The Role of Hidden Food Allergy / Intolerance in Chronic Disease by Alan

A large body of medical literature has indicated that hidden food allergy is a frequent cause of a wide range of physical and mental conditions. Hidden allergies can be “unmasked” by means of an elimination diet, followed by individual food challenges. Although the concept of hidden food allergy remains controversial, the evidence strongly suggests that identification and avoidance of allergenic foods can relieve a number of common and difficult-to-treat medical problems. (Alt Med Rev 1998;3(2):90-100) Introduction Food allergy is well recognized in clinical medicine as a cause of acute attacks of asthma, angioedema and urticaria, and as a contributing factor in some cases of eczema and rhinitis. These types of allergic reactions are considered to be mediated by IgE antibodies, and usually can be diagnosed by medical history and skin-prick or IgE-radioallergosorbent (RAST) tests. Another type of food reaction, often referred to as “hidden” or “masked” food allergy, has been the subject of controversy for many years. Some practitioners have observed that hidden food allergies are a common cause of (or triggering factor for) a wide range of physical and emotional disorders. According to one estimate, as many as 60 percent of the population suffers from undetected food allergies. A wide range of symptoms and disorders are reported to have a significant allergy component. See Table 1. On the other hand, many conventional physicians doubt hidden food allergy is a common problem, and some even deny altogether its existence as a clinical entity. Skeptics emphasize the fact that many of the conditions said to be related to allergy fluctuate in severity and have a significant psychological component. Consequently, it may be difficult to distinguish between a true food reaction and a conditioned (psychogenic) response or a spontaneous exacerbation of symptoms. It also has been pointed out that food-induced symptoms should not be called allergies unless an immune-mediated mechanism can be demonstrated. While it is true many food reactions would be more appropriately labeled food intolerance, the term “allergy” will be used in this article in reference to adverse reactions to foods. Proponents of the food allergy-disease connection argue that hidden food allergies are often overlooked because they are difficult to identify. Unlike the more obvious immediatehypersensitivity reaction that can trigger acute asthma or anaphylaxis, a hidden food reaction frequently can be delayed by many hours or even several days. Alan R. Gaby, M.D. Professor, Bastyr University; Past-president, American Holistic Medical Association; Contributing Medical Editor, Townsend Letter for Doctors and Patients; Contributing Editor, Alternative Medicine Review. Correspondence address: 125 NE 61st Street, Seattle, WA 98115