Food Allergies

Immediate and Delayed Patterns - a Common Cause of Disease 

Food allergy is a complex of immune responses that can cause chronic disease. We think more than 80 Million North Americans have disease from Food Allergy!

There are different types of food allergy. The immediate or type 1 food allergy pattern is easily recognized because it involves quick and dramatic symptoms. Hay fever is the most common type 1 allergy and can be diagnosed by allergy skin tests. Some food allergy is also type 1 and shows up on skin tests. Delayed patterns of food allergy are not so obvious and generally go unrecognized. Allergy skin tests do not show this problem nor do IgE antibody tests such as RAST or ELIZA. Symptom onset is delayed many hours after eating foods and chronic disease is often the result.

Here are our basic assumptions:

v     Food allergy is caused by immune responses to food materials.

v     There are several different mechanisms of food allergy.

v     Everyone has food allergy - it’s a matter of how much.

v     Most symptomatic people do not know they have food allergy.

v     The existence of food allergy is often missed or ignored.

v     Laboratory tests for food allergy must include the IgE and IgG factions.

v     Diet revision is both diagnostic and therapeutic. 

v     You get better by following a proper diet revision plan.

v     You get symptoms back when you eat the wrong food. 

v     Immune responses to food materials create many symptoms in any and all tissues of the body in complex patterns. 

v     We refer to all types of immune responses to food as food allergy, not “food sensitivity” nor “food intolerance”.

Food Allergy as Common Disease

The advocates of a broad definition of food allergy run the risk of being evangelical. The conviction that food allergy is a ubiquitous cause of disease comes from several vantage points:

v     Knowing the wide range of benefits of diet revision in clinical practice

v     Observing food reactive symptoms in recovering patients

v     Understanding the immune mechanisms behind food allergy

v     Recognizing problems in the food supply

v     Recognizing the frequency of problems in the digestive tract

Many books in the popular literature talk about food allergy, sensitivity and intolerance. Many books and articles proclaim the benefits of diet revision and a ground-swell of interest and concern has engaged an ever-enlarging group of patients in the search for nutritional solutions to their health problems. A variety of practitioners have emerged with dubious schemes to test for and treat “food sensitivity”.  MD’s, unfortunately, have retreated to the safe ground of prejudice and believe that food allergy is something for quacks and charlatans and not real doctors.  Often, the patients who benefit from proper diet revision are distanced from a medical profession who is not interested or denies the problem of food allergy. Some of the issues that arise are semantic and political; some of the issues arise from vested interests attempting to control public opinion.  Other issues involve the very complex biology of food-body interactions, which are not well understood. Yet other issues involve the changes in the food supply, which have accelerated in the past few decades.

Mysterious Illnesses

When you do not know about food allergy mysterious diseases surround you.  When you know about food allergy, a lot of common illness patterns begin to make sense. Linda Gamlin writing about food allergy in the New Scientist stated that: “Evidence is growing that many debilitating and chronic symptoms of ill health come from an intolerance for certain foods.  “The medical establishment finds many aspects of food intolerance difficult to swallow, but the main problem is the plethora of symptoms and the variations from one patient to another. Doctors working with food intolerance report more than 40 possible symptoms and conditions...the severity also varies. Some patients are said to have nothing more than the occasional migraine or bout of fatigue, while at the other end of the scale the sufferer is unable to work or lead any sort of normal life.”

The Most Common Symptoms

The most common presentation of food allergy is a nonspecific illness with many symptoms in many parts of the body over a long period of time (months to years). Flushing, sweating, fevers with food allergy feel like an infection or the “flu”. The illness may be mild and involve symptoms that either come and go over many years or   the illness may progress and become disabling.

Common Symptoms:


Abdominal pain

Fatigue

Aching, stiffness

Fever

Cravings

Compulsive eating

Headache

Drowsiness

Nose congestion

Edema (water retention)

Indigestion, flatulence

Mental fogginess

Sore throat

Irritability

Joint pain

Muscle aching

sweating

Sleep disturbances

Diarrhea


 

A whole-body disease:

Over time food allergic symptoms may appear in any part of the body.  Symptom clusters may have descriptive names or diagnoses such as eczema hives asthma irritable bowel, migraine, chronic fatigue, depression, fibromyalgia.

Other symptom complexes remain ill-defined and nameless.  Many patients with food allergy have a combination of these specific and non-specific problems and we have called it the Type III pattern or the “Sick-all-over Syndrome”.

Since food allergy is a whole-body disease, a lottery selection of disturbances may evolve over many years. In many patients, we can trace the illness pattern back to infancy with slow, intermittent emergence of symptoms.

In other patients the illness begins abruptly with few prior symptoms and progresses rapidly.

A non-specific food-allergic illness may eventually become a more severe chronic illness such as arthritis, inflammatory bowel disease, asthma, or lupus erythematosis.

Food allergy is often confused with infections, bacterial and viral.  Symptoms such as aching, fever, fatigue, headache are common to both allergy and infection. The diagnosis may be colds, flu, Epstein Barr virus, Candida yeast infection, or just “a virus”. But food allergy keeps recurring, whereas infections are usually infrequent events.  Abnormal eating patterns are often part of any food allergy complex. Many patients describe intense food cravings with compulsive eating and excessive weight gain. Others develop food aversions, become picky, fussy eaters and may have erratic weight fluctuations or lose weight.  Abnormal eating experiences and problems with weight management may be symptoms of food allergy.

A small number of the patients are starving from food deprivation. They have learned to avoid eating because it causes them so much discomfort; the longer they avoid food the less tolerance they have for eating.

See case histories for examples.

Bias toward type 1 immune activity - simple linear ideas

American and Canadian allergists tend to focus on type 1 hypersensitivity mediated by IgE-armed basophils and mast cells. Some of these physicians view allergy practice as exclusively concerned with type I reactions and ignore or diminish any effort to describe, investigate and understand other forms of immune reactivity.

Thus two camps have arisen - the exclusively IgE group and the IgE plus other mechanisms group. Since the type 1 model is simpler, easier to study, and easier to deal with in practice, the exclusively IgE-group tends to dominate the allergy literature and this group tends to demand compliance with the IgE-model both in research and in clinical practice. The IgE model is simple and linear; the same responses are expected from a sensitized individual; skin tests, serum IgE measurement, and double-blind oral challenges are correlated.

Even when applied to patients with clearly defined IgE-mediated allergy, the model is unrealistic since no human body is a linear machine. Single, discrete allergic responses do occur, but they are not the only reactions and are not fully characteristic of immune networks.

Patients tend to have evolving and multiple reaction patterns over time, and show marked variability in their reactivity. Type 1 reactivity (manifesting as discrete “reactions”) may be a marker for a more generalized hypersensitivity that will be expressed as chronic or, at least, chronically recurrent disease. 

The restrictive linear-model IgE definition of allergy has confused both patients and physicians who are not yet initiated into the esoteric issues of the trade.