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Pollen allergy

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Related Terms
  • Airborne allergen, airborne particles, airborne pollen, allergen, allergen immunotherapy, allergen-specific IgE test, allergen-specific immunoglobulin E test, allergens, allergic, allergic reaction, allergic response, allergic rhinitis, allergy, allergy shots, antibodies, antibody, antihistamines, Bermuda grass, blue grass, cockleweed, corticosteroid sprays, cypress tree, elm tree, flowering plants, hay fever, Ig, IgE, immune, immune defense system, immune reaction, immune response, immune system, immunoglobulin, immunoglobulin E, immunology, Japanese cedar, leukotriene, leukotriene receptor antagonists, nasal corticosteroid sprays, nasal sprays, oak tree, orchard grass, pigweed, pollen counts, pollen grain, postnasal drip, radioallergosorbent test®, ragweed, RAST®, rhinoconjunctivitis, Russian thistle, sagebrush, skin test, sweet vernal grass, sycamore tree, tumbleweed, Western red cedar,

Background
  • Researchers estimate that pollen from flowering plants and grasses causes seasonal allergies in 35 million Americans.
  • Flowering plants have both male and female anatomies. Pollen is a collection of pollen grains, which are the tiny, egg-shaped male cells of flowering plants. Just a pinch of pollen contains thousands of pollen grains. Pollen grains are microscopic (about 15-100 microns).
  • Depending on the specific plant, the pollen is either released into the air or carried by insects to the female part of another plant. Plants, such as grasses and low-growing weeds (like ragweed), have airborne pollen, while plants with bright flowers (like roses) have waxy pollens that are carried from plant to plant by insects (like bees).
  • Airborne pollens are responsible for causing allergy symptoms, such as runny nose, itchy eyes, nasal congestion, and sneezing. Pollen is responsible for most cases of hay fever, which is also called allergic rhinitis. This allergic condition is characterized by a collection of allergic symptoms, predominantly in the nose and eyes, which occur after airborne pollen is inhaled. According to the American Lung Association, an estimated 26.1 million Americans suffer from hay fever symptoms each year. These allergies are seasonal because they occur when the allergy-causing plants are in bloom.
  • Since each type of plant has unique pollen, some pollen is more likely to cause allergies than others. The main physical features that distinguish one type of pollen from another include shape, size, and ornamentation of the outer wall.
  • Allergy symptoms are most common during the spring and summer months. One of the most common allergy-causing plants in the United States is ragweed.
  • Wind-pollinated plants like ragweed produce large quantities of pollen to ensure that some of it reaches the right target.
  • Pollen counts measure the amount of airborne pollen that is present in the air. Pollen counts are reported as number of pollen grains per cubic meter of air. When pollen counts are high, allergic individuals can take extra precautions to avoid exposure by limiting the amount of time spent outdoors, keeping the windows closed, and/or regularly washing the hands to remove pollen.
  • Pollen allergies may also be treated with medications, such as antihistamines, nasal corticosteroid sprays, and leukotriene receptor antagonists. Decongestants may also help treat nasal congestion (stuffy nose) that is often associated with pollen allergies.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. American Academy of Allergy Asthma & Immunology. . Accessed April 17, 2009.
  2. American Lung Association. . Accessed April 17, 2009.
  3. Asthma and Allergy Foundation of America. Rhinitis and Sinusitis. . Accessed April 17, 2009.
  4. Can D, Tanac R, Demir E, et al. Efficacy of pollen immunotherapy in seasonal allergic rhinitis. Pediatr Int. 2007 Feb;49(1):64-9.
  5. Centers for Disease Control and Prevention. . Accessed April 17, 2009.
  6. National Pollen and Aerobiology Research Unit. . Accessed April 17, 2009.
  7. Natural Standard: The Authority on Integrative Medicine. . Copyright © 2009. Accessed April 17, 2009.
  8. Ridolo E, Albertini R, Giordano D, et al. Airborne pollen concentrations and the incidence of allergic asthma and rhinoconjunctivitis in northern Italy from 1992 to 2003. Int Arch Allergy Immunol. 2007;142(2):151-7. Epub 2006 Oct 20.

Causes
  • In the early spring, the pollens from trees, such as the western red cedar, elm, oak, birch, ash, hickory, poplar, sycamore, maple, cypress, and walnut, often trigger allergy symptoms. In the late spring and early summer, pollinating grasses, including timothy, Bermuda, orchard, sweet vernal, red top, and some blue grasses, commonly cause seasonal pollen allergies.
  • Ragweed causes most allergies in the late summer and fall months. Other weeds, including sagebrush, pigweed, tumbleweed, Russian thistle, and cockleweed, can trigger allergic symptoms.
  • Since trees, grasses, and weeds generally grow at the same time each year, pollen seasons are very similar each year in the same location. However, the amount of pollen in the air varies each year, based on the previous year's weather, the current weather, and other environmental factors.

Symptoms
  • Pollen allergies are seasonal because they occur when the allergy-causing plants are in bloom. Weather can also influence symptoms. Allergy symptoms are usually minimal during rainy or windless weather because pollen is unable to become airborne during these conditions. The highest pollen counts typically occur in hot, dry, and windy weather.
  • Common symptoms of pollen allergy include cough, headache, itchy nose, itchy mouth, itchy throat, itchy skin, nosebleeds, impaired smell, watery eyes, sore throat, wheezing, fever, cross-reactivity allergy to some fruits, conjunctivitis (pinkeye), nasal congestion (stuffy nose), postnasal drip (mucus that drips from the sinuses, down the throat), runny nose, rhinoconjunctivitis (swelling of the nose and eyes caused by allergens), and swelling of the nasal tissues that can lead to headaches.

Diagnosis
  • Skin test: The standard diagnostic test for pollen allergies is a skin test. During the test, the skin is exposed to different allergy-causing substances. The skin is then observed for an allergic reaction. If an allergen triggers an allergic reaction to a test, the patient will develop reddening, swelling, or a raised, itchy red wheal (bump) that looks similar to a mosquito bite. The healthcare provider will measure the size of the wheal and record the results. The larger the wheal, the more severe the allergy. A skin test is typically conducted in a healthcare provider's office. Skin tests cause minimal, if any, discomfort. The needles used barely penetrate the skin's surface and will not cause bleeding.
  • Allergen-specific immunoglobulin (IgE) test: An allergen-specific immunoglobulin E (IgE) test, commonly referred to as a radioallergosorbent test (RAST®), may also be used to determine pollen allergies. However, this test is less accurate than a skin test. It is usually performed in patients who have severe, co-existing skin diseases (such as eczema or psoriasis) that cover large areas of the body. This is because the skin test is performed on the arms and back, and there may not be enough unaffected skin to perform a conclusive test.
  • The allergen-specific IgE test is conducted in a laboratory setting. During the procedure a sample of blood is taken from the patient. The blood is then sent to a laboratory that performs specific IgE blood tests. The suspected pollen allergen is bound to an allergosorbent (paper disk). Then, the patient's blood is added. If the blood contains immunoglobulin antibodies (proteins that detect and bind to foreign substances that enter the body) to the pollen antigens, the blood will bind to the allergen on the disc. A radiolabelled ANTI-IgE antibody is then added to the disc to measure the level of immunoglobulin E present in the blood. The higher the radioactivity, the higher the level of IgE in the blood and the more severe the allergy is.
  • A qualified healthcare provider will interpret the results of the test. In general, the sensitivity of these tests range from 50-90%, with the average being about 70-75%. The patient will receive test results in about seven to 14 days.

Treatment
  • General: Allergy treatment depends on the severity of symptoms. Commonly used allergy medications include antihistamines, cromolyn sodium, decongestants, leukotriene inhibitors, and nasal sprays. Allergen immunotherapy (allergy shots) may also help relieve pollen allergy symptoms. Patients should tell their healthcare providers if they are taking any drugs (prescription or over-the-counter), herbs, or supplements because they may interact with treatment.
  • Allergen immunotherapy (allergy shots): Allergen immunotherapy, also known as allergy shots, is often used to treat patients who suffer from severe allergies, or for those who experience allergy symptoms for more than three months a year. Allergen immunotherapy involves injecting increasing amounts of a diluted allergen into a patient over several months.
  • There are two phases of immunotherapy: the build-up phase and the maintenance phase. During the build-up phase, allergy shots are injected into the upper arm once or twice a week for several months (typically three to six months). The dose is gradually increased until the maintenance dose is reached. The maintenance phase begins once the effective therapeutic dose is reached. This dose is different for each patient because it depends on the patient's level of allergen sensitivity and their response to immunotherapy during the build-up phase. Once the maintenance dose is reached, the patient will continue therapy every two to four weeks for two to five years or more.
  • Antihistamines: Short-acting antihistamines like diphenhydramine (Benadryl®) have been used to relieve mild to moderate allergy symptoms. Most short-acting antihistamines are available over-the-counter. Use cautiously, especially in children because these medications often cause drowsiness and they have shown to temporarily impair cognition (slow learning) in children, even if they do not cause drowsiness. However, loratadine (Claritin®), another over-the-counter medication, does not usually cause drowsiness or affect learning in children.
  • Longer-acting antihistamines like fexofenadine (Allegra®) are available by prescription for mild to moderate allergy symptoms. They typically cause less drowsiness than short-acting antihistamines, and they are equally effective. Although these medications usually do not interfere with learning, use cautiously in children. Side effects may include drowsiness, dry mouth, headache, sore throat, stomach pain, vomiting, or diarrhea.
  • Cromolyn sodium: Cromolyn sodium is available over-the-counter as a nasal spray (Nasalcrom®) for treating hay fever. Eye drop versions of cromolyn sodium are available for itchy, bloodshot eyes. Side effects may include sore throat, bad taste in the mouth, cough, stuffy nose, burning or itching in the nose, sneezing, headache, or stomach pain. They do not cause rebound nasal congestion.
  • Decongestants: Decongestants may help relieve symptoms, such as nasal congestion (stuffy nose). These drugs shrink the tissues and blood vessels in the eyes and nose that swell in response to contact with an allergen like pollen. Nasal decongestant sprays like oxymetazoline (Afrin®) should not be used more than twice daily for three consecutive days because rebound nasal congestion (significant return of stuffy nose) may result. Oral decongestants such as pseudoephedrine (Sudafed®) are not likely to cause rebound nasal congestion. Common side effects of oral decongestants include increased heartbeat, high blood pressure, anxiety, or insomnia (difficulty sleeping).
  • Leukotriene receptor antagonists: Leukotriene receptor antagonists block the action of leukotrienes, which are chemicals in the body that are involved in the allergic response. New leukotriene receptor antagonists, such as montelukast (Singulair®) and zafirlukast (Accolate®), can effectively treat hay fever without some of the common side effects like drowsiness. These long-acting medications are taken once daily.
  • Nasal corticosteroid sprays: Nasal corticosteroid sprays can effectively relieve nasal allergy symptoms (like itchy nose and sneezing) in patients who are not responding to antihistamines. Commonly prescribed corticosteroid sprays include fluticasone (Flonase®), mometasone (Nasonex®) and triamcinolone (Nasacort AQ®). Side effects may include nosebleeds, burning in the nose, runny nose, bloody mucus in the nose, cough, upset stomach, vomiting, diarrhea, or dizziness. Nasal sprays may also irritate the throat.

Integrative therapies
  • Good scientific evidence:
  • Bromelain: Bromelain has been studied in various clinical studies for sinusitis with mixed results. Further research is necessary. Avoid if allergic to bromelain, pineapple, honeybee, venom, latex, birch pollen, carrots, celery, fennel, cypress pollen, grass pollen, papain, rye flour, wheat flour, or members of the Bromeliaceaefamily. Use cautiously with history of bleeding disorder, stomach ulcers, heart disease, liver or kidney disease. Use caution before dental or surgical procedures or while driving or operating machinery. Avoid if pregnant or breastfeeding.
  • Butterbur: Good scientific evidence suggests that butterbur may be effective for allergic rhinitis prevention in susceptible individuals. Comparisons of butterbur to prescription drugs, such as fexofenadine (Allegra®) and cetirizine (Zyrtec®), have reported similar efficacy. Additional studies are warranted before a firm conclusion can be made.
  • Avoid if allergic or hypersensitive to Petasites hybridus or other plants from the Asteraceae/Compositae family (such as ragweed, marigolds, daisies, and chrysanthemums). Raw, unprocessed butterbur plant should not be eaten due to the risk of liver or kidney damage or cancer. Avoid if pregnant or breastfeeding.
  • Nasal irrigation: There is good evidence from clinical studies to recommend the use of nasal irrigation in the treatment of allergic rhinitis. One study demonstrated that reflexology massage may be equally effective; however, the advantage of irrigation (i.e. inexpensive, performed at home, minimal adverse side effects) makes the technique beneficial. Methodological and statistical reporting are lacking in some of these trials. A well-conducted, randomized controlled trial, fully reporting data would make the case for allergic rhinitis stronger.
  • Early research suggests that nasal irrigation may help treat chronic sinusitis, with improvements in sinus-related quality of life, decreases in symptoms, and decreases in medication use. Further study is needed before a conclusion can be made.
  • Nasal irrigation is generally well tolerated. Use cautiously with history of frequent nosebleeds. If the irrigation liquid is hot, the nose may become irritated.
  • Probiotics: Use of probiotic Enterococcus faecalis bacteria in hypertrophic sinusitis (sinus inflammation) may reduce frequency of relapses and the need for antibiotic therapy. Further research is necessary before a firm conclusion can be made. Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.
  • Unclear or conflicting scientific evidence:
  • Acupuncture: There is currently insufficient available evidence on which to base recommendations for acupuncture in non-allergic rhinitis. However, studies suggest that it may offer possible benefits. Additionally, more studies are needed of stronger design to determine whether or not acupuncture offers benefit in sinusitis.
  • Acupuncture should be avoided in patients with heart disease, pulmonary disease, infections, bleeding disorders, medical conditions of unknown origin, or neurological disorders. Pregnant women, the elderly, diabetics, people with a history of seizures, and those receiving radiation therapy and/or taking drugs increasing bleeding risks should also avoid acupuncture.
  • Aromatherapy: Despite widespread use in over-the-counter agents and vapors, there is not enough scientific evidence to recommend use of eucalyptus oil as a decongestant-expectorant (by mouth or inhaled form). Essential oils should be administered in a carrier oil to avoid toxicity. Avoid with a history of allergic dermatitis. Use cautiously if driving/operating heavy machinery. Avoid consuming essential oils. Avoid direct contact of undiluted oils with mucous membranes. Use cautiously if pregnant.
  • Black seed: Studies in patients with allergies found that black seed decreased subjective measures of severity of allergies. The effect of black seed for allergies is still not clear and further study is required before a conclusion can be made. Avoid with a known allergy/hypersensitivity to black seed, its constituents, black seed oil, or to members of the Ranunculaceae family. Allergic contact dermatitis has been reported after topical use of black seed or the oil from the seed.
  • Cat's claw: It has been suggested that cat's claw may help treat allergies and related respiratory diseases. However, there is currently limited scientific evidence to support this claim. More well-designed trials are needed to determine whether cat's claw is a beneficial treatment.
  • Avoid if allergic to cat's claw or Uncaria plants or plants in the Rubiaceae family, such as gardenia, coffee, or quinine. Avoid with history of conditions affecting the immune system (such as AIDS, HIV, some types of cancer, multiple sclerosis, tuberculosis, rheumatoid arthritis, lupus). Use cautiously with bleeding disorders or with history of stroke, or if taking drugs that may increase the risk of bleeding. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk, and do not use immediately after these procedures. Avoid if pregnant or breastfeeding. Cat's claw may be contaminated with other Uncaria species. Reports exist of the potentially toxic Texan-grown plant Acacia gregii being substituted for cat's claw.
  • Choline: Oral tricholine citrate (TRI) effectively relieved allergic rhinitis symptoms in limited available study. Further research is needed before a firm conclusion can be made. Choline is generally regarded as safe and appears to be well tolerated. Avoid if allergic to choline, lecithin, or phosphatidylcholine.
  • Ephedra: Preliminary study suggests that ephedrine nasal spray may help treat allergic rhinitis. Additional research is needed before a recommendation can be made.
  • Ephedra taken by mouth can cause serious side effects, including heart attack, seizure, and stroke. Therefore, ephedrine nasal sprays should only be used in the nose. The U.S. Food and Drug Administration (FDA) has collected thousands of reports of serious toxicity linked to ephedra (including over 100 deaths). Ephedra products are banned from dietary supplements because of serious health risks, including heart attack, heart damage, breathing difficulties, and fluid retention in the lungs. Avoid with history of high blood pressure, abnormal heart rate, heart attack, stroke, seizure, eating disorders, anxiety, prostate disease, mental illness, kidney disease, stomach ulcers, heart disease, eye disease, depression, diabetes, thyroid disease, or sleep problems. Avoid if pregnant or breastfeeding.
  • Eucalyptus oil: There is currently insufficient available evidence to recommend either for or against eucalyptus oil as a decongestant-expectorant. Avoid if allergic to eucalyptus oil or with a history of seizure, diabetes, asthma, heart disease, abnormal heart rhythms, intestinal disorders, liver disease, kidney disease, lung disease, or the blood condition known as acute intermittent porphyria. Use caution if driving or operating machinery. A strain of bacteria found on eucalyptus may cause infection. Toxicity has been reported with oral and inhaled use.
  • Honey: Currently, there is insufficient human evidence to recommend honey for the treatment of rhinoconjunctivitis. Avoid if allergic or hypersensitive to honey, pollen, celery or bees. Honey is generally considered safe in recommended doses. Avoid honey from the genus Rhododendron because it may cause a toxic reaction. Avoid in infants younger than 12 months of age. Use cautiously with antibiotics. Potentially harmful contaminants (like C. botulinum or grayanotoxins) can be found in some types of honey and should be used cautiously in pregnant or breastfeeding women.
  • Horseradish: Several studies suggest that some horseradish constituents may offer antibiotic activity and may help treat sinusitis. Additional high-quality clinical studies are needed before a conclusion can be made. Avoid if allergic or hypersensitive to horseradish (Armoracia rusticana), its constituents, or members of the Brassicaceae family. Large oral doses may provoke allergic reactions. Use cautiously with clotting disorders, hypotension (low blood pressure), thyroid disorders, kidney disorders and inflammation, gastrointestinal conditions, and ulcers. Use cautiously if taking anticoagulants or antiplatelets (blood thinning agents), antihypertensives (blood pressure-lowering agents), anti-inflammatory agents, or thyroid hormones. Use cautiously if undergoing treatment for cancer. Avoid medicinal amounts of horseradish if pregnant or breastfeeding; based on herbal textbooks and folkloric precedent, horseradish has been used to induce abortion.
  • Hypnotherapy, hypnosis: It has been suggested that hypnotherapy may be effective for allergies and may help treat hay fever. However, further research is necessary. Use cautiously with mental illnesses such as psychosis/schizophrenia, manic depression, multiple personality disorder, or dissociative disorders. Use cautiously with seizure disorders
  • Kiwi: Conclusive data on kiwi's therapeutic benefits for preventing lung conditions and other respiratory problems is currently lacking. Kiwi and other fruits high in vitamin C may benefit lung conditions in children, especially wheezing. More research is warranted before a recommendation can be made. Avoid if allergic or hypersensitive to kiwi, latex, birch pollen, banana, chestnut, fig, flour, melon, poppy seeds, rye grain, sesame seeds, and related substances. Kiwi is generally considered safe when taken in amounts naturally found in foods. Use cautiously with anti-platelet drugs like aspirin, cilostazol, or clopidogrel. Use cautiously with hormone therapies or serotonergic drugs. Avoid if pregnant or breastfeeding because clinical trials testing safety in supplemental doses are currently lacking. The amount found in foods appears to be safe in most people.
  • Lactobacillus acidophilus: Limited available study suggests that the Lactobacillus acidophilus (L. acidophilus) strain L-92 (L-92) may be effective for the treatment of Japanese cedar-pollen allergy. Further research is needed to confirm these results. L. acidophilus may be difficult to tolerate if allergic to dairy products containing L. acidophilus. Avoid with history of an injury or illness of the intestinal wall, immune-disease, or heart valve surgery. Avoid with prescription drugs, such as corticosteroids, because of the risk of infection. Use cautiously with heart murmurs. Antibiotics or alcohol may destroy L. acidophilus. Therefore, it is recommended that L. acidophilus be taken three hours after taking antibiotics or drinking alcohol. Some individuals may use antacids, such as famotidine (Pepcid®) and esomeprazole (Nexium®), to decrease the amount of acid in the stomach one hour before taking L. acidophilus.
  • MSM: According to preliminary clinical study, MSM reduces symptoms associated with seasonal allergic rhinitis (SAR). However, larger controlled trials are needed to confirm these findings. Avoid if allergic or hypersensitive to MSM. Long-term effects of supplementation with MSM have not been examined. Avoid if pregnant or breastfeeding.
  • Onion: Research shows that topical application of an alcoholic onion extract significantly reduced responses to allergies. Although intriguing, more research is needed in this area to establish the efficacy and dosing of topical onion extracts. Avoid if allergic or hypersensitive to onion (Allium cepa), its constituents, or members of the Lilaceae family. Use cautiously with hematologic (blood) disorders, diabetes, hypoglycemia (low blood sugar), and hypotension (low blood pressure). Use cautiously if taking anticoagulants or antiplatelets (blood thinners). Avoid medicinal doses if pregnant or breastfeeding.
  • Perilla: Preliminary evidence suggests some benefit of perilla extract for seasonal allergies. Further clinical trials are required before conclusions can be made. Avoid if allergic/hypersensitive to perilla or members of the Lamiaciae/Labiatae family. Use cautiously with cancer, low HDL-cholesterol, and immune disorders. Use cautiously if taking NSAIDS or barbiturates. Avoid if pregnant or breastfeeding.
  • Probiotics: Only a few types and combinations of probiotics have been studied for allergies. They have been studied mostly in children, teenagers, and young adults. Further research is necessary before a firm conclusion can be made. Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.
  • Reflexology: Reflexology involves the application of manual pressure to specific points or areas of the feet called "reflex points" that are believed to correspond to other parts of the body. Results from early studies are not conclusive regarding the use of reflexology for chronic sinusitis.
  • Avoid with recent or healing foot fractures, unhealed wounds, or active gout flares affecting the foot. Use cautiously and seek prior medical consultation with osteoarthritis affecting the foot or ankle or with severe vascular disease of the legs or feet. Use cautiously with diabetes, heart disease, unstable blood pressure, cancer, active infections, past episodes of fainting (syncope), mental illness, gallstones, kidney stones, or with a pacemaker. Use cautiously if pregnant or breastfeeding. Reflexology should not delay diagnosis or treatment with more proven techniques or therapies.
  • Shea butter: Shea butter is derived from the nut of the shea tree (Vitellaria paradoxa), which grows in West Africa. In human research, shea butter was shown to produce relief from nasal congestion. More research is needed before a conclusion can be made
  • Avoid with known allergy/hypersensitivity to shea butter or its constituents. Use cautiously with allergies to latex. Use cautiously if taking anticoagulants. There is currently insufficient available safety evidence for use of shea butter during pregnancy or breastfeeding.
  • Sorrel: Research suggests that an herbal combination preparation containing sorrel, Sinupret®, may have beneficial effects in improving symptoms of sinusitis when used with antibiotics. It is not clear if these same effects would be seen with sorrel alone or what dose may be safe and effective. For allergic rhinitis, there is not enough evidence to make a conclusion at this time. More research of sorrel alone is needed.
  • Avoid sorrel with a known allergy to sorrel or any of its constituents. Avoid large doses of sorrel because there have been reports of toxicity and death. Many tinctures contain high levels of alcohol and should be avoided when driving or operating heavy machinery. Sorrel formulations may cause nausea or vomiting when taken with the prescription drugs metronidazole (Flagyl®) or disulfiram (Antabuse®). Avoid if pregnant or breastfeeding.
  • Spirulina: Anti-inflammatory properties of spirulina may help improve symptoms of allergic rhinitis. However, further high-quality studies are needed to confirm these findings. Avoid if allergic or hypersensitive to spirulina or blue-green algae. Use cautiously with phenylketonuria (a genetic disorder of a liver enzyme that disrupts normal body functions), autoimmune diseases, bleeding disorders, diabetes, and osteoporosis. Use cautiously with products containing the blue-green algae species Anabaena spp., Aphanizomenon spp., and Microcystis spp.; in underweight patients or in those taking antiobesity agents or appetite suppressants; of if consuming a high-protein diet. Avoid in children or if pregnant or breastfeeding.
  • Stinging nettle: For many years, a freeze-dried preparation of Urtica dioica has been prescribed by physicians and sold over-the-counter for the treatment of allergic rhinitis. Clinical trials demonstrating statistical significance over placebo and/or equivalence with other available treatments are needed to support the use of nettle in the treatment of allergic rhinitis.
  • Avoid if allergic or hypersensitive to nettle, the Urticaceae family or any ingredient of nettle products. Use cautiously with diabetes, bleeding disorders, and/or low sodium levels in the blood. Use cautiously with diuretics and anti-inflammatory drugs. The elderly should also use nettle cautiously. Avoid if pregnant or breastfeeding.
  • Thymus extract: Thymus extract may reduce symptoms of allergies due to its potential immune stimulating effects. More clinical trials are required before recommendations can be made involving thymus extract for this use. Avoid if allergic or hypersensitive to thymus extracts. Use bovine thymus extract supplements cautiously due to potential for exposure to the virus that causes "mad cow disease." Avoid use with an organ transplant or other forms of allografts or xenografts. Avoid if receiving immunosuppressive therapy, with thymic tumors, myasthenia gravis (neuromuscular disorder), untreated hypothyroidism, or if taking hormonal therapy. Avoid if pregnant or breastfeeding; thymic extract increases human sperm motility and progression.
  • Vitamin E: Although thought to aid in reducing the nasal symptoms of allergic rhinitis, vitamin E intake may not be effective. Current evidence is limited, however, and more studies are needed before a firm conclusion can be drawn.
  • Avoid if allergic or hypersensitive to vitamin E. For short periods of time, vitamin E supplementation is generally considered safe at doses up to 1,000 milligrams per day. Avoid doses higher than 1,000 milligrams a day. Avoid with retinitis pigmentosa (loss of peripheral vision). Use cautiously with bleeding disorders. The recommended dose of vitamin E for pregnant women of any age is 15 milligrams; for breastfeeding women of any age, the recommended dose is 19 milligrams. Use beyond this level in pregnant women is not recommended.
  • Fair negative scientific evidence:
  • Grape seed: Grape seed has been used to treat immune system disorders due to its antioxidant effects. However, a well-designed human study of allergic rhinitis sufferers showed no improvement in allergy symptoms with administration of grape seed extract ingredients. Avoid if allergic or hypersensitive to grapes or other grape compounds. Use cautiously if taking blood thinners such as warfarin, aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or anti-platelet agents. Use cautiously with bleeding disorders or if taking drugs that may increase the risk of bleeding. Use cautiously with drugs processed using the liver's "cytochrome P450" enzyme system. Use cautiously with blood pressure disorders or if taking ACE inhibitors. Avoid with disorders that increase the risk of bleeding or with active bleeding disorders (stomach ulcers, bleeding into the brain, etc.). Avoid if pregnant or breastfeeding.

Prevention
  • Avoid going outside in the morning and evening because this is when outdoor pollen levels are the highest.
  • Keep windows closed, and, if possible, use an air conditioner in the house and/or car.
  • Do not dry clothes outside.
  • Regularly wash the hands and face to remove pollen.
  • A humidifier may help remove some of the allergens out of the air.
  • Consider installing central air conditioning with a high-efficiency particulate air (HEPA) filter attachment. The HEPA filter can trap airborne pollen from outdoor air, preventing it from circulating in the air inside.
  • Use a vacuum cleaner with a double-layered microfilter bag or a HEPA filter.
  • Change furnace and air conditioning filters regularly.
  • Sleep with the windows closed.

Pollen counts
  • Pollen counts measure the amount of airborne pollens that are present in the air. Several methods can be used to generate pollen counts. Pollen counts are reported as pollen grains per cubic meter of air. Certified aeroallergen counters at many universities, medical centers, and clinics provide these counts on a volunteer basis.
  • For instance, the American Academy of Allergy, Asthma & Immunology (AAAAI) has a network of pollen counters across the United States. Certified pollen counters use specialized air-sampling equipment to capture airborne pollens.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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