Also indexed as: Allergic Rhinitis, Allergy (Hay Fever), Pollen
Allergy, Seasonal Allergy
Sniffling, sneezing, and wheezing? It must be pollen season. If
you suffer from hay fever, you can find relief through a number of treatments. According to
research or other evidence, the following self-care steps may be helpful:
- Try butterbur
- To help with symptoms, take an herbal extract standardized to
contain 8 mg of petasin per tablet two or three times a day for two weeks
- Get relief with nettle leaf
- Ease symptoms by taking 450 mg of nettle leaf capsules or tablets
two to three times a day
- Go on a low-allergen diet
- Work with a knowledgeable health professional to find out if
dropping certain foods from your diet will help your hay fever
- Take an allergy test
- Make an appointment with your healthcare provider or an allergist
to find out what airborne agents you may be allergic to and how you can reduce their
effects
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full hay fever article for more
in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About hay fever
Hay fever is an allergic condition
triggered by the immune system’s response to inhalant substances (frequently
pollens).
Researchers have yet to clearly understand why some people’s immune systems over-react to exposure to pollens while
other people do not suffer from this problem. Symptoms of hay fever are partly a result of
inflammation that, in turn, is activated by the immune system.
Product ratings for hay
fever
What are the symptoms?
Inhaled allergens trigger sneezing and inflammation of the nose and mucous membranes
(conjunctiva) of the eyes. The nose, roof of the mouth, eyes, and throat begin to itch
gradually or abruptly after the onset of the pollen season. Tearing, sneezing, and clear,
watery nasal discharge soon follow the itching. Headaches and irritability may also occur.
Medical options
Over the counter topical nasal decongestants such as oxymetazoline (Afrin®) and
phenylephrine (NeoSynephrine®) may provide relief from nasal congestion, but they should
only be used for a few days. The oral decongestant pseudoephedrine (Sudafed®) may help relieve nasal
congestion, while antihistamines such as
diphenhydramine (Benadryl®),
brompheniramine (Dimetapp®),
chlorpheniramine (Chlor-Trimeton®), and
loratadine (Claritin®) might help dry excess mucous and reduce sneezing. Cromolyn sodium (Nasalcrom®) is used as a nose
spray to prevent hayfever symptoms.
Prescription antihistamines are often prescribed for relief of hay fever symptoms. These
include cetirizine (Zyrtec®),
desloratadine (Clarinex®), and
fexofenadine (Allegra®). Inhaled
corticosteroids, such as flunisolide (Nasalide®), triamcinolone (Nasacort®),
fluticasone (Flonase®), and mometasone (Nasonex®) may also be suggested to prevent
and treat nasal symptoms.
Dietary changes that may be helpful
People with inhalant allergies are likely
to also have food allergies.1
2 A hypoallergenic diet has been
reported to help some people with asthma and
allergic rhinitis,3 but the effect of such a diet on hay fever symptoms has not
been studied. Hay fever sufferers interested in exploring the possible effects of a food
allergy avoidance program should talk with a doctor. Discovering and eliminating offending
food allergens, should they exist, is likely to improve overall health even if such an
approach has no effect on hay fever symptoms.
Vitamins that may be helpful
Although vitamin C has antihistamine
activity, and supplementation, in preliminary research,4 5 has been
reported to help people with hay fever, 2,000 mg of vitamin C per day did not reduce hay fever
symptoms in a placebo controlled trial.6 Thus, while some doctors recommend that
hay fever sufferers take 1,000–3,000 mg of vitamin C per day, supportive evidence
remains weak.
In a double-blind study of people with hay fever, adding 800 IU of vitamin E per day to regular anti-allergy treatment
during the pollen season significantly reduced the severity of hay fever symptoms by 23%,
compared with placebo plus regular anti-allergy treatment.7
Quercetin is an increasingly popular
treatment for hay fever even though only limited preliminary clinical research has suggested
that it is beneficial to hay fever sufferers.8
The oral administration of a thymus extract
known as Thymomodulin® has been shown in preliminary studies and double-blind trials to
improve the symptoms of hay fever and allergic rhinitis.9 10
11 Presumably this clinical improvement is the result of restoration of proper control
over immune function.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Two double-blind studies have compared
butterbur extract to standard antihistamine drugs in people with hay fever. The first
compared it with the drug cetirizine (Zyrtec)
and found the drug and butterbur extract relieved symptoms equally well. However, cetirizine
caused significantly more adverse effects, including a high rate of drowsiness.12
The second study compared butterbur extract with
fexofenadine (Allegra) and placebo. Butterbur extract was as effective as fexofenadine at
relieving symptoms, and both were significantly better than placebo.13
People with hay fever had better symptomatic relief and reductions in levels of immune
cells associated with allergic reactions (eosinophils) when treated with an herbal formula
containing horny goat weed compared with a
formula without horny goat weed and another herb by itself.14 Traditionally 5 grams
(1 tsp) of horny goat weed is taken three times per day, usually after being simmered
(decocted) in 250 ml (1 pint) of water for 10 to 15 minutes.15
In a double-blind study, an extract of the butterbur plant (Petasites hybridus)
was significantly more effective than a placebo at improving symptoms in people suffering from
seasonal allergic rhinitis.16 The study used a preparation standardized to contain
8 mg of total petasin per tablet. One tablet was administered either two or three times a day
for two weeks; the larger amount was found to be more effective than the smaller amount.
Tinospora cordifolia is an herb used in traditional Indian (Ayurvedic) medicine for increasing longevity,
promoting intelligence, and improving memory and immune function. In a double-blind trial, an
extract of Tinospora cordifolia was significantly more effective than a placebo at
relieving symptoms of allergic rhinitis, including sneezing, runny nose, nasal obstruction,
and nasal itching. The study used 300 mg of a standardized extract three times a day for eight
weeks.17
Tylophora is an herb used by Ayurvedic doctors in India to treat people with allergies. It contains compounds that have been
reported to interfere with the action of mast cells, which are key components in the process
of inflammation responsible for most hay fever symptoms.18 Mast cells are found in
airways of the lungs (among other parts of the body). When mast cells are activated by pollen
or other allergens, they release the chemical histamine, which in turn leads to a wide number
of symptoms familiar to hay fever sufferers—itchy eyes, runny nose, and chest tightness.
Ayurvedic doctors sometimes recommend 200–400 mg of the dried herb daily or 1–2 ml
of the tincture per day for up to two weeks.
In an isolated double-blind trial, nettle
leaf led to a slight reduction in symptoms of hay fever—including sneezing and itchy
eyes.19 However, no other research has investigated this relationship. Despite the
lack of adequate scientific support, some doctors suggest taking 450 mg of nettle leaf
capsules or tablets two to three times per day, or a 2–4 ml tincture three times per day
for people suffering from hay fever.
The Japanese herbal formula known as sho-seiryu-to has been shown to reduce symptom, such
as sneezing, for people with hay fever.20 Sho-seiryu-to contains licorice, cassia bark, schisandra, ma huang, ginger,
peony root, pinellia, and asiasarum root.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
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asthma treated with elimination diet. Ann Allergy 1977;39:8–11.
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1942;96:497.
5. Ruskin SL. High dose vitamin C in allergy. Am J Dig Dis
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ascorbic acid on cutaneous and nasal response to histamine and allergen. J Allergy Clin
Immunol 1982;69:484–8.
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different diseases. Curr Ther Res 1987;42:1011–7.
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butterbur and fexofenadine on objective and subjective outcomes in perennial allergic
rhinitis. Clin Exp Allergy 2004;34:646–9.
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rhinitis. Zhong Xi Yi Jie He Za Zhi 1989;9:720–1, 708 [in Chinese].
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Pharmacology. City of Industry, CA: Art of Medicine Press, Inc., 2003.
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of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized,
double-blind, placebo-controlled study. Arch Otolaryngol Head Neck Surg
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cordifolia in allergic rhinitis. J Ethnopharmacol 2005;96:445–9.
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tylophorine, a major alkaloid of Tylophora indica, on immumopathological and inflammatory
reactions. Ind J Med Res 1980;71:940–8.
19. Mittman P. Randomized double-blind study of freeze-dried Urtica
diocia in the treatment of allergic rhinitis. Planta Med 1990;56:44–7.
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(TJ-19) for perennial nasal allergy. Clin Otolaryngol 1995;88:389–405.