6 THE NEXT STAGE
How easily you adapt to your new diet will depend on a number of factors including:
- The degree of improvement you've experienced.
- How motivated you are
- Whether you have identified all your food intolerance problems.
- How long you were ill for and how severe your problems were.
- How restricted your diet has become.
- The amount of support you have.
If there has been any improvement please do not give up on yourself—keep going. One of the things that quite commonly happens is that there is some major improvement and then things seem to get a little sluggish and you start to doubt the wisdom of your new diet. Give it a chance.
The older you are the longer you have been putting your body under stress. Your body's first reaction is likely to have been one of celebration and joy and now, after the party is over, it is taking time to recover. Trust it and let it heal in its own time. If you return to your old diet you will simply set yourself back. It is possible, and very useful, to re-test foods but if you had an adverse reaction do not re-test for at least six months. Hopefully, as your body recovers it will be able to tolerate more foods over time. If an allergy has been diagnosed and the reactions you experienced were very severe your wisest course of action will be to always avoid the food.
There are cases where people find they have become intolerant of virtually all foods. I suspect that this is more to do with an undiagnosed food chemical intolerance rather than a problem with the foods themselves. However, if you find that this is happening then rotate the foods that you can eat and gradually introduce others. You rotate foods by never eating the same food on more than one day in any four day cycle.
If you have been carrying large amounts of excess weight you will have found this diminishing. If this is the case you will probably experience times of extreme hunger—do not starve your body, feed it. This seems to be part of an adjustment process and I doubt you will gain any weight. After a few days the need for extra food will subside and if you still need to lose weight it will once again begin to diminish. Avoid the temptation to speed up this process—you will only place extra stress on your body. It doesn't need it. Feed it the right foods for it, and your mind, and your weight will adjust quite naturally.
When you have identified a food intolerance problem you may want to find out more about your condition. The internet is a wonderful place for accessing this information but what you need to try avoid doing is overwhelming yourself with information. At first limit yourself to a couple of sites and gradually build up your store of information. If you want to explore the medical literature you will probably, at some point, find conflicting articles. Personally I am very wary of any articles or research, regardless of who is responsible for it, that categorically states that a particular food is not a problem or that a specific condition is never caused, or at least made worse, by food intolerance. Remember that:
- The individual doctor or researcher may have specific interests that “colour” their work.w Research is often funded by large corporations including pharmaceutical companies and food manufacturers.
- The research may have been limited to a very small number of cases.
- Food intolerance is often simply not accepted.
- The overall evidence is clear—any food can lead to any symptom.
So search, read and discuss—information is liberating. But, in the final analysis, trust your own results from your own eliminating/testing. The only person who can help you stick to your diet is you. You can help yourself in a number of ways:
- Plan your meals—get really organised.
- Eat regularly and so avoid getting hungry and being tempted to eat the wrong foods.
- Buy cookbooks that provide you with recipes you can use and experiment with.
- Congratulate yourself on having done so well.
- Build in treats that you know you can tolerate.
- Make contact with others with a similar problem.
Be extremely cautious about any processed food or food prepared by others. The easiest way of getting caught out is by trusting someone who says "It's safe—I checked". Ask for a list of the ingredients and check for yourself. If this seems like overkill take note of the following case reported by Schwartz.[Schwartz, RH. Near-fatal anaphylaxis to chicken soup and near-anaphylactic events to cow's milk occurring in the hospital. J Allergy Clinical Immunol; 1993;91(1pt2):152.]
A child with a known milk allergy was given chicken soup in a hospital and the result was a nearly fatal case of anaphylaxis. The sodium caseinate that was in the soup had not been recognised by the staff as being a milk protein. More worryingly, they had also perceived reactions to milk as relatively harmless.
Don't assume that because you understand your problems that everyone else will—they won't.
You will have setbacks—accidental ingestion of the food or substance you can't tolerate. The best advice I can give is treat yourself gently. The reaction will pass so don't give in to any cravings that might come. Eat the foods that are safe, rest and learn from the experience.
You've simplified your diet, carried out food tests using the elimination diet and are feeling better. You're quite confident that you know what causes your problem and are careful to avoid the problem foods. Then, inexplicably you have a reaction and find that, no matter how hard you think back and check the food you've eaten, there is no way in which you could have eaten one of your problems foods. You have introduced some new foods but all the ingredients listed are ones you know you are okay with. Have you found a new food problem?
It is possible but, before you put yourself through the rigors of further eliminating and testing, re-check the foods you have introduced. If any of these are processed products remove them from your diet for at least seven days and then try again. If you have a reaction again then the likely culprit is a hidden ingredient that is probably on your NO list. How did this happen? Quite simply legislation may permit a manufacturer not to list an ingredient constituting less than a specific percentage of the total product. You can, if you so choose, write to the manufacturer to verify your own results.
This was demonstrated very clearly in a report by Enrique et al in respect of eggs. They cite the instance of a twenty-five year old woman who had been diagnosed with an egg allergy and told to avoid all forms of egg protein. Two months later she experienced a further reaction after eating a strawberry and cream candy. No egg compound was stated on the candy label. Tests confirmed that it was the candy she was reacting to and also identified the presence of ovoalbumin, which is added to candies as a binder, and this was confirmed by the manufacturers.[Enrique E, Cistero-Bahima A, Alonso R, San Miguel MM. Egg protein: a hidden allergen in candies. Ann Allergy Asthma Immunol. 2000;84(6):636.] Cantani reported on similar problems with milk.[Cantani A. Hidden presence of cow's milk proteins in foods. J Investig Allergol Clin Immunol 1999;9(3):141-5.] Other possible forms of contamination are listed by Steinman [Steinman HA. Hidden allergens in foods. J Allergy Clin Immuno 1996;98(2):241-50.] including:
- Manufacturing plants using the same equipment to make different products such as milk ice cream and dairy free ice cream.
- The use of the same oil to cook different foods.
- “Natural” flavours.
- Ingredient switching that involves use of a different oil, nut, sugar, herb or spice.
- Binders and emulsifiers which are not defined
The move towards wanting to eat organic food seems to arise naturally as part of wanting a healthier diet. Certainly, when one reads about the potential health problems that can be caused by pesticides it seems like the only logical step to take but is it always the right way to go? I ask this question because when no pesticides are used the plant produces more of its own natural toxins so some vegetables and fruit will at times have a higher salicylate content than those grown with the use of pesticides. I am not advocating eating non-organic food but I am raising this issue especially for anyone with a salicylate sensitivity. If you are salicylate sensitive and have found that some of your problems have become worse after switching to organic food this could be the reason why.
One of the areas I have not covered in this book is that of botanical families and the reason for this is I tend to find these mislead people. As Barnes Koerner and Sampson say "Although it is often helpful to think of foods in certain botanical families, no clinical evidence supports consistent broad intra-botanical or intra-species cross-reactivity".[Barnes Koerner C, Sampson HA. Diets and Nutrition. In: Metcalfe DD, Sampson HA, Simon RA. Food Allergy: Adverse reactions to foods and food additives, 2nd ed. Blackwell Science 1997.]
Sometimes the problem is misread and the true problem is in fact a food chemical one. I think the safest approach is never to assume that you will react to all members of a botanical family rather to test of each of the foods individually and if you find you react to them all then first check that you do not have a salicylate or other food chemical sensitivity.
Biochemical individuality is about far more than the foods you can tolerate. It very much deals with the amount of each nutrient that your body needs. For example, some people need far more B6 than others. To assess your individual needs on this level you would need medical help and it may not be forthcoming. Many doctors still believe that the RDA (recommended daily allowance) for vitamins and minerals is more than adequate for all and that we all need the same amounts. Others disagree strongly saying that the RDAs will simply stop the occurrence of diseases such as scurvy (lack of vitamin C) or pellagra (lack of B3).
In 1969 Linus Pauling introduced us to “Orthomolecular Medicine” which focuses on using naturally occurring substances like vitamins, minerals, trace elements, enzymes and amino acids to treat illness and maintain health. Doctors embracing this approach had some startling successes including the treatment of schizophrenia with B vitamins by Dr Hoffer and others. But, sadly this approach has never been embraced more generally by the medical profession. This is not because it does not work or is in some way flawed.
There is a great deal of evidence to indicate that existing diets do not provide adequate amounts of vitamins and minerals even by RDA standards. Werbach's[Werbach M R. Nutritional Influences on Illness: A sourcebook of clinical research 2nd edition. Third Line Press 1996.] survey of nutritional influences on illness includes a section on nutritional deficiencies. To give you an overview of the type of problems that exist, I will summarise a selection of the findings:
- An American study found that the majority of the US population, especially adult women, were obtaining levels of calcium below the Recommended Dietary Allowance.
- Chromium deficiency is common in western diets relying on high intake of refined foods.
- Iodine deficiency is common in many countries.
- Magnesium intake is often low. Vitamin B3 is often deficient in elderly people.
- Selenium is frequently inadequate in Western diets.
- Thousands of people develop vitamin A deficiency each year.
- Vitamin C intake is often below recommended daily amounts.
- Zinc is commonly inadequate in Western diets.
There are also vitamins and minerals that can help people with food related problems. Some examples follow:
- Vitamin C can help reduce a reaction which raises the blood histamine level and may also reduce MSG sensitivity.
- Vitamin B12 may help reduce sulphite sensitivity.
- A magnesium deficiency may increase allergic reactions and lead to symptoms similar to chronic fatigue syndrome.
- Calcium supplementation may reduce allergic reactions.
- Vitamin B6 may reduce MSG sensitivity.
- A molybdenum deficiency may lead to sulphite sensitivity.
- Vitamin B3 may slow down the release of histamine.
- Vitamin B5 may reduce allergic reactions particularly those involving the nasal passages and help in cases of chronic fatigue.
Getting adequate vitamins and minerals is essential not just to maintain health but also to reduce the impact of allergic reactions on the body. Philpott says that vitamins C, B6 and B3 "have the most important value in preventing such maladaptive reactions".[Philpott W H, Kalita D H. Brain Allergies: The Psychonutrient and Magnetic Connections. Keats 2000.] A poor diet that doesn't provide us with the full range of vitamins and minerals that we need can also lead to illness both physical and mental. Some examples follow:
- Vitamin B1 deficiency can lead to irritability, depression, confusion, and an acute sensitivity to noise.
- Diets low in pantothenic acid can make some people depressed, withdrawn and irritable.
- Low potassium levels can lead to fatigue.
- A good quality multi vitamin and mineral supplement with additional vitamin C would seem to be essential for all of us especially if we have been ill or are getting older.
- Older readers should note that studies have shown that many older people do not absorb adequate amounts of many essential nutrients. Supplementation may be the way to remedy this.
Some links between an excess of iron and the development of cancer cells has been found which is why some vitamin companies now produce multi vitamin and mineral supplements that exclude iron. Supplements of individual vitamins and minerals should be taken with great care as many of them rely on other vitamins and minerals to be of any benefit and some in large doses can be toxic. Some examples of problems follow:
- Evening primrose oil can exacerbate temporal lobe epilepsy and may exacerbate mania.
- High doses of folic acid may decrease levels of B12.
- High doses of iron can lead to stomach problems.
- Manganese intoxication can lead to irreversible movement and other neurological disorders. It can also lead to high blood pressure in some people over forty.
- Too much selenium has been associated with hair loss, thickened, fragile nails, nausea and fatigue.
- Exceptionally high doses of Vitamin A can lead to birth defects.
- Large doses of vitamin B6 can lead to neurological symptoms.
- Very large doses of vitamin C can lead to diarrhoea.
Find out as much as you can before you supplement with single vitamins and minerals—it is generally thought that the safest option is to only take individual vitamins and minerals alongside a multi. Pregnant women should seek medical advice as some supplements can be harmful to the foetus.
Be very cautious about the preparations you buy—you really do need to look for quality and you do need to be sure that any supplement you buy is safe for you. If the label is confusing then check with the manufacturer. And if you start to feel worse after taking any supplement—stop taking it immediately. Never start taking more than one supplement at a time—if you have a reaction you will not know which supplement is to blame.
Beware of hypo-allergenic supplements as these may not be safe for you. If you feel unsure of how to go about boosting your system with vitamins and minerals consult a nutritionist and/ or read some of the very good books on the market.
Ideas for other ways in which you can boost your system follow. By making sure that you eat as much fruit and vegetables as you can you will help keep your system balanced towards alkalinity which will also help you feel better. Increase the amount of exercise you take, relax more and do things that interest you. Ill health affects all aspects of our lives and we need to start to put the balance back.
Having said that—don't go mad and try to do too much! This will over tire you and then frustrate you if you find yourself ill again. Gently build up your activities and take lots of rest. Some people have found great help from taking digestive enzymes—find out if these could help you. Various herbs, such as echinacea, can help boost the system but take them with care (reactions to herbs are not unusual) especially if you are salicylate sensitive. You may also like to consider using a water filter to reduce the amount of chlorine and other water contaminants being ingested.
In an article on the detoxification enzyme systems, Liska explores the complex process involved in the body's ongoing battle to deal with toxins. "These mechanisms exhibit significant individual variability, and are effected by environment, lifestyle, and genetic influences". Impairment of these systems could lead to the development of conditions such as Parkinson’s Disease, Fibromyalgia, Chronic Fatigue Syndrome, and other immune system disorders.[Liska DJ. The detoxification enzyme systems. Altern Med Rev 1998: 3(3), 197-98.]
It has been suggested that the difficulties some individuals experience with food chemicals and food additives is due to some impairment in this detoxification system that predominantly takes place in the liver. Some individuals have seen improvement in their sensitivities as a result of using supplements to help the liver. Amongst these “cysteine”, a sulfur amino acid is used by the body to manufacture glutathione which plays a vital role in the body's ability to eliminate toxins.
Also, ensure your diet is as high as it can be with fruit and vegetables as many of these, including cabbage and Brussels sprouts, encourage enzyme activity. This effect of vegetables and fruits could in part explain why they seem to protect against certain cancers. And look after your gut. The gastrointestinal tract provides a physical barrier to many unwanted products and, after the liver, is the second major site in the body for detoxification. You need to have a healthy gut so eat well and ensure that you have a good supply of healthy bacteria. If you have had gastrointestinal problems, or still have them, you may find some of the acidophilus supplements useful.
Carl Pfeiffer says that "Every thought and feeling we have can alter, and is altered by, the chemistry of our body".[Pfeiffer CC. Mental and Elemental Nutrients. Keats 1975.] If you have been ill for a long time and are now experiencing better health do not be surprised if, after the initial relief and joy, you experience some feelings of anger and grief about the time you have lost and that you may have been misdiagnosed for many years. By all means look at these feelings, write them out, talk them through with a friend or counsellor but do not get stuck in them
The simple truth is that although improvement in your condition may have been a long time in coming it has arrived. For many people the answer may never appear. Consider yourself lucky, focus on the positive feelings and look to the future. The past, no matter how right or wrong elements in it may have been, has now gone. As you recover, focus on the present and when you feel stronger turn your attention to the future remembering that now you are free of chronic ill health there are many things you can once again dream of doing and actually begin to do.
But please don't make the mistake of rushing into a whole range of new activities. If you were ill for a long time you need to allow yourself time to recover. Release your imagination, explore ideas, rest and try to take pleasure from the moment, the here and now. Getting healthier is an amazing experience, take the time to savour it and the fact that you have been the one to bring it about.
When you feel ready to embark on your new life be gentle with yourself. List all the things you want to do and prioritise them. Don't try do them all at once—you'll exhaust yourself. By being clear about your goals you'll achieve them more easily and with less effort. As you throw yourself into new activities do remember to take the time to monitor your diet and health. As your body and mind changes you may need to make adjustments in your diet.
You may have found yourself, rather than feeling inspired, feeling lost, cast adrift with little idea of what to do next, as if everything that seemed real and solid before has changed. This is most likely to arise if you had been having many psychological symptoms that have now improved or disappeared. The best advice I can give you is to take some time to get to know yourself.
Enjoy the process. Don't assume that just because you did something before in a certain way that you have to continue doing so. You have changed and you can now choose what you do and how you respond. You may find it useful to take some time to explore what your dreams are. A couple of brain storming exercises might help. Firstly write out fifty things you enjoy doing and then write out fifty things you really want to do. Let your imagination fly.
Remember, it was not your fault you were ill. You have always tried to do the best for yourself. Celebrate your achievement.
You may find it useful to make contact with others with a similar problem. How you do this will depend on you as an individual and also where you live. Some options include:
- Support groups—check in your area or with a national organisation that deals with your condition.
- On-line through discussion forums.
- Reading books and articles. If books are out of print then ask at your library—in the UK many can be borrowed via the British lending library.
- One to one—if you know someone else with similar problem arrange to meet regularly.
Support can also come from family, friends and work colleagues but don't expect them to understand if you don't explain it to them. Anybody who has seen you have a reaction will probably be understanding but some of those who haven't may be very sceptical and may even hinder you.
Have patience with others and do try to avoid evangelising—rather than helping this often has the effect of putting people off. I always try to remember what I was like before I knew about my food intolerance problems—basically I knew nothing about allergy or food intolerance and really wasn't very interested. You can't change others so don't be hurt if people don't follow your advice or don't believe you.
Your biggest source of support is always going to be yourself
Nobody else can control what you eat but you. Become your own best friend and stop worrying about what anybody else thinks.
Tips and tricks
Here are a few suggestions to help make your life a little easier.
Plan your meals ahead so that you always have food available that you can eat.
Use your freezer—make up extra batches of meals for the days when you just can't be bothered.
Never trust food given to you by others unless you know for definite that they understand what your problems are. Even then you would be better to check by asking for details of the ingredients.
Prepare a list of foods that you can eat (rather than ones you can't) that you can give to others or restaurants to help them in preparing a meal for you.
If you are making a long journey always take more food with than you think you will need—unexpected delays can turn into nightmares if you don't have food and drinks with you that are safe for you.
Take time out to invent or discover new recipes—this will help you stop getting bored with the food you eat.
If you buy any processed food—ALWAYS check the ingredients as these do change.
Use the word “allergic” rather than “food intolerant” with people you don't know—allergy is more accepted and most people will understand that this means you have a problem.
Don't assume that anybody cooking for you will know what foods contain salicylates, MSG, sulphur, additives, milk, wheat etc...
Eat as balanced and varied diet as you can.
Avoid defining yourself as allergic or food intolerant (or any other label). Remain the person who you are. You are not your condition or illness.
Never forget that what works for you may not work for anyone else—avoid converting and being converted to particular diets and/or supplements.
Take advice but then check it out for yourself—nobody has all the answers. The best expert on you is always you.
If reactions affect your mind prepare to deal with them. Have strategies in place for avoiding contact, explaining your behaviour, making yourself feel safe. You may also find it useful, when well, to write yourself a note which you can read when a reaction takes hold—it should explain what is happening and reassure you that it will pass. If you have someone who understands what is happening talk to them as sometimes this helps minimise the effects of the anxiety.
Be gentle with yourself.