Spring has sprung, the days are getting longer, daffodils are blooming and many of us are hoping for a beautiful summer. But for the millions of hay fever sufferers in the UK, the season of sneezing, runny noses and itchy eyes is just around the corner, and for many, this range of debilitating symptoms can have a very real impact on everyday life.
Seasonal allergic rhinitis, or “hay fever” occurs when your body identifies pollen as a threat and launches an inappropriate immune response to this normally harmless substance. While hay fever frequently begins at a young age, it can affect both adults and children, affecting an estimated 10-15% of children and 26% of adults in the UK – equating to around 16 million of us – with a 2020 study suggesting that the figure could actually be as high as 49% of adults.1,2
Symptoms can arrive with tree pollens as early as March and continue through the summer months with grass pollens. When pollens come into contact with the nostrils, eyes, or throat of an individual with sensitivity, the immune system produces the antibody IgE (immunoglobulin E). IgE then binds to white blood cells, which causes the release of pro-inflammatory histamine, resulting in sneezing, itchy and watery eyes, swelling and inflammation of the nasal passages and an increase in mucous production.
Conventional hay fever treatment
Avoidance of the allergic triggers and the use of antihistamines. Often symptoms are managed by:
- Monitoring pollen forecasts daily and staying indoors with the windows closed when the count is high (generally on warmer, dry days). Rain washes pollen from the air so counts are normally lower on cooler, wet days
- Avoiding drying washing on a clothesline outside when pollen counts are high
- Taking antihistamines, a common type of allergy medication, and most are readily available from a pharmacy without prescription
However, antihistamine medication isn’t for everyone. Remember, they don’t address the root causes of hay fever — they just treat the symptoms. In fact, many antihistamines are not recommended for people with high blood pressure, heart disease, kidney or liver disease, glaucoma, thyroid problems, or women who are pregnant or breastfeeding.
In this blog we will examine some of the natural nutrients, as well as dietary and lifestyle considerations that may help to support those who suffer with symptoms of hay fever, but also of relevance to those who suffer with a wider range of year-round allergies such as those to dust, dust-mites and moulds.
Preparation is key, and ensuing a great level of these key nutrients, supporting gut health and following an anti-inflammatory, low histamine diet should be implemented as early as possible before symptoms start to appear.
Oxidative stress, defined as “an imbalance between oxidants and antioxidants in favour of the oxidants, leading to a disruption of redox signalling and control as well as molecular damage”. When the level of oxidants overwhelm our antioxidant defence mechanisms, the molecular damage that can ensue is thought to be, to some degree at the heart of most disease states. In allergic rhinitis, one potential contribution of oxidative stress is a dysfunction of the barrier function in the nasal epithelium which is thought to contribute to the uptake of allergens and harmful exogenous particles.3
Vitamin A plays an essential role in maintaining the integrity of the mucous membranes. It is important for gut mucosal turnover and barrier function, and intestinal IgA secretion. Some studies report that vitamin A can regulate immunity, induce immune function, possess antioxidant activity, maintain the integrity of the airway epithelium, promote normal development of airway smooth muscle, and reduce airway hyperresponsiveness. Demonstrating that supplementing with vitamin A can play a protective role in allergic diseases.4
Vitamin C contributes to the protection of cells from oxidative stress during allergic responses. It also supports immune system function by stabilising cell membranes and helping to reduce the release of histamine.5
Furthermore, the adrenal glands are one of the organs with the highest concentration of vitamin C in the body and need this important vitamin to help synthesise hormones. During hay fever, the adrenal glands release the hormone cortisol, to counteract the inflammatory effects of histamine in the body.
Vitamin C is a water-soluble vitamin and is quickly used up in the body, especially by smoking, alcohol, stress, exercise and certain medications. Vitamin C is also quickly depleted during times of inflammation. Many people simply do not get enough vitamin C from their diets due to a lack of fresh fruit and vegetables. If supplementing, to maximize effectiveness, vitamin C is best taken with bioflavonoids — the natural pigments in fruits and vegetables that help to increase bioavailability.
Vitamin D (+ magnesium)
Vitamin D is produced when the skin is exposed to UV radiation (from sunlight), hence giving rise to its name ‘the sunshine vitamin.’ Few foods naturally contain adequate amounts of vitamin D, so supplementation, particularly in the autumn and winter months, is important. Traditionally seen as a nutrient to support calcium homeostasis and bone health, its essential role in immunity and allergy is now well researched.
Vitamin D is an important regulator of the immune system, acting directly on immune cells to promote an anti-inflammatory state. Vitamin D signalling has been shown to boost innate immunity against pathogens of bacterial or viral origin, but it also suppresses inflammatory immune responses that underlie autoimmunity and regulate allergic responses. These findings have been bolstered by clinical studies linking vitamin D deficiency to increased rates of infections, autoimmunity, and allergies.6,26 Vitamin D deficiency can also contribute to microbiome dysbiosis, which has in turn been linked to extra-intestinal immune disease states such as atopic conditions and allergies.7
It should be noted that all of the enzymes that metabolise vitamin D require magnesium as a co-factor – and it is therefore essential to ensure that adequate magnesium levels are assured to obtain the optimal benefits of vitamin D.8 As well as activating vitamin D, magnesium has a protective role against oxidative stress and a deficiency in the mineral increases endothelial cell susceptibility to oxidative stress and promotes endothelial dysfunction.
This conditionally essential amino acid is thought to regulate a number of different immune functions through its antioxidant and anti-inflammatory properties. The antioxidant enzyme superoxide dismutase (SOD3) can inhibit the release of inflammatory cytokines, and low levels have been observed in hay fever patients. Taurine treatment has demonstrated an increase in SOD3 activity in animal models as well as being efficacious in alleviating allergic inflammatory reactions by reducing mast cell infiltration into the nasal cavity.9
Quercetin is a naturally occurring polyphenol flavonoid, found in a variety of fruit and vegetables, including onions, apples, berries, tea, tomatoes, grapes and brassica vegetables. which has potent antioxidant action and promotes a healthy inflammatory response. It has anti-allergic functions that are known for inhibiting histamine production and pro-inflammatory mediators.
Quercetin counteracts the allergic response by suppressing IgE antibody formation, thereby acting at a very early step in the allergic response. It inhibits the release of histamine and proinflammatory substances implicated in allergic reactions. Quercetin also has membrane stabilising properties and can have an anti-inflammatory effect on the mucous membranes.10
Other hay fever supportive nutrients
Beta 1-3, 1-6 Glucan
Beta 1-3, 1-6 Glucan is best known for its immune supporting properties, with extensive research indicating it may optimise the function of the immune system. Put simply, Beta 1-3, 1-6 Glucan ‘primes’ the immune system, alerting the body to help defend itself against foreign invaders.
In terms of its role in hay fever, Beta 1-3, 1-6 Glucan is capable of binding to receptors on the surface of innate immune cells, and this action is suggested as playing a role in reducing the symptoms caused by IgE production, especially histamine release. Beta Glucan ‘down-regulates’ sensitivity and immune over reaction and normalises Th1/Th2 ratio.11 It can be taken throughout the year to help fight a wide range of allergies and for overall immune support.
Methylsulfonylmethane (MSM) is an organic compound containing sulphur that naturally occurs in the human body, as well as in a variety of food sources. Typically used to address musculoskeletal pain and joint inflammation, as well as several skin complaints, its benefits in supporting allergic rhinitis are now becoming apparent.
Supplementing with MSM has proven to exhibit significant relief from hayfever symptoms as well as onset. MSM has been shown to have anti-inflammatory properties and can mitigate the abnormal immune responses that trigger inflammation. Human studies have demonstrated a positive effect of antioxidant capacity, which may also play a role in the mechanism of action of MSM under allergic rhinitis conditions.12
Curcumin, the active ingredient in turmeric exerts potent anti-inflammatory and antioxidant effects. In a recent double-blind study, supplementing with curcumin alleviated hay fever symptoms including sneezing, excess mucous production and nasal congestion through a reduction of nasal airflow resistance. Curcumin was found to exert diverse immunomodulatory effects, including the suppression of pro inflammatory markers.13
Omega-3 Fatty Acids
Up until around 100 years ago the omega-6/3 ratio has been around 4:1 or less, but the typical western diet now provides a ratio of around 20:1 in favour of omega-6. The overconsumption of linoleic acid, mainly from industrial omega-6 seeds oils such as soybean, corn, sunflower and safflower oil, coupled with a lack of omega-3 fatty acids in the diet creates a pro-inflammatory and pro-allergic state.
Omega-3s are utilized by the body to resolve and lower inflammation, whereas omega-6 polyunsaturated fatty acids are primarily used for increasing inflammation. Thus, the rise in the omega-6/3 ratio over the past 100 years is likely to be driving chronic low-grade inflammatory conditions including allergies.14
The best natural sources of Omega-3 are flaxseeds, fish and shellfish, particularly oily fish such as mackerel and sardines. Increasing dietary intake of omega-3 fatty acids can help to reduce the production of inflammatory prostaglandins and inflammatory cytokines. Omega 3 is a membrane stabiliser, which inhibits inflammatory cascades and supplementation with this fatty acid has demonstrated immunoregulatory benefits for inflammatory conditions such as allergies.15
Hay fever, the hygiene hypothesis and gut health
Western societies seem to suffer with hay fever in far larger numbers than the rest of the world which has led to scientists believing that the ‘hygiene hypothesis’ is one of the potential contributors. This hypothesis suggests that our increasingly hygiene-focused lifestyles, removed from the bacteria we would be normally be exposed to in nature, has decreased the diversity of bacteria found in our own microbiome.
As your gut plays a central role in immune system homeostasis, this has implications for our immunity, which can be unnecessarily sent into overdrive by pollen – but supporting the diversity of your gut bacteria has the potential to support immune function and have a positive impact on allergic symptoms.16
Probiotics are living microorganisms that confer a physiologic benefit to the host and are found naturally in fermented foods such as yoghurt, kefir, miso and sauerkraut. They have been used successfully in a number of immune and allergen-mediated conditions such as atopic dermatitis and rheumatoid arthritis.19,20
Several studies have highlighted the potential therapeutic use of probiotics to both prevent and reduce the symptoms of hay fever, thus improving quality of life and the reliance on traditional medicines such as antihistamines.16,17
Evidence suggests that probiotics may serve as immunomodulators with the ability to alter both innate and adaptive immune responses and could therefore have the ability prevent the overstimulation of the immune system as found in hay fever. Probiotics react with your natural gut bacteria and confer an array of beneficial effects on your gut’s immunologic barrier to maintain both gastrointestinal and systemic immunity.18
Different probiotic strains will convey different health benefits for the host so a broad-spectrum formula with both Lactobacillus and Bifidobacterium strains is recommended – and it is advisable to take a probiotic supplement in preparation for the hay fever season as opposed to waiting until your symptoms develop.
Dietary support for hay fever
Some foods are particularly high in naturally occurring histamine and can create a similar response in people who are sensitive to these foods. This is not necessarily an allergic response but more as a result of a high intake of histamine, coupled with a compromised ability to break-down histamine, which results in similar symptoms. A low-histamine, anti-inflammatory diet can often reduce the severity of allergy symptoms.
Foods high in histamine include: fermented foods, aged cheese, citrus fruits, fish, shellfish, avocados, spinach, cocoa, leftover meat or fish, fermented alcohol like wine, champagne, and beer.
Foods low in histamine include: freshly cooked meat, poultry (frozen or fresh), freshly caught fish, eggs, rice, quinoa, fresh fruits, fresh vegetables (except tomatoes, spinach, avocado and aubergine), olive oil, coconut oil, leafy herbs and herbal teas.
Certain foods can make symptoms much worse, so knowing those triggers is an important part of an overall plan. Recommendations are to include lots of anti-inflammatory, immune supporting foods such as:
- Blueberries, blackberries, purple grapes, blackcurrants, raspberries – these contain anthocyanins which are considered powerful antioxidants and possess anti-inflammatory properties. They also contain high quantities of vitamin C and quercetin, making them an excellent anti-inflammatory agent.
- Garlic and onions: garlic is a great source of quercetin. It can also help to boost the immune system and is a good source of vitamin C and potassium. Onions are another source of quercetin. Onions also contain high amounts of vitamin C and biotin.
- Ginger is known to slow down histamine production by reducing IgE levels.21
- Omega-3 rich foods are known to have anti-inflammatory properties. Sources include wild salmon, mackerel, sardines, herring, walnuts, chia seeds and flaxseeds.
Stress – as mentioned, our gut microbiota and the integrity of the intestinal epithelium work together to support both our innate and adaptive immune response. Psychological stress has shown to be associated with both microbial dysbiosis and intestinal permeability, as well as exacerbating intestinal and systemic inflammation – and thus can contribute to the dysfunction of our immune system.22
Sleep – prolonged sleep restriction and the accompanying stress response invoke a persistent unspecific production of pro-inflammatory cytokines (chronic low-grade inflammation) and also produce immunodeficiency, which both have detrimental effects on health.23
Acupressure – a component of Chinese medicine represents a non-invasive manipulation technique in which manual pressure is used to stimulate acupuncture points along meridians on the body or ear. Acupressure is thought to stimulate biologically active points and can help to reduce the concentrations of stress hormones and has shown therapeutic effects for patients with hay fever. Self-applied acupressure has been shown to improve quality of life, a reduction in both symptoms and anti-allergy medication intake.24
Saline nasal irrigation, either as a spray or rinsing the nose has proven to be a simple and inexpensive treatment that can reduce the symptoms of hay fever and reduce the reliance on conventional medication for the condition.25
- Hay fever may occur in almost half of UK adults and have a significant impact on everyday life
- Supplement, dietary and lifestyle preparations should be implemented as early as possible, ideally before any symptoms begin
- Oxidative stress is likely to be at the heart of hay fever, and ensuring a great level of antioxidant nutrients is recommended
- Anti-inflammatory and immune supportive nutrients, such as beta 1-3, 1-6 glucans and omega 3 fatty acids can be supportive
- Gut health and the balance of our microbiome is essential for an appropriate immune response and the administration of probiotics has been shown to improve hay fever symptoms
- A low-histamine, anti-inflammatory diet can often reduce the severity of allergy symptoms.
- It is also important to consider lifestyle factors such as stress and disturbed sleep, which can exacerbate hay fever symptoms.
Our Aller-G Formula provides a powerful combination of nutrients including quercetin and beta glucan, alongside vitamins A, C, and D, selenium and zinc.
- Why are Allergies on the Rise? Allergy Statistics — Natasha Allergy Research Foundation (2021). (Accessed: February 14, 2023).
- Statistics and Figures | Allergy UK | National Charity (2021). (Accessed: February 14, 2023).
- Han M, Lee D, Lee SH, Kim TH. Oxidative Stress and Antioxidant Pathway in Allergic Rhinitis. Antioxidants (Basel). 2021 Aug 9;10(8):1266. doi: 10.3390/antiox10081266. PMID: 34439514; PMCID: PMC8389336.
- Su J, Li T, Pan H. Association of vitamin A supplementation with immune-related allergic diseases: A meta-analysis. Front Nutr. 2022 Nov 18;9:984161. doi: 10.3389/fnut.2022.984161. PMID: 36466392; PMCID: PMC9715979.
- Vollbracht C, Raithel M, Krick B, Kraft K, Hagel AF. Intravenous vitamin C in the treatment of allergies: an interim subgroup analysis of a long-term observational study. J Int Med Res. 2018 Sep;46(9):3640-3655. doi: 10.1177/0300060518777044. Epub 2018 Jun 27. PMID: 29950123; PMCID: PMC6136002.
- Mailhot G, White JH. Vitamin D and Immunity in Infants and Children. Nutrients. 2020 Apr 27;12(5):1233. doi: 10.3390/nu12051233. PMID: 32349265; PMCID: PMC7282029.
- Murdaca G, Gerosa A, Paladin F, Petrocchi L, Banchero S, Gangemi S. Vitamin D and Microbiota: Is There a Link with Allergies? Int J Mol Sci. 2021 Apr 20;22(8):4288. doi: 10.3390/ijms22084288. PMID: 33924232; PMCID: PMC8074777.
- Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018 Mar 1;118(3):181-189. doi: 10.7556/jaoa.2018.037. PMID: 29480918.
- Zhou J, Lu Y, Li F, Wu W, Xie D, Feng Y. In vitro and in vivo Antiallergic Effects of Taurine on Allergic Rhinitis. Int Arch Allergy Immunol. 2020;181(6):404-416. doi: 10.1159/000505209. Epub 2020 May 15. PMID: 32417836.
- Jafarinia M, Sadat Hosseini M, Kasiri N, Fazel N, Fathi F, Ganjalikhani Hakemi M, Eskandari N. Quercetin with the potential effect on allergic diseases. Allergy Asthma Clin Immunol. 2020 May 14;16:36. doi: 10.1186/s13223-020-00434-0. PMID: 32467711; PMCID: PMC7227109.
- Kirmaz C, Bayrak P, Yilmaz O, Yuksel H. Effects of glucan treatment on the Th1/Th2 balance in patients with allergic rhinitis: a double-blind placebo-controlled study. Eur Cytokine Netw. 2005 Jun;16(2):128-34. PMID: 15941684.
- Hewlings S, Kalman DS. Evaluating the Impacts of Methylsulfonylmethane on Allergic Rhinitis After a Standard Allergen Challenge: Randomized Double-Blind Exploratory Study. JMIR Res Protoc. 2018 Nov 29;7(11):e11139. doi: 10.2196/11139. PMID: 30497995; PMCID: PMC6293242.
- Wu S, Xiao D. Effect of curcumin on nasal symptoms and airflow in patients with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2016 Dec;117(6):697-702.e1. doi: 10.1016/j.anai.2016.09.427. Epub 2016 Oct 24. PMID: 27789120.
- DiNicolantonio JJ, O’Keefe J. The Importance of Maintaining a Low Omega-6/Omega-3 Ratio for Reducing the Risk of Autoimmune Diseases, Asthma, and Allergies. Mo Med. 2021 Sep-Oct;118(5):453-459. PMID: 34658440; PMCID: PMC8504498.
- Kumar A, Mastana SS, Lindley MR. n-3 Fatty acids and asthma. Nutr Res Rev. 2016;29(1):1-16. doi:10.1017/S0954422415000116
- Luo C, Peng S, Li M, Ao X, Liu Z. The Efficacy and Safety of Probiotics for Allergic Rhinitis: A Systematic Review and Meta-Analysis. Front Immunol. 2022;13:848279. Published 2022 May 19. doi:10.3389/fimmu.2022.848279
- Zajac AE, Adams AS, Turner JH. A systematic review and meta-analysis of probiotics for the treatment of allergic rhinitis. Int Forum Allergy Rhinol. 2015;5(6):524-532. doi:10.1002/alr.21492
- Maldonado Galdeano C, Cazorla SI, Lemme Dumit JM, Vélez E, Perdigón G. Beneficial Effects of Probiotic Consumption on the Immune System. Ann Nutr Metab. 2019;74(2):115-124. doi:10.1159/000496426
- Fang Z, Li L, Zhang H, Zhao J, Lu W, Chen W. Gut Microbiota, Probiotics, and Their Interactions in Prevention and Treatment of Atopic Dermatitis: A Review. Front Immunol. 2021;12:720393. Published 2021 Jul 14. doi:10.3389/fimmu.2021.720393
- Bungau SG, Behl T, Singh A, et al. Targeting Probiotics in Rheumatoid Arthritis. Nutrients. 2021;13(10):3376. Published 2021 Sep 26. doi:10.3390/nu13103376
- Kawamoto Y, Ueno Y, Nakahashi E, Obayashi M, Sugihara K, Qiao S, Iida M, Kumasaka MY, Yajima I, Goto Y, Ohgami N, Kato M, Takeda K. Prevention of allergic rhinitis by ginger and the molecular basis of immunosuppression by 6-gingerol through T cell inactivation. J Nutr Biochem. 2016 Jan;27:112-22. doi: 10.1016/j.jnutbio.2015.08.025. Epub 2015 Sep 1. PMID: 26403321.
- Ilchmann-Diounou H, Menard S. Psychological Stress, Intestinal Barrier Dysfunctions, and Autoimmune Disorders: An Overview. Front Immunol. 2020 Aug 25;11:1823. doi: 10.3389/fimmu.2020.01823. PMID: 32983091; PMCID: PMC7477358.
- Irwin MR. Why sleep is important for health: a psychoneuroimmunology perspective. Annu Rev Psychol. 2015 Jan 3;66:143-72. doi: 10.1146/annurev-psych-010213-115205. Epub 2014 Jul 21. PMID: 25061767; PMCID: PMC4961463.
- Israel L, Rotter G, Förster-Ruhrmann U, Hummelsberger J, Nögel R, Michalsen A, Tissen-Diabaté T, Binting S, Reinhold T, Ortiz M, Brinkhaus B. Acupressure in patients with seasonal allergic rhinitis: a randomized controlled exploratory trial. Chin Med. 2021 Dec 18;16(1):137. doi: 10.1186/s13020-021-00536-w. PMID: 34922567; PMCID: PMC8684198.
- Hermelingmeier KE, Weber RK, Hellmich M, Heubach CP, Mösges R. Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis. Am J Rhinol Allergy. 2012 Sep-Oct;26(5):e119-25. doi: 10.2500/ajra.2012.26.3787. PMID: 23168142; PMCID: PMC3904042.
- DiNicolantonio JJ, O’Keefe JH. Magnesium and Vitamin D Deficiency as a Potential Cause of Immune Dysfunction, Cytokine Storm and Disseminated Intravascular Coagulation in covid-19 patients. Mo Med. 2021 Jan-Feb;118(1):68-73. PMID: 33551489; PMCID: PMC7861592.
If you have questions regarding the topics that have been raised, or any other health matters, please do contact our team of Nutritional Therapists.
Last updated on 22nd March 2023 by cytoffice