The long-term consequences of undiagnosed and untreated allergies include just about anything due to the constantly elevated level of inflammation and the generation of free radicals that damage tissues and organs. In addition, people with allergies are more likely to develop more allergies, increasing the misery and the long-term health risks.
What is an allergy?
Allergies occur when the body’s immune system (which has the important role of protecting us from foreign invaders) reacts to non-threatening substances such as food or pollen, as if they were harmful. This can cause chemical reactions in the body which sufferers experience as unpleasant (and sometimes life-threatening) symptoms.
It’s important to be aware that reactions to food-related reactions are not necessarily allergies. The can also be classed as intolerances. Adverse reactions to food can be divided into five distinct groups.
- Classical true food allergy, such as peanut anaphylaxis – where there is an immediate IgE immune mediated reaction. This will require emergency adrenaline injections and may necessitate medical resuscitation.
- Delayed food allergies are sometime referred to as hidden or masked allergies. The reaction to the causative foods can take up to several days to manifest and may take much longer to resolve following removal of that food from the diet.
- Food Intolerances which are not immune mediated but may be due to enzyme deficiencies, and other mechanisms that mimic true allergic reactions.
- Contaminants or poison present in food causes toxicity, which then causes recognisable reactions.
- Food aversion occurs when a person is convinced that they are allergic to a food, but when challenged with the food, fail to have any reaction.
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True Food Allergy
True Food Allergy, is an immediate IgE-mediated reaction. A small protein particle called an allergen is responsible for triggering the antibody response – this causes mast cells to release histamine, resulting in tissue inflammation and swelling. The antibody called Immunoglobulin E (IgE) accounts for 90% of true food allergic reactions. A reaction can occur even to minute traces of the offending allergen and in exquisitely sensitive individuals, even airborne food allergens can trigger anaphylaxis – as in severe fish and peanut allergy.
Classical IgE Mediated food allergy presents with immediate red skin rashes, swelling of the face and neck and even anaphylaxis with shock and circulatory collapse. In adults, the foods most commonly implicated in anaphylaxis are peanuts, tree nuts, shellfish, fish and egg (white).
Exacerbations of eczema and rhinitis can occur in food allergy. Vomiting and diarrhoea, oesophagitis can also occur. Frequently patients think they are allergic to one food but may actually be allergic to 3 or more foods.
Oral Allergy Syndrome occurs when allergic reaction is localised to the mouth and throat and is triggered by fruit and vegetables such as apple, peach, celery, tomato and cherry.
Delayed T-cell mediated food allergic reactions are typically seen with contact dermatitis and Coeliac Disease – these take 24 hours or more to evolve. These types of reactions do not involve IgE antibodies. IgG-mediated reactions are very common and usually undiagnosed. Research has confirmed a connection between IgG or delayed allergy and inflammatory bowel conditions such as Irritable Bowel Syndrome. IgG antibodies can be measured to identify the specific foods implicated.
Food Intolerance (Non-allergic food hypersensitivity)
Food Intolerance is an adverse reaction that does not involved the immune system. Reactions are dose-dependant – smaller amounts of the offending food may be tolerated, but at a certain dietary threshold a reaction will occur.
This may be due to an enzyme deficiency such as occurs in lactose intolerance. When lactase (the enzyme that enables us to digest lactose – the sugar in milk) is depleted the result is cramps, flatulence and frothy diarrhoea after drinking cows milk. It affects up to 20% of the population, beginning in teenage years and gets worse with advancing age. Lactose intolerance is more common in Asians, African, Hispanic and Mediterranean populations.
Intolerance to sucrose in table sugar and fruit can lead to similar symptoms if there is a deficiency of the intestinal enzyme which breaks sucrose down to absorbable fructose and glucose.
Food Toxic Reactions & Food Additives
Food Toxic reactions have no immune basis, but are due to bacterial endotoxins and contaminants. This results in vomiting, diarrhoea, flushing and certain neurological symptoms in all individuals who consume the food.
Other biologically active toxins include algae that infest shellfish with paralytic neurotoxins, glyco-alkaloids in potatoes and amatoxin in mushrooms. Mycotoxins in grain produce such as wheat, rye, barley and oats can cause Ergotism with gangrene and convulsions. Scromboid toxicity occurs when fish putrefies and releases histamine causing allergy-like reactions.
Food additives such as colourants and preservatives may trigger pseudo-allergic reactions. These are not IgE mediated, but possibly involve direct Mast Cell and Basophil Histamine Release. Histamine may even occur naturally in foods and when absorbed in the GI tract, the histamine content triggers an allergic-like reaction. A similar reaction can also be seen with naturally occurring dietary salicylate in aspirin-sensitive people. Other chemicals found in food can cause ill effects such as caffeine induced palpitations. Capsaicin in chilli’s induces a typical “hot curry” burning oral sensation, and alcohol-induced flushing and nasal congestion is due to local vasodilatation.
Allergy vs Intolerance
As detailed above, an allergy is mediated by the immune system, and markers for such reactions can be measured in the blood. An intolerance is often completely confined to within the gastro-intestinal tract and thus is NOT detectable by a blood test. The gold standard for this kind of problem is elimination and provocation testing.
Possible Symptoms Associated with Food Allergies:
Cognitive & Psychological
Head & Neck
Muscle and Joints
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There seems to be so many tests available to detect food allergies that it can be very difficult to know where to start. Most medical tests in New Zealand are assessing immediate (IgE) allergies, however this is often not enough, as some foods may provoke a delayed (IgG)response.
The SKIN PRICK test: this test is usually ordered by your doctor (however, we can also arrange it), and involves using a small needle to gently prick the skin and introduce a drop of fluid containing a known allergen. The reaction – noted within the next half hour will help identify IMMEDIATE (IgE) allergic reactions to a limited number of allergens. The usual substances tested include dust mites, animal hair, various pollens and highly suspect foods. However, not all food allergies will show up here as a) the antibodies are not so concentrated in the skin and b)not all allergic reactions are immediate.
The standard BLOOD TEST: A sample of your blood is taken and sent to a specialist laboratory for what is known as the ‘RAST’ (Radio AllergoSorbent Test). This measures the amount of specific IgE antibodies (which trigger a histamine release) in your blood to various environmental and food allergens. House dust mite IgE will be raised if you have an allergy to house dust mites and the result is then graded, depending on the level of that particular IgE in the blood. Over 400 different allergens can be tested for in this way, but usually only half a dozen or so of the most likely culprits are tested due to the cost – between $24 and $30 for each item tested.
The ELIMINATION AND CHALLENGE TEST: Considered by many allergists to be the “gold standard” – the diets is reduced down to a minimal “low-reactive” diet until symptoms have abated. Then foods get gradually reintroduced in a controlled manner and symptoms are noted. This method is very effective but is also very difficult to comply with and can take many months to test all foods.
At HOUSE OF HEALTH we can guide you through the Elimination & Challenge test, providing comprehensive support as you go through the process. We also offer a comprehensive medical blood test that is sent to a laboratory in the United States for IgE and IgG allergies to at least 96 different foods. Vegetarian panels are also available as are extended spice panels. Results take around 3 weeks and include a food rotation plan to help you reduce your exposure to the problem food families and avoid developing more allergies in the future.
Select either delayed allergy or immediate and delayed allergy to download a sample report (requires Adobe Acrobat). For more details call our office for an appointment.
Some practitioners perform tests that have not been shown to have an acceptable degree of diagnostic reliability on repeated testing. They shouldn’t be relied on for allergy diagnostic purposes as they are of an inferior nature according to the British Society for Allergy and Clinical Immunology.
VEGA testing involves the measurement of disordered electromagnetic currents in the body to certain substances. Results are very unreliable according to the British Medical Journal.
APPLIED KINESIOLOGY tests muscle strength in the presence of various allergens, with a loss of strength indicating an allergy. This test is equally unreliable according to the British Society for Allergy and Clinical Immunology. However, in some cases, with a very experienced practitioner, we believe that this method may be of value. At House of Health we offer QRA analysis – a method that uses a form of applied Kinesiology with some of the principles of traditional Chinese medicine.
HAIR ANALYSIS involves testing a hair sample in either a VEGA or EAV machine, testing for energy fluctuations according to various substances. These methods have been assessed and found to be unreliable allergy tests.
PULSE testing involves counting the pulse rate, ingesting a food substance and noting any difference in the pulse rate 10-20 minutes later. This is incredibly unreliable due to the fact that there are so many factors that affect pulse rate, not least of which is the digestive process itself!
The Nutron and ALCAT tests (also known as leucocytotoxic tests) measure cellular changes in the blood after introduction of various food allergens. These tests had a poor reliability for diagnosing allergies when they were subjected to clinical trials according to the European Academy for Allergology and Clinical Immunology.
What Can I Do?
So, you think (or know) you have an allergy – it’s time to contact us. We will take a full clinical history from you including your symptoms, details of when they occur and any other relevant information. Some allergies can be pinpointed without any further testing. We will then be able to offer you advice requiring diagnostic testing and support options to help minimise your symptoms, plus dietary and other practical advice.
Our BradCliff Breathing Specialist may be of help also.
or give us a call 09 846 5566