Allergy - not just avoidance

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[UPDATED MARCH 2022]

Introduction

When I first started treating patients with diet in the early 1980s, all I knew was that avoiding certain foods made people better. I diagnosed allergies to foods and started with desensitisation, namely Enzyme Potentiated Desensitisation (EPD). For many people this works extremely well, but it means regular treatments for some people long term. I have since learned that there are many other things that can be done to modify allergy reactions, which means that many people do not have to be so dependent on EPD.

I also run into problems with some patients who are multiply intolerant to allergens such as foods, inhalants, chemicals or micro-organisms, those who maybe cannot get to see me for EPD, or for whom it has not worked. See Allergy to Foods, Inhalants & Chemicals - signs and symptoms of. For these groups of patients obviously we need other ways of tackling food allergy.

The things that are worth trying are as follows.

Diet

Food should be properly chewed because this allows more rapid digestion. Allergies may arise because foods are not properly chewed or digested and this presents a large antigenically interesting load in the small intestine, to which one gets allergic reactions. Gandhi once said that we should chew our drinks and drink our foods! Again, generally speaking we tend to overeat and small regular meals are much better dealt with by the body. Reduce the total load of toxins in the diet such as colourings, flavourings, additives, sweeteners, all of which increase the allergic load. My impression is that fats are generally less allergenic than proteins and carbohydrates, so include plenty of cold pressed vegetable, nut and seed oils in the diet. We must eat the PK diet. See the links below:

Good Digestion

It has been known since the 1930s that allergy is associated with hypochlorhydria (see Hypochlorhydria). The quick efficient digestion of foods very much reduces the allergic load (see above). Associated with hypochlorhydria almost always is poor pancreatic function and pancreatic enzyme supplements can be very helpful. They are available on prescription, but equally there are many available on the market and I usually use BioCare's Polyzyme Forte 1 - 3 capsules with meals, depending on the size of the meal. To test for this one would do a Comprehensive Digestive Stool Analysis. Magnesium carbonate 1-2 grams may also be helpful taken 60-90 minutes after a meal - it neutralises stomach acid and provides an alkali environment to permit efficient digestion of food in the duodenum. In this respect it mimics sodium bicarbonate normally present in bile salts, and additionally supplies a dollop of magnesium - a mineral we are all short of!.

Nalcrom

Nalcrom is the only drug available on prescription for the treatment of food allergies. All GPs can prescribe this. Its inhaled form is called Intal and has been long used for the treatment of asthma. Nalcrom coats allergy cells in the gut to make them less irritable and therefore less reactive. Although it is said just to work for type I IgE allergy, there is no doubt it works more widely than this and some of my patients find it extremely useful to take, especially if they are going out for a meal where their diet cannot be controlled to prevent allergies. The usual dose is 100 - 300mg depending on the size of the meal, ten minutes before food. The capsules should be emptied into the mouth, which will afford protection in the mouth and the oesophagus - both surfaces with which food obviously comes in contact. The problem with Nalcrom is that it is rather expensive - 100 capsules cost about £40 - and GPs are reluctant to prescribe as a result. However, this for some people is an extremely useful addition. See Treatment of patients with food allergy using Nalcrom.

For people who have Type I allergy (IgE - usually causes urticaria, heat lumps and sometimes eczema) antihistamines can be very useful. The leukotriene inhibitors such as Singulair [sold as 'Montelukast'] are also worth trying. Please see here for discussion of Type I hypersensitivity (allergy) and note that this article links to Types 2, 3 and 4 hypersensitivity articles - Wikipedia article on Type I hypersensitivity.

Probiotics

There is no question that in the gut probiotics have a general anti-inflammatory effect and have been widely trialled in food allergic disorders such as irritable bowel syndrome, Crohn's disease and ulcerative colitis. It is well worth taking high dose probiotics and the current flavour of the month is Kefir. (see Probiotics - we should all be taking these all the time and double the dose following antibiotics and gastroenteritis). Probiotics are now available on NHS prescription as VSL-3. See also Kefir.

Improved Immune Tolerance

The immune system is exquisitely sensitive to micronutrients and almost any micronutrient deficiency could result in immune dysfunction. I like everybody to take my standard package of nutritional supplements. (See Nutritional Supplements).

Having said that, there are some micronutrients which are particularly helpful, namely zinc, essential fatty acids and vitamin D3. Zinc deficiency is so common that it is virtually pandemic in this country and 30mg of zinc at night can be extremely helpful. The essential fatty acids which reduce inflammation are from the Omega 3 and Omega 6 series - see VegEPA. Vitamin D3 has a profound immune modulating effect. The best source of vitamin D3 is sunshine. Roughly speaking, 60 minutes of summer sunshine on a fair skinned person in a swimming costume would give a dose of 10,000iu of D3. I like all my patients to take 10,000iu daily as a routine. I now have concentrated D3 and often use 50,000iu as a weekly dose. Please see here - My online shop webpage on Vitamin D3 powder and also here - Vitamin D - most of us do not get enough

Hormonal Effects

Having normal thyroid and adrenal function undoubtedly has a profound immune modulating effect. The important thyroid hormone appears to be T3 and I have had several patients whose allergy reactions have been greatly modulated by correcting this. (See Thyroid and Adrenal Gland - the gear box of the car (DHEA and cortisol) – underactive).

Antioxidant Status

Many food allergy reactions are made much worse by poor antioxidant status. The idea here is that when one reacts allergically to a food, this produces free radicals, in particular superoxides. Normally these are mopped up by superoxide dismutase, glutathione peroxidase and Co-enzyme Q10. If any of these are deficient, then allergy reactions will be made worse. (See Antioxidants). Also see Inflammation.

Detoxification

Chemicals act as immune adjuvants to switch on allergies. This was first documented in Japan, where hayfever is much more common in the cities than in the countryside despite pollen counts being much higher in the countryside. The reason is that diesel particulates from car exhaust fumes stick onto pollen and make them more allergenic. There is no doubt that pesticides are very good at switching on allergies and there is evidence to suggest that heavy metals may do the same. Indeed, heavy metals are used in vaccinations as immune adjuvants in order to increase the reaction of the immune system to the virus particles. When I do blood tests, sweat tests, or fat biopsies, I invariably find a chemical toxic load and so reducing this will be extremely helpful. (See Toxic Problems and Detoxing - Far Infrared Sauna (FIRS) ).

Reduce Irritability Generally

I suspect an awful lot of irritability and general hypersensitivity, which may also be to light, noise, pain, smells, as well as allergies to foods, chemicals and inhalants is mediated by membrane instability. This can be tackled with attention to fats and lipids. See Lipids, fats and essential fatty acids. It may be this is a symptom of a tendency to acidity and many people have been helped by correcting the acid alkali balance. See Acid-Alkali balance.

Sleep

Chronic lack of sleep results in a generalised irritability and all the above problems will be made worse. Please see Sleep is vital for good health - especially in CFS

Tranquilisers

In extreme circumstances I do recommend the prescribing of tranquilisers in order to reduce the general level of irritability, anxiety and sensitivity. I do not like doing this, but interestingly it sometimes does also reduce food allergy effects and again has been extremely helpful for some patients.

Hyperventilation

Again a common problem which results in increased sensitivity, anxiety and arousal. (See Hyperventilation).

Desensitise

There are two well recognised techniques of desensitisation which are extremely helpful, namely Enzyme Potentiated Desensitisation (EPD) and Neutralisation

Low dose naltrexone

Low dose naltrexone has an immune modulating effect and can help some people significantly with their allergic responses - see Low dose naltrexone

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