Brief Background

Allergies are the result of an overactive immune response to typically harmless environmental or dietary substances, such as pollens, pet dander, dust mites, foods, and more. In sensitized individuals, exposure to allergens triggers IgE production and a cascade of immune responses involving mast cells, histamine release, and inflammatory mediators. The outcome? A spectrum of symptoms ranging from sneezing and congestion to hives, eczema, and even anaphylaxis.

While acute symptom management is essential, functional medicine takes a deeper view,  targeting immune modulation, barrier integrity, inflammation resolution, and nutrient sufficiency to reduce allergenic load and improve resilience.

Key Functional Considerations for Treatment

Rather than simply suppressing allergic responses, functional strategies aim to:

• Reduce immune system hyperreactivity
• Restore gut-immune barrier integrity
• Balance histamine levels and inflammatory mediators
• Address nutrient gaps and oxidative stress
• Support detoxification and mucosal defense

Blood chemistry patterns that may guide these strategies include:

• Histamine or eosinophil elevation
• Nutrient deficiencies (e.g., vitamins A, C, D, E, zinc, magnesium)
• Markers of inflammation or oxidative stress
• Iron or B-vitamin imbalances that may impair barrier and immune function

Evidence-Based Therapeutic Strategies

Nutrition

• Adopt an Anti-Inflammatory Diet: Emphasize vegetables, fruits, whole grains, legumes, wild-caught fish, nuts/seeds, and healthy fats (especially omega-3s and monounsaturated fats like olive oil).
• Eliminate Trigger Foods with Guidance: Ensure safe elimination without sacrificing nutritional adequacy. Engage professional support for complex elimination diets.
• Limit Pro-Inflammatory Foods: Reduce or eliminate processed foods, excess sugar, refined grains, fried foods, and high-omega-6 seed oils.
• Watch for Cross-Reactivity and Histamine Load: Be mindful of patients with multiple sensitivities, oral allergy syndrome, or histamine intolerance. Diet personalization is essential.

Supplementation

• Quercetin & Phytonutrients: Stabilize mast cells and reduce histamine release.
• Vitamins A, C, D, E: Support immune tolerance and mucosal defenses.
• Minerals: Zinc, magnesium, iron, and selenium modulate inflammatory responses.
• Probiotics: Certain strains (e.g., Lactobacillus rhamnosus, Bifidobacterium) regulate allergic inflammation.
• Omega-3s & MUFAs: Help resolve inflammation and support membrane health.
• Butterbur & Stinging Nettle: Reduce allergic rhinitis symptoms.
• Glutamine & Fiber: Support gut barrier integrity and SCFA production.

Lifestyle & Stress Management

• Prioritize Quality Sleep: Poor sleep quality worsens allergy symptoms and increases sensitization risk.
• Reduce Environmental Exposures: Address indoor air quality, minimize outdoor pollen exposure, and use natural products.
• Lower Toxic Load: Reduce alcohol, smoke, and chemical exposures that impair detoxification.
• Support Immune Development Early: In children and pregnant individuals, optimize maternal nutrition and minimize unnecessary antibiotic use.

Movement & Exercise

• Opt for Low-Allergen Activities: Swimming, water aerobics, indoor cycling, and strength training reduce exposure and support lung function.
• Use Moderate Intensity as a Therapeutic Tool: 30-minute sessions at 65–70% max heart rate may reduce rhinitis symptoms via improved anti-inflammatory activity.
• Include Resistance Training: Can improve allergic rhinitis symptoms and reduce inflammatory markers.
• Caution with Exercise-Induced Reactions: Screen for food-dependent exercise-induced anaphylaxis.

Monitoring & Follow-Up

• Retest vitamins A, D, C, and zinc periodically to ensure repletion.
• Use allergy symptom diaries to assess patient progress.
• Consider intestinal permeability or microbiome testing in GI-symptomatic patients.
• Modify protocols based on seasonal exposure or regional allergen trends.

Conclusion & Clinical Reminder

Allergy care goes beyond antihistamines and avoidance. By supporting the immune system, gut integrity, and systemic resilience, functional medicine practitioners can help patients experience meaningful, lasting relief.

With personalized nutrition, lifestyle modifications, targeted supplementation, and appropriate follow-up, you can address the root causes of allergic inflammation and restore immunologic balance.

Call to Action: Optimize Your Practice with Optimal DX

Take your allergy support strategies to the next level with Optimal DX.

As a member, you'll gain access to:

• The Protocol Builder that generates customized treatment plans using over 50 health concern templates, including allergy support
• Functional Health Reports that translate blood chemistry into actionable insights for immune and barrier function
• In-Depth Clinical Content, including therapeutic reference guides like this one, exclusively available in the Optimal DX Resource Center

Empower your practice with clinical precision. Join Optimal DX today and start building better treatment plans with confidence.

References

Adineh, Parisa, et al. “Nuts, Vegetables, Fruits, and Protein Dietary Pattern during Pregnancy Is Inversely Associated with Risk of Childhood Allergies: A Case-Control Study.” Scientific Reports, vol. 14, no. 1, 2024, p. 842. doi:10.1038/s41598-024-51488-8.

Allergens. National Institutes of Health: National Institute of Environmental Health Sciences. Accessed June 20, 2024. https://www.niehs.nih.gov/health/topics/agents/allergens.

Amanullah, Iram, et al. "Effect of Vitamin E in Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomised Controlled Trials." Postgraduate Medical Journal, vol. 95, no. 1129, 2019, pp. 601–611.

Bhusal, Khuma Kumari, et al. "Nutritional and Pharmacological Importance of Stinging Nettle (Urtica dioica L.): A Review." Heliyon, vol. 8, no. 6, 2022.

CDC Physical Activity Basics. https://www.cdc.gov/physical-activity-basics/guidelines/adults.html 

D'Auria, Enza, et al. “Personalized Nutrition in Food Allergy: Tips for Clinical Practice.” Frontiers in Pediatrics, vol. 8, 2020, p. 113. doi:10.3389/fped.2020.00113.

Engels, G., and J. Brinckman. “Stinging Nettle.” HerbalGram, no. 110, American Botanical Council, pp. 8–16. Accessed July 5, 2024. https://www.herbalgram.org/resources/herbalgram/issues/110/table-of-contents/hg110-herbpro-stingingnettle/.

Gaby, Alan R. Nutritional Medicine. Fritz Perlberg Publishing, 2017.

Ghalibaf, Mohammad Hossein Eshaghi, et al. "The Effects of Vitamin C on Respiratory, Allergic and Immunological Diseases: An Experimental and Clinical-Based Review." Inflammopharmacology, vol. 31, no. 2, 2023, pp. 653–672.

Groetch, Marion, and Carina Venter. “Nutritional Management of Food Allergies.” Journal of Food Allergy, vol. 2, no. 2, 2020, pp. 131–141. doi:10.2500/jfa.2020.2.200032.

Lee, Eric C. K., et al. “The Natural History and Risk Factors for the Development of Food Allergies in Children and Adults.” Current Allergy and Asthma Reports, vol. 24, no. 3, 2024, pp. 121–131. doi:10.1007/s11882-024-01131-3.

Liu, Jiaomei et al. “The association between allergic rhinitis and sleep: A systematic review and meta-analysis of observational studies.” PloS one vol. 15,2 e0228533. 13 Feb. 2020, doi:10.1371/journal.pone.0228533

Mlcek, Jiri, et al. “Quercetin and Its Anti-Allergic Immune Response.” Molecules (Basel, Switzerland), vol. 21, no. 5, 2016, p. 623. doi:10.3390/molecules21050623.

Minty, Bryanne. “Food-dependent exercise-induced anaphylaxis.” Canadian family physician Medecin de famille canadien vol. 63,1 (2017): 42-43. 

Morales, Eva, et al. “Combined Impact of Healthy Lifestyle Factors on Risk of Asthma, Rhinoconjunctivitis and Eczema in School Children: ISAAC Phase III.” Thorax, vol. 74, no. 6, 2019, pp. 531–538. doi:10.1136/thoraxjnl-2018-212668.

Overview: Allergies. National Institutes of Health. InformedHealth.org. Accessed June 20, 2024. https://www.ncbi.nlm.nih.gov/books/NBK447112/.

Pattanayak, Santanu et al. “Confronting allergies: strategies for combating pollution and safeguarding our health.” Frontiers in allergy vol. 5 1521072. 7 Jan. 2025, doi:10.3389/falgy.2024.1521072

Peltonen, Henna, et al. “Associations of Multiple Lifestyle Behaviors with Allergic Disease Symptoms and Sensitization in 9–11-Year-Old Finnish Children.” BMC Pediatrics, vol. 24, no. 1, 2024, p. 749. doi:10.1186/s12887-024-05218-8.

Prossegger, Johanna et al. “Winter Exercise Reduces Allergic Airway Inflammation: A Randomized Controlled Study.” International journal of environmental research and public health vol. 16,11 2040. 8 Jun. 2019, doi:10.3390/ijerph16112040

Roschek Jr, Bill, et al. "Nettle Extract (Urtica dioica) Affects Key Receptors and Enzymes Associated with Allergic Rhinitis." Phytotherapy Research, vol. 23, no. 7, 2009, pp. 920–926.

Singh, Chanpreet. You can still exercise with allergies. Learn how to ease your symptoms. Nuvance Health.2024.

Stengler, Mark, et al. Prescription for Natural Cures: A Self-Care Guide for Treating Health Problems with Natural Remedies Including Diet, Nutrition, Supplements, and Other Holistic Methods. 3rd ed., Turner Publishing Co, 2016.

Thomet, Olivier A. R., et al. "Anti-Inflammatory Activity of an Extract of Petasites hybridus in Allergic Rhinitis." International Immunopharmacology, vol. 2, no. 7, 2002, pp. 997–1006.

Todorova, Velislava, et al. "Plant Adaptogens—History and Future Perspectives." Nutrients, vol. 13, no. 8, 2021, p. 2861.

Tongtako, Wannaporn et al. “The effect of acute exhaustive and moderate intensity exercises on nasal cytokine secretion and clinical symptoms in allergic rhinitis patients.” Asian Pacific journal of allergy and immunology vol. 30,3 (2012): 185-92. 

Yu, Tao et al. “Resistance exercise and its impact on allergic rhinitis.” American journal of otolaryngology vol. 46,3 (2025): 104613. doi:10.1016/j.amjoto.2025.104613

Vlieg-Boerstra, Berber, et al. “The Immune-Supportive Diet in Allergy Management: A Narrative Review and Proposal.” Allergy, vol. 78, no. 6, 2023, pp. 1441–1458. doi:10.1111/all.15687.

Vollbracht, Claudia, et al. “Intravenous Vitamin C in the Treatment of Allergies: An Interim Subgroup Analysis of a Long-Term Observational Study.” The Journal of International Medical Research, vol. 46, no. 9, 2018, pp. 3640–3645. doi:10.1177/0300060518777044.

Xi, Yang et al. “Allergy-related outcomes and sleep-related disorders in adults: a cross-sectional study based on NHANES 2005-2006.” Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology vol. 18,1 27. 22 Mar. 2022, doi:10.1186/s13223-022-00669-z

Yamada, S., et al. “Effects of Repeated Oral Intake of a Quercetin-Containing Supplement on Allergic Reaction: A Randomized, Placebo-Controlled, Double-Blind Parallel-Group Study.” European Review for Medical and Pharmacological Sciences, vol. 26, no. 12, 2022, pp. 4331–4345. doi:10.26355/eurrev_202206_29072.

Yang, Dengyu, et al. "Quercetin: Its Main Pharmacological Activity and Potential Application in Clinical Medicine." Oxidative Medicine and Cellular Longevity, vol. 2020, 2020, p. 8825387.

Zhang, Ping. “The Role of Diet and Nutrition in Allergic Diseases.” Nutrients, vol. 15, no. 17, 2023, p. 3683. doi:10.3390/nu15173683.