Food Allergy, Gluten Sensitivity and Celiac Disease

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FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, January 21, 2014
Food Allergy, Gluten Sensitivity and Celiac Disease Personal Viewpoint by Ralph Campbell, MD
(OMNS Jan 21, 2014) What may have been called food intolerance or food sensitivity in the past may
now qualify as food allergy. On the other hand, certain conditions which mimic allergy symptoms
should not come under that umbrella. We need an understanding of food allergy before successful
management can be accomplished. There are no quick-fix remedies.
We tend to categorize by symptomatology, which accounts for the overlap of intolerance, sensitivity
or true allergy: 1) nasal symptoms of stuffy nose and sneezing; 2) bowel symptoms of intestinal
cramping or gas; 3) lung symptoms of wheezing and 4) skin that itches or produces a rash.
What is and Allergy, Really?
For decades, allergists have considered what we might call an allergic reaction to be a true allergy
only if it is of the Th2 type (a type of immune cell) that produces measurable IgE antibodies. The
other type, Th1, produces tissue antibodies that protect against infection. When a baby is born, it no
longer has the protection of mothers antibodies, making it vulnerable to infectious diseases. The
infants immune system can take either route: the allergy pathway or the fight infection pathway.
Residing in our cell membranes are hormone-like substances called prostaglandins. Treatment will
be addressed later, but for now we need to understand a bit about good fatty acids vs. bad to see
how the choice is made. Omega-6 fatty acids (as derived from grains), incorporated in a
prostaglandin, leads to the allergy pathway, whereas the omega-3 fatty acids (plentiful in fish oils) in
a prostaglandin influence the development of the Th1 antibodies.
Heredity seems to play a part in the predisposition to develop allergies as well as the mechanism I
just described, which is more nurture than nature. The predisposed cell, upon exposure to a food
allergen (antigen), produces IgE antibodies which attach to mast cells. With further exposure, the
food antigen (a protein in the food) reacts with the IgE type of antibody causing mast cells to
breakdown and release histamine. It is the histamine, for the most part, that produces allergy
symptoms. The food protein that remains intact by somehow escaping denaturing from heat or
digestive processes, can become an antigen by sneaking into the blood stream via the leaky gut
syndrome (the descriptive term for a porous gut) enabling distribution to cells in the nose, lungs or
skin. For the gut, symptomatology may include colic-like cramping, mucus (even bloody mucus) in
the stool, or irritable bowel syndrome that can produce either diarrhea or constipation. Nasal
mucosal lining sensitization produces a stuffy, itchy nose or sneezing, while skin sensitization is
manifest as eczema or topical dermatitis (both produce itching). Food allergens play a prominent
part in wheezing; but so can irritants in the air, infection, and even exercise. The preservative,
sodium sulfite, although certainly not a food itself, commonly contributes to wheezing and nasal

symptoms.
I put allergy reactions into two categories: rip-snortin,' and those fitting Dr. William G. Crooks
description of hidden allergies. (Dr. Crook was a pediatric allergist and a pioneer in the science of
food allergy.) Under the first category, I would include sneezing, wheezing, vomiting, intestinal
cramping, hives and life-threatening, angioneurotic edema. The hidden allergies are manifest by a
plugged up, itchy nose, runny nose with post-nasal drip causing a rattly cough, or mild abdominal
cramping with mucus in the stool. Exposure to more than one allergen at the same time may create
symptoms where a single exposure will notthe important concept of allergy load.
The severe reactions are clearly IgE antibody related, for which there are reliable tests. Even though
there is documentation of milder allergies being on a different immune basis, this is given little
attention, especially in infants with cows milk allergy and the fact that they are often outgrown
without the benefit of treatment.

Detection and Treatment

In a recent, very detailed study (1), a few workable, simple concepts come through among a maze of
immunology jargon that only a few can comprehend. They contend that food allergy is increasing
due to taking the Th2 pathway. A September 17, 2013 Reuters Health article by Lorraine L. Janeczko
reports the findings of Dr. Peter Gillet, a gastroenterologist at the Royal Hospital for Sick Children in
Edinburgh. He feels there has been a 64% rise in food allergy over a twenty year period, there. Also
America and several other countries are showing large rises. The rate of rise is much greater in a
more recent five year period. However the increase is attributed to more awareness and more
testing in which only IgE mediated allergy is accepted. This leaves me to believe there are many
more undetected cases out there.
The immunology study describes different types of tests, including the old standard of the prick or
scratch skin test in which an antigen is scratched into the skin where the formation of a hive-like
wheal is proof of allergy. They are taking new looks at old tests and treatment that were rejected in
the past: oral specific, the regular and gradual administration of escalating doses and sublingual, in
which the antigen rapidly enters the blood stream. In desensitizing a patient to a potent antigen,
such as peanut, these methods are undertaken in the presence of a doctor who is prepared for the
worst. Intricate immune pathways are presented in the article. The good news comes from the
admission that they are far from understanding the complex mechanisms leading to the successful
results in allergen-specific immunology. We dont need to hold our breath while waiting for the full
development of the new paradigm, but rather, utilize what we already know that works. A further
admission is that the gold standard for testing for food allergy still is the oral challenge. This is
strengthened by observing the short-comings of some of the tests in which the test occasionally may
be negative, but the patient can still have a bad reaction with future contact. The flip side is that the
test may be positive, but the patient has no clinical signs of allergy after exposure.
I know that for the pediatric population the elimination-and-challenge test is totally adequate and
reliable for detecting food allergies and items like food colorings and other food additives.
Remember that
Symptoms arise within 2 hours after ingestion for most allergy problems, and that burning and
itching sensations in the mouth or palate come immediately.Make a list of everything ingested that
brings on those symptoms. Find commonality from your lists that leads to suspects.Withdraw the

suspects from the diet and note whether the allergy symptoms disappear.If adding back the suspect,
one at a time, causes a return of symptoms, you have nailed a suspect. After a time of freedom from
a reaction, periodically present a small, isolated challenge to see if the problem is still there. If not,
reintroduce the food by gradually increasing doses.
Real Help with Vitamin C
Histamine, released in an allergic reaction, is the main chemical responsible for symptoms.
Antihistamines are commonly prescribed. As with most medicines, there are side effects, most
commonly drowsiness. Newer antihistamines claim to have less of this effect and to diminish
symptoms better, but my personal experience does not bear this out. Response to these drugs is on
an individual basis and varies. Fortunately, there is a natural remedy, without side-effects, that
really works. That is vitamin C, due to vitamin Cs ability to neutralize histamine. The minimal
amount in a daily multivitamin or an orange wont do the trick, but for many adults 2,000 mg every 2
hours until symptoms subside, will. I have had this experience with my patients. According to
weight, scale down the amount, but dont hesitate to give repeated doses if the initial dose doesnt
finish the job.
Not Allergy, but Allergy Look-Alikes
Certain foods, such as red wines (with or without sulfites) and moldy cheeses create histamine
release that is not on an allergy basis. Infection in the respiratory tree can create similar symptoms.
No one is allergic to running, but in some, exercise triggers wheezing.
Lactose intolerance may cause intestinal distress of gas and mild cramping, similar to that derived
from food sensitization, and act much like irritable bowel syndrome. Interestingly, there is a strong
familial tendency for its development. Those of Asian decent are much more susceptible. Although
straight cows milk is poorly tolerated, the good news is that milk treated with lactose digesting
probiotics, such as Lactobacillus acidophilus, is youtube.com/watch?v=YtKPS5FXsWk well tolerated.
After weaning, many Asian infants go on to some form of fermented milk.
Gluten Sensitivity and Celiac Disease
Dr. Tom OBryans article, The Conundrum of Gluten Sensitivity, published in the National Health
Federations publication, Health Freedom News, showed that he had done his homework concerning
the newer diagnostic tests that are providing a new look at gluten sensitivity as well as out-and-out
celiac disease. He also described signs and symptoms of celiac disease outside the intestinal tract,
which broadens its scope. I wish to provide a different slant on the subject that is derived from a
pediatric point of view that extends from old time through current technological advances.
In my pediatric practice, I saw and successfully managed many cases
http://www.johnmooreservices.com/ac-repair of wheat allergy. At the same time, I had only one
patient with classic celiac disease: a scrawny infant with the pathetic, heart-rending look of
starvation and a flat area where his buttocks should be; a picture right out of the textbook. The best
and only diagnostic tool for food allergy at that time was the food challenge. In the previously
mentioned article in Immunotherapy by Enrique Gomez et al, the oral challenge was said to be the
current gold standard as well. When positive, the infant/toddler was kept off of wheat for a time and
periodically challenged, since wheat allergy, and the even more common cows milk allergy, were
known to clear spontaneously after a period of abstinence. Besides intestinal allergy symptoms, an
infant with wheat allergy often exhibits nasal allergy signs which appear very shortly after ingestion
of the allergen, making the relationship obvious.

I see a continuum of simple allergy to the auto-immune condition of celiac disease. I cant agree that
it isnt celiac disease until the intestinal villi are completely destroyed. It is a process. True, once the
immune system response is under way, the only way to stop it is to refrain from intake of any of the
gluten-containing grains. Intestinal biopsy that searches for destroyed villi is the only reliable test.
Discovering the multiple double-, triple- or polypeptides of gluten can lead to lots of tests. Since
there are false negatives as well as false positives results to the tests, and all require blood-letting,
even if I had had access to them, I would have not employed them.
Scientific curiosity drives us to look for the precise causes of disease. But if the motive for such
specificity is to enable developing target patentable pharmaceuticals, it would be better not to look.
Avoiding the antigen does the job well enough.
Diagnoses Increase
What I am seeing, especially in well-educated young people who have computer savvy, is selfdiagnosis of gluten sensitivity derived from bombardment by the press, the Internet highway and TV
news. It seems to be the in vogue diagnosis to have. An industry (much like the cholesterol industry)
of gluten-free foods is springing up. It is difficult to motivate the gluten-free adherents to obtain
differentiation between simple wheat allergy and celiac disease. What has happened?
Dr. OBryans article and the Enrique Gomez article referred to above, agree that there has been a
marked increase of incidence in the last few decades. A 2010 Medscape article referred to a Mayo
study by Joseph Murray in which they analyzed stored blood samples of Air Force recruits in the
1950s for gluten antibodies. These antibodies were practically non-existent in the 50s samples but
the article mentioned a large increase in incidence in the last three decades. Auto-immune diseases,
in general, are on the increase. I believe that at the heart of these problems is the way we abuse our
immune systems by direct attacks and nutritional deficiencies. Both diets and environmental toxins
exposure have changed exponentially since the 50s.
Most current diets are very deficient in the vitamins that are essential as co-factors of enzymes that
keep our metabolic wheels turning. Recommended Daily Allowances (RDAs) are barely able to
prevent classic deficiency diseases like rickets or beriberi. I could fill pages with citations about the
effect of environmental toxins on the immune system. A recent boon for those who treat allergy
problems has been the gain in knowledge of omega-3 fatty acids (FAs). Whether the young immune
system takes the Th1 pathway or the Th2 pathway that produces measurable IgE antibodies which
mark big time allergies, is largely determined by the ratio of omega-6 FAs to omega-3 FAs. Rather
than having closer to the ideal of 2:1, current diets create a ratio more like 20:1.The make-up of our
prostaglandins (hormone-like substances in cell wallsready to spring into actionis determined by the
essential fatty acids in the mix: those provoking inflammation and clumping of platelets or those
doing the opposite. The leaky gut syndrome concept is getting some new, deserved attention. Just
what causes the gut permeability that can allow whole proteins to sneak from the gut into the blood
stream and promote the antibody formation of simple allergy or auto-immunity in which the
antibodies mistake normal body cells as foreign invaders?
Conclusion
We might keep trying to satisfy our scientific curiosity by seeking to pin-point the causes of food
allergy, and auto-immune diseases that can be documented by specific tests. But should we wait for,
or expect to be able to rely 100% on, new tests while other more straightforward, proven diagnostic
tools are available? Lets not get bogged down with minutia. Rather, let us attempt to get straight,
understandable information to the public that possibly could get them on a helpful, less cumbersome

and less expensive track. Immune systems arent functioning like they used to. A tangible effect is
noted with antibody levels in response to various vaccines that are producing antibody levels well
below the expected. I feel that the rapid rise in auto-immune diseases is getting away from us. Too
often, drugs are not meeting our expectations. Let us concentrate on ways to improve immune
health while continuing to identify the agents that weaken our immune systems. Immune health
cannot be isolated from general health. Since it is nearly impossible in our culture to achieve a
completely healthy diet, the intake of optimal amounts of vitamin supplements is essential.
(Dr. Ralph Campbell, board-certified in pediatrics, is also an octogenarian orchard farmer. He lives
and works in Montana.)

References:
1. Gomez E et al. Immunotherapy, 2013,
5(7): 755-768
http://www.ncbi.nlm.nih.gov/pubmed/?ter
m=Immunotherapy%2C+2013+5%287%2
9%3A+755-768+Gomez
For further reading:
Campbell R, Saul AW. The Vitamin Cure for Childrens Health Problems. Laguna Beach, CA: Basic
Health Publications, 2012.
Downing D. The Vitamin Cure for Allergies. Laguna Beach, CA: Basic Health Publications, 2010.
Nutritional Medicine is Orthomolecular Medicine
Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more
information: http://www.orthomolecular.org
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