Wheat Allergy vs. Gluten Allergy - November 2012
Everywhere we turn these days, Gluten-Free is big news. When patients are tested for Foods at Full Spectrum Family Medicine, the only gluten we test for is wheat, because wheat is the gluten contain-ing grain that we, as Americans, overeat. Gluten is the generic name for a certain type of protein found in Wheat, Durum, Semolina, Kamut, Spelt, Barley and Triticale. Oats do not contain gluten, but they can be contaminated with gluten on the farm or in the factory.
If you have Celiac disease, you must avoid all gluten permanently, or risk damage to your intestines. Patients that have Celiac disease often have symptoms that make them stand apart from our typical allergy patient. They may complain of bloody diarrhea, severe abdominal pain, difficulty gaining weight and anemia. It takes the average Celiac patientseven years to be diagnosed properly.
The vast majority of our allergy patients are wheat allergic but do not have Celiac disease, and therefore may eat non-wheat glutens. Wheat allergic patients are often clueless that food is causing their problems. They typically exhibit fatigue, brain fog, asthma and unexplained body aches and may have tested negative for Celiac disease. Their symptoms are not consistent. They feel better if they skip meals. They LOVE certain foods and tend to overeat what they love.
Our goal at Full Spectrum Family Medicine is to encourage our patients to adopt the Paleo or Cave Man Diet, which consists of meat, chicken, fish, vegetables, nuts and fruits. Grains other than wheat can be added to this diet usually with no symptoms. Spelt is a delicious gluten containing grain that is very close to wheat and needs to be eaten with caution so a new spelt allergy won't be triggered. We encourage patients to eat most foods on a four-day rotation to prevent future food allergies from developing.
An excellent book that explains why wheat has suddenly become such a big problem is, The Wheat Belly, by William Davis, M.D. The good news is that removing wheat from your diet for just a couple of days will usually result in a noticeable improvement of your annoying symptoms.
How to Treat Anaphylaxis - January 2013
Previously we discussed two kinds of food allergies: IgE and IgG. IgG food reactions are never life threatening. IgE foods, like peanuts, shrimp and shellfish can lead to death due to an anaphylactic reaction that causes the chest and throat to tighten and close. Other triggers of anaphylactic reactions are insect stings, medica-tions and allergy shots.
Anyone who suspects they are allergic to bees or has suspicions about IgE foods, should carry an EpiPen. EpiPens are available by prescription and are becoming more available in schools.
If an EpiPen is ordered for you, please feel free to ask for a demonstration of how to use it. This can be done either at our office, or at a pharmacy. Often, a demonstration EpiPen (without a needle) is included with your (real) EpiPen so you can practice.
When to Use an EpiPen: If you start to break out in hives and notice there is tightness in the throat that leads to tightness in the chest, and possibly asthma-type breathing, an EpiPen is indicated.
How to Use an Epi-Pen Your EpiPen will come with directions. It is quite simple: Pull off the top on one end and aim the other end into your thigh and shoot it, right through blue jeans if necessary, and hold in place for the count of ten. The medication, epinephrine, will work quickly to open your throat and chest. Your heart will speed up and you will feel quite shaky, like you had several cups of coffee, but you will breathe easier. After using an EpiPen, it is possible after 10 minutes that the tightness will return. If it does, a 2nd dose of a new EpiPen can be given in the other thigh. EpiPens now come in twin packs so a 2nd EpiPen is available if needed.
If an Epi-Pen has been administered, that person needs to immediately be followed up by a doctor at an Urgent Care or an ER. Anaphylaxis is life threateneing and may require further treatment.
More on Anaphylaxis
Additional Resources: www.foodallergy.org; www.epipen.com
Candida Albicans - February 2013
Candida albicans is a fungus that lives in our gut and is normal flora; it belongs there! Like most things in our body, we function best when we are in balance. If we have too much Candida growing in our gut, we can suffer with many symptoms including fatigue, brain fog, depression, muscle pain, short attention span, memory loss, headache, hypoglycemia and digestive disorders.
It has been suggested that half of us walk around with too much Candida. The imbalance is most often triggered by excessive use of antibiotics or steroids or by a diet that is high in carbohydrate and low in protein. Candida lives off sugar and yeast, so if our diet is high in sweets, alcohol (which is a sugar), pop, breads, or, if we eat large amounts of yeast foods like cheese, we grow increasing amounts of Candida. As the Candida grows, it demands more sugar, so we become "sugar cravers." Some of our "healthier eaters" become fruit cravers, since fruit breaks down into simple sugars and also will make Candida grow.
Read more Candida albicans
Serial Endpoint Titration - April 2013
The allergy testing for environmental allergies that is done at Full Spectrum Family Medicine is called Serial Endpoint Titration or SET. An antigen, like ragweed, is placed with a needle on the patient's upper outer arm and a 4 mm bubble is created. The bubble or wheal is then allowed to grow for 10 minutes. If the patient is not allergic to the antigen, the wheal will only grow to be about 5-7 mm. A series of wheals of different strengths or dilutions is applied. If the wheal grows to be 9 mm or larger, that suggests the patient is allergic to the antigen and would benefit from immunotherapy in the form of allergy shots or allergy drops.
A thorough history done before a patient is tested helps reveal which antigens a patient is likely to be allergic to, and even how allergic they may be. The typical panel of antigens includes pollens like ragweed, grass, trees, dust mites, dog, cat and several molds. If indicated, extra molds, trees and weeds can be included. We can also test for some farm antigens like hay and horse.
SET testing is more time consuming than prick testing or panel testing, where many antigens can be tested in one quick application. The advantage of SET is that it reveals not only if a patient is allergic to an antigen, but specifically how allergic. This information allows a serum to be created that is strong enough to be effective, but safe enough to not trigger allergic reactions.
More on Allergy Testing.
Coping with Seasonal Allergies - May 2013
It has been an especially long winter this year with a delayed spring, and most of us are very excited to be able to put away our mittens and even open our windows at home. For patients who have allergies to tree pollen and grass, this time of year can be both a blessing and a curse.
One of the best things you can do to prepare for spring pollen is to come for weekly allergy shots, or use your allergy sub-lingual drops if you have been tested and given treatment at our office. You will experience relief, and starting early is very helpful. Tree pollen is already registering at a high level, and grass pollen won't be too long in coming as well.
Many patients will find some relief with over-the-counter antihistamines like Claritin, Allegra and Zyrtec. Unlike Benadryl, these OTCs do not trigger significant fatigue and it is possible to feel alert while taking them. A word of caution, when these products are labeled "D", as in Claritin-D, they contain a decongestant that can keep you up at night and raise your blood pressure. If you don't have heart problems or hypertension, just remember to use the 12 hour "D" product in the daytime only, and use the 12 hour plain version at night.
Read more, Coping with Seasonal Allergies
Sub-Lingual Immunotherapy - June 2013
Full Spectrum Family Medicine uses a method of allergy testing called Serial Endpoint Titration or SET. This method tests for environmental allergens such as ragweed, dust and mold. Once testing is completed, an allergy serum can be created that is given in weekly allergy shots here at our office.
If coming in to Full Spectrum for weekly shots is inconvenient, or if insurance coverage for allergy shots is not available, we offer another method of treatment at the office. It is called sub-lingual immunotherapy (SLIT) and we have been offering it as an alternative to allergy shots for several years. The advantage of SLIT is that it doesn't require a weekly trip to our office, and for patients who are needle-phobic, no shot is necessary. The drops are placed under the tongue on a regular schedule and this can be done at home. The disadvantage of SLIT is that the drops are not FDA approved, and therefore no insurance will cover the cost, so patients must pay out of pocket for them.
SLIT drops have an excellent reputation in Europe. In both England and France, allergy shots have been almost eliminated and allergy drops are the main form of immunotherapy. Here in the U.S., most allergists do not offer SLIT. Allergy shots have the potential to trigger life-threatening anaphylactic reactions which is why the shots are typically given iin a doctor's office; patients are required to remain in the office for 20 minutes after receiving their shot to make sure they don't get a tight chest or throat. SLIT drops are much less likely to trigger an anaphylactic reaction and therefore are considered quite a bit safer
Read more on SLIT
Should You be Tested for Allergies? - July 2013
How do you know if you have allergies and should have allergy testing? It is quite interesting how many patients will say they don't know if they have allergies. The answer gets even more complicated when food allergies are included, since foods can trigger an amazing variety of symptoms, as has been discussed in earlier columns.
A questionnaire was developed to assist us in determining who would benefit from testing. The first ten questions deal with environmental allergies. The last nine questions address food allergies. If most of the questions are answered 'yes', it is likely that allergy testing would be beneficial and solutions to symptoms can be found.
Check current pollen counts for trees, grass, weeds and mold: www.weather.com
Improving Overall Health through Gut Health - August 2013
In the book, The Second Brain, Michael Gershon, M.D. said that 90% of our neurotransmitters are made in our gut, suggesting that anxiety, depression and irritability can all improve if our gut is able to produce our necessary neurotransmitters including dopamine, norepinephrine and serotonin.
How can we keep the gut healthy? One of the best ways to decrease irritation to the gut is to stop eating the two foods that are most likely to trigger gut symptoms: wheat and dairy. Another gut irritant is sugar, which comes in all kinds of forms including high fructose corn syrup. Too much sugar in the diet is a set up for Candida overgrowth, which has been discussed in previous columns. Adding protein or good fat to every meal and snack can decrease the glycemic effect of foods that are good for us, like fruit, but are high in sugar.
Another great boost for our gut is to take a probiotic daily to ensure good bacteria are present and able to do their imperative work for our whole body. The microbiome, which is bacteria living in our gut, has become a new frontier in medicine. These bacteria are so numerous, they outnumber our human cells by 10 to 1.
Two new methods of treating a sick gut have a huge "yuck" factor, but are very interesting. In the New York Times article from July 7, 2013, "Why I Donated My Stool", the author describes a "stool transplant", fecal microbiota transplant, or F.M.T., to a friend with ulcerative colitis. Obviously, this was conducted under the guidance of a doctor and there are some risks involved with this procedure. A very interesting read!
Another "crazy" idea is suggested in the book, An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases, by Moises Velasquez-Manoff, published in September, 2012. He also suffers from ulcerative colitis and was quite desperate to find an answer for his multitude of symptoms. He decided to become infected with worms, to populate his gut, because it had been studied that people with worms are much less prone to many diseases, including ulcerative colitis.
Both of these authors are suggesting there is still much to learn about healing the gut. It will be fascinating to see answers discovered for confounding diseases, particularly autoimmune diseases.
New York Times article on Michael Gershon, M.D.
The Ups and Downs of the Pollen Count - September 2013
Ragweed and other weed pollens are out in force now, and many allergy patients are struggling with the great outdoors. The weeds will continue to be troublesome until we get our first hard frost, which usually happens by mid October.
In the meantime, there are some things that can help. Air conditioning creates a safe haven for those reacting to outdoor pollens. Even a window air conditioning unit in the bedroom, if you don't have central air, can be helpful at night. Riding in the car with the windows up and the air conditioning on, also creates a better environment for our patients.
Coming weekly for allergy shots, or using prepared allergy drops and/or taking a daily antihistamine all will help to bring allergy symptoms under control. This is also a good time to reduce the foods that can trigger allergy symptoms, if they are known, since it is easier to control what you eat than to control what is floating in the air.
It is really interesting to watch pollen counts go up and down through the seasons. This year in the Lansing area TREE pollen was low on 4/1/13. By 4/22/13 it had jumped to high and by 4/29/13, TREE pollen was recorded at a very high level. GRASS pollen started to show up around 5/6/13 and by 5/28/13 it was at a very high level. TREE and GRASS pollen were gone by 7/8/13. WEED pollen came on the scene around 6/17/13 and continues to be a problem. It hit the very high level around 8/12/13.
Read More: The Ups and Downs of the Pollen Count
Feel Well Feasting - November 2013
Holidays and food go together. It may be quite inconvenient all year round to have food allergies, but it can feel tragic during the holidays to not be able to enjoy all the goodies. Luckily, food sensitivities/allergies are quite "in" right now. Gluten-free products are currently the biggest growth item in the food industry. The trick is finding foods that won't make us feel worse, and yet still taste good and let us enjoy special holiday gatherings.
There are many resources available for making items that are dairy-free, corn-free, soy-free and wheat-free. One of my favorite magazines is called, Living Without. They have a website: www.LivingWithout.com. One of the magazine's goals is to create beautiful meals that heal the body without leaving anyone feeling deprived. There are recipes for special holiday treats and many include sweets. Eating too many carbs and sweets will make Candida overgrow and trigger a host of health issues, so the holidays should not be a license to forget everything we have been doing to get our health back on track. But when you want a special cake or cookie recipe - it is a great resource.
An excellent way to make healthy holiday meals is to add more vegetables that taste great. My favorite cookbook for delicious vegetables is, One Bite at a Time, by Rebecca Katz. Often allergies run in families, so by "cleaning up" the passing dish one family member brings, the whole family will benefit as well. For example, instead of the traditional green bean casserole, Rebecca's recipe for Bombay Beans can be an appreciated substitute.
Read More: Feel Well Feasting
Testing and Treating Children for Allergies - January 2014
Children can be tested for both inhalant and food allergies at FSFM after they have reached the age of 6. Since allergy testing involves needles, most children are reluctant to be tested, and their parents dread it for them as well. Luckily, we can provide a prescription ahead of time for Emla Cream, which numbs the arms of the children and reduces the discomfort of testing by about 80%. Adults sometimes request the cream too.
The Emla Cream is applied to the upper outer arms about 1 1/2 hours before allergy testing and the arm is wrapped with Saran wrap, so the cream doesn't rub off. Before testing, the cream is wiped off and the arms will remain numb for 4 hours. We have video of "how to apply Emla Cream" that is available at our office for parents and children to view ahead of time.
Inhalant or environmental testing involves applying many very small bumps (4 mm) of various antigens like ragweed, dust, and cat, and watching the bumps grow on the child's upper arms. If a child has no allergies, the bumps will remain very small and not get itchy. If positive reactions are found, allergy serum for weekly shots or allergy drops for sub-lingual (under the tongue) use at home can be prepared.
Food testing actually triggers symptoms that the child is experiencing on a regular basis. As with adults, the two most common symptoms caused by foods in the testing are fatigue and brain fog. Surprisingly, parents will say their child is a more hyper than tired, and yet, in the testing both extremes are manifested. Brain fog is often obvious when children struggle to solve simple math problems or spell words during the testing. After the foods are "turned off", the child is suddenly quite capable of thinking clearly and both parents and children are shocked by the difference. Milk and wheat are the two foods most likely to trigger brain fog and fatigue. Corn is often a trigger for hyperactivity in children.
Read More: Testing and Treating Children for Allergies
Glutathione: "The Mother of All Antioxidants" - March 2014
It is possible that you have never heard of Glutathione, even though it has been referred to as "the mother of all antioxidants." Each cell of our body produces it, but about 25 % of us don't make enough glutathione. Glutathione is a peptide, made of up 3 amino acids: cysteine, glycine and glutamic acid. It helps reduce oxidative stress in the body, therefore protecting healthy cells from damage. It reduces inflammation, which has been associated with almost every disease process.
Glutathione has been around a long time as a treatment, but because the GI track destroys it, the best way to have it enter the body was by IV, which was both expensive and inconvenient. I attended an American Academy of Environmental Medicine conference in 2011 and met Dr. Tim Guilford. In 2005, Dr. Guilford developed a way to make Glutathione available in a liquid, oral form called Liposomal Glutathione.
Glutathione has been used to help with many symptoms our patients deal with every day like depression, fatigue, body pain and brain fog. It has also been used successfully to treat serious illnesses like chronic fatigue, fibromyalgia, autism, Parkinson's disease, M.S., Alzheimer's, ALS, heavy metal toxicity and peripheral vascular disease, to name a few.
It boosts the immune system, so it is a great way to stop a cold or flu from escalating. It relieves tension and body pain because it reduces inflammation. It helps repair cellular damage, so energy and stamina improve. It helps detoxify heavy metals and aids organ function. It helps the brain to remove free radicals as well, hence brain function improves.
I asked Dr. Tim what side effects his product, Liposomal Glutathione, can produce and he said, "malaise and headache." More typically, it relieves these two symptoms. It has been used safely with children on the autism spectrum.
Full Spectrum Family Medicine is able to purchase Lipsomal Glutathione directly from Dr. Tim Guilford's company, Your Energy Systems, LCC.The suggested dosage for an adult is 2 teaspoons first thing in the morning on an empty stomach, or split into doses during the day. A maintenance dose of 1 teaspoon daily is suggested, when symptoms are stabilized. It has a strong sulfur smell, so mixing it with a small amount of juice will hide the scent. The bottle should be refrigerated and has a long expiration date. A bottle will last 2 weeks if 2 teaspoons are taken per day and the cost per bottle is $35.
If you would like more information, we have a Liposomal Glutathione handout available. Many patients have been pleased with the results. The website also has helpful information as well: www.readisorb.com. On the website you will find a link with endorsements both from Dr. Mehmet Oz and Dr. Jeffrey Bland. Jeff Bland has a PhD in Nutritional Biochemistry and was a speaker at the annual Integrative Healthcare Symposium in New York City that I was privileged to attend in February 2014.
Grain Brain - April 2014
There is a new book called Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar--Your Brain's Silent Killers, by David Perlmutter, MD, that takes the Wheat Bellybook and goes one step further. Dr. Perlmutter presented at the Integrative Healthcare Symposium I attended in February, 2014 and said he believes a high fat diet is the best way to attain brain health. He is a Board-Certified Neurologist and Fellow of the American College of Nutrition.
Dr. Perlmutter is a brilliant speaker and has a thriving practice in Naples, Florida, where he helps patients who have almost given up hope of finding answers. His message is that we currently eat way too much sugar in our diet and not nearly enough good fat and dementia is one of the outcomes of this high carb/low fat diet fiasco.
Dr. Perlmutter said, "An excess of dietary carbohydrate, particularly fructose, alongside a relative deficiency in dietary fat and cholesterol, may lead to the development of Alzheimer's Disease." Diabetics are particularly at risk. "When you let Type 2 diabetics know they're doubling their risk for Alzheimer's disease, they suddenly open their eyes and take notice."
He said our ancestor's diet consisted of 75% fat, 5% carbohydrates and 20% protein. Our current American diet is 60-70% carbs, 15-30% protein and 15-30% fat. The carbohydrates we eat raise our blood glucose and result in a product of protein and sugar called glycated proteins. Glycated proteins produce nearly 50% more radicals than non-glycated proteins. As we have discussed before, free radicals trigger inflammation in our body. So sugar is an inflammatory agent that causes destruction to every organ in our body, including our brain.
Read More: Grain Brain
It is very sad to say good-bye to our wonderful summer. We have been blessed with regular rains and many sunny days and no blistering heat. For our allergy patients, the pollen counts have been manageable, although mold levels have continued to be elevated and have been the main trigger of symptoms this summer. Rain temporarily washes out the pollen in the air, but kicks up the mold level.
As the colder weather approaches, indoor allergies become the main focus. As discussed in these columns previously there are good techniques you can use at home to keep your allergies under control.
1) If you are on immunotherapy in the form of allergy shots or SLIT (sub-lingual immunotherapy) drops, be sure to come for weekly shots or use your at-home drops according the to schedule
2) Adding a daily antihistamine like Claritin, Allegra or Zyrtec, which are now all over-the- counter, can help control allergy symptoms. Remember if you use the “D” form of an antihistamine, it contains pseudoephedrine which can make it difficult to sleep, so use the “D” form only in the daytime.
3) Keeping pets out of the bedroom 24 hours a day and running a HEPA filter in your bedroom can greatly reduce symptoms and leave you feeling more “detoxified” each morning.
4) Washing sheets weekly in hot water and purchasing a new pillow yearly and covering the mattress and pillow with an allergy cover will make your bed less allergic, especially if dust mites are one of your allergy triggers.
5) Remember to change your furnace filter regularly, dust your home and especially dust your bedroom on a regular basis
If you have chronic health problems like: fatigue, brain fog, body pain, gut problems, mood issues, rashes, asthma, arthritis or autoimmune disease, food sensitivities could be a cause and food testing may provide answers that lead to almost immediate improvements.
Please consider having your family members tested for both food and inhalant allergies at our office. We have openings! Allergies are genetic, so it is very likely that if you have benefitted from testing, your loved ones will as well.
Patients are welcome to come to FSFM as “allergy only” patients. They will be scheduled to see Dr. Will or Dr. Wendy first as an initial visit, and then can be have allergy testing done. The appointments can all be set up with one phone call: (517) 333-3550. It is a pleasure helping people find ways to feel better every day of the year!