Fatigue—physical or mentalCRACKING THE CODE: UNMASKING HIDDEN ALLERGIES
“Before last year, I never knew the meaning of fatigue. I’d run circles around my husband,” Kate said. “I’m a graphic artist. I worked ten-hour days, raised two kids, went for a run before work every morning . . . I’m sorry, I didn’t mean to cry,” she added, as her eyes filled with tears. “I’ve lost my life. I can’t exercise, I feel like a zombie at work, I’m missing out on my kids’ lives. Going to dance recitals or soccer games feels like agony. All I want to do is lie down and rest. My brain feels like glue. Every little thing I do takes so much effort. I’m just not the person I once was.”
Like so many other women, Kate had built her life around taking care of other people. Her family and her clients came first. Even with a debilitating illness, her main concern was its effect on others. “I don’t even know what to call this disease,” she told me. “It’s not like I have cancer or heart failure. Sure, I’m depressed, but who wouldn’t be?”
Kate’s symptoms seemed to come out of nowhere. It’s a story I’ve heard from many of my patients. The inner dialogue escalates like this:
Kate stopped making plans to go out on weekends. A pattern emerged. She’d feel worse and worse as the week went on, then spent the weekend resting, trying to recover. She’d feel her best by Sunday night, although never really well. Her internist examined her and ran blood tests. Everything was normal. That was a relief, but also a source of frustration.
When Kate first consulted me, I thought that her weekly symptom pattern was a good place to start. In fact, it quickly led to the most important aspect of her illness: she always felt unwell at her workplace.
The previous August she’d taken two weeks’ vacation and traveled upstate with her family. Poison ivy struck on day one, carried on the smoke from a fire in an empty field. A day later her face turned red and began to swell and itch. She found an urgent care center a few miles away, and a doctor gave her a prescription for five days of steroids.
Almost at once a turnaround occurred. Not only did her skin rash clear, but her chronic symptoms greatly improved. Her fatigue vanished; her mood lifted. By the end of the first week she was hiking in the Adirondacks with her kids. Kate was elated.
But when her vacation was over and she returned to work, her world came crashing down all over again. After a few days following her usual routine, the devastating cycle of symptoms returned, but now it was even worse. Her doctor concluded that work stress had to be the culprit and referred her to a psychologist. Yet after meeting with Kate, the psychologist felt that stress was not the cause, that it had to be something physical, and referred her to me.
I considered various possibilities that might explain Kate’s rapid improvement after taking medicine for poison ivy. My leading suspicion was that she was allergic to something in her workplace, which was why two weeks away plus a dose of steroids had restored her almost to normal. If something in her workplace was making her sick, being away on vacation could improve her symptoms. And steroids could temporarily suppress allergic reactions. Putting those two factors together could account for Kate’s turnaround on her trip.
I considered that her problem was unlikely to be a simple allergy. If you’re allergic to cats, for example, and you visit a friend who has cats, your eyes may itch and water or you may sneeze or wheeze, but the symptoms will usually start soon after you’re exposed and will usually clear within hours of leaving your friend’s home. Kate’s pattern indicated a delayed allergic reaction, one that’s more typical of mold allergy.
We needed more information, so I gave Kate two assignments:
Kate worked for a major graphic arts company in a midtown office building. As she carefully surveyed the walls and ceilings, she realized that the heating and cooling vents near her desk looked sooty rather than pure white. With a little bit of investigation, she had located a possible source of mold: the ducts that blew air into her work space.
As most of her work was done on a laptop, Kate was able to work from home for a week. The cycle of symptoms began to improve. She wasn’t back to normal by the end of the week, the way she’d been on steroids, but she was better on Friday than she’d been on Monday. She’d broken the pattern by avoiding her office, but she wanted to get back to work with the artists on her team.
Through testing at her office, it was discovered that samples taken from within the ducts grew eight species of mold. Fixing the problem required careful cleaning of the ducts and rebalancing of the entire system to prevent moisture from accumulating at junctures in the ductwork. Everyone working in the office noticed how much fresher the air felt, and Kate was able to return to her desk without her debilitating symptoms coming back. But she was still not well.
Finding mold contamination was just the first step. I still needed to address two factors for Kate to regain her normal vitality. Both were factors internal to Kate: allergy and toxicity.
As a result of heavy mold exposure, mold allergy had become a real problem for Kate. We needed to consider other sources of mold, outside her office.
Moreover, two of the mold species found in the air ducts produce toxins that can affect immune function. These toxins don’t necessarily leave your body as soon as exposure ends. Your liver discharges them into bile and they’re secreted into your small intestine; then they are reabsorbed into your bloodstream, so they keep recycling within your body. Kate would need help with detoxification.
By applying the steps I will share with you in the chapters ahead, I was able to help Kate improve her personal environment. She diminished her mold exposure at home, where excess moisture in her bathroom had permitted mold growth behind the sink. And by following the Immune Balance Diet, she reduced dietary mold and supported detoxification. In order to enhance the detoxification process, I asked Kate to take two dietary supplements:
Kate’s complete recovery took about a month.
To help Kate restore her health, we considered three questions that are essential for anyone who suspects he or she may have hidden allergies:
In this chapter I’ll take you through the questions I ask my patients in order to get the answers I need.
The Allergy Solution Process of Discovery
You are about to embark on a fantastic voyage of discovery to an uncharted sphere of new understanding about yourself and your personal environment. It is likely to be a defining event. You will be asking yourself new questions about your symptoms, meant to bring out hidden clues about your health. Some you’ll be able to answer right away, like whether your joints ache or whether you have brain fog. Other questions will seem more obscure, like whether you have an abnormal sense of smell or taste. The questions are designed to enable you to gather critically important information about yourself and your personal environment, both around you and inside you.
What may emerge is a whole new way of seeing and thinking about health, with you at the center. Each item can seem like an isolated detail, but even small clues can unlock the mystery of your health journey and get you closer to uncovering what your allergic triggers might be and how they influence your life. There are some thought-provoking questions here, and don’t be surprised if the process is emotional. It is often a revelation to stop and think about how your symptoms impact your life.
In the pages ahead, you’ll take four steps toward unmasking your allergies.
First, using the Allergy Solution Checklist of Symptoms, you’ll identify and record your health issues.
Second, in the Rate Your Symptoms section, you’ll use the questions provided to measure the severity, frequency, and duration of your symptoms.
Third, in the Search for Triggers section, you’ll find questions designed to help you think about the timing and rhythm of your symptoms, and how these relate to your personal environment. This can help you identify what is triggering your symptoms, bringing you closer to understanding your allergies.
Fourth, in the Search for Origins section, I will highlight key issues that often lead up to allergies.
When you’re done, you’ll have a lot of new information about yourself and your health. And I want you to bring all of the information you collect here with you when you go to see your doctor. Quite likely it will spark a very productive conversation, stimulating new ideas and new areas for exploration. It is about helping you and your doctor look closer, know more, understand your own health journey more fully, and make significant progress toward uncovering your allergies.
The Allergy Solution Checklist of Symptoms
First step: make a list of the symptoms that bother you. These are the symptoms you’re going to rate and evaluate. These are the symptoms you’ll be working to eliminate. If you have too many symptoms to remember, this list may jog your memory. For now, just record them. You’ll analyze them later.
I’ve seen each of these symptoms occur as the result of allergies in different patients. If you don’t see your symptoms listed here, just fill them in at the end.
Fatigue—physical or mental
• What have you stopped doing because of fatigue?
_______________________________________________
General unwellness or malaise
Weight problems
Trouble losing weight
Trouble gaining weight
Food cravings
Excessive appetite
Pain
Headache
Earache
Sore throat
Sinus pressure
Chest pain
• Where in your chest?
_______________________________________________
Heartburn
Abdominal pain
Above your belly button?
Below your belly button?
Back or neck pain
• Which joints?
_______________________________________________
Muscle pain
• Which muscles?
_______________________________________________
Pain in a different area of your body
• Which area?
_______________________________________________
Poor sleep
Trouble falling asleep
Trouble staying asleep
Waking up not well rested in the morning
Mood disturbances
Depression
Anxiety
Mood swings
Irritability
Cognitive problems
Brain fog—trouble focusing or concentrating
Poor memory
Confusion
Hyperactivity
Dizziness
Feeling light-headed or off balance
Spinning in your head
Face
Eyes
Are they gooey?
Ears
Throat
Hands or feet
Scalp
Butt
Genitals
Is there a discharge?
Different area of your body
• Which area?
_______________________________________________
All over
Runny nose, sneezing
Postnasal drip, throat clearing
Abnormal sense of smell or taste
Decreased smell or taste
Heightened sensitivity to odors
Cough
Dry
Wet—coughing up mucus
Difficulty breathing
Wheezing
Irregular heartbeat
Rapid heartbeat
Pounding heartbeat
Gas
Abdominal bloating
Belching or burping
Flatulence
Diarrhea
Constipation
Dry, flaky, or scaly skin
Acne
Hair loss
Other symptoms you are experiencing
_______________________________________________
_______________________________________________
Describe Your Symptoms
Allergic symptoms usually fluctuate, depending in part upon your exposure to allergic triggers. Doctors describe these fluctuations using the terms severity, frequency, and duration. Severity has two parts: how intense the symptom gets at its worst and the overall impact of the symptom on your life. Frequency and duration determine the pattern of your symptoms.
For each symptom you have selected or written down on the above list of symptoms, ask yourself:
Is the symptom always present, or does it come and go?
Always present—never completely without it
Comes and goes—sometimes it’s not present at all
When it’s present, does it fluctuate in intensity?
Whenever I have it, it’s always the same
Sometimes it’s stronger and sometimes it’s milder
What percent of time is the symptom at its worst?
10, 20, 30, 40, 50, 60, 70, 80, 90
What percent of time is the symptom at its mildest?
10, 20, 30, 40, 50, 60, 70, 80, 90
What percent of time are you free of the symptom?
0, 10, 20, 30, 40, 50, 60, 70, 80, 90
What percent of the time are you free of all symptoms?
0, 10, 20, 30, 40, 50, 60, 70, 80, 90
Once you understand the pattern of your symptoms, you can rate them. For each symptom on the checklist that you’ve selected or written down, answer the questions in the section below. This will allow you to keep track of your progress. It’s the key to accurate journaling, which will be useful when you start the Power Wash in Chapter 6. Record your answers in the table provided after the questions:
Record and Rate Your Symptoms
Use this table to record the symptoms that trouble you and to rate them with regard to:
| SYMPTOM | OVERALL SEVERITY (RATE 1 TO 4) | PEAK SEVERITY (RATE 1 TO 4) | FREQUENCY (RATE 1 TO 8) | DURATION (RATE 1 TO 8) |
The Search for Triggers
Allergy detective work is the search for triggers. Nothing produces such dramatic and total relief as identifying an allergic trigger and eliminating it. Not all triggers can be eliminated, of course. But knowing what they are is of great benefit in creating an individualized treatment program.
Sometimes the trigger is obvious, because the symptoms are immediate and your exposure is episodic. Allergy to cats or to peanuts usually falls into the “obvious” category. But many of the cases described in this book involve triggers that were not obvious. They had to be ferreted out. The function of the next list is to help you identify the non-obvious triggers for your allergic symptoms.
Please answer the questions below for each symptom on the Checklist of Symptoms that you selected or wrote down. These questions apply to symptoms that fluctuate in severity or that come and go. I’ve listed the most common types of triggers, but the list is not exhaustive.
Is there a rhythm to the occurrence or severity of the symptom?
Worse during the night or in the morning when you first wake up?
• Could be something you ate the night before.
• Could be something in your bedroom:
Dust and dust mites are the most common bedroom allergens. They hide in carpets, drapes, pillows, mattresses, books, and stuffed animals.
Laundry detergent or fabric softener used on your sheets might be a problem.
Has there been a leak or flood, perhaps in an attached bathroom?
Is there a lot of pressed-wood or particleboard furniture? When new or when damp, it can off-gas formaldehyde, an allergen and irritant.
Is there a new carpet, new drapes, or fresh paint? These off-gas volatile organic compounds (VOCs), which can provoke allergic or toxic symptoms.
Is your mattress brand new or very old? Either way, it may be a source of VOCs.
Does your pet sleep with you?
Is the symptom not bad in the morning but worse in the evening or as the day goes on?
• Consider allergy to a food you eat every day.
Worse on weekdays?
• Perhaps there’s a trigger at work or school.
Worse on weekends?
Do you eat or drink differently on weekends than during the week?
What do you do for recreation on weekends? Where do you go?
Worse premenstrually?
• You may be allergic to progesterone. After ovulation, the level of progesterone in your body rises dramatically. You’ll need a skilled allergist to test for that.
• You may be allergic to yeast. The level of yeast in your body grows premenstrually, under the influence of increasing progesterone.
Worse in spring?
• Pollen allergy is likely. Check the pollen levels in your area at the time of peak symptoms.
Worse in late summer or early fall?
• Pollen allergy is likely. Check the pollen levels in your area at the time of peak symptoms.
Worse in mid- to late fall?
• Mold allergy is likely. Check the mold spore count in your area.
Worse when heat comes on?
• Check for contamination in the heating system. Mold, dust, or other pollutants should be considered.
Worse when air-conditioning is running?
• Check for contamination in the air conditioner or cooling system. Mold is a strong possibility, although some people just react to cold air.
Better in deep winter, when there’s a freeze?
• Mold or pollen is likely.
Better in summer, regardless of location?
• Food allergy often improves in summer.
Are there any locations in which the symptom is more likely to occur or get worse?
Indoors: consider indoor mold, dust, dust mites, or some contamination or pollution of your living or working space. There’s a long list of possibilities.
Outdoors: consider outdoor molds, pollen, or air pollution.
In the country: consider mold, local pollen, or agricultural pollution.
In the city: consider pollution from car exhaust, diesel fumes, dry cleaners, and other urban sources.
In your car?
• If it’s new, high levels of VOCs are likely.
• If it’s old, check for mold or for leaks in the exhaust system.
In trains or planes: VOCs from cleaning products are possible culprits.
In a hotel:
• If it’s new or newly renovated, VOCs from cleaning products, furnishings, or construction materials are likely.
• If it’s old, mold or dust is likely.
Are there any locations in which the symptom is less likely to occur or less likely to be severe?
On vacation? Maybe there’s something in your home or workplace that harbors allergens.
In the country, in the mountains, at the beach? Maybe it’s a pollutant in city air.
In the city? Maybe it’s outdoor mold spores.
Are there any environmental conditions in which the symptom is more likely to occur or get worse?
Damp weather? Might be outdoor mold spores.
Before a thunderstorm? Probably outdoor mold spores.
On clear, windy days? Probably pollen or dust.
Are there any activities during or after which the symptom is more likely to occur or get worse?
Housecleaning? Think dust.
Gardening? Think mold.
Eating or drinking? Think food.
Are there any medications you’ve taken that seem to make the symptom worse?
Antibiotics? If you’re not allergic to the antibiotic, maybe you’re allergic to the yeast that’s very likely to be growing in your gut because of the antibiotic. By knocking out bacteria, antibiotics leave your gastrointestinal tract open to a yeast overgrowth.
Are there any medications you’ve taken that seem to make the symptom better?
Antihistamines? The symptoms these help are often caused by allergy.
Steroids? These usually relieve symptoms of allergy while you’re taking them, and they may also help reduce nonallergic inflammation. But steroids have very serious side effects.
Antibiotics? These usually help bacterial infections, but some have anti-inflammatory effects that are separate from the antibiotic effects. Consider three possibilities:
• The symptom that improves with an antibiotic is the result of a bacterial infection stemming from the inflammation caused by an underlying allergic problem.
• The allergic condition is actually the result of a bacterial infection.
• The improvement is unrelated to the antibiotic effect of the medication. There’s another explanation.
The Search for Origins
I believe that to identify and reverse your allergies, it helps to understand how they developed. Genetics plays a role, but the galloping allergy epidemic of the last 40 years is due to environmental factors rather than genetic changes. Genes merely create susceptibility. As I explained in Chapter 1, children with a defective gene for creating the detoxifying enzyme GST develop asthma only if they’re also exposed to environmental toxins like cigarette smoke or diesel exhaust. That is an excellent reason for eliminating cigarette smoke and diesel exhaust from the environment.
What Leads Up to Your Allergies?
It helps to know which factors tip the balance away from health, because fixing them can enable you to restore health. I call these factors Antecedents. In my clinical experience, the most common Antecedents for developing allergic illness are:
I deal with each of these in detail throughout this book. To better understand the origins of your own allergies, ask yourself if your symptoms started during or after the following circumstances:
Cracking the Case
Now let’s look at another case history to see how multiple Antecedents converged to create one woman’s personal perfect storm of allergy—and how her detective work cracked the case.
Daphne is a 42-year-old design engineer who has traveled all over the world working on various projects for a number of high-profile clients. Five years ago, when she was asked to be the maid of honor at a friend’s wedding in Southeast Asia, Daphne went on a drastic diet. She lost 35 pounds in three months but also developed severe abdominal pain, which improved when she treated herself with over-the-counter antacids.
She went to the wedding, but when she returned, she found that most of the foods she usually ate made her sick with unpleasant gastrointestinal symptoms. With every meal she would suffer nausea, burping, and abdominal bloating. She developed frequent diarrhea, which led to further, unintended weight loss.
She consulted a gastroenterologist who found that she was infected with a stomach bacterium called H. pylori, which is a frequent cause of stomach ulcers and inflammation. The doctor suspected she had acquired the infection on her trip to Southeast Asia for the wedding. He treated her successfully with two antibiotics, but curing the infection seemed to do very little to help her symptoms. Daphne continued to have burping, belching, and bloating every day, along with frequent diarrhea, and was beginning to get exasperated.
Then, for the first time in her life, Daphne developed a sinus infection; she went on to develop recurrent sinusitis every few weeks. The sinus symptoms were pressure in her face, swelling of her cheeks, and a postnasal drip. Respiratory symptoms compounded the misery of her digestive symptoms.
Daphne was referred to an allergist who found that she was allergic to dust mites and many types of pollen. A year of allergy shots produced no benefit.
On her own, Daphne realized that drinking milk would cause a runny nose and watery eyes. She decided to totally eliminate all dairy products, and her sinus problems and digestive problems improved for a while.
A year before consulting me, she started a new job in a new building. When the heat went on in November, all her sinus symptoms returned. She decided to investigate the reasons for her illness on her own. She discovered that the building’s insulation was made of polyethylene foam, which had been sprayed just before she began working there.
She also learned that isocyanates, a by-product of polyethylene foam spray, are potent allergens and well-known causes of occupational asthma. She obtained a 12-inch chunk of the hardened foam and found that when she held it up to her face her eyes watered, her nose ran, and her face swelled. Once again she thought she had solved her problem.
Daphne took a job in an older building and her sinus problems improved, but only for a short time. She then realized that other environmental chemicals—solvents and cleaning solutions in particular—had the same effect on her as polyethylene foam.
Then, two months before seeing me, she developed intense, burning pain in her legs and debilitating fatigue. She returned to her allergist, who found that she had become allergic to latex as well as to bananas, a fruit that can provoke allergy in people allergic to latex. (Visit www.drgalland.com for more information on latex allergy.) Although she removed possible sources of latex exposure at home and work and avoided foods that cross-react with latex, she got worse instead of better. Now very much unable to perform at her usually high level, she went on medical leave from her job.
When Daphne came to my office, I praised her for her determination to get to the roots of her illness and for her persistent allergy detective work. The key to her illness had been overlooked, and it seemed to me that it was hiding in plain sight.
The complex cascade of increasing allergies had started during her trip to Southeast Asia. Her allergies had been preceded by two significant events: a crash diet for weight loss and the use of antacids. These would produce nutritional deficiency resulting in immune dysfunction and would increase her risk of acquiring a gastrointestinal infection. Her gastroenterologist had identified a bacterial infection, but its treatment had not cleared up her digestive symptoms. Perhaps there was another infection that had slipped beneath the radar.
In fact, there was. I found that Daphne had two parasitic infections: an amoeba called E. histolytica and a worm called Ascaris. When I treated her with the appropriate antibiotics, there was a remarkable response. For the first few days all her symptoms intensified. She had increased pain in her legs and face, increased facial swelling, and increased mucus drip and runny nose. Then, within two weeks, all her symptoms began to improve. Her energy increased and her food reactions diminished.
Treating Daphne’s parasites had the effect of resolving her allergic symptoms, but we still needed to look at her nutrition. She had become quite drained and depleted of nutrients while suffering from gastrointestinal complaints including diarrhea. On the most basic level, whatever she had been eating was not being properly digested, but passing through her digestive system without her getting the full nutritional benefit.
Now that she was able to eat more normally, I had her begin the Immune Balance Diet (which you will read about in Chapter 8) to provide an enhanced level of nutritional support. Her pain, facial swelling, and mucus drip all disappeared. Her sinusitis was gone. Daphne was gratified to have her health back.
Ever the detective, Daphne insisted on visiting her previous office, where she was again confronted with the hardened polyethylene foam and cleaning solvents, just like before. But now Daphne had no adverse reaction to either.
Conclusion
In this chapter we looked at hidden allergies that can cause a bewildering array of unexplained symptoms. We saw how Kate, the graphic artist and mother, went from energetic to exhausted due to an undiscovered allergy. Like a detective tracking down clues, we reviewed a detailed history of her symptoms and learned that these symptoms almost vanished when she was out of the office, which led me to suspect a mold allergy, a common environmental cause of illness that we resolved at Kate’s office. Her case illustrates the Allergy Solution Process of Discovery, with the goal of gathering information about yourself and your symptoms to solve the puzzle of your condition.
We met the design engineer Daphne, a world traveler who had developed a mysterious case of abdominal pain and sinusitis. After we cleared up her parasites, we addressed her nutrition with the Immune Balance Diet and resolved her symptoms.
Solving the allergy puzzle involves diligent detective work, and I have provided tools to help you gather the information you need. Now that you’ve trained a spotlight on your allergic symptoms and the factors most likely to be triggering them, you’ve taken an important step toward reversing your allergies and regaining your health. I believe this detailed information is so essential to understanding a person’s health that you should bring the completed Allergy Solution Checklist of Symptoms—and all the incredibly valuable data about yourself that you gather with the tools here—to your doctor for an in-depth review.
The chapters ahead will provide a way to zero in on aspects of diet that may be contributing to hidden allergies and keeping you from feeling truly well. But first, I’m going to send you on a mission to reduce your exposure to toxins in your personal environment, something all of us should do to remove toxins that may be contributing to our allergies and undermining our health.