With spring's sunshine and flowers come wind and pollen, which for many people signals the onset of allergy season. Tree pollens are the most prevalent pollens in the spring and many trees are prolific pollinators. Grass and weed pollens follow in late spring and summer, and airborne mold spores can be found almost year round, as well as other common allergens such as dust, dust mites, and animal dander.

While many over-the-counter remedies promise symptomatic relief, practitioners of Traditional Chinese Medicine (TCM) believe that addressing the causes of allergies, treating the whole person, and focusing on balancing the immune system leads to substantial long-term health benefits in managing allergies.

What are allergies?
Allergic rhinitis, or hay fever, is an example of misplaced immunity. It is a learned response by the immune system wherein rapid physiological changes resulting in itchy eyes and throat, sinus congestion and sneezing, Asthma, and even diarrhea are produced. Typically, exposure to an allergen such as tree pollen elicits a massive release of IgE antibodies which attach to white blood cells known as mast cells. These cells are mostly located in the lungs and upper respiratory tract, the lining of the stomach and the skin. When these cells are stimulated, they release a number of chemicals including histamine which produce the allergic symptoms.

IgE-mediated allergies result in almost immediate symptoms and may be life-long or "fixed." There are also other types of allergic responses, which can be transient. One example is the delayed hypersensitivity reaction in which the allergic response may take up to 72 hours to manifest itself. These immune system reactions are often IgG-mediated and are commonly seen with food as well as inhalant allergies. Additionally, practitioners may also use the term allergy to describe other immune system responses such as nonspecific hypersensitivity or intolerances which are not classic allergic reactions but produce undesirable health effects in response to environmental exposures.

One useful theory of allergy is the Total Load Theory, which states that for some people exposure to a single allergen may not be enough to trigger a symptomatic response; however, exposure to several allergens near the same time elicits an allergic response. For example, let's say that one is allergic to cow's milk and to cypress pollen. She may drink milk daily without any noticeable allergic response, however when cypress pollens are present, she suffers from allergies. By avoiding dairy products during pollen season, she may be able to lessen her "allergic load" and reduce her symptoms without reliance on symptomatic medications.

Allopathic Treatment of Allergies
Basic allopathic [western] medical therapies often rely on inhibiting the allergic response; antihistamines (Chlor-trimetron, Benadryl, etc.) are a good example. Other types of drugs used to treat allergic rhinitis or asthma include ones which act on the nervous system (Albuterol, epinephrine), cortico-steroids (prednisone), and decongestants.

Western medicine also emphasizes the importance of avoiding the allergen if possible, and the use of air filters to decrease exposure. When avoidance or elimination is impossible or impractical, the next level of treatment may be desensitization, the injection of small amounts of the allergen in gradually increasing doses in order to neutralize over time the number of antibodies present.

Although allopathic medicine is very effective at treating the allergic response, side effects such as drowsiness in some people, immune system suppression or over-reliance on medications cause many to seek alternative approaches to managing their allergies. Many turn to their acupuncturist for advice and treatment.

Allergies, Respiratory Health and Traditional Chinese Medicine
TCM often views allergic rhinitis as related to Wind noting that symptoms come and go rapidly, cause congestion, and make the person want to avoid windy situations. This Wind often coexists with a deficiency of the Protective or Wei Qi. The nearest thing we associate with the Wei Qi in the west is resistance to colds and other respiratory infections. People with Wei Qi deficiency catch colds easily, and allergy symptoms may be particularly bad in the spring or fall, seasons which are generally windy.

The acupuncturist also looks for constitutional or more deeply-rooted signs in each person who presents with allergies. The principle here is treating the whole person. Often people with chronic allergies show signs of Spleen or Kidney Deficiency as well as Lung signs according to TCM. The goal of the acupuncturist is to develop a plan which addresses the person's acute symptoms and provides relief, while addressing the underlying immune system imbalance which is thought to be at the root of the person's allergies. Treatments often include dietary modification, the use of specifically chosen herbal formulas, and acupuncture.

Let's look briefly at an example of TCM treatment for allergies:
John presented with acute allergy symptoms of one-month's duration which included sneezing, runny nose with lots of watery phlegm, extreme fatigue and occasional loose stools. After taking his history and doing an examination, his acupuncturist assessed his condition according to TCM as Wei Qi Deficiency resulting from a weakness of the Lung and Spleen. In addition to general recommendations for his condition, John was given Minor Blue Dragon formula which has decongestant properties for those with copious clear phlegm, as well as Astra 8, an herbal formula designed to tonify the Lung and Spleen Qi. He was also told to minimize or avoid dairy products and excessively sweet or spicy foods.

As John's condition improved, he and his acupuncturist developed a plan to strengthen his immune system in preparation for next year's allergy season. This plan included replacing coffee with green tea, which is rich in catechins which exert anti-allergy effects, as well as taking quercetin, a bioflavinoid which has been shown to stabilize mast cells thus slowing the release of histamine and other chemicals related to allergies.

We can see that a comprehensive plan consists of both general therapies which are useful in the treatment of allergies as well as an individualized approach to each patient. After allergy symptoms are managed effectively, we then begin to address the long range plan of modifying the person's response to his environment which, if successful, reduces the frequency and severity of future allergic responses.