Allergy symptoms occur when your immune system becomes sensitized and overreacts to an allergen—something that usually is harmless, such as pollen, dust mites, molds, insect stings, or food. The same substances that trigger hay fever symptoms may also cause asthma, a condition known as allergic asthma or allergy-induced asthma.
Allergies are the most common health issues affecting children in the U.S. and are the 6th leading cause of chronic illness in the U.S. affecting an estimated 40 million to 50 million people. In 2015, 8.2 percent of adults and 8.4 percent of children were diagnosed with hay fever. The chemicals released by the immune system lead to allergy signs and symptoms, such as nasal congestion, runny nose, itchy eyes, or skin reactions. For some people, this same reaction also affects the lungs and airways, leading to asthma symptoms.
Asthma is a chronic disease of the lungs characterized by repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Airflow is obstructed by inflammation and airway hyper-reactivity occurs in reaction to certain exposures including exercise, infection, allergens, occupational exposures, and airborne irritants. In 2010, it was estimated that 25.7 million people had asthma in the United States with 18.7 million being adults aged 18 and over and 7.0 million children aged 0-17 years.
There are a few theories that may explain the rising rates of asthma including 1) increased stress on the immune system due to factors such as greater chemical pollution in the air, water, and food; 2) earlier weaning and earlier introduction of solid foods to infants; 3) food additives; and 4) genetic manipulation of plants resulting in food components with greater allergenic tendencies.
Asthma can be divided into two categories – extrinsic and intrinsic. Extrinsic (allergic) asthma is considered an immunologically mediated condition with a characteristic increase in serum IgE and is often triggered by allergens suspended in the air (e.g., pollen, dust, smoke, automobile exhaust, animal dander). Intrinsic asthma is a bronchial reaction that is triggered by factors not related to allergies (e.g., chemicals, cold air, exercise, infection, emotional upset). Many people have more than one kind of asthma trigger.
Several factors are believed to influence the development and progression of asthma and allergic diseases. A family history of allergies is a major risk factor for allergic asthma. Having hay fever or other allergies yourself also increases your risk of getting asthma. Studies have indicated that food allergies also play an important role in asthma. The most common food irritants are milk, eggs, soy, nuts, fish, wheat, and peanuts. Dietary patterns of ‘high-fat, sugar, and salt’ are significantly associated with the prevalence and severity of asthma.
Exposure to food colorings and preservatives are another risk factor for asthma and allergies. Sulfites, commonly used as preservatives in wine, prepared salads, and dried fruit can cause allergy-like reactions (especially asthma and allergic rhinitis), urticaria (hives), and rarely, anaphylaxis. Wheezing is the most common reaction. Tartrazine (yellow dye number 5) and benzoates have been reported to cause asthma attacks in susceptible individuals. Tartrazine is commonly found in processed foods, vitamin preparations, and prescription drugs. It is estimated that 4-14% of individuals with asthma are sensitive to acetylsalicylic acid and may react to this dye.
The composition of the gut microbiota is thought to influence the development and progression of allergic diseases. In the KOALA Birth Cohort Study, infants with greater amounts of pathogenic E. coli or C. difficile had a greater incidence of eczema, recurrent wheeze, or allergic sensitization. Studies have also shown that an overgrowth of the yeast Candida albicans in the digestive tract may be a causative factor in allergic conditions such as asthma.
Mold and damp building exposure is a major factor in the asthma epidemic. Studies have shown that dampness or mold in houses causes 21% of asthma in the US and a 30-50% increase in asthma and asthma-related health problems. The incidence may be higher as one study found that 67% of adult-onset asthma developed after working in a water-damaged office building.
The most important step for effective treatment of allergies and asthma is identifying and avoiding allergens that trigger symptoms. Although air-borne allergens such as pollen, dander, dust mites, and outdoor air pollutants are often difficult to avoid entirely, measures can be taken to reduce exposure. Eliminating dogs, cats, carpets, rugs, and upholstered furniture where allergens can collect is a good first step. If this cannot be done entirely, it is important to make sure the bedroom is as allergy proof as possible. An air purifier can be used to help improve indoor air quality.
Organic, mostly plant-based foods should be consumed when possible. Dietary salt intake should be reduced, and food additives/preservatives should be avoided. Any foods known to cause adverse reactions should also be avoided.
Several natural products have been shown to be beneficial in supporting healthy respiratory function. Clinical studies have demonstrated significant improvements in respiratory measures and asthma symptoms with supplementation of 1-2g of vitamin C. Curcumin may play a protective role in healthy respiratory function by modulating pro-inflammatory chemicals (cytokines) and reducing oxidative stress. Individuals with higher vitamin D levels have been shown to have increased lung function. In addition, several clinical studies have shown that increasing the intake of omega-3 fatty acids through supplementation with fish oil offers significant respiratory benefits including improvements in airway responsiveness to allergens and improvements in respiratory function.
A number of historical herbal remedies support healthy lung function and breathing. Glycyrrhiza glabra (licorice) has a long history of use as an anti-inflammatory and anti-allergic agent, and Piper longum has traditionally been used to promote a healthy respiratory tract. The leaves of Tylophora asthmatica have been used extensively in Ayurvedic medicine for a respiratory condition, and its use has been documented in scientific literature. In a double-blind clinical study of 135 patients with respiratory symptoms, those given 200 mg of tylophora leaves twice daily for 6 days demonstrated improvements in symptoms and respiratory function during the treatment and for up to 2 weeks after treatment. In another double-blind study of 103 patients, those receiving 40 mg of the dry alcoholic extract of T. indica daily for only 6 days demonstrated significant improvement in asthma symptoms compared with placebo.
Medications may be necessary if the symptoms become severe and an emergency action plan should be developed for severe attacks. It is important to work with your doctor to find the best treatment options and check in with your doctor on a regular basis.
 American College of Allergy, Asthma, and Immunology. Allergy Facts. http://acaai.org/news/facts-statistics/allergies (Retrieved May 1, 2019)
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