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Allergies: Dubious Diagnosis and Treatment, 21/6/2012
Many dubious practitioners claim that food allergies may be responsible for virtually any symptom a person can have. In support of this claim—which is false—they administer various tests purported to identify offending foods. Claims of this type may seem credible because about 25% of people think they are allergic to foods. However, scientific studies have found that only about 6% of children and 1-2% of adults actually have a food allergy, and most people with food allergies are allergic to less than four foods .

When we think of allergies, we immediately think of an allergy whose symptoms occur within minutes of ingesting a food or chemical. The symptoms include hives and itching. . . .

Although the ELISA/ACT test can assess the levels of certain immune responses, these are not necessarily related to allergy and have nothing whatsoever to do with a person's need for supplements. Moreover, many of the symptoms listed in SPL's brochure are unrelated to allergy and are not appropriately treated with supplement products.

Other food immune complex and IgG tests, which assess immune reactions that are common but not necessarily related to allergy

Nambudripad's Allergy Elimination Technique (NAET), based on the notion that allergies are caused by "energy blockage" that can be diagnosed with muscle-testing and permanently cured with acupressure and/or acupuncture treatments.

The correct way to assess a suspected food allergy or intolerance is to begin with a careful record of food intake and symptoms over a period of several weeks. Symptoms such as swollen lips or eyes, hives, or skin rash may be allergy-related, particularly if they occur within a few minutes (up to two hours) after eating. Diarrhea may be related to a food intolerance. Vague symptoms such as dizziness, weakness, or fatigue are unlikely to be food-related. The history-taking procedure should note the suspected foods, the amounts consumed, the length of time between ingestion and symptoms, whether there is a consistent pattern of symptoms after the food is consumed, and several other factors. Although nearly any food can cause an allergic reaction, a few foods account for about 90% of reactions. Among adults these foods are peanuts, nuts, fish, and shellfish. Among children, they are egg, milk, peanuts, soy, and wheat .

If significant symptoms occur, the next step should be to see whether avoiding suspected foods for several weeks prevents possible allergy-related symptoms from recurring. If so, the suspected foods could be reintroduced one at a time to see whether symptoms can be reproduced. However, if the symptoms include hives, vomiting, swollen throat, wheezing, or other difficulty in breathing, continued self-testing could be dangerous, so an allergist should be consulted.

Proper medical evaluation—done best by an allergist—will include careful review of your history and skin testing with food extracts (using a prick or puncture technique) to see whether an allergic mechanism is involved in your symptoms. In cases where skin testing might be dangerous, a radioactive allergy sensitivity test (RAST) may be appropriate. The RAST is a laboratory test in which the technician mixes a sample of the patient's blood with various food extracts to see whether antibodies to food proteins are present in the blood. It is not as reliable as skin testing and is more expensive. A negative prick or RAST test indicates a low probability of allergy to the test substance. Positive tests, however, have much less predictive value .

The only sure way to diagnose an allergy to a suspected food, food coloring, or other additive is challenge testing in which the patient ingests either the suspected food or a placebo . This may be appropriate if the patient's history suggests a food allergy but the skin or RAST tests are negative. Because dangerous reactions can occur, challenge testing should be done in a hospital or office that is specially equipped for that purpose.

Aetna Policy Coverage Policy Bulletin 0038. Allergy Testing and Allergy Immunotherapy

BlueCross BlueShield of Tennessee Medical Policy Manual

University of Iowa Virtual Hospital: Food allergy basics

Sicherer SH. Manifestations of food allergy: Evaluation and management. American Family Physician 59:415-424, 1999.

American Academy of Allergy: Position statements—Controversial techniques. Journal of Allergy and Clinical Immunology 67:333-338, 1980. Reaffirmed in 1984.

Chambers VV and others. A study of the reactions of human polymorphonuclear leukocytes to various antigens. Journal of Allergy 29:93-102, 1958.

Benson TE, Arkins JA. Cytotoxic testing for food allergy: Evaluations of reproducibility and correlation. Journal of Allergy and Clinical Immunology 58:471-476, 1976.

Lehman CW. The leukocytic food allergy test: A study of its reliability and reproducibility. Effect of diet and sublingual food drops on this test. A double-blind study of sublingual provocative food testing: A study of its efficacy. Annals of Allergy 45:150-158, 1980.

Proposed notice: Medicare program; Exclusion from Medicare coverage of certain food allergy tests and treatments. Federal Register 48(162):37716-37718, 1983.

British Advertising Standards Organization. Adjudication: Allergy Testing Service, May 1999.

Sampson HA. Food allergy. JAMA 278:1888-1894, 1997.

Latex Allergy, 9/2/2001
Latex Allergy

The Latex Allergy Epidemic

Some have even been forced to terminate their careers for this reason. Medical and dental procedures on sensitized individuals may be complicated by anaphylactic events, as may the use of latex pacifiers by infants. The FDA has received more than 2000 reports of injury and several reports of death associated with latex allergy.

The surge of latex allergy among health-care workers is primarily attributable to greater use of disposable gloves to prevent the spread of AIDS and hepatitis B. Increased demand and cost pressures for gloves has led some manufacturers to shorten the manufacturing time by reducing the number of washing and purifying steps, which increases the amount of sensitizing protein that the gloves will transmit.

The American College of Allergy, Asthma, and Immunology has published guidelines and recommends that people who have been diagnosed as allergic wear an identification card (or bracelet) and a self-injectable adrenalin device. Sensitive individuals should be sure that their health-care providers are aware of their condition so that they are not exposed to latex during medical procedures or surgery. A few states have introduced bills to ban the use of powdered latex gloves in medical facilities.

American College of Allergy, Asthma, and Immunology Latex Allergy Home Page

The Education for Latex Allergy / Support Team & Information Coalition (Elastic) maintains a comprehensive list of Internet sites with information related to latex allergy.

Latex Allergy Links

Occupational Safety & Health Administration (OSHA) Latex Allergy Page

Potential for allergy to natural rubber latex gloves and other natural rubber products. OSHA Technical Information Bulletin, April 1999.

Disciplinary Action Withdrawn against Robert Sinaiko, M.D., 30/3/2005
(c) EPD is an experimental immunotherapy treatment "vaccine" based on the theory that using Beta-Glucuronidase as a biological response modifier alters the immunological response to antigen(s) in man and four species of animals (mouse, rat, guinea pig and dog), and that ultra-low (homeopathic) doses, via intradermal injection, of activator (Beta-Glucuronidase) and antigen(s) (allergens) can be used for multiple conditions involving allergy and immune dysfunction.

On May 12, 1993, L.T.S. was taken by his mother to see respondent. Respondent is an internist/allergist. The patient was almost 9 years old. Respondent was told that the patient had been prescribed Ritalin, 5 mg, twice a day for ADHD. Respondent was also advised by the child's mother, that the patient was "jittery" on Ritalin. Additionally, respondent was advised that while school problems continued to exist for L.T.S., the mother reported that "they weren't severe to begin with." Further, respondent charted that the child's emotional problems were now due to a custodial battle between the parents. Following a physical examination, respondent noted his impression of L.T.S. to be "ADDH-Mild" (circled) (sic) with a notation to "R/O allergy process." Respondent's plan, therefore, was for the child to undergo an "IgG Food & Mold MAST," to "continue Ritalin for now at present dose" and to return for a follow-up appointment in 2 to 3 weeks.

Close to the time of the June 1, 1993 visit, respondent reviewed the allergy testing results from the IgG-Specific MAST Panel performed on May 18, 1993 and respondent began a course of treatment for minor patient L.T.S. which included an elimination (replacement) diet and an oral antifungal medication, Amphotericin B. Respondent prescribed 250 mg capsules, number 100. There is no notation in the records as to what decision was made, if any, regarding the Ritalin prescribed by the patient's physician. The child's mother used the summer vacation to provide L.T.S. with a "medication holiday."

On June 15, 1993 Dr. Vreeland ordered a Complete Blood Count (CBC) and a serum IgE (an indicator of systemic allergy) for the minor patient L.T.S. The patient was also referred to a Board Certified allergist for an evaluation by Dr. Vreeland.

On July 15, 1993 the minor patient was seen by Nathan Schultz, M.D. at the Allergy & Asthma Medical Group of Diablo Valley. He was seen as a result of the referral of Dr. Vreeland for an allergy evaluation.

On July 19, 1993 Dr. Schultz noted in his written report to Dr. Vreeland, that the patient was brought to the appointment by his father and that the father brought with him a report from Lifeline Testing and Counseling Services completed by Lisa Zottnick, M.S., C.E.T. Dr. Schultz noted Lisa Zottnick's impression that the patient met the criteria for ADHD. The patient's father also reported to Dr. Schultz that for this diagnosis or the diagnosis of learning disabilities, the minor was first treated with Amphotericin B and then with Nystatin. In addition, Dr. Schultz also noted that following food testing (IgG MAST test), a specific food elimination diet was recommended. The expert testimony established that the IgG MAST test was not accepted as a valid diagnostic test for a minor patient with a diagnosis of ADHD. The IgG MAST test is for serious allergic conditions such as serum sickness and certain forms of hypersensitivity pneumonitis. Following a family history and physical examination, Dr. Schultz stated his impression that the minor patient showed no evidence of allergic disease, advised that the patient could discontinue the use of Nystatin and further instructed the father to liberalize the patient's diet. Dr. Schultz concluded that he did not think that any further allergy evaluation of the patient was necessary.

Patient J.H., a then 22 year old male, was first seen by respondent on April 3, 1986 for a number of complaints. On April 4, 1986 the patient was seen by respondent for the remainder of his work-up. The initial diagnoses of respondent were, among other things: right maxillary sinusitis; seborrheic dermatitis, related to fungal allergy; mild seasonal allergic rhinitis; mild allergy causing "sinus blockage"; and flu-like symptoms and rash secondary to "candida colonization of [the) gut; allergic dietary yeast; and Eustachian Dysfunction." For the diagnosis of "increased" Candida colonization of the intestinal tract the patient was placed on a special diet and various forms of Nystatin; nose spray and oral.

Male patient R.S., 24 years old at the time, was first seen by respondent on September 26, 1990, complaining of sinus pressure since age 10 or 12, and over the past 2 or 3 years, a sensation of sinus blockage and postnasal drip. After a history and physical examination were performed, respondent's impressions were: 1. "Chronic Sinus Blockage; 2. Monilial Enteritis; 3. Noradrenergic depletion, due to chronic infection (monilial enteritis), with fatigue, cognitive symptoms, and failure of the sympathetic innervation of the upper respiratory tract; and 4. Milk Allergy (leading to upper respiratory hypersecretion) by history." For these disorders respondent prescribed a rapidly-tapered dose of Prednisone; Diflucan, 100 mg daily for 30 days, and Nystatin, 2 tablets, 3 times a day. In a letter to the referring physician five days later, October 1, 1990, respondent summarized the symptoms as "sinus" blockage, postnasal drip, "dull" occipito-frontal headaches, sore throat when tired, and sporadic bouts of inappropriate fatigue. Under the "Discussion" portion of his letter, respondent stated: "I do not think the majority of R.'s allergic-like symptoms are due to common inhalant sensitivity. The refractoriness to common treatments (and some not-so-common ones) is more in favor of abnormal sensitivity to something he is in contact with through his alimentary tract. The abdominal tenderness supports this impression, and suggests there is an ongoing inflammatory process in the gut. That this is more likely infectious than strictly allergic is supported by the significant tenderness and by the low grade fever (though it is hard to know what to make of such a minor temperature elevation found on an isolated occasion). The use of tetracycline for acne in his teens, and more recent use of Flagyl for Giardia, favor Candida as the infectious agent. To the pharyngeal sensitivity to environmental molds (increased symptoms when he used a humidifier in boulder (sic) -- those things really put out a lot of mold spores), his symptoms can be explained on the basis of sensitization, by monilial enteritis, of his Mucosal-Associated Lymphoid Tissue (MALT), to mold antigens." The patient had reported to respondent the use of two courses of Flagyl that he received in November of 1986 and again a few months later, in early 1987 (four years prior to treatment by respondent), for a Giardia infection. This past medical history, according to respondent, favored a gastrointestinal infection with Candida as the present infectious agent. On several dates in October the patient called respondent for further Prednisone.

On July 2, 1991 the patient reported occasional loose stools and has slight abdominal tenderness on physical examination. Respondent noted that the stool examination, showed some unidentifiable bodies, (described as UFO'S or "Unidentified Fecal Objects" by the laboratory) and a slight amount of Candida which was reported as normal by the laboratory. At this time respondent's impression was "persisting terminal ileal inflammation" with questions regarding possible "early Crohn's?," "Candidiasis?" and "Food allergy?" In addition to continuing on the Diflucan and Nystatin the patient was given gamma globulin, vitamin B12 and magnesium sulfate.

Patient R.S. was next seen on September 2, 1992 when respondent noted that the patient was doing well and charted the impression of "Food Allergy." Respondent's plan was to continue with the EPD injections.

Respondent, Robert Sinaiko, was educated at Brandeis University and graduated in 1966. He got his medical degree at Loyola University Stritch School of Medicine in Chicago, Illinois. He did his internship at the U.S. Public Health Service Hospital in San Francisco from 1970-71. He did his residency in internal medicine there from 1971-73 and Allergy and Clinical Immunology training at Kaiser Foundation Hospital in San Francisco from 1977 to 1979. From 1973-76 respondent did his military service with the U.S. Public Health Service. He was Board Certified in 1979 in Internal Medicine and he was Board Certified in Internal Medicine and Clinical Immunology In 1985. He is certified by the American College of Occupational and Environmental Medicine. He has an unpaid assistant clinical professorship in the Department of Medicine at UCSF School of Medicine. During his training at Kaiser San Francisco he trained under Benjamin Feingold, M.D. the Chief of Allergy. From 1979 to 1985 respondent remained at Kaiser Foundation Hospital at their South San Francisco clinic. In 1985 respondent left Kaiser Foundation and went into solo practice in Oakland, California. He transferred his private practice to San Francisco in 1988.

Respondent shall take and pass an oral clinical examination in Allergy and Immunology, with specific focus on the diseases which gave rise to the Accusation in this matter. The examination shall be designated and administered by the Division or its designees. This examination shall be taken within 90 days after the effective date of this decision. If respondent fails the first examination, respondent shall be allowed to take and pass a second examination which may consist of a written as well as an oral examination. The waiting period between the first and second examination shall be at least three months. If respondent fails to pass the first and second examination, respondent may take a third and final examination after waiting a period of one year. Failure to pass the oral clinical examination within 128 months after the effective date of this decision shall constitute a violation of probation. The respondent shall pay the costs of all examination.

Within 30 days of the effective date of this decision, respondent shall submit to the Division for its prior approval a plan of practice in which respondent's practice shall be monitored by another physician in respondent's field of practice, who shall provide monthly reports to the Division or its designee. The monitor must be board certified by the American Board of Internal Medicine with subspecialty certification in Allergy and Immunology. The Medical Board of California may, at its discretion, also consider a proposed monitor who has certification in the subspecialty of Infectious Disease.

Multiple Chemical Sensitivity: A Spurious Diagnosis, 19/3/2011
In the 1950s, Randolph suggested that human failure to adapt to modern-day synthetic chemicals had resulted in a new form of sensitivity to these substances. His concern with foods then expanded to encompass a wide range of environmental chemicals. Over the ensuing years, the condition he postulated has been called allergic toxemia, cerebral allergy, chemical sensitivity, ecologic illness, environmental illness (EI), immune system dysregulation, multiple chemical sensitivity, total allergy syndrome, total environmental allergy, total immune disorder syndrome, toxic response syndrome, 20th century disease, universal allergy, and many other names that suggest a variety of causative factors. These labels are also intertwined with Gulf War syndrome, sick building syndrome, toxic carpet syndrome, and other politically controversial diagnoses.

Most physicians who diagnose and treat MCS identify themselves as "clinical ecologists" or "specialists in environmental medicine." About 400 of them belong to the American Academy of Environmental Medicine (AAEM, which Randolph founded in 1965 as the Society for Clinical Ecology, is composed mainly of medical and osteopathic physicians. Clinical ecologists also play a significant role in the American Academy of Otolaryngic Allergy (AAOA), which Randolph helped found in 1941.

Clinical ecology is not a recognized medical specialty. Environmental medicine and occupational medicine are components of the specialty of preventive medicine, but the theories and practices of clinical ecology are not. Critics of clinical ecology charge that: (a) MCS has never been clearly defined, (b) no scientifically plausible mechanism has been proposed for it, (c) no diagnostic tests have been substantiated , and (d) not a single case has been scientifically validated. The theories and practices of clinical ecology have been severely criticized by the American Medical Association , the American College of Physicians , the Canadian Psychiatric Association, the International Society of Regulatory Toxicology and Pharmacology , the American Academy of Allergy, Asthma and Immunology , the American College of Occupational and Environmental Medicine , and several prestigious scientific panels that have investigated them. In 1997, the academy's board of directors reviewed the evidence again and concluded that "a causal connection between environmental chemicals, foods, and/or drugs and the patient's symptoms is speculative and not based on the results of published scientific studies."

The fact that MCS has not been meaningfully defined does not deter clinical ecologists from diagnosing it—typically in all or nearly all of their patients. Their diagnostic evaluation usually includes an "ecological oriented history," a physical examination, and laboratory tests. The history-taking procedure may include a lengthy questionnaire that emphasizes dietary habits and exposure to environmental chemicals. The nature and purpose of the physical examination is unclear because no combination of physical findings can establish the diagnosis. Standard allergy test results are often normal.

Psychologist Herman Staudenmayer, Ph.D., of Denver, Colorado, has treated "MCS" patients for more than 30 years. He believes that although some people are very sensitive to various microorganisms, noxious chemicals, and common foods, there is no scientific evidence that an immunologic basis exists for generalized allergy to environmental substances.

In 1989, Terr reported similar observations on 90 patients, including 40 covered in the previous report. He also noted that 32 of the 90 patients had been diagnosed as suffering from "Candidiasis hypersensitivity"—a fad diagnosis considered "speculative and unproven" by the American Academy of Allergy and Immunology .

Johnson, who operates Johnson Medical Associates in Richardson, Texas, was reprimanded, fined $4,500,ordered to take 32 hours of continuing medical education courses related to allergy and immunology, and required to provide ready access to patient records if the Board investigates him in the future . Johnson's Web site says that he is a fellow, former board member, and course director of the American Academy of Environmental Medicine.

Anderson JA and others. Position statement on clinical ecology. Journal of Allergy and Clinical Immunology 78:269-270, 1986.

Terr AI, Bardana EJ, Altman LC. Position statement: Idiopathic environmental intolerances (IEI). American Journal of Allergy and Immunology 103:36-40, 1999.

Staudenmayer H. Multiple chemical sensitivities or idiopathic environmental intolerances: Psychophysiologic foundation of knowledge for a psychogenic explanation. Journal of Allergy and Clinical Immunology 99:434-437, 1997.

Stay Away from Cytotoxic Testing, 26/2/2007
To perform the test, about 10 cubic centimeters of a patient's blood were placed in a test tube and centrifuged to separate the white cells (leukocytes). These were mixed with plasma and sterile water and applied to a large number of microscope slides, each of which had been coated with a dried food extract like that used by allergists for skin testing. The cells were then examined under a microscope at various intervals over a two-hour period to see whether they had changed their shape or disintegrated-supposedly signs of allergy to the particular food. Typically, the test results are used to explain the patient's symptoms and to design a "personalized diet program" that includes vitamins and minerals-sold by those administering the test.

The American Academy of Allergy, Asthma and Immunology (AAAAI), the nation's largest group of allergists, has concluded that cytotoxic testing is ineffective for diagnosing food or inhalant allergies . Its position paper noted:

In 1985, the Health Care Financing Administration (HCFA), which administers Medicare, determined that cytotoxic testing be excluded from Medicare coverage. HCFA had proposed this policy in 1983 because the test "lacks an acceptable rationale" and does not correlate with clinical evidence of food allergy .

American Academy of Allergy: Position statements—Controversial techniques. Journal of Allergy and Clinical Immunology 67:333-338, 1980. Reaffirmed in 1984.

Chambers VV and others. A study of the reactions of human polymorphonuclear leukocytes to various antigens. Journal of Allergy 29:93-102, 1958.

Benson TE, Arkins JA. Cytotoxic testing for food allergy: Evaluations of reproducibility and correlation. Journal of Allergy and Clinical Immunology 58:471-476, 1976.

Lehman CW. The leukocytic food allergy test: A study of its reliability and reproducibility. Effect of diet and sublingual food drops on this test. A double-blind study of sublingual provocative food testing: A study of its efficacy. Annals of Allergy 45:150-158, 1980.

New York Academy of Medicine Committee on Public Health. Statement on cytotoxic testing for food allergy (Bryan's test). Bulletin of the New York Academy of Medicine 64:117-119, 1988.

Proposed notice: Medicare program; Exclusion from Medicare coverage of certain food allergy tests and treatments. Federal Register 48(162):37716-37718, 1983.

Bee Pollen and Royal Jelly, 31/7/2003
Bee pollen has also been claimed to improve athletic and sexual performance; slow the aging process; promote both weight loss and weight gain; prevent infection, allergy, and cancer; and alleviate more than 60 other health problems.

Some cases of asthma and anaphylaxis have been fatal. The potential for serious reactions is widespread because at least 5% of Americans are allergic to ragweed pollen, and bee pollen contains pollen from ragweed or plants that cross-react with ragweed, such as dandelions, sunflowers, or chrysanthemums . It has been speculated the presence of these allergens might enable regular users to become desensitized (as would happen with allergy shots).

Although violation of an FTC consent agreement can trigger large penalties, Royden Brown continued to promote bee pollen illegally. In May 1994, S&S Public Relations Inc., of Chicago, issued a letter stating: "It's allergy season, but many sufferers aren't suffering anymore. They're using Aller-Bee-Gone, bee pollen tablets that are credited with relieving the symptoms of allergies, asthma, and other respiratory ailments." The accompanying news release added that Brown's lifetime goal was "to eliminate degenerative disease worldwide through the use of bee pollen.

Thien FC and others. Asthma and anaphylaxis induced by royal jelly. Clinical and Experimental Allergy 26:216-222, 1996.

Mansfield LE, Goldstein GB. Anaphylactic reaction after ingestion of local bee pollen. Annals of Allergy 47:154-156, 1981.

Clinical and Experimental Allergy 27:333-336, 1997.

Journal of Allergy and Clinical Immunology 83:793-796, 1989.

Helbling A and others. Allergy to honey: Relation to pollen and honey bee allergy. Allergy 47:41-49, 1992.

Wandycz K. Allergies: Runny nose? Itchy throat? Bee pollen helps some allergy victims, but for most people it's a waste of money. Forbes, April 25, 1995, p 414.

Hausen BM and others. Propolis allergy (I): Origin, properties, usage and literature review.

Glenn Braswell's Advisors, 11/2/2013
Douglas Hunt, MD,* who practices in Burbank, California and has hosted a radio show. The directory of the American College for Advancement of Medicine (ACAM) lists his specialties as allergy, bariatrics, chelation therapy, hypoglycemia, metabolic medicine, nutrition, preventive medicine, and "yeast syndrome." (ACAM is a professional organization that promotes chelation therapy and many other dubious treatment methods. In1998, the FTC secured a consent agreement barring ACAM from making unsubstantiated advertising claims that chelation therapy is effective against atherosclerosis or any other disease of the circulatory system .)

Gary S. Ross, MD,* practices in San Francisco and teaches nutrition and clinical science at Meiji.College of Oriental Medicine in Berkeley. The ACAM directory lists his specialties as allergy, chelation therapy, degenerative disease, family practice, nutrition, and preventive medicine.

Carol Uebelacker, MD,* who practices in Milwaukee and is listed in the ACAM directory with specialties of allergy, cardiovascular disease, bariatrics, chelation therapy, family practice, and gynecology.

Charles Anderson, MD, who practices in Essex Junction, Vermont, and is listed in the ACAM directory as specializing in allergy, family practice, nutrition, and "yeast syndrom."

Dennis Harper, DO, who practices in Utah, is listed in the ACAM directory as specializing in allergy, chelation therapy, osteopathic manipulation, and "yeast syndrome."

Ronald L. Hoffman, MD, who practices in New York City, is a radio host and has written several books. The ACAM directory lists him as specializing in allergy, family practice, hypoglycemia, nutrition, and preventive medicine. His Hoffman Center is said to specialize in "chronic fatigue syndrome, fibromyalgia, heart problems, attention deficit disorder and autism, gastrointestinal problems, liver disease, autoimmune disorders, rheumatoid arthritis, adjunctive support for cancer, psychiatric ailments, multiple chemical sensitivity, allergies, and menopausal and hormonal issues." His Web site offers "personalized metabolic testing" in which "observations of physical, blood, urine and saliva changes in response to a special glucose challenge" enable patients to be categorized according to their "metabolic type." The types, which are not recognizes by medical science, are then used as a basis for an "individualized diet and supplement prescription." He also markets supplements, some of which are private label formulations.

James R. Privitera, MD, who practices in Covina, California, and is listed in the ACAM directory as specializing in allergy, chelation therapy, metabolic medicine, nutrition. In 1975, he was convicted of conspiring to prescribe and distribute laetrile (a quack cancer remedy) and was sentenced to six months in prison.

Joseph D. Weissman, MD,* who is board certified in allergy and immunology, is a clinical assistant professor, at the University of California.

Be Wary of "Fad" Diagnoses, 13/5/2014
"Environmental illness"also referred to as "multiple chemical sensitivity"is based on the notion that when the "total load" of physical and psychological stresses exceeds what a person can tolerate, the immune system goes haywire and hypersensitivity to tiny amounts of common foods and chemicals can trigger a wide range of symptoms. Doctors advocating this notion call themselves "clinical ecologists" or specialists in "environmental medicine." Their treatment approach involves elimination of exposure to foods and environmental substances to which they consider the patient hypersensitive. Extreme restrictions can involve staying at home for months or living in a trailer designed to prevent exposure to airborne pollutants and synthetic substances. In many cases, the patient's life becomes centered around the treatment. The American Academy of Allergy, Asthma and Immunology (AAAAI), the nation's largest professional organization of allergists, has warned: "Although the idea that the environment is responsible for a multitude of health problems is very appealing, to present such ideas as facts, conclusions, or even likely mechanisms without adequate support is poor medical practice." In 1997, the AAAAI reviewed the evidence again and concluded that "a causal connection between environmental chemicals, foods, and/or drugs and the patient's symptoms is speculative and not based on the results of published scientific studies.

Yeast Allergy

The American Academy of Allergy, Asthma and Immunology regards the concept of candidiasis hypersensitivity as "speculative and unproven" and notes that everyone has some of its supposed symptoms from time to time. The academy has warned that some patients who take the inappropriately prescribed antifungal drugs will suffer side effects and that overuse of these drugs could lead to the development of resistant germs that endanger everyone.

Another test claimed to locate "hidden allergies" is the ELISA/ACT, developed by Russell Jaffe, M.D., Ph.D., and performed by Serammune Physicians Lab (SPL), of Reston, Virginia, which Jaffe directs. This test is performed by culturing the patient's lymphocytes and seeing how they react to up to 300 foods, minerals, preservatives, and other environmental substances. After the test is completed, the practitioner (typically a chiropractor) recommends dietary modification and supplements. Although the ELISA/ACT test can assess the levels of certain immune responses, these are not necessarily related to allergy and have nothing whatsoever to do with a person's need for supplements. Moreover, many of the symptoms listed in an SPL brochure are unrelated to allergy and are not appropriately treated with supplement products.

The correct way to assess a suspected food allergy or intolerance is to begin with a careful record of food intake and symptoms over a period of several weeks. If significant symptoms occur, the next step should be to see whether avoiding suspected foods for several weeks prevents possible allergy-related symptoms from recurring. If so, the suspected foods could be reintroduced one at a time to see whether symptoms can be reproduced. However, if the symptoms include hives, vomiting, swollen throat, wheezing, or other difficulty in breathing, continued self-testing could be dangerous, so an allergist should be consulted.

http://www.quackwatch.org/11Ind/kadile.html, 15/7/2012
4. During the year 1995, and in subsequent years, respondent caused to be distributed and published to the public a brochure advertising his services as a physician, which brochure stated: "Relentless study of allergy and the environment led to his board certification in Environmental Medicine. In 1992, he received a Fellowship from that same organization." There is no other description of the "board" or "organization" which purported to certify respondent or award him a "Fellowship." By failing to state the full name of the board which certified him in "environmental medicine," respondent violated § Med 10.02(2)(w), Wis. Adm. Code, and committed unprofessional conduct.

74. On 6/7/00, respondent began treating Andrew E., a child who was born in 1995. The mother's chief complaint was that the patient had multiple allergies and asthma. Respondent's chart reveals the following history: the child was prescribed Defendol (echinacea, cat's claw, and astragalus) _ capsule/day, and a Proventil® inhaler which was said to be needed "not very often." The mother stated that the child was allergic to "milk, cats, dogs, horses, horsebarns, cefzil, prelone." An "environmental survey" refers to allergies of 2 years duration, wheezing, and the desire of the mother to control asthma without steroids. The mother's written responses to the "environmental survey" are that in the fall of 1995 the patient had "milk sensitivity" and in the winter of 1997 or spring of 1998 he developed asthma, resulting from an exposure at a relative's house. A recent flare-up was noted as having occurred in May, 2000. The mother stated that the patient had been diagnosed with asthma by a Dr. Hayes and prescribed Proventil; both diagnosis and prescription had been affirmed later by a Dr. Loewen. The mother wrote that the Proventil did help ease the wheezing, but was "not a satisfactory long-term solution." The child was said to experience wheezing, fever/cold symptoms for 1 _ weeks following exposures, behavioral problems with food allergies, nose rubbing, and cough, and that these were caused by pet hair and dander, milk, dairy products, and food colors. However, he could go weeks without symptoms. The patient was noted to have been breast fed to 8 months, to have spit up often but not been colicky or ever had severe diaper rash, and to have had eczema and rashes. The child's diet was reviewed, as were a number of common irritants such as tobacco smoke and household products. The survey notes that the patient's family has dogs and a cat, said to be outside animals, and that the neighbors have horses. "Allergy" without further elaboration was noted in the father, brother, aunt, and grandparent, and the father, aunt, and grandparent were noted to have a food or drug allergy but there was no mention of what that allergy might be. There is no detailed discussion of the events leading up to the patient's reactions, and no discussion of the eczema.

C. Respondent failed to note that it would be unusual for a child to develop a milk allergy at 6 months, in that most children are not fed cow's milk until they are 1 year of age, and this child was said to have been breast fed until 8 months. While a 6 month old child might react to cow's milk, this is not likely to be an allergy.

used "provocation neutralization" as a method of testing patients for allergies, which method is not effective or accepted by responsible medical practitioners, and has billed third party payers for such testing but falsely stating that he used standard medical allergy testing methods (which were not, in fact, used), for the purpose of obtaining money for the "provocation neutralization" tests which were administered;

Sinaiko Reconsideration Hearing Oral Argument, November 6, 1998, 30/3/2005
There is another side to that story: The use of E.P.D. in allergy treatments is the treatment of choice in England. Hardly a third-world country. Regarding the use of E.P.D. in this country, check the New England Journal of Medicine for late 1996, and there is an article that claims it's safer than other drugs. I don't know whether it is or it isn't. I have no idea. All I know is, there is a nationwide controversy going on among physicians who use the traditional allergy treatment and physicians who are looking for something better.

If we look at the things that we submitted into our evidence, articles from the scientific literature, it's clear from those, it's clear from that excellent research which is reported in the peer-reviewed literature—this is the gold standard that the judge alluded to—it's clear that there are significant and sometimes profound changes that happen in immune function, and the chief of allergy and immunology at UC Irvine says, yes, allergists will tell you. if a patient is allergic and has fungal overgrowth or candida overgrowth in the intestine and you reduce it or eradicate it, the allergy symptoms improve. Now, sometimes I wonder if what I am being accused of is listening to wrong experts. It's not that I don't listen. It's that I listen to the wrong ones, the ones that were not chosen to testify by our friend here.

In the medical records for Susan Lasly you will find that Dr. Sinaiko described an almost identical situation for the female patient there. In addition, you will also find that in this particular case, with regard to the patients in the accusation you see the investigational tests that Dr. Sinaiko relies on in reaching his diagnoses for these patients are themselves tests that are questionable and dubious in nature. You have in front of you part of either Exhibit 38, which is this IGG mold allergy test which says on its face that it's for investigational use only and that the actual prescription that was filled for purposes of Dr. Sinaiko using that test in determining that this boy had a fungal infestation or infection of the gut, that prescription had to be filled, as I indicated earlier, in a pharmacy in Oregon that formulated and compounded it and sent it down to the person—the mother of the child.

The other thing that you should be aware of that is in Exhibit 25 is that, in regards to the patient who did commit suicide, that the letterhead for the informed consent for the evaluation for allergy is actually on the letterhead of Joseph McGovern, Jr. That's the same clinical oncologist that is also mentioned in the video, Your Honor, and that patient never saw Dr. govern. He had already surrendered his license before that patient became a patient of Dr. Sinaiko's.

In summary, it is not enough that Dr. Sinaiko tells his patients that he has breakthrough knowledge that can help them. It is not enough that he thinks that he can help them. It is not even enough that he wants to help them. By perpetrating and perpetuating his patient's own belief that all that ails them is due to some exotic allergy that usually only he has been able to diagnose and treat, this doctor, who is supposed to keep his patients safe from harm, becomes the harm.

Contact Reflex Analysis Is Nonsense, 24/8/2014
Versendaal claimed that CRA can "test every conceivable condition in the human body . . . help that patient, and know how long it will take for that patient to get well." Testing is done by pulling on the patient's outstretched arm while placing one's finger or hand on one of about 75 "reflex" points on the patient's body. The nine main "reflexes" pictured below, are the "right master allergy reflex," "left master allergy reflex," "metabolic reflex," "master heart/blood quality reflex," "hemoglobin reflex," "coronary reflex," "virus reflex, and "yeast reflex." Others include the "parasite reflex," "vaginal tract reflex," "pineal gland reflex," "virus reflex," "blood quality reflex," "gouty arthritis reflex," "pus reflex," and "yeast infection reflex."

Eighty percent of diseases are due to allergy.

In 2007, Eric Berg, D.C.who operated The Health and Wellness Center in Alexandria, Virginia, was reprimanded, fined $1,500, and ordered to stop using and promoting Body ResponseTechnique (BRT), Nambudripad's Allergy Elimination Technique (NAET), CRA, and testing with an Acoustic Cardiograph (ACG). The consent agreement indicates that Berg had made many therapeutic claims that were not supportable by reasonable scientfic or medical evidence .

Applied Kinesiology: Phony Muscle-Testing for "Allergies" and "Nutrient Deficiencies", 23/8/2014
Contact Reflex Analysis (CRA) proponents claim that over a thousand health problems can be diagnosed with a muscle test during which the chiropractor's finger or hand is placed on one of 75 "reflex points" on the patient's body. If the patient's arm can be pulled downward, a condition corresponding to the "reflex" is considered present, and dietary supplements (typically made from freeze-dried vegetables or animal organs) are prescribed. CRA's chief proponent,. the late Dick A. Versendaal, D.C., taught that 80% of disease is due to allergy; the two main causes of disease are gallbladder disease and staphylococcus infections; and obesity is commonly caused by parasites.

Health Kinesiology (HK), founded by Jimmie Scott, is said to use "muscle testing/monitoring to to identify the priority order of the energy balancing that needs to be done with his/her client, exactly what stresses are interfering with well being, and which energy balancing methods to use for that individual." According to Scott, it can "eliminate allergies, release physical toxicity, emotional traumas, overcome learning blocks, & perform at your best, among other things!" In one technique—the Allergy Tap™—the practitioner "places the offending substance over a specific acupuncture point on the belly and taps eight pairs of specific acupuncture points."

Nambudripad's Allergy Elimination Technique (NAET) is based on the notion that allergies are caused by "energy blockage" that can be diagnosed with muscle-testing and permanently cured with acupressure and/or acupuncture treatments. Its developer, Devi S. Nambudripad, D.C., L.Ac., R.N., Ph.D., is described on her Web site as an acupuncturist, chiropractor, kinesiologist, and registered nurse who practices in California.

Allergies.:What is the Allergy Tap? Health Kinesiology Web site, accessed 1/25/02.

Questionable Organizations: An Overview, 10/7/2014
A few groups promote a mixture of science-based and dubious practices. The American Academy of Otolaryngic Allergy, for example, promotes the concepts of clinical ecology, and the American Academy of Osteopathy espouses cranial therapy. Some groups have even set up their own certifying boards.

American Academy of Otolaryngic Allergy (AAOA)

British Society for Allergy, Environmental and Nutritional Medicine (BSAENM)

Nambudripad Allergy Research Foundation

British Advertising Standards Authority Criticizes Ads for YorkTest Laboratories FoodScan Test, 21/6/2012
The prevailing scientific view is that food intolerance tests are not trustworthy. The American Academy's Practice Guidelines state: "IgG and IgG subclass antibody tests for food allergy do not have clinical relevance, are not validated, lack sufficient quality control, and should not be performed." Several other prominent medical organizations have expressed similar views . The proper way to investigate food intolerance is a careful history followed by dietary strategies to determine whether suspected foods are problematic .

Allergy or intolerance? YorkTest Laboratories Web site, accessed June 19, 2012.

Bernstein IL and others. Allergy diagnostic testing: An updated parameter, Part 1. Annals of Allergy, Asthma & Immunology 100:S1-S148, 2008.

FTC Dietary Supplement Advertising Cases 1984 to July 2003, 5/6/2011
QVC, Inc., File No. C-3955(June 14, 2000) (Consent order) (Unsubstantiated claims on its “home shopping” network that Cold-Eezer or Cold-Eeze brand zinc lozenges can prevent colds and alleviate allergy symptoms.)

The Quigley Corp., (File No. C-3926)(February 10, 2000)(Consent order)(Allegedly unsubstantiated claims by Quigley that Cold-Eezer and Cold-Eeze brand zinc lozenges that it manufactures can prevent colds and alleviate allergy symptoms and that Kids-Eeze Bubble-Gum can reduce the severity of cold symptoms in children.)

CC Pollen Co., 116 F.T.C. 206 (1993) (consent and $200,000 in disgorgement) (bee pollen to help lose weight, alleviate allergy symptoms permanently, and reverse the aging process, and other health benefit claims; failure to disclose that the infomercial was a commercial, not an objective news or documentary program)

TV Inc., 113 F.T.C. 677 (1990) (consent) (bee-pollen products to prevent, alleviate, or cure allergy symptoms, the aging process, impotence and sexual dysfunction; to promote weight loss; and to relieve pain; failure to disclose that the infomercial was a commercial, not an independent and objective television program)

Dubious "Yeast Allergies", 28/3/2011
According to its promoters—some of whom practice "clinical ecology"—one out of three Americans suffers from yeast-related illness, which they refer to as chronic candidiasis, candidiasis hypersensitivity, Candida-related complex, the yeast syndrome, yeast allergy, yeast overgrowth, or simply "Candida" or "yeast problem." Many clinical ecologists view this alleged problem as an underlying cause of MCS. It is also touted as an important factor in AIDS, rheumatoid arthritis, multiple sclerosis, and schizophrenia, as well as "hypoglycemia," "mercury-amalgam toxicity" and at least twenty other conditions. In recent years, proponents have suggested that chronic fatigue syndrome and Candida infections are closely related . This article uses the term "candidiasis hypersensitivity" in quotation marks to indicate that neither infection nor actual allergy is present.

The American Academy of Allergy, Asthma and Immunology has strongly criticized the concept of "candidiasis hypersensitivity syndrome" and the diagnostic and treatment approaches its proponents use. AAAAI's position statement concludes: (1) the concept of candidiasis hypersensitivity is speculative and unproven; (2) its basic elements would apply to almost all sick patients at some time because its supposed symptoms are essentially universal; (3) overuse of oral antifungal agents could lead to the development of resistant germs that could menace others; (4) adverse effects of oral antifungal agents are rare, but some inevitably will occur; and (5) neither patients nor doctors can determine effectiveness (as opposed to coincidence) without controlled trials. Because allergic symptoms can be influenced by many factors, including emotions, experiments must be designed to separate the effects of the procedure being tested from the effects of other factors . Several years ago, Crook told me that he had no intention of conducting a controlled test because he was "a clinician, not a researcher."

Anderson JA and others. Position statement on candidiasis hypersensitivity. Journal of Allergy and Clinical Immunology 78:271-273, 1986.

Live Cell Analysis: High-Tech Hokum, 29/12/2006
Allergy cell count: "High eosinophil count indicates possible allergy, food sensitivity or presence of parasites."

Physicians Cyto Laboratories is a clinic specializing in allergy and immunology testing. Founded in 1978, it began marketing its "Darkfield Video Analysis” in 1985. Marketing director Stephen Thompson says that the test is used “as a general health screening tool on all of our patients” and that “the blood is a window to an individual’s health and can reflect various problems.” According to Thompson, the screening reveals nutritional, allergy, or other problems in about 90% of its patients, most of whom sign up for additional testing and “recovery” programs. (Conventional allergists believe that less than 15% of the general population suffers from food allergies.)

Disciplinary Action against Paula Bickle (1998), 30/5/2004
(b) Respondent diagnosed Patient Three as possibly having Epstein Barr or chronic fatigue syndrome, thyroid problems, paramenopausal syndrome, an allergy problem, a systemic yeast infection, a low-grade infection due to dental work, and a mineral deficiency.

(g) Respondent recommended that Patient Three have an allergy test which would be performed by a chiropractor who independently contracted with the Cascade Pacific Health Group.

2.5 On February 6, 1996, Patient Three went to Cascade Park Health Group for the allergy test recommended by Respondent The test was performed by a chiropractor and was not authorized by Respondent's delegator.

(l) Respondent told Patient Three that the hair analysis and the allergy testing

NRJAC Resolution on Multiple Chemical Sensitivity, 21/8/2003
The document itself is a one-sided view that misrepresents the 1994 booklet as a consensus statement and fails to mention that the theories and practices of MCS proponents have been severely criticized by the American Medical Association , the American College of Physicians , the Canadian Psychiatric Association, the International Society of Regulatory Toxicology and Pharmacology , the American Academy of Allergy, Asthma and Immunology , the American College of Occupational and Environmental Medicine , and several prestigious scientific panels.

Staudenmayer H. Multiple chemical sensitivities or idiopathic environmental intolerances: Psychophysiologic foundation of knowledge for a psychogenic explanation. Journal of Allergy and Clinical Immunology 99:434-437, 1997.

Anderson JA and others. Position statement on clinical ecology. Journal of Allergy and Clinical Immunology 78:269-270, 1986.

Terr AI, Bardana EJ, Altman LC. Position statement: Idiopathic environmental intolerances (IEI). American Journal of Allergy and Immunology 103:36-40, 1999.

Dubious Diagnostic Tests, 14/9/2014
Nambutripad's Allergy Elimination Technique

Delayed food allergy pre-screening survey

Discovery!™ Food Allergy HomeTest Kit

Some Notes on Jeffrey Bland and Metagenics, 11/9/2013
In 1993, Bland founded the Institute for Functional Medicine, a HealthComm division that oversaw the company's web site, develops educational products, and sponsors an annual International Symposium on Functional Medicine. In 1997, he invited practitioners to join him on the Functional Medicine Section of CompuServe's Natural Medicine Forum, which HealthComm co-sponsored. Brochures accompanying the invitation stated that the company's UltraClear Plus "provides nutritional support for pathological or imbalanced detoxifiers and may be suitable for patients with" chronic fatigue syndrome; chemical and environmental sensitivity; alcohol and chemical dependency; food allergy; "management of endo- and exotoxicity"; and arthralgia and myalgia. The UltraBalance Web site has carried similar claims that I consider improper.

—Food allergy

Supplies low-allergy-potential rice protein concentrate with added limiting essential amino acids L-lysine and L-threonine to increase the biological value of the protein.

Reliable Agencies and Organizations, 23/10/2012
National Institute of Allergy and Infectious Diseases (NIAID)

*American Academy of Allergy, Asthma, and Immunology

Asthma and Allergy Foundation of America

Commercial Hair Analysis: A Cardinal Sign of Quackery, 2/8/2010
Some hair analysis proponents claim that hair analysis can detect allergies. The claim is completely senseless. In 1987, the Lancet published a study in which the ability to diagnose allergic disease was studied in 9 fish-allergic and 9 control subjects, who provided specimens of blood and hair for testing. All fish-allergic subjects had previously been shown at Guy's Hospital to have a positive skin prick test to fish. The specimens were submitted as coded, duplicate samples to five commercial laboratories that offered to test for allergy. All five laboratories were not only unable to diagnose fish allergy but also reported many allergies in apparently non-allergic subjects and provided inconsistent results on duplicate samples from the same subject .

Sethi TJ and others. How reliable are commercial allergy tests? Lancet Jan 10;1(8524):92-94, 1987.

Dubious Mercury Testing, 21/4/2010
Skin testing for allergies is both an art and a science. Correct concentrations of a suspected offender must be correctly applied and interpreted. To be valid, patch testing must be done by a qualified tester using appropriate controls. Mercury patch testing is usually done with corrosive mercury salts that cause the skin to redden and possibly swell. Even very dilute concentrations can cause redness . Anti-amalgamists misinterpret these signs of irritation as allergy or toxicity. So-called "positive" tests indicate only that the body can detect the substance. True allergy to mercury is very rare. Its symptoms are like those of any other allergy and include itching, rashes, and swelling. Allergic responses do not include "brain fog," forgetfulness, or other nonspecific symptoms. Moreover, sensitivity to mercury might be the result of exposure to mercury from other sources, such as certain vaccine preparations, preservatives in cosmetics, or foods (most notably fish).

Some Notes on the Overdiagnosis of "Toxic Mold" Disease, 1/10/2006
Indoor mold growth is variable, and its discovery in a building does not necessarily mean occupants have been exposed. Human response to fungal antigens may induce IgE or IgG antibodies that connote prior exposure but not necessarily a symptomatic state. Mold-related disease has been discussed in the framework of noncontroversial and controversial disorders. . . . . When mold-related symptoms occur, they are likely the result of transient irritation, allergy, or infection. Building-related illness due to mycotoxicosis has never been proved in the medical literature. Prompt remediation of water-damaged material and infrastructure repair should be the primary response to fungal contamination in buildings .

Chapman JA and others. . Toxic mold: phantom risk vs science. Annals of Allergy, Asthma and Immunology 91:222-232, 2003.

Trout DB and others. Clinical use of immunoassays in assessing exposure to fungi and potential health effects related to fungal exposure. Annals of Allergy, Asthma and Immunology 92:483-492, 2004.


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