Conscious Choice: Food Allergies

November 1999

Food Allergies

by Mary Wisniewski

I am an unlikely candidate for alternative medicine. I’m the sort of person who read Bertrand Russell in high school for fun. I snicker openly at crystals and reiki.

But by the time at I came into Dr. Martha Howard’s office at Wellness Associates last year with a variety of uncomfortable symptoms, I was at the end of my Western medicine rope.

Since high school, I had suffered from migraines, indigestion, and rheumatic aches in my legs. I also had gone through bouts of serious depression. My primary doctors thought these were all different problems, and sent me to different specialists for treatment. I was given different pills for the aches in my legs, head, and stomach — and other pills for the kinks in my mood. After fourteen years of experimenting, nothing worked. In fact, many of the drugs made me worse — the pills for depression played havoc with my already shaky digestion.

Before I could see Dr. Howard, I had to fill out an eight-page form about how I was feeling — in every little detail. Do you ever feel stuffed up after eating? How often do you go to the bathroom?

Howard, a slim, gray-haired woman who wore undoctorly gray corduroy overalls over a pink T-shirt, reviewed my form and asked me more questions. Then she told me what I least expected to hear. "I think you’re allergic to something."

"Oh, no, I don’t have any allergies," I corrected her. I meant I didn’t sneeze during pollen season; I didn’t puff up like a blowfish when I ate peanuts; and I had survived both bee stings and penicillin shots. I wasn’t allergic in any of the ways I understood.

"You’re probably allergic to some common food," she insisted, and recommended both a skin test and a blood test.

She was right. The blood test showed I was highly allergic to barley, chocolate, and sardines. Fortunately, I hate sardines. But I love chocolate. And barley is in most store-bought baked goods and all beer. I had to overhaul my entire diet and start baking my own bread.

But the information changed my life. Two months after I cut the forbidden foods from my diet, all my symptoms disappeared and did not return. I am grateful for my health — but I’m also angry that I had not learned this before.

Different Interpretations

Some food allergies are severe and obvious — as little as half a peanut can send an allergic person into cardiac arrest (see sidebar). These allergies only affect about one or two percent of adults and five percent of children, according to the Food Allergy Network, in Fairfax, Virginia. Severe allergies are caused by the immune system’s reaction to a certain food. The body creates IgE antibodies to that food. When these antibodies react with the food, histamine and other chemicals known as mediators are released from body cells. These mediators can cause hives, asthma, or other symptoms. A severe allergic reaction, known as anaphylaxis, can include hives, swelling, difficulty breathing (either because of swelling in the throat or asthma), vomiting, diarrhea, cramping, and a fall in blood pressure. The eight foods that cause 90 percent of all of this type of IgE reaction are milk, eggs, wheat, peanuts, soy, tree nuts, fish and shellfish.

Most people are familiar with this type of allergy — they might remember the little boy at the birthday party who couldn’t eat cake with the walnuts in it because he’d have to go to the hospital. Conventional American medicine also recognizes food intolerance, such as milk intolerance, in which a person lacks an enzyme needed to digest milk sugars.

But according to Howard and other doctors who have studied food sensitivities, most traditional, Western-trained physicians have been slow to recognize the effects of more subtle forms of food allergy. These types of allergies can cause seemingly unrelated ailments such as acne, arthritis, depression, fatigue, headaches, insomnia, intestinal problems, excessive weight, sinus problems, ulcer, and eczema.

"They (allopathic practitioners) will recognize an allergy in something that causes an antihistamine response," Howard said. "It causes an immediate type of response — sneezing, runny eyes, swelling in the eyes or throat, which causes the kind of reactions that can send people into anaphylactic shock and send them to the hospital. In common terminology, that’s an allergy."

But Howard said there’s another type of allergic response to food called delayed-type hypersensitivity, which is recognized in standard medical books but for some reason is not often considered by doctors.

"They’ll tend to call it just a sensitivity or say that’s all in your head," Howard said. "But if they’d look in their medical books, they’d see there’s a type of allergy called delayed-type hypersensitivity triggered by another immunoglobulin called IgG."

In the IgG response, the body has identified a substance, for whatever reason, as a foreign protein that needs to be attacked. "Your immune system is then attacking the food," Howard explained. "It’s a delayed response and it’s much more vague. It’s an irritable bowel, bloating, gas, sinusitis, joint pains, fatigue. It happens anywhere from an hour to a day or two after you’ve taken the offending substance."

Howard believes that about 20 percent of the population suffers from this delayed-type hypersensitivity. "Think of the many people who believe they have spastic colon or irritable bowel syndrome," Howard said. "I believe that’s a garbage diagnosis for people who have delayed-type hypersensitivity."

John Quinn, a naturopath who advises customers at Sherwyn’s Health Food Store on allergy remedies, also believes that food allergies are more common than most people suspect, and that they’ve become more common than they were in the past. "The liver’s taking a beating because of all the garbage in food," Quinn said.

Sources of Trouble

Doctors and other health practitioners offer many explanations as to why people develop food allergies and intolerances. One possibility is genetics, noted Yosef Pollack, a licensed acupuncturist who practices traditional Chinese medicine at American WholeHealth. "Some people are just incapable of producing certain enzymes. They just can’t digest them."

A Canadian study that supports the theory of hereditary food allergies found that African-Americans, Native Americans, and Asians have a higher incidence of milk intolerance than people of European ancestry.

Howard agreed that some allergies are probably genetic. But she says another possibility is that the body has learned to react to a certain food because it is associated with something else, according to Howard. In immunology, this is known as a hapten. A certain food — the hapten — may have had a pesticide on it, or a person may have had a viral illness at the time of consuming the food. "So your body learns an immune response to the food. It thinks [the food] is just as bad as the virus or pesticide."

"It’s almost as if two people ran at you in a dark alley and you got hit over the head," Howard explained. "When you woke up, you just knew you were mugged. You didn’t know that just one of them beat you up and the other was running away. If you saw either of those two faces again, you would be afraid. That’s the same thing your body does. If there’s a pesticide or mold on grapes, and the body reacts to the mold or pesticide, it reacts to the grapes, too. That’s why people are reacting more and more to things, because they’re reacting to the pesticides."

In my own case, Howard believed I was actually allergic to barley — not a pesticide — because I wasn’t allergic to any other grain that might have received the same types of pesticide.

Dr. Jacqueline Krohn, author of The Whole Way to Allergy Relief and Prevention, suggested that discouraging breast feeding and substituting cow’s milk (a common problem food) fostered several generations of allergic people.

A food allergy may also be temporary — prompted by stress or some sort of imbalance, according to Pollack. "Some things you may be tolerant of today, five, ten years later you won’t tolerate anymore. You may be emotionally stressed out, or you may be lacking vitamins," according to Pollack.

Krohn noted that when allergens, stress factors, or infection have created an overload, a person may be unable to tolerate a food that he or she could tolerate under better conditions. Krohn wrote that low sensitivity foods can sometimes be tolerated separately, but not together. Correctable conditions, such as low stomach acid, nutritional imbalances, or so-called "leaky gut syndrome" (a digestive condition thought to diminish adrenal function) may also account for some food allergies, according to Krohn.

Testing

Testing for the recognized, IgE type of allergy can be done in a doctor’s office with a skin-prick test. The doctor places a drop of the substance being tested on a person’s forearm or back and pricks the skin with a needle, allowing a tiny amount to enter the skin. If the patient is allergic to the substance, a weal (like a mosquito bite) will form in about fifteen minutes. This type of test is used for such common allergens as pollen and milk.

Testing for other types of allergies takes longer. The test for IgG (also known as IgG4) is a blood test, performed at a laboratory, which measures the summary of antibody reactions of the blood to certain types of food. A person highly allergic to sardines, for instance, might have a reactivity level of 2250 for that food, compared to a zero reaction for halibut. Foods with low-to-moderate levels may be tolerated occasionally — I tested 546 for cocoa, so I can have some every four days.

The prick test is commonly done in doctor’s offices; the blood test is less frequently recommended. Why don’t allopathic doctors test more often for IgG?

"It’s not in their usual way of doing things," Howard explained. She warned that doctors "tend to react defensively to new information, especially if it comes through the integrative establishment. . . .It’s a defense response." she mused, "I certainly think it is a mistake for them to ignore this part of their own knowledge. Documentation for this response exists is in allopathic medicine." Howard noted that allopathic doctors often will recognize this delayed-type hypersensitivity when it affects the lungs — as in delayed type-sensitivity numinitis. Yet, typically, they don’t recognize other IgG conditions, such as delayed-type sensitivity colitis."

Lucina Sarber, a Chicago woman with a variety of food sensitivities, said that for twenty years she had been diagnosed as having an ulcer or a spastic colon. She recalled once having to suffer through three-hours of tests — a sigmoidoscopy, endoscopy, acidity tests, and an upper-lower G.I. series — "the worst tests you can imagine." At the end of it, she saw a hospital doctor and he asked Sarber what was the problem. "after all those tests, I want you to tell me," Sarber said. "He said,‘they lost all your tests.’ I almost lunged across the desk and went for his neck."

Sarber later ran into a nutritionist seeing people for free in a health food store. "She asked me if I’d ever had a glucose tolerance test or a stool test," Sarber recalled. Sarber hadn’t, so the nutritionist had the tests performed. Sarber found out she had a hypersensitivity to sugar in all its forms. Through carefully watching her sugar intake and taking lactic acid tablets to help her digestion, Sarber has conquered twenty years of debilitating gastrointestinal suffering.

Dr. Larry Stoller, a psychologist with American WholeHealth, said that practitioners in his field have been slow to recognize the role of food allergies on mood. He said even three years ago, he would have scoffed at the idea of food allergies causing depression, but now he is "well aware" of the problem.

"There are times when food sensitivities play a major role in creating and maintaining mood problems — chronic anxieties, depression, the whole range," Stoller said. "It’s something to be looked into whenever anyone isn’t showing a prompt response to treatment."

"I don’t think this is being recognized in my field generally," Stoller said. "In the pockets of alternative and complementary medicine, yes."

Howard had a patient whose dry eyes and headaches were so disabling she couldn’t go anywhere. She had seen four other doctors and been told she might have a rheumatological disease known as mixed connective-tissue disease. Howard tested her and found the woman was allergic to milk and eggs. The woman cut them out of her diet and has joined a motorcycle club. "She is very healthy," Howard says.

Treating Allergies and Intolerance

Foods that cause severe histamine IgE responses must be avoided altogether, according to all allergy research. Though there are some treatments — such as lactose intolerance tablets — for food intolerance, there is no injection that can cure food allergies.

For IgG allergies, it is recommended that once the offending foods are identified, a patient must abstain from them completely for three months to one year. After the avoidance period has passed, a patient can begin re-introducing foods to determine their effects. If there is no reaction, a patient can add that food to the diet and eat it every four days, but no more than that. Eating it frequently will reestablish a sensitivity to that food, according to information from the Great Smokies Diagnostic Laboratory in Seattle, Washington, which tests for IgG allergies. If a re-introduced food continues to cause a reaction, it should be avoided. Some foods may be "fixed allergies," which means they will cause symptoms whenever they’re eaten. All practitioners interviewed who recognize non-IgE food allergies agree that people should choose real, additive- and pesticide-free food.

Chinese medicine does not refer to food reactions as a food allergy or food poisoning, but will recognize certain signs and symptoms as "toxic heat." Chinese medicine addresses this through "cooling the environment" by providing a cooling mineral or herb, according to Pollack. He may recommend that people avoid offending foods for perhaps six months, but not necessarily forever, while the patient is undergoing herbal therapy to address the problem. But Pollack noted that some reactions are more severe than others — and may involve genetic dispositions to reject certain foods. "If that’s true, we may suggest‘don’t ever eat this again.’" Quinn also may recommend a product called "Bioallers," a homeopathic product which he says can help patients desensitize their body to grains, milk, animal hair, and other irritants. "It’s one of our biggest sellers."

Dealing with a food allergy can be extremely challenging, especially if it involves something common, like wheat or corn. Avoidance requires constant label reading — to check for offending ingredients like corn syrup, (or, in the case of a barley allergy, malt or maltodextrin. I’m always running into bad news: oh, no, I can’t eat Pringles!) Fortunately, this modern urban society, which may be the cause of some allergies, offers a wide variety of foods that can substitute for forbidden substances.

Of course, even with the blessings of variety, it’s not always easy to give up foods you’ve loved all your life. People can develop an emotional attachment to certain foods — like chocolate chip cookies — and carob chip cookies just aren’t the same. But once you’ve recognized an allergy and know for certain how it affects you, it’s easy to give a substance up because life without it is so much nicer.

This past spring, I was at the Abbey Pub and ordered a pint of Guinness, a perfectly wonderful drink which is basically liquid barley. I really wanted the Guinness, and decided that maybe my allergies were all in my head. I hadn’t drunk half the glass when my face got flushed, and my throat and nose filled up with phlegm. My friends laughed at me — and bought me a non-allergenic pint of cider. It was delicious.

Resources

Dr. Martha Howard, Wellness Associates of Chicago, 706 W. Junior Terrace, Chicago, IL; 773-935-6377

John Quinn, Naturopath, Sherwyn’s Health Foods, 645 W. Diversey Pkwy., Chicago IL; 773-477-1934

Yosef Pollack, L.Ac., American WholeHealth, 150 E. Huron, Ste. 1100, Chicago, IL; 312-266-8565

Dr. Larry Stoller, Psychologist, American WholeHealth, 990 W. Fullerton, Ste. 300, Chicago, IL; 773-296-6700

Great Smokies Diagnostic Laboratory, Ashville, NC; 800-522-4762

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