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In order to further study the question of spray residues and their effect on health, I asked three of my patients to take part in an experiment. Each of them was known to be susceptible to a wide range of chemicals. I invited them to my office for a peach-eating session, using fruit from the local market. After eating these commercial peaches, one patient developed a rash, with itching, burning and stinging, and the formation of red wheals (urticaria). The second had a frightening attack of asthma. The third developed a headache. To make the test complete, similar-looking peaches were obtained from an abandoned orchard where the fruit grew wild, unblessed by the exterminator’s spraygun.

After an interval, the three were given some of these peaches, without their being identified as unsprayed fruit. To these items they had no reaction at all: they tolerated them perfectly well. In the following season, I tested 15 more patients in a more elaborate experiment which was mentioned briefly in the previous chapter. I obtained four lots of peaches, all of the same type, but each treated quite differently. The first were picked from trees in an abandoned orchard, having received no sprays, fungicidal treatment, or fertilization for the previous three years. The second lot were the same as the first, except that they had been manually dusted with sulfur as an antifungus measure. The third were from one of the University of Illinois plots which had received the recommended spray schedules using DDT and dieldrin. The fourth were peaches from the same source sprayed with the pesticides parathione and dieldrin.

For several days before the test, all of the patients avoided both peaches and chemicals to which they knew they were susceptible. The patients were assembled in my office and were given the various peaches, without any knowledge of which batch they were receiving. Three of the fifteen became ill when they ate plain, uncontaminated peaches. They were evidently allergic to peaches per se. A larger number of the others reacted to both the sulfured and the sprayed peaches. Some of them became so ill, in fact, that they refused to go on with the testing. This was good common sense on their part, but it detracted from the completeness of the experiment. Nevertheless, several of those who had no reaction to the organic peaches were made ill by the sprayed peaches, regardless of the type of spray used. Clearly there were people who were made sick by eating infinitesimally small amounts of insect spray, similar to the amounts millions of people eat every day.

One good effect of this discovery was that patients who had long stopped eating fruit, from the belief that they were made sick by it, were able to start again, provided they ate only organically grown, uncontaminated fruits.

“Multiple fruit sensitivity” turned out to be not such a very rare condition. An investigation of spraying practices exposed some of the underlying reasons for this problem. Peaches, apples, and cherries were the most commonly contaminated, as well as the most heavily contaminated, fruits. Although the total number of spraying applications varied with rainfall and other conditions, peaches, apples, and cherries were often sprayed between ten and fifteen times each season. Recommended spraying started with blossoming and ended only a few weeks prior to harvesting. Needless to say, these fruit were fairly well saturated with spray.

They are hardly unique in this respect, however. It turned out that most of the commercially produced fruits in the United States are copiously sprayed. Some of them are sprayed with many different agents, and it became almost an impossible task to decide which spray caused which symptom in a patient. This problem has increased year by year.

Once a fruit has been sprayed with a combination of pesticide and kerosene, or some other chemical solvent, there is no known way of removing the spray residue. Air passes quite readily through the skin of a piece of fruit and with it comes the spray ingredients, to be incorporated into the pulp itself. Washing, rubbing, peeling, cooking, and any other attempt to clean the spray off do not eliminate spray residues. The experimental proof of this assertion is the chemically sensitive patient, who gets sick from commercial, sprayed fruit no matter how he rubs or washes it.

Some individuals, however, who are not violently susceptible to chemicals, may be able to eat stewed fruit, but not raw, fresh specimens of the same lot. The reason appears to be that when the fruit is stewed, some of the pesticides are boiled off. Some of my patients have, in fact, gotten sick simply by standing over a pot of stewing commercial fruit, inhaling the vapors which contain part of the pesticides escaping into the atmosphere. Stewing organically grown fruit does not have that effect on these patients, however.

It must be emphasized that a highly susceptible person, eating an ordinary diet, rarely suspects the fact that a daily piece of fruit causes any problem at all. The reason for this is that the small, daily dose of pesticide may merely serve to reinforce and perpetuate his symptoms of illness. All he knows is that he felt badly yesterday and feels just as badly today. He naturally does not associate his headache or his asthma or his fatigue with something so innocent, and apparently unconnected, as the supposedly beneficial fruits and vegetables. It is only when he overindulges and takes in an extraordinary amount of these products (and pesticide) that he breaks out of the level of chronic disease and precipitates an obvious reaction.

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Chemical tinkering with the hydrocortisone molecule has produced drugs such as prednisolone. This suppresses inflammation but has very little effect on the excretion of salt by the kidneys, so it will not cause water retention.

Unfortunately, these are not the only bad effects of corticosteroids. Because they suppress inflammation, which is a valuable part of the body’s fight against disease, they tend to make infections more likely. Viruses and fungi, in particular, are likely to flourish.

If corticosteroids are taken over a long period of time, the adrenal glands’ natural activity is suppressed. Stopping the drug leaves the body without corticosteroids which can lead to collapse in the worst cases. This means that corticosteroids taken by mouth should never be stopped abruptly if they have been taken for more than a few weeks. The glands must be given time to recover their natural level of activity, by gradually reducing the dosage. Even after as little as two weeks, corticosteroids should be withdrawn gradually, by halving the dose each day, to avoid a flare-up of the original problem.

In general, applying corticosteroids locally lie where they are needed) is preferable to taking them by mouth or injecting them, because it reduces the dose needed and thus minimizes side-effects. This means applying the drug in creams or ointments for eczema, inhaling it for asthma, or injecting it directly into an affected joint for rheumatoid arthritis. Some of the drug still gets into the bloodstream however-for example, it can be absorbed through the skin. Children with eczema who are smothered in high-dose corticosteroid cream by their parents can develop Cushing’s Syndrome, although this is now very rare as doctors are more aware of the dangers.

Corticosteroids are valuable weapons in the fight against many diseases, but must always be used with some caution. The doctor’s instructions, as regards the amount and timing of the dose, must be followed exactly.

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Sublingual therapy is approached in exactly the same way, the neutralizing dose being determined by a series of injections. But the mixture of extracts for home use is supplied as drops, one of which is placed under the tongue. There is rapid absorption into the bloodstream from this area, and it bypasses the liver, so the extract is not broken down rapidly. The effect of drops is not as long-lasting as that of a subcutaneous injection – the treatment has to be repeated every few hours. However, they are useful for inhalant allergies, or reactions to substances that are “only encountered occasionally, because the drops can be used only when needed. Sublingual therapy has been successfully used to treat patients with allergic reactions to house-dust mite and pollen. It is also claimed to be effective for patients sensitive to synthetic chemicals, where industrial alcohol is used instead of an extract. The question of using mixtures of extracts for neutralization is a difficult one. The trials of this technique have all involved solutions containing single food extracts. Yet some practitioners use up to 70 food extracts in a mixture. Whether the method still works under these conditions is uncertain.

There is also concern over the possible dangers of this technique to patients with violent allergic reactions. It is theoretically possible for such a person to suffer anaphylactic shock when injected intradermally with their allergen, and this could be fatal. However, this technique has now been widely used for many years, and no fatal (or even near-fatal) reactions have occurred. Nevertheless, anyone who has experienced immediate and violent allergic reactions to food (or other allergens) should be carefully assessed before such treatment begins.

Finally, it is claimed that the provocation-neutralization method can be used as a diagnostic test, to determine which foods are the culprits and avoid the need for an elimination diet. These claims are rejected by the majority of doctors because they feel the test is too unreliable. Detailed trials show that there are often positive reactions to extracts of foods that do not provoke symptoms when eaten (false positives). Occasionally foods that cause symptoms will not produce a positive wheal (false negatives).

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Before embarking on an elimination diet, some understanding of how foods can cross-react with one another is necessary. Foods derived from two related plants (or two related animals) will have similar proteins. They do not have to look like one another to be alike chemically – our own proteins are 99 per cent the same as those of the chimpanzee and the gorilla, our nearest living relatives. In the same way, the potato and the tomato may look quite different, but the plants they come from are closely related.

If you are allergic to one sort of food, you may show a reaction to food from a related source, because the IgE antibodies that bind to the first protein will also bind to a similar related protein. Cross-reactions also seem to occur in food intolerance, although the mechanism is not understood in most of these cases.

Biologists use various methods to work out how closely two animals or plants are related. Having done so, they express these relationships by grouping creatures together in a hierarchical scheme – very closely related creatures belong to the same species, related species belong to the same genus (plural genera), related genera belong to die same family, related families belong to the same order, and so on. There are often further subdivisions within each level, such as the subfamily and the tribe, which are subdivisions of the family.

How is this sort of classification scheme relevant to food sensitivity? Practical experience of thousands of patients suggests that they can cross-react to related foods, although they do not always do so. It also seems, from this collected experience, that the family level in biological classifications is a useful one in deciding which foods will cross-react – although sometimes one has to look at higher or lower levels to understand the cross-reactions that are seen. For example, all cereals are grasses, and belong to the grass family, Gramineae. Some food-sensitive people react to all cereals – to all members of the family. But others react only to wheat or maize, the two most commonly eaten cereals in the West. Many who react to wheat also react to rye and barley, and sometimes oats. If one looks at the classification of the Gramineae, one finds that wheat, rye, barley and oats all belong to the same subfamily, the Pooidae, and wheat, rye and barley are in the same tribe, the Triticeae. Maize is in a different subfamily, and rice in a different subfamily again, so there is less likely to be a cross-reaction between wheat and these cereals. This nicely explains the observation that wheat-sensitive folk are more likely to tolerate rice than any other commonly eaten cereal.

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The foods that are most likely to cause problems are those that you always eat in large quantities or hinged on during pregnancy, those you have a craving for, and, paradoxically, those that you actively dislike but eat because they ‘do you good’. You should also be suspicious of foods that are known to be potent allergens. Apart from milk, these are: eggs, peanuts, other nuts, wheat, chocolate, fish, oranges and other citrus fruits, chicken and beef. If you eat a lot of any of these foods, then add them to your list.

Anything with a drug-like action, such as coffee, tea, wine (especially red wine), beer, spirits or other drugs, is also a prime suspect, especially in the case of colic. Try cutting out all these drug-like items, plus cow’s milk, for two weeks and see if the baby improves. Eat extra protein from other sources and take a calcium supplement, which your doctor can prescribe.

If there is no improvement, then you should try eliminating all the other suspect foods that you have listed. Avoid them for two weeks, but substitute other foods that will fulfil your nutritional needs. Remember to cut out all the ‘hidden’ forms of foods, especially with ubiquitous foods such as milk, eggs and wheat. Read the labels on packaged foods carefully and see p292 for some of the synonyms used, as these can be deceptive. Avoid all restaurant or takeaway food during this time as it is difficult to know what you are eating.

If you have cut out more than two or three foods, and your baby gets better, then you will probably wish to test the foods to see which ones were the cause of the trouble – often it will just be one food. Wait until the baby has been well for about a week, and then reintroduce each food in turn, beginning with those least likely to cause trouble, and testing cow’s milk last. Eat a normal-sized portion of the food to be tested, every day for a week. If the baby remains well, discontinue that food and go on to test another one, again eating it every day for a week. Make a note of which foods cause symptoms and which do not. When all have been tested, those that produced no symptoms in the baby can become part of your normal diet again.

It is possible that the baby will remain well, and not respond to any of the foods – a brief period of avoidance can sometimes clear up the sensitivity. If this happens, continue with your normal diet, but be careful not to eat too much of any one food.

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In the case of asthma, it is the effect of histamine on the smooth muscles of the bronchi that produces the symptoms. These vital tubes, which carry air to the lungs, go into a spasmodic contraction. How the allergens reach the airways, and the types of allergens involved, will be dealt with in Chapter Three. The way in which mast cells cause other allergic reactions, such as hay-fever and perennial rhinitis, will also be described there.

As one might expect, people with these allergic disorders tend to have a higher level of IgE in their blood than others. But there are a few whose IgE levels are normal. Conversely, there are quite a large number of people who have high levels of IgE, and give positive skin-prick tests to common allergens (see box), but who display no symptoms. Perhaps these symptom-free individuals have fewer, or less accessible, mast cells than others, making them less susceptible to high IgE levels. Or perhaps the mechanisms behind allergy are more complex than they appear, and IgE is only part of the story.

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Chemicals that normally would not bother you can give off fumes when they get hot. You may suddenly notice fumes from asphalt surfaces, from car tyres, or from car interiors on hot days. Open up cars and air them before driving off in hot weather. You may be able to tolerate synthetic materials unless you wear them or sleep on them -thereby making them warm enough to give off fumes. You may be able to use plastic bags, boxes, or plastic wrap, unless you use them on warm food. Decorating and furnishing materials, such as paints and plastics, may not bother you unless they get heated, so take care with paint on radiators, around windows and doors, and with lagging and insulating materials, and with fabric or plastic lampshades that get heated. Televisions, computers and audio equipment can give off fumes when hot, so you may have to moderate their use and ventilate well when they are on.

Avoid using a foam padded ironing board cover, or one with a metallic cover. Use a pure cotton cover, and pad with a pure cotton sheet or blanket.

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Veneers and Sheets

Veneers are thin layers of wood glued to a thicker surface, often particle board. The particle board is often the cause of reactions to veneers rather than the veneer itself.

Melamine and plastic sheets used as a covering on particle boards can give off fumes when new, but usually air off well. Again, the particle board is the more likely source of problems.

Wallpaper

Wallpaper, including lining paper, is best avoided if you are highly sensitive to moulds as moulds grow on it. Wallpaper also contains chemical finishes, such as formaldehyde, rosin and vinyls which will affect you if you are exceptionally chemically sensitive. Again, it is best avoided.

For wall finishes, use plaster with simple emulsion paint, or tile walls where appropriate.

For stripping wallpaper, use a steam stripper rather than solvent strippers.

Wiring

Some people who are extremely sensitive to plastics can react to plastic-covered electric wiring if it heats up. If this affects you, contain wiring behind skirtings if possible. Alternatively, you can contain wires in steel conduit, or use mineral-insulated copper cable (MICC). The latter option is usually cheaper.

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If you suspect your baby is ill in any way, you should always go to see a doctor to obtain a proper diagnosis. You should always make sure that all other possible causes, as well as allergy and sensitivity, are considered. Never jump to conclusions yourself.

What Symptoms Might I See?

If your baby has been sensitive or allergic from birth, it may be very difficult to work out what are symptoms, and what are just features of the baby itself. Some allergic or sensitive babies are constantly snuffly, or restless; some cry constantly, are grizzly, irritable and have difficulty in sleeping. Some have colic, excessive wind and constipation. Some have rough skin, itchy eyes and dermatitis. Some have flushed, red faces and shiny skin. With a newborn, it can sometimes be impossible to tell whether he or she is reacting or not. Unless you feel strongly that something is wrong, or the baby has clear reactions to changes in routine, it may be unwise to draw any conclusions.

If you suspect a very tiny baby of reacting, the first thing to check is its milk, whether breast or bottle. You might also investigate whether he or she is sensitive to cleaning, sterilising and laundry agents, toiletries, or other chemicals you are using; or to inhalants such as house dust mites, moulds or pets.

Many babies develop the first clear signs of allergy and sensitivity at between two and six months. It is not possible to say whether this is due to some particular vulnerability or immaturity of the body’s immune, digestive and other systems, or whether this simply coincides with many babies’ first exposures to foods other than milk, or to other allergens, or chemicals causing sensitivity.

Eczema is particularly common at this stage of a baby’s life often flaring up for a while and then disappearing, either totally or to reappear later in life. Asthma can occur in very young children; some doctors argue that babies under one year cannot develop asthma because they are incapable of wheezing. Non-wheezing asthma can be observed, however – a hoarse, dry cough unrelated to a head cold or virus, which can become productive of phlegm. Gut symptoms of allergy and intolerance are also common. As babies grow older, it is often easier to detect their symptoms as they develop more of their own character and temperament, and a particular routine and diet. It becomes simpler to spot changes and triggers, whether it is a change of diet, a new food, a new pet, a new childminder, a change of season, new bedding, moving house, vaccinations, or a viral or gastric infection.

Symptoms due to other types of sensitivity (e.g. chemicals, inhalants) include breathing and nasal symptoms, eczema, urticaria and asthma. Digestive symptoms are most likely to be caused by food sensitivity. Many parents whose babies go on to develop more serious symptoms as children or adults often recall that their child was unhappy and restless as a young baby, with mild symptoms. It is often difficult to distinguish low level symptoms from an occasional head cold or virus, or from the general crankiness that babies or toddlers often exhibit when they are tired, hungry, bored, or thwarted in their desires.

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Certain environments do not favour house dust mites. They are killed by sunlight. The majority of mites live in the top 1-2 cm (% inch) of any surface, and sunlight can penetrate far enough to kill by light or drying many of the mites present, although it does not remove their faeces or debris. Washing at high temperatures (90oC/194°F plus) also kills mites, and, if thorough, can remove them and their faecal debris completely. A dry environment kills them. They do not survive at a relative humidity level below 55 per cent, and if you can create localised dry conditions, say by drying a pillow on a radiator or hot water tank, or by drying a bed with hot water bottles, or with an electric blanket, this will kill them, although again faeces and debris are not removed. House dust mites do not occur in any concentration in the Alps; the combination of low humidity and low temperatures is probably the reason for this.

Synthetic materials are often claimed to deter house dust mites and advice is often given to use synthetic bedding, to avoid problems with house dust mite allergy. Despite the prevalence of this advice, there is little evidence to substantiate it, and the experience of many people with allergies indicates the need for caution.

People who replace old bedding with new bedding (of any material) often get a great improvement if they are allergic to mites, but house dust mites will colonise new bedding, even if synthetic. Problems with mites can, and do, recur in synthetic bedding after a while, unless you take preventative measures to deter them (so the benefits can be due simply to the newness of the bedding, not to the change to synthetic material).

There is some evidence that synthetic carpets can reduce the level of airborne allergens (including house dust mites) because their increased level of static electricity attracts particles and holds them down. There are also some benefits to using synthetic bedding, compared to wool or feathers, in that it can be readily washed and dried. However, washing at low temperatures (40°C/105°F or less) does not kill mites. It simply rinses out the faecal pellets, but not always the mites themselves, who are tenacious and cling on to survive. You need a high temperature of wash to kill and eliminate mites.

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