Allergies are caused by allergens—which are substances that cause allergies! That’s a circular answer that doesn’t get us anywhere. More specifically, why does the body react the way it does? And why do some people suffer from allergies while others don’t?

The body responds to allergens the same way it responds to a tick bite or an internal infection by parasitic worms. It’s as if something tricks the body into believing that an everyday substance is a harmful parasite.

Let’s take it step by step. When you’re first exposed to an allergen—whether pollen, dust, or a certain food—your immune system produces antibodies to that specific molecule. The next time you’re exposed, the IgE antibodies spring into action and trigger a response that lasts a day or two and involves many different types of immune cells like eosinophils, leukocytes, and T helper cells. These cells produce swelling, inflammation, and tissue changes.

If you continue to be exposed to the substance, either constantly or intermittently, chronic inflammation sets in as immune cells remain active, causing changes to the function and structure of affected organs, like your respiratory tract or skin. The long-term consequences of chronic inflammation produce the “burden of disease” among those with allergies—nagging symptoms, reduced quality of life, work days lost, doctor visits, and so on.

In people who have a particular genetic make-up, chronic inflammation can result in a decrease of the barrier function of epithelial cells. Your skin, respiratory tract, lungs, and digestive tract are all lined with epithelial cells that are supposed to keep bad stuff out as they let good stuff through. About 10% of people with European ancestry have a genetic mutation that allows the skin to lose some of its barrier function, predisposing them to atopic dermatitis.

Genetic research has identified other genes and mutations that make people more likely to develop allergies. In general, allergies are tied to both environmental and hereditary factors.

There’s no doubt that allergic and immune disorders have become more commonplace in industrialized societies over the last 30 years. As infectious diseases go down in countries, allergic and autoimmune diseases go up. And as the socioeconomic level of a society or family rises, so does the incidence of asthma, Crohn’s disease, and atopic dermatitis. [4] Could growing up in an environment that’s too clean negatively affect the immune system? That’s what the hygiene hypothesis proposes.

There are many theories about how this might happen. As mentioned above, allergic responses mirror the body’s response to parasites. One version of the hygiene hypothesis suggests that exposure to natural germs and parasites in the early years of life trains children’s immune systems to keep the two types of T helper cells (TH1 and TH2) in balance. TH1 reins in some of
the inflammatory responses, but TH2 doesn’t. A TH1 response develops from exposure to parasites; TH2 is the primary response in infants and in allergies. [1]

Interestingly, exposure to animals early in life may protect children from some allergies later on. Studies show that children who grew up on farms were less likely to have hay fever, asthma, or dermatitis. [5] Even having a cat or dog in the home during infancy seems to protect kids from allergies later in childhood. [6]

Since the microbiota of the gut has an impact on lungs through the gut-lung axis and on the skin through the gut-skin axis, researchers are investigating whether probiotic supplementation could prevent allergies in kids. [internal link] One recent study found that a specific probiotic strain, Lactobacillus rhamnosus, could prevent eczema in children who had a genetic predisposition toward that condition.[7]

Over 25 million Americans have asthma, and over 7 million of those are children and teenagers. [8] It’s the most prevalent non-communicable disease in kids. Asthma is an obstructive airway and chronic inflammatory disorder. Due to inflammation, respiratory passages swell, the muscles of the bronchial tubes constrict, and extra mucus is secreted, limiting the flow of exhaled air. During an asthma attack, which can happen several times a week or even daily, the person feels a tightening in the chest, finds it hard to get a full breath, coughs, and wheezes. Corticosteroid inhalers and other medications are often prescribed, and patients are advised to be tested for and avoid allergens.

Although allergens like pollen, dust, and pets can produce asthma symptoms or attacks, so can other environmental factors. Emotional upset, pollutants, tobacco smoke, and fumes can make symptoms worse. [8]

An obvious response toward allergies is avoidance. It makes sense that if something is making you feel sick, you should stay away from that substance if you can. But that can be easier said than done—especially with airborne allergens like dust or pollen. The Mayo Clinic gives a room-by-room plan for allergy-proofing your home. Avoidance strategies can be time-consuming, expensive, and intrusive—but many people prefer these measures to taking drugs that can have unwanted side effects. Simple efforts like putting a plastic barrier over mattresses and pillows take little effort but can reduce symptoms. [9]

What if you don’t want to get rid of your cat, tear up your carpet and replace it with wood flooring, or move to a part of the country where ragweed doesn’t grow?

Immunotherapy has been used for decades to treat or eliminate specific allergies. It can be given by injection (allergy shots) or sublingually (pills or drops under the tongue). According to the Asthma and Allergy Foundation of America, the treatments work best for people with allergies to pollen, pets, dust, and bee stings and for those with allergic asthma. They’re not as effective for food allergies, drug allergies, or eczema.

NAET (Nambudripad’s Allergy Elimnation Technique) and similar techniques are complementary and alternative medicine (CAM) approaches that apply elements of Eastern and Western medicine to allergies and sensitivities. While the person receiving the therapy holds onto the allergen, the practitioner uses kinesiology and acupressure to “reprogram” the body to
stop reacting to the substance. According to published case studies, food allergies that produced eczema and more severe reactions were cleared using this approach. [10] Although it’s not a mainstream therapy, it may appeal to those who prefer using CAM before trying more invasive approaches.

Are allergies dangerous? Allergies cause a wide spectrum of symptoms and disease burden. For some, their seasonal hay fever means taking over-the-counter antihistamines a few weeks every summer. For others, year-round rhinitis leads to constant discomfort and causes nasal polyps to develop. Others suffer with unsightly, itchy patches of eczema that can become infected. And people with allergic asthma find they must cut back on their activities because exercise can bring
on an attack or even land them in the emergency department.

No matter where you are on that spectrum, taking steps to reduce the allergenic load makes sense. Many people who start out with just one type of allergic disorder, like atopic dermatitis, go on to develop additional problems like allergic rhinitis and allergic asthma. This is known as the “allergic march.” [1]

These three major manifestations of allergies—dermatitis, allergic rhinitis, and asthma—form what’s known as the atopic triad. The allergic march ends with having two or three “comorbidities,” but because of the underlying mechanisms they share, treatment approaches are often the same, making the triad easier to deal with than three separate health problems.

Imagine a bucket containing all the inflammation-inducing events your body encounters each day. Normally, your body has the capacity to handle the onslaughts of infectious invaders, environmental toxins, and processed foods that pour into the bucket. But every allergen takes up space in the bucket, eventually causing it to overflow. That’s when allergic symptoms happen, and the signs of inflammation in your body become impossible to ignore. But if you can eliminate some of those allergens, the overall burden on your system is less, so your symptoms may be less severe—and you’ll be at lower risk for developing additional allergic disorders.

Now imagine you can change the size of the bucket. Shrinking the bucket means you have less capacity to respond to inflammatory triggers. Stress and lack of restful sleep shrink your bucket.

How can you create a bigger bucket? Make sure you’re eating an anti-inflammatory diet and drinking plenty of pure water so your body can efficiently flush out toxins. Various fruits, vegetables, and herbs have different antioxidant and anti-
inflammatory properties, so eating a diet rich in plant foods is important. But given our busy lifestyles and picky taste buds, we don’t always have the time or inclination to eat as well as we should. So-called superfood drinks make it easy. One study found that consuming a single serving of a polyphenol-rich beverage (fruits and greens shake) produced immediate reductions in inflammatory markers in the blood. [11]

Only about half of people who have asthma are able to satisfactorily control their symptoms with medications. For that reason, natural remedies are being studied extensively. Magnesium sulfate may be given by IV as an emergency procedure for a severe asthma attack, so it seems reasonable to expect that taking magnesium supplements could help prevent asthma symptoms. Magnesium is a known bronchodilator—that is, it helps widen the passages of the respiratory tract by relaxing the musculature. Not all studies have shown magnesium supplementation to help with asthma. [12] That could be the result of the kind of magnesium used in the studies because some forms of magnesium aren’t well absorbed. Make sure to choose a bioavailable chelated formula.

Because inflammation plays a central role in all types of allergic reactions, it’s a primary focus of natural therapies for dermatitis, allergic rhinitis, and asthma. Research has identified scores of powerful natural anti-inflammatories and antihistamines that can down-regulate the cells and processes of the immune system that accompany chronic inflammation. Many of these are available as nutritional supplements.

For example, quercetin, a flavonoid found in fruits and vegetables, has been shown to decrease all asthmatic symptoms in allergic mice by switching the TH1/TH2 balance toward the less-inflammatory TH1 and lowering other pro-inflammatory markers. [13] Quercetin is noted for its natural anti-histamine properties.

[14] Turmeric, ginseng, ginger, boswellia (Indian frankincense), green tea extract, cranberry, pomegranate, hops, licorice, stinging nettle, and black pepper all have proven anti-inflammatory properties. Butterbur root has been used for centuries to treat asthma, and a 2004 study found that an extract of butterbur root reduced the frequency and severity of asthma attacks. [15] Since then, ongoing research suggest that it may help prevent migraine headaches and act as a natural antihistamine for allergic rhinitis.

[16] Some safety issues were raised about butterbur in Europe, so make sure you use only purified extracts and professional grade supplements. And use all herbal and nutritional preparations under the guidance of your trusted healthcare provider.

1 Galli SJ, Tsai M, Piliponsky AM. The development of allergic inflammation. Nature. 2008;454(7203):445-454.doi:10.1038/nature07204

2 Bonnet B, Messaoudi K, Jacomet F, et al. An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen. Allergy Asthma Clin Immunol. 2018;14:14.Published 2018 Apr 10. doi:10.1186/s13223-018-0239-8

3 Wilson JM, Platts-Mills TAE. Home Environmental Interventions for House Dust Mite. J Allergy Clin Immunol Pract. 2018;6(1):1-7. doi:10.1016/j.jaip.2017.10.003

4 Okada H, Kuhn C, Feillet H, Bach JF. The 'hygiene hypothesis' for autoimmune and allergic diseases: An update. Clin Exp Immunol. 2010;160(1):1-9. doi:10.1111/j.1365-2249.2010.04139.x

5 Cabana MD. Early probiotic supplementation for the prevention of atopic disease in newborns-probiotics and the hygiene hypothesis-. Biosci Microflora. 2011;30(4):129-133.doi:10.12938/bifidus.30.129

6 Ownby DR, Johnson CC. Does exposure to dogs and cats in the first year of life influence the development of allergic sensitization?. Curr Opin Allergy Clin Immunol. 2003;3(6):517-522.doi:10.1097/00130832-200312000-00015

7 Morgan, A.R.; Han, D.Y.; Wickens, K.; Barthow, C.; Mitchell, E.A.; Stanley, T.V.; Dekker, J.; Crane, J.; Ferguson, L.R. Differential modification of genetic susceptibility to childhood eczema by two probiotics. Clin. Exp. Allergy 2014, 44, 1255–1265.

8 Chabra R, Gupta M. Allergic And Environmental Induced Asthma. [Updated 2021 Mar 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526018/

9 Platts-Mills TAE. Allergen avoidance. Journal of Allergy and Clinical Immunology. 2004;113(3):388-39.Doi:10.1016/j.jaci.2003.12.027

10 Terwee CB. Succesful treatment of food allergy with Nambudripad's Allergy Elimination Techniques (NAET) in a 3-year old: A case report. Cases J. 2008;1(1):166. Published 2008 Sep 19. doi:10.1186/1757-1626-1-166

11 Nemzer BV, Rodriguez LC, Hammond L, Disilvestro R, Hunter JM, Pietrzkowski Z. Acute reduction of serum 8-iso-PGF2-alpha and advanced oxidation protein products in vivo by a polyphenol-rich beverage; a pilot clinical study with phytochemical and in vitro antioxidant characterization. Nutr J. 2011;10:67. Published 2011 Jun 15.doi:10.1186/1475-2891-10-67

12 Abuabat F, AlAlwan A, Masuadi E, Murad MH, Jahdali HA, Ferwana MS. The role of oral magnesium supplements for the management of stable bronchial asthma: a systematic review and meta-analysis. NPJ Prim Care Respir Med. 2019;29(1):4. Published 2019 Feb 18. doi:10.1038/s41533-019-0116-z

13 Jafarinia, M., Sadat Hosseini, M., kasiri, N. et al. Quercetin with the potential effect on allergic diseases. Allergy Asthma Clin Immunol 16, 36 (2020). https://doi.org/10.1186/s13223-020-00434-0

14 Mlcek J, Jurikova T, Skrovankova S, Sochor J. Quercetin and Its Anti-Allergic Immune Response. Molecules. 2016;21(5):623. Published 2016 May 12. doi:10.3390/molecules21050623 15Danesch UC. Petasites hybridus (Butterbur root) extract in the treatment of asthma–an open trial. Altern Med Rev. 2004;9(1):54-62.

16 Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of allergic rhinitis: a systematic review. Annals of Allergy, Asthma & Immunology. 2007;99(6):483-495. doi:10.1016/s1081-1206(10)60375-4.

17 Ebrahimi M, Ghayour-Mobarhan M, Rezaiean S, et al. Omega-3 fatty acid supplements improve the cardiovascular risk profile of subjects with metabolic syndrome, including markers of inflammation and auto-immunity. Acta Cardiol. 2009;64(3):321-327. doi:10.2143/AC.64.3.2038016

18 Hewlings S, Kalman DS. Evaluating the Impacts of Methylsulfonylmethane on Allergic Rhinitis After a Standard Allergen Challenge: Randomized Double-Blind Exploratory Study. JMIR Res Protoc. 2018;7(11):e11139. Published 2018 Nov 29. doi:10.2196/11139