Allergy - A brief introduction to Functional Medicine and Investigations
The understanding and treatment of allergies and intolerances is a huge subject. Even Consultant Allergists, immunologists and other specialists in these fields admit that the complexity is enormous and that science and research changes our understanding more frequently than most areas of medical study.
My comments here are an attempt to simplify the issues of a confusing area of medicine and provide some guidance to those in need of help.
We have to establish that allergies are defined by reactions that can be shown through changes in blood tests. These changes may be a rise in the white cells frequently associated with allergies known as eosinophils, the finding of allergy-related compounds made by white blood cells such as leukotrienes, cytokines, histamine and many others, and the production of specific cytokines called interleukins that stimulate or suppress activity of white blood cells and metabolic processes.
Intolerances tend not to be a term used by orthodox or conventional doctors but could, arguably, be used to indicate physical or psychological responses when no blood test changes are noted. As an example, caffeine keeping someone awake could be considered an intolerance even though there is no measurable immune system response.
It is important to establish the cause of an allergy or an intolerance and wherever possible to remove the cause. This might be simple enough if one reacts to a mushroom or a sardine which can comfortably be removed from the diet. However, if it is a food allergy/intolerance to a common food such as wheat, dairy or yeasts then removal becomes harder and support is needed through specific dietetics or a nutritionist.
There is a condition known as the leaky gut syndrome. Medically speaking, this is called increased intestinal permeability and occurs when inflammation is present in the gut. Such inflammation can allow undigested food particles (and bowel bacteria) to enter the bloodstream causing the immune system to respond. If the body mistakes a food protein or molecular structure for an infective agent such as a virus or bacteria then, an immune response occurs.
Anyone with any current or past digestive issues would be encouraged to test for the leaky gut syndrome before any other investigations or treatment is commenced.
Airbourne allergens such as grass pollens, moulds or chemical pollutants are even harder to avoid and treatment options need to be explored. Again, due to a process known as molecular mimicry, airborne particles share the same proteins or structure as food particles so that a leaky gut can actually trigger inhaled allergy.
Conventional allergists use avoidance where possible or first-line symptomatic treatment along the lines of over-the-counter or stronger prescribed anti-histamines. In severe cases steroids may be required and can generally only be used long-term topically through inhalers or nasal sprays or in short bursts if taken as ointments or tablets.
Testing through skin-prick analysis or immunoglobulin (Ig) blood tests can isolate allergy-causing substances which can then be treated with desensitizing courses of injections.
There are pioneering techniques such as neutralization or Enzyme Potentiated Desensitisation (EPD), but the availability of practitioners is limited due to a lack of education and training facilities for doctors who might otherwise utilise such techniques.
Natural treatments from plant extracts that ‘moderate’ the immune response, such as glyconutrients, can be prescribed by specialist practitioners and physicians trained in Functional Medicine. These are also used in Chinese or Ayurvedic (Indian) herbal medicine and are used in association with lifestyle, breathing, exercise and practical therapeutics such as acupuncture.
Several published and peer-reviewed studies on the use of homoeopathy suggests that when properly prescribed by a homoeopath this may be of benefit.
Psychology plays an important part. There is a well-publicised case of Helen, an individual with multiple personalities, showed that she developed hives when she ate honey but only did so when she was Helen and not when she was any other character. Conditions that may have an allergic component such as asthma or eczema are associated with levels of psychological and physical stress and this, too, must be considered.
Dr R Sharma
