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FOOD ALLERGIES

By: Dr. Sushma Shah - Naturopathic Doctor

FOOD ALLERGIES OVERVIEW

As many as two out of five Americans believe that they have allergies to certain foods. In fact, fewer than 2 percent have true food allergies. A food allergy occurs when the body's immune system reacts to otherwise harmless proteins in certain foods. While most food allergies are mild, in some cases they can cause anaphylactic shock, a serious, sometimes life-threatening, reaction. Food allergies affect mostly young children. With the exception of peanut allergy, the majority of children outgrow their allergic sensitivities.

  1. "Food sensitivity" includes all types of adverse reactions to food.

  2. "Food allergy" refers specifically to an immunological reaction.

Most of the literature focuses on immunologically-mediated mechanisms, especially that of food allergy (IgE), and it is likely that the majority of food reactions involve other mechanisms. These mechanisms include:

  • Hypoglycaemic reactions, especially to sugars and other refined carbohydrates

  • Non-IgE histamine release sometimes called pseudo-allergic reactions, such as to food additives such as tartrazine

  • Enzyme deficiencies such as are found in lactose intolerance, fructose intolerance, and sensitivity to dietary amines (deficiency of diamine oxidase)

  • Inappropriate binding of dietary lectins to cell walls or extra cellular molecules, such as wheat lectins binding to deficient IgG in rheumatoid arthritis

  • Neurotoxic molecules, such as glutamate

  • Pharmacological actions, such as from salicylate-rich food

SIGNS AND SYMPTOMS OF FOOD ALLERGIES

  • Swelling or itching lips, tongue, and mouth
  • Dermatitis or hives
  • Runny and itchy nose
  • Headache
  • Stomach pain or upset (gas, bloating, diarrhoea)

The following symptoms should be treated as a medical emergency:
  • Immediate and extreme facial swelling and itching
  • Breathing difficulties
  • Rapid increase in heart rate
  • Rapid drop in blood pressure
  • Itching or tightening of the throat
  • Sudden hoarseness

WHAT IS CAUSING THE FOOD ALLERGY?

The foods that most commonly cause allergic reactions are peanuts, tree nuts (walnuts, pecans, and almonds), milk, eggs, soy, fish, shellfish, and wheat. In most cases, allergies occur when an individual who has a genetic sensitivity to certain allergens is exposed to the substance. However a chronic intake of a certain type of food group can actually cause sensitivity to that particular food or food group and may show up as a delayed sensitivity which brings out the symptoms above 24 - 48 hours later.

It is well-documented that food allergy is an expression of an inherited genetic predisposition. Hence, allergic histories can often be found in both parents and siblings. One study discovered that when both parents are allergic, 67% of the children are also allergic. When only one parent is allergic, 33% are allergic.

Inadequate digestion of food products due to hypochlorhydria and/or pancreatic enzyme deficiency is also thought to be a significant cause of food allergies. Insufficient brush border enzymes such as lactase and sucrase also affect the body's ability to breakdown food to an elemental form.

When proteins are not digested completely, they retain their antigenic properties. These antigenic molecules may then be absorbed through a damaged mucosal barrier or "leaky gut" and exposed to the immune system. This in turn can create a state of chronic immune hypersensitivity and inflammation. In general, foods with a higher protein content (>20%) are more likely to be allergenic.

TESTING FOR FOOD ALLERGIES

Conventionally accepted medical approaches of assessment for this condition may include various tests such as:

  • Blood tests - RAST and Elisa food testing for IgG + IgE food antibodies
  • Skin tests - small punctures made with needles containing tiny amounts of allergens
  • Challenge or provocative testing - your provider may place food extracts under your tongue or inject them.

TREATMENT OPTIONS

The most serious allergic reaction, anaphylactic shock, can come on suddenly and accelerate quickly. In some instances, survival may depend on an injection of epinephrine. If you have history of anaphylactic shock, you should keep a preloaded syringe of epinephrine with you. Alternative therapies reduce inflammation, minimize hypersensitivity reactions, and heal the digestive tract.

NUTRITION


Note: Lower doses are for children.
  • An elimination/challenge trial may help uncover sensitivities. Remove suspected foods from the diet for two weeks. Reintroduce one at a time and watch for reactions. Do not perform a challenge with peanuts if there is history of anaphylactic shock.
  • A rotation diet, in which the same food is not eaten more than once every four days, may be helpful in minimizing allergic reactions.
  • Reduce pro-inflammatory foods in the diet including saturated fats (meats, especially poultry, and dairy), refined foods, and sugar. If you are sensitive to antibiotics, eat only organic meats. Increase intake of vegetables, whole grains, and essential fatty acids (cold-water fish, nuts [unless allergic to them], and seeds).
  • Omega 3 and certain Omega 6 essential fatty acids, such as flaxseed, borage, or evening primrose oil can be anti-inflammatory. Children should be supplemented with cod liver oil (1/2 to 1 tsp. per day).
  • Specific supplements

ENVIRONMENTAL ALLERGIES

Allergic rhinitis (also called hay fever) is the most common form of allergy to the environment. Symptoms often vary with the seasons.

SIGNS AND SYMPTOMS

  • Stuffy, runny nose
  • Sneezing
  • Itchy nose, eyes, and throat
  • "Sinus" symptoms—headache, feeling of pressure behind the eye, pain above the cheekbones and on the lower forehead, aching teeth
  • Skin rashes or hives
  • Diarrhoea or frequent urination

WHAT CAUSES IT?

Your body's immune system is overreacting to irritants in the environment.

Offending factors:
  • Pollens, grasses, or ragweed (in certain seasons and areas)
  • Dust and household mites
  • Changes in temperature or humidity
  • Spicy foods
  • Smoking or prolonged exposure to second-hand smoke
  • Pollution

Food and environmental allergies are known to cause the following illnesses:

ADD/ADHD Celiac Disease Eczema Hypoglycaemia
Arthritis Chronic Fatigue Fatigue Hypertension
Asthma Depression Fibromyalgia Irritability
Autism Diabetes Headaches Irritable Bowel Syndrome
Candidiasis Ear Infections Hyperactivity Leaky Gut
Migraines Sinusitis Stress/Tension
Premenstrual Syndrome Skin Rashes Weight Challenges


WHAT TO EXPECT AT YOUR PROVIDER'S OFFICE

Conventionally accepted medical approaches of assessment for this condition may include an examination of your nose and nasal secretions. You may also be referred to an allergist, a physician who can pinpoint what you are allergic to by performing skin or blood tests.

Under the concepts of functional medicine, assessment is oriented toward determining what is impeding your body's ability to function normally. While some of the conventional medical approaches may help in this determination, they may not necessarily apply to a functional approach. Your healthcare provider will determine which assessment tools are most helpful in establishing a treatment strategy specific to your health needs.

OUR CLINIC OFFERS THE FOLLOWING ALLERGY ANTIBODY ASSESSMENTS

  • IgG Food –IgG antibody levels for 93 different foods raging from various seeds to meats
  • IgG assessments for various specific individual and group environmental substances, trees, molds, mites
  • IgG Food with IgE Food - IgG antibody levels to 88 foods, IgE antibody levels to 19 foods, and Total IgE
  • IgG Foods - 88 foods and Total IgE
  • IgE Molds - 15 common molds and Total IgE
  • IgE Inhalants - 14 common environmental inhalants specific to 18 North American geographic regions and Total IgE
  • IgG Vegetable Food Add-On - 21 vegetarian foods with a total IgE
  • IgG Spices - 24 commonly used herbs and spices and Total IgE

TREATMENT OPTIONS

Take steps at home to eliminate allergens (such as covering your pillows and mattress with plastic covers and using an air purifier). Pet’s hair could also cause allergies among individuals. Certain complementary and alternative therapies (particularly dietary changes) may also be used to successfully treat this condition.

COMPLEMENTARY AND ALTERNATIVE THERAPIES

Allergic rhinitis may be successfully treated with alternative therapies, beginning with dietary changes.

NUTRITION
  • Do not eat foods that trigger your allergies


  • Eat fewer foods and additives that are likely to cause inflammation and allergic reactions, such as saturated fats (meats and dairy products), refined foods, eggs, citrus, bananas, chocolate, peanuts, shellfish, food coloring, preservatives, caffeine, alcohol, tobacco, and sugar

  • Eat fresh fruits and vegetables, whole grains, nuts, and seeds

  • Drink plenty of water and fresh juices

Common Symptoms of Food Allergies  
   
Gastrointestinal Musculoskeletal
vomiting joint pain
diarrhoea low back pain
gas bursitis
infantile  
colic Auto-Immune
abdominal pain and colic rheumatoid arthritis
loss of appetite Systemic Lupus Erythematosus(SLE)
constipation Ankylosing Spondylitis(AS)
malabsorption multiple sclerosis
gastritis  
ulcerative colitis  
intestinal haemorrhage  
functional intestinal obstruction  
duodenal ulcer  
irritable bowel syndrome  
celiac disease  
weight gain  


Neurological

Immune
headache chronic or recurrent infections
fatigue dermatologic acne
insomnia canker sores
irritability eczema
hyper kinesis itching
depression rash
anxiety urticaria (hives)
personality change angioedema dermatitis
seizures  
migraines  
Genitourinary
bed-wetting
chronic bladder infections
nephrosis
Others
fainting
hypoglycaemia
anaemia
sinusitis
eosinophilia
arrhythmia
failure to thrive
Respiratory  
coughing and wheezing , recurrent croup  
chronic rhinitis  
asthma , recurrent otitis media  
recurrent bronchitis  


ALLERGY TESTING - METHODS COMPARISON

  • The double-blind, placebo-controlled food challenge (DBPCFC) is considered the gold standard in diagnosing food allergies. This procedure can be somewhat invasive (requiring subjects to have food antigens administered via a nasogastric tube), is time consuming and potentially dangerous if the reaction is severe. In addition, the DBPCFC is only able to confirm specific food reactions based upon patient history and prior evaluation.

  • Conventional skin testing and RAST tests measuring IgE-mediated reactions cannot guide physicians as to the potential for delayed, non-IgE-mediated reactions. In one study, researchers surmised that because an IgG subclass was involved in late-onset reactions, patients exhibiting delayed bronchial allergic reactions failed to show positive skin test reactions or RAST results to a specific allergen.77 A recent study by Jahn-Schmid et al, demonstrated the increased sensitivity of ELISA testing in detecting food allergies when compared with RAST testing.

  • Skin testing, while a valuable indicator of IgE mediated reactions also has its limitations. This diagnostic test should ideally be performed by a skilled physician as it may trigger life-threatening symptoms such as anaphylaxis

  • The Food Antibody Assessment identifies IgG antibodies to a vast array of food substances using panels for 88 foods. There is also a panel for IgE antibodies to 19 of the most common allergenic foods as well as a total IgE measurement. Additional profiles are available for a more comprehensive antigen assessment. These include an IgG Vegetable Add-On Profile, an IgG Spices Profile, an IgE Inhalants Profile and an IgE Molds Profile. Each additional profile may be ordered separately or combined.

  • The IgG Vegetable Add-on Profile is a beneficial extension of the Food Antibody Assessment for vegetarians or those with a varied diet. This Add-on profile evaluates IgG for 21 vegetarian foods, including grains, fruits, nuts, and beans. This panel includes artichoke, bean sprout, cantaloupe, cashew, cherry, coconut, flax seed, garbanzo, filbert, kamut, millet, mung bean, navy bean, oat bran, parmesan cheese, pistachio, safflower, triticale, watermelon, wheat bran, and wild rice.

  • IgE Inhalants, IgE Molds, and IgG Spices Profiles
  • Hypersensitivities to foods can also occur as a consequence of sensitization to inhalant allergens. A syndrome known as the pollen-food allergy or oral allergy syndrome can occur when inhaled pollens that patients are sensitized to (such as birch, ragweed and mugwort) cross react with plant proteins. These patients often experience symptoms in the oral and pharyngeal mucosa.

    The IgE Inhalants Profile measures relative levels of antibodies to 18 region-specific inhalants. It is customized to include common allergens found in any one of 18 geographic regions throughout the United States, and Canada.

    The IgE Inhalants Profile includes a total reactivity result for general molds. Should this general test be positive, the clinician may want to determine the specific mold(s) affecting a patient. The IgE Molds Profile should then be performed.

    An elevated total IgE on the Food Antibody Assessment with negative individual IgE food results should direct the clinician towards additional IgE Inhalants and Mold testing.

    The IgG Spices Profile determines separate IgG titers for 24 commonly used spices

  • Antibody Testing with ELISA - a detailed and comprehensive analysis is crucial for the clinician to make accurate, precise diagnoses of food and environmental allergies. With the Allergy Antibody Assessment, IgE and IgG levels are assessed using an Enzyme-Linked Immunosorbent Assay (ELISA). This advanced immunological procedure uses an enzyme binding process to detect antibody levels, and has been hailed as a "safe, economical, and highly sensitive test".
  • Because the ELISA method identifies antibodies associated with both immediate and late-onset, delayed reactions, it offers a clear advantage over other conventional food antibody assessments (Adapted from the GSDL allergy assessments)

    The information on this handout is the property of SUSHMA SHAH N.D., and is not intended to treat, diagnose or cure any disease. For any questions, or concerns, please contact me at 416 913 4325 (HEAL) or email me at info@naturesintentionsnaturopathy.com


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