It seems that I’ve had food allergies for quite a while. Since long before I realized what they were, in fact. They proceeded to wax and wane, something I still find slightly mysterious sometimes. Eventually I got it that something was going on. That took something between months and years; I suspect that I may have had real issues before 1981, but I certainly got it around then that I was allergic to something.
When I was finally tested, in 1990, the results were skewed in a distinct and observable direction. (We are talking fairly recent blood tests here; skin tests aren’t worth much for telling you what your gut is going to do, and the early blood tests weren’t very accurate. Things appear to have changed.) I showed up with low antibody titers against a few foods, and high titers against several yeasts and molds.
The foods that I react to are milk, wheat, onions, yeast, and a few other things, like peppers (Capsicum type, not black or pink peppercorns). Those foods are very nearly ubiquitous. Some of the things I don’t get to eat are pizza, lasagne, bread (especially with butter on it), yogurt (I seemed to be allergic to the bacilli that turn milk into yogurt, but either that wasn’t the case or I got over it by abstaining), cheese, even some salads... It goes on and on. It is not any fun at all.
As it turns out, however, I was and am entirely immune to shellfish, so I could eat all the rock shrimp and bok choi on rice that I could possibly want, which was plenty. (I still like that sort of thing.)
...And of course that wasn’t all. I mean, gimme a break. Did I say I was allergic to duck? Lamb? Tempeh? Tofu? Swiss Chard? Collard greens? Kohlrabi? Nori? Lettuces? Tomatoes? Satsuma-Imo? Pasternaks? Summer Savory? Kalonji? Mochi? Jakfruit? Breadfruit? Poi? Finocchio? Greater (or lesser) Galingale? Grains of paradise? Oregano, basil, marjoram, summer savory, sage, tarragon, dill?
Nohow, no way. Moreover, I like all those things. (Yes, including poi. ...And yes, they’re all real.)
...But still, I really miss bread. Even fake cheese is risky: almost all of it contains casein or sodium caseinate, and that’s milk protein. (Helps it melt right. If you’ve never tried melting fake cheese that doesn’t contain some sort of casein, let me merely suggest that you read H. P. Lovecraft instead.)
I made lasagne with rice pasta instead of the usual noodles, and without cheese, which was okay provided I made the tomato sauce myself so there were no onions in it. It approached edibility, if a bit shyly. My idea of real food, however, is more along the lines of roast duck and jakfruit salad... but that’s back at the cooking page.
My allergist (and several other people) have indicated to me that current thinking about ordinary food allergies (the relatively bland kind that merely make you miserable, not the kind that send you into anaphylaxis) runs along the following lines:
If the lining of your gut is intact, it doesn’t pass anything as large as a protein. Molecules of that size are broken down into smaller ones by enzymes. There’s a reason for this: your body recognizes and attacks foreign proteins. (That’s why you can’t arbitrarily give someone a blood transfusion from just anybody, and it’s why you can’t graft tissues from one person into another unless the tissue types match extremely well. Even then, you have to suppress the recipient’s immune system, or the graft gets rejected. If the graft is the person’s heart and lungs, this can be a serious inconvenience.)
An infant’s gut lining is not fully developed, and is somewhat permeable. There are at least two schools of thought about this, and I strongly suspect that I fall on the side that advocates giving them only breast milk until they are about a year old. That seems to be about the time when the baby’s gut lining finishes its development.
It further turns out that there are special proteins (and possibly other components) in mother’s milk and colostrum that help the baby’s gut handle what’s in it, which is a developing colony of various bacteria, some of which are necessary for digestion, some of which help you make Vitamin K, and so on.
So much for the good stuff.
In addition, everyone’s gut has other things in it; for example an odd yeast called Candida albicans and Monilia (I forget the species name that goes with that genus name, but you can easily look it up), which can behave like a yeast or a fungus, depending on conditions. Under ordinary circumstances, your gut seems to ignore Monilia, which is just as well. I wish mine did.
When a person has a gut lining that is not intact, and proteins can pass through it into the bloodstream, the person can become sensitized to them. Once that happens, the person’s immune system is primed to respond to those proteins by attacking them.
If the person is exposed to the proteins, an allergic response is at least likely. (I should point out here that I am not an expert; it is entirely possible that there are conditions under which a sensitized person can be exposed without having any noticeable reaction. Consult your allergist for details. Film at 11. Your mileage may vary... mine sure did.)
If the allergic response involves the gut, you have the possibility of setting up a vicious cycle in which eating causes you to have allergic responses that involve your gut becoming annoyed and permeable, which allows you to become sensitized to more things, to which you can then have allergic reactions that keep your gut in a permeable state... Oh, joy!
This is to say nothing of all the other things that can make your gut permeable and start or keep the cycle going. (I talk about something that may have started me along this path in a little bit.)
Allergies being what they are, by the way, sensitization need not occur immediately upon first exposure. Sometimes people have to be exposed to a protein repeatedly before they become allergic to it. (Sometimes they don’t become allergic to it. As far as I can tell, I've touched poison ivy or California poison oak any number of times. I can't be sure exactly how many, because I've never reacted. So go figure.)
One way or the other, about 3% of the population eventually develops one or more food allergies. That’s right, about 3%. At least, that’s what I remember hearing. There are other kinds of sensitivities as well, and they probably account for some more. It’s a good thing humans are mostly pretty robust. Otherwise a lot more of us would have this kind of problem.
When I was in high school and college, I had several attacks of what was diagnosed as viral gastroenteritis. During these attacks I had symptoms that were at least vaguely similar to my current allergy symptoms. (Not identical, but certainly recognizable.) I don’t know precisely when my allergy symptoms started, partly because I didn’t quite “get it” about what was happening at the time. Since 1981, anyway, there hasn't been any question.
Now imagine what happens if you become allergic, as I did, to the Candida/Monilia stuff, which is always present in your gut. Imagine what happens if the symptoms of the allergy include irritation of the gut lining. This is not a happy situation. I became sensitized to more and more things, most of which seem to have been foods. My gut lining was almost certainly compromized during the bouts of gastroenteritis, and I appear to have become sensitized at that time. I certainly show antibody titer to Monilia now, or did when I was last tested.
It is probably impossible to eliminate Monilia from your gut for more than a day or two (it's everywhere around you), and my allergist eventually decided to try desensitizing me to it. As long as he had long-acting vaccine, this seemed to help. My symptoms were reduced, though not by any means eliminated: Monilia wasn’t the only thing I was reacting to.
He also put me on what is called an elimination diet, and I received a few little surprises. (This is straightforward enough: you eliminate various foods from your diet. Sounds easy, doesn’t it? Argh. You end up making almost all of your food from fresh ingredients, and you have to watch labels like a hawk. Certain words, like "textured vegetable protein" or "spices" can cover an amazing amount of territory that you don't want to cross.) After about 4 weeks, when I had managed to climb about three quarters of the way onto the diet and had concluded that I was indeed allergic to yeast, onions, and so on, I decided to try eliminating wheat because I had blood-tested allergic to it, back in 1990. Two days later, three years of chronic bronchitis and asthma of previously uncertain origin quietly disappeared. I put away my steroid inhalers and have not used them since.
This means no regular bread (wheat and yeast both; not a happy combination), no matzo, no noodles, no spaghetti, no lasagne, no pizza (wheat, yeast, onions, milk), no this, no that... It was not exactly a happy experience. There’s milk in most foods, and even fake cheeses contain milk protein, so I don’t get to eat them. Flour shows up in remarkable places. Even standard soy sauce contains wheat. It just goes on and on.
Let me address this severally.
I already mentioned desensitization. Unfortunately, everybody “knows” that you can’t desensitize for food allergy, so there are no long-acting vaccines for foods. In a slightly devious way, this actually makes sense: if some people are reacting to their gut flora as well as the foods in question, you are not going to get predictable or even particularly good results if you try to desensitize directly and specifically for foods. This is not rocket science. Unfortunately, it does not mean that desensitizing for foods is useless. Too late now, alas. It currently costs hundreds of millions of dollars to bring a new drug online, and the FDA seems to regard each vaccine as a new drug.
Worse, my allergist reported, in 1998 or early 1999, that the suppliers he used to use had ceased to make some of the vaccines he needs, and were also becoming increasingly difficult to deal with in any case. So much for my desensitization shots...sigh... (I tried the short-acting vaccine for Candida/Monilia and it was a laugh. The only effect I was ever able to discern was some soreness at the place where they injected me with it.
Time to execute Plan B... if you even have a Plan B...
My allergist ran into a guy up in Vancouver BC who has what I find to be an interesting and refreshing notion: why not feed people something that doesn’t really get very far into the gut, and thus cannot disturb the gut lining, especially the lining of the lower gut?
What a novel thought. The trick is to make it sufficiently nutritious that it will sustain life for fairly long periods. ...Well, that's the first trick. The second trick is to make it sufficiently palatable that people find it usable.
This guy made up a food-substitute that is readily absorbed, mostly in the stomach and the first foot or so of small intestine. It smells kinda crummy, and it tastes bad. It does, however, sustain life, and a few people have lived on it for quite a while. I managed, by dint of some considerable effort, to last three days on it. (You’re supposed to do a minimum of ten.) At the end of the three days, I had no symptoms to speak of.
Those of you who do not suffer from allergies can probably appreciate this only in the following terms: imagine having a cold. All the time. It gets a little better or a little worse, but it just won’t go away. You’re always kinda dragged out, your nose drips, you wanna go home and go to bed. Always. Think about that for a moment: always.
Then your doctor suggests that you try this ucky-smelling, ucky-tasting medicine. You have to eat a certain amount of it every day, and you can’t eat anything else, at least at first. After three days, your cold is gone...
...But you know that if you stop taking the ucky medicine, it will almost certainly come back.
Feh!
I’ve used the stuff (it’s called Alpha Enfood) to sustain myself for short periods on several occasions; I have never actually succeeded in drinking enough of it in one day to meet my caloric intake requirement, because I can only just barely stand the smell and taste. It's also ripping expensive. I am not in a position to recommend this to anyone, partly because I’m not a physician, and partly because I have no idea whether it would do the same for anyone else that it did for me. ...But: I can tell you that it certainly helped me, even when I only used it for relatively short periods. You can find it on the Web if you want to try it.
At least it’s a start.
Some time in July of 1999, I went to see my allergist again. He showed me an abstract from a journal, in which it was reported that a combination of probiotics and pancreatic enzymes helped some people with really serious food allergies. (Some of these people tested allergic to more than half of the foods for which they were checked, and many had whole-body eczema most or all of the time.) The rationale behind the protocol was that the probiotics (so-called, what a stupid name!) help to sweep other organisms (Monilia, for example) from the gut, and the pancreatic enzymes predigest the proteins from foods. This combination seems entirely reasonable for what I understand my own problem to be.
Let me interject a tiny rant here: an antibiotic is a chemical that you take to kill off microorganisms. Therefore, a probiotic is a chemical that you take (FOS, for example) to enhance the growth of microorganisms. Microorganisms themselves are biotics, neither pro- nor anti-, because they aren't chemicals. Instead, because some moron had a cute idea, we are stuck calling these chemicals "prebiotics" (which doesn't mean a damned thing), and calling the bugs themselves "probiotics", which seriously smacks to me of marketing -- someone wants you to think that these things are in favor of life or enhance your life. Argh. Let me return to the protocol before I blow a gasket...
My allergist (I should tell you who he is: Dr. Gordon P. Baker, M. D.) had already tried this combination on himself, and had found that it let him eat rice without having symptoms. That also encouraged me. (Very few people become allergic to rice, but I’ve known two among my circle of fairly close acquaintances. It does happen, and like any other food allergy it isn’t fun.)
I tried this protocol, and it took me a while to settle into it (you have to choose an probiotic that works for you, and you have to figure out how much of the enzymes to take and when), but it works. In fact, it works so well that for a while I could walk into Buca di Beppo, eat anything I wanted, top it off with Tiramisu, and be perfectly happy the next day. I aimed blessings at Gordon Baker with every bite.
It is possible to screw it up, as I have learned, and I am currently trying to be a good boy about the things I'm sensitive to. I'm also avoiding the enzymes as much as possible, because they, too are proteins, and it is possible to sensitize yourself to them. I switched types a couple times, but I missed noticing it at the beginning of 2001, and had a very rough six months during which I was sick almost all the time, lost a lot of weight, and had trouble figuring out what was wrong -- all of the tests returned either nominal or negative.
This brings up another issue: tests. Many of them don't give you the information you need. For example, as far as I can tell my gut flora was totally off balance during the first half of 2001, but a stool culture returned "normal". This is because they aren't looking at the balance of organisms. All they want to know is whether you are growing things like _Campylobacter_ or _Helicobacter_. If those things are not present, you could have serious malabsorption and other problems, and they'll still tell you that you have a "normal" culture. That is certainly what they told me, and it pisses me off because I could have been through with the problems in half the time if I hadn't believed them.
Ahem. To return once again to the protocol:
I suspect that choice of probiotic is crucial to this approach. I’ve tried several, and only two seem to help. I’m not sure, in fact, whether it’s both or only one, because I haven’t been willing to do a careful trial. For that reason, I’m reluctant even to name the ones I’m currently using. I have no idea whether they would work for anyone else.
I do want to mention one other thing: so-called "prebiotics" (see rant, above). I found that when I took only the so-called "probiotics", I could hold myself in place, but it was difficult to make any real headway. When I added FOS (Fructo-Oligosaccharides), I started to feel noticeably better. FOS seems to help the "good" bacteria in the lower gut grow at the expense of the "bad" ones, and I seem to need that extra little bit of help. There are arguments against FOS as well, but on balance I decided that it was worth trying, and I'm very glad I did.
If you want to read a particularly annoying rant against FOS, btw, you can find one on Dr. Natasha Trenev's Web site. I think her statement on this subject is full of nasty yellow-journalism, and beneath her dignity, but you can read it if you want to know what she thinks. I can tell you that she and her husband make really fine "probiotics".
It is tempting to think that if you eat a meal with only a little bit of allergen in it, you can take only a little bit of enzyme.
This is an example of Magical Thinking. Unfortunately, there’s no magic here; the little pills don’t know what you ate, and they don’t know which proteins you react to. Any time you eat a meal that contains stuff you’re allergic to, you have to take enough enzyme to disassemble all the protein in that meal. If you do this often enough, you increase the risk that you'll become sensitized to the enzymes. Can you take a hint? I wasn't too good at it, and I sensitized myself at least three times that I'm aware of.
A friend reported to me that if he showers at his girlfriend’s place in the evening, he wakes up with more gut pain than he does if he showers at his own place, where he has installed a filter that removes chlorine from the water. That seemed odd to me, but it’s not terribly expensive, and the water certainly smells better without chlorine in it, so I installed such a filter. I seem to have slightly less gut pain in the morning than I used to...
At one point I ran into Gordon (my allergist) again (we have known each other for much longer than I’ve been a patient) and he mentioned that one of his other patients had experienced some improvement with a combination of alpha-Lipoic acid and N-Acetyl-Cysteine (usually called “NAC” in health-food places, because very few people are chemists).
It seems that some asthmatics show up with reduced levels of glutathione in their airways, and that althought it is possible to work with inhaled glutathione, it is easier to have the body make more of it. The combination of Lipoic acid and NAC seems to be something your body makes glutathione from. Gordon had suggested this to the other patient for his asthma, but he reported improvement in his diverticulitis.
That seemed interesting, so I added NAC to the alpha-lipoic acid I was already taking, and within two days my gut pain took a nosedive. Needless to say, I am a very happy camper. I feel considerably improved, I have less pain and more energy... can’t ask a whole lot more than that, except perhaps that the allergies should quietly go away.
(It is now more than two years later, and the popular scientific press has begun to report that some people with IBS, colitis, or Crohn's respond well to this combination. It certainly works for me, though I have none of those things.)
Someone else reminded me about colloidal silver. It turns out that you can very easily make a suspension of nanoparticles of silver in water, and that such a suspension is a mild antibiotic that seems to be specific to prokaryotes -- that is, it isn't toxic to humans, just to bacteria and probably yeasts. (Forgive me -- it has been a very long time since I studied enough biology to remember whether yeasts are prokaryotic. I do think they are.)
In larger quantities, silver is not always a good thing, but colloidal silver contains so little of it that you are not likely to hurt yourself with the stuff. (If you take grams of silver compounds, you may turn blue, and you will stay that way. Micrograms, however, are not going to do that to you.)
If you buy it at health-food stores, colloidal silver is ridiculously expensive. I wouldn't do that. It's easy enough to make, and there is plenty of information on the Web. I bought some silver wire, and I made a little holder for two 6" pieces that keeps them about 2" apart and approximately parallel. When I want more colloidal silver I hang them in distilled water overnight with perhaps 20 volts DC between them. In the morning I filter out the silver oxide that also forms during the process, leaving behind a pale golden liquid. Q. E. D. Some folks will tell you that the voltage must be between 27 and 30, or some such nonsense. This (as we say in the trade) turns out not to be the case. You certainly want about 27 volts if you're in a hurry; you also want water that conducts a bit better than distilled water does. I'm not in a rush, so I just let it run longer at lower voltage. It may not be as efficient, and it may produce more silver oxide sludge in the water, but the resulting "golden liquid" is clearly The Right Stuff.
One thing to remember: keep the colloidal silver away from the probiotics! If I take silver in the morning, I don't take "bugs" until at least the afternoon, and preferably the evening. No point wasting them -- the silver is indiscriminate, and it kills the "probiotic" bugs just as happily as it kills any others.
If you have food allergies, and if you have any reason to suspect that a permeable gut is involved, you may want to investigate this with your allergist. The abstract in which the protocol is mentioned is, if I read this right, Allergy Clin. Immunol. volume 103, number 1, part 2, page S217, and it’s #838, “Pancreatin and Probiotic Therapy for Multiple Food Allergies”, by M. McCann and N. Trenev. (That could easily be something like “Journal of Allergy and Clinical Immunology”; I can’t tell because I only have a crummy photocopy of a single page.)
The prescription version of the enzymes is called Creon (I’m sure that’s a trademarked name), and there are various OTC versions as well. My experience was that I needed to take one enzyme tablet around the beginning of a meal, one in the middle, and one at the end. If the meal was particularly dangerous I took more; sometimes I took one about half an hour after I ate. Sometimes I also doubled up on the one in the middle or the one at the end of the meal. At least one of the brands cautions you not to use more than six tablets a day...
There is, of course, no guarantee of anything, but I must
report that I regard these two protocols (probiotics plus FOS
plus silver if you're into it, and, when necessary, enzymes;
and Lipoic acid plus NAC) as very pleasant and surprisingly
effective approaches for my own troubles. In fact, I’m
absolutely overjoyed, and so is my allergist.
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Last modified: Mon Jan 21 18:49:55 PST 2002