Delayed Food Allergies - The Allertol® Method
“Let your food be your medicine, and your medicine be your food.”
Roman father of medicine, Hippocrates, 400 B.C.
“What is food to one man is bitter poison to others.”
Roman healer and philosopher, Lucretius, 50 B.C.
“There is no love sincerer than the love of food.”
Irish poet George Bernard Shaw, 1903.
“The food you love most in life, may not love you back.”
Texas physician John P. Shea, M.D., 2008.
Delayed Immune Responses
Delayed immune responses to food will be described here as chronic food allergies or delayed food allergies. They usually occur hours after eating or drinking, but can begin to occur before the end of a meal. Watch repeated sneezing in a restaurant for example. Anything ingested can be a culprit, but dairy products seem most common. Food and drink addictions are most commonly associated with delayed food allergies.
Unlike the immediate food allergy reaction, which can result in severe sudden reactions including anaphylaxis and death, the delayed food allergy reaction results in less severe and more chronic reactions. And unlike the immediate reaction, which is caused by an antibody called IgE, the delayed reaction is felt to be the result of other immune system mediators, including T cells. Immediate, severe food allergies can be tested reliably with Immunoglobulin E ( IgE) blood test, but there is not a consistent blood test for delayed food allergies, and skin testing may produce inconsistent results.
Delayed food allergies are often “hidden” in the diet, and seldom suspected. The patient will often state “I can’t be allergic to that; I love it and have it all the time!” And the delayed food allergy patient may be allergic to many foods with different and confusing reactions. The immediate food allergy patient becomes acutely aware of which food must be avoided, and experiences the same set of severe sudden symptoms. An example is severe asthma within minutes of eating peanut, a tree nut, fish or seafood. Allertol® is not used for these life-threatening food allergies.
Like allergy shots, the allergy drops use FDA approved antigen extracts to create a custom made solution. In the United States, millions of patients have received benefit from allergy drops. In some areas of Europe, sublingual immunotherapy is used more often than shots. Much like a series of allergy shots, allergy drops are used to gradually change the immune system over a period of several years.
Listed below are some of the most common questions and information about food allergies. Click on a question to see content. Click on the questions again to hide the content.
They are drops of offending allergen, food or inhalant, placed under the tongue, creating allergen tolerance.
Receptors under the tongue called dendritic cells detect molecules in the allergy drop solution and present them to immune system T cells. These T-regulatory cells induce and maintain tolerance to antigens, and can prevent development of future sensitivities. They do this by training the immune system to tolerate foods by a process called "down regulation". The immune system is taught to become more tolerant of food molecules in the allergy drop solution. This results in significant symptom reduction and less need for medications.
Allergy drop therapy has been safely administered in the U.S. and in Europe, with no fatal reactions. A literature review by Southwestern Medical School in Dallas, revealed no severe life-threatening reactions in 15 consecutive years of allergy drop therapy worldwide.
Allergy drops can prevent the development of asthma in children who are asthma-prone. Studies have shown that the development of asthma is many times less likely to develop in children that receive allergy drop therapy. This preventative effect lasts for years after completion of treatment with the drops. Because allergy drops are painless, they are ideal for use in children, and have received by children as young as 2 months of age. Long-term compliance is over 95%.
As noted by the World Health Organization and the Cochrane Study Group out of London, sublingual immunotherapy (SLIT), or allergy drops, have been shown to be a safe and effective alternative to allergy shots, subcutaneous immunotherapy (SCIT).
Sublingual testing is done by simply placing a solution of suspected foods under the tongue. If you are experiencing chronic symptoms all year that are indoors as well as outdoors, you will be tested with foods that are common in your particular diet, especially daily food favorites.
1) Benefits: symptom reduction, limiting need for medications, doctor visits, and surgery, increasing quality of life.
2) Risks: temporary exacerbation of typcial food allergy symptoms.
3) Alternatives: continued medical management and food avoidance elimination diet.
You may want to keep a diet diary of what you eat and drink on a typical day, and note anything you seem to have frequently and to excess. Try to omit those foods to which you are addicted 4 days, and reintroduce. Note symptom changes. For example, chronic delayed allergy to dairy is common, so if you crave milk or cheese, try giving up all dairy products for 4 days, then re-introduce.
Dairy products are common culprits. Symptoms include nasal blockage while trying to sleep with dry mouth and snoring, frequent nose blowing, repeated sneezing, chronic throat clearing, headache, wheezing/coughing spells, chronic fatigue, IBS-diarrhea, trouble swallowing with middle of the back itching, chronic skin itching, rashes, intermittent ear fullness and buzzing tinnitus with dizziness, chronic sinus and ear infections.
A detailedreview of systems, multisystem symptom history, will indicate the likelihood of presence of delayed food allergies and also provide a treatment guide. Sublingual evaluation and treatment of chronic delayed food allergies is carried out. Upon initial symptom improvement, sublingual immunotherapy with custom made allergy drop solution is provided. The drops are then slowly tapered to one drop at bedtime. When symptoms of delayed food allergy have resolved for a year (allergen tolerance), the drops are discontinued.
In less than 10% of patients the delayed food allergy is not revealed by inital multi-food SLIT testing. Then it becomes necessary to discover other potential culprits such as coffee, tea, NutraSweet, preservative etc. Elimination diet is then recommended, to evaluate these possibilities.
As an alternative to the Allertol® Method of testing multiple foods, standard elimination diet can be done by removing the suspected food from the diet 4 days, followed by reintroducing the food on the 5th day, watching for symptoms to reappear. Returning the food to the diet has been called a "food challenge", but the real challenge is trying to remove a favorite food from the diet when "that's in everything I eat!"
The rotation diet is another time-honored method of finding the food that is causing chronic symptoms, and preventing development of new food sensitivities. Eat the suspected food only every three or four days.
Allergy drops are used three times a day. A drop is placed under the tongue first thing in the morning, at mid-afternoon, and at bedtime.
Severe, anaphylactic allergy is not treated with allergy drops. A past history of severe immediate allergic reaction, a severe medial illness, or pregnancy may preclude use of allergy drops. A history of glycerin sensitivity may be a contraindication to use of the drops, however this problem usually improves gradually with continued use of the drops.
Allertol® is not used to prevent or treat immediate life-threatening allergy /anaphylaxis.
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Shea, John P. MD Otolaryngologist
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