Spring is a beautiful time of the year. The multitude of colors from trees and flowers blooming, makes it appear the world has awakened after its winter nap. However, for 40-60 million Americans, each bright flower petal is a potential assault on their nasal passages.
According to the American College of Allergy, Asthma & Immunology, these are individuals who suffer from allergic rhinitis. They are part of 20-30% of adults and an even higher percentage of children in both the United States and Europe that are affected.
What is allergic rhinitis?
The American College of Allergy, Asthma & Immunology defines allergic rhinitis as “an allergic reaction to airborne allergens, like seasonal grass or ragweed pollen or year-round allergens like dust and animal dander.”
Often referred to as “hay fever,” allergic rhinitis (AR) is neither caused by hay, nor accompanied by a fever. While sometimes mistaken for the common cold, its cause is not a virus or bacteria and it is not contagious. Instead, it is typically characterized by sneezing, congestion, coughing, sinus pressure, itchy watery eyes, itchy nose, mouth, and throat, and fatigue.
These symptoms often interfere with daily life, especially in the area of sleep. This can lead to daytime sleepiness and make a significant impact on quality of life. In addition to absenteeism, there is the issue of “presenteeism” where the individual goes to work but is less productive due to battling symptoms. Some estimate that in the case of AR, presenteeism causes a larger economic cost than absenteeism.
Is it a cold or allergic rhinitis?
While symptoms of AR are very similar to the common cold, there are a few distinct differences:
- AR sufferers will typically have nasal discharge that is thin and watery, while the common cold is characterized by thicker, or yellowish nasal discharge.
- AR symptoms do not include a fever, but the common cold often does include a fever.
- AR symptoms begin immediately after exposure to allergens and will continue until the exposure stops. Meanwhile, a cold begins a day or 2 after exposure and lasts anywhere from a few days to a week or more.
- AR is caused by your own immune system attacking allergens that you have been exposed to. The common cold is caused by a virus.
How do you treat allergic rhinitis?
The usual treatment of allergic rhinitis is symptomatic treatment with antihistamine and corticosteroid medications. Additionally, allergen immunotherapy (commonly referred to as “allergy shots”) has been proven effective for reducing sensitivity and symptoms for many. In recent years, sublingual immunotherapy (SLIT) has been introduced as a new delivery system for the treatment. SLIT is still limited, but its utilization is growing. Both pharmaceutical symptomatic treatment and SLIT involve introducing a substance into the body. There is another treatment that does not rely on any chemical substance and is supported by a growing body of research. Acupuncture has been used in Eastern medicine for centuries to treat a variety of conditions. In recent years, modern research methods have shown acupuncture to be useful in treating AR.
Acupuncture therapy for AR? Research says, yes.
A 2016 study published in the Chinese Journal of Integrative Medicine detailed a non-randomized controlled trial comparing acupuncture with medication for the treatment of AR. The participants were divided into 2 groups and evaluated for clinical symptoms and signs, including sneezing, runny nose, stuffy nose, nasal itching, and turbinate edema. One group received 8 weeks of acupuncture therapy while the other received budesonide nasal spray with cetirizine tablets for the same time frame.
Participants were evaluated again at 4 and 8 weeks after treatments began, and then 12 weeks after the end of treatment. While symptom scores decreased in both groups, researchers noted: “There was no statistically significant difference in the effective rates of the acupuncture group at 4 and 8 weeks after the start of treatment, as well as at 12-week follow-up, compared with those of the medication group”.
Additionally, there were no severe side effects in the acupuncture group, leading study authors to deem acupuncture “safe” and able to provide a “comparable effect to the medication treatment on patients with moderate to severe allergic rhinitis.”
This isn’t the only time acupuncture has been methodically studied as a possible treatment for AR. In 2020, researchers conducted a literature search for studies on this topic and found multiple clinical trials. They conducted a systematic review and analysis to compare various acupuncture methods and their effectiveness for treating AR. In total, 39 studies that included 3,433 participants were include in this meta-analysis.
Results reveal that “all acupuncture types were superior to sham acupuncture in terms of total nasal symptom score and rhinoconjunctivitis quality of life questionnaire.”
Moxibustion, a specific type of traditional Chinese medicine (TCM) dating back over 2,500 years, was deemed to be the most effective, reducing nasal symptoms in 6 treatments. TCM often refers to “needling” and “moxibustion” collectively. Both therapies are based on the same meridian and acupoint theory.
The study showed manual acupuncture combined with conventional medicine as the most effective intervention in improving the quality of life in 9 treatments.
Overall, the meta-analysis determined “all acupuncture methods are effective and safe for AR.” Sixteen of the randomized controlled trial (RCT), covering 1,201 patients, included information about safety. Very few adverse events were reported. Examples of those listed among the acupuncture group included minor discomfort, pain, headache and skin trauma. Examples among the conventional medicine group were lethargy, headache, stomachache and thirst. None of the side effects were considered major; therefore, researchers conclude: “Based on these findings, it is evident that acupuncture therapy is not inferior to pharmacologic therapy. Therefore, for AR patients who are either unresponsive to conventional medicine or are intolerant to adverse events, acupuncture therapy should be administered.”
The American College of Allergy, Asthma & Immunology, as well as the Mayo Clinic and the Asthma and Allergy Foundation of America all offer tips to help prevent or minimize allergic rhinitis, namely, “avoid the allergens that trigger symptoms when possible.” Of course, that can sometimes be unavoidable, but there are ways to limit exposure.
- Stay indoors when pollen counts are high, especially in early morning when counts tend to be at their highest. (Best outdoor time is right after a good rain has cleared pollen from the air.)
- Don’t hang clothes outside to dry.
- Avoid using window fans that pull in pollen and mold from the outdoors.
- Wear glasses or sunglasses and try not to rub your eyes to prevent pollen from getting in your eyes.
- Wear long hair pulled back to minimize the amount of pollen caught in the hair.
- Shower and/or change clothes as soon as possible after being outside to wash off any pollen that may have accumulated on clothing and skin.
- Wear a mask to do outdoor chores like lawn mowing.
- On high pollen days, utilize air conditioners in your home and car, rather than open windows.
- Perform routine maintenance on AC units to keep filters clean.
- Utilize mattress and pillow covers that reduce exposure to dust mites.
- Frequently wash bedding in hot water.
- Keep humidity in the home low, using a dehumidifier when needed to prevent mold growth.
- Wash moisture prone areas frequently.
- Use damp rag or mop, rather than dry-dusting or sweeping.
- Wash your hands and change clothes immediately after petting animals.
- Keep allergies in mind when selecting a household pet. Choose an animal that you have determined does not trigger your AR reaction. If you have a pet to which you find you are allergic, try to keep the animal out of your primary living areas, especially your bedroom.
- Close off air ducts on your AC unit to reduce spread of pet dander, if needed.
- Choose hardwood, tile or other hard surface over carpet.
- Drink plenty of water. This helps flush out allergens from the body.
- Be aware of air quality in your area. Many weather reports and apps will include information on pollen counts. Know when it will be better/worse, and when possible, plan your activities accordingly.
- “Don’t sniff, BLOW!” When you are feeling that tickle in your nose, go ahead and blow it! This will help get allergens out of the body.
- Use a sinus rinse or even just a saline nose spray to help “rinse” pollens out of the nasal passages before they can trigger a reaction.
- Keep a journal to track reactions to narrow down what does/does not trigger your symptoms and help you better plan for prevention, as well as treatment.
- Maintain a healthy lifestyle that includes a good nutritious diet, exercise and good sleep. Chiropractic care is a whole-person approach to health care that can relieve many AR symptoms and help you achieve your overall health goals. Some chiropractic practices also offer acupuncture treatments.
NOTE: If you have severe AR reactions, talk to your doctor about emergency medications to keep with you. Also let the people close to you know about your allergy and what to do if you have a reaction. Wearing a medical alert bracelet or necklace is vital to help health care personnel treat you appropriately in the event you are unable to communicate your needs yourself.
These preventative steps often help minimize the effects of allergens and AR symptoms. If prevention is not enough, talk to your doctor of chiropractic about other conservative, natural steps you can take. Well versed in wellness care, your doctor of chiropractic is an excellent resource for information on preventing illness. Additionally, some have received special training to become certified to provide acupuncture. If your AR is not responding to prevention and natural treatment, your chiropractor can refer you to another health care provider to assist in your care.
As seasons change, it is good to know that research is finding support for AR sufferers who are looking for non-medication treatment options.
Chen YD, Jin XQ, Yu MH, Fang Y, Huang LQ. Acupuncture for moderate to severe allergic rhinitis: A non-randomized controlled trial. Chin J Integr Med. 2016 Jul;22(7):518-24. doi: 10.1007/s11655-016-2453-x. Epub 2016 Mar 21. PMID: 27048410.
Yin Z, Geng G, Xu G, Zhao L, Liang F. Acupuncture methods for allergic rhinitis: a systematic review and bayesian meta-analysis of randomized controlled trials. Chin Med. 2020 Oct 12;15:109. doi: 10.1186/s13020-020-00389-9. PMID: 33062045; PMCID: PMC7552548.
Hoyte FCL, Nelson HS. Recent advances in allergic rhinitis. F1000Res. 2018 Aug 23;7:F1000 Faculty Rev-1333. doi: 10.12688/f1000research.15367.1. PMID: 30210782; PMCID: PMC6107993.
“Allergic Rhinitis” American College of Allergy, Asthma & Immunology https://acaai.org/allergies/types/hay-fever-rhinitis accessed 4/12/2021
Deng H, Shen X. The mechanism of moxibustion: ancient theory and modern research. Evid Based Complement Alternat Med. 2013;2013:379291. doi:10.1155/2013/379291
Mayo Clinic Staff. “Seasonal Allergies: Nip Them in the Bud” https://www.mayoclinic.org/diseases-conditions/hay-fever/in-depth/seasonal-allergies/art-20048343 accessed 4/12/2021
Asthma and Allergy Foundation of America “Preventing Allergic Reactions and Controlling Allergies” https://www.aafa.org/prevent-allergies/ accessed 4/12/2021