WARNING: the foods we cook for Abby are safe for her, but not necessarily for everyone. Please confirm any ingredients are safe for you before using in your diet. Food Allergies can kill and the best policy is complete avoidance. Read this post for more info.

Thursday, March 1, 2012

Allergies. Gluten. Mast Cells. Innate Immune Response.

The number 1 issue with Abby from birth has always been her allergies. I am realizing now that maybe some of her food issues over the years were not all allergies, but based on the 6 rounds of skin testing and multiple blood tests- she clearly has allergies.

My question lately has been, since she reacts in a similar way to either allergens or foods that upset her GI- is there really a difference in how we should handle them?

I suppose. I know she has a lot of allergies, but not enough to cut her down to 5 or 6 foods that she currently tolerates. I am slowly teasing the two issues a part, but as I do, I keep finding new and complex information on the web and I feel like I used to know quite a bit about allergies and now I really don't know much.

From Gluten sensitivity to mast cells to true Allergies.. then there is EE and other types of inflammation- how do you possible tease it all apart?

She has a few hard and fast absolutes- shellfish,NSAIDs.. but she also randomly will test strong positives on skin testing for corn,tomato,dairy,soy,tree nuts,oatmeal, and a few others. Why allergic one year and not the next?

One allergist felt perhaps it was related more to her genetics. Abby is not treatable with any of the prescription meds, back in the day before her steroid diabetes, steroids did not even completely eliminate her airborne allergies though they did help her gut. This allergist explained since she is the product of both families who have significant allergies she got a full whama jama of allergy genes.. Of course he was much more elegant when explaining it, and it sure made sense at the time.

Another Allergist felt because Abby was so hyper sensitive and had what he felt was rotational allergies, that it was basically the concept of the "straw that broke the camels back" because it is impossible to avoid all of her allergies eventually her body becomes hypersensitive- one final exposure would throw her over the edge- okay, so that kind of made some sense to us as well.

So, then we figure out that she has this depletion. Which introduced me to the concept of mast cell disorders- I am not even going to try to explain because I don't have a great grasp on it yet, but basically the body over reacts and attacks- again kind of fits Abby, and there does seem to be quite a few Mito patients that have diagnosed mast cell disorders. They have what they call Triggers- things that set those mast cells into a frenzy.

Recently I have been reading about Leaky Gut Syndrome- goodness, that really fits her symptoms too-

So right now I am left with, I don't know what she is "truly" allergic to, but she sure doesn't tolerate much. Not much help! :-)

IT does seem that once Abby gets to the hyper sensitive stage, it is hard to turn off her bodies over active response. The question is, which diagnosis fits best and would allow us to treat it? We also know when she is in this heightened "sensitivity" mode, she gets sick very easily. Finding a capable immunologist or Allergist in Houston is no easy feat.

If the GI isn't able to find something to treat, I think we are going to go for the total and complete elimination diet and strip the environment as much as possible. Over the years my dust control efforts in her room have been defeated by her teenage privacy issues. No fun to live in a naked room, but we are going to have to do something.

Here is a neat article I got in my email this morning that discusses "Gluten sensitivity" and how it is different then celiac disease. I think I could easily make a zillion blog entries about "allergies"... standby :-) What caught my attention in this article was their term " Innate immune Response" boy that fits ... but so does everything else!

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« Back to: Non-Celiac Gluten Sensitivity (main page)
This Q&A was designed to help you better understand non-celiac gluten sensitivity and what sets it apart from celiac disease and wheat allergies.
What is non-celiac gluten sensitivity?
Non-celiac gluten sensitivity has been coined to describe those individuals who cannot tolerate gluten and experience symptoms similar to those with celiac disease but yet who lack the same antibodies and intestinal damage as seen in celiac disease. Early research suggests that non-celiac gluten sensitivity is an innate immune response, as opposed to an adaptive immune response (such as autoimmune) or allergic reaction.
OK, so what is an innate immune response?
Humans are born with an innate immune system. An innate immune response is not antigen specific, meaning that it is nonspecific as to the type of organism it fights. Although its response is immediate against invading organisms, the innate immune system does not have an immunological memory to invading organisms. Its response is not directed towards self tissue, which would result in autoimmune disease.
Unlike non-celiac gluten sensitivity, celiac disease is antigen specific (including tissue-transglutaminase, endomysium and deamidated gliadin antibodies, and in some small children also gliadin antibodies) and does result in an attack on its own tissue. Intestinal damage, or enteropathy, is the direct result.
What are the symptoms of non-celiac gluten sensitivity?
Non-celiac gluten sensitivity shares many symptoms with celiac disease. However, according to a collaborative report published by Sapone et al. (2012), individuals with non-celiac gluten sensitivity have a prevalence of extraintestinal or non-GI symptoms, such as headache, “foggy mind,” joint pain, and numbness in the legs, arms or fingers. Symptoms typically appear hours or days after gluten has been ingested, a response typical for innate immune conditions like non-celiac gluten sensitivity.
If the symptoms are so similar, how is it different from celiac disease?
Non-celiac gluten sensitivity has been clinically recognized as less severe than celiac disease. It is not accompanied by “the enteropathy, elevations in tissue-transglutaminase, endomysium or deamidated gliadin antibodies, and increased mucosal permeability that are characteristic of celiac disease” (Ludvigsson et al, 2012). In other words, individuals with non-celiac gluten sensitivity would not test positive for celiac disease based on blood testing, nor do they have the same type of intestinal damage found in individuals with celiac disease. Some individuals may experience minimal intestinal damage, and this goes away with a gluten-free diet.
Research has also shown that non-celiac gluten sensitivity does not result in the increased intestinal permeability that is characteristic of celiac disease. Increased intestinal permeability permits toxins, bacteria and undigested food proteins to seep through the GI barrier and into the bloodstream, and research suggests that it is an early biological change that comes before the onset of several autoimmune diseases.
Is non-celiac gluten sensitivity different from a wheat allergy?
Yes. Allergies, including those to wheat, are associated with positive IgE assays. Diagnosis is made through skin prick tests, wheat-specific IgE blood testing and a food challenge. Individuals who have gluten-related symptoms but test negative for a wheat allergy may have non-celiac gluten sensitivity.
Related Content:
International Physician Task Force Identifies Definitions for Celiac Disease and Gluten-Related Disorders
Collaborative Report Suggests New Classification for Gluten-Related Disorders
Study Defines Difference Between Celiac Disease and Gluten Sensitivity

Want more information on Celiac and Non-Celiac Gluten Sensitivity? Visit- http://www.celiaccentral.org/


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