treatments
homeopathy
acupuncture
underlying disposition
immediate triggers

Dear Dr.Allan,

I suffer from allergies, asthma & anaphylaxis(exercise induced). I have had shots for about 4-1/2 years & some of my allergies were reduced, but then I developed asthma & anaphylaxis. I am tired of taking pills & inhalers, but then again I don't want to itch, sneeze & wheeze all day. By the way I never had any problems until I moved to Southern Georgia. Can you suggest anything. I take Zyrtec, Accolate, Serevent, Proventil, Aerobid on a daily basis and keep the following medicines for emergencies, a breathing machine, several epi-pens, prednisone, and Clariten ready tabs. I have a well stocked bathroom. I am 32 years old and am very tired of all of this. I am extremely tired of going into anaphylaxis (sic) shock. One day I was just driving home from work and barely made it to the Base Clinic then they had to transport to our local Hospital. Another day I had went for a bike ride and went into it 1 mile from my house, that was the longest mile I've ever ridden(I live in a very rural area - no houses) it was either ride or expire on the spot. I don't eat 5-6 hours before I workout so that rules out food I think. The real bad attack I believe was caused by Eola drops containing ma-juang taken 30 minutes before I had left work(with a diet coke).

Signed Sick of being Sick
01/04/99

Not an easy case to puzzle out, but let’s do what we can. (Please note that this is a rough draft.)

Two aspects of Hypersensitivity reactions are:

one/ the immediate triggers, and
two/ the underlying disposition to manifest allergic responses

and there are, no doubt, many facets to each of these. The trick is to find the facet that you can work with, and we will certainly talk about various treatment options you might try.

Let’s talk about the underlying disposition first.

Several "experts" have observed that hypersensitivity often starts after a particular massive exposure to a chemical toxin/pollutant/antigen. The immune system becomes overwhelmed and maladaptive. The "gain" mechanism ceases to function: like for instance if your eyes become dark adapted and then stuck there so you are blinded by the light. Another analogy that I like is that its as though the immune system caught a spy in war time and now it thinks that all foreigners (and liberals) are spies. The immune system starts giving violent responses to innocuous foreign substances (such as pollens for example) and/or bits of its own body.

Okay, but what to do about that? The body does innately try to heal, and we have to help it first and foremost by reducing the immune challenge as far as possible. Therefore you should be exposed to as few "challenging" chemicals as possible.

With severe hypersensitivity there is usually a major food sensitivity involvement (though your suspicion is that it is not a major factor in your case), and food is one area where we have a lot of control of what reacts with our immune system. A super-healthy diet is essential. Though the ideal diet will differ from subject to subject there are some general guidelines.

Avoid additives! This means avoiding factory prepared foods. I’m probably exaggerating when I say that diet coke is one big additive, but you get the picture.

Additives I guess includes pollutants! Pesticide residues can be a major problem for people with environmental sensitivities. Eat organic food were possible, and if you are juicing (which is a very good idea if you are looking for optimal nutrition) root vegetables, carrots in particular, must be organic. (Carrots can collect toxins. Dr. Shou Lan says that in China they use carrots to clean the fields and she won’t touch them.)

Avoid stimulants! Your body is already out of kilter. Stimulants will destabilise it further. No caffeine: coffee, tea, cola, chocolate. (And no "decaf": this is a factor prepared food, highly artificial and certainly suspect.)

Find out which foods you tolerate well. (Not necessarily food that you crave! Foods that you crave are suspect!) Find out which foods disagree with you. You can do this by "avoidance and challenge". Avoid the food for 4 days to two weeks to "unmask" the reaction - the reactions are often exhausted - and then challenge yourself with the suspect food..

In designing a diet for a hypersensitive person (organic) animal products are fine for now. At the moment the challenge is to find foods that do not tax your immune system. (Later we can talk about diets for general health.)

Some people with environmental sensitivities will need to undertake rigorous "rotation diets" where particular well tolerated foods are only eaten once every five (a four day rotation) or eight days (a seven day rotation). (This is because your hypersensitive immune system is likely to start rejecting anything you are exposed to on too regular a basis.)

Dust, molds, pollens. You need avoid these as much as you can, which is difficult, yes, and there are degrees… Certainly the environment needs to be as "clean" as possible, but that does not mean that you can or should use commercial cleansers! These contain toxic solvents and chemicals and must be avoided! Try baking soda, vinegar (if you tolerate it), ash...

Avoid scented soaps, perfumes, commercial cosmetics. Try simple essential oils for fragrances, sparingly and rotating them! Try the health food shops so-called hypoallergenic cosmetics (if they aren’t animal tested -excuse my ethical interjection here) and see is they feel good.

Having said all this, we have to suspect, in your case, that the problem relates to South Carolina, the base, your house, your particular environment, and we’ll return to that when we consider immediate triggers. Here we are still talking about underlying disposition. How can we change that? Remove allergenic challenges as much as possible. Optimise your nutrition. Optimise the personal and social stresses in your life. (Easy, eh?) And… support the immune system.

We are probably going to want at some point to work, cautiously, with the adaptogen/ the deep immune tonic herbs. Usually these are used for rather extended periods (6 weeks, rest, repeat). Unfortunately (because of "leaky-gut syndrome") people with hypersensitivities tend do develop new sensitivities to anything they take for a long period. You might try rotating, for instance, Siberian ginseng, Reishi mushroom, North American ginseng, Astragalus - cautiously. We need to regulate, not stimulate the immune system. Start with small doses, and remember that while allergic reactions often have an immediate facet to them they can be delayed by up to 72 hours!

I may have to come back and expand on this section, however, in the meanwhile take a look at a treatment for most conditions, and lets proceed to the next section for now…

Immediate triggers:

(rough notes)

Environment - your particular environment - needs to be explored. Heaven forbid, but it may be something intrinsic to your house that is pushing you over the edge and you may have o move. Meanwhile, explore the possible triggers...

Your suspicion that "Ma huang"/ephedra is a trigger, coupled with the fact that you suffer from the relatively rare (and poorly understood) exercise induced response, is very interesting. Now, it may simply be an allergenic trigger, in which case avoid it, but…

Ephedrine, one of the substances in Ma huang, mimics epinephrine/adrenaline quite closely. To quote The Merck Manual: "Ephedrine has alpha and beta effects similar to epinephrine but differs from it in being effective orally, having a slower onset and longer duration of action, and a greater stimulant effect on the CNS, producing alertness, anxiety, insomnia, and tremor. The peripheral actions of ephedrine are partly due to direct effects and partly to release of endogenous norepinephrine…"

There’s a paradox here. Epinephrine/adrenaline is what we use as the emergency treatment for anaphylaxis… Anaphylaxis involves swelling of tissues restricting air ways (and possibly compromising circulation). Adrenaline has immediate and strong anti-inflammatory actions. So your "epi-pen" can be life saving, but… you suspect ephedra was a powerful trigger. Exercise is a major, or the major trigger for you. Exercise adrenalates! Is adrenalation part of the triggering response here? (I will put up a page on adrenalation and the Autonomic Nervous System soon.) And if so what can we do about it?

In your answer to my further enquiries you paint a picture of yourself as "soft spoken" but a "worry wart". We are going to have to work on stress. Exercise is a great stress handler, but a problem in this case. Meditation is the great stress handler. This is something that we might explore…

We do need to puzzle out the precise immediate triggers, and if worse comes to worse you may need to move! because it could be the house, it could be the Base, it could be South Carolina...

Treatments: (again it may take us some time to puzzle this out effectively)

Constitutional homeopathy should help some. Send me also a nutshell portrait of your personality. (S.S. has sent some further information and we are working on this)

From the further information that you've sent, I'm going to suggest that you try taking homeopathic Sulphur as an LM potency - LM1.

Why sulph.?

I don't know enough about your emotions and psychi, yet, to find your constitutional remedy with confidence, but we are beginning to get a clear picture of the "physicals".
Sulph. is one of the many remedies black lettered for aggravations from physical exertion,
its one of several remedies black lettered for skin, red, and for swollen eyes
one of two remedies black lettered for itchy eyes.

Sulph. is one of the greatest of "polycrests": it covers innumerable symptoms. It has a reputation as the great skin remedy - though one of my teachers cautions not to prescribe it simply for skin, on skin symptomolgy alone, but only on the totality of symptoms. Here we have skin as part of the totality. (As to "mentals": while we don't have a clear picture yet, S.S. describes herself as a "worry wart" - sulph. is famously cerebral. The sulph. stereotype is the absent minded professor.)

Sulph. of course is one of Hahnemann's great "anti-psoric" remedies and is often used to clear the (psoric) ground where other well chosen remedies fail to work as expected - though this might be thought a questionable practice if the symptoms do not indicate sulph. Here they would seem to.

Why sulph. LM1?

Hahnemann, in his last years, innovated and used the LM potencies rather than the "centisimal potencies" most commonly used in homeopathy. Apparently he felt that there were several problems with the centisimal potencies: one needs to find the right centisimal potency, two, one needs to find the right frequency of repetition (remember the homeopathic maxim the less is more!), and three, there was always the danger of aggravation.
With the LM potencies - which are diluted 1 in 50,000 (instead of 1 in 100 i.e. centisimally) - Hahnemann simply started with LM1 and worked up to LM30, he repeated hem every day or every second day, and apparently he found that they do not produce aggravations. [

If we were using centisimal potencies in his case we would start with a sulph. 6C as a split does (i.e. 3 pellets dissolve in the clean mouth, repeated 3 times at 30 minute intervals, e.g. 6:00, 6:30, and 7:00). Repeat once a week.]

The prescription for S.S., then, is sulph. LM1. and we are going to take this in a manner called "plussing"
The remedy, sulph. LM1, can be ordered from Helios Pharmacy.
When the phial arrives: shack 1 to 10 of the "poppy seed sized" grains (one will do! but so will ten) into a small amount of preferably distilled water in a small bottle (half an ounce or an ounce, 25 or 50 cc.s).
Now we are going to "succuss" this. Close he bottle and "bang" it on a book (i.e. a soft surface!) 20 times, raising the bottle about 10 cm (3 inches) and bringing it down sharply on the book. Why? See "Beyond Substance",
Pore half the contents of the bottle into a shot glass and sip it.
Then top up the bottle, and succuss it again (bang it 20 times).
Repeat this practice every second day.
Report and changes observed to me.

I have found acupuncture very useful with allergy and asthma symptoms.

Needles are he most effective way of stimulating acupuncture points but not necessarily the most convenient. If you got hold of a "laser pointer" (they are selling them in variety stores in Toronto for $20) you might try "laser acupuncture".

Points I often use include: Spleen 10 (anti-inflammatory action)

I often use herbs effectively with asthma, but from your history it seems we have to be very careful using herbs.

Could you please tell me more specific details about the anaphylactic reactions: details of symptoms (and setting)?

(additional rough notes)