Unorthodox
Techniques for Diagnosing & Treating Asthma & Allergy
Allergy is a science-based specialty
Conventional allergy practice and testing relies upon an understanding
of the immune basis of diseases such as food allergy, hay fever,
stinging insect allergies, drug allergies and asthma. Accurate
allergy diagnosis and treatment requires reliable testing procedures,
such as skin prick testing or blood allergy testing.
Philosophies underlying unorthodox medical practice
Many unorthodox allergy practices claim that common symptoms
such as headaches, migraine, irritable bowel, muscle tension,
aches and pains, addiction, PMS, fatigue and depression are either
due to "hidden allergies" or secondary to noxious external
triggers.
Blurring the meaning of the word "immunity" with that of "energy", allergic and other disease is often described as a result of disturbed / imbalanced vital life force or energy, or secondary to noxious external triggers such as environmental toxins and chemicals, food allergens or chronic Candida infection.
Conventional allergy testing is of little use in these situations, as these conditions do not have an allergic basis.
Those promoting these philospohies of illness often claim that the body can generally cure itself if only given the opportunity to correct these imbalances by avoiding or eliminating environmental toxins or allergens. Blending concepts of immunity, neurology and eastern mysticism, claims are usually accompanied by quasi-religious and pseudo-scientific jargon, and emotive language designed to encourage unrealistic expectations.
The following is a summary of the most common alternative techniques used. They have not been subject to reliability testing in the same way as conventional tests. No Medicare rebate is available in Australia for these tests. Reliance on the results of such tests to guide medical treatment is inadvisable.
INAPPROPRIATE TESTING
Cytotoxic testing (Bryans' test)
Use: Diagnosis of food sensitivity / allergy.
Method: A suspension of patient white cells is dropped
onto a slide coated with dried food extract. The slide is then
examined under the microscope to detect changes in appearance
and movement of cells, and whether they look alive or dead. Significant
changes are interpreted as representing a sensitivity or "allergy"
to that food.
Evidence: Studies have shown results to be poorly reproducible
when duplicate samples have been submitted to the same laboratory
for testing. Furthermore, patients are frequently given positive
results to foods for which no symptoms occur, and negative results
for foods allegedly triggering symptoms.
Alcat testing
The ALCAT test is essentially a variation of the same
test, with the exception that a mixture of patient blood cells
and food extracts is placed into a Coulter counter.
Oral provocation and neutralisation
Use: This technique is commonly promoted for
the diagnosis and treatment of sensitivity to foods, inhaled allergens
as well as environmental chemicals.
Method: The patient is "provoked" by administering
dilute allergen or chemical extracts, usually as liquid drops
under the tongue. The dose required to trigger symptoms is assessed,
then further dilute extracts prepared. Symptoms are then expected
to disappear when the more dilute extract is administered. If
so, the patient is instructed to use this "neutralising dose"
before exposure to the offending environmental chemicals or foods.
Evidence: Blinded provocation studies have shown that patients
are unable to distinguish between placebo controls and food extracts.
Furthermore, studies of doctors practising this technique have
shown that they are also unable to discriminate between reactions
to placebo or active extracts.
Subcutaneous provocation and neutralisation
Subcutaneous provocation and neutralisation is a variation
of the above technique, with the exception that extracts are injected
rather than administered orally.
Vega testing (electrodermal testing)
Use: Diagnosis of food sensitivity / allergy.
Method: This test is based on the concept that disease
will cause a change in the body's electrical charge which can
then be detected using special equipment. Vega machines claim
to measure changes in the resistance to flow of electric charge
between acupuncture points over fingers and toes. The patient
holds one (negative) electrode in one hand, and then the positive
electrode is applied to acupuncture points over fingers or toes.
The machine is then adjusted until a reading of 80 to 100 scale
units is produced. A food extract in a sealed glass container
is brought into the electrical circuits. If a reduction in current
is observed, the patient is told that they are sensitive to that
substance. If a child is tested, then the parent is initially
assessed, and then reassessed while holding the child's hand.
Evidence: Vega testing has been promoted as being useful
for diagnosing a range of diseases from allergy, sinusitis, chronic
Candidiasis through to cancer. There is no evidence that it is
reliable in diagnosing allergic or other disease. Results are
not reproducible in blinded studies, and do not correspond to
results from conventional allergy or other scientific testing.
Kinesiology
Used: Diagnosis of food sensitivity / allergy.
Method: This technique is based on the concept that the
body itself can recognize toxins or foods that cause symptoms
and that this will result in muscle weakness if exposed. Muscle
strength is measured at rest, and then repeated after exposure
to food. "Provocation" to food occurs by having drops
of food extracts given under the tongue or by holding a vial of
food extracts in one hand. Onset of weakness is interpreted as
indicating a food "allergy" or sensitivity. If a child
or infant is being tested, the parent's strength is assessed first,
and then re-measured while holding the child's hand. The two test
results are then subtracted to give the final results. Evidence:
There is no evidence that results are useful for diagnosing any
disorder, including allergies.
Pulse testing
Use: Diagnosis of food sensitivity / allergy.
Method: This test is based on the rationale that allergic
reactions are mediated by nerve impulses transmitted by the nervous
system. Promoters of this test state that sensitivity to a food
will result in a temporary increase in heart rate after exposure.
Evidence: This technique is subjective by its very nature,
and there is no evidence that results are useful for diagnosing
any disorder, including allergies. The auricular cardiac reflex
test is a variation, in which food sensitivity is attributed based
on changes in pulse waveform.
Hair analysis
Use: Diagnosis of food sensitivity / allergy
and other non-specific symptoms
Method: Trace elements are measured from samples of hair,
and nutritional deficiencies or excesses are related to the patient's
symptoms.
Evidence: There is no evidence that vitamin or mineral
analysis from hair samples is useful for diagnosing disease. There
is no evidence that treatment based on results of such analysis
has any clinical benefit. Blinded studies have shown that testing
laboratories frequently report variable and non-reproducible results
from the same samples.
Radionics (psionic medicine, dowsing)
Use: Diagnosis and treatment of food sensitivity
/ allergy, infections and various medical conditions
Method: Radionics is based on the concept that all life
forms are submerged in the electro-magnetic energy field of the
earth, and that disease will be reflected by changes or "imbalances"
in an individual's electromagnetic field that are said to lie
outside the normal electromagnetic spectrum. Practitioners of
radionics claim to be able to detect changes in energies and vibrations
arising from internal organs affected by disease using a pendulum-like
device. Such "dowsing" is said to detect energies and
force fields through subtle vibrations that are then amplified
by the device. Sometimes more sophisticated instruments are used
that purport to "tune in" to disease-specific energies.
Practitioners claim that by focusing their own thoughts and energies,
they can treat disease by restoring normal energy balance in patients
in order to heal. Sometimes the operator is with the patient,
and sometimes the practitioner "connects" with the patient
at a distance using an object such as lock of hair, blood sample
or even a photograph.
Comment: This technique appears to combine concepts of
kinesiology, reflexology, vega testing and eastern mysticism.
There is no evidence that it is effective for the assessment of
treatment of any disorder, including allergies. Those who practice
this technique are essentially claiming extrasensory powers.
Iridology
Use: Diagnosis of various disorders
Method: Iridology is based on the concept that each area
in the iris represents a corresponding part of the body. As such,
this shares a similar conceptual framework with those of reflexology
and acupuncture. A person's state of current and past health can
therefore be diagnosed from the color, texture, and location of
pigment flecks in the eye. Detection of imbalances can be treated
with dietary supplements or herbal medicines.
Evidence: There is no published evidence that this technique
is useful for the diagnosis of any allergic disorder. Furthermore,
studies have shown iridologists to be unable to distinguish patients
with visceral disease from healthy controls, and for results to
be not reproducible when iris photographs from the same individuals
taken a few minutes apart were examined.
INAPPROPRIATE USE OF CONVENTIONAL TESTING
Food specific IgG, IgG4. IgE
Use: Diagnosis of food sensitivity / allergy.
Method: Proteins called antibodies to food are measured
using standard laboratory techniques.
Evidence: Antibodies to food can be detected in healthy
adult patients and children, regardless of whether or not these
foods provoke symptoms, and even when allergy is not present.
There is no good evidence that measuring IgG antibodies is useful
for diagnosing adverse or allergic reactions to food, nor that
IgG antibodies cause symptoms. Low levels of food-reactive IgE
are also found in some healthy individuals without clinical sensitization
or evidence of clinical reactivity. Inappropriate use of food
allergy testing in patients with inhalant allergy, for example,
may lead to inappropriate and unnecessary dietary restrictions,
with particular nutritional implications in children. These are
examples of the inappropriate use of a conventional diagnostic
tests.
Lymphocyte subset analysis
Use: Conventionally used for the assessment
of patients with suspected immune deficiency or some types of
cancers such as leukaemia or lymphoma. Also used by some unorthodox
practitioners to assess patients with suspected "chemical
sensitivity" or chronic fatigue syndrome or "environmental
allergies".
Method: Different types of white cells known as "lymphocyte
subsets" are measured using standard laboratory equipment.
Evidence: The normal range is very wide, varies from day
to day and will be influenced by such factors as time of collection,
exercise, infection and the presence of many different diseases
and sometimes even depression. Misinterpretation of minor changes
when immune deficiency or cancer is clearly absent can mislead
patients into thinking that a serious problem exists when it does
not. It can falsely raise concern that they are suffering from
an immune disorder, a common concern when the distinction between
concepts of "energy" and "immunity" are blurred.
UNORTHODOX TREATMENTS
Homeopathy
Use: Treatment of various conditions including
allergies
Method: Based on the concept of "like cures like",
proponents argue that if a particular substance or toxin can trigger
symptoms in large amounts, extremely dilute extracts of the same
substance can relieve the same symptoms, regardless of cause.
Disease is thought to result from a disturbance in the body's
ability to heal itself, and that only a small stimulus is needed
to start the healing process. Extracts of plant, mineral or animal
origin (eg. adrenal gland, thyroid, thymus, spleen) are first
prepared. These are then serially diluted, with vigorous agitation
at each step to a point where not a single molecule of the original
extract remains. Proponents claim that these extremely dilute
extracts retain the "memory" or "spirit" of
the original extract that will revive the body's "vital force"
and provide relief when taken orally.
Evidence: While there is a superficial resemblance between
homeopathy and conventional immunotherapy, only the latter has
been shown to have a clear dose-response relationship between
administered dose clinical efficacy and changes in immune response.
As extracts are diluted beyond the limit by which a single molecule
of the original extract will remain, they are effectively placebos.
Homeopaths often consider that the more dilute the extract, the
more potent is its effect, the opposite to the conventional view
of pharmacology. There is no convincing evidence that homeopathy
benefits patients with allergy or asthma beyond that of placebo,
and no evidence of a physiological or therapeutic effect. While
toxicity from homeopathy has only been demonstrated in a few cases
of accidental contamination with heavy metals, the promotion of
so-called homeopathic "vaccines" is of particular concern
when considering the risk of transmissible disease in children
when used instead of conventional vaccination.
Nambudripad's Allergy elimination
technique)
Use: Treatment of food, inhalant and chemical
sensitivity / allergy
Method: This treatment is based on the concept that allergen
is perceived by the brain as a threat to the body's well being,
and that exposure to allergen disrupts the flow of nervous energies
from the brain to the body via "meridians", and that
blocked energy flow results in allergic symptoms. The technique
seeks to "re-programme" the brain by applying acupressure
applied to both sides of the spinal column (where energy flowing
along meridians intersects with nerve roots) while the patient
is in direct contact or close proximity to purported allergen.
Evidence: This technique, which appears to combine concepts
of kinesiology, reflexology, acupuncture and radionics. Proponents
claim to be able to cure almost any allergy or sensitivity. This
is a particularly dangerous technique, particularly when considering
potentially dangerous food allergies.
Clinical Ecology/ Environmental Illness
Use: Treatmemt of a variety of illnesses, usually
attributed to exposure to dietary or environmental toxins, and
sometimes electromagnetic radiation.
Method: Promoters of clinical ecology claim that much
illness results from exposure to dietary or environmental toxins
and sometimes Candida. These concepts arose in the first half
of the 20th century, when many ill-defined conditions were attributed
to "allergy", and well before the key components of
the immune system were identified or their function understood.
A variety of "diagnostic tests" are used to confirm
"sensitivity" such as those alluded to above. Patients
with this diagnosis usually display physical and emotional symptoms
(particularly fatigue) involving multiple organ systems. Conventional
medical tests are generally normal, showing no evidence of organ
dysfunction, and objective examination generally fails to confirm
objective evidence of organic disease. Patients usually complain
that a number of distinct and chemically unrelated substances
may trigger symptoms, such as smells, natural foods, food additives,
environmental chemicals and even electromagnetic radiation. Treatment
involves major environmental avoidance strategies, dietary changes,
sometimes elimination of Candida using antifungal agents or special
diets, and "neutralization" of chemicals in order to
minimize exposure and strengthen the immune system. Evidence:
There is no evidence of immune dysfunction in these patients.
Similar symptoms may also be found in some patients suffering
from anxiety and depression. Some patients diagnosed with environmental
illness by alternative practitioners benefit from treatment of
anxiety or depression . Major lifestyle changes can impact on
employment, social functioning and nutrition.
Chronic Candidiasis
Use: Treatment of a variety of ailments including
allergy, irritable bowel, food allergy and intolerance, autoimmunity,
arthritis and psychological conditions.
Method: This approach is based on the concept that imbalance
of gut flora results in overgrowth of Candida albicans within
the gut. Release of fungal toxins results in a variety of symptoms
including fatigue, arthritis, irritable bowel, food intolerance
as well as psychological symptoms. These toxins weaken the immune
system further, predisposing to further symptoms from ingested
foods. Treatment centres on dietary supplements, administration
of antifungal drugs such as nystatin, and restriction of "Candida
friendly" foods such as those contain sugars, yeast or molds.
Evidence: Given that Candida is a normal gut organism,
immune responses (antibodies, cell mediated responses) to this
organism are both expected and observed in healthy controls as
well as those allegedly suffering from this condition. There is
evidence of neither overgrowth of Candida nor altered immune responses
to this organism in patients complaining of this syndrome. There
is neither a scientific rationale nor published evidence that
elimination of Candida with diets or anti-fungal therapy is useful
for the management of any disorder including allergies.
Reflexology, Chiropractic, Acupuncture
There is limited evidence that these techniques are
useful for relief of pain, but controlled studies have found evidence
of neither subjective nor objective evidence of their use in asthma
or allergic rhinitis
Adverse consequences may arise from unorthodox testing and
treatments
Treatment based on inaccurate results is not only misleading,
but can lead to ineffective, expensive and sometimes harmful treatments,
and delay more effective therapy. False positive results can also
be misleading. For example it can lead to unnecessary dietary
avoidance, with risk of malnutrition, particularly in children.
Unnecessary environmental and chemical avoidance can impact on
employment and social functioning. Moreover, creating a perception
of illness where none exists, or when psycho-social factors are
to blame, is particularly unhelpful. Some practices, such as use
of homeopathic "vaccines" and claims of being able to
"cure" food allergies have potentially dangerous consequences
for those with true life-threatening allergies.
Cytotoxic food testing
Black AP. A new diagnostic method in allergic disease. Pediatrics
1956; 17: 716-724.
Bryan WRK, Bryan MP. The application of in vitro cytotoxic reactions
to clinical diagnosis of food allergy. Laryngoscope 1960; 70:
810.
Bryan WRK, Bryan MP. Diagnosis of food allergy by cytotoxic reactions.
Trans Am Soc Ophthal Otolaryngol Allergy 1967;8:14.
Bryan WRK, Bryan MP. Cytotoxic reactions in the diagnosis of food
allergy. Otolaryngol Clin North Am 1971; 4: 523.
Ulett, G. A. and S. G. Perry (1974). Cytotoxic testing and leukocyte
increase as an index to food sensitivity. Ann Allergy 33(1): 23-32.
(1985). Medicare program; exclusion of cytotoxic leukocyte testing
from Medicare coverage--HCFA. Notice of ruling.Fed Regist 50(129):
27691-3.
Benson, T. E. and J. A. Arkins (1976). Cytotoxic testing for food
allergy: evaluation of reproducibility and correlation. J Allergy
Clin Immunol 58(4): 471-6.
(1988). Statement on cytotoxic testing for food allergy (Bryan's
test). Committee of Public Health. Bull N Y Acad Med 64(1): 117-9.
Ulett, G. A., E. Itil, et al. (1974). Cytotoxic food testing in
alcoholics. Q J Stud Alcohol 35(3): 930-42.
King, W. P. (1978). Testing for food allergy: a statistical comparison
of cytotoxic and intracutaneous tests. Laryngoscope 88(10): 1649-59.
Ulett, G. A. and S. G. Perry (1975). Cytotoxic testing and leucocyte
increase as an index to food sensitivity. II. Coffee and tobacco.
Ann Allergy 34(3): 150-60.
Stein, H. L. (1975). Unreliability of cytotoxic food testing.
West J Med 122(6): 491-2.
Franklin W, Lowell FE. Failure of ragweed pollen extract to destroy
white cells in ragweed-sensitive patients, J Allergy 1949; 20:
375-377,
Lieberman p, Crawford L, Bjelland J, Connell B, Rice M, Controlled
study of the cytotoxic food test. JAMA 1974; 231: 728-730.
Benson TE, Arkins JA. Cytotoxic testing for food allergy: evaluations
of reproducibility and correlation. J Allergy Clin Immunol 1976;58:471-476.
Lowell FC, Heiner DE. Food allergy cytotoxic diagnostic technique
not proven. JAMA 1972;220:1624-1630.
Acupuncture
MacPherson H, Thomas K, Walters S, Fitter M. A prospective
survey of adverse events and treatment reactions following 34,000
consultations with professional acupuncturists. Acupunct Med.
2001 Dec;19(2):93-102.
Medici TC, Grebski E, Wu J, Hinz G, Wuthrich B. Acupuncture and
bronchial asthma: a long-term randomized study of the effects
of real versus sham acupuncture compared to controls in patients
with bronchial
asthma. J Altern Complement Med. 2002 Dec;8(6):737-50; discussion
751-4.
Steurer-Stey C, Russi EW, Steurer J. Complementary and alternative
medicine in asthma: do they work? Swiss Med Wkly. 2002 Jun 29;132(25-26):338-44.
Review.
Martin J, Donaldson AN, Villarroel R, Parmar MK, Ernst E, Higginson
IJ. Efficacy of acupuncture in asthma: systematic review and meta-analysis
of published data from 11 randomised controlled trials. Eur Respir
J. 2002 Oct;20(4):846-52. Review.
Malmstrom M, Ahlner J, Carlsson C, Schmekel B. No effect of chinese
acupuncture on isocapnic hyperventilation with cold air in asthmatics,
measured with impulse oscillometry. Acupunct Med. 2002 Aug;20(2-3):66-73.
Shapira MY, Berkman N, Ben-David G, Avital A, Bardach E, Breuer
R. Short-term acupuncture therapy is of no benefit in patients
with moderate persistent asthma. Chest. 2002 May;121(5):1396-400.
Gruber W, Eber E, Malle-Scheid D, Pfleger A, Weinhandl E, Dorfer
L, Zach MS. Laser acupuncture in children and adolescents with
exercise induced asthma. Thorax. 2002 Mar;57(3):222-5.
Linde K, Jobst K, Panton J. Acupuncture for chronic asthma. Cochrane
Database Syst Rev. 2000;(2):CD000008. Review.
Davis PA, Chang C, Hackman RM, Stern JS, Gershwin ME. Acupuncture
in the treatment of asthma: a critical review. Immunopathol (Madr).
1998 Nov-Dec;26(6):263-71.
W, Peake MD. Acupuncture in treatment of stable asthma.Respir
Med. 1998 Sep;92(9):1143-5.
Chronic Candidiasis / Candida hypersensitivity syndrome
Lacour M, Zunder T, Huber R, Sander A, Daschner F, Frank U.
The pathogenetic significance of intestinal Candida colonization--a
systematic
review from an interdisciplinary and environmental medical point
of view. Int J Hyg Environ Health. 2002 May;205(4):257-68.
Clinical ecology. Council on Scientific Affairs, American Medical
Association. JAMA. 1992 Dec 23-30;268(24):3465-7.
Dismukes WE, Wade JS, Lee JY, Dockery BK, Hain JD. A randomized,
double-blind trial of nystatin therapy for the candidiasis hypersensitivity
syndrome. N Engl J Med. 1990 Dec 20;323(25):1717-23.
Clinical ecology. American College of Physicians. Ann Intern Med.
1989 Jul 15;111(2):168-78. Review
Autogenous urine therapy
Grieco MH. Controversial practices in allergy. JAMA. 1982
Jun 11;247(22):3106-11.
Millman S, Millman M. Bacterial autogenous vaccines: preparation
and identification of micro-organisms. Ann Allergy. 1970 Jun;28(6):267-75.
Rogalski C, Kleine-Tebbe J, Rytter M, Haustein UF, Paasch U. Anaphylactic
shock after traditional Russian beauty-treatment-unpleasant surprise
in a strongly penicillin-sensitized patient.Asian Pac J Allergy
Immunol. 2002 Sep;20(3):197-202.
Dunne AP. The use of injected and sublingual urine in the treatment
of allergies. Irish Med Times 1981; 19: 24-6.
Steel RS. The specificity of urinary proteose. Med J Aust 1932;
2: 800
Liberman J, Bigland AD. Autogenous urinary proteose in asthma
and other allergic conditions. Br Med J 1937; 1: 62.
Plesch J. Urine therapy. Med Press1947; 218: 128
Enzyme potentiated immunotherapy
Radcliffe MJ, Lewith GT, Turner RG, Prescott P, Church MK,
Holgate ST. Enzyme potentiated desensitisation in treatment of
seasonal allergic rhinitis:double blind randomised controlled
study. BMJ. 2003 Aug 2;327(7409):251-4.
Ippoliti F, Ragno V, Del Nero A, McEwen LM, McEwen H, Businco
L. Effect of preseasonal enzyme potentiated desensitisation (EPD)
on plasma-IL-6and IL-10 of grass pollen-sensitive asthmatic children.
Allerg Immunol (Paris). 1997 May;29(5):120, 123-5.
Di Stanislao C, Di Berardino L, Bianchi I, Bologna G. A double-blind,
placebo-controlled study of preventive immunotherapy with E.P.D.,
in the treatment of seasonal allergic disease. Allerg Immunol
(Paris). 1997 Feb;29(2):39-42.
Cantani A, Ragno V, Monteleone MA, Lucenti P, Businco L. Enzyme-potentiated
desensitization in children with asthma and mite allergy: a double-blind
study.J Investig Allergol Clin Immunol. 1996 Jul-Aug;6(4):270-6.
Astarita C, Scala G, Sproviero S, Franzese A. Effects of enzyme-potentiated
desensitization in the treatment of pollinosis: a double-blind
placebo-controlled trial. J Investig Allergol Clin Immunol. 1996
Jul-Aug;6(4):248-55.
Fell P, Brostoff J. A single dose desensitization for summer hay
fever. Results of a double blind study-1988. Eur J Clin Pharmacol.
1990;38(1):77-9.
McEwen LM. Enzyme potentiated hyposensitization: V. Five case
reports of patients with acute food allergy.
Ann Allergy. 1975 Aug;35(2):98-103
McEwen LM, Nicholson M, Kitchen I, White S. Enzyme-potentiated
hyposensitization. 3. Control by sugars and diols of the immunological
effect of beta glucuronidase in mice and patients with hay fever.
Ann Allergy. 1973 Nov;31(11):543-50
McEwen LM, Starr MS. Enzyme-potentiated hyposensitisation. I.
The effect of pre-treatment with -glucuronidase, hyaluronidase,
and antigen on anaphylactic sensitivity of guinea-pigs, rats and
mice.
Int Arch Allergy Appl Immunol. 1972;42(1):152-8.
Insulin resistance
Lebovitz HE. Insulin allergy and insulin resistance.
Curr Ther Endocrinol Metab. 1997;6:500-4.
Goldfine AB, Kahn CR. Insulin allergy and insulin resistance.
Curr Ther Endocrinol Metab. 1994;5:461-4.
Ganz MA, Unterman T, Roberts M, Uy R, Sahgal S, Samter M, Grammer
LC. Resistance and allergy to recombinant human insulin. J Allergy
Clin Immunol. 1990 Jul;86(1):45-51.
Patterson R, Roberts M, Grammer LC. Insulin allergy: re-evaluation
after two decades.Ann Allergy. 1990 May;64(5):459-62.
Grammer L. Insulin allergy.
Clin Rev Allergy. 1986 May;4(2):189-200.
Ross JM, Murali MR, DeLara TC, Cheron RG. Anaphylaxis and immunologic
insulin resistance in a diabetic woman withketoacidosis. Diabetes
Care. 1984 May-Jun;7(3):276-9.
Chiropractic
Cochrane Database Syst Rev. 2002;(4):CD001002. Update of:
Cochrane Database Syst Rev. 2001;(1):CD001002.Manual therapy for
asthma. Hondras MA, Linde K, Jones AP.
J Manipulative Physiol Ther. 2001 Jul-Aug;24(6):369-77. Chronic
pediatric asthma and chiropractic spinal manipulation: a prospective
clinical series and randomized clinical pilot study. Bronfort
G, Evans RL, Kubic P, Filkin P.
N Engl J Med. 1999 Feb 4;340(5):391 A comparison of active and
simulated chiropractic manipulation as adjunctive treatment for
childhood asthma. Balon J, Aker PD, Crowther ER, Danielson C,
Cox PG, O'Shaughnessy D, Walker C,Goldsmith CH, Duku E, Sears
MR.
Clin Exp Allergy. 1995 Jan;25(1):80-8. Chronic asthma and chiropractic
spinal manipulation: a randomized clinical trial. Nielsen NH,
Bronfort G, Bendix T, Madsen F, Weeke B.
J Manipulative Physiol Ther. 1992 Mar-Apr;15(3):171-80. Chiropractic
adjustment in the management of visceral conditions: a critical
appraisal. Jamison JR, McEwen AP, Thomas SJ.
Alcat testing
Potter PC, Mullineux J, Weinberg EG, Haus M, Ireland P, Buys
C, Motala C. The ALCAT test--inappropriate in testing for food
allergy in clinical practice. S Afr Med J. 1992 Apr 4;81(7):384.
Radionics
McCarney R, Fisher P, Spink F, Flint G, van Haselen R. Can
homeopaths detect homeopathic medicines by dowsing? A randomized,
double-blind, placebo-controlled trial. J R Soc Med. 2002 Apr;95(4):189-91.
Skrabanek P. Paranormal health claims. Experientia. 1988 Apr 15;44(4):303-9.
Provocation/neutralisation
WILLIAMS Rl (1965) The provocative skin food test. Laryngoscope
75:1428-1437.
WILLIAMS RI (1971) Skin titration: testing and treatment. Otolaryngol
Clin N Am 4:507-521.
WILLOUGHBY JW (1965) Provocative food test technique. Ann Allergy
23:543- 554.
Lewett DL, Fein G, Greenberg MH. A double-blind study of symptom
provocation to determine food sensitivity. N Engl Med 1990;
323: 429-433
Breneman JC, Crock We, Deamer W, et al Report of
the Food Allergy Committee on the sublingual method of provocative
testing for food allergy. Ann Allergy 1973; 31 : 382-3.
Samter M, Sublingual desensitization for allergy not recommended.
JAMA 1972; 215: 1210.
Vega testing
Stewart, T. C. (1991). Vega testing in the diagnosis of allergic
conditions. Med J Aust 155(6): 423.
Katelaris, C. H., J. M. Weiner, et al. (1991). Vega testing in
the diagnosis of allergic conditions. The Australian College of
Allergy. Med J Aust 155(2): 113-4. (http://www.mja.com.au/public/guides/vega/vega.html),
Voll R. The phenomenon of medicine testing in electroacupuncture
according to Voll. Am J Acupuncture 1980;8:87.
George T Lewith, Julian N Kenyon, Jackie Broomfield, Philip Prescott,
Jonathan Goddard, and Stephen T Holgate. Is electrodermal testing
as effective as skin prick tests for diagnosing allergies? A double
blind, randomised block design study. BMJ 2001; 322: 131-134
Semizzi M, Senna G, Crivellaro M, Rapacioli G, Passalacqua G,
Canonica WG,
Bellavite P. A double-blind, placebo-controlled study on the diagnostic
accuracy of an
electrodermal test in allergic subjects. Clin Exp Allergy. 2002
Jun;32(6):928-32.
Food IgG antibodies
Barnes, R. M. (1995). IgG and IgA antibodies to dietary antigens
in food allergy and intolerance." Clin Exp Allergy 25 Suppl
1: 7-9.
Husby, S., F. Schultz Larsen, et al. (1989). IgG subclass antibodies
to dietary antigens in atopic dermatitis." Acta Derm Venereol
Suppl (Stockh) 144: 88-92.
Kruszewski, J., A. Raczka, et al. (1994). High serum levels of
allergen specific IgG-4 (asIgG-4) for common food allergens in
healthy blood donors. Arch Immunol Ther Exp (Warsz) 42(4): 259-61.
Johansson, S. G., A. Dannaeus, et al. (1984). The relevance of
anti-food antibodies for the diagnosis of food allergy. Ann Allergy
53(6 Pt 2): 665-72.
Dannaeus, A., S. G. Johansson, et al. (1977). Clinical and immunological
aspects of food allergy in childhood. I. Estimation of IgG, IgA
and IgE antibodies to food antigens in children with food allergy
and atopic dermatitis. Acta Paediatr Scand 66(1): 31-7.
Eysink, P. E., P. J. Bindels, et al. (2002). Do levels of immunoglobulin
G antibodies to foods predict the development of immunoglobulin
E antibodies to cat, dog and/or mite? Clin Exp Allergy 32(4):
556-62.
Merrett J, Burr ML, Merrett TG. A community survey of IgG4 Antibody
levels. Clin Allergy 1983; 13: 397-407.
Reflexology
Brygge T, Heinig JH, Collins P, Ronborg S, Gehrchen PM, Hilden
J, Heegaard S, Poulsen LK. Reflexology and bronchial asthma. Respir
Med. 2001 Mar;95(3):173-9.
Petersen LN, Faurschou P, Olsen OT, Svendsen UG. Foot zone therapy
and bronchial asthma--a controlled clinical trial. Ugeskr Laeger.
1992 Jul 20;154(30):2065-8.
Hondras, M. A., K. Linde, et al. (2001). Manual therapy for asthma."
Cochrane Database Syst Rev(1): CD001002.
Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG. A review of the
evidence for the effectiveness, safety, and cost of acupuncture,
massage therapy, and spinal manipulation for back pain. Ann Intern
Med. 2003 Jun 3;138(11):898-906.
Kober A, Scheck T, Schubert B, Strasser H, Gustorff B, Bertalanffy
P, Wang SM, Kain ZN, Hoerauf K. Auricular acupressure as a treatment
for anxiety in prehospital transport settings. Anesthesiology.
2003 Jun;98(6):1328-32.
Iridology
Simon A and others. An evaluation of iridology. JAMA 242:1385-1387,
1979.
Cockburn DM. A study of the validity of iris diagnosis. Australian
Journal of Optometry. 64:154-157, 1981.
Kinesiology
Garrow, J. S. (1988). Kinesiology and food allergy. Br Med
J (Clin Res Ed) 296(6636): 1573-4.
Bridon, F. (1999). Kinesitherapy and asthma: current trends. Rev
Mal Respir 16 Suppl 3: S138-9.
Garten, H. (2002). Pothmann R, et al: Evaluation of applied kinesiology
in nutritional intolerance of childhood. Forsch Komplementarmed
Klass Naturheilkd 2001; 8:336-344. Forsch Komplementarmed Klass
Naturheilkd 9(2): 115-6.
Ludtke, R., B. Kunz, et al. (2001). Test-retest-reliability and
validity of the Kinesiology muscle test. Complement Ther Med 9(3):
141-5.
Pothmann, R., S. von Frankenberg, et al. (2001). Evaluation of
applied kinesiology in nutritional intolerance of childhood. Forsch
Komplementarmed Klass Naturheilkd 8(6): 336-44.
Schmitt, W. H., Jr. and G. Leisman (1998). Correlation of applied
kinesiology muscle testing findings with serum immunoglobulin
levels for food allergies. Int J Neurosci 96(3-4): 237-44.
Sommella, M. and C. Serra (1969). EMG and electrodiagnostic investigations
in Garrow 15. Kinesiology and food allergy, Br Med 1 1988; 296:1573.
Pulse testing
Coca AF (1982): The Pulse Test. Easy Allergy Detection. Arco
Publishing Inc, New York.
Hair analysis
BARRETT S (1985) Commercial hair analysis: science or scam?
JAMA 254: 1041-1045.
FLETCHER OJ (1982) Hair analysis. Proven and problematical applications.
Postgrad Med 72:79-88.
RIVLlN RS (1983) Misuse of hair analysis for nutritional assessment.
Am J Med 75:489-493.
HAMBIDGE KM (1982) Hair analyses: worthless for vitamins, limited
for minerals. Am J Clin Nutr 36:943-949.
Seidal S et al. Assessment of commercial laboratories performing
hair mineral analysis. JAMA 2001; 285: 67-72.
DEEMING SB & WEBER CW (1978) Hair analysis of trace minerals
in human subjects as influenced by age, sex, and contraceptive
drugs. Am J Clin Nutr 31:1175-1180.
Radionics
Wilcox J. Alternative medicine: radionics. Nurs Times. 1976
Apr 15;72(15):568-70.
RADIONICS and the black box judgement for defendant. Br Med J.
1960 Jul 30;5195:398-9.
RADIONICS and the black box. Action for fraud against Mr. de la
Warr. Br Med J. 1960 Jul 9;5192:156-8.
Homeopathy
Ernst E. Rise in popularity of complementary and alternative
medicine: reasons and consequences for vaccination.Vaccine. 2001
Oct 15;20 Suppl 1:S90-3; discussion S89.
Lehrke P, Nuebling M, Hofmann F, Stoessel U. Attitudes of homoeopathic
physicians towards vaccination.Vaccine. 2001 Sep 14;19(32):4859-64.
Sulfaro F, Fasher B, Burgess MA. Homoeopathic vaccination. What
does it mean? Immunisation Interest Group of the Royal Alexandra
Hospital for Children.Med J Aust. 1994 Sep 5;161(5):305-7.
Livartowski A, Toulotte K, Reinert P. The practitioner and vaccination
(results of a sample survey. Pediatrie. 1987;42(6):483-7.
Thorax. 2003 Apr;58(4):317-21.
Contact Dermatitis. 2001 Sep;45(3):185. An unusual case of baboon
syndrome due to mercury present in a homeopathic medicine. Audicana
M, Bernedo N, Gonzalez I, Munoz D, Fernandez E, Gastaminza G.
Gac Med Mex. 1991 May-Jun;127 (3):267-70. Mercury poisoning caused
by a homeopathic drug. Montoya-Cabrera MA, Rubio-Rodriguez S,
Velazquez-Gonzalez E, Avila Montoya S.
Individualised homeopathy as an adjunct in the treatment of childhood
asthma: a
randomised placebo controlled trial. White A, Slade P, Hunt C,
Hart A, Ernst E. Allergy. 2002 Aug;57(8):694-700.
Allergy. 2002 Aug;57(8):655-8. Alternative medicine in allergies
- prevalence, patterns of use, and costs. Schafer T, Riehle A,
Wichmann HE, Ring J.
BMJ. 2002 Mar 2;324(7336):520. Use of ultramolecular potencies
of allergen to treat asthmatic people allergic
to house dust mite: double blind randomised controlled clinical
trial. Lewith GT, Watkins AD, Hyland ME, Shaw S, Broomfield JA,
Dolan G, Holgate ST.
Health Technol Assess. 2000;4(37):1-191. Systematic review of
treatments for atopic eczema. Hoare C, Li Wan Po A, Williams H.
Br Homeopath J. 2000 Oct;89(4):169-73. No beneficial effect of
isopathic prophylactic treatment for birch pollen
allergy during a low-pollen season: a double-blind, placebo-controlled
clinical trial of homeopathic Betula 30c. Aabel S.
BMJ. 2000 Aug 19-26;321(7259):471-6. Erratum in: BMJ 2000 Sep
23;321(7263):733. Randomised controlled trial of homoeopathy versus
placebo in perennial allergic rhinitis with overview of four trial
series.
Cochrane Database Syst Rev. 2000;(2):CD000353. Homeopathy for
chronic asthma. Linde K, Jobst KA.
Lancet. 1994 Dec 10;344(8937):1601-6. Is evidence for homoeopathy
reproducible? Reilly D, Taylor MA, Beattie NG, Campbell JH, McSharry
C, Aitchison TC, Carter
R, Stevenson RD.
Lancet. 1986 Oct 18;2(8512):881-6. Is homoeopathy a placebo response?
Controlled trial of homoeopathic potency,
with pollen in hayfever as model. Reilly DT, Taylor MA, McSharry
C, Aitchison T.
Thorax. 2003 Apr;58(4):317-21. Individualised homeopathy as an
adjunct in the treatment of childhood asthma: a placebo controlled
trial. White A, Slade P, Hunt C, Hart A, Ernst E.
Clinical Ecology/ Environmental Illness / Multiple Chemical
Sensitivity / Idiopathic environmental intolerance
Terr AI. Environmental sensitivity. Immunol Allergy Clin North
Am. 2003 May;23 (2):311-28.
Guglielmi RS, Cox DJ, Spyker DA. Behavioral treatment of phobic
avoidance in multiple chemical sensitivity. J Behav Ther Exp Psychiatry.
1994 Sep;25(3):197-209.
Staudenmayer H, Selner JC, Buhr MP. Double-blind provocation chamber
challenges in 20 patients presenting with "multiple chemical
sensitivity". Regul Toxicol Pharmacol. 1993 Aug;18(1):44-53.
Clinical ecology. Executive Committee of the American Academy
of Allergy and Immunology. J Allergy Clin Immunol. 1986 Aug;78(2):269-71.
Terr AI. Environmental illness. A clinical review of 50 cases.
Arch Intern Med. 1986 Jan;146(1):145-9.
Caress SM, Steinemann AC, Waddick C. Symptomatology and etiology
of multiple chemical sensitivities in the
southeastern United States. Arch Environ Health. 2002 Sep-Oct;57(5):429-36.
Bornschein S, Hausteiner C, Zilker T, Forstl H. Psychiatric and
somatic disorders and multiple chemical sensitivity (MCS) in 264'environmental
patients'. Psychol Med. 2002 Nov;32(8):1387-94.
Caccappolo-van Vliet E, Kelly-McNeil K, Natelson B, Kipen H, Fiedler
N. Anxiety sensitivity and depression in multiple chemical sensitivities
and
asthma. J Occup Environ Med. 2002 Oct;44(10):890-901.
Tarlo SM, Poonai N, Binkley K, Antony MM, Swinson RP. Responses
to panic induction procedures in subjects with multiple chemical
sensitivity/idiopathic environmental intolerance: understanding
the relationship
with panic disorder. Environ Health Perspect. 2002 Aug;110 Suppl
4:669-71.
Levallois P, Neutra R, Lee G, Hristova L. Study of self-reported
hypersensitivity to electromagnetic fields in California. Environ
Health Perspect. 2002 Aug;110 Suppl 4:619-23.
Black DW, Okiishi C, Schlosser S. The Iowa follow-up of chemically
sensitive persons. Ann N Y Acad Sci. 2001 Mar;933:48-56.
Otto T, Giardino ND. Pavlovian conditioning of emotional responses
to olfactory and contextual stimuli: a potential model for the
development and expression of chemical intolerance. Ann N Y Acad
Sci. 2001 Mar;933:291-309.
Bornschein S, Forstl H, Zilker T. Generalization of acquired somatic
symptoms in response to odors: a pavlovian
perspective on multiple chemical sensitivity. Psychosom Med. 2000
Nov-Dec;62(6):751-9.
Devriese S, Winters W, Stegen K, Van Diest I, Veulemans H, Nemery
B, Eelen P, Van de Woestijne K, Van den Bergh O. Psychological
treatment of psychogenic idiopathic environmental intolerance.
Occup Med. 2000 Jul-Sep;15(3):627-46.
Staudenmayer H. A nine-year follow-up of people diagnosed with
multiple chemical sensitivities. Psychosomatics. 2000 May-Jun;41(3):253-61.
Other references
Teuber, S. S. and C. Porch-Curren (2003). Unproved diagnostic
and therapeutic approaches to food allergy and intolerance. Curr
Opin Allergy Clin Immunol 3(3): 217-21.
Golbert TM. A review of controversial diagnostic and therapeutic
techniques employed in allergy. J Allergy Clin Immunol 1975;56:
170--190.
Lowell FE. Some untested diagnostic and therapeutic procedures
in clinical allergy. J Allergy Clin Immunol 1975;56:168-169.
American Academy of Allergy. Position statements-controversial
techniques. J Allergy Clin Immunol 1981;67: 333-338.
ROBERTSON DAF, AYRES RCS, SMITH CL & WRIGHT R (1988) Adverse
consequences arising from misdiagnosis of food allergy. Br
Med J 297:719-720.
TARNOW-MoRDI WO, Moss C & Ross K (1984) Failure to thrive
owing to inappropriate diet free of gluten and cows' milk. Br
Med J 289: 1113-1114.
ROBERTS I,F, WEST RJ, OGILVIE D & DILLON MJ (1979) Malnutrition
in infants receiving cult diets: a form of child abuse. Br
Med J 1:296-298.
Ali NS, Azam SI, Noor R. Women's beliefs regarding food restrictions
during common childhood illnesses:a hospital based study.J Ayub
Med Coll Abbottabad. 2003 Jan-Mar;15(1):26-8.
Gow PJ, Connelly NJ, Hill RL, Crowley P, Angus PW. Fatal fulminant
hepatic failure induced by a natural therapy containing kava.
Med J Aust. 2003 May 5;178(9):442-3.
Ernst E. Serious adverse effects of unconventional therapies for
children and
adolescents: a systematic review of recent evidence. Eur J Pediatr.
2003 Feb;162(2):72-80. Epub 2002 Dec 04. Review.
Steenkamp V, Stewart MJ, Zuckerman M. Death due to use of traditional
medicines in Africa: a preventable cause of neonatal and infant
mortality. J Pediatr Gastroenterol Nutr. 2003 Feb;36(2):294-5.
Massachusetts. Supreme Judicial Court, Suffolk. Commonwealth v.
Twitchell.
North East Rep Second Ser. 1993 Aug 11 (date of decision);617:609-21.
Minnesota. Supreme Court. State v. McKown. Wests North West Rep.
1991 Sep 20 (date of decision);475:63-71.
Tagwireyi D, Ball DE, Nhachi CF. Poisoning in Zimbabwe: a survey
of eight major referral hospitals. J Appl Toxicol. 2002 Mar-Apr;22(2):99-105.
MacPherson H, Thomas K, Walters S, Fitter M. A prospective survey
of adverse events and treatment reactions following 34,000 consultations
with professional acupuncturists. Acupunct Med. 2001 Dec;19(2):93-102.
Knepper K. Withholding medical treatment from infants: when is
it child neglect?
J Fam Law. 1994-1995 Winter;33(1):1-53.
Van Metre TE (1983) Critique of controversial and unproven procedures
for diagnosis and therapy of allergic disorders. Pediat Clin
N Am 30:807-817.
Christie L, Hine RJ, Parker JG, Burks W. Food allergies in children
affect nutrition intake and growth. J Am Diet Assoc 2002; 102:
1648-51.
Henriksen C, Eggesbo M, halvorsen R, Botten G. Nutrient intake
among two-year old children on cows' milk-restricted diets. Acta
Paediatr 2000; 89: 272-8.
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