About 50 million Americans, or one in five Americans, have allergies. Not only do allergies affect many people, but their impact is significant as they are the sixth leading cause of chronic illness. Women are often more affected by allergies, which may indicate a hormonal origin.

This article will discuss allergies, typical signs and symptoms, and the link between allergies and female hormones. A Functional Medicine approach utilizes labs to help evaluate this connection and formulate a holistic plan for reducing symptoms and regaining health.

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What Are Allergies?

Allergies occur when our bodies come in contact with a harmless foreign object called an allergen. Our bodies mistake this allergen as a threat and thus create an immune response, often exaggerated, to fight it.

There are many types of allergies, including but not limited to the following:

• Food allergies: eggs, milk, peanuts, tree nuts, fish, shellfish, wheat, and soy are the most common
• Skin allergies: resulting in eczema or hives
• Insect sting allergies: from bees, yellow jackets, hornets
• Pet allergies: such as from cats or dogs
• Drug allergies: common drug allergies include penicillin, sulfa antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin and ibuprofen, anticonvulsants, and chemotherapeutics
• Dust allergies
• Cockroach allergies: people can react to cockroach saliva, feces, and body parts, as they commonly shed
• Allergic rhinitis, or hay fever: symptoms can be seasonal or last all year. In seasonal cases, airborne offenders, including mold spores, grass, weeds, and pollens, are the cause. Year-long causes are pet hair or dander, mold, and dust mites.
• Pollen: pollen is a yellowish powder essential for the pollination of plants. Birds and insects can carry it, and because of this, pollen is commonly found in the air.
• Latex: latex is a type of rubber derived from tree sap. It's commonly used in many medical and dental supplies.
• Mold
• Ragweed
• Seasonal allergies: occur in response to the seasonal blooming of certain plants

There seems to be a genetic component to allergies, although the actual allergy may differ.

Allergy symptoms can vary from person to person but typically include a runny and itchy nose, nasal congestion, shortness of breath and wheezing, coughing, headache, fatigue, rashes, fever, nausea, and vomiting.

How Do Hormones Affect Allergies?

When your immune system notices an allergen in the body, it calls on a type of cell called a mast cell to become active. Mast cells, located in the mouth, gut, nose, skin, lungs, and blood, release a substance called histamine. Histamines cause the release of other immune cells and inflammatory molecules while activating receptors that cause localized inflammatory responses. This response leads to the above mentioned symptoms, such as sneezing and a runny nose.

Estrogen, a primarily female hormone but also made in males, influences the amount of circulating histamine. Mast cells have estrogen receptors on them, and when estrogen attaches to these receptors, it causes the release of histamine. Histamine also affects estrogen, causing it to be released. This interdependent relationship can be a vicious cycle for some.

Additionally, the other primary female hormone, progesterone, also has receptors on mast cells and has been shown to inhibit histamine secretion.  

Because of this, we see an increase in allergic reactions during certain times in the menstrual cycle when estrogen is higher or unopposed. It's also important to note that xenoestrogens, or synthetic chemicals known as endocrine disruptors found in pesticides, plastics, and more, elicit the same response.

Functional Medicine Labs to Test for Root Cause of Allergies Due to Hormonal Imbalances

Specialty lab tests enable practitioners to find the root cause of illness. This allows for more targeted and effective treatment plans that address the underlying issues rather than just managing the symptoms. Some of the most common labs ran for this diagnosis are:

DUTCH Complete

The DUTCH Complete test, by Precision Analytical, is a urine test assessing hormone metabolites. Looking at metabolites allows us to see how hormones are being broken down in the body, which can be important when evaluating imbalances. The DUTCH Complete shows the first two phases of estrogen metabolism.

GI Map

The GI-MAP checks a marker in the stool called beta-glucuronidase, which is involved in the third step of estrogen metabolism. In the microbiome of the large intestine, a collective group of microbes referred to as the "estrobolome" package up estrogen metabolites formed in earlier steps of metabolism. The estrobolome can release beta-glucuronidase, causing estrogen to go back into the bloodstream.

Other Lab Test to Check

The following labs can also help to assess allergens and get to the root cause of various types of allergies:

• Histamine levels: This test assesses the total amount of histamine in the blood.
• IgE testing: This test gives the total amount of IgE antibodies present in the blood sample.
• Environmental IgE testing: This test evaluates 88 environmental allergies.
• Food allergy IgE testing: This test evaluates 93 common food allergies and the response to a person's IgE antibody.
• Vitamin D: Vitamin D can affect mast cell sensitivity and histamine production.
• Comprehensive Gut Testing: Comprehensive gut testing, such as GI 360 by Doctors Data, can be useful as histamine receptors are located in the gut, and the functioning of the gut can affect histamine release.
• Genetic testing: Genetic SNPs, or single nucleotide polymorphisms, are changes in the genes that cause enzymes to run differently. Two enzymes, DAO and HNMT, have the ability to degrade histamine. The 3x4 Genetic Test + Blueprint Report evaluates these two genes and shows if they are altered, increasing or decreasing their efficacy.

Functional Medicine Treatment for Allergies Due to Hormonal Imbalance

Based on a detailed intake and lab results, practitioners can personalize treatment for each patient. Below is a typical approach to treatment for allergies due to hormonal imbalances.

Nutrition

While working on the root cause of allergies is important, short-term reduction of high histamine foods, such as fermented foods, processed meats, aged cheeses, legumes, and citrus fruits, may help. Increasing or focusing on low histamine foods such as fresh meats, vegetables and fruits (no citrus), and whole grain products may also be helpful.  

Cruciferous vegetables such as broccoli, kale, and cauliflower can aid in healthy estrogen detoxification. Cruciferous vegetables contain compounds that are helpful for multiple stages of estrogen detoxification.

Reduce exposure to xenoestrogens. Since xenoestrogens act like estrogen, they play a significant role in allergy symptoms. So, limiting xenoestrogen exposure can be helpful. Parabens, pesticides, and bisphenol A (BPA) are a few examples of xenoestrogens.

Estrogen Detoxification

Since estrogen can cause both the increased production of and reduced breakdown of histamine, making sure our estrogen levels are not elevated can be important to allergy sufferers. There are three main steps in estrogen detoxification, and many different vitamins, minerals, and phytonutrients can influence each step. DIM (3,3’-diinolylmethane), magnesium, glutathione, and calcium-d-glucarate are just a few examples that can aid in estrogen detoxification. You can read more on Estrogen Detoxification here.

Summary

Allergies can be bothersome for many sufferers, as they can have systemic effects. Many do not realize there is a connection between hormone levels and allergies, specifically in relation to histamine. Tracking menstrual cycles with allergy symptoms may help determine if allergies are rooted in hormonal origins. Functional medicine testing can help determine the root cause of hormonal imbalances, allowing for proper treatment.