Archive for 30th March 2009

FOOD ALLERGY: TOTAL EXCLUSION DIET

The principle of a total exclusion diet is that you either fast, or eat just one or two specific foods, for a period of up to five days, then reintroduce and test foods. The fast or two-food period will clear your system of foods that you eat commonly, and should unmask background symptoms. You can become very weak and HI on a diet of this kind. You can do it at home, but should never do it without a doctor’s knowledge and supervision.

The best-known version of a two-food diet, the lamb and pear diet, is often prescribed for up to five days. You eat nothing but lamb (baked or grilled, with no oil or cooking fat) and pears, and drink nothing but water, preferably filtered or bottled. You can eat as much of these two foods as you want or need – for breakfast, lunch, tea or dinner – but nothing else at all.

Lamb and pears are chosen for the diet because, it is argued, they rarely cause reactions. The diet originated in the United States where lamb and pears are not common items in the diet, and hence are uncommon causes of allergy and intolerance. In the UK, however, they are much more frequently eaten and do cause reactions, although relatively rarely. Some doctors in the UK therefore prefer to use other, less often eaten foods, such as turkey and peaches, or rabbit and raspberry.

After the fast, or two-food diet, you start reintroducing and testing foods. Reintroduction is usually done on a stricter basis than for single-food testing or a special exclusion diet. It is usually recommended that you eat foods singly (not combined with any other foods), that you leave four hours or more in between testing foods, and that you organise foods on a rotation, so as to avoid problems with cross-reaction between related foods. (For more information on testing foods and organising a rotation diet. A doctor will usually give you a diet sheet to follow, based on your own history and preferences, which will help you with the complexity of planning. Depending on how many foods you test (and how many you react to), it can take between two and four weeks to devise a permanent diet.

The drawbacks of this type of exclusion diet are fairly obvious. It is time-consuming and almost impossible to combine with an active life. The foods you eat can be costly. You can be very weak and hungry while carrying it through, apart from any reactions you might get to foods you test. If you have a lot of food sensitivities, it can take a long time to devise a manageable diet.

On the other hand, if you are as highly sensitive as that, this is the only way to work out a tolerable diet, and it can turn up some surprises. People often find that they are not sensitive to foods that they had assumed to be a problem, and that, conversely, something unexpected turns up to be a real villain. Often just one or two foods turn out to be the root causes of symptoms and that can be an enormous relief. It really does sort out what is going on and if you can stick it out, it is an invaluable process.

There are two in-patient units in the UK where you can go through this type of diet with constant medical supervision.

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UNDERTAKING AN ELIMINATION PROGRAMME FOR ALLERGY TREATMENT

The basic principle of an elimination programme is to remove from your environment, as far as is practicable, the things that you suspect of causing reactions. You then monitor your symptoms and see if they improve after a period of time. If you want to confirm the results of the trial, you can then reintroduce the substances or start using them again. You do this with care, monitoring your symptoms as you do it.

To make the programme work, you have to be thorough and you have to be systematic. You also have to be patient and to give things time to settle before you make a judgement. It is better to eliminate only one group of substances at a time, say only foods, only house dust mites, or only chemicals, and do it thoroughly, rather than to try several things at once and only do each partially. People often start by doing the latter because it seems less work and they hope it will be sufficient to make them feel better.

If you have only mild allergies or sensitivities, a partial approach will work well. However, if you are significantly affected by your reactions or if you have multiple sensitivity, most people find that the only way to work out what affects them is to eliminate one thing at a time, and to do it wholeheartedly. Although it appears more work, it is shorter in the long run and less confusing.

Choose yourself which approach you will adopt. Whichever way you go, keep an open mind as you go along, monitor symptoms carefully and retest things whenever you are not sure.

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ALLERGY TO CLOTHING/BABY CLOTHES: HIGH STREET NAMES

It is relatively easy to find 100 per cent cotton jersey vests, underwear and sleepsuits for newborns and up to 12-month size (80-90 cm). Boots, Mothercare and Woolworths, in particular, are good sources, but check labels to make sure that all cuffs and trimmings are of cotton. Marks and Spencer usually have a selection of pure cotton baby-wear, but these are more highly treated and not always well tolerated. Next sell a very good range of soft 100 per cent cotton jersey rompers and nightwear for babies. They often have cotton fleece all-in-ones which are much warmer than sleepsuits for winter babies. Most of their baby clothes have very little fabric finishes applied, unlike Next adult clothing in cotton jersey which is often highly treated. Next sell by mail order as well as in their High Street shops.

One brand name to look out for in the High Street shops is Fix, who make virtually all their range in 100 per cent pure cotton. Their clothes are not treated with formaldehyde and are not chlorine-bleached. Another name to look for is Stummer who make pure cotton velveteen rompers and outfits; these are warmer than cotton jersey for tiny babies. Honeybee make a good range of sleepsuits, sweat shirts, polo neck jumpers and T-shirts.

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ALLERGIC REACTION TO BEDDING:IF YOU ARE ALLERGIC TO COTTON

If you are allergic to cotton but not chemically sensitive, you have the choice of synthetics and latex as well as of other natural fibres. If you are chemically sensitive as well as allergic to cotton, you will have to look to other more expensive natural fibres, such as wool, linen and silk. It is worth trying polycotton, sometimes tolerated well by even very sensitive people.

If you have to use cotton because of multiple allergies, avoid very flocky cottons, such as candlewick bedspreads or terry towelling, which irritate more. You may be better able to tolerate smooth woven cottons, or T-shirt fabric. Try using a T-shirt as a pillowcase or to cover the upper part of your bedding. Look for a cotton jersey mattress cover (sources overleaf). The sources of supply which follow cover:

• Anti-dust mite and modified feather products

• Pure cotton bedding

• Wool, linen and silk bedding

• Synthetic and latex bedding and mattresses

• Cotton mattresses

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ALLERGY TO PLANTS AND TREES: RESINS AND BALSAMS ARE SECRETIONS PRODUCED BY TREES

Resins and balsams are secretions produced by trees and plants following injury. Natural turpentine is produced this way, as is latex. Balsam of Peru is a chemical known commonly to cause reactions. It has an odour resembling vanilla and cinnamon. It, and related balsams, are used as flavouring agents in many food products, confectionery, drinks, and for flavouring and perfume, home medicines and toothpaste. Balsam of Peru cross-reacts with a number of common chemicals such as coal tar products.

Rosin is a resin produced as a distillation of natural oil of turpentine. It has a very wide use in all sorts of applications from fabric finishes, through adhesive tape, to varnishes and lacquers, and sensitivity is well documented.

Many natural oils and resins (such as natural turpentine and essential oils like rosemary) are used in producing building and decorating materials with no synthetic chemicals. Some individuals can be sensitive to these. .

Linseed oil is produced by pressing from the seeds of the flax plant. It is used as a sealant in some building products and as a component of linoleum. It is relatively inert and rarely causes reactions. Linoleum is a type of flooring that causes few problems to the chemically sensitive. Forbo-Nairn manufactures linoleum which can be ordered through any carpet or flooring supplier.

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