Food and Environmental Allergies and Nutritional Support for Allergies

Controlling The Body's Burden
Chris D. Meletis, ND

The Centers for Disease Control report that hay fever symptoms result in 14.1 million annual visits to primary care physicians.1 Overt allergic disease affects 20 percent of the US populace with an impact on some 50 million Americans.2-3 Of those that suffer, 35 million are specifically afflicted with seasonal hay fever. If one was to add in to the statistics asthma and chronic obstructive pulmonary disease the numbers become even more staggering. Without question allergic disease is a serious health crisis and is currently ranked the 6th leading cause of chronic disease in the United States.2
Surprisingly, the allergic burden blamed for seasonal and year round allergies is not limited to environmental exposures. Clinically food allergies have been identified as a leading contributor to allergy symptoms. Food allergies can cause numerous respiratory symptoms including: asthma, cough, nasal congestion, excess mucus production, hoarseness, postnasal drip, tonsillitis, sore throat, sneezing and stuffy nose.
 

Food allergens can be broken down into two categories: Immediate and Delayed. It is the delayed or hidden food allergens that erode away ones health, frequently going undetected since the response is not immediate but rather delayed up to 72 hours, long after the offending food(s) were ingested. Patients experiencing delayed (IgG) food sensitivities will experience a worsening of their environmental allergens. Thus, identifying and controlling food sensitivities is essential.

As spring arrives plants and trees begin to bloom leading to over 31 million cases of sinusitis alone. With the slightest inclination many of these cases could be either totally avoided or managed conservatively. Instead of waiting in anticipation for another season of suffering, one should begin building the health of his or her respiratory system proactively by implementing some simple health principals. This discussion will explain how eliminating offending foods from the diet along with supplementation to augment the body's natural defenses—with nutrients like quercetin, bromelain and vitamin C—will help support respiratory health.

Allergic Symptoms: A Barometer of the Body's Preparedness
By definition if allergic symptoms flare up at a specific time of year then they are likely caused by seasonal allergic rhinitis. The body manifests with allergic symptoms because the personal threshold of resistance has been overwhelmed. Outdoor or indoor levels of pollen, spores and pollutants, when combined with daily environmental and food allergen burdens, become too great a challenge for the body to resist. Ideally one builds his or her body's defenses in a proactive fashion prior to the first signs and symptoms. Yet, if allergies have caught an individual off guard, it is imperative to take action. Though allergy symptoms vary from person to person, it is important to use specific symptoms as a personal barometer of the readiness and success of warding off the infamous biochemical allergic cascade. (Table 1)

Seasonal or perennial allergic rhinitis share a common symptom picture. The big difference is that in the case of perennial allergies identifying the cause of symptoms is often more difficult since there can be an overlap between current seasonal allergies and daily allergic burdens such as house dust mites, animal dander, chemical exposures, medicines or foods. Yet regardless of allergic symptoms' duration, supplementing the body's defenses is a must to control suffering. Among my favorite respiratory-support nutrients both for my own personal use and for my patients is a combination of quercetin, bromelain and vitamin C. Before discussing in detail the science behind the use of these supplements I will touch upon a common condition that can contribute to the exacerbation of allergic rhinitis and sinusitis—food allergies—as well as the link between heart disease and allergies/sinusitis.
 

When it comes to allergies the goal is simple, lessen the body's burden and strengthen its ability to resist the allergic irritants.

Food + Environmental Allergens = Respiratory Distress
One of the easiest ways to lessen personal allergic burden is to recognize that food allergy/sensitivities play a large role in the amount of suffering a person experiences either with seasonal or perennial allergies. This is because it is the total burden on an individual's system that ultimately determines how readily the body releases histamine and inflammatory substances that lead to many of the miserable symptoms of allergic reactions. Most people are unaware of their food allergies because we have been led to believe that food allergies are related only to asthma and hives—the classic "anaphylactic reactions." Yet, delayed food allergies are also called hidden food allergies because they can contribute to digestive problems, body aches, headaches and symptoms typically not associated with classic allergy symptoms. The combined environmental and food allergen burden result in total susceptibility to succumbing to allergic symptoms.

ELISA immunoassay testing for delayed food allergies helps identify delayed IgG immunoglobulin allergens. This technology is used worldwide and has now been applied to home test kits that can identify 96 different foods reactions ranging from dairy, wheat, corn, fish, vegetables, fruits, sugar cane, numerous nuts, eggs and other commonly consumed foods. A simple fingerstick done at home, much like that done by diabetics, makes gaining insight into ones own personal delayed food allergies both affordable and convenient. Once collected, the sample is sent from the home to a CLIA (nationally licensed) laboratory. Within a couple of weeks, results are sent back directly to the patient's home. These results indicate low, moderate or high reactions to different foods.

Choosing the correct laboratory is critical for accurate and reproducible results. The lab that I use in my clinical practice, which offers this home testing option for delayed/hidden food allergies, has an international presence that includes Europe and Asia. This clinically powerful tool can help an individual identify allergies to foods consumed daily that may otherwise go undetected since delayed food allergies can take upwards of 72 hours to manifest their full effect.
Clinical Cases:

  1. A 48-year-old woman presented with a 10-year history of cough and allergy symptoms. She was tested for food allergies and was positive for elevated antibodies to dairy, shrimp, corn, barley, oat, sesame, banana, grape, pear and rice. With this new gained knowledge she improved dramatically with complete remission of her symptoms.
  2. A 40-year-old male with allergic shiners (dark circles under eyes) that had been on Allegra® for years to control year around sinus and throat discomfort was able to discontinue his prescription medication and become symptom free when he avoided his high and moderate food allergens that included dairy, banana, peanuts, baker's and brewer's yeast.
  3. An 8-year-old boy with history of ear infections and sore throats was able to stop taking his maintenance dose of antibiotics, acid blocker, ear drops and antihistamine prescription. Allergies included wheat, peanuts, oranges and soy

Runny Noses and Heart Disease
For individuals willing to endure allergy symptoms, the consequence within the body doesn't end with a runny nose. Allergies trigger inflammatory responses that can elevate C-reactive protein (CRP), which can accelerate cardiovascular system damage. By controlling allergic symptoms such as sinusitis, rhinitis, pharyngitis, bronchitis or conjunctivitis individuals are simultaneously controlling inflammation—hence the term "-itis," which simply means inflamed. C-Reactive Protein is a measure of the total amount of inflammation within the body and can be measured with a simple and affordable blood test. The higher the CRP, the higher the heart disease risk, even with a low cholesterol reading.5 Ensuring we maintain a low CRP level is part of a holistic approach to allergy support, helping fuel individual potential for maximal wellness.

Winning the Battle
Moist mucous membranes are resistant and resilient to allergic irritation and possible secondary infection. Staying well hydrated during allergy season—and year round—is important since a healthy individual is comprised of about 70 percent water content.

The smartest approach to battling allergens is avoidance, literally trying to dodge as many pollen molecules as possible. Table 2 outlines ways to minimize pollen exposure.

Anyone suffering from allergy symptoms already knows that this condition can reduce "quality of life" by lessening enjoyment of leisure activities and decreasing the ability to perform tasks at home and work. Researchers have measured substantial impairment in verbal learning, decision making and psychomotor speed in those suffering from allergies.6-7

Recommendations for my patients that are serious about battling allergies include minimizing allergen exposure and supporting the body in controlling the allergic response. The goal is simple—minimize the total burden of allergic exposure by:
  • Checking the pollen count (with local media)
  • Staying indoors when it is high such as early evening when pollen counts peak
    Sleeping with windows closed
  • Driving with vehicle car windows closed
  • Wearing a mask when mowing the lawn or better yet hire out the job
  • Protecting the eyes with glasses/sun glasses to stop pollen entering the eyes
  • Washing hair prior to bed (to rinse out allergens collected throughout the day)
  • Staying well hydrated: moist mucous membranes are more resistant to irritation
    Testing for food allergies
  • Minimizing mold and mildew in house
  • Using Air filters/HEPA for bedroom
  • Cleaning central ventilation system in home or office
  • Remembering indoor/outdoor pets (carry pollen and allergens on their fur)
  • Cleaning carpets regularly with a HEPA vacuum

    Nutritional Support for Allergies
    The above recommendations may look simple enough, yet total avoidance is neither practical or feasible. Therefore proactively strengthening defenses with strategic supplementation can help an individual cope with this frustrating condition. Consequently, when pollen, dust and other allergens begin to fly the body will have been fortified and prepared for the impending barrage.

    The foundation of natural medicine is best captured by the doctrine stated 400 BC by Hippocrates, the father of western medicine, "May your food be your medicine and your medicine be your food." Indeed, when supplementing with plant based medicinals like quercetin, bromelain and vitamin C, one actually nourishes the body rather than merely treating allergic symptoms, leaving the body stronger and healthier overall.

    Quercetin
    My strong recommendation for my patients with allergies is quercetin in conjunction with bromelain. Quercetin is a naturally occurring polyphenolic plant compound. Quercetin actually helps prevent histamine release from mast cells (immune cells); this is in sharp contrast to prescription and over-the-counter antihistamine drugs that merely seek an "antidote" to histamine's effects. Quercetin supports the body by increasing its resistance to allergic response.

    Mast cells play an important role within the body relative to allergies, immunity and inflammation. As with all aspects of health one can have too much of a good thing. For instance, mast cells play a role in creating the momentary watering of an eye to flush out a speck of dirt, yet in an undernourished or overwhelmed body excess mast cell stimulation leads to unnecessary and preventable misery.

    Quercetin serves as a potent inhibitor of histamine and cytokine release from mast cells and basophils. Recent research has concluded that quercetin is suitable for the support of allergic and inflammatory diseases.8 When compared to one potent mast cell stabilizing drug, quercetin had twice the effect on nasal mast cell scrapings when given at the same concentration as the drug.9

    Quercetin embodies the concept of holistic care. While combating the allergic cascade it simultaneously nourishes and helps protect against chronic diseases. In a progressive study, it was clearly demonstrated that those with higher quercetin intakes had lower mortality from ischemic heart disease, lower lung cancer and asthma rates and a trend toward a reduction in risk of type 2 diabetes. The researchers concluded, "The risk of some chronic diseases may be lower at higher dietary flavonoid intakes."10

    Bromelain
    Bromelain, a powerful anti-inflammatory, is a glycoprotein with proteolytic enzyme properties. Derived from the stem of the pineapple plant, it confers both anti-inflammatory and mucolytic properties thus decreasing congestion and irritation of the mucous membranes bombarded during allergy season.11 The mucolytic properties are particularly important, since the addition of excess mucous creates a superb breeding ground for bacteria. All too frequently a secondary opportunistic infection tries to move into the sinuses or bronchial airway thanks in large part to uncontrolled inflammation and copious quantities of mucous. The result is frequently one of the inflammatory "itis" conditions: sinusitis, conjunctivitis, rhinitis, pharnygitis and potential bronchitis. Bromelain's ability to reduce levels of plasma kininogen down regulates the production of kinin, a group of pain-inducing polypeptides. It also activates plasmin, the mechanism by which bromelain reduces edematous swelling of airway tissue, such as nasal congestion, and helps quench the pervasive inflammation.12-13

    A study evaluated bromelain's use in 116 children under the age of 11 years diagnosed with acute sinusitis. Patients were treated with either bromelain; bromelain combined with standard therapies; or with standard therapies alone. Symptom duration determined the success of the various therapies. The shortest period of symptoms were observed in patients treated with bromelain as an isolated therapy.

    According to the researchers, "Patients of the bromelain monotherapy group showed a statistically significant faster recovery from symptoms compared to the other treatment groups."13-14

    Due to its efficacy after oral administration, its safety and lack of undesired side effects, bromelain has become an internationally revered nutraceutical that helps ameliorate sinusitis and bronchitis. It has also been shown to lessen blood stickiness, angina pectoris, post-surgical traumas, thrombophlebitis, pyelonephritis and can actually enhance absorption of drugs, particularly various antibiotics.15

    Vitamin C
    Lower vitamin C concentrations were observed among people with current or former asthma than among people who never had asthma.16 During infections and stress, vitamin C concentrations in the plasma and leukocytes (white blood cells) rapidly decline. Vitamin C supplementation improves immune function such as antimicrobial and natural killer cell activities, lymphocyte proliferation, chemotaxis, and delayed-type hypersensitivity. Furthermore, vitamin C protects cellular integrity against reactive oxygen species (free radicals) generated during inflammatory responses like those that occur during allergic reactivity and infections.17

    Further emphasizing the importance of vitamin C and other antioxidants was a study that points to asthma diagnosis as it relates to antioxidant status. Lower levels of serum vitamin C, alpha-carotene, beta-carotene, and beta-cryptoxanthin were noted in those with asthma. The authors concluded that low vitamin C and alpha-carotene intakes are associated with asthma risk.18-19

    The authors of another study also conclude that vitamin C plays an essential role in defending against oxidant attack in the airways. In fact they go as far to suggest that the results point to vitamin C deficiency as either a possible underlying factor in the pathophysiology of asthma or as a response to asthmatic airways inflammation.20 Furthermore, vitamin C levels have been found to be lower in children with chronic sinusitis.21 This indicates that allergic rhinitis or asthma—both conditions characterized by airway passage inflammation—require sufficient quenching and control with antioxidants such as vitamin C, protection with nutrients such as quercetin and direct anti-inflammatory control with proteolytics such as bromelain.

    Summary
    The scientific research and my clinical experience both lead to the same conclusion: the use of quercetin, bromelain and vitamin C serve as important supplements when it comes to helping control allergic symptoms, sinusitis and asthma. Identifying hidden food allergies also helps take an unnecessary burden from the body. When combined with supplementation and an active allergen surveillance program, tracking food allergies serves as the cornerstone for those serious about allergy symptom management and whole body health.

    Chris Meletis, ND
    Dr. Chris D. Meletis is an educator, international author and lecturer. His personal mission is "Changing America's Health One Person at a Time." He believes that when people become educated about their health that this is when true wellness is achieved.

    Dr. Meletis has authored 14 books and was awarded the 2003 naturopathic physician of the year by the American Association of Naturopathic Physicians. He has also written over 200 nationally published health and wellness articles. He served as Chief Medical Officer and Dean of Naturopathic Medicine for the National College of Naturopathic Medicine and has participated in starting 16 clinics providing care for uninsured families.

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References
1. United States Centers for Disease Control and Prevention. National Center for Health Statistics. National Ambulatory Medical Care Survey; 2002 Summary, table 13.

2. American Academy of Allergy, Asthma and Immunology. Task Force on Allergic Disorders. Executive Summary Report. 1998.

3. American Academy of Allergy, Asthma and Immunology. The Allergy Report: Science Based Findings on the Diagnosis and Treatment of Allergic Disorders, 1996-2001.

4. Nathan RA, Meltzer EO, Selner JC, Storms W. Prevalence of Allergic Rhinitis in the United States. Journal of Allergy and Clinical Immunology (1997) 99:S808-14.

5. Ridker PM, Cannon CP, Morrow D, Rifai N, Rose LM, McCabe CH, Pfeffer MA, Braunwald E. C-Reactive Protein Levels and Outcomes after Statin Therapy (2005) 352:20-28.

6. Marshall PS. Effects of allergy season on mood and cognitive function. Ann Allergy (1993) 71:251-258.

7. Metlzer EO, Nathan RA, Seiner JC, Storms W. Quality of life and rhinitic symptoms: results of a nationwide survey with SF-36 and RQLQ questionnaires. J Allergy Clin Immunol (1997):99:815-19.

8. Kempuraj D, Madhappan B, Christodoulou S, Boucher W, Cao J, Papadopoulou N, Cetrulo CL, Theoharides TC. Flavonols inhibit proinflammatory mediator release, intracellular calcium ion levels and protein kinase C theta phosphorylation in human mast cells. Br J Pharmacol. 2005 Aug;145(7):934-44.

9. Otsuka H, Inaba M, Fujikura T, Kunitomo M. Histochemical and functional characteristics of metachromic cells in the nasal epithelium in allergic rhinitis: studies of nasal scraping and their dispersed cells. J Allergy Clinic Immunol 1995; 96:528-36.

10. Knekt P, Kumpulainen J, Jarvinen R, Rissanen H, Heliovaara M, Reunanen A, Hakulinen T, Aromaa A. Flavonoid intake and risk of chronic diseases. Am J Clin Nutr. 2002 Sep;76(3):560-8.

11. Rimoldi R, Ginesu F, Giura R. The use of bromelain in pneumological therapy. Drugs Exp Clin Res (1978) 4:55-66.

12. Taussig S. The mechanism of the physiological action of bromelain. Med Hypothesis (1980) 6:99-104.

13. Kelly GS. Bromelain: a literature review and discussion of its therapeutic applications. Altern Med Rev. 1996; 1:243-57.

14. Braun JM, Schneider B, Beuth HJ. Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain-POS in children with acute sinusitis in Germany. In Vivo. 2005 Mar-Apr;19(2):417-21.

15. Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci. 2001 Aug;58(9):1234-45.

16. Ford ES, Mannino DM, Redd SC. Serum antioxidant concentrations among U.S. adults with self-reported asthma. J Asthma. 2004 Apr;41(2):179-87.

17. Wintergerst ES, Maggini S, Hornig DH. Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Ann Nutr Metab. 2006;50(2):85-94. Epub 2005 Dec 21.

18. Harik-Khan RI, Muller DC, Wise RA. Serum vitamin levels and the risk of asthma in children. Am J Epidemiol. 2004 Feb 19;159(4):351-7.

19. Rubin RN, Navon L, Cassano PA. Relationship of serum antioxidants to asthma prevalence in youth. Am J Respir Crit Care Med. 2004 Feb 1;169(3):393-8.

20. Kongerud J, Crissman K, Hatch G, Alexis N.Ascorbic acid is decreased in induced sputum of mild asthmatics. Inhal Toxicol. 2003 Feb;15(2):101-9.

21. Unal M, Tamer L, Pata YS, Kilic S, Degirmenci U, Akbas Y, Gorur K, Atik U Serum levels of antioxidant vitamins, copper, zinc and magnesium in children with chronic rhinosinusitis. J Trace Elem Med Biol. 2004;18(2):189-92.
 

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