by NOHA Professional Advisory Board Member Martha H. Howard, MD, who has practiced integrative and preventive medicine since 1982, in her family practice combining both traditional Chinese medicine and allopathic medicine. She is a member of the American Academy of Holistic Medicine and of the International Society for the Study of Subtle Energy and Energy Medicine; a board member of the National Institute for the Clinical Application of Behavioral Medicine; and a former board member of the American Association of Acupuncture and Oriental Medicine; and has served on the National Committee on acupuncture certification. Dr. Howard is the medical director of the Wellness Associates of Chicago.

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Asked why Dr. Howard, as a medical doctor, uses the word "clients" rather than the customary word, "patients," she replied, "I believe our current medical model is dysfunctional, in that it encourages too much disease management and crisis intervention—rather than health care and prevention.

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Asked why Dr. Howard, as a medical doctor, uses the word "clients" rather than the customary word, "patients," she replied, "I believe our current medical model is dysfunctional, in that it encourages too much disease management and crisis intervention—rather than health care and prevention. The current model uses the word ‘patient,’ which implies passivity. The word ‘client’ implies an informed person who is paying for expert advice. Part of breaking out of our current dysfunctional model is the promotion of change in the way we think and talk about it."

Many of my clients tell me that they feel better when they do not eat—that if they want to feel alert and energetic, they stay away from food until after they have finished their work day. If they do eat, they feel that "brain fog" sets in, and they are sluggish, bloated, sleepy, and full of gas. They tell me that they seem to be getting worse over time and are reactive to more and more foods. They never feel well after they eat. Often they also have sinus congestion, headaches, muscle or joint pain, and generalized fatigue.

They say that they have been tested and told there is "nothing really wrong," that it is "irritable bowel syndrome." Many of them also say that they have been tested for allergies and no foods have come up. They have been told by alternative practitioners that they have "systemic candida," but restrictive diets and candida-killing supplements and antibiotics haven’t helped either.

What is wrong here? I have found by testing more than fifteen hundred new clients over the last ten years that a person with the problems described above is usually having a type of allergic response to food called "delayed-type hypersensitivity." In this type of immune response, the person’s immune system is actually attacking their food.

Here’s a little "short course" to explain two different types of allergic response—the immediate type response, which is associated with an immune globulin called "IgE" (immune globulin E); and the delayed type response, which is associated with an immune globulin called "IgG4" (immune globulin G4).

The immediate type response is more familiar to most people and it is the one for which skin testing is done at an allergist’s. It is the response that causes a runny nose, swollen and itchy eyes, swelling in the lips or face, and in the worst case swelling of the throat and constriction of the airways that is severe enough to stop the person from breathing. This extreme reaction is called "anaphylactic shock." People who react to foods in this way know it! They are the people who may wind up dead or in a hospital if they eat the allergenic food by mistake.

The delayed type response is "sneakier." It is delayed for at least thirty to forty minutes after eating the food and causes a generalized inflammatory response, which can last up to four days. The delayed type response should be called "the great masquerader" because it causes so many varying symptoms and takes so many forms. Many people get swelling in the intestines and sinuses, and complain of abdominal discomfort, bloating, and gas, as well as constant head congestion and recurrent sinus problems. For some people the only symptoms may be sinus problems and headaches. For some, it may be swelling and joint pain. Others may have "brain fog" and fatigue, or bladder pain and frequent urination. Some unlucky ones may have all of these. It is difficult to tell which of the "mucus membranes"—the pink lining of sinuses, throat, stomach, intestines, and bladder, will be most affected by the swelling and irritation caused by the immune response to the offending food.

It is important to know how the two different immune responses work, because the "logic" of testing for them and treating them is determined by the cellular biology of what they do in the body. Learning about the immune system is like studying a war. The invaders are of all different kinds—infective organisms (bacteria, viruses, or fungi); poisons; or allergens (irritants from the environment or diet—like dust, mold, pollen, animal danders, or food).

The body’s defending army has different types of warriors with different weapons, fighting on different fronts. These "immune warriors" mount a defense when they sense and attack. We are familiar with some of these from reading about AIDS—Helper T-cells, Suppressor T-Cells, NK (Natural Killer) cells. There are others—B-cells, macrophages, leukocytes, and the immune globulins we mentioned, IgE and IgG4.

When you are allergic and run into a face full of dust, mold, or pollen, IgE responds by going out and locking on to a receptor on a big cell called a Mast cell, which is full of histamine and serotonin. This causes the Mast cell to dump its contents and the histamine causes the swelling reaction. (That’s why we are given anti-histamines as one of the treatments for this type of response.) This type of allergic response is tested by pricking the skin with the allergen, which causes a hive-like swelling if you are allergic. YOU CAN BE TESTED AS NOT ALLERGIC TO ANY FOODS IN THIS TYPE OF RESPONSE BUT STILL HAVE BIG PROBLEMS WITH FOOD, BECAUSE YOU HAVE THE DELAYED TYPE RESPONSE AND WERE NOT TESTED FOR IT!

IgG4 acts much more like an antibody attacking a bacterium, virus, or fungus. No one is certain what makes the body identify the food as harmful. There are a number of theories. One—which may account for the increasing allergies to wheat, dairy, and eggs in the United States—is that certain substances (called "haptens" in immunology) that are constantly associated with a food make it more allergenic. In the case of wheat, these would be either molds, chemical fumigants, or bleaches. In the case of dairy and eggs, these would be antibiotics or pesticides. The theory is that the body reacts to the mold, or pesticide, or antibiotic in the food, and then the constant association between the toxic substance and the food eventually makes the body react negatively to the food, even when it is not associated with the toxic substance.

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The theory is that the body reacts to the mold, or pesticide, or antibiotic in the food, and then the constant association between the toxic substance and the food eventually makes the body react negatively to the food, even when it is not associated with the toxic substance.

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Once the body, for wherever reason, has identified the food as an attacker it makes a "clone" of antibodies to the food. (Yes, the immune system fights with armies of clones!) These antibody clones all have the ability to come out in large numbers and specifically attach only to the "attacking" food. Once each IgG4 antibody attaches to each particle of the allergenic food, another particle called "complement" also attaches. If the invader had been a bacterium, that would be the end of the problem. The bacterial wall would be broken, the bacterium would die, and the debris from the dead bacterium could be pretty easily swept away by the body.

But when the attacker is a food, the whole system goes wrong. The IgG4, the complement, and the food particle all stay together, becoming an "antigen (the food)/antibody (the IgG4) complex." This complex is highly inflammatory—that is, it causes redness, irritation, and swelling in the tissues. It takes the body a long time to break it down—three or four days, which accounts for the long-lasting nature of the delayed type response. Many of my clients whose main symptom is migraine headaches say that the headache just "bounces back" as soon as their pain-killer wears off, and they can’t let up on the pain killers for three or four days.

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As the body tries to get rid of these particles through the kidneys and bladder, or through the intestine, many people develop kidney pain, urinary frequency or retention, intestinal swelling, bloating, gas, or hemorrhoids. They also have chronic sinus problems, or "allergic gastritis" with heartburn or even ulcers. . . . people are often treated with three or more medications, when what they really need to do is remove the offending food . . . from their diets. Another big symptom is weight gain and the inability to lose weight, even when dieting.

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This antigen/antibody complex can cause more than just migraines! It can cause swelling, water retention, pain and irritation in any body tissue it touches, or in any tissue connected with the one in direct contact with the complex. As the body tries to get rid of these particles through the kidneys and bladder, or through the intestine, many people develop kidney pain, urinary frequency or retention, intestinal swelling, bloating, gas, or hemorrhoids. They also have chronic sinus problems, or "allergic gastritis" with heartburn or even ulcers. These people are often treated with three or more medications, when what they really need to do is remove the offending food or foods from their diets. Another big symptom is weight gain and the inability to lose weight, even when dieting.

Now that we know the damage this little antigen/antibody particle can leave in its wake, what do we do? First, it is important to test accurately for foods that a person’s immune system has identified as "invaders." This can now be done easily with a type of blood test called an ELISA (enzyme-linked immunoabsorbent assay) test, a result of the research that was developed to find an accurate way of diagnosing AIDS.

In the ELISA test, a small wand with a food applied to it is dipped into a blood sample. There are circulating antibodies in the blood of people who have delayed type sensitivities. If they are very allergic to a food, for example, dairy, there will be a large number of antibodies to it in their blood. If less allergic, there will be fewer, and if they are not allergic at all, the will be none. When the wand with the food sample is dipped into a person’s blood sample, the lab is able to measure the number of antibody "hits" on the sample. This number of hits is then compared to a standard scale, and classified as a negative, low, moderate, or significant response. Over the last ten years, this type of testing has been developed to be very accurate and very inexpensive. The lab we use at Wellness Associates of Chicago is Meridian Valley Lab. They are able to test 95 different foods for about $200. When this type of testing was first done, it cost $30 per sample, which would make testing 95 foods cost almost $3,000!

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When these foods are common ones in the American diet—wheat and/or other gluten-containing grains, dairy, and eggs—it takes some time to make the transition and be able to shop and prepare food at home and make varied, enjoyable foods or to eat out and avoid the allergens.

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Once ELISA results are returned, it is important to guide the person with good nutritional advice. The best advice initially is to AVOID ALL FOODS IDENTIFIED AS SIGNIFICANT ALLERGENS, AND ROTATE ALL FOODS (ONE SERVING EVERY FOUR DAYS) IDENTIFIED AS MODERATE ALLERGIES. Once this is done, it is amazing how the symptoms resolve over the next few weeks.

"No, this is not what Dr. Rinkel meant by a Rotary Diversified Diet."

When these foods are common ones in the American diet—wheat and/or other gluten-containing grains, dairy, and eggs—it takes some time to make the transition and be able to shop and prepare food at home and make varied, enjoyable foods or to eat out and avoid the allergens. It is possible, and can even be challenging and fun!. It can also lead to a much healthier diet, with many more servings of fresh fruits and vegetables. There are now those of us who believe (as I do) that the foundation of the food pyramid should be fresh fruits and vegetables instead of grains—but that’s the start of another article! Any one with questions about the information in this article is welcome to contact me at my office—773-935-637, fax 773-929-4446, e-mail howbetter@worldnet.att.net