Understanding Allergies: Do We Manage or Cure?

Paul Reller, L.Ac.

As we take a hard look at allergies in the United States we can clearly see that there is an oversimplification of this increasingly prevalent and important problem. The medical community on the whole, and the public, still views the subject of allergies as primarily limited to the common hayfever and allergic rhinitis, and groups such as the Mayo Clinic still stress that allergies affect about 10-16% of the population and are well controlled by steroid and antihistamine medications. This is a small piece of the big picture, and most studies confirm a steady increase in allergic diseases over the last 30 years, mostly in developed industrialized countries. The alarming prevalence of serious food allergies, and episodic allergic reactions such as angioedema, are a cause of great concern. At least 12 million Americans have food allergies and severe episodes account for more than 30,000 emergency room visits each year. Even more prevalent are the allergies to dust mites, pet dander, molds and fungi that are ubiquitous in our homes. The underlying connection between the variety of serious and not-so-serious allergic reactions is the function of the immune system and the health of your reactions to allergens.

Clinically, one sees a greater and greater percentage of patients aware of allergies today, as well as a growing body of scientific study pointing to a more serious and complex problem. As you look more closely at the subject of allergies on the Mayo Clinic website, you see that there are more and more types of allergic reactions that are presenting serious, prevalent, and growing health problems. Are we taking the subject of allergies too lightly? Are we looking inside of ourselves to see what is wrong or are we blaming the environment and failing to see what we need to do to shore up our defenses? An interesting study in Japan in 2010 found that patients with allergies had a much improved immune response to their allergies when they took regular walks in nature, such as parks and forests (see the link to a NY Times article on this study below in information resources). It seems that plant chemicals, such as phytoncides, an airborne chemical emitted from plants to protect them from pathogenic antigens and insects, also works on the human physiology. This is why herbal chemicals are effective in the treating of allergic pathologies. While we develop allergies that cause unwanted symptoms, simply blaming and avoiding nature, rather than utilizing nature to restore our immune defenses, is not a productive attitude.

The first line of immune defense against allergens lies in our membranes, and with increased allergic reactivity, these membranes become chronically inflamed. One of the most significant new health threats with chronic allergies is the fact that these chronically inflamed membranes leave a patient more vulnerable to community infections, drug resistant staph and other bacterial infections, as well as more serious viral infections such as avian flu etc., which are becoming more prevalent in the U.S. For many individuals, the chronic immune stress in allergies and frequent infections contributes to much more serious and chronic syndromes, such as autoimmune disorders, neuroendocrine disorders, etc. which depend upon optimum health and function of the immune system. Working to improve immune function and membrane health, rather than just relying on prescription medications to relieve symptoms, will provide your body with protection that may prevent a host of serious pathologies. Complementary Medicine will help you to achieve these goals. The first line of immune reaction to allergens and antigens in the sinus membranes, bronchioles and gastrointestinal membranes, is the mast cell, which often accumulates to enhance local immune reactivity. Many scientific studies now prove that a variety of Chinese herbs effectively inhibit the mast cell activation and excess release of pro-inflammatory mediators, such as cytokines, histamine, nitric oxide, prostaglandins, and protein kinases. These effects are dose-dependent, and professional products and guidance is highly recommended for effective therapy. Links to a variety of these studies are seen below in additional information.

The membrane health involves the sinuses, bronchioles, esophagus, stomach, small intestine, and of course the skin. Unwittingly, many patients increase the sensitization to allergens in these membranes with common use of medications. For instance, studies have shown that chronic antacid use dramatically increases the risks of allergen sensitization. In a 2005 human study of 152 patients at the Medical University of Vienna, Austria, on antacid treatment for dyspepsia, increased food allergen sensitization was seen in 25 percent of the patients after 3 months (see study cited below). The antacid medications studied include the histamine receptor and proton pump inhibitors that have now gone generic and may be purchased without prescription. This study also found that gastric hypofunction, often made worse with these medications, was integrally tied to both allergen sensitization and the phases of a developing allergic reactivity to food allergens. This is just one example of how standard medicine has failed to address the health of our protective membranes, resorting instead to medications to reduce symptoms, at the expense of our overall health. Medications used to treat sinus allergies, asthma, and skin disorders have been shown to hurt the membrane immune health with chronic use, leaving the patients more exposed to onset of various allergic sensitizations and developing allergic reactivity, as well as a higher risk of autoimmune disorder.

With public attention and concern about allergies and related health problems there has, of course, developed a new health industry around allergy testing and treatment. With this new attention to allergies has grown the oversimplification of diagnosis, as well as the oversimplification of treatment. The diagnosis of food allergies from standard testing is problematic, and this will be explained later in the article, and many patients without a serious allergic reaction to foods are diagnosed with multiple food allergies with these tests. All foods and external chemicals produce some antibody immune reaction in the human, and judging which of these are serious allergens is not entirely clear from tests that measure antibodies. They do point to potential allergic reactions when the body is producing higher than normal antibodies. The sensible thing for the patient to do is to objectively analyze whether these potential food allergens do produce the symptoms, by noting symptoms after eating the foods. With serious allergic reactions, there are clinics that challenge the patient with the food allergens while monitoring them in a safe clinical environment. For most patients, who have not had serious reactions, this is prohibitively expensive, though. Often, for the patient analyzing mild potential allergic symptoms, a diary is useful, noting each day the foods consumed, and the relationship to symptoms, such as digestive upset, skin reactivitiy, etc.

While more and more patients with persistent allergic reactions of the sinuses and bronchioles are learning that their allergic sinusitis, rhinitis and allergic asthmatic symptoms are strongly linked to food allergies, the correction of this complex allergic pathway may not be simple. Correction of gastrointestinal dysfunction, restoration of small intestine mucosal health, and clearing of microbial overgrowths such as Candida and Heliobacter pylori are the first steps in the process, but disseminated allergens and antigens in the blood and lymph circulation presents a sometime complex picture. The subject of superantigens (explored on a different article on this website) also complicates the subject, with the potential that food molecules could induce a state of sensitivity and/or exagerrated immune responsiveness after a latent period of days to weeks, and stimulate a broad unwanted immune response that lasts well after the food is not consumed. Superantigens are now associated with a variety of diseases, and appear to be the link between the prevalence of chronic allergic respiratory diseases and skin allergies producing eczematous reactions. This mechanism, of course, makes the analysis of food allergies more complicated. The patient must realize that foods are not the problem, though, but rather the dysfunction acquired in the individual immune system, and that a thorough holistic approach may be needed to restore a healthy immune response, and get past these potential allergies. The patient who simply starts being fearful of many foods may wind up with health problems related to poor nutrition.

Allergic reactions point to a more systemic problem in your overall health and the health of the community. Overcoming allergic reactions depends on a holistic look at all of the potential insufficiencies in your health that allows immune missense to occur. We cannot entirely eliminate allergens from our environment, so we must take the steps to insure that our immune response to allergens is healthy.

The most alarming aspect of allergic immune dysfunction that can be seen clinically has to do with the percentage of children now affected by allergies. Health problems that we overlook may be passed onto our children. Recent research into inheritable traits has proven that common health problems may be acquired and passed on in one generation, and that these traits may be cleared from inheritance in subsequent generations if addressed (see the Feb.19 issue of the British journal Nature on acquired trait inheritance). P. Brock Williams announced at the 2005 American Academy of Allergy, Asthma and Immunology that his objective measurement of increases in IgE antibody levels in asthmatic parents and their children confirms this acquired immune trait, and in fact shows that offspring had dramatically higher numbers of allergen-specific IgE than their parents with allergies.

The International Study of Asthma and Allergies in Childhood (ISAAC) shows that our community immune health is declining steadily. One of the most striking relationships in this study is the MacDonald's index: the more MacDonalds outlets you have in a country, the higher is the prevalence of allergy and allergic asthmatic symptoms. Clearly this shows a complex relationship to the overall health of the community and not just the changing environment.

The most striking thing one notices when looking at the research into allergies is the lack of specific reasons or patterns. Different types of allergic diseases have increased dramatically in different areas while other have stayed steady. Objective evidence has also been non-specific, with different types of T-cell responses seen and increases in IgG more than IgE responses noted. This also confirms that we should be looking at overall immune health and problems that affect our immune health rather than looking for the magic bullet.

Complementary and Integrative Medicine, acupuncture, herbal medicine and nutraceutical prescription can effectively manage symptoms, but also offers the patient with allergic disease the opportunity to correct the underlying mechanisms and perhaps cure the problem, or at least see the symptoms better controlled by your own immune responses.

Examining the Risk vs Benefit of Standard Medication

There are a few reasons why patients currently choose to incorporate Complementary and Integrative Medicine into their treatment of allergies. One, they want to decrease their use of prescription medications due to side effects or warnings of risk with chronic use; two, they want to lessen the side effects and risks; and three, they want to not only control symptoms but to actually get healthier, and to improve the health of the systems contributing to immune missense. Currently, standard allopathic medicine alone offers no evidence of significant benefit in many types of chronic allergy, yet produces risk with chronic use that engenders much concern from the medical community, and has prompted numerous warnings from the FDA and other health regulatory commissions. Because of this, more and more medical doctors are starting to incorporate Complementary Medicine into their practice. Thoughtful patients will turn to the physicians that specialize in these therapies to improve the results of a multidisciplinary treatment stategy. The best outcome is to overcome allergies and to escape the need for future therapy at all, especially allopathic medications that come with risk when taken chronically. This requires a more thorough and comprehensive treatment protocol in most cases.

There are still only 3 types of standard medication to treat allergies. Antihistamines, Decongestants and Anti-inflammatories, although in allergic asthma and other serious allergic reactions Bronchodilators, such as Anitcholinergic agents, Beta-adrenergic agonists, Theophylline, and Anti-IgE antibody meds are used. Many current allergy medications combine these various types of drugs. The problems with this approach is that it not only presents serious negative consequences of long term chronic use, but also overlooks key features of various allergic mechanisms, and fails to address underlying non-inflammatory parameters and contributing health problems. Evidence also points to damage to the membranes and natural immune responses by continous use of these drugs and authorities now recommend a treatment protocol that at least alternates these types of drugs each month or so if the patient uses them daily.

“A modern treatment of chronic rhinosinovitis syndrome (CRS) should adapt its schemes to evidence-based medicine. Unfortunately, basic evidence on drug efficacy in CRS is still missing. As mentioned by the EPOS expert panel, validated trials are lacking even for the most prescribed medications against CRS such as antibiotics. Finally, as for all treatment for chronic diseases, an adequate management of CRS should include a regular evaluation of efficacy (and a) multidisciplinary approach.”

- (an NIH PubMed citing of a paper published in Therapeutic Clinical Risk Management 2007 March; 3(1) by the Dept of Otorhinolaryngology, Univ of Ghent and Univ Catholique de Louvain, Belgium)

Antihistamines: while short term use of antihistamine presents little threat of risk other than drowsiness, hypotension or interaction with other drugs that may potentiate depression or anxiety, the FDA has issued serious warnings concerning long term chronic use. In 1992, the FDA warned that nonsedating antihistamines, astemizole (Hismanal) and Seldane, could cause cardiac arrhythmias if accumulation of blood levels increased above therapeutic indications. Some of these antihistamines had to be taken off the market due to the serious risk due to the problem with accumulation to toxic dose, yet are we concerned with mildly toxic blood levels with chronic use?

Concurrent use of the antibiotic erythromycin, ketoconazole, itraconazole and other drugs have been shown to cause great increases in blood level accumulation of antihistamine. Keep in mind also that antihistamines are now added to a variety of common over-the-counter products, including sleeping aids, allergy remedies, cold and flu meds, etc., and are added to a number of pain medications, usually denoted by the PM version of the drug. Also, antihistamines have been documented to excrete in breast milk and nursing mothers have been cautioned, especially if levels rise. Many antihistamines are broken down mostly in the liver and poor liver function or competition in catabolism could decrease an individuals rate of drug breakdown. Risk of toxic blood levels seems to be largely ignored.

Chronic use of antihistamines are documented to cause weight gain and insomnia, as well as other common health problems that are typically ignored by the prescribing physicians. Insomnia is often improved at first by the taking of antihistamines, many of which affect the CNS sleep centers and cause drowsiness, but chronic use typically results in a disruption of healthy sleep regulation. Natural allergic responses are sometimes diminished with chronic antihistamine use and patients will become more prone to frequent viral, fungal and bacterial infections.

The reasons that antihistamines may cause increased CNS depression when combined with alcohol or other anti-depressants and anti-anxiety drugs is alarming to some. This serious threat is why second and third generation of antihistamines were developed to decrease risk, and are called nonsedating. First generation antihistamines easily crossed the blood brain barrier and affect the central nervous system (CNS). The first generation antihistamines are also lipophylic and are metabolized by the liver P450 oxidative enzymes, thus competing for enzyme breakdown with antidepressants, anti-arrhythmics, beta blocking blood pressure medications, and antipsychotic medications used for common depression and anxiety. Second generation non-sedating antihistamines, while not directly crossing the blood brain barrier to effect the CNS, were the first drugs studied in relation to drug interactions with P450 enzyme competition, and still contain this threat of altering blood levels of both the antihistamine and these other drugs. Third generation non-sedating antihistamines do not cause these interactions, but studies show that clinical response varies widely among and within patients (Armstrong and Cozza M.D. analysis published in Psychosomatics 2003; 44:430-34). This study also asserts that Claritin/Altavert safety profile has been the subject of much professional debate, and drug interactions and competition is still problematic with certain patients, especially concerning patients taking concurrent anti-histamine antacid medications and cardiovascular drugs.

Histamines are important chemicals in the area of proper stomach function also, and inhibition has shown potential nutrient depletion of B12, calcium, folic acid, iron, zinc and vitamin D. The FDA has issued warnings that caution should be used in prescribing these drugs to patients with peptic ulcers or small bowel obstructions, as well as those with prostrate hypertrophy, glaucoma and bladder obstruction. Certain antihistamines come with precautions that caution should be observed in use with patients with history of bronchial asthma, hyperthyroidism, cardiovascular disease and hyptertension.

Coupled with these extensive problems of risk with antihistamines are the consequences of long term corticosteroid use (see article on this website) and the damage done to sinus membranes from chronic use of decongestants. Common prescriber warnings state that there are potential side effects with decongestants of nervousness, sleeplessness, increased blood pressure, racing heart, and rebound rhinitis, where more than three days use in a row of nasal decongestant spray may cause the congestion to become more severe which will lead to increased use of the decongestant and dependency on the medication.

The key question in evaluating long-term risk versus benefit is not whether we may be one of the unlucky few who face serious consequences, but rather, if these medications can cause such significant harm, what are they doing to my general health. As far as benefit concerns, are these drug regimens correcting the immune membrane health and addressing key health factors that contribute to the problem? Are they possibly perpetuating the health problem while controlling symptoms?

New Recommendations for Treatment Strategy for Chronic Rhinosinovitis Syndrome (CRS), commonly called Hayfever, Rhinitis or Sinovitis:

The NIH has published recent extensive analysis of rhinosinovitis syndromes and recommended a change in treatment guidelines. These recommendations are that instead of just focusing on reducing mucosal inflammation, swelling, infection and aeration of the membranes, that modern treatment should, “First of all...consider the patient in totality: from etiology (including contributing health problems) when possible, to (differences in individual) clinical features. When considering patients with CRS, comorbidities (associated health problems)... must not be underestimated...A modern treatment of CRS should adapt its schemes to evidence-based medicine. Unfortunately, basic evidence on drug efficacy in CRS is still missing. As mentioned by the EPOS expert panel, validated trials are lacking even for the most prescribed medications against CRS such as antibiotics...A multidisciplinary approach and follow-up is mandatory as diseases such as cystic fibrosis can generate sinus diseases.”

Understanding the Mechanisms of Allergic Reactions

One theory in allergic immune missense is that the immune system makes mistakes when it is overtaxed. The cytotoxic immune system is a very complex interaction of chemical mediators in our body because it has to respond to millions of potential threats from viruses, fungi, mold, mildew, pollen, toxic chemicals, etc. As our environment gets more complex and less healthy, and as our community becomes more global, the stress on the cytotoxic immune system increases exponentially. When our general health suffers, this immune system is struggling even more, as the body is less capable of producing the right metabolic chemicals to supply the needs of the immune complex. As the cytotoxic immune complex recognizes allergens, the cytokines, or protein messengers, activate the T-cell and B-cell responses. When the B-cell responses are triggered too easily, unwanted inflammatory responses cause allergy symptoms. The main antibodies secreted by B-cells related to allergic reactions are the IgE (immunoglubulin E) and IgG (immunoglobulin G). By creating a healthier immune system, there is a chance that this immune memory response can be modified, and overexcitation of antibody responses to allergens will be decreased.

B-cells are immune blood cells that are able to use a 'memory' mechanism to produce specific protein antibodies to the allergens. The whole process of activating B-cells to produce the antibodies involves both the protein complement system and the T-cells though. The B-cell binds to the allergen or antigen and combines this with a protein marker that is then recognized by a T-cell, which carries a matching receptor to this marker. This activates the T-cell, which releases complement protein cytokines, or interleukins, that transform the B-cell into an antibody-secreting blood cell. T-helper cells are integral to this process, and types of T-helper cells produce different groups of cytokines, or immune modulating signaling chemicals. A chronic imbalance of T-helper cell type 1 (TH1) versus T-helper cell type 2 (TH2) is thought to be responsible for many types of chronic allergic pathologies as well as autoimmune pathologies. Restoration of both the B and T cell responses is thus important in therapy. While allopathic pharmaceuticals target individual mechanisms within this cascade of immune events, herbal medicine provides an array or chemistry that may effectively modulate both the B-cell and T-cell responses.

B-cells are produced and processed in the bone marrow and liver, with billions of types of antibodies produced. Problems with the metabolic function of the liver and marrow may thus produce specific problems with the allergic responses. Increasing the healthy functions of the liver and marrow may be just as important as avoidance of the allergens in correcting the allergic reaction. Some of our complex B-cell memory was obtained from the colostrums of our mother’s first breast milk. One theory states that problems with this memory B-cell system may contribute much to certain allergic states. Bovine colostrums have proven to be beneficial in some instances to correct this problem.

T-cells are lymphocytes produced in the thymus, and are the main component of the cell-mediated immune responses. All T-cells originate from stem cells in the bone marrow, though, which circulate to the thymus to develop into T-cells. The thymus is a specialize immune organ located under the sternum, in the mediastinum. This organ is most active during the childhood and pre-adolescent years, and begins to diminish in size and capacity after the teens, shrinking in size by about 3% per year. This may explain why aging individuals often experience more difficulty with allergies and autoimmune pathologies. A memory of this adaptive immune development continues through adulthood, and both stored progenitor cells and new lymphocytes are available throughout adulthood. A process of selection, involving the genetic MHC/HLA (major histocompatibility complex / human leukocyte antigen), is used to screen developing expression of T-cells to insure that T-cells viable to the individual are released into circulation, while others undergo apoptosis, or programmed cell death. This system is a major reason why individuals show differing degrees of allergic and autoimmune response. About 98% of T-cells developing in the thymus fail this selection process and die. We see that the health and function of the bone marrow, thymus, and the T and B cells are important in the regulation of allergic responses.

A complete process of trying to stop the allergic memory of overreaction must involve therapy aimed at improving the healthy function of all of these aspects of the immune response. The allopathic approach, which still tries to target a single problem in a part of the cooperating immune system, will not achieve this goal, and hence, modern pharmaceutical research has been stymied. The patient that chooses a holistic approach to improve the whole health of the system has a great chance to stop this allergic missense.

This holistic process involves identification of the right allergens, decrease in exposure to these allergens as you work to improve the health of the immune system, stimulation and restoration of the immune memory, stimulation of more healthy B-cells and T-cells, stimulation of healthy complement proteins and inflammatory mediators by improving liver health, and improving the health of the membranes, where ill health and inflammatory processes may be altering the healthy function of these antibodies and complement proteins. Testing may be the first step in correctly identifying allergens. Other methods may be to keep a diary of symptom onset and compare this to exposure. Some patients have utilized physicians using muscle testing reactions.

Testing

Testing for allergies usually involves testing either reactivity or antibody levels that are somewhat specific for the allergen. Both of these testing methods do fall short in assuring complete objectivity. Skin reactivity may gauge the immune reactivity of an area of skin but this may be different than the reactivity by antibodies or other immune complex in the membranes or in the lining of the gastrointestinal tract. Blood tests may find high IgE antibody levels to specific antigens, but for the individual these may or may not indicate a real allergic response, as the body creates antibodies for all foreign molecules, and some of these tests are affected by medications such as antihistamines.

Analysis is sometimes subjective. Tests often indicate allergic reaction to a substance that the patient isn't bothered by, and often tests show little evidence of allergic reactivity while the patient still has episodes of allergic symptoms. Nevertheless, tests are a good addition to the accumulation of objective evidence that can be assembled to find a comprehensive treatment plan. Other methods of objective assessment include keeping a diary of exposure and reaction, keeping in mind that some symptoms may not occur immediaately after exposure and so need a pattern analysis, and use of muscle testing, which is a reactivity of the strength of contraction with exposure, and is subtle.

The reasons for this accumulation of objective evidence is not merely to avoid the allergen for the rest of your life. Often times, even partial avoidance of the allergens during a period of increasing the healthy response of the immune system may help tremendously to change the pattern of hyperreactivity. In other cases, the persistence or duration of exposure may be a key factor in the allergic response. Studies indicate that certain populations may have high percentages of allergy to certain allergens simply because exposure lasts for months instead of weeks. Often, the patient reports that their specific allergy resolved when they moved to a new geographical place, even though both places obviously contain the allergen. Changes in allergic reactivity are commonly reported over time, and this indicates that the body does have the capacity to resolve specific allergies. Knowledge of the specific allergens may be very important to this process of cure.

Atopic allergen reactivity may be tested by blood samples or skin tests. ImmunoCAP is a blood test that measures allergen-specific IgE and is not affected by antihistamine use, with claims of more accuracy and objectivity. RAST, or radioallergosorbant test, has been shown to be less sensitive than skin tests.

Food allergies may be identified with the ELISA (enzyme-linked immunoSorbent assay), which detects antibodies or antigens, from the blood. Great Smokies Laboratory has performed these tests along with tests of stool samples for analysis of the bacteria, fungi etc. in the intestines. The ELISPOT (enzyme-linked immunosorbent spot) test is a modified version of the ELISA that is very sensitive. IgG antibody assessment (ELISA/EIA) has been used to identify food allergens that contribute to irritable bowel syndrome, with mild improvement from eliminating these foods from the diet. Once again, relying on just one focus, and not treating with a thorough, holistic approach, is often a recipe for failure. Attention to potential allergies should be part of a broader treatment protocol.

Newly developed testing technology, such as the lymphocyte proliferation test (LPT), provides a cytometric analysis of antigen-specific proliferation of peripheral lymphocytes, and may provide useful information concerning balance of immune responses in chronic allergic syndromes. A lymphocyte is a type of white blood cell, and lymphocytes are categorized according to type and function. Small lymphocytes consist largely of T and B cells, while the larger lymphocyte category includes natural killer cells (NK), which are activated largely by interferons, a type of cytokine. Each individual inherits a Major Histocompatibility Complex (MHC) that genetically guides the innate immune system in utilizing NK cells to destroy cells infected with or altered by allergens and antigens. T and B cell responses are adaptive and provide additional protection against allergens and antigens. T cells are produced in the thymus, and B cells in the bone marrow. B cells produce the antibodies (humoral immunity), while T cells are involved in cell-mediated immunity. Chronic allergic or antigenic responses may alter the balance of T-helper cell response (TH1/TH2), and contribute to persistence of unwanted inflammatory reactions related to classes of cytokines (immune modulators). These newer tests may help identify these pathological immune processes and guide therapy to reestablish balance of lymphocyte responses.

Reliability of the labs is a problem shown in testing and review, and the patient is advised to request that a reliable lab be used. Ultimately, these lab tests show possible ranges of allergic responses and the patient must still go through a series of elimination diets and see if possible results support the lab findings. As always, the cure is often more complicated than we would like it to be. Often, diagnosis of food allergies is best left to the naturopathic doctor.

Other testing facilities that are recommended by experts include: Geneva Diagnostic Laboratory or Asheville, NC: 800-522-4762; and ImmunoScience Inc. of Las Vegas, NV: 925-460-811.

Food allergies and the rising incidence of food allergy in the U.S.

The U.S. Centers for Disease Control and Prevention (CDC) reported in 2010 that the incidence of food allergy in U.S. children is rising dramatically. The key findings of studies showed that between 1997 and 2007 the prevalence of reported food allergy of children under the age of 18 increased 18%. These studies also found that children with food allergy are 2-4 times as likely to have asthma, other allergies, and allergy-related pathologies. The CDC reported that 4% of children in the U.S. now have a food allergy. Since the health of the immune system may decline with age, we may assume that there is a dramatic rise in the incidence of food allergy in the aging population as well. The reasons for this dramatic rise in food allergies and allied pathologies is still not clear, but many experts blame genetically engineered crops, while others believe that a lack of exposure to germs and bacteria with the increased use of bactericidal products has weakened the development of strong immune system responses in the population. Other theories include changes in the way parents introduce food varieties too quickly to infants, the dramatic rise in caesarean births creating an incomplete innate immune response, the rise in more complex food production technology and the rise in overall consumption of prepared foods, and finally the increase in testing and treatment, or simple recognition of food allergies. All of these probably contribute to some extent, and the choice of which cause is probably not going to produce workable solutions. As with all complex problems, tackling all of the likely culprits will insure a better and quicker outcome. It is likely that there is a correlation with the introduction of genetically altered foods and the dramatic rise in food allergies, though, as these have occurred simultaneously.

Studies have indicated that up to 90% of food allergies in the United States are related to wheat, soy, peanuts, tree nuts, milk, eggs, fish and shellfish. Since the identification of pathological allergens is complicated, though, and almost any food could present some immune antibody response, this fact is often disputed. As study of these common allergenic foods progresses, though, the facts are revealing the complexity of such analysis. For example, at least 27 proteins in wheat have been identified as potential allergens. Different strains of wheat may have a differing protein profile. Therefore, one wheat product may produce an allergic reaction while another may not. Genetic engineering has further complicated this issue, as this gene altering makes small changes in the expression of these proteins to achieve resistance to pests, chemicals or environmental stresses. The industry would have us believe that they will be able to alter these allergen proteins to eliminate allergies, thereby eliminating the threat of food allergies by genetic engineering. In a fairy tale world this is certainly a possibility, but in the real world, the complexity of this project, and the cost, will certainly make this difficult. Will the public believe the industry when they say that they will engineer crops for the public health rather than for profit? Will the public, and the government overseers, believe that this can or will be accomplished. By the time we find out it may be too late for millions of us with food allergies that alter our diet and lifestyle and decrease quality of life.

Such organizations as the Center for Science in the Public Interest have voiced much concern about the potential of genetically engineered crops to produce new food allergens. Genetic engineering alters the protein amino acid sequencing in such prevalent allergenic food crops as wheat and soy. Small changes in the amino acid sequence of proteins in these crops could, or have, resulted in creation of new IgE allergen epitopes, which may involve amino acid sequences as short as 6-8 amino acids in the protein expressed by the altered genes. This was reported by the United Nations Food and Agricultural Organization and the World Health Organization in 2001. Minor genetic changes could also alter the protease recognition sites on these proteins, inhibiting the immune mechanisms for countering the allergen protein by efficiently breaking down the protein in the stomach or small intestine. These genetically engineered crops must submit a safety study to the FDA, EPA and USDA, but these risk assessments typically present the sequence of the gene prior to transformation rather than the exact sequence of the genetically altered proteins in the crop, and do not account for small genetic changes that may occur during the genetic engineering or that may occur after the gene is transformed. These genetically engineered wheat and soy crops could present new allergen proteins to the human system. The array of potential allergen proteins in these altered crops would make identifying the allergen difficult as well, as one wheat or soy food product could contain the allergen protein, and the next one purchased may not.

As far back as 1994 allergens have been detected in genetically engineered crops. The New England Journal of Medicine, March 14, 1996, reported that the transfer of a protein sequence from a Brazil nut into a new soy strain created an allergenic strain of soy. The scientists that created this genetically engineered soy stated that proteins within the soy would inhibit binding of IgE to the transferred 2S albumin, but subsequent study of individuals with a Brazil nut allergy proved allergic to the genetically engineered soy. It was recommended that allergenicity of genetically engineered food proteins be assessed in human trials before approving their use if the amino acid sequence was transferred from an allergenic food. As time went on, though, scientific study has revealed that this type of assessment is much more complicated than we had assumed, and the identification of more and more proteins exhibiting common allergenicity is occurring even today. The threat of transfer of a gene sequence from an allergenic food is not the whole picture of threat, though, as further studies continue to reveal. The number of possibilities in this type of genetic assessment is extremely large, and hence, genetically engineered crops are banned in many countries and even the United Nations and the World Health Organization remain concerned.

There is no consensus on the causes of a dramatically rising incidence of food allergies, or even whether this rise in incidence actually exists. Various demographic studies over the last 20 years have produced a large variance in statistical results, some exagerrating the incidence of food allergy dramatically, while others appear to downplay this incidence. The Centers for Disease Control study is based largely upon clinical evidence from hospitals and clinics, though, not demographic studies. A European study, the EuroPrevall, is currently being conducted to combine more rigorous clnical test assessment with demographic studies. The subject of allergy testing is also controversial, though, as most food allergies produce an IgG-mediated reaction that is less tested and more difficult to assess than the IgE-mediated responses that produce more immediate and dramatic symptoms. The threshold of reactivity from IgE or IgG antibody levels is also variable from one individual to another, and between one allergen and another. Blood and skin tests do not predict IgG sensitivies as accurately as they predict IgE sensitivities. Many experts still insist that the gold standard of allergy testing is the elimination diet. If the suspected allergens are eliminated in the diet and symptoms improve, we are most assured that the allergic hypersensitivity exists. The array of symptoms may include fatique, anxiety, depression, attention deficits, headaches, nasal congestion, chronic sinusitis, recurrent ear infections, vertigo, sore throat, asthma, heartburn, diarrhea/constipation, eczema, arthritis, edema and easy bruising.

Herbal products are proving effective to treat allergies

A variety of herbal products are effective if they are of high quality and prescribed properly. Herbal medicines are able to control inflammatory mechanisms, increase vascular and neural vasomotor responses, promote healing of tissues, act as broad spectrum antibiotic, antiviral and antifungal agents, support healthy immune responses, both specific local and systemic, and address potential contributing health problems such as fibrosis, subclinical hypothyroidism, acid reflux and other esophageal reflux syndromes, and asthmatic mechanisms. In addition, herbal products may help alleviate some of the risk of damage to the membranes and overall health from chronic use of drugs. Some of the common herbal pill formulas in my clinical practice are listed below. Other tinctures and raw herb formulas are used as more specific and stronger phytomedication when needed.

• Allergen: a general herbal formula to alleviate symptoms and help the immune system is very effective in many cases, especially with nasal and eye symptoms
• Advanced Defense: a formula to stimulate better immune responses
  
• Colostroplex: bovine colustrum supplement may help with food allergy problems especially
• Phellostatin: a formula that has a broad spectrum effect against overgrowth of fungi, bacteria, and other pathogens
• Ecliptex: a liver tonic with milk thistle is often useful to improve B-cell response
• Astra C: a simple immune tonic with 3 forms of Vitamin C to improve the health of the mucosa to correct localized immune dysfunctions in nasal allergies and asthma
• Nasal Tabs: a symptom relieving formula for nasal/sinus allergies
• Xanthium relieve surface: a simple formula to relieve skin symptoms or head congestion symptoms related to allergies

More importantly, though, may be the restoration of esophageal and gastrointestinal health and function. While the standard medical industry has treated all problems of gastric dyspepsia and acid reflux with the same one-size-fits-all protocol, research in recent years has demonstrated that this has increased allergen sensitization and allergic reactivity dramatically. Restoration of gastric function, rather than blocking of function, is now proven to be the correct treatment protocol for a vast majority of patients. The use of herbal and nutrient formulas to affect this improvement in gastric function and protein digestion may include DigestiveAid (Vitamin Research Products), Resinal K liquid, Chzyme, EnteroMend, N-Accelle, Phellostatin, and BioPro (probiotic formula from Vitamin Research Products). A step-by-step restoration and proper individualized assessment of gastrintestinal health and function may treat the basic underlying problems that lead to chronic food allergies and sinus and skin allergies as well. Food allergies now are found to be the underlying mechanism for many chronic and difficult sinus allergies, and addressing the health of the gastrointestinal system may also decrease the systemic distribution of allergens in circulation via poor gut membrane health. The so-called “leaky gut syndrome” is now well known and shown to be a major contributor to allergic sensitization and reaction via unwanted allergens bypassing our natural gut defenses.

Examples of herbal formulas to treat allergies that are now being studied in the United States includes such formulas as Food Allergy Herbal Formula-2 (FAHF-2), which was studied in 2008 and supported by the Food Allergy Initiative and the National Institutes of Health grant #AT001495-01A1, with the study results published in The Journal of Allergy and Clinical Immunology Volume 123, Issue 2, Pages 443-451, February 2009. This simple classic formula, consisting of Prunus mume (We mei), Zanthoxylum schinifolium (Huai jiao), Angelica sinensis (Dang gui), Zingiber officianalis (Ginger), Cinnamonium cassiae (Gui zhi), Panax ginseng, Phellodendrum chinense (Huang bai), Coptis chinensis (Huang lian), and Ganoderma lucidum (Ling zhi or Reishi mushroom), was found to suppress IgE-mediated mast cell activity, reduce basophils and mast cells, and induce a shift in specific immune responses mediated largely by elevated CD8 interferon gamma. Use of this formula for a prolonged period of up to 3 months reduced long-term TH2 cytokine secretion as well, to effectively treat allergic anaphylactic responses. The study authors stated: “In conclusion, our studies with FAHF-2 have shown a beneficial effect that lasted long after the treatment regimen ended, a therapeutic effect not provided by other treatments. The long-term immunomodulatory effects of FAHF-2 on TH1 and TH2 responses, but not overall immune suppression, could provide the optimal immune meilieu for establishing tolerance to peanut and other IgE-mediated food allergies. FAHF-2 is currently being tested as a US Food and Drug Administration (FDA) investigational new botanical drug in patients with food allergy including PNA. FAHF-2 might thus be the first available effective treatment for patients with PNA and other food allergies.” The various herbs in this TCM formula are included in most other common professional TCM herbal formulas prescribed to treat chronic food allergies, including those mentioned above.

Information Resources

Treatment with Complementary and Alternative Medicine for allergies in Europe is proving very successful and well utilized. Some of the data on the practice and research support is listed below with links to published data.

1. A 2005 study at the Medical University Vienna in Austria found that common medications to treat stomach acidity produced an increased sensitization to food allergens in 25 percent of patients within 3 months of use: http://www.ncbi.nlm.nih.gov/pubmed/15671152
2. A 2006 follow-up study at the Medical University Vienna in Austria found that gastric hypofunction was highly related to food allergen sensitization, as well as the development of the phases of food allergic reactivity. The common prescription of chemicals to block gastric function to reduce symptoms of poor stomach acid function has resulted in a high number of individuals in developed countries with serious food allergies: http://www.ncbi.nlm.nih.gov/pubmed/16670517
3. A2008 study at the Medical University Vienna found that gastric acid inhibiting medications increase the gastric pH and substantially reduce the gastric digestive function, leading to poor protein digestion and increased risk of food alleries, almost all of which are related to food proteins and peptides: http://www.ncbi.nlm.nih.gov/pubmed/18539189
4. Current use of Complementary and Alternative Medicine by medical doctors in Europe as far back as 2002 proves that this treatment protocol works for a growing body of patients: http://www.ncbi.nlm.nih.gov/pubmed/12121187
5. By 2004 studies showed that 30% of all patients with in Europe chose to treat with Complementary and Alternative Medicine, with a great percentage choosing acupuncture and herbal medicine: http://www.ncbi.nlm.nih.gov/pubmed/15330007
6. A German study at the Medical University of Lubeck found that patients who chose Complementary and Alternative Medicine to treat allergies were motivated by concern for Quality of Life and desire to take control of their health: http://www.ncbi.nlm.nih.gov/pubmed/14642985
7. A Japanese study in 2010 found that when patients spent time in nature, such as parks and forests, that their immune system functioned better due to inhaling phytochemicals that plants create to protect them from the harmful effects of antigens, allergens and insects: http://www.nytimes.com/2010/07/06/health/06real.html?_r=1
8. A 2008 meta-analysis of the effectiveness of acupuncture in the treatment of allergies in Germany, tested with double-blinded placebo trials, demonstrate the proven benifits: http://www.ncbi.nlm.nih.gov/pubmed/19055209
9. A 2006 meta-analysis in Australia of current clinical trials and evidence supporting the use of acupuncture and herbal medicine in the treatment of allergic rhinitis: http://www.ncbi.nlm.nih.gov/pubmed/16670510
10. A 2010 study at the esteemed Mount Sinai School of Medicine in New York found that a common Chinese herbal formula used to treat food allergies, called food allergy formula 2 (FAHF-2) in the study, found that this formula effectively reduced mast cell and basophil numbers and suppressed IgE-mediated mast cell activation to effectively protect against such food allergic reactions as peanut anaphylaxis. FAHF-2 consists of 9 common Chinese herbs, and is derived from the classic formula Wu mei wan, which is composed of Wu mei, Huai jiao, Xi xin, Huang lian, Huang bai, Zhi fu zi, Gui zhi, Gan jiang, Ren shen, and Dang gui, although the processed Fu zi is rarely used today. Standard medicine has produced no viable safe pharmaceutical approach to these threatening food allergies. Integration of Traditional Chinese Medicine would seen a sensible approach: http:/www.ncbi.nlm.nih.gov/pubmed/21134573
11. This food allergy formula 2 mentioned above was studied in 2009 at Mount Sinai School of Medicine and found to provide long-term protection from anaphylaxis (severe food allergy) by inducing a beneficial shift in allergen-specific immune responses mediated largely by CD-8 T-cell interferon gamma (IFN-g) production. These effects lasted for 36 weeks after discontinuing the treatment of 7 weeks of formula, and reduced specific IgE antibodies to strong food allergens by 50 percent: http://www.ncbi.nlm.nih.gov/pubmed/19203662
12. For a full view of one of the Mount Sinai School of Medicine in New York studies of this common and classic food allergy formulas, Wu mei wan, or FAHF-2, click on this link to the U.S. National Institutes of Health government website of medical studies, or copy the address below and paste it to your server: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059770/
13. A 2010 study at Kyung Hee University, South Korea, found that a Chinese herb Corydalis hereocarpa, with the active chemical Libanoridin, effectively inhibits allergic inflammatory response by the inflammatory mediators found to be excessive in the allergic responses, IL-1beta, IL-6, IL-8 and TNF-alpha: http://www.ncbi.nlm.nih.gov/pubmed/20100031
14. A 2007 study at the Chosun University Medical School in Gwangju, South Korea, found that Quercetin, an antioxidant chemical found in a number of Chinese herbs, including Sang ji sheng (Loranthus parasiticus), Fan shi liu (Psidium guajava fruit), Di er cao (Hypericum, or St. John's wort), and Man shan hong (Rhododendrum dahuricum), and available in a purified extract, effectively treats allergic inflammatory responses by decreasing the inflammatory mediators IL-6, IL-8, TNF-alpha, and attenuating NF-kappaB and p38 chemokines: http://www.ncbi.nlm.nih.gov/pubmed/17588137
15. A 2007 study at Kyung Hee University in Seoul, South Korea, also found that green tea, with the active chemical epigollocatechin, was an effective addition to an allergy regimen, inhbiting the production of the inflammatory mediators that drive allergic responses, IL-6, IL-8, and TNF-alpha, through inhibition of intracellular calcium ion triggering: http://www.ncbi.nlm.nih.gov/pubmed/17135765
16. A 2010 study at the Tunghai University in Taiwan found that the Chinese herb Anoetochilus formosanus effectively modulates inflammatory allergic responses by modulating immune cytokines in allergic asthma, reducing IgE responses, and airway hyperresponsiveness: http://www.ncbi.nlm.nih.gov/pubmed/20092984
17. A 2010 study at Mount Sinai School of Medicine, in New York, found that the TCM formula entitled Food Allergy Formula-2, or FAF-2, reduced basophils and mast cell numbers as well as suppressing IgE-mediated mast cell activation to inhibit allergic responses to food allergens: http://www.ncbi.nlm.nih.gov/pubmed/21134573
18. Legislators such as Congresswoman Nita Lowey have been insisting on greater attention to the fast-growing threat of food allergies since 2008, which cause a wide variety of health problems, not only acute digestive and skin reactions, but chronic respiratory congestion, and angioedema. As Congresswoman Lowey reports, the Centers for Disease Control admits that the mechanisms by which people develop food specific allergic reactions are still largely unknown: http://lowey.house.gov/index.cfm?sectionid=18&parentid=17§iontree=17,18&itemid=383

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.