Diet to support Hayfever, OAS and Sinus
by Sue Kira, Naturopath & Clinical Nutritionist
– What is sinus/sinusitis?
– Symptoms of sinus/sinusitis
– What causes sinusitis?
– What is hayfever?
– Causes of hayfever
Is there a link between food and airborne allergies?
– Testing for reactions to pollens and foods
– Healing from hayfever, sinusitis and OAS
Case Study: Treating the cause, rather than suppress the symptoms
About Respiratory Allergies
In this article I hope to clarify some of the confusion around respiratory allergies and their causes and treatments. Some people get what is called sinusitis or ‘sinus’, others call their symptoms hay-fever, or allergic rhinitis. Other manifestations of respiratory allergies may be asthma. For more information about asthma go to the Diet for Respiratory Conditions.
However, the focus of this article is on hayfever, sinus and oral allergy syndrome (OAS).
What is sinus/sinusitis?
The sinus cavities are the air-filled spaces inside your cheekbones, the low central area of your forehead, and the bones behind your nose. Sinusitis occurs where there is an infection or inflammation in these cavities.
When you have an infection in the sinuses, apart from air in the cavities you also have bacteria and mucus, which leads to congestion and inflammation and the subsequent feeling of pain and pressure. Commonly there is discharge of yellow or green mucus from the nose and or throat. There can be associated headache and sometimes a fever if the infection gets out of control.
This relates to acute sudden onset or short term sinusitis, but sometimes you can get more chronic long term forms of sinusitis which can also be caused by an infection. However you can also get chronic sinus from growths in the sinuses called nasal polyps, commonly triggered by respiratory allergies. A deviated septum can also cause sinus issues.
Symptoms of sinusitis/sinus
The most common symptoms of sinus disorders are nasal congestion that makes it hard to breathe through your nose along with pain, swelling and stuffy feelings around your eyes, ears, cheeks, nose or forehead. This pain can also extend to your neck and the rest of the head, especially if the lymph nodes in your neck are also inflamed and congested.
What causes sinusitis?
Sinusitis is commonly caused by a virus or bacteria, and very rarely from a fungal infection. Tooth infections can also trigger sinus pain and associated symptoms.
Another reason for sinus pain and congestion is because you may actually be suffering from migraines, instead of true sinusitis. A migraine doesn’t include symptoms such as mucus changes (green or yellow) or fever from infection, but all of the other symptoms can be present.
What is hayfever?
Hayfever (also known as allergic rhinitis) can have many of the symptoms of sinusitis, but also extra symptoms such as runny and/or itchy nose, itchy eyes, itchy ears, itchy throat, sneezing, wheezing, shortness of breath, and swelling anywhere on the face or throat. Your mouth, tongue, throat or lips may also be swollen, red, blistered, or sore and itchy. Hayfever can involve the lungs and even trigger asthma in some people.
Causes of hayfever/allergic rhinitis
Generally allergic rhinitis is an allergic response to airborne (breathed in) or contact allergens (brushed against your skin or put into your mouth). These include:
- pollens
- plants (grass, native plants etc)
- certain raw fruits and vegetables
- dust
- dust mites
- animal hair or dander (dead skin cells)
- cockroach or other insect poo
- reactions to having contact with, or smelling, various chemicals
Is there a link between food and airborne allergies?
The answer is yes!
In some situations, if you are allergic to pollens, then you may react to similar proteins found in certain foods.
Why? Because the proteins that are reactive molecules in certain plants and grasses are very similar to proteins commonly found in some raw fruits and vegetables. Then you can get ‘cross-reactivity’ where your immune system thinks it is the same protein that it reacted to with pollens.
For instance, about 60% of people who are allergic to birch tree pollen also react to celery and apples, which contain similar types of protein molecules. The immune system can become confused with these proteins and react to them in just the same way as to the airborne allergies.
Because these foods are eaten, rather than inhaled like pollens, usually the reaction affects the mouth and lips rather than the respiratory passages, but it can also exacerbate existing respiratory symptoms. Generally, raw foods create these reactions, so cooking apples or celery can somewhat change the protein molecules which may prevent a reaction from occurring. Some very sensitive people can also react to the cooked versions of these foods.
Oral allergy syndrome (OAS)
The medical recognition of the connection of reactive foods in hayfever sufferers is only recent, yet the condition is more common than realised. Research has been revealing the foods that relate to various allergens.
This condition has been given a clinical name called ‘Oral Allergy Syndrome’ (OAS) or ‘Pollen Fruit Syndrome’ (PFS). A ‘syndrome’ has more than one thing going on. In this case there is hay-fever (occasional or long term) plus any of the following: asthma; rhinitis; swelling or blistering ulcers of the mouth, throat, face or tongue; cracking or bleeding lips; and sometimes digestive reactions as the food passes through the digestive tract. Other reactions include the skin on your hands peeling, caused by removing the skin from fruits or vegetables such as mangos or potatoes.
Some also get headaches, migraines or diarrhoea and other digestive upsets. This is more of a ‘contact’ type allergic reaction and usually the reaction is very soon after eating a food, but can occur up to an hour later.
Commonly the reaction only lasts a few minutes to a few hours, but for some, it can last up to three days while the reactive food passes through and out of the digestive system. If one or more of these foods are eaten daily then the symptoms can be constant and on-going. The reaction can also amplify as time goes on because of the constant assault on the immune system, which in rare cases can lead to cardiovascular symptoms or anaphylaxis.
Different reactions to foods depending on the airborne allergy
While a list of foods may have similar proteins which ‘cross-react’ with certain allergens, it is possible to react to only one type of food, or even different types of the one food. For example, one type of apple may cause a problem but other types can be eaten with no reaction. Look out for any itching, tingling, lip swelling or blistering after any foods that you eat.
Testing for reactions to pollens and foods
Skin prick testing and blood testing is available for substances that commonly trigger allergic rhinitis such as various pollens and pets. But cross reactive foods will rarely appear in an allergy test.
An immunologist or health practitioner can organise a pollen test for you and the results will show which specific pollens you are allergic to. When you get the results, there may be a report which lists foods that are cross reactive to the specific pollens you are allergic to.
Alternatively, you can search online for the foods that may have the potential to cross react and create symptoms ( and see the list below). For example, you may be reactive to ragweed pollen which has similar protein structures to bananas. While you may not be allergic to bananas if tested, you may still get a cross reaction.
You can also observe if you get reactions from eating specific foods. Try them raw and cooked. If your symptoms are severe then it’s best to get tested and avoid foods that might cross react.
List of common pollens and some potential cross-reactive foods:
Alder Pollen
cherry, peach, apple, pear, almond, hazelnut, parsley, celery
Birch Pollen
almonds, apples, apricots, buckwheat, carrots, celery, cherries, coriander seeds, fennel seeds, hazelnuts, honey, kiwi fruits, nectarines, parsley seeds, parsnips, peaches, pears, plums, potatoes, prunes
Grass Pollen
celery, fennel, kiwi fruit, melon, oranges, peanut, Swiss chard, tomato, watermelon, wheat
Mugwort Pollen
spices, celery, carrot, peppers, coriander, parsley, fennel, melon, watermelon, sunflower seeds
Ragweed Pollen
apple, banana, chamomile tea, gourds, honey, honeydew, nuts, sunflower seeds, watermelon
Healing from hayfever, sinusitis and OAS
It is important that you seek professional help as there can be a variety of contributing factors to these reactions. In clinic I found that many people with sinus, hay-fever and allergy symptoms in general, do well by adopting a leaky gut healing protocol diet.
The reason for this is because 80% of the immune system is in the gut, so by supporting gut healing you also support the immune system. Secondary to gut healing but equally important to do concurrently, is to remove foods from the diet that have the potential to cross react. This then gives the immune and digestive systems a rest and a better opportunity to be less reactive.
Quite often, having a break from eating certain foods allows those foods to be eaten again later in small amounts, especially when it isn’t hay-fever season.
Supportive testing of deficiencies followed by nutrient therapy, may include the use of immune and gut supportive vitamins and minerals such as zinc and vitamin C. More information can be found in the Diet for Immune Support article.
Foods to avoid
If you have hay fever, sinusitis or oral allergy syndrome, the following foods are best avoided to give your immune system a break.
Note: For most of these food groups raw foods are best avoided, while cooked foods are normally better tolerated.
Fruits to avoid:
- Apples
- Acerola cherries
- Apricots
- Cherries
- Figs
- Kiwi fruit
- Lychee
- Mango
- Nectarine
- Passionfruit
- Pear
- Plum
- Peach
- Prune
- Persimmon
- Pomegranate
- Pineapple
- Strawberries
- Dates
- Melons
- Oranges
- Bananas
Vegetables to avoid:
- Beans
- Carrots
- Celery
- Broccoli
- Capsicum (bell peppers)
- Potatoes
- Tomatoes
- Parsnips
- Peas
- Cucumber
- Zucchini
- Onion
- Chard (spinach)
- Cauliflower
- Cabbage
Nuts to avoid:
- Almonds
- Hazelnuts
- Walnuts
- Peanuts
- Coconut
Other foods to avoid:
- Lentils
- Soybeans
- Sunflower seeds
- Chamomile (herb tea)
Herbs & Spices to avoid:
- Anise
- Basil
- Dill
- Caraway seeds
- Chicory root or leaves
- Coriander seeds and leaves
- Cumin seeds
- Fennel
- Marjoram
- Parsley
- Paprika
- Pepper
- Tarragon
- Thyme
- Garlic
Other foods that can create reactivity and congestion (both raw and cooked) to avoid:
- Foods and grains that contain gluten
- Foods and drinks that contain dairy
- Artificial additives, food colours and preservatives
What is left to eat?
After reading this you might think, ‘What’s left to eat if I follow this diet plan?’
First, a reminder that most of these foods are fine to eat if cooked. Also most of them, whether cooked or raw, may be ok to eat outside of your allergic reactive ‘season’ but it is most important to be guided by your symptoms and the support of your health practitioner.
There are also many foods that you may not be reactive to if you don’t have an allergy to all the pollens and substances that have cross reactive species. The above food lists are a compilation of the reactive foods to many of the different pollen types.
However, because there is variability and some people may react mildly and others more severely to certain foods, it is best to have a rest from all of them to allow your immune system to settle down. This may only be for three weeks in many cases, but check what is best with your health care practitioner. Then re-introduce each food one at a time, and see if you get any reactions.
This is best done away from your hay fever season. Out of season you might find that all the foods are fine, raw or cooked. But you may still react to some of the listed foods for other reasons, so go carefully, monitor any symptoms, and check with your health practitioner before starting a new diet.
Specific foods generally fine to eat
The following foods are generally fine to eat if you suffer from hay fever, sinusitis or oral allergy syndrome, but don’t consume them if you have had an issue with them in the past or have been recommended not to eat.
Fruits: (can be raw or cooked, but if in doubt, have cooked only)
- Raspberries
- Blueberries
Vegetables: (best cooked, except the salad vegetables)
- Brussels sprouts
- Sprouted seeds
- Sweet potato
- Pumpkin (winter squash)
- Acorn squash (summer squash)
- Snow peas
- Swede
- Turnip
- Eggplant
- Lettuce species
- Greens of spring onions/chives
- Beetroot/beets
- Rocket
- Watercress
Nuts & Seeds: (raw, soaked or cooked)
- Macadamia
- Pecan
- Pine
- Pepitas
- Cashews
Legumes: (sprouted and cooked)
- Chickpeas
- Kidney beans
- Other legume beans/peas but not lentils or soybeans (incl tofu/tempeh)
Condiments/seasonings:
- Salt
- Rosemary
- Ginger
- Turmeric
- Cinnamon
- Nutmeg
- Plain mayonnaise
- Fats (all types)
- Cacao powder or nibs
Other foods:
- Beef
- Lamb
- Chicken
- Turkey
- Fish and seafood
While a diet to support Hayfever, OAS and Sinus is not considered a cure for these conditions, the idea is to eliminate foods considered detrimental and include foods that support your body to do its natural job of healing. For this reason it’s recommended that the diet is free of gluten, dairy and additives.
As mentioned, the foods to avoid are usually fine if cooked, so these foods are included in this diet in their cooked form, but don’t eat them cooked if your practitioner says to avoid them. The only raw foods are those from the foods considered to be acceptable, which are mostly salad greens, some legumes and sprouted nuts and seeds.
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Case Study: Treating the cause, rather than suppress the symptoms
Client name and identifying information changed
Suzy first started getting allergy problems as a child. Insect bites seemed to be the main culprit when she was young, but allergy tests revealed she was also allergic to dust, dust mites, most animal furs, dander and many pollens. But Suzy could not remember having hayfever when young.
The allergist prescribed ‘desensitisation drops’ taken orally for Suzy over a few months. After the course finished she then only had the normal response to insect bites and no other apparent symptoms.
But later in life Suzy developed a bad case of hayfever which could only be controlled with cortisone nasal sprays. At the time Suzy had children, was in a stressful relationship, and worked on a permaculture farm where she was exposed to substances like mushroom compost, hay bales, many weeds and their seeds.
Suzy saw a naturopath who helped to sort out much of her ‘leaky gut’ issues and correct her zinc deficiency. Her relationship also ended. All appeared to be under control for many years, provided she used the nasal drops during summer.
Many years later, Suzy developed ‘oral allergy syndrome’ (OAS) where she had blistered lips in reaction to chilli, paprika, tomatoes and capsicums. Symptoms from the raw varieties were worse, but even when cooked, these foods caused minor inflammation of the lips.
It was at this point that Suzy decided she needed help again and came to see me.
After discussing her history, Suzy and I both felt it was possible that her allergies progressed this way due to the on-going suppressive effects of the desensitisation program she had as a child, and/or the allergy nasal drops which she continued to use each summer, because her itchy eyes, runny nose and sneezing kept re-occurring year after year.
I realised it was time for her to stop suppressing symptoms and start dealing with the underlying causes.
For Suzy this meant adjusting her diet by eliminating all inflammatory types of foods she was eating, such as chocolate, ice-cream and other sugar laden foods, as well as going off gluten, dairy and caffeine.
Normally I recommend no alcohol, but she had already stopped a few years previously. We also cut out the ‘red foods’ that triggered her oral allergy symptom.
Other OAS foods were also removed for six weeks to allow her immune system to recover. Gut support and leaky gut healing was administered, plus supplementing with extra zinc on top of a zinc rich diet. Probiotics were also integral for her program.
The diet alone removed the symptoms within a couple of weeks, but the gut healing and immune support from zinc and probiotics was administered until tests showed rectification.
The following summer was the first for many years that Suzy didn’t need any nasal drops. Time will tell how she progresses, as factors such as diet and stress can fluctuate in a person’s life, depending on their choices and circumstances.