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The Big Itch – Eczema

November 16, 2013

Tags: order, food, water, allergy, aloe vera, apples, artificial colorings, attention, balm of Peru, bell & hot pepper, carbs - white, coconut oil - virgin, comfort food, conditioner, cortisone, dermatologist, disease - chronic, dairy, disfiguring, eczema, eggplant, fat - bad, food elimination, gluten, gut, heart, inflammation, itch, label, make-up, nightshades, nuts, ocean, ointment, pruritus, personalities, potato, preservatives, probiotic, psychological theories, rash, remedy, shampoo, skin, soothing, spices, stress, sugar, sunburn, sunlight, swimming, tomato, vitamin D, wisdom

Today, in a New York Times blog, I published a version of this:

One remedy does not work for all - that is the wisdom coming out of these letters. Seeing a good dermatologist and soothing your skin with some cortisone and/or other substance stands at the beginning.

Leave out gluten, dairy, nuts, nightshades (tomato, bell & hot pepper, eggplant, potato) - they are, in my experience, the worst offenders. But I have seen people react to spices, artificial colorings, preservatives, even to apples. Use nothing on your skin than virgin coconut oil, aloe vera gel (best directly from the plant), and your prescription ointment. Try to avoid make-up and read the labels of your shampoo and conditioner: Balm of Peru is only one ingredient that lets rashes bloom! Take a probiotic and vitamin D, and go out into the sun as often as possible - but never to the point of reddening or burning.

Then listen to your body - to the itch? What food makes you itch? What activity? Because every body is different, and my itch is not your itch. As soon as your itch gets better, avoid the cortisone cream, and go all coconut oil.

If your body itches consistently after a certain food, eliminate it - it is hurting you. Eczema is an inflammation of your skin (often on the basis of your gut being inflamed, too). And every bit of inflammation lowers the threshold for the itch, and a new allergy.

A lot of psychological theories are floating around – that certain personalities get it, that one gets it during stress, and so on. I think it is probably the inferior food we fall for in times of stress – comfort food that is loaded with sugars, white carbs and bad fats,. And when you have a chronic disease and an extremely itchy, disfiguring rash – yes, you might seem odd to so some people …

When you have healed, try to introduce some of the eliminated foods again - very, very cautiously. Some you might have to leave out forever, or may have them only very occasionally.

Go swimming in the ocean, whenever you can! - And my heart goes out to you poor thing!

Irritable Bowel Syndrome?

September 6, 2010

Tags: food, order, water, allergy - blood-mediated, allergy - cell-mediated, apple, allergies – fast and slow, autoimmune disease, back pain, blood test for allergies, cancer, chocolate, citrus, constipation, corn, craving, dairy, depression, diabetes type II, diarrhea, drugs – medical, eggplant, eggs, flavor enhancers food allergy, food colorings, food intolerance, fruit, gluten, heartburn, HFCS (High Fructose Corn Syrup), infection, irritable bowel syndrome, Irritable Bowel Syndrome?, joint pain, lectins, mental fog, MSG, nightshades, nuts, obesity, pain, peanut, peppers - bell and hot, pills, potato, preservatives, prescription medication rash, recreational drugs, runner’s diarrhea, seafood, skin problem, skin test for allergies, soy, stomach ache, stool – floating, thirst – excessive, tomato, yeast

In my thirty years in medicine, I have never diagnosed anybody with “irritable bowel syndrome.”

Not that I didn't want to make the diagnosis. But it always seemed to be the last resort - if there wasn't a better explanation for the patient's symptoms. And there always was.

If my patients came with the label, I quietly looked for a more appropriate diagnosis, mostly some kind of food intolerance and/or infections. And if they came with any of the myriad of gastrointestinal complaints, they deserved a thorough workup.

Food allergies: Physicians differ between food allergies and food intolerance. For the patient the difference is minimal: The only action that will help is leaving out the offending food.

Allergies are mediated either through blood – then they show up in blood tests. Or they are cell-mediated, which means they can’t be detected by blood tests; skin prick test is the way to go then.

If you usually feel good (or even just better) in the morning before you eat, food problems are likely. – Floating stools point to a food culprit, too.

There are rare and dangerous diseases, therefore a doctor should eliminate serious diagnoses. But this is what you can do yourself:

• Write a food journal. Everything that goes into your mouth should go in here – including beverages, pills and chewing gum. A pattern might become clear once you regularly record everything.
• In my experience, these are the most common food offenders: dairy, soy, nuts, gluten, corn – especially HFCS (High Fructose Corn Syrup), nightshades (tomato, potato, eggplant, bell and hot peppers), citrus, seafood, lectins, food colorings, preservatives, flavor enhancers (like MSG), eggs, apples and other fruit, chocolate (though probably less common than people think – it usually are the non-cacao ingredients that cause trouble), yeast. And don’t forget: prescription medication! Recreational drugs.
• Read labels! Of course, foods without labels – like kale and carrots – are healthier anyway because only processed food is required to be labeled.
• Has anybody in your family a bowel disease? You might have the same.
• Jot down pains, headache, heartburn, stomach ache, bloating, diarrhea, constipation, blurred vision, slow urination, skin rashes, blocked nose or ears,
• Don’t eat after dinner – and don’t have dinner late. The sheer bulk in your stomach may create the discomfort; besides it prevents the cell repair that should be taking place nightly – but can’t happen when your body is busy digesting.
• Are you very thirsty – especially during and after a meal? That might be a sign of a food allergy. Don’t suppress your thirst – this is how your body gets rid of the offending food: by diluting it.
• If you suspect food allergies, leave out the whole list above plus whatever you suspect for a week. Then one by one, every few days reintroduce another food from the list. – Sometimes only repeated exposure shows the problem – that happens mostly with cell-mediated allergies.
• Blood-mediated allergies are the quick ones – that can bring you to the emergency room - like peanuts. Never try to force your body into accepting any food that it doesn’t want!
• Slow allergies make you sick over time – by the chronic inflammation in your body. That causes for instance cancer in the long run.
• Take a probiotics regularly. I personally like Primal Defense (this is not an endorsement – only an idea to start with. Begin with a small dose, slowly take more. If a probiotic does not agree with you, change the brand.
• Most people benefit from fish oil – to counteract the constant inflammation that comes with food allergies.
• Chew well.
• Eat vegetables, vegetables, vegetables. Not only are they good for you – they also seem to cause fewer allergies.
• Serious runners suffer from a curious disease called “runner’s diarrhea” (about fifty percent of them.
• Obesity might be a sign for food allergies: We tend to crave exactly the foods that are worst for us.
• And most importantly: Don’t eat it if it hurts you!

Unfortunately, you can even have a bowel disease without any gastrointestinal complaints: About fifty percent of gluten intolerance (celiac sprue) patients never notice anything wrong with their belly. But they might have joint or back pain, diabetes, autoimmune disease, mental fog, depression – and a host of other problems.

Ugly Reflux

August 21, 2010

Tags: food, herbs, movement, order, water, acidity, alcohol, aloe vera, antibiotics, artichoke extract, Ayurvedic Medicine, Barrett's esophagus, betaine HCl, bone-enhancing drugs, cabbage juice, caffeine, calendula, chamomile, chewing, chocolate, citrus, coloring, corn syrup, dairy, DGL, digestion, eggplants, elm - slippery, enzymes - digestive, eating late, endoscopy, enzymes - digestive, esophageal cancer, flavorings, food allergies, food - cooked, food intolerance, food - processed, food - raw, foods - spicy, germs, gluten, grains - whole, gut, heartburn, HFCS, hiatal hernia, H. pylori, indigestion, infection, inflammation, junk food, licorice, marshmallow, mastic gum, meals - too big, neem, nightshades, nuts, over-eating, peppermint, peppers, plantain banana, potato, PPIs - proton pump inhibitors, preservatives, probiotics, reflux, SAD (Standard American Diet), stabilizers, starches - white, stomach, stomach acidity - high and low, stress, sugars, timing of food intake, tomato, trans-fats, Ugly Reflux, Zollinger-Ellison syndrome

Reflux is one of those ailments which keep people going to the doctor and take medication forever – and on the face of it, there’s no cure.

And, in the long run, it can be a dangerous disease. Longstanding erosion of the esophagus can lead to Barrett’s esophagus and even cancer.

Why are so many people with the diagnosis of reflux?

Reflux is, in most parts, another disease with owe to SAD – the Standard American Diet. People have intolerances to certain foods and allergies, and those keep the esophagus (and possibly the stomach and the whole gut) inflamed. Instead of eliminating the offending foods, the doctor prescribes Zantac or Tagamet or even one of the stronger proton inhibitors. And has gained a life-long patient.

In the long run, those stomach medications create new problems: Since they all reduce acidity, they also may hinder digestion, and further infections as the stomach acid is supposed to kill invading germs.

PPIs (proton pump inhibitors, drugs lik, Prilosec, Prevacid and Nexium), the strongest anti-heartburn medications can also be addictive, can trigger food allergies, and can weaken your bones.

Heartburn only comes in very rare cases from producing too much acidity for no good reason (that condition is called Zollinger-Ellison syndrome, and should be ruled out by your doctor if the burning goes on relentlessly, regardless what you do). Normally, your stomach reacts with acidity when you eat something wrong. Or if you just each too much, period. So, why fighting the acidity, if you can eliminate the underlying cause?

Sometimes physicians diagnose a “hiatal hernia” – a gap in the diaphragm that allows the stomach to come a bit into the chest area. No connection has been found between HH and reflux. It seems that many people have a hiatal hernia, for reasons unknown – or for carrying a paunch that pushes the organs up into the lung cavity; for instance, it is very well known, that heartburn is extremely common in highly pregnant women. Perhaps also lacking exercise makes the diaphragm go limp. Whatever it is, hiatal hernia does not cause reflux.

If you want to break that cycle – here is what you can do:

Find out what your body does not tolerate. It is not difficult. Write a food journal. The most common culprits are, in my experience,
• Gluten
• Dairy products
• Corn syrup (HFCS)
• Tomatoes (and the whole nightshade family actually – peppers, eggplants, potatoes, too).
• Chocolate could be the culprit.
• Or nuts.
• Harsh foods: alcohol, caffeine, citrus, and spicy foods.
• ANYTHING can lead to a reaction. And not only burning in your esophagus; bloating, cramps, diarrhea, constipation, joint pains, migraine headaches, and many more symptoms can stem from food intolerance.
• Certain medical drugs are the culprits – Fosomax, for instance, that is intended to make your bones stronger (I would not touch it because of its side-effects. Better food and more movement certainly gives you stronger bones without side-effects).
• Sometimes it is not the kind of food but how it is prepared: raw versus cooked. Usually, cooked is easier on the stomach.
• It might be the timing: Some people get away with a raw salad or an acidic fruit during the day, but not at night, as the last meal that lingers in their stomach.
• Or a whole food group: Many people do better without sugars and white starches and reduced whole grains.
• Basically, all junk foods and processed foods are under suspicion. They contain trans-fats and preservatives, coloring, stabilizers, flavorings that are alien to you body.
• Drink enough water - but not with meals or right afterward.

Of course, it is better, to not be indiscreet in the first place. But if you are looking for healing alternatives:
• Mastic gum is my favorite; it is an agent that covers the stomach and helps if you have been indiscreet, food-wise. Unfortunately, mastic is not cheap. An alternative, paid by insurance is Carafate, with a similar action.
• DGL licorice helps – it is a deglycyrrhized licorice that does not have the bumping effect on blood pressure. This comes also as a lozenge.
• Other herbs that soothe the stomach are chamomile tea, aloe vera juice (or eat directly from the plant – the jelly-like inside of the leaf; avoid the green outside leaf – it is a harsh laxative), slippery elm, plantain banana, calendula and marshmallow (the real herb – not the sweet candy!), cabbage juice, artichoke extract. But watch it: I, for instance, have a chamomile allergy; that would make the situation worse.
• It is always a good idea to start out with the Ayurvedic herb neem which kills all sorts of infections because, unbeknownst, germs can cause all the indigestion. Ask your doctor.
• In an acute attack, sleep with your upper body a bit elevated (turns the flux downward).
• Always chew your food well! Big chunks might lie in your stomach like stones.
• Help your whole digestive tract with probiotics.
• Eliminate stress – especially when you eat. Sit down for three meals a day – don’t gobble things down on the run!

This is what to avoid – besides hurting foods:

• Too big meals.
• Eating after dinner.
• Peppermint – as it has a relaxing effect on the sphincter that closes of the stomach.

A reminder: Before you embark on a natural healing course, it is a good idea to have endoscopy – because you don’t want to overlook anything serious. And make sure your doctor looked for an H. pylori infection. On the other hand, there is evidence, that a bit of H.pylori might be necessary for normal digestion – and triple antibiotic definitely could do some harm.

And then – just to confuse things: Elderly people often have too low stomach acidity, and if they are taking medications that lower it even more, one can imagine that this will lead to problems. There is a supplement for this condition: betaine HCl. And some patients with can be helped with digestive enzyme – a whole new topic.

Aches and Pains

May 11, 2010

Tags: food, aches, Aches and Pains, allergy, anti-inflammatory, apple, banana, blond hair, blue eyes, bursitis, celiac disease (see: gluten), corn, dairy, eggplant, fasciitis, fish oil, food allergy, food intolerance, food sensitivities, garlic, gluten, gluten enteropathy, inflammation, itis, joint pains, milk products, milk, nightshades, nuts, olive oil, pain, peanut, peppers, phlebitis, phyto-nutrients, potato, probiotic, red hair, rosemary, shrimp, sprue (see: gluten), arthritis, tendinitis, tomato, turmeric, Zyflamend

In my twenties doctors had different explanations about the weird aches and pains I complained of. They were either from aging (in my twenties!!), or they were all in my head, or – poor redheads all over the world! – it was just that redheads had lower pain thresholds.

Research meanwhile has confirmed that redheads have actually higher pain thresholds. Besides, I had a whopping but unrecognized case of gluten intolerance, probably since birth. Took me many years to figure it out.

You, too, might have gluten intolerance. Estimates go that one of one-hundred-five people has, most of them not yet diagnosed. Most of them are blond and blue-eyed – but not all of them (otherwise the diagnosis would be easy!).

Of course, aches and pains can have other causes than celiac disease (another word for gluten intolerance; as is non-tropical sprue). But food is often the culprit - dairy, in my opinion, the worst since it is highly inflammatory (besides fattening). If you have arthritis, tendinitis, bursitis, fasciitis – or any “…itis" in your body, leave out milk and milk products for at least a month, and see if you get better.

Other suspicious foods are nuts (which, on the other hand, are very wholesome if you can tolerate them), nightshades (tomato, potato, eggplant, bell and hot peppers). Food additives can give bad reactions (and should not be in your food in the first place). Food intolerances can be very individual – for some it is an innocuous apple, for others shrimp or peanut or banana. By keeping a food journal you might find out – or help your doctor to find out.

Finding the cause and avoiding the offender, is the first step. On top of it, there are many herbs that reduce inflammation, like turmeric, garlic, rosemary. In fact, so many plants contain inflammation-dousing phyto-nutrients that eating more vegetables and herbs already might give you relief. If you want an herbal preparation, I usually recommend Zyflamend (be sure you have no allergy to any individual herb in there).

A good fish oil (you should not burp up fish!) has excellent anti-inflammatory action. As does olive-oil (unheated) in your salads. And lastly, a good probiotic, to quench the fire in your belly: Most inflammation originates in an inflamed bowel.

Food “Allergies”, Anyone?

April 29, 2010

Tags: food, allergy, arthritis, asthma, bleeding gums, bloating, cramps, breast soreness, bulemia, bursitis, celiac disease (see: gluten), coffee, corn, cravings, dairy, depression, diarrhea, dizziness, eczema, eggplant, eyes - itchy, fatigue, food allergy, Food “Allergies” - Anyone?, food intolerance, food sensitivities, gluten, gluten enteropathy, headaches, heartburn, interstitial cystitis, itch, joint pains, listlessness, low blood pressure, migraines, mouth sores, muscle weakness, nightshades, nuts, obesity, pain, peppers, phlebitis, potato, sinus problems, skin problems, sprue (see: gluten), tendinitis, thirst - excessive, tickling in throat, tomato, urine flow - slow, wheat

What we often call food “allergies” might be forms of intolerance with different pathways, physiologically speaking. The poisonous effect of wheat gluten in gluten enteropathy worked via a different mechanism than dairy-induced asthma; or the poison ivy dermatitis; or likely immune-complex regulated arthritis. Science has not totally elucidated these mechanisms; food “allergy” might be the incorrect term but has become common.

The diagnosis is difficult to make and to confirm; but if you don’t even think of allergy, the diagnosis can’t be made. Many physicians are not trained in this. However, you might need professional help if self-observation does not solve the problem. Since all of these conditions can also be caused by far more serious diseases, by all means work with your doctor.

Here is a list of signs that should make you wonder if you have an unrecognized food issue:

Food cravings: The more you like a food the more likely it is that you are allergic to that food. The more frequent you eat a certain food or a food group the more likely is that you will develop an allergy to it.

Fatigue: After a meal you are tired. We all are tired after a heavy meal; but if you are extremely tired even after a smaller meal you should search for an allergy.

Abdominal discomfort after a meal - often within minutes but unfortunately it can even take a day or two - you feel bloated and distressed in your stomach. Diarrhea is already a more severe sign and, if chronic or intermittently recurrent, should be evaluated by a physician. Heartburn seldom is recognized as stemming from food allergies – but it often goes away when you stop eating nightshades (tomato, bell and hot peppers, eggplant, potato), nuts or dairy.

Weakness: About fifteen minutes after a meal lift your arms: If they feel heavy or ache more than usual - compared how light you felt in the morning - this might be a case of allergy.

Musculo-skeletal system: joint, tendon and muscle problems, bursitis, etc. Leave out nuts and dairy. Get evaluated for celiac disease (gluten intolerance).

Mouth: Burning in your mouth, tickling in your throat or sores in your buccal mucosa or on your tongue might signal an allergy.

Bladder: Slow flow of urine can be a sign of food allergy, due to a swelling of the urethra. Or burning of the urethra in males. Or recurrent signs of urinary tract infections – with or without bacteria growing out in culture. Irritable bladder (interstitial cystitis) might respond to leaving out coffee and certain foods.

Thirst! If you are thirstier than other people – always running around with a water bottle in your hand – think allergy.

Other diseases and complaints that might be caused - but not necessarily - by food allergies headaches, asthma, swollen glands, bleeding and inflamed gums, abdominal discomfort and bloating, diarrhea, skin problems and itching of perfectly normal looking skin, recurrent infections (sinus, UTI, etc.), itchy eyes, listlessness and mild depression, obesity and bulimia, anal itch and/or rashes, low blood pressure, dizziness, breast pain - a long list that is probably longer, recurrent phlebitis.

Most common food "allergies" I have encountered in patients: dairy, nightshade (tomato, potato, eggplant, all peppers except black pepper, chili, cayenne, paprika), nuts, wheat, corn, beef, food dyes and food preservatives. But basically every food can become a culprit. If you have pinpointed one food item as allergenic for you, compare it with other items in the same botanical family (like nightshade).
Aspen eyes, by Peggy Peters

Iguazu Falls, by Xin Liu

Alexa Fleckenstein M.D. 2012, by Lolita Parker jr.

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