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Why me? the case of sadie, the allergic lady

'I have been unwell for years and now I know it's because I am allergic,' Sadie announced as soon as we entered my office. 'I am an asthmatic and also suffer recurring headaches and poor energy. I wake up unrefreshed, with a heavy head and with aches and pains everywhere, especially in my muscles,' she continued as she prepared herself to lie down on the examining couch.

I had already studied her case history and it was obvious Sadie had not shown any other signs of allergy, apart from her 'mild' asthma, until a few years ago, although she remembers her mother telling her she could not tolerate cow's milk when she was weaned.

'Don't worry,' the doctor told her. 'She'll grow out of it.' Which is what doctors used to say to mothers in the old days.

Somewhat hyperactive and suffering recurring bouts of respiratory and ear infections, Sadie was often given antibiotics while she was growing up. During her teens she developed vaginal thrush and this infection recurred a few times every year. She was wheezing a lot and, after a lung function test, was given asthma medications (puffers) and told she would have to use them regularly, probably for the rest of her life. She had quite severe premenstrual tension and it was obvious her skin was not the best. She also had problems controlling her weight, which seemed to creep up from time to time for no apparent reason.

The physical examination showed that this patient was indeed allergic and that she had tinea as well as signs of thrush in her throat. When I told her this, Sadie replied that the doctor who had diagnosed her as allergic a few months before had given her a course of antifungals, some allergy drops and a diet.

I can't tell you my relief,' Sadie told me, 'when I finally found someone who was able to tell me why I was so unwell. I was tested and found to be allergic to many foods (rye, peanuts, milk, yeast) and several air-borne inhalants (moulds, house dust and dust mites). The doctor arranged for me to take some allergy drops (desensitising vaccine) which I have to put under my tongue every morning. I followed the anti-candida diet and avoided all the foods on the list. I felt a lot better after the first few days but then all my symptoms came back a couple of months later. Some of them actually got worse and I found I could not tolerate other foods, such as bread and soya milk. It seems that the more foods I avoid the more sensitive I become to some of the remaining foods.'

Allergy Tests

She gave me a copy of her diet and her allergy tests, which were as follows:

A skin-scratch test which was positive for moulds, Trichophyton (a group of moulds which includes Candida albicans), house dust and dust mites.

The follow-up tests for the particular allergens, necessary for preparing an individual's vaccine, called 'end pointing'.

A cytotoxic test (a blood test which measures the effect of a food concentrate on white blood cells) which was positive for the foods listed above.

A Radio-allergo Absorbent Test (RAST) which was positive for house dust, peanuts and milk.

As soon as I read the report I knew I was in for a long explanation.

To begin with the allergy tests. There was no immunoglobulin E level on the report. This is a general index of the body's capacity to react to inhaled allergens. It is very important because often one can have very high levels yet low skin-test responses to individual allergens.

The skin-scratch test was done for moulds in general rather than for the moulds you may actually be exposed to, which should be identified (via mould plates) and individually tested under the skin ('intradermally'). In Sadie's case the skin-scratch test was indeed positive for something. It was important for her to know, however, that the scratch test is only a screening test. Its main purpose is not so much to find out what or even if someone is allergic but to determine the dilution that will be used to do the follow-up test (intradermal). A negative skin-scratch test does not mean that someone is not allergic. All it means is that no sensitivity mediated by immunoglobulins (called 'IgE mediated') could be found at that level for that substance. It is quite possible to be allergic when the test is done intradermally, sublingually or by 'challenge'. To 'challenge' is to avoid a substance for a certain period and then try a sudden exposure to it. The reason why these other tests are not done first is that one needs an indication of the degree of the patient's response, if any, so one knows at what dilution the intradermal challenge can safely begin.

As well, only those allergies that are mediated by immunoglobulins can show up by this method. If the person happens to be allergic but if the allergy is mediated by other immunoglobulins or some other mechanism (there are several), then the test will tell you nothing. This test is usually done with foods, but sometimes also with chemicals and inhaled substances.

The follow-up test, or 'end pointing', was done on the same day, shortly after the skin-scratch test. This can sometimes corrupt results. End pointing is ideally done a few days later, although occasionally one can do it after a few hours.

The cytotoxic test is an old and inaccurate test for food intolerances. The Antigen Leucolyte Cellular Antibody Test (ALCAT), while still far from perfect, is much more accurate than the cytotoxic. Be that as it may, an intolerance to rye may well mean that the patient has to avoid all gluten grains (wheat, malt, barley, oats) and not just rye, as Sadie was told. An allergy to peanuts may mean avoiding soya and other members of the legume family (such as carob, lentils and split peas, etc.). This may well be one of the reasons why Sadie reacted to soya milk.

The RAST test did not include any of the chemicals (such as formaldehyde and isocynates) or Candida. The fact that Sadie's doctor did not ask for a test for antibodies to Candida means he would not be able to ascertain whether she was only allergic to Candida moulds or also infected by those organisms. This factor is very important because it enables the therapist to adjust the treatment programme. If you are indeed suffering with a Candida infection as well as allergy, then treating the infection can actually make the allergy worse for a while.

Furthermore, chemical sensitivity can play havoc with your immune system and cause all sorts of trouble. While most chemical sensitivities are not IgE mediated, it is often possible to get some information about sensitivities to isocynates, formaldehyde and a few other chemicals. Formaldehyde is particularly important because a positive result to it alerts the physician to the fact that other chemical sensitivities are likely.

It is now possible to measure the degree to which you are affected by chemicals so that the doctor can get a good idea of your body's capacity to deal with them. Of course some patients are so sensitive that even minimal amounts of some chemicals affect them profoundly and, of course, it is impossible to eliminate all chemicals from a person's environment, short of living in an airtight bubble. So the next thing we do is to provide these people with solutions. There are special filters and other methods which clean the air and remove many mycotoxins and outgassed chemicals from the air.

Allergies, or what are perceived as allergies, are often not as simple as they first appear to be and the solutions need to be more complex than just taking some allergy drops or going on a diet.

Causes

Lastly no attempt appeared to have been made to investigate why Sadie had become allergic or oversensitive in the first place.

Many people who suddenly find they have become allergic ask themselves: 'Why me?' Indeed, why should anyone become allergic?

Worse still, why should someone like Sadie, who had never been bothered by allergies, suddenly develop an intolerance to common foods like wheat, milk or chocolate pudding, not to mention dust or moulds? Why does someone suddenly develop asthma after living in the same house, eating the same foods and being exposed to the same chemicals for decades? Why, after growing up with gas cooking and heating, should anyone become sensitive to a small gas leak you can't even smell? Why should Sadie, after having carpets in her home since she was born, become sensitive to the carpet's backing, its formaldehyde outgassings or the pesticides residue buried in it? Indeed, why should she be so sensitive that the residues from long-forgotten pesticides used to clear her house of white ants years ago interfere with her health now?

And of course, one may wonder why an allergy which has not caused much trouble since childhood (such as milk in Sadie's case) should flare up all of a sudden. Yet all this happens quite often and to a lot of people. We call them 'Why me?' patients precisely because that is the first thing they ask when we tell them they are allergic. Some people become allergic shortly after a bout of Candida infections. Some people become allergic when the total load on their system has reached the point at which it overcomes their resistance - the last straw syndrome.

The Last Straw Principle

Often we see people who have been exposed to one or more chemicals or air-borne allergens such as mould or dust at levels considered normal but for a prolonged period. After a time, bio-accumulation occurs or the detoxification system fails to function adequately. This unbalances the immune system and the person becomes allergic. Sometimes this happens after a viral infection too. It is quite possible to be invaded by a virus without showing any symptoms whatsoever, except perhaps some mild flu-like episodes. When viral attacks occur, our immune system gets to work. It wants to defend us so that we do not get ill. We are exposed to viruses all the time, yet we are not sick with viral illnesses all the time because our immunity works hard.

It is equally possible for someone to harbour a 'silent' virus for years on end before the virus is re-activated by such factors as a chemical.

Many people do not realise that a sudden onset of allergies is a common and well-documented result of viral infections. When the immune system becomes confused by various attacks it can begin to send out antibodies against everything even vaguely irritating, such as dust, and even against the tissues of the person's own body (auto-immune disease).

Substances that are usually only an irritation, such as dust or pollens; substances that contain potentially toxic components only in minute and usually harmless quantities (such as salycilates in apples or solanine in tomatoes) suddenly have antibodies made against them and turn into antigens (substances that provoke allergic reactions). Perfumes, tobacco smoke, detergents, traffic pollution, insect sprays, even household detergents and ordinary paint can become a problem. It is as if the body takes its revenge on dust, pollens, moulds or gluten for the harm viruses have inflicted upon it.

That is how our immune system can react to viral and sometimes even to bacterial or fungal attacks. The immune system ties up these 'enemies' in groups and puts them on hold, as it were, in lumps. Like police cars responding to a call from headquarters for assistance when a siege is underway, the body sends more and more 'soldiers' - antibodies and white blood cells - to the places where those lumps are held. Meanwhile the system rounds up more and more suspects, making more and more lumps.

The tissues where the lumps are located can become swollen with them and begin to send alarm signals of their own. Histamine is released, neutrophils run around and the tissues can become sore. One of the effects of histamine release is that it can trigger an allergy or make an existing allergy worse. In such cases other protective mechanisms come to help. The inner body surfaces start to make more mucus to trap and wash away all this stuff, therefore if you are an asthmatic, your symptoms are aggravated and you may need more, or more frequent, medications. Sinusitis flares up, noses drip, mucus builds up in the throat and eyes won't open in the morning: they water and swell, for the same reason. You may start to cough or sneeze or have diarrhoea as the body tries to expel the mess. While all this is happening, the 'memory' of your immune system will code all these factors as 'enemies' and when you are in contact with them again, you will have an allergic response. You cannot avoid dust, mould or perfumes all the time, so you are affected time and time again. And each time your immune system slams on the brakes, as it were, to protect you, to make sure you don't have a reaction. So for years on end, after the original viral invasion, you don't actually react much to anything. You are blissfully unaware that you may be allergic. But the immune system can wear out. When it does, you experience an allergic reaction, perhaps for the first time in years.

Mould Plates

I gave Sadie a few mould plates and instructed her how to place them in her bedroom and around her home to find out what moulds were present, and to what degree. I explained to her that I would receive a report from the mycologist (a pathologist who specialises in organisms such as moulds/fungi) and then decide on desensitisation or neutralisation for the relevant fungi.

Treatment

The next thing was to investigate Sadie's immune system and the possibility that something had triggered off her allergies. I arranged the appropriate blood test and advised her to remain on antifungals (Nystatin powder) and add probiotics (acidophilus), echinacea (an anti-viral herb) as well as an immune-boosting type of vitamin supplement.

I also suggested to Sadie that she read one of my books, Chronic Fatigue, the Silent Epidemic which would help her to understand what was happening to her. We made an appointment for a couple of weeks later. Next time we saw each other I was armed with all the reports, and her comments.

'I feel a little better,' she told me.

'Well,' 1 said to her, 'you are indeed allergic. It is impossible to say at this stage whether the allergies are just a consequence of other factors but you are suffering from a condition known as the post-viral syndrome. I suspect the reason is that your immune system is working overtime to shield you from allergic reactions to certain moulds. The mould plate near your bedhead was full of penicillum, cladosporium and alternaria (all powerful moulds/fungi) and the rest of your bedroom showed abnormal growths of several moulds, including those just mentioned. Your lounge room was not quite as bad but still far from ideal.

'Under such conditions it is quite possible that when you were attacked by a virus your body was unable to defend itself properly. You go to bed every night and rest. Your immune system obviously does not, busy as it is defending you from the mycotoxins spores you breathe all night long. By the time you wake up, your immune system is already tired. It then has to face a long day of more hard work.'

Sadie protested almost immediately, 'I have never had a viral illness. Surely I would know if I had one!'

'I wish that were true,' I replied. 'Viruses can enter a human body without provoking any symptoms whatsoever, apart from a sore throat or a slight flu-like feeling. They can take up permanent residence, sometimes right inside some of the cells that are part of our immune system, and slowly reduce resistance. In some cases this can precipitate or trigger an allergy. So you see, it could be either way.

'Given the fact that you are exposed to these moulds every night, though, I suspect the first scenario. The blood test told me about the activity of the virus. Now I will first try to desensitise you against those particular moulds and get you to clear your bedroom of fungi. If necessary, I will try to neutralise the allergy. Then after a suitable period, I will check your response to the virus. If the virology reports show an improvement, we'll know the allergies inhibited your ability to fight off the viral effects. If they are the same, or worse, then we'll know there is no way to fix your allergies until we have enabled your body to fight the virus.'

I then arranged for someone to take care of the mould in Sadie's bedroom and thoroughly clean her house. I arranged for her to obtain a special type of electrostatic air cleaner that not only helps remove dust and mould particles but also removes chemicals from the air. I suggested to Sadie that she turn the air cleaner on for at least a couple of hours before she goes to bed. Two weeks later Sadie was much, much better; but still not as well as either of us would have liked. Her virology report showed she was still much affected by cytomegalovirus (CMV).

Sadie was given the anti-viral herbs echinacea, Korean ginseng, reishitaki and a series of daily intravenous vitamin C injections, to which we added some magnesium and vitamin B6, for five consecutive days. After the second vitamin C injection, Sadie felt as if she was coming down with the flu. She was hot and sweaty, had pains and aches and her neck glands were slightly swollen.

'Exactly the response I was hoping for!' I told Sadie. 'You see, when your body is finally able to, it starts to fight the virus. That makes you feel exactly like you feel when you have a viral infection such as the flu.'

After one more vitamin C injection Sadie felt better. A couple of weeks after the last vitamin C injection Sadie said she felt better than she had in years. 'I don't know why but it was not until a week after the last vitamin C injection that I started to feel really well. My wheezing has all but gone!'

I explained to Sadie that vitamin C does not actually kill viruses or anything else. What the combined effects of the herbs and the vitamin C did, however, was to stimulate her natural anti-viral capacity. I said that she should shortly find that her allergies either disappeared altogether or reduced sufficiently for her to resume a normal life and eat most foods with impunity.

The moral of this story is simply that all allergies ain't allergies!