The Everything Guide to Herbal Remedies: An easy-to-use reference for natural health care

CHAPTER 9

Taming Allergies and Asthma

Allergies and asthma are everywhere: Roughly 45 million Americans have allergies, which are exaggerated immune system reactions to benign things like pollen and cat fur. And close to 20 million Americans have asthma, a chronic disease involving the respiratory system (and often the immune system, as well). Both conditions are growing increasingly common, leading experts to think that our environment may be contributing to the problem—and conventional medical treatments aren’t doing much to stop it.

What’s Behind the Symptoms?

Allergies are the result of an exaggerated immune response to an agent, or allergen, that’s not really dangerous but is treated as such by the body’s defenses. Allergies are closely related to atopic dermatitis and asthma, two other conditions in which the immune system overreacts to a harmless trigger.

The term allergies applies to several distinct diseases, all with their own symptoms and treatments. However, they have a common underlying cause: a hypersensitivity to otherwise benign things. Some of the most common allergic conditions are:

·        Allergic rhinitis, also known as hay fever or nasal allergies

·        Allergic asthma, a type of asthma triggered by an allergic reaction

·        Insect bite/sting allergies

·        Skin allergies

·        Food allergies

·        Drug allergies

·        Eye allergies, also known as allergic conjunctivitis

Some herbs used to treat allergies and asthma can cause allergic reactions themselves in sensitive individuals. Anyone who’s allergic to plants in the Asteraceae/Compositae family, which include ragweed and daisies, should avoid remedies made with other family members, such as arnica (Arnica montana), butterbur (Petasites hybridus), calendula (Calendula officinalis), chamomile (Matricaria recutita), echinacea (Echinacea purpurea), and yarrow (Achillea millefolium).

Some of these conditions overlap: Food allergies can trigger an allergic reaction in the skin as well as in the digestive tract, for example, and inhaled irritants that can trigger an episode of allergic rhinitis might also bring on allergic asthma.

The Allergic Response

Allergic symptoms typically include inflammation. In the case of allergic rhinitis, that can mean itchiness (in the eyes and nose and possibly the skin in other parts of your body), sneezing, and a runny nose. If the airways are irritated, symptoms can also include coughing, wheezing, and shortness of breath. In skin reactions, you might develop red patches, hives, or a rash.

An allergic response is a misguided reaction of your immune system to something that doesn’t present a threat (and doesn’t bother other people, unless they happen to be allergic to the same thing).

Many people treat the sniffles caused by nasal allergies with nonprescription decongestant nasal sprays. But overuse of these sprays can make things worse, creating a chronic condition known as nonallergic rhinitis. That happens when the tissues in your nasal passages become conditioned to the chemicals in the spray, causing you to use more and more to get the same results.

Allergies are caused by a complex process that can be traced back to an antibody called immunoglobulin E, or IgE, which the body releases in response to a trigger (a substance to which it’s been exposed before and is now sensitized). In the bloodstream, IgE antibodies bind to mast cells, which are located in the tissues that line the nose, bronchial tubes, gastrointestinal tract, and skin. This triggers the release of chemicals called mediators(including histamine and leukotrienes) and sets off a chain reaction that produces the classic “allergic” reaction. IgEs are the key to allergies. If your immune system produces IgEs whenever it encounters cats (or more precisely, proteins from the cat’s skin), you’ll be allergic to cats.

Most experts think that both environment and genetics play a role in who’ll develop allergic conditions. Allergies run in families, and research shows that people with allergies are more likely to develop asthma. Allergies are also closely tied to dermatitis, and people with allergic asthma and certain allergies—or who have family members with allergic conditions—are more likely to develop dermatitis.

Conventional Versus Herbal Treatments

Conventional medicine tackles allergic conditions in two ways: by individually treating symptoms of an acute allergy (or asthma) attack and attempting to prevent or minimize future attacks. These treatments focus almost entirely on symptom management—shutting down the body’s reactions to triggers by suppressing the individual functions. For example, nasal allergy sufferers are given antihistamines to avert the sniffling-and-sneezing symptoms of an allergic reaction. Asthmatics are given steroid medications that reduce inflammation in the airways.

Although they have their drawbacks, the conventional drugs that are used to treat these conditions are valuable in many cases—and essential in serious ones. However, herbs can be used quite effectively, alone or as a support for conventional medications. For example, herbal remedies can be used safely to relieve congestion in the upper and lower respiratory tracts, relax spasms, and soothe inflamed tissues in the airways. Herbal remedies also work to support the body’s immunity and other functions.

Allergic Rhinitis

Also known as hay fever, allergic rhinitis is the most common type of allergic reaction. If it is caused by outdoor irritants, such as pollen from trees or grasses, it is labeled a seasonal allergy. When it’s triggered by things that are present year-round, allergic rhinitis is designated as perennial. This type of allergy is generally caused by indoor irritants, such as pet dander (dandruff-like material that collects in the animal’s fur), dust mites (tiny insects that live in pillows and other soft goods in your house), mold, and cockroach droppings.

Typical Symptoms

Rhinitis—which means “inflammation of the nose”—occurs when the nasal membranes become irritated and start producing excessive mucus. Mucus is the fluid produced naturally to trap dust and other particles in the nose and keep them out of the lungs; it’s usually thin and barely noticeable as it drains down the back of your throat. In a case of rhinitis, mucus becomes thick and plentiful—clogging things up and draining quite noticeably out the front of your nose. Plain old rhinitis is the stuffiness you get with a cold (this is called infectious rhinitis). Allergic rhinitis is what happens when you encounter an allergen.

How can I tell if I have a cold or allergies?

Sometimes, it can be tough to tell. But generally speaking, you’ll know it’s an allergic reaction by your nose (allergies produce clear mucus; colds and flu create yellowish discharge), your temperature (allergies won’t produce a fever), and the duration of your symptoms (colds and flu clear up within about a week, while allergies disappear as soon as the trigger is gone—and hang around as long as the allergen does).

Pharmaceutical Treatments

The most popular conventional treatments for allergic rhinitis are over-the-counter (OTC) decongestants and antihistamines. Decongestants treat congestion by constricting the blood vessels in the nasal cavities, thereby reducing the amount of mucus that gets into your nose. Antihistamines block the actions of histamine, thereby relieving your runny nose, itchy eyes, and sneezing.

For mild to moderate symptoms, your doctor might suggest OTC decongestants like pseudoephedrine (Sudafed) or short-acting antihistamines, like OTC loratadine (Claritin) and diphenhydramine (Benadryl). Your doctor might also prescribe longer-acting antihistamines, like fexofenadine (Allegra) and Cetirizine (Zyrtec), as well as a nasal spray, azelastine (Astelin).

Some doctors recommend an OTC spray, cromolyn sodium (Nasal-Crom), which is a mast cell stabilizer that prevents the release of histamine.

Another type of nasal allergy treatment, immunotherapy (or allergy shots), is used to desensitize you to allergens. In immunotherapy, you’ll be given a series of injections, each containing a slightly higher dose of the allergen that’s causing your problems.

For cases that don’t respond to decongestants and antihistamines, some doctors prescribe a leukotriene inhibitor, such as montelukast (Singulair), which blocks the substances that trigger allergic (and asthmatic) responses.

Other pharmaceuticals used to treat serious allergies are corticosteroids, including skin creams and nasal sprays such as fluticasone (Flonase) and mometasone (Nasonex).

Herbal Remedies

If you’d rather skip the drugs (or limit your dependence on them), you can alleviate some of the symptoms of allergic rhinitis with these herbs:

• Butterbur (Petasites hybridus)

Butterbur is traditionally used to treat allergies, coughs, and congestion (it inhibits both histamine and leukotriene release). Recent research has shown that a butterbur extract is as effective as the drugs cetirizine (Zyrtec) or fexofenadine (Allegra) in treating seasonal nasal allergies.

• Echinacea (Echinacea purpurea)

Echinacea is the go-to remedy for the common cold, and research shows it can lessen the severity of allergic rhinitis, too.

• Nettle (Urtica dioica)

Nettle is a classic hay fever remedy throughout Europe. It acts like a mast cell stabilizer to stop runny nose and other allergic rhinitis symptoms.

• Tinospora (Tinospora cordifolia)

Also known as guduchi, this is a classic Indian remedy for allergic rhinitis. It’s been shown in recent research to provide significant relief from sneezing, itchy eyes, and other symptoms. It also acts as an immunostimulant, making it an effective form of immunotherapy.

Skin Allergies

Some allergies cause symptoms in your skin. The most common are atopic dermatitis (a chronic condition that produces red, itchy patches) and urticaria (which produces itchy, raised bumps). These reactions can be caused by many things, including something you’ve inhaled or eaten. A third type of skin allergy is contact dermatitis, which is triggered by direct contact with an allergenic substance.

Atopic Dermatitis

Dermatitis, also known as eczema, is a broad term encompassing many types of skin inflammation. The most common is atopic dermatitis, a chronic, itchy condition in which the skin is overly sensitive to certain triggers. Although it’s technically not an allergy, atopic dermatitis primarily affects allergy-prone people and often accompanies other allergic conditions. More than 15 million Americans have it.

Atopic dermatitis most often affects children and babies (see Chapter 6). Although there’s no known cause, there are several “triggers” that can cause flare-ups. These include:

·        Allergens, such as pollen or mold

·        Irritants, such as certain fabrics, soaps, chlorine, or cigarette smoke

·        Certain foods, especially eggs, peanuts, and milk

·        Other factors, like stress, high temperatures, and low humidity

According to the National Institutes of Health, roughly 2.5 percent of Americans under the age of sixty-five have atopic dermatitis. But this relatively rare condition costs between roughly $600 and $1,250 per patient, per year—representing more than a quarter of the average patient’s health care costs. All that adds up to more than $1 billion annually.

Urticaria

Urticaria is a fancy name for hives, a condition that affects about 20 percent of the population at one time or another. Most often, urticaria appears suddenly and disappears a few hours later. In some people, however, the hives stick around much longer, or go away only to reappear a short time later. The most common triggers for urticaria are certain medications, foods, and insect bites.

Contact Dermatitis

If your skin encounters an allergen, you might develop contact dermatitis, in which the affected skin turns red and itchy (as it would after touching poison ivy). Experts have identified more than 3,000 allergens that can cause allergic contact dermatitis. They include: OTC antibiotic creams and ointments, fragrances in many skin and hair care products (even products labeled “unscented” can contain fragrance), and metals such as the nickel in jewelry and the mercury in dental fillings.

Occasionally, a substance won’t cause an allergic response unless it’s triggered by something else, such as sunlight (these reactions are called photoallergies). This can be the case with skin preparations and some medications. Other people will react to an allergen only after they begin to perspire.

Treatments

Conventional medicine generally treats allergic skin reactions with pharmaceuticals designed to stop the symptoms, if not the reaction itself.

These include:

·        Topical antihistamines and corticosteroids, which control itching and swelling

·        Topical immunomodulating drugs to reduce the immune system’s response

·        Oral or topical antibiotics to treat infection in inflamed skin

·        Oral or injectable corticosteroids

·        Oral immunomodulators

Each of these drugs has potential side effects. The last two, which are generally reserved for cases that haven’t responded to the other drugs, can cause serious problems, including hypertension and kidney problems. Herbal medicine has some effective alternatives:

• Astragalus (Astragalus membranaceus)

Astragalus is used in traditional Eastern medicine to treat all sorts of allergic diseases. In the lab, it’s been shown to suppress atopic dermatitis.

• Hops (Humulus lupulus)

Native Americans used this herb as a multipurpose skin remedy. New research shows that drinking a hop extract can inhibit all sorts of allergic reactions, including atopic dermatitis.

• Oats (Avena sativa)

Used in baths and skin care treatments, oatmeal relieves itching and inflammation and creates a barrier to help skin heal.

• Saint John’s wort (Hypericum perforatum)

Saint John’s wort is a traditional remedy for many skin problems. Used topically, it inhibits inflammation-building enzymes to relieve atopic dermatitis.

• Tea (Camellia sinensis)

Tea contains phytochemicals that have been proven effective at suppress-ing all types of allergic response, including inflammatory skin diseases.

Food Allergies

Roughly 12 million Americans have diagnosed food allergies, a condition in which the immune system reacts to the ingestion of a trigger food by creating inflammation in various parts of the body. Food allergies can trigger symptoms in the digestive system as well as the skin and respiratory tract. True food allergies affect about 7 percent of U.S. children and 2 percent of adults. Typical symptoms of food allergy are:

·        Swelling and an itchy sensation in mouth and throat

·        Abdominal pain (cramping, bloating)

·        Diarrhea

·        Nausea and vomiting

·        Skin rash

·        Coughing or shortness of breath

Most often, a food allergy makes you uncomfortable. However, in rare cases, an allergenic food will trigger a potentially life-threatening condition called anaphylaxis, which is an immediate reaction that can cause loss of consciousness and death. Every year, about 30,000 people go into anaphylactic shock caused by a food allergy, and 150 people die from it.

Identify—and Avoid

Because there’s no cure for food allergies (and no magical antidote that you can take once you’ve eaten something allergenic), the only way to avoid an allergic reaction is to avoid the foods that might cause it. While food allergies are more common in children (and typically disappear as the child grows up), allergies to peanuts, nuts, and seafood seldom go away.

Lots of people who think they have food allergies actually have food intolerances. A true food allergy typically involves a reaction in the skin as well as the digestive system. If you’ve eaten a food to which you’re allergic, symptoms may appear right away—within a few minutes—or may take up to two hours to appear. Food intolerances produce digestive symptoms only.

There are more than 200 foods and food ingredients that can provoke an allergic reaction, but the vast majority are caused by nuts (walnuts, almonds, and pecans), legumes (peanuts and soybeans), milk, eggs, fish, shellfish, and wheat.

It’s fairly easy to avoid allergenic foods—when you can see them. But restaurant meals and manufactured foods often contain potential triggers like milk, soy, and egg whites (which won’t be listed on the label if they’re part of a flavoring or coloring agent). If you’re severely allergic, even a tiny amount can cause a reaction.

Herbal Helpers

If you’ve had an allergic reaction to a food, you can use a few herbal remedies to help relieve the symptoms:

• Chamomile (Matricaria recutita)

This herb works as an anti-inflammatory and is useful as a tea and a topical remedy. Research shows it can relieve itching triggered by a food allergy just as well as pharmaceutical preparations.

• Ginger (Zingiber officinale)

Ginger is a proven stomach-settler that appears to “deactivate” the inflammatory response in laboratory tests.

• Peppermint (Mentha x piperita)

Peppermint soothes digestive tissues and appears to have an antihistamine -like effect. Research shows it can be effective against stomach upset (including bloating and mild gastrointestinal spasms), cramping, nausea, and vomiting.

• Rooibos (Aspalathus linearis)

Research shows that rooibos works as a bronchodilator and antispasmodic.

• Witch hazel (Hamamelis virginiana)

This is a classic skin remedy that relieves allergic itching and inflammation.

Asthma

Asthma is a chronic disease that’s generally divided into two types: allergic (or extrinsic) or nonallergic (intrinsic). Of the two, allergic asthma is the most common, affecting about 60 percent of all asthmatics.

Various Triggers

Nonallergic asthma, as the name implies, is not associated with an allergic response. It shares the same symptoms—coughing, wheezing, and difficulty breathing, all caused by inflammation and airway obstruction—but is triggered by things like stress, exercise, and cold or dry air. Thus, it doesn’t involve the immune system.

Allergic asthma, on the other hand, is caused by the same kind of overblown immune response that’s behind allergies. It’s triggered by inhaled allergens, such as dust mites, pet dander, mold, and pollen.

Conventional Treatments for Asthma

There’s no cure for asthma (either the allergic or nonallergic kind), and treatments focus on managing symptoms and making attacks less frequent and intense. Western medicine prescribes two types of asthma drugs: long-acting control (or preventive) and short-acting (or emergency).

Long-term control medicines make the airways less sensitive and less reactive, and reduce coughing and wheezing. These drugs include:

·        Inhaled anti-inflammatories, including nonsteroidals (or mast cell stabilizers) and corticosteroids

·        Beta-agonist bronchodilators (inhaled or taken orally), relax the smooth muscle surrounding the bronchial tubes

·        Leukotriene modifiers, which act on chemicals that trigger inflammation and mucus production to reduce swelling and keep the airways open

·        Injectable anti-IgE therapy, which prevents the IgE antibodies from binding to mast cells and producing an allergic reaction; this is used in people with moderate to severe allergic asthma

Herbs can also prevent allergies and asthma. A recent study found that children who eat lots of tomatoes, eggplants, green beans, and zucchini have much lower rates of asthma. Other studies show that babies born to women who regularly eat vegetables (along with fish and legumes) have fewer allergic conditions.

Short-acting, or emergency, medications reduce symptoms during an asthma attack. They include:

·        Inhaled beta-agonist bronchodilators, which relax the muscles in and around the airways

·        Oral corticosteroids, which are generally reserved for severe cases that don’t respond to the other short-term drugs

The list of potential side effects for these drugs is a long one. For example, corticosteroid inhalers can cause hoarseness and thrush (a fungal infection of the mouth). Beta-agonist bronchodilators can cause nervousness, increased heart rate, and insomnia.

Herbal Asthma Alternatives

Herbs that have been used successfully to treat asthma include:

• Boswellia (Boswellia serrata)

This Ayurvedic herb, also known as Indian frankincense, is taken internally to combat inflammation and has shown antiasthma potential. In one study, people who took oral extracts saw a significant improvement in their symptoms.

• Coffee (Coffea arabica)

The caffeine in coffee, which is also found in many other herbs—including guarana (Paullinia cupana), mate (Ilex paraguariensis), and tea (Camellia sinensis)—can improve airway function for up to four hours in people with asthma. Chemically speaking, caffeine is related to the asthma drug theophylline; it’s a bronchodilator that also reduces fatigue in the respiratory muscles.

• Eucalyptus (Eucalyptus globulus)

Eucalyptus has analgesic, anti-inflammatory, and mucolytic properties (meaning it destroys mucus). In one study, people with severe asthma who were given oral doses of eucalyptus extract were able to cut back on their use of oral steroids.

• Ginkgo (Ginkgo biloba)

Ginkgo contains phytochemicals that block the exaggerated immune response that characterizes asthma. Research shows it’s effective at dilating the bronchial tubes to keep breathing normal; it’s also useful for long-term management of asthma and its associated inflammation.

• Grapefruit (Citrus paradisi)

Grapefruit and other citrus fruits are high in antioxidants (including vita-min C), and research shows that consuming lots of them can improve lung function and reduce wheezing in asthmatic people.

• Maritime pine (Pinus pinaster)

Pine bark is a powerful antioxidant and a traditional remedy for coughs and bronchitis. Research has shown that it reduces the severity of symptoms of mild to moderate asthma.