Interesting reading ----- roz http://www.telegraph.co.uk:80/et?ac=002242...1/7/thtest.html THE case of the civil servant who sneezed some four million times before discovering he was allergic to his home-made muesli sent shivers down many spines. If, as Patrick Webster claimed in June, 60 doctors failed over 35 years to diagnose his food allergy, what does this mean for the rest of us? Just what proportion of sinus problems - not to mention cases of IBS, migraine, arthritis and eczema - are due to an adverse reaction to something in our diet? Allergy specialists estimate that between 15 and 20 per cent of the population probably suffer from some kind of food intolerance. Part of the problem is that it is extremely difficult to get a definitive diagnosis. Classic allergy is easy to define and detect. The body responds to a normally harmless substance - nuts, shellfish, house mites, cats - by producing the IgE antibody, which usually helps protect us against invading bacteria or viruses. A simple skin prick test or a Rast blood test will reveal which allergens provoke an IgE response. However, a growing number of doctors now recognise what a small band - and many complementary therapists - have suspected for years: that there are other, complex reactions to food that do not involve the IgE antibody but which can cause patients severe distress. "People have said that if the skin prick test is negative, the condition does not exist," says Dr Michael Radcliffe, associate specialist in allergy at the Middlesex Hospital, London. "That is nonsense. If you listen to patients and look at various high-quality studies using food elimination and reintroduction, it becomes clear that there is a range of reactions to food that we do not understand. "There is only one way to measure what we know as food intolerance and that is to take out all potentially troublesome foods from the diet, then gradually put them back and see what happens. The elimination diet is the gold standard." By Dr Radcliffe's admission, the elimination diet requires enormous commitment and motivation from the patient, even when conducted under medical supervision. And medical supervision is hard to find, says Muriel Simmons, chief executive of the British Allergy Foundation. "The average waiting time for an appointment at an NHS allergy clinic is two years in England and Wales and five years in Scotland. It is not surprising that people turn to all sorts of other methods to try to find out what is causing the problem. Many are pure quackery, and few practitioners seem prepared to submit their techniques to proper scientific study." When Health Which? magazine looked at allergy testing methods, including applied kinesiology, blood and hair analysis and electrodermal testing, it concluded that "none of the tests had any diagnostic value for any form of food hypersensitivity." Researchers were given different results and conflicting advice by different practitioners of the same test. As Jonathan Brostoff, formerly professor of allergy and environmental health at University College London Medical School and a leading authority on the subject, points out, there are many people walking around who claim to have had their food sensitivities identified. However, this proves very little. "Given that the most common sources of food intolerance are wheat and milk, such therapists can achieve a reasonable success rate by diagnosing sensitivity to these two foods in all their patients. If eggs, oranges, chocolate, tea and coffee are added to the list, they may well achieve success with 50 per cent or more." Dr Radcliffe, who took over Prof Brostoff's clinic last month, hopes that a reliable, repeatable and scientifically verifiable test will be found. Among the contenders is a version of the patch test, which has long been used by dermatologists investigating skin problems caused by allergic reactions. Blood/hair analysis Health Which? investigated two blood tests - the cytotoxic test and the Elisa method - and a hair-testing service. It was highly critical of all three. However, the Elisa test, carried out by York Laboratories, was the "only one to come up with even roughly matching results for samples taken from the same researcher." The Elisa test uses a small blood sample taken at home and sent to a laboratory where it is mixed with a number of common allergens. The theory is that if you are sensitive to a particular food, your body will produce an IgG antibody. A colour change in the blood sample indicates the presence of an IgG reaction. Laboratories using the Elisa test claim that around 70 per cent of patients experience some benefit within a month or two of changing diets. The most common problems are gastro-intestinal symptoms, headaches and skin conditions. Research suggests that IgG may be linked to food sensitivities, but the case is not proven. Three clinical trials involving the Elisa test are due to start on IBS and migraine patients within the next year. Dr Radcliffe is helping to set up a double-blind randomised controlled trial at Southampton University where half the patients will be given a diet based on the correct test results and the rest will be given a diet which is not based on the results. York Nutritional Laboratory 0800 074 6185; Immunology###Home 01353 862220 Various machines can, according to their operators, detect allergic reactions to foods and other substances. They are based on technology developed in the middle of the last century by a German scientist, Dr Reinhold Voll. The patient holds a metal rod in one hand while a probe is applied to an acupuncture point on the skin. As the patient is exposed to different allergens, the machine measures the body's response. Some studies have indicated that electrodermal testing is a useful diagnostic tool, but most doctors believe it has no scientific basis. Allergy specialist Dr Keith Scott-Mumby has used a Vega machine of the kind found in many health food shops and describes it as "little better than electronic dowsing. You can influence the result by what you are thinking." According to a survey by Allergycare, which operates around 600 Vega machines on a franchise basis, 84 per cent of those who responded to its consumer questionnaire felt better as a result of their consultation with a Vega machine operator. However, the British Allergy Foundation is concerned that some operators have very little training. "People with no nutritional expertise hand out diet sheets and patients can be made ill by being given a huge list of things they should exclude from their diet," says Muriel Simmons of the foundation. The Best machine, a faster and more sophisticated computerised version of the Vega, sends through the skin an electrical "signature" of each potential allergen and assesses the response. More than 100 foods can apparently be tested in 15 minutes and the system scans 29,000 remedies. No independent clinical trials have been done, but BioTech Health and Nutrition Centre, which distributes the machine in Britain, estimates its accuracy in assessing intolerance at 85 to 90 per cent. Allergycare 01823 325023; BioTech Health and Nutrition Centre 01730 233414 This approach to allergy testing is based on the theory that sensitivity to certain foods can interfere with energy flow and that this interference can be assessed by testing muscles. The potential allergen is placed between the patient's lips. The practitioner then moves the patient's limbs into various positions and applies pressure to gauge whether muscle strength is affected by the presence of the allergen. There is very little scientific evidence for this therapy. In one experiment, six patients were identified as having a "positive" reaction to milk. When these were retested in a double-blind way, the results were no better than chance. And when repeated, different people were identified as having milk allergies. Health Which? researchers were given different - and sometimes conflicting - advice from different practitioners. There is no shortage of anecdotal evidence for the efficacy of kinesiology, though standards and success rates vary widely, depending upon the skill of the practitioner. Claire Moffat, a kinesiologist with 15 years experience estimates that she has a success rate of around 70 per cent in identifying and treating food intolerance. "Obviously, some practitioners are better than others. But kinesiology does not rely on intuition. It gives consistent, reproducible results." Association of Systematic Kinesiology: send an sae to 39 Browns Road, Surbiton, Surrey KT5 8ST. If you are advised to give up certain foods, check with your GP that you are not putting your health at risk. Try the recommended diet for a month. If you see no improvement, you are probably barking up the wrong tree. A reputable practitioner will support patients by giving nutritional advice. 'I was poisoning myself' FOR most of the Nineties, Verity Rawlings, 51, from Exmouth in Devon, suffered from digestive problems and felt generally lethargic and unwell. "I had terrible nausea and tiredness. I looked and felt five months pregnant. My stomach was so distended, I couldn't do up my shoelaces." Verity's GP diagnosed stress and advised her to give up her much-loved antiques business. But after she had closed the shop, Verity's symptoms got worse, so she opened another. "I decided I was just going to have to live with the problem." After reading about the symptoms of food intolerance in a magazine, Verity sent a tiny blood sample to York Nutritional Laboratory. "When the results came back, I was astonished. It said I was highly allergic to citrus fruit. I used to eat a lot of fruit and after I gave up work, I looked forward to my evening gin and tonic with lemon or lime. It was in my stomach overnight, which is why I was in such terrible pain. "Within a week of giving up citrus, the IBS, nausea, bloatedness and exhaustion disappeared. I lost half a stone immediately and another half a stone came off later. I am active and full of life again for the first time in six years. I was poisoning myself without realising it." 2 November 2000: Let them eat cake - safely 30 June 2000: [UK News] Home-made muesli made man sneeze 4m times in 35 years 15 June 2000: Coffee could save victims of nut allergy 30 March 2000: Allergies hit 40pc of the population 28 December 1996: [UK News] Research yields clues to peanut allergy deaths 30 August 1996: [UK News] Pregnant women told to avoid peanuts 29 July 1996: [UK News] Peanut testing kit could end allergy fears Is Ritalin a friend or foe? Click here to save up to 50 per cent on health books at Amazon.co.uk. Search Health for Front Page | UK News | International | Weather | Crosswords | Matt cartoon | Feedback City News | City Analysis | Small Businesses | Personal Finance (Telegraph Money) | Alex cartoon Sport | Football | Rugby Union | Rugby League | Cricket | Golf | Tennis | Motor Racing | Other Sport Features | Review | Books | Gallery | Technology (Connected) | Travel (Planet) | Motoring | Property Education (Virtual School) | Students (Juiced) | Teenagers (T2) | Obituaries | Opinion (Daily Telegraph) Expat World (Global Network) | Search | Site Plan | Daily Index | Appointments | Jobs ### ET | Classifieds | Horoscopes ï¿½ Copyright of Telegraph Group Limited 2000. Terms & www.telegraph.co.uk.