In the absence of a reliable test, the diagnosis of candidiasis has to be based solely on the symptoms reported. This is a rather unsatisfactory situation, but fortunately the treatment for Candida infestation (described below) is fairly innocuous, so it does not matter too much if it is sometimes given unnecessarily.

For many people, it may be difficult to distinguish candidiasis from food intolerance at the outset, because the two have a great deal in common, at least in the symptoms they cause. Previous Candida infections, such as recurrent vaginal thrush, are a strong clue, but they are not infallible. Some women patients who are plagued by thrush turn out not to have candidiasis, despite many likely symptoms. Others with no history of thrush, and no abdominal bloating or wind, turn out to have candidiasis. The only sensible course of action is to decide which is the more likely and try the treatment for that problem first. In general, someone with food intolerance will respond to an elimination diet within a week, whereas someone with candidiasis may take much longer to respond to an anti-Candida diet – the response is also more gradual and less dramatic. So if there is any doubt, it is probably best to start with the elimination diet procedure. The first stage of this involves cutting out sugar anyway, so the simplest type of Candida problem will be sorted out during that stage. If there is no reponse to either Stage 1 or Stage 2, then go on to the anti-Candida diet. If this has no effect, then it may be worth trying Stage 3 of the elimination diet.

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What makes good old milk so troublesome? Allergic people react to one or more of three milk components: protein, fats and carbohydrates.

‘Certain milk proteins are absorbed unchanged in allergic people,’ explains Del Stigler, a pediatrician and allergist in Denver, Colorado. ‘Beta-lactoglobulin, for instance, is a relatively large protein molecule which the normal intestine will strain out. But the intestine of an allergic person is abnormal, and larger molecules like lactoglobulins penetrate into the bloodstream unchanged, triggering reactions.’ Casein is another troublesome milk protein. But heating milk, says Dr Stigler, breaks down both.

‘Some people who are allergic to milk can tolerate milk that’s been heated. For instance, we don’t see as much allergy to formula or evaporated milk, which have been processed at a high temperature of 260 to 280 degrees. That breaks down the protein. People who are allergic to raw milk,’ Dr Stigler adds, ‘can often tolerate well-cooked milk.’ On the other hand, Dr Stigler told us that some people can drink raw milk, but not the heated, homogenized-pasteurized type.

He also says that whole milk (and butter and cheese) is sometimes better tolerated than skim or low-fat. Fat, it seems, slows the time that the stomach takes to empty food into the intestines, allowing more time for milk to be absorbed and fewer problems to develop.

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1. List all ingredients of mixed dishes and combination foods. If you eat a ham sandwich, for instance, note the kind of bread and dressing.

2. Don’t rely on your memory. Fill in the information just before or after you eat. Carry the diary with you in your handbag, pocket or attach? case to record meals eaten away from home. Or jot down some notes and add them later.

3. Rate your symptoms on a scale of one to four to distinguish between mild and severe reactions. For example, a mildly unpleasant or slightly noticeable symptom would get a one; an extremely unpleasant or very marked reaction would rate a four.

4. Weigh yourself every morning after going to the bathroom. A sudden weight gain plus increased thirst, decreased urine output, tighter shoes or tight rings are all signs of oedema, or fluid retention – a common food reaction.

5. Note any foods you crave.

Symptoms to look for

James Ñ Breneman, chairman of the Food Allergy Committee of the American College of Allergists, has noticed that food allergy symptoms often fall into certain patterns:

- Hives, runny nose, asthma, heartburn, sleepiness or drowsiness can occur within one

hour;

– abdominal cramps, gas pains or headaches may occur within two to four hours;

– delayed hives may appear six to twelve hours later;

– a weight gain or water retention can occur within twelve to fifteen hours;

- confusion, forgetfulness, depression, inability to concentrate or other mental symptoms

may appear within twelve to twenty-four hours; and

– canker (cold) sores, aching joints, muscles or back can occur after three to five days.

Other symptoms to note include rashes, itching or burning skin, cramps, nausea, diarrhoea, constipation or bloating; weeping or itchy eyes, visual problems, sneezing, sinusitis; ringing in the ears or earaches; sore throat, hoarseness or cough; inexplicable fatigue; nervousness, tension or anxiety; a floating feeling; insomnia, dark, puffy circles under the eyes – or any of the signs of allergy described in Chapter 2, Are you allergic?

It goes without saying that there can be other medical reasons for all of those complaints. But if you’ve already seen a doctor, and he or she cannot explain why you are ill, food allergy should be considered. As a matter of fact, people with food allergy often have a long history of undiagnosed health problems – backed up by a slew of X-rays and gastrointestinal tests that don’t explain their problems.

Note: Chronic infection in infants and young children can mimic gastrointestinal problems associated with milk and wheat allergies. In the case of a child who is vomiting or choking, or who has diarrhoea or difficulty in swallowing, consult a doctor without delay.

After you’ve kept a diary for a week or two, you can use it to help recognize problem foods. Doris J. Rapp, a pediatrician and allergist in Buffalo, New York, suggests that you make a list of all foods eaten on a day you felt well. Compare that list to a list of foods eaten on a day you felt terrible. Cross out all foods which appear on both lists. The foods left on the second list are your prime suspects. Then you eliminate them.

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Think about it. It’s not just corn on the cob that you may be allergic to – it’s corn syrup, corn starch, corn oil. It’s not just those poached eggs – it’s the eggs that are used in almost every baked good on the market. We don’t want to kid you: pinpointing a food allergy and keeping the offender out of your diet can be tough. But it can be done – thousands of formerly ill people attest to that. Yes, it will take some patience. And some Dick Tracy-type detective work. And a bit of re-education about how food works in your system. But it’s worth it in the long run – and there’s an added bonus.

If you have a food allergy, it’s likely you also have a problem with at least one type of airborne substance – be it dust, mould, animal dander or chemicals. Well, managing food allergy goes a long way towards increasing your tolerance of airborne allergens. So overcoming food allergy can make a big difference in how well you feel and how much you enjoy life. Ready to get well? Then read on, and remember we’re right there with you.

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The two symptoms Dr Saifer was talking about are found mainly in people who have a food allergy. But they aren’t the only two signs of food allergy. If you answer yes to any of the following questions, your problems may be food related:

Did you have colic as an infant?

Do you have frequent attacks of indigestion, nausea, vomiting, diarrhoea or gas?

Are there foods that you can eat freely in one season (winter, for example), yet they bother you during other times of the year?

Do you feel tired after you eat?

Do you feel better if you skip a meal?

Do you have to loosen your belt after meals?

Are there any specific foods that you particularly dislike?

Are there any foods that you crave or eat frequently?

Another sign often associated with (but not limited to) food allergy is a patchy tongue. Little round or oval smooth patches appear on the back, edges and tips of the tongue. They tend to come and go.

. . . Or is it something in the air?

Chemical allergy is another problem that can sneak up on you. Billions of pounds of chemicals are produced each year, to say nothing of the fumes given off by cars, industry and even home appliances. Ultimately, chemicals and fumes end up in our bodies. And invariably, some people can’t tolerate them. Maybe you, too, are chemically sensitive – but don’t know it.

‘You may have a gas stove, yet never suspect you’re allergic to gas when you’re home every day,’ says Dr Theron Randolph, a well-known allergist in Chicago, Illinois. ‘Yet when you take a vacation — say, up to the mountains where the air is good -you may come home only to become sick within minutes after walking through the door. But when you were living with the same stove every day, you never suspected it.’

Petroleum-derived chemicals, by virtue of their infinitesimal size, find their way into the most sensitive parts of the body -like the brain. In fact, since petrochemicals are fat-soluble and have a special affinity for the nervous system, they tend to affect sight, hearing, personality, memory and reasoning.

The following questions will help you evaluate whether or not you’re sensitive to chemicals.

Are you more aware of smells and odours than other people seem to be?

Do the odours of perfumes, marking pens, correction fluid, freshly printed newspaper, car exhaust, fresh paint or new car interiors make you ill?

Do you (or your child) do well in school one day and poorly the next?

Is your behaviour unpredictable, turning from Dr Jekyll to Mr Hyde (and back again) at the drop of a hat?

Are you cranky, listless, impatient and ill-tempered more often than not?

Did any health problems begin shortly after exposure to a chemical – after refinishing furniture, cleaning a carpet, mopping up spilled petrol or doing pool maintenance?

‘There are an awful lot of folks who could be helped if it occurred to them that they may have an allergy,’ said Dr Saifer. She added that once they realize they have an allergy, their aim should be to reduce their overall exposure to allergens by using ‘avoidance tactics’ – specific methods to keep the allergens with which they come in contact to a minimum.

Reducing exposure not only eases existing allergies, but may also prevent allergy from surfacing in the first place.

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The first thing that a person can do,’ Dr Tichenor told us, ‘is pay very close attention to his or her body for a period of time – a week or a month or whatever. Try to see if there’s any health problem that can be related to certain foods or anything else in [his or her] daily life.’

‘Start by learning to be your own detective,’ says Doris J. Rapp, a pediatrician and allergist in Buffalo, New York. ‘If you feel fine only when you’re away from home, and worse within several hours after you return, chances are that something in your house is causing the problem. On the other hand, if you feel fine at home but ill at work, at school or when travelling, that’s a sign that you’re sensitive to something outside the home. If allergic symptoms are unrelated to where you are and never disappear with change of location, you may have a food allergy. That is particularly true if you’ve had the allergy since infancy.’

Food allergy, in fact, is a number one suspect for most people with allergy problems, according to Albert Rowe, Jr, a California doctor who practised with his late father and has treated allergy patients for over thirty years. Dr Rowe feels strongly that food allergy is far more prevalent than allergies to chemicals and inhalants.

‘One way to approach an unknown food allergy is to eliminate a suspected food for a period of several days and then reintroduce it in large amounts for a day and see what happens,’ Dr Tichenor told us. Chances are if you have a severe, immediate reaction to eggs or seafood, you don’t need to test your sensitivity. Those with allergies outside the home usually experience a worsening of symptoms during the warm months of the year, indicating a sensitivity to pollen or mould,’ says Dr Rapp. ‘Also, if you smell chemicals before others and either detest or crave the odour, it may indicate a chemical sensitivity.’

That kind of detective work – an investigation of your water, your home, your workplace, your prescription drugs, your clothing – is what this book is all about.

‘Allergies sometimes can be relieved entirely or in part within one to two weeks by making changes in a person’s home or by altering what’s eaten,’ wrote Dr Rapp in her book, Allergies and Your Family.

Highly sensitive people or those who are allergic to many, many things will probably have to make more and larger adjustments than less sensitive people. No doubt some people will realize that their allergies are complex enough that they need to see a doctor to help them with their avoidance programme. If you want to make an appointment with a clinical ecologist, write to the Society for Clinical Ecology for the addresses of doctors in your area who can try to help you.

A couple of final points. If you are currently being treated for asthma or other allergic problems, it’s important that you continue taking your present medication or injections unless otherwise advised by your doctor. And if you have medical problems unrelated to allergy, they should be treated. In the event that you go to an eye doctor, a gynaecologist, a primary care doctor or any medical professional for other matters, he or she will have to know about your allergies and how they’re being handled. It’s a good idea to take along a list of what you’re allergic to. If your second doctor doesn’t believe in your sensitivities, or dismisses them as unimportant, don’t hesitate to ask your allergy doctor to refer you to someone who is more receptive. There’s no sense in going to a doctor who’s going to disregard factors that you know are harmful to you.

One last word of encouragement. Allergies are a special challenge. But as you’ll discover as we go along, they can be licked. No one promises that it will be easy. But chances are it will be worth it.

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