Healing Molly

Standing in here for David Williams on the occasion of the birth of his son takes me back to my firstborn daughter’s experience with severe asthma. Molly was six years old, very sick and worsening. I spent hours searching for hope on the web and elsewhere. Within mainstream medicine there was no theory of the onset of asthma, therefore no path to healing. In the alternative world there were a thousand unconfirmed theories.

Diligence paid off and we found a nutritionist with a theory that was logically sound, supportable through established diagnostics, and came with a clear treatment plan, therefore represented a testable hypothesis about the onset of her asthma and how it might be reversed. In short, the theory was this: intestinal permeability resulting from environmental factors results in heightened immune reactions mediated through IgA and IgG, which results in inflammatory symptoms and may be reversible through treatment of the permeability, avoidance of the offending foods, and waiting for a relaxation of the immune reaction. Testing for permeability was positive and reversed through treatment. Testing for IgA and IgG sensitivities was positive and specific. A thoroughgoing elimination diet resulted in immediate cessation of symptoms and weaning from all medications over time and permanent reversal of all symptoms even after return to a normal diet

A good hypothesis needs more than a single data point for confirmation, but here are some questions that arise from our experience:

  • How is it that the institutional history of the study of allergy, which arose out of IgE mechanisms and did not account for IgA or IgG, can still result in training allergists without reference to those important mediation pathways?
  • How might it be possible to create an incentive for such hypotheses to become the subject of serious clinical trials, given that they are unlikely to result in a pharmaceutical product?
July 22, 2005

One thought on “Healing Molly”

  1. I’m a pediatrician and a pediatric pulmonologist (and a friend of David’s!)

    I’m not sure I agree with your understanding of the pathogenesis of asthma and atopy (allergy). It is not necessarily the case that knowledge of pathophysiology suggests a path to treatment. For asthma and allergic diseases in general, “how one gets there” is not nearly as important as how one treats the asthmatic/atopic patient.

    For example, whether a patient became senstitized in utero to a particular allergen, or whether gut exposure was the culprit, or whether the pathophysiology is completely unknown, pharmacotherapy is (or ought to be) the same.

    However, I agree with you that avoidance is the mainstay of any treatment of allergic disase. Having said this, I’ve thought about it for a while and I can’t figure out what you mean by “(t)esting for permeability” or “revers(al) through treatment”. Can you elaborate?

    Finally, in defense of my colleagues the allergists, they do, in fact know what IgA and IgG is, and have pretty good handles on their role in the development of atopic disease. For us dilletantes, total IgE (and possibly some specific IgE’s) is usually a helpful place to start.

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