Your Complete Guide to Autoimmunity and Allergy Testing

This article originally appeared on Healevate.

Why do you get hay fever every spring, while others are totally unaffected? Why can one person cuddle up with their dog, while you break out in hives from merely petting the furry little guy? Allergies and autoimmunity are complicated conditions that exist on a spectrum, and have a few things in common.

  1. The underlying cause of both is inflammation.
  2. Having the right genetics predisposes you to developing them.
  3. The epigenetic factors responsible for manifesting the symptoms are probably more important than the genes themselves, since the environmental influences on the genes are what cause them to be turned on or off.

Epigenetics are all of the environmental factors that control your genes, so if you’re stressed out, not sleeping, eating an inflammatory diet, not exercising, and are surrounded by toxins in your home and on your body, there’s a good chance you’ll have some kind of inflammatory symptoms. These could be itchy, watery eyes from allergies or fatigue, brain fog, and constipation from an autoimmune condition.

These factors cause your immune system to kick up and start overreacting to normal stimuli, which ultimately produces systemic inflammation. Identifying the symptoms can help you get to the bottom of what’s causing your autoimmunity or allergies.

Symptoms of Autoimmunity and Allergies

Autoimmune and allergy symptoms are all on the inflammatory spectrum, so they can literally affect your entire body and cause many symptoms simultaneously.

Immune/inflammation: Asthma, wheezing, coughing, runny nose, post nasal drip, itchy or watery eyes, sneezing, unresolved infections, autoimmunity, swelling, anaphylaxis, and throat closing.

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity, hair loss, nail pitting, dry eyes, skin, and mouth.

Gastrointestinal: Stomach pain, acid reflux, IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), cankers, and food sensitivity.

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, and insomnia.

Nerves: Tingling, pins and needles, numbness, and paresthesia.

Hormones: High or low blood sugar, weight gain or loss, excessive sweating, imbalance in thyroid, adrenal, and sex hormones.

Musculoskeletal: Joint and muscle pain, muscle weakness, and fibromyalgia.

Liver: Elevated liver enzymes, poor detoxification, and chemical sensitivity.

Cardiovascular: High or low blood pressure, rapid heart rate, and palpitations.

Which Test Should You Choose for Autoimmunity or Allergies?

Lab testing for allergies and autoimmunity can be exhausting, since the symptoms are vast and systemic.

Allergies are more easily tested, as you can do IgE antibody testing or skin prick testing to identify environmental allergens.

If your symptoms are outside the realm of typical allergies, then further investigation is warranted. Start with general testing to confirm that you have an inflammatory or autoimmune-based condition.

The serum labs for nonspecific markers of inflammation will let you know if you have an inflammatory or autoimmune process going on inside your body. If your symptoms coincide with a specific illness—for example, stomach pain, brain fog, and depression would possibly correlate to celiac disease—then specific testing should be initiated as well.

An important feature of reversing inflammatory, allergic, and autoimmune processes is finding the root causes. GI infections, food sensitivities/intolerances, toxicity, and hormone imbalances are all causes that could be contributing to your condition, and should be identified.

Autoimmunity and Allergy Testing

Allergy tests:

  • IgE antibody testing
  • Skin prick (scratch) testing

General inflammation and Autoimmunity tests:

  • CRP (C-reactive protein)
  • ESR (erythrocyte sedimentation rate)
  • ANA (anti-nuclear antibody)
  • APA (anti-phospholipid antibodies)
  • RF (rheumatoid factor)
  • Lactoferrin
  • Calprotectin

Testing for specific conditions is the next logical step if general testing suggests an autoimmune or inflammatory process, or if your symptoms correlate to a specific condition. For example, TPO (thyroperoxidase antibody) and TGA (thyroglobulin antibody) should be tested for autoimmune hypothyroidism (Hashimoto’s).

Allergy Tests

Environmental allergies to pollen, trees, weeds, dust, mold, and animals are fairly common, affecting over 40 million Americans annually.

Allergies are a hypersensitivity reaction to a substance that normally doesn’t cause a problem in most people. Once the substance is encountered and your immune system identifies it as foreign, it creates specific antibodies against the substance’s antigens (proteins).

IgE antibodies are one of several types of antibodies. They’re created when your body has a true allergic response to a substance and is considered a fixed allergy in that it will almost always provoke an immune response when the allergen is encountered. This type of testing analyzes your blood for the presence of IgE antibodies.

The skin prick or scratch test is often used as a quick screen, as it can be completed during an office visit. This test is administered on your back or arm, and anywhere between 20 to 40 substances can be tested, from dust, dander, and pollen to mold and foods.

A drop of the allergen is placed on your skin, and then a lancet is used to prick the skin, allowing the allergen to penetrate. Fifteen minutes later the results will be interpreted. A positive reaction will form a raised red bump that may itch (called a wheal). This type of test is usually performed in your doctor’s office.

General Inflammation and Autoimmunity Tests

CRP (C-reactive protein) is a protein made largely in the liver, immune, and fat cells in response to various inflammatory processes, such as tissue damage, infection, and disease states.

It’s released into the blood within a few hours of the inflammatory event; thus, it’s called an acute phase reactant. It’s a general marker of inflammation and isn’t specific to any particular condition. It can be used to track inflammatory and autoimmune conditions, as well as monitor flares. It’s often ordered with an ESR.

ESR (erythrocyte sedimentation rate) describes the inflammatory process in which red blood cells (erythrocytes) clump or aggregate together, causing sedimentation. The ESR measures the rate at which the erythrocytes settle in one hour in a vertical tube. It’s useful for assessing tissue destruction and levels of inflammation. Similar to CRP, the ESR is also a non-specific marker.

ANA (anti-nuclear antibody) is measured to assess levels of antibodies produced against the nucleus of a cell. It can be useful for identifying autoimmune conditions that affect multiple tissues throughout the body, such as lupus (SLE). ANA is a general indicator and isn’t specific to one particular condition.

APA (anti-phospholipid antibodies) reflect antibody production against phospholipids, which are required for blood clotting. APA is useful in blood clotting disorders, some of which are autoimmune, and for diagnosing lupus.

RF (rheumatoid factor) is an antibody that’s detectable in up to 80% of rheumatoid arthritis (RA) cases, but it can also be present in other autoimmune conditions such as lupus, scleroderma, and Sjogren’s. It can be helpful in distinguishing RA from other arthritic disorders.

Lactoferrin is a protein produced to combat inflammation. Lactoferrin can be measured in a stool sample and reflects inflammatory processes. It’s useful in diagnosing ulcerative colitis (UC) and Crohn’s versus non-inflammatory IBS. Since it isn’t specific, other causes of inflammation must be investigated such as dysbiosis, GI infection, and food intolerance.

Calprotectin is another protein measured in the stool that’s produced by a white blood cell called a neutrophil. Since neutrophils aggregate at the site of inflammation, calprotectin is more useful for diagnosing UC and Crohn’s against non-inflammatory IBS, as well as monitoring their progression. Other sources of inflammation should still be ruled out with other tests.

Testing for Specific Conditions

These are some of the common antibody (Ab) and gene tests associated with specific conditions. They may be helpful in diagnosis, along with other advanced tests and procedures such as biopsy or imaging.

Hashimoto’s: Thyroperoxidase Ab (TPO) and Thyroglobulin Ab (TGA)

Graves’: TPO, Thyroid Stimulating Hormone Receptor Ab (TSHR Ab), Thyroid Stimulating Immunoglobulin (TSI)

Diabetes (Type 1): Islet Cell Ab (ICA), Insulin Autoantibody (IAA), Glutamic Acid Decarboxylase Ab (GADA)

Autoimmune Hepatitis: Smooth Muscle Ab (SMA), Liver Kidney Microsomal Type 1 (Anti-LKM-1)

Ulcerative Colitis: Perinuclear Anti-Neutrophil Cytoplasmic Ab (pANCA)

Crohn’s: Anti-Saccharomyces Cerevisiae Ab (ASCA), Anti-CBir1, Anti-Omp C

Rheumatoid Arthritis: RF, Myeloperoxidase Ab (MPO), Cyclic Citrullinated Peptide Ab (CCP)

Lupus (SLE): MPO, APA, Anti Double Strand DNA (Anti dsDNA)

Myasthenia Gravis: Acetylcholine Receptor Ab (AChR)

Ankylosing Spondylitis, Juvenile Rheumatoid Arthritis (JRA), Reactive Arthritis (such as Reiter’s Syndrome): HLA-B27 gene test

Celiac: HLA-DQ2 and HLA-DQ8 gene tests, Anti-Tissue Transglutaminase Ab (tTG), Deamidated Gliadin Peptide (DGP), Endomysial Ab (EMA)

There are also specialty lab tests for celiac that involve testing IgG and IgA antibodies against gliadin, glutenins, gluteomorphins (made during the digestion of gliadin), and tissue transglutaminase. Cyrex Laboratories offers this panel, which is called the Array 3: Wheat/Gluten Proteome Reactivity & Autoimmunity.

Cyrex also offers the Array 5: Multiple Autoimmune Reactivity screen that measures IgG and IgA antibodies against 24 tissues and organs in the body. It includes many of the specific antibody tests, including ASCA, ANCA, TPO, TGA, GAD 65, and APA (discussed previously).

This test is very useful because it screens most of your body at once for AI, and when you have one known autoimmune condition, there’s an increased risk for autoimmune activity against other tissues. The tests in this panel can also be obtained in smaller panels according to condition or tissue type, including diabetes, neurological, and joint autoimmune reactivity screens.

Most of these tests can be obtained and completed by going through Direct Labs, which is a centralized location to buy and organize tests from labs such as LabCorp or Quest, as well as specialty lab companies who do mold and inhalant allergy testing.

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7 Interventions to Stop the Eczema Flare Before It Erupts

Get out of the Stress-Eczema Flare-Clear Skin-Repeat Cycle 

Is your life causing your eczema flares? Read on to find out if it is…

I believe it’s possible to teach old dogs new tricks. Yes, I’m referring to myself as an ‘old dog’ even though I’m not that old! However, it’s a fitting phrase to describe when I decided to retrain myself not to get stuck in the cycle of stress-eczema flare-clear skin-repeat.

My pattern was pretty obvious. I take good care of myself on every front except…drum roll…stress management. This is true for most of us, but this is a huge part of what I do to help heal people.

Yet, I wasn’t doing it for myself.

I was too focused on my job, side projects, and raising my son who was a baby at the time.

I dove into everything head first and never said no. I was all GO, GO, GO, 24/7.

Until my body would hit the wall from stress and I’d start get flare ups on my hands, wrists, forearms, stomach, and thighs. Tingling would turn into little red spots that itched so bad they’d spread out like an oil spill. Broken, inflamed skin would leave ugly patches.

I was especially embarrassed of my hands, wrists, and arms because people could see them. The palms of my hands and wrists were the worst unfortunately and people would sometimes look a little too long when I handed them payment, opened doors, or waved hello.

It’s amazing how many things our hands are involved in and how self conscious you can become once you’re aware that people are looking.

Gloves year round, anyone???

My usual approach was once I got sick of dealing with it, I’d really dial in my diet, take anti-inflammatory herbs, and engage in some stress reduction. That usually did the trick.

The itching would soon begin to subside, redness would retreat, and the bumps and patches would fade. After several weeks of being “good,” my skin would be clear again. AWESOME!!!

Then, I’d go back to my normal routine and inevitably have a flare up within a couple of months that was worse than the one before. It also started to get harder to treat.

Clearly I had a very short memory and I wasn’t learning from my past history!

Breaking the Cycle

After this cycle had been going on for over a year, I decided something need to change (there’s a longer version of this story that I’ll save for another day, but I’ll share the most important piece now).

The key change in retraining myself was managing my stressors. I needed to practice what I preached to my patients. Priority number one was establishing boundaries and stepping away from being a “yes” girl. I started to say “No” to many opportunities when I felt I had too much on my plate or felt I couldn’t give 100%. I also said “No” to social and family events if I was busy or starting to feel like I was being pulled in too many directions.

I also did a better job of decompressing and taking care of me, which meant giving myself breaks to exercise and have some quiet down time daily to do some deep breathing, journaling, or meditate (even if I had to sneak away to the “bathroom” to get it 😉). I also made consistent sleep a priority as much as I could with a nursing baby.

These are habits I’ve maintained to this day, except I don’t have to hide in the bathroom anymore for peace and quiet!

Stress management was the single biggest change I made to break the cycle, but I also developed strategies to tame a flare if I felt one coming on that I’m going to share with you.

7 Interventions to Stop Your Flare Before It Erupts

1. Clean your diet up. Most of us let our diet go when we’re under stress. Naturally, our bodies crave sugar and carbs to fuel our stress response (but we’re not running away from tigers and lions anymore). Sugar in general promotes inflammation, but so do gluten and dairy. I recommend eliminating these first if you haven’t already. Eating a diet focused on whole foods- meat, fish, eggs, veggies, fruits, and healthy fats will be supportive of calming inflammation.

If you’ve already pared down your diet, you might be sensitive to something else you’re eating. Start paying attention to how you flare responds to food. Do certain ones make you itch more? Do they give you other symptoms of inflammation like mucus production or joint pain? Is the response immediate or delayed?

Using a diary requires some effort, but it’s the best way to track the effects of diet and lifestyle. When I feel a flare come on, I open up an spreadsheet on my computer. I make columns for meals, immediate and delayed reactions, supplements, exercise, stress, sleep, and observations. I record everything that was notable and if nothing is notable I leave that spot blank. This way I can identify immediate issues, but also patterns that may otherwise be hard to see. This is actually how I figured out that I had a histamine issue.

2. Avoid Histamines. These nasty chemicals are produced in the inflammatory response and are part of the reason you itch. You can be consuming them in food or supplements like probiotics. There is a detailed list in my free triggers guide “Eczema: Seven Sneaky Sources Making Your Flare Worse.” Additionally, fish, seafood, cured and deli meats, aged cheeses, dried fruits, citrus fruits, pickles, and any fermented foods such as yogurt, kefir, kombucha, and sauerkraut. Basically, if it’s aged in any way- pickled, preserved, fermented, dried, salted or cured, it contains histamines. That makes left overs a no-go too.

Unfortunately, bone broth which is very healing, also contains high histamine levels, so watch out for any histamine related symptoms including itching, runny nose, mucus or phlegm, redness, etc.

Some strains of the probiotic group Lactobacillus (L. casei and L. bulgaricus) are known to produce histamine which may aggravate your eczema. From my clinical experience, I’ve also seen patients have a histamine reaction to other probiotics too, so pay attention to how your body responds to them. Remember- everyone is unique and we’ll all have different reactions to different substance.

3. Consume anti-inflammatory foods (or their supplement form). I’m a big fan of food as medicine. Some of the best anti-inflammatory foods are herbs and spices, specifically turmeric, ginger, and garlic. Together, these are pack a triple threat anti-inflammatory, antimicrobial, and gut and skin healing punch. They can be consumed easily in meals- especially any Asian or Indian recipes, added to smoothies, pre-made tea bags, or in this healing tea/infusion recipe.

The supplement forms can be used too. Sometimes you’ll find an anti-inflammatory combo with all or a few of these ingredients or they can be used separately. I prefer to use them for specific actions when using them as separate often highly concentrated supplements. In this capacity is use turmeric (curcumin) for inflammation, ginger for gut healing and calming, and garlic as an antimicrobial.

4.  Avoid extreme temperatures. Whether you’re indoors or outdoors, or doing things like bathing or exercising, really hot or cold temperatures can have a negative effect on eczema. In the past, I’ve had a histamine reaction during exercise that resulted in extremely red and itchy legs in both summer and late fall. It’s really hard to workout when you stop to scratch every 10 seconds (plus people stare at your tomato red legs)!

Similarly, hot showers will do the same to me. I know when I’m in a flare to keep showers lukewarm or even cold.

5. Take a timeout. Not the kind where you sit in the corner and think about what you did wrong, but to similarly be still and contemplate. A couple of times each day take 10 minutes to just sit in silence while deep breathing. This doesn’t have to be a full on meditation (although if you want to- go for it because it’s amazing for stress reduction). The point is to let your mind quiet down and focus your intention to calmness and healing.

We spend all of our time in a stressed out, fight or flight mode (a.k.a. sympathetic nervous system ), which promotes inflammation, rather than the rest, digest, and reproduce mode (a.k.a. parasympathetic nervous system), which promotes healing. Chilling out, naps, eating, and sex are way more appealing anyway!

6. Laugh and play. Similar to the previous point, taking time to laugh and play does wonders for inflammation and counteracting the effects of the sympathetic nervous system. If you’re in a flare you might need to take a “personal day” from work.

Send the kids to school (if you have them) and just chill out watching funny movies or meet a comedic friend for lunch. When the kids come home, do something fun like playing games or something you all enjoy together. If you don’t have kids, grab a spouse, partner, or friend do your favorite activity.

The goal is enjoy life and put a smile on your face. There are lots of positive chemical effects that occur in your body when you smile, laugh, or share intimate moments with those you’re close with.

Bonus tip– if you’re a stay at home mom with a baby or small kids it’s hard to take a personal day. Instead of calling in sick to your boss, call a friend or family member to watch the kids for a couple hours (or more if possible) so you can focus on some fun or alone time. No running errands or chores- this time is for you to enjoy yourself!!

7. Pamper your skin with healing moisture. Once you get out of your not-too-hot shower, be sure to apply moisturizer ASAP. I’m a fan of my healing salve recipe, however, there are many options, especially if you’re just into the beginning of a flare. Coconut oil, shea butter, or a combination of the two may just be enough to get your skin going in the right direction. If you start to develop lesions, bumps, or extreme redness, the salve might be a better choice.

There are also many choices available online now too. I’ve had many clients tell me about creams and lotions that have worked for them. The key here is to get a clean and green one- avoid synthetic chemicals, dyes, and scents. Many of the good natural formulas have a base of coconut oil, shea butter, beeswax, and/or tallow (usually from beef) combined with essential oils or healing herbs. Going with a blend like this will help avoid topical reactions on the skin.

What remedies have you tried that have helped calm your symptoms down? Let us know in the comments section. Thanks!

Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

The No Cause, No Cure Paradigm for Eczema is Wrong

I’ve always been a questioner. This is why I believe eczema can be healed and reversed (and new science backs this). When I was a little kid, I asked lots of questions because I wanted to know how and why things worked. Conversations I’d frequently have with my parents would go something like this:

Me: “Why does my tummy hurt?””

Parent: “Probably because you just swallowed your gum.”

Me: “Why would gum make my tummy hurt?”

Parent: “When you swallow your gum it can stick to your insides.”

Me: “Why would it stick to my insides?”

Parent (frustrated): “Oh, I don’t know, it just does!”

At this point I usually stopped the dialogue because I was clearly annoying my parents and I was frustrated that I didn’t get the answers I desired. Even as little kid I couldn’t understand why gum wouldn’t be digested like the rest of my food?? It also didn’t make sense to me that it would stick to my insides. There is always a reason why (even if not everyone know the answer).

Those same feelings of frustration and disbelief came to the surface for me when I was told I had Eczema. I was instantly transported back to my childhood when I heard the words “there is no known cause or cure.” It was so infuriating and disheartening.

No cause. No cure. Yet, you’re still miserable, with a very real rash that makes you crazy because you want to keep scratching it incessantly and your doctor hasn’t provided you with any help at all. This is exactly how I felt.

The majority of conventional medicine still clings to the old idea that eczema, also known as atopic dermatitis, is purely a topical rash that makes your skin red and itchy, causes lesions, and is related to allergies.

And if you’ve ever had an eczema breakout you know that this isn’t just something to brush off, or something you should have to live with-  it’s a problem that affects the way you look and feel too.

I’ve never accepted the no cause, no cure paradigm- there’s always a reason why something is happening. Your body just doesn’t start to malfunction- it’s way too smart for that. There are complex physiological processes that occur over time that culminate in conditions like eczema. We’ll get into the details of that later.

Those of us in the functional medicine community, as well as many researchers, are redefining what eczema actually is. In December 2014, this groundbreaking study published in The Journal of Allergy and Clinical Immunology confirmed what many of us suspected all along- that eczema is indeed an autoimmune condition. The study showed that by blocking 2 key proteins involved in the body’s ability to fight off bacteria and viruses, the eczema was reversed. In the process of eczema, these proteins mistakenly target the body’s own tissues, causing an autoimmune reaction which can result in the body attacking the skin. That sounds like a cause to me!

But before we get into the details of how eczema develops as as autoimmune (AI) condition, let’s review what eczema is and briefly discuss the types.

What is Eczema?

As an inquisitive and frustrated kid, I’d reach for the encyclopedia when I got one of those “it just is” answers from an adult. Encyclopedias helped, but were still limited in information on many topics.

Now we have an overabundance of information coming at us 24/7 thanks to the internet, but it’s hard to digest and make sense of it all. So, let’s break eczema down.

Eczema is more commonly referred to as Atopic Dermatitis (AD) clinically. That term is very telling since atopy or atopic is Greek for “being out of place” and dermatitis is “inflammation of the skin”. What’s interesting is that in my graduate training (which was conventional medical clinical pathology) we learned that atopy refers to an allergic reaction or hypersensitivity occurring in a part of the body NOT in contact with the allergen. Based on this definition you’d think that conventional medicine would’ve realized the cause of eczema isn’t occurring on the skin level, but that hasn’t been the case.

Eczema or Atopic Dermatitis (AD) is defined by the Mayo Clinic as “a condition that makes your skin red and itchy. AD is long lasting (chronic) and tends to flare periodically and then subside.” It’s the most common type of eczema and research suggests that a family history of atopic conditions such as eczema, allergies, asthma, and hay fever is a predisposing factor in developing it. The data compiled from my research analyzing over 7,000 patients shows that 1 in 5 people with a family history of eczema have eczema. 20% is significant.

Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

Typical symptoms include:

  • Itching, which may be mild to severe, especially at night
  • Raw, sensitive, swollen skin from scratching
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Weeping wounds
  • Thickened, cracked, dry, scaly skin
  • Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees

Eczema symptoms and appearance differs from person to person. A mild form might look like red, irritated, and slightly speckled skin, to more severe forms where the skin is significantly inflamed, with lesions that are bloody and weeping. Discolorations often occur during the outbreaks and as the skin heals.

7 Types of Eczema (Yes, …there’s actually more than one)

There are many different types of eczema according to various sources. You could go a little crazy researching them all on Dr. Google, so we’ll cover the most common ones here.

Most varieties of eczema are named for where they occur or because they look slightly different than your typical atopic dermatitis. Regardless of where it located or how it looks, it’s still eczema.

  • Contact Dermatitis occurs when an irritant or allergen contacts the skin causing redness, burning, swelling and sometimes blisters. It can be caused by things such as frequent hand washing, solvents, chemicals, foods, metals, animals, pollen, and plants like poison ivy. For the record, I don’t believe contact dermatitis should be classified with these other forms of eczema as the cause is external contact and can happen to anyone regardless of health conditions and family history. It doesn’t appear to be AI in nature.
  • Dishydrotic Eczema occurs on the palm side of fingers, palms of hands, bottom of toes, and soles of feet. It presents as red spots, bumps, or blisters. Scaly patches, flaking, and deep cracks can form from damage to the skin. This type is 2 times more common in women. I can vouch for that since this one type that I had in a very classic presentation which makes it easier to distinguish from some of the other types.
  • Hand Eczema is different from dishydrotic in that it occurs on the back of your hand and fingers, as well as the webbing between fingers. It visually looks more like typical atopic dermatitis.
  • Neurodermatitis, also called Lichen Simplex Chronicus, which is similar to AD in that there’s significant itching but differs in that the surrounding skin is healthy. It occurs in isolated patches that look thick, discolored, dry, scaly or flaky and can be mistaken for psoriasis. There can be underlying dysfunction of the nerves in this area.
  • Nummular Eczema, also known as Discoid Eczema is characterized by coin or circular shaped lesions that can be raised. Inflammatory reactions occurring in the body and dry skin are thought to play roles in developing this type of eczema. It can look like ringworm which is a fungal infection so it’s worth ruling that out.   
  • Seborrheic Dermatitis, Scalp Eczema, or Cradle Cap typically occurs in areas where there are high concentrations of oil producing sweat glands including the scalp, face, neck, upper back, shoulders, and chest. Individuals with immune system dysfunction are at increased risk for seborrheic dermatitis. It can have an oily or greasy appearance, unlike the other types of eczema, with white to yellow flakes.
  • Stasis Eczema/Dermatitis, also called venous stasis dermatitis, is a special type of eczema that occurs in areas where there’s decreased venous blood flow resulting in pressure build up causing fluid leakage from veins. Red, swollen, flaky, itchy skin occurs initially and if not taken care of can progress to ulceration, infection, and/or permanent thickening or scarring of the skin.

What Causes Eczema

If you type in ‘causes of eczema’ in Google, you’ll get a variety of answers like:

  • No true known cause
  • Dry or irritable skin
  • Genetic variant that affects the skin’s barrier function
  • Stress
  • Immune system dysfunction
  • Hormone Fluctuations
  • Bacterial or viral infections or imbalances
  • Environmental conditions such as cold, dry weather or humid, hot weather
  • Allergens

Unfortunately, while many of the above are absolutely true, most conventional doctors still treat it like it’s a condition that only occurs on the surface and don’t address most of that list. They’re likely to suggest topical treatments and possibly tell you to avoid a couple of foods, allergens, and hot or cold weather. They neglect the impact of the true root causes beneath the surface.

The worst fact of all is that some doctors are still of the old school thinking that there is no cause or cure for eczema.

Thankfully, research is evolving and know we know otherwise.

Given that eczema is now considered an autoimmune condition, we know the conditions need to be ‘just right’ for one to manifest.

These are the 3 key factors that come together to initiate autoimmunity:

  1. A genetic predisposition/family history
  2. Intestinal permeability (leaky gut)
  3. Environmental triggers such as stress, infection, gut or skin dysbiosis (imbalance between the good and bad bugs), food sensitivities or allergies, trauma, hormone imbalances, toxins, and nutrient imbalances.

With autoimmunity, the immune system mistakenly targets a body tissue and tries to attack it like it’s a foreign invader. If you have eczema, this means that the autoimmune process is attacking your skin. And to get rid of eczema, you need to address each of your root causes, which are covered in numbers 2 and 3 above.

For me, the perfect storm for eczema flares was high stress levels, hormone imbalances, GI infections and dysbiosis, leaky gut, and food sensitivities. Histamine containing foods, exercise, and hot showers made it even worse. This scenario is very similar for most of my clients as well.

A New Paradigm for Eczema

Just like when I was a kid, I wasn’t satisfied with the explanation of what causes eczema, so I developed my own process to explain the cycle of how it occurs.

Stage 1: Flare Up

You know when a flare up is coming because your body send you little signals in the form of tingle, slight itchiness or a burning sensation. On the inside the panic begins to set in and you’re thinking, “Oh no, not again!” These are the subtle hints that you’re body is unhappy and it’s trying to tell you. The flames have been stoked and a fire is beginning to burn inside.

From a physiological standpoint, your immune system is activated from one or more triggers like foods, chemicals, toxins, or microorganisms (bacteria, fungi, parasites, viruses) and has begun attacking your body tissues. Having a genetic predisposition toward eczema or autoimmunity, and a leaky gut make this the perfect storm.

At this point, trying to stop or slow the flare is a good idea as it will help begin to reverse the inflammatory process. Start with your diet as many significant triggers for eczema are food related. At a minimum go gluten and dairy free, but likely you’ll find other foods that need to be avoided while you heal.

Getting stress under control right now is key as it’s often what pushes you over the edge into a flare. It’s hard to eliminate it, but try to manage stressors by maintaining boundaries, saying no, or asking for help. If you can completely eliminate a stressor (like avoiding a toxic person or situation) even better! Also, finding an outlet like journaling, deep breathing, meditation, or walks in nature can profoundly reduce the stress response.

Stage 2: Outbreak

Your flare up transitions to a full blown outbreak when the tingle, burn or minor itch escalates to constant itching causing red, inflamed skin with welts, wounds, and/or blisters. At this point it can appear to be treatment resistant since all of the root causes likely haven’t been addressed.

The outbreak occurs when the inflammatory process mediated by the immune system goes unchecked. The inflammatory chemicals have kicked up and are peaking resulting in your extreme discomfort and many symptoms. During this phase eczema can interfere with life, making social gatherings, work, sleep, and sanity difficult due to the incessant itching. There’s a full blown inflammatory fire raging inside.

Getting to the bottom of all of your triggers and root causes is essential now so you can heal.  Addressing diet and stress may do the trick for some, but others may require deeper digging or testing which is easiest with assistance of a trained professional. Even though I do this for a living, I call upon my friends and colleagues to make sure I’m not missing anything. We can all use some help now and then!

If you haven’t begun dialing in your diet- there isn’t a better time. You need to focus on taming the fire burning within. Anti-inflammatory supplements and foods are super important now. This blog article I wrote provides a recipe, as well as 6 healing foods and supplements to help put out the flames.

Topically, some people may benefit simply from coconut oil, but I personally didn’t and many of my patients echo that sentiment. The same can be said of shea butter. However, by combining these an easy and wonderful healing salve can be made.

Eczema Healing Salve Recipe

  • ½ cup unrefined, organic coconut oil
  • ½ cup unrefined, organic shea butter
  • 10 drops calendula essential oil
  • 10 drops yarrow essential oil
  • 10 drops rosemary essential oil
  • 5-10 drops frankincense essential oil

Mix these together in a bowl by hand or with a mixer. It will be hard and clumpy at first, but eventually will soften and everything will come together. Note: you can play with the essential oils as some people respond better to certain ones than others. If you can’t some of these, that’s fine too. These all have healing, calming or anti-inflammatory properties.

The most important thing to remember in the outbreak phase is the root causes. If you don’t identify and address them all, your eczema is likely to return at some point.

Stage 3: Healing

Relief is in sight!  This is when you start to feel better and symptoms are less severe, but still present. You may or may not be itchy. Your skin still shows signs of irritation, but no open wounds and blisters. It may also appear thick, leathery, scaly, dark, or ashy now. The fire within is now just smoldering embers.

Your immune system is now ramping down and under control, but in physiological time things go slow which is why there are still visible signs (think of how long it takes to completely heal a cut or broken bone).

Steering clear of dietary triggers or any other triggers you’ve identified through self investigation or testing is still a must to maintain healing. Continue use of natural topicals to protect the skin and help rebuild integrity. Nutrients like vitamins A,C, D, and E, biotin, zinc, selenium, and collagen support healing and skin structure.

Stage 4: Clear Skin

Hooray!! When you’re suffering through an eczema flare you often don’t think this day will come, but it is possible to completely reverse eczema and have clear skin again. You’re skin is fully healed and looks great again. No more hiding in long sleeves or gloves!

Think of this stage as maintenance or dormancy. You immune system is finally calmed down and balanced so the attack on skin is over. The fire is out completely!

Maintaining a healthy diet, stress levels, and getting adequate sleep will help keep you here in your happy place.

Common Treatments for Eczema

Again, if you look eczema treatments up in Google, you’ll get a list that looks like this:

  • Over-the-counter medications such cortisone cream, Benadryl cream, or antihistamines (Benadryl, Claritin, and Allegra)
  • Prescription medications topical corticosteroids, oral steroids, and oral antihistamines.  
  • Moisturizers that contain petroleum jelly, mineral oil, or synthetic emollients like lanolin or glycerin
  • Special baths with bleach, salt (sea salt or table salt), baking soda, epsoms salts, oatmeal, or apple cider vinegar.  
  • UV Light/Phototherapy
  • Wet Dressings
  • Stress Reduction

While the medications may be helpful at first for managing symptoms, they don’t address the root causes and the eczema returns. Long term, the topical creams can damage the integrity of the skin and the topical steroids and oral medications shut off the body’s natural inflammatory response which is counterproductive to healing the body.

The moisturizers typically suggested sometimes work and other times cause more irritation due to the ingredients. Unfortunately, if they do work it’s only addressing issues at the skin level and not what’s beneath the surface.

Special baths can definitely be helpful in managing symptoms, but some need to be use with caution. I am personally not a fan of the bleach baths, ever. Sea salt, table salt and apple cider vinegar can be great, however should be tested first since they could irritate open wounds. Oatmeal baths are also very soothing as long as you know you don’t have Celiac or it’s skin variant called Dermatitis Herpetiformis. If you do, you should probably avoid oatmeal completely as it’s often contaminated with gluten.

Phototherapy from the sun is my preferred use. While using phototherapy lamps that emit UV light definitely have benefit, there are a few more risks associated with them due to broader spectrum of the light rays, such a burning, blistering, accelerated aging/breakdown of the skin, and skin cancer. More recently narrow band UVB therapy, which uses a smaller spectrum and thus less radiation, is a better option for artificial light therapy.

Wet dressings can be very helpful in healing eczema when used with natural moisturizers. However, topical corticosteroids are often used and I believe they’re a bad long term strategy for the reasons given above.

My Methodology for Healing Eczema

While some of the commonly used treatments listed above can be helpful at soothing or even resolving some symptoms, they’re all missing the most important factor: addressing the ROOT CAUSES.

Even if you’re in remission and asymptomatic, you’re still at risk for a flare up because you haven’t addressed the important factors lingering beneath the surface. You’re trigger might be work, family, or financial stress, a stomach virus or infection, passing of a loved one or pet, a divorce or separation, moving to a new town or job, or even injuring yourself exercising.

My major trigger was always work related stress (or not addressing it) as it is for so many that suffer from eczema.

The good news is that I healed my eczema and we, together, can heal yours too.

My process starts with a detailed history, from birth until now, that identifies all of the contributing factors to your eczema and what potential root causes need to be investigated.

Next we order the appropriate tests to identify your specific and individual underlying causes.

From there, I design a comprehensive program based on your results and history that addresses all of your root causes in a systematic way. We don’t throw the kitchen sink at you all at once and hope it works. Instead, the plan is outlined in a step-by-step manner that makes it easy for you to follow and allows your body to heal.

If you’re tired of living in the eczema cycle of remissions and flare ups, or have an active, raging outbreak that itches so bad and looks so horrible it’s affecting every aspect of your life and you don’t think it will ever end, I invite you to work with me and my team to heal your eczema for good.

We’ll work together to put the pieces of your health puzzle in place. We’ll guide you at every step with a plan of action to get your body healing and skin happy again.

If you’d like 1-on-1 support troubleshooting which root causes are contributing to your Eczema, and get a specific plan to reverse it, the first step is to book a 1-hour “Eczema Root Cause Troubleshooting Session”.

 

 

 

Strict Elimination Diets are Possible- Part 2 of 4 (Working Out and Adjusting Your Program)

Week number two is in the books! There was definitely less drama on the skin side (no hives or red bumps= win), but there were definite peaks and valleys. Overall I’m feeling great for the most part.

Diet Observations

Monday was Day 8 and I felt amazing 90% of the time. I had lots of energy and significantly less itching than Saturday and Sunday. My workout was great and my brain was firing on all cylinders. The only bump in the road on this day was a little gas with my acorn squash at dinner. I plan on testing that again soon to see if it was random, or if I have issues with acorn squash.

I added in progesterone (only cycle days 15-28), DHEA, licorice root extract, an adaptogenic herb blend, and vitamin C to help support my hormones and adrenals again. Curious to see if it makes a significant difference in my symptoms.  I’ve been recovering from adrenal fatigue and major hormone depletion since the birth of my son 3 years ago. It’s considerably better, but far from 100%.

Days 9 and 10 were positive as well, with high energy all day, however, the itchy skin and runny nose seemed to be making a bit of a comeback. By the evening on Day 10, I considered the itching moderate. It’s strange too since there’s a completely random distribution- palm of hand, scalp, belly, or arm- really anywhere. There aren’t any red spots or welts of anymore, just itchy skin that isn’t even pink or red most of the time. I’m still trying to make the connection between certain foods and the itching flares, but there’s no obvious link yet. I have a few other theories on my itching too, but I’d like to see if I can eliminate the GI causes first.

Another Day 10 observation was that I have a harder time breaking down shredded beef than ground beef. I felt as if it was sitting in my stomach for a long time despite having taken my usual amounts of HCl and digestive enzymes. Seems odd, however, the ground beef is already in smaller pieces and easier to chew. I noticed by the end of the day my jaw hurt from so much chewing. I suspect I got a little lazy and wasn’t chewing enough by the end of the day which contributed to the poor digestion.

Day 11 was similar to the previous 2 days, except that I had a little more fatigue in the morning that I suspect was from a killer workout the day before. I knew I’d need to take it easy and do light recovery movements so I wouldn’t over stress my adrenals and nervous system. A positive was that my skin was looking clear and radiant. No sign of any acne or redness. Win!

Anyone that’s done an elimination diet knows eating out can be traumatic, so I was excited and nervous for Day 12. I went out to lunch with my sister which meant extra planning. Luckily, we are blessed to have some local, truly Paleo restaurants here which made my day much easier. Agra Culture Kitchen and Press is an amazing choice if you want healthy food in the Twin Cities. They cater to many diet variations- Paleo, gluten free, vegan, vegetarian, fresh pressed juices and Bulletproof coffee (which I really miss). They made my meal out of the house very easy and stress free. Anyhow…this day was short of miraculous. I was symptom free 90% of the day! No itching (my worst symptom), no runny nose, no NOTHING!!

My nirvana didn’t last on Day 13, sadly.  The itching resumed at a low level in the morning, but after breakfast it was gone again. The main issue today was that I was hangry (hungry and angry). This is usually a result of low blood sugar. I set myself up for disaster since I ate breakfast 2 hours late, which lead to a day of grouchiness (my husband didn’t appreciate it… sorry dear). Clearly my adrenals and blood sugar are still not 100% which I already assumed.

Meal timing and content are important when you have adrenal fatigue. If your calories or carbs are too low, you will feel fatigued and sluggish mentally. Eating at least every 4 hours is a good idea to keep blood sugar and energy levels even throughout the day. That’ll keep the people around you happier too!

Days 13 and 14 also brought perfect, Bristol #4 bowel movements. That’s another big win in my book.

Day 14 was similar to the previous day in that I started out itchy, but it went away fairly early in the day.

Week two was definitely better than week one with several wins and a decrease in symptoms. So far, so good.

Adjusting Your Program on the Fly

I never operate in a “set in stone” manner, nor do I expect my clients to either. Humans have a complex physiology with a seemingly infinite number of variables (many of which we don’t know much about yet). We need to pay attention and tune in to what is happening when we change the inputs (diet, supplements, exercise, stress, sleep, etc.) and adjust accordingly to our own individual needs.

Here are some of the modifications I’m making:

  1. Sticking to lower histamine foods given my reactions in week 1. The histamine issue may be worse than I thought, so I’m trying not to eat leftovers either (which sucks a bit since I’d mostly been making my meals for the day in the morning). Freshly cooked is best with histamine. I’ve also axed fish and shellfish for now which saddens me because I love them. I also realized I may need to test methylation, Candida, and my gut microflora as those can be causes of histamine issues.
  2. Adding in supplements when necessary. I realized I need to use more HCl and enzymes with certain proteins that I don’t seem to breakdown as efficiently. I add in one extra cap of each. I also added in a DAO enzyme supplement to help clear histamine when necessary.
  3. In order to maintain my energy and facilitate recovery post-workouts I added in an amino acid powder with no additives immediately after my workout, plus an extra meal later that day.

There will probably be more to come. The point is that you need to be alert to what your body is telling you and listen.

Hard Workouts are Possible on a Strict Elimination Diet

One of my biggest fears, and why I put this elimination off for so long, was that I thought it would kill my workouts and recovery. You can’t use protein powders like whey, beef or pea, and many supplements you’d replace those with are off the table as well.

This elimination is about as strict as they come, however, it doesn’t limit quantity which is helpful. I also wasn’t used to eating so many purely whole food meals in a day. I have a shake for breakfast half the time and always have one after workouts.

Surprisingly, my experience has been exactly the opposite of what I expected. I generally have more energy and feel more satiated during the day.

My workouts are 80% weight lifting and 20% metabolic conditioning. Certain days are definitely more taxing than others.  I do this 3 times per week and fill in the other days with hiking, sprinting, mobility work, or riding my mountain bike. As a rule though, I always have rest days and listen to my body. If I’m feeling really fatigued I don’t push as hard or I skip a day. I’ve suffered severe adrenal fatigue and really don’t want to go there again.

I eat my breakfast 60 minutes before my workouts to give enough time to digest. I adjust the portion down sometimes if I feel I won’t be digested enough. I’m also taking vitamins and supplements that support energy metabolism (which I also did before).

The second workout during week one was when I noticed a little more fatigue which could’ve just been part of the adjustment period, but I made some changes to be safe. As soon as my workout is done, I have my straight amino acid powder and try to eat within 30-45 minutes to replenish my muscles and prevent excessive soreness. To further aid in recovery, I often add in a fourth meal if I’m feeling a little hungrier.

Strength and endurance haven’t decreased 2 weeks in which I’m ecstatic about. I’m hoping I can maintain this throughout the duration.  So far, lots of energy and normal levels of post-workout soreness and fatigue.

Next week I’ll discuss supplementation and keys to success, as well as my progress update!