Allergies, histamine

[Archived Posts]

Female, 57, challenging case of pseudo allergies, histamine, chronic digestive issues, yeast, SIBO

Part 1
Female, 57, Childrens’ Nursery Manager
Goal: Reduce digestive symptoms & allergic rashes

Primary presenting symptoms:
Nausea/sickness, bloating, painful abdomen, diarrhoea, BMs inconsistent & unpredictable – 2-6/day type 5-6. Pale or light brown stools. Very low energy, flatulence, wind, skin rashes. Post nasal drip, sinus infections (antibiotic use), deviated septum. Hot flushes. Post-menopausal (no flushes previously). Racing heart/pulse. Occasional thrush, cystitis, past small fibroids. Her questionnaire symptoms list was heavily populated in most areas but significantly in mood/mind, skin & gut. Doesn’t tolerate many foods including gluten, dairy, sugar, oats, soya. Cannot prepare foods in nursery due to reaction.

Diagnosis, history:
Allergic symptoms as child, not diagnosed – cloves, strawberries, dairy.

Symptoms started September 2013 after being on HRT & soya supplements for one month (was tired and having hot flushes). Diarrhoea continued when off HRT. Antibiotics prescribed as thought infection. Diarrhoea continued. Sept 2013 diagnosed: non-mediated food allergy, chronic spontaneous urticaria, oral allergy syndrome, dermographism, pseudo allergy syndrome plus allergy to salicylates & sulphites. IgE testing showed normal levels, although soya and grass slightly elevated but within normal blood levels.

Dietician gave handout on dairy & soya avoidance and list of salicylates & sulphites. Hiatus hernia via endoscopy. Colonoscopy x 2 clear. IBS diagnosis with one GP and not with another. Racing heart fine on trace, although ectopic heartbeats. High ANA (result unknown). Meds: anti-histamine, nasal spray

Is the sulphite sensitivity mediating the allergy symptoms and diarrhoea? Reflecting on this case, maybe probiotics course may help as I only did Culturelle at the beginning then was reluctant to use any once we were supporting SIBO (except S. Boulardii).

The consultants & GPs are confused by her presentation and client is frustrated with lack of support. Consultant says ANA may be thyroid autoimmune activity but appears they are not testing thyroid hormones nor antibodies. This may be an area to test privately. I also want to consider the Advanced Chronic Viral profile for EBV, CMV, HHV-6, HSV-1 & HSV-2 given reaction to humic acid I suspect a significant viral burden.

I’d be very grateful for any advice to move forward with her, she is a very committed client keen to get to the root cause and has a good budget for testing and supplements. Thank you in advance.

Posted By Jane Barnett 23/11/17

 

 

 

[Christine Bailey]

Dear Jane,

Many thanks for your question about your client with multiple allergies, food reactions, digestive symptoms and low energy.

It is worth pointing out that a positive ANA test means autoantibodies are present. By itself, a positive ANA test does not indicate the presence of an autoimmune disease and it is worth mentioning certain medications are thought to also lead to high levels. Autoantibodies start the cascade of inflammation, causing the body to attack itself. The antibodies that target “normal” proteins within the nucleus of a cell are called antinuclear antibodies (ANA). Most of us have autoantibodies, but typically in small amounts. The presence of large amount of autoantibodies or ANAs can indicate an autoimmune disease. To investigate this further I would suggest Cyrex 5 array which can pinpoint specific autoantibodies to key organs and tissues.

However, looking more functionally at this lady I suspect there is a gut infection and this may be one of key contributing factors to this dysregulation in immune function. Therefore, consider a comprehensive stool test with parasitology including Helicobacter Pylori and if her symptoms suggest it I would also look at the SIBO hydrogen breath test. In my experience gut infections can trigger a range of food reactions and in some cases this can continue even after eradication and this may be where a focus on immune modulation or even desensitization therapy may be relevant.

For example, vitamin A has been shown to be helpful with TH1/ TH2 balance

Albers et al. Effects of supplementation with vitamins A, C, and E, selenium, and zinc on immune function in a murine sensitization model. Nutrition. 2003 Nov-Dec;19(11-12):940-6. http://tinyurl.com/y7sw4dro

 

Allergic sensitization is the outcome of a complex interplay between the allergen and the host in a given environmental context. The first barrier encountered by an allergen on its way to sensitization is the mucosal epithelial layer. Allergic inflammatory diseases are accompanied by increased permeability of the epithelium, which is more susceptible to environmental triggers. Therefore, removing triggers and restoring gut barrier health would be important.

Allergens and co-factors from the environment interact with innate immune receptors, such as Toll-like and protease-activated receptors on epithelial cells, stimulating them to produce cytokines that drive T-helper 2-like adaptive immunity in allergy-prone individuals.  In this milieu, the next cells interacting with allergens are the dendritic cells lying just underneath the epithelium: plasmacytoid DCs, two types of conventional DCs (CD11b + and CD11b-), and monocyte-derived DCs. It is now becoming clear that CD11b+, cDCs, and moDCs are the inflammatory DCs that instruct naïve T cells to become Th2 cells. The simple paradigm of non-overlapping stable Th1 and Th2 subsets of T-helper cells is now rapidly being replaced by that of a more complex spectrum of different Th cells that together drive or control different aspects of allergic inflammation and display more plasticity in their cytokine profiles. At present, these include Th9, Th17, Th22, and Treg, in addition to Th1 and Th2. Allergic sensitization is a complex interplay between the allergen in its environmental context and the tendency of the host’s innate and adaptive immune cells to be skewed towards allergic inflammation.

As your client clearly has dysregulation and inflammation you may wish to look at agents to lower inflammation. I would consider vitamin D, probiotic support and turmeric and / or collagen as well. Reishi mushroom extract has also been shown to inhibit the effects of nuclear factor kappa beta, as outlined above, making it a multimodal agent in the complementary management of autoimmune conditions.  Quercetin is useful for histamine type reactions while you may wish to look at support detox pathways, immune health with glutathione

Ronald van Ree, et al. Allergic sensitization: host-immune factors Clinical and Translational Allergy20144:12  http://tinyurl.com/yamjpbwg

Nakashima S, et al. Effect of polysaccharrides from Ganoderma applanatum on immune responses I. Enhancing effect on the induction of delayed hypersensitivity in mice. Microbiol Immunol, 1979;23(6):501-513. http://tinyurl.com/ybnhw5kr

Moro G, Arslanoglu S, Stahl B, et al. A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age. Arch Dis Child, 2006;91:814-819.  http://tinyurl.com/y8gbytfn

 

You also mentioned viral load – if her health history indicates this then yes you may wish to look at testing. Lyme disease may also be relevant as well. Other triggers could include Chlamydia which can be tested via Regenerus labs.

So the first approach is really to look for underlying triggers. Stress of course could be playing a role too so you may need to support adrenal health. Hormone fluctuations could also be aggravating some of her symptoms.  While you wait for results you could still add in agents to lower inflammation, modulate response and support barrier function. Dietary wise consider a rotation diet – this is where people eat as wide a range of foods as possible but rotate it to avoid reacting to additional foods. This can be helpful if she is finding that more and more foods appear to be problematic. I would also consider using a digestive enzyme at this stage as well.

Zampieron, et al. Natural Support for Autoimmune and Inflammatory Disease Source: Journal of Restorative Medicine, Volume 1, Number 1, 1 September 2012, pp. 38-47(10) http://tinyurl.com/yb3mvka6

 

SUGGESTED SUPPLEMENTS

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.

Lower inflammation / Immune modulation

Arthred Collagen powder (ARG) – take 1tbsp three times a day – http://tinyurl.com/j2arfe4

KappArest (BRC) – take 2 with each meal – http://tinyurl.com/jms9v3n

Vitamin D3 Complete (ARG) – take 1 daily – http://tinyurl.com/jqx3ttt

EFA-Sirt Supreme (BRC) – take 2 with each meal – http://tinyurl.com/h3czc9x

Mycocyclin (ARG) – take 1 dropperful daily – http://tinyurl.com/gnukuvy

Probiotic support

Lactobacillus GG Culturelle (ARG) – take 1 capsule three times a day – http://tinyurl.com/zonwo4a

BioDoph-7 Plus (BRC) – take 1 capsule twice daily – http://tinyurl.com/hs3vsyr

Saccharomyces boulardii (ARG) – take 1 capsule twice daily – http://tinyurl.com/z27sdwn

Digestive enzyme support

Full Spectrum Digest (ARG) – take 1-2 with each meal

I hope this helps answer your question

Christine

 

[Author]

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