It is that time of year again, the daffodils are blooming, days are getting longer and warmer, and the beginnings of spring have emerged. Unfortunately, for a substantial proportion of the population, it signifies the beginning of a range of debilitating symptoms which can cause a very real burden to everyday life.
The UK has one of the highest rates of hay fever in the world, with statistics showing that between 10-15% of children and 26% of adults in the UK suffer – this equates to around 16 million of us.1,2 According to the director of Pollen UK and the scientific director of Allergy UK, by 2030 nearly half of the population are predicted to be affected by hay fever in England.
Climate change, pollution, urbanisation, nutrient deficiencies and stress have all been linked to rising figures, and while these factors spell bad news for many of us, it is possible to help minimise the risk and impact of symptoms through natural nutrients. In this week’s blog, we will give a timely reminder of some of the nutrients that may help to reduce the risk and symptoms of hay fever during the period of suffering.
What is Hay fever?
The medical term for hay fever is ‘allergic rhinitis’ and it is caused by our immune system mounting an attack on airborne pollen from plants, trees, and grass. Pollen is the fine powder released by plants as part of their reproductive cycle. Grass pollen is the most common allergen but tree and weed pollens can also cause allergic reactions.3
The excessive reaction in sufferers causes the immune system response to produce the antibody ‘IgE’ (immunoglobulin E). The IgE binds to white blood cells, and this causes the release of the chemical histamine and subsequent inflammation. It is histamine that is responsible for the classic symptoms associated with hay fever and explains why the most common type of intervention normally comes in the form of antihistamines.
Hay fever shares symptoms with perennial (year-round) allergic rhinitis but occurring as a reaction to pollen during the early spring and summer months.
What are the symptoms?
- Itchy eyes/throat
- Sneezing, blocked/runny nose
- Watering, red eyes (allergic conjunctivitis)
- Headaches, blocked sinuses
- Shortness of breath
- The sensation of mucous running down the back of the throat, sometimes called ‘post-nasal drip’
Why is hay fever on the rise?
Current research indicates that coping with the hay fever season is set to get harder, with climate change projected to increase the severity of the pollen season. The pollen season is also expected to start earlier and last longer as temperatures warm and carbon dioxide concentrations rise. This is likely to lead to more severe symptoms and for prolonged periods of time.4,5 The UK is also facing a threat from changes in the geographical distribution of allergenic plants, due to climate change.6
Pollution and urbanisation
England’s urban population is growing faster than the rural population and in cities globally, pollution is increasing. Many studies demonstrate a strong collaboration between airborne pollutants and hay fever. Air pollutants can modify pollen allergenicity through interaction with allergens by various mechanisms, which include7
- facilitating pollen allergen release
- acting as adjuvants to stimulate IgE-mediated responses
- modifying allergenic potential
- enhancing the expression of some allergens in pollen grains
Research shows that the allergenicity of grass pollen is greater in urban than in rural areas.8
Allergies are considered disorders of the immune system and chronic stress can lead to dysregulation of the immune system. According to the World Health Organisation, stress has been classified as the ‘health epidemic of the 21st century’.9
The Hygiene Hypothesis
The modern hygiene hypothesis suggests that the increased risk of allergies is due to our insistence on cleanliness and lack of exposure to a wide range of microbes. This deprives our bodies of immune stimulation, disrupting normal immune development. Reduced exposure to microorganisms in early life is responsible for a shift in the balance between T1/T2 cells towards the overactive T2 arm, which stimulates IgE-mediated allergic responses.10
Poor gut health
There is a complex interaction between diet, our microbiota, and the immune system. Consuming Western-style diets may contribute to the loss of key microbial species that are important for the immune system. A lack of diversity in the gut microbiota is associated with all types of allergies, especially seasonal.
Prepare and be ready
For many, hay fever starts at the onset of spring, and for others it arrives slightly later. It is beneficial beforehand to take care of yourself, minimise your stress and exposure to pollutants, and support both your immune system and gut health. Avoiding mucous-forming, pro-inflammatory foods may be beneficial as well as reducing your allergic potential by avoiding common allergenic foods. It may be worthwhile finding out if you have any food intolerances.
If you want to avoid OTC antihistamines and the side effects that come with them, then there are nutrients that act as natural antihistamines in the body, which we will take a look at below. As well as being made in the body, histamines are also found in certain foods, so reducing consumption of high histamine foods such as wine, cheese, coffee, and chocolate may prove beneficial too. Diet is an important source of nutrients that can modulate the risk or severity of allergic diseases11 and below we will discuss nutrients that deserve particular attention.
Support the immune system – antioxidants
A strong immune system is essential to help fight hay fever symptoms. Vitamins A, C, D, E and the minerals zinc and selenium are all antioxidants that can support immune function.
Oxidative stress enhances inflammatory responses relevant to allergy and therefore, antioxidants may play a key role in allergic disease.12 Epidemiological studies have suggested that fruits and vegetables that contain several antioxidants help protect against allergic diseases.13 Furthermore, many environmental pollutants induce oxidative stress and are one of the factors accounting for the rise in hay fever.
Vitamin C has been widely discussed as helpful in reducing the symptoms of hay fever and is a really important anti-allergy nutrient. It has antioxidant properties and hence may provide a beneficial role in fighting free radicals in respect of allergic reactions. Vitamin C contributes to the normal function of the immune system, and it is reported that it also has natural antihistamine properties by breaking down the molecular structure of histamine, therefore decreasing its volume in the blood.
Furthermore, adrenal fatigue is often experienced by hay fever sufferers. 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. 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.
Studies reveal that vitamin D has important functions in the immune system and might influence the course of immune-mediated disorders. Lower vitamin D levels have been associated with allergic disease and elevated serum IgE.
In one study, a remarkable correlation was observed among vitamin D deficiency and allergy.14 Vitamin D levels are associated with Th1/Th2 balance in allergic rhinitis.
It has also been suggested that vitamin D deficiency might impair epithelial barrier integrity, that in turn leads to immune imbalance that compromises immunological tolerance.
An adequate intake of selenium is essential for a healthy immune system although deficiencies are common due to soil and food chain depletion. Selenium helps to alleviates hay fever by increasing glutathione peroxidase levels, which play a vital role in detoxicating excess histamine levels. Selenium also helps to stabilise membranes.15
Further support for the immune system
Beta Glucan 1 3, 1 6
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 fighting 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. It can be taken throughout the year to help fight a wide range of allergies and for overall immune support.
Quercetin is found in a variety of fruits and vegetables and is probably the most talked about bioflavonoid with respect to hay fever. It is a potent antioxidant and also promotes a healthy inflammatory response. 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.
Omega-3 Fatty Acids
The increased incidence of allergic conditions, such as hay fever, is associated with the over-consumption of omega-6 fatty acids (pro-inflammatory) in relation to omega-3 fatty acids (anti-inflammatory) – common in Westernised diets. EPA and DHA may have immunomodulatory properties to mitigate unwanted inflammation and reduce the risk of allergy development. 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.
Propolis is a sticky resin gathered by honey bees from leaf buds, the bark of trees and other botanical sources. Bees metabolise the propolis and use it to seal, disinfect and protect their hives. Propolis is used by the bees for a range of protective purposes within the hive due to its natural antibiotic, anti-fungal and antibacterial properties. Propolis is a complex food, and over 180 natural compounds have been identified including vitamins, minerals, fatty acids and amino acids. Propolis is one of nature’s richest sources of bioflavonoids and this is one of the reasons that it is considered to be an excellent natural antioxidant. Because of the many compounds propolis contains, including flavonoids, its high antioxidant levels are beneficial in boosting immunity.16 One study clearly demonstrated that propolis may be effective in the relief of symptoms of allergic rhinitis through inhibition of histamine release.17
Support gut health 18-23
Most of our immune system resides in the gut, so we should pay close attention to the health of our gut in relation to allergy. The microflora hypothesis of allergic diseases states that an unhealthy microbiota composition, attributable to urbanisation or westernisation, contributes to the development of allergies. Furthermore, there are many studies that suggest the involvement of dietary habits and the gut microbiome in allergic diseases. The gut microbiota produces bioactive metabolites which influence host immune responses through the interplay with regulatory T (Treg) and dendritic cells. Therefore, the composition of the intestinal microbiota potentially links with the development of allergic diseases.
Many published studies indicate that probiotics are beneficial in relieving hay fever. Probiotics can interact with the host immune system and may modify the natural course of the allergic disease.
Mechanisms of action include:
- downregulation of systemic immune markers
- regulatory effect on Th2 balance
In one randomised controlled trial of 173 subjects with hay fever, either two capsules of probiotics or identical placebos were administered. At the end of 8 weeks, those taking the probiotics had improved (less symptoms) by 68%.
Further studies have shown that probiotics
- alleviated nasal symptoms, prevented the pollen-induced infiltration of eosinophils into the nasal mucosa
- modulated Th2-skewed immune responses in allergic rhinitis
- modulated immune responses and alleviated the severity of symptoms in hay fever
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. Research shows that vitamin A is associated with a decreased odds of hay fever, which may be related to the role of vitamin A in modulating intestinal immune responses.
Other gut supporting nutrients include omega 3, D3, and quercetin.
The percentage of people suffering with hay fever is set to increase, and for those already suffering, symptoms are likely to get worse and the time experiencing symptoms prolonged. OTC antihistamines can cause an array of side effects and so natural antihistamines are a desirable alternative. The immune system, microbiome and allergies are closely intertwined and to minimise the risk of developing hay fever, or to alleviate the symptoms associated with it, it is a good idea to nurture and support both. Being mindful of your exposure to pollution and stress levels can also be beneficial.
- The UK has one of the highest rates of hay fever in the world, with statistics showing that between 10-15% of children and 26% of adults in the UK suffer
- Climate change, pollution, nutrient deficiencies, urbanisation and stress have all been linked to rising figures
- The medical term for hay fever is ‘allergic rhinitis’ and is caused by our immune system mounting an attack to airborne pollens from plants, trees, and grass
- This excessive reaction causes the immune system to produce the antibody ‘IgE’ (immunoglobulin E). IgE binds to white blood cells, and this causes the release of the chemical histamine
- Symptoms include Itchy eyes/throat, sneezing, blocked/runny nose, watering, red eye headaches, blocked sinuses, shortness of breath, tiredness
- Support the immune system with antioxidants (vitamin C, vitamin D, selenium, quercetin), and omega 3’s, probiotics, Beta Glucan 1 3, 1 6
- Support gut health with vitamin A and probiotics
If you have questions regarding the topics that have been raised, or any other health matters, please do contact me by phone or email at any time.
Amanda Williams and the Cytoplan Editorial Team
- Why are Allergies on the Rise? Allergy Statistics — Natasha Allergy Research Foundation (2021). Available at: https://www.narf.org.uk/the-allergy-explosion (Accessed: March 31, 2022).
- Statistics and Figures | Allergy UK | National Charity (2021). Available at: https://www.allergyuk.org/about-allergy/statistics-and-figures/ (Accessed: March 31, 2022).
- Hay fever symptoms & treatments – Illnesses & conditions | NHS inform (no date). Available at: https://www.nhsinform.scot/illnesses-and-conditions/immune-system/hay-fever (Accessed: April 1, 2022).
- Climate change expected to make European hay fever seasons much worse | New Scientist (2021). Available at: https://www.newscientist.com/article/2272420-climate-change-expected-to-make-european-hay-fever-seasons-much-worse/ (Accessed: March 31, 2022).
- Trouble ahead as hayfever incidence rockets (no date). Available at: https://www.pharmacymagazine.co.uk/clinical/trouble-ahead-as-hay-fever-incidence-rockets (Accessed: March 31, 2022).
- When is hay fever season in the UK? – Met Office (no date). Available at: https://www.metoffice.gov.uk/weather/warnings-and-advice/seasonal-advice/health-wellbeing/pollen/when-is-hayfever-season (Accessed: April 1, 2022).
- Sedghy, F. et al. (2018) “Interaction Between Air Pollutants and Pollen Grains: The Role on the Rising Trend in Allergy,” Reports of Biochemistry & Molecular Biology, 6(2), p. 219. Available at: /pmc/articles/PMC5941124/ (Accessed: April 1, 2022).
- D’amato, G. et al. (2001) “The role of outdoor air pollution and climatic changes on the rising trends in respiratory allergy,” Respiratory Medicine, 95(7), pp. 606–611. doi:10.1053/rmed.2001.1112.
- Stress: The Health Epidemic of the 21st Century | SciTech Connect (2016). Available at: https://scitechconnect.elsevier.com/stress-health-epidemic-21st-century/ (Accessed: March 24, 2022).
- Deo, S.S. et al. (2010) “Role played by Th2 type cytokines in IgE mediated allergy and asthma,” Lung India, 27(2), pp. 66–71. doi:10.4103/0970-2113.63609.
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- Keles, E., Ozkara, S., Ilhan, N., Gungor, H., Karlidag, T., & Yalcin, S. (2015). The Relationship between Th1/Th2 Balance and 1α, 25-Dihydroxyvitamin D 3 in Patients with Allergic Rhinitis. Turkish Archives of Otorhinolaryngology, 53(4), 139–143. https://doi.org/10.5152/TAO.2015.1187
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- Shinmei, Y., Yano, H., Kagawa, Y., Izawa, K., Akagi, M., Inoue, T., & Kamei, C. (2009). Effect of Brazilian propolis on sneezing and nasal rubbing in experimental allergic rhinitis of mice. Immunopharmacology and Immunotoxicology, 31(4), 688–693. https://doi.org/10.3109/08923970903078443
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