Allergies: Complex Holistic Dysfunctions

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

Sections

Understanding the Mechanisms of Allergic Reactions

One theory in allergic immune mis-sense 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, especially herbal formulas, provide an array of chemicals that may effectively modulate both these 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 specialized 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 percent 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.

With chronic allergic rhinosinusitis we see that almost all patients respond to various allergens and antigens, such as fungi, with an exaggerated eosinophil response. Eosinophils (acidophils) are white blood cells that are the main immune response to parasites and certain types of infections, working with mast cells to control the symptoms of allergy and asthma. Eosinophils originate in the bone marrow and are acid-loving, concentrating in small granules that produce histamine and major basic protein (MBP), which is toxic towards parasites such as helminths, and stimulates histamine from mast cells. MBP is structurally similar to lectins, or a large and varied family of proteins that were some of the earliest immune cytokines. Eosinophilia, or chronic excess of eosinophils, is seen in patients with parasitic infection of the intestines, collagen vascular disease, dermatitis, reflux esophagitis, overuse of antibiotics, and in asthma. When the nasal and sinus mucosa is unhealthy we see an exaggerated level of fungi growth and a response of eosinophils with MBP, which in turn perpetuates the condition. Treatment strategies that just relieve the swelling and symptoms thus maintain this unhealthy mucosal state and immune response, and leave the mucosa more susceptible to overgrowths of fungi, bacteria and parasitic microbes.

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 this 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 mis-sense.

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.

A second hypothesis that is gaining recognition is that the deficiency in the immune system may also be related to a lack of exposure to pathogens in early childhood. This is euphemistically called the Hygiene Hypothesis, but has nothing to do with the popular definition of hygiene, or cleanliness, but rather the scientific definition, conditions or practices conducive to maintaining health and preventing disease. The mistaken idea that the best preventive practice is to just kill as many microbes as possible was obviously a bad idea. A large number of studies have demonstrated that this lack of exposure to pathogens, bacteria, fungi, viruses and other microorganisms in the natural environment are associated with poor and dysfunctional immune responses, incidence of allergies, and autoimmune disorders. The whole planetary Biome is evolved for a reason, and our human systems are both reactive to it and symbiotically dependent on it, which we have only recently learned in modern science. Of course, ancient Chinese Daoists spoke of this often, but have ridiculed for such notions by modern science. Today, we are learning just how right they were with this holistic balanced view of the world. For instance, in 2015, experts at Helsinki University in Finland, which now has some of the highest rates of incidence of autoimmune diseases such as Diabetes Type 1, and of allergic syndromes, conducted a test comparing the populations of Finland with their counterparts across the border in the Russian Karelia, where the incidence of allergic syndromes and autoimmune disorders are among the lowest in the world. These experts noted that since World War II that the Finnish population adopted increased use of antibacterial chemicals and antibiotics, and that the natural microbiota to which they were exposed was reduced, in the soil, environment, food etc. The children in Russian Karelia continued their traditional lifestyle and were not as economically blessed. Consequently, hay fever in children in this Russian region is almost non-existent, while 27 percent of Finnish children were sensitized to common pollens (PMID: 25772429). Subsequent studies showed that there was a great difference in the intestinal microbial colonies as well, with species such as E. coli greatly reduced in Finland, and the types of bacterial endotoxins from more predominant species not stimulating the strong learned and adaptive immune responses needed for the future. A variety of factors are proven to contribute to this lack of immune learning, and it is not suggested that Finnish children should just get sick more often and play in the dirt, as is cynically implied. The overuse of unnecessary vaccines could also contribute, as well as a high incidence of use of C-section births, etc. To fully fix the problem an intelligent and comprehensive plan must be devised.

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. In standard medicine, these tests are useful to detect potential allergens that may generate a life-threatening anaphylaxis response, and here the standard suspects of such severe allergic reactions are emphasized as "90 percent of all allergic reactions", which ignores the broader subject of allergies that have milder effects with immune reactivity. This, of course, leads to contentious diatribe in medicine, with many Medical Doctors warning all patients not to trust any Naturopaths, Chiropractors or Licensed Acupuncturists because they sometimes utilize "alternative" testing. The fact is that with anaphylaxis, we must trust Medical Doctors and Epi-Pens (epinephrine was derived from an herb, ephedrine,though), and must practice avoidance and desensitization, but this is not the complete picture with allergies, and other types of testing and treatment obviously have a validity, but need to be put in perspective, and integrated with standard testing and treatment. Only recently did the staunch dichotomy in this field lighten up in standard medicine, with the integration finally of immunologists into standard practice, who practice sensitization to allergens to potentially eliminate these allergies, or at least make the responses mild. For the patient, all of this is just confusing, but gaining some increased understanding and a less black and white view is important in dealing with this complex subject.

Analysis in allergy testing 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 immediately 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.

In response to the failure of standard allergy testing to provide completely reliable answers, there has been a plethora of allergy tests that have been heavily promoted but unproven. Each of these types of testing may have some use, but do not provide the definitive answers we seek. IgG tests such as Hemocode and Yorktest identify IgG reactivity, which equates with one type of allergic response, not the whole response. Applied kinesiology and pulse analysis, often used with NAET (Nambudriprad's Allergy Elimination), have shown no objective evidence of reliability, and may work largely due to placebo effect, but do provide perhaps some evidence.

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). Th1/Th2 imbalances are implicated in many autoimmune disorders, and may begin with poor immune reactions to chronic allergens and antigens. These newer tests may help identify these pathological immune processes and guide therapy to reestablish balance of lymphocyte responses.

The MELISA test (memory lymphocyte immunostimulation assay) is a blood test that detects hypersensitivity to metals, chemicals, environmental toxins, and molds, all from a single sample, and is thus very effective, but has been challenged as producing too many false positives. The company that is refining this test, or the MELISA Foundation, has challenged these challenges, and of course the industry is reluctant to acknowledge the sizable number of patients with an allergy to a metal in a surgical device or prosthetic. The validity is obviously hard to measure as well, since it only measures the reaction to the toxin, not the toxin itself. The Foundation has shown that patients tested positive for metal toxicity consistently are relieved of symptoms after removal of the metal toxin.

As genetic testing becomes developed and more affordable, there is the potential that such testing could identify patients that are more susceptible to various allergies. For example, a 2015 study at the University of Liverpool, aWolfson Center for Personalized Medicine, in London, England, UK, found that genetic phenotyping of the MHC (Major Histocompatibility Complex) showed that subtypes of the HLA portion of this individualized genetic code (Human Leukocyte Antigen) carried increased risk for hypersensitivity allergic drug reaction to specific pharmaceuticals, in this case Nevirapine, a reverse transcriptase inhibitor used to treat patients infected with HIV (PMID: 25714001). Such testing could become more common in the near future, requiring only a swab of the mouth membrane for a sample, and HLA MHC typing could be used to identify a wide range of individual subtypes, or allelotypes and phenotypes, in the population that are at higher risk for serious allergic reactions, either acute or chronic.

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 percent. Obviously, the standard protocol of prevention and treatment of serious food allergies has failed.

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 at least 4% of children in the U.S. now have a diagnosed food allergy, but this refers to only children diagnosed with a clear risk of anaphylaxis in response to specific foods. While the subject of food allergy is complex and difficult to clearly diagnose, and many individuals assume food allergies now out of fear, without objective evidence, the solution to these problems is simply to gain a better objective understanding of immune responses and allergic reactions. 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, but perhaps not serious food allergies, as the adult should have developed sufficient immune sense and protection against anaphylaxis and other serious immune pathological reactions. 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 (the Hygiene Hypothesis). Other theories include changes in the way parents introduce food varieties too quickly to infants while avoiding completely the most prevalent allergic foods, hurting the learned immune responses, 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 that were not diagnosed in the past. All of these causes of the rise in diagnosed food allergies probably contribute to some extent, and the choice of which cause is probably not going to produce workable solutions, as all of these causes probably contribute. 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.

The subject of which foods to avoid and which to include in the infant and child diet is confusing, not only to parents, but to experts in the field. Of course, if the child has inherited or developed a serious anaphylaxis reaction to specific foods, these need to be avoided completely outside of professional sensitization therapy, but too broad of an adoption of avoidance and desensitization has not helped the entire population. This controversy is tied to the subject of desensitization and sensitization to allergens. The standard tactic with food allergies is desensitization and avoidance, but obviously this has not proved to be the complete answer, and is now considered an oversimplification of the allergic protections and responses. Sensitization, or immunology, involves exposure of the innate immune system to low levels of the allergens to improve the learned immune responses. Today, immunologists are finally recognized as scientifically proven and effective physicians, although in the recent past they were widely derided as practicing a pseudo-science, much like the physicians that practice Traditional Chinese Medicine and Naturopathy. While some would dumb down this debated of desensitization and sensitization as an either/or question, the real explanation is that we need to understand and intelligently apply these principles to the problem of allergies.

Complete avoidance of some well known allergic foods, such as peanuts, nuts, eggs, dairy, wheat and shellfish will not completely protect the individual, and is now proven to increase overall the allergic sensitivity, even with the complete avoidance by the mother, which may epigenetically pass traits of the immune system to the child. On the other hand, too strong and quick of introduction of foods, and their allergens, to infants is also proven to increase the immune dysfunctions. In the same way, with adults, while desensitization is a sound tactic to allergens, complete avoidance may not be sensible, and for patients with indistinct allergic reactions, the complete avoidance of all suspected foods may not only lead to a difficulty in providing complete nutrition, and increased stress affecting the immune system, but also to a worsening of the overall immune responses. Some temporary desensitization needs to be combined with improvement in the immune function to guarantee success. With this protocol, the lifelong avoidance of specific foods would not be necessary. With infants. the introduction of a varied diet by the mother, even during pregnancy and breastfeeding, is important, combined with sufficient duration of breast feeding, and introduction of colostrum, but the slow and steady introduction of more complex foods after 4-6 months of breast feeding to build a learned set of immune responses is also important. While attention of normal homeostatic mechanisms is more complex than simple avoidance of foods and giving in to all the advertising of supposedly better infant foods, it is the best approach.

Studies have indicated that up to 90 percent of serious food allergies in the United States are related to wheat, soy, peanuts, tree nuts, milk, eggs, fish and shellfish, or in other words, common foods with complex proteins that are often now altered in food production or with genetic modification. 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 also 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.The cost of patented genetic engineering on such as scale may also make our food outrageously expensive.

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 exaggerating 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 clinical 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. While IgE antibodies are predominantly in our membrane tissues, IgG antibodies may be prevalent on both the membranes of the skin, mouth and bronchioles, and in the gut, and sensitization to allergens on the skin may induce allergic reaction in the gut, and vice versa. Blood and skin tests do not predict IgG sensitivities 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 fatigue, 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.

Finally, the importance of the healthy homeostatic function of gastric acid secretion is also being recognized as integral to the immune function and allergic disease. A review of current scientific study of gastric acid secretion homeostasis by the Virginia Commonwealth University Health System and McQuire Veterans Affairs Medical Center in 2012 (cited below) reports that gastric acid secretion prevents IgE-mediated food allergy, bacterial overgrowth, enteric infection, spontaneous bacterial peritonitis, and possibly community-acquired pneumonia, one of the most common causes of death in our hospitals and nursing homes. Restoration of gastric function is of prime importance in resolving allergies, and this review found that gastric acid secretion is regulated by 5 systems, neural, hormonal, pacrine, nutrient chemical, and bacterial balance (biota). Obviously, a holistic approach to treatment and prevention is necessary, and simply taking chemicals that inhibit gastric acid secretion is a ticket for an adverse outcome. Complementary and Integrative Medicine, in the form of Traditional Chinese Medicine, with acupuncture, herbal and nutrient medicine, and advice and guidance with diet and lifestyle, is able to achieve restoration of homeostatic gastric function and elimination of allergic sensitivity.

Most food allergies involve difficult to digest proteins, and gastric acids are very important to the effective digestion of these difficult proteins, as are the various mechanisms in the small intestine that are regulated by enzymes. A variety of factors are researched to increase understanding of why some proteins in food produce a high incidence of allergic reactivity. The peanut is a good example. Two proteins in the peanut, Ara h2 and Ara h6, are now found to be the most causative of allergic reactions, and the most resistant to breakdown by pepsin in the stomach. Roasting peanuts causes the major allergen, Ara h2, to become a stronger inhibitor of the digestive enzyme trypsin, making it harder to digest. Ara h2 also inhibits another protein allergen in peanuts, Ara h1, from being digested. Roasting of peanuts thus enhances the possibility of allergic reaction. Glycosylation of the Ara 1 protein is shown to increase allergic sensitivity and reaction as well, and heating the peanut with sugar and fat, commonly seen in commercially produced foods, produces these glycosylated peanut proteins, or AGEs (advanced glycosylation endproducts). For individuals with a deficient function of the gastric acid secretion, this problem would be heightened. By utilizing Complementary Medicine to restore gastric function and gastrointestinal health and homeostasis, these problems could be dramatically reduced.

Simply avoiding these common food allergens, such as peanuts, nuts, eggs and dairy, long recommended in standard medicine, has been clearly shown to have been a mistake, as large randomized controlled human clinical trials show that a dramatic decrease in risk of developing childhood food allergies occurs when the mother consumes some of these foods during pregnancy and nursing, and some of these foods are introduced to further stimulate the learned immune responses when solid food is introduced to the infant after 4-6 months of breast feeding. Of course, introduction of new foods should proceed slowly with infants and children, so that there immune system has an easier time learning how to produce the right memory for antibodies that is compatible with the HLA/MHC genetic complex. Once again, too simplistic of a view of our holistic physiology by standard medicine resulted in a dramatically mistaken health protocol. Traditional medicine has provided sensible diet and lifestyle advice based on centuries of observation and trial and error, but such knowledge is often discounted in modern science.

Molds and mildew fungi, as well as fungi common to the human gut and skin, are a growing concern in public health

The U.S. Centers for Disease Control and Prevention (CDC) refers to a 2004 report on management of health effects related to mold fungi exposure in the home, school, and business, by Dr. Eileen Storey MD MPH, of the University of Connecticut Health Center's Division of Occupational and Environmental Medicine, on their website concerning the health threats of mold fungi. This study and report was developed under supervision of the U.S. Environmental Protection Agency (EPA). Many communities, such as the City and County of San Francisco, have recognized the public health threat of mold fungi, and passed laws making mold growth in buildings a public nuisance on a legal par with rodent infestations and extreme garbage accumulation, due to the overwhelming evidence of adverse health consequences to often unseen toxic mold fungi. California, like many states, passed laws specifying permissible exposure limits for toxic mold fungis and guidelines for landlord responsibility, in this case entitled The Toxic Mold Protection Act, Health and Safety Code 26100-26156, as well as Civil Code 1102.6. Various communities now provide public health department services to find and help pay for professional evaluation of suspected toxic mold and fungi levels, and advice on how to contact the landlord with a registered letter to prompt professional cleanup. Older wood frame houses may develop small leaks from repeated wood expansion and contraction that allow moisture to collect in the walls, or have aging pipes that develop small leaks, and create pockets of toxic mold fungi hidden in the walls. In addition, aging and poorly maintained schools are a common source of toxic mold fungi, exposing many students and teachers to health risks on a daily basis.

Mold and mildew are colloquial terms applied to large and diverse number of fungal species, where large growth may be visible. Mold is ubiquitous in nature, and is a common component of household and workplace dust. Fungi exist in many forms, such as single-cell yeasts, hyphae filaments, mycelium (aggregates of hyphae), and visible spore-producing bodies. Most fungi depend on moisture and a source of organic nutrient, and prefer a temperature range of 59-86 degress farenheit, although some species may grow in environments that are cold or hot as well. Temperate climates are more likely to harbor toxic mold fungis in the environment. Most fungal molds are relatively harmless, but a variety of species produce toxins, called mycotoxins, and the term "Toxic Mold" often refers to a small subset of fungal species, such as Black Mold, or Stachybotrys chartarum. Even within the fungal species Stachybotrys chartarum, though, only a third of the examples studied have a chemotype that produces the mycotoxin macrocyclic trichothecene mycotoxins. Professional evaluation of mold fungi needs to be performed to affirm that the mold fungi is toxic. Many species of Aspergillus, Penicillium, Serpula, Stachybotrus, and Paecilomyces may produce mycotoxins, and are found in damp environments, and common species of Tinea and Candida are also well known to produce toxic effects as well. Some of the mold fungi are common to the human organism, though, and normally do not cause disease. Overgrowths and toxicity is an important consideration, not just the elimination of all fungi. The immune responses and symbiotic Biota, or healthy microbial environment, is also a prime consideration, not just the eradication of all fungi. In fact, if harsh antifungal medications are taken, the consequences often leave to patient with a damaged Biota, and an increased problem with healthy immune responses to fungi that are ubiquitous, or unavoidable.

Fungal metabolic byproducts may have toxic, allergenic, or immunologic health effects. Mold fungi is found to be a significant cause of a large percentage of cases of allergic rhinitis, and allergic asthma. The approach to treatment and prevention, though, needs to be thoughtful and holistic, not just the eradication of fungi. Attention to the environmental concerns, evaluation of home, school and workplace, as well as both decrease in mold fungi toxins, as well as improvement in membrane health and local immune balance, is essential. The environmental report cited above states that studies have identified a number of toxic mold species, and sometimes bacteria growing with the mold fungi, that are contributing to health problems. Not only allergies and asthma, but digestive problems, cognitive deficits, and neuro-psychiatric symptoms have been identified, often mimicking other common health problems, such as bronchitis, COPD, IBD, ADHD, and anxiety depression mood disorders. Specific disorders, such as sarcoidosis, an inflammatory disease of the eyes, sinus, lungs, skin, lymph nodes, liver and other tissues, are seldom diagnosed, as there are often no apparent symptoms to prompt tests. Sarcoidosis may occur with hypersensitivity to environmental factors, such as mold fungi, and is more prevalent following an extreme immune response to an infection. Dry cough, shortness of breath, fatigue, and joint ache are common symptoms, as well as itchy or dry eyes, dry mouth, and mildly enlarged lymph nodes. Recurrent respiratory infections, perceived as a cold or flu, are often directly attributed to mold fungi toxins as well.

In allergic rhinitis and asthma triggered by fungi, the course of the disease begins with sensitization, and then the immune cells present the fungal antigen to T-helper cell type 2 lymphocytes, that produce Th2 cytokines, such as IL-4 and IL-5, stimulating increased IgE antibody responses that are specific to the antigens. The circulation of these IgE antibodies further sensitizes nasal mucosa, lung membranes, and other mucosa to the fungal antigens. In the future, exposure to the fungal spores or glucans may trigger more extreme responses. The early phase of the allergic response typically involves clear sinus mucous, congestion, sneezing, and sometimes post-nasal drip with persistent or recurrent cough, and mild hoarseness. Lower in the lung, the allergens may trigger asthmatic responses. Over time, the symptoms and inflammatory responses may become more chronic and less specific. This makes diagnosis difficult. Two diagnoses that are linked to fungal infection are Allergic Bronchopulmonary Aspergillosis, and Allergic Fungal Sinusitis, but these often occur in patients already with a diagnosis of asthma or cystic fibrosis, and thus are commonly overlooked until the patient presentation is severe. Fibrosis is found in recent years to be much more prevalent than previously considered, and research has identified novel treatments in Complementary Medicine, such as nattokinase and serratopeptidase, two proteolytic enzymes that speed clearing of unhealthy fibrin accumulations in the lung tissues.

Testing and evaluation of fungal infections and related diseases often depends on a careful analysis of many facts, not just a test. In fact, most of the tests performed are non-specific, with the accumulation of data from both interviews with the patient and laboratory tests providing clues to the diagnosis. Often, the 5 minute interview with the medical doctor cannot achieve this careful and thoughtful analysis. This is why the Integrative physician in Complementary Medicine may be very helpful, not only providing an array of natural therapies, but when given copies of the lab reports, may take the time to piece together the big picture to help make the right diagnosis and create the right individualized treatment protocol. The Licensed Acupuncturist and herbalist is an ideal candidate to integrate into the treatment plan.

To learn more about environmental interventions concerning mold and mildew fungi, you can access these resources: California Department of Health Services http://www.dhs.ca.gov/ps/deodc/ehib/ehib2/PDF/MOLD... Mold in My Home: What Do I Do; and New York City Department of Health and Mental Hygiene Bureau of Environmental and Occupational Disease Epidemiology "Guidelines on Assessment and Remediation of Fungi in Indoor Environments" http://www.ci.nyc.ny.us/html/doh/html/epi/moldrpt1..... Home mold test kits continue to improve yearly, are inexpensive, and provide a partial analysis of toxic mold fungi in the air or from swabs of visible mold, and the lab analysis ranges usually from $40-100. These commercial tests cannot be taken as the ultimate guide to toxicity of mold fungi in the home, though, as the array of types of mold fungi and great variance in individual susceptibility, as well as the questions of reliability in the tests pose problems. Professional analysis of the home and screening of these consultants is important, establishing clear criteria in advance before paying for expensive remediation. The best overall tactic is to understand how toxic mold fungi can grow in the walls and to make sure that this is prevented. Information and resources are provided by the U.S. CDC by just clicking here: http://www.cdc.gov/mold/faqs.htm . Often, simple remedies can help to clear common mold fungi in the home, but not potentially toxic types hidden in the walls. For some advice on simple remedies for the most superficial growth of mold fungi, just click here: http://www.huffingtonpost.com/organic-authoritycom/mold-treatment_b_1989372.html . As with most problems, mold fungi and allergies to them are not as simple as we would like, but greater understanding allows each of us to take intelligent steps to correct this very prevalent problem in the home and workplace.

Allergies to Dust Mites and Pet Dander

Many patients have what they think are allergies to dust and pet hair, but what they are really reacting to are dust mites and pet dander. Mites are a ubiquitous insect that serve a great purpose in the ecosystem, and are found on perhaps every human face and head on the planet. As revealed in an amazing article in the February 2015 issue of the National Geographic, by Rob Dunn, with amazing photos of mites using electron microscopy by Martin Oeggerli, most mites (genus pyroglyphidae) are so small that a dozen of these critters can exist on the head of a pin. Face mites live in hair follicles, and come out to feed during sleep, living a lifespan of only a few weeks, and laying many eggs in the hair follicle. These mites are complex creatures, having evolved an array of appendages and tools to accomplish a broad set of tasks needed for survival, and an amazing variety of mites with diverse appearance have been found, with well over a million species. We have ignored these important species so thoroughly that recent study continues to easily uncover new or unknown species. Is killing dust mites with chemicals as viable remedy? Our scientists have tried and failed, and since we now know that mites are very important to our ecosystem in so many ways that it is unimaginable, killing mites would do more harm to humans than the alleviation of dust mite allergies would benefit us. The solution to the problem is to find a more complex and holistic way to improve the human immune protections against these allergens.

Dust mites are not parasitic, but live on dead skin, which actually makes up most of the dust in our homes, not just inert dirt. Skin cells shed at an incredible rate, and leave a trail of human skin dust that is the food of an amazing number of microscopic mites. When our skin, nasal and respiratory membranes are unhealthy, the immune responses overreact to these dust mites, or rather the protease enzymes and endotoxins found in the exoskeletons of the mite feces and decaying bodies. Again, simple avoidance of dust mites is not enough to stop this allergic reaction once it is programmed, and we couldn't completely avoid dust mites and dead dust mites even if we tried. To decrease dust mite reactivity, simply dusting the home and using air filters is not the best strategy. Since dust mites feed on fresh dead skin dust, washing the face with a rough defoliating cloth or brush before bedtime, and shaking out the bedding, especially the pillowcases in the morning is the best way to decrease the food that these critters eat, and may decrease their numbers. Even the most dusted home will still create dust mites that react with the respiratory membranes at night because we will all continue to shed skin. Once again, a too simplistic explanation has been given to us in standard medicine, and we haven't paid attention to the basic knowledge that we need to help decrease our allergy. Besides the facial scubs before bedtime and shaking out the bedding in the morning, we need to improve the health of the sinus and respiratory membranes as well to truly get rid of the dust and dander allergies.

Pet dander proteins are also common allergens, and dander from cats creates allergies much more than dog dander. Dander is a general term for material shed from the skin of pets, and is similar to dandruff, or human skin dust. Dander from older pets is created much more than from younger pets, and like human skin dust, is small and light enough to get stirred up into the air. We can't really avoid it if we have a pet, but some precautions may decrease the allergic reaction, especially at night, when our immune systems focus more on work in the interior of the body rather than the exterior. This means that for persons with pet dander allergies, especially cat owners, that you may be advised to not allow the cat, or dog, on the bed, and not sleep with them. You may also buy fine pet combs and give the pet a combing outside the bedroom while wearing a fine particle mask, or a bath more often, to clear excess dander. Improving the pet diet and supplementing with essential fatty acids, vitamins and taurine may also help reduce dander. You must also improve the health of the respiratory membranes and the immune balance in these membranes as well. Complementary and Integrative Medicine can help achieve this goal.