Archive for the 'Allergies' Category

It is widely observed that patients with food intolerance often have candidiasis as well – and those whose main problem is Candida often turn out to have food sensitivities. Although there are no hard data to support these observations, many doctors working in this field feel that there must be a link between the two.

Sensitivity to man-made chemicals also seems to be part of the picture. Some patients date the onset of their candidiasis to some heavy chemical exposure, such as installing cavity-foam insulation (this releases large amounts of formaldehyde into the house). Others began to react badly to various chemicals at about the time they developed candidiasis.

One explanation for the link with food intolerance runs as follows: although Candida is normally a yeast (individual egg-shaped cells), it can convert to a hyphal form (tiny threads, as described above) in certain circumstances. In the laboratory, this occurs if there is a shortage of the vitamin bio-tin, or of other nutrients. Assuming the same thing happens in the gut, then a vitamin deficiency might make the yeast convert to the hyphal form. Once in this form, the hyphae grow into the gut wall, just as the hyphae of a mould penetrate a piece of stale bread. This creates tiny holes in the gut wall, making it more permeable. More undigested food molecules pass through the gut wall than in healthy individuals, making food intolerance much more likely.

Unfortunately, there is no evidence to support this explanation, apart from some rather dubious circumstantial evidence. Candida can convert to the hyphal form in infected areas of the skin or vagina, but it only does so partially – most of the Candida is still in the typical yeast form. Whether Candida ever converts to the hyphal form in the gut is unknown. Even if it does, the idea that it penetrates the gut wall, leaving tiny holes, is questionable.

This explanation also fails to explain the observed link with chemical sensitivity. Many of the chemicals concerned are airborne ones, such as exhaust fumes or solvents, which enter our bodies through the nose and lungs. So the leakiness or otherwise of the gut wall will not make someone more sensitive to such chemicals.

At present, there is no good explanation for the link between candidiasis, food intolerance and chemical sensitivity. It is clear that Candida interacts with the body in various ways, which are both complex and subtle – in particular, its relationship with the sex hormones and with the immune system. Perhaps these effects unbalance the body’s normal control mechanisms, and make food and chemical sensitivities more likely. Alternatively, there could be some underlying fault (in the control of the immune system, for example) that makes the body more vulnerable to Candida invasion, on the one hand, and more apt to react inappropriately to foods and chemicals, on the other.

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Basically, an elimination diet is simply a self-test. You avoid a prime suspect such as milk or wheat, in all forms, for up to three weeks, and see how you feel. Then you eat the food again – preferably in generous portions at several meals. Meanwhile, continue to observe your symptoms.

Obviously, you only need to test the food or foods you’re unsure of. If you go into anaphylactic shock, get giant hives or suffer a splitting headache each time you eat shellfish, eggs or any other food, there’s certainly no need to test them. Just avoid them. Elimination diets are designed to help people (or their doctors) confirm suspicions about a particular food. And they provide a starting point for those individuals who experience symptoms every day but don’t have the foggiest notion which foods are to blame. Elimination diets are especially useful for diagnosing people who may have many, many food allergies.

If you’re one of those people, begin by testing common food allergens – milk, eggs, wheat, corn, yeast, beef and so on -continuing with the less common ones until you’ve identified all the culprits. Tailor the plan to your individual problem, though. If you have a hunch about wheat, by all means start with wheat. The same goes for eggs, corn and so on.

Allergy doctors sometimes ask hard-to-diagnose people to fast – to go without any food at all – for three days or so before starting an elimination diet. This makes it somewhat easier to pinpoint the allergen. However, going without food can be extremely stressful (and hazardous in some cases), so we don’t recommend that you fast without close medical supervision.

Even if you don’t fast, the first four or five days on an elimination diet can be pretty rough – if you’re on the right track. For one thing, foods like milk, wheat and eggs – so often the glue and mortar of baked goods and other dietary staples – aren’t easy to avoid. And even if you eliminate every trace, you may at first feel worse instead of better: withdrawal symptoms, more or less. Don’t let all that discourage you, though. By the fifth day or so, you’ll feel much better.

‘If food allergy is the problem, the patient is virtually well on the fifth or sixth day,’ wrote Dr Breneman in an article on elimination diets, published in the New York State Journal of Medicine.

After two or three weeks on an elimination diet for, say, milk or wheat, try the excluded food. Choose a day on which you feel free of symptoms until lunchtime. Then eat the food in various forms for three consecutive meals. To test milk, for example, you could have a big cheese sandwich at lunch, a generous scoop of cottage cheese with dinner, and milk and cereal for breakfast the next morning. If the food provokes symptoms, stop eating it. Proceed to the next prime suspect. Dr Rapp emphasizes that it’s important to test only on a day when you’ve felt well all morning. And for good reason. If you wake up with a headache, for example, and your headache gets worse after you’ve tested the food, you won’t be sure if the food made you worse or if your headache was due to something else and would have got worse anyway.

Like all good detective work, food diaries and elimination diets take some time and careful observation. There may be a false lead or two along the way. If you get to the point where you feel you really need the guidance of an allergy doctor, by all means take along your diary and other records. They’ll be an enormous help in fine tuning the diagnosis.

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Food allergies are a lot harder to pin down than allergies to airborne substances, cosmetics or drugs. Skin tests are little help – doctors say they’re far less reliable for food than for inhalants such as dust or pollen. And symptoms don’t usually fall into simple, easily observed patterns because of the complex (and not fully understood) way that foods trigger allergy, and because of the motley makeup of our modern diet.

A few people can feel their lips, mouth and throat begin to swell or itch even before the food in question reaches their stomach. More often than not, however, trouble erupts farther along, as food is processed by the digestive system – resulting in anything from nausea and queasiness to gas and diarrhoea, plus various difficulties in between. As food allergens wend their way to the rest of the body, symptoms are no different from those of inhalant allergy – wheezing, or skin rashes, or dizziness, or joint pains and so on. These symptoms can take time to develop – a few hours, maybe, or a day or so. Because of that time lag, you may have difficulty linking what you ate to how you feel. Granted, some people – about one out of twenty -are so sensitive that the smallest nibble of an offending food can spark an immediate, recognizable reaction. If you break out in hives each time you eat prawns, you’ve got an open-and-shut case of prawns allergy. But it’s seldom that simple. Since food takes about four or five days to journey from entrance to exit, most people react later. So you might blame your symptoms on the cheese you ate at lunch, when the real cause is the eggs you ate for breakfast. Or the melon you ate yesterday.

Here’s another variable: do you seem to tolerate a food sometimes, but not others? You still can be allergic to a food even if you don’t react every time you eat it. The problem food may very well be eaten for quite a while, with no symptoms. Then, as antibodies accumulate to a certain threshold, the attack occurs. One doctor compares this ‘allergic threshold’ to water filling a rain barrel. All’s well until the water level reaches the brim. Then a tiny drop causes an overflow. By rotating foods, or eating troublesome food only at widely spaced intervals, you can keep most food allergies from reaching that critical point.

How close you come to going over the edge also depends on how much you eat, and when. Perhaps you’re only mildly allergic – you may be able to get away with one or two strawberries, but eating a whole punnet is a full-scale disaster. Or, since cooking breaks down food to a degree, you may discover, for instance, that you can eat celery cooked, but not raw. Or your symptoms may appear only if two or more allergenic foods are eaten at the same meal – in effect, overwhelming the system. That’s particularly true for closely related foods like beef and milk, or mushrooms and yeast.

By the same token, you may react to a food only during the pollen season or when suffering from other airborne particles. Or when you have a cold. Or when drinking alcohol. Or if eaten on an empty stomach.

Another interesting twist is that allergic reactions are not always uncomfortable. In fact, you may feel better after eating allergenic food. Doctors call that reaction ‘allergic addiction’, and compare it to the temporary lift one gets from smoking cigarettes. And just as a craving for cigarettes is a sure sign of a confirmed smoker, a food craving may very well point to a food to which you are actually allergic. The leading proponent of this theory is Dr Theron Randolph, a Chicago allergist, who told us that if you continue to eat foods to which you are allergically addicted, they will eventually make you chronically ill, even if they now give you temporary lifts.

To completely unravel a food allergy problem, you’ll have to sort out not only your symptoms but also exactly what’s in your diet. Food labels, unfortunately, do not spell out every last ingredient. ‘Spices’, for example, can include any of several unnamed ingredients, natural and synthetic. Vegetable oil’ can mean corn, soybean, peanut, sunflower, coconut, olive, cottonseed or other oils. Sometimes labels are completely misleading. ‘Non-dairy’ creamers and other dairy substitutes may contain whey, lactose or casein — all milk products.

All that isn’t to discourage you, but to sharpen your awareness.

Dining out? Restaurant meals are a potpourri of several ingredients. Even a simple meatball sandwich may contain up to two dozen ingredients, including beef, soya, pork, onion, oil, butter, milk, egg, black pepper, wheat, rye, yeast, sugar, caramel and others. Add a dash or two or ketchup, and you add tomatoes, vinegar, corn sweetener, onion powder, assorted spices and flavourings.

No wonder food allergy can be a hard case to crack! To help you sort it all out, your doctor will probably ask you to be your own – or your child’s – detective. And the first step in solving this ‘crime’ against your health is gathering the clues.

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If neither of your parents have allergies, you have only one chance in ten of being allergic yourself. If one of your parents is allergic, your chances are fifty-fifty. If both your parents are allergic, your chances of being allergic rise to 75 per cent.

That’s not because we inherit allergies. We do, however, inherit genes that make us more likely to be allergic. Scientists call this ‘genetic predisposition’, and what it means is that heredity sets the stage, but nothing happens unless you encounter an allergen (or several). Then – bingo! -you’ve got a reaction.

Beyond that, doctors and medical researchers know little about why some people and their families develop allergies and others get off scot-free. What they do know is that delaying our initial encounters with common food allergens such as milk, wheat, eggs, corn and food additives in infancy seems to go a long way towards preventing food allergies from taking hold. Chalk up another one for breastfeeding. And when foods are eventually introduced, doctors say the best game plan is to introduce them singly and even then for only a few days at a time. That enables parents to recognize a food allergy right from the start, before the connection between allergen and allergy is muddled by exposure to a whole gamut of foods. Food additives, of course, can be withheld indefinitely with no nutritional loss.

Children are also far less likely to develop allergies of any kind if the people around them – especially parents – don’t smoke. Following this principle of ‘early avoidance’ with all highly allergenic materials – such as dust, pollen, pets, moulds and toxic chemicals – may prevent allergies even in highly allergy-prone families.

Scientific research bears that statement out. In one experiment, for instance, doctors focused on the health of fifty newborns who, based on family history and blood levels of IgE, were bound to become allergic. A few simple preventive steps were taken with twenty-five of these children: they were breastfed for at least six months and ate no other food except hypoallergenic milk substitutes; their bedrooms were kept as free as possible of dust and moulds; and no pets were allowed in their homes. By the time the toddlers were two years old, only six had any sign of allergy, even though all twenty-five were allergy prone. In contrast, no preventive steps were taken to safeguard the other twenty-five infants. Consequently, sixteen of the unprotected children – nearly three times as many as the protected group – developed allergy within the first two years (Journal of Allergy and Clinical Immunology).

That doesn’t, however, imply that opportunities for allergy control cease at age two. Many allergies don’t show up until early school age – or even adulthood. If anything, the need for avoidance tactics increases throughout life. Infections, exposure to industrial pollution, degenerative diseases (such as diabetes and atherosclerosis) and the ageing process all play a role in heightening an inherited tendency towards allergy.

Above all, though, exposure stokes the fires. Fortunately, there are hundreds of avoidance tactics, major and minor, at your disposal. You may need to make just a few simple changes in your routine to get your allergies under control. Highly sensitive people may need to make more or bigger adjustments. Regardless of your degree of sensitivity, though, the sooner you begin your natural allergy relief programme, the better.

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Plenty of people are sneezing, wheezing and itching without the foggiest notion why. Others endure nameless aches and pains without so much as an inkling that their problems may be allergy based. Yet it’s often easy to recognize the characteristic habits, complaints or physical signs of an allergy – if you know what to look for.

This chapter will tell you exactly what to look for. It will help you figure out whether or not you (or any of your family) are allergic. And if you are, it will also help you focus on whether the cause is your diet, your environment – or both. As a first step, take the following quiz.

Allergy self-quiz

Do you have watery, itchy red eyes?

Do you habitually rub your eyes, nose or ears?

Do you have a stuffy, runny nose?

Do you get coughing spells followed by wheezing?

Do you breathe through your mouth?

Do you speak in a nasal tone?

Do you have a high-pitched, squeaky voice?

Do you constantly clear your throat?

At this point, you may be saying to yourself, ‘This sounds more like a cold than an allergy’. Well, some eye, ear, nose and throat allergies – like hay fever – can easily be taken for a hard-to-shake cold, especially in children and adults who frequently get colds. The difference? Colds usually last only a few days, then disappear. If the sniffing and stuffiness linger, or if the ‘colds’ occur more than six times a year, you’re probably dealing with an allergy.

Here are some other telltale signs that could mean you have an allergy:

Allergic shiners are dark circles or bags under the eyes – a discoloration caused by swelling of tissues around the nose. Occasionally, shiners will be accompanied by an annoying spasm of the eyelid.

Long, silky eyelashes – inexplicably – often coincide with allergy.

Gelatin like discharge from the corner of the eye is often part of hay fever.

Frequent sties, cysts (chalazia) or tiny white scales along the lower edge of the upper eyelids can be marks of allergy.

Facial grimaces – like nose twitching and mouth wrinkling – are common to people with nasal allergy. ‘Rabbit’ or ‘bunny nose’ contortions momentarily relieve itching.

A nose crease is a horizontal line across the lower third of the nose, where the soft, bulblike portion meets the more rigid bridge. Either an allergic salute or habitual rubbing produces this wrinkle.

The allergic salute – in which a person pushes the nose upward with the palm or heel of the hand – is almost a dead giveaway of a nasal allergy. The ‘salute’ is basically a reflex attempt to relieve an itchy nose or to free sticky nasal accumulations and let more air into the nostrils.

Although many of those signs are accepted hallmarks of an inhalant allergy (such as that to pollen, moulds or pets), people who suffer from other types of allergies can have them, too.

And there are also a number of other symptoms that can bother allergy sufferers of all kinds. For instance:

Are you bothered by itching of the roof of your mouth or throat?

Do you have ringing in your ears, perhaps accompanied by dizziness?

Is your hearing good at times, but poor at others?

Do you ears frequently ‘pop’?

Do you often experience a feeling of fullness in your head?

Do you get headaches?

Is your face very pale?

Do your cheeks bloom in round, red patches, like blotches of rouge?

Do you have pimples around your mouth and chin?

Do you get rashes on your face, neck, inner elbows, inner wrists, hands or knees?

Do you get hives?

Do you have any other skin problems?

Are your lips swollen and puffy?

Do you have exquisitely tender spots, which tend to bother you off and on?

Are your hands and feet cold?

Are your fingers stiff and swollen, especially in the morning?

Do you have unusual body, hair or foot odour that persists no matter how often you wash?

If you answered yes to any of the above, it’s quite possible you suffer a hard-to-pin-down allergy. Until now, you may not have even associated your difficulties with allergy.

‘People have symptoms of allergy that they don’t think of as symptoms at all,’ said Phyllis Saifer, a pediatrician and allergist in Berkeley, California. ‘For instance, I hear patients say, “I thought everybody got diarrhoea after they drank milk.” Or they say, “I always loosen my belt after I eat. Doesn’t everybody?” ‘

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Doctors employing the new approach to allergy take a complete medical history before they do anything else. In fact, they’ll probably ask more questions about your diet and environment than anyone else ever has. If necessary, they’ll also take tests and use immunotherapy. But most use different methods of diagnosis and treatment from those of traditional allergists. Above all, though, doctors taking the more comprehensive approach emphasize that you — the allergic person – must help to identify your allergens and then avoid them whenever you can. In this way, your sensitivities will tend to get better instead of worse.

Part of the success of this person-centered approach to allergy lies in the fact that it can help to uncover allergies that other doctors may not consider. After all, if you have five stones in your shoe and you remove only one, walking will still be painful.

But don’t rush to your regular allergy doctor with the good news that factors he or she hasn’t considered may be your problem. As we’ve already mentioned, these new developments in allergy constitute one of the most controversial areas in medicine today. Doctors advocating the broad approach, however, feel that it’s just a matter of time before the newer view is incorporated into conventional allergy practice.

As it stands now, many people who finally seek out a clinical ecologist have been to as many as twenty or thirty traditional doctors without finding satisfactory relief. The extended approach to allergy has come to the rescue of thousands of allergy sufferers who’ve tearfully parted ways with the family pet, cleaned the house from attic to basement and sworn off their favourite foods, only to feel miserable because non-traditional triggers were not considered. The approach has also helped – and proved right – many people whose complaints were previously written off as ‘nerves’ or hypochondria.

This new approach has also helped many clinical ecologists and other doctors who often have allergy problems themselves or have a family member with chemical sensitivities. In many cases, that’s what hooked them into the approach in the first place, explained Dr Wellington S. Tichenor, a doctor of internal medicine in New York City, who incorporates the broader approach to allergy in his practice. Dr Tichenor described clinical ecologists as ‘people who are observant enough to realize that when they eat beef, they become bloated … or when they eat chicken, they get diarrhoea … or when they eat honeydew melon, they get a sore throat. And their own experience may make them more sympathetic and supportive than other doctors.

‘If what the clinical ecologists are saying is true, it’s going to have a very significant impact on medicine in general and allergy in particular,’ Dr Tichenor continued. Scientific documentation, he told us, has only recently started to accumulate. But it’s going to have a significant impact on society, since the potential benefits in terms of health expenditures and economic costs are immense. Society and businesses will save money because allergic people will be on the job and functioning at their best. Tracking the cause of your fatigue or chronic discomfort to the office copy machine or commuter bus exhaust means fewer days missed from work due to illness – and doing a better job overall. In very sensitive people, it can mean the difference between earning a living or going on disability benefit.

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