Many thanks for your question regarding a 13 year old with a range of symptoms including nausea, fatigue, hayfever, asthma, dark circles under the eyes.
She appears to have been diagnosed with certain additional allergies including latex allergy, but you mentioned other tests have been inconclusive. She is currently taking medication which includes anti-histamines and Ranitidine. Ranitidine is a member of the H-2 (histamine blocker) family of drugs, which prevents the release of acid into the stomach. Ranitidine is used to treat stomach and duodenal ulcers, gastro-oesophageal reflux disease, erosive esophagitis, and Zollinger-Ellison syndrome. Ranitidine is available as a prescription drug and also as a nonprescription over-the-counter product for relief of heartburn.
In view of the nausea I wonder whether Helicobacter pylori was tested – this can commonly result in nausea in my experience especially amongst children and teenagers. You mentioned that the IgA is 1,764 which does indicate an immune response to something which may include environmental toxins, pollens, moulds etc as well as foods. While yes, quercetin can be useful for lowering histamine, along with vitamin C – the real key here is to identify why the client is reacting and to identify the underlying triggers.
Latex allergy can be a disabling, and even a life-threatening condition. Many will experience itching or swelling whilst others will have breathing, nasal or eye problems. When latex is in direct contact with the mucous membranes, some may even experience anaphylactic shock. Latex allergy is more common in certain groups. These include those who have atopic conditions such as eczema, asthma and hay fever, children who have spina bifida, those who are subject to repeated exposure at their workplace (such as healthcare workers) and, especially, those have pre-existing hand dermatitis. Those who are allergic to fruits may also become allergic to latex. Atopy is a tendency whereby some become sensitised and produce IgE antibodies in response to ordinary exposure to allergens. Eczema, asthma and hay fever are common ‘atopic’ diseases, and atopy is common among people with latex allergy. About 40% of people who have latex allergy may also have an allergy to plant-derived foods, especially fresh fruit. This association is called the latex-fruit syndrome.
It occurs because there are proteins in some foods that are structurally similar (due to the sequence of their amino acid building blocks) to latex proteins. These can act as allergens in the same way latex proteins do. The foods that most commonly cause reactions in people with latex allergy are avocado, kiwi, banana and chestnut. There are, however, many other cross-reacting foods.
There are two types of allergic reactions to latex. One is to the latex protein, a natural component of rubber, which is known as Type I (IgE-mediated) allergy.
The other is Type IV (contact) allergy, more likely to be caused by the chemicals used in processing natural rubber products, than the latex itself.
It is important your client is aware how common latex is – it is found in many everyday products and it may be that she is being exposed to this without knowing.
A recent study in Clinical and Molecular Allergy Journal which looked at the immune response modulation by curcumin in a latex allergy model, suggests that the Indian spice is capable of reducing or suppressing the Th2 response induced in mice by exposing them to latex allergens.
Kurup, et al. Immune response modulation by curcumin in a latex allergy model Clinical and Molecular Allergy20075:1 http://tinyurl.com/y8h6mub9
You also mentioned the presence of Methanobrevibacter. These are bacteria commonly found in the guts of healthy humans, fulfilling the important role of enabling efficient digestion of polysaccharides, which are complex sugars. It does this by combining hydrogen with carbon dioxide to produce methane, while supporting the extraction of energy from nutrients. Methane-producing microorganisms are known as methanogens. Methanobrevibacter smithii can make up 10% of all anaerobes (oxygen-hating bacteria) in the colon. In general, higher levels of methanogens can be associated with constipation. They can also be linked to IBS symptoms and other digestive conditions
Weaver GA, Krause JA, Miller TL, W. M. (1986). Incidence of methanogenic bacteria in a sigmoidoscopy population: an association of methanogenic bacteria and diverticulosis. Gut, 27, 698-704.
Pimentel M, Mayer AG, Park S, Chow EJ, Hasan A, Kong Y (2003). Methane production during lactulose breath test is associated with gastrointestinal disease presentation. Digestive Diseases and Sciences, 48(1), 86-92.
You may wish to investigate a hydrogen breath as well as the stool test.
Her range of atopic symptoms do suggest the need to look at modulating the immune system and starting first with the gut. I would first explore however Helicobacter pylori as well as the breath test. One of the concerns with the Ranitidine is that it may be affecting absorption of certain vitamins and minerals – you may wish to consider a multi (powder or liquid if needed) and / or Biolab vitamin and mineral blood testing. Clearly if a pathogen is identified, eradication would be recommended.
It may well be the case that the immune system has been under additional stress after the vaccine. The current HPV vaccines are based on virus-like particles (VLPs) that are formed by HPV surface components. VLPs are not infectious, because they lack the virus’s DNA. However, they closely resemble the natural virus, and antibodies against the VLPs also have activity against the natural virus. When vaccinated with the HPV vaccine, an immune response is triggered in the body. And with an immune response are possibly mild symptoms of infection due to cytokines and other mediators of inflammation released in the body.
Slade BA, et al. Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. JAMA. 2009 Aug 19;302(7):750-7. http://tinyurl.com/jevfqrj
With her symptoms of ongoing fatigue I presume that general bloods like iron and ferritin have been tested. I agree with you that there may also be an element of adrenal fatigue and do also consider possibility of thyroid dysregulation and presence of autoimmune conditions. Food IgG reactions may also be playing a role but if her diet is very limited testing may not be appropriate. Cyrex Labs have a list of medications that are not permitted if you wish to consider testing. This is what is listed on their website
Immunosuppressant and corticosteroid drugs can reduce antibody production and cause false negative results.
Limited assessments on the effects of aspirin, acetaminophen, and antipsychotics on Arrays 1-4 have been performed. No noticeable effects were observed.
Inhalers can affect the results of Cyrex’s oral fluid testing (Array 1). Wait two weeks after completion of inhalant dosages before collecting the specimen.
Unknown cross-reactive epitopes from foods and microorganisms may stimulate the antibody production in the absence of a true antigen. Cyrex has already developed Array 4 in order to recognize the most common antigens in this regard.
A gluten-free diet can cause false negative results on gluten protein/peptide tests.
Certain conditions, such as ileal pouch surgery, may cause a false positive celiac serology.
From the information I have read about this girl, you may wish to consider a glandular supplement for this client. Perhaps one which includes immune-supportive combination glandular available which includes spleen (important for immune function and digestion from a Chinese medicine perspective), thymus (immune function), pancreas (digestion), and adrenal – http://tinyurl.com/kydwcdv. Combining this with further immune support such as nutrients, turmeric etc may help her body to surmount an improved immune and adrenal response.
Vitamin A, vitamin D, probiotics and zinc should also be included to help with modulation
Semba RD. Vitamin A, immunity, and infection. Clin Infect Dis. 1994 Sep;19(3):489-99. http://tinyurl.com/pkfy2ns
Rumore MM. Vitamin A as an immunomodulating agent. Clin Pharm. 1993 Jul;12(7):506-14. http://tinyurl.com/orp6scs
Ooi JH, et al. Vitamin D regulation of immune function in the gut: why do T cells have vitamin D receptors? Mol Aspects Med. 2012 Feb;33(1):77-82. http://tinyurl.com/gmfbhbh
Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 1998 Aug;68(2 Suppl):447S-463S. http://tinyurl.com/nsd939t
Colostrum functions to reduce inflammation, supports immune function, as well as promotes gastrointestinal epithelial growth and repair. Colostrum helps to improve the mucosal immune response, as it provides immunoglobulins. Colostrum also contains lactoferrin and thus exhibits similar protective properties against infection.
Antiviral therapies also may be of benefit. There are a variety of supplements which have been studied as antiviral agents. This includes l-lysine, licorice, humic acid, monolaurin, and olive leaf. On the Clinical Education resources there is a pdf on the anti-viral products available which you can find here with a variety of suggested combinations – http://tinyurl.com/bgvyl6h. Humic acid supports the body in responding against viral agents by binding to the virus as well as acting like a chelator and displacing them from the cells. Do also read the 3 articles on the Clinical Education web page on the subject of humic acid: http://tinyurl.com/p2h6dky.
To support breathing do consider meditation techniques, breathing techniques, magnesium and Epsom salt bathing as well.
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Multi for lowering inflammation
Wholly Immune (ARG): 1 scoop daily in 8oz liquid. http://tinyurl.com/33v5um9 Contains nutrients (B complex vitamins, vitamin C, vitamin A), botanicals, and mushroom extract to support immune and adrenal function.
Bio-D-Mulsion (not forte) (BRC): Dosage to be determined by current serum level. http://tinyurl.com/kfpjyw6
Immuno-Gland Plex (ARG): ½-1 capsule daily with breakfast – open and distribute on or within food. http://tinyurl.com/kydwcdv Contains thymus, adrenal, spleen, and pancreatic glandular.
Lactobacillus plantarum / rhamnosus / salivarius (ARG): 1 capsule orally upon rising and before bed. http://tinyurl.com/393wuqc
Phospholipid Colostrum with Sunflower Phospholipids (ARG): 1 scoop daily. http://tinyurl.com/mzeqb43
Humic Monolaurin Complex (ARG): Gradually increase up to 1-2 caps up to three times a day. http://tinyurl.com/ozcvswg
Clearly some of the above contain dairy which may or may not be tolerated by your client. In addition, if she is reactive try one supplement at a time and simply place a little on her lips in case of a reaction. A good lower allergen powder would be Nutri Clear (BRC).
I hope this helps with your client
Registered Nutritional Therapist Helen Perks is collaborating with Clinical Education to bring you the first-ever Functional Medicine book club for Practitioners.
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