ALLERGIC RHINITIS OR HAY FEVER
It is a type of inflammation of the nasal mucous membrane due to the over-reaction of the immune system to any kind of allergens present in the environment.
When working well, our immune system protects us from the bacteria, viruses and toxins that enter our bodies. With hay fever though, something goes horribly amiss and it starts to over-react to harmless substances such as pollens, grasses, and animal dander. This allergic response results in a cluster of symptom that make life miserable.
PATHOPHISIOLOGY
Exposure to allergens generates allergen-specific IgE after T-cell release of interleukins 4 and 13, and B-cells producing IgE antibody which produces sensitization which leads to cross link of atleast two IgE antibodies bound to the high-affinity IgE receptor on presensitized effector cells, that is, mast cells or basophils8.
Phases of allergic response-
§ Early phase-
Duration- 20 minutes to an hour.
Symptoms includes- sneezing, pruritus and clear rhinorrhea.
Mediator- Histamine appears to be a major mediator.
§ Late phase-
Duration- begins in 3 to 6 hours, peaks at 6 to 8 hours and subsides in 12 to 24 hours.
Symptoms- sneezing, nasal obstruction, lacrimation, etc.
Mediator- chemokines and cytokines play a major role. Eosinophil activates release of leukotrienes which develops nasal congestion.
TYPES-
1. Seasonal – It occurs only in a particular season or only for a limited period of the year. It is also called as intermittent allergic rhinitis. It is caused by sensitivity to airborne mold spores or to pollens from trees, grasses or weeds.
2. Perennial– It remains throughout the whole year. It is also called as persistent allergic rhinitis. It is generally caused by sensitivity to dust mites, pet dander, mold or cockroaches.
SYMPTOMS-
§ Sneezing
§ Clear rhinorrhea9
§ Stuffiness of the nose
§ Itching in the nose and the eyes
§ Lacrimation
§ Heaviness in the head or headache
§ Fatigue
§ Hyposmia/ anosmia10
§ Some skin complains like urticaria also can be present.
§ Facial pain and fullness10
§ Wheezing
§ Feeling of chest tightness
§ Dyspnoea
RISK FACTORS11–
§ Genetic factors.
§ Environmental factors.
§ Production of IgE.
FACTORS TRIGGERING-
§ Smoking
§ Temperature changes
§ Cold climate
§ Humidity
§ Air pollution
§ Sprays
§ Fumes
PHYSICAL EXAMINATION-
On physical examination, it may show following:
§ Conjunctival swelling
§ Nasal polyps or enlarged nasal turbinates
§ Erythema
§ Swelling of the eyelids
§ Middle ear effusion
DIAGNOSIS-
A detailed history taking along with the following investigations may help to confirm the diagnosis:
1. Skin-prick testing13–
A small volume of a set of known allergens is injected into the dermis and any “weal and flare” reaction is taken as a positive response to that allergen.
1. Blood test13–
RAST (Radio-allergo-sorbent test) detects specific circulating IgE antibodies.
1. Nasal smear-
It may reveal large number of eosinophils and presence of neutrophils14.
DIFFERENTIAL DIAGNOSIS-
§ Viral rhinitis
§ Bacterial rhinitis
§ Vasomotor rhinitis
§ Hormonal rhinitis
§ Rhinitis medicamentosa
§ Atrophic rhinitis
§ Gustatory rhinitis
MANAGEMENT-
§ Avoid exposure to dust or exposure to any allergen as much as possible.
§ Wearing mask may prevent entering of the allergens.
§ Use of glasses or sunglasses.
COMMON ALLERGENS
§ Grass pollen
§ Dust mites
§ Animal saliva
§ Animal dander
§ Mold
While hay fever may seem to be about surface symptoms only, it is really a deep-seated complaint. Commonly prescribed sprays and tablets that suppress hay fever symptoms may bring temporary relief but don’t get to the root of the problem. They are also associated with side effects and so are probably the least helpful option for long-term improvement.
I will share with you some simple self-help measures that go a long way to reducing the frequency and intensity of hay fever symptoms, and explore some of the homeopathic treatment options from the perspective of indications and safety.
SIMPLE STEPS FOR MANAGING HAY FEVER
There are several self-help measures at little cost which may help with hay fever. They are:
1. Drink plenty of water. When you’re well hydrated the mucous membranes of your nose remain moist to expel allergens more easily.
2. Consider using a neti pot. These small pots can be filled with a warm sea salt solution and used to flush your nasal passages and expel irritants.
3. Coat your nostrils. Lightly smear a non-absorbent ointment, such as paw-paw ointment/ mustard oil, onto the inner surface of your nostrils to create a protective film that traps allergens.
4. Know your triggers. Most hay fever sufferers are affected by the wind but some are worse indoors while others itch and sneeze when outside. Avoid your triggers when pollen counts are high.
5. Use Food as your Medicine
· Healthy fats and oils such as olive oil, fish oil and even moderate amounts of animal fats are important for a healthy immune system. Studies show that those who eat mostly polyunsaturated and trans-fats, as found in many margarines and processed foods, are more likely to suffer allergies.
· Onions and garlic can be used for their homeopathic effect – the symptoms they cause, they can also treat. Both contain natural compounds that reduce the inflammation of hay fever. Add them liberally to your meals or, if you are up to it, eat them by themselves to reduce nasal irritation and streaming eyes.
· Local raw honey can be used as a crude form of homeopathy to de-sensitise yourself to local pollens from which the honey was produced. Start by taking a small amount each day before the start of hay fever season, gradually increasing to a teaspoon or more. Continue right through the season for best results.
· Spices such as horseradish, mustard, chillies and fenugreek also help through a crude homeopathic effect – they can relieve the very hay fever-like symptoms they produce. Add them liberally to meals or take them alone to thin mucus and expel irritants.
THE CONVENTIONAL APPROACH – ALLOPATHIC TREATMENT
Conventional medicine treats hay-fever with antihistamines, steroids, or de-sensitisation treatments. For stubborn cases that fail to improve, laser surgery may be recommended to destroy the mucus-forming nasal tissue. Let’s look at each option in more detail.
Antihistamines
Anyone can be affected by the side-effects of antihistamines but children and the elderly are more vulnerable. Antihistamines can worsen conditions such as glaucoma, enlarged prostate gland, difficulty in passing urine, or bowel blockage, and their safety during pregnancy hasn’t been established. They also hold increased risks for those with liver or kidney disease.
Some of the most common side-effects include: headache; drowsiness; dizziness; blurred vision; confusion; dry mouth; constipation; and difficulty passing urine. Once the antihistamine effect wears off, hay fever symptoms are usually return.
Steroids
Steroids (corticosteroids) for hay fever are available as sprays, creams and tablets. Steroids generally produce more problems than antihistamines. They may lead to unpleasant or dangerous side-effects such as high blood pressure, bleeding from the bowels or stomach, reduced healing, poor muscle growth, weight gain, and electrolyte imbalances. Long term use increases the likelihood of these symptoms along with diabetes, glaucoma, and eye damage. In addition, patients may experience mood swings, personality changes, agitation, nervousness, tiredness, lack of energy, and depression.
De-sensitisation treatments
The homeopathy effect can take place anywhere – even with some approaches used by conventional medicine. Modern allergy treatments that expose people to small amounts of the substance to which they are allergic unknowingly use the homeopathic principle of ‘like treats like’. Homeopaths have used this approach for two centuries but are aware that if even smaller amounts are used, and in potency, the results are faster and better.
Homeopaths also know that while a homeopathic remedy prepared from an allergen (the substance that triggers an allergic response) can bring temporary relief or surface improvement, a deeper-acting remedy that addresses the person’s whole state of ill-health will lead to the hay fever being eradicated permanently and better health overall.
Laser surgery
Laser surgery is used to vaporise the mucus membranes of the nose to inhibit the symptoms of hay fever. Care has to be taken to prevent burning of the nasal tissue. Success is variable and re-vaporisation is often needed when symptoms return over time.
Making a choice
Suppressing symptoms for short term relief does not produce the best long term results for hay fever and is associated with side effects and even permanent injury. When safer options are available, we would all be wise to explore those first. Homeopathy is one of those options. If we want the best result for the least risk when treating our health problems, we must think carefully about the different types of treatment option available.
Conventional medicine depends on the allopathic effect for most of its treatments. It relieves symptoms by palliating or suppressing them for short periods of time. The drawback is that side effects are common and continual suppression can lead to worsening health.
Homeopathy seeks to stimulate the body’s innate ability to self-heal. The goal of treatment is to strengthen rather than weaken this ability so that full healing is more likely. Homeopathy does this through potentised remedies that closely match the symptoms of the person’s disease and are free of toxic side-effects.
HOMEOPATHY AND HAY-FEVER RESEARCH
Numerous studies indicate homeopathy should be a treatment of choice for allergies. They showed that homeopathy alleviated the symptoms of hay fever and other hypersensitivity disorders and led to improved quality of life without dangerous side-effects.
TREATING HAY FEVER WITH HOMEOPATHY
Treating yourself with homeopathy during an acute phase of hay fever is easy as long as you know which remedy matches your symptoms. Relief with the correct remedy is usually rapid – sometimes within minutes – and all remedies are considered safe for use during pregnancy and with babies through to the elderly when taken according to instructions.
COMMON HOMEOPATHIC REMEDIES FOR HAY FEVER
Allium cepa
This remedy, prepared from the red onion, treats the symptom of streaming eyes and nose that is worse in warm and stuffy rooms. (People who need All-c may even crave and feel better for eating onions.) Their nasal discharge burns while tears from the eyes are bland – the opposite to Euphrasia’s symptoms. Sneezing can be intense and frequent and eyes are sensitive to the light.
Arsenicum album
This is one of the best remedies for hay fever. Burning or itching in the nose, eyes or throat being a strong indication. The discharges from both eyes and nose will be burning (but check to make sure that Allium cepa or Euphrasia are not better indicated – Euphrasia has the opposite symptoms). An improvement of the symptoms in the open air, although sensitive to light, is usually an indication for this remedy.
Euphrasia
A classic remedy for hay fever where, again, there is lots of sneezing with streaming eyes and nose. If the water from the eyes burns the cheeks and the discharge from the nose is not too bad, this remedy is needed. (Allium cepa has the opposite symptoms). The remedy is indicated if the symptoms improve in the open air – obviously away from pollen. Sensitivity to light may be apparent in both Euphrasia and Allium cepa.
Natrum muriaticum
Initially, there is a streaming, bland discharge from both the eyes and nose with lots of sneezing. Later, there is nasal discharge that is thick and clear like the white of an egg with loss of taste and smell. This is not one of the main remedies for hay-fever but it can bring great relief to the type who gets easily burned, feel generally miserable, uncomfortable, blotchy and irritated in the sun.
Nux vomica
This is one of the best remedies for when there is lots of sneezing, streaming from the eyes and nose, and an irritable, nasty mood. (If they are sweet tempered, it is unlikely to help.) The symptoms are worse in dry air and relieved when the atmosphere is damp.
Ambrosia artemisaefolia
Intolerable itching and watering from eyes. Burning of eyes. Sneezing and watery nasal discharge. Nose and head feel stuffy. Nose bleeds.
Arum triphyllum
Irritation or itching in the nose leading to boring, picking, rubbing. May pick at lips and face. Throat, mouth, tongue, and palate may burn, making it difficult to eat or drink despite having a thirst. People who need Arum-t may experience concurrent hoarseness and peeling or chapping of the lips.
Sabadilla officinarum
Hay fever with frequent, spasmodic sneezing that exhausts the person. Sneezing from tickling inside the nose, and sneezing that causes the eyes to water. Profuse, watery nasal discharge and red and burning eyelid margins. Symptoms worse in the open air, better in a warm room. Dry mouth but little thirst.
Solidago
Burning, stinging eyes. Paroxysms of sneezing with mucus discharge from nose.One of the main remedies for people allergic to house dust mite.
Wyethia helenoides
Tremendous itching of the upper palate of the mouth causing the person to make “clucking” noises in effort to provide some relief. Itching of the nose and throat, along with a constant desire to swallow saliva to relieve the dryness may also be present.
Histaminum
Consider this remedy when either no other remedy seems accurate or if other remedies have been tried and haven’t worked.
EXTRA REMEDIES
Pulsatilla pratensis
The main indications for this remedy are a weepy, needy, state of mind, together with discharges that are thick, bland (not acrid) and green or yellow. Pulsatilla frequently has one side of the nose blocked or congested.
Sulphur
Watery, burning nasal discharge, or a blocked nose, when outside. Frequent sneezing. Blocking of nose on alternate sides. Burning pain in eyes. Symptoms worsened by warmth and becoming warm in bed. Better for being in open air. May be lazy, opinionated, and desire sweets, alcohol, and spicy food.
Kali bichromicum
Consider this remedy when thick, stringy, green or yellowish mucus from the nose or throat is present. There may also be a post-nasal or pain at the root of the nose relieved by hard pressure.
Ammonium phosphoricum
Sneezing with excessive running from nose with excessive lachrymation, only in the morning.
Agraphis nutans
Ailments from- smell of lilies and exposure to cold winds. Catarrh with chilliness. Want of covering. Adenoids. Enlarged tonsils. Throat and ear affections with free discharges.
Ailanthus glandulosa
Copious, thin and bloody discharge from the nose. Rawness in the nostrils with sneezing. Loss of smell. Congestion of nose and eyes. Purulent lachrymation. Stitching pain in the chest. Frontal headache. Tongue dry and brown. Pain in swallowing extends to ears. <morning, >hot drinks.
Arsenicum iodatum
Chronic nasal catarth. Discharge like glue or yellow honey or greenish. Thin, watery and excoriating discharge from posterior nares. Sneezing, burning pain in eyes. Colds with hunger. Intense thirst for cold water. Dull aching headache <morning, <stooping. Pain over root of the nose. Hay-fever. Catarrh of middle ear. Irritation and tingling of nose. Ulcers in the nose<sneezing, <open air. Coryza with cough and dyspnoea. Loss of smell. <Dry cold weather, <in room.
Bromium (bromine)
Ailments from dust. Severe coryza with sneezing and soreness in nose. Bleeding of nose. Obstruction of right nostril. Margins of nose corroded. Annual coryza. Lachrymation from right eye, especially. Fan like motion of alae. Acute coryza of june or july. Cold with first hot weather; with headache. Cold sensation of the mucous membrane of the nose as if cold from inhaling cold air. Rawness round about the nostrils. <Warmth, <overheating, <warm room, <dust, <draft. >Nose bleed, >motion, >riding.
Eucalyptus globulus
Thin, watery and foul chronic catarrh. Nose does not stop running; stuffed up sensation with tightness across the bridge. Involvement of frontal sinuses. Dull congestive headache during coryza.
Justicia adhatoda
Coryza profuse, fluent and acrid with constant sneezing and lachrymation. Loss of smell and taste. Coryza with cough. Fullness and heaviness of the head with heat sensation.
Sanguinarinum nitricum
Watery mucous from both nostrils. Frequent sneezing and profuse lachrymation. Sensation in the nose “as if he has taken string horse-raddish”. Burning pain in nostrils bilaterally. Soreness of the nostrils. Discharge from posterior nares tinged with blood.
Scilla maritima
Constant sneezing and fluent acrid coryza. Sneezes during cough. Tendency to rub eyes, <morning. Involuntary urination on sneezing. Ulcerated nostrils. Dyspnoea, >sitting, <cold water.
Solanum nigrum
Nose deep red but the tip of nose black. Sneezing. Acute profuse coryza with watery discharges from right nostril (left being closed). Burning in the nose with swelling and pain. Sensation of chilliness alternating with heat.
Trifolium pretense
Coryza which preceds hay-fever. Watery discharge from nose with irritation, <night. Sensation “as if breathing hot air”.
CASE TESTIMONIAL
Sinusitis, Headaches, Hay Fever, High Blood Pressure, Rising PSA Levels, Insomnia and Anxiety
Case Report
Nisha’s story shows the widespread changes that can happen when a remedy is chosen for the patient’s overall symptom complex, rather than just a few isolated symptoms. In Nisha’s instance, he only needed the one remedy in a range of potencies and the results were extremely good. For others, a series of remedies may be needed to achieve the same improvements – it all depends on whether the symptoms change or stays the same during treatment.
Barry started his treatment knowing only a little about homeopathy. Like many people he thought of homeopathy as being similar to herbal medicine, relying on plant-based remedies. In fact, homeopathy draws its remedies from many kingdoms – animal, vegetable, mineral, and “imponderables”. The remedy that was helpful for Barry was a potency prepared from a mineral salt.
Nisha’s Story
I did not start by approaching a homeopath for treatment. My introduction was in attending a homoeopathy workshop principally in support of my wife who was interested to see if this alternative resource could help a member of our family who has autism.
Being impressed by the presentation I did subsequently seek a consultation which I particularly liked because it dealt in some detail with the causative factors. An hour and a half’s consultation probed issues of what might be considered unrelated except this embraced the whole person in body mind and spirit. My experience with the conventional medical resource is that they deal only with the body and symptoms.
My ailments were multi-factorial albeit they might be considered minor. The main issue was blocked sinuses causing headaches and associated side-effects. This condition was exacerbated during spring due to the high pollen count in the atmosphere, also leading to hay fever. Medical help sought many years before offered only a temporary solution with surgery, removing the nose and cutting/removing cartilage. I remember asking the doctor how successful it would be and how long would the effects last. His response dissuaded me from taking this option even though I have now suffered with this complaint for 50 years.
The homeopathic treatment was an infinitely small dose of a natural herbal compound in a liquid form that that I was to take once a week. Within three weeks my sinuses were 85% clear! The improvements were however ongoing and other issues started to clear up as well. I have been on blood pressure tablets two years and with this medical drug my blood pressure had been lowered from 180/105 down to approximately 155/85.
Now, approximately eight weeks after starting homoeopathy my blood pressure is 113/73 and I shall have to get my doctor to reassess my dosage or even cease all medication. Furthermore, my regular prostate tests have shown a PSA of 5.5, 6.0, and 7.9, progressively increasing over the last three years, supposedly age-related. My recent tests reported a PSA 5.0. My sinus now varies between 95% and 100% clear. Several other issues I referred to as multifactorial have also improved or disappeared. Other body functions have changed (for the better) as well. I now sleep the night through and have found a softening in anxiety. Situations that worried me no longer affect me emotionally. In spite of these improvements I am told that my treatment hasn’t finished yet, so is homoeopathy good or is it good?
Testimonial : Mehak Singh
DOSING
· Low potencies to be used, like 6C, 12C, 30C
· Instructions on how to dose: Preferably in liquid doses, single drop of the remedy, in 1/4th cup of water and take a sip from the same cup every 2-3 hrs or even closely, if the intensity of symptoms is high.
· If there is no improvement by 3-4 doses, just reassess your symptoms and choose a different remedy that matches your symptoms more closely – no harm will be done.
· Do not take high potencies unless prescribed by a professional homeopath.
· Recurrent/ chronic trouble : Should you find it difficult to sort through your symptoms, an appointment can be made with me and I will assess your symptoms in full and make a constitutional prescription to help you get on top of the problem once and for all. Homeopaths also know that while a homeopathic remedy prepared from an allergen (the substance that triggers an allergic response) can bring temporary relief or surface improvement, a deeper-acting remedy that addresses the person’s whole state of ill-health will lead to the hay fever being eradicated permanently and better health overall.
Do be aware that self-treatment does have its limits. While the remedies and potencies in home use kits help to provide symptomatic relief they are unlikely to get deep enough to correct a predisposition to chronic hay fever. A course of treatment by a qualified homeopath is much better suited to this. The bonus is that other health problems should also improve along with your hay fever during this deeper treatment.