Allergy Partners Discusses Complimentary and Alternative Medicines for Seasonal Allergies

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At Allergy Partners, we are frequently asked about herbal, homeopathic, ayurvedic or non-medicine based treatments for seasonal allergies. These, as well as other non-traditional treatments, fall under the category of complementary and alternative medicines or “CAM” for short.

seasonal allergies

As allergists, we are frequently asked about herbal, homeopathic, ayurvedic or non-medicine based treatments for seasonal allergies. These, as well as other non-traditional treatments, fall under the category of complementary and alternative medicines or “CAM” for short. CAM has been defined as a group of diverse medical and health care systems, practices and products that are not generally considered part of conventional medicine. Examples include natural products (i.e. herbs, probiotics), mind and body medicine (i.e. yoga, acupuncture), as well as manipulative and body-based practices (i.e. spinal manipulation, massage therapy). The 2007 National Health Interview Survey showed that approximately 38% of adults and 12% of children use CAM. Because of the increased use of these practices, the federal government created the Office of Alternative Medicine in 1991 that was re-established as the National Center for Complementary and Alternative Medicine (NCCAM) in 1998. Their mission is “to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care.” The NCCAM is one of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the Department of Health and Human Services. NCCAM has commented on the use of CAM for seasonal allergies that was the inspiration for this blog post. The different treatments include:

1.    Natural Products
The herb butterbur may decrease allergy symptoms, but concerns have been raised about its safety. A randomized controlled trial of butterbur versus cetirizine (aka Zyrtec) from 2002 showed that the effects were similar for both treatments in terms of reducing symptoms of seasonal allergies. Regarding its safety, the raw, unprocessed butterbur plant contains chemicals called pyrrolizidine alkaloids (PAs). PAs can cause liver damage and can result in serious illness. Only butterbur products that have been processed to remove PAs and are labeled or certified as PA-free should be used. Several studies, including a few studies of children and adolescents, have reported that PA-free butterbur products are safe and well tolerated when taken by mouth in recommended doses for up to 12 to 16 weeks. The safety of longer-term use has not been established. Also, butterbur may cause allergic reactions in people who are sensitive to plants such as ragweed, chrysanthemums, marigolds and daisies.

Except for butterbur, herbs have not been shown to relieve seasonal allergy symptoms. Capsaicin, quercetin, and pine bark extract have not been proven to be helpful for seasonal allergies (although capsaicin nasal sprays have been shown to safely improve nasal symptoms in patients with non-allergic rhinitis). Chamomile and echinacea are two popular herbs that can cause allergic reactions in some people. Some herbs or other dietary supplements may interact with medications or have side effects of their own. Some dietary supplements may contain potentially harmful ingredients not listed on the label.

A general note of caution regarding dietary supplements; although these products are regulated through the Food and Drug Administration (FDA), the rules for dietary supplements are not the same as those for prescription or over-the-counter drugs. In general, the regulations for dietary supplements are less strict; for example, a manufacturer does not have to prove the safety and effectiveness of a dietary supplement before it is marketed. Once a dietary supplement is on the market, the FDA monitors safety and product information (label claims and package inserts), and the Federal Trade Commission (FTC) monitors advertising.

2.    Acupuncture
A randomized control trial of acupuncture for allergies was published in 2013. They took over 400 patients with seasonal allergies and divided them into 3 treatment groups: one that received acupuncture, one that received sham (fake) acupuncture and one that received no acupuncture. Acupuncture led to statistically significant improvements in symptoms and antihistamine use after 8 weeks, but the improvements may not be significant because there was NO difference after 16 weeks. This study combined with a couple of others point towards the preliminary suggestion that the use of acupuncture for seasonal allergies has not been shown to incur any meaningful benefit

3.    Local Honey
Many people believe that eating local honey will make them immune to pollen. The theory that eating so-called "natural" honey benefits those with allergies is purely anecdotal. There are several concerning issues related to the ingestion of honey for allergies. First, much of the pollen in honey is not the type that humans are allergic to (flowers and other blooming plants). Humans are normally allergic to tree, grass or weed pollen which is not contained in honey. Second, local honey likely contains many substances to which the patient is NOT allergic. Subsequently, a susceptible individual who frequently consumes honey may develop an allergy to these other substances. Anaphylactic allergic reactions to honey have been seen, so there are potentially serious risks associated with it. Finally, babies under the age of 1 should not be given honey, Clostridium botulinum spores in honey can grow in intestines and cause botulism poisoning.

4.    Sinus Irrigation
Daily sinus irrigation (one type being neti pots) remains a potentially effective treatment for allergies and sinus infections in many patients. Washing the nasal cavities with saline reduces postnasal drainage, removes secretions and rinses away allergens/irritants. Sinus irrigation is associated with improvement in a variety of rhinitis conditions (with some studies showing benefits in children and pregnant women). Patients should use distilled, sterilized or previously boiled water with this strategy.

Unfortunately, there is a real lack of well-designed studies which makes it difficult for clinicians to recommend most CAM therapies with confidence. Patients who do wish to pursue CAM should consider the financial costs (which may be substantial) and be aware that long-term safety data on most of these therapies are lacking. For those patients who seek advice about what brand of herbal medicine to use, they can visit an independent source such as Consumer Labs which tests various brands of herbal therapies for content and quality.

Dr. Ananth Thyagarajan (Dr. T.)

Contact Information: 
Amanda Reed, Marketing and Corporate Communications Manager 
Allergy Partners, P.A. 
828-277-1300 phone 
828-277-2499 fax 
PR: NOVA MedMarket

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