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Dr H Morrow Brown MD
FRCP (Edin) FAAAAI (USA)
General Medical Council Registered Specialist
for Allergy and Respiratory Medicine

Explained

Milk is an Occasional Cause of Arthritis

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Arthritis and Rheumatism can be caused by Food Intolerance

Cases of arthritis due to foods are indistinguishable from rheumatoid arthritis except that they tend to have negative blood tests for genuine rheumatoid arthritis. How frequently foods, especially milk, are the cause is completely unknown, because it is so unusual for dietary manipulation to be introduced when first consulted, or indeed even when arthritis is fully established.

One Rheumatologist, Gail Darlington in Epsom, has made a special study of the effects of food on the joints, and published a double-blind study in the Lancet which showed quite clearly that dietary manipulation could be a very effective treatment. The only result was she was criticised by her colleagues who simply would not believe the results, yet would not try out the dietary method themselves. If all cases of suspected or proven rheumatoid arthritis or ‘fibromyalgia’ were put on a restricted dietary regime for a few weeks to identify cases which would benefit from dietary treatment the result might be surprising.

Over the years I have seen thirty cases, almost all women, with from moderate to severe arthritis or “polymyalgia” problems who made a full recovery with dietary manipulation. Most had been arbitrarily dismissed by their medical advisers, and some were quite young women who initiated the consultation because they had either noticed improvements on desultory dieting, or had read about the possibility that foods could cause joint problems. Unless strict avoidance of all milk products and beef, or better a diet consisting of the few foods which very seldom cause problems, is tried out for a few weeks it will never be known how often food, particularly milk, is causing joint problems. It is obviously not necessary to stop the usual drugs, but if improvement seems to be happening the drugs could then be withdrawn to find out if they are still necessary.



A puzzling case of “arthralgia”

Phyllis aged 34 had a history of fluctuating pain in all her joints for five years without objective evidence of joint disease. Pain had affected all joints, abdomen, chest, and shoulders, and she had had extensive investigations. Three consultant physicians and an orthopaedic surgeon all made different diagnoses, and finally a psychiatrist diagnosed manic depressive psychosis in a hysterical personality.

MilkAfter two years of continuous suffering while living in Nottingham she began working in London, staying there during the week with a vegetarian who did not take milk. Her pains became progressively better during the week only to relapse abruptly at home during the weekend.

When she gave up this job and came back to Nottingham where she was eating a normal diet all the time she became much worse, but she did not realise the significance of the improvement when working in London.

Skin tests and immunology were all negative., but I recognised the significance of the improvement in London and a milk free diet produced complete freedom from pain within a few days.

Joint pains were repeatedly provoked by even a trace of milk in many foods, so there was no doubt whatever that she is very sensitive to milk which was the cause of her problems.

It was significant that her highly emotional state also disappeared, suggesting that this had been partly due to the milk intolerance and partly to frustration with her medical advisers. Again the immunological blood tests had been unhelpful and misleading, and the key to the cause of her sufferings was in the clinical history.



“Rheumatoid” Arthritis can be caused by milk

Shiela aged fifty six had observed that her joints, which were severely affected by confirmed rheumatoid arthritis of eight years duration, felt much easier when she was unable to eat, but her doctor ridiculed the idea that food could be causing her rheumatoid arthritis, which was quite severe with characteristic deformities of the hands. However, her father had had rhinitis, her mother asthma, her four sons were all atopic, and one of them had found that his chronic nasal symptoms were relieved by avoiding milk. She had had severe eczema as a teenager which faded out to be replaced by seasonal and perennial rhinitis with nasal polyps. Skin tests were positive for mites, cats, and grass pollen, but RAST blood test was only slightly positive and total IgE was normal.

A diet containing only the few foods which seldom cause problems resulted in definite improvement, the sedimentation rate (ESR) fell from 80mm to 10mm after a month, indicating that the inflammation was subsiding, and the joints were obviously much less inflamed. Adding foods to establish the cause demonstrated that milk repeatably caused a flare-up of pain and swelling of the joints. She gradually improved by avoiding milk completely, except for one relapse which was due to assuming that sheep’s cheese and milk would be acceptable. She no longer required the usual medication which had been causing some side-effects.

After eight years she found that milk no longer affected her and, aged 73, had surgical replacement of the finger joints. The photographs before and after withdrawal of milk illustrate the improved appearance, but cannot express the relief of pain and disability.

She was so delighted with the success of avoiding milk that she told her story to everyone who would listen, including one lady who was in a wheel chair because of arthritis. She also found that milk was the cause of her arthritis, and made such progress that she was able to discard her chair. Every time I saw Shiela I enquired about this case as I wanted to meet and question her, but contact had been lost and I never got in touch with the other case of milk arthritis which seemed to be much a more severe one. To find out if milk is the cause of any chronic problem entails nothing more than a strictly milk-free diet for a few weeks, and there is nothing to lose except some weight!
Before Milk Free Diet After five months Milk Free Diet After 3-1/2 years Milk free

 

They sacked the milkman and lived happily ever after

A teacher aged 53, had had worsening polyarthritis for four years which cleared completely on diet of the few foods that rarely cause problems. She then began to take a little milk on her cereal, and found that every time her joints would relapse in six hours lasting for three days. She was then completely symptom free for some months while totally avoiding milk products, except that that her joints always ached the morning after intercourse. She was advised to use a condom and this effect ceased to occur.

A skin test using her husbands semen by pricking through a drop on the skin with a Morrow Brown plastic needle was negative at first, but she woke up early next morning because of the itching of a delayed reaction. This was shown to occur every time the semen test was carried out, so her husband was also advised to avoid milk. He discovered to his astonishment that the chronic eczema in his ears which had been a nuisance for 30 years cleared up completely!

They then discovered that intercourse without a condom no longer caused aching joints the next morning, and that the delayed positive skin test reaction to his semen occurred only when he was having milk. It was apparent that if he took any milk a minute trace of milk passed into his semen which was enough to trigger his wife’s joint pains, and to also to cause a delayed reaction to a skin test. No laboratory tests were available to prove these remarkable findings scientifically, so was impossible to investigate further.

To confirm this bizarre presentation of milk allergy or intolerance in a manner acceptable to the “evidence based medicine” criteria required today intercourse would have had to be repeated with another partner when taking milk and when abstaining from milk, and all participants would have to be blindfolded. ---They did not feel that they could cooperate in such an experiment, sacked the milkman, and have been milk free and happy ever since! This must be the most bizarre case ever found to be caused by milk.



Allergy to Semen

Allergy to Semen is rare, but it does happen and may often fail to be diagnosed.. It was first reported over fifty years ago and can cause anaphylaxis in its most extreme form. There may be extreme local itching and inflammation, or generalised symptoms of varying severity, which will not occur when a condom is used. This will clearly indicate the cause of the problem, but it is not always so simple, as in the story below. Useful information is available on the internet, especially through Google, on this delicate subject.



Sexually Transmitted Allergy to Coca-Cola

Coca-Cola bottleA unique example of allergy associated with sex was published some years ago which is worth mentioning to emphasise how an allergy can be tracked down and eliminated.. The lady concerned was very keen on horse riding, and began to experience extreme irritation in her genital area after riding, especially when wearing thin riding pants in the summer. This directed attention to the saddle, which had been treated with a special polish containing Balsam of Peru, a well known sensitiser. Prick tests with the polish and with Balsam of Peru produced intense reactions in minutes, so the problem was apparently solved by avoidance of this polish.

A few months later she began to experience more serious reactions in the private parts which occurred after intercourse. This clearly indicated that she was reacting to seminal fluid, but it seemed curious that she did not react every time, and that skin prick tests using semen were sometimes positive and sometimes negative.

Further careful history taking disclosed that her partner was positively addicted to Coca-Cola, and that her reactions usually appeared after he had drunk more than usual before intercourse. Enquiry revealed that Balsam of Peru is a very complex product, and that it is sometimes present in chocolates, chewing gum, various toilet articles, and Coca-Cola !!! Tiny traces present in his semen were enough to cause this reaction

We are not told if her partner gave up his Cola Fix so that they lived happily ever after, but this fascinating story illustrates how complex allergies can affects the most intimate aspects of life.



How the affected part of the body can change with time

Catherine was 54 when she was referred last year at her repeated insistence. She had a strong family history of allergy and intolerance, starting with her maternal grandfather who had asthma, her mother with ‘IBS’ aggravated by milk, a sister with ‘IBS’, and two daughters who had found that gluten caused colic and constipation. One daughter was very naughty and hyperactive every Thursday evening after fish and chips. The fish was blamed until mother discovered that the batter was coloured with tartrazine and she tolerated fish without batter. She also misbehaved if she had yellow sweets.

Sliced breadCatherine had had no problems until aged about twenty-nine,, when she developed asthma followed by ‘IBS’ which she established was triggered by gluten, and then severe arthritis, but with negative tests for rheumatoid factor. She insisted in being referred to the allergy clinic where my assistant advised her to avoid milk products, with the result that the joints cleared up within a week. Even now a small amount of cheese or cream will cause joint pains.

Aged 38 she developed ulcerative colitis, which was fully confirmed, and further advice from the allergy clinic to avoid dyes and additives, as well as milk, resulted in a full recovery. Two slices of ordinary bread will produce colicky pains within an hour, followed by constipation, but a biopsy had been negative for Coeliac disease. Avoidance of gluten, milk products, and additives and dyes resulted in no trouble with joints or gut The ulcerative colitis relapsed a few years ago after a trip to the USA where she was unable to control her diet

She also had asthma for about 20 years, mainly triggered by coughing.. In the last year this had become a major problem with waking in the small hours with asthma and severe coughing. Peak flows were 350 -450 in the day, but about 200 in the night. The only treatment was a bronchodilator aerosol, because she had been prescribed all the usual steroid aerosols over the years, but she could not tolerate them because they had all caused coughing fits and made her worse. She observed that this was particularly a problem with the inhalers containing lactose powder, which cannot be guaranteed to be completely free from traces of milk protein which would cause a reaction in the sensitised bronchi.

She lived in an ancient house with a damp cellar and three cats, but a battery of 40 skin tests were all negative, and skin tests using extracts of her own dust and cat hair were also negative. As she was no better away from home, there was no suggestion of an environmental factor, and the cause is a mystery..

Examination of a tiny sample of sputum showed nothing else but eosinophil cells, so the diagnosis was definitely allergic asthma of unknown causation. A trial of enteric coated oral steroids 30 mg/day had not made any difference, but the soluble steroid Betnesol in the same equivalent dosage banished the cough and the drop in peak flow at night in a few days. Obviously the enteric coating had not dissolved and the steroid was not absorbed. Transfer to Qvar aerosol brought about complete control of both asthma and cough, with normal peak flow rates, and she has been completely well since.

This patient is to be commended because in spite of the dismissive attitudes of many colleagues she persisted in trying to find the causative factors rather than accept that she had to put up with arthritis or colitis or asthma with all the suppressive medication this would entail;. She is also an example of how the part of the body affected by the allergy or intolerance can change over the years with the result that as she developed these problems she encountered different medical departments, all with disbelieving attitudes to the simple idea that food or azo dyes could cause illness.

 

"It is a paradox that while Britain has the highest incidence of allergic disease in the world, it also has the most inadequate allergy service"

 
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