Spring is in the air and the sneezing begins


Angela Jones
outlines the treatment of hay fever and rhinitis

Hay fever and rhinitis are complaints that may seem trivial to the observer. However, to the sufferer they are the source of considerable annoyance and even distress, often detracting from a person’s quality of life. A large range of over-the-counter and prescription medications are available for the treatment of rhinitis and hay fever. They fall into two main groups: the antihistamines and the topical steroids. Both of these types of drug work by suppressing the body’s immune response to allergens (substances that cause an allergic response, such as pollen or house dust mite). They are generally only effective if taken on a once-or twice-daily basis. Although more refined than they used to be, these conventional medications can still cause a number of side effects, the most worrying of which is sedation that can interfere with the individual’s ability to concentrate, drive and to operate machinery.

Using homeopathy to treat rhinitis and hay fever is attractive for several reasons. First, it offers a mode of therapy that is individualised to the patient. Every allergy sufferer experiences his or her allergy in a different way. Nasal discharges may be bland, burning or itching. There may be unbearable itching in the palate, the ears, the throat, the eyes or a combination of any of these. Rather than offering blanket suppression of symptoms, the homeopath selects a medicine that is matched to the symptom or allergy picture of the patient.

Second, the treatment may not need to be taken continuously. Often, a short course at the beginning of the hay fever season or a few doses of a constitutional medicine may give relief for weeks or even months at a time. Third, homeopathic medicines are free from the sedative side effects of conventional antihistamine therapy. Finally, the homeopathic treatment of hay fever and rhinitis has been subjected to scientific investigation by the team at Glasgow Homoeopathic Hospital. The results, published in several articles in The Lancet, have found homeopathic treatment to be significantly superior to placebo – in other words, it works!

Before discussing the medicines that can be used to treat hay fever and rhinitis, it will be useful to say a little bit about the medical definitions of these conditions. Hay fever covers any allergic reaction due to the exposure of a susceptible person to pollens or fungal spores. The “season” for any individual varies, depending on which substance they are allergic to, with the tree pollens, such as birch, arriving first in the spring, followed by the grass pollens in the summer and ending with fungal spores in the autumn. The areas affected by hay fever may be nose, ears, mucous membranes of mouth and throat and the eyes. In severe cases, the lungs may become affected, causing bronchospasm and wheezing – so-called “hay asthma”. Very severe cases may even develop a temperature, although I have never witnessed this myself. This must be where the term “hay fever” originated.

Rhinitis means, simply, inflammation of the nasal passages leading to discharge, sneezing and/or nasal blockage. The inflammation can be caused by infections, such as that caused by the common cold virus, or by allergy. The allergic version takes two forms: seasonal allergic rhinitis which is part of the hay fever picture, and perennial rhinitis which goes on throughout the year and is most commonly related to allergy to the house dust mite.

Isopathic medicines
Definition
It is important to ascertain which allergen is responsible for the hay fever/rhinitis symptoms if the isopathic approach is to be used. This approach is similar to conventional immunisation, in that the substance to which the patient is allergic is administered in order to reduce the allergic response. The difference is that the substance is administered in homeopathic potency, usually 30c, orally rather than injected, and for a short course of a few days only. This often results in relief of symptoms and the course can be repeated when relief is waning.

All the common allergens are available in potentised form from the specialist homeopathic pharmacies: mixed tree pollens, mixed grass pollens, specific tree pollens, fungal, such as Alternaria, cat/dog/rabbit/ horse hair, house dust mite, and so on.

It is also possible to have customised medicines made up if an unusual allergen is thought to be the culprit (see case history 1).

Case history 1
A 60-year old carpenter began to develop allergic rhinitis for the first time in his life after using an unusual tropical wood. Conventional anti-histamines did not control his symptoms very well so dust was swept from his workshop and made up to a homeopathic potency of 30c. Administration of the tailor-made medicine cured his symptoms.

How to use isopathy
A frequently employed regime for the treatment of perennial rhinitis due to house dust mite allergy is as follows: give one dose of house dust mite 30c twice daily for five days in the first instance. Wait at least three weeks to assess response. There may be a temporary worsening of symptoms. Repeat the course if required. Occasionally patients need a daily dose, especially at times of intense exposure, such as moving house or decorating. A similar regime could be used for any of the pollens or other allergens. Despite the risk of temporary exacerbation of symptoms – the phenomenon is known as “aggravation” – there is no risk of anaphylactic shock.

Homeopathic medicines
As in most homeopathic treatment, there are a number of therapeutic strategies that can be used in the treatment of hay fever and rhinitis. One option is to choose the medicine purely on the actual symptoms of the problem, the so-called local medicine. A medicine is chosen whose symptom picture, or materia medica, most closely resembles that of the sufferer. If you are having difficulty in choosing one, it may be wise to try one medicine for a week, following it with an alternative only if the first has not been effective. Some practitioners suggest that two medicines can be given in alternating doses. I would not recommend this approach as it can cause confusion in interpreting the results of treatment.

Local medicines
The following are the symptom pictures of some of the local medicines which are commonly used in managing hay fever and rhinitis. They may be given in the 6c potency, initially two to four times daily and reducing the frequency with improvement. 
 
Allium cepa:

  • Bouts of sneezing
  • Burning nasal discharge causing sore nostrils and upper lip
  • Eyes itch and water profusely but do not burn
  • Better in cold room or open air
  • Worse in evening
  • Tickly cough

Ambrosia:

  • Intolerable itching of eyelids
  • Profuse tears due to smarting and burning of eyes
  • Runny nose, may have stuffed-up feeling
  • Asthmatic attacks


Ammonium muriaticum:

  • Hot acrid nasal discharge corrodes lip
  • Obstructed stuffy feeling and loss of sense of smell
  • Unable to clear nose by blowing


Aralia racemosa:

  • Frequent sneezing
  • Marked wheezing, especially when lying down
  • Feeling as if something in throat
  • Worse for least current of air


Arsenicum iodatum:

  • Irritation and tingling in nose with constant desire to sneeze
  • Nasal discharge burning
  • Burning watering of eyes
  • May have dry wheezy cough


Arundo:

  • Everything itches
  • Burning and itching in ears and eyes
  • Annoying itch in roof of mouth, throat and nose


Euphrasia:

  • Eyes severely affected with profuse burning watering
  • Burning and swelling of eyelids
  • Nasal discharge and sneezing but not burning
  • Headache and aversion to bright light
  • Worse for warmth


Sanguinaria:

  • Chronic rhinitis or hay fever complicated by nasal polyps
  • Dryness and burning of ears, throat and nasal passages


Wyethia:

  • Particularly for symptoms confined to back of nose and throat
  • Dry and intensely itchy
  • Dry wheezy cough


Constitutional medicines
The constitutional approach to prescribing for hay fever/rhinitis arises from the fact that many constitutional types are particularly prone to hay fever or rhinitis as part of their make-up. Thus, if a constitutional medicine is given, as well as raising the general level of health, the tendency to troublesome symptoms is reduced.

Case history 2
Mr X was a 34 year-old accountant who visited me for treatment of irritable bowel syndrome. He was troubled by bouts of burning diarrhoea which occurred especially in the morning, causing him to be driven out of bed and sometimes persisting so that he was late for work. He was a generally fit and energetic type but had a slight tendency towards eczema, hay fever and asthma for which he took conventional medication.

In general, he was a warm-blooded individual, often throwing the bedcovers off at night and sticking his feet out of bed. He admitted to being quite thirsty and to liking fatty rich foods and sweet things. He was fairly untidy in the house but careful with his work. He enjoyed current affairs and documentary programmes and tended to read factual books rather than fiction.

I felt that his overall constitution fitted that of the medicine Sulphur and therefore gave him three doses of Sulphur 30c at 12­hourly intervals. He made a good recovery from his IBS and needed a further course of Sulphur after about 12 weeks. When reviewed the following autumn he remarked that he had had virtually no hay fever symptoms that year. Indeed, he had not needed to buy any antihistamines at all.

Case history 3
Miss Y was a 28 year-old bar manager who consulted me specifically for allergic rhinitis. She was extremely sensitive to any smell and had severe bouts of sneezing several times every day which she found disruptive and debilitating.

She was in good general health and loved to travel. Indeed, she really lived from one holiday to the next and had already visited all the continents. Slightly plump, she admitted cheese and bacon were her favourite foods. She was moderately thirsty.

In view of her food preferences and her marked desire for travel, I thought that the medicine Calcarea phosphorica would be helpful as it seemed to match her constitutional type. It had an effect from day two and she has only needed one repeat dose in the past 12 months!

These cases illustrate the use of two constitutional medicines. Two others that are commonly seen are:

Pulsatilla:

  • Changeable
  • Profuse discharges, often yellowish
  • Markedly better for open air and gently moving about; and

Silica:

  • Chilly persons
  • Often constipated
  • Thin despite good appetite
  • Sweaty feet
  • Nasal obstruction and marked tendency to sinusitis.

Beginners reading this guide should feel reasonably confident in using the local medicines and possibly also the isopathic method of desensitisation with potentised allergens. However if a constitutional approach is needed, it is always advisable to consult a qualified homeopathic practitioner.

Angela Jones MA BM BCh MRCGP DCH DRCOG DFFP MFHom is a member of the Faculty of Homeopathy and an NHS GP who uses homeopathy in her practice.