Food Sensitivities and Seasonal Allergies · complexes are deposited in gut tissue which leads to...

Food Sensitivities & Seasonal Allergies

• the causes• the testing• the treatment

with Dr. Derek Lee,

Direct Energy’s Health and Wellness Doctor

for North America.

Disclaimer

• The information in this webinar/conference call is meant for educational purposes only. It is not intended for the diagnosis, cure, mitigation, treatment or prevention of any disease or disorder in a specific individual.

• Some material was referenced from:

• Bipin Kothyari, Head Medical Science,Western Allergy

• Dr. Jason Bachewich, ND from Rocky Mountain Analytical Labs

Outline1. Food Sensitivities/Allergies

• the causes - inflammation, leaky gut syndrome, parasite

• testing - finger prick blood testing versus serum

• treatment - healing the gut

2. Seasonal Allergies: Allergic Rhinitis

• the causes - inflammation, parasites

• testing - skin scratch testing

• treatment - healing the gut, sublingual drops (SLIT)

Major Food Reactions• IgE: Type 1 hypersensitivity reaction

• immediate

• shrimp, hives

• people know they have this reaction

• typically do not test for this

• IgA: damage to digestive tract wall lining

• delayed

• IgG: Type 3 hypersensitivity reaction

• delayed

• takes 24 hours - 2 weeks to react to food

IgE• Reaction occurs within minutes of

exposure to food/air borne allergen after priming on initial exposure.

• Half-life of IgE antibodies is only approximately 24 hours. Very short.

• If you are being tested by a skin prick test, unless you are being tested within 1 day of exposure to the allergen, you may get a negative test result.

• Skin prick test may be useful only if tested within 24 hours of last exposure to allergen.

http://en.wikipedia.org/wiki/IgE

rashes, hives, swelling of airways

Hives: Due to Parasite Infection?

• Chronic random hive reactions may be due to parasitic infection if there seems to be no link to certain foods

• Parasites hatching or implanting in the bowels are releasing chemicals that are producing similar IgE reactions

• http://www.ncbi.nlm.nih.gov/pubmed/15368795






• Possible solution: black walnut

Cross Reactivity Syndromes for IgE Reactions

Latex - Fruit Syndrome

• latex allergy shows relationship to sensitization to banana, pear, avocado, chestnut, kiwi, papaya, tomato, and potato

• compounds in cereals can also cross react with mammal and insect proteins

Birch - Fruit Syndrome

• tomato, celery, apple, kiwi, carrot, zucchini, lentil, soybean, cherry, hazelnut, mango and more

Bird - Egg Syndrome

• mostly in adults over 30 due to older type vaccinations where egg protein was incorporated

Major Food Reactions• IgE: Type 1 hypersensitivity reaction

• immediate

• shrimp, hives

• people know they have this reaction

• typically do not test for this

• IgA: damage to digestive tract wall lining

• delayed

• IgG: Type 3 hypersensitivity reaction

• delayed

• takes 24 hours - 2 weeks to react to food

IgG

• Delayed reaction

• See the formation of antibody-antigen complexes

• End result is inflammation

inflammation

chronic migraineschronic joint painmuscle paineczema, psoriasis

IgG Food Reactions

• Delayed reaction.

• Reactions occur hours to days (2 weeks) after food is consumed and varies with the person.

• Often difficult to identify trigger food without testing.

• Good news: eliminating IgG reactive foods (28 days) will result in symptom improvement.

Common Symptoms Associated with IgG Food Reactions

• Weight gain

• IBS symptoms

• Mood disorders (90% of body’s serotonin is produced in the gut which is responsible for our sense of ‘well-being’. If this production is limited, mood disorders may result.)

• Depression

• Anxiety

• ADD / ADHD

• Asthma or respiratory problems

• Eczema, psoriasis

• Joint pain

• Hypertension

Food Allergy Testing• For IgG there are 2

choices:

• Serum

• Finger prick

• No difference

• But serum test involves taking blood sample via syringes while finger prick testing is quick and relatively painless

If IgG Reaction is Suspected

• Alternative to food testing?

• Omit suspected food for roughly 5 days. Food antigen is cleared, but IgG antibodies are still being produced and present in high numbers.

• On day 6, consume a large amount of the suspected food. If food is truly IgG reactive, it will provoke a large immune response and an exacerbation of symptoms.

Trevino R, Dixon H. Food Allergy. American Academy of Otolaryngic Allergy. Thieme Publishing 1997. pp. 8-9

IgG: A Cycle of InflammationDisruption of

Gut Liningfood intolerance, alcohol, stress,

anti-inflammatory drugs, antibiotics, candida, fatty acid

deficienciesImproper

Absorptionimproper gut lining leads to

improper absorption and food is seen as an invader which triggers

production of IgG antibodies

InflammationIgG antibodies from a complex with the food antigens - these complexes are deposited in gut

tissue which leads to gut inflammation

Leaky Gutinflamed gut causes nutrients and waste to leak from the gut and aggravates (worsens) improper

absorption and more IgG antibodies are produced

Multiple Food IntolerancesIgG antibodies produced to

multiple foods as a result of gut inflammation

Food Intolerance and Weight GainFood Intolerance(food reactions)

Inflammationrelease

of ghrelin

fluid enters cells

Causes of Weight Gain

exorphins

• Gherlin suppresses pro-inflammatory processes and augments anti-inflammatory effect, in addition to stimulating appetite.

• Feel less pain, but appetite increases.

• Exorphins are compounds formed outside the brain that produces the ‘feel good’ effect.

• Gluten and dairy are common exorphins.

food cravings (carbs)

appetite stimulation

fluid retention

*Removing food allergens can jump start

weight loss!

IgG ResearchMigraines

• Diet avoidance led to significant reduction in migraines and migraine attacks. (Revista Alergia Mexico 2007:54(5):162-8)

• Restriction diets avoiding allergens successfully controlled migraines. (Digestion 2010;81:252-264)

Dyspepsia (heart burn)

• Patients with IBS and dyspepsia showed elevated IgG levels to 14 common foods: milk, eggs, beef, wheat, etc. (Clinical and Experimental Allergy, 37,823-830)

IBS

• 150 patients: half on sham and half on elimination diet

• after 6 weeks, 10% reduction in symptoms

• after 12 weeks, 26% reduction in symptoms

• note this is without a gut healing protocol (Gut 2004;53:1459-1464.doi:10.1136)

Obesity

• Obese juveniles showed increased IgG levels (Exp Clin Endocrinol Diabetes 2008;116:241-245)

Candida

• Increased IgG levels with increased candida symptoms (The Journal of Alternative and Complementary Medicine, vol 3, 10,2007:1129-1133)

Cancer

• Renal cell carcinoma and survival: patients with high IgG levels were more likely to die and vice versa. (Cancer Immunol Immunother 2010;59:1141-1147)

Seasonal Allergies: Allergic Rhinitis (AR)

Mean Annual Productivity Loss ($) Per Employee

*P<0.05 for Allergic rhinitis /hay fever vs. other conditions.Lamb CE, et al. Curr Med Res Opin. 2006; 22:1203-1210.

Allergic Rhinitis a Major Contributor to Health related Absenteeism

13

AR is Associated With:

• Fatigue and daytime sleepiness

• Daily activity impairment

• Reduced work productivity

• Impaired cognitive functioning

• Reduced learning abilities

• Impaired sleep

• Impaired quality of life

Marshall PS, et al. Psychosom Med. 2002;64:684-69; Stuck BA, et al. J Allergy Clin Immunol.2004;113:663-668; ousquet J, et al. J Allergy Clin Immunol. 2006;117:158-162; Tanner LA, et al.Am J Manag Care. 1999;5(suppl 4):S235-S247; Blanc PD, et al. J Clin Epidemiol. 2001;54:610-618; Wilken JA, et al. Ann

allergy Asthma Immunol. 2002;89:372-380; Marshal PS, et al. Ann Allergy Asthma Immunol. 2000;84:403-410; Vuurman EFPM, et al. Ann Alllergy. 1993;71:121-126;Leger D, et al. Arch Intern Med. 2006;166:1744-1748.

AR Imposes a Significant Burden on Quality of Life

No Family History

One Parent With AR

Both Parents With AR

57/334

(17.1%)

11/21

(52.4%)

31/120

(25.8%)

Total, N = 816

No Allergic diseases, n=449 (some children had more than one allergic disease)

Rhinitis, n = 99

Gerrard JW, et al. Ann Allergy. 1976;36:10-15.

Impact of Family History on Diagnosis of AR

AtopicDermatitis

GIDistress

Recurrent OtitisMedia

Allergic Rhinitis

Allergic Asthma

InhalantSensitivity

FoodSensitivity

Gen

etic

Pred

ispo

siti

on

Time(~ Years)

Weinberg EG. Curr Allergy Clin Immunol.2005;18:4-5

The Allergy March

Nasal Symptom Mediators

Nasal Symptom Mediators

Mast cell stabilizers inhibits degranulation of

Mast cells & histamine release

Anticholinergic agents block effects of

acetylcholine

Intranasal corticosteroidsBlock the action of I M early in

the allergic response

Antihistamines block H1 receptorsLeukotriene modifiers

block Leukotriene synthesis or their

receptors

Immunotherapy reduces patient sensitization to

allergensAllergenExposure

Runny Nose, Sneezing, Itchy Nose, Congestion

Immune Response cells

Basophilis, NeutrophilisNasal cells, T-lymphtocytes, Eosinophilis

Histamines, Prostaglandin, Leukotriene, Tryptase, Cheokines, Cytokines

Exposure to allergens triggers the release of multiple IM

Mechanisms of Action

• Desensitization Process

• Includes administration of increasing doses of specific allergen over time to a sensitive individual

• Increase tolerance for the particular allergen

• Decrease symptoms

• Effective when optimally administered

• Indicated for patients unresponsive or intolerant to conventional therapy or to treat the root cause

What is Allergen Immunotherapy ?

• Clinical experience with SLIT spans more than 30 years.

• In other parts of the world, especially in Europe, sublingual treatment has become increasingly commonplace.

• In 1998, the World Health Organization referred to it as a "viable alternative" to injection therapy.

• Favourable results with more than 50 double-blind, placebo-controlled studies have been published in peer-reviewed journals.

Clinical Experience

Experimental Group

Dilu

tion

Decrease Skin Reactivity

Vasco Bordignon et al, Ann of Allergy Asthma Immunol. 2006;97: 158-163.

N =64

Multiple Daily Administration of Low Dose SLIT in AR

Experimental TimeVasco Bordignon et al, Ann of Allergy Asthma Immunol. 2006;97: 158-163.

N =64

Day

s w

ith A

ntih

ista

min

eReduction in Drug Use

Multiple Daily Administrations of Low Dose SLIT in AR

Ref Age range (Yrs)

Patients A/P* Allergen Duration Disease+ Main resultsMain results

1 5 - 12 30/28 Mites 18 months R/A Nasal and pulmonary symptom score; skin reactivity; specific and aspecific bronchial reactivity

2 6 – 16 15/15 Mites 1 year R/A/C No diff. ACT- PLA in symptom scores

3 7 – 17 33/31 Olive 2 years R/A Asthma and eye symptoms in pollen seasons

4 6 – 14 20/21 Paietaria 6 months R/CNasal symptoms scores; few changes in medication

scores; increased threshold dose of conjunctival provocation test

5 8 – 15 12/12 Mites 2 years A Total and nocturnal asthma score; drug intake; delayed skin reactivity

6 4 – 14 24/20 Grasses 3 months R/A/C Nasal and lung symptom score; no change in medication score

7 7 – 15 8/7 Mites 6 months R/A Asthma symptoms, asthma episodes and use of B2 agonists; no change nasal scores

89

5 – 12 8 – 14

47/3915/15

MitesParietaria

6 months13 months

R/AR/A/C

Asthma score and nasal symptoms SLIT + Fluticasone = Fluticasone alone for asthma;

Extrapulmonary symptoms in the SLIT group

10 6 – 13 11/11 Grasses 2 years R/A/C All medication scores; no change in symptom scores and nasal change

11 6 – 13 68/74 Grasses 3 years R/A/C Symptom scores only in the subgroup with more severe symptoms

12 3 – 14 39/38 Grasses 3 years R/C Total symptom scores and rescue medication intake; no immunological change

* A, active; P, placebo. R, Rhinitis; A, asthma; C, conjunctivitis. ACT – PLA, active – placebo. Source: Curr Opin Allergy Clin Immunol 2005; 5 (2) 173 – 177. Lippincott Williams & Wilkins

Randomized, DB Controlled studies of SLIT in Children

37

Ref. Author SAE Details

1 Calderon 1 1 mild uvula edema hospitalized for observation in the highest dose group (~15 mcg Phl p5)

2 Fiocchi 1 Severe (4/4) vomiting

3 Gozalo 1 1 severe asthma: treatment beta agonist and systemic steroids

4 Grosclaude 2 2 persistent asthma

5 Hirsch 1 One drop-out because of worsening of asthma and generalized weaknesses for weeks with 1 episode of severe bronchial obstruction.

6 Mitsch 3 Severe abdominal pain when SLIT was taken with antibiotics.(1x) ‘Severe’ worsening of their allergy (2x)

7 Pradalier 1 Generalized urticaria for 48 hours

8 Rolinck- W 1 Asthmatic crisis requiring hospitalization

9 Tari 3 Severe asthma (3)

10 Lima 2 Motorbike accident, Epiglottitis

SLIT – Serious Adverse Reactions:

47

Ragweed

Negative Control

(Saline)

Histamine

Other allergen

s

Measure longest

diameter

Positive test = Diameter

2 - 3 mm > Negative Control

Skin Test Results

AR Treatment Strategy

• Pollenguard is available in 5 ml metered dosage pump • Initiate the treatment with One drop three times a day

prior to the meal • The drop may be placed below the tongue for 2 min then

swallowed • The therapeutic plan is indicative and may be modified

according to patient condition and possible reaction• Pre-seasonal – 30 to 60 days prior to and through out the

allergy season• Co-seasonal: Year- round treatment

Seasonal Allergies and Food Sensitivities

An allergy is the immune system’s excessive sensitivity and over-response to exposure from a normally harmless foreign substance, or allergen, such as plant pollen, house dust mites, animal hair or certain foods. The immune system responds, as if to a real threat, by triggering an immune response or allergic reaction. Allergy is a health problem that is becoming more and more common worldwide.

Leaky Gut / Parasitic Overgrowth + Over exaggerated immune response = Allergies/Food Sensitivities

Dr. Derek Lee – drlee@betterhealthpro

How Seasonal Allergies Develop

• Hypersensitivity to air borne particles• How does this sensitivity develop?

o One alternative theory centers on parasitic overgrowth in the gut.

o We all have parasites but usually a small % in our GI tracts

o If too many parasites flourish, as living organisms, they produce waste/toxins which “leak” through the gaps in our digestive tract and leads to a hypersensitivity response. This creates the heightened immune reaction to airborne allergens.

• There does seem to be a hereditary component to allergies (but allergies may differ)

• Current methods to treat seasonal allergies (anti-histamines, allergy shots)

How Food Allergies / Sensitivities Develop

• It’s all about the digestive tract• Outer skin has multiple layers for protection• Digestive tract in some places is only 1 cell

thick. (has to be thin to allow fluids and particles to pass into blood stream)

• “Leaky Gut” syndrome: constant exposure to food particles and liquids leaking pass gaps in between cells activates immune response (old bathtub caulking). Body develops sensitivity or allergy to the particles leaking through.

Where To Start for Food Allergies?

1. Food allergy/sensitivity test (see example), must eat everything for 1 week pre test

2. Elimination diet (removing the cause of sensitivity) 3. Seasonal allergy testing4. Heal the Leaky Gut5. Probiotics – 3 types: Lactobacillus acidophulus super strain

DDS1, Bifidobacterium bifidum super strain Malyoth, Lactobacillus bulgaris super strain LB-51 (different strains have varying potency)

6. Probiotics grow a protective mat over the cell walls lining digestive tract and repairs leak

7. Add supplementation: vitamin D, omega 3 fatty acids, vitamin C, L-glutamine, hypoallergenic rice protein, black walnut for parasites

8. Digestive enzymes9. Antibiotics??? Kill the bad bacteria first then start the protocol?

Dr. Derek Lee - [email protected] - 905-474-5120

Why Test For Food and Airborne Allergies?• Two of the antibodies involved in allergic reactions

are immunoglobulin E (IgE) and immunoglobulin G (IgG). IgE production occurs right after ingestion or inhalation of an allergen and is referred to as a Type I immediate hypersensitivity reaction. IgG antibodies are produced for several hours or days after exposure to an allergen and are called Type III delayed hypersensitivity reactions.

• Because IgG allergies are delayed hours or days after exposure and can be caused by multiple foods, they are virtually impossible to identify without testing. IgG allergy testing requires a simple finger poke, either at home or in your practitioner's office. The blood from the finger poke is used to saturate three test strips which are left to dry. The laboratory tests these dried blood spots for IgG antibodies to a variety of different foods.

• IgE testing is useful for unexplained allergic reactions like hives, or for uncovering allergies to inhaled particles. IgE Allergy Testing requires a needle puncture to withdraw blood, and the blood is centrifuged and the red cells removed, leaving clear serum. The serum comes to the laboratory for analysis.

Where To Start for Seasonal Allergies?

1. Seasonal allergy testing2. Allergy testing kits diagnose specific allergies. This simple

and painless diagnostic IgE response scratch test identifies which allergens are causing patients to react

3. Test can be performed in-office, with specific and reproducible results in 20 minutes for suspected tree, grass, dust mite, cat, weed, and ragweed sensitivities.

4. PollenGuard: Sublingual Immunotherapy Treatment works by delivering a low dose of antigen in drop form under the tongue, 2– 3 times daily. This process builds the immune system’s tolerance to allergens, thus reducing symptoms and the need for additional medications. In most cases, the allergy condition can be eliminated entirely.

5. Heal the Leaky Gut (as above)6. Anti-parasitics – black walnut

Questions?

Contact Dr. Derek Lee at

[email protected]

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