Aaaaa…choo!  The hay fever season peaks for many of us over the spring and summer months. In preventing allergy, we again see the importance of balance, moderation, and attention to our self care is key to minimising allergic conditions.  

Allergy is increasing in the Western world. There are several theories about this. The “hygiene hypothesis” is that because of the decline in infections (through antibiotic use, hygienic environments and immunisation; all of which have reduced childhood death), our immune systems have balanced toward allergy.

Just before birth our immunity to infection is slightly down, skewing us toward allergy. If we have a vaginal birth and our mother has a good gut bug balance, we are exposed to the right bacteria to balance our immunity. You’ll see there are some “ifs” there so paying more attention to gut flora in pregnant women and to babies who are born by Caesarian or have antibiotics in the neonatal period may help.  Because processed foods are sourced from a narrow range (for example, wheat, corn, dairy), we need to ensure a variety of vegetables, nuts, seeds, lean meats in our diet to minimise allergic drivers.

Mechanisms

Allergy tends to change its personality as we age; the classical allergic march of eczema in early childhood changing to asthma, only to “grow out of” asthma and experience hay fever later. Many of these reactions are triggered by a response of our immune system to triggers such as house dust mite, grass pollens, fungi or peanuts. These well known allergic reactions are mediated in the immune system by Immunoglobulin E, which has an immediate reaction to exposure.

 There are several immunoglobulin systems (Ig for abbreviation) and they act at different sites and different stages of our immune responses. The effect of IgG for example is more delayed and IgG is commonly associated with food allergy and long term immunological memory. Just as our brain has memory and learns, so does our immune system, and interestingly the biochemical pathways are very similar!

Food allergy

Because most food allergy is IgG based, it can be difficult to pick up as the reaction may occur some time, even a day or so after eating the food. In some types of reactions, withdrawal of the food causes a reaction. This makes detective work on food allergy tricky and even the sophisticated tests available at considerable cost, can be confusing to interpret.  The commonest food reaction is our community is to wheat, followed by dairy. Food allergies may require special testing, elimination of the particular food solves the problem and dietary advice will be needed. Variety is the key to prevention.

Take care of your digestion to help your allergies

Prevention and long term control of both food allergies and IgE allergies means paying attention to the health of your gut. Eating smaller meals, less processed natural foods is generally best and many of us need additional support as we get older with extra acid or digestive enzymes. Eating at a leisurely pace at the table rather than eating “on the run” also helps. Avoiding foods we react to is important.

Keep your “good” bacteria

Having a normal balance of bacteria in the bowel is a key determinant of health, so how can this be disturbed? Apart from poor digestion and food reactivity mentioned above, taking antibiotics kills desirable gut bacteria. This is a major reason we try to avoid antibiotics unless they are really necessary. If you need an antibiotic course, it is really important that the “gap” in bacterial flora is replaced with desirable species (probiotics) as soon as possible.

Millions of bacteria (flora) normally live in our gut, mainly in the large bowel and they serve us well if they are in the right proportions. They help keep harmful bacteria at bay, help manufacture vitamins and their by-products nourish our large bowel. Because over 50% of our immune system lines our gut, having the right balance of gut bugs helps keep the right immune balance. Allergy is an immune imbalance where at the time we over react to some things, we drop our guard against infection at the same time.

Probiotics

Probiotics (means “for life”) are good bacteria taken by mouth in large enough numbers to reinforce flora numbers down in the large bowel. They must be able to survive transit through our acid stomachs, and must be of a stain proven to successfully colonize our colon. It is common to give 50 billion bacteria per dose and 2 doses daily is the most common in an adult. New Zealand is a world leader in the expanding branch of science studying probiotics and developing effective strains.

Stress

When we are stressed for whatever reason, we become more prone to allergy and to infection at the same time. Think colds and hay fever. Lack of sleep, laughter, poor diet, lack of exercise (or too much exercise in some people) all make us more allergy-prone. Paying attention to our lifestyle helps prevent allergy as for all chronic conditions.

Weight control

When we are overweight especially around the waist, the fat sends out inflammatory messenger molecules which increase allergic tendency. Diet, exercise and stress management programmes help us get rid of pro-inflammatory abdominal fat.

Fish Oil

EPA and DHA are the essential omega 3 oils found in fish and fish oil capsules. These oils are essential for our bodies to make the natural internal messenger molecules to switch off inflammation and allergy so it makes sense to keep these topped up. Suboptimal levels of EPA and DHA are almost the norm in our diet. Clues to insufficiency are dry skin and hair, excessive thirst especially in children, dandruff, and “chicken skin” on the back of upper arms.

Allergen avoidance

Allergens are things which trigger an allergic response in us. Common are house dust mite, grass pollens. Taking steps to minimize exposure to these makes sense and helps especially in conjunction with the measures outlined above.

Symptom care

Good treatments are available if symptoms start. There is now an excellent range of non-sedating antihistamines available from your pharmacist directly or on prescription from your GP.

There are some natural health products which have shown promise in helping symptoms as well. Luteolin from perilla seed extracts would be one of the most studied. Zinc and vitamin C supplements help increase the immune environment against infections and at the same time reduce allergic tendency.

- Dr Tony Edwards