Bucket full of Histamine: A primer on seasonal allergy and a functional medicine approach.

#allergy, #Histamine, #foodsensitivity, #congestion, #itchyeyes, #runnynose, #Hives, #rash

Are you ready for spring? Most of us look forward to the coming of spring with warmer weather, longer days, and more sunshine. Others feel a little dread at the coming of spring when the trees, flowers, and grasses begin to bloom bringing on the annual onslaught of troublesome symptoms of itching, sneezing and eye irritation to name a few. It is not a comforting thought. Some rely on over-the-counter remedies such as antihistamines, decongestants, and nasal steroids for their symptom management. However, there are many natural, integrative functional medicine therapies to consider. 

Allergy and allergy-like symptoms are a result of having a "bucket" that is too full and overflowing. The bucket represents the liver and detoxification pathways. It carries the histamine burden produced as a result of exposure to various histamine producing foods, chemicals, hormones, stress, and environmental factors. Histamine is produced by immune cells, primarily mast cells, located throughout the body in skin, GI tract, and lungs. Once released, histamine promotes inflammation. When exposures become excessive and the burden too great, the bucket fills and overflows due to inability to breakdown and eliminate all the histamine. This "overflow" of histamine leads to symptoms such as inflammation, hives, heartburn, stomach pain, itching and swelling. To reduce symptoms, you must stop filling the bucket.

According to the Asthma and Allergy Foundation of America, more than 100 million Americans suffer some type of allergy. Allergies are the sixth leading cause of chronic illness in the US.

What is a seasonal allergy? 

• An allergy is an exaggerated immune response to a typically harmless substance (allergen) that the body perceives as a threat. 

• In seasonal allergic reactions, the immune system produces antibodies (such as IgE antibodies) in response to environmental exposure to an allergen such as tree pollen, grasses, mold, and weeds. 

• When the immune system encounters the allergen again, it triggers the release from mast cells of histamine and other chemicals.  The inability to breakdown and eliminate excess histamine leads to allergy symptoms such as excess mucous production and itchiness.  

• Allergic reactions can range from mild (e.g., itching, sneezing, hives) to severe (e.g., anaphylaxis, a life-threatening allergic reaction). They can be for specific environmental factors like tree pollen that tends to be worse March-May or grasses that are typically worse June-August. For some, it can be all the above and lead to constant year-round symptoms. 

• Allergies are typically diagnosed through allergy testing, which may include skin prick tests, blood tests, or oral food challenges.  
  

Common seasonal allergy symptoms 

• Runny nose  

• Itchy nose  

• Sneezing 

• Watery eyes 

• Itchy and swollen eyes 

• Hives or rashes 

• Itchy skin 

• Nasal congestion 

• Coughing 

• Post-nasal drip 

• Headaches 

• Tingling lips 

• Burning in mouth 

Root causes that exacerbate allergy or allergy-like symptoms 

• Stress: Psychological stress can exacerbate or trigger nasal congestion, runny nose, and sneezing, even in the absence of allergies. 

• Gastroesophageal Reflux Disease (GERD): GERD can cause coughing, throat irritation, and postnasal dripping, which may be mistaken for allergies. 

• Hormonal Changes: Estrogen stimulates mast cell release of histamine and reduces DAO enzyme in the gut leading to nasal congestion and other allergy-like symptoms.

• Food Sensitivities: Some individuals may experience nasal congestion, sneezing, or coughing after consuming certain foods to which they are sensitive. 

• Physical Factors: changes in humidity, temperature, or barometric pressure can exacerbate symptoms. 

If it seems like you're experiencing allergy-like symptoms but you're not sure if it's due to allergies or something else, it's essential to consider other potential causes and seek appropriate medical advice.  

Consult with a functional medicine healthcare practitioner: If you're unsure about the cause of your symptoms, it's a good idea to see a practitioner. They can help you determine whether your symptoms are indeed allergy-related or if there might be another underlying issue.  

Keep Track of Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, any patterns you notice, and any potential triggers such as food or environmental factors. This information can be helpful when discussing your symptoms with a healthcare provider. 

Consider Other Possible Causes: Allergy-like symptoms can sometimes be caused by factors other than allergies, such as infections (like bacterial, viral, flu or common cold). Environmental exposures like smoke and air pollution), or common medications like NSAIDs and blood pressure medication. 

Undergo Allergy/Sensitivity Testing: If your symptoms persist or if you want to confirm whether allergies are the cause, your functional medicine healthcare provider may recommend allergy testing. This can involve skin prick tests, blood tests to evaluate histamine, or finger-stick blood tests such as the Food Explorer IgE/IgG to identify specific allergens that may be triggering your symptoms.  

Wellness tips to start early before allergy season

To stop filling the bucket and get ahead of allergy or allergy-like symptoms, be proactive weeks or months before allergy season begins. Take measures to minimize your exposure to allergens and reduce your symptoms.  

Identify and avoid/remove Triggers: Determine which allergens trigger your symptoms (e.g., pollen, dust mites, pet dander) and take steps to minimize your exposure to them.  

Consider Microbiome and IgE/IgG testing: Stress and inflammation related to allergies can affect gut health and lead to IgG immune response to a variety of foods. Food sensitivities will keep IgE levels chronically elevated. The symptoms of an IgG response can exacerbate allergy symptoms.  Desire Wellness Group offers simple in-home Microbiome stool test and IgE/IgG finger stick blood tests to determine gut health, immune response to foods and environmental allergens. 

Stay Informed: Know what allergens are prevalent during the season and try to avoid them as much as possible. Check local pollen counts and air quality reports regularly. 

Practice allergy hygiene to stop filling the bucket!

• Keep home and Indoor Air Clean: Reduce exposure to environmental allergens. Regularly clean your home to remove dust, mold, and other allergens. Vacuum carpets, wash bedding in hot water, and use allergen-proof covers on pillows and mattresses.  Use air purifiers with HEPA filters to reduce indoor allergens like dust, pollen, and pet dander. Keep windows closed during high pollen days. 

• Practice Good Hygiene: Shower and change clothes after spending time outdoors to remove pollen and other allergens from your body and clothing. Shower before going to bed. 

Use Saline Nasal Irrigation: Rinse your nasal passages with saline solution to flush out allergens and ease congestion. Neti pots or saline nasal sprays can be helpful. 

Try natural supplement remedies:  

• Quercetin – decreases release of histamine. Found in broccoli, onion, fruit, tea. 

• Butterbur- comparable to Cetirizine but without drowsiness. Studied for allergy and migraine. 

• NAC- Antioxidant. Thins mucous, decreases pulmonary and nasal congestion.  

• DAO- enzyme abundant in small intestine. Plays role in histamine metabolism. 

• Nutrient insufficiency impact histamine metabolism

Stay Hydrated: Drinking plenty of water can help thin mucus and keep your respiratory system functioning well. 

Prioritize gut health and nutrition:

• Avoid histamine in the diet. A balanced diet rich in fruits, vegetables, fiber and omega-3 fatty acids can help support your immune system ensuring an abundance of good probiotic bacteria to reduce inflammation and seasonal allergy symptoms.  Fiber improves allergy symptoms by reducing mast cell histamine release.  Good sources: Lentils, beans, berries, seeds, and nuts.  Dysbiosis negatively impacts histamine tolerance.

Limit Outdoor Activities: Try to avoid spending extended periods of time outdoors during high pollen time-early in morning, cool evenings after hot day, and on windy/storm days when allergens are more likely to be stirred up. 

Wear Protective Gear: If you must spend time outdoors during allergy season, consider wearing sunglasses to protect your eyes and a hat to keep pollen out of your hair. 

Allergy Medications: If you need medication, remember over-the-counter oral decongestants are not effective for allergy.  If necessary, opt instead for nasal decongestant spray and saline spray to help alleviate allergy symptoms.  

Consider Allergy Shots: If allergies are severe and not well-controlled with other methods, allergy shots (immunotherapy) may be an option. Talk to an allergist to see if this treatment is right for you. 

Allergy seasons and allergens to be aware of through the year.

Allergy season can vary depending on geographic location, climate, and the specific allergens prevalent in the area. However, in many regions, allergy seasons typically occur during the spring, summer, and fall months when certain allergens are most abundant.

Here's a general breakdown of when allergy season may occur for different allergens: 

Spring: 

• Tree Pollen: Allergy season for tree pollen often begins in the early spring, typically in February or March, and can last until late spring or early summer, depending on the region and the specific types of trees. 

• Grass Pollen: Grass pollen allergy season usually starts in late spring and can continue into the summer months, peaking in late spring or early summer. 

Summer: 

• Weed Pollen: Allergy season for weed pollen, including ragweed, starts in the summer, typically in late July or August, and can last until the first frost in the fall. 

• Mold Spores: Mold spores can be prevalent in the summer months, especially in warm, humid climates or in areas with frequent rainfall. 

Fall: 

• Ragweed Pollen: Ragweed allergy season typically peaks in the fall, starting in late August or early September and lasting until the first frost. Ragweed is a common allergen in many parts of the United States and can produce large amounts of pollen. 

• Mold Spores: Mold spores can continue to be a problem in the fall, particularly in areas with decaying vegetation or damp conditions. 

It's important to note that allergy season and associated allergens can vary based on weather and environment. Monitor your local pollen counts and allergen levels to optimize management of your allergy symptoms. 

Start preparing for allergy season using the above tips several months in advance to minimize the impact of allergens on your health.  

 By starting your preparations well in advance of allergy season, you can better manage your symptoms and minimize their impact on your daily life. We hope this blog has been helpful to you. Start early and don't give up on improving or alleviating your symptoms. Remember to consult with a functional medicine practitioner for personalized treatment recommendations and support in navigating the options available. 

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