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From the Townsend Letter
May 2014

Seasonal Allergies and Asthma: Removing Total Burden For Powerful Symptom Relief and Whole Body Wellness
by Chris D. Meletis, ND, and Kimberly Wilkes
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Seasonal allergies and asthma are two respiratory-related conditions often "joined at the hip." A study published in April 2013 found that 75% of asthmatic adults aged 20 to 40 years old, and 65% of asthmatic adults aged 55 years and older, suffer from at least one allergy.1
Another study, presented in November 2013 at the American College of Allergy, Asthma and Immunology's (ACAAI) Annual Scientific Meeting, found that the number of people with asthma who also have a cat allergy more than doubled over 18 years, from 1976 to 1994. The same study found that people who have asthma are more likely to be allergic to environmental allergens such as ragweed, ryegrass, and Alternaria fungus.2
Clemens von Pirquet coined the term allergy in 1906 to describe the tendency of some individuals to develop signs and symptoms of reactivity - otherwise known as hypersensitivity reactions - when exposed to certain substances.These hypersensitivity reactions involve an abnormal adaptive immune response aimed at what should be harmless, noninfectious environmental sub­stances (allergens).3  
Asthma is an inflammatory disease of the lower respiratory tract characterized by intermittent constriction of the bronchial airways. Asthma attacks can cause symptoms ranging in severity from mild to life-threatening. These symptoms include wheezing, breathlessness, chest tightness, and coughing.4
According to the Centers for Disease Control, by 2004, 1 in every 15 residents in the US - 20 million people - had asthma, with half of those cases attributed to allergic asthma.5 Currently, more than 25 million people are known to suffer from the disease.6
This article will discuss the connections between asthma, allergy, and other diseases, and why a person must reduce the total burden before a supplement regimen can be effective.

Two Diseases Linked To Many Conditions
Allergies and asthma can take a huge toll on health, not only due to their direct effects on the body but also because they are linked to other conditions - some of them life-threatening.
Studies have demonstrated an association between allergies, asthma, and suicidality. Researchers also have found that there is a greater incidence of suicidal thoughts during the allergy season.7,8 The link between asthma and suicide is thought to be due to low serotonin levels caused by low oxygen (hypoxia).9
Seasonal allergies also are linked to sleep apnea, which in turn is linked to high blood pressure and cardiovascular conditions. Sleep apnea may be the reason why men who have seasonal or chronic rhinitis have on average a 3.5 mm Hg higher systolic blood pressure than those without allergic rhinitis.10 Furthermore, scientists have discovered that asthma is a risk factor for obstructive sleep apnea.11
There's also a link between asthma, allergies, and migraines. People who have migraines are more likely to have asthma compared with people who don't suffer from migraines. In fact, researchers in the 1970s began referring to asthma as a "pulmonary migraine."12
Plus, a study published in Cephalalgia found that people who have both migraines and hay fever suffer from a more severe form of headache compared with people who have migraine but who don't have seasonal or year-round allergies.13
This supports the results of another study, which found that migraine patients who have allergic rhinitis and who received allergy shots experienced 52% fewer migraine attacks than those who didn't receive allergy shots.14
Other conditions and health challenges linked to asthma include an increased risk of pulmonary embolism and a more difficult time becoming pregnant.15,16
Additionally, an interesting study in the August 2013 issue of Annals of Allergy, Asthma & Immunology found that boys who have a history of allergy or asthma also have an increased risk of attention deficit/hyperactivity disorder (ADHD). The increased risk of ADHD in boys with allergies and asthma may be due to medications used to treat these conditions.17

Controlling Total Burden
Mast cells and basophils - two types of white blood cells that trigger an inflammatory reaction - are primary culprits behind both allergies and asthma. An antigen (allergen) stimulates these two related cell types. Both mast cells and basophils are full of granules of histamine and other allergic chemical mediators. When allergen/antigens in the blood contact mast cells or basophils in sufficient numbers, a burst of histamine and other allergic mediators is released into the bloodstream. It is the histamine and other allergic mediators that trigger the misery of allergic reaction: runny, itchy nose and sneezing; watery, itchy red eyes; tickling and itching in ears, nose, and throat; skin rash; headache; asthma; and so on.
We each have a personal threshold as to how much exposure our bodies can handle before reacting to an allergen. This personal threshold often is determined by the total burden that a person is experiencing. Addressing the concept of total burden is one of the most critical aspects of treating allergies.
Total burden equals:
1.  how much exposure the person is receiving to the actual allergen itself,
2.  foods that can cross-react with the allergen,
3.  factors that are comprising gut health,
4.  factors that can make allergies and asthma worse,
5.  hidden household sources, plus
6.  factors that weaken immune health.

In order for a supplement regimen to have any effect against allergies or asthma, each of these six total burden factors must be addressed.

Minimize Exposure to Allergens
This is the most straightforward and direct step in treating allergies. There are some simple ways to help keep exposure to a minimum, including:

  • Keep your home's doors and windows closed.
  • Use the air conditioner rather than opening a window.
  • Increase laundry water temperature, because research has shown that many people who have seasonal allergies also have dust mite allergies.18
  • Wash bedding and pillows often.
  • Limit outdoor activity, particularly in the morning (5 a.m. to 10 a.m.) and midevening.
  • Keep track of pollen counts in your area and don't exercise outside during your allergen peak.
  • Don't go outside more than necessary on windy days.
  • Keep your car windows up and sun roof closed, and keep air on recirculate while driving.
  • Shower prior to going to bed, including your hair, because pollen will collect on you throughout the day.
  • Change your clothes after being outside; otherwise you will contaminate your inner sanctum.

Avoid Foods That Cross-React With Allergens
Certain foods cross-react with pollen allergens. If a person minimizes exposure to a grass or pollen allergen but continues to eat a related food, his or her hay fever symptoms may remain active.
Researchers now believe that most food allergies are acquired due to cross-reactivity with pollen allergens. Consequently, people who have pollen allergies might develop many plant food allergies - even to new foods that they've never eaten before.19,20
Studies have reported upon the following cross-reactivities21-23:

  • an association between ragweed allergies and hypersensitivity to watermelon, melon, cucumber, and banana;
  • birch pollen allergies and sensitization to hazelnut, apple, carrot, potato, kiwi, other vegetables, and soy. Up to 70% of birch-pollen allergic patients also develop an allergy to celery or carrot. Most of these patients suffer from allergy symptoms even outside of the birch pollen season, indicating that food caused allergy symptoms are to blame;
  • mugwort pollen allergen and sensitization to celery, carrot, spices, nuts, mustard, and legumes;
  • grass pollen allergies and sensitization to tomato, potato, pea, peanut, watermelon, melon, apple, orange, and kiwi.
  • an association between plantain pollen allergy and melon hypersensitivity.

Furthermore, researchers also have established a connection between allergies to cypress pollen and peaches as well as between olive pollen and tomato, kiwi, potato, and peach.20,24
Yet, the cross-reactivity isn't limited to only fruits and vegetables. One study found cross-reactivity between grass pollen allergies and allergies to egg white and pork.25
Clearly, it's critical that patients who suffer from hay fever also be tested for food allergies and intolerances.
Another food-related item to be wary of is alcohol - in particular wine and beer. First, wine and beer that contain high levels of sulfites can actually be lethal for some asthmatics.26,27
Second, wine and beer - especially red wine and dark beer - might make seasonal allergies worse because they contain histamines formed naturally as part of the wine- and beer-making process. People who are sensitive to histamine in alcohol are thought to have low levels of diamine oxidase, an intestinal enzyme that helps the body process histamine normally.28

Protecting the Gut
The gut is the daily filter to the burden that we unintentionally welcome into our bodies. A leaky gut (increased intestinal permeability) caused by overeating sugar and refined carbohydrates, antibiotic use, and emotional stress can allow food particles to pass through the walls of the colon and enter the systemic circulation. This can result in food allergies' developing or already-existing food allergies' worsening.29
Therefore, along with lifestyle measures such as eating a low-glycemic diet and reducing stress, taking a good probiotic is essential to strengthen the health of the intestines.30 Furthermore, some studies have shown that probiotics can reduce the symptoms of seasonal allergies by enhancing immunity.31

Factors That Worsen Allergies And Asthma
Air pollution is another factor that adds to the total burden of a patient with allergies or asthma. In the modern world, people are exposed to both an increased amount of air pollution and a greater variety of pollutants.
The scientific literature is filled with studies demonstrating the damage that these pollutants cause in people with asthma.32,33 Studies also show that pollutants from traffic exhaust contribute to the development of allergies.34,35 In an animal study, diesel exhaust particle exposure increased rates of allergic reactivity and asthma and increased the production of antigen-specific IgE and histamine.36

Hidden Sources Inside the Home and Out
There are many sources of indoor pollution that can contribute to total burden of people suffering from allergies and/or asthma.
Indoor building materials, new furniture, and fresh paint may all contribute to allergies. In addition, perfluorocarbons used as stains as well as water repellents applied to furniture fabrics and carpeting can make allergies and asthma worse, as can phthalates (compounds added to plastics to make them more flexible). Dry cleaning, paint, paint thinner, glues, inks, nail polish and polish remover, and various building and construction materials are also hidden sources of allergies. All of these substances are linked to higher rates of allergic and respiratory problems.36 They suppress Th1 function and lead the immune system into a Th2-dominant state, the type of immunity that is enhanced when a person is fighting an allergen.
Other substances strongly associated with asthma and allergies include herbicides and pesticides, which have been shown to induce Th2-dominant immune responses.36
Old mattresses, which can accumulate increased concentrations of dust mites and other allergens over time, are another household object that can contribute to total burden.
Surprisingly, feather pillows and bedding have been shown in numerous studies to have no effect on the risk of allergic rhinitis or asthma and to actually reduce the risk of wheezing. This is because down bedding accumulates dust mite allergens at a lower rate than synthetic bedding.37-40
Toxic mold inside the home is becoming another growing issue. Mycotoxins from Stachybotrys chartarum, otherwise known as toxic black mold, cause symptoms that can be confused with seasonal allergies including respiratory problems, skin inflammation, irritation of the mucous membranes, and fatigue. Toxic mold can cause severe health problems such as damage to internal organs and even death. It can even be a direct cause of asthma and allergic rhinitis, since proteins found in the mold are human allergens.41-43
It's critical to consider toxic mold as a cause of allergies or asthma, especially if the living environment was exposed to water or allergy symptoms occur year round.

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