (December-February): Household allergens and mold are common in the winter. Molds can be particularly problematic in the Midwest, as mold continues to thrive in cool, damp environments. Spore counts can also spike during the warm periods throughout the winter season. 

Common Seasonal Allergy Symptoms:

• Runny nose
• Sneezing
• Nasal congestion
• Post-nasal drip
• Throat discomfort (typically a result of post nasal drip)
• Coughing spells
• Itchy nose (rhinitis)
• Itchy, irritated and/or watery eyes
• Swollen eyes
• Itchy skin
• Hives or rashes
• Headaches

Managing Seasonal Allergies Symptoms:

The go-to approach to dealing with pesky symptoms are typically over-the counter remedies and prescriptions, such one or a combination of the following:

• Saline nasal sprays: X-lear nasal spray is the go-to choice at our office
• Nasal irrigation or sinus rinses
• Corticosteroid nasal sprays such as fluticasone (Flonase Allergy), budesonide (Rhinocort Allergy), triamcinolone (Nasacort Allergy 24hr)
• Oral Antihistamines such as cetirizine (Zyrtec), fexofenadine (Allegra), or loratadine (Claritin)
• Oral decongestants such as pseudoephedrine (Sudafed)
• Oral antihistamine and decongestant combos such as  cetirizine + pseudoephedrine (Zyrtec-D), fexofenadine + pseudoephedrine (Allegra-D), loratadine + pseudoephedrine (Claritin D)
• Immunotherapy (allergy shots)

An Integrative Approach to Seasonal Allergies:

If you’ve tried the pills, shots, etc. and are still struggling, it might be time for a root cause approach. Root cause medicine aims to go beyond the mere alleviation of symptoms, focusing instead on discovering and treating the underlying causes of illness. Exploring potential root causes of your seasonal allergies can help you regain control over your health through integrative approaches to relieving your symptoms and ideally putting you at ease once and for all.

Potential Root Causes of Seasonal Allergies:

Histamine 

Histamine is a chemical molecule released from immune cells when your immune system is responding to foreign particles, playing a key role in your body’s inflammatory response. The symptoms you experience from seasonal allergies are due to an adverse response to the release of histamine. Depending on a variety of factors, the body’s ability to secrete histamine can be negatively impacted and cause systemic overload – this is when symptoms arise. Potential root causes of histamine overload include:

• Undiagnosed food allergens (IgE), intolerances (IgG), and sensitivities (IgG), which can keep histamine levels chronically elevated.
• Exposure to various allergens in the home without proper air filtration.
• Nutrient deficiencies and insufficiencies such as B vitamins, vitamin C, vitamin D and more.
• Dysbiosis of the gut can negatively affect histamine tolerance.

The Gut Connection 

There is emerging evidence on the gut microbiome and seasonal allergies. One study found similarities in the gut microbiome profile of those suffering from seasonal allergies. It showed an overall decrease in microbial diversity, with an increase in particular microbes such as Bacteroidetes (gram-negative bacteria). Microbial diversity in the gut is essential in maintaining optimal health, especially when it comes to modulating immune responses. An overgrowth of gram-negative bacteria can lead to dysbiosis of the gut and trigger unwanted symptoms. One of the most profound ways that we alter our gut microbiome is through our daily dietary decisions. The foods we consume have either a positive or negative impact on our microbial diversity, so prioritizing intake of whole foods will support a well balanced microbiome. [8] [9] [10]

Nutrition 

Epidemiological, clinical, and animal studies have all shown that the lack of nutrient density and inflammatory nature of the Western diet promotes allergies and exacerbates symptoms, whereas nutritionally balanced diets, such as an anti-inflammatory diet, play a critical role in the prevention and treatment of allergic diseases, chronic pain and sleep issues. Following this nutrition plan would include prioritizing intake of fruits and vegetables (phytochemicals), dietary fiber, complex carbohydrates, high-quality sourced protein, and omega-3-rich fats. 

Reducing inflammation in the body through your dietary decisions can help mitigate the immune response and gastrointestinal response associated with the release of histamine that occurs as a result of an allergic reaction. In doing so, allergy related symptoms will improve in addition to a reduction in chronic pain and improvements in sleep quality. For some, reducing high-histamine foods or foods that stimulate histamine release can assist in reducing symptoms of seasonal allergies while the root cause is being addressed. [11] [12]

• Anti-inflammatory food favorites: berries, fatty fish, broccoli, peppers, avocado, mushrooms, dark chocolate, green tea, turmeric, ginger, bone broth, olive oil
• Mucus eliminating foods: ginger, garlic, carrots, leafy greens, cayenne pepper, onion, lemons, watercress, and more
• Quercetin rich foods: apples, parsley, sage, dark cherries, olive oil, blueberries, blackberries and more
• Bee pollen and local raw honey: have immune protective effects and anti allergy action [13] [14] 
• Vitamin C rich foods: acerola cherries, black currants, cantaloupe, citrus fruits, peppers (chili, yellow), parsley, strawberries, broccoli, brussel sprouts, Kadadu plums, rose hips, guava, mustard spinach, kale, collard greens, kiwi, lemon, papaya, banana, potatoes and more
• Omega-3-rich Foods: fatty fish such as salmon, tuna, sardines, nuts & seeds and more

• Fiber rich Foods: avocados, apples, beans, berries, broccoli, brussel sprouts, cabbage, celery, cucumber, figs, kale kiwi, lentils, nuts & seeds, tart cherry, passion fruit, olives & olive oils, pumpkin, spinach, fresh herbs
• Herbal teas: turmeric, dandelion root, nettle, marshmallow root, peppermint, ashwagandha
• High histamine foods: Fermented foods like sauerkraut, hard cheeses, mushrooms, chocolate, spinach, tomatoes, pineapples, avocados, and leftovers.

Supplements

Quercetin

As an antioxidant and anti-inflammatory, Quercetin is a great option for managing seasonal allergies. Quercetin has proven to suppress pro-inflammatory cytokines, which are part of the histamine release cascade. Supplementation has been shown to be effective in reducing pollen allergy symptoms. [15] [16]

Turmeric (Curcumin)

Turmeric has been shown to contain bioactive compounds (curcuminoids) that have medicinal properties. It is a potent antioxidant and anti-inflammatory. Curcumin has been shown to alleviate nasal symptoms (sneezing and rhinorrhea) and nasal congestion through reduction of nasal airflow resistance in those with allergic rhinitis.[17] 

Ginger

Zingiber Officinalis, commonly known as ginger, has been clinically used as a natural anti-inflammatory. A 2020 study showed that ginger extract was just as effective as loratadine (Claritin) in those with allergic rhinitis, resulting in reduced nasal symptoms and improved quality of life. [18]

Diamine Oxidase (DAO)

There are specific supplements that are geared at decreasing histamine by providing the body with DAO, which is the enzyme needed to break down histamine. If histamine intolerance is part of the root cause of your allergies, taking DAO may help reduce symptoms. [19]

N-Acetyl Cysteine 

NAC is a form of the amino acid cysteine. It is a precursor to the “master antioxidant” glutathione. Its primary mechanism of action is thinning mucus that forms in mucus membranes of the respiratory and gastrointestinal tract. Regarding seasonal allergy responses, this can help decrease congestion and mucus build-up. One small-scale study showed that a prophylactic application of topical NAC reduced nasal reaction to the late-phase response to ragweed. [20] 

Spirulina 

Spirulina is a blue-green algae (Cyanobacteria), that is known for its nutrient profile, antioxidant and anti-inflammatory properties. It has also been shown to be effective in the reduction of symptoms associated with allergic rhinitis. One study found spirulina to be more effective than cetirizine (Zyrtec) in reducing allergy symptoms and reducing inflammation. [21] [22] [23] 

Nettles

Stinging nettles, or Urtica Dioica, is a plant that has shown to improve symptoms associated with allergic rhinitis due to its natural antihistamine properties. [24]

Breathe-X by LifeSeasons

This supplement is a a well thought out blend of Vitamin C, Magnesium, Bromelain, Citrus Bioflavonoids, Astragalus Root, and Nettles, created to help combat inflammation, promote healthy mucosal cells, and regulate histamine production to support nasal and sinus respiration.

Lab Testing

Functional lab testing is often necessary in root cause analysis of health issues, as they provide extremely valuable insight into your individual health status. Below is a list of tests we may consider running on our patients when helping them with their seasonal allergies:

Allergen Testing

Often, there is more than one allergen that is the culprit for your symptoms. Allergen testing (IgE + IgG) can help determine environmental and food allergies that may be playing a role in triggering your symptoms.

Histamine Testing

Assessing histamine levels in the body can help define the severity of your allergic response. In addition to histamine levels, it is important to assess additional biomarkers such as DAO, LPS, and Zonulin to look at intestinal permeability, inflammation, and the body’s ability to break down histamine.

Microbiome Assessment

Stool analyses are a comprehensive approach to looking at your individual microbiome for both pathogenic and beneficial microbes in the gut to determine if there is dysbiosis that needs to be address.

Micronutrient Testing

Existing chronic inflammation and gut dysbiosis can lead to decreased absorption of nutrients essential to our immune system, inflammation reduction and overall health. Assessing nutrient status is a great way to identify individualized nutrient needs while addressing the root cause of allergic response.

How We Can Help:

If trying to find the root cause of your seasonal allergies, optimize your diet, and balance your gut microbiome sounds daunting, we are here for you! Reach out to our office to schedule a consultation with Carly, our nutritionist, who can help you find out which root cause might be contributing to your allergy symptoms, pain issues, and poor sleep quality.

What’s Next?

Want to learn about nutrition and how it plays a role in the development, maintenance and management of chronic pain? Attend our free webinar on Thursday, April 4th, 2024 at 6PM. Please RSVP using the link below if you are interested in attending! Also, stay tuned for our upcoming newsletter on chronic pain and our practice.

Webinar RSVP

Additional Resources:

1. Asthma & Allergy Foundation of America. (2024, March 14). Allergy facts. https://aafa.org/allergies/allergy-facts/#:~:text=How%20Common%20Are%20Seasonal%20Allergies,(5.2%20million)%20of%20children
2. Farnsworth, C. (2023, November 20). Nose breathing vs. Mouth Breathing: What to know. Medical News Today. https://www.medicalnewstoday.com/articles/nose-breathing-vs-mouth-breathing 
3. Hill, C., Kelly, E., & Chin, K. (2024, January 8). 20 foods that are high in Vitamin C. Healthline. https://www.healthline.com/nutrition/vitamin-c-foods#bottom-line 
4. Kim SD, Jung DW, Lee JW, Park JH, Mun SJ, Cho KS. Relationship between allergic rhinitis and nasal surgery success in patients with obstructive sleep apnea. Am J Otolaryngol. 2021 Nov-Dec;42(6):103079. doi: 10.1016/j.amjoto.2021.103079. Epub 2021 May 14. PMID: 34020179.
5. NHS. (2020, August 3). Vitamin C. NHS choices. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-c/ 
6. Nunez, K. (2021, February 1). Nose breathing: Benefits, how to, exercises to try. Healthline. https://www.healthline.com/health/nose-breathing#differences 
7. Prasad S, Aggarwal BB. Turmeric, the Golden Spice: From Traditional Medicine to Modern Medicine. In: Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. Chapter 13.Available from: https://www.ncbi.nlm.nih.gov/books/NBK92752/