Why antihistamines aren’t the answer and how to relieve allergies naturally
Understanding the underlying drivers of seasonal allergies is essential to developing a more effective and sustainable management strategy. While conventional medicine focuses on symptomatic relief through antihistamines, corticosteroids, and decongestants, these interventions often provide only temporary respite and may even contribute to long-term dependency or side effects such as drowsiness, dry mouth, or impaired cognitive function. In contrast, a naturopathic approach seeks to identify and address the root causes of allergic responses by supporting immune modulation, enhancing detoxification pathways, restoring gastrointestinal integrity, and reducing allergenic load through environmental and lifestyle modifications.
The role of the immune system and histamine dysregulation
Allergic reactions are the result of an exaggerated immune response to typically harmless environmental antigens, such as pollen, dust mites, or mould spores. 1 In sensitised individuals, exposure to these antigens triggers the activation of mast cells and basophils, which release histamine and other inflammatory mediators. This cascade leads to the hallmark symptoms of allergic rhinitis and conjunctivitis. However, the overproduction or poor clearance of histamine is often a symptom of a deeper immune dysregulation, not simply an isolated event. 1
Histamine itself is a biogenic amine that plays various roles in the body beyond allergic responses. It is involved in gastric acid secretion, neurotransmission, and regulation of circadian rhythms. 2 The body’s ability to break down histamine is dependent on enzymes such as diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT). When these enzymes are inhibited, due to genetic factors, chronic stress, gastrointestinal inflammation, nutrient deficiencies (such as B6, copper, or vitamin C), or exposure to histamine-rich foods, histamine accumulates in the body and can provoke or worsen allergy symptoms. 2 Therefore, enhancing histamine degradation and modulating immune function at the root is critical.
Adverse effects of long-term antihistamine use
Antihistamines are often the first response to seasonal allergies. They provide relief from allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and urticaria. Antihistamines antagonise H1 receptors to reduce the large quantity of fluid moving from capillaries into surrounding tissues secondary to histamine release. There are two classes of antihistamines, first-generation and second-generation. First-generation antihistamines such as Promethazine and Diphenhydramine cross the blood-brain barrier (BBB) into the central nervous system (CNS), often producing sedative effects and cognitive impairment. Second-generation antihistamines such as Loratadine and Fexofenadine do not cross the BBB and are not associated with sedation. 3
Due to their effects on the CNS, first-generation antihistamines pose the greatest long-term risks. Clinical studies have reported long-term use is significantly associated with increased risk of falls and fracture amongst the elderly population. 4 Emerging research suggests chronic overuse of first-generation antihistamines is associated with an elevated risk of developing dementia. 5 As clinicians, it is important to consider these risks for your clients who depend on antihistamines to get them through allergy season. Natural alternatives to antihistamines work to remedy this risk, while functioning to address the root cause of allergic symptoms.
Gut health: The allergy–microbiome connection
A well-functioning digestive system is foundational to managing allergic responses. The gut-associated lymphoid tissue (GALT) comprises nearly 70% of the immune system and plays a pivotal role in distinguishing between harmful pathogens and benign antigens. 6 Dysbiosis is strongly correlated with increased intestinal permeability and immune hyperreactivity. 7
Intestinal permeability allows partially digested food particles, toxins and microbial fragments to translocate into the bloodstream, triggering systemic inflammation and sensitisation. 4
A naturopathic approach prioritises gut healing through dietary modifications of eliminating inflammatory foods such as refined sugar and alcohol, targeted probiotic therapy and the inclusion of gut-repairing nutrients like L-glutamine, zinc carnosine, Slippery elm, and Aloe vera. 1,7 Beneficial bacteria such as Lactobacillus rhamnosus, Bifidobacterium longum and Saccharomyces boulardii have been shown to reduce allergic responses by promoting regulatory T-cell activity, modulating cytokine profiles and enhancing mucosal barrier function. 7
The liver and detoxification pathways
The liver plays a central role in detoxifying histamine and other inflammatory metabolites through phase I and phase II enzymatic processes. 1 When these pathways are impaired, due to overexposure to environmental toxins, poor diet, alcohol use, or genetic polymorphisms in detoxification enzymes, histamine can accumulate in tissues and perpetuate allergic inflammation. 1. Supporting hepatic detoxification is a critical element of any holistic allergy management protocol. This may involve the inclusion of hepatoprotective and detox-enhancing botanicals such as Milk Thistle (Silybum marianum), Dandelion Root (Taraxacum officinale), Schisandra (Schisandra chinensis), and Globe Artichoke (Cynara scolymus). 1,8 Additionally, nutrients like N-acetylcysteine (NAC), alpha-lipoic acid (ALA), quercetin, magnesium and B-complex vitamins are essential cofactors in liver detox pathways. 8
Nutritional considerations for allergy relief
A nutrient-dense, anti-inflammatory diet is vital for modulating immune responses and minimising allergy symptoms. Foods rich in quercetin, a natural bioflavonoid found in onions, apples, and capers, have been shown to stabilise mast cells and reduce histamine release. 9 Similarly, omega-3 fatty acids found in flaxseeds, walnuts, and fatty fish such as salmon and sardines can downregulate inflammatory prostaglandins and cytokines. 10
Vitamin C is a well-known antihistamine agent, as it both reduces histamine levels and enhances DAO activity. Other essential nutrients include vitamin D, which plays a regulatory role in immune function and magnesium, which helps relax bronchial smooth muscle and stabilise mast cells. 1
Fermented foods like sauerkraut, kefir, miso, and kimchi support a healthy microbiome and provide naturally occurring enzymes that assist in histamine breakdown, though some individuals with histamine intolerance may initially need to limit high-histamine foods. 1
Herbal support
Herbal medicine provides allergy support through offering anti-inflammatory, immune-modulating and mucosal-healing properties. Nettle (Urtica dioica) is an antihistamine herb that reduces inflammation and histamine activity.1 Eyebright (Euphrasia officinalis) is traditionally used for allergic conjunctivitis and can be applied topically. 11 Reishi mushroom (Ganoderma lucidum), an adaptogenic and immunomodulatory fungus, helps balance an overactive immune system while supporting adrenal function, especially useful for those under chronic stress. 12 Herbs such as Astragalus (Astragalus membranaceus), Echinacea (Echinacea purpurea or Echinacea angustifolia), and Baical Skullcap (Scutellaria baicalensis) can further support immune modulation and reduce allergic reactivity. 12,13 Botanicals like Liquorice root (Glycyrrhiza glabra), Marshmallow root (Althaea officinalis), Slippery elm (Ulmus rubra), Chamomile (Matricaria chamomilla), and Turmeric (Curcuma longa) support gut healing, reduce mucosal inflammation and help regulate the gut-immune axis. 1
Lifestyle and environmental considerations
Reducing exposure to environmental allergens is a cornerstone of managing seasonal allergies. While complete avoidance may be impractical, there are several strategies that can significantly decrease allergen burden. Keeping windows closed during high pollen days, using HEPA filters in the home and vehicle and changing clothes and showering after outdoor exposure can help reduce indoor allergen levels. 14
Nasal irrigation with saline solution or a neti pot can flush out pollen and irritants from the nasal passages, decreasing the inflammatory response. Incorporating regular movement and spending time in nature outside of peak allergy seasons also supports immune resilience and overall well-being. 15
Nervous system regulation
Chronic stress triggers the release of cortisol and corticotropin-releasing hormone (CRH). These stress hormones stimulate mast cells to release histamine, aggravating allergy symptoms. Additionally, stress impairs histamine metabolism, worsens gut-mediated histamine issues and amplifies immune overreaction. Making stress management another critical, yet often overlooked, component in relieving allergies and histamine intolerance. 1,16 Mind-body practices such as yoga, meditation, breathwork and forest bathing have all been shown to reduce stress markers and improve immune balance.
Identifying underlying hypersensitivities
In some cases, seasonal allergies are compounded by hidden food sensitivities or chronic low-grade infections such as Candida overgrowth, Epstein-Barr virus reactivation, or intestinal parasites. 1 Functional testing, such as comprehensive stool analysis, or organic acids testing, may help uncover these hidden contributors.
Conclusion
Seasonal allergies are more than just a nuisance, they represent a signal of underlying imbalances within the immune system, gut and detoxification pathways. While antihistamines may offer quick symptom relief, they do not address the root causes and may lead to long-term suppression without resolution. A naturopathic approach recognises the complexity of allergic disorders and seeks to restore health through a comprehensive and personalised strategy. By focusing on gut healing, supporting liver detoxification, optimising nutrient status, leveraging the power of medicinal herbs and reducing allergen exposure, individuals can achieve lasting relief and greater resilience during allergy season. This holistic approach not only alleviates symptoms but also enhances vitality.
References
- Hechman L 2018 clinical naturopathy
- Shulpekova, Y. O., Nechaev, V. M., Popova, I. R., Deeva, T. A., Kopylov, A. T., Malsagova, K. A., Kaysheva, A. L., & Ivashkin, V. T. (2021). Food Intolerance: The Role of Histamine. Nutrients, 13(9), 3207. https://doi.org/10.3390/nu13093207
- Farzam, K., O’Rourke, M. C., & Sabir, S. (2023, July 10). Antihistamines. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538188/
- Cho, H., Myung, J., Suh, H. S., & Kang, H.-Y. . (2018). Antihistamine use and the risk of injurious falls or fracture in elderly patients: a systematic review and meta-analysis. Osteoporosis International, 29(10), 2163–2170. https://doi.org/10.1007/s00198-018-4564-z
- Su, C.-H., Huang, K.-H., Yang, Y., Gau, S.-Y., Chung, N.-J., Wu, P.-T., Tsai, T.-H., & Lee, C.-Y. (2024). Cumulative dose effects of H1 antihistamine use on the risk of dementia in patients with allergic rhinitis. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaip.2024.05.027
- Vighi, G., Marcucci, F., Sensi, L., Di Cara, G., & Frati, F. (2008). Allergy and the gastrointestinal system. Clinical and experimental immunology, 153 Suppl 1(Suppl 1), 3–6. https://doi.org/10.1111/j.1365-2249.2008.03713.x
- Shen, Y., Fan, N., Ma, S. X., Cheng, X., Yang, X., & Wang, G. (2025). Gut Microbiota Dysbiosis: Pathogenesis, Diseases, Prevention, and Therapy. MedComm, 6(5), e70168. https://doi.org/10.1002/mco2.70168
- Hodges, R. E., & Minich, D. M. (2015). Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application. Journal of nutrition and metabolism, 2015, 760689. https://doi.org/10.1155/2015/760689
- Ghababaei, F., & Hadidi, M. (2023). Recent Advances in Potential Health Benefits of Quercetin. Pharmaceuticals (Basel, Switzerland), 16(7), 1020. https://doi.org/10.3390/ph16071020
- Zivkovic, A. M., Telis, N., German, J. B., & Hammock, B. D. (2011). Dietary omega-3 fatty acids aid in the modulation of inflammation and metabolic health. California agriculture, 65(3), 106–111. https://doi.org/10.3733/ca.v065n03p106
- Christopher Hobbs, Ph.D. (n.d.). Eyebright (Euphrasia officinalis). Herbal Therapeutics Database. Retrieved July 25, 2025, from https://christopherhobbs.com/herbal-therapeutics-database/herb/eyebright/
- Alanazi, H. H., Elasbali, A. M., Alanazi, M. K., & El Azab, E. F. (2023). Medicinal Herbs: Promising Immunomodulators for the Treatment of Infectious Diseases. Molecules (Basel, Switzerland), 28(24), 8045. https://doi.org/10.3390/molecules28248045
- Yin, B., Li, W., Qin, H., Yun, J., & Sun, X. (2021). The Use of Chinese Skullcap (Scutellaria baicalensis) and Its Extracts for Sustainable Animal Production. Animals : an open access journal from MDPI, 11(4), 1039. https://doi.org/10.3390/ani11041039
- Cipriani, F., Calamelli, E., & Ricci, G. (2017). Allergen Avoidance in Allergic Asthma. Frontiers in pediatrics, 5, 103. https://doi.org/10.3389/fped.2017.00103
- Cleveland Clinic. (2022). Nasal irrigation. In Cleveland Clinic Health Essentials. Retrieved July 25, 2025, from https://my.clevelandclinic.org/health/treatments/24286-nasal-irrigation
- Theoharides, T. C. (2020). The impact of psychological stress on mast cells. Annals of Allergy, Asthma & Immunology: Official Publication of the American College of Allergy, Asthma, & Immunology, 125(4), 388–392. https://doi.org/10.1016/j.anai.2020.07.007