Hay fever or allergic rhinitis

Diphenhydramine and other first generation anti-histamines are the least expensive and first place to start.  Hydroxyzine (18 cents)(Vistaril) 50 mg is an inexpensive prescription alternative.  Loratadine (30-40 cents each)(Allegra (65 cents), Claritin) is a second generation anti-histamine.  Second generation anti-histamine have less of a sleep effect.  Cetirizine (Zyrtec) 5 mg or 10 mg ($2.00 each) and fexofenadine ($1.33 generic)(Allegra $2.00) are unreasonably expensive prescription second generation anti-histamines.

Butterbur Helped in Large DB: In a DB PC study of 330 patients with hay fever in Germany and Switzerland in 11 centres, butterbur extract was as effective at combating symptoms of hay fever as treatment with a conventional antihistamine (Telfast 180). In addition they found that Butterbur extract did not cause drowsiness. An extract can inhibit the body's ability to produce leukotrienes, biomolecules that are involved in the inflammatory response to allergens. They also help stimulate the body's production of prostaglandins, chemicals that play a role in reducing inflammation. Treating Intermittent Allergic Rhinitis: A Prospective, Randomized, Placebo and Antihistamine-Controlled Study of Butterbur Extract. Schapowal A, et al. Phytotherapy Research August 22, 2005.

Butterbur Helps Hay Fever Symptoms: Butterbur one QID did as well an anti-histamine without drowsiness in good DB study. Swiss. Brit Med J 1/12/02 324:144

Butterbur Helped Allergic Rhinitis: In a 7-day DB PC study of 186 patients with intermittent allergis rhinitis, Butterbur Ze339 three times a day resulted in a significantly greater decrease in symptoms. Butterbur Ze339 for the treatment of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized, double-blind, placebo-controlled study. Schapowal A; Petasites Study Group.Landquart, Switzerland. Arch Otolaryngol Head Neck Surg. 2004 Dec;130(12):1381-6.

Butterbur No Benefit for Allergic Rhinitis in Study: Butterbur (Petasites hybridus) contains the active ingredient petasin, which exhibits antileukotriene and antihistamine activity. In a DB PC study of 35 grass pollen allergy sufferers with intermittent allergic rhinitis, 50 mg twice daily of butterbut There was no significant clinical efficacy of butterbur use vs placebo use on objective and subjective outcomes in IAR. Effects of butterbur treatment in intermittent allergic rhinitis: a placebo-controlled evaluation. Gray RD, Haggart K, et al. University of Dundee, Scotland. Ann Allergy Asthma Immunol. 2004 Jul;93(1):56-60 

Butterbur as Good as Fexofenadine for Allergic Rhinitis: In a 2-week DB PC crossover study of 16 patients with perennial allergic rhinitis and house dust mite sensitization were butterbut 50 mg twice daily did as well as fexofenadine 180 mg once daily. The maximum % peak nasal inspiratory flow fall from baseline after nasal AMP challenge was significantly attenuated (P<0.05) compared to PL (46), with BB (34) and FEX (39). The area under the 60-min time-response curve (%.min) was also significantly attenuated (P<0.05) compared to PL (1734), with BB (1052) and FEX (1194). There was also a significant reduction (P<0.05) in total nasal symptom score with BB (1.8) and FEX (1.8), compared to PL (2.8). A placebo-controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis. Lee DK, Gray RD, et al. University of Dundee, Scotland, UK. Clin Exp Allergy. 2004 Apr;34(4):646-9.

Butterbur Helped Seasonal Allergic Rhinitis in DB: 20 patients in a DB PC crossover study for 2 weeks each.  In butterbur phase they received 50mg/d. Inhibits leukotriene synthesis. Butterbur, a herbal remedy, attenuates adenosine monophosphate induced nasal responsiveness in seasonal allergic rhinitis. Lee DK, Carstairs IJ, et al. Clin Exp Allergy. 2003 Jul;33(7):882-6

Butterbur as Good as Anti-histamine in Seasonal Allergic Rhinitis: Large DB 125 patients. 12 side-effects in 61 anti-histamine patients with 8 having drowsiness problems. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. Schapowal A; Petasites Study Group. BMJ. 2002 Jan 19;324(7330):144-6. Author notes that extracts of butterbur have been used in bronchial asthma, smooth muscle spasms, and headache.

Lactobacillus: Even Heat-Treated Lactobacillus Can Help Child Allergic Rhinitis: Live Lactobacillus paracasi 33 (LP33) may effectively improve the quality of life for children with perennial allergic rhinitis. It has been demonstrated that heat-killed lactic acid bacteria (LAB) suppress specific immunoglobulin E synthesis and stimulate interleukin-12 production in animals. In a 30-day DB PC study of 90 patients with allergic rhinitis induced by house-dust-mite, groups A and B received two capsules per day of live or heat-killed LAB (5 x 10(9) colony-forming units/capsule), while those in Group C received placebo capsules. Groups A and B rhinoconjunctivitis-related quality of life improved, as compared with the placebo group, in terms of both frequency (9.47, 6.30, vs. -3.47; p < 0.0001) and level of bother (5.91, 6.04, vs. -2.80; p = 0.004). The efficacy and safety of heat-killed Lactobacillus paracasei for treatment of perennial allergic rhinitis induced by house-dust mite. Peng GC, et al. China Medical University Hospital, Taichung, Taiwan, ROC. Pediatr Allergy Immunol. 2005 Aug;16(5):433-8. Ed: By yogurt or capsule, lactobacillus is a good investment.

Lactobacillus: Allergic Rhinitis Patients Helped by Yogurt: In a very small crossover study of 13 patients with nasal allergies and 7 healthy controls with all consuming two cups of yogurt or two cups of skimmed milk each for a four month period found yogurt feeding appeared to improve or prevent allergic recurrences in rhinopathic patients. Effects of dietary yoghurt on immunological and clinical parameters of rhinopathic patients. Aldinucci C, Bellussi L, Monciatti G, Passali GC, Salerni L, Passali D, Bocci V. Eur J Clin Nutr. 2002 Dec;56(12):1155-61

Lactobacillus: Allergic Rhinitis and Hayfever Less with Yogurt Consumption: In a study of 293 New Zealand farm children ages 7-10, inverse associations were found for early-life exposures: at least weekly consumption of yogurt with hayfever (odds ratio (OR) = 0.3) and allergic rhinitis (OR = 0.3); any unpasteurized milk consumption with atopic eczema/dermatitis syndrome (AEDS) (OR = 0.2); cats inside or outside with hayfever (OR = 0.4) and AEDS (OR = 0.4); dogs inside or outside with asthma (OR = 0.4). Farm residence and exposures and the risk of allergic diseases in New Zealand children. Wickens K, Lane JM, Fitzharris P, Siebers R, Riley G, Douwes J, Smith T, Crane J. Allergy. 2002 Dec;57(12):1171-9

Lactobacillus: Allergic Rhinitis Helped: Ingestion of fermented milk containing Lactobacillus paracasei-33 (LP-33), a strain newly isolated from the human intestinal tract, was used in a DB PC study of 80 patients with 60 drinking the yogurt-type milk daily for 30 days. Scores for the overall quality of life significantly decreased in the LP-33 group as compared with the placebo group, in both frequency (-16.02 vs. -7.27; p = 0.037) and level of bother (-16.35 vs. -6.20; p = 0.022). Subjects reported no severe adverse effects. Treatment of perennial allergic rhinitis with lactic acid bacteria. Wang MF, Lin HC, Wang YY, Hsu CH. China Medical University Hospital, Taichung, Taiwan. Pediatr Allergy Immunol. 2004 Apr;15(2):152-8

Rosmaric Acid Enriched Perilla Helps Allergic Rhinitis: In a DB study of extract of Perilla frutescens enriched for rosmarinic acid (50 or 200 mg), no adverse events and no significant abnormalities were detected in routine blood tests. Extract of Perilla frutescens enriched for rosmarinic acid can be an effective intervention for mild Seasonal Allergic Rhinitis at least partly through inhibition of PMNL infiltration into the nostrils. Use of this alternative treatment for SAR might reduce treatment costs for allergic diseases. Tokyo. Extract of Perilla frutescens Enriched for Rosmarinic Acid, a Polyphenolic Phytochemical, Inhibits Seasonal Allergic Rhinoconjunctivitis in Humans. Takano H, Osakabe N, et al. Exp Biol Med (Maywood). 2004 Mar;229(3):247-54