Hidden and Masked Allergy
One of the dividing principles between conventional allergy and clinical ecology is the concept of the hidden or ‘masked’ allergy. Conventional allergists and immunologists don’t recognize the existence of the phenomenon. Clinical ecologists use their understanding of it all the time to treat many patients and many diseases.
Basically, a hidden allergy means that a substance is capable of making a person ill but that constant exposure to it (as with a frequently eaten food) mutes the person’s reaction to it. A so-called masked allergy is a variant of this, whereby exposure to the substance temporarily diminishes or ‘masks’ the symptoms. Both phenomena make diagnosis very difficult.
The symptoms of a hidden allergy can be protean, bizarre, changeable and paradoxical.
- Protean: the foremost characteristic of an illness caused by a masked allergy is the incredible variation in the pattern of a patient’s symptoms. Naturally, this constantly endangers his or her credibility, especially in the eyes of doctors.
- Bizarre: symptoms are peculiar because a twisting of the patient’s perception is a prime ingredient of this form of illness. Often the complaint bears no relationship to anatomical structures. Symptoms are unique to the individual and defy description in ordinary terms: individuals speak of ‘cobwebs over the face’, ‘legs full of boiling water’, ‘a feeling of floating outside the body’, etc.
- Changeable: symptoms come and go without apparent reason and move from one body system to another, causing, for example eczema, then asthma, migraine, spastic colon, etc. Naturally, this constantly endangers his or her credibility, especially in the eyes of doctors.
- Paradoxical: these are illnesses full of contradiction: lethargy that swings in and out of hyper-activity, anorexia with bouts of bingeing, tachycardia (fast heart) alternating with pseudo-heart block, feeling miserably cold or tormented by heat.
From this, you may deduce a hidden allergy is a complex and mysterious phenomenon. No wonder recognition was so long in coming. In fact the first person to uncover the hidden allergy effect was Dr Herbert Rinkel, one of the founders of clinical ecology. It was by observing his own responses that led him to postulate the mechanism of ‘masking’.
What we have learned since is that while there is food residue in the bowel, there may be no reaction. If we eat a food every day or several times a week, it means there is always some of that substance on-board. This may help to hide the allergic reaction: since there is already some present, eating more of it may have little or no immediate effect. That is why you must allow a five-day (minimum) cleansing period on an exclusion program, before you begin testing and re-introducing foods.
This residue effect also explains why allergies to everyday foods has gone unnoticed for so long.
The body seems to get accustomed to an allergen, in a sickly sort of way. Only when too much is encountered at one time do symptoms break through. This also seems to happen when the body’s resistance is lowered temporarily, such as due to stress or acute illness. Age can have the same effect, so that an allergen that may have been harbored unwittingly for decades gradually comes to the surface.
The crucial key to this bewildering variability of symptoms is another revolutionary clinical ecology concept.
Not all allergies are constant and predictable. Many appear to come and go. The key to this shifting pattern is the concept of ‘cyclical’ and ‘fixed’ allergies.
Fixed allergies, as the name implies, never really change. Once acquired, they are with one for life. In general fixed allergies are severe. Allergies to insect stings, strawberries and shellfish tend to be of this type. These are usually immunollogically-induced allergies and, in accordance with our present understanding at any rate, there is no reason to expect them to alter.
Cyclical allergies, on the other hand, vary considerably in the severity of reactions they produce. The more often the allergen is encountered, the worse the reaction becomes. Conversely, if the allergen is avoided for a long period, the reaction tends to dampen down.
The actual period of avoidance varies a great deal. In some cases as little as a few days may result in loss of response to a single mild dose. Other people may have to avoid the allergen for many months. The majority of allergens lie somewhere in between.
The cyclical effect is of great importance when it comes to allergy food challenge testing. The optimum interval between avoidance and testing for a food is five to ten days. Five days are needed for unmasking (see hidden allergy from the mechanisms of allergy page) but, beyond that time, the sooner the tests are carried out the better. After ten days certain allergens may begin to lose their effect and so be missed on a single challenge feed. As a result the patient may consider a food safe, eat it frequently and suffer baffling exacerbation symptoms.
This cyclical nature of allergens means that it is not usually necessary to avoid an allergen for life or, indeed, for more than a few months at a time, before trying it again. However, the patient must understand that returning to a frequent intake of the allergen will not work – it will just make the symptoms start up all over again. A hostile food will always have to be treated with some caution.
Rotation dieting is an attempt to prevent the build-up of cyclical allergies. By eating foods in line with a careful timetable, say every four days, it is usually possible to maintain the safe character of a food. Remember also, a food eaten below its ‘threshold dose’ will appear not to cause a reaction.