A few months ago I went to see a doctor in Harley Street with my younger daughter, Kitty. For a couple of years she had been complaining of a range of vague symptoms such as headaches, nausea, dizziness, stomach upset, muscle aches and fatigue. Nothing dreadful, but enough to make A-levels more of slog than they should be and almost enough to interfere with going out at weekends.
Lots of people suffer from similar combinations and they are hard to treat. In trying to find a remedy for Kitty’s symptoms, I discovered some interesting things about why food intolerance develops; and a new way of looking at it that could make a difference to its future treatments.
Like most sufferers, we had seen the GP regularly, been referred to a couple of specialists and discussed the possible causes, such as stress, too much late-night studying, hormones and over-exercising (she does a lot of sport). But nothing improved. Trying a change of diet seemed the next step.
As a medical journalist who has written two books with nutritionist Patrick Holford of the Institute for Optimum Nutrition, I was well aware of the gulf separating the mainstream from clinical nutritionists on this topic.
On one side, lots of happy patients claim that cutting out wheat, dairy and a variety of other foods has really made a difference.
On the other, conventional medical wisdom says that real allergies are life-threatening – the peanut or bee sting that can swell your throat in seconds – and all the rest is credulity and hype which, by anathematising major food groups, can quite possibly be dangerous.
We were seeing the Italian immunologist and allergy specialist Dr Attilio Speciani, and it was immediately clear that credulity and hype played no part in his approach. He ran a thorough range of tests, some standard, some rather more specialised and some for inflammation.
These excluded a number of possible causes other than food and gave him a picture how Kitty’s system was working overall.
This was not something any other medics had been interested in. For example, at one point, she had been seen by a rheumatologist because one possible diagnosis had been hypermobility.
The rheumatologist declared she wasn’t hypermobile and suggested she see a physiotherapist for her muscle pains; the rest of the symptoms were ignored.
One of Dr Speciani’s tests was for Immunoglobulin G response to any food, which is usually taken as a sign of food intolerance. (These are proteins or antibodies made by the immune system in response to a potential threat, whereas the strong bee-sting-type allergy causes an Immunoglobulin E response.) Kitty had an IgG response to eggs, yeast and, curiously, nickel.
Speciani dismissed the eggs as an issue. “The test is useful to tell what foods produce a reaction,” he says, “but you have to know how to interpret it. For instance, this company sets the threshold for a significant response to eggs too low, and Kitty’s is fine.”
Another complication is that an IgG response may simply mean your system has produced a reaction in the past; it may not be an issue now.
After a careful physical examination, Speciani explained what he had found. The key issue was a chronic low level of inflammation, possibly due to nickel and yeast. The inflammation was making her muscles more painful than usual after exercise, and the body was producing water to try to reduce it. This in turn was causing the puffiness she had around the stomach and thighs.
The inflammation was also linked to the nausea, which – via the vagus nerve, running from the stomach to the brain – contributed to the dizziness and headaches. She also showed up as being very low on protein because of her vegetarian diet.
For the first time, we had an overall picture of what was going on, and a plan of action: cut out foods with nickel and yeast for a couple of months, eat more protein, take enzymes to help with digestion and nausea and some omega-3 capsules to lower the inflammation.
The diet took a certain amount of planning and determination – who’d have thought so many things had nickel in them? – but two months later Kitty’s symptoms are much improved.
Why, though, do these intolerances develop in the first place? Dr Speciani’s reply suggests that the mystery is not that we sometimes become intolerant to certain foods but that it doesn’t happen more often.
Next week: I’ll be looking at the roots of food intolerance and the new markers linking food and inflammation that may make it easier for doctors to accept food intolerance as real and treat it better in the future.