Chapter 6

Historically the answer to the problem of food allergies revolved around testing to find hidden sensitivities and then avoiding them. The best way to test foods is by adding them one by one to your base diet and waiting for a ‘hyper-acute’ reaction. The hyper-acute reaction is the ‘bloody’ nose that you’ll get after eating the incriminating food.

Most people are familiar with and understand the idea that someone can consume an occasionally eaten food and feel ill afterwards. Due to this, the public concept of food allergy has been limited to rare or exotic foods. To make matters worse most physicians also take this simplistic view of food allergy.

Case studies reporting food allergy being tied to different types of arthritis appeared as early as 1917. Many physicians noticed a difference between immediate and delayed exacerbation of symptoms after a food was ingested. However, the key discovery came when they observed what would normally be a delayed reaction could be converted into an immediate one if the food were omitted from the diet for at least five days. When a food is reintroduced the reaction usually occurs within 4 to 6 hours (except for slowly absorbed foods such as cereals). Today’s physicians describe this phenomenon as a ‘masked’ food allergy.

The concept of masked food allergy was originally identified by Dr. Herbert Rinkel, a well-known allergist practicing in Oklahoma City. After he graduated in medical school, he developed a severe nasal allergy (allergic rhinitis), which was characterized by severe, persistent nasal discharge. His medical colleagues skin-tested him for all the well-known inhalant allergies and all these tests proved negative. Fortunately he was familiar with the work of Dr. Albert Rowe (author of the 1931 book FOOD ALLERGY). Rowe lived in California and was an emeritus lecturer in medicine at the University of California is San Francisco. Dr. Rowe discovered early on in his career that food allergy was a major cause of many illnesses. Rowe also knew that diagnosing it via ordinary skin prick tests was next to useless.

Dr. Rinkel recalled that as a medical student, like many of his colleagues, he had been fairly poor. Grants were not common in the US at that time and, generally speaking, medical students going through college had to support themselves or be supported by their parents. Rinkel's father, who was an egg farmer, helped support his son during his medical studies by sending him a gross of eggs (144) each week. This was the main source of protein for Rinkel and his family.

This high ingestion of eggs continued after he graduated so he suspected eggs as a cause of his problems. One afternoon, in an attempt to produce an adverse reaction, he consumed a large quantity of eggs, but to his surprise his nasal symptoms actually improved. He abandoned the idea that foods were connected to his sinus problems until some years later when he did just the opposite.

He abstained from eggs for about five days and discovered that his nasal discharge improved considerably. He then inadvertently ate some angel food cake (which happens to contain eggs) at a birthday party. He suddenly collapsed unconscious and his rhinitis symptoms returned worse than ever.

Through this serendipitous chain of events Dr Rinkel realized that he might have stumbled on something fundamental regarding the basic nature of food allergy. He repeated the experiment by re-establishing his consumption of eggs, omitting them again for five days and then repeating the egg ingestion, which caused a recurrence of the symptoms of unconsciousness and severe nasal discharge. He then extended his observations with a number of his patients. Rinkel found a similar, shared phenomenon occurring with different foods and medical conditions, including joint pain. His observations were first published in 1944.

The first physician to draw widespread attention to the inter-relationship of food allergy and arthritis was Michael Zeller, M.D. Dr. Zeller was a clinical instructor in medicine at the University of Illinois College of Medicine in Chicago. He wrote a paper published in 1948 in the Annals of Allergy entitled 'Rheumatoid Arthritis: Food Allergy as a Factor'. In this paper Dr Zeller strongly emphasized his observations that symptoms of arthritis could frequently be relieved by appropriate food exclusion diets. The reproduction of arthritic symptoms on subsequent re-ingestion of certain foods established that food allergies were partially responsible for rheumatoid arthritis symptoms. Repeated re-introductions of identified food allergens after a minimum 5 day interval consistently reproduced pain, joint swelling and general inflammation.

As the concept of food allergy gained acceptance a number of testing techniques popped up in both conventional (allopathic) and alternative medicine practices.

Skin prick testing is a fairly useful test for inhalant allergies but does not really help in the diagnosis of food allergy. This type of testing is very popular and is used extensively by Allergists and Ear, Nose and Throat specialists. The simple fact that this is an ineffective testing technique is probably the single biggest issue that has held back the interest in food allergy in the conventional allopathic medical community.

The test involves placing a single drop of allergen extract on the inner forearm. A lancet is introduced through the drop of extract on the skin at an acute angle and, having slightly penetrated the skin, is given a deliberate vertical lift before being removed. Responses to these tests are read after 10-20 minutes. Many of the tests can be performed within a few minutes of each other and the whole test is therefore both simple and quick to perform. Unfortunately it is not very effective because most patients with well-established food allergies will fail to react positively to this test.

Patients with genuine food allergies who have been informed categorically that their allergies do not exist, purely on the basis of this test, have been harmed. D r Keith Eaten of Reading has published a trial showing that prick testing is of no value in diagnosing food allergy. As he put it, one is better off spinning a coin to determine food allergies than relying on this test.

Another test used primarily by M.D.’s is the RAST test (Radioallergosorbent Test). This test involves taking a blood sample and measuring the quantity of immunoglobin E antibodies that form when this blood is exposed to different allergens. It is thought that the higher the count of IgE antibodies, the more allergic the patient.

The RAST test is useful in diagnosing allergies to dust, dust mite, molds, animal danders, pollens and some foods. It has, however, many drawbacks: (a) it can only be used for testing a very limited number of food allergies; (b) it costs about five times more per allergy tested than does provocative neutralization testing (described later); (c) it measures only immediate responses, and many food allergies are delayed. (d) interpretation and technique vary somewhat from laboratory to laboratory, and false negatives and false positives often occur; (e) it is however probable that in the future the RAST test may be refined and become more useful.

Cytotoxic testing is one of the more controversial tests for food allergy. It does have it’s proponents, and it is very attractive to health care providers since it suggests that countless food and chemical allergies can be diagnosed from a single sample of intravenous blood.

The term cytotoxic literally means 'having a toxic effect on cells'. The blood sample is incubated on a microscope slide with a weak solution of suspected food allergen and the effect on certain specific white cells is noted. In a positive test the polymorphonueclear leucocytes (one type of white cell) slow down, become rounded and in strongly positive cases, disintegrate. There is no doubt that this phenomenon occurs, but the interpretation of the results depends completely upon the expertise of the technician.

The biggest criticism o f the cytotoxic tests is that companies offering the test often go directly to the public. Sometimes they appear to discover huge numbers of food sensitivities and as a result some people may end up on a very harsh and possibly nutritionally difficult as well as inadequate diet.

Applied Kinesiology is particularly favored by chiropractors, many who have realized the impact of food allergy on health. Initially the practitioner establishes the patient's muscle strength and tone by observing how easily he or she can lift, for example, a 50 pound weight. An allergen is introduced, usually under the tongue, and the muscle strength again measured.

The theory is that an allergic reaction will weaken the muscle tone and this can be detected by the practitioner. There is something to this test, but it has been very hard to validate. A wide array of things including light, color, smells and especially thoughts have been shown to change muscle strength. This array of variables makes it more difficult to weed out the impact of food allergy.

Radionics are used by some alternative health practitioners. They claim to be able to diagnose food allergies from hair samples. A pendulum is dangled over the hair sample, and if it rotates in one way allergy is indicated, if it rotates the opposite way it is not. This test is entirely dependent on the intuitive abilities of the health practitioner. John Mansfield, M.D. saw many patients after they had been tested in this way and the allergies detected (via intradermal and elimination diet testing) had little relationship to their hair test results.

Sublingual testing consists of placing one measured drop of the food allergen to be tested under the patient's tongue using a specially designed dropper pipette. The area under the tongue is one of great absorbability since that’s where the large sublingual veins reside. That’s why angina patients place nitroglycerin tablets under their tongue during an attack. The sublingual veins allow for quick absorption of the drug into their system.

During sublingual testing the patient lies quietly on a couch and a baseline of any symptoms are noted. Pulse and the size of the pupils are measured at regular intervals. If symptoms or other changes occur, successively weaker levels of the antigen are administered until they are counteracted. A more elaborate description of this technique can be found in Richard Mackarness' book NOT ALL IN THE MIND.

Sometimes, particularly with very soluble foods such as milk, tea, coffee, orange, etc., one can see dramatic and obvious reactions after these are introduced under the tongue. With less soluble foods, particularly wheat and corn, reactions can easily fail to materialize despite the fact that the individual has a wheat or corn sensitivity. In fact Dr. John Mansfield could not recall seeing a single patient who has had a dramatic reaction to wheat, corn, or any other cereal given sublingually.

While the previously described elimination diet is the gold standard for determining food sensitivities, clinical intradermal testing can also be helpful. Allergists who have worked for years giving patients arbitrary and increasing doses of injected allergens for inhaled allergy problems have known that occasionally patients would report a startling improvement in their condition within an hour or so of receiving an allergy injection. This improvement would often last for nearly a week. Such patients would often return and ask for another injection (exactly the same as the last one). This rapid relief puzzled most allergists. It was considered by most to be a psychological quirk.

In 1957 Dr. Carleton H. Lee of Kansas, Missouri, made the discovery which explained this interesting phenomenon. Dr Lee's wife had severe asthma which she discovered was related to the consumption of certain common foods. Unfortunately she reacted to a huge range of foods and could remain well only on two or three specific foods. Other foods would quickly bring on moderate or severe asthmatic attacks within a few hours.

Although food extract injection therapy had never before been found to have had any use, Dr. Lee persisted in experimenting with injecting food extracts in the hope of helping his wife. He eventually discovered that he could produce asthmatic symptoms with one carefully measured dose of food extract injected intradermally (between the layers of the skin). More importantly he found that another specific concentration would relieve this asthma within 10 minutes.

This specific dose became known as the neutralizing dose. He then went on to observe that this specific dose, (when given by a small subcutaneous injection just under the skin), would protect his wife for the next two or three days should she eat that particular food. A mixture of all the neutralizing doses of the foods to which she was sensitive, administered in a single injection about three times a week, would enable her to eat normally without any asthma.

Intradermal provocation neutralization testing and treatment was born. The word provocation refers to the provoking the production of symptoms with one dose of the injected allergen. The term neutralization relates to the relief of symptoms with another dose. Neutralization therapy is the treatment of the problem by low, tailor-made doses of the allergen, usually and most effectively administered by subcutaneous injection. Administration can also be effected with sublingual (under the tongue) drops.

Soon Dr. Lee discovered that he could utilize the same principles to neutralize' reactions to inhaled allergens, such as house dust, dust mites, molds, animal furs, and pollens. It had been possible to treat such problems before with conventional incremental desensitization, but the success rate was low (often below 20 percent) and the treatment took months or even years to work. The relief with inhaled allergen neutralizing injections often starts within half an hour of the first neutralizing injection being administered and lasts for several days.

Theron Randolph, M.D. and later William Rea, M.D. championed the use of the above techniques in the U.S. by opening large clinics in Chicago and Dallas respectively. The major drawback of intradermal testing is that the quality of the results are very much dependent on the experience and expertise of the testing technicians. The major advantage is that neutralizing doses can help ‘protect’ those with a very large number of food allergies by somewhat blocking the reactions. This can assist in helping to manage symptoms until the source of their food allergies can be turned off.

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