Allergies

Allergies are a normal physiological process to the world around us, and within us. We interact with foods, chemicals and other substances such as microbes and moulds every day, whether by ingestion, inhalation or physical contact with the body’s tissues. Our body’s immune system is designed to correctly identify and differentiate between self and nonself—that is, between what our body needs and what is foreign to it. When it encounters foreign substances, it reacts by making antibodies or releasing certain chemicals, such as histamines. The problem arises when we have an inappropriate response, or “hyperresponse.” Then the antibodies attach to the antigens, causing a variety of internal reactions.

The most obvious and well known allergic reaction is an anaphylaxis reaction, which can be life threatening and is a medical emergency. The most common agent for this type of reaction are insect stings, medications and blood products.

Besides the normal allergy conditions that many think of such as hayfever, skin rashes or reaction to medications, many health conditions may be related to allergies: asthma, bladder infections, candidia infections, canker sores, colic, depression, diarrhoea, ear infections, eczema, gall bladder disease, irritable bowel syndrome, headaches, psoriasis, sinusitis and ulcers. Many of these conditions are caused by food allergies. Even situations that one would normally mistakenly attribute to passing viral infections or recurrent “colds”.

The following conditions may also be related to allergies and other sensitivities:

Gastrointestinal symptoms

Vague gastrointestinal (GI) symptoms (such as abdominal pain, bloating, gas, and diarrhoea) that are not caused by serious disease can sometimes be triggered by food sensitivities.

Musculoskeletal pain (including back pain)
Eating allergenic foods has been reported to produce a variety of musculoskeletal syndromes in susceptible people.

Multiple Food Protein Intolerance (MFPI) of infancy
Many infants who are intolerant to one food have been found to also be intolerant to several other food proteins, including soy formula and extensively hydrolyzed formula. This syndrome has recently been dubbed Multiple Food Protein Intolerance (MFPI) of infancy. As a group, these infants tend to have symptoms of severe colic, gastroesophageal reflux and esophagitis (inflammation of the esophagus due to irritation by stomach acids from repeated episodes of reflux), or atopic dermatitis (eczema).

Multiple chemical sensitivity
Multiple chemical sensitivity, also known as idiopathic environmental intolerances, is a poorly understood and controversial chronic disorder in which a person may have a variety of recurring symptoms believed to be due to reactions to very small amounts of substances in the environment. Avoidance of these substances, though often difficult, has been reported to bring at least partial relief, and psychological counselling has also been reported to be helpful.

Leaky gut syndrome
Allergy to food has been associated with increased permeability, or “leakiness”, of the intestine. Some alternative health practitioners believe this increased permeability, sometimes referred to as the “leaky gut syndrome”, is an important treatable cause of food allergy. However, the reverse may also be possible. Allergic reactions in the intestine tend to cause temporary increases in permeability, which would explain the apparent connection between the two. More research is needed to better understand the role of intestinal permeability in the development and treatment of food allergies.

Symptoms

The symptoms of allergies will depend on the allergen and the method of exposure. In an anaphlyaxis reaction the symptoms be quite severe, with initial complaints of being uneasy, with agitation, flushing and palpitations. It can progress to coughing and sneezing, difficulty breathing and swelling of the tongue and throat. Shock can develop, and a person can go into convulsions. Many people that are aware of such severe allergies carry treatments with them, or carry identification stating their allergy.

Most allergic reactions are not as obvious as an anaphlyaxis reaction. Besides some of the physical complaints listed above, there are some signs that may be observed which points to allergy being the cause. Dark circles under the eyes (known as allergic shiners), or swelling around the eye socket, horizontal creases below the lower lid (known as Dennie’s lines), chronic nasal secretions, a horizontal line on the nose from wiping the nose so much (known as the allergic salute), recurrent ear infections in children, eczema, urinary frequency, hives, headaches, GI symptoms, fatigue, difficulty with concentration, muscle spasms and joint pain.

Diagnosis and Pharmaceutical Interventions

Food tolerance test

Testing for food sensitivities can be done by using a food tolerance test that combines IgE, the first antibody produced in an immediate allergic reaction, with IgG, the antibody produced in a delayed hypersensitivity reaction. Delayed hypersensitivity reactions are not commonly tested for by a standard clinician, and reactions cans take several hours, days, or even weeks to appear. More information on IgG testing

Elimination and reintroduction

Many consider a reliable way to determine a food allergy is to have the patient eliminate a suspected food from the diet for a period of time and then reintroduce it later. Once a food is eliminated, the symptoms it may be causing either improve or resolve, typically after several days to three weeks. The body then becomes more sensitive to the food, so when the food is reintroduced, the symptom is more likely to recur. This tool shows with a high degree of certainty which foods are problem foods, as the patient will directly experience the problems after eating the food. The testing requires a great deal of patience and, as with all other forms of allergy testing, is best undertaken with the help of a physician who can monitor the diet. Reintroduction of an allergenic food has been reported to lead occasionally to dangerous reactions in some people with certain conditions, particularly asthma—another reason this approach should not be attempted without supervision.

Scratch testing

This form of testing is one of the most widely used. A patient’s skin is scratched with a needle that contains a portion of the food, inhalant, or chemical that is being tested. After a period of time, the skin is examined for reactions. If there is a reaction, it is determined that an allergy exists. Although this test is accepted by most allergists, scratch testing is subject to a relatively high incidence of inaccurate results, with some tests showing positive when the person is not truly allergic to the substance (false positive) and some tests showing negative when an allergy really exists (false negative).

Pharmaceutical Interventions

There are many medications targeted to respiratory allergies and hayfever. Most of these are antihistamine in nature. Examples are Zyrtec, Clarinase, Telfast and Claratyne. They can produce side effects of drowsiness and fatigue, nausea/vomiting, and sometimes stomach upset. They should not be used by women who are breast feeding or infants.

Lifestyle and Dietary Modifications

People with inhalant allergies are often advised to reduce exposure to common household allergens like dust, mould, and animal dander (hair, skin flakes etc), in the hope that this will reduce symptoms even if other, non-household allergens cannot be avoided. Care of the household can be important for those with environmental allergies: regular cleaning of windowsills with dilute bleach solution for moulds; reducing dust-mite harbouring objects in the environment (carpets, stuffed toys, curtains); mattress and pillow covers; regular vacuuming with a HEPA filter; using an air filter; and keeping pets out of the bedroom.

Stress management for individuals with allergies is important, as many may think they are no longer able to partake in normal outdoor activities or foods. Proper sleep and exercise can help with managing stress.

Identification and elimination of food allergies is very important to almost any allergy treatment, whether it is for food allergies or not. Food tolerance testing is a reasonable and stress free way to identify problematic foods and then eliminate them from the diet. An immune supportive diet which eliminates refined foods and saturated fats, and is low in alcohol, can help balance the natural processes that can happen with allergies. This diet places an emphasis on whole foods, high quality vegetables and fruits, low saturated fats from animal meats, except for fish, and an abundance of clean water.

Nutritional Factors Shown to be Beneficial

Probiotic support

Probiotics may be important in the control of food allergies because of their ability to improve digestion by helping the intestinal tract control the absorption of food allergens and/or by changing immune system responses to foods. Probiotics may also be important in non-allergy types of food intolerance caused by imbalances in the normal intestinal flora.
Dose: 1–10 billion live bacteria daily.

Dietary enzymes

According to one theory, allergies are triggered by partially undigested protein. Proteolytic enzymes may reduce allergy symptoms by further breaking down undigested protein to sizes that are too small to cause allergic reactions.
Dose: 1-2 capsules with meals

Betaine HCl

Hydrochloric acid secreted by the stomach also helps the digestion of protein, and preliminary research suggests that some people with allergies may not produce adequate amounts of stomach acid.
Dose: The amount of betaine HCl used varies with the size of the meal and with the amount of protein eaten. Typical amounts recommended by doctors range from 600 to 2,400 mg per meal.

Vitamin C

Vitamin C is a natural antihistamine, and can help with the immune problems that some people with chronic allergies face.
Dose: 3-6 grams a day

Glutamine

Glutamine, an amino acid, is the preferred fuel for the cells of the gastrointestinal tract, which may be under constant attack when faced with food allergies. It can reduce intestinal permeability, which contributes to “leaky gut syndrome”. Glutamine may also play a role in supporting the immune system.
Dose: 2-4 grams a day

Nettles (Urtica dioica)

Nettles have long been used to treat respiratory allergies, and have an antihistamine effect.
Dose: 2-4 grams a day

Quercetin

Quercetin is a flavonoid found in fruits and vegetables. It is anti-inflammatory and can reduce the histamine reaction found in most seasonal allergies.
Dose: 400-500 mg three times a day

Plant Sterols

Sterol compounds from plants, naturally occurring fats also called phytosterols, have been shown to have significant activity in humans. It is a natural immune modulator, helping to provoke a stronger response of the T-helper cells, which are very active cells needed during some conditions, in particular chronic allergies and infections.
Dose: 100 mg three times a day, away from food and dairy products