What is Sinus?
What you call Sinus is actually Allergic Rhinitis.
Allergic Rhinitis is what we erroneously call Sinus in Singapore. Sinus typically refers to the air-filled cavities located in the bones of the skull behind your face.
Allergic Rhinitis mainly happens to the mucus membranes in the nose when you’re exposed to certain allergens such as pollen and dust, which cause you to sneeze, have a runny and itchy nose, and have other symptoms.
Why Is My Nose Dripping Despite Trying Everything?
Allergic Rhinitis Symptoms
Allergic sensitivities and symptoms can vary from person to person. People with allergic rhinitis can suffer from symptoms like sneezing, runny nose or nasal congestion (or blocked nose).
- Runny nose
- Sneezing
- Itchy nose
- Feeling tired and weakness
- Sore throat
- Blocked nose
- Itchy throat or roof of the mouth
- Teary and itchy eyes
- Red eyes
- Coughing
These symptoms, while not life-threatening, can greatly impact a person’s quality of life, but sinus TCM treatment can provide relief.
Allergic Rhinitis Causes
Allergic rhinitis often has a genetic component. If someone in your family, especially parents or siblings, has allergic rhinitis, asthma, or eczema, your risk of developing allergic rhinitis is increased. This suggests a genetic predisposition to allergic reactions and sensitivities.
Exposure to the following may trigger allergic rhinitis:
POLLEN: Pollen is a common trigger for allergic rhinitis, particularly during certain seasons (seasonal allergic rhinitis). Trees, grasses, and weeds release pollen into the air, and when individuals with sensitivities inhale this pollen, it can lead to allergic symptoms like sneezing, runny or stuffy nose, and itchy eyes.
DUST: Dust mites are tiny organisms found in household dust. Their droppings and body fragments can be potent allergens. When you’re exposed to dust, especially in indoor environments, it can trigger allergic rhinitis symptoms, particularly if you are sensitive to dust mites.
SMOKE: Smoke, whether from tobacco or wood-burning fires, can irritate the nasal passages and worsen symptoms for people with allergic rhinitis. It doesn’t directly cause allergic rhinitis but can exacerbate the condition.
FRYING OF OIL: Cooking oil fumes, when inhaled, can irritate the respiratory system and potentially trigger symptoms similar to allergic rhinitis in some individuals. However, this is more of an irritant response than a true allergy.
MOLD: Mold spores in the air, especially in damp or humid environments, can trigger allergic rhinitis in susceptible individuals. Mold allergies can cause symptoms similar to pollen allergies, such as sneezing, congestion, and itchy eyes.
CERTAIN PETS: Some people are allergic to proteins found in the skin cells, saliva, or urine of cats, dogs, and other pets. Exposure to these allergens can lead to allergic rhinitis symptoms. It’s worth noting that pet allergies can be triggered even if you don’t own a pet but are exposed to environments with pet allergens.
WASTE FROM INSECTS: Cockroach allergens, found in their droppings and body parts, can act as potent allergens. If you are exposed to areas infested with cockroaches, it can trigger allergic rhinitis symptoms, especially in urban environments.
CERTAIN FOODS, LIKE PEANUTS: While allergic rhinitis primarily involves reactions in the respiratory system, some allergens, like peanuts, can cause systemic allergic reactions. These reactions may include nasal symptoms along with more severe symptoms like hives, throat swelling, and difficulty breathing. Food allergies can sometimes be associated with allergic rhinitis.
What Happens When You’re Exposed To Allergens?
On exposure to allergens, your immune system overreacts; this is known as a hypersensitivity reaction. Allergic Rhinitis is a Type 1 hypersensitivity reaction.
Your body recognizes these allergens, which are usually harmless to other people, as foreign substances that are trying to do you harm and fights them.
These allergens bind to T cells, causing them to become overactive and produce high levels of cytokines. This in turn triggers the immune system to respond, over-activating your B cells, basophils, and eosinophils into a hypersensitive response.
Such an overreaction may harm the very cells and tissues the immune system is designed to defend. This damages the nasal tissues, leading to symptoms such as itchiness, swelling, and a runny nose.
14 Ways To Prevent Allergic Rhinitis
It’s possible to live an allergic-rhinitis-free life or to at least have fewer episodes of it. You can do the following to avoid having it:
- Recognize your allergens and avoid them.
- Do not keep pets if they trigger your allergic rhinitis.
- Keep pets out of your bedroom or places where you spend the most time.
- Get your house, office space, and business space cleaned regularly.
- Clean surfaces with damp, clean clothes.
- Exterminate insects.
- Change your bed sheets and pillowcases regularly.
- Use a face mask when moving along a dusty road.
- Avoid the smoke from burning refuse and cigarette smoking.
- Stay in well-ventilated rooms.
- Stay indoors during the high pollen season.
- Use humidifiers so the air you breathe in is less dry.
- Block out the symptoms using Western medicine.
- Balance your immune system with Chinese medicine.
Treatment of Allergic Rhinitis Using Western Medicine
There exist different classes of drugs to treat Allergic Rhinitis. There is of course the well-known antihistamines, but do not forget that decongestants, steroids, mast cell stabilizers and even monoclonal antibodies are part of the bigger tool box.
1. ANTIHISTAMINES FOR ALLERGIC RHINITIS
These drugs block the action of histamine. Histamine is released by mast cells and basophils (part of the immune system in your body).
If you take antihistamines before exposure to allergens, you’ll most likely not experience Allergic Rhinitis. But if you take them after exposure to allergens, you’ll experience less severe symptoms.
Examples of antihistamines used in the treatment of Allergic Rhinitis include:
- Loratadine
- Fexofenadine
- Diphenhydramine
- Cetirizine
- Atarax (Hydroxyzine Hydrochloride)
2. DECONGESTANTS FOR ALLERGIC RHINITIS
Like the name implies, these drugs decongest the nose and sinuses.
Decongestants reduce inflammation and swelling and increase mucus drainage. This reduces runny and blocked noses and frees up your airways. They come in nasal sprays, drops, tablets, etc.
Decongestants can be addictive and, when taken for too long, become counterproductive, such that your symptoms become worse after stopping. Therefore, do not take them for more than 3–5 days.
Examples include:
- Phenylephrine
- Pseudoephedrine
- Oxymetazoline
3. CORTICOSTEROIDS FOR ALLERGIC RHINITIS
These act by reducing inflammation via reduced migration of inflammatory cells and also by reducing the activity of the immune system. They can be used long-term, unlike decongestants.
Examples include:
- Fluticasone
- Flunisolide
- Triamcinolone
- Budesonide
4. OTHER DRUGS FOR ALLERGIC RHINITIS
The two other common drugs are Singulair and Fasenra.
Singulair is a mast cell stabilizer. It’s chemical name is Montelukast and its action is to reduce mast cells disintegrating and releasing histamine. Singulair has known side effects, of which the common ones are upper respiratory infection, headache, sore throat, earache and ear infection. The less common ones include anxiety, agitation, suicidal thoughts and uncontrolled muscle movements. This is the reason why Singulair is one of the treatment choices that have to be considered very carefully.
Fasenra is a kind of Biologic – this means it is made from living cells instead of a chemical compound – which lowers the number of eosinophils in the blood. This therapeutic strategy is helpful not just for Allergic Rhinitis, but also for Allergic Asthma.
How does Fasenra work? It works by inhibiting a certain cytokine IL5 in a very strong way. Although Chinese herbs are not as ‘strong’, they definitely help by intervening in that particular pathway, by tweaking IL5 levels so that the immune system is slightly more balanced.
At Chinese Doc Singapore we treat allergic rhinitis alongside the other allergic conditions, and it does not matter if you are already on:
- Anti-histamines to manage the symptoms
- Steroid sprays to reduce the inflammation
- Acarizax or Oraltek to build tolerance to specific allergens
Even if you have already had a septoplasty or a turbinoplasty — which may help a lot or a little — Chinese medicine is still worth a shot. Especially if the blocked nose or the drippy sneezing is still affecting you.
Xiao Qing Long Tang (小青龙汤) for Allergic Rhinitis
This is one well-known formula to treat allergic rhinitis and drippy nose. It is also known as Sho-seiryu-to in Japanese Kampo medicine. This formula contains eight ingredients and is highly effective in treating allergic conditions like allergic rhinitis. It leads to:
- Decrease in the levels of histamine receptors.
- Lower levels of both IgE and T helper 2 cytokines.
- Reduction in eosinophil activity.
Each ingredient in the formula works independently to target the areas affected by Allergic Rhinitis. With the combined effort of these ingredients, Xiao Qing Long Tang achieves an additive effect in reducing the hypersensitivity reaction. It has been proven effective for centuries.
Yu Ping Feng (玉屏风) for Allergic Rhinitis
This allergic rhinitis herbal formula is anti-inflammatory and also regulates the immune system. It contains three ingredients in varying quantities that work together to bring about the following:
- Decreased infiltration of eosinophils.
- Decreased release of immune factors like IgE.
- Decreased degranulation of mast cells and eosinophils.
Studies have shown improvement in the treatment of allergic rhinitis using Yu Ping Feng granules with antihistamines such as loratadine.
10 Herbs I Use To Treat Allergic Rhinitis
- Paeonia Suffruticosa (Mu Dan Pi) — This herb clears Heat and cools the Blood. It is particularly useful when allergic rhinitis presents with signs of Heat, such as red, inflamed nasal passages or irritability. It also helps to invigorate Blood and reduce inflammation.
- Ligusticum Chuanxiong (Chuan Xiong) — Known for its ability to invigorate Blood and promote Qi movement, this herb is commonly used to treat allergic rhinitis by relieving headaches and nasal congestion. It is especially helpful when there is stagnation contributing to sinus discomfort.
- Forsythia Suspensa (Lian Qiao) — A key herb for clearing Heat and resolving toxicity, it is often used in cases where allergic rhinitis is accompanied by sore throat, fever, or yellow nasal discharge, indicating Wind-Heat invasion.
- Liquidambar Formosana (Lu Lu Tong) — This herb promotes the movement of Qi and Blood while unblocking the channels. It is useful for relieving nasal obstruction and alleviating discomfort associated with chronic sinus congestion.
- Cimicifuga Foetida (Sheng Ma) — Commonly used for nasal conditions, this herb is particularly effective to treat allergic rhinitis by relieving nasal obstruction and reducing inflammation. It opens the nasal passages and is often used for sinusitis and allergic rhinitis with significant congestion.
- Herba Centipeda Minima (E Bu Shi Cao) — This herb is not a centipede! But it does have a powerful ability to unblock nasal passages. We commonly use it for allergic rhinitis, nasal congestion and even sinusitis.
- Angelica Dahurica (Bai Zhi) — This herb disperses Wind and alleviates pain, making it highly effective for frontal headaches and nasal congestion. It also helps to dry Dampness and clear nasal passages.
- Xanthium Sibiricum (Cang Er Zi) — A commonly used herb for nasal disorders, it is especially effective in treating sinus congestion, runny nose, and headaches. It works by expelling Wind and opening the nasal orifices.
- Magnolia Biondii (Xin Yi Hua) — This flower is well known for its ability to unblock the nasal passages. It is frequently used in formulas targeting sinus congestion and is particularly effective to treat allergic rhinitis.
- Glycyrrhiza Uralensis (Gan Cao) — Often included as a harmonizing herb, it helps moderate the harsh properties of other herbs in a formula. It also has anti-inflammatory properties and supports the Lung Qi, which is essential in managing allergic rhinitis.
Conclusion
Allergic rhinitis (or Sinus, as it is commonly called in Singapore) is a medical condition due to a variety of causes. There are varying medications on the market to treat this common but debilitating ailment. However, each has its own limitations and potentially damaging side effects.
TCM can be very helpful in the treatment of Allergic Rhinitis. Herbal formulas like Xiao Qing Long Tang and Yu Ping Feng are made of variety of herbs with a broad variety of active ingredients to balance out your immune system. With TCM herbs, you are not relying on single-compound drugs that have a harsh effect on the body.
Chinese herbs are able to treat the imbalance in a Type 1 hypersensitivity response of our immune system. TCM is also able to reduce the over-production of pro-inflammatory chemicals. Nevertheless, as with any medical treatment, it should be prescribed under the guidance of a trained TCM practitioner so that the dosage can be controlled to avoid complications and abuse.
If you’re considering using the TCMs mentioned above or any other ones, message us for a consultation. This way, you can obtain a proper diagnosis and treatment plan tailored to your specific health condition.
Chinese herbs can help! Book in for a consultation and herbs.
FAQs
FAQ: What is Type 1 Hypersensitivity?
Allergic Rhinitis is a Type I Hypersensitivity reaction. There are four types of hypersensitivity reactions.
In Type 1 Hypersensitivity, the body overreacts to certain stimuli, in this case, allergens. Typically, the reaction takes place in two phases. The earlier phase occurs within 20 minutes of allergen exposure due to an over-production of an antibody known as IgE.
FAQ: What are the cells associated with the General and Specific Immune system?
There are two types of cells in our immune system: general and specific.
The cells of the general immune system form the defense mechanism that kicks in when harmful substances like viruses or allergens invade the body. These cells include eosinophils, which play a major role in the allergic response, as well as mast cells and basophils.
On the other hand, the cells of the specific immune system work with more specificity. These cells can be categorized as either T cells or B cells. The former can recognize and attack specific types of invading substances, while the latter produces antibodies against them.
T and B cells usually work together to create a targeted defense system for the body.
FAQ: What are T Cells and B Cells in relation to Allergic Rhinitis?
when allergens such as pollen or dust get into the body, they bind themselves to T cells. This causes them to become overactive and produce high levels of cytokines. It then triggers the immune system to respond, over-activating cells like B cells and eosinophils into a hypersensitive allergic response.
Such overreaction may harm the very cells and tissues the immune system is designed to defend. It damages the nasal tissues, leading to symptoms such as itchiness, swelling and a runny nose.
FAQ: What happens to T Cells when they come in contact with allergens?
What happens to the T cells when in contact with allergens?
The T cells will transform into T helper 2 cells, which release chemicals called cytokines, including IL-4, IL-5, and IL-13.
IL-4 and IL-13 activate B cells to transform into plasma cells to produce antibodies like IgE, which causes allergic rhinitis. These antibodies are specifically designed to target allergens.
On the other hand, IL-5 activates eosinophils, which is a general type of white blood cell in the immune system. They invade tissues where the allergens are present and release other chemicals that affect your nasal passage, causing irritation. This damages the blood vessels in your nose, causing irritation and swelling.
