Seasonal allergies can hit singers hard, and I often get asked for advice on how to manage them. So I reached out to my colleagues Cara Redpath, Registered Nutritional Therapist, and Jenevora Williams, Vocal Health expert and Director of Education for Vocal Health Education. My colleague Sarah Algoet, Voice Educator, also chimed in about antihistamines! Between us, we’ve created a comprehensive guide for singers looking to survive (and maybe even thrive!) during the allergy season.
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Disclaimer: The information provided in this article is for educational purposes only, and should not be used in place of medical advice. It is as accurate as possible at the time of publication.
Part One: What are seasonal allergies?
Seasonal allergies are caused by the histamine* response in the body, as the result of an immune trigger. Tree pollens, flower pollens, grass pollens, and new dust particles as the season changes are usually the cause. When these particles come into the body, and your body mistakes them for a life-threatening condition. As a result, the immune system kicks into gear and sends histamine racing through your body to protect you. (Thanks body!)
*The science bit!
Cara explains: “Histamine is an inflammatory chemical released from the mast cells in response to an immune trigger. Immune triggers can include viruses, pathogens and allergenic foods. When the invading particle comes into the body, the body mistakes it for a life-threatening condition, and it releases an antibody called IGE. IGE then goes to the mast cells and degranulates them, releasing histamine. Histamine is an inflammatory chemical, and it is always released with other inflammatory chemicals as well. It’s these inflammatory chemicals driven by histamine that cause the allergy-like reaction.”
What does a seasonal allergy reaction look like?
Any allergic inflammatory response like this is going to impact your whole overall health of your body. Everyone’s exact reaction is unique to them, but common symptoms include:
- Scratchy, raspy, itchy, inflamed throat
- Constant throat clearing
- Husky voice, or even voice loss
- Post-nasal drip
- Running, itchy nose
- Watery, itchy eyes
- Itchy, sore ears
- Sinusitis pain
- ‘Brain fog’, inability to concentrate
- Fatigue
The Histamine Bucket Analogy
Let’s imagine that your body has a histamine bucket, and as long as your histamine bucket doesn’t overflow, you won’t get any allergy symptoms. Everyone has some level of histamine active in their body at any time, and when seasonal allergies come along, that histamine bucket level rises. If the histamine bucket overflows, that’s when the symptoms will appear. (Note from Georgia: I love this analogy from Cara, it’s such a clear way to picture it!).
Why do some people get worse symptoms than others?
Different people have different levels of histamine in their bucket day-to-day, depending on how their immune system works. This is why some people are more susceptible to seasonal allergies, while others can walk through a field of grasses and not sneeze once. (Note from Georgia: Who are these lucky people?!)
For example, two people in the same environment can have different reactions if they have different base levels of histamine in their bucket. However, two people in different environments with the same base level of histamine in their bucket can have different reactions. This is why there are multiple ways to go about treating symptoms!
Atopic people: the itchy, scratchy, sneezy, wheezy crowd
Seasonal allergy reactions are more likely to happen in people who are characterised as atopic. Atopic is just a fancy word for people who are itchy, scratchy, sneezy, wheezy. Atopic people tend to have eczema, asthma, seasonal allergies and food intolerances. There tends to be a family history of atopy, so your parents, grandparents, and siblings likely have similar reactions to you if you are atopic.
On the other hand, for a non-atopic person, or someone who has no immune upregulation, their histamine bucket is sitting at a quarter full on a standard day. So when the seasonal pollens arrive, their bucket does fill up, but as long as it doesn’t overflow, they won’t experience any symptoms.
However, an atopic person might have their histamine bucket sitting at three-quarters full as their standard day-to-day level. Along come the seasonal pollens, and they fill up and overflow the histamine bucket, because there just wasn’t much room left. Once it overflows, that’s when your seasonal allergy symptoms start.
Part Two: Treating seasonal allergies: Lower the histamine bucket levels
The best way to treat seasonal allergies is to find ways to lower the histamine bucket level.
There are two main ways we can do this:
- Limit your exposure to the seasonal allergens in your environment
- Support your body to lower your histamine levels
1. Limit your exposure to the seasonal allergens
Firstly, you can limit your exposure to seasonal allergens by being aware of where and how you are being exposed. Outdoors, you can protect your airways through masks and nose breathing, and monitoring the pollen count to time your outings with the lowest levels. Indoors, you can use an air purifier, and remove allergens from your skin and clothing.
Outdoors: Minimise the pollen entering your body
Monitor the Pollen Count
Avoid going outdoors at the worst times of day for pollen: when the pollen count is at its highest. Check your local weather service for pollen count information, as it varies based on the season, plants, weather, temperature, and location.
Pollen count is generally lower in the morning and rises through the day, worse in dry windy conditions and better when it rains – but can be worse after a period of rain.
Protect yourself from Pollens
Did anyone else notice their seasonal allergies were better during the pandemic?
If you have to go outdoors when the pollen count is high, wearing a mask can help reduce how much pollen enters your system.
You can also naturally filter the air going in to your body by breathing through your nose (your built-in air filter) rather than your mouth. This is called nose-breathing and is well documented in its effectiveness for filtering out allergens.
Protect your eyes by wearing sunglasses.
Tip! Put vaseline around your nose to trap the pollen on the outside.
Indoors: Reduce seasonal allergens in your home
Remove pollen from your body
Pollen is sticky and it stays on the surfaces it comes into contact with.
When you come indoors, remove your outer layers and wash your hands and face to rinse off any pollen directly clinging to your skin.
Practicing nasal rinses, or nasal douching, along with gargling, can help remove any allergens that have collected in your respiratory system. Use a saline solution, several times a day and especially when coming indoors and before sleep. This can also help relieve soreness and inflammation, so that’s a double win.
Before bed, it can be good practice to have a shower and wash your hair so that you can wash away any pollen that’s accumulated on you throughout the day. Above all, you don’t want to be sleeping in a bath of pollen all night!
Reduce pollens in your home environment
You can reduce the pollens and other seasonal allergens in your home environment by:
- Investing in a HEPA filter air purifier
- Airing your house at night rather than during the day, when the pollen counts are lower, to reduce how much pollen is coming indoors
- Covering your pillow with your bed linen during the day so that no pollen can gather on it
- Vacuuming regularly and dust with a wet cloth (this traps the dust without releasing it into the air)
2. Support your body to lower your histamine levels
Secondly, there are many ways you can support your body to lower your histamine levels during allergy season, from flushing them out naturally, to processing them faster. Medications are an option too, and can be very effective, but it is important to be aware of possible side effects that can be particularly noticeable for singers.
Hydration will help!
Jenevora Williams reminds us: “Use your natural in-built cleaning system and help your body flush away all those seasonal allergens by staying well hydrated.” The body’s response of the running nose and watery eyes is to remove the irritating allergens, and it will be able to do so more effectively if it is well hydrated and has plenty of fluids to do the flushing with.
Staying hydrated will also help your voice recover faster from any inflammation too, because as we know, the voice likes to stay lubricated!
One way to think about if you’re staying on top of your hydration is, for example, if you usually drink X amount of liquids per day, you’ll need to increase that to replace all the fluids you’re losing through the natural flushing out process.
An Anti-Inflammatory Diet: Help your body process the allergens
Cara Redpath shares her top tips for building an anti-infllammatory diet to support your body during the allergy season.
Protein with every meal
“Firstly, make sure that your diet is anti-inflammatory in nature, so wanting to make sure that blood glucose is balanced. That’s the most important thing, and that requires protein at breakfast, lunch and dinner, and a breakfast that is not high in refined carbohydrates.”
Cara taught me you can never eat too many eggs, and that porridge was traditionally eaten for supper, before bed, not for breakfast. Who knew! Thanks to our chats, I now reach for high-protein snacks like hummus, cheese, nut butters and greek yoghurt.
Brightly coloured vegetables
Cara says “Make sure you’re getting between 8 and 10 portions of brightly colored vegetables and a variety of colors every day. These vegetables contain antioxidants, polyphenols, and micronutrients such as Vitamin C and B vitamins, which help your body’s immune system process the allergen and deal with histamine better.”
One way to make sure you’ve got a large variety of vegetables is to buy frozen vegetables as well as fresh vegetables. They keep well, and they don’t lose any of their precious goodness during the freezing process. Plus, it’s a good way to eat veggies out of season without a large carbon footprint!
Anti-inflammatory foods
Include lots of anti-inflammatory foods in your diet, throughout all your meals.
Omega-3 Rich foods: cheese, seeds, walnuts, and oily fish.
Culinary herbs: rosemary and thyme.
Aromatics: ginger, garlic, turmeric
Healthy fats: avocado and olive oil.
Cara tells us: “Thyme is especially good when it comes to dealing with seasonal allergies and the throat and voice. I do recommend that people drink thyme tea if they are particularly prone to their seasonal allergies affecting their voice as thyme is very good for removing any infections or specific attacks on the throat and vocal cords.”
Nettles: The magic of quercetine
Nettles contain a lot of quercetin, a natural antihistamine. Nettles also have the added bonus of being very rich in vitamin C. Again, vitamin C and a vitamin C-rich diet helps to reduce the histamine in the body.
Cara says “Nettle tea is very good as a natural antihistamine. It will never take the place of antihistamines but it can be very helpful to use preventatively and through allergy season. Ideally, nettle tea will be made from spring nettles, as spring nettles contain the most potent nutrition and potent particles.”
Other quercetine-rich foods include onions: all onions including spring onions, red onions, and shallots, and also apples, especially stewed apples with their skin on.
What about supplements?
“There are loads of supplements that can support an anti-inflammatory diet. It depends why the inflammation is there so what’s causing the histamine bucket to be high and they are personalized and individualized to the unique person.” We cover a few of them in our Podcast episode: essentially it would be high dose omega-3, quercetin, and potentially berberine but again very very specific to the individual.”
The best way to find out what supplements can best support you is to work with a registered nutritionist.
Listen to Cara Redpath’s Podcast, The Joy Pod, here: The Joy Pod
3. Medication options
If you haven’t found any relief with natural remedies or diet and lifestyle interventions, or it’s dramatically impacting your activities of daily living for example your job, your work and your sleep, then you should go to see your doctor.
Depending on where you live, and what is available over the counter, a pharmacy can also be a good option.
What medications are used to treat seasonal allergies?
The main medications used to treat seasonal allergies are:
- Antihistamines
- Eye drops
- Nasal Sprays
They are all designed to either block the body’s response to histamine, or reduce the discomfort of the symptoms caused by the histamine.
Jenevora Williams reminds us that as singers it is VERY important to know what the possible side effects are. It is always important to share with the doctor or pharmacist what other medications you are on, and know that everyone’s responses are different so you may be fine on one and not on another. (See more about antihistamines below!).
What about allergy desensitivity regimes?
An allergy desensitivity regime (also called immunotherapy) is where a specific allergen is identified as an immune system trigger for you, and you are exposed to small amounts of the allergen over a long period, basically building up an immunity to it.
Cara says “Typically allergy desensitivity regimes take a long time, so they will not help you this allergy season, but could help in the future. It’s going to be effective in so far as an immune trigger will have been removed or better tolerated so there will be less histamine in your histamine bucket. However, it can only ever be part of the solution, as the root cause of the allergic reaction is not the allergen itself, but the upregulation of the immune system essentially overreacting to the allergen.”
Why antihistamines can be problematic for singers
My colleague Sarah Algoet from SingSing! Kindly shared this information about antihistamines and how they affect singers with me. Sarah has a bunch of webinars on this subject in her online library for singers.
Antihistamines and dryness
Antihistamines can dry out the mouth and the voice.
As Sarah explains:
“They don’t really dry us out in that we’ve decreased water. The glands that lubricate our vocal folds are a combination of serous glands and mucinous glands. The serous glands put out thin, watery fluid. The mucinous glands produce thick fluid, and we mix the lubricant to get the right viscosity. With antihistamines, they shift from serous to mucinous predominance. It’s like thickening the oil in your car engine. It doesn’t let your vocal folds come together and especially pull apart efficiently, so it increases cell damage on the surface of the vocal folds.”
Finding the right antihistamine
It is best practice not to introduce antihistamines immediately before a performance. Some antihistamines have a reasonable balance between effectiveness and undesirable side effects, and of course everyone will respond to them slightly differently. Most importantly, try them out when you’re well, and you don’t have an impending performance.
Older antihistamines like chlorphenamine (Piriton), cinnarizine, diphenhydramine (Benadryl), hydroxyzine and promethazine can include side effects such as:
- dry mouth & voice
- sleepiness (drowsiness) and reduced co-ordination, reaction speed and judgement
- blurred vision
- Benadryl is also dangerous* for singers because of its topical anesthetic effect
Modern antihistamines like acrivastine, cetirizine (Zyrtec), fexofenadine (Allegra) and loratadine can include side effects such as:
- dry mouth & voice
- drowsiness – although this is less common than with older types of antihistamines
- headache
- feeling sick
*Note: It can increase the risk of vocal injury to sing through pain, and medications that have a topical anaesthetic effect can mask pain in your voice. Always let your medical team know that you are a singer, and what performance commitments you have.
Sarah says: “The modern ones don’t make you too sleepy and don’t dry you out too much, but on the other hand they don’t work as well. There’s a reasonable balance. Allegra is the least likely to make people sleepy. It is the only antihistamine approved for use by commercial airline pilots. So it’s a good place to start.”
Source: NHS & Dr. Robert Sataloff (edited)
Part Three: How to support your singing through seasonal allergies
So, how do you keep singing when you’ve got all these symptoms, despite your best efforts to keep your histamine low?
Maintaining good vocal care habits can help, along with implementing more vocal rest, prioritising silent practice, and minimising your performances where possible.
Vocal Care
Prioritise the three pillars of vocal care: Rest, Hydration and Energy.
1. Vocal Rest
Your voice is likely to get tired faster, and as a result it might be uncomfortable or even sore. Voices recover through rest, so making sure you are getting enough rest is key to being able to keep singing through the allergy season.
- Ensure you get enough sleep – you may find you need more than usual.
- Be mindful of how and how much you are using your voice. If you have a lot of speaking to do over the phone or in person, consider if a text or email could replace that engagement.
- Choose quiet environments to speak and meet with others, so that you are able to speak at a normal volume and not overuse your voice.
- Be very intentional in your singing practice: prioritise ‘silent practice’, such as visualisation, memorisation, research, character development, and listening exercises
- Trust you gut and listen to your voice: if it’s telling you to stop, stop!
2. Hydration (Again!)
Yes, hydration has made it into this article twice. Why? Because so many people don’t drink enough water, and it’s a free and relatively easy change to make to your day.
Try to hydrate regularly throughout the day by drinking at meals, and keeping water with you between meals by using a drink bottle. Here is an example of how I spread out my hydration to ensure I drink enough when I need to replenish fluids:
- Breakfast: two glasses of water
- Morning: a big milky coffee, and a big bottle of water
- Lunch: two glasses of water
- Afternoon: a second bottle of water and a cup of herbal tea
- Dinner: a glass of water
To be clear, any way you can add more water to your day is a win for your voice.
Additionally, steaming with not-too-hot water can also help support your voice to recover. The studies aren’t clear on how much steam can help with hydration, but it can definitely help with soothing inflammation, so along with throat gargles and nasal rinses, add it to your routine. Not sure how? Check out this video.
3. Energy and Warming Up
Energy is a less-obvious element to good vocal care, but that doesn’t make it less important.
The way I like to explain it to my clients is that when we are tired, or feeling unwell, we tend to under-energise our voices, and disconnect our voices from our bodies. That feeling of only singing from your throat? That’s what I’m talking about!
So when you’re feeling low during allergy season, when you ARE singing, it is super important to make sure you are well connected to your body, energising your voice, and using your best vocal coordination.
Start by moving your body – put on some music and groove. This will get you out of your head and your worries about how your allergies are affecting your voice! And it’ll get your body warmed up and ready to support your voice.
SOVT (Semi-Occluded Vocal Tract) exercises can be a great place to start for finding your optimum coordination without tiring out your voice. Lip trills, ‘vvv’, ‘mmm’ hums and ‘blowfish’ are my favourites!
If your voice is tired, limit your warm up time to a few minutes before you perform.
4. Performing
If you have to perform when your voice is affected by seasonal allergies, once you’ve done all the things above, the only thing you can do is trust. Trust that your muscle memory will be there for you and carry you through.
- Don’t ‘make sure’ it’s there by singing your performance through multiple times, ‘just in case’, especially if your voice is feeling tired. Save it for the show!
- Reach out to your voice coach or singing teacher for support, and for ways you can possibly adjust your repertoire to your current vocal constraints.
- If your voice is telling you not to sing, trust it, and cancel or postpone the performance. No single performance is worth pushing through on a voice that doesn’t want to sing, and risking injuring it.
Final Thoughts: How to manage the seasonal allergies as a singer
To sum up, there are so many ways to support yourself as a singer during the allergy season, that it can feel a bit overwhelming to know where to start.
My recommendation would be to choose one place in your lifestyle to start, and see what changes you can make there. Introducing new habits can take time, and a lot of patience with yourself!
1. Lower your histamine bucket
Remember, the goal to treating seasonal allergies is to lower your histamine bucket! You can do this through:
- Removing allergens indoors
- Reducing pollen exposure outdoors
- Hydration
- Building an anti-inflammatory diet
- Medications
Working with a professional to support you through implementing these changes, or helping you identify the things that would have the biggest impact for you, can speed up this process.
For support with diet, you can contact a Nutritional Therapist such as Cara Redpath, who you can find here: https://www.cararedpathnutrition.com/ and on Instagram @cara_redpath_nutrition.
For support with medications, please visit a pharmacy, and/or book an appointment to see your doctor.
2. Support your singing
To support your singing during allergy season, be very intentional with how and when you use your voice, and practice all the good voice care habits you can!
- Rest
- Hydration
- Warming Up and Energy
- Practice strategy
Work with your voice coach or singing teacher to plan your performances and get the most out of your voice, while also protecting it and caring for it.
And always, always listen to your voice and if it’s telling you not to sing, don’t.
For support with your singing, you can book a Vocal SOS session with myself, Georgia Aussenac, or any other voice coach or singing teacher knowledgeable in voice care.
Jenevora Willams is specialised in voice rehabilitation and can be found here: www.jenevorawilliams.com and @jenevorawilliams, and also at www.vocalhealth.co.uk and @thevocalhealth where she is the Director of Education.
About the Authors
Georgia Aussenac is a Voice Coach specialising in fostering confidence, joy and fun for adults looking to make singing a part of their lives.
Georgia also coaches English-speaking singers and voice teachers on French diction.
With a particular passion for everything vocal health, Georgia offers Vocal SOS coaching to anyone who uses their speaking voice professionally and is struggling to keep up with the demands of their job.
You can work with Georgia online from anywhere in the world, as long as your schedules match up!
DipCNM, Dip Child Health, MBANT, CNHCreg
Cara Redpath is a Certified Nutritionist, based in Oban, on the west coast of Scotland, and working with clients in person and online. She specialises in chronic health conditions and fertility, pregnancy and women’s health.
After experiencing a physical injury that triggered a whole host of other health conditions, Cara felt let down by traditional medicine. While she has great respect for every medical practioner and the challenges they’re faced with daily, her own experiences left her feeling unsupported and misunderstood.
Her role is to connect the dots: to create a supportive, clinically effective space for you, to uncover the root cause of your symptoms, and then to work alongside you to develop a nutritional and lifestyle solution to bring harmony and joy back into your life.
Cara regularly runs retreats, and hosts the Joy Pod with her colleague Ashley Roy.
Dr Jenevora Williams is an expert in the fields of vocal health and singing teaching. After a successful career in Opera, Jenevora turned her attention to investigating healthy and efficient vocal function. The combination of academic study and practical experience has resulted in a unique perception for understanding the human voice. She was the first singing teacher to be awarded a PhD in voice science in the UK, and won the 2010 BVA Van Lawrence Prize for her outstanding contribution to voice research. Her book, Teaching Singing to Children and Young Adults, has been enormously popular with singing teachers throughout the world.
She is well-known for her imaginative and rigorous international training courses for singing teachers and voice professionals. She now runs Vocal Health Education and Evolving Voice, training the first generation of Voice Rehabilitation Specialists worldwide. As a teacher of singing, she works with professional singers of all ages in both voice rehabilitation and career mentoring.
My Story
My Story A journey of finding what it means to be a ‘singer’ Growing up, I was ‘the singer.’ In my early twenties, a teacher I really looked up to told me I didn’t have what it took to be a singer. I was devastated. I lost my voice, and all the joy was gone. It took me a long time to build my confidence back up, and reclaim my
How to survive seasonal allergies as a singer
Seasonal allergies can hit singers hard, so understanding what they are, the many options for how to treat them, and how to support your singing through seasonal allergies is the key to surviving this time of year!
Create a custom warm up for singing
Do you feel like you don’t really know how to warm up your voice to sing and so you generally skip a warm up? Like, you know you should probably do something, like some hums or sirens, but you’re not sure what to do? You know your singing practice goes better when you are warmed up first, but you don’t know how to do it by yourself? Let me help!
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