Friday, November 1, 2013

Food Intolerance

The idea of food intolerance is highly controversial yet gaining
in popularity amongst physicians, researchers, and laypeople.
Part of the problem for the slow acceptance of this concept is that
the foods most frequently associated with intolerance are often
very common (such as dairy and grain products). This seems to
defy logic. How can milk or cereal be harmful? Also, the precise
meaning of intolerance varies from one practitioner to another and
is sometimes confused with food allergy.Food allergy causes specific immune reactions in the body that
can be identified and diagnosed by standard medical tests. Food
allergy tends to produce specific symptoms linked to the offending
agent (allergen).In contrast, food intolerance does not provoke the immune
system and thus cannot be assessed using allergy tests. Also,
the symptoms of food intolerance tend to be relatively vague and
nonspecific. Here is a partial list of common symptoms that are
typically linked to food intolerance: headache, fatigue, depression/
anxiety, muscle pain, joint pain, vomiting, nausea, stomach
ulcers, diarrhea, constipation, flatulence, etc. These symptoms
can be produced by many causes and are
thus not specific to food intolerance.
Whereas allergic reactions typically
occur almost instantly after provocation,
there may be a considerable
lapse of time before food intolerance
symptoms manifest, making
the connection difficult to validate.There can be numerous reasons why
the body cannot tolerate certain
foods including: enzyme deficiency
resulting from a heredity factor, stress, environmental
pollution, and poor nutrition.The best resource that I have seen on this topic is Food Allergies
and Food Intolerance by Jonathon Brostoff, M.D., and Linda treatment of these two concepts, most of
the book focuses on the intolerance issue.Historical BackgroundThe controversy about adverse reactions
to food can be traced back almost one
hundred years to the work of Baron
Clemens von Pirquet, a Viennese doctor.
Von Pirquet first used the term allergy in
1906 to mean "altered reactivity," apparently
in a rather broad sense that includes
immune activation and other physiological
processes produced by allergens. Keep
this original concept of allergy in mind
when we discuss Edgar Cayce's use of the
term later in this article.During the 1920s, skin prick tests were
developed that provided a lab technique
for detecting immune reactions. Moreover,
several specific medical conditions, including
hay fever, asthma, rhinitis (runny or
congested nose), and a certain type of eczema
(red, itchy, flaky skin) were linked to
immune reactivity that could be clearly
identified. Thus, the definition of allergic
disorders became increasingly narrowed
and closely associated with abnormal immune
response.Not everyone agreed with this narrow
interpretation of allergy. Some practitioners
preferred a more general interpretation that
includes allergens that are not directly
linked to immune reactions. This is where
food intolerance comes in, as a way of explaining
delayed or nonspecific reactions
to food that are not detected by allergy
skin prick tests.As a practical matter, the distinction between
food allergy and food intolerance often
becomes blurred. Brostoff and Gamlin
point out that in the physician's office, if a
patient has the symptoms of a disease that
is regarded as allergic (e.g., asthma or
atopic eczema), and if the symptoms are
clearly linked to diet, the illness will probably
be diagnosed as food allergy, even if
skin-prick tests are negative. Some clinicians
avoid the whole issue of food allergy
vs. intolerance by lumping all such
problems under the heading of food sensitivity.Diagnosing Food IntoleranceAs stated, the standard skin-prick tests
used to diagnose allergies do not work for
food intolerance. Unfortunately, there is
no simple laboratory process for evaluating
this syndrome. The only reliable
method for assessing food intolerance is
to systematically eliminate certain foods
from the diet and see if symptoms decrease
or go away. The offending foods
are thus identified and can be reintroduced
to see if the symptoms return.This is not always as easy as it sounds
because few people are intolerant to just
one food. Therefore eliminating foods one
at a time may not have a notable effect.
Optimally, all the offending foods have to
be eliminated simultaneously for a clear
diagnosis and effective treatment.Cayce and Food ReactionsThe Edgar Cayce readings contain numerous
examples of what we now call food
allergy and intolerance. As noted in the
historical overview, Cayce tended to use
the term allergy in a more general sense to
include almost any reaction to food that
produces illness, regardless of whether
there is a specific immune response. The
concept of intolerance was not available
during his era, so he used the word allergy
to cover a variety of conditions.For example, consider this excerpt from
reading 3326-1 that addresses the cause of
migraine: "As we find, while the body is in
the developing stages, the sources of the
conditions to which the body becomes allergic
in the digestive system should be
looked for - that deal with all migraine
headaches... Do these [treatments], being
mindful of the diet, and we will correct conditions
for this body. These are the
sources of migraine headaches." Interestingly,
this thirteen-year-old girl also suffered
from eczema and neuritis, which may
have also been linked to her digestive
problems.From a medical perspective, migraine is
very important in relation to our discussion
of allergy and intolerance. Numerous
scientific studies have clearly shown that
migraine is linked to food reactivity in
many individuals that do not exhibit any
measurable immune response to skin prick
tests. Thus, when migraine is triggered by
food, it represents a great example of food
intolerance causing illness.From a treatment standpoint, Cayce's
therapeutic recommendations in reading
3326-1 included the advice to avoid eating
chocolate, a well-known trigger for migraine.
Throughout the thousands of
physical readings, Cayce often made such
specific recommendations for individuals
to avoid certain specific foods. Whether
his advice was indicative of a classic food
allergy or what we would now call food intolerance
is difficult to say. It would probably
be best to regard all such instances as
food sensitivity and leave it at that.
Without Edgar Cayce to give a reading
identifying foods to which the body may
be intolerant, how can a person know what
to avoid? The best answer that I have
seen is the elimination diet discussed
above. Since there are many approaches
to doing an elimination diet, I cannot cover
this important topic in this issue. Check
back next month for specifics on how to
use this type of personal assessment if
you think you may be suffering
from food intolerance.