Allergy

Not all allergies are constant and predictable. Many appear to come and go. The key to this shifting pattern is the concept of ‘cyclical’ and ‘fixed’ allergies. Fixed allergies, as the name implies, never really change. Once acquired, they are with one for life. In general fixed allergies are severe. Allergies to insect stings, strawberries and shellfish tend to be of this type. These are usually immunollogically-induced allergies and, in accordance with our present understanding at any rate, there is no reason to expect them to alter. Cyclical allergies, on the other hand, vary considerably in the severity of reactions they produce. The more often the allergen is encountered, the worse the reaction becomes. Conversely, if the allergen is avoided for a long period, the reaction tends to dampen down.

Not all allergies are constant and predictable. Many appear to come and go. The key to this shifting pattern is the concept of ‘cyclical’ and ‘fixed’ allergies. Fixed allergies, as the name implies, never really change. Once acquired, they are with one for life. In general fixed allergies are severe. Allergies to insect stings, strawberries and shellfish tend to be of this type. These are usually immunollogically-induced allergies and, in accordance with our present understanding at any rate, there is no reason to expect them to alter. Cyclical allergies, on the other hand, vary considerably in the severity of reactions they produce. The more often the allergen is encountered, the worse the reaction becomes. Conversely, if the allergen is avoided for a long period, the reaction tends to dampen down.

The allergy-aware doctor today thinks in terms of target or ‘shock’ organs. The concept is really very simple: some part of the body, or a particular organ (for reasons which are not clear) receives more of an allergic reaction than the rest. Whatever the environmental stressor, whether it is a food, a chemical, a hidden infection or some other insult to the tissues, the symptoms appear at the weak point and are ‘referred’ to this organ, regardless of the actual trigger. Thus you may also hear the term “end-organ failure”. The symptoms experienced will depend largely on the function of this organ and whether it is excited (stirred up) or depressed (slowed down).

The allergy-aware doctor today thinks in terms of target or ‘shock’ organs. The concept is really very simple: some part of the body, or a particular organ (for reasons which are not clear) receives more of an allergic reaction than the rest. Whatever the environmental stressor, whether it is a food, a chemical, a hidden infection or some other insult to the tissues, the symptoms appear at the weak point and are ‘referred’ to this organ, regardless of the actual trigger. Thus you may also hear the term “end-organ failure”. The symptoms experienced will depend largely on the function of this organ and whether it is excited (stirred up) or depressed (slowed down).

One of the dividing principles between conventional allergy and clinical ecology is the concept of the hidden or ‘masked’ allergy. Conventional allergists and immunologists don’t recognize the existence of the phenomenon. Clinical ecologists use their understanding of it all the time to treat many patients and many diseases. Basically, a hidden allergy means that a substance is capable of making a person ill but that constant exposure to it (as with a frequently eaten food) mutes the person’s reaction to it. A so-called masked allergy is a variant of this, whereby exposure to the substance temporarily diminishes or ‘masks’ the symptoms. Both phenomena make diagnosis very difficult.

One of the dividing principles between conventional allergy and clinical ecology is the concept of the hidden or ‘masked’ allergy. Conventional allergists and immunologists don’t recognize the existence of the phenomenon. Clinical ecologists use their understanding of it all the time to treat many patients and many diseases. Basically, a hidden allergy means that a substance is capable of making a person ill but that constant exposure to it (as with a frequently eaten food) mutes the person’s reaction to it. A so-called masked allergy is a variant of this, whereby exposure to the substance temporarily diminishes or ‘masks’ the symptoms. Both phenomena make diagnosis very difficult.

Confusion can arise from the fact that there may be pharmacological effects masquerading as an ‘allergy’. For example, the headache, flushing, racing pulse and giddiness that can come on after too much caffeine is really a drug reaction, not an allergic one. Obviously individual variations in trigger thresholds make this one sometimes hard to observe. Few people understand the incredible range of pharmacological substances that are to be found in plant substances. Most “green-minded” people think of herbs as kind, nurturing and gentle: wouldn’t hurt anyone, right? But, hey, I like to point out that foxglove, hemlock, opium poppy, marijuana, deadly nightshade and countless plants stuffs are dangerous, even poisonous. “Beware the humble carrot” wrote Richard Mackarness; this innocuous looking vegetable contains a neuro-toxin. Not relevant? I had a patient in the 1980s, a young boy, who had epileptic fits every time he ate carrots or anything from the same food family: parsnip, celery, parsley, dill, fennel, coriander etc.

Confusion can arise from the fact that there may be pharmacological effects masquerading as an ‘allergy’. For example, the headache, flushing, racing pulse and giddiness that can come on after too much caffeine is really a drug reaction, not an allergic one. Obviously individual variations in trigger thresholds make this one sometimes hard to observe. Few people understand the incredible range of pharmacological substances that are to be found in plant substances. Most “green-minded” people think of herbs as kind, nurturing and gentle: wouldn’t hurt anyone, right? But, hey, I like to point out that foxglove, hemlock, opium poppy, marijuana, deadly nightshade and countless plants stuffs are dangerous, even poisonous. “Beware the humble carrot” wrote Richard Mackarness; this innocuous looking vegetable contains a neuro-toxin. Not relevant? I had a patient in the 1980s, a young boy, who had epileptic fits every time he ate carrots or anything from the same food family: parsnip, celery, parsley, dill, fennel, coriander etc.

Do your ears swell up when you wear certain types of jewelry?  You might have metal hypersensitivity and these fall into several categories and sources: Metal pollution Then there is the matter of hypersensitivity to metals such as nickel and chromates. These are cell-mediated immunity reactions, without antibody involvement. These too are probably best not called allergies, but clearly there is a sensitization effect that fulfils the prescription of the von Pirquet phenomenon. Don’t forget too that metals can be poisons as well as sensitizers. Mercury and lead are pretty obvious poisons, but so are aluminium (from cooking), cadmium (from tobacco), thallium (rat poisoning and industrial exposure), zinc and iron smelting wastes are EPA regulated toxic materials yet are sold and used legally as fertilizers. There are many other potential metal poisons and it has been my contention for some years now that what I call “metal pollution” may turn out to be a far more serious hazard than chemical pollution, such as pesticides and atmospheric pollution.

Do your ears swell up when you wear certain types of jewelry?  You might have metal hypersensitivity and these fall into several categories and sources: Metal pollution Then there is the matter of hypersensitivity to metals such as nickel and chromates. These are cell-mediated immunity reactions, without antibody involvement. These too are probably best not called allergies, but clearly there is a sensitization effect that fulfils the prescription of the von Pirquet phenomenon. Don’t forget too that metals can be poisons as well as sensitizers. Mercury and lead are pretty obvious poisons, but so are aluminium (from cooking), cadmium (from tobacco), thallium (rat poisoning and industrial exposure), zinc and iron smelting wastes are EPA regulated toxic materials yet are sold and used legally as fertilizers. There are many other potential metal poisons and it has been my contention for some years now that what I call “metal pollution” may turn out to be a far more serious hazard than chemical pollution, such as pesticides and atmospheric pollution.

Over time it has become obvious that some individuals are sensitive to environmental chemicals. It is hard to describe this as an allergy; probably the term ‘low-grade poisoning’ would be better since many of these chemicals would make anyone exposed to them in sufficient concentration feel ill. The problem is just that certain individuals react to smaller doses. We are all subject to a barrage of alien chemicals in our bodies (Greek word: xenobiotics, meaning alien to life). We have chemical pathways in our bodies designed to remove toxic substances: a process called detoxication or biotransformation. The trouble is these new man-made chemicals have no equivalent in nature and so we do not have the right systems in our body to fully eliminate the toxicity. In fact, in its attempts to deal with the problem the body sometimes, by mistake, actually coverts these xenobiotics into something even more toxic (Casarett and Doull’s Toxicology. Basic Science of Poisons. Third Edition, Editors: Klaasen CD, Amdur MO, Doull J, Macmillan, New York 1986). 

Over time it has become obvious that some individuals are sensitive to environmental chemicals. It is hard to describe this as an allergy; probably the term ‘low-grade poisoning’ would be better since many of these chemicals would make anyone exposed to them in sufficient concentration feel ill. The problem is just that certain individuals react to smaller doses. We are all subject to a barrage of alien chemicals in our bodies (Greek word: xenobiotics, meaning alien to life). We have chemical pathways in our bodies designed to remove toxic substances: a process called detoxication or biotransformation. The trouble is these new man-made chemicals have no equivalent in nature and so we do not have the right systems in our body to fully eliminate the toxicity. In fact, in its attempts to deal with the problem the body sometimes, by mistake, actually coverts these xenobiotics into something even more toxic (Casarett and Doull’s Toxicology. Basic Science of Poisons. Third Edition, Editors: Klaasen CD, Amdur MO, Doull J, Macmillan, New York 1986).