January is drawing to a close & what a diverse month it has been!
My first patient this month came to me with simple allergy/ hypersensitive symptoms. In the previous few months she had recently started a new relationship. Her partner commented that she was constantly sniffing and trying to clear her throat. Not a criticism but an observation. She realised that she had had these symptoms for many years but had just got used to them as they were not causing her many quality of life problems.On visiting the clinic we tested for potential triggers in particular cows milk and house dust mites. She substituted dairy products and washed her bed linen at 60 degrees leading to her symptoms being radically reduced within 2 weeks. Now she has choices – eat cows milk products resulting in a sniffly nose or change to non dairy foods & the symptoms reduce. Simple.
If only everything was that simple. In my Clinic last week I saw two ladies independently. Both had had severe reactions to shellfish resulting in anaphylaxis in the past & both had been prescribed epipens (auto injectors).
Lady 1. She had started to develop digestive disorders. Some bloating, belching disruptive bowels. Visited GP a few times. Had routine blood tests including one for celiac disease. All OK. GP diagnosed IBS. On recommendation of a friend she came to see me. Test resulting in lactose intolerance, non-celiac wheat sensitivity and gut dysbiosis. Non of which are potential allergens . A personalised plan was devised. She felt so much better that the following month she brought both her children to me. She then told me that her friends at the gym told her she should be tested by the NHS privately where she paid over £300 for an IgE blood test. All the results came back negative including no raised IgE to shell fish. This obviously was of great concern as she always went into anaphylactic shock when eating shell fish.
Lady 2 had the same when she paid via a private hospital for IgE blood tests. Again negative to shell fish. She was showing more signs of allergy, hives – urticaria, swelling – angiooedema and at times difficulty in breathing. I advised her to immediately make an appointment with her GP for referral to the Allergy and Immunology department . She was obviously extremely anxious about eating and was losing weight. Although I could advise her with regard to her diet in the very short term she needed more in-depth diagnosis from the hospital .
With regard to testing no test is perfect as false positive and negatives can be up to 50% in IgE blood test and skin prick testing . These are the only 2 tests accepted by the NHS. Of most importance is taking an in depth history of all symptoms eg skin, breathing , nasal, gut including a time line of symptoms. This should go as far back as possible to establish whether they were born naturally or by Ceasarian section , breast or bottle fed .
A patient centred approach not symptom based is the way forward.
Digestive health – I have seen a sharp increase in demand for the sale of my digestive health supplements pack this month especially from my previous patients. Obviously we have enjoyed an excellent festive season and now trying to regain the health we felt prior to the festivities !