PREVENTIVE ASTHMA MEDICATION: IMMUNOTHERAPYThis is another area of treatment which excites considerable debate among the medical profession. Despite the fact that immunotherapy is accepted in the general treatment of certain allergies, it is still one of the most controversial areas of asthma therapy. Some of the reasons for this are:•The effects of immunotherapy treatment tend to be are inconsistent from one patient to another;• It is not possible to predict how long immunotherapy treatment will block an allergic response to a particular allergen;•It is possible to have a positive response to an allergen which may not be the cause of asthma;•Immunotherapy can be dangerous if not practised under professional supervision.But regardless of these problems, immunotherapy remains a viable option for carefully selected patients. If asthma triggers are identified as strongly allergic in origin and skin or blood tests support sensitivity to an allergen which responds well to immunotherapy, then it is very likely that immunotherapy will reduce the frequency and severity of asthma attacks.Immunotherapy attempts to neutralize the effects of allergens. The treatment consists of a long-term series of injections containing a gradually increasing amount of allergen extract. If a patient is highly allergic, the doctor increases the allergen doses very slowly over a longer period of time. Some allergic asthmatics report long-lasting improvement after immunotherapy, others report symptoms returning after stopping the treatment.Despite the continuing debate as to its effectiveness, immunotherapy is regarded as a viable preventive measure by a growing number of doctors as well as allergy prone asthmatics. While undergoing immunotherapy courses, it is usual for asthmatics to remain on their standard medication program.*22\148\2*

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Nothing can reproduce the taste of eggs, but some other foods can mimic their cooking quantities. In puddings, where they are used to ‘set’ a liquid, gelatine is a useful substitute. You will have to experiment with each recipe, but one teaspoon of gelatin is roughly equal to one egg. Dissolve the gelatin in water before adding to the other ingredients. In biscuit recipes, one egg can be replaced by 2 tablespoons of water, 1 tablespoon of vegetable oil and ? teaspoon of baking powder. Commercial egg-replacers and egg-white replacers are also available.

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Coffee and tea, including coffee-flavoured cakes etc Chocolate, cocoa and all chocolate-flavoured items Coca-cola, Pepsi-cola and other cola drinks

Sugar and any foods containing sugar. Don’t worry if you eat a small amount (eg in tinned tomato soup) during Stage 1. On Stage 2 and 3 you need to be much more careful.

Saccharin and other artificial sweeteners

All alcoholic drinks, including alcohol-free beers and foods cooked in wine, beer etc. Don’t eat too much vinegar or pickled foods – no more than a small portion twice a week.

All colourings, preservatives, antioxidants, flavour enhancers, flavourings, thickeners, emulsifiers, stabilizers and other additives. Anything identified by an E-number: some of these are natural ingredients, but that does not mean they are automatically safe, and at this stage it is easier to just avoid the lot. Read the labels on everything – don’t be taken in by ‘Natural’ or ‘Healthy’ on the packet. Some unlabelled food contains additives (see p305). Remember that margarines contain colourings and are highly processed – any food like this should be avoided. So should bacon, ham, corned beef and anything smoked.

Continental sausages and very ripe cheeses – they are often a rich source of histamine.

All take-aways and fast food. Keep restaurant-eating to a minimum because there are a lot of unexpected additives in such meals. Anything that makes the gut more permeable: curries and other very spicy foods, raw pineapple and papaya, aspirin and other NSAIDs. At the same time, you should try to eat plenty of fresh vegetables and fruits. Green leafy vegetables are particularly important, and salads are valuable. Choose fresh meat or fish rather than pies, sausages or fish-fingers (even if these are additive-free).

If you have been eating bran, gradually cut this out (your bowel may need time to adjust so don’t do it suddenly). A daily intake of vegetables, potatoes, wholemeal bread and fruits should supply all the fibre you need. Try to eat less salt, and avoid highly salted foods such as peanuts and crisps. Keep your diet varied, don’t eat too much at one sitting, and don’t have huge amounts of a single food.

If you drink a lot of coffee or tea, cut it out gradually or you may get withdrawal symptoms. Avoid painkillers that contain caffeine. Other medicines may contain colourings – ask you doctor to prescribe uncoloured equivalents.

Decaffeinated coffee and tea are not allowed. Herb teas can be used to replace tea and coffee, but not mate (or matte), which contains some caffeine and tannin, nor redbush tea, which shares many chemical constituents with ordinary tea, even though it lacks caffeine. Jasmine tea, gunpowder tea and other ‘green teas’ are true teas so these should not be taken.

Stay on this diet for at least a month, unless you feel much better before then.

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Digestive enzymes are mostly found in the gut, where they break food down into smaller molecules (see p20). The purpose of digestion is to reduce food molecules to their basic building blocks, which can then be used by the body to construct its own molecules – rather like demolishing an old house and then using the bricks to build something else. There are also some digestive enzymes (mostly protein-splitting enzymes) within the gut wall and in the liver: these complete the digestion of food molecules after they have been absorbed.

Detoxification enzymes are charged with destroying or disarming all the toxins that get into our bodies. Some of these toxins are found in food, where they mostly serve defensive purposes (see pl5). Others are produced by the bacteria living in our gut – the gut flora. To add to this ‘natural’ load, there are a variety of synthetic substances that have to be detoxified, including alcohol and nicotine, medicinal drugs, food additives, and pesticide residues in food. Most of the body’s detoxification enzymes are found in the liver, but there are also some in other parts of the body, such as the surface of the blood platelets – the tiny ‘cells’ in the blood that help it to clot.

Detoxification enzymes respond to the body’s particular needs – if more toxin is taken in then more of the appropriate enzymes are produced to cope with the added load. An obvious example of this is alcohol – the more we drink, on a regular basis, the more it takes to feel inebriated. Give up alcohol for a few months and a half of shandy is enough to make you tipsy. In effect, the body has become much more sensitive to the effects of alcohol, because the liver has scaled down its production of the necessary detoxification enzymes.

Although this works for alcohol, it is by no means certain that it works for all toxins – with some toxins, the body may only have a limited capacity to cope with them, and increasing the load may not increase the detoxification enzymes. Even with alcohol there is a limit – the task of detoxification eventually becomes too much for the liver, which begins to fail. When this happens, the vital role that the liver normally plays becomes apparent – alcoholics suffer badly from the effects of natural toxins, especially those produced by gut bacteria, which they can no longer detoxify.

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Eat plenty of freshly-crushed garlic, as this is thought to combat yeasts in the gut. Fresh herbs, and green leafy vegetables, such as spinach and ‘greens’, are also recommended as they contain anti-fungal agents. It may also be worth trying a herbal tea, called taheebo or pau d’arco – it is said to have anti-fungal properties, although this has not been verified scientifically. Eating live yoghurt may also be worthwhile as it contains some of the ‘useful’ members of the gut flora, and may help to reestablish a healthy balance among the inhabitants of the gut.

Giving up fruit may make you concerned about Vitamin C deficiency, but if you eat sufficient quantities of fresh vegetables this should not be a problem. Cabbage, broccoli and brussels sprouts are rich in Vitamin C, and potatoes are a valuable source. It is important not to soak potatoes, as this leaches out the vitamin, and not to overcook cabbage and other green vegetables, as heat gradually destroys Vitamin C. Rosehip tea is also an excellent source of this vitamin, as is fresh lemon juice, which is permissible on this diet as it contains little sugar.

Again, you should stay on this diet for at least a month, and longer if you begin to feel partially better. If there is a good improvement on this diet, fruit and other excluded foods can be gradually reintroduced later, but not sugar. If you feel worse on this diet, then you may have food intolerance – to eggs or cheese, for example.

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This book deals with both food allergy (Jane’s problem) and food intolerance (Susan’s problem), but it concentrates most attention on food intolerance, since this is the area that has been sadly neglected by conventional medicine.

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If so, you could be one of the millions of people – primarily women – with allergies to something in their cosmetics. And ‘cosmetics’ means face creams, lotions, rouge, blusher, powder, eyeliner and shadow, lipstick, nail polish and polish remover, as well as nail lengtheners, shampoos, hair dyes, hair waves, hair straightness, hair removers (depilatories), shaving cream, perfumes, cologne, sachets, bubble baths, douches, mouthwash, toothpaste – even dentures!

It’s easy to see why cosmetics and other personal grooming products are the most common cause of skin reactions. They’re usually applied daily, directly to the skin. And, as we mentioned in earlier chapters, chronic exposure breeds allergy. Also, over 5,000 different chemicals and compounds go into these products – as bases, dyes, fragrances, preservatives and the like – multiplying the odds that something is going to disagree with you, no matter how minuscule the amount.

No wonder one doctor estimates that 85 per cent of people who are allergic to cosmetics don’t even realize which substances are causing the problem. Where do you start?

With creams and lotions. These accounted for almost half of all allergic reactions in a study of seventy people sensitive to cosmetics, according to Dr Schorr. It’s not that creams and lotions are any more allergenic than other products, he says. People simply tend to apply them to already irritated skin -which is more prone to react. And they use them all over their body.

An American study of cosmetic reactions found that the most frequent reactions were to: deodorants/antiperspirants, depilatories (hair removers), moisturizer lotions, hair spray, mascara, bubble bath, eye cream, hair colour, dye or lightener, facial creams or cleansers and nail polish – in that order.

Is a woman with cosmetic allergies dreaming if she hopes to wear makeup? Must men swear off all grooming aids? Not at all. They merely have to choose products carefully and apply them with extra care.

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Sounds great. Except for two problems. While repellents turn off biting insects, they attract some bees and stinging insects. And some people may be more sensitive to the chemicals in repellents than they are to mosquito bites themselves.

To get around those problems, some doctors recommend taking tablets of thiamine (à Â vitamin) as an internal insect repellent. It seems that when we consume large quantities of thiamine, some is excreted in our perspiration, creating an odour that repulses bugs. (Humans can’t smell it.)

In addition, you can wear light-coloured clothing (such as khaki or tennis whites), with long trousers and sleeves to expose as little skin as possible. Put up good screens, Discourage mosquitoes from breeding by eliminating, filling in or draining watery areas around your house: rain barrels, old cans and tires, stagnant puddles, ditches, hollow trees and stumps, and marshy ground. Install an electronic bug zapper near your front door or in the garden. Or buy non-toxic insect traps.

Delayed reaction to stings or bites

Headache. Malaise (general uneasiness). Hives. Aching joints. Lymph gland involvement.

Psychological reaction

Rapid heartbeat. Rapid, shallow breathing. Weakness. Dizziness.

You should consult a doctor without delay -

• when a local reaction exhibits undue swelling covering two joints of leg, arm or hand, or when a sting causes swelling in the throat, nose or eye, particularly the latter. A sting close to the eye should be seen by a doctor because resulting complications can threaten eyesight.

• when a sting results in symptoms of a generalized systemic reaction, no matter how mild.

• when multiple stings produce signs of a toxic reaction.

• when the swelling accompanying a normal or local reaction persists. (Infection may have set in.)

• when symptoms of a delayed reaction appear.

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‘I almost always prescribe air filtration,’ says Dr Boxer. ‘I feel it’s helpful. I’ve seen asthma patients who were helped immensely by just using an air filter.’

‘Air filtration is certainly a very natural way of controlling symptoms,’ says Dr Falliers. There are dozens of products, and each has to be examined for what it does and doesn’t do.’

Air filters may be installed in the ductwork of either your warm-air furnace or air conditioning system. Or you can buy portable models that sit anywhere in the room. Or even hook up to the cigarette lighter in your car. Portable units can sometimes be rented.

Activated Charcoal Filters. The odour-eating capacity of activated charcoal varies with the humidity and temperature of the air in the room, the concentration of fumes and the type of odours in the air. Dr Guy O. Pfeiffer, of Mattoon, Illinois, studied activated charcoal filters and found that they’re generally pretty good for absorbing cooking and food odours (even from burned dinners and foods such as garlic, onions, cheese and citrus); cigarette and tobacco odours; diesel and petrol fumes; smog and ozone; and the odours from pets, mothballs and perfume. Charcoal is slightly less powerful against pollen, coal smoke, mildew, chlorine, fish odour and some noxious gases. And it’s useless against carbon monoxide and formaldehyde. Installed piggyback with another type of filter, however, charcoal can be helpful; one catches what the other misses.

Electronic Air Cleaners. The most common type of electronic air cleaner is the electrostatic precipitator. Until a few years ago, electronic air cleaners were standard equipment for treating asthma and respiratory allergy. They act much like an electromagnet for air pollution: a fan draws in particles, zaps them with an electric charge and collects them on a plate. The charged particles are supposedly taken out of circulation. However, J. Gordon King, a consultant in air contamination, writes that although electrostatic precipitators are popularly advertised as being 95 to 99 per cent efficient, they’re not. In reality, says Mr King, electrostatic air cleaners available for home use rarely trap more than 80 per cent of the particles in the air. What’s worse, efficiency can drop to as low as 20 per cent within a short period of time – especially for bigger particles like pollen (Respiratory Care).

That means electrostatic air cleaners are no more effective than putting a sheet of gauze over your mouth. And the charged particles that escape the filter build up on walls and furniture faster than if no cleaner was used at all. To top it all off, all electronic air cleaners produce ozone, a highly toxic gas which causes headaches in some people. So you may not want to bother with them at all.

HEPA (High Efficiency Particulate Air) Filters. These filters work a lot better than electronic air cleaners. Air that’s been cleared by a HEPA is free of 99.97 per cent of all contaminating particles, according to the US National Bureau of Standards. That’s about as clean as you can get in today’s environment. And they maintain their efficiency throughout their operating life of two to five years. HEPA filters work well against pollens, moulds, yeast and other fungi, bacteria and viruses – a boon to allergy sufferers prone to frequent colds and flu attacks. HEPA filters have been known to relieve hay fever and asthma symptoms within ten minutes to half an hour. When potassium permanganate or activated charcoal is added, an HEPA filter can clear the air of jumbo particles like dust and pollen as well as minute chemical odours.

HEPA units with metal casings are better for chemically sensitive people than units with casings made of pressboard (which contains formaldehyde) or plastic.

HEPA filters did wonders for reducing nightly asthma attacks for asthmatic children at a summer camp in West Virginia, according to the camp’s medical director Dr Merle S. Scherr. In his report, Dr Scherr emphasized that HEPA units are an important part of treatment of allergic asthma (West Virginia Medical Journal).

HEPA units are also a godsend for preventing nightly asthma attacks for asthmatic children at home in winter. Normally, cold nights require furnaces to work harder, so furnace fans circulate more dust – and trigger more asthma. But when HEPA filters were tested on eighteen children with hard-to-control asthma, the children collectively logged 140 nights of undisturbed sleep with use of the filter, as compared with only forty-five peaceful nights without the filter. ‘This … not only relieved the parents of having to get up in the night and care for these children,’ say the researchers who conducted the study, ‘but we feel that the child, if well rested, felt better, performed better during the day and was probably more resistant to illness.’ Several of the children were also able to cut down on their asthma medicine, and they no longer missed any school (Annals of Allergy).

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