How to manage SNOT and the 12 Seasons of Texas!

By: Susan Attel, APRN, MSN, FNP-BC

Have you seen the meme circulating with Texas’s 12 seasons? Apparently, we’re somewhere between the Third Winter and “The Pollening”! While we may LOL at the craziness of our weather patterns, for many this is truly a difficult time, anticipating weeks to months of sniffling, sneezing and chapped noses.

And, did you know some airborne allergens can mimic food allergies? I remember my son telling me his throat was starting to tickle and feel scratchy when my daughter was eating trail mix with nuts. I immediately thought he had a life-threatening airborne nut allergy (because what kind of parent would I be if I didn’t completely overreact at times?), but an allergist found no food allergies at all.  She did however discover a birch tree allergy.  I later read that up to 90% of those w/ birch pollen allergy cross react with certain foods like apple, stone fruits, celery, carrot, and yes, nuts. (1) Who knew??  Birch trees are among many spring pollinating trees in North Texas.

Luckily, a functional medicine approach can support even the most pollen-allergic person!


With a whole systems, functional approach, we see improvement when we address the gut.  Several studies, including a recent review article support the idea that changes in our microbiome and the intestinal barrier, AKA “leaky gut,” contribute to more allergic disease (2,3).  And it begins early: decreases in diversity in a baby’s intestines can increase risk for allergies in school age children (4).  If you are a new mom, breast feed if possible, and if not possible consider using formula containing prebiotics (5).

As an adult, the same recommendations for your gut apply to nasal allergies as well. Avoid inflammatory foods like gluten and dairy (6-7), eat lots of fresh, organic fruits and vegetables (8), and include fermented foods to help feed the “good” bacteria in your gut (9).  Also avoid antibiotics whenever possible (10).


One trick that works in my family is to have a Rainbow Food challenge! Whoever eats the most foods from the phytonutrient-rich rainbow (our brightly colored fruits & vegetables), or is the 1st to eat at least 1 food from each color of the rainbow, wins!  I have experienced that people will come in for treatment of their chronic stomach/ bowel issues, hormone imbalances, or even pain, and when they address their leaky gut all of a sudden they realize their allergy symptoms are better too.  Win-win! So many people just chalk up Spring to be an inevitable, uncomfortable, snotty mess.  But it doesn’t have to be that way!


In addition to taking care of your gut, what else can be done when those allergies start to flare? For one, sinus rinsing.  In case you haven’t heard, we are big fans of sinus rinsing.  It has been shown to reduce nasal histamine levels as well as a type of leukotriene (C4), which are both inflammatory components that can lead to big sniffling, sneezing fits (11).  So overcome your fear of drowning (it really isn’t that bad) and give your nose a shower!


At the risk of oversharing my family hacks, when the kids were little they would see who had the longest string of mucus after their sinus rinse – yes, we went there.  May sound bizarre, but it is a great idea for kids who love to compete with their sibling in just about anything! And also a great way to make a family activity out of something you may otherwise encounter a lot of resistance to do. There are even online videos of children sinus rinsing if they need some motivation.


Another important key is good air quality (12). We recommend high quality “ultraHEPA” air purifiers, like AirDoctor. Not only do they filter pollen, but the higher quality purifiers will filter viruses, bacteria, dust mites, and mold as well, thus removing the most common triggers of nasal allergies.


Acupuncture has a good body of research to support its use with allergic rhinitis as well (13,14). Acupuncture as treatment for allergic rhinitis has even been endorsed as a clinical practice guideline by the American Academy of Otolaryngology (15). We are so fortunate to have Amy Adams, licensed acupuncturist, as a member of our collaborative team at Carpathia.  In addition, she can guide you with specific Chinese herbs that might be helpful, such as Xin Yi San (XYS).


There are several nutrients that are helpful to reducing histamine and other inflammatory components that lead to the allergic response. Other nutrients serve to thin nasal mucus.  Vitamin C, bromelain, N-Acetyl cysteine (NAC), Butterbur, Quercetin, and stinging nettle have all been shown to help reduce allergy symptoms (16-24).

Following the adage “Food is Medicine” we strongly recommend “eating the rainbow” for your Vitamin C, especially citrus fruits, brightly colored peppers, and cruciferous vegetables.  Bromelain is the enzyme in pineapple, although you’d need to eat more than a healthy serving for a therapeutic dose. NAC and Butterbur are more widely available as supplements.  However, butterbur contains a plant compound called kaempferol, which is also found in foods like broccoli, Brussels sprouts, spinach, apples and green tea. It isn’t well known what role kaempferol plays in the anti-allergy action of butterbur but it is speculated to be helpful.

Quercetin inhibits several inflammatory compounds, including blocking histamine release from our white blood cells (17).  Vegetables such as onions, the most studied quercetin containing food, and broccoli; fruits (apples, berries, and grapes); some herbs and tea contain Quercetin. Stinging nettle leaves can be transformed in teas, soups, and other sweet and savory dishes.


If we needed another reason to be sure our vitamin D levels are optimal, a recent study showed Vitamin D levels over 75 were associated with less allergic rhinitis than levels below 50 (25).  And lastly, medicinal mushrooms, which have mostly been studied for their anti-tumor properties, have recently been shown to reduce allergy symptoms too (26).  The three studied include Agaricus blazei Murill, Grifola frondose (“hen of the woods”), and Hericium erinaceus (“lion’s mane”). Research participants took a blended mushroom extract by mouth for 2 months before the pollen season; they reported less general allergy symptoms and used less allergy medication. The mushroom blend reduced several components that trigger the allergic response including IgE and mast cells.  There is a great coffee that contains Lion’s mane mushrooms too!


Several combination supplement products are available that provide multiple layers of support during allergy season.  When you are in a flare, or even just see that the pollen counts are high, you can take these up to three times a day.  And of course reach out if you need additional support; we are available to help you reset and even provide prescription relief when needed.  You are always welcome to see me at Carpathia to cocreate a personalized plan during what can be a challenging time for those of us who are allergy sufferers.  As a girl who was once nicknamed a “walking snot factory” (aren’t kids the best?), I get it!



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