MECHANISMS OF ALLERGY
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.
Cyclical and Fixed Allergies
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.
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