  ❓Parents have asked me if a diagnosis of a food allergy can be made by placing the food on the skin. 👎The answer is, not always. Why is that? Not all concentrations of the allergen can lead to a reaction. ➡️Some reactions might be due to a 𝘊𝘰𝘯𝘵𝘢𝘤𝘵 𝘋𝘦𝘳𝘮𝘢𝘵𝘪𝘵𝘪𝘴. ⚠️𝐂𝐨𝐧𝐭𝐚𝐜𝐭 𝐃𝐞𝐫𝐦𝐚𝐭𝐢𝐭𝐢𝐬 happens when a substance gets in contact with the skin, causing a localised reaction. ✅It can be either 𝘪𝘳𝘳𝘪𝘵𝘢𝘯𝘵 (80% of reactions) or 𝘢𝘭𝘭𝘦𝘳𝘨𝘪𝘤 (20% of reactions), leading to different reactions. ✳It affects people that deal with the substances frequently, though it can happen to anyone. 🔅Most commonly, it affects people working in the 𝘤𝘩𝘦𝘮𝘪𝘤𝘢𝘭, 𝘱𝘩𝘢𝘳𝘮𝘢𝘤𝘦𝘶𝘵𝘪𝘤𝘢𝘭 or 𝘣𝘦𝘢𝘶𝘵𝘺 𝘪𝘯𝘥𝘶𝘴𝘵𝘳𝘺. 🔅𝘔𝘦𝘤𝘩𝘢𝘯𝘪𝘤𝘴 and 𝘩𝘦𝘢𝘭𝘵𝘩𝘤𝘢𝘳𝘦 𝘸𝘰𝘳𝘬𝘦𝘳𝘴 can also be affected. ⚕Treatment starts with avoidance of contact with the substance causing the reaction. Following this, the creams used are very similar to the ones used in eczema. It is not frequent the need for oral or intravenous medication. 🔬How to make a diagnosis? It is fairly easy, as there is a good association between the contact and the onset of the reaction. In some cases, when there is a mix of chemicals, patch testing can be used (I will speak about this in another post). There is also a difference in signs. 🔷️𝐈𝐫𝐫𝐢𝐭𝐚𝐧𝐭: 🔹️Blisters 🔹️Dry skin leads to cracking 🔹️Cracking leads to sores and crusts Swelling 🔶️𝐀𝐥𝐥𝐞𝐫𝐠𝐢𝐜: 🔸️Hives 🔸️Itching 🔸️Red skin 🔸️Dry and flaking skin 🔸️Swelling, especially if affecting mucosas ‼️Nickel can give irritant and allergic contact dermatitis. www.facebook.com/permalink.php?story_fbid=305625454898006&id=100063516604410 
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  📝Recent research showed an association between the decrease or absence of anti-inflammatory bacteria and the increase in some 𝐩𝐬𝐲𝐜𝐡𝐢𝐚𝐭𝐫𝐢𝐜 𝐝𝐢𝐬𝐨𝐫𝐝𝐞𝐫𝐬.
This was associated with the increase in pro-inflammatory bacteria. And what are the bacterias involved? 🔷️The anti-inflammatory bacteria (good): 🔹️𝘍𝘢𝘦𝘤𝘢𝘭𝘪𝘣𝘢𝘤𝘵𝘦𝘳𝘪𝘶𝘮 🔹️𝘊𝘰𝘱𝘳𝘰𝘤𝘰𝘤𝘤𝘶𝘴 🔶️The pro-inflammatory bacteria (bad): 🔸️𝘌𝘨𝘨𝘦𝘳𝘵𝘩𝘦𝘭𝘭𝘢 They believe this relates to the low production of 𝐁𝐮𝐭𝐲𝐫𝐚𝐭𝐞 from the absent bacteria, as this leads to an anti-inflammatory effect, mainly in the bowel. ⚠️The name 𝐁𝐮𝐭𝐲𝐫𝐚𝐭𝐞 comes from the 𝘓𝘢𝘵𝘪𝘯 𝐁𝐮𝐭𝐲𝐫𝐮𝐦, which means butter. But please don’t go and start eating it by the bucket load, as this is not the best way to increase 𝐁𝐮𝐭𝐲𝐫𝐚𝐭𝐞 in your system! Take this research with caution, as the study did not take into account individual variables. And despite the finding of this exciting relation, some studies directly aimed at this association have not yet proven the link. What is important is that there starts to exist some evidence that might lead to a better understanding of the connection between gut health and mental health. This study was done at 𝐊𝐢𝐧𝐠’𝐬 𝐂𝐨𝐥𝐥𝐞𝐠𝐞 𝐋𝐨𝐧𝐝𝐨𝐧, in association with the 𝐌𝐚𝐮𝐝𝐬𝐥𝐞𝐲 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥. www.facebook.com/permalink.php?story_fbid=305625131564705&id=100063516604410   📝In March this year, researchers from the 𝘈𝘶𝘴𝘵𝘳𝘢𝘭𝘪𝘢𝘯 𝘕𝘢𝘵𝘪𝘰𝘯𝘢𝘭 𝘜𝘯𝘪𝘷𝘦𝘳𝘴𝘪𝘵𝘺 made a fantastic discovery.
✅They realised that a protein we produce in our bodies significantly influences our immune system’s reaction to allergens. ➡️People who produce less amount of Neuritin have a higher risk of dying of 𝐀𝐧𝐚𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬 and developing 𝐚𝐥𝐥𝐞𝐫𝐠𝐢𝐞𝐬. 🔬Studies in mice showed some key components that mediate allergic reactions were substantially raised in mice lacking Neuritin. They proceeded to give Neuritin to those mice, and it managed to restore the lost function, decreasing the production of 𝐈𝐠𝐄 and other 𝐚𝐧𝐭𝐢𝐛𝐨𝐝𝐢𝐞𝐬. ❗To make matters more important, it was also found that Neuritin also plays a vital role in decreasing 𝐚𝐮𝐭𝐨-𝐢𝐦𝐦𝐮𝐧𝐞 𝐝𝐢𝐬𝐞𝐚𝐬𝐞, 𝐚𝐬𝐭𝐡𝐦𝐚 and the control of 𝐜𝐚𝐧𝐜𝐞𝐫 cells. ❗❗This means we might have a chance to introduce a protein our body produces and give it to patients who are deficient in it, helping them either outgrow their 𝐚𝐥𝐥𝐞𝐫𝐠𝐢𝐞𝐬 and 𝐚𝐬𝐭𝐡𝐦𝐚 or decrease the severity of the symptoms. www.facebook.com/permalink.php?story_fbid=253986310061921&id=100063516604410   ℹIt was first described more than 60 years ago but only recently started to be more noted and looked into. ❗In 2011 the 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘍𝘰𝘰𝘥 𝘚𝘢𝘧𝘦𝘵𝘺 𝘈𝘨𝘦𝘯𝘤𝘺 raised concerns regarding the high levels of amines (histamine included) present in foods bought in supermarkets, which might be considered a health risk. ▶️It affects around 1% of the population, with nearly 80% of those being of middle age. ▶️It happens when there is an imbalance between the amount of histamine circulating and our capacity to degrade it. ⚕Symptoms can happen due to either deficiency of the enzymes that degrade histamine or medication, leading to decreased enzymatic activity. ⚠️The main symptoms depend on the organs affected 🔷️When the problem is 𝐃𝐀𝐎 deficiency 🔹️Headaches 🔹️Nausea and vomiting 🔹️Diarrhoea, abdominal pain and problems with digestion 🔹️Blocked nose 🔹️Sneezing 🔹️Itchy skin, rashes, and hives 🔹️Asthma and difficulty breathing 🔹️Hypotension 🔹️Irregular heartbeat 🔹️Muscular and joint pains 🔶️When the problem is 𝐇𝐍𝐌𝐓 deficiency, mainly it affects 🔸️Brain 🔸️Liver 🔸️Lining of lungs ✅The best way to reduce symptoms is by either reducing or stopping eating foods containing histamine or taking antihistamines. ‼️The use of DAO (Diamine Oxidase) supplements is still debatable. www.facebook.com/permalink.php?story_fbid=248295930630959&id=100063516604410    ⚠️They are the most used class of medication in the USA and the 07th in the UK. The first one discovered in 1937 was a compound called 933F, followed shortly after by 929F. ⛔The big problem is that both were very toxic to the human being. ❗In 1942 Antergan and in 1945 Diphynhidramine were discovered. ‼️Second generation were only developed in the 1980s. ✅Currently, there are over 40 different ones. 🔷️Often people divide them between drowsy and non-drowsy. 🔷️Some others call them slow acting or fast acting. 🔷️The correct name is first generation and second generation. 🔹️Saying this, there is some debate about a potential third generation. 🔹️To make matters slightly more confusing, some second generation also have first generation properties. ✅But we are only talking about the ones acting on H1 receptors. ✳ These are used for all sorts of allergic reactions: ▶️Food allergy ▶️Hayfever ▶️Insect venom allergy ▶️Allergy to chemicals ▶️Urticaria or angioedema ▶️(etc) ❓What are the main differences? ➡️All 1st generation and a couple of second generation need to be metabolized in the liver, to become active. ➡️1st generation have less afinity for the H1 receptors, than other generations. ➡️2nd generation reaches peak plasma level and onset of action much faster than 1st generation. ➡️2nd generation are mainly excreted unchanged in urine (Cetirizine) or faeces (Fexofenadine). ➡️1st generation are less specific for H1 receptors and pass the blood-brain barrier, leading to sedating effects. ➡️Some 2nd generation can also be used topically on the nose or eyes (Azelastine), having a faster effect than when taken by mouth, but must be applied several times a day. ✴In reality, there are 4 different types of histamine receptors (from H1 to H4). 1️⃣H1 was described in 1966 2️⃣H2 was described in 1972 3️⃣H3 was described in 1983 4️⃣H4 was described in 1994 ❇We have antagonists (actual name is reverse agonists) for H1 and H2, but not for the others. 🔻H1 are further divided into 7 different chemical groups. www.facebook.com/permalink.php?story_fbid=223913006402585&id=100063516604410  This was another blog post collaboration I have done for My Baba.
If you want to read the full article and find how to help your reflux suffering child, click on the link below. www.mybaba.com/how-to-wean-reflux-baby/ www.facebook.com/permalink.php?story_fbid=219521503508402&id=100063516604410   ❓Often people ask me what they should do when they see a "𝘮𝘢𝘺 𝘤𝘰𝘯𝘵𝘢𝘪𝘯" label. ⁉️My first question to them is, how many variations of that wording have they seen? ✅In a study done many years ago, the researchers found over 20 different ways of writing an allergy warning in food. ▶️They asked people how they would act, depending on what was written, and the variability was incredible. 𝐒𝐨 𝐭𝐡𝐚𝐭 𝐲𝐨𝐮 𝐤𝐧𝐨𝐰, 𝐚𝐥𝐥 𝐯𝐚𝐫𝐢𝐚𝐭𝐢𝐨𝐧𝐬 𝐦𝐞𝐚𝐧 𝐞𝐱𝐚𝐜𝐭𝐥𝐲 𝐭𝐡𝐞 𝐬𝐚𝐦𝐞. ✅Several other studies went to see what was the actual variation of allergen concentration. ✳What did they find? ➡️In products with a warning, 6.5 to 93% contained an allergen. ➡️In products without a warning, 11 to 53% contained an allergen. ⚠️In reality, there is still a significant risk of a not labelled food, to contain a substantial amount of allergens. ❓But why is it that the food industry has this massive variability in warnings they use and still have so much potential cross-contamination of allergens? ❌The problem tracks back to political parties, the way they are funded or the individual politician's financial interest. ❗What I am saying might be controversial, but let's look at what is known. ⚠️Most of you have never heard of the "𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘍𝘰𝘰𝘥 𝘍𝘰𝘳𝘶𝘮". 🔻This is the most powerful lobby within the 𝘌𝘜 – the 𝐟𝐨𝐨𝐝 𝐢𝐧𝐝𝐮𝐬𝐭𝐫𝐲 𝐥𝐨𝐛𝐛𝐲. 🔻They have offices inside the 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘗𝘢𝘳𝘭𝘪𝘢𝘮𝘦𝘯𝘵 and manage to block all resolutions that can lead to improvement of food quality when this affects the profit the food industry has. 🔻It is easy to see what they have done so far, as most are widely published. (the list is far too long for me to place it here). ⚠️In the 𝘜𝘚𝘈 alone, in the 2014 elections, the food industry donated $𝟏𝟕𝐌, in total, to both parties. ❇This comes to the 𝐏'𝐬 I have spoken about before. Those, also called 𝐄𝐃'𝐬 (𝘌𝘭𝘪𝘤𝘪𝘵𝘪𝘯𝘨 𝘋𝘰𝘴𝘦), look into the dose needed to cause an allergic reaction and the percentage of allergic people who will react. ✅So a 𝐏𝟏 or 𝐄𝐃𝟏 means that the potential cross-contamination in a particular food will lead to 1% or fewer allergic people reacting to that food. ✴The best collaboration done so far is the one between the food industry in Australia, the Government and Allergy Organizations. (see the attached table to see the ED for the 14 main allergens) ⛔Such an agreement does not exist in the 𝘌𝘜 at present. ✴The hope for the 𝘜𝘒, at the moment, is that the so called "𝐍𝐚𝐭𝐚𝐬𝐡𝐚'𝐬 𝐋𝐚𝐰" will lead to a change in this practice. ▶️But we need to go deeper than simple labelling, look into manufacturing practices, and avoid allergens altogether. www.facebook.com/permalink.php?story_fbid=218423533618199&id=100063516604410    ⚠️There are two primary sources of 𝐕𝐢𝐭𝐚𝐦𝐢𝐧 𝐀. ✅𝐏𝐥𝐚𝐧𝐭 𝐬𝐨𝐮𝐫𝐜𝐞, or 𝘱𝘳𝘰𝘷𝘪𝘵𝘢𝘮𝘪𝘯 𝘈: ▶️All mammals get two-thirds of carotenoids from beta carotenes. ▶️Yellow, red and green (leafy) vegetables (spinach, carrots, sweet potatoes and red peppers) ▶️Yellow fruit (mango, papaya and apricots) ✅𝐀𝐧𝐢𝐦𝐚𝐥 𝐬𝐨𝐮𝐫𝐜𝐞, or 𝘱𝘳𝘦𝘧𝘰𝘳𝘮𝘦𝘥 𝘝𝘪𝘵 𝘈: ▶️Cheese ▶️Fortified low-fat spreads ▶️Milk and yoghurt ▶️Eggs ▶️Oily fish ▶️Liver and liver products such as liver pâté (don’t eat more than once a week, and pregnant women should avoid them altogether) ❇Examples of low concentration of Vit A (𝘪𝘯 𝘮𝘪𝘤𝘳𝘰𝘨𝘳𝘢𝘮𝘴 𝘢𝘯𝘥 % 𝘰𝘧 𝘥𝘢𝘪𝘭𝘺 𝘷𝘢𝘭𝘶𝘦). 🔻𝐏𝐥𝐚𝐧𝐭𝐬: ➡️Peppers, sweet, red, raw, ½ cup (117/13) ➡️Mangos, raw, 1 whole (112/12) ➡️Black-eyed peas, boiled, 1 cup (66/7) ➡️Apricots, dried, 10 halves (63/7) ➡️Broccoli, boiled, ½ cup (60/7) ➡️Pistachio nuts, dry roasted, 1 ounce (4/0) 🔻𝐀𝐧𝐢𝐦𝐚𝐥𝐬: ➡️Egg, hard-boiled, 1 large (75/8) ➡️Salmon, sockeye, cooked, 3 ounces (59/7) ➡Yoghurt, plain, low fat, 1 cup (32/4) ➡️Tuna, light, canned in oil, drained solids, 3 ounces (20/2) ➡️Chicken, breast meat and skin, roasted, ½ breast (5/1) ‼️Though most get their Vit A from plant sources, in reality, its absorption is not great. 🔸️When we eat beta carotenes, only 𝟺𝟶 𝘵𝘰 𝟼𝟶% 𝘢𝘳𝘦 𝘢𝘣𝘴𝘰𝘳𝘣𝘦𝘥. 🔹️In contrast, between 𝟾𝟶 𝘵𝘰 𝟿𝟶% of retinol from animal proteins will be absorbed. ❗To make the matter a bit more complicated, 𝘥𝘦𝘧𝘪𝘤𝘪𝘦𝘯𝘤𝘺 𝘪𝘯 𝘻𝘪𝘯𝘤, 𝘱𝘳𝘰𝘵𝘦𝘪𝘯 𝘢𝘯𝘥 𝘧𝘢𝘵 𝘢𝘣𝘴𝘰𝘳𝘱𝘵𝘪𝘰𝘯 (conditions like abetalipoproteinemia) affect carotenoid absorption. ❎𝐂𝐚𝐫𝐨𝐭𝐞𝐧𝐨𝐢𝐝𝐬 are 𝘱𝘪𝘨𝘮𝘦𝘯𝘵𝘴 𝘧𝘰𝘶𝘯𝘥 𝘪𝘯 𝘱𝘭𝘢𝘯𝘵𝘴. ▶️They are the reason for the bright red, yellow and orange colours you see in plenty of fruits, vegetables, algae and bacteria. ▶️Their importance is related to their ability to help absorb light so that photosynthesis can be done. They are also antioxidants. You can take supplements, if you can't eat any of the above. www.facebook.com/permalink.php?story_fbid=169430051850881&id=100063516604410    As we spoke before, 𝐕𝐢𝐭𝐚𝐦𝐢𝐧 𝐀 is 𝘧𝘢𝘵-𝘴𝘰𝘭𝘶𝘣𝘭𝘦. ⚠️We don’t eat Vit A, even in supplements. When we consume 🍎fruits, 🥕vegetables or 💊supplements, in reality, we are taking something called “𝘳𝘦𝘵𝘪𝘯𝘺𝘭 𝘦𝘴𝘵𝘦𝘳𝘴” (also known as preformed Vit A) or 𝘱𝘳𝘰𝘷𝘪𝘵𝘢𝘮𝘪𝘯 𝘈. ✅One way or another, they suffer alterations to become 𝘳𝘦𝘵𝘪𝘯𝘰𝘭𝘴. This is simply because those are easier absorbed in the small bowel. ❎As they are absorbed, small molecules called “𝐜𝐡𝐲𝐥𝐨𝐦𝐢𝐜𝐫𝐨𝐧𝐬” will transport them into the Liver. ❎If the Liver has reached its full capacity of Vitamin A, other small molecules called 𝐕𝐋𝐃𝐋 (𝘝𝘦𝘳𝘺 𝘓𝘰𝘸-𝘋𝘦𝘯𝘴𝘪𝘵𝘺 𝘓𝘪𝘱𝘰𝘱𝘳𝘰𝘵𝘦𝘪𝘯𝘴) will transport it (often already changed into retinyl palmitate) to other tissues. ✴Those tissues are mainly: 1️⃣Adipose tissue (AKA fat) 2️⃣Lungs 3️⃣Kidneys ❎Another group of molecules called 𝐋𝐃𝐋 (𝘓𝘰𝘸-𝘋𝘦𝘯𝘴𝘪𝘵𝘺 𝘓𝘪𝘱𝘰𝘱𝘳𝘰𝘵𝘦𝘪𝘯𝘴) might also do that transport. ‼️𝐕𝐞𝐫𝐲 𝐢𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐭𝐨 𝐤𝐧𝐨𝐰: ▶️VLDL and LDL are what is called “bad cholesterol” ▶️HDL is what is called “good cholesterol” ✴Bear in mind any disease affecting the bowels (and I am referring to the 𝘴𝘮𝘢𝘭𝘭 𝘣𝘰𝘸𝘦𝘭) will affect fat absorption capacity. In turn, this will affect Vitamin A absorption as well. ❓Remember we spoke about Vit A being fat soluble? ✅Conditions that affect Vit A absorption: ➡️Cystic Fibrosis ➡️Pancreatic problems ➡️Inflammatory Bowel Disease ➡️Cholestasis (conditions preventing bile passing to the bowel, from the Liver) ➡️Small bowel bypass surgery ➡️Significant parasitic infestation ➡️Kidney problems ➡️Alcoholism ➡️Low fat in the diet ⚠️People with any of these conditions should take 𝐕𝐢𝐭 𝐀 𝐬𝐮𝐩𝐩𝐥𝐞𝐦𝐞𝐧𝐭𝐬. When Vit A is not absorbed, it will be excreted in stools. The one that becomes inactivated in the bloodstream will be excreted in the urine. ✴The big problem is that our body absorbs Vit A better than it destroys it. ⛔This can lead to excessive accumulation and 𝐕𝐢𝐭 𝐀 𝐭𝐨𝐱𝐢𝐜𝐢𝐭𝐲. www.facebook.com/permalink.php?story_fbid=151235170337036&id=100063516604410    𝐕𝐢𝐭𝐚𝐦𝐢𝐧 𝐀 Also known as Retinol or Retinoic Acid. Those names derive from an area in the back of the eye. It was the first 𝘧𝘢𝘵-𝘴𝘰𝘭𝘶𝘣𝘭𝘦 but not the first Vitamin to be discovered. 🇪🇬It all started with the 𝘌𝘨𝘺𝘱𝘵𝘪𝘢𝘯𝘴, as they found that some types of 𝘣𝘭𝘪𝘯𝘥𝘯𝘦𝘴𝘴 could be cured by 𝘦𝘢𝘵𝘪𝘯𝘨 𝘭𝘪𝘷𝘦𝘳. 🔶️This Vitamin plays a vital role in 👁𝘷𝘪𝘴𝘪𝘰𝘯, 𝘨𝘳𝘰𝘸𝘵𝘩, 𝘤𝘦𝘭𝘭 𝘥𝘪𝘷𝘪𝘴𝘪𝘰𝘯 and 𝘪𝘯𝘵𝘦𝘨𝘳𝘪𝘵𝘺 (mainly 𝘢𝘪𝘳𝘸𝘢𝘺𝘴, 𝘶𝘳𝘪𝘯𝘢𝘳𝘺 𝘵𝘳𝘢𝘤𝘵 and 𝘨𝘶𝘵), 𝘳𝘦𝘱𝘳𝘰𝘥𝘶𝘤𝘵𝘪𝘰𝘯 and 𝘪𝘮𝘮𝘶𝘯𝘪𝘵𝘺. We cannot forget how important it is for foetal development. 🤰But beware, pregnant women DO NOT need a Vitamin A dose higher than the daily recommended dose. ✅Due to this, many believe it is 𝐭𝐡𝐞 𝐦𝐨𝐬𝐭 𝐞𝐬𝐬𝐞𝐧𝐭𝐢𝐚𝐥 𝐕𝐢𝐭𝐚𝐦𝐢𝐧 in animal life (not just humans). 🔻When there is a deficiency, it can lead to: ➡ ️Blindness ➡️Poor growth ➡️Low fertility ➡️Low immune response ➡️Dry skin and hair ➡️Broken fingernails ✴𝐍𝐨𝐭𝐞 𝐨𝐟 𝐜𝐚𝐮𝐭𝐢𝐨𝐧: If you use creams containing Vit A, do not go on long sun exposures, leading to skin cancer development! On the other hand, sun exposure decreases skin Vit A. ✳𝗪𝐡𝐚𝐭 𝐭𝐨 𝐝𝐨? Use it after sun and/or at nighttime. ❓Is there a connection between Vitamin A and allergies? 🔸️The only relationship found so far is between lack of it and increased risk of allergic asthma and allergic rhinitis (hayfever). ‼️There is a hypothesis saying that Vit A might help prevent an adverse reaction when eating different kinds of food. ⚠️𝐅𝐢𝐧𝐚𝐥 𝐧𝐨𝐭𝐞. ❌Too much Vitamin A can also lead to problems. Such as: ➡️Nausea ➡️Vomiting ➡️Vertigo ➡️Blurry vision ➡️Bone thinning ➡️Liver damage ➡️Headache ➡️Diarrhoea ➡️Nausea ➡️Skin irritation ➡️Pain in the joints and bone ➡️Birth defects www.facebook.com/permalink.php?story_fbid=145674797559740&id=100063516604410  |
AuthorDr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health. Categories
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Email address: officedrcosta@gmail.com
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Email address: officedrcosta@gmail.com
Contact number: 07949990798
Website design & content by LIT Communication: www.litcommunication.com
