New Hope for a New Year: Dr. Nadeau & Promising Research for Multiple Food Allergies

"I've had no allergic reactions yet this year, right mom?" asks my 8-year-old with a smile.

Yeah, I guess you could look at it that way.  Although it was just December when we ended up in the ER due to anaphylaxis.

I'm glad I have my son to look on the brighter side of things for me.  Like I've said in the past, he is incredibly resilient.  Although each new year brings with it new challenges that make managing Tristan's allergies even more difficult, the thought of what a happy and strong child I have encourages me to keep him healthy, and not let his allergies prevent him from doing whatever he wants to do.  Our upcoming challenge: a two night sleepover in Marin with his classmates.  It will be the first of many overnight trips he takes with his school.  I am terrified and elated for him, but mostly terrified.

My hope is that my boys & others like them will at some point never have to worry about a food making them sick. 

Honestly I really don't think of myself as a half-empty kind of gal, but when it comes to thinking about my children's food allergies, I don't usually let myself think about a life where their allergies get better--a life where parents don't take offense at the thought of packing something other than peanut butter sandwiches for their kids' lunches, where allergy bullying doesn't exist, or where I don't ever have to worry about my child getting sick or worse from eating the wrong thing.  I have to, for my own fear of disappointment, remain conservative at all times.  I have to answer questions like, "Do you think he'll ever grow out of them?" with a conservative "No, I don't think so."  I have to plan ahead for future budgets to include several thousands of dollars in Epi-Pens, medical treatments, and other allergy medicines.  I have to toughen the kids up for future disappointments, visits to the doctor, and a lifetime of always feeling a bit left out of things.

But with the new year, and successful treatment of Tristan's latest allergic reaction, I must admit it does feel like a nice clean slate.  And with some exciting activity in the allergy world, I am cautiously optimistic about the year ahead.

Facebook, via some allergy wise friends, brought my attention to a few wonderful developments that piqued my interest: positive feedback from participants in Stanford's peanut patch studies, a well-organized and insightful look at the "Social Consequences of Food Allergy," and a recent settlement for Lesley University students in Cambridge, MA, drawing attention to the need for allergen-free food options in college dining halls.

Most notably, I had the chance to attend Dr. Kari Nadeau's recent talk in San Francisco, "Finding a Cure for Food Allergies."  There, I was first touched by a personal testimonial from a family who is successfully desensitizing their two young sons to multiple nut allergies, under the guidance of Dr. Nadeau at Stanford University.

Dr. Nadeau fully impressed me with her current and vast knowledge about food allergy research.  What shallow understanding I took away from her talk would possibly cause my university biology professors to hang their heads in shame.  It seemed that doing a bit of background research could've helped me here.  Nevertheless, I found her research insightful, creative, and promising.

Nadeau spoke about phase one of her trial to desensitize food allergic children and adults via microscopic amounts, and change the way the immune system processes allergens.  The ongoing debate between desensitizing by introducing minute amounts of allergen versus strict avoidance is hard to ignore.  The old theory was that by avoiding allergens, the allergic cells would die over time because they wouldn't be stimulated.  That seems to me a pretty simplistic explanation that may only apply to the select group who actually eventually "grow out" of their allergies; as we know, not everyone does.

Nadeau seems to be proving the newer theory of desensitization right.  The key to her success is to introduce the allergens beginning with miniscule amounts (100 micrograms, where 1 microgram = 1/1,000,000 of a gram), and to administer subsequent exposures slowly and methodically.  She warned that trying to slowly introduce an allergen to a food allergic person at home can not only be dangerous, it can actually increase a person's sensitivities to that food.

In the past, desensitizing someone for, let's say a peanut allergy took roughly two years.  For someone like Tristan with multiple allergies including peanuts, dairy, egg, and tree nuts (we avoid all tree nuts), we could expect a desensitizing process for him would take at least 20 years.  But with Dr. Nadeau's new experimental methods, children and adults with multiple food allergies are currently in food therapy with simultaneous multiple foods, making a cure for multiple food allergies much more attainable and for someone like Tristan, much more real.

In Nadeau's eyes, the big question is how sustainable is the desensitization?  The key to sustaining desensitization is maintenance doses--once desensitized, getting to 4 g per day of each food for a certain amount of time.  She referenced a milk allergy study in Italy where patients who had milk daily were still desensitized over 20 years (not sure about this exact stat), and patients who had just had milk haphazardly had only a 50% success rate.  The goal is to understand how much and how long a patient would need to have the food to stay desensitized.  For a first hand look at life with maintenance doses, check out the Shkedim* blog.

In general, Dr. Nadeau says, the best preventative medicine for allergies is a healthy diet, including non-processed and organic foods.  She also believes in the importance of probiotics and maintaining a healthy level of vitamin D to decrease the likelihood of allergies.  If you're from San Francisco, aka "Fog City," your doctor may have recommended supplementing your baby's diet of breastmilk with vitamin D within the first year of life.  This seemed to be a newer recommendation, as I only got it with Addison (no food allergies) and not with the boys (multiple food allergies).  Recent research also indicates that smoking exposure is also associated with allergies and asthma.

Admittedly, hearing from Dr. Nadeau about phase 1 of her research has got even me filled with hope about an allergy-free future, sometime in Tristan's lifetime.  Dr. Nadeau is now in fundraising stages for phase 2 of her study.  To get more information about Kari Nadeau and the Stanford Alliance for Food Allergy Research, visit their website.