Allergy medications are among the most frequently used drugs. Some are over-the-counter, while others require a prescription. There are also herbal alternatives.
The immunology of secretions in airway mucosa is the first barrier against environmental irritants and pathogens. Hence it is important to keep them moist. Many of the drugs and herbal alternative listed below are warming, cooling and/or drying - and not very MOISTENING to airway mucosa. Sinus and respiratory problems that are precipitated by "dryness or dry-heat" may become worse with some of them. This is particularly the problem in arid regions like New Mexico, where the addition of the following yin nourishing and jinye [fluid] generating substances are beneficial:
Antihistamines Bendaryl, Chlor-Trimeton, Zytrec, Allegra, Claratin, Clarinex: These are first-line drugs for allergic and seasonal rhinitis. They are better for the cough, and not so much for eye symptoms. Bendaryl, and Chlor-Trimeton cause drowsiness. Zytrec, Allegra, Claratin, Clarinex are less or not sedating. All of them should be used regularly 3 to 5 hrs before exposure to allergens. They are used with caution in asthmatics, those with sleep apnea, cardiovascular disease, or glaucoma; and with hypnotic or sedating drugs. They are not recommended for children younger than 6 years old.
Herbal alternatives. jing jie & fang feng are considered the Chinese herbal antihistamines, but in CM terminology together they dispel wind, release the exterior & dredge the Liver, and are vital for persistent lung obstruction to open the chest. According to Professor Zhao Shao Qin, Jing Jie has a broader range of applications for internal disharmonies characterized by "Wind"- such as Bi syndromes, skin rashes, facial paralysis, bleeding, menorrhagia etc. The formula called Liu Wei Di Huang Wan has also been used for allergic disorders. One study found that it suppressed IgE mediated [allergic histamine] reactions in mice in combination with another formula called Mai Men Dong Tang [see below], Blue Tansy (Tanacetum annum) essential oil is exceptionally beneficial for sneezing, itchy eyes, and runny nose. Apply a drop on a Q-tip and place topically under the tongue. DO NOT use Tansy (Tanacetum vulgare) which is too harsh.
Decongestants Benadryl, Sudafed, Neo-synephrine/phenylephrine, Afrin, Claratin-D, Allegra-D, Tavist-D: These are first-line drugs for upper respiratory cold & flu symptoms, ear congestion, sinusitis etc, and are frequently combines with mucolytics, expectorants, and cough suppressants in various ways. Phenylephrine causes vasoconstriction, which can lead to rebound stuffiness if used topically for more than 3-4 days in a row. Phenylephrine also has side-effects such as jitteriness, or paradoxical sleepiness. Decongestants are used cautiously with hypertension, prostate disease, arrhythmia, glaucoma, diabetes; or if taking a beta blocker drug. They are not recommended for children under 12 years old. Chronic decongestant use can precipitate sinusitis with 25% of allergic rhinitis sufferers at risk.
Herbal alternatives. Xin yi hua and cang er zi are classic Chinese herbal decongestants. Xin yi hua/ Magnolia bud is the primary herb for sinus problems. The essential oil can be inhaled for relief of sinus congestion.
Mucolytics & Expectorants: Mucolytics [e.g. detromethoprim] loosen mucous. Expectorants [e.g. guifenesin] moves phlegm and mucous it up & out. They are often combined with decongestants in OTC products.
Herbal alternatives. Ju hong/ citrus reticulata/ grapefruit seed is a good expectorant, as are Jie geng/platycodon, and yuan zhi/ polygala tennifolia, Expectorant essential oils are Eucalyptus globulus (also antiviral for the upper airways), and E. radiata (antiviral for the lower airways). Caution using Eucalyptus EO with small children. Myrtle hydrosol is also mucolytic/expectorant for sinuses.
Anti-tussives: These suppress cough reflexes via several routes. Codeine is one of the best cough suppressants.
Herbal alternatives. Anti-tussives include xing ren/apricot seed, bei mu/ fritillaria, kuan dong hua/ tussilago, qian hu/platycodon, Shu qu cao/ Gnaphalium affine has antitussive and expectorant properties. Frankincense essential oil dries-up watery chest congestion; Cypress EO for a heavy phlegmy sensation in the chest; and Pine EO for an annoying residual cough. Rosewood EO is a non-toxic, non-irritant choice for children. Place a few drops in a bowl of water place in their room.
Mast-cell Stabilizer & Leukotriene Inhibitors: Mast-cell stabilizers [e.g. Cromolyn, Nasalcrom] are best used before seasonal allergy symptoms appear. They are beneficial for runny nose, sneezing, itchy eyes; and particularly beneficial to prevent attacks of allergic asthma. They are not so effective for congestion. Leukotriene Inhibitors [e.g Singulair] are beneficial for perennial (year-round) allergies which are usually due to dander, dust, molds, and mites vs. pollen.
Herbal alternatives. Jade Wind Screen, a Chinese formula that boosts nonspecific immunity, is most effective when used before allergy season ensues. Myrtle hydrosol is prophylactic against seasonal allergic asthma and bronchitis when taken internally 2-3 times a week before allergy season, then daily if symptoms appear. Place 3 -5 drops in 1 quart of purified water and sip throughout the day. Myrtle is also one of the only hydrosols that can be used for eye allergy symptoms (Catty, 2001). Apply the dilution above as an external compress, or as an eye rinse.
Oud is the oleo-resinous essential oil from Aloeswood. The resinous wood itself is called Chen Xiang (Sinking Fragrance) in Chinese herbal medicine. Oud EO is used for asthma in aromatherapy. While Chen Xiang is used for kidney deficiency-type asthma in Chinese medicine. It is a very beautifully aromatic herbal!
Khella (ammini visnaga) essential oil contains two powerful broncho-dialating compounds. These compounds were isolated in the drug 'Intal/ Ventolin", a mast-cell stabilizer asthma medication (Price, 2003). This drug was safe, but was taken off the market because the inhaler relied on chlorofluorocarbons (CFC) to deliver medication into the lungs. CFCs damage the ozone layer (Ellis, 2014).
Other anti-asthmatic herbs are ma huang/ephedra, di long/earthworm, yun xiang cao [a species of lemongrass], ai ye yu/ artemesia argyi. Shan cong zi/ litsea cubeba essential oil relaxes bronchial smooth muscles. The herb is used in China for bronchial asthma. Shu qu cao/ Gnaphalium affine [Helichrysum luteoalbum, Jersey cudweed] has anti-asthmatic, anti-tussive, and expectorant properties. Some may find inhaling sweet orange essential oil very beneficial for reactive airways. Others may find that it triggers wheezing.
Corticosteroids Flonase, NasalCrom, Beconase, Nascort, Naonex: These are potent anti-inflammatory agents, best overall for allergy symptoms. Steroids have side-effects that are minimized with topical/ inter-nasal use, and for a short interval (7- 10 days). Steroids are so effective for all allergy symptoms because they block 3 inflammatory pathways (LOX, COX 1, COX 2), and suppress hyperimmune response (cytokines such as TNF, interleukins, interferons etc.).
Herbal alternatives. Xuan Shen moderates the 3 major inflammatory pathways, and suppresses hyperimmune response like steroids- but without side effects. German chamomile essential oil (not Roman chamomile) has demonstrated to be 50% as potent as a steroid drug (Price, 2003). Blue tansy (Tanacetum annuum) essential oil is anti-inflammatory, and is exceptionally effective for all annoying seasonal allergies symptoms. DO NOT use Tansy (Tanacetum vulgare) oil, which is too harsh. Place a drop of each EO on a Q-tip, then place the Q-tips under the tongue. Myrtle hydrosol is also anti-inflammatory, and mucolytic to the GI tract where allergies may have their root.
Anti-cholinergic ipatropium/ Atrovent: This drug is used for COPD exacerbations due to upper respiratory infections such as bronchitis, and pneumonia. It is also used to prevent vasomotor [hormone related] rhinitis. Atrovent is similar to the broncho-dilators, such as Albuterol, typical used for asthma, However Atrovent dilates the larger airways, while Albuterol dilates the smaller airways. Elders who tend to have fewer small airway receptors can respond better to Atrovent compared to Albuterol.
Herbal alternatives. Yin Qiao San is the classic Chinese formula for the initial stages of upper and lower respiratory infections [viral or bacterial], as well as acute sinusitis. Ma Xing Xi Gan Tang is another classic formula for acute and chronic respiratory complaints characterized by profuse clear fluids in the lung. Shan cong zi/ litsea cubeba herb is used in China for chronic bronchitis.
Elecampane, Inlua helenium, is used in Western herbal medicine to treat purulent bronchitis. Another species called Sweet Inula (I. graveolens) treats bronchial congestion. The inula flower, Xuan fu hua, is used in Chinese medicine for phlegm accumulation leading to cough and wheezing with copious sputum and harmful fluid in the Lungs. Inula cleanses intestinal mucosa. It contains quercetin & isoquercetin, which are useful for upper respiratory allergies (Price, 2003).
INTEGRATED MEDICINE TIP: There are several homeopathic remedies for different allergic symptoms. Hespar Sulf. Calcaren is indicated for a headache at the root of the nose that worsens when stooping forward. It is a major remedy for sinusitis. Kali Bichromicum is indicated for yellow mucous, and scalp tenderness that feels better when moving the head. Allium Cepa is indicated for a burning watery nasal discharge and forceful sneezing. Apis Mellifica is indicated for stinging, red, and swollen eyes. Euphrasia is indicated when the outer eye lids are raw, and there is forceful sneezing. A homeopathic doctor can best advise on the precise remedy needed.
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