Memorandum by Margaret Moss (AL 64)
I am writing in response to your consultation
about allergy services. I see many patients suffering from allergy,
intolerance, or sensitivity to foods and environmental chemicals,
who have failed to obtain help from the NHS. I suggest that we
require:
(a) more teaching on this topic at undergraduate
level, for doctors, nurses and dieticians;
(b) more postgraduate training on this topic
for allergy specialists, paediatricians and GPs;
(c) a broader approach than just IgE mediated
immediate allergy, to consider biochemical causes of food intolerance
and sensitivity to chemicals;
(d) provision of good quality nutritional
supplements, to address biochemical causes of food and chemical
intolerance;
(e) sophisticated laboratory services, able
to perform reliable tests for nutritional deficiencies, and for
biochemical defects that can lead to poor detoxification. Inability
to detoxify leads to a lack of tolerance of substances which cause
no obvious trouble to the rest of the population; and
(f) employment of nutritional therapists
in primary care, so that the majority of patients can be treated
cheaply and quickly, without needing referral to a hospital.
There are many mechanisms other than the action
of IgE antibodies, that cause food and chemical intolerance. For
example, farmers short of the enzyme paraoxonase are susceptible
to poisoning by organophosphates. People who cleave beta carotene
too efficiently can build up a toxic load of vitamin A. Many of
my patients with food and chemical sensitivity are inefficient
at converting the amino acid, cysteine, to sulphate. Sulphate
is required to deal with amines and phenols, which occur naturally
in foods,and for the integrity of the gut wall. Patients may also
be deficient in the phenolsulphotransferase enzymes, that transport
sulphate. Some people lack the lactase enzyme, which splits milk
sugar into simple sugars. Patients may fail to break down milk
and wheat proteins adequately, so that fragments of protein, called
peptides, including the opioids in milk and wheat, cause symptoms
in the mind or body.
Allergy and intolerance should not be seen simply
as acute problems with peanuts or pollen. The contribution of
food and chemical sensitivity to chronic illness extends to schizophrenia,
autism, ME, fibromyalgia, migaine, arthritis, irritable bowel
syndrome and eczema.
You may wish to refer to the following:
1. Brostoff J, Challacombe SJ. 2002. Food
Allergy and Intolerance. 2nd edition. Saunders. London.
2. Moss M, Waring RH. 2003. The Plasma Cysteine/Sulphate
Ratio: A Possible Clinical Biomarker. J Nutr Env Med 13(4): 2l5-229.
May 2004
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