Food Allergies & ADHD

Food allergy is common in infant and young children. It can be frustrating for parents – colicky infants, vomiting and not tolerating formula or sometimes even breast milk. And for the child, the impact is even more so – failure to thrive is common, which may lead to developmental delay as poor nutrient intake or tolerance impairs achievement of developmental milestones. Thus, it is important for parents and pediatrician to diagnose food allergy in a timely manner to avoid long-term detrimental outcomes.

The good news is most of these allergies in young children will resolve by 4-5 years of age. However, before that happens, the child has to stay clear of the offending allergic foods as each accidental exposure to the offending will strengthen the immune reaction. Thus, the more a child is exposure to the offending before his outgrowing of the allergy, the immune response becomes stronger and stronger, which means it will take longer for the child to outgrow the allergy.

Children with ADHD frequently have hidden food allergy or intolerance. The reason why I use the word “hidden” is because these allergies or intolerances are difficult to identify. Most of the time we don’t even know they exist because when we think of food allergy we are thinking of the very obvious ones, like some who is allergy to seafood, and ate something with shrimp, and within minutes reacted with full body hives, facial swelling, itching mouth and throat, etc.

However, these are not what we’re seeing in children with ADHD or even autism. Their reactions are a lot more subtle and slow. In fact, the food reactions we frequently suspect in children with ADHD or autism are Food Intolerance. Food intolerance and food allergy shares many similar signs and symptoms, such as diarrhea, vomiting, runny nose, nasal congestions, hives, rash, etc. However, they are very different physiologically.

WHAT IS THE DIFFERENCE BETWEEN FOOD ALLERGY AND FOOD INTOLERANCE?

We frequently refer to any food reaction as food allergy. However, most of these reactions are food intolerances instead of allergies. Food reactions are common, but most are caused by a food intolerance rather than a food allergy. Food allergy and food intolerance share very similar signs and symptoms, which is why many people are confused between the two.

Food allergy triggers an immediate immune response, usually involving the immunoglobulin E (IgE). IgE-mediated response activates a cascade of systemic reactions, involving multiple organ systems. That is why this is the more severe form food intolerance. Fatal peanut allergy usually falls into this category. Even a tiny amount of the offending food can cause an immediate, severe reaction or anaphylactic shock, which is a life-threatening allergic reaction.

An anaphylaxis is characterized by systemic responses, such as difficulty breathing due to swelling of airway, hives along with itching, flushed or pale skin, weak and rapid pulse, dangerously low blood pressure, nausea/vomiting or diarrhea, dizziness or fainting.

An anaphylactic event requires emergent medical treatment, and delay of treatment may result in death. People with severe food allergies are usually prescribed and “epi” epinephrine pen that they carry around in case they consume or come in contact with their allergen by accident.

With a true allergy, the offending food needs to be avoided completely, especially in young children. Food allergies are common in the first years of life. With every repeated exposure to the offending food, the immune system becomes better in attacking that allergen, which means the response will become more and more intense each time the body is expose to the allergen. Children usually outgrow their allergies by 4 or 5 years of age. However, repeat exposure may prevent or delay the time to outgrow the allergy.

Food intolerance, on the other hand, usually does not involve the immune system, and reaction also comes on a lot slower – usually after two hours of ingestion of food, and up to 48 hours – and more subtle presentation. The individual usually is able to tolerate a small amount of the offending foods without much adverse effect.

Symptoms of food intolerance are generally less serious, less obvious and appear very subtly and slowly. That’s why that trouble food is seldom identified. Some common signs and symptoms include nausea, vomiting, abdominal cramps, constipation, diarrhea, asthma, eczema (atopic dermatitis), etc. Food intolerances may also result in behavioral symptoms frequently seen in ADHD and autism.

Causes of Food Intolerance

There are many causes of food intolerance or food allergy. There may be a lack of enzymes to fully and efficiently digest a nutrient, as in lactose intolerance, where the body does not produce enough lactase (enzyme that breaks down lactose into glucose and galactose). People frequent thought they are allergy to milk. If you are allergy to milk, you cannot have any diary product at all – milk, cheese, yogurt, and anything made with or contains dairy ingredient. If you are lactose intolerant, on the other hand, you can tolerate small amount of milk with your morning cereal or coffee, enjoy yogurt, cheese, or ice cream without problem. But you cannot tolerate drinking a lot of milk by itself.

Your child may be sensitive to food additives, such as preservatives, food coloring, etc, which is basis of the Feingold diet, introduced by Dr. Benjamin Feingold in 1975 to treat children with ADHD. Autoimmune conditions, such as Celiac disease, may trigger adverse reaction to foods.

Milk protein allergy, common in infants and young children, may cause projectile vomiting, constipation, blood in stool and failure to thrive in young children.

FOOD ALLERGY VS FOOD INTOLERANCE

Food Allergy (IgE) – Immediate Response

1. Usually only allergic to one to two offending foods.

2. Only trace amounts of offending food is enough to trigger an immediate intense allergic reaction.

3. Allergic reactions usually appear within minutes up to two hours of ingesting offending foods.

4. Primarily affects multiple systems, such as the skin (hives, rashes, and eczema), respiratory (asthma, throat swelling, and runny nose) and digestive tract (vomiting, diarrhea or constipation).

5. More common in children, rare in adults. But we’re seeing more adults developing new allergies as they age.

6. Children tend to avoid these foods on their own. Addictive cravings and withdrawal symptoms are rare.

7. Offending food is self-diagnosed due to the immediate appearance of allergic reactions.

8. A few food allergy may not be outgrown, especially peanut allergy, which is the more fatal allergy.

Food Intolerance (IgG) – Delayed Response

1. More food may be involved.

2. Accumulation of the offending foods over a period of time to trigger a reaction.

3. Reaction usually appears at least two hours after ingesting offending food, and up to 24-48 hours

4. The tissue organ affected depends on the cause of food intolerance.

5. Very common in both young children and adults.

6. Addictive craving and withdrawal symptoms are common.

7. The offending food is difficult to identify due to involvement of multiple foods and delayed onset of symptoms.

8. Allergic foods are frequently favorite eaten foods in larger amounts, such as milk and wheat.

9. The food intolerance may be resolved after three to six months of complete elimination.

FOOD ALLERGY AND CHILDREN WITH ADHD

So now we know your child most likely have food intolerance and not food allergy. This explains why the food allergy test usually comes back clean. The allergy tests that your pediatrician use – RadioAllergoSorbent Testing (RAST) and skin prick – only identify allergic reaction caused by the immunoglobulin E (IgE). Remember, the reactions we see in food intolerance do not involve the immune system, thus, RAST and skin prick will pick up nothing.

The focus of food allergy has always been on the physical manifestations. We frequently forget about that fact that the intestine is our biggest immune organ, blocking all kinds of foreign substances from entering our body. However, when our body is reacting to certain foods or chemicals in the foods we eat, and is showing associated GI symptoms, that means the GI tract is being attack. Chronic exposures to these insults may weaken the gut barrier that is supposed to be selective. Over time, this lead to leaky gut, where the intestine being so permeable and porous that it is allowed more foreign substances and semi-digested protein to enter the blood steam.

This feeds into a vicious cycle of offending food irritating the intestinal wall, the intestinal become porous and allowing undigested food particles (from poor digestion) into the blood stream, triggering allergic reaction. Along with all these, the undigested food, especially carbohydrates, creates an ideal environment for the yeast and bad bacterial to thrive, making the intestinal more susceptible to insults.

The best we have is observation and keeping a food and behavior log. Sometimes you maybe able to pinpoint a few food that your child reacts to. Some parents would swear that every time their child eats or drinks anything with red coloring, will act up after. You’ll probably notice when your child’s eczema worsens with eating dairy products. Or your child starts acting silly and not able to focus after eating a lot of wheat product.

There is another interesting point to make – many children with ADHD or autism, crave foods that they are intolerant to, such as dairy and gluten. They are the ones who are usually big milk drinker and eats mainly bread and crackers, and love mac n’ cheese.

Get this home food sensitivity test kit and test your reaction to 96 common food allergens

What You Need to Know About Leaky Gut…

What is Leaky Gut Syndrome?

Leaky gut, as the words suggest, is describing a “HOLEy” intestine.

By the way, leaky gut does have a fancier scientific name – “increased intestinal permeability” or “intestinal hyperpermeability”.

In a normal healthy intestine, the cells lining the intestinal walls are glued very tightly to each other. In fact, the joining point of the cells are called tight junction, so we’re reminded that they’re tight.

The intestine is the body’s first line of defense against the outside world. No matter how clean you wash your hands, utensils, cook your food or raw food. There’ll be unwanted guests being ingested the same time.

This is where our intestines save our lives everyday as our shining armor. The intestine wall is supposed to block out everything that is harmful to our body, and selectively allow what our body needs to pass through into the circulatory system or lymphatic system. Just like a bouncer at the club entrance. No entrance if you’re not on the VIP list.

For reasons we’ll discuss shortly, the intestine lining gets challenged and the integrity of the tight junction is being sabotaged, resulting in a compromised defense mechanism and the intestinal wall become less selective of what’s allowed to cross the barrier into the blood stream.

This can be dangerous, as we already mentioned, God knows what else is in the food we eat.

With the not-so-tight junction now, anything that can fit through the gap, will enter. That means, partially digested food now can get through without being thoroughly digested. Bacteria, virus and fungus can enter into the bloodstream. Toxins from liver and bile generated from the body.

The not-so-tight junction is now free for all.

These uninvited guests trigger autoimmune reactions, which can lead to gastrointestinal problems such as abdominal bloating, excessive gas and cramps, fatigue, food sensitivities, joint pain, skin rashes, and autoimmunity.

Leaky gut results in hepatic dysfunction and pancreatic insufficiency, which further impede food digestion and toxin accumulation, and making the gut more permeable, creating a vicious cycle of food allergy, malnutrition, bacterial dysbiosis and hepatic distress.

So…what happened now?

First we need to figure out why our gut becomes leaky or “holey”.

There are many possible causes of leaky gut. Definitely, anything that’s harmful to the intestines, such as chronic inflammation, food sensitivity, nonsteroidal anti-inflammatory drugs (NSAIDS) therapy, cytotoxic drugs and radiation or certain antibiotics, excessive alcohol consumption, or compromised immunity.

And here’s a list of medical conditions that are associated with leaky gut

• Inflammatory bowel disease
• Infectious enterocolitis
• Spondyloarthropathies
• Acne
• Eczema
• Psoriasis
• Urticaria
• AIDS/HIV infection
• Cystic fibrosis
• Pancreatic insufficiency
• Hepatic dysfunction
• Irritable bowel syndrome with food intolerance
• CFIDS
• Chronic arthritis/pain treated with NSAIDS
• Alcoholism
• Neoplasia treated with cytotoxic drugs
• Celiac disease
• Dermatitis herpetiformis
• Autism
• Childhood hyperactivity
• Environmental illness
• Multiple food and chemical sensitivities

Leaky gut syndrome may trigger or worsen disorders such as Crohn’s disease, celiac disease, rheumatoid arthritis, and asthma.

And I would be wary of any diagnosis of leaky gut syndrome if you don’t have Crohn’s disease, celiac disease, irritable bowel syndrome, rheumatoid arthritis, or asthma.

How do you know if you have leaky gut?

Having one of the above medical conditions make you at higher risk of have leaky gut. Having one of the symptoms below should increase your suspicion for leaky gut.

SYMPTOMS ASSOCIATED WITH LEAKY GUT:

• Fatigue and malaise
• Joint and muscle pain
• Fevers of unknown origin
• Food allergies and intolerances
• Abdominal pain and distension
• Diarrhea
• Skin rashes
• Toxic feelings
• Cognitive and memory deficits
• Shortness of breath

If you have one or more of the medical conditions associated with leaky gut along with a few of the symptoms above, it may be wise to consider the possibility of leaky gut.

There are tests that can confirm your diagnosis of leaky gut. Or you can just start treating your leaky gut empirically with a clean nutrient dense plant-based diet that is free from toxins and filled with antioxidants.

I would suggest the second option, if you don’t want to bother with the testing and wait.

The treatment of leaky gut generally does not involve any big gun pharmaceuticals that are loaded with toxins and dangerous side effects.

To find the right treatment, we need to first understand the causes. Otherwise, we’re just keep putting bandaids on the symptoms.

So…what causes leaky gut?

Leaky gut syndrome is generally not recognized by conventional physicians. If you ask your general physician if you have leaky gut, chances are you’ll get a funny look like he/she does not know what you’re talking about.

On the other hand, a functional medicine doctor may consider runny some tests to look for clues to confirm leaky gut or bacterial dysbiosis.

Related articles: Testing for leaky gut

The leaky gut is the manifestation of the vicious cycle of allergy, malnutrition, bacterial dysbiosis and hepatic stress.

Each problem feeds into the next and the cycle just keep going and your symptoms continue to get worse.

The relationship between food allergies and sensitivities and the leaky gut is complicated. The leaky gut or intestinal that is “holey” is a cause of food sensitivities because it allows anything to past through. Then, when the intestine is exposed to all kinds of allergens, the immune system is activated, mast cells are deployed and histamine is released. This immune reaction makes the gut even leakier, then more undigested food past through, then more allergic reaction. And it keeps going, and going, and going…

Now with damaged epithelial cells and really leaky gut, nutrients are not absorbed properly. As a result, malnutrition happens, which further aggravates the structure, integrity and function of the epithelial cells in the intestines.

Under normal conditions, intestinal epithelial cells dies and regenerate every three to six days. This is a very demanding task that requires lots of energy and nutrients. The malnutrition, which is the result of poor nutrient absorption from the leaky gut, would hider epithelial cell repair and regeneration. As a result, the intestinal wall continues to get weaker and weaker because the body cannot catch up with the demand to regenerate new cells.

With nutrients not being absorbed properly, the microbiota in the gut will be affected. You can imagine overgrowth of all kinds of bacterial, fungus, other organism out of proportion leading to bacterial dysbiosis. These guys are supposed to be living in harmony with each other and with our guts. When certain one species grow too fast, they overcrowds the other. Even if it’s the good bacteria that is growing too fast. Too much of a good thing is not always better.

Related article: Bacterial Overgrowth/Dysbiosis

This results in disruption of the intestinal harmony and with the now bigger organism population, we also have a waste control problem.

The liver in people with leaky has to work extra hard to remove the unusual guests that enters the leaky gut, and get rid of the toxic waste generated in the crazy overpopulated gut microbiota.

The situation is putting the liver in stress.

Cytochrome P-450 oxidase is induced and the liver starts making more free radicals. The result is damaging to the liver cells. The liver dumps the toxic free radicals into the bile, which is excreted via the intestine.

The problem does not stop here. This is just the beginning.

While the toxic bile is traveling in the intestine towards the colon and hopefully, out of the body, some of the toxin is being reabsorbed back into the system. Remember from physiology class, our body normally reabsorbs some of the bile back.

Yikes…

Not only that, the toxic bile is damaging to the bile duct, intestinal wall and it can also reflux into the pancreas, affecting nutrient digestion.

This whole scenario just feeds further into the leaky gut, making the intestine more permeable to intruders.

And the cycle keeps going.

Now that we have a better understanding of the etiology of leaky gut.

Now let’s break the cycle, patch up the HOLES and heal your leaky gut.

Heal Your Leaky Gut

Journey to a Happy Healthy Gut

Now that we have more understanding of what leaky gut is and what the causes are, let’s explore the journey to healing.

Notice that I use the word “journey”…meaning healing is a process and will take time.

Remember the vicious cycle of leaky gut did not happen overnight and so is the healing process.

Are you ready for a change for the better?

Here are the critical steps toward a healthy and happy gut.

We know the gut is very delicate and sensitive, and so the first order of business is to stop putting toxin in your body.

Translation: Change your diet.

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As Michael Pollan eloquently states “Eat Food. Not Too Much. Mostly Plants” in his book “Omnivore Dilemma”.

Researches, studies, multiple counts of experiences point toward the beneficial effects of an anti-inflammatory plant-based diet.

I recommend eating an plant-based diet that is rich in essential fatty acids, such as omega-3 fatty acids and gamma linolenic acid GLA, and insoluble fiber.

Many naturally occurring substances from plant-based foods help repair the intestinal mucosal surface or support the liver when stressed by enteric toxins.

Essential fatty acids (EFAs) are the substrates for prostaglandin synthesis. Fish oil has been shown to resolve intestinal mucosal injury and stops the systemic response to endotoxin. Gamma-linolenic acid (GLA) promotes the synthesis of E-series prostaglandins, which decrease permeability.

Our body can make GLA from linoleic acid via an enzymatic reaction catalyzed by deta-desaturase (D6D). However, this reaction is limiting and consumption of excessive vegetable oils may increase the free radical content of bile and exacerbates the effects of endotoxin.

EFAs should be consumed in the most concentrated and physiologically active form to avoid exposure to large quantities of polyunsaturated fatty acids from dietary oils.

Good dietary sources of GLA are evening primrose oil, black currant seed oil, hemp seed oil and borage oil.

Insoluble fiber has been shown to decrease permeability. So eat a diet rich in insoluble fiber or supplement with pure cellulose or rice bran. An added benefit of rice bran is gamma oryzanol. It is an antioxidant in rice bran that has healing effects in gastric and duodenal ulceration.

Soluble fiber, on the other hand, increases permeability, and should be consumed in limited amount.

Avoid any foods that you’re allergic and/or sensitive to as allergic reactions increase gut permeability. When taken before eating, Quercetin may help to stop the release of histamine and inflammatory mediators in an allergic reaction.

Chewing your food well may actually help to nourish your gut with salivary Epidermal Growth Factor (EGF). It is a polypeptide that stimulates growth and repair of epithelial tissue. It is found throughout your body, with high concentrations in salivary glands, prostate glands and in the duodenum.

Take a probiotics supplement containing Lactobacillus GG may help repopulate the good bacteria population that is the result of the leaky gut, and reverse bacterial dysbiosis.

In addition, supplementing your diet with glutamine can be beneficial. Glutamine is an important substrate for the maintenance of intestinal metabolism and integrity. Glutamine supplementation has been shown to reverse intestinal mucosal injury, resulting in less villous atrophy, increased mucosal healing and decreased passage of endotoxin through the gut wall.

Support your liver with glutathione (GSH), which is an important component of the anti-oxidant defense against free radical-induced tissue damage. Hepatic GSH is a key ingredient for reducing toxic oxygen metabolites and oxidized xenobiotics in the liver. When the liver is working overtime trying the get rid of the toxic waste in the leaky, the demand for glutathione is high because the liver is using it up very quickly.

The most effective way to increase glutathione level in liver is to supplement with its dietary precursors, cysteine or methionine, such as N-acetylcysteine. Flavonoids in milk thistle (silymarin) and in dandelion root (taraxacum) also help to support the liver by protecting against reactive oxygen species.

An additional step to support and nurture your liver is to let it rest, as in stop ingesting more toxins from processed foods, fast foods, food colorings, food additives, pesticides, preservatives, artificial sweeteners, medications, legal drugs, etc.

And of course avoid alcohol even if it’s red wine.

Sorry…I know it’s confusing. One says red wine is good for you and another says alcohol is bad for you. If you have a leaky gut, alcohol is definitely bad for you. So sober up, at least until your leaky gut is under control.

And did you know…you can get the same resveratrol from a supplement and minus the alcohol and save your liver.

NSAIDS are all your pain-killers. They are known to cause GI bleed. I know you need them to control your pain. Did you know most of your aches and pains are the result of systemic inflammation caused by all the toxins you put in your body?

That’s why I put this step last. Because when you start doing all the things listed above, your body is slowly healing itself and recovering, and the inflammation eventually stops and so will your aches and pain. And when that they comes, you’ll not need your pain killer anymore.

Bone broth is supposed to be good for leaky gut. A colleague buys “chicken feet” from Whole Foods and boils them with some vegetables for 24 hours in a slow cooker to get all the gelatin out of the bone. Just flavor with a little salt and you have a yummy broth for your tummy.

Relaxation helps lower stress hormone. Activities like yoga, meditation, walk in the nature, hiking, exercise, etc. These activities not only reduce your stress hormones, but they can also increase your feel good hormone – endorphins.

When you follow these steps, your gut will start feeling better, aches and pain will disappear, brain fog will clear up, and ADHD symptoms will improve.

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