Something I posted on this other thread might be of interest in this discussion:
http://www.ibsgroup.org/ubb/ultimatebb.php...=1;t=031913;p=2 First, as is always the case when this subject comes up, it seems those with the least study on the subject make the most firmly declarative statements on the matter. And thus contain as much, if not more, inaccuracy than folks who never read a thing and simply relied upon common sense.These books are recommended to be read as a starting point to understanding the subject of what food allergy is as opposed to food �intolerance� (a very general term which is defined at least 4 different ways depending upon whom you read�there is no standardized nomenclature, therefore we must define what we are saying when we use a certain term or it confuses and confounds the hell out of suck people trying to honestly learn something�) ________________________________________________�FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT�, Professor Jonathan Brostoff , M.D.. Allergy, Immunology and Environmental Medicine, Kings� College, London
http://www.amazon.com/exec/obidos/ASIN/089...6487508-3420903 FOOD ALLERGY AND INTOLERANCE, Professor Jonathan Brostoff, MD, Stephen Challacombe, MD (NEW 2002)
http://www.amazon.com/exec/obidos/ASIN/070...product-details __________________________________________________ Once we have made a study via these books, then there are at least 15 years worth of papers to read, published in journals from around the world and presented at medical conferences as well. An integrative study must be done, inclusive of literature which may not conform to ones filters as the authors used different names for patient selection than perhaps another did, so if you exclude anything whereby the nomenclature does not match exactly you exclude a large amount of information from ones personal study.Having said that as a preamable and without delving into authorship just a couple of comments to amplify: ____________________________________________�well of course she is intolerant to those foods. the ELISA test does not lie.� _____________________________________________Ah my friend if only �twer true.
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The problem with any immunoassay is not with the assay itself, however, but how we apply it. What is �accurate� si the question crying for definition. The latest generation ELISA and RAST indeed are quite accurate at detecting what they say they can detect: all they can claim to detect is that which they claim which is basically one or another specific immunoglobulin�in this case to foods.The problem is that this does not translate, in any given patient, directly into CLINICAL reactivity to that food. So, while a well done test indeed may not lie, the immune system does not reveal its behavior as clearly as we would like.
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The results have to be taken into the context of history. As Le Grande Fromage does state, in his own inimitable way, if it is true food allergy�IgE�Type I Gel & Coombs Hypersnesitivity�the history and dietary intake records alone will reveal basically all true food allergy. The reaction is not dose dependent, it is rapid onset, and thus it is highly reproducible with oral challenge. "Don't try this at home kids without the epi standing by" for some people get anaphylactic. But you know who you are by now.Thus by the time we are adults we know if we have a true food allergy. This occurs (general concensus) in about 2% of the general population, but more frequently as a comorbidity in IBS victims�some of Stefaninis work with �allergy treatments� in IBS patients suggests perhaps 8%.Indeed if one does IgG and IgG subclasses, one is looking at another possible mechanism by which a person may suffer delayed-hypersensitivity reactions to foods. Keep in mind the limitations just mentioned, and the fact that there are multiple possible mechanisms which lead to the end game of proinflammatory mediator release in the body inr esponse to food challenge�lost oral tolerance�.and IgG is but one. If you only look at trees in a forest you may never see the ragweed which is causing the actual symptoms and reach a conclusion just as tentative as assuming Ig[x]+ is diagnostic�you may see nothing, when the patient is reactive to something but the mechanism does not involve IgE or IgG�or any Ig[x] at all for that matter. This is a handy book to read to learn about the immune system and some basics on hypersensitivity�THE IMMUNE SYSTEMPeter Parham, Ph.D.Professor, Structural Biology, Microbiology and ImmunologyStanford University
http://www.amazon.com/exec/obidos/ASIN/081...5533461-6834310 __________________________________________"Intolerances include chemical intolerances such as chinese restaurant syndrome and don't involve the immune system (at least not directly)." ___________________________________________Whether that is true or not depends not upon physiology but upon terminology. Complement activation, T Cell responses, cytotoxic responses, ad nauseum all involve one form or another of an immunologic reaction but they are not �allergy��. Some who hold-forth on the subject include these in �intolerance� and some refer to them as �non allergic hypersensitivity��some do say that intolerance is only enzymatic and/or biochemical�or biochemical are pseudoallergy�
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terms-dujour should not be used to as the medium of information conveyance. It is awkward but until the medical field as a whole comes to a concensus we need to make the extra effort to define the context of anything on the subject and use specificity instead of the bizzwords as they are not uniform yet.It is easier sometimes to simply separate classic allergy from everything else, then use specifics for other reactions�beyond IgE there are many other mechanisms of chemoactive consequences from food sensitivity of one form or another. Those books from Brostoff help a bit�though the second is a might heavy for lay people. __________________________________________�There are no specific tests for them, only double-blinded challenges. Intolerances appear to be relatively rare too, however.� ___________________________________________This is quite misleading, as if one looks at the literature as a whole as regards non-IgE mediated loss of oral tolerance, there is a notable frequency in the overall population of the U.S. at this time. While it is not a pandemic, neither is it a rare problem. Many people can be shown to have some degree of lost oral tolerance via one or more mechanisms, manifesting itself through one or more specific symptom sets.It is very difficult to arrive at the actual number since it is an area that no one has done such a single broad investigation of�to quantify the frequency in mixed-population of the symptomatic and symptom free.Almost anyone can throw any number out there an claim it to be �the answer� and anyone who does at this time almost assuredly is wrong�it is not rare yet it is not a pandemic�.it is somewhere in between�and the issue is quite moot as is dancing angels on the head of a pin. What is germane is isolating the person who has symptomology which is elicited by lost oral tolerance of one mechanism or another, to one food or chemical or another or more, as opposed to some other pathology and modifying diet to ablate the symptoms.To this end there are technology and lifestyle solutions now available and in use which can and do accomplish this. To suggest otherwise is to merely reflect a lack on information.MNL
