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I have not visited this site for awhile because I was starting to get really discouraged listening to all the things that people were having to do to live with IBS. Since then I have been seeing a Homeopathic doctor. When I told her about my IBS she immediately tested me for food allergies. All the regular doctors I had gone to in the past had never even thought about testing me for food allergies. All they ever said was not to eat spicy foods. Well, it turns out that I have several food allergies, the most severe being dairy and garlic. These are two foods that I used to eat several times a day. My husband's family owns a dairy and ice cream plant, so this was hard news to take. I have been trying my best to stay away from all of my allergy foods and it has helped my IBS greatly. When I do eat something I'm allergic to I pay for it either the next day or two days after. Food allergies may not be the diagnosis for everyone, but I suggest you give it a try. It's worthwhile. It's a simple blood test. Homeopathic doctors can also help your whole body. Because of my food allergies, my immune system was working overtime causing me to get infections very easily. Now I am not having as many problems. One of the great things about the homeopathic cures is that you don't feel any bad side affects. There's no medication that makes you feel drowsy or gives you headaches. I'll stop preaching now, but I wanted to share this with all of you in the hopes that maybe I can help a little.
 

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Are you talking about food allergies or intolerances? Allergies are rarely missed because the reactions are ususally quite severe and get worse with time. Intolerances, however can go undiagnosed quite easily due to their mild reaction and the fact that the reaction could be confused as being attributed to many other things.
 

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Are you talking about food allergies or intolerances? Allergies are rarely missed because the reactions are ususally quite severe and get worse with time. Intolerances, however can go undiagnosed quite easily due to their mild reaction and the fact that the reaction could be confused as being attributed to many other things.
 

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Are you sure that you mean allergies? An allergic response would come up immediatley, within and hour or two. An intolerant reaction could take several days to arise, and can depend on dosage.Also, it is my experience that blood tests for allergies are extremely inaccurate. I have found that skin tests are much more accurate.If you had severe allergic reactions to dairy and garlic, you would know it before having a blood test, as the effects would be immediate enough for you to isolate it back to the things that you had consumed in the past couple of hours. As I said before, it is more likely (much more likely) that you mean intolerances. If it is intolerances that you mean, these cannot be tested for with a blood test anyway.I'd get your homeopathic doctor to explain what they mean more clearly, because what you are saying and describing do not seem to be the same thing at all. Could this be an example of the brain-gut connection, Eric?
 

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Are you sure that you mean allergies? An allergic response would come up immediatley, within and hour or two. An intolerant reaction could take several days to arise, and can depend on dosage.Also, it is my experience that blood tests for allergies are extremely inaccurate. I have found that skin tests are much more accurate.If you had severe allergic reactions to dairy and garlic, you would know it before having a blood test, as the effects would be immediate enough for you to isolate it back to the things that you had consumed in the past couple of hours. As I said before, it is more likely (much more likely) that you mean intolerances. If it is intolerances that you mean, these cannot be tested for with a blood test anyway.I'd get your homeopathic doctor to explain what they mean more clearly, because what you are saying and describing do not seem to be the same thing at all. Could this be an example of the brain-gut connection, Eric?
 

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Comment: ___________________________________"Also, it is my experience that blood tests for allergies are extremely inaccurate. I have found that skin tests are much more accurate." ____________________________________Simply stated, allergies are Type I hypersensitivity reactions due to the body forming specific IgE antibodies against something, in this context some "food" or foods.It is 100% correct that most allergy can be isolated from patient history and dietary intake monitoring since they are not dose-dependent, do show rapid onset of symptoms, thus are highly repeatable.Skin testing as it is commonly done for environmental allergy is reasonably predictive of actual allergy, it is not reasonably predictive of actual food allergy. In fact it is less than 50% positively predictive for food allergy. That mean that basically the wheal and lfare response only correlates to an actual systemic allergic reaction to the foods less than 50% of the time, so you can flip a coin and have a better chance of being correct. So all SPT tests which are + should be confiremd by oral challenge. The othter forms of skin testing for food which are a bit more predictive, such as patch tests, are not practical for food unless the patient eats normally a very narrow diet since it would take forever to test each food.But if this is the case you do not need to patch tests anyway since history will yield the allergy.Blood tests for allergy (test for circulating specific IgE) due to changes in technology for modified RAST and ELISA are more accurate than they once were. However, again,for food allergy one must always remember that the presence of specific IgE does not automatically mean clinical allergy.So the patient should have an oral challenge for each test-positive food to confirm which ones are real allergy and which ones are false positive. While this ounds unwieldy, for the person with allergies to things that appear not only as whole foods but as additives (like corn...the extracts are used everywhere) the test can narrow the field of the oral challenges that must be performed.In the general population overall (mixed population) about 2% suffer real IgE food allergy. Among IBS patients with diarrheic or cyclic symptoms, recent discoveries suggest that food allergy exists as a comorbidity at a higher rate, perhaps 8%. This can be seen by those who do test positive by RAST or ELISA for specific IgE and then respond with rapid onset of symptoms to an oral challenge. This is a comorbidity for a number of IBS victims that is frequent enough to need to be ruled out.The figures for SPT and immunoassay testing accuracy are not made up they are common knowledge in the business, and are set forth by JAMA as well. _______________________________________"As I said before, it is more likely (much more likely) that you mean intolerances. If it is intolerances that you mean, these cannot be tested for with a blood test anyway." ________________________________________Part A is correct. Part B is no longer correct."Intolerance" or "sensitivity" or "term du jour" is irrelevant. You have food allergy, then you have food reactivity which is non-IgE mediated. Fod intolerancce which is non-pseudoallargy is very very hard to detetc clinically, due to the fact that they are the polar opposites of allergy. The nature of the mechansism results in them being DOSE dependent and DELAYED onset (up to 72 hours) so establishing cause-effect by dietary intake monitoring only yieldss the very worst-strongest intolerances. THe rest are missed and symptoms persist aand dietary logging shows no discernable pattern.In that class the reactions which cannot be detected by either allergy tests or in vitro assya for food or chemical sensivitity are reactions which occur due to enzyme deficiency, such as lactose intolerance (and this is easy to do with a proper oral challenge and if real responds to simple lactase supplementation) and pseudoallergy reactions since they are direct-reactions with the mast cells of the gut.Primary sourvces, just for example, of pseudoallergy are from lectins found in foods like legumes. If a person is lectin-sensitive this is becasue lectin can mimic an IgE mediated reaction in the absecne of specific Ige. They cn plug right into gut mast cells cause them to degranulate and produce symptokms which are like food ALLERGY (rapid onset of GI distress, repeatable). Also some foods have histamine in them by nature so the inflammatory mediator is directly introduced into the gut and then the bloodstream without any cellular reaction or specific immunoglobulin.Tuna, for example, sometimes has histamine in it from harmelss bacteria which may reproduce during canning if you don't kill them all.The vast mnajority of non-allergic food intolerances which provoke symptoms in diarrehic or cyclic IBS patients, and patients with functional diaarhea, involve on or more of up to 8 different methods of provoking different white blood cell types to react to some foods or additives inappropiately (ie: as if a pathogen had been introduced).This can be detected accurately by the most current generation of quantitative common-end-point cellular immune response testing,just developed over the last 7 years, by measuring and specific mediator release from white blood cells on exposure to provocation in vitro. Nothing should happen since food is not pathogenic. Healthy people do not release mediators, symtomatic people do. The inflammatory mediators cause symptoms. This is one of several mechanisms whereby the inflammatory response system can be and is provoked in IBS d's and cyclics and in functional diarhea. Its quite simple.With the offending foods removed, thus avoiding the provocation of mediator release in the small bowel and microvasculature, and thus the onset of sympotms which are provoked by non-alleric food sensitivities. This is far more prominent in IBS d's, cyclics, and in FD than is allergy or pseudoallergy (which can effect anybody, even people without IBS who suffer weird very intermmittent bouts of apparent allergy symptoms).There is also an earlier generation of in vitro test, developed in the 1980's, which is a qualitative assay that has been in use since the late 1980's which is also clinically useful as it can detect cellular response as well, but qualitatively. The main advance is in technology...we can now do quantitive assay of expulsion of intracellular contents as oppsed to trying to estimate from qualitative changes in WBC character, so its a bit more accurate way of detecting a reaction.Tests for food intolerance IgG and subclasses specific to foods as a marker can have some usefulness, but one must remember this is only (1) of 8 possible mechanisms therefore even a positive will only result in partial relief since it will not detetct the other types of clelular reactions that can occur.Skin testing for food sensitivity or intolerance is 100% useless since the patient does not have cricualting antibodies specific to the food so as to manifest a response. There is recent evidence of specific IgE locally in the small bowel, however, which suggests that another heretofore unseeen IgE mechanism may be one of the several involved in prodocing the food reactivity seen in IBS patients and others.Getting a copy of this book for about $15 and reading it, written by one of the leadinf authorities on the subject of food intolerance, and the only physician to publish bookd for both consumers and physicians on the subject, will help claraify the differences immunologically and clinically between food ALLERGY and food INTOLERANCE, and provide guidelelines for personal management of diet to avoid these conditions.FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTIONAND TREATMENT", Professor Jonathan Brostoff (M.D.. Allergy, Immunology and EnvironmentalMedicine, Kings' College, London)http://www.amazon.com/exec/obidos/ASIN/089...r=2-1/102-64875 08-3420903[/URL] _____________________________________"Could this be an example of the brain-gut connection, Eric? " _____________________________________the so called "brain-gut" interafce always included the central nervous system, the enteric nervous system, the immune system, and the endocrine system. They are inextricably linked, interractive and coresponsive regardless of whether We are talking health or disease in the gut.In the case of food sensisitivty we are merely taliking about the inflammatory response system being actibvated inappropriately in response to some thing or things in the diet. Exactly why the 8 or so different mechanisms which mediate this are provoked into action inappropriately in response to food or chemical aditives as opposed to say pathogens like it is supposed to only react, is not known yet.Only what happens in each system, what cells are inovlved, what different types of body tissues are involved and affected, and what proinflammatory medtaors which effect organ function are released...only these things so far can be quantified. Also precuroser events which lead to this system of combined dysfunction can also be isolated. But how even A results in dysfunction B is not known, only the means of effect not the why of effect.There are clear indications from research being done independently from several perspectives that like most syndromes there will likely be more than one specific causal basis thus more than one underlying etiology, since we already know there are more than one symptom-causal mechanisms at work.Eat well. Think well Be well.MNL
 

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Comment: ___________________________________"Also, it is my experience that blood tests for allergies are extremely inaccurate. I have found that skin tests are much more accurate." ____________________________________Simply stated, allergies are Type I hypersensitivity reactions due to the body forming specific IgE antibodies against something, in this context some "food" or foods.It is 100% correct that most allergy can be isolated from patient history and dietary intake monitoring since they are not dose-dependent, do show rapid onset of symptoms, thus are highly repeatable.Skin testing as it is commonly done for environmental allergy is reasonably predictive of actual allergy, it is not reasonably predictive of actual food allergy. In fact it is less than 50% positively predictive for food allergy. That mean that basically the wheal and lfare response only correlates to an actual systemic allergic reaction to the foods less than 50% of the time, so you can flip a coin and have a better chance of being correct. So all SPT tests which are + should be confiremd by oral challenge. The othter forms of skin testing for food which are a bit more predictive, such as patch tests, are not practical for food unless the patient eats normally a very narrow diet since it would take forever to test each food.But if this is the case you do not need to patch tests anyway since history will yield the allergy.Blood tests for allergy (test for circulating specific IgE) due to changes in technology for modified RAST and ELISA are more accurate than they once were. However, again,for food allergy one must always remember that the presence of specific IgE does not automatically mean clinical allergy.So the patient should have an oral challenge for each test-positive food to confirm which ones are real allergy and which ones are false positive. While this ounds unwieldy, for the person with allergies to things that appear not only as whole foods but as additives (like corn...the extracts are used everywhere) the test can narrow the field of the oral challenges that must be performed.In the general population overall (mixed population) about 2% suffer real IgE food allergy. Among IBS patients with diarrheic or cyclic symptoms, recent discoveries suggest that food allergy exists as a comorbidity at a higher rate, perhaps 8%. This can be seen by those who do test positive by RAST or ELISA for specific IgE and then respond with rapid onset of symptoms to an oral challenge. This is a comorbidity for a number of IBS victims that is frequent enough to need to be ruled out.The figures for SPT and immunoassay testing accuracy are not made up they are common knowledge in the business, and are set forth by JAMA as well. _______________________________________"As I said before, it is more likely (much more likely) that you mean intolerances. If it is intolerances that you mean, these cannot be tested for with a blood test anyway." ________________________________________Part A is correct. Part B is no longer correct."Intolerance" or "sensitivity" or "term du jour" is irrelevant. You have food allergy, then you have food reactivity which is non-IgE mediated. Fod intolerancce which is non-pseudoallargy is very very hard to detetc clinically, due to the fact that they are the polar opposites of allergy. The nature of the mechansism results in them being DOSE dependent and DELAYED onset (up to 72 hours) so establishing cause-effect by dietary intake monitoring only yieldss the very worst-strongest intolerances. THe rest are missed and symptoms persist aand dietary logging shows no discernable pattern.In that class the reactions which cannot be detected by either allergy tests or in vitro assya for food or chemical sensivitity are reactions which occur due to enzyme deficiency, such as lactose intolerance (and this is easy to do with a proper oral challenge and if real responds to simple lactase supplementation) and pseudoallergy reactions since they are direct-reactions with the mast cells of the gut.Primary sourvces, just for example, of pseudoallergy are from lectins found in foods like legumes. If a person is lectin-sensitive this is becasue lectin can mimic an IgE mediated reaction in the absecne of specific Ige. They cn plug right into gut mast cells cause them to degranulate and produce symptokms which are like food ALLERGY (rapid onset of GI distress, repeatable). Also some foods have histamine in them by nature so the inflammatory mediator is directly introduced into the gut and then the bloodstream without any cellular reaction or specific immunoglobulin.Tuna, for example, sometimes has histamine in it from harmelss bacteria which may reproduce during canning if you don't kill them all.The vast mnajority of non-allergic food intolerances which provoke symptoms in diarrehic or cyclic IBS patients, and patients with functional diaarhea, involve on or more of up to 8 different methods of provoking different white blood cell types to react to some foods or additives inappropiately (ie: as if a pathogen had been introduced).This can be detected accurately by the most current generation of quantitative common-end-point cellular immune response testing,just developed over the last 7 years, by measuring and specific mediator release from white blood cells on exposure to provocation in vitro. Nothing should happen since food is not pathogenic. Healthy people do not release mediators, symtomatic people do. The inflammatory mediators cause symptoms. This is one of several mechanisms whereby the inflammatory response system can be and is provoked in IBS d's and cyclics and in functional diarhea. Its quite simple.With the offending foods removed, thus avoiding the provocation of mediator release in the small bowel and microvasculature, and thus the onset of sympotms which are provoked by non-alleric food sensitivities. This is far more prominent in IBS d's, cyclics, and in FD than is allergy or pseudoallergy (which can effect anybody, even people without IBS who suffer weird very intermmittent bouts of apparent allergy symptoms).There is also an earlier generation of in vitro test, developed in the 1980's, which is a qualitative assay that has been in use since the late 1980's which is also clinically useful as it can detect cellular response as well, but qualitatively. The main advance is in technology...we can now do quantitive assay of expulsion of intracellular contents as oppsed to trying to estimate from qualitative changes in WBC character, so its a bit more accurate way of detecting a reaction.Tests for food intolerance IgG and subclasses specific to foods as a marker can have some usefulness, but one must remember this is only (1) of 8 possible mechanisms therefore even a positive will only result in partial relief since it will not detetct the other types of clelular reactions that can occur.Skin testing for food sensitivity or intolerance is 100% useless since the patient does not have cricualting antibodies specific to the food so as to manifest a response. There is recent evidence of specific IgE locally in the small bowel, however, which suggests that another heretofore unseeen IgE mechanism may be one of the several involved in prodocing the food reactivity seen in IBS patients and others.Getting a copy of this book for about $15 and reading it, written by one of the leadinf authorities on the subject of food intolerance, and the only physician to publish bookd for both consumers and physicians on the subject, will help claraify the differences immunologically and clinically between food ALLERGY and food INTOLERANCE, and provide guidelelines for personal management of diet to avoid these conditions.FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTIONAND TREATMENT", Professor Jonathan Brostoff (M.D.. Allergy, Immunology and EnvironmentalMedicine, Kings' College, London)http://www.amazon.com/exec/obidos/ASIN/089...r=2-1/102-64875 08-3420903[/URL] _____________________________________"Could this be an example of the brain-gut connection, Eric? " _____________________________________the so called "brain-gut" interafce always included the central nervous system, the enteric nervous system, the immune system, and the endocrine system. They are inextricably linked, interractive and coresponsive regardless of whether We are talking health or disease in the gut.In the case of food sensisitivty we are merely taliking about the inflammatory response system being actibvated inappropriately in response to some thing or things in the diet. Exactly why the 8 or so different mechanisms which mediate this are provoked into action inappropriately in response to food or chemical aditives as opposed to say pathogens like it is supposed to only react, is not known yet.Only what happens in each system, what cells are inovlved, what different types of body tissues are involved and affected, and what proinflammatory medtaors which effect organ function are released...only these things so far can be quantified. Also precuroser events which lead to this system of combined dysfunction can also be isolated. But how even A results in dysfunction B is not known, only the means of effect not the why of effect.There are clear indications from research being done independently from several perspectives that like most syndromes there will likely be more than one specific causal basis thus more than one underlying etiology, since we already know there are more than one symptom-causal mechanisms at work.Eat well. Think well Be well.MNL
 

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Thanks for picking me up there Mike!
What I meant by the brain-gut connection was whether he could be feeling better because he THINKS that he is allergic to stuff, where he is actually showing symptoms of intolerances. It was said tounge in cheek, beacuse I actually know very little about the brain-gut connection!!
 

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Thanks for picking me up there Mike!
What I meant by the brain-gut connection was whether he could be feeling better because he THINKS that he is allergic to stuff, where he is actually showing symptoms of intolerances. It was said tounge in cheek, beacuse I actually know very little about the brain-gut connection!!
 

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Warning! Be careful about saying that ALL positive SPT should be tested with an oral food challenge. My son has severe life-threatening food allergies, and an oral food challenge would be extremely dangerous---so dangerous, in fact, that Johns Hopkins University wouldn't take that risk (thank goodness). Just FYI.
 

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Warning! Be careful about saying that ALL positive SPT should be tested with an oral food challenge. My son has severe life-threatening food allergies, and an oral food challenge would be extremely dangerous---so dangerous, in fact, that Johns Hopkins University wouldn't take that risk (thank goodness). Just FYI.
 

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Very true FoodALlergyMum. I have a life-threatening peanut allergy, and I would not want it orally challenged (even if my allergist believed in challenging allergies)!!
 

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Very true FoodALlergyMum. I have a life-threatening peanut allergy, and I would not want it orally challenged (even if my allergist believed in challenging allergies)!!
 

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"Warning! Be careful about saying that ALL positive SPT should be tested with an oral food challenge. My son has severe life-threatening food allergies, and an oral food challenge would be extremely dangerous---so dangerous, in fact, that Johns Hopkins University wouldn't take that risk (thank goodness). Just FYI. " _________________________________Oral challenge confrimation means what you just said, being tested under the supervision of a physician, and that a careful history has been part of the allergy workup (which is standard) so that the allergist knows if the reaction to a specific food is benign or potentially anaphylactic. It is standard procedure to do confirmatons only on foods where no history of anaphylaxis has been shown, and if the allergist does have a patients with a history of anaphylaxis but must confirm the source it is alwasy done under controlled conditions (preferably as an in patient with the epi at hand).Saying that all positive SPT must be confirmed by oral challenge to state the patient has actual food allergy means simply that: you cannot say for certain if the person is clinically allergic unless confirmed by symptom onset, since more than 50% of SPT + are false +'s, but it does not denote doing oral challenge informally. Same goes for any IgE in vitro assay...just becasue specific IgE is present does not denote clinical allergy, thats all.Sorry I was not more clear on that in my efforts to be brief. Sometime one forgets that not everyone knows what "oral challenge" for allergy actually means. No allergist would would have a patient do self adminstered oral challenges, esp. if there is a histiory of anaphylactic response of any kind (to food or inhalants or venoms sicne cross-reactivity is common), or if he did not hava proper history which ruled it out. In fact I do not know of one who would do IgE challenges without syupervisoon period.Of you know when....run away.MNL
 

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"Warning! Be careful about saying that ALL positive SPT should be tested with an oral food challenge. My son has severe life-threatening food allergies, and an oral food challenge would be extremely dangerous---so dangerous, in fact, that Johns Hopkins University wouldn't take that risk (thank goodness). Just FYI. " _________________________________Oral challenge confrimation means what you just said, being tested under the supervision of a physician, and that a careful history has been part of the allergy workup (which is standard) so that the allergist knows if the reaction to a specific food is benign or potentially anaphylactic. It is standard procedure to do confirmatons only on foods where no history of anaphylaxis has been shown, and if the allergist does have a patients with a history of anaphylaxis but must confirm the source it is alwasy done under controlled conditions (preferably as an in patient with the epi at hand).Saying that all positive SPT must be confirmed by oral challenge to state the patient has actual food allergy means simply that: you cannot say for certain if the person is clinically allergic unless confirmed by symptom onset, since more than 50% of SPT + are false +'s, but it does not denote doing oral challenge informally. Same goes for any IgE in vitro assay...just becasue specific IgE is present does not denote clinical allergy, thats all.Sorry I was not more clear on that in my efforts to be brief. Sometime one forgets that not everyone knows what "oral challenge" for allergy actually means. No allergist would would have a patient do self adminstered oral challenges, esp. if there is a histiory of anaphylactic response of any kind (to food or inhalants or venoms sicne cross-reactivity is common), or if he did not hava proper history which ruled it out. In fact I do not know of one who would do IgE challenges without syupervisoon period.Of you know when....run away.MNL
 

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Oh ps ___________________________________________What I meant by the brain-gut connection was whether he could be feeling better because he THINKS that he is allergic to stuff, where he is actually showing symptoms of intolerances. It was said tounge in cheek, beacuse I actually know very little about the brain-gut connection!! ______________________________________________Actually much more is not known than is known anyway so you are OK there. And what you suggest is entirely possible..that is one can attenuate symptomology or amplify symptomology based upon belief or "valuation" or expectation". It is the basis for effective psychological therapies...sometimes it is highly effective and sometimes ineffective and everything between...depdning upon theetiology of the primary causal bais for IRS activation.It is very hard, for example, to hypnotize oneself out of an immunlogic reaction to soemthing, esp. if specific immunoglobulin is involved, but there are other mechanisms less "fixed" which are wasie to attenuate.MNL
 

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Oh ps ___________________________________________What I meant by the brain-gut connection was whether he could be feeling better because he THINKS that he is allergic to stuff, where he is actually showing symptoms of intolerances. It was said tounge in cheek, beacuse I actually know very little about the brain-gut connection!! ______________________________________________Actually much more is not known than is known anyway so you are OK there. And what you suggest is entirely possible..that is one can attenuate symptomology or amplify symptomology based upon belief or "valuation" or expectation". It is the basis for effective psychological therapies...sometimes it is highly effective and sometimes ineffective and everything between...depdning upon theetiology of the primary causal bais for IRS activation.It is very hard, for example, to hypnotize oneself out of an immunlogic reaction to soemthing, esp. if specific immunoglobulin is involved, but there are other mechanisms less "fixed" which are wasie to attenuate.MNL
 
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