Dr Charles Forsyth

Ecological Physician

 
 

INTRADERMAL PROVOCATION NEUTRALIZATION SKIN TESTING

FOR FOOD, CHEMICAL AND INHALANT SENSITIVITIES


This is a form of skin testing and desensitization that is totally different to the conventional skin prick testing and the incremental desensitization which is used in NHS clinics.  The latter is very ineffective in that only about one person in six responded and there was a small but distinct risk of anaphylactic shock.  In contrast, neutralizing treatment appears to be totally safe - there have been no reported fatalities at all despite there being several thousand clinics using this technique worldwide. Adverse reactions are very rare and have never, to our knowledge, been serious. Neutralizing vaccines only take a few days or weeks to work and the success rate is very high - probably over 80%. There have been over twenty clinical trials, both in the United Kingdom and the United States, that have validated its effectiveness and safety.


There is little point in identifying allergies to biological inhalants, food or chemicals if the patient cannot either avoid them or reduce their sensitivity to them.  For example, allergy to dust mites, moulds and pollens can only really be successfully avoided by emigration to hot dry climates, which for most people is quite impractical. Patients who are allergic/intolerant to 8 or 10 major foods find it pretty impractical to avoid these on a long term basis and so even though we may have found the cause of their symptoms, approaches that do not reduce their food sensitivities are not especially helpful.


Intradermal provocation neutralization skin testing is a processs that is both diagnostic and therapeutic. It can provide patients with dramatic improvements in their problems without the need to take extreme measures in in the avoidance of foods or inhaled allergens.


Prior to the development of neutralization treatment, the technique known as incremental desensitization had a bad name with both doctors and patients in that it was time consuming and ineffective. In the latter, the patient is given increasing doses of items to which they were highly sensitive and each desensitizing injection gave them ever stronger and stronger reactions. Frequently the treatment had to be abandoned because of these reactions and the overall success rate for all year round type allergies was only about 15%. The success rate for food allergies was so low that it was rarely even tried. The biggest single problem with intradermal provocation neutralization skin testing is that most physicians know so little about it, and many think that it is the old incremental desensitization technique.


In contrast, neutralization treatment is effective in over 80% of patients with food allergy and intolerance, and biologically inhaled allergies such as dust, dust mites, animal furs and pollens. It is also very effective in protecting people against chemical sensitivities such as petrol, diesel, perfumes, gas, etc. This protection is normally afforded within a few hours or days. This technique has been used extensively in America since 1970, and in the UK since the late 1970’s. An extremely conservative estimate is that over 30 million people worldwide have benefited from this treatment, and there has not been one fatality. This is not surprising as the dose of allergen given is very low.


The dose used for neutralization is the strongest concentration of the allergen that produces a negative skin reaction. This strength is known as the neutralization strength.


If symptoms are provoked at a higher strength than the neutralization dose, then the neutralizing dose will turn off the symptoms caused by the stronger strength. Thus the desensitization dose is tailor made to each person's individual needs and produces a completely negative response on the skin.


In practice these treatment doses are very dilute. For example the most common neutralizing doses of house dust mite are the 4th, 5th or 6th concentration. The 4th concentration is a 1 in 625 dilution of the solution from the allergy supply companies. The 5th concentration is a 1 in 3125 dilution and the 6th concentration is a 1 in 15,625 dilution. 


It is, therefore, not at all surprising that patients are able to give these concentrations to themselves without any problems at all. The Committee on Safety in Medicine accept that this procedure is totally different to incremental desensitization, and state that their strictures in regard to the use of incremental desensitization do not apply to our totally different technique.


The patient is given, for treatment purposes, a cocktail of his/her neutralizing concentrations that can then be self-administered by a single subcutaneous injection given on alternate days (or by sublingual drops taken three times a day). Patients need to take the treatment for about eighteen months for inhalant sensitivity, or three years for food sensitivity before they can inhale or eat these allergens safely without the protection of their neutralization treatment.


A problem found by some patients with neutralization therapy is that their neutralizing levels may change after several weeks or months as they become less sensitive. The signal that this is happening is that the patient begins to notice a reoccurrence of the original symptoms. These symptoms are rarely as bad as the original presenting symptoms. Retesting and adjusting the neutralization levels appropriately usually resolves the problem almost immediately. Patients with straightforward allergies have little problem with changing levels. Patients with complex allergies and unstable immune systems have more problems in this respect.



CLINICAL TRIALS SUPPORTING THE VALUE OF NEUTRALIZATION FOR FOOD AND INHALANT SENSITIVITIES


There are over 25 studies validating the use of this  technique - here are 6 of them:


  1. Double-Blind Study of Food Extract Injection Therapy.  Miller J.B. Annals of Allergy March 1977: 38; pp185-192    A double-blind cross-over study. In most cases the response if lifelong severe intractable symptoms was rapid and dramatic (within 3-4) days. Symptoms returned within 3 of the 4 days on placebo injections


  2. Elimination of Oral Challenge Reaction with Patients by Injection of Food Extracts. A Double-Blind Evaluation. Rea W.J. et al. Archives of Otolaryngology April 1984: Vol 110; pp248-252   The phenomenon of Subcutaneous Food Neutralization can be scientifically endorsed for clinical treatment of food reactions.


  3. Low Dosage Sublingual Therapy in Patients with Allergic Rhinitis due to House dust Mite.  Scadding G. & Brostoff J. Department of immunology, Middlesex Hospital. Clinical Allergy 1986: Vol 16; pp483-491


  4. Provocation - Neutralization: A Two Part Study. Part I - The Intracutaneous Provocative Food Test : A Multi-Center Comparison Study.  King W. et al. Otolaryngology - Head and Neck Surgery Sept. 1988: Vol 99 no.3; pp263-71


  5. Provocation - Neutralization: A Two Part Study. Part II - The Subcutaneous Neutralization Therapy : A Multi-Center Comparison Study.  King W. et al. Otolaryngology - Head and Neck Surgery Sept. 1988: Vol 99 no.3; pp263-71    Triple Blind Studies provide evidence that subcutaneous neutralization treatment is an effective form of food hypersensitivity therapy. These two studies led by the American Academy of Otolaryngic Allergy to recommend neutralization as the treatment of choice to ear, nose and throat specialists treating rhinitis. Most ENT specialists in the USA now use neutralization as the preferred choice for perennial rhinitis.


  6. Treatment of Equine Allergic Disease with Allergy Neutralization: A Field Study.  Mansfield J., Valler B., Burrel M. & Curl V. The Burghwood Clinic, Banstead. Journal of Nutritional & Environmental Medicine 1998: 8; pp329-334    The first study worldwide of neutralization on an animal model. 87% of horses with COPD (equine asthma) responded well after neutralization. 92% of horses with urticaria responded well.

 

Neutralisation

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