One source of stress
and dismay right now for many patients in our clinic is seasonal allergies. While this can be a mild irritation for some people, for many, it will cause great anxiety, fatigue, low mood and inability to function.
If you are a regular seasonal allergy sufferer, you probably know that regular use of over the counter antihistamines and corticosteroid nasalsprays are very common to lower symptoms of itchy eyes, sneezing and coughing, and runny nose.
When the over the counter medicines do not help enough, you may even ask your doctor to prescribe drugs like Allegra and Zyrtec. While all these medications are helpful to stop symptoms, they can also cause many side effects, including extreme fatigue and drowsy and depressed feelings, and may even impair your ability to drive and perform daily function as well.
Typical outdoor environmental allergy-causing factors include grasses, tree, and weed pollens, while the most common in-house culprits are dust mites and pets. From a naturopathic perspective, foods that contribute to inflammation in our bodies will increase our reactivity to environmental allergies. The most common foods to increase allergic response are cow’s milk products and wheat foods. Also, poor sleep and low intake of inflammation lowering foods like fish may also be a contributing factor.
Natural Hope For Seasonal Allergies
Coming from the plant Petasites hybridus, Butterbur is an exciting example of the benefits of working with natural medicines to treat common symptoms. A member of the daisy family, this botanical medicine has already been shown helpful in cases of bronchial asthma, gastrointestinal cramping, uterine spasms, and headache, and is now a showing up in quality research studies as an effective allergy remedy.
One study from 2006 showed symptoms of seasonal allergic rhinitis to improve in 90% in 580 patients. In this study, the patients who also used a conventional drug with the herb did not find any better improvement than using the herb alone.
Really? As Good As the Drugs?
Although not well-publicized, Butterbur has been shown to be equally as effective as the leading allergy medications fexofenadine (Allegra) and cetirizine (Zyrtec). A study compared Allegra directly to Butterbur in 380 patients in a double-blinded, randomized study—a type study conventional research considers the most stringent and trustworthy. In this study, both the drug and the herb were equally as effective. A second controlled and blinded study of 131 patients comparing the herb with Zyrtec also found equally effective benefits. The drug group was shown to suffer from drowsiness and fatigue, despite the fact that this medication was touted as being ‘non-drowsy.’
How does butterbur work?
Seasonal allergies are an over-response by your body’s immune system whereby pollen taken into the nasal passages can activate your immune cells to make a number of inflammation-causing molecules. This response is known in the medical world as a ‘type I Hypersensitivity.’ One of the molecules made during this response is the leukotriene—an immune molecule that can keep the symptoms of itchiness, red eyes, and runny nose going on for a long time. Studies have shown that the petasine compounds found in butterbur naturally inhibit the production of leukotrienes.
Dosage of Butterbur
The most well studied form of butterbur for seasonal allergies is the leaf extract called ‘Ze 339’, which has 8 mg petasines per tablet. In studies, patients took an average of 2 to 4 tablets of Ze 339 daily for 14 days.
Safety of Butterbur
While drowsiness and fatigue are common side effects of anti-histamine and allergy medications, no studies to date have shown any side effects or toxicities of Butterbur. Although not at all common, there are single accounts of possible short-term digestive upset and some burping. However, it is not clear if it is safe to take Butterbur for the long term, so it may be best to use it no longer than the two to four weeks duration observed in studies.
It should be noted that the Butterbur plant naturally contains a chemical called pyrrolizidine alkaloids which can be toxic to the liver, but this chemical is easily removed and is not present in most butterbur products. Nevertheless, you should check the label of your Butterbur product to make sure these have been removed.
Seasonal allergies are caused by both environmental factors combined with an over-responsive immune system. In our practice, we have found basic naturopathic principles are a key to lower the over-responsiveness in allergic patients.
General steps for healthy immune balance during allergy season include:
- adequate sleep (at least 7 hours a night)
- sufficient water intake (at least 50 ounces a day)
- removing allergens by using a high quality air filter in the bedroom and work area
Steps to lower overall inflammatory response should include:
- avoiding cow’s milk products as well as sugar and wheat-derived foods
- intake of fish oil and essential fatty acids to help lower inflammatory response
- intake of a small amount of local honey or honey comb
Finally, as we discussed above, Butterbur is a solid and safe choice that an effect equal to drugs to help lower symptoms and feel bonafide relief from seasonal allergy.
Peter Bongiorno ND, LAc practices in New York, and authored Healing Depression: Integrated Naturopathic and Conventional Therapies He can be reached by visiting InnerSourceHealth.com
Meier B, Meier-Liebi M. Drogenmonographie Petasites. In: Hänsel R, Keller K, Rimpler H, Schneider G, eds. Hagers Handbuch der pharmazeutischen Praxis. 5th ed. Berlin: Springer Verlag, 1994:81-105.
Käufeler R, Polasek W, Brattström A, Koetter U. Efficacy and safety of butterbur herbal extract Ze 339 in seasonal allergic rhinitis: postmarketing surveillance study. Adv Ther. 2006 Mar-Apr;23(2):373-84. http://www.ncbi.nlm.nih.gov/pubmed/16751170
Schapowal A, Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002;324:144-146 http://www.ncbi.nlm.nih.gov/pubmed/16114089
Thomet OAR, Wiesmann UN, Schapowal A, Bizer C, Simon HU. Role of petasine in the potential anti-inflammatory activity of a plant extract of petasites hybridus. Biochem Pharmacol. 2001;61:1041–1047. http://www.ncbi.nlm.nih.gov/pubmed/11799030