-- Chemicals in products such as cleaning solvents, paints and perfumes
-- Food additives such as dyes and preservatives
-- Microorganisms such as yeast (Candida albicans)
-- Multiple foods, especially milk, chocolate, corn and wheat
-- Prescription and over-the-counter drugs
-- Your hormones, especially progesterone
CAM practitioners may cite anecdotal case reports and clinical experience as evidence, but they haven't proved that these substances cause an allergic reaction, which conventional allergists define as an overreaction of the immune system to usually harmless substances such as ragweed pollen. A person may develop symptoms after exposure to a substance without necessarily being allergic to it. Nevertheless, CAM proponents suggest that "allergies" to many different substances cause a variety of diseases. None of these is a recognized allergic condition:
-- Environmental illness (multiple food and chemical sensitivities). Foods, food additives and environmental chemicals - especially chemicals found in cleaning solvents, paints, smoke, gasoline, perfume, and office-machine fumes - are said to cause fatigue, headache, nausea, dizziness and disorientation.
-- Candida hypersensitivity syndrome (yeast hypersensitivity). Candida albicans, a fungus that lives inside all humans, usually causes no problems other than yeast infections. But CAM proponents claim that it's responsible for allergies, arthritis, cancer and AIDS.
-- Attention-deficit/hyperactivity disorder (ADHD). Although ADHD is a recognized medical condition, CAM practitioners falsely claim that sensitivity to food dyes, preservatives and other additives causes its characteristic erratic behavior and inability to concentrate. Actual causes aren't known, though family history and altered brain function may play a role. Conventional doctors usually treat ADHD as a brain disorder.
-- Allergic toxemia (tension fatigue syndrome). A cluster of common symptoms such as fatigue, headache, abdominal pain, paleness and respiratory problems are supposedly caused by allergies to multiple substances, especially foods.
CAM allergy tests
Complementary and alternative practitioners claim their tests reveal allergies that conventional allergy tests miss. These unconventional tests may include:-- Antigen leukocyte cellular antibody test (ALCAT). The practitioner draws samples of your blood and exposes them to 150 to 200 different extracts of foods, drugs, chemicals, pollen, mold and animal dander. A computer analyzes changes in leukocytes, a type of blood cell. If your blood cells flatten, fragment or disintegrate in response to an extract, it's considered evidence of allergy.
-- Applied kinesiology testing. In one hand, you hold a vial containing a suspected allergen while the practitioner bends your opposite arm to measure muscle strength. A decrease in strength is considered a sign of allergy.
-- Cytotoxic testing. This test is similar to ALCAT. The practitioner draws samples of your blood and exposes them to different extracts. The difference is that a technician looks through a microscope for evidence of cellular changes that indicate allergy.
-- Electrodermal testing. In one hand, you hold a negative electrode attached by a wire to an aluminum plate. The practitioner adds vials of food extracts to the plate. He or she then completes the circuit by probing various points on your body with a positive electrode. Fluctuations in the low-voltage electrical current supposedly indicate an allergy to a particular food.
-- Provocation-neutralization testing. A CAM practitioner places drops of suspected allergens under your tongue (sublingual testing) or injects them under your skin. The dose is gradually increased until one is found (the provocation dose) that makes you experience any symptom that may be interpreted as allergic, including headache and dizziness. Then the dose is gradually decreased until one is found (the neutralization dose) that relieves the symptom. If you're extremely allergic to a substance, sublingual testing could trigger a life-threatening anaphylactic reaction.
-- Skin endpoint titration testing. You receive multiple injections - sometimes up to nine - of increasingly high concentrations of suspected allergens under your skin. If a wheal or welt appears, it's considered evidence of an allergy.
Though these tests may seem sophisticated, and may superficially resemble the standardized skin and blood tests your allergy specialist uses, no controlled clinical trials show they can convincingly diagnose any allergic conditions.
CAM allergy treatments
No matter how elaborate a CAM theory or test may be, it likely won't lead to treatments that relieve your allergies. No convincing evidence suggests that CAM treatments are safe and effective for allergic disorders. In fact, some may harm you or make your allergies worse. For example:Antifungal treatments
If you're diagnosed with candida hypersensitivity syndrome, the practitioner may suggest you follow a restrictive diet that excludes foods containing yeast, such as bread. You may also be asked to eliminate sugar on the grounds that it encourages the growth of yeast. Some treatments require you to take unnecessary antifungal drugs, a practice that conventional doctors condemn because it can cause such side effects as liver damage.
Elimination diets
If a CAM test indicates that you have multiple food allergies, CAM practitioners may recommend eliminating many types of food. Since this can lead to poor nutrition, they may also recommend a diet that allows a single serving of a suspect food only once every four or five days (a rotary diversified diet).
Endpoint titration immunotherapy
This treatment is based on skin endpoint titration testing. The CAM practitioner injects extracts of suspected allergens under your skin with the goal of eventually desensitizing you to them. Although this treatment is sometimes called optimal-dose immunotherapy, the treatment dose is far too low to be effective.
Enzyme potentiated desensitization
A very low dose of an allergen such as pollen is mixed with a protein molecule (enzyme) and injected under your skin. The enzyme theoretically prevents your immune system from overreacting to the allergen. A single injection is supposedly effective for an entire allergy season.
Extreme environmental avoidance
Although avoidance of known allergens, such as cat dander, is an accepted method of conventional allergy control, CAM practitioners take avoidance to extremes. They claim that allergens are numerous and widespread. So, for example, they may advise you to completely remodel your home to make it safe from chemical contaminants, move to an isolated community with low pollution levels or wear a mask in public.
Herbs and dietary supplements
CAM practitioners claim that certain herbs and dietary supplements mimic the effect of conventional allergy treatments. Examples include:
-- Bitter orange -- Country mallow -- Echinacea -- Ephedra -- Grape seed extract -- Pycnogenol -- Quercitin -- Spirulina -- Stinging nettle -- Thymus extract -- Vitamin C -- No evidence shows that these herbs and supplements work as well as prescription drugs or immunotherapy. Some may be dangerous. For example, the Food and Drug Administration banned ephedra in 2003 because it increases the risk of heart attack, seizure, stroke and sudden death. And since echinacea is a member of the ragweed family, it might actually worsen your allergies.
Homeopathy
Homeopathic remedies are over-the-counter tablets containing extremely diluted plant and animal extracts. The extracts are chosen because they supposedly cause the same symptoms they're meant to relieve. Since onions make eyes water, for example, onion extracts are used in hay fever remedies. Neutralization therapy
Based on provocation-neutralization testing, neutralization therapy aims to relieve allergy symptoms with injections or under-the-tongue drops of neutralizing substances. Such substances include extracts of known allergens, chemicals and foods.
It's possible that some CAM allergy approaches may someday be proved safe and effective. But until then, the scientific evidence overwhelmingly favors conventional allergy tests and treatments. If a conventional treatment doesn't relieve your symptoms, keep working with your doctor until you find a treatment that does.
