Human Brain & Mind

Food Allergy and the Brain

Food proteins cause allergy and other immune mediated diseases. I will argue that this is an important but ignored problem in terms of suffering, disability and cost to the health care system. The prototypic antigenic proteins are found in wheat, cow’s milk, cereal grains, eggs and soy. Proteins are identification tags that immune cells recognize. Proteins that trigger immune responses are antigens. Immune cells make antibodies to bind to antigens. Antibodies are proteins, so that immune activity can be visualized as complex interactions of protein molecules with immune cells acting as intermediaries. Diamond et al reminded neuroscience researchers that everyone likely has populations of B cells making antibodies that can recognize brain antigens. They stated:" Although B cells that are reactive with self antigen are normally silenced during B cell maturation, the blood–brain barrier (BBB) prevents many brain antigens from participating in this process. This enables the generation of a B cell repertoire that is sufficiently diverse to cope with numerous environmental challenges. It requires, however, that the integrity of the BBBs is uninterrupted throughout life to protect the brain from antibodies that cross-react with brain antigens. Under conditions of BBB compromise, and during fetal development, we think that these antibodies can alter brain function in otherwise healthy individuals."

Food protein antigens make their way through human bodies in a remarkable fashion. Consider the long and improbable path of milk proteins through a mother's gut, into her blood, through her liver, out into her breast milk, through her infant's gut mucosa, finally arriving in the infant nasal mucosa to cause rhinitis, the infant lung to cause asthma or the infant skin to cause eczema. There are many potential paths from mouth to target organ for food antigens to follow. Every tissue of the body can manifest a food allergic response. Some activity is noticed in minutes; the onset of other activity is delayed hours to days.(Betty Diamond, Patricio T. Huerta, Paola Mina-Osorio, Czeslawa Kowal1 & Bruce T. Volpe.  Losing your nerves? Maybe it's the antibodies. Nature Reviews Immunology 9, 449-456 (June 2009) | doi:10.1038/nri2529)

Allergy of the Nervous System

Some old knowledge is very valuable, but is forgotten. Dr. Walter Alvarez, a well-known physician of the Mayo clinic and popular medical writer for several decades, provided a personal perspective on food-mind interactions, many years ago, in his introduction to the text, "Allergy of the Nervous System": "For years I knew I was highly sensitive to chicken, I suffered from what I called "dumb Monday," when I was too dull to do much constructive work like writing. Finally, I discovered that bad Mondays were due to the Alvarez family's habit of having chicken for Sunday dinner... My most remarkable personal experience with brain dulling due to food allergy came many years ago when... I ate a whole broiled chicken. Next day I had severe diarrhea and with this I became so dulled I could not read with comfort. And that night I had a hallucination of sight, such as I had never had before and haven't had since."

Alvarez and other astute physicians knew about food allergy and its mental effects for many years. Food allergy was implicated in depression, anxiety, hyperactivity in children, epilepsy, migraine, Meniere's syndrome, Multiple Sclerosis, and Guillain-Barre Syndrome. Unfortunately, this wisdom, shared by many prominent physicians for many years, has somehow been lost to subsequent generations of physicians and needs to be renewed.

Immune activity produces mental-emotional symptoms. Anaphylaxis victims are said to have "panic attacks" if they end up in the psychiatry department. Children with food allergy may have nightmares, tantrums and fail to learn at school because of attention deficits. Some of these children grow into troubled adults with "learning disability". Others remain hyper, moody, and volatile. Delayed pattern food allergy patients are sometimes described as "depressed" or "neurotic". Migraine sufferers may have neurological symptoms that suggest a stroke or a seizure. The occasional patient will have food-triggered epilepsy. Changes in sensation, motor control, balance and vision accompany food allergy and may suggest the diagnosis of serious neurological diseases such as Multiple Sclerosis or Alzheimer's disease.

Important disturbances of brain function occur during immune activity in the body with the strongest influences on the autonomic nervous system and mood-emotion circuits. Changes in arousal, mood, sleep-waking patterns, appetite, thirst and temperature regulation are regularly reported by patients who have immune mediated disease. The defense against infection features fever, loss of appetite, general malaise and the tendency to sleep. In patients with delayed patterns of milk and wheat allergy will report fatigue, progressing to sleepiness after eating the offending food. They may also experience increased thirst, frequent urination, hot and cold sensations, and headaches. Immune activity produces mental-emotional symptoms. Anaphylaxis victims are said to have "panic attacks if they end up in the psychiatry department.

Children with delayed pattern food allergy may have nightmares, tantrums, and fail to learn at school because of attention deficits. Some of these children grow into troubled adults with "learning disability". Others remain hyper, moody, and volatile. Delayed pattern food allergy patients are sometimes described as "depressed" or "neurotic". Migraine sufferers may have neurological symptoms that suggest a stroke or a seizure. The occasional patient will have food-triggered epilepsy.Often changes in sensation, motor control, balance, and vision are symptoms of food allergy and suggest the diagnosis of serious neurological diseases such as Multiple Sclerosis. (Egger J. et al Oligoantigenic diet treatment of children with epilepsy and migraine. Jour Pediatrics 1989;114:51-8. Epilepsy precipitated by food sensitivity. Clin Electroencephalography 1981;12:642-4.)

Food-provoked symptoms are not "psychological" as many physicians have claimed. Adverse immune reactions to foods or "food allergies" have a physiological basis and can be explained by insightful medical biology. Dr. Aas, a Norwegian allergist and researcher, remarked at the Marabou symposium on "Food Sensitivity" : "In my institute I am the only experimental monkey that we have and from several passive transfer experiments on myself, with occasional rather severe reactions, I am the first to admit that allergic reactions are accompanied with intellectual and emotional disturbances. If you have not experienced that, I ask you to be a volunteer in my laboratory."

The concept of allergy as reacting defensively to foreign materials can be extended to the nervous system which also reacts with defensive procedures. Both immune and nervous systems interact when things go wrong at the level of molecules and cells. The molecular-cellular mechanisms are monitored (but not controlled) at the level of consciousness. The experience of symptoms is the monitor image in consciousness of problems at the molecular-cellular level. In technical terms, we can speak of information and noise in the system of person and environment. Information noise is the disorder and chaos in experience that confuses or interferes with a successful relationship with our environment, the achievement of our goals with associated peace of mind. Molecular noise is the disorder or chaos created by substances flowing through our body-brain. Information noise is equivalent to molecular noise. At the level of equivalence we cannot tell the difference between a molecular problem and a personal problem. As noise increases, the system becomes more unstable or hypersensitive. This instability is expressed as emotional disturbances associated with physical symptoms.

Milk Allergy

Cow's milk contains many antigenic proteins. Patients of all ages with gastrointestinal tract disease may have difficulty digesting these proteins and may absorb them as antigens. Casein is the most commonly used milk protein in the food industry. Lactalbumin, lactoglobulin, bovine albumin, and gamma globulin are other protein groups in cow’s milk. There are at least 30 antigenic primary proteins in milk. Digestion probably increases the number of possible antigens to over 100. Milk proteins tend to stay intact as milk is converted to dairy products of all types. While lactose intolerance may not be an issue with yogurt ingestion, for example, milk protein allergy remains. Many patients have been fooled by health claims for lactose-free or lactaid-fixed milk and continue to have symptoms from milk allergy when they ingest these products. Digested fractions of each of the milk proteins may induce the production of IgE, IgA, and IgG antibodies and may trigger complex, variable immune responses. Skin tests with whole milk proteins are therefore misleading. Type 1 responses do appear regularly on skin tests showing IgE activity against intact proteins, but secondary antigens are not detected. Milk antigens tend to get through the digestive tract mucosa intact and are responsible for a host of delayed immune responses that do not depend on IgE and do not show up on skin tests. The role of milk proteins in triggering the most serious pathology usually goes undetected. Cow's milk allergy can play a role in causing asthma, rhinitis, eczema, urticaria, serous otitis media, pulmonary alveolitis (hemosiderosis), milk-induced enteropathy in infants, eosinophilic gastroenteritis, gastrointestinal bleeding with iron deficiency anemia, migraine headaches, attention deficit hyperactivity disorder, Crohn's disease, rheumatoid arthritis, and insulin dependent diabetes mellitus.

Gluten Proteins

Immune responses to gluten, the proteins found in cereal grains are a common cause of disease. Often, an assortment of related whole-body problems accompanies celiac disease. We think the related problems are typical of delayed pattern food allergy and use celiac disease research information to create a model of food allergy. Celiac patients have increased gastrointestinal permeability and demonstrate the whole-body effects of food allergy, including brain dysfunction, arthritis, and inflammatory lung disease. Diabetes, thyroid disease, purpura, anemia, rheumatoid arthritis, sacroileitis, sarcoidosis, vasculitis, lung disease, myositis, eye inflammation, and schizophrenia are all linked to gluten intolerance. These associations suggest a tendency to immune hypersensitivity diseases and a role for food antigens in causing systemic autoimmune disease.

Celiac disease may present as a vague illness, even a mental illness. Patients complain of dysphoria with fatigue, difficulty in concentration, loss of recent memory, irritability, loss of pleasure and interests, often with sleep disturbances. Sleep and dreaming are influenced by food problems. Most people eat their major meal in the evening and snack at night. This food is digested and absorbed during the night and symptoms often emerge as you sleep. Some allergenic effects tend to peak at night - asthma, migraine, body pains, and itching are often at their worst. Sleep disturbances include difficulty falling asleep, frequent waking and nightmares. Celiac disease in adolescents has been associated with an increased prevalence of depressive and disruptive behavioral disorders. A significant decrease in psychiatric symptoms was found at 3 months on a gluten-free diet. (Pynnonen PA. et al. Gluten-free diet may alleviate depressive and behavioral symptoms in adolescents with celiac disease: a prospective follow-up case-series study. BMC Psychiatry 2005, 5:14)

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