Doctorweblog. About Health & Medicine

Plus-one cases are rarely seen by a physician. The plus-one patient is basically a happy person, mildly stimulated by a “natural high.” He rarely, if ever, thinks of himself as a candidate for serious illness.

Plus-three and plus-four cases, on the other hand, are sometimes brought to a physician, and such cases could be presented. (In her manic phase, for instance, Nora Barnes was a plus-four case.) These cases are relatively rare, however, since before the average food or chemical addict reaches this stage, his withdrawal symptoms have usually become more and more pronounced. It is this withdrawal phase which brings him to the doctor’s office—not the previous “high.”

This is why a discussion of stimulatory reactions focuses on the plus-two stage. It is here that we find at least three serious medical problems: hyperactivity in both children and adults; obesity; and alcoholism, the acme of the food-addiction problem.

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Since the end of World War Two, a staggering array of synthetic hormones, tranquilizers, and antibiotics, has been used to treat meat, poultry, and fish.

The most common hormone used for this purpose—diethylstilbesterol, or DES—was given as a medicine to pregnant women to prevent miscarriage. It is now known that the substance has caused cancer in the children of women who used it, the so-called “DES babies.” The United States government is now waging a major campaign to warn such children, the potential victims, of the danger that was incurred.

For years, however, this hormone and other related substances, such as Ralgro and Zeranol, were implanted in chickens, cattle, and sheep to make them grow fatter and come to market sooner. Industry has argued that only minute amounts of the chemicals were left in the meat which reached the consumer. But a growing number of scientists countered that it only took a few parts per billion to cause cancer in experimental animals.5

In addition to the use of hormones, it is common practice to inject animals with tranquilizers just before they are slaughtered and to dip certain foods (such as fish) in an antibiotic solution, to prevent them from spoiling. One of my patients became sick from eating store-bought fish. One day, her husband went deep sea fishing and brought back some fresh bluefish. She had no adverse reaction to this fish and soon learned that she could eat most freshly caught fish with impunity. She could also eat pieces of large commercial fish which were sawed into small portions while still frozen. Her problem apparently arose from the antibiotic solution which the industry routinely uses to treat smaller fresh fillets.

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Migraine remedies often contain a drug to reduce nausea and vomiting (antiemetics), as well as a pain-killer. One problem in migraine, is that absorption from the stomach is much reduced once an attack starts, so that pain-killers taken by mouth have little effect. Anti-emetics can improve the absorption of the painkiller, so they are useful for migraines, even if nausea is not a symptom. The main drugs used are buclizine, cyclizine and metoclopramide. These are safe drugs with few side effects.

Because of the problem of non-absorption, it is very important to take migraine treatments as soon as an attack begins – or in advance, for those patients who have advance warning of their attacks, in the form of visual

disturbances, mood changes etc

Composition of migraine

preparations containing painkillers and other drugs

Midrid – paracetamol, plus a sedative, and a sympathomimetic

Migraleve – paracetamol, codeine and buclizine (anti-emetic) in the pink tablets; paracetamol and codeine in the yellow tablets.

Migravess – aspirin and metoclopramide

Paramax – paracetamol and metoclopramide (anti-emetic)

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Fish: the family concept is irrelevant when it comes to fish, because all the fish in the main group eaten (the bony fish) share a special type of protein known as a parvalbumin. The paralbumins are known to provoke allergic reactions, and they probably account for the fact that many people are sensitive to all the types of fish they have tried. It is uncertain whether paralbumins are found in the other main group of fish, the sharks, rays, skates and dogfish (cartilaginous fish). The two groups are only very distantly related, and it is possible that people sensitive to bony fish could tolerate cartilaginous fish.

Crustaceans, Phylum Crustacea:

crab, lobster, crayfish, shrimp, prawn. A very large group, including many different families. Many patients react to all forms of Crustacea, so the family concept does not seem relevant here. There may be.some common allergen in all of them, as in fish. Also see the section on unexpected reactions, below.

Molluscs, Phylum Mollusca:

mussels, cockles, winkles, oysters, clams, scallops, squid, cuttlefish, octopus, snails (escargots). Again, this is a very broad group, but the family concept does not seem to be relevant here, because people who are sensitive to one type are usually sensitive to them all.

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Others who may be concerned about their nutritional status, but cannot afford individual testing and see if they show any signs of deficiency. These are not foolproof signs, however – the same symptoms can be produced by other forms of illness, and there are several deficiencies that do not appear in the table because they produce no clear-cut signs. But if you do show some of these signs, then there is a chance that you are lacking certain nutrients, especially if your diet has not been good. The simplest and cheapest answer is to take a general supplement. This may be slightly more expensive than run-of-the-mill vitamin tablets but it is far more likely to do you good – and not to do you any harm. It is also free of artificial colours, unlike most commercial preparations which come in lurid shades of red or orange as an indication of their health-giving properties! Avoiding colourings is important if you are embarking on an elimination diet.

One sign that you may notice is white spots on the fingernails. These can be an indication of zinc deficiency, and if you show no other deficiency signs, and generally eat a good diet, then taking a zinc supplement may be all you need to do. Zinc is relatively safe and non-toxic, so a sensible supplement is unlikely to do any harm.

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There is evidence that people with food intolerance have more leaky gut walls than healthy individuals – so they let more undigested food molecules through. This has major health implications which will be considered later, but how does the gut become more leaky in the first place?

Inflammation, produced by immune attack, can make the gut wall more leaky. One source of inflammation is disease – any gut infection that produces diarrhoea may inflame the gut wall. In babies, such infections are often the start of food intolerance.

Alternatively, foods themselves might provoke inflammation of the gut wall, if there is a localized allergic response to them. This is not something that most allergists would agree with – they see IgE/mast cell reactions to foods (see p29) as being all-or-nothing affairs which produce immediate and unmistakable symptoms. The idea that there might be a small-scale, localized IgE reaction, whose main effect is to make the gut more permeable, is not widely accepted. The main evidence in its favour is the effect of a drug, sodium cromoglycate, on some patients with food intolerance.

The effects of this drug have mainly been studied in migraine patients. If such patients undertake an elimination diet, a large proportion of them get better and can then identify one or more foods which provoke their symptoms. Each time a culprit food is eaten it will provoke a migraine -but not if sodium cromoglycate is given in advance. Sodium cromoglycate is

known to stabilize mast cells and prevent them from releasing their inflammatory mediators. And the drug is not absorbed from the gut in any appreciable quantity. So the logical conclusion is that it prevents reactions to culprit foods by blocking mast-cell reactions in the gut wall.

There is a third way in which the gut wall might be made more leaky. We all produce a special type of IgA antibody called secretory IgA or SIgA. The production of SIgA is stimulated by the Peyer’s patches, and it pours out into the gut, where it binds to its target antigen. By binding to antigens, and locking them into immune complexes, SIgA effectively makes them much bigger. The bigger they are the more difficult it is for them to pass through the gut wall. So SIgA reduces the number of food molecules that cross the gut wall – and the number of microbes, because SIgA is made to these as well. Like IgA in the blood, SIgA does not cause any inflammation.

There is some evidence that people with food intolerance have less SIgA than healthy people. However, there are patients who have severe deficiencies of SIgA, and, although they are ill in other ways, they show no more signs of food sensitivity than the population at large. This suggests that SIgA deficiency alone is not enough to cause food intolerance.

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As children get older, their early symptoms often disappear or at least diminish, although they may often be replaced by another type of allergic disease. Whether the majority of children do actually ‘grow out of it’ as doctors so often state is a debatable point. It may be that the outward signs of the allergy subside but that the underlying condition persists, especially in the case of an allergen to which the patient is exposed on a regular basis, such as cow’s milk or eggs. Some doctors who specialize in treating food allergy believe that the allergic reaction is simply suppressed by the body temporarily, but that it will recur in adult life, possibly in a different form. There is no solid evidence to support this idea but it is not entirely implausible. Many people who have asthma or eczema as children later ‘grow out of it’, but then succumb to other health problems in their twenties, thirties or forties.

If this theory is correct, it might be better to investigate their allergic problems more closely in childhood, and, in the case of food allergens, to eliminate the incriminated foods from their diet, rather than simply waiting for them to ‘grow out of it’. Experience shows that cutting out allergenic foods for a period of time – for a few months, a year, or sometimes longer – can often eliminate the sensitivity in the long term, as well as providing more immediate relief from the child’s symptoms. But there are a variety of other factors to consider – some of which will be discussed in more detail later.

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Achievers are different to the E-types in that their desire for the approval of others is not as pronounced. They are more confident and self-centred. They seek to achieve partly for the status and kudos and certainly for the material rewards they desire and believe they deserve. They are very ambitious. In time, achievement for achievement’s sake becomes a prime motivator. They thrive on challenge and in extreme cases believe their life has no meaning without it.

Achievers are always on the go. So busy are they, in fact, that they hardly have time to draw breath, an expression many of them use when describing a typical day in their lives. Such shallow breathing practices help to explain why so many of them are burnt out. They work hard and long hours. Being positive and highly motivated, many of them are into taking care of themselves, as they perceive ‘taking care’ to be. Many of them play some sort of sport, work out with weights, do aerobics, or jog or swim regularly.

The more extreme achievers get into heavy competition sport or take part in triathlons. Many of them stay away from junk food preferring whole meal breads, sprouts, lentils, and other high-fibre natural foods.

The big problem is they never get time to rest. The irony is that high-fibre, natural foods are harder to digest than refined, fast foods and if they don’t take time out to sit quietly they never absorb the nutrients from their food which, being high fibre, passes rapidly through and out of them. Insidious malnutrition is a big problem for achievers who are perplexed at feeling so tired when they are working so hard at keeping fit and eating properly.

Extreme achievers take themselves, life and everything they do very seriously, often too seriously. They view life as a struggle for existence and remain stressed until they change this attitude. Some achievers pursue their chosen path in lieu of a relationship or because their present relationships are unfulfilling.

Achievers have to recognise that time out for quiet, restful moments in their day, plus eight hours’ sleep, is imperative if they are to have it all. Reduction in work and exercise loads are also needed. Retaining the high goals they have set themselves is fine. Extending the time frames needed to achieve these goals is the answer. Apply the principle of the hare and the tortoise rigorously.

Achievers always argue that their exercise regimen is a release from stress and up to a point this is true. It is at least a diversion from work and it does at least get some oxygen into the blood and the blood moving. Unfortunately, high impact exercises also fill the muscles with lactic acid, which lowers the body’s calcium reserves predisposing it to nervousness, headaches and irritability. The tension achievers incur through the course of a busy day has already put high levels of lactic acid in their muscles. To achieve true tension release from their busy schedule, achievers will benefit from taking up yoga, Tai Chi or yogic walking. The only good reason to go to a gym is for a sauna, swirl pool and massage.

Achievers burn out because they want results too quickly. If they can get the balance between work and rest right, they lead a fulfilling life and end up achieving more than they ever dreamed possible. High achieving is fine—over-achieving makes us ill.

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Pure synthetics and synthetic blends commonly cause allergy and chemical sensitivity. Moreover, using synthetics can cause irritation, even if you are not actually allergic or sensitive to the fibres themselves; many people with sensitive skin, for instance, find that wearing or sleeping on synthetics makes their skin worse. This is because the materials do not allow sweat to escape and dry as well as natural materials do. Sweat on the skin increases its permeability to allergens, as well as causing friction and irritation. If you avoid synthetics (even if you are not specifically allergic or sensitive to them), it can be of general benefit and help you relieve other reactions.

Synthetic materials and blends are found everywhere and in every application, from carpets to clothes to insulating materials. Many different chemicals are used, and it may be that you are sensitive to one type of chemical and not to another. Although it is generally better, if you are chemically sensitive, to reduce your load of potential troublemakers as far as you can, you may find that you can use or wear some fabrics or fibres and not others.

To help you work out if there are synthetics that suit you, the three main types of synthetic fibre in general use are:

Fibre Brand Name

Polyamide Nylon

Polyester Terylene, Crimplene, Dacron

Acrylics Acrilan, Courtelle, Orion, Dralon

Lycra is a brand name for polyurethane elastomer.

Some people who react to pure cotton find they can tolerate it in a blend with a synthetic fibre (polycotton or polyester cotton). Similarly, some people who react to pure synthetics can also tolerate polycotton blends. Fabric resins are applied to polycotton blends, although, again, they wash out readily.

Synthetic materials are often used in fastenings, trimmings, elastic and in thread, even on garments or items of cotton or other natural fibres. If you are very sensitive, these may be enough to cause reactions.

Wearing synthetic fibres or using synthetic bedding may give you problems, while using it in furnishings may not. This is because the fibres warm up as you wear or sleep on them and give off fumes. You may not need to avoid synthetics except in clothing and bedding.

Dyes on synthetic fibres can sometimes cause allergy and sensitivity and you may mistake this for sensitivity to the fibre. Dyes do not generally cause reactions but Disperse azo dyes are known to be troublesome. These are rarely used on cotton, rayon or wool, but usually on synthetics. Dyes in nylon stockings and tights (even flesh-coloured) are a known area of sensitivity.

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Meat Fish Shellfish

Milk

Cheese

Eggs

Wheat

Rye

Oats

Barley

Rice
Gin Cabbage

Vodka Brussels sprouts

Bananas Bean sprouts

Pears (without peel) Leeks .

Mangoes Celery

Papaya Lettuce

Pomegranates Potatoes (without skin)

Peas
(From The Complete Guide to Food Allergy and Intolerance by Dr Jonathan Brostoff and Linda Gamlin.)
Foods High in Salicylates
HERBS
Mint, thyme, tarragon, rosemary, dill, sage, oregano, marjoram and basil. Also celery seed and sesame seed.
SPICES
Aniseed, cayenne, cinnamon, cumin, curry powder, fenugreek, mace, mustard, paprika and turmeric.
FRUITS AND FRUIT JUICES
VEGETABLES
Cucumbers, gherkins, olives and endive.
NUTS
Almonds, brazil nuts, macadamia nuts, peanuts, pine nuts, pistachios, walnuts, coconuts and water chestnuts.
BEVERAGES
Coffee, tea, cola drinks and peppermint tea.
ALCOHOLIC DRINKS

MISCELLANEOUS
Honey, liquorice, peppermint; yeast extract, stock cubes and yeast products; tomato sauce; many processed foods and instant meals.
(From The Complete Guide to Food Allergy and Intolerance by Dr Jonathan Brostoff and Linda Gamlin.)

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