Approaches to Allergic Rhinitis

Adam Rinde, NDNaturopathic Physician

Sound Integrative Health, PLLCKirkland, WA

Phone: 425-889-5894email: DrRinde@SoundIntegrative.com

Definition

•Allergic rhinitis is a collection of symptoms, predominantly in the nose and eyes, caused by airborne particles of dust, dander, or plant pollens in people who are allergic to these substances.

•When these symptoms are caused by pollen, the allergic rhinitis is commonly called hay fever.

•Affects 20% of N. Americans

Signs of Allergic Rhinitis

•Allergic Shiners•Nasal Creases•Nasal Mucosa blue/gray, boggy•Creases below inferior eyelids•Mouth Breathing•Cobble stoning of posterior pharynx

Symptoms

•Sneezing

•Throat Irritation

•Runny Nose

•Burning Eyes

•Shortness of Breath

•Nasal Congestion

•Nasal Itching

Causes of Allergies

• Pollens (trees, grasses, weeds)

• Molds

• Dust Mites

• Pet Dander

• Cockroaches

• Rodents

Weed Pollen

•Common in late summer and fall

•most common: ragweed, pigweed, sage, mugwort, yellow dock, sheep sorrel, english plantain, lambs quarter, and russian thistle

*

Tree Pollen

• Common in Early Spring

• most common tree allergens birch, oak, maple, cedar, olive, elm

GRASSES

•Common in Late SpringCommon in Late Spring

•Most common grass allergens: Most common grass allergens:

Kentucky Blue Grass, Orchard, Kentucky Blue Grass, Orchard, Retop, Timothy, Vernal, Meadow, Retop, Timothy, Vernal, Meadow, and Bermudaand Bermuda

MOLDS

•Appear in Summer and Fall

•Common Indoor Molds : Pennicillium, Aspergillus

Dust Mites

•Present Year Round

•Feed on Pillows, Mattresses, Stuffed Toys, Carpets, Upholstered Furniture, and Pet Shedding

Other Causes

Complications of Allergic Rhinitis

• Learning disorders

• Sleep Disorders

• Fatigue

• It is commonly associated with – Asthma, Atopic Dermatitis, Nasal Polyps,

Fatigue

Diagnostic Methods

• Skin Prick Test• RAST Test (Blood)• Nasal Cytology• Diagnostic Imaging

– X-Ray– CT Scan– MRI

General Therapeutic Approaches

• Avoidance and Environmental Control

• Pharmacotherapy

• Immunotherapy

• Natural Lifestyle Measures

• Natural Medicine

Avoidance and Environmental Control

• Identify specific allergen's and set up avoidance strategies

• Maintain A Healthy Home Environment

The Healthy HomeEnvironmental Control

•EPA estimates that indoor pollutants are maybe two to five times higher then outdoor pollutants

•Americans spend 90% of their time indoors

The Healthy HomeGeneral Measures for

reduction of Dust• Humidity Control

•Hypoallergenic Bedding•Hypoallergenic Floors•Vacuum•HEPA filter

The Healthy HomeGeneral Measures for reduction of Mold

• Humidity Control• Ventilation• Control Water

Damage• Yard Waste

Management• Air Conditioning

Management

•

The Healthy HomeGeneral Measures for reduction of Pet Dander

• Secure Bedroom• Bathing Pets• Hygiene• Dust Often

Strategies for Weed Pollen Avoidance

• Avoid Outdoors between 5-10 am on dry, hot, and windy days

• Windows-Close them!• Use Dryer instead of

outdoor hangers

Strategies for Grass Pollen Avoidance

• Wear mask when mowing

• Cut grass Short• Choose low-pollen

grass covers.– include: Irish Moss,

Bunch, Dichondra.

Strategies for Tree Pollen Avoidance• Avoid 5-10 a.m outdoor

activities• Plant allergen-free trees

– examples: crape myrtle, dogwood, fir, fig, palm, pear, plum, redbud, and redwood trees

– female ash, box elder, cotton wood, maple, poplar, or willow..

Nasal Lavage (Netti Pot)

Air Filtering Technology

•High Efficiency Particulate Air (HEPA)

•ULPA- Ultra HEPA Filters

•Electrostatic Filters

•Electrostatic Precipitators

•Ionization

Pharmacotherapy

• Second Generation antihistamines

• Leukotreine receptor inhibitors (Singulair)

• First Generation antihistamines (sedating)

• Decongestants (alpha-adrenoreceptor agonists)

• Nasal Corticosteroids• Intranasal Antihistamines• Intranasal Chromolyns

(Nasalchrom)• Intranasal anticholinergics

(Atrovent)

Immunotherapy

• Can be highly effective

• Effect often not noticed for -12 months.

Natural Nutrients and Botanicals

Allergic Rhinitis Options

• Neti Pot (one-three times per/day)• Vitamin C (1-2 grams per/day)• Freeze Dried Nettles (300 mg TID)• Quercetin 1-2 grams daily• Butterbur (Petasites hybridus) 8 mg total

petasine three times daily.• Probiotics (Lactobacillus GG, Lactobacillus P,

Bifidobacterium longum)/• Quercetin Nasal Spray

Neti Pot

• 1 tsp sea-salt in lukewarm water wash intra‑nasally in shower + 1 tsp Bicarb.– QD‑BID am or evening before bed during

pollen season, before outdoor jobs until infection.

• For green/yellow mucus: – Add 3‑4 dropperfulls colloidal silver.

• For swelling inflammation: – Open 1 cap Quercetin in H20

Nasal Irrigator

Resources

• HEPA Filters: – Air filter, Austin air junior plus $300 and $25

for shipping purchased @ www.needs.com

• Mold Testing Kits– PNK microbiology 866-871-1984 ask for MEA

ager plates. $45 analysis/plate.

• Allergy Control Products– http://www.achooallergy.com/

Approaches to Allergic Rhinitis

Adam Rinde, NDNaturopathic Physician

Sound Integrative Health, PLLCKirkland, WA

Phone: 425-889-5894email: DrRinde@SoundIntegrative.com