Herbal Therapeutics for Seasonal Allergies
A two- phase approach
What is an allergy?
An allergy is a state of immune hypersensitivity to a normally harmless environmental substance.
A benign agent in the environment comes into contact with the body and triggers and immune response. What we define as an allergic response is really the 2 nd interaction with the stimuli, that the body recognized last time as a dangerous foreign particle and formed antibodies to.
Allergic reactions are distinctive because of excessive activation of mast cells and basophils by
Immunoglobulin E (IgE). This reaction results in an inflammatory response, which can range from uncomfortable to dangerous.
As we know, the etiology of allergies is complex, and there is a lot of discussion as to why it has become increasingly more prevalent in our society. The answers are very similar to why our entire immune system is misfiring. There appears to be some genetic contributors, but the change in incidence and severity is likely due to a host of lifestyle and environmental contributors.
Allergic variability
As you know, it is typical for individuals with allergies to have the severity of their allergies vary from year to year. This can be due to antigen environmental variability (different amount of allergens in the air) and/or has to do with stress variability, nutritional status total antigenic load, immune wind up, or other ‘ground’ factors, that is, factors that have to do with the individual more than the environment.
We can’t change the amount of allergen in the environment if it is a pollen or similar offending agent, though we can limit our exposure often times.
But we can change the ground state, the healthy immune state of the atopic individual. If there is systemic inflammation, due to food allergies, stress, poor diet, adrenal dysregulation, poor sleep, total antigenic load etc, then the individual’s immune system is in hyperdrive and ‘primed’ to respond more easily. This idea of physiologic priming is also influential in the case of conditions like anxiety, inflammation, pain and many more situation. increases the experience of allergic symptoms and the converse, lack of systemic inflammation, rest, good nutrient levels and low antigenic load reduces the severity of allergic response regardless of environment. increases the experience of allergic symptoms and the converse, lack of systemic inflammation, rest, good nutrient levels and low antigenic load reduces the severity of the allergic response regardless of environment.
Terms to Recall:
Antigen: any substance that triggers and immune response
Allergen: benign substance that doesn’t trigger an immune response in an average person but does in atopic individuals
Antibody=Immunoglobulin
IgE: Type of immunoglobulin
Atopy: IgE mediated allergies
Atopic individual: Someone prone to allergic response.
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Th2 pathway: Immune response where the Thelper cell triggers B cells to produce IgE antibodies to an antigen
Th2 allergy pathway: Immune response where Thelper cells trigger B cells to produce antibodies to typically benign environmental substances like dander, pollen, dust etc.
Th2
This is a classical Th2 pathway response. Remember that Th2/Th1 responses are somewhat oversimplified. But they can offer us one way of examining part of the mechanism of this condition.
TH2 Cytokines research in allergies: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893428/ but then this calls Th1/Th2 model into question: http://www.ncbi.nlm.nih.gov/pubmed/12946237
How are we exposed to antigens in a type hypersensitivity response?
There are 4 routes of exposure to allergens:
1)Skin contact (latex, animal scratches, metal, poison oak etc) where the allergen diffuses across the skin, usually resulting in a rash that is inflamed red and itchy.
2)Injected is by insect sting or hypodermic needle. Injected allergies can result in dangerous types of allergic response due to the systemic nature of the spread of the allergen. Lung and throat constriction can ensue. These are more serious than topical skin contact allergies due to possibility of severity.
3)Ingested allergies (IgE) such as peanut or shellfish can also lead to severe, life threatening responses as well. This is not the same as the delayed hypersensitivity response. This response is immediate and usually very obvious and shows up on IgE tests.
4)Inhaled allergens are the focus of the this class and an increasingly common type of allergen in
Portland during the fall and Winter (mold and mildew) and spring and summer (pollen) and non seasonal dander, mites etc.
Seasonal Allegies:
Protocol
The most effective approach to dealing with allergies is not only having a protocol that works, but in committing to following a protocol that works, and then actually following it for an adequate period of time. It requires preventative steps. However we tend to be much better at being reactive then proactive. So a sound allergy protocol is heavily influenced by compliance.
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The allergy protocol that we recommend is a two-phase protocol that acknowledges that most allergy sufferers (most people and herbal clients for that matter) are not perfect in their quest to be the best herbal patient, and will not completely stick to a given protocol.
This protocol also takes into account that most people wait until they have unbearable symptoms before they seek care, especially herbal support. Furthermore, this protocol takes into account that it takes some time to change the terrain or internal body environment before change is apparent.
PREVENTION
PHASE 1 – Prevention
Aim to change the terrain BEFORE allergy season: This is the preventive phase of the protocol and aims to change the terrain within the body-mind before a client faces allergy season. This phase is crucial to avoid the full brunt of the condition but can be difficult to convince people to undertake any herbal/food/lifestyle protocol before uncomfortable symptoms develop. It is a rare individual that is pro-active with their health, which means that far more people are more or less reactionary. We will hammer this point in with a modified Chinese proverb.
"To fight a disease after it has occurred [or treat allergy symptoms after allergy season has begun] is like trying to dig a well when one is thirsty or forging a weapon once a war has begun." The
Yellow Emperor's Classic of Internal Medicine, The Nei Ching, c.
1000 B.C.
When does prevention begin? This protocol should ideally begin at least 6-8 weeks before expected exposure to allergens. For Portland Spring allergies this is mid to late
January. For Oregon Mold allergies, this is 6 weeks prior to Oct 15. It is of course even better if someone adopts a whole allergy-preventative lifestyle and spends the whole year changing the terrain.
Allergen Load: It is important to remember that each of us has an allergy threshold. We are all exposed to different types of allergens in our day-to-day lives. This includes environmental allergens like pollen, mold, and dust, as well as food allergens and chemicals in personal care products etc. All of these contribute to the total allergen load our bodies are equipped to handle at any particular point in time. Some allergens are easier to avoid than others, and some are totally our of our control.
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PHASE 2 - Phase 1 + Symptom Support
Relative need for Phase 2: The necessity of Phase two is contingent on compliance with
Phase 1. Depending on how much success we have with implementing phase 1, we will have some remainder of allergy symptoms during our typical allergy season.
Once Allergy Symptoms Appear: This protocol is helpful for acute allergy symptoms and represents what we can do once allergy symptoms have already begun. And again, this is NOT an ideal time to try to deal with allergies, because the allergen threshold has already been reached and it takes very little to set off the immune system reaction to an allergen at that point.
PHASE 1
Decrease total Antigen Exposure and REDUCE Contact with Inflammatory
Substances – as well as things that aggravate Pitta & Kapha Doshas in particular:
Starting in January or in September – THINGS TO AVOID:
 All other known or potential allergens like: pet, dust mite, dust, mold, chemical etc.
 All known and potential food allergens (wheat, gluten, corn, other grains, dairy, soy, legumes, eggs, nuts, certain fruits etc.). Preferably always avoid all food allergens once you have identified them.
 Tuna, swordfish, or shark, or seafood from the gulf or Japan...or maybe any west coast seafood
 Meat, other than grass-fed or wild meat
 Dairy even if there is no true allergy because it increases cold and damp excess as well as Kapha in the body. This contributes to excess mucus/phlegm production.
Dairy includes including ice cream, yoghurt, cheese, cream in coffee, etc. Casein is like glue and a common allergen.
 Oranges/orange juice (also phlegm producing)
 All chilled and iced drinks and foods as these cool the system down too much and also increase mucus production. These foods aggravate Kapha and Phlegmatic constitutional tendencies.
 Omega 6 fats (corn oil, canola, cotton seed, safflower, should be avoided as they encourage inflammation and an allergic response. Also aggravate Pitta as they cause inflammation.
 Eating out at any questionable establishments, which unfortunately is most restaurants. (Especially when the ingredients are unknown) - and particularly avoid eating fried foods in restaurants, as the quality of oil is most often toxic and contribute to inflammation in the body.
 Adrenal-depleting foods like coffee, caffeinated drinks, and alcohol, which are also heating and aggravate Pitta.
 Refined sugar, which deregulates the immune system.
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 Processed carbohydrates (pasta, pizza, baked goods) – also cause inflammation.
 Personal care products with ingredients you don’t recognize or that you recognize as chemicals.
Specific Dietary Recommendations for Phase 1:
 General Food Recommendations: Eat whole foods, colorful veggies, and meat from healthy grass-fed hormone-free animals, as well as fresh wild seafood if from a safe source (if that still exists).
 Eat Mast Cell Stabilizing herbs and especially Bioflavonoids DAILY o Dark berries, colorful veggies (see charts at end of this document) o Berries (rich in bioflavonoids, and especially proanthocyanidins)
 Blueberry, huckleberry, raspberry, elderberry, blackberry, black cherry, currants, hawthorn berry, pomegranate, goji berry, bilberry, aronia berry, cranberry. o Dosage is ½ cup day of fresh berries.
 Some companies make freeze dried concentrates or even solid extracts. Which are fine if you can’t eat them fresh.
 If not in season, get frozen berries and make smoothies with immune amphoteric and anti-inflammatory powders. o Colorful Veggies:
 Beets, carrots, purple kale, purple potatoes, purple sweet potatoes, winter quash, sunburst squash, yams, rainbow chard, lacinato kale, peppers, chili peppers, tomatoes, carrots, etc.... o Proanthocyanidins:

Are a type of flavonoid molecule found in many plants such as: apples, maritime pine bark, cinnamon, aronia fruit, cocoa beans, grape seed, grape skin (procyanidins and prodelphinidins, and red wines of Vitis vinifera (the common grape). Bilberry, cranberry, black currant, green tea, black tea, and many other plants also contain these flavonoids.
Cocoa beans contain the highest concentrations.
Açaí oil, From the fruit of the açaí palm (
Euterpe oleracea also contains proanthocyanidins .
 These molecules are strong antioxidants (reduce oxidative damage in the body)
 anti-inflammatory (reduce inflammation by preventing aberrant inflammatory activity and reducing pro-inflammatory prostaglandins)
 antihistaminic in that they stabilize mast cells (preventing mast cells from degranulating and releasing histamines)
 increase capillary integrity (by binding with collagen fibers to strengthen capillaries). This is helpful for capillary fragility/easy bruising, varicose veins, allergic symptoms, vascular issues, eye conditions involving cappillaries.
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 Omega 3 Fatty acids to correct an imbalanced O3/O6 ratio.
 Probiotics to insure healthy digestion – homemade fermented vegetables (kimchi etc is best)
LIFETYLE
 Take steps to regulate digestion and elimination, as well as liver function. (bitters, carminatives, mild cholagogues)
 Neti pot yes, but use boiled water that is no longer hot-tinctures should be well diluted if used in neti.
 Exercise such as High Intensity Interval Training (HIIT) combined with walks, hikes, yoga, qi gong, and the like.
 REDUCE UNPRODUCTIVE CHRONIC STRESS!!!!! o Special Note: Stress has a very detrimental effect on immune function. o Stress is very heating. o Unresolved stress causes increased allergic response.
 Short Fasts: Allergies are excessive responses and respond well to an allergy free short fast. Short fasting can reduce excessive response if the person is strong enough to handle a fast. Fasting is cooling and draining of excess, especially if combined with appropriate cooling remedies like Gotu kola, and other cooling detoxifying herbs.
Phase 1 Herbs:
1.
Immune Amphoterics - herbs to help balance excessive immune response
 American Ginseng
 Ashwaganda
 Eleuthero
 Holy Basil
 Licorice
 Maitake
 Panax Ginseng (Asian)
 Reishi
 Astragalus (also stabilizes mast cells)
 Codonopsis
 Ginsengs
 Cordyceps
 Atractylodes- (transforms dampness) and thereby also dries up runny nose
2.
Anti-inflammatory Herbs –
Down-regulate excessive inflammatory immune response, without suppressing immune capability (as certain pharmaceuticals do).
Appropriate use is small amounts, along with immune amphoterics, especially if already a lot of inflammation and excess heat in the body.
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Use your humoral evaluation skills combined with client reports to determine the level of inflammation present.
 Boswelia serrata
 Chai hu Bupleurum sinensis
 Dan Shen Salvia militorrhiza
 Ginger
 Gotu kola
 Licorice
 Yarrow
 Chamomile
 Sarsaparilla
 Turmeric
 Unprocessed Rehmannia
 Baikal Skullcap
3.
Mast cell stabilizers
 Green tea
 Huckle and Blueberry
 Eleuthero
 Licorice
 Euphrasia
 Quercetin
 Pomegranite
 Goji
What if we start too late? If we start too late and want to catch up, we can approximate catching up by following the Phase 1 protocol as closely as possible.
Did you notice that anything helping out a complex interconnected system like the immune system doesn’t only help the immune system. It helps the entire person.
Taking steps to help with allergies is really taking steps to help the entire person live better in their environment.
Phase 2
If your client needs Phase 2 it means the terrain is not yet optimal
What if we start too late? If we start too late and want to catch up, we can approximate catching up by following the Phase 1 protocol to a T and increasing the dosages of the herbs.
1)
Use additional antihistaminic herbs that stabilize mast cells and/or astringe mucous membranes – as needed when allergy symptoms like itchy, burning, runny eyes and nose etc. are present.
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o Eyebright-Must be fresh some say? o Butterbur /Petasites (use PA free) o Osha and Oshala- Anti-histaminic-Also strongly antibacterial and anti viral and dries up upper respiratory secretions and catarrh. o Bayberry-Drying, warming and astringent-We’ll see this on coast trip o Horseradish (Amoracia rusticana) – bronchodilating and decongesting o Ginkgo o Goldenrod o Echinacea o Nettle (freeze dried is best) o Euclyptus o Garlic, o Green tea, o Huckle and Blueberry, Pomegranite, Goji
2)
Use cooling anti-inflammatory herbs along with immune amphoterics to down regulate excessive immune response. This is similar but not exactly the same as the mast cell stabilizing herbs. o Licorice o Turmeric o Baikal skullcap o Unprocessed rehmannia o Gotu kola o Chai hu Bupleurum
3)
Continue Immune amphoterics
Protocol/Formula Examples
Protocol/Formula Examples for Phase 1
 Avoid – client specific allergy trigger list
 Daily ½ cup of bioflavonoid/proanthocyanidin rich fresh berries o Or equivalent frozen berries or powder in a dairy free and soy-free smoothie.
 Morning/Day Time Formulas o Maitake, or Reishi related powdered concentrated extract ¼ tsp or capsules as directed - in smoothie or a little warm water. Only extracted mushrooms in water. (Mushroom Science for capsules)
1) Immune Tonic for - Depleted person, fatigued from stress, worry, emotional stress, overwork, yin deficiency, food sensitivities, and difficulty focusing/foggy thinking or forgetfulness.
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After all necessary lifestyle adjustments and modifications
Tincture Formula 1: o Ashwagandha o Gotu cola o Tulsi o Hawthorn o Turmeric o or Tincture Formula 1:
 Eleuthero
 Hawthorne
 Gotu kola
 If pronounced yin deficiency, pale, blood deficiency w scanty menstruation, or have PMS w breast distention, and may have night sweats - add Peonia lactiflora.
 If very sensitive and formula is too stimulating add skullcap.
 If digestion is very poor with abdominal distention and difficulty digesting is pronounced (constipation or chronic loose stool), and food allergies add cinnamon or digestive pairs
 If formula is too warming, remove Turmeric, and increase Gotu Kola.
 Turmeric??
2) Immune Tonic for – Person with frequent/recurring respiratory infections, excess heat and inflammation (may have tendency to allergy-induced skin conditions), digestive dysfunction (especially with chronic loose stool with undigested food/may alternate w constipation), may have (excessive sweating or night sweats, asthma with wheezing), deficient insomnia with disturbed sleep/restlessness/anxiety, fatigue/physical and emotional exhaustion. o Tincture Formula 2: o Astragalus, o American ginseng, o Atractylodes, o Unprocessed rehmannia, o Licorice.
 If too stimulating and disturbed shen is pronounced, add
Hawthorne.
 If astragalus is not well tolerated (legume allergy) or too warming/stimulating, substitute American ginseng.
 If pelvic stagnation with dark sluggish menstrual flow and cramps, add small amount of Dang gui (Angelica sinensis), or Angelica archangelica.
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 If hemorrhoids, abdominal bloating, epigastric discomfort, liver/gallbladder stagnation – add bupleurum.
3) Person with stress-related deficient or situational depression and/or anxiety with difficulty focusing/concentrating or ADHD, over-worked, addicted to coffee to ‘get going’, recovery from illness or trauma surgery or radiation treatment, excessive physical labor, may have dull mindedness/mental fog poor memory (excessive pot smoking?), poor sugar metabolism, tendency toward recurring infections when allergic triggers or high stress, fatigued, o Holy Basil, Rhodiola, Jiao gu lan, Hawthorne, Mimosa Bark.
4) Person with significant damp heat and inflammation in stomach & intestines, respiratory system, or painful urinary dysfunction, fever, or hot irritated, and/or swollen skin conditions, or liver fire rising (liver heat with headache, irritability, red eyes), other pronounced inflammatory conditions, or auto-immune flare-ups, and may have lack of thirst, or thirst with no desire to drink. May also have poor fat metabolism and liver heat condition. o Baikal skullcap – can be added to anti-inflammatory protocols as needed.
Should not be used long term as a tonic.
Teas o Jiao gu lan and/or Vana Tulsi /Damiana/Gotu Kola tea in the morning as a
‘pick-me-up’ during daytime. Can be used in combination with tincture protocol. o Green tea also ok as variety. Very high in Polyphenols and has somewhat balanced stimulating/calming compared to coffee which is unidirectional stimulating.
 Evening Formulas o Ashwaganda (powder) Reishi (powdered extract)
 Nourishing /Calming Evening Drink.
 Stir 1 tsp Ashwaganda and 1/8 tsp (or equivalent capsules) Reishi into hot water with ½ tsp honey (ideally rose petal honey) (or stevia) and a pinch of cardamom, or few drops of cardamom extract or small pinch of nutmeg. Evening drink while winding down.
Preferably with low lighting. o Essential oil of Lavender in diffuser by bedside for 15-30 min prior to going to bed. o Yoga stretching and heart-centered meditation just prior to crawling into bed or other nervous immune reregulating exercises
David Winston examples:
1) Astragalus, Eleuthero, Reishi, Bai-Zhu Atractylodes, Licorice, Schisandra berry and
Maitake. It helps to nourish and strengthen the immune system, allowing it to regain normal regulatory control, thus inhibiting allergic response.
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2) Reishi mushroom, Turmeric rhizome (Curcuma longa), Ashwagandha, Huang Qin root, Licorice and Unprocessed Rehmannia glutinosa)
Example Formulas Phase 2
1) Echinacea root, Osha root (Ligusticum porteri, or grayi, Eyebright herb Euphrasia officinalis, Horseradish root Armoracia rusticana, Bayberry root bark, Myrica gale (or cerifera)
Bioflavonoids/Proanthocyanidin Sources (mast cell stabilizers)
Anthocyanin-rich foods Anthocyanins Flavanols Proanthocyanidins
Blackberry
Blueberry
Grapes, red
Raspberries (red)
Strawberry
89-211
67-183
25-92
10-84
15-75
13-19 6-47
1
2
9
-
88-261
44-76
5-59
97-183
Red wine
Plum
Red cabbage
Red onion
Blood orange juice
Flavanol-rich foods
Green tea
Black tea
Chocolate, dark
Apple, red delicious with peel
Apricot
1-35
2-25
25
13- 25
3-10
-
-
1-4
-
1-55
1-6
0
-
-
5-158
43-63
2-12
10-25
24-70
106-334
-
-
-
Anthocyanins Flavanols Proanthocyanidins
- 24-216 -
4
90-322
89-148
8-13
Table 1: Common Dietary Flavonoids
(Select the highlighted text to see chemical structures.)
Flavonoid
Subclass
Dietary Flavonoids Some Common Food
Sources
Anthocyanidins Cyanidin, Delphinidin, Malvidin,
Pelargonidin, Peonidin, Petunidin
Red, blue, and purple berries; red and purple grapes; red wine
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Flavanols
Flavanones
Flavonols
Flavones
Isoflavones
Monomers (Catechins):
Catechin, Epicatechin, Epigallocatechin
Epicatechin gallate, Epigallocatechin gallate
Dimers and Polymers:
Theaflavins ,
Thearubigins, Proanthocyanidins
Catechins: Teas (particularly green and white), chocolate, grapes, berries, apples
Theaflavins, Thearubigins:
Teas (particularly black and oolong)
Proanthocyanidins:
Chocolate, apples, berries, red grapes, red wine
Hesperetin, Naringenin, Eriodictyol
Quercetin, Kaempferol, Myricetin,
Isorhamnetin
Apigenin, Luteolin
Daidzein, Genistein, Glycitein
Citrus fruits and juices, e.g., oranges, grapefruits, lemons
Widely distributed: yellow onions, scallions, kale, broccoli, apples, berries, teas
Parsley, thyme, celery, hot peppers,
Soybeans, soy foods, legumes
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