Ellen Kamhi PhD, RN, AHG, AHN-BC, The Natural Nurse discusses food allergies, histamine release, leaky gut syndrome, testing for leaky gut, natural therapies and herbs for allergies, nettles, quercitin, Vitamin C

1. Presents…
FOOD ALLERGIES
Ellen Kamhi PhD, RN, AHG, AHN-BC
www.naturalnurse.com
www.facebook.com/NaturalNurse

2. Prevalence of Food
Allergy
l Experts agree that allergies in developed countries are
becoming more common.
l In the U.S., food allergies afflict 2-2.5% adults and 6-8%
children.
l 100-175 people in the U.S. die each year.
l Death generally result from anaphylactic shock, often to
peanuts or tree nuts.
l More than 160 foods have been associated with allergic
reactions.

3. What is Food Allergy?
l Food allergy is an inappropriate immune
response to an otherwise harmless food.
l True food allergy involves several types of
immunological responses.
l Food allergens are usually proteins.
l Some foods may contain haptens or haptens
carrier.

4. Basic Terminology
l Allergic reactions are Antigen-Antibody reactions
l Antigen = a foreign substance
l Antibody = a protein produced in response to an
antigen that is capable of binding specifically to
the antigen!
l Haptens - a small molecule that has the ability to
combine with an Ab or a cell-surface receptor.

5. Antibodies (Immunoglobulins)
Five classes of Immunoglobulins:
1) IgG: Main class of antibodies in blood-also from
mother-to-child (20%)
– 2) IgA: Small amount in blood, but larger amount in tears, milk,
saliva, mucus and the lining tissues
– 3) IgM: First Antibody secreted during the primary response
– 4) IgE: Found mainly in body fluids and skin --- Associated with
allergy reactions!
– 5) IgD: Found in B-Cell membrane

6. GALT
l The Gastrointestinal lining contains most of
the immune cells in the body (Gut
Associated Lymphoid Tissue (GALT)
l It engages in a continuous fight with
potentially pathogenic bacteria, fungi,
parasites, lectins, allergens, while leaving
symbiotic bacteria unscathed.

7. http://www.callerio.org/micro/fig2-e.jpg
http://www.nature.com/nri/journal/v3/n1/images/nri982-f1.gif

8. What is Histamine?
Histamine triggers the inflammatory response.
Histamine is produced by basophils ( a type of white
blood cell) and by mast cells ( a resident cell in tissues
of the body; present more in skin, lungs, eyes,
digestive tract, mouth, nose and conjunctiva) in
response to antigens.
Found in almost all animal body cells, histamine
increases the permeability of the capillaries to white
blood cells and other proteins, in order to allow them
to engage foreign invaders in the affected tissues.

9. Nature of IgE Allergic Reactions
Antigen + IgE + Mast cells = Mediator release
Mediators= histamine and others
Picture credit: from Dr. Gary E. Kaiser
http://www.cat.cc.md.us/courses/bio141/lecguide/index.html

10. Primary & Secondary Responses to an
Antigen- DELAYED or HIDDEN
Primary response: first response when host’s B-cell
recognize the
antigen
Secondary response: upon second exposure to the
antigen, the Memory cells will divide, thus make
more of the total antibody

11. Types of Food Allergies
l Immediate hypersensitivity with IgE which
occurs within minutes to a few hours after
ingestion of offending foods.
– Systemic: Itching, urticaria (hives), Vomiting, Abdominal
cramps, diarrhea and respiratory distress, and in severe
cases anaphylactic shock
– Localized: hives and eczema or atopy (an umbrella term
covering clinical presentations of food allergy etc)
l Delayed hypersensitivity reactions (>8hours
after ingestion): cellular immunity involving
T-lymphocytes and macrophages

12. Allergy vs. Intolerance
l True Allergy-Total avoidance necessary!
l Intolerance- Small amount may be
tolerated

13. Most
Common
Sites for
Allergic
Reactions

14. Symptoms-Food Allergy*
l Nausea
l Diarrhea
l Abdominal cramps
l Pruritic rashes
l Angioedema
l Asthma/rhinitis
l Vomiting
l Hives
l Laryngeal edema
l Anaphylaxis
* Exercise exacerbates symptoms

16. Other Types of Food Allergy,
Non-IgE Mediated
l Immune Complex-mediated
l Symptoms usually gastrointestinal
l Delayed type hypersensitivity
l Symptoms usually gastrointestinal

17. Anaphylaxis
Potential fatal reaction to a food allergen causing
reduced oxygen supply to the heart and other body
tissues.
Symptoms include: difficult breathing, low blood
pressure, pale skin, a weak rapid pulse, loss of
consciousness, death.

18. Periodontal Disease is Really a
Periodontal Infection
Science is showing that the gums
are a major entry point for
microorganisms to invade the rest
of the body.
Candida
Helicobacter
Pylori

19. l The small and large
intestines measured
together and laid flat
equal about 25 feet
in length.
l The total surface area
of villi and microvilli
in the intestines that
is capable of
absorbing nutrients
is about the size of a
tennis court.

20. Intestinal Permeability
l Note the severe
damage to the
intestinal
microvilli

21. Candidiasis Infection
l IMAGE CREDIT: http://www.dietsforweightloss.net/wp-content/uploads/2010/02/candida.jpg

22. Intestinal permeability – Common
Causes
l NSAIDS
l Steroids
l PPI and antacid use
l Infection (enteritis)
l Antibiotic use wiping out healthy bacteria
l Yeast and parasites in gut
l Stress, alcohol, over-exercise
l Food allergies perpetuate with inflammation

23. Intestinal Permeability
l Measurement of urinary clearance post
challenge drink.
– Lactulose
– Mannitol
– Lactulose/Mannitol Ratio

24. Normal Gut Mucosa

25. Intestinal Permeability
Intestinal Permeability

26. Permeability Can Occur Between
Junctions or Transcellularly
l Altered permeability
between tight
junctions
l {tested with
Lactulose, a dimer }
l Altered permeability
transcellularly (thru
the cell)
l {Use Mannitol, a
monosaccharide}

28. http://www.undergroundwellness.com/images/mucosal_barrier_degradation.png

29. Most Common
Allergenic Foods
l Legumes (Peanuts and Soybeans)
l Mollusks and shellfish (snails, mussels, oysters,
scallops, clams, squid)
l Milk
l Eggs
l Fish (cod, salmon, haddock etc)
l Crustacea (shrimp, crawfish, lobster etc.)
l Wheat
l Tree nuts (almonds, walnuts, Brazil nuts etc)
l Selected food additives

30. What AreMajor Food
Allergens ?
The eight foods identified by the FDA and must be
listed on all labels!
Milk
Eggs
Fish (e.g., bass, flounder, cod)
Crustacean shellfish (e.g. crab, lobster, shrimp)
Tree nuts (e.g., almonds, walnuts, pecans)
Peanuts
Wheat
Soybeans
These eight foods, and any ingredient
that contains protein derived from one or more of them,
are designated as “major food allergens” by the FDA

31. Cross-Reaction

32. Tree Nut: Hidden Ingredients
l Almonds
l Brazil nuts
l Cashews
l Chestnuts
l Filberts/hazelnuts
l Gianduja*
l Hickory nuts
l Macadamia nuts
l Marzipan/almond paste
l Nougat
l Nu-Nuts ® artificial nuts
l Nut butters (cashew butter)
l Nut milks (almond milk)
l Nut oil
l Nut paste (almond paste)
l Pecans (Mashuga nuts)
l Pine nuts
l Pistachios
l Pralines
l Pure almond or other nut extract
l Walnuts
* Gianduja is a creamy mixture
of chocolate and chopped nuts
found in premium or imported
chocolate

33. Wheat Allergy – Hidden Ingredients
l Bleached all-purpose flour
l Bran
l Bread, bread crumbs
l Bulgur wheat, Durum wheat
l Cake and pastry flour
l Cereal extracts, cereal
binder, cereal filler, cereal
protein
l Cracker meal
l Cream of Wheat ®
l Malt-O-Meal ®
l Couscous
l Durum
l Enriched flour, bread flour
(white or wheat)
l Farina
l Flour, granary flour
l Gliadin
l Gluten
l Grain-based coffee
substitutes
l Graham cracker, graham
flour
l Hydrolyzed protein
l Hydrolyzed vegetable protein
l Instant soup stock
l Modified food starch
l MSG (Monosodium
glutamate)
l Pasta, noodles
l Puddings, wheat thickeners
l Soy sauce
l Spelt, Triticale

34. Wheat Allergy – Hidden Ingredients
l Vegetable starch
l Vitamin E pills (some)
l Wheat flour and wheat bran
l Wheat germ, wheat starch
l Wheat gluten, gluten flour
l Wheat semolina, semolina
flour
l White (grain) vinegar
PLEASE NOTE:
•Stabilizers, spices and
emulsifiers can also indicate
the presence of wheat
•Some alcoholic beverages
(beer, whisky and gin) may
cause allergic reactions in
individuals with wheat
allergies.
•Oats, barley, rye, triticale, and
spelt may also cause problems for
people with gluten sensitivity.
•Buckwheat is an herb and does
not contain gluten.
www.gluten.net

35. Soy Allergy: Hidden Ingredients
The following are label ingredients that may
contain the presence of soy protein:
l Hydrolyzed plant protein
l Hydrolyzed vegetable protein
l Natural flavoring
•Vegetable broth
•Vegetable gum
•Vegetable starch
Many gluten free products contain soy.
Check the label.

36. Evidence of GMO Soy-Related Allergy Problems
May be due to gene transfer
Soy transgenes were
confirmed in human gut
bacteria
Soon after GMO soy was
introduced into the UK, soy
allergies skyrocketed by 50%.
http://www.responsibletechnology.org/gmo-dangers/health-risks/
articles-about-risks-by-jeffrey-smith/
Genetically-Engineered-Foods-May-Cause-Rising-Food-Allergies-Genetically-Engineered-Soybeans-
May-2007

37. Mice Fed GMO Soy
Pancreas
§ Reduced digestive
enzymes
§ Altered cell structure
§ Altered gene expression
Journal of Anatomy, 2002
European Journal of Histochemistry, 2003

38. Hidden Food Ingredients in Ready-
Made Food Products
l Milk and milk product derivatives
l Egg and egg derivatives
l Peanuts, tree nuts, and derivatives
l Fish derivatives (surimi, fish sauce, fish paste etc.)
l Soy and its derivatives

39. Food Allergy Elimination Diet
l The gold standard to see if a patient has clinical reactivity
to a food and benefit from elimination
l Generally a 3 week process of going down to a low
antigenic diet and systematically adding foods every 2-3
days to see if a reaction occurs.
l The reaction may be IgE, IgG, or non-immune
“intolerance.” The important part is to know which foods
a person reacts to and eliminate them.

40. Natural Medicines for Allergy
Reduction
l There are many natural products with research
and proven safety that can be used be used
along with or in place of medications
l Elimination/ avoidance still necessary
l Evidence-based natural alternatives

41. Quercetin
l Yellow plant bioflavonoid found in onions, apples, wine, black
tea, broccoli, squash
l One of the most bioactive flavonoids forming the backbone
for many others
l Acts as a mast cell stabilizer and leukotriene and
prostaglandin inhibitor
l Has a wider spectrum of activity than Cromolyn
( drug antihistamine)

42. Quercetin
Quercetin is more effective than cromolyn in
blocking human mast cell cytokine release and
inhibits contact dermatitis and photosensitivity
in humans.
Quecetin is a promising candidate as an effective mast
cell inhibitor for allergic and inflammatory diseases,
especially in formulations that permit more sufficient
oral absorption
Molecular Immunopharmacology and Drug Discovery Laboratory, Department of
Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston,
Massachusetts, United States of America.
PLoS One. 2012;7(3):e33805. http://www.ncbi.nlm.nih.gov/pubmed/22470478

43. Bromelain
l A proteolytic enzyme derived from pineapple
stems
l Stimulates the release of anti-inflammatory
prostaglandins, and inhibits pro-inflammatory
PGs
l Active in a broad range of pH, thus digests
protein in stomach and small intestine
l People allergic to pineapple or bee stings
should avoid bromelain

44. Vitamin C
l A natural anti-histamine – prevents
release and aids in detoxification
l 2 grams daily lowered histamine levels
by 38% in just 1 week in 1 study
l Population studies show people with the
highest Vitamin C levels have the lowest
incidence of allergies
l Best to combine with ROSEHIPS
& Bio-Flavonoids

45. Butterbur
l Butterbur – Petasites hybridus is a shrub
that decreases histamine and
leukotrienes
l Butterbur has been found in studies to
be as effective as Allegra and Zyrtec
l People with ragweed allergy may react
to butterbur.
2004 Clinical & Exp Allergy, 2005 Phytotherapy Research

46. Nettles
Antihistamine herb used in many
traditions.
Good safety profile !

47. Vitamin D
Vitamin D supports immune function
and seals the mucosal barrier

48. Netti Pot
l Ancient
Ayurvedic
Technique
l Nasal rinse to
remove allergy
producing
particles from
the Nasal
Cavity
http://www.youtube.com/watch?v=skXglNl7C78

49. Diet
An anti-allergy, histamine reducing diet is one
that is made of:
l unrefined, whole foods
l high in colorful fruits and vegetables
l high in plant protein
l low in dairy and meats

50. Food Allergy Web Sites
Food Allergies News for Teens Entering College
http://www.faanteen.org/
Food Allergy and Anaphylaxis Alliance
http://www.foodallergyalliance.org
Food Allergy and Anaphylaxis Network
http://www.foodallergy.org
Food Allergy Alert! Receive recalls via e-mail
USDA Food and Drug Administration FDA Consumer
http://vm.cfsan.fda.gov/~dms/wh-alrg1.html

51. THANK YOU!
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at SOHO! Ellen Kamhi PhD, RN, AHG, AHN-BC