The Allergic Denial

BreadWhen I was growing up I wasn’t that healthy. I often had weekly migraines and got more than my fair share of ear infections and sinus problems. I got taken to all sorts of consultants. I had my adenoids and tonsils removed. I remember this well because Ringo Starr was down the corridor having the same thing done.

One of my strongest memories at boarding school was the excruciating pain of my regular migraines, and trying not to cry in the dormitory. The pain was too much to bear and my migraines crescendoed in violent vomiting.

All this went on until my late teens, by which time I had also acquired a face like a lunar landscape from acne. At one point the tissue inside my nose had become so inflamed that I couldn’t breath through my nose and had an operation where they burn the tissue away. The day after I was as high as a kite, breathing in all this extra oxygen. No one mentioned the possibility of allergy.

I loved milk and cheese. My boarding school was attached to a dairy farm and we used to guzzle the stuff and have milk drinking competitions. This was in the days of the ‘pint a day’ ads. Macaroni cheese, cheese fondues, cheese on toast – these were my favourite things.

Then, at the age of 19 I met the Wrights (who set up Green Farm, now Higher Nature) and tried their weird dairy-free diet. Guess what? The migraines stopped, my skin cleared up and my sinus problems virtually went away. I had what is called allergic rhinitis, but it had taken more than 20 years to be diagnosed as such.

My case is minor. There are many people who suffer for decades with much more serious conditions only to discover, sometimes too late, that they were allergic to a common food. I’ve had patients with rheumatoid arthritis, schizophrenia, terrible IBS, migraines, asthmas, eczema, chronic fatigue who have had complete relief when they eliminated their trigger foods. Liz, who was diagnosed as schizophrenic and spent five years on heavy duty tranquillisers, is no longer schizophrenic as a result of eliminating her allergens.

I learnt that, whenever I have dairy products (sometimes I can get away with pure fat butter) I can feel the blood vessels in my nose start to pulse, then I’m producing more mucus, then a dull headache appears, which can develop into a full-blown migraine. I later had an allergy blood test measuring both IgE and IgG antibodies and, sure enough, I react to dairy products by both measures. The testing process is the same, involving something called an ELISA test.

Antibodies are produced by the immune system and can be tailor-made to recognise a particular type of protein, for example milk or wheat protein. The convention is that food allergies are caused by IgE antibodies, with the exception of coeliacs disease, which is caused by a type of IgA antibody. But growing evidence is showing that IgG antibodies are also involved.

About ten years ago, when the operation had been more or less perfected, I had a procedure to open up the rather deviated channels into my sinuses, and the tiny drainage holes. I was told ‘you’ll never have another sinus infection in your life’. That wasn’t true although the operation did make a significant difference.

Over the years my sinuses have been a real Achilles heal. A few years ago, after an extensive trip off the beaten track in the mountains, desert and jungle of Ethiopia with my daughter, my sinus problems were back. I tried everything I knew but I was still suffering. So I did a YorkTest Food Scan test – a blood test that measures levels of IgG antibodies to foods. I had become sensitive to a whole lot of new foods, including yeast and eggs which we had eaten almost every day in Ethiopia. (Fortunately, this kind of allergy needn’t last for life – if you avoid the food strictly for 3-4 months your body can unlearn the intolerance). I immediately avoided the suspect foods and, within 48 hours, I was better. It was like chalk and cheese. Now, several months on, I am no longer reacting to eggs, but have to be careful about yeast.

All in the mind

The reason I tell you this story is that, over 30 years of visits to doctors and top consultants the majority, not all, have told me that no-one reacts to dairy products, that all this talk about food allergies is rubbish, that the tests are meaningless. It’s all in the mind.

A classic example of this was a report in 2010 that claimed that ‘nine out of ten Britons who believe they have a food allergy or intolerance are perfectly healthy’, researchers say. How did they reach this conclusion? Apparently the researchers from Portsmouth University, did a skin prick test on a thousand children whose mothers had, for one reason or another, kept their child off a food and found that very few tested positive. Dr Carina Ventner, a dietician, was quoted in the Daily Mail as saying: “’Our concern is that people are self-diagnosing allergies which is very unreliable and could even mask a different illness which would remain undiagnosed and untreated.” Cutting wheat out of the diet could lead to a deficiency in B vitamins, while avoiding dairy products will lower levels of calcium, vital in maintaining strong bones, she added.

What is strange about this so-called study is that it doesn’t exist if you search the medical library database. Nor is there any study at all listing this author. Also, if it was based on a rather unreliable skin prick test, and simply selected children whose mothers kept them off a food group, then it is all rather meaningless. But what would the motive be? Well, the report was funded by the Flour Advisory Board. It’s just an attempt to stop people avoiding wheat.

Even the most serious wheat allergy, coeliacs disease, is rarely checked for. It is caused by an IgA antibody reaction but recent research is finding raised levels of IgG antibodies in those with coeliacs and mental illness1. Coeliac disease affects 1 in every 111 normal, healthy adults2. Among those who report gastrointestinal symptoms, it occurs in 1 in 40 children and 1 in 30 adults. Among those who have a father, mother, brother, sister, or grandparent with coeliac disease, the risk is 1 in 11. So the condition is far from rare. Yet up to one in ten people with coeliacs disease go undiagnosed3 sometimes with serious consequences.

For example, last year I heard of a case of a man, finally diagnosed in his forties. He was dead within a year. Intestinal cancer is often the first symptom that leads to the diagnosis of coeliacs because the medical profession don’t take allergies seriously, fuelled by erroneous reports like the one above.

Many people avoid dairy products because, like me, they react to them. By the way, having an allergy to dairy products is not the same as being lactose intolerant. This common condition results from not being able to make enough of the enzyme, lactase, that digests milk. That causes all sorts of digestive problems such as bloating and diarrhoea. I don’t get any of those. Just migraines and sinus problems. Dairy allergy is to the protein in milk. That’s why a pure dairy fat, such as butter or ghee, is much less allergenic than skimmed milk – less fat more protein.

The allergic convention is wrong

The conventional understanding of an allergy is that you produce IgE antibodies against a food. Skin prick tests are sometimes used to discover IgE based allergies.These kind of antibody reactions are for life. They don’t go away like the IgG antibody reactions can. Yet, one top ENT consultant said she’d never heard of anyone with sinus problems having an allergy to milk. That is so strange because I have met hundreds! If you are lucky you may get a skin prick test. This is reasonably accurate for picking up IgE allergies, but not IgG allergies, but usually you are tested for less than ten substances, so you have to guess right in the first place.

There seems to be some kind of blanket denial that any other kind of intolerance to foods even exists, much like the blanket denial that there might be something wrong with GM foods.

This is in sharp contrast to what people report. In a US survey of 3,300 adults 43 per cent said that they experienced adverse reactions to food. An audit by York University of over 5,000 chronic sufferers of a wide range of illnesses that hadn’t responded to conventional treatment, reported that 70% found relief from their symptoms by eliminating food allergens, identified through the same FoodScan test I had. In fact, almost a quarter obtained 100 per cent relief! In this audit, 92 per cent who slipped up and ate their identified allergens noticed a return of symptoms. The sceptics might say that this is just wishful thinking, a kind of placebo effect – that you’ve paid your money for a test, you believe in it and get better.

But even ‘double-blind’ studies show the same kind of result. These aren’t easy to do but, for example, one group of researchers tested 150 irritable bowel syndrome (IBS) sufferers and gave real or fake results to their doctors, who then advised them what to avoid, not knowing if the results were real or sham. Only those on the real allergy-free diet got better. On top of this, those who complied better got better results in the ‘real allergy-free diet’ group while compliance made no difference in the ‘sham diet’ group4. Other studies have shown the same thing. (I’ve written extensively about it in my book Hidden Food Allergies).

Allergy or food intolerance?

The definition of an allergy is that the body’s immune system reacts against a substance. Despite two decades of research on IgG antibodies, these are still not conventionally accepted as causing an ‘allergy’. To get round not offending the so-called experts IgG tests are often called Food Intolerance tests rather than allergy tests. But the mechanism of reaction is essentially the same. The body makes an antibody that attacks a food protein causing symptoms. The one difference is that IgE based reactions tend to occur fast – within an hour of consumption, while IgG reactions can be delayed, even with symptoms developing the next day. If you take IBS as an example, sufferers do not have more IgE reactions than healthy people. But they do have more IgG reactions. Also, if they avoid their IgG reactions they are much more likely to get better. To quantify this the NNT (numbers needed to treat) is 2.5. In other words, if five people had an IgG test and avoid their suspect foods, two would get better. The NNT for the best drug is 17.5.

You can’t say IgE associated reactions are really allergies because they are based on science, and say that IgG associated reactions are not when the science supports it, at least in this case for IBS. That’s just bad science.

In truth, there are no ‘perfect’ allergy tests. You can even be shown to have an IgE allergy, but get no symptoms. But, at least having an IgE and/or IgG test gives your health practitioner and you more information to go by.

Allergies and inflammatory health problems are on the increase

In the time I’ve been in the field of health care it is impossible not to notice the increase in children with asthma, eczema, also the increase in IBS, sinus problems, and people reporting that they react to one food or another. The official figures confirm all this. One study, for example, states that ‘asthma prevalence increases by 50% every decade’5. The same is true with eczema. A report in the Royal Society of Medicine says there’s a 42% increase in new cases of eczema each year6. Some say the same is true for IBS. There has also been a 500 per cent increase in hospital admissions for allergies. Is this all psychological or is something really going on?

The increase in allergic and inflammatory health problems is, I believe, all part of humanity’s shift into an unhealthier state, paralleling the rise in metabolic syndrome, diabetes and even cancer. When the body’s systems are stressed they react by going into an inflammatory state. The body produces inflammatory chemicals that make the immune system hyper-reactive. This increases risk for allergy and, if inflammatory goes on and on, it weakens the immune system, which then increases cancer risk. Anything that challenges immunity – from vaccines to viral infections, antibiotics to allergies, and probably GM foods – feeds inflammation. The body’s immune system fights overloaded fat cells, and is tipped into inflammation by an onslaught of high sugar and fat foods, devoid of anti-inflammatory omega 3 fats and vitamin D.

This fundamental shift in our body’s metabolism is fuelling most of the common 21st century diseases. The pharmaceutical answer is anti-inflammatory drugs – pain killers. The average person takes 373 a year, and rising. These, in turn, damage the gut which is a wafer thin membrane separating food and your bloodstream. The epithelial cells that make up this surface are less than half a sheet of paper thick, covering a surface area of about a tennis pitch. When anti-inflammatory drugs damage this surface, as do antibiotics and alcohol, your risk of developing a food allergy goes up. This is because undigested food protein gets into the blood and the immune system reacts. You have more antibodies in the gut that anywhere else precisely because this is the gateway into the body and the antibodies are the bouncers. You also need probiotics, beneficial bacteria, because they form the first line of defence in the gut.

This kind of thinking leads nutritional therapists like myself to test for allergies and give supplements such as probiotics, glutamine and digestive enzymes, to heal the gut, and more omega 3 and other natural anti-inflammatories to calm things down. This kind of approach works much better than drugs.

Patrick Holford.  www.patrickholford.com

REFERENCES

  1. Dickerson F. et al., ‘ Markers of gluten sensitivity and celiac disease in recent-onset psychosis and multi-episode schizophrenia.’ Biol Psychiatry. 2010 Jul 1;68(1):100-4
  2. Gerarduzzi,T. et al., Celiac disease in USA among risk groups and general popula- tion in USA, J Pediatr Gastroenterol Nutr, vol. 31, pp. 104 (2000)
  3. Steele R; Diagnosis and management of coeliac disease in children. Postgrad Med J. 2011 Jan;87(1023):19-25
  4. Atkinson W et al., ‘Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial.’ Gut. 2004 Oct;53(10):1459-64
  5. Braman S. ‘The Global Burden of Asthma’ CHEST July 2006 vol. 130 no. 1 suppl 4S-12S
  6. Simpson CR, Newton J, Hippisley-Cox J, Sheikh A. Trends in the epidemiology and prescribing of medication for eczema in England. JRSM 2009; 102: 108-117
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