May 24, 2021

It is hard to ignore the arrival of the yellow blanket of pollen that visits every spring. Tree pollen causes the biggest headache (pun intended) around this time of year, with grass pollen peaking in the summer and weed pollen in the fall. According to the CDC, seasonal allergies, also referred to as hay fever, affect 20 million adults each year.1 Knowing you have company, however, is probably of little comfort if you are presently suffering from allergic rhinitis.

Seasonal allergies occur when the body identifies pollen as a harmful substance and mounts an immune response. Release of histamine (a compound stored in granules within mast cells and basophils) leads to the bothersome symptoms of sneezing, itchy/watery eyes, runny nose, cough, fatigue and sinus headaches.  

Treatment is often focused on minimizing symptoms. Over-the-counter (OTC) medications that block histamine 1 receptors such as fexofenadine, loratadine and cetirizine can provide temporary relief, but can also cause side effects of drowsiness, dry mouth and fatigue. For a more natural approach to seasonal allergies consider these options:

Try a natural antihistamine

Quercetin is a bioflavonoid found in many fruits and vegetables that inhibits basophil and mast cell degranulation without the side effects of OTC antihistamines. It is best taken for the duration of allergy season as a preventative measure. You can increase your intake by eating foods high in quercetin (i.e.: onions, apples, grapes and berries) or by taking a quercetin supplement.

Stinging nettleand butterburare botanicals that downregulate histamine. Both can be taken in supplement form or stinging nettle can be consumed as a tea.

D-Hist is a great option for seasonal allergy prevention. This supplement contains quercetin along with bromelain (which is found in pineapples and increases quercetin absorption), stinging nettle leaf, N-acetyl cysteine or NAC (an amino acid precursor that helps decrease thickness of mucus and aid in clearing airways), and vitamin C (an immune system booster and potent antioxidant).

Optimize vitamin D and vitamin C levels

Vitamin D helps support immune system function and low levels have been associated with allergies and asthma. While found in some fortified foods, vitamin D is obtained primarily from the sun. Levels are often lowest in the winter when more time is spent indoors and more clothes are worn when outdoors. Many  people are often unaware that they have a low vitamin D level. In fact, according to the most recent National Health and Nutrition Examination Survey (NHANES), 40% of the general population have low vitamin D levels.2  Consider having your vitamin D level checked, adding a supplement if levels are low, and spending some time in the sun each day to boost your immune response.

Vitamin C decreases oxidative stress and enhances immune function. Increased intake of vitamin C rich foods will help diminish those unwanted allergy symptoms. My favorite foods that are high in vitamin C include strawberries (in season right now!); bell peppers; citrus fruits such as oranges, grapefruit, lemons and limes; and cruciferous vegetables like kale, broccoli and brussel sprouts.

Talk to your doctor

Allergy symptoms can be worsened by underlying gut issues. Food sensitivities, an imbalanced microbiome and small intestinal bacterial overgrowth can all increase systemic inflammation that exacerbates seasonal allergies. Further in-depth testing may be needed to determine overall health and how the immune system is affected. If you think there could be a more deeply rooted issue going on in your gut, Spruce MD provides this specific testing.

If none of the above therapies resolve symptoms, glucocorticoid nasal sprays can be used for seasonal allergy symptoms. Nasal glucocorticoids are considered the first-line conventional treatment for allergic rhinitis but have potential side effects of local irritation of the nasal mucosa, including drying and burning.

As a fellow sufferer of hay fever, I am hit pretty hard each spring by the rain of pollen. Dread of the itchy eyes, bouts of sneezing and pressure headaches grows as the first leaves begin to bud. Anecdotally, however, my symptoms have been minimal this year. With correction of my vitamin D level, improved gut health and taking quercetin daily, I have only suffered from the intermittent sneeze – no packing tissues in every pocket, no teary eyes, no exploding head. I have instead enjoyed our blooming city by biking the Swamp Rabbit Trail, planting a vegetable garden and playing in the yard with my kids….before those pesky mosquitoes arrive, but I’ll save them for another post.

Mary Brittain Blankenship, MD, FAIHM

Dr. Blankenship

Mary Brittain Blankenship, is the founder and physician at Spruce MD Integrative Medicine. Board certified in both Internal Medicine and Integrative Medicine, she sees patients locally at her practice in Greenville, SC and virtually nationwide.

Registered Dietician

Integrative and Functional Medicine Providers