Quercetin and Bromelain

Two other natural products that may be worth consideration against allergies are quercetin and bromelain. Quercetin is an antioxidant flavonoid that is found in many fruits, vegetables, and herbs. The anti-inflammatory effect of quercetin helps stabilize mast cells. These are the cells in your eyes, nose, and lungs (and other places in your body) that are highly sensitive to allergens.
Think of mast cells as floating mines. When they come into contact with allergens like ragweed pollen or dust mite poop, a switch gets thrown on these cellular “mines” and all hell breaks loose. Mast cells start releasing histamine and other chemicals called kinins (pronounced KYE-nins), which then turn on a cascade of other nasty things like leukotrienes and prostaglandins. The end result is sneezing, itching, inflammation, and congestion.
Quercetin, especially when combined with bromelain (an enzyme derived from pineapple), seems to stabilize mast cells and make them less likely to trigger the release of such chemicals.
We think such an approach may be more logical than trying to block the effect of histamine with antihistamines.
Think of it this way. If your mast cells are like a barn holding in a bunch of wild horses (histamine molecules), then what would be more efficient—reinforcing the door and walls of the barn to keep those wild histamines inside or trying to protect all the grass in your pasture from having those histamine “horses” nibbling away at it? Antihistamines are like a chemical barrier that tries to protect your grass once the horses are out of the barn. But they are not 100 percent efficient, and some histamine will always find a target and wreak havoc. Keeping the barn closed tightly (or the mast cells stabilized) seems to us to be a more effective approach.

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Butterbur (Petasites hybridus)

Another interesting allergy treatment involves the herb butter-bur. This botanical medicine has been used to treat symptoms of migraine headaches, asthma, and allergy. It has anti-inflammatory activity and blocks the formation of compounds called leukotrienes (pronounced lew-co-TRY-eens). These rascals cause all sorts of mischief in the nose, including itching, sneezing, swelling, and congestion. In some respects, leukotrienes may be even more of a problem than histamine. Leukotrienes contribute to the inflammatory cascade that underlies both allergy and asthma. The prescription asthma and allergy drug Singulair (montelukast) also works by inhibiting leukotriene formation. Swiss researchers compared butterbur with the antihistamine cetirizine (Zyrtec) in a randomized, double-blind study. They found that both products were equally effective at controlling symptoms, but butterbur was significantly less sedating than Zyrtec.

Q. I have suffered from chronic sinusitis, which in turn led to bronchitis and frequently into pneumonia. My physician put me on Allegra and then switched me to Clarinex.
I continued to have sinusitis and pneumonia annually for 5 years, so my doctor sent me to an allergist. He diagnosed several allergies and added a prescription for Nasacort to the Clarinex.
Two years ago, having suffered through another bout of sinusitis and pneumonia, I saw an integrative alternative medicine physician. He took me off Clarinex and prescribed butterbur, stinging nettles, and quercitin instead. I’ve taken this combination for 2 years and it has reduced the frequency of the sinusitis.I read that I should take butterbur only 6 weeks a year. Now I am concerned about the danger of liver damage.

A. Pharmacologist David Kroll, PhD, offered this clarification on butterbur. “I wanted to follow up on a reader who wrote to your newspaper column regarding the potential liver toxicity of butterbur (Petasites hybridus), an herb that’s become popular due to positive efficacy trials in migraine prevention and allergic rhinitis. While the herb is potentially toxic to the liver, it shouldn’t be a problem with high-quality products like Petadolex. I do-fear that some less honorable companies may latch onto this herb and not take such care with the high-tech extraction process that is necessary to reduce the risk. That might lead to some major liver injury cases.”
There is one fly in the ointment, however. Concerns have been raised about potential liver toxicity associated with compounds in butterbur. If the herbal preparation is not manufactured under very stringent quality-control conditions, there could be problems. As a result, we suggest that people use butterbur only temporarily (say, for 6 weeks during hay fever season) and that they monitor their liver enzyme activity with medical supervision. One product that should be safe is Petadolex. The German manufacturer is Weber and Weber, and it is available in the United States.

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