The sneezin' season

Spring flowers may be beautiful to most of us, but for as many as three million people in the UK plant pollen means one thing: hay fever. Complementary medicine may offer the solution

More than ever people are turning to alternative solutions to hay fever and allergies. Discover what's available to stop the symptoms:

Herbal remedies

Hay fever is usually treated with antihistamines which are the most widely used drugs for allergies because they counteract the effects of histamine, a chemical produced when the body overreacts to allergens. The herb butterbur (Petasites hybridus) has shown promise in trials in controlling hay fever and appears to be as effective as an over-the-counter antihistamine, cetirizine, but without the drowsiness which affected two thirds of those taking the antihistamine drug. Following a successful study reported in the British Medical Journal in January 2002, five out of seven further trials on different types of butterbur have shown positive results. The herb outperformed placebos, while having an equal effect to medication. Even nose congestion improved, a symptom that antihistamines usually cannot reach. It seems to work by inhibiting the inflammatory compounds caused by allergic reactions. You should not medicate yourself with untreated butterbur, as the plant contains liver-toxic substances called pyrrolizidine alkaloids, which are removed during commercial processing. Several standardised butterbur extracts are available over the counter in the UK. Bioforce Petaforce capsules contain 25mg of petasites extract and are available from health stores. Visit Bioforce (www.bioforce.co.uk) for details.

The butterbur extract, taken in tablet form four times daily, was standardized, in the original trial, to contain 8mg of petasine, a chemical component of the plant that researchers believe to be associated with antispasmodic and anti-inflammatory action. The butterbur extract used in trials was licensed for use against hay fever, with the product name of Tesalin, in Switzerland in 2003 by the Swiss-based manufacturers Zeller. However, you should not medicate yourself with untreated butterbur, as the plant contains liver-toxic substances called pyrrolizidine alkaloids, which are removed during commercial processing.

There are several standardised butterbur extracts available over the counter in the UK. Bioforce Petaforce capsules contain 25mg of petasites extract and are available from health stores (£5.99 for 30 capsules). Visit Bioforce (www.bioforce.co.uk) for details.

Nettle leaf is a traditional remedy said to take the 'sting' out of hay fever. Researchers believe it may prevent the body from making inflammatory chemicals known as prostaglandins. At least one German preliminary study found that capsules made from freeze-dried leaves had an anti-allergy action in people, but more research is needed. Solgar Nettle Leaf Extract Vegicaps are available (£14.35 for 60 capsules).

Medical herbalists might recommend a package of herbal remedies, such as feverfew as a decongestant and plantain to depress mucus production, but they work best and exert their maximum effect when you start taking them at least three months before the pollen season.

Elderflower is an anti-inflammatory, and infusions, or teas, of the flowering tops may help to relieve symptoms. Camomileis considered a natural antihistamine and as a relaxing tea or infusion can also help to soothe the emotional problems surrounding allergies like hay fever. However, you may react badly if you have an adverse reaction to ragwort, which is a related plant.

A course of Echinacea (as tincture or tablets), ginseng or garlic (Lichtwer Pharma's Kwai One-A-Day odourless capsules.; visit www.Lichtwer.co.uk for details) may boost resistance to allergens and (in the case of garlic) reduce catarrh. Try steam inhalations containing a few drops of essential oils of eucalyptus, peppermint, lavender or pine to clear congestion.

Standardised herbal products available in health stores include Bioforce's Luffa Complex, which contains extracts of seven tropical herbs, including spikenard, heart seed, thyrallis, sponge cucumber and okoubaka, recommended for allergies and hay fever type conditions (£6.94 for 120 tablets or £7.49 for 50ml tincture).

American trials suggest that rye plant extract may also reduce allergy symptoms by strengthening resistance and supporting respiratory function. A standardised extract, Oralmat Drops, is available at health stores or from www.oralmat.co.uk

Euphrasia, or eyebright, contains tannins that relieve eye irritation and itchiness and help to reduce wateriness and inflammation in the mucous membranes. Place cotton wool pads soaked in an infusion (pour boiling water over the fresh or dried herb, soak for ten minutes and strain) on the eyelids. Bioforce's Euphrasia fresh herb tincture is taken by mouth only and never on the eyes (£7.49 for 50ml).

Homeopathy
A homeopath may recommend homeopathically potentised pollens taken daily before the hay fever season begins as a kind of inoculation. In a study in the Lancet in 1986, Dr David Reilly and his team at the Glasgow Homeopathic Hospital found a preparation of mixed grass pollens effective in treating hay fever.

The most commonly recommended remedy for hay fever is Allium cepa (common onion). Ideally, you should consult a homeopath to determine which preparations best suit your individual constitution, but if you're buying over the counter, ask yourself which symptom you would most like to remove to guide you to the most appropriate remedy. Try Euphrasia if your eyes are more irritated than your nose; Natrum mur if you lose your sense of taste and smell and your nose streams; Nux vomica for sneezing; Arsenicum album for a hot, irritating nasal discharge; Pulsatilla for a blocked nose and Kali iodatum for severe symptoms.

Acupuncture

Traditional Chinese medicine sees hay fever as the failure of the body's defensive energy (wei chi) to protect the body from repeated invasions of Wind (a climate factor that can disrupt well-being). This leads to what is described as 'the retention of chronic Wind in the nose' with typical hay fever symptoms - sneezing, watery nasal discharge, itchy eyes and throat. Treatment would work on acupuncture points to expel Wind, followed by points to strengthen wei chi.

A small study in the American Journal of Chinese Medicine in 1975 found that symptoms decreased following acupuncture, but more research is needed.

Nutritional therapy
Honeycomb contains propolis, which has antihistamine and anti-inflammatory properties and is said to improve immunity to allergens. Chew a small square of honeycomb produced in your local area, three times a day for three months, before and during the hay fever season. Regularly eating honey that is local to the area in which you live is said to be the most effective way to `innoculate' yourself against hay fever as the honey contains traces of the actual pollen that you might be sensitised to. Bee pollen products, such as Comvita Propolis tablets are said to work in a similar way, but avoid bee remedies if you are allergic to bee stings or bee pollen.

Vitamin C acts as an antihistamine and is believed to detoxify histamine once it is released. In one study, histamine levels were reduced by 38% in both men and women, after taking 2g vitamin C per day.

Flavonoids, such as quercetin, also act as antihistamines and are believed to work in synergy with vitamin C, but while there is anecdotal evidence, again there is no hard evidence. However, some naturopaths and nutritional therapists advise people with hay fever to take 400mg of quercetin two to three times a day.

The National Institute of Medical Herbalists www.NIMH.org.uk

The Faculty of Homeopathy
www.trusthomeopathy.org

The Society of Homeopaths
www.homeopathy-soh.org

British Acupuncture Council
www.acupuncture.org.uk

British Medical Acupuncture Society
www.medical-acupuncture.co.uk

Health expert and author Susannah Olivier and Dr Sarah Brewer contributed to this article