A person with allergies is like a rain barrel. If you fill up the rain barrel with all the things you’re allergic to, symptoms will present and that barrel will overflow,” says Alex Bingham, M.D., family practice, the Marino Center for Integrative Health, affiliated with Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School.
Dr. Bingham uses the rain barrel analogy to describe how he and other doctors at the Marino Center treat and care for their allergy and asthma patients. “The first part of my job is to figure out what the different things in that rain barrel are that are contributing to the allergy symptoms,” says Dr. Bingham.
Allergies are a common problem among people in the United States, affecting two out of 10. And if you’re an allergy sufferer, sneezing and wheezing your way through the high pollen counts summer typically brings; or itching and scratching your eyes every time you visit Aunt Jane and her cat “Fluffy,” then you want to know what exactly is causing your symptoms, and maybe more importantly you want relief!
Dr. Bingham says alternative methods for allergy testing are different than conventional methods regarding environmental allergens (dust mites, pollen, dogs, cats, mold, insect stings, etc.) Conventional testing typically involves a skin prick test. Each prick on the skin contains a small amount of a specific allergen that is being tested for. After a few minutes, if a red, itchy bump appears on the skin’s surface, that’s a positive indication for an allergy.
At the Marino Center, Dr. Bingham tests for environmental allergens using another type of skin test. “We use a finely tuned and precise way of testing,” says Dr. Bingham. “The technique was developed in the 1930’s, not too long after the skin prick test.”
During this method, Dr. Bingham injects a measured amount of liquid containing an allergen into the skin. Enough allergen is injected to create a small, raised bubble on the skin. The size of the bubble is measured right after the liquid is injected and then again after a short period of time. Dr. Bingham says if the bubble has grown a certain amount, that’s an indication of an allergy.
Conventional methods for allergy testing stop at the sign of an allergy, however, the alternative method used at the Marino Center continues. “Next, we decrease the dose of the injection to an amount that’s five times weaker than the initial injection.”
Dr. Bingham says injections continue, each time with a smaller dose of allergen until no reaction is produced. “There’s something really special about that first time it doesn’t react. That’s the concentration we use for our treatment.”
Treatment, called immunotherapy, can be administered by patients at home, much like a diabetic with insulin shots. Dr. Bingham says that follow-up studies show that within weeks of beginning treatment, about 85 percent of the time patients will stop experiencing allergic reactions or will see a dramatic decrease in the severity of the reaction.
Diagnosing food sensitivities, Dr. Bingham says, isn’t as straight forward as environmental allergies. “It’s different with food, because we’re talking about reactions that may take one, two or three days to start happening.”
Dr. Bingham says that’s the biggest difference between conventional methods and alternative methods for food allergy/sensitivity is: symptom reaction time. “Generally, the conventional method is going to be very discriminating in what is called a food allergy. The only type of food allergy that is acknowledged is something that causes immediate symptoms, caused by an IgE, immediate-type, hypersensitivity reaction.”
Dr. Bingham says alternative methods for diagnosing food allergies include a broader range of food sensitivity causes. “I would say that 90 percent of food reactions are sensitivity reactions and not immediate hypersensitivity reactions. By only treating one type of food allergy, most of the food sensitivities are missed.”
At the Marino Center, one method of testing for food allergies or sensitivities is done by what is called an elimination-challenge diet. A patient takes out certain foods of their diet for two weeks. Dr. Bingham says during this two-week period, patients notice an improvement in symptoms. “Patients report resolution and /or improvement of their sensitivity symptoms. Often, they also report clearer thinking and their energy levels go up. They feel better in general and their moods improve.”
Foods are slowly reintroduced and by this process of rechallenge, the food sensitivity is discovered. Dr. Bingham says after a period of three to six months, the body often loses the ability to react to the sensitive food. Patients can then slowly reintroduce that food into their diet one to two days a week.
Another way of determining food sensitivities is by using skin testing. This is only performed for foods that the patient is currently eating at least three to four times a week (to prevent any possible IgE, immediate food reactions). In this case, a relatively large amount of the food in question is injected into the skin raising a bubble. Food sensitivity is then confirmed by growth of the wheal or by provocation of the symptoms in question. It is highly accurate and specific to the individual food. It is an effective way to test for many of the foods that are “hidden” in the diet (often used in processed foods, as “stabilizers, modifiers, sweeteners” and to prolong shelf life, add flavor or nutrition) such as soy, corn, wheat, dairy, eggs and yeast. After discovery, the sensitive food is treated just as in the elimination-challenge diet.
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