Allergies: Complex Holistic Dysfunctions

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

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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 percent 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, and especially in infants and children. By 2015, the advice to simply avoid allergens, such as peanuts, proved to be creating harm in its oversimplification, actually contributing to risk of developing allergies later in life, and finally the realization that a more holistic approach centered on improving the host immune responses, including the Biome, not just avoiding allergens, was needed. The long-derided Hygiene Hypothesis, that increasing avoidance of contact with the many allergens in foods and the environment was mainly responsible for allergic reactivity, is finally becoming widely accepted, prompting a completely revised approach to treatment and prevention. Resolving the underlying factors driving allergic reaction is an investment in overall and future health, and may change the epigenetic factors that are often passed on to your children as well. By gaining an understanding of the pathophysiology of allergic disease, the individual can take the step-by-step sensible approaches to either cure the allergic reaction or prevent it.

The alarming prevalence of serious food allergies, anaphylaxis, and episodic allergic reactions such as angioedema, are a cause of great concern, and research has shown that immune sensitivity to foods, as well a gastrointestinal dysfunction, is often a precursor to sinus and bronchiole allergies and asthma. 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, and skin allergies, where the U.S. CDC reports that between 2007 and 2009, 11 percent of children under the age of 18 had a skin allergy. 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. Standard medicine is no longer able to deny the failure of their protocols, namely use of antihistamines, leukotriene inhibitors, and steroids to merely control symptoms, or the failure of their preventive protocols, as this alarming rise in human allergic disease occurs. Neither can we pretend that the primary consideration is avoidance of allergens, as the human organism has developed a wide range of allergic reactions to literally thousands if not millions of environmental and food molecules. Indeed, landmark studies, such as that of Dr. Mark Holbreich, a nationally recognized expert in childhood immunology, have shown that children raised on traditional small farms in Europe and the United States have incidence of allergy and asthma half to a fifth of that in the general population of the same geographic area. Dr. Holbreich believes that study points to increased exposure to environmental allergens is the reason, and that avoidance and fear of allergens has only made the situation worse. A long history of antimicrobial and antiseptic attitude in the United States has made it the leader in incidence of allergy, atopy and hypersensitivity disorders, yet the prevalent advice to parents, as well as adult patients, is to just increase fearful avoidance of potential allergens, instead of building a healthy adaptive immune response.

Complementary and Integrative Medicine (CIM) protocols, such as immunotherapy sensitization with homeopathic allergens stimulating responses, probiotic therapies, and herbal medicines, derided as fake medicine just a few years ago, are now touted as the primary treatment protocol in the near future for allergic disorders. A 2014 human clinical study of the combination of herbal medicine and immunotherapy at Johns Hopkins University Medical School is now highly touted, and strong evidence of a more effective protocol to integrate into standard care is expected. The acupuncture profession, or TCM, offers a synergistic combination of protocols to integrate into standard care to improve long-term outcomes, provide a more thorough and holistic approach, and achieve better quality of life outcomes with a relative low cost and ease of therapy, using just short courses of acupuncture and guidance, with periodic use of a wide array of herbal and nutrient chemicals. By 2015, these therapies have been thoroughly tested and proven to work, and now the public and their medical doctors just need to integrate this care intelligently to finally address a serious public health problem in a better manner. Such therapy is not an "alternative" to standard care, and utilization of Epi-Pens and standard protocols, as well as the more recently introduced work of immunologists, to treat more serious anaphylaxis and other responses in allergic disease should certainly not be avoided, but limitations must be realized, and integration of broader strategies is sensible. Such esteemed medical centers as the UCSF Benioff Children's Hospital, a new state-of-the-art facility in University of California Mission Bay medical campus in San Francisco, now offers acupuncture and herbal medicine as part of the integrative protocol in children's health. While this transition to true Complementary and Integrative Medicine and TCM takes place, there will be many restrictions on allowing a true TCM clinical practice, but the mere fact that a taboo specialty has finally become accepted says a lot to the patient population.

Of course an ounce of prevention is worth a ton of treatment after the fact, and CIM/TCM is also a valuable tool in preventive medicine. Sinus allergy, or allergic rhinitis, has increased in prevalence in the United States dramatically in the last decade or so, especially in childhood, and childhood rhinitis has been shown to be highly linked to childhood asthma, with over 90 percent of children with allergic asthma also experiencing allergic rhinitis, and with over 60 percent of these children experiencing allergic rhinitis first. Often childhood allergic rhinitis is preceded by food allergy or sensitization to common food allergens as well, presenting a phenomenon where immune hypersensitivity affects all of the body membranes, perhaps even the skin, with increased incidence of allergic or atopic dermatitis, commonly called eczema. Large scientific studies have linked a number of factors to this phenomenon, including caesarian birth, birthing as twins or triplets with assisted reproductive technology, insufficient breast feeding, introduction of complex foods at too early of an age, exposure to pathogenic molds and fungi in the first years of life with sensitization, sensitization to various allergens in various foods, such as peanuts, prolonged exposure to antibiotic therapy in the first years of life or use of acetaminophen in infancy, maternal IgE levels to common allergens (atopy, or epigenetic inheritance of allergic propensity), and family income level. Avoidance of allergens is also an area of increased concern, and in 2015, in response to the large LEAP study, the American Academy of Allergy, Asthma and Immunology published new guidelines that call for gradual introduction of commonly allergic foods into the infant diet starting between 4 and 11 months of age. This tactic has been part of a traditional approach in medicine for thousands of years in TCM, with breast feeding and avoidance of too complex foods in infant diets, but gradual introduction of simple foods, in a step-by-step manner, and emphasis on whole natural foods that are easy to digest, without complete avoidance of foods commonly seen as allergens. This large array of factors that are linked to the alarming rise in childhood allergies, combined with other individual environmental and intrinsic health factors, make gathering of proof of just one factor as responsible for the large increase in allergy syndromes difficult, and confusing.

What is apparent from such study is that the whole immune health is involved in allergies, and this is the basis from which successful treatment of allergies must proceed. While allopathic medicine has largely focused on just relieving the symptoms, Complementary and Integrative Medicine (CIM) has focused upon the underlying roots of allergic disorders as well, and getting help from a Licensed Acupuncturist and herbalist provides an array of treatment protocols and attention to both the underlying dysfunctions in the individual's health as well as the relief of symptoms with treatments that have no long-term adverse side effects. Since allergy syndromes are also associated with a variety of other health problems, such as insomnia, sleep apnea, attention deficit and hyperactivity disorder (ADHD), depressive and anxiety mood disorders, obesity, GERD, and even epilepsy, pursuing a holistic course of therapy to correct these immune dysfunctions and stress is very important. A 2016 study at the Rush University Medical Center and the Northwestern University Feinberg School of Medicine, in Chicago, Illinois, U.S.A. showed that patients with chronic rhinosinuvitis (CRS) and GERD are much more likely to have atopic allergic conditions and asthma that patient with just CRS (PMID: 27283453). We see that real treatment for resolution of allergic sinus and asthmatic conditions involves not just antihistamines and inhalers, but an holistic approach that addresses the whole health of the individual, and integration of Complementary Medicine and the TCM specialty is essential in this regard.

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 and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) 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. Histamine via the histamine type 1 receptors (H1) is one of the major mediators of allergic reactions and inflammation, but histamine stimulation of the type 2 receptors (H2), that are expressed on immune cells and gastric secretory cells, exerts significant modulatory effects on the immune system that may drive a shift to the T-helper type 2 cells over the T-helper type 1 family, contributing to the Th2 dominance of Th1, or the Th2/Th1 imbalance, that is at the heart of autoimmune disease. Studies have shown that histamine at the H2 receptors inhibits interferon gamma by Th1 cells, but has no effect on the IL-4 production of the Th2 cells. By utilizing Complementary and Integrative Medicine to restore membrane health and histamine function, rather than just taking an antihistamine every day, one may greatly add to the prevention of autoimmune disease. Homeostatic restoration is the key to success.

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 gastrointestinal dysfunction we see more and more patients unable to fully digest complex protein peptides, developing sensitization to gluten and dairy proteins, and sometimes celiac disease, or a breakdown in functional villi in the small intestine leading to higher levels of IgA or IgG antibody reactions, often tied to Irritable Bowel Syndrome, which is increasingly seen. Preventing or reducing this sensitization to allergens in the gut is not achieved with simple avoidance of the allergen or allergens, but is cured by restoring gut membrane function and health.

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.

Complementary and Integrative Medicine (CIM), 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.

The alarming rise in childhood allergies to foods, which creates a four-fold risk of developing allergic rhinitis and asthma

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, via epigenetic changes (atopy). 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, 1981 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. In 2011, study at the Columbia University Medical Center headed by Dr. Oded Rechavi PhD, proved that inheritable traits are often passed on without genetic DNA involvement, utilizing the epigene, and small viral-silencing agents called viRNAs. To solve the problem of dramatically rising incidence of childhood allergies, future parents need to address their intrinsic immune health and allergic reactivity. We also need to find a better understanding of the variety of factors that create these issues of rising allergies, especially IgE mediated allergies, and epigenetic traits, in order to protect future generations, as well as help present sufferers. Many studies have now shown that the advice to avoid all common food allergens in pregnancy and early infancy were completely opposite to what is needed, and resulted in a failure to create a healthy adaptive immune system. We must look at such outrageous reversals in standard medicine for what they are, a narrow attitude concerning the holistic traditional views in medical history.

In 2014, the Pierre and Marie Curie University, in Paris, France, a leading institution of research in allergies and inflammatory disorders, concluded that the major determinants of incidence of allergic rhinitis and asthma in young children were peanut sensitization and mold exposure (PMID: 24831804). These 2 major concerns are linked. The reasons why so many children have an allergy to, or hypersensitivity to, peanuts is still unclear. A 2003 study at McGill University Medical School found that peanut allergy accounts for the majority of severe food-related allergic reactions, tends to present early in life, and almost always results in a lifetime allergic hypersensitivity to even minute amounts of peanut residues in foods (CMAJ May 13, 2003; 168(10): 1279-85). New guidelines in 2015 by the U.S. National Institute of Allergy and Infectious Diseases reversed the longstanding advice to avoid peanuts altogether for infants and children, and even for mothers during pregnancy and nursing. A large randomized controlled human clinical trial by Boston's Children Hospital, published in the Journal of the American Medical Association (JAMA), showed that pregnant and nursing mothers that actually ate peanuts passed on the innate and learned immune responses that led to dramatically decreased risk of their child getting a peanut allergy. The enormous rise in childhood peanut allergies between 1997 and 2009 could be partially attributed to this idea that simple avoidance of the allergen will solve the problem. Allergies are generally acquired because of a complex immune mis-sense in the host, not because the allergen is intrinsically pathogenic. Generally, food allergies seen in childhood are outgrown, but this peanut allergy apparently is not, and this is still not well understood. There is also a connection between mold allergies and peanut allergy. Peanuts are particularly susceptible to contamination during growth and storage, and it is very common that stored peanuts are infected with the pathogenic mold fungus Aspergillus flavus. This leads to the release of a highly toxic and carcinogenic substance called aflatoxin. Aflatoxin B1 and B2, produced by the Aspergillus flavus are considered the most toxic and carcinogenic substances known in nature. Many international studies have identified commercial peanut butter, peanut and sesame cooking oils, and even common cosmetics as significant sources of aflatoxin contamination. It is apparent that the peanut presents significant threat to public health when methods of growing and storage encourage the contamination with Aspergillus mold toxin.

Since some forms of Aspergillus are the most common low-level pathogenic household mold fungi as well, there is no wonder that many children acquire this allergic hypersensitivity to Aspergillus toxin in foods, and acquire allergic rhinitis and asthma early in life. The peanut has always presented significant challenges to our immune system, being a unique organism that our innate food immune responses may find challenging. The peanut is a bean that contains 2 sets of chromosomes from 2 different species, and for most of human history was considered a problematic food, thus given to feed animals, and used to restore nitrogen to soil, but not consumed by humans, much like the soybean, until proper processing methods were devised. Since the 1940s, peanuts have been hybrid and an array of elaborate methods of processing have been created, enhancing the allergic potential to 20 different proteins, as well as an array of natural allergens. The common methods of roasting the peanuts in the United States, avoided in Asian countries due to the well-known associated health problems, both alter these problematic proteins and cause the major peanut allergen Ara h2 to become a strong inhibitor of the digestive enzyme trypsin, as well as enhancing the effects of Ara h2 in protecting another problematic allergen in peanuts, Ara h1, from being broken down in digestion. Studies in recent years have identified hydrolyzation of peanut proteins such as Ara h1 increase the allergic reaction as well. Hydrolyzation is a method in food production of breaking glycosidic bonds between sugars and combining sugars, proteins and fats into complex molecules called Advanced Glycolyzation Endproducts (AGEs), which are difficult for our human metabolism to break down and may lead to other diseases as well, such as atherosclerosis and obesity. These complex molecules in food production can be created and combined with glutamates to make fast foods seem very appealing, tricking our innate taste and appetite controls. The consequences have been devastating to our population, especially children. Apparently, the appeal of the peanut in processed food is much more important than the health considerations in the United States. Allergic hypersensitization to peanuts is most dramatic with low dosage of the peanut allergens and proteins, especially if innate immune reactions to the many peanut proteins have not been developed, and commercial foods are often contaminated with peanut residues, as the equipment in food preparation is shared for various foodstuffs. It is becoming obvious that the lack of food safety concerns in growing, storage and processing of peanuts by large food corporations is the major factor in childhood acquisition of childhood allergic rhinitis and asthma, whose incidence has practically doubled in the last decade. Peanuts aren't the problem, but food safety is.

A growing concern with the prevalence of peanut allergies and the relationship to an explosive growth in incidence of childhood allergic rhinitis and asthma is the relationship between the rise in genetically modified organisms (GMOs) and the use of glyphosate herbicides matched to these GMO crops, Roundup, as well as the types of pesticides that have come to dominate agriculture. A large 2004 study (cited with link in Additional Information) at the University of Southern California Kack School of Medicine found that the strongest environmental predictors of childhood allergic asthma were exposure to herbicides and pesticides (PMID: 15121522). The incidence of peanut allergy in childhood doubled from 1997 to 2002, the same years that the Roundup-ready GMOs and matching glyphosate herbicides virtually took over world agricultural practices. These peanut crops are routinely rotated with GMO crops, especially cotton, and the contamination of the soil with glyphosate herbicides matched to the GMO crops is extensive, both affecting peanut crops, and the natural microbial balance in the soil, decreasing natural protections against fungal overgrowth. During this time, 90 percent of the U.S. cotton crop became GMO, modified to allow resistance to glyphosate herbicides, and to produce Bt (Bacillus thuringiensis) proteins that act as an intrinsic insecticide. While peanuts are not genetically engineered, they grow in bean pods located in the soil, and are especially subjected to both chemicals in the soil, and more importantly, to a lack of protection from the normal microbial balance that prevents overgrowths of pathogenic mold and fungi. In fact, such mold and fungi disease is now the reason why Roundup Ready GMO crops are being abandoned in much of the U.S.A.

The corporate agricultural and chemical industry in the United States has responded to these concerns by stating that they will soon introduce genetically modified peanuts to try and alleviate this rise in the incidence of peanut allergy. Since we can assume that the chemists and biologists working for these companies are highly intelligent and informed, and not unaware of the problems causing peanut allergy, this seems a rather cynical, and potentially harmful approach to alleviating this enormous health problem. Experts working on the genetic modification of peanuts, such as Peggy Ozias-Akins, of the University of Georgia, have stated that eliminating all of the proteins related to peanut allergies is unrealistic, and the more genetic modification that occurs, the more the peanut crop will be altered, rendering it more susceptible to fungal infections (Wired Magazine 11.30.08). The obvious concerns of mold, fungi, and peanut sensitization from the common problem of mold and fungi contamination of peanuts is not being addressed. In addition, the simple protocol of developing inexpensive testing for the various pathogenic mold fungi in homes and schools, and public education of how to clear these pathogens, is not being implemented. By insuring that improperly grown and processed peanuts are not bringing problematic allergens to a majority of our children, and that parents and communities are able to easily identify and correct environments with pathogenic mold fungis, much of our problem with allergic disease could be alleviated, at a much lower cost than these diseases are presenting to our society.

A number of studies concerning childhood allergies and causes point to the importance of both establishing biota, or symbiotic colony of microorganisms, especially bacteria, which is one of our most important immune protections, and the importance of clearing allergic sensitivities in the parent to avoid passing on epigenetic traits associated with allergies and allergic sensitization. For instance, a number of studies have shown a strong association between caesarian birth and acquiring of an allergy or allergic asthma, especially when the parent has a history of allergies. This is explained by research that demonstrates that the human body produces specific types of bacteria that grow abundantly in the vagina just before birth, which help the infant to both digest foods better, including mother's milk, and which provide a beginning to establishing a healthy Biota. The colostrum in the mother's milk also provides significant memory immune cells antibodies to build a healthy immune system, and shortening the time that the child is breast fed is associated with allergy and asthma. In addition, the introduction of too much variety in the infant's diet too soon comes with increased risk of developing allergies, as the biota in the infant needs time to develop. Increased prescription of antibiotics in infancy is also associated with increased incidence of future allergic rhinitis and asthma, as well as other health problems associated with a poor biota. On the other hand, as that child grows and starts eating a variety of food, as well as putting almost anything at hand into his or her mouth, the avoidance of foods and germs may lead to a deficient immune response and increased risk of allergies. This was unfortunately given the name 'the Hygiene Hypothesis', which technically means the need to devise a better protocol of disease prevention in habits, lifestyle and diet, but is instead associated with cleanliness. In this case, hygiene does not refer to allowing children to be dirty. This scenario is somewhat complex, and therefore it is not easy to isolate these various factors in studies to prove broadly that a particular factor is responsible by itself.

The International Study of Asthma and Allergies in Childhood (ISAAC) shows that our community immune health is declining steadily, as well. 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 with global warming and the rise in weed pollen counts.

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. Arguing about what to do about a health problem, rather than just getting to work to correct it, is surely not sensible. A more holistic attitude is needed, and inclusion of Complementary and Integrative Medicine and traditional medicine is part of the answer.