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Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

Can Taking Probiotics for Allergies Provide Symptom Relief?

Written by on May 18, 2022

Heidi Turner

Written by on May 18, 2022 — Reviewed by Heidi Turner

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

Targeting Your Gut With Probiotics May Heal Allergy Symptoms

Key Points

  • Probiotics may be beneficial for seasonal and food allergies and can improve histamine intolerance symptoms.
  • Allergies are an inappropriate immune response to foods and other substances that are normally harmless.
  • Poor gut health is strongly correlated with allergies, sensitivities, and intolerances.

Probiotics may be helpful for improving your seasonal (and other) allergies. While conventional treatment of allergies like avoiding allergens (e.g. birch pollen, foods, fragrance ingredients, etc.) and adding medications (antihistamines, steroids, bronchodilators) can come in handy, a more natural approach, such as adding probiotics to target the gut microbiome, may be a game-changer when it comes to healing allergy symptoms. 

Of course the development of allergies is multifactorial, but reduced microbial exposure and alterations to the gut microbiome from our standard Western diet are probably both important contributors. Since the gut houses the majority of your immune system, any gut dysfunction may lead to allergy symptoms [1].

Taking probiotics for allergies can reduce the incidence and symptoms of seasonal allergies [2, 3, 4], reduce histamine levels [5, 6], improve lactose intolerance symptoms [7, 8, 9], and reduce dairy allergies and related symptoms [10, 11, 12].

In this article, we’ll review what allergies are, how the gut is involved in their development, and also how using probiotics for allergies can have beneficial effects and likely improve your most bothersome symptoms.

Probiotics for Allergies: Seasonal

Pollen season can mean a run on antihistamines, nasal sprays, and eye drops at the local drug store by pollen allergy sufferers. But using probiotics for allergies is another option you may want to consider as they’ve been found to significantly reduce symptoms, improve quality of life during allergy season, and reduce the need for conventional allergy medication [13, 14].

A 2016 systematic review and meta-analysis of randomized controlled trials that looked at the effect of probiotics for allergies, specifically allergic rhinitis (AR), found significant clinical benefits for improving seasonal allergy symptoms like nasal and eye symptoms, and quality of life. Several of the trials included in this study also reported a reduction in the immune system activity that’s associated with allergic responses [2].

While some probiotic trials have found mixed results, the majority have shown clear benefits for using probiotics for seasonal allergies: 

  • A 2022 systematic review and meta-analysis found eight of nine probiotic types were able to improve at least one clinical symptom of AR [4].
  • A 2017 randomized controlled trial found pediatric patients given probiotics had significant improvement in allergy symptoms while the placebo group had a significant worsening of allergy symptoms and quality of life [15].
  • In one clinical trial, participants who consumed yogurt with added probiotics experienced the suppression of an inflammation-promoting molecule and immune cells associated with allergies (eosinophils) along with significant improvement in eye allergy symptoms (but not nasal or throat symptoms) [16].
  • A literature review found the probiotic Lactobacillus to provide significant improvement in AR symptoms along with improved immune system balance [17].

Probiotics for Allergies: Food

Any food can cause an allergic reaction, but cow’s milk is one of the most commonly problematic foods. Probiotics can improve cow’s milk protein allergy (CMPA) in kids, likely related to the ability of probiotics to heal dysbiosis and improve overall gut health [18]:

  • One systematic review and meta-analysis found kids who took probiotics became more tolerant of cow’s milk protein at 24 and 36 months, when compared to kids who didn’t take probiotics [10].
  • More kids who eliminated all cow’s milk protein and took a probiotic experienced significant improvements in atopic dermatitis (eczema) compared to kids who just eliminated the cow’s milk protein [11].
  • One nonrandomized trial found 78.6% of kids who took an extensively hydrolyzed casein (a protein in milk) formula plus a probiotic became tolerant to cow’s milk after 12 months when compared to 43.6% of the group taking just the extensively hydrolyzed casein formula [12].

Probiotics may be helpful for other food allergies, too, as the mechanism of action is the same. Since food allergies are an inappropriate immune system response and probiotics help to enhance immune system function, it makes sense that they may benefit those with food allergies.

Two additional benefits of probiotics for those with food allergies include their anti-inflammatory effects and their ability to increase the protective mucous membrane of the intestines. Probiotics have been well-studied, are safe, and have a wide range of health benefits, so they’re worth a try. 

Probiotics for Lactose Intolerance

Some folks may not have an actual allergy to cow’s milk, but an intolerance to the sugar it contains (lactose). Probiotics may improve lactose intolerance symptoms by boosting the natural production of lactase, the enzyme needed to break down lactose [19].

Additional studies have found:

  • Probiotics are associated with significant improvements in lactose intolerance symptoms (abdominal bloating, pain, cramping, diarrhea, vomiting, and flatulence) and improved digestion [8].
  • Those who took a novel probiotic had significant improvement in symptoms following a lactose challenge when compared to placebo, although there was no significant effect on measured lactose digestion [9].

Probiotics for Histamine Intolerance

While histamine intolerance is not an allergy, histamine buildup can lead to symptoms that mimic allergic reactions (histamine is the main chemical mediator involved in allergies). Also, a direct relationship exists between gut dysfunction and histamine, which is related to how the immune system responds. 

Histamine buildup can occur as a direct or indirect result of gut dysbiosis through the following mechanisms:

  • Bad gut bacteria produce excess histamine.
  • A damaged intestinal lining (leaky gut) may lead to issues breaking down histamine.
  • Damage to the intestinal lining leads to immune system activation and reactivity, producing more histamine.

Histamine studies have shown:

  • Patients with histamine intolerance are more likely to have gut microbial imbalances and leaky gut when compared to controls [20].
  • 30 to 55% of patients with digestive symptoms may also have histamine intolerance [21].
  • Gastrointestinal diseases affect the expression of gut histamine receptors [22].

When it comes to probiotics for histamine intolerance, controversy exists amongst the experts. Some probiotics can produce histamine [23], so people with histamine intolerance are often cautioned to avoid probiotics, or at least the histamine-producing ones. However, evidence suggests that some probiotics like Lactobacillus and Bifidobacterium actually reduce histamine [5, 6].

There’s no direct research in humans to show that probiotics lower histamine, however the available research on probiotics and histamine indicates a potential benefit:

  • Two in-vitro studies have found several probiotic strains of Lactobacillus bacteria were able to reduce histamine activity [5], and a specific Lactobacillus strain was able to degrade histamine in food [6].
  • An animal study found probiotics were able to decrease allergy behaviors and reduce histamine signaling in mice [24].

It’s important to note that probiotic research does show a clear benefit for a myriad of gut conditions like small intestinal bacterial overgrowth [25, 26, 27], infections [28, 29, 30, 31], and leaky gut [32, 33, 34, 35]. So, it’s likely that any probiotic supplement can help to reduce the buildup of histamine and improve symptoms by enhancing the landscape of the gut microbiome. 

What Are Allergies?

Allergies are an inappropriate immune response to foreign substances (antigens) that would normally be harmless [36]. Allergens trigger the immune cells (regulatory T cells) in your body to make immunoglobulin E (IgE) antibodies, which bind to immune cells (mast cells and basophils) and trigger [37]:

  • The release of chemical substances like histamine
  • An inflammatory response

When you come into contact with allergens (through inhalation, ingestion, injection, or direct contact) you can experience a myriad of negative symptoms [36]:

  • Itching
  • Flushing
  • Rash (atopic dermatitis/eczema)
  • Rhinitis (congestion, runny nose, sneezing, and itching)
  • Hives (urticaria)
  • Swelling of the lips, tongue, and airway
  • Swelling under the skin (angioedema)
  • Nausea
  • Vomiting
  • Abdominal cramping
  • Shortness of breath
  • Wheezing and bronchospasm
  • Abnormal, high-pitched breathing (stridor)
  • Fainting

The most common allergens are food and pollen [36, 38] and some common allergic conditions include:

  • Allergic rhinitis (AR), sometimes called hay fever or seasonal allergies, is caused by inhalation of outdoor and/or indoor allergens. Typical symptoms include runny nose, nasal congestion or blockage, sneezing, watery/itchy/or red eyes, and nasal itching [17].
  • Asthma, an obstructive airway disorder that limits the flow of air into and out of the lungs caused by environmental allergens or other agents. Typical symptoms include coughing, shortness of breath, wheezing, and chest tightness [39].
  • Atopic dermatitis (eczema), is the most common chronic inflammatory skin disease and is associated with other allergic conditions like food allergies, AR, and asthma. Typical symptoms include dry skin, eczema, lesions, and thickened/leathery skin [40].

Gut Health and Allergies

If you’ve read my book Healthy Gut, Healthy You, you’re probably not surprised to learn that gut health and your gut microflora have a huge impact on immune system function and your risk of developing allergies. Since your small intestine houses the greatest density of immune cells in the body, it plays a key role in maintaining immune system balance [1, 41].

The very large surface area of the small intestine helps you fight off pathogens and other microorganisms, and at the same time absorb needed nutrients [42]. Any damage to the delicate lining of the small intestine can affect this balance and lead to a variety of symptoms, including allergies:

  • One observational study found patients with AR and asthma have higher levels of immune cells and pro-inflammatory markers that participate in the allergic response in the small intestine when compared to controls [43].
  • One review highlighted the role of the gut microbiome in allergic diseases, finding infants with food allergies, AR, and asthma have been shown to have reduced levels of healthy bacterial species and elevated levels of pathogenic gut bacteria [44].

Gut Health and Seasonal Allergies

There’s a strong correlation between the gut microbiota and seasonal allergies. Observational research has shown that kids with dysbiosis (imbalance of gut microbes) are at greater risk of developing seasonal allergies [44, 45] and adults who have seasonal allergies have been found to have dysbiosis [46, 47] along with lower levels of butyrate-producing bacteria (butyrate has anti-inflammatory properties that may improve the lining and immune system of the gut) [47, 48], compared to healthy controls. In addition, kids with high levels of butyrate have shown to have a lower risk of developing allergies later in life [49].

Let’s look at the some observational studies showing the overlap between gastrointestinal disorders and seasonal allergies:

  • Patients with AR, asthma, and/or eczema seem to have an increased risk of developing inflammatory bowel disease (IBD) [50].
  • Patients with AR have higher rates of reflux, gastritis, peptic ulcers, IBS, functional GI disease, gastroenteritis, colitis, and constipation when compared to those without AR [51].
  • Patients with IBS, dyspepsia, and constipation have significantly higher risk of having hay fever, allergic conjunctivitis (eye inflammation due to allergies), eczema, and asthma when compared to those without a GI disorder [52].
  • Patients with AR and asthma are significantly more likely to have GI symptoms [53].

Gut Health and Food Allergies

Food allergies, sensitivities, and intolerances can be the result of:

  • Enzyme deficiencies: Your body produces a variety of enzymes that help you digest food into an absorbable form. If you don’t have enough of a certain enzyme, you may develop an intolerance to the food it’s supposed to digest, such as lactose [54]. When it comes to histamine, lack of the enzyme diamine oxidase (DAO) can lead to excess histamine, which can cause allergic reaction symptoms and altered immune system responses [55, 56, 57].
  • Immune system dysregulation and increased intestinal permeability (leaky gut): An altered immune response and leaky gut are common in many chronic diseases, including food allergies. When your gut lining is too permeable, large food particles can leak into the bloodstream and elicit an immune system response. This immune system dysregulation can lead to food sensitivities and other systemic symptoms (brain fog, joint pain, skin lesions, mood changes) [58, 59, 60, 61, 62, 63, 64, 65, 66, 67].
  • Gut microbiome imbalances: Bacterial overgrowths, such as SIBO, can lead to symptoms when certain foods like FODMAPs are consumed. Other gut bacterial overgrowths and/or gut infections can also contribute to food intolerances [68, 69]. And dysbiosis early in life likely contributes to the development of food allergies [70].

Using Probiotics for Allergies Is an Effective Strategy

If you’ve been experiencing seasonal or food allergy symptoms and/or the symptoms of histamine intolerance, it may be an indicator of poor gut health. Probiotics for allergies are low-cost, have a low risk of side effects, and are likely effective based on their immunomodulatory effects and ability to improve the landscape of the gut microbiome, so they’re worth a try. 

Probiotic bacteria are just one important piece of the allergy puzzle though. Since allergy symptoms have strong connections to gut health, only using probiotics for allergies may not lead to significant symptom relief. You may want to implement our Great-In-8 action plan in order to experience more complete healing. If you go through the steps and still struggle with allergy symptoms, reach out to us at Ruscio Institute for Functional Medicine clinic.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

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