Sometimes it is easy to know to what substances you are allergic or sensitive. You get a rash every time you eat strawberries or have sneezing and itchy eyes every spring when a certain tree pollinates. But often it can be difficult to know exactly what your allergens are as there may be multiple substances you react to or the effects may be ongoing as is often the case with food allergies. Then we have to go through a diagnostic process to figure it out.
Symptoms & Signs
Symptoms are changes in how you feel when you have a disease or disorder. Examples include itchy eyes, feeling hot and headaches. Signs are changes that can be observed. Examples include a runny nose, a flushed appearance or a rash. Knowing the common, and uncommon, signs and symptoms of allergies is the first step in the diagnosis of allergies, sensitivities and intolerances (see “Allergies – An Introduction” for definitions of these terms).
Airborne Allergies and Sensitivities – The most common symptoms and signs include sneezing, runny nose, nasal congestion and itchy eyes. Coughing and throat irritation can also be present. Asthma with shortness of breath and wheezing occurs in some individuals. Some people also have fatigue, difficult concentration and mood changes, especially when exposure is prolonged. Mold and chemical exposures can have toxic effects as well as allergic symptoms.
Food Allergies and Sensitivities – This is more complex as the signs and symptoms can be acute or chronic (long standing) and involve reactions to multiple foods. They can manifest with GI symptoms, such as indigestion, tingling/burning of lips or mouth, irritable bowel syndrome, heartburn, constipation, and diarrhea among others, as well as signs and symptoms throughout the body. Common problems include headaches (including migraines), fatigue, cloudy thinking/poor memory, mood changes/anxiety/depression, recurrent infections (e.g. bladder, respiratory, ear), poor sleep, menstrual disorders, skin diseases (e.g. eczema, psoriasis, hives, etc.) and many others. They may even contribute to severe conditions such as autoimmune disorders and seizures.
Anaphylaxis – This is a sudden, severe allergic reaction that is life threatening. It usually occurs within a few seconds to a few minutes of oral, blood or skin exposure although it may take up to a half hour or longer. The person manifests symptoms and signs of shock with a severe drop in blood pressure, severe shortness of breath (may die of asphyxiation), rapid heart rate and dizziness or weakness. There may also be a skin rash, nausea, vomiting or diarrhea. It may be caused by certain foods, commonly peanuts, tree nuts, fish/shellfish, eggs and milk, and occasionally others. It may also be caused by exposure to certain drugs, insect stings and latex. People subject to anaphylactic reactions need to carry epinephrine (Epi-Pen) for emergency injection upon exposure. While not actual anaphylaxis, airborne allergies, especially to animal dander, can trigger life threatening asthma attacks.
Allergists employ different strategies to test for allergies.
Skin testing involves pricking the skin, or using patches, to expose the person to possible allergens and then measuring the size of any reaction on the skin to determine if an allergy is present. This is commonly used and sometimes yields useful information. But there are many false positives and some false negatives, consequently the results cannot always be relied upon.
Blood testing involves drawing blood and then measuring levels of antibodies that react with suspected allergenic substances. This is usually done only if skin testing has not yielded satisfactory information or if it is not done for some other reason. The challenge with the blood tests is that while they measure the presence of antibodies that does not always correlate with allergic reactions as it sometimes just indicates past exposure to a substance. These tests do not detect sensitivities, only true allergies.
Elimination testing is done by discontinuing one or more foods for an extended period of time to see if symptoms and signs improve. This is the most definitive of these approaches and works best for food allergies and sensitivities. It is, however, time consuming as exposure must be discontinued for a month or more in the case of foods and it is not practical for seasonal pollen or mold allergies to determine specific offending substances. For reactions to animal dander, the individual must be removed from the environment, or the animal removed and the house thoroughly cleaned, for a month or more. Some practitioners may only have the food discontinued for a period of days to a few weeks which is not always adequate. It is difficult to be certain all offending foods are identified unless one goes on a very restricted, hypo-allergenic diet for a month or more. If one is willing to be disciplined enough to meet these requirements,it can be very successful in identifying offending foods.
Challenge tests are not commonly done as they carry some element of risk depending upon the severity of the reaction. A person is exposed to increasing amounts of a food to see if a reaction occurs. This may follow an elimination test or be used to see if desensitizing treatments have been effective. They are done in a doctor’s office in case of severe reactions.
Nambudripad Allergy Elimination Technique was developed by Devi Nambudripad, DC as a synthesis of concepts existing in Western and Chinese medicine. The treatment component is discussed in “Allergies – What Are Your Treatment Options?“. The diagnostic method is non-invasive (no skin puncture or blood draw) and can usually be accomplished in one visit, although complicated cases involving multiple allergies occasionally require additional testing as treatment progresses. It utilizes a Muscle Response Test (MRT) in the presence of substances suspected of causing allergies or sensitivities. The substances are present in liquid form in small vials held by the patient while the practitioner tests muscle strength. If muscle strength weakens when in contact with the vial, this indicates the presence of an allergy or sensitivity to the substance. It detects both allergies and sensitivities without differentiating between them. This is not a concern as NAET treatment is effective for both. Conventional testing, with the exception of elimination diets, will detect only potential allergies and not sensitivities. Underlying nutritional and metabolic imbalances will also be part of the NAET test (vitamins, minerals, hormones, organs, etc.). Addressing these weaknesses is part of the treatment and greatly improves results and overall health. This approach can also be used to identify allergies or sensitivities to substances not usually considered. We have experience with diagnosing and treating adverse reactions to joint replacements, jewelry, dental work, perfumes and chemicals.
This is Part 3 of a four part allergy series by Soaring Crane Acupuncture: