How to manage Food Allergies with Homoeopathy

Dr Shruthi Shridhar

Introduction
Food allergy is an immune system reaction that occurs soon after eating a certain food. Even a small amount of the allergy-causing food can trigger signs and symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life threatening anaphylactic reaction.

It is easy to confuse a food allergy with a much more common reaction known as food intolerance. While bothersome, food intolerance is a less serious condition that does not involve the immune system.

Causes
When you have a food allergy, your immune system mistakenly identifies a specific food or a substance in food as something harmful. Your immune system triggers cells to release antibodies known as immunoglobulin E (IgE) antibodies to neutralize the culprit food or food substance (the allergen). The next time you eat even the smallest amount of that food, the IgE antibodies sense it and signal your immune system to release histamine, as well as other chemicals, into your bloodstream. These chemicals cause a range of allergy signs and symptoms. They are responsible for causing allergic responses that include dripping nose, itchy eyes, dry throat, rashes and hives, nausea, diarrhoea, laboured breathing, and even anaphylactic shock.

Signs & Symptoms –

Food allergy symptoms usually develop within a few minutes to two hours after eating the allergen containing food. The most common food allergy signs & symptoms include –

• Tingling or itching in the mouth
• Hives, itching or eczema
• Swelling of the lips, face, tongue and throat or other parts of the body
• Wheezing, nasal congestion or trouble breathing
• Abdominal pain, diarrhoea, nausea or vomiting
• Dizziness, light-headedness or fainting

Anaphylaxis 

• Constriction & tightening of airways
• A swollen throat or the sensation of a lump in your throat that makes it difficult to breathe
• Rapid pulse
• Dizziness, light-headedness or loss of consciousness

Adverse Food Reactions 

Food Intolerance –

• Enzyme deficiencies – Lactase(primary or secondary), fructose(maturational delay)
• Gastrointestinal disorders – Inflammatory bowel disease, irritable bowel syndrome
• Idiosyncratic reactions – Caffeine in soft drinks (Hyperactivity)
• Psychologic – Food phobias
• Migraines – Rare

Food Factors –

• Infectious organisms – E. Coli, Staphylococcus aureus, Clostridium
• Toxins – Histamine (scombroid poisoning), saxitoxin (shellfish)
• Pharmacologic agents – caffeine, theobromine (chocolate, tea), tryptamine (tomatoes), tyramine (cheese)
• Contaminants – heavy metals, pesticides, antibiotics

Food Hypersensitivities – IgE Mediated

• Cutaneous – urticaria, angioedema, morbiliform rashes, flushing, contact urticaria
• Gastrointestinal – oral allergy syndrome, gastrointestinal anaphylaxis
• Respiratory – acute rhinoconjunctivitis, bronchospasm
• Generalized – anaphylactic shock, exercise induced anaphylaxis

Mixed IgE and Cell Mediated –

• Cutaneous – atopic dermatitis, contact dermatitis
• Gastrointestinal – allergic eosinophilic oesophagitis and gastroenteritis
• Respiratory – asthma

Cell Mediated –

• Cutaneous – contact dermatitis, dermatitis herpetiformis
• Gastrointestinal – food protein-induced enterocolitis, proctocolitis, enteropathy syndromes, celiac disease
• Respiratory – food induced pulmonary hemosiderosis (Heiner syndrome)

Unclassified –

• Cow’s milk – Induced anaemia

Diagnosis
Individuals with food allergy develop symptoms by eating foods that are simply part of a healthy diet for the vast majority of the population. The only way for the allergic individual to manage their condition is to avoid eating the food that causes the allergic reaction. Unfortunately, the public generally overestimates the number of people with food allergy. As a result many people avoid certain foods unnecessarily. Reliable diagnostic methods are required in order to avoid such unnecessary dietary restrictions.

The first step in the diagnosis of a food allergy involves a medical specialist taking a full clinical history, and performing a clinical examination. The clinical history is a detailed record of past allergic reactions and other allergic conditions, such as asthma, eczema and hay fever, and consideration of any seasonal or environmental symptoms. The clinical examination consists of a close look to see if there are allergic symptoms in the skin, eyes and nose. If the patient is asthmatic, the clinician may assess this by measuring measure peak flow. This information will help the specialist decide which tests are appropriate. The first test is usually a test for the detection of food-specific IgE antibodies. Skin prick testing and blood tests are the main tests used for this purpose. However, the presence of specific IgE does not necessarily mean that a person will experience symptoms. Therefore, it is normally necessary to perform a provocation or challenge test with the suspect food, which involves introducing the food to the patient in gradually increasing amounts in very controlled conditions. Challenge tests must be performed in a hospital or clinic, where any serious reactions can be safely managed. Before the challenge test is performed the patient needs to avoid the suspected food(s) for a period in order to be free of symptoms.

The specialist needs to consider the clinical history, the suspected food, the severity of the symptoms, and the availability of diagnostic reagents before choosing the diagnostic test(s). It is important that the specialist has access to well-documented tests. The specialist will interpret any test result in combination with findings from the clinical examination and the patient’s clinical history. For that reason it remains the case that accurate food allergy diagnosis is a specialized procedure requiring considerable clinical expertise. If a food allergy is suspected, diagnosis by a qualified medical practitioner who specializes in allergy is required. Self-diagnosis of food allergy is notoriously unreliable and highly over-reported, while the missed diagnosis of a serious food allergy could be potentially life threatening. Therefore, people who suspect that they have a food allergy should seek specialist medical advice.

Skin Prick Testing:
Skin prick tests are frequently used to screen for food-specific IgE as they can be performed at the first visit and the results are ready available. Furthermore, skin prick testing is cheap. The test is usually safe even in case of severe nut allergy as the method introduces a very small amount of allergen just under the outer layer of the skin. A tiny prick is made with a 1mm lancet through a drop of allergen extract placed on the skin, usually on the forearm. The drops are then wiped away carefully. The site where the allergen was introduced may then become red and swollen with a raised wheal in the centre that looks like a nettle sting (= positive response). The weal may enlarge and reaches its maximum size within 15-20 minutes, after which the diameter of the wheal is recorded. The reaction fades within an hour.

A negative response usually means the patient is not sensitised to that allergen. But skin prick testing for food allergens may be unreliable and “false negatives” can occur:

1. Where the reaction to food is not immediate.
2. If the patient is taking drugs containing antihistamines. These should be stopped five days before testing. Drugs containing antihistamines prevent histamines from attaching to your cells and causing symptoms.
3. If the allergens in the extracts are unstable as is often the case for fruits and vegetables. In these cases, skin testing with native foods by the prick-prick technique is much better, but not standardized and possibly less safe. In this test, the lancet is plunged several times into the food immediately before pricking the patient’s skin.

A positive response usually means the patient has IgE antibodies to that allergen. However, a patient may have a positive skin test but suffer no symptoms when coming into contact with the allergen. Positive skin tests may e.g. occur after sensitisation but before an individual has experienced allergic symptoms to a food. People may also still have positive skin tests to foods and inhalants, even when they have grown out their allergy and no longer have an allergic reaction when they eat a previously offending food.

The skin prick test is a good method to rule out a food allergy to egg, milk, peanuts and fish in children. But a positive result may need to be confirmed with a challenge test. A positive result in skin prick tests with fruits and vegetables also may need to be confirmed with a challenge test.

Blood tests:
Several types of blood tests are available to test for food allergies. A blood sample has to be taken from the patient and analysed in a well-equipped laboratory. Therefore the results of the blood tests are not available immediately. Unlike for skin prick tests, antihistamines do not interfere with blood test, which means that the blood tests can be used in patients with severe allergic symptoms from e.g. the skin without stopping the intake of antihistamines.

The idea with most of the available tests is to measure the amount of IgE in the blood that can bind to specific food allergens.

Homoeopathic Remedies For Some Common Food Allergies –

• Banana – Coffee, Ignatia, Kali Phos, Nux Vomica, Rumex
• Chicken – Bacillinum, Bryonia
• Dal – Calcarea Carb, Lycopodium, Pulsatilla
• Egg – Calcarea Carb, Cinchona, Colchicum, Ferrum Metallicum, Ledum, Lysinnum, Pulsatilla, Sulphur
• Fish – Fluoric Acid, Kali Sulph
• Gluten – Aluminum Acidicum
• Honey – Natrum Carb, Phosphorus
• Milk – Aethusa, Arsenic, Lac. Defloratum, Mag. Sulph, Natrum Carb, Psorinum, Tuberculinum³⁺
• Mutton – Lysinnum, Lecithin mother tincture
• Onions – Carcinosin, Lycopodium, Sulphur, Thuja
• Peanuts – Molubdinum
• Raisins – Ipecac
• Rice – Ignatia, Kali, Natrum, Pulsatilla, Sulphur, Tellurium
• Tomatoes – Oleander mother tincture

Dr. Shruthi Shridhar – M.D. Part I
Department of Organon of Medicine & Homoeopathic Philosophy
Dr. G. D. Pol Foundation’s Y.M.T. Homoeopathic Medical College P.G. Institute & Hospital.