Allergies: Complex Holistic Dysfunctions

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

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New Recommendations for Treatment Strategy for Chronic Rhinosinusitis Syndrome (CRS), commonly called Hayfever, Rhinitis or Sinusitis, or just Allergies:

The NIH has published recent extensive analysis of rhinosinositis syndromes and recommended a change in treatment guidelines. These recommendations are that instead of just focusing on reducing mucosal inflammation, swelling, infection and aeration of the membranes, that modern treatment should, "First of all...consider the patient in totality: from etiology (including contributing health problems) when possible, to (differences in individual) clinical features. When considering patients with CRS (chronic rhinosinusitis), comorbidities (associated health problems)... must not be underestimated...A modern treatment of CRS should adapt its schemes to evidence-based medicine. Unfortunately, basic evidence on drug efficacy in CRS is still missing. As mentioned by the EPOS expert panel, validated trials are lacking even for the most prescribed medications against CRS such as antibiotics...A multidisciplinary approach and follow-up is mandatory as diseases such as cystic fibrosis can generate sinus diseases." We see from a number of guideline revisions in recent years that the subject of treatment of allergies in standard medicine has been deemed very inadequate, offering merely a somewhat effective palliative treatment protocol that now is generating alarm at the long-term adverse health effects, and is clearly ignoring the associated health problems that can eventually become threatening to the health and quality of life of patients with chronic allergic disease.

In 2012, a large randomized controlled human clinical trial of corticosteroids in pills or nasal spray to treat acute episodes of allergic sinusitis, by experts at the University of Utrecht School of Medicine in The Netherlands, led by Dr. Roderick Venekamp, and they found that this increasingly prescribed therapy was not effective. Dr. Venekamp stated in an interview that there was no rationale for this treatment and no clinically relevant effect that would justify this now common prescription. There are clearly adverse health effects and risks from corticosteroid medications, and it appears that medical doctors were resorting to corticosteroids because of the negative findings suggesting that their long history of prescription of antibiotics and antihistamines were mistaken as well. To see a review and interview of this study that was published in the Canadian Medical Association Journal, just click here: https://www.sciencedaily.com/releases/2012/08/120807132205.htm . Other studies led by Dr. Venekamp show that there is almost no proof of benefit from antibiotics or corticosteroid sprays for chronic allergic rhinitis, and that the few studies used to support these treatments are of poor quality and have been designed with bias to support this pharmacological care. Obviously, we need to limit these medications in the relief of symptoms to avoid adverse health effects, and work on the underlying pathology of allergic sinusitis, or rhinosinusitis with a more holistic approach.

A 2007 study of the treatment of chronic rhinosinusitis (CRS), by experts at the University of Buffalo School of Medicine, State University of New York, in the U.S.A. noted that "antihistamines are not recommended for CRS, unless the patient has an accompanying allergic rhinitis. Also, although topical and oral decongestants are often used, side effects such as rhinitis medicamentosa (with topical agents) and hypertension (with oral agents) can occur (Slavin et al 2005)... Studies have also shown that irrigation with hypertonic saline alleviates symptoms in CRS patients (Heatley et al 2001; Slavin et al 2005)" (PMCID: PMC1936313). Of course there is never any mention of the many studies showing efficacy with herbal medicine and acupuncture. In recent years there have been studies that show that probiotic courses have a positive effect for many patients as well, improving the cycle of dysfunction that leads to eosinophilia and exagerrated immune responses to parasites that enter the bloodstream. We clearly see that depending on the standard symptom-relieving treatments alone is not only not smart and sensible, but actually contributes to health problems and antibiotic-resistance.

Is Acupuncture Actually Proven to Work in the Treatment of Allergies?

In 2015, a large population study was conducted in Taiwan by China Medical University, with randomized patients surveyed from a list of a million patients in a national insurance database, and 29 percent of these patients diagnosed with chronic rhinosinusitis used TCM medical care integrated with standard treatment. Clearly, this level of use of acupuncture and herbal medicine in treatment of common upper airway inflammation and allergy proves that it is considered effective. The study also found that the need for endoscopic sinus surgery was much lower in the group that utilized CIM/TCM (PMID: 25511322). One may wonder why medical institutions in the United States still does not support this safe and effective therapy, discouraging patients with reports that there is still no proof that 'acupuncture' works for CRS. In this large population study in Taiwan, the researchers also noted that besides acupuncture needle stimulation, that 97 percent of the patients surveyed that utilized CIM/TCM used herbal medicine. In actual TCM practice, the individualized combination of simple and benign therapies is what makes the treatment effective, but studies in standard medicine insist on proof that a one-size-fits-all superficial needling treatment alone be studied, and that this treatment must outperform substantially what is called in the study design 'sham' needling. Obviously, this study design is easily manipulated to decrease the outcome measure, and is not performed to show that the treatment is safe and effective, which was the original goal of the RCT (randomized human clinical trials for new pharmaceuticals). Slowly, we are changing this system of proof, and allowing real and truthful outcome measures to be revealed and published. The safety of this inexpensive and effective integrative treatment protocol is not in question.

For too long we have viewed acupuncture with a misguided perspective. Of course, when the acupuncture specialty was introduced it was seen as something very strange, people sticking you with needles and talking about an unseen energy called Qi, and it came from China, a communist country. It was easy to depict this centuries-old proven medical specialty as fringe medicine, uproven and introducing a strange alternative to standard care. This was over 40 years ago, though, and still we are saddled with these wrong depictions and characterizations of acupuncture that has greatly impeded the proper application of this holistic protocol. Of course, it has been hard to produce large heavily funded 3-stage human clinical trials of simplified one-size-fits-all superficial needling therapies that meets the same criteria as pharmaceutical study that now spends billions of dollars on these clinical trials for a single drug. There is neither the funding, the organization, or the logical impetus for such scientific trials, which do not actually test the real clinical practice of the specialty of Traditional Chinese Medicine, which in its historical essence combines a number of benign therapies to achieve the greater sum of its parts and provide effective care with virtually no adverse effects. By both isolating needle stimulation in these studies, and insuring that each patient gets neither the individualized approach or actual professional needle stimulation that is also individualized, it is very hard to prove by this standard that simplified acupuncture by itself provides the patient with better results than antihistamines and steroids. The real question is why we continue to believe in these false standards of proof, and why patients seeking therapy from the Licensed Acupuncturist continue to believe that they should only be seeking superficial needle stimulation with no sensations elicited, not strong triggering of effects, and often no combination of the needle stimulation with an effective individualized course of herbal and nutrient medicines. This treatment of acupuncture as a purely palliative and oversimplified treatment that is performed superficially instead of how it has been utilized in China and Korea for many centuries, as part of an intense holistic integrative and complementary practice, producing sometimes dramatic results with short courses of therapy, has decreased its intrinsic effectiveness in the United States.

Despite these drawbacks, though, all of the TCM therapies are now proven to work with these randomized controlled human clinical trials that were designed purely to judge the safety and efficacy of pharmaceuticals. While we still lack billion dollar large scale human clinical studies, many sizable studies have been performed and the results published. Some of these studies are cited in the section below entitled Additional Information and Links to Scientific Studies, both proving efficacy of acupuncture needle stimulation itself, and more importantly, efficacy of a large array of herbal and nutrient chemicals to achieve specific goals. Of course, all of these many scientific studies cannot be cited in this article, and the totality of this scientific study must be taken into consideration, not just one modality or chemical achieving just one of the many goals of therapy in holistic approach. Since 2010, we finally see larger human clinical trials that actually meet the criteria for human clinical trials of pharmaceuticals. In the past, we have seen numerous laboratory studies showing the exact mechanisms of benefit of needle stimulation with laboratory animals, but these have largely been discounted by a biased medical industry. In 2009, a meta-analysis of randomized controlled human clinical trials that met high quality standards was conducted at Tianjin University, in Tianjin, China. This 2009 meta-analysis found only 12 small studies involving 1076 patients that met this criteria. The range of proven benefits was wide, though, and the meta-analysis primarily analyzed cure rates, even though there is no cure for allergic diseases in standard medicine. Even within a Chinese university medical system that teaches TCM, there existed an obvious scientific bias (PMID: 19563205). Also in 2009, a meta-analysis of these effects from a limited treatment protocol were conducted at the Korea Institute of Oriental Medicine, in Daejeon, South Korea. Here too, only 12 randomized controlled clinical trials (RCTs) meeting high standards of quality were found in the entire world literature, and only 2 of the these RCTs actually compared simplified acupuncture stimulation alone with standard pharmacological treatment (PMID: 19441597). In these 2 RCTs, the limited acupuncture therapy outperformed the outcome measures of the pharmaceuticals, though.

We see in such analysis that 1) there has been difficulty in devising randomized controlled human clinical trials as the standard of proof, 2) since there are so few studies at this time, there is neither sufficient proof of efficacy or of acupuncture not being effective, 3) in the quality human trials that actually compare the variable effects of simplified needle stimulation to standard pharmacological treatment, which now comes with many warnings of adverse effects with long-term or chronic use, the simplified acupuncture treatments were measured as more effective, and 4) none of these RCTs actually measure the treatment outcomes of the best practices in integrative care with TCM. Actual clinical practice with TCM in China and Korea uses stronger stimulation that is individualized, and more importantly, combines these short courses of acupuncture needle stimulation with effective professional herbal and nutrient medicines, as well as patient counseling with diet and lifestyle therapeutic protocols, and treatment to resolve associated and underlying health problems that absolutely must be addressed if a substantial reduction of the allergic syndrome is to be achieved. A comprehensive and thorough holistic treatment protocol is obviously needed for difficult health problems such as allergies, and can be achieved with just short courses of such holistic care.

By 2015, we see some progress in applying these unrealistic standards of proof to isolated one-size-fits-all simplified needle stimulation in RCTs, though, and a meta-analysis conducted at Shanghai Jiaotong University School of Medicine, in Shanghai, China, cited in the section of this article entitled Additional Information and Links, showed that with even higher standard of quality applied, as well as measures of Rhinitis Quality of Life, that now 13 quality randomized controlled human clinical trials in the last 30 years, involving 2365 patients, did effectively prove that this simplified treatment protocol consistently reduced symptoms, dependency on pharmaceutical antihistamines and steroids, serum IgE antibodies, and improved the Quality of Life measures (PMID: 25590322). A 2011 study at the Korea Institute of Oriental Medicine, in Daejeon, South Korea, measured the outcome for a 48 year old patient with comorbid allergic rhinosinusitis and asthma, integrating a simple common acupuncture treatment 3 times per week for just 5 weeks, using just the points DU23, Yintang, LI4 and LI20, with de qi elicited at the points and electroacupuncture applied to the LI20 sites. The Quality of Life scores improved from 38 to 23, measured 3 weeks after the end of the integrative therapy, and the nasal symptom score was reduced from 6 to 5, with the expiratory volume improved significantly, and no asthma-related symptoms reported after discontinuation of the inhaled corticosteroid (PMID: 21785632). Such study provides useful guidelines for treatment, and indicates that repeated courses such as this over time will have even more dramatic benefits. Integration of herbal medicine into this protocol would obviously increase the benefit, and the time and money spent would be minimal, perhaps even saving money in the long term with reduced medication need. For many, this will still not be enough, though, to fully validate the treatment. For many intelligent patients, on the other hand, it is obvious that a more intensive and holistic approach is needed, that this more intensive approach is meant to be used in short treatment courses, not with chronic dependency, and that it should be fully integrated with standard care, not considered as an alternative. When such an attitude is adopted, the results can be very rewarding. When patients persist in the belief that they should just seek a spa-like superficial acupuncture treatment every 2 weeks to help with their allergies, the results will often be disappointing. Another important consideration that has emerged, is that the standard care, a mere symptom management with problematic chemical pharmaceuticals, and the ignoring of associated health problems and future health, is not really producing the end-results that we need.

Standard medicine needs to integrate with Complementary Medicine to provide the desired results of treatment. When this will actually occur is still being debated. In 2015, clinical guidelines for treatment of Allergic Rhinitis were finally published from experts at 11 University Medical Schools in the U.S.A., including Johns Hopkins, the University of Chicago, St. Louis University, Georgetown University, Morehouse, Wayne State, and Louisiana State University. In these revised practice guidelines, it was recommended that: "Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with AR (allergic rhinitis) who are interested in nonpharmacologic therapy. The development group provided no recommendation regarding the user of herbal therapy for patients with AR." This first step clearly shows that despite much reluctance in the field, standard medicine can no longer insist that CIM/TCM does not work in this realm. Hopefully, the wording will soon evolve to show that TCM clinicians that are highly trained in this field and integrate proven herbal medicines, diet and lifestyle advice, and treat the whole patient and underlying and related health conditions, present the potential for much better outcomes than just the standard Medical Doctor with minimal training in needle stimulation. To see this published guideline for care, just click here: http://www.ncbi.nlm.nih.gov/pubmed/25644617 . Such treatment would not only improve outcomes, but reduce long-term adverse side effects, and make healthcare more affordable in the long run.

Examining the Risk vs Benefit of Standard Medication

There are a few reasons why patients currently choose to incorporate Complementary and Integrative Medicine into their treatment of allergies. One, they want to decrease their use of prescription medications due to side effects or warnings of risk with chronic use; two, they want to lessen the side effects and risks; and three, they want to not only control symptoms but to actually get healthier, and to improve the health of the systems contributing to immune missense. Currently, standard allopathic medicine alone offers no evidence of significant benefit in many types of chronic allergy, yet produces risk with chronic use that engenders much concern from the medical community, and has prompted numerous warnings from the FDA and other health regulatory commissions. Because of this, more and more medical doctors are starting to incorporate Complementary Medicine into their practice. Thoughtful patients will turn to the physicians that specialize in these therapies to improve the results of a multidisciplinary treatment stategy. The best outcome is to overcome allergies and to escape the need for future therapy at all, especially allopathic medications that come with risk when taken chronically. This requires a more thorough and comprehensive treatment protocol in most cases.

There are still only 3 types of standard medication to treat allergies. Antihistamines, Decongestants and Anti-inflammatories, although in allergic asthma and other serious allergic reactions Bronchodilators, such as Anitcholinergic agents, Beta-adrenergic agonists, Theophylline, and Anti-IgE antibody meds are used, as well as macrolide antibiotics, despite the alarming rise in antibiotic resistance from overuse of antibiotics, and the fact that bacterial infection by gram-positive bacteria plays an inconsequentlal role in the pathology of chronic allergic rhinosinusitis and asthma. Many current allergy medications combine these various types of drugs. The problems with this approach is that it not only presents serious negative consequences of long term chronic use, but also overlooks key features of various allergic mechanisms, and fails to address underlying non-inflammatory parameters and contributing health problems. Evidence also points to damage to the membranes and natural immune responses by continous use of these drugs and authorities now recommend a treatment protocol that at least alternates these types of drugs each month or so if the patient uses them daily.

With the mounting evidence of problems associated with antihistamines, decongestants and anti-inflammatory medications with long-term use, the pharmaceutical industry is investing in a more natural approach long used in herbal medicine, immunotherapy. Allergists have long used injections of allergens to stimulate the allergic responses to build a better immune protection. While this type of therapy in standard medicine was long derided as quackery, studies in recent years have clearly shown that building up membrane immune balance and function not only decreases symptoms, but in fact can stop allergies altogether. In Europe, such allergy immunotherapy is now standard, but in the United States, the FDA approval has been slow. In 2013, large pharmaceutical companies, such as Merck and Stallergenes, announced that they have completed large clinical trials showing the efficacy of immunotherapy, and are introducing less expensive products, with sprays, pills and and liquid extracts available that target specific allergen reactions. These medications are refined plant and dust mite allergens that are introduced with a slowly increasing dosage to stimulate a better immune response.

While there are limitations to this immunotherapy, since most patients are actually allergic to a number of allergens, not just one specific targeted allergen, combined with a more holistic approach, utilizing Complementary and Integrative Medicine, this immunotherapy approach could completely halt the allergic responses in a few years, requiring no further treatment. An array of aids to therapy in Complementary Medicine are proven to enhance membrane immune function and health, and standard herbal tinctures, utilizing aromatic compounds to effectively deliver a broader and gentler allergen immunotherapy, are available. In addition, herbal and nutrient medicines to enhance overall immune health and function, decrease irritating inflammation from viral, fungal and bacterial overgrowths in unhealthy membranes, and acupuncture, can be integrated into this therapy as well. Patients are now provided with an array of therapeutic tools that can be used intelligently to both effectively control symptoms and reverse these immune allergy dysfunctions. There is no reason why harsher medications, such as antihistamines, decongestants and anti-inflammatories, cannot be used only when necessary, with an integration of immunotherapy and Complementary Medicine providing a safer and better long-term outcome.

"A modern treatment of chronic rhinosinovitis syndrome (CRS) should adapt its schemes to evidence-based medicine. Unfortunately, basic evidence on drug efficacy in CRS is still missing. As mentioned by the EPOS expert panel, validated trials are lacking even for the most prescribed medications against CRS such as antibiotics. Finally, as for all treatment for chronic diseases, an adequate management of CRS should include a regular evaluation of efficacy (and a) multidisciplinary approach."

- (an NIH PubMed citing of a paper published in Therapeutic Clinical Risk Management 2007 March; 3(1) by the Dept of Otorhinolaryngology, Univ of Ghent and Univ Catholique de Louvain, Belgium)

Antihistamines: while short term use of antihistamine presents little threat of risk other than drowsiness, hypotension or interaction with other drugs that may potentiate depression or anxiety, the FDA has issued serious warnings concerning long term chronic use. In 1992, the FDA warned that nonsedating antihistamines, astemizole (Hismanal) and Seldane, could cause cardiac arrhythmias if accumulation of blood levels increased above therapeutic indications. Some of these antihistamines had to be taken off the market due to the serious risk due to the problem with accumulation to toxic dose, yet are we concerned with mildly toxic blood levels with chronic use?

Concurrent use of the antibiotic erythromycin, ketoconazole, itraconazole (anti-fungals), and other drugs have been shown to cause great increases in blood level accumulation of antihistamine. Keep in mind also that antihistamines are now added to a variety of common over-the-counter products, including sleeping aids, allergy remedies, cold and flu meds, etc., and are added to a number of pain medications, usually denoted by the PM version of the drug. Many patients with chronic health problems are unaware of the multiple remedies being taken that contain antihistamines. Also, antihistamines have been documented to excrete in breast milk and nursing mothers have been cautioned, especially if levels rise. Many antihistamines are broken down mostly in the liver and poor liver function or competition in catabolism could decrease an individuals rate of drug breakdown. Risk of toxic blood levels seems to be largely ignored, but is a significant health concern.

Chronic use of antihistamines are documented to cause weight gain and insomnia, as well as other common health problems that are typically ignored by the prescribing physicians. Insomnia is often improved at first by the taking of antihistamines, many of which affect the CNS sleep centers and cause drowsiness, but chronic use typically results in a disruption of healthy sleep regulation. Natural allergic responses are sometimes diminished with chronic antihistamine use and patients will become more prone to frequent viral, fungal and bacterial infections. When combining chronic antihistamine use with nasal sprays, containing corticosteroids, this risk is multiplied.

The reasons that antihistamines may cause increased CNS depression when combined with alcohol or other anti-depressants and anti-anxiety drugs is alarming to some. This serious threat is why second and third generation of antihistamines were developed to decrease risk, and are called nonsedating. First generation antihistamines easily crossed the blood brain barrier and affect the central nervous system (CNS). The first generation antihistamines are also lipophylic and are metabolized by the liver P450 oxidative enzymes, thus competing for enzyme breakdown with antidepressants, anti-arrhythmics, beta blocking blood pressure medications, and antipsychotic medications used for common depression and anxiety. Second generation non-sedating antihistamines, such as the most popular Claritin (Loratadine), as well as Allegra (Fexofenadine) and Zyrtec (Cetirizine), while not directly crossing the blood brain barrier to effect the CNS, were the first drugs studied in relation to drug interactions with P450 enzyme competition, and still contain this threat of altering blood levels of both the antihistamine and these other drugs. Third generation non-sedating antihistamines do not cause these interactions, but studies show that clinical response varies widely among and within patients (Armstrong and Cozza M.D. analysis published in Psychosomatics 2003; 44:430-34). This study also asserts that Claritin/Altavert safety profile has been the subject of much professional debate, and drug interactions and competition is still problematic with certain patients, especially concerning patients taking concurrent anti-histamine antacid medications and cardiovascular drugs.

While the second generation antihistamines are "non-sedating", the clinical trials showed that at higher than recommended dosages, or when the active chemical accumulates to higher levels in the blood, sedation may occur, and combined fatigue and drowsiness did occur in 3-9 percent of patients of the second-generation "non-sedating" antihistamines in clinical trials. In a large study by the group Allergy and Asthma Specialists, published in the American Journal of Therapeutics, July, 1998, insomnia was reported in 15 percent of patients taking Claritin-D 12-hour chronically. While these antihistamines are are for symptomatic relief only, and recommended for daily use only when symptoms are a problem, many patients are led to believe that they should take them daily year-round to prevent allergic symptoms, and many patients take more than the recommended dosage to relieve symptoms. Histamines are important chemicals in the area of proper stomach function also, and inhibition has shown potential nutrient depletion of B12, calcium, folic acid, iron, zinc and vitamin D. The FDA has issued warnings that caution should be used in prescribing these drugs to patients with peptic ulcers or small bowel obstructions, as well as those with prostrate hypertrophy, glaucoma and bladder obstruction. Certain antihistamines come with precautions that caution should be observed in use with patients with history of bronchial asthma, hyperthyroidism, cardiovascular disease and hypertension.

Coupled with these extensive problems of risk with antihistamines are the consequences of long term corticosteroid use (see article on this website) and the damage done to sinus membranes from chronic use of decongestants. Corticosteroid nasal sprays are commonly coupled with antihistamine allergy medications, and many allergy drugs contain both an antihistamine and a decongestant. Chronic corticosteroid use often leads to diminished immune responses, and higher risk of oral fungal infections, hoarseness and chronic low-grade cough are common adverse effects. Common prescriber warnings state that there are potential side effects with decongestants of nervousness, sleeplessness, increased blood pressure, racing heart, and rebound rhinitis, where more than three days use in a row of nasal decongestant spray may cause the congestion to become more severe which will lead to increased use of the decongestant and dependency on the medication, as well as potentially toxic blood levels accumulating. While the second generation antihistamines are "non-sedating", the clinical trials showed that at higher than recommended dosages, or when the active chemical accumulates to higher levels in the blood, sedation may occur, and combined fatigue and drowsiness did occur in 3-9 percent of patients of the second-generation "non-sedating" antihistamines in clinical trials. In a large study by the group Allergy and Asthma Specialists, published in the American Journal of Therapeutics, July, 1998, insomnia was reported in 15 percent of patients taking Claritin-D 12-hour chronically. While these antihistamines are are for symptomatic relief only, and recommended for daily use only when symptoms are a problem, many patients are led to believe that they should take them daily year-round to prevent allergic symptoms, and many patients take more than the recommended dosage to relieve symptoms.

The question of efficacy of second-generation antihistamines is still being debated, as well. An article in the March 11, 2001 New York Times, entitled The Claritin Effect; Prescription for Profit, reported that clinical allergists saw that Claritin appeared to work well for only about 30-40 percent of patients, and that research by the author found that the FDA Advisory Committee concluded in 1987 that the proposed 10 mg dose of Claritin was "minimally effective versus placebo". The dose of 40 mg was considered minimally effective, but sedating, and evidence of risk of liver cancer in study animals at this dose per body weight was found. Nevertheless, Claritin was approved, and become the largest selling antihistamine ever, largely due to the enormous TV advertising campaign. Only in 2011, though, did we finally have a large independent study of the efficacy of Claritin (Loratadine) on healthy subjects, by the University of Illinois (NCT01451996), with randomized objective measurements, that is ongoing in 2013.

The key question in evaluating long-term risk versus benefit is not whether we may be one of the unlucky few who face serious consequences, but rather, if these medications can cause such significant harm, what are they doing to my general health. As far as benefit concerns, are these drug regimens correcting the immune membrane health and addressing key health factors that contribute to the problem? Are they possibly perpetuating the health problem while controlling symptoms? Utilization of Complementary Medicine in the treatment of chronic allergies may decrease drug dependence, result in better relief of symptoms, work to improve the underlying problems with membrane immune health and contributing health problems, and decrease costs of these very expensive allergy medications in the long-run. Whether or not one is paying out of pocket for these antihistamines, whose cost is typically over a hundred dollars per month, the cost is passed on to the consumer via higher insurance premiums and taxpayer-funded health care. Trying a competent course of treatment in Complementary Medicine for 2-3 months, with a professional physician, such as a Licensed Acupuncturist and herbalist, makes sense in a number of ways.

Herbal products are proving effective to treat allergies

A variety of herbal products are effective if they are of high quality and prescribed properly. Herbal medicines are able to control inflammatory mechanisms, increase vascular and neural vasomotor responses, promote healing of tissues, act as broad spectrum antibiotic, antiviral and antifungal agents, support healthy immune responses, both specific local and systemic, and address potential contributing health problems such as fibrosis, subclinical hypothyroidism, acid reflux and other esophageal reflux syndromes (GERD), and asthmatic mechanisms. In addition, herbal products may help alleviate some of the risk of damage to the membranes and overall health from chronic use of drugs. In 2015, a published report of a meta-review of all scientific study of herbal medicine to treat rhinosinusitis, by experts at the University of Vergata, and the University of Sienna School of Medicine, in Italy, showed that current scientific evidence supports the integration of herbal medicine in treatment. To see this study, just click here: http://www.ncbi.nlm.nih.gov/pubmed/26015644 . There are very many herbal medicines used in clinical practice, but many of them contain the same basic core herbs, formulated for centuries in China, as well as utilized in local herbal medicine across the planet. Quality assurance is the main issue today, as the practice is still largely unregulated in the United States, and public studies have revealed the extent to which companies are marketing fake and misleading products sold off the shelf in pharmacy chains, and off the internet. Professional products, obtained through a licensed herbalist, such as a Licensed Acupuncturist, insures that you are getting an effective medicine, and that there are no chemicals and drugs in the products that could elicit adverse reactions in individuals.

Some of the common herbal pill formulas in my clinical practice are listed below. Other tinctures and raw herb formulas are used as more specific and stronger phytomedication when needed.

  • Allergen: a general herbal formula to alleviate symptoms and help the immune system is very effective in many cases, especially with nasal and eye symptoms
  • Advanced Defense: a formula to stimulate better immune responses
  • Colostroplex: bovine colustrum supplement may help with food allergy problems especially
  • Phellostatin: a formula that has a broad spectrum effect against overgrowth of fungi, bacteria, and other pathogens
  • Ecliptex: a liver tonic with milk thistle is often useful to improve B-cell response
  • Astra C: a simple immune tonic with 3 forms of Vitamin C to improve the health of the mucosa to correct localized immune dysfunctions in nasal allergies and asthma
  • Nasal Tabs: a symptom relieving formula for nasal/sinus allergies
  • Xanthium relieve surface: a simple formula to relieve skin symptoms or head congestion symptoms related to allergies, especially with irritation of the eyes or ears
  • EpiCor: a nutrient medicine and immune modulator derived from nutritional yeast in a patented process, EipCor contains a number of key metabolites that are proven to aid membrane immune functions, clear oxidants, or reactive oxygen species, and increase the levels of protective secretory IgA, to boost the first line of immune defense in the membrane tissues against allergens
  • CordySeng: the herbs Cordyceps (Dong chong xia cao) and American Ginseng (Xi yang shen), are combined with Reishi mushroom extract (Ling zhi), astragalus (Huang Qi), ginger and licorice root, to provide a potent immunostimulant and modulating formula
  • Lectin Lock: food allergies often involve hypersensitivity to a group of difficult to digest proteins called lectins. With ill health of the gut membranes and Biota, the lectins may not be broken down and cleared as well as they need to be. Research has discovered a number of nutrient chemicals that naturally lock onto and help eliminate over-accumulation of lectins, including N-acetyl glucosamine from crab shell, chemicals in okra, bladderwrack, sodium alginate, and mucin. Lectin hypersensitivity has been linked in studies to respiratory irritation, congestion, itchy nose, and the sensation of excess mucous in the throat.
  • QuerCelain: studies in recent years have found that a number of chemicals in Chinese herbs, such as Quercetin and Bromelain, as well as magnesium and vitamin C in the form of magnesium ascorbate, greatly aid the human cell ability to better regulate histamine formation and release to achieve better immune function, and help maintain and repair membrane tissues as well. This type of therapy will result in healthy histamine responses and no need to take antihistamines to control allergy symptoms in the future, and can be successfully incorporated with a holistic approach in therapy. Quercetin, an important herbal chemical found in a number of Chinese herbs, has also been shown to exert significant effects to calm airway smooth muscle swelling via inhibition of tissue-specific phosphodiesterase, calming allergic asthma and nasal swelling.

More importantly, though, may be the restoration of esophageal and gastrointestinal health and function. While the standard medical industry has treated all problems of gastric dyspepsia and acid reflux with the same one-size-fits-all protocol, research in recent years has demonstrated that this has increased allergen sensitization and allergic reactivity dramatically. Restoration of gastric function, rather than blocking of function, is now proven to be the correct treatment protocol for a vast majority of patients. The use of herbal and nutrient formulas to affect this improvement in gastric function and protein digestion may include DigestiveAid (Vitamin Research Products), Resinal K liquid, Chzyme, EnteroMend, N-Accelle, Phellostatin, and BioPro (probiotic formula from Vitamin Research Products). A step-by-step restoration and proper individualized assessment of gastrintestinal health and function may treat the basic underlying problems that lead to chronic food allergies and sinus and skin allergies as well. Food allergies now are found to be the underlying mechanism for many chronic and difficult sinus allergies, and addressing the health of the gastrointestinal system may also decrease the systemic distribution of allergens in circulation via poor gut membrane health. The so-called "leaky gut syndrome" is now well known and shown to be a major contributor to allergic sensitization and reaction via unwanted allergens bypassing our natural gut defenses.

Examples of herbal formulas to treat allergies that are now being studied in the United States includes such formulas as Food Allergy Herbal Formula-2 (FAHF-2), which was studied in 2008 and supported by the Food Allergy Initiative and the National Institutes of Health grant #AT001495-01A1, with the study results published in The Journal of Allergy and Clinical Immunology Volume 123, Issue 2, Pages 443-451, February 2009. This simple classic formula, consisting of Prunus mume (Wu mei), Zanthoxylum schinifolium (Huai jiao), Angelica sinensis (Dang gui), Zingiber officianalis (Ginger), Cinnamonium cassiae (Gui zhi), Panax ginseng (Ren shen), Phellodendrum chinense (Huang bai), Coptis chinensis (Huang lian), and Ganoderma lucidum (Ling zhi or Reishi mushroom), was found to suppress IgE-mediated mast cell activity, reduce basophils and mast cells, and induce a shift in specific immune responses mediated largely by elevated CD8 interferon gamma. Use of this formula for a prolonged period of up to 3 months reduced long-term TH2 cytokine secretion as well, to effectively treat allergic anaphylactic responses. The study authors stated: "In conclusion, our studies with FAHF-2 have shown a beneficial effect that lasted long after the treatment regimen ended, a therapeutic effect not provided by other treatments. The long-term immunomodulatory effects of FAHF-2 on TH1 and TH2 responses, but not overall immune suppression, could provide the optimal immune meilieu for establishing tolerance to peanut and other IgE-mediated food allergies. FAHF-2 is currently being tested as a US Food and Drug Administration (FDA) investigational new botanical drug in patients with food allergy including PNA. FAHF-2 might thus be the first available effective treatment for patients with PNA and other food allergies." The various herbs in this TCM formula are included in most other common professional TCM herbal formulas prescribed to treat chronic food allergies, including those mentioned above.