Severe Allergies and Environmental Illness: General Recommendations
Though certainly I am well-known for my work with cancer patients, I do treat allergies and environmental illness as a major presenting complaint. Usually the patients I see have been through every type of testing and treatment, both alternative and orthodox, for their symptoms. An allergy-environmental illness syndrome can be quite devastating, and like chronic fatigue, often affects very bright, previously very ambitious and functional people.
Environmental illness is an issue hotly debated, and often derided, both in the lay press and at austere medical conferences. This is a syndrome of such severe allergic responses to multiple chemicals and substances in the ambient environment that patients often become housebound, at times living in specially designed non-allergenic homes, often dependent on gas masks to filter out potential offending chemicals. Even minuscule amounts of offending agents, sometimes perfume wafting over from a person across the street, or exhaust fumes from a bus a block away, can provoke a host of symptoms ranging from incapacitating fatigue and depression to concentration and memory lapses and even, some claim seizures. Such symptoms can last for days at a time, making normal life such as work, family, and fun impossible.
The orthodox medical world tends to dismiss environmental illness as the figment of the imagination of alternative practitioners, but increasingly more mainstream physicians are beginning to accept that our modern world is a minefield of potential allergic responses that can indeed wreck the life of a susceptible patient.
Many of my patients with allergies, and its related illness, Chronic Fatigue Syndrome, report no family history of allergies, and no allergies whatsoever as a child. Many female allergy patients, in my experience, have very severe premenstrual syndrome involving debilitating pain that often end up with visits to the local emergency room. Many of my environmental illness patients can pinpoint almost to the day when the real trouble began. In one such patient, she developed severe bronchitis that was so severe her orthodox physician almost hospitalized her. As is so often the case, she was treated with antibiotics – even though most bronchitis is viral in nature and not amenable to antibiotic therapy. She gradually recovered from the acute episode but ended up with severe persistent asthma – something she’d never suffered before.
Most of my very sick environmental illness patients have an overly strong parasympathetic system and a correspondingly very weak sympathetic system. When the parasympathetic system is dominant, a crescendo of physiologic and biochemical processes follow, that often lead to allergic reactions. First, Dr. Kelley, before I met him, suggested that the parasympathetic system ultimately stimulates immune function. Indeed, over the past decade, molecular biologists have found acetylcholine receptors on many types of immune cells, including those that populate the spleen and thymus, as well as the various lymphocyte and natural killer cell classes, and mast cells and basophils. Even neutrophils appear to be influenced by parasympathetic firing. And though for many years, doctors suspected that “stress suppresses immunity,” we now know that norepinephrine, the main sympathetic neurotransmitter, does indeed inhibit splenic and thymic function directly, and in contrast to parasympathetic activation, also inhibits the various subclasses of lymphocytes.
So, as a start, in a parasympathetic dominant patient, the immune system is over-active. This translates, practically, into over-responsive mast cells, basophils, and lymphocytes. These cells are constantly primed to go into action, perhaps too much so, and are too quick to release the basic mediators of inflammation, such as histamine, serotonin, bradykinin and the various pro inflammatory interleukins.
The situation is compounded because when the parasympathetic system fires, the body tends to turn alkaline, both in the blood and at the cell membrane interface. In an alkaline environment, calcium tends to leak out of cell membranes. Calcium is a main intramembrane cement, that when deficient in the membrane, leads to membrane porosity. Basically, when the parasympathetic system fires, the cells become leaky, in fact, they can become very leaky. This means two things: first potential allergens easily enter cells, as the usually carefully restrictive ion channels, protein pores and other communication channels start losing control and their normal selectivity. Secondly, the mediators of inflammation produced in immune cells, such as the basophils, mast cells and lymphocytes, easily leave. Since in a state of extreme parasympathetic dominance the immune cells are already hyper responsive, even minuscule amounts of antigen can cause a copious release of inflammatory mediators. This explains the environmental illness patients who will feel very ill if someone walks into the room who had been smoking six hours ago. A few molecules are enough to send them into a downward allergic spiral.
I remember reading years ago about Dr. Theron Randolph’s patient who was “so allergic” that even distilled water precipitated hives. I have treated patients myself who report that literally even the change in wind direction produces hives. What Dr. Randolph saw was a patient in such extreme parasympathetic dominance, with extremely porous cell membranes, that the pressure of water molecules could extrude inflammatory mediators such as histamine.
The parasympathetic dominance explains why these patients can be so difficult to treat, unless one addresses the underlying neuro-physiological cause. As long as the patient is parasympathetic dominant, their cells will be leaky and their immune cells will be hyperactive, a combo destined to cause trouble. These are the patients who after elaborate testing, whether sublingual, elimination, muscle testing, standard provocation approaches, etc., who are put on a “clean allergy free diet” then develop allergies to all the new foods. These are the patients who despite rotation diets, neutralization therapies, acupuncture desensitization, etc. still come out allergic. I remember reading about some of Randolph’s patients who were finally reduced to eating wild animal meat flown in from a distributor in the mid-west. If the cells are leaky and the immune cells are hyperactive, it doesn’t matter what you do. Patients will tell you they are reacting to distilled water, and they really are.
Parasympathetic dominants are genetically designed to use red meat, fat and (horror of horrors) even cholesterol effectively. They need protein and fat to produce cellular energy and cannot efficiently metabolize carbohydrates. These are the classic Dr. Atkins’ patients who thrive on red meat, the more the better, the Eskimos among us. They do poorly on carbohydrate fuels, and usually terribly on grains.
Interestingly enough, some of the pioneers in environmental medicine found that their allergy patients tended to react to most grains, sugars, and other high carbohydrates foods and energy sources. Such patients often ended up on a high meat diet by default. Red meat is filled with sulfates and phosphates, that in the body as we learned in physiology are quickly turned into phosphoric and sulfuric acid in the blood stream, resulting in a very acidifying effect. As the body turns more acid, less alkaline, calcium re-accumulates in the cell membranes, the membranes get tighter, antigens have a harder time getting in, and inflammatory mediators have a more difficult time leaving. The allergic responses lessen.
Such patients do terribly with most fruits and leafy greens, which are very alkalinizing, and cause their symptoms to get worse. Alkalinizing fruits and vegetables stimulate the parasympathetic system, and in a parasympathetic dominant this is a disaster. Instinctively, such patients tend to hate salads and avoid fruits, but too often force themselves to eat such foods because of their highly promoted “health benefits.”
It’s been interesting to read books announcing that grains are the enemy of mankind. For parasympathetic dominants, this is indeed true. Eskimos, the Inuit, the classic meat eaters of tradition, lived on an all meat, high fat diet, and were completely unadapted to using grains, fruits, etc, which didn’t exist in the Arctic until western civilization arrived. There are meat eating groups other than Eskimos of course, and none do well with grains, none do particularly well with fruit or very alkalinizing vegetables.
Such patients, to get over the allergies, require large daily doses of calcium up to three grams a day, which stimulate the sympathetic system. Such patients do terribly on magnesium in supplement form, which is the most alkalinizing mineral around, and which suppresses sympathetic firing. Such patients do lousy with potassium, which as Pottenger pointed out sixty years ago stimulates the parasympathetic system, and which in these people is already far too strong. For such folks, the standard calcium magnesium ratio of 2:1 often presented as ideal is an invitation to disaster.
If one chronicles the history of allergy treatments over the past one hundred years, one finds often the practitioners instinctively gravitated toward a high red meat, high fat diet. Dr. Blake Donaldson, a New York practitioner from seventy years ago, treated thousands of what we would call high allergy patients with a high meat/high fat diet, with reported great success. He didn’t understand why the diet worked, but he was basically giving very sick, very strongly parasympathetic dominant patients the diet they needed to turn on their sleeping sympathetic system and turn off their overly powerful parasympathetic nerves.
More recently, Randolph to some extent and his followers, particularly Newbold, and others such as Atkins, claimed the only way to treat allergy patients was with a high meat high fat diet. Newbold, for example reached a point of frustration with allergy testing, elimination diets, rotation diets, etc. and just put his patients on meat all day long. He and his colleagues were giving parasympathetic dominants the ideal food, food that normalized their autonomic system, normalized their acid base levels, tightened the cell membranes, reduced the hyperactive immune drive, reduced the inflow of antigen and the outflow of inflammatory mediators.
Sympathetic dominants hold on to calcium, to use my own analogy, like a magnet does a nail. Their cells are loaded with calcium, their membranes are so tight nothing goes in, and little leaves. Then, the strong sympathetic effect directly blunts the normal immune responses. These are the folks who never get allergies, who can walk in back of a polluting bus in New York City smoking a cigarette and eating junk ice cream and feel great. There’s no mystery, they simply have an overactive sympathetic system, a weak parasympathetic system, and tight cell membranes coupled with an unresponsive immune system. Also, the high levels of norepinephrine and epinephrine keep them at a slightly euphoric level. May sound great, but these people strongly hold on to metabolic wastes that become trapped in the cells. These wastes are a ticking time bomb of free radical sparks and metabolic poisons. These sympathetic dominant people may feel wonderful because of the epinephrine high but they often feel great even as their bodies become ravaged with pancreatic cancer or they drop dead of a heart attack (remember, norepinephrine and epinephrine are toxic to the heart, that’s why beta blockers help with heart failure).
Sympathetic dominants can push themselves too hard, too much, too long, they work too hard, they are too ambitious, too driven, too motivated. Norepinephrine, epinephrine, and the effects of sympathetic hyper-activity do all this. But this way of life can blow out the adrenals eventually, and in such a circumstance, they can develop what appear to be allergies, but are more inflammatory reactions caused by adrenal weakness.
One problem remains with chronically ill, chronically debilitated allergy patients, even as they improve. Of course, the brain, and the autonomic nerves ultimately control all metabolism, and the brain is an organ for learning. Allergy patients, at a conscious, unconscious and neurophysiologic reflex level, learn that the world is the enemy. Everything is the enemy, the air, the water, even food, which should be nourishing. Even as these patients improve, the reflexes for parasympathetic reactivity and hyper-responsiveness remain, and must be untrained. The brain resists such reprogramming, because it “knows” the environment is trying to do damage. No matter how much calcium or red meat you pour into someone, the brain will try and override whatever you do, try and provoke symptoms to warn that the world is the enemy. Remember how powerful trained reflexes are – Pavlov showed this 100 years ago.
I do find, fortunately, that as patients stay on their protocol, eventually the brain learns that it isn’t necessary to react to food and air and water with a strong parasympathetic discharge, it will eventually enjoy not being so vigilant. We tend to intellectualize our reactions, and allergy patients are often very smart people, who really do consciously believe the world is the enemy, and even on a conscious level will resist improvement. It’s not neurotic — it’s their trained belief in self-preservation. Eventually, even consciously, they will learn that the right food will nurture, air will sustain, the world, as awful as it can be, is still a wonderful place. They can go back to school, back to work, back to life. But they will fight it for a while.
The clinical ecologists tended over the decades to strongly reinforce the idea that the world is the enemy. These patients really don’t need any encouragement in that direction, they already know it. What you have to do is convince them the world can be a great place. And feed them lots and lots of grass fed, organic meat!
By Nicholas Gonzalez, M.D.