Alternative and Integrative Therapies for Allergies

Good scientific evidence:

Bromelain: Bromelain may be a useful addition to other therapies used for sinusitis (such as antibiotics) due to its ability to reduce inflammation/swelling. Studies report mixed results, although overall bromelain appears to be beneficial for reducing swelling and improving breathing. Better studies are needed before a firm conclusion can be made.

Avoid if allergic to bromelain, pineapple, honeybee, venom, latex, birch pollen, carrots, celery, fennel, cypress pollen, grass pollen, papain, rye flour, wheat flour or other members of the Bromeliaceae family. Use cautiously with history of bleeding disorders, stomach ulcers, heart disease, liver disease or kidney disease. Use cautiously before dental or surgical procedures or while driving or operating machinery. Avoid if pregnant or breastfeeding.

Butterbur: Good scientific evidence suggests that butterbur may effectively prevent allergic rhinitis in susceptible individuals. Comparisons of butterbur to prescription drugs, such as fexofenadine (Allegra®) and cetirizine (Zyrtec®), have reported similar efficacy. Additional studies are warranted before a firm conclusion can be made.

Avoid if allergic or hypersensitive to Petasites hybridus or other plants from the Asteraceae/Compositae family (like ragweed, marigolds, daisies and chrysanthemums). Raw, unprocessed butterbur plant should not be eaten due to the risk of liver or kidney, damage or cancer. Avoid if pregnant or breastfeeding.

Nasal irrigation: Good scientific evidence suggests that nasal irrigation can effectively treat allergic rhinitis. A well conducted, randomized controlled trial that fully reports the data would make the case for allergic rhinitis stronger.

There is also good scientific evidence that nasal irrigation may effectively treat chronic sinusitis. A large, randomized, double-blinded study would lend strong support to the usage of nasal irrigation for the treatment of chronic sinusitis.

Nasal irrigation is generally well tolerated. Use cautiously with history of frequent nosebleeds. If the irrigation liquid is hot, the nose may become irritated.

Probiotics: Use of probiotic Enterococcus faecalis bacteria in hypertrophic sinusitis (sinus inflammation) may reduce frequency of relapses and the need for antibiotic therapy.

Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.

Unclear or conflicting scientific evidence:

Acupuncture: More well-designed studies are needed to determine whether or not acupuncture offers benefit in chronic sinusitis patients.

Preliminary research suggests that acupuncture may effectively treat hives. However, further research is needed to confirm these results.

Applied kinesiology: Applied kinesiology is commonly used to diagnose food allergies. However, there is conflicting scientific evidence as to whether applied kinesiology is an effective diagnostic tool. Further research is warranted before a firm conclusion can be drawn.

Aromatherapy: Despite widespread use in over-the-counter agents and vapors, there is not enough scientific evidence to recommend use of eucalyptus oil as a decongestant-expectorant (by mouth or inhaled form). The available studies are of poor quality, and have used combination therapies or 1,8-cineole (eucalyptol), which is a component of eucalyptus. Further studies are needed before a firm conclusion can be made.

Cat's claw: It has been suggested that cat's claw may help treat allergic respiratory diseases. However, there is limited scientific evidence to support this claim. More well-designed trials are needed to determine whether cat's claw is a beneficial treatment.

Choline: Oral tricholine citrate (TRI) effectively relieved allergic rhinitis symptoms in one study. However, further research is needed before a firm conclusion can be made.

Honey: Currently there is insufficient human evidence to recommend honey for the treatment of rhinoconjunctivitis. One poor quality trial reported no benefit of the use of honey for the treatment of rhinoconjunctivitis. Further research is necessary before a firm conclusion can be made.

Hypnotherapy, hypnosis: It has been suggested that hypnotherapy may help treat hay fever. However, further research is necessary to determine whether it is an effective treatment.

Lactobacillus acidophilus: A small study was conducted to evaluate the effects of Lactobacillus acidophilus strain L-92 (L-92) on the symptoms of Japanese cedar-pollen allergy with positive results. Further research is needed before a decision can be made.

Perilla: Preliminary evidence suggests some benefit of perilla extract for seasonal allergies. Further clinical trials are required before a firm conclusion can be made.

Probiotics: Only a few types and combinations of probiotics have been studied as a possible treatment for allergies. They have been studied mostly in children, teenagers and young adults. Further research is necessary before a firm conclusion can be made.

Sorrel: There is no reliable human evidence evaluating sorrel monotherapy as a treatment for bronchitis. However, it is an ingredient in the combination herbal product Sinupret®, which also contains cowslip flower, European elderflower, gentian root and verbena. This proprietary formula has been used historically in Europe for the treatment of acute bronchitis and sinusitis. Although no studies have been conducted comparing the combination product to placebo, there is initial evidence from a comparison trial of various expectorants vs. Sinupret® in the treatment of acute bronchitis. Additional evidence is necessary before a firm conclusion can be drawn regarding the use of sorrel or Sinupret® in the management of bronchitis.

Stinging nettle: For many years, a freeze-dried preparation of Urtica dioica has been prescribed by physicians and sold over-the-counter to treat allergic rhinitis. Clinical trials demonstrating statistical significance over placebo, and/or equivalence with other available treatments, are needed before a firm conclusion can be made.

Vitamin E: Although thought to aid in reducing the nasal symptoms of allergies, vitamin E intake may not be effective. However, current evidence is limited, and more studies are needed before a firm conclusion can be drawn.

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