Herbs & Dietary Supplements Database : Allergic Reactions & Herbs

Dr. James Manos (MD)
July 5, 2019

Herbs and dietary supplements that may cause or prevent allergic reactions

Introduction: Allergy & Anaphylaxis

Anaphylaxis is a sudden allergic reaction that can be life-threatening. Symptoms may be mild to start, but they become severe in minutes or even seconds. Occasionally, the symptoms develop gradually over 24 hours. The more quickly the symptoms begin, the more likely the reaction will be severe. Many people susceptible to anaphylaxis carry emergency medicine (such as epinephrine (adrenaline)). Anaphylaxis is a medical emergency, and the incidence is increasing, particularly during the first 2 decades of life. Anaphylaxis occurs when the immune system overreacts to an allergen. The body releases substances to protect it from allergens. Instead, those same substances cause blood pressure (BP) to drop suddenly (hypotension) and airways to constrict so that the affected person has trouble breathing (dyspnea, i.e., shortness of breath).

Signs & symptoms include itching (often the first symptom), redness, hives, swelling, sweating, swelling of the nose or throat, hoarseness, wheezing, difficulty speaking, trouble breathing, chest tightness, abnormal heart rate or rhythm, shock, heart attack, stomach cramps, diarrhea vomiting, diarrhea, dizziness, and fainting. Many substances can cause anaphylaxis. Sometimes the cause isn't known. Common triggers include antibiotics (especially penicillin); aspirin; nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen), and prescription opiate pain medications (such as codeine); foods, such as nuts, shellfish, milk, eggs, and berries; insect bites or stings; egg-based vaccines; latex (as in condoms and rubber gloves); food coloring and preservatives (such as tartrazine, also known as FDC yellow dye No. 5) and exercise (1).

Allergies to specific plants and other substances (such as latex or nickel) can build up over time. Products someone has used for years may suddenly cause mild to severe allergy symptoms, especially if the person is already allergic to something. People should check to see if new herbs, foods, or other products they plan to use are in the same ‘family’ as known allergens (4).

Angioedema is swelling that happens just below the surface of the skin, most often around the lips and eyes. In people with an allergic reaction, their body (mast cells and basophils) produces a substance called histamine, which causes blood vessels to swell. Angioedema is like hives, but with hives, there are itchy red welts on the surface of the skin. Angioedema is a deeper swelling. Both hives and angioedema are usually caused by an allergic reaction to either food or medication.

Things like pollen or insect stings can also cause angioedema. In rare cases, it may be a sign of an underlying condition, such as leukemia or Hodgkin's disease. There are two basic types of angioedema: a) Hereditary angioedema (HAE), a rare condition that is genetic. b) Acquired angioedema (AAE). Angioedema can take anywhere from minutes to hours to develop. It may affect just one side of the body but not the other. In most cases, angioedema is mild. Severe angioedema can cause the throat or tongue to swell, obstructing the airway, and can be life-threatening (10).

Atopy or atopic syndrome is a predisposition toward developing specific allergic hypersensitivity reactions. Atopy may have a hereditary component (passing traits to offspring from its parents or ancestor). However, contact with the allergen must occur before the hypersensitivity reaction can develop (an allergen is an antigen that produces an abnormally vigorous immune response in which the immune system fights off a perceived threat that would otherwise be harmless to the body). Atopy (atopic syndrome) is characterized by a tendency to be ‘hyperallergic.’ A person with atopy typically presents with one or more of the following: eczema (atopic dermatitis), allergic rhinitis (hay fever), allergic conjunctivitis), or allergic asthma. People with atopy also tend to have food allergies (9).

Common food allergens:
Seafood
Crustacean shellfish

Nuts (esp. peanut)

Eggs

Milk
Wheat
Soy
Other food allergens:
Sesame
Corn
Gelatin
Spice
Seed
Fruits & Vegetables

I) Dietary supplements. The following nutrients may help support the immune system and reduce or prevent allergic reactions though there is no scientific evidence that they will help prevent anaphylaxis:

Herbs & dietary supplements that may cause allergic reactions, including anaphylaxis

Although anyone can be allergic to any herbs, the following is a list of herbs that are more apt to cause allergic reactions in sensitive individuals:

· Arnica flower (Arnica montana)

· Artichoke leaf (Cynara scolymus); in those with an allergy to artichokes

· Blessed thistle herb (Cnicus benedictus)

· Cayenne pepper (Capsicum spp.)

· Cinnamon bark (Cinnamomum verum)

· Dandelion root or herb (Taraxacum officinale); it may trigger a reaction in those with latex allergy

· Echinacea (Echinacea purpurea)

· Fennel oil and fennel seed (Foeniculum vulgare)

· Feverfew (Tanacetum parthenium/Chrysanthemum parthenium)

· Ginkgo biloba leaf extract

· Poplar bud (Populus spp.); it may trigger a reaction in those with salicylate (aspirin) sensitivity

· Psyllium seed (Plantago spp.); an allergic response is more common with powder or liquid form

· St. John's wort (Hypericum perforatum)

· Yarrow (Achillea millefolium)(1).

Note from the author: any herb or dietary supplement may cause an allergic reaction that may be severe – even life-threatening (anaphylaxis). People with atopy (see above) and/or allergies to a substance are at increased risk. People who have allergies to a herb may also have an allergy to herbs in the same (herb) family (e.g., Asteraceae family – see below).

Some herbs, such as chamomile and Echinacea, may cause allergic reactions in people allergic to related plants. Also, people with pollen allergies may have allergic reactions to bee products, such as bee pollen, honey, royal jelly, and propolis (a hive sealant made by bees from plant resins). Children under 1 year of age should not eat honey (5).

Roman chamomile may cause an allergic reaction in people sensitive to the Asteraceae/ Compositae family. This family includes ragweed, chrysanthemums, marigolds, daisies, and many others. If someone has allergies, he/she should be sure to check with a doctor before taking Roman chamomile (6).

Regarding angioedema (see above), some foods may trigger angioedema in people who are allergic. The following are the most common food triggers:

Some people may have a reaction in response to citrus fruits, sulfites (used as an antioxidant or preservative in many foods and beverages), and yellow dye No. 5 (also called tartrazine; those who are allergic to aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) are more likely to have an allergy to yellow dye No. 5) (10).

Herbs & dietary supplements that may prevent allergic reactions

a) Quercetin, a flavonoid and antioxidant in many plants, may help reduce allergic reactions. Quercetin may interact with some medications metabolized by the liver.

b) Vitamin C supports the immune system function and enhances the effect of quercetin. It is advised to lower the dose if diarrhea develops (1). Vitamin C supplements may interact with other medications, including chemotherapy drugs, estrogen, warfarin (Coumadin), and others (10). (Note from this text: the author does not support high doses of Vitamin C, more than 1 gram daily).

c) Zinc. Animal studies suggest that zinc may help protect against gastrointestinal symptoms (stomach cramps, nausea, vomiting, or diarrhea) that sometimes accompany anaphylaxis.

Some research suggests that mothers who take fish oil supplements (containing omega-3 fatty acids) during the late stages of pregnancy may lower the occurrence of allergies in their children. However, the evidence for this is insufficient. Fish oil may cause an allergy itself. Some people allergic to seafood, such as fish, might also be allergic to fish oil supplements. There is no reliable information showing how likely people with seafood allergies are to have an allergic reaction to fish oil; however, until more is known, it is advised patients allergic to seafood avoid or use fish oil supplements cautiously (7).

Fish liver oils like cod liver oil should be avoided in pregnancy because they can cause dangerous levels of vitamin A in the body.

The European Food Safety Authority (EFSA) recommends that ‘women of childbearing age (in particular, those intending to become pregnant), pregnant and breastfeeding women, as well as young children, select fish from a wide range of species, without giving undue preference to large predatory fish such as swordfish and tuna’. Following this recommendation, the European Commission released an ‘Information Note’ that suggests that women who might become pregnant, women who are pregnant or are breastfeeding, and young children should not eat more than one small portion (less than 100 g) per week of large predatory fish, such as swordfish, shark, marlin, and pike. If they do eat a portion of this fish, they should not eat any other fish during the same week. Nor should they eat tuna more than twice per week. The European limits for allowable levels of mercury in fish (0.5 mg/kg for fish in general, but 1.0 for certain larger predatory species, including shark, swordfish, marlin, tuna, and orange roughy) are based on the guideline levels established by Codex Alimentarius in 1991.

(Note from the author: cod liver oil as a source of omega-3 fatty acids should be avoided by pregnant women).

About angioedema (see above), supplements that may help treat symptoms include:

a) Vitamin C may help lower histamine levels, although there isn't much evidence. It is advised to reduce the dose if diarrhea develops. Vitamin C supplements may interact with other medications, including chemotherapy drugs, estrogen, warfarin (Coumadin), and others.

b) Vitamin B12 (by injection) may help reduce the frequency of ongoing attacks, although there isn't much evidence. Doctors don't know whether taking oral B12 would work the same way.

c) Quercetin, a plant-based flavonoid, may reduce the likelihood of an allergic reaction, although there isn't much evidence. People sensitive to citrus or taking calcium-channel blockers to treat high blood pressure should avoid quercetin. Quercetin may interact with many other medications, including blood thinners. Exceedingly high doses have been associated with kidney damage, so it is advised to not take quercetin for more than 2 months without taking a break.

d) Bromelain is sometimes used to help reduce inflammation. It is often combined with turmeric (Curcuma longa; curcumin) because it strengthens the bromelain's effects. People who are allergic to pineapple should not take bromelain. Both bromelain and turmeric may increase the risk of bleeding, especially in people who take blood-thinning medication such as aspirin, clopidogrel (Plavix), or warfarin (Coumadin) (10).

II) Herbs.

Some herbs may help support the immune system and reduce the frequency or severity of allergic reactions, although there is no evidence that they can prevent anaphylaxis. Anaphylaxis is a medical emergency, so people should never use herbs to treat it. Pregnant or nursing (breastfeeding) women should not take herbs unless under the supervision of a qualified practitioner. People should inform their doctor about any herbal medicines they plan to use (1).

People should be aware that some supplements may interact with medications or other supplements or have side effects. Keep in mind that most dietary supplements have not been tested in pregnant women, nursing mothers, or children (5).

The following herbs may help support the immune system and reduce the frequency or severity of allergic reactions:

a) Alpinia galanga. One of the several plants commonly called galangal and used as a spice in Thai food, Alpinia galanga is a member of the ginger family. Preliminary animal studies suggest it may have antihistamine properties. However, alpina may increase stomach acid (note from the author: that means that it is contraindicated in people with stomach problems such as PUD (peptic ulcer disease) and GERD (gastroesophageal reflux disease)). Someone can take capsules or drink tea. To make tea, it is advised to steep 1 g in 1 cup of boiling water for 10 minutes, strain, and cool.

b) Chinese skullcap (Scutellaria baicalensis) may have antihistamine properties. It should not be used by pregnant or nursing (breastfeeding) women. Chinese skullcap can potentially interact with a variety of medications.

c) Licorice (Glycyrrhiza glabra) has been used traditionally to support the immune system and may have antihistamine properties. Licorice should only be used under the direction of a trained physician. People who have high blood pressure, heart disease, kidney disease, low potassium, sexual dysfunction (in men), a history of hormone-sensitive cancers, or are anticipating having surgery within two weeks should not take licorice. Licorice can interact with several medications, including warfarin (Coumadin), and others. Note from the author of this text: To decrease the chances of serious side effects, deglycyrrhizinated licorice (DGL) preparations are available).

d) Stinging nettle (Urtica dioica) may have anti-inflammatory and antihistamine properties. People interested in taking this herb should look for freeze-dried, encapsulated nettles, which are believed to retain most of the antihistamine effects of the plant. Pregnant or breastfeeding women should not take this herb. People who have kidney problems or diabetes before taking stinging nettle should consult their doctor. Stinging nettle may interact with several medications, including warfarin (Coumadin), lithium, blood pressure medications, sedative medications, and others (1).

Several studies suggest that medicinal plants traditionally used in Asia to prevent or treat allergic reactions may help prevent anaphylaxis. These herbal remedies include a) Sweet chestnut tree (Castanea crenata) contains quercetin. Animal studies showed that it reduced skin and blood vessel reactions related to anaphylaxis. b) Spreading sneezeweed (Centipeda minima) contains flavonoids and is used in Traditional Chinese Medicine (TCM) for its anti-inflammatory and antihistamine effects. c) Asian rose (Rosa davurica) has been traditionally used to support the immune system. In an animal study, it inhibited anaphylaxis. d) Hardy orange (Poncirus trifoliata) has been traditionally used to treat allergies. Animal studies have shown that it inhibits anaphylaxis (1)

There have been several studies in Europe on the herb butterbur for allergic rhinitis, most of which indicated that butterbur may be helpful. Raw butterbur extracts contain pyrrolizidine alkaloids, which can cause liver damage and cancer. Extracts of butterbur that are almost completely free from these alkaloids are available. However, no studies have proven that the long-term use of butterbur products, including reduced-alkaloid products, is safe (5).

Regarding angioedema (see above), following a good nutritional plan and using some herbs in between attacks may help reduce or prevent angioedema. Herbs and supplements may help reduce mild symptoms, especially if someone often has angioedema. It is important for someone to tell his/her doctor about all medications, herbs, and supplements he/she is taking.

The following herbs have been used:

a) Goldenseal (Hydrastis canadensis) has been used for gastrointestinal symptoms such as stomach pain, diarrhea, and reduced appetite that may go along with a severe allergic reaction. Some health care providers may recommend goldenseal for people with food allergies to prevent or reduce allergic reactions. Goldenseal interacts with a number of medications, including blood thinners and cyclosporine. It may also lower blood sugar. People should ask their doctor before taking goldenseal if they take any other medication or have diabetes.

b) Licorice root (Glycyrrhiza glabra) has been used traditionally to reduce inflammation in the case of an allergic reaction. It may also help support immune system health. People who have high blood pressure, erectile dysfunction, edema, or heart failure; hormone-sensitive cancers such as breast, prostate, ovarian, or uterine cancer; diabetes; kidney disease; liver disease; or who are taking corticosteroids prescribed by a doctor should not take licorice. Licorice interacts with a number of medications, so if someone takes any medications, he/she should consult his/her doctor. (Note from the author of this text: To decrease the chances of serious side effects, deglycyrrhizinated licorice (DGL) preparations are available).

c) Chamomile (Matricaria recutita) has been used traditionally to treat hives, although no scientific evidence exists. Chamomile can make the effects of other sedatives stronger. It also interacts with many other medications. People who are allergic to ragweed should not take chamomile (10). Roman chamomile may cause an allergic reaction in people sensitive to the Asteraceae/ Compositae family. This family includes ragweed, chrysanthemums, marigolds, daisies, and many others. If someone has allergies, he/she should be sure to check with a doctor before taking Roman chamomile (6).

Precautions/ Alerts

Some herbs & dietary supplements may help support the immune system and reduce the frequency or severity of allergic reactions, although there is no evidence that they can prevent anaphylaxis. Anaphylaxis is a medical emergency, so people should never use herbs or dietary supplements to treat it. Pregnant or nursing (breastfeeding) women should not take herbs or dietary supplements unless under the supervision of a qualified practitioner. People should inform their doctor about any herbal medicines or dietary supplements they plan to use (1).

People should be aware that some supplements may interact with medications or other supplements or have side effects, and keep in mind that most dietary supplements have not been tested in pregnant women, nursing mothers, or children (5).

Thanks for reading!

Reference (links)

1.http://umm.edu/health/medical/altmed/condition/anaphylaxis

(Retrieved:1 March 2014)

2.http://ods.od.nih.gov/factsheets/Zinc-HealthProfessional

(Retrieved:24 November 2012)

3.http://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

(Retrieved:24 February 2013)

4.http://www.aafa.org/display.cfm?id=9&sub=19&cont=254

(Retrieved:21 March 2014)

5.http://nccam.nih.gov/health/allergies/seasonal

(Retrieved:21 March 2014)