Sneezing bouts, runny or blocked nose, itchy, red or watery eyes, itchy throat and malaise. Many suffer from these symptoms with the arrival of spring. Rather than enjoying the warm sun and the blooming flowers, many take refuge indoors to avoid any potential triggers in the environment. As science is progressing, mankind is increasingly suffering from exposure to substance as innocuous as pollen!
Different trees produce pollen at different times of the year starting from spring and going all the way through to autumn thus prolonging the suffering of many hay fever sufferers. While in spring the major culprit is grass pollen, in autumn many suffer due to allergies to mould and fungal spores.
Historical Background: Hay Fever is a modern epidemic and its roots can be traced to the early 19th century. C.H. Blackley, a physician from Scotland after ten years of extensive research demonstrated ‘‘pollen’’ to cause the symptoms of hay fever in 1871. He convincingly reproduced the symptoms of hay fever in his laboratory by placing a small amount of grass pollen into the noses of his patients. He also invented the skin test in its simplest form, where he scratched the surface of skin with pollen on the forearm of a person. Only those patients who suffered with the hay fever allergy developed a ‘‘red wheal’’ at the site as a special reaction to pollen (1).
Blackley also explored the prevalence of this ailment and found that the ‘‘farming classes’’ did not suffer from any symptoms of hay fever. According to Blackley, the lower classes were less susceptible to hay fever because of either ‘‘continued exposure or did not have the predisposition caused by academic toil’’(1).
What is Hay fever and what are the treatment options? Hay fever is a common allergic condition that affects up to one-in-five people at some point in their lives. Allergy is an exaggerated or adverse immunological reaction to normally innocuous substances in the environment. An allergic person’s immune system believes allergens to be damaging and thus it produces a special type of antibody (IgE) to attack the invading pathogen (pollen in this case).
This leads other blood cells to release further chemicals (including histamine) that cause the symptoms of an allergic reaction. This explains why taking antihistamines help to manage the symptoms. If symptoms are not controlled by antihistamines, steroidal nasal sprays are used to control inflammation, which may have potential side effects and are not beneficial to everyone. The market is flooded with over-the-counter allergy medicines with the allergy sufferers buying every single product to control their allergy symptoms. Improved awareness of allergies and allergen avoidance has profited many companies by launching products like anti-allergy bedding, vacuum cleaners, air filters, household cleaning products and detergents. The list is growing endlessly every day.
A second-line approach to more severe allergies is immunotherapy (‘allergy shots’), which involves regular injections of small amounts of the relevant allergen(s) over a long period (several months to several years); this leads to a gradual desensitization of the body to them. This concept of using small doses of what might cause a problem in order to help prevent or heal the person is the basis for a type of natural medicine called homeopathy (2).
In a 6-year outpatient study at Bristol Homeopathic Hospital, over 70% of patients with chronic diseases reported clinical improvement following homeopathic treatment. 6544 patients were involved in the study and 70.7% reported positive health changes with 50.7% recording their improvement as better (+2) or much better (+3). Outcomes were based on scores on a 7-point Likert-type scale at the end of the consultation and were assessed as overall outcomes compared to the initial baseline assessments (3).
There are various ways in which homeopathy can be prescribed to relieve the symptoms of hay fever.
Isopathic prescribing is based on the patient’s proven allergies (e.g. house dust mite or mixed pollen) as shown by skin testing. The substance that the patient is allergic to is given in a homeopathic potency. A high quality research has shown improvement in various respiratory allergies (hay fever, asthma and perennial allergic rhinitis) using this type of prescription. The researchers showed a 28% improvement in nasal air flow of patients using homeopathy as compared with 3% in the placebo group (P=.0007) (4).
Therapeutic prescribing aims to address the acute symptoms of hay fever to bring some relief. Some useful remedies are:
Allium Cepa: The common name is red onion. We are aware of the excoriating effect on mucous membrane when we cut a raw onion. The eyes water profusely which is bland, while the discharge from the nose is irritating to the nostrils. There can be violent sneezing and the excessive mucus may produce a hacking cough. The kind of hay fever which can benefit from allium cepa is the one which is worse on being in a warm room and better off when in cool open air.
Euphrasia: Eye bright is the local name of this herb and as the name suggests it is prescribed when the eyes are strongly affected. It is useful for relief in allergic manifestations such as a sensation of ‘sand’ in the eyes and when the eyes are agglutinated in the morning. The nasal and throat symptoms are less marked but include watery mucus. Euphrasia tincture can also be used as an eye-wash by diluting one drop in one glass of cooled sterile water. It is very soothing for sore eyes at any time.
Sabadilla: is an important hay fever remedy when a patient is sneezing constantly. There is itching in the nose with irritating runny discharge and watery eyes which will all suggest a need for this remedy.
Wyethia: This remedy is useful when there is immense itching in the nostrils, ears and strikingly the roof of the mouth. This causes a peculiar urge to rub the palate with the tongue to relieve the itching.
Arundo: Another useful remedy to consider when there is unusual itch. There is runny nose and the person may lose their sense of smell. The person is distressed by itching inside the ears and there may be burning sensation as well.
Apis: is particularly useful when a person has intense and dramatic swelling around their eyelids, which puff up and look baggy. The eyes ‘sting’ and the delicate tissues around the eyes are red, hot, swollen to touch although cold compress provides relief. Apis is one of the useful remedies used for insect bite and is made from the honey bee. In all inflammatory conditions, there is characteristic burning and stinging which calls for this specific remedy.
Constitutional prescribing on the other hand prescribes a constitutional remedy to boost the entire constitution of the patient. Following are a few remedies which in my clinic have been useful in treating the symptoms of hay fever:
Arsenicum album: The main corner stone of this remedy is treating the marked ‘restlessness’ on the mental as well as physical level. Whatever is the ailment: hay fever, asthma or digestive disturbance, the patient is highly anxious especially at midnight lasting until 3 am. This aims to address the anxiety associated with hay fever.
Natrum muriaticum: The most distinguishing symptom for prescribing this remedy is that the patients’ discharges have the consistency of raw egg white. The patient suffers with repeated violent sneezing especially in the mornings. This remedy can be used for treating rhinitis which can often be accompanied by violent, pulsating headaches made much worse by the heat of the sun, or by increased emotional sensitivity.
Silicea (also called Silica): Silicea is an invaluable constitutional remedy which can be helpful to individuals who have low resistance to infection who may have frequent bouts of colds, sore throats, and swollen lymph nodes. In hay fever or colds, the patient suffering from thick yellow-green lumpy expectoration calls for this remedy.
I have mentioned only a few remedies but going to a qualified homeopath for a detailed consultation is required (the list may be obtained from the SOH website).
A few home/herbal remedies are mentioned below that may be useful to build immunity slowly.
Butter Bur: The use of broad leaves of butterbur to wrap butter goes back to ancient times. This invaluable herb has historically been used for a variety of health conditions such as anxiety, whooping cough, asthma and hay fever. A study published in the British Medical journal showed that one tablet of butter bur taken four times daily was as effective as the oral antihistamine in controlling the symptoms of hay fever. The study was carried for a period of two weeks but the butter bur group of patients showed fewer side effects usually associated with antihistamine (drowsiness + fatigue)5.
How it is used: Commercial tablets are available using the leaves, rhizomes and roots of butter bur.
Turmeric: The use of turmeric in Ayurvedic and Chinese medicine has a long history owing to its anti-inflammatory and antioxidant properties. This herb boasts its use in various ailments ranging from relieving arthritis pain, aiding digestion and liver function, regulating menstruation and reducing the symptoms of allergies such as hay fever.
How it is used: Turmeric's underground stems (rhizomes) are dried and consumed as a powder or in capsules, or fresh juices. A convenient way of consuming turmeric is by taking it in the form of ‘turmeric honey’. This requires mixing equal amount of turmeric and honey and eating one teaspoon of this mixture 4 or 5 times a day.
Stinging Nettle: (Urtica dioica): Herbal medicines and homeopathy both employ the use of stinging nettle leaves to combat the symptoms of allergy such as asthma, hives and hay fever. Confirming ancient use, recent studies have shown that not only does nettle leaf block histamine receptors but it also blocks the release of enzymes from mast cells, thereby bestowing the herb with its anti-allergic properties6.
How it is used: Freeze-dried leaves or capsules can be used (recommended dosage = 300 mg daily). Tea is again a convenient way of consuming this very useful herb. Boil water and add one teaspoon of dried nettle leaves and let it simmer for a few minutes. Add honey to taste and enjoy two-three times daily.
References
1. Waite KJ. Blackley and the development of hay fever as a disease of civilization in the nineteenth century. Med Hist. 1995;39(2):186-196.
2. Pandey V. Hay fever & homeopathy: a case series evaluation. Homeopathy. 2016;105(2):202-208.
3. Spence DS, Thompson EA, Barron SJ. Homeopathic treatment for chronic disease: a 6-year, university-hospital outpatient observational study. J Altern Complement Med. 2005;11(5):793-798.
4. Taylor MA, Lancaster T, Reilly D, et al. Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial seriesCommentary: Larger trials are needed. BMJ. 2000;321(7259):471-476.
5. Schapowal A. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002;324(7330):144.
6. Roschek B, Fink RC, McMichael M, Alberte RS. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytother Res. 2009;23(7):920-926.