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Intradermal Provocation Neutralisation Skin Testing For Food, Chemical And Inhalant Sensitivities

There is little point in identifying allergies to biological inhalants, foods or chemicals if the patient cannot either avoid them or be desensitized to them. Allergies, for example, to dustmites, moulds and pollens can only really successfully be avoided by emigration to hot, dry climates, which for most people is quite impractical. Patients who are allergic or intolerant to 8 or 10 major foods may find it impossible to avoid these foods on a long term basis. Having a severely restricted diet over a prolonged period could lead to an unacceptably restricted diet and the development of further problems. So although the patient may understand the cause of their problems, an approach that does not contain a technique of desensitisation can be limited in its usefulness.

Intradermal provocation neutralisation skin testing is both a diagnostic facility and a treatment rolled into one and can provide patients with dramatic improvements in their problems without the need to take extreme measures in terms of avoiding foods or inhaled sensitivities.

Prior to the development of neutralisation treatment, the technique known as incremental desensitisation was used. This was abandoned due to its inefficacy and the potential risk of anaphylaxis. The patient was given increasing doses of items to which they were highly sensitive and each desensitizing injection gave them stronger and stronger reactions. Frequently, the treatment had to be abandoned because of these reactions. The success rate for food sensitivities was particularly low.

In contrast neutralisation treatment, otherwise known as low dose immunotherapy, is highly effective in over 80% of patients with food allergy or intolerance and biologically inhaled allergies such as dust, dustmites, moulds, animal furs and pollens. It is also very effective in protecting patients against chemical sensitivities such as petrol, diesel, perfumes, formaldehyde, phenol, gas, etc. The protection is normally afforded within a few days. The treatment dose is the strongest allergen dilution that produces a negative skin reaction. This strength is known as the neutralizing end point. If symptoms are provoked at a higher strength than the neutralizing dose, then the neutralizing dose will turn off the symptoms occasioned by the stronger strength. Thus the neutralising dose is a dose that 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 dose of housedust mite is the 4th, 5th, or 6th concentration. The 4th concentration is a "1 in 625" dilution of the concentrate received from the allergen supply companies. The 5th concentration is a "1 in 3,125" dilution and the 6th concentration is a "1 in 15,625" dilution.

This technique has been used extensively in the United States of America since 1970 and it has been used by our clinic in an average of over 60 test sessions per week since 1978. An extremely conservative estimate is that over 30 million people worldwide have had this form of testing and treatment and there has not been one fatality reported. This is not surprising as the dose of allergen given to the patients is very low. Patients are therefore able to give these concentrations to themselves without any problems at all. The Committee on Safety in Medicine accepts that this procedure is totally different to incremental desensitisation and state that their restrictions in regard to the use of incremental desensitisation do not apply to intradermal provocation neutralisation.

The patient is given, for treatment purposes, a cocktail of his/her neutralizing concentrations which can then be self-administered by a single subcutaneous injection given on alternate days or, for chemicals, by sublingual drops given 3 times a day. Patients often need to take the treatment for about 11/2 years for inhalant sensitivity or 3 years for food sensitivity before they can inhale or eat these allergens without the protection of their neutralisation treatment.

A problem found by some patients with neutralisation therapy is that after several weeks or months their neutralizing end points may change as they become less sensitive. The signal that this is happening is that the patient begins to notice a recurrence of the original symptoms. The symptoms are not severe and rarely as bad as the initial presenting symptoms. Retesting and adjusting the neutralizing levels appropriately usually resolves the problem almost immediately. Patients with straightforward allergies have little problem with changing neutralizing levels. Patients with complex allergies and unstable immune systems have more difficulties in this respect. Improving patients nutritional status, treating any underlying intestinal dysbiosis or reducing the body's load of chemicals, toxic metals and biotoxins, frequently amplifies the effect of low dose immunotherapy.

The Burghwood Clinic, 34 Brighton Road [A217], Banstead, Surrey SM7 1BS, England
t: +44 (0) 1737 361177