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Nutritional Relief for Allergy and Asthma

By Yousry Naguib, Ph.D.

Vitamin Retailer magazine, March 2004

Sneezing, dripping noses, aching sinuses, wheezing, and itchy, watery, red eyes are just some of the symptoms that more than 35 million Americans suffer each year during the allergy seasons. Allergy is an over-reaction of the immune system induced by exposure to a particular allergen (antigen). Exposure to what is normally harmless substance, such as pollen, causes the immune system to react as if the substance is harmful.

Allergy is a very common problem, affecting at least 2 out of every 10 Americans. About 10 percent of children in the United States are allergic to one or more substances. Most allergies are inherited, when one parent is allergic, their child has a 50% chance of having allergies. That risk jumps to 75% if both parents have allergies.

There are several types of allergies, including food allergies, hay fever, eczema, urticaria, insect stings, plant allergies, chemical sensitivity, and anaphylaxis. Anaphylaxis is a life-threatening allergic response characterized by lowered blood pressure, swelling, and hives.

Although, any allergen can trigger anaphylaxis, the most common are insect stings, certain foods, such as shellfish and nuts. Anaphylaxis may begin with severe itching of the eyes or face and, within minutes, progress to more serious symptoms, which include difficulty swallowing and breathing, abdominal pain, cramps, vomiting, and diarrhea. This allergy can quickly result in an increased heart rate, sudden weakness, a drop in blood pressure, and ultimately unconsciousness and death; and it requires emergency medical attention.

Hay fever is an allergic reaction caused by the pollens of ragweed, grasses, and other plants whose pollen is spread by the wind. Urticaria is characterized by itchy, swollen, red bumps or patches on the skin that appear suddenly as a result of the body’s adverse reaction to certain allergens. They can appear anywhere on the body including the face, lips, and throat. Foods that might cause allergies include, milk, egg, nut, fish, shellfish, soy, and wheat.

Common allergens include pollen (a fine, powdery substance released by plants and trees), animal dander, feathers, mites, chemicals, drugs, and a variety of foods. Pollens that cause allergic reactions come from plants: trees (oak, elm, birch, maple, hickory, cedar, juniper), grasses (Timothy grass, Bermuda grass, Orchid grass, velvet grass), and weeds (ragweed, desert broom, feverfew, and marigold’s family).

Allergies’ symptoms include respiratory problems, a stuffy and/or runny nose, sneezing, itchy skin, red and watery eyes, ache, fatigue, fever, diarrhea, stomachache, and vomiting. Symptoms could be seasonal or chronic depending on the particular allergen involved. Pollens from grass and trees usually cause seasonal allergies; while chronic allergies are usually caused by allergens present in the environment year-round, such as animal fur, dust, or feathers.

In an allergic reaction, the body starts to produce a specific type of antibody called Immunoglobulin E (IgE) to fight the allergen. Antibodies are specialized proteins produced by white blood cells that circulate in the blood. They seek and attach to foreign proteins, microorganisms, or toxins in order neutralize them. The antibody IgE anchors itself in the receptor on the surface of mast cells, signaling them to produce histamine, leukotrienes, cytokines and other like substances that can bring on symptoms of an allergy including itching, runny nose, coughing, and sneezing. Mast cells are plentiful in the nose and sinus membranes, and in the gastrointestinal (GI) tract where allergens tend to invade the body.

Current anti-IgE therapies, used in the most severe cases of allergies and asthma, involve the injection of antibodies into the bloodstream once or twice a month.

Medical treatment of allergy often includes anti-histamines, decongestants, bronchodilators, corticosteroids, and allergy shots. Anti-histamines are often prescribed for respiratory allergies, to prevent symptoms of congestion, sneezing, itchy, and runny nose by blocking histamine receptors. Benadryl is the most common over-the-counter anti-histamine prescribed for respiratory allergies.

Decongestants (such as Sinutab, Triaminic, Sudafed) decrease nasal congestion and swelling by constricting the blood vessels in the nasal membranes, thus allowing the mucus to drain more effectively.

Bronchodilators work by relaxing the muscle bands that tighten around the airways, during an allergy episode, letting more air in and out of the lungs and improving breathing. Bronchodilators also help clear mucus from the lungs. The three main types of bronchodilators are beta-agonists, anti-cholinergics, and theophylline.

Immunotherapy, also called allergy desensitization or allergy shots, is given to increase a person’s tolerance to the substances that provoke allergy symptoms.

Asthma is an inflammatory disease that is characterized by narrowing of the bronchi (lung passageways) making airflow into and out of the lungs to be restricted, and hence making breathing difficult and causing a feeling of not getting enough air into the lungs.

Asthma is a frequent disease with a prevalence rate ranging from 5 to 15%. Half of the people with asthma develop it before the age 10. Anyone can get asthma, although it tends to run in families. An estimated 12 million adults and children in the United States have asthma.

There are two types of asthma -- one is triggered by an allergy (referred to as allergic asthma) and the other has no known cause. Asthma can be triggered by inhaled allergens, such as pet dander, dust, cockroach allergens, and mold spores. It can also be triggered by rapid changes in temperature or humidity, upper respiratory infections, exercise, stress or smoke (cigarette). Symptoms include wheezing, shortness of breath, tightness in the chest, and frequent coughing.

There is no known way to prevent the episode of asthma, except keeping away from foods, irritating substances or environmental allergens that might be suspected to trigger another episode.

Asthma can be treated by bronchodilators, and anti-inflammation drugs. These medicines lead to fewer symptoms, better airflow, less sensitive airways, less airway damage, and fewer asthma episodes. Asthma medications can also be taken using a device called a metered dose inhaler (MDI), a small aerosol canister in a plastic container that releases a burst of medication when pressed down from the top.

People with asthma or allergy should eat a healthy diet and avoid foods such as nuts, yeast-based foods, seafood, dairy foods, and foods containing preservatives or dyes. Certain food additives, especially meta-bisulfite, can be dangerous for the child with asthma. Monosodium glutamate (MSG) can also cause problems for some people with asthma.

Nutrients that may help asthma and allergy include: magnesium, B-vitamins, antioxidants, such as vitamin E, vitamin C, and selenium.

Vitamin B1 (Thiamin) plays a key role in the body’s metabolic cycle for generating energy through the breakdown of carbohydrates, and the formation of red blood cells. The suggested daily intake (RDA) for vitamin B1 is 1.2 to 1.5 mg for males and 1 to 5 mg for adult women.

Vitamin B2 (Riboflavin) helps metabolism of fats, carbohydrates and proteins for energy production. Vitamin B2 is also required for the production of antibodies, and boosting the immune system. Vitamin B2 deficiency mainly affects skin and mucous membranes. The suggested daily intake of vitamin B2 for adults is 1.7 mg.

Vitamin B5 (pantothenic acid) supports adrenal function and the central nervous system, and boosts energy. Vitamin B5 and vitamin C are the nutrients most needed by the adrenal glands. The recommended dosage of vitamin B5 is 500 mg a day.

Vitamin B6 (Prridoxal 5’-phosphate) plays an essential role in the production of red blood cells and the cells of the immune system. A study on 76 children with asthma showed that supplementation with 100 mg B6 twice daily resulted in fewer asthma attacks, less wheezing, cough, and less use of bronchodilators and steroid medications [1].

Vitamin B12 (referred to as Cobalamin or Cyanocobalamin) deficiency has been linked to some types of asthma. Vitamin B12 is necessary for the proper digestion and absorption of foods, for protein synthesis, and for the normal metabolism of carbohydrates and fats. Vitamin B12 protects against toxins and allergens.

Vitamin B12 has been shown to effectively block most of the adverse reactions to sulfites, which can produce headache, congestion, drippy nose and bronchial spasms. In one study, eighteen sulfite-sensitive subjects were given 2 mg of vitamin B12 and then were given sulfites. All but one had no adverse reaction, indicating its benefits to food related allergies. For people with sulfite allergies, a 2 to 4 mg dose of vitamin B12 once a day was found to be adequate to prevent most symptoms [2]. In general, B vitamins help support adrenal function and strengthen the immune system.

Vitamin C - Research studies demonstrated that Vitamin C is a potent antioxidant protecting against free radical damage, and has the ability to boost interferon (a natural antiviral substance) and antibodies levels in the body, and hence maintaining a strong immune system to alleviate allergy symptoms.

Vitamin C intake was associated with lower incidence of wheezing and bronchial hyper-responsiveness in three studies [3,4,5], but others found no effect [6]. A National Institutes of Health study published in the Proceedings of the National Academy of Sciences (April 16, 1996) suggests that 200 mg of vitamin C daily is more appropriate.

Magnesium – Low magnesium intake was speculated to play a role in asthma. Intracellular magnesium was assessed in 22 asthma patients and compared with 38 controls. Magnesium levels were significantly lower in individuals with asthma versus controls [7].

A study published in Lancet (1994) showed that bronchial hyper-reactivity is directly related to the intake of magnesium, and that high magnesium intake was associated with a reduction in wheezing [8]. Magnesium helps relax smooth muscles in the bronchial tubes. A therapeutic daily dose of 400 to 800mg is recommended.

Zinc – Test tube studies showed that zinc might prevent cold viruses from reproducing themselves. Its beneficial effects in preventing or treating cold in humans has been demonstrated in only five out of eleven double-blind, placebo-controlled studies. A study conducted by the Cleveland Clinic and published in the July 15, 1996 issue of the Annals of Internal Medicine showed that within 24 hours of coming down with cold symptoms, 50 people began dissolving Cold-Eeze zinc lozenges in their mouths every two hours while they were awake. Those taking the zinc lozenges recovered in an average of 4.4 days, compared with 7.6 days for those who had been given placebo [9].

Bee Pollen, when taken in small amounts, acts in the same manner as conventional immunotherapy.

Beta Glucan, a polysaccharide derived from the cell wall of common baker's yeast, has been shown to activate and modulate the immune system.

CoQ10 - In a recent study, CoQ10 concentrations in both plasma and whole blood of 56 men and women between the ages of 19 to 72 years suffering from allergic asthma were found to be significantly lower as compared with that of 25 healthy subjects aged 25 to 50 years old. The study suggested that supplementation with CoQ10 might be helpful to patients with asthma [10].

Quercetin, a bioflavonoid, is anti-histaminic and anti-allergic. It was shown to inhibit mast cells from releasing inflammatory compounds [11]. The recommended dose is 500 mg twice daily.

Essential fatty acids (EFA) are thought to inhibit production of inflammatory substances [12], and supplementation with fish oil or evening primrose oil (EPO) or black currant may help people with asthma.

MSM (Methyl-sulfonyl-methane) is composed of sulfur, which plays a role in alleviating allergies through detoxification and elimination of free radicals. In a recent study, fifty subjects with seasonal allergy were given 2,600 mg of MSM orally per day for 30 days. All respiratory symptoms were significantly improved by the third week. The study concluded that MSM might be efficacious in the reduction of symptoms associated with seasonal allergy [13].

Probiotics are thought to improve the balance of germs in the intestines, which may enhance the immune system. In a Finnish study published in the Lancet medical journal (2001), 159 pregnant women with a family history of allergies were randomly given either Lactobacillus GG or placebo twice a day for three weeks before they gave birth. After they delivered, breast-feeding mothers took the probiotic capsules for six months, while bottle-fed babies were fed the contents of the capsules mixed with water for the same amount of time. At the age of two, 23 percent of those fed probiotics have developed eczema, compared with 46 percent of the infants given placebo treatment [14].

Herbs, which have been suggested to relieve distress due to cough, or infection, or inflammation, include standardized extracts of astragalus, Sida cordifolia, licorice root, ginger root, eyebright, nettle root, mullein leaf, and cayenne.

Astragalus ((Astragalus membranaceous) helps to boost energy and strengthen the lungs. This herb should not be used if a fever or any other sign of infection are present.

Belladonna (Atropa belladonna) contains the active ingredients atropine and scopolamine, which are anticholinergic, meaning that they work by blocking certain nerve impulses involved in the parasympathetic nervous system, which regulates certain involuntary bodily functions or reflexes, including pupil dilation, secretion of glands, and the relaxation of the bronchioles in the lungs, and thereby alleviates the wheezing symptoms of an asthma attack [15]. Caution should be exercised since ingestion of high concentration of atropine can cause severe illness and death.

Black cumin seed oil (Nigella sativa) is known to inhibit the contaction of tracheal smooth muscle that is stimulated by histamine and acetylcholine [16,17]. It has always been a primary treatment for asthma and allergies in the Middle East.

A Middle Eastern herbal blend comprising black cumin, chamomile (Matricaria recutita), cinnamon (Cinnamomum cassia), cloves (Syzygium aromaticum), rosemary (Rosemarinus officinalis), sage (Salvia officinalis), spearmint (Mentha spicata) and thyme (Thymus vulgaris) has been shown to relax tracheal muscles. Black cumin seed and oil bioactive constituents: nigellone and thymoquinone strongly inhibit lipoxygenase. Fixed oil of Nigella sativa and derived thymoquinone inhibit eicosanoid generation in leukocytes and membrane lipid peroxidation, and prevent the release of histamine from mast cells [18].

Boswellia, an Indian herb, has been shown in a double-blind, placebo-controlled study to significantly reduce the symptoms of asthma. Seventy percent of 40 subjects who took 300 mg of a boswellia preparation three times a day for six weeks showed improvement of asthma symptoms, fewer attacks, and easier breathing [19].

Butterbur (Petasites hybridus)—extracts of butterbur have been used in bronchial asthma, and studies have shown that they inhibit the biosynthesis of the inflammatory leukotrienes [20].

Elderberry (Sambucus nigra) has been popular since ancient Egypt. Both the flowers and berries ease the congestion and inflammation associated with hay fever [21].

Eyebright-this herb is sometimes used in combination for alleviating allergy symptoms. Eyebright (Euphrasia officinalis) has been used as a tonic and as a mild astringent since the Middle Ages. It can greatly relieve runny, sore, itchy eyes due to colds or allergies [22]. Eyebright is usually used in combination with Goldenseal and Mullein for alleviating allergy symptoms.

Ginger root (Zingiber officinale) has been used in the in Asian medicine to promote cleansing of the body through perspiration. Ginger is also a circulatory stimulant, relaxes peripheral blood vessels, promotes sweating, and eases cold symptoms.

Licorice root (Glycyrrhiza glabra) soothes the lungs and helps to strengthen adrenal function. This herb should not be given to people with high blood pressure. Licorice root helps to protect & heal distressed mucous membranes of the intestinal tract [23]. Licorice and astragalus are usually used combined.

Lobelia (Lobelia inflata), also known as Indian tobacco, is a popular remedy as an expectorant and antispasmodic. Its extract containing lobeline and related alkaoids has been used for acute bronchial asthma [22].

Khella (Ammi visnaga) contains the active compound Khellin, a prototype for the drug cromolyn [24], a bronchiodilator and antispasmodic that makes it useful for asthma sufferers [25].

Khella is a traditional Egyptian remedy for kidney stones. It relaxes the muscles of the ureter, and hence reduces the pain caused by the stones and helps ease the stone down into the bladder. A daily dose of 250 to 300 mg of a standardized extract for 12 percent khellin is recommended. Khella works better with hawthorn extracts, which help dilate the bronchial, urinary and blood vessels without affecting blood pressure.

Ma huang (Ephedra sinica) is a natural decongestant that contains pseuo-ephedrine (the active ingredient in Sudafed). This herb can stimulate the nervous system, causing an increased heart rate. Individuals with high blood pressure or arrhythmias (irregular heart beat) should refrain from taking ephedra.

Mullein leaf (Verbascum thapsus) is an old-time remedy for bronchitis and dry, unproductive coughs. It is a good expectorant, and in the process of clearing out the congestion, it also soothes irritation in the throat and bronchial passages [26].

Nettle root (Urtica dioica) helps reduce the inflammation in the sinus cavities and alleviate allergy symptoms. Nettle root may also help stabilizing mast cells; support the adrenals and drying out the sinuses. The diuretic properties of nettle root are well recognized, and several pharmaceutical preparations incorporating Nettle are marketed in Europe for this purpose. In a randomized, double blind study, freeze-dried Urtica dioica (stinging nettles) was found to effectively relieve symptoms associated with allergic rhinitis [27].

Sida Cordifolia has been used for over 2,000 years to treat bronchial asthma cold & flu, chills, lack of perspiration, headache, nasal congestion, aching joints and bones, cough & wheezing, and edema. Sida cordifolia is considered to have diaphoretic, diuretic, central nervous system stimulating and anti-asthmatic activity.

The stem of this plant contains a number of active compounds, including small amounts of an essential oil, and most important, 1-2% alkaloids composed mainly of ephedrine and pseudoephedrine, with ephedrine ranging from 30-90%, depending on the source. The effects of ephedra are generally attributed to the alkaloid "ephedrine" which produces central nervous system (CNS) stimulation, peripheral vasoconstriction, elevation of blood pressure, bronchodilation, and cardiac stimulation [28]. Pseudoephedrine has similar activities as ephedrine, except that its hypertensive and central nervous system effects are weaker.

A number of companies now offer homeopathic remedies for allergies and asthma, such as Hyland's Hayfever, which contains ambrosia, euphrasia, allium cepa and sabadilla in its formulation; Allergy Relief (Bioforce), which contains cardiospermum; and Aller-7™ (InterHealth), which is a combination of seven plants extracts from Phyllanthus emblica, Terminalia chebula, Terminalia bellerica, Albizia lebbeck, Piper nigrum, Zingiber officinale and Piper longum.

Aller-7™ was evaluated against various biochemical and physiological parameters involved in respiratory health and normal breathing, and was shown to be a potent anti-histaminic, anti-inflammatory, anti-spasmodic and antioxidant agent, which may serve as a safe, natural dietary supplement for promoting respiratory health [29]. The manufacturer recommends a dosage of 660 mg twice daily for adults; and suggests that due to the natural properties of Aller-7TM results may not appear for 2-4 weeks in some people.

Alternative medicine (vitamins, botanicals, and homeopathy) offers a wide range of benefits to people with allergy and asthma.

References

[1] Collipp PJ et al. Pyridoxine treatment of childhood bronchial asthma. Annals of Allergy 1975; 35:93

[2] Anonymous. Vitamin B12 confirmed as effective sulfite allergy blocker. Allergy Observer 1987; 4(2):1, March-April

[3] Schwart J, Weiss ST. Dietary factors and their relation to respiratory symptoms. Am J Epidemiol 1990; 132:67

[4] Bucca C. Effect on vitamin C on histamin bronchial responsiveness of patients with allergic rhinitis. Ann Allergy 1990; 65:311

[5] Mohsenin V. Effect of vitamin C on NO2 induced airway hyper responsiveness in normal subjects. Am Rev Respir Dis 1987; 136:1408

[6] Malo JL. Lack of acute effects of ascorbic acid on spirometry and airway responsiveness to histamine in subjects with asthma. Ann Allergy Clin Immunol 1986; 78:1153

[7] Dominguez LJ et al. Bronchial reactivity and intracellular magnesium: a possible mechanism for the bronchodilating effect of magnesium in asthma. Clin Sci (London) 1998; 95:137

[8] Britton J et al. Dietary magnesium, lung function, wheezing, and airway hyper-reactivity in a random adult population sample. Lancet 1994; 344:357

[9] Sally Eauclaire “Preventing Colds and Flu: Natural Remedies that Boost Your Immunity.” Vegetarian Times; Dec, 1996

[10] Gazdik F et al. Decreased levels of CoQ10 in patients with bronchial asthma. Allergy 2002; 57:811

[11] Pearce FL et al. Mucosal mast cells: effect of quercetin and other flavonoids on antigen-induced histamine secretion from rat intestinal mast cells. J Allergy Clin Immunol 1984; 73:819

[12] Wu D, Meydani M et al. Effect of dietary supplementation with black currant seed oil on the immune response of healthy elderly subjects. American Journal of Clinical Nutrition 1999 Oct; 70(4):536-43

[13] Barrager E et al. A multi-centered, open-labeled trial on safety and efficacy of MSM in the treatment of seasonal allergic rhinitis. J Altern Complement Med 2002; 8:167

[14] Marko Kalliomaki et al. “Probiotics in primary prevention of disease: a randomized placebo-controlled trial”Lancet 2001; 357:1076.

[15] Lotvall J. Contractility of lungs and air-tubes. Eur Respir J. 1994; 7:592

[16] Aqel MB. Relaxant effect of the volatile oil of Rosmarinus officinalis on tracheal smooth muscle. J Ethnopharm 1991; 33:57

[17] Chakravarty N. Inhibition of histamine release from mast cells by nigellone. Ann Allergy 1993; 70:237

[18] Houghton PJ et al. Fixed oil of Nigella sativa and derived thymoquinone inhibit eicosanoid generation in leukocytes and membrane lipid peroxidation. Planta Med 1995; 61:33

[19] Gupta I. et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical trial. Eur J Med Res 1998; 3:511

[20] Andreas Schapowal. Randomized controlled trial of butter bur and cetirizine for treatin seasonal allergic rhinitis. BMJ 2002; 324:144

[21] Jaber R. Respiratory and allergic diseases: from upper respiratory tract infections to asthma. Prim Care 2002; 29:231

[22] Francis Brinker. Treatment of respiratory allergies with pharmaceutical and botanical medicines. Journal of Naturopathic Medicine 1999; volume 4, No.1

[23] Azimov MM. Pharmacological study of the anti-inflammatory slyderinine. Farmakol Toksikol 1988; 51:90

[24] Cox J.S.G. et al. Disodium cromoglycate. Adv Drug Res 1970; 5:115

[25] Derbes V.J. et al. Observations on the action of Khellin in attacks of bronchial asthma. Ann. Allergy 1951; 9:354

[26] Turker AU. Biological activity of common mullein, a medicinal plant. J Ethnopharmacol 2002; 82:117

[27] Mittman P. Randomized, double-blind study of freeze dried Urtica dioica in the treatment of allergic rhinitis. Planta Med 1990; 56:44

[28] Dr. Albert Leung, second edition of "Encyclopedia of Common Natural Ingredients Used in Foods, Drugs, and Cosmetics"; John Wiley & Sons, 1995

[29] Bagchi D, Bagchi M, Saxena VS, Pratibha N, Amit A, Anti-Allergic Potential of a Novel Botanical Extract Formula, FASEB, 17:A1061, Abs. 660.1, 2003

 

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