From The Inside Out

Allergies plague millions throughout the world. For many years, allergy testing has involved extensive skin scratch tests known as “prick testing,” where concentrated extracts of the allergens in question are injected into the skin, and the resulting reaction is evaluated. Many allergists have assessed the accuracy of this method, and determined that there are multiple inconsistencies in extract preparation, techniques of testing, consistency of result interpretation, and, without a doubt, significant discomfort and risk to the patient. Researchers have studied alternatives to this somewhat unreliable technique, and several advancements have been made. One major development came onto the market in the early 1980’s when 3M and several other groups began introducing allergy testing alternatives using a simple blood test. These “in-vitro tests,” now performed in the laboratory instead of on the patient’s skin (referred to as “in-vivo tests”), flooded the marketplace, and clinicians eagerly began evaluating these safer and more simple testing protocols for precision and dependability. The world of allergy diagnosis had advanced into the future! 

Physicians actively involved in allergy testing found these laboratory tests reliable and much less invasive to their patients, who in turn were much more eager to undergo the tests, as they made the painful and somewhat risky allergy skin testing rather obsolete. Surprisingly, in many medical communities, patients continue to be subjected to skin scratch testing today. “There are many reasons for the continued prevalence of skin testing,” states Dr. Leonard A. Rubinstein, an Ears, Nose, and Throat Specialist in Sarasota who has been treating patients with allergies for over 20 years. He too was originally trained in allergy skin testing, but made a conscientious decision years ago to forego subjecting patients to it. “Allergy doctors, like all doctors, are accustomed to what they have learned and tend to resist change. Also, medical insurance continues to pay rather well for the skin tests, and doctors who are primarily insurance network participants find that the testing is relatively inexpensive to administer, allowing for a significant profit in the end. Many studies have found that blood tests are more accurate and give less false positives, but so many doctors still refrain from promoting them.”

So why is it so important to identify the source of allergy problems, rather than simply treating the symptoms with antihistamines, steroids, nasal sprays, and other pharmaceutical agents? “Medications have associated side-effects for both children and adults…it’s not safe to take medications long-term,” states Dr. Rubinstein. Research has shown that both food and environmental allergies have been implicated in a wide range of medical conditions affecting virtually every part of the body—from mildly uncomfortable symptoms such as indigestion and gastritis, to severe illnesses such as celiac disease, arthritis, eczema, psoriasis, and chronic infection. Allergies have been linked to serious disorders of the central nervous system including depression, anxiety, and chronic fatigue. Attention Deficit Disorder (ADD) has also been associated with allergies. 

Food allergies cause the immune system to synthesize and release reactive chemicals such as histamines, cytokines, lymphokines, and interferons. These hormone-like substances can dramatically influence cellular physiology, producing far-reaching effects of the immune, endocrine, and nervous systems. “Even your natural hormone secretions can become imbalanced as a result of untreated allergies, leading to mood disturbances, headaches, depression, irritability, insomnia, and even libido problems,” states Dr. Rubinstein who, in addition to his original specialty in Ears, Nose, and Throat, has received formal post-graduate training in Anti-Aging and Regenerative Medicine, and has become a Diplomat of the American Board of Anti-Aging and Regenerative Medicine.

When evaluating allergies, one needs to remember that some never affect the skin, so skin testing is the wrong choice for those whose respiratory system, gastro-intestinal system, joints, or nervous system are affected. The blood tests use a sophisticated methodology for identifying the specific allergy antibodies that may exist in a patient’s blood. Newer blood testing methods like the Immuno-CAP system of Phadia Corporation have shown to be quite accurate in identifying the presence of these abnormal antibodies. Furthermore, since food allergies can cause both immediate (IgE antibodies) and delayed (IgG antibodies) responses, only blood testing can identify them. “The delayed food allergies are referred to as ‘hidden food allergies,’ whose effects may not show up for hours, or even days after exposure to an antigenic substance. These can even cause a patient to gain and retain excess weight, even with dieting,” states Dr. Rubinstein, who has been very successful in helping patients lose unwanted pounds through allergy evaluation and treatment. “Spices, inhalants, and molds can be assessed to gain a greater insight into the etiological offending antigen.” Dr. Rubinstein serves as the Medical Director of the Allergy Clinic of Sarasota, a CLIA state-licensed allergy testing laboratory that performs thousands of allergy blood tests yearly.  

Over the past 20 years in Dr. Rubinstein’s office, patients have been spared from the painful and confusing skin testing as a result of this new, in-vitro, allergen-specific IgE testing method that has quickly grown in popularity to be considered the “gold standard” in allergy testing. Dr. Rubinstein prides himself in his uniquely integrative approach to Allergy which includes conventional (Western) components as well as Homeopathic and Oriental components. He believes in assessing the patient’s nutritional needs, their environment, and even their hormonal balance. His recommended treatment is also much less painful than the traditional allergy shot regimen. As an alternative, he offers allergy drops administered under the tongue, also known as sublingual immunotherapy. The drops are absorbed by the dendritic cells located under the tongue that prove to be a more effective route to build tolerance to antigens. Additionally, the drops tend to cost less and require fewer clinical visits, and can conveniently be taken at home.